Abstract: Various system embodiments comprise a neural stimulator, a premature ventricular contraction (PVC) event detector, a heart rate detector, an analyzer, and a controller. The neural stimulator is adapted to generate a stimulation signal adapted to stimulate an autonomic neural target. The analyzer is adapted to, in response to a PVC event signal from the PVC event detector, generate an autonomic balance indicator (ABI) as a function of pre-PVC heart rate data and post-PVC heart rate data. Other aspects and embodiments are provided herein.

Abstract: An example implantable medical device (IMD), such as an implantable cardioverter defibrillator, may be configured to store a ventricular tachycardia zone, wherein the ventricular tachycardia zone specifies ventricular depolarization rates indicative of ventricular tachycardia, and to deliver pacing pulses to at least one ventricle of a heart in response to detecting intrinsic atrial depolarizations at rates within the ventricular tachycardia zone. The IMD may further store a maximum ventricular tracking rate that is greater than a lower bound of the ventricular tachycardia zone, and be further configured to deliver the pacing pulses to the at least one ventricle in response to detecting intrinsic atrial depolarizations at rates up to the maximum ventricular rate. In this manner, the IMD may be configured with overlapping pacing and tachyarrhythmia detection zones.

Abstract: Embodiments of an improved implantable medical device system for orientation-independent telemetry to and from the device are disclosed. The system includes an external controller which produces an electromagnetic field to induce a current in a coil in the implantable medical device and vise versa. In a preferred embodiment, the external controller comprises three orthogonal coils, each of which is potentially activated to generate or receive the electromagnetic field. Algorithms are disclosed to allow for the choice of one or more of the coils best suited for telemetry based on the chosen coil's orientation with respect to the telemetry coil in the implantable medical device. Because all three of the orthogonal coils are potentially activated if necessary, the result is that at least one of the coils will be in a proper orientation with respect to the coil in the implantable medical device, thereby improving telemetry efficiency.

Abstract: An apparatus is disclosed for punctually stimulating nerve endings located in the region of the ears, said nerve endings extending to brain stem nuclei. The apparatus (1) has a support (2) which is to be positioned in the region of the neck or the upper arm of a patient, and which is provided with at least some of the electrically active structural components (4, 7, 13) of the apparatus (1) arranged for forming a therapeutic current, and which furthermore accommodates feed batteries (3) that deliver at least part of the operating power for the apparatus.

Abstract: A lead assembly for an implantable medical device includes a lead body having a first portion adapted for coupling to a pulse generator and a second portion adapted for implantation. First and second co-radial conductive coils are electrically isolated from each other and include a first and second number of coil turns. The first and second number of coil turns include a number of matched turns and a number of unmatched turns, and the number of unmatched turns is less than approximately 2.0% of the total number of unmatched and matched turns. First and second electrodes located at the second portion are respectively coupled to the first and second conductive coils. At least one capacitor element is connected in parallel with one or both of the first and second conductive coils and/or between the first and second conductive coils.

Abstract: Systems and methods for temporarily pacing a patient's heart are provided. One system includes a vascular treatment system having a vascular access system and a therapy system. The therapy system includes an indeflator and an elongate medical device and the elongate medical device has an inflatable member and an electrode. The indeflator is adapted to provide pressurized fluid to the inflatable member and electrical signals to the electrode, with its operation manually or automatically controlled. Devices for electrically and fluidly coupling the indeflator and the elongate medical device are also provided.

Abstract: To provide radio-frequency (RF) bandstop filtering within an implantable lead, such as a pacemaker lead, one or more segments of the tip and ring conductors of the lead are formed as insulated coils to function as inductive band stop filters. By forming segments of the conductors into insulated coils, a separate set of discrete or distributed inductors is not required, yet RF filtering is achieved to, e.g., reduce lead heating during magnetic resonance imaging (MRI) procedures. To enhance the degree of bandstop filtering at the RF signal frequencies of MRIs, additional capacitive elements are added. In one example, the ring electrode of the lead is configured to provide capacitive shunting to the tip conductor. In another example, a capacitive transition is provided between the outer insulated coil and proximal portions of the ring conductor. In still other examples, conducting polymers are provided to enhance capacitive shunting. The insulated coils may be spaced at ¼ wavelength locations.

Abstract: A case for defibrillator electrode pads on a release liner is described which protects the pads prior to use and retains them in either an electrically connected or electrically disconnected configuration. When the case is closed, spring contacts on opposite sides of the inside of the case retain the pads and release liner in place. The retention either holds electrical conductors in contact with each other to retain the pads in electrical connection with each other, or in a different configuration in which the pads are not electrically connected.

Abstract: The invention is directed to a method of bonding a hermetically sealed electronics package to an electrode or a flexible circuit and the resulting electronics package that is suitable for implantation in living tissue, such as for a retinal or cortical electrode array to enable restoration of sight to certain non-sighted individuals. The hermetically sealed electronics package is directly bonded to the flex circuit or electrode by electroplating a biocompatible material, such as platinum or gold, effectively forming a plated rivet-shaped connection, which bonds the flex circuit to the electronics package. The resulting electronic device is biocompatible and is suitable for long-term implantation in living tissue.

Abstract: The present invention is an electrode array for neural stimulation. In particular it is an electrode array for use with a visual prosthesis with the electrode array suitable to be positioned on the retina. The array includes multiple attachment points to provide for even pressure across the electrode array surface. The attachment points are arranged so as to not damage retinal tissue stimulated by the electrode array.

Abstract: Medical electrical lead systems and related methods are described. The medical electrical lead systems may be configured to be at least partially implanted in a body of a subject. Some variations of the medical electrical lead systems may comprise a lead body comprising a proximal end and a distal end and a lumen extending at least partially therebetween, at least one electrode in the proximity of the distal end of the lead body, and a reservoir in fluid communication with the lumen, where the reservoir is located at a position removed from the distal end of the lead body. Certain variations of the medical electrical lead systems may comprise a lead body comprising a proximal end and a distal end and first and second lumens extending at least partially therebetween, and at least one electrode in the proximity of the distal end of the lead body.

Abstract: An improved pacemaker lead including a lead body supporting at least one flexible conductor element that provides an electrical signal path between a proximal connector element and a distal electrode. The lead body includes an insulating structure that protects the flexible conductor element(s) wherein the insulating structure is realized from a polymer blend of a thermoplastic polyurethane elastomer and an isobutylene block copolymer. The mole fraction of the isobutylene block copolymer of the polymer blend is in the range of 2-15% (most preferably on the order of 10%). The polymer blend of the insulating structure has a maximum tensile strength in the range of 20-40 MPa (most preferably in a range of 25-35 MPa). In the preferred embodiment, the hardness of the polymer blend can be characterized by a Shore hardness in a range of 70-80 A.

Abstract: A method and programmer for programming a neurostimulation device are provided.

Abstract: Therapy optimization includes tracking electrode motion using an electroanatomic mapping system and generating, based on tracked electrode motion, one or more mechanical dyssynchrony metrics to thereby guide a clinician in therapy optimization (e.g., via optimal electrode sites, optimal therapy parameters, etc.). Such a method may include a vector analysis of electrode motion with respect to factors such as times in cardiac cycle, phases of a cardiac cycle, and therapy conditions, e.g., pacing sites, pacing parameters and pacing or no pacing. Differences in position-with-respect-to-time data for electrodes may also be used to provide measurements of mechanical dyssynchrony.

Abstract: When a medical procedure is performed on a patient in whom an implantable medical device is implanted, the medical procedure may have undesired effects on the medical device, such as triggering a response that initiates therapy by the device that is unnecessary and potentially dangerous to the patient. Systems and methods may facilitate performing of such medical procedures on such patients by temporarily reprogramming the medical device, monitoring for one or more detectable characteristics associated with the medical procedure to be performed, and restoring normal programming of the device based on detection and/or lack of detection of the detectable characteristic(s).

Abstract: A stimulation electrode is described for a hearing impaired patient. An intra-fluid electrode branch is immersed in cochlear fluid within an interior volume of a patient cochlea and has electrode contacts for delivering a cochlear stimulation signal to adjacent neural tissue. An intra-modiolus electrode branch penetrates through the cochlea and has one or more electrode contacts for delivering a modiolus stimulation signal to cochlear nerve tissue within the modiolus of the patient.

Abstract: A method and system are provided to determine a defibrillation threshold (DFT). The method and system determine local conduction (LC) information for at least one LV region of the heart, and designate a ULV pacing electrode, where the ULV pacing electrode is located proximate to a region of the heart for which the LC information satisfies a predetermined LC characteristic. The method and system pace the heart from the ULV pacing electrode such that the region of the heart, for which the LC information satisfies the predetermined LC characteristic, becomes re-polarized early in a repolarization phase following pacing of the heart. The method and system deliver a ULV shock, obtain upper limit of vulnerability (ULV) information based on a heart response to the ULV shock; and obtain a DFT based on the ULV information.

Abstract: A subcutaneous cardiac device includes a subcutaneous electrode and a housing coupled to the subcutaneous electrode by a lead with a lead wire. The subcutaneous electrode is adapted to be implanted in a frontal region of the patient so as to overlap a portion of the patient's heart.

Abstract: In one embodiment, there is disclosed an implantable pulse generator for electrically stimulating a patient, which comprises: a housing enclosing pulse generating circuitry; a header coupled to the metallic housing, the header including an inner guide having cylindrical passages for accepting feedthrough wires such that the inner guide is slidingly coupled to the plurality of feedthrough wires, wherein the inner guide has an exterior surface which intersects a portion of each cylindrical passage to create an exposed portion of each feedthrough wire, an outer seal having an interior surface sized to support terminals against the exposed portion of the feedthrough wires, and an outer clip component fitting over at least a portion of the outer seal component.

Abstract: Techniques for detecting heart sounds to reduce inappropriate tachyarrhythmia therapy are described. In some examples, a medical device determines that a cardiac rhythm of the patient is treatable with a therapy, such as a defibrillation pulse, based on a cardiac electrogram (EGM). The medical device analyzes detected heart sounds, and withholds or allows the therapy based on the analysis of the heart sounds.