Position sensitive lingual muscle simulation system for obstructive sleep apnea

An implantable neurostimulator (INS) and method of use, the INS including an electrical lead having formed thereon at least a pair of bi-polar electrodes, wherein the electrical lead is configured for placement of the pair of bi-polar electrodes proximate protrusor muscles of a patient, a pulse generator electrically connected to the electrical lead and configured to deliver electrical energy to the pair of bi-polar electrodes, the pulse generator having mounted therein a sensor and a control circuit, and the sensor is configured to generate signals representative of an orientation of the pulse generator and communicate the signals to the control circuit and the control circuit is configured to determine the orientation of the pulse generator and deliver electrical energy to the bi-polar electrodes when the determined orientation correlates to a pre-determined orientation.

Lead for stimulating the baroreceptors in the pulmonary artery

An apparatus includes a flexible lead body extending from a proximal end to a distal end, an expandable electrode coupled proximate the distal end, the expandable electrode having an expanded diameter dimensioned to abut a wall of a pulmonary artery, and an implantable pulse generator electrically coupled to the expandable electrode. The expandable electrode includes a plurality of electrode zones. The implantable pulse generator is adapted to deliver a baroreflex stimulation signal to a baroreceptor in the pulmonary artery via the electrode.

BILATERAL VAGUS NERVE STIMULATION

An example system includes a first lead configured to be positioned in or beside a left internal jugular vein (IJV) of a patient to deliver a first stimulation signal to a first vagus nerve, the first lead including one or more first segmented electrodes positioned on a distal portion of the first lead and a first anchoring mechanism; a second lead configured to be positioned in or beside a right IJV of the patient to deliver a second stimulation signal to a second vagus nerve, the second lead including one or more second segmented electrodes positioned on a distal portion of the second lead and a second anchoring mechanism; and circuitry configured to deliver electrical energy to the first lead to deliver the first stimulation signal and the second lead to deliver the second stimulation signal to provide bilateral stimulation to the first vagus nerve and the second vagus nerve.

Wireless ECG in implantable devices

An implantable medical device such as an implantable pacemaker or implantable cardioverter/defibrillator includes a programmable sensing circuit providing for sensing of a signal approximating a surface electrocardiogram (ECG) through implanted electrodes. With various electrode configurations, signals approximating various standard surface ECG signals are acquired without the need for attaching electrodes with cables onto the skin. The various electrode configurations include, but are not limited to, various combinations of intracardiac pacing electrodes, portions of the implantable medical device contacting tissue, and electrodes incorporated onto the surface of the implantable medical device.

Personalized and contextualized treatment of sleep apnea and obesity comorbidity

A sleep apnea and obesity comorbidity treatment system includes a transceiver and a control module. The control module is configured to: receive sensor data, where the sensor data is indicative of a glucose level of a patient and a ketones level of the patient, transmit the sensor data to a remote feedback device, receive feedback information from the remote feedback device based on the sensor data, and where the feedback information provides indications to the patient to maintain or alter a behavior of the patient based on the glucose level and the ketones level, and based on the feedback information, performing an operation to maintain or alter at least one of a diet or physical activity of the patient.

Obstructive sleep apnea patient programmer for implantable devices

An implantable neurostimulator system including an electrical lead having formed thereon a pair of bipolar electrodes, the electrical lead is configured for placement of the pair of bipolar electrodes proximate protrusor muscles of a patient. The system also includes a pulse generator electrically connected to the electrical lead and configured to deliver electrical energy to the pair of bipolar electrodes, the pulse generator having mounted therein a sensor configured to detect one or more physiological parameters, a memory, a control circuit, and a telemetry circuit. The system also including a communications telemetry module (CTM) in communication with the telemetry circuit and configured to receive a data collected by the sensor and data related to delivery of electrical energy to the bipolar electrodes, and an external programmer in communication with the CTM and configured to display a user interface the data collected by the sensor and data related to delivery of electrical energy ...

UNIDIRECTIONAL NEURAL STIMULATION SYSTEMS, DEVICES AND METHODS

An embodiment relates to a method for delivering a unidirectional afferent nerve stimulation treatment. A test neural stimulation is delivered, and a physiologic response to the test neural stimulation is monitored. At least one neural stimulation parameter for the test neural stimulation is adjusted if the test neural stimulation does not elicit a desired physiologic response. If the test neural stimulation does elicit the desired physiologic response, at least one treatment parameter for a unidirectional afferent nerve stimulation is determined using the at least one neural stimulation parameter for the test neural stimulation that provided the desired physiologic response. The unidirectional afferent nerve stimulation is delivered using the at least one treatment parameter.

WIRELESS ECG IN IMPLANTABLE DEVICES

An implantable medical device such as an implantable pacemaker or implantable cardioverter/defibrillator includes a programmable sensing circuit providing for sensing of a signal approximating a surface electrocardiogram (ECG) through implanted electrodes. With various electrode configurations, signals approximating various standard surface ECG signals are acquired without the need for attaching electrodes with cables onto the skin. The various electrode configurations include, but are not limited to, various combinations of intracardiac pacing electrodes, portions of the implantable medical device contacting tissue, and electrodes incorporated onto the surface of the implantable medical device.

Paced ventilation therapy by an implantable cardiac device

An implantable cardiac rhythm management device for treating tachyarrhythmias such as ventricular fibrillation which also has the capability of detecting and treating respiratory arrest. The device restores respiratory function by electrically stimulating the diaphragm with pacing electrodes which may be normally used by the device for cardiac pacing. In response to detection of ventricular fibrillation and respiratory arrest, the device delivers shock pulses to terminate the fibrillation and diaphragmatic pacing pulses to restore breathing.

Drug eluting implants to prevent cardiac apoptosis

Implantable devices are configured to be positioned in or near the heart and to carry and deliver an anti-apoptotic drug to a treatment site in or near the heart. The implantable devices include, but are not limited to, leads, stents, heart valves, atrial septal defect devices, cardiac patches and ventricular restraint devices. Depending on the composition of the device, the drug may be carried by the device through a coating applied to the device, or may be included in the device during the device manufacturing process. The drug may also be included in microparticles, such a microspheres, that are delivered locally through a conduit, such as a catheter.

Drug delivery system for implantable cardiac device

A drug delivery system incorporated into a cardiac device for delivering a dose of a drug to a patient upon detection of a particular medical condition. The cardiac device may be, for example, an implantable cardioverter/defibrillator, cardiac pacemaker, or combination device that communicates via a radio frequency link with a drug delivery device. The drug delivery device is preferably an electrically modulated transdermal drug delivery device for delivering the drug transdermally in accordance with a signal received from the cardiac device.

MEDICAL LEAD HAVING A VARIABLE CHANGE IN STIFFNESS

According to one embodiment, the present invention includes an elongate implantable medical lead having a distal portion that is relatively flexible, a proximal portion that is relatively stiff, and a transition portion which has a variable transition stiffness. The transition stiffness varies over the length of the transition portion that generally decreases in a distal direction. The relatively stiff proximal portion of the lead gives the lead steerability while the gradual change in stiffness in the transition portion reduces the likelihood that the lead will prolapse when it is guided into a branch vein. The distal stiffness is less than the proximal stiffness giving the lead a safe end that is unlikely to puncture vascular walls and is able to maneuver around various tortuosities when the lead is implanted into a patient.

APPARATUS AND METHOD FOR OUTPUTTING HEART SOUNDS

An apparatus for outputting heart sounds includes an implantable system and an external system. The implantable system includes a sensor for generating sensed signals representing detected heart sounds, an interface circuit and a control circuit for receiving the sensed signals, generating data representing the heart sounds therefrom, and transmitting the data to the external system via the interface circuit. The external system includes an interface circuit for communicating with the implantable system, and a control circuit for receiving the data representing the heart sounds and for generating control signals that cause an output device to generate outputs representing the sounds. The implantable system may also include a sensor(s) for detecting cardiac electrical signals. In this case, outputs representing the cardiac electrical signals are also output.

Personalized and Contextualized Treatment of Sleep Apnea and Obesity Comorbidity

A sleep apnea and obesity comorbidity treatment system includes a transceiver and a control module. The control module is configured to: receive sensor data, where the sensor data is indicative of a glucose level of a patient and a ketones level of the patient, transmit the sensor data to a remote feedback device, receive feedback information from the remote feedback device based on the sensor data, and where the feedback information provides indications to the patient to maintain or alter a behavior of the patient based on the glucose level and the ketones level, and based on the feedback information, performing an operation to maintain or alter at least one of a diet or physical activity of the patient.

Chronotropic status monitor for implantable cardiac device

An implantable cardiac device with an exertion level sensor is programmed to determine a heart rate appropriate for a given measured exertion level in accordance with a physiological model and/or previously collected physiologic data. The device then compares the model's heart rate with a measured intrinsic heart rate. Based upon this data, the device is able to recognize changes in the patient's heart rate response and predict or recognize a chronotropically incompetent condition.

WIRELESS ECG IN IMPLANTABLE DEVICES

An implantable medical device such as an implantable pacemaker or implantable cardioverter/defibrillator includes a programmable sensing circuit providing for sensing of a signal approximating a surface electrocardiogram (ECG) through implanted electrodes. With various electrode configurations, signals approximating various standard surface ECG signals are acquired without the need for attaching electrodes with cables onto the skin. The various electrode configurations include, but are not limited to, various combinations of intracardiac pacing electrodes, portions of the implantable medical device contacting tissue, and electrodes incorporated onto the surface of the implantable medical device.

Method and apparatus for stimulation

A medical device system and method are disclosed for treating obstructive sleep apnea. The system includes a pulse generator and a medical electrical lead including multiple electrodes carried by a distal portion of an elongated lead body. The method includes advancing the distal portion within protrusor muscle tissue below the oral cavity and delivering electrical stimulation pulses via the electrodes to sustain a protruded state throughout a delivery time period to sustain a protruded state of a patient's tongue throughout the therapy delivery time period. The therapy delivery time period may span multiple respiration cycles.

CARDIAC RHYTHM MANAGEMENT SYSTEM AND METHOD

A system and method for cardiac rhythm management, which includes an electrode system having at least one electrode and control circuitry coupled to the electrode system from which a first cardiac signal is sensed. The control circuitry includes a pulse circuit to produce electrical pulses at a first value to be delivered to the electrode system in a first cardiac region. At least one cardiac signal is sensed from a second cardiac region, where the cardiac signal includes indications of cardiac depolarizations from the second cardiac region which occurs in direct reaction to the electrical pulses delivered to the first cardiac region. The first value of the electrical pulses are then modified by a pulse adjustment circuit when a cardiac depolarization which occurs in direct reaction to the electrical pulse delivered to the first cardiac region is detected from the second cardiac region.

Apparatus and method for outputting heart sounds

An apparatus for outputting heart sounds includes an implantable system and an external system. The implantable system includes a sensor for generating sensed signals representing detected heart sounds, an interface circuit and a control circuit for receiving the sensed signals, generating data representing the heart sounds therefrom, and transmitting the data to the external system via the interface circuit. The external system includes an interface circuit for communicating with the implantable system, and a control circuit for receiving the data representing the heart sounds and for generating control signals that cause an output device to generate outputs representing the sounds. The implantable system may also include a sensor(s) for detecting cardiac electrical signals. In this case, outputs representing the cardiac electrical signals are also output.

Obstructive and central sleep apnea combination therapy control

Apnea events may be detected based on a primary biomarker, e.g., respiration, in the one or more physiological signals. The apnea events may be characterized as one of an obstructive sleep apnea (OSA) event, a central sleep apnea (CSA) event, or a combination OSA/CSA event based on a secondary biomarker, e.g., a frequency spectrum or a morphology of the respirations in the one or more physiological signals. A first electrical stimulation may be provided to treat OSA in response to a first one or more of the apnea events being characterized as OSA events. A second electrical stimulation may be provided to treat CSA in response to a second one or more of apnea events being characterized as CSA events. A third electrical stimulation may be provided to treat combination OSA/CSA in response to a third one or more of the apnea events being characterized as combination OSA/CSA events.

Implantable and rechargeable neural stimulator

One aspect of the present subject matter relates to an implantable medical device. An embodiment of the device comprises a rechargeable power supply adapted to be recharged through an ultrasound signal, a neural stimulator connected to the rechargeable power supply, and a controller connected to the rechargeable power supply. The neural stimulator is adapted to generate a neural stimulation signal for delivery to a neural stimulation target through an electrode. The controller is further connected to the neural stimulator to control the neural stimulator according to a neural stimulation protocol. Other aspects are provided herein.

HIGH FREQUENCY STIMULATION TO BLOCK LARYNGEAL STIMULATION DURING VAGAL NERVE STIMULATION

An implantable medical device and associated method deliver a therapy to an autonomic nerve. The therapy delivery includes delivering therapeutic low frequency (LF) electrical stimulation pulses to the autonomic nerve and delivering a high frequency electrical signal to the autonomic nerve during the LF frequency stimulation pulse delivery. The high frequency stimulation signal blocks activation of autonomic nerve fibers innervating a non-targeted tissue during the therapeutic LF stimulation pulse delivery.

Techniques for placing medical leads for electrical stimulation of nerve tissue

This disclosure is directed to extra, intra, and transvascular medical lead placement techniques for arranging medical leads and electrical stimulation and/or sensing electrodes proximate nerve tissue within a patient.

System and Method for Therapy

Disclosed is a system for stimulation of a subject. The stimulation may be to provide therapy to treat the subject. Stimulation may be of selected muscle groups and/or portions. 1. A method for activating a lingual muscle of a subject , comprising:recalling a first stimulation parameter;recalling selected predetermined input values related to the first stimulation parameters;receiving subject input values;comparing the recalled selected predetermined input values and the received subject input values; anddetermining a subject stimulation parameter based on the comparison of the recalled selected predetermined input values and the received subject input values and the related recalled first stimulation parameter.2. The method of claim 1 , further comprising:providing a subject input device;wherein the provided subject input device is operable to store subject input values from the subject.3. The method of claim 1 , further comprising:providing a subject sensor;wherein the provided subject sensor is operable to transmit the subject input values.4. The method of claim 1 , wherein the subject input values includes at least one of a breath rate of the subject claim 1 , an oxygenation of at least a portion of the subject claim 1 , or combinations thereof.5. The method of claim 4 , further comprising:determining a treatment efficacy as either (i) proper when the subject stimulation parameter are within a threshold of the recalled first parameter or (ii) improper when the subject stimulation parameter are outside a threshold of the recalled first parameter; andoutputting the determined treatment efficacy.6. The method of claim 5 , further comprising:altering a stimulation of the subject when the outputted determined treatment efficacy value is less than a threshold.7. The method of claim 6 , wherein altering a stimulation of the subject further comprises:recalling a second stimulation parameter.8. The method of claim 7 , further comprising: comparing the subject input ...

Method and apparatus for diaphragmatic pacing

A diaphragmatic pacing system and method. The method includes monitoring a signal representing a patient's respiratory activity, and delivering an electric stimulus from a lead to the phrenic nerve when the signal indicates that the respiratory activity is below a predetermined level. Physiological state information, such as the respiration activity or minute ventilation, is sensed using the implanted lead and the method delivers an output based on such input. Another embodiment provides concurrent sensing and pacing of heart and diaphragm using a single implanted pulse generator. The implantable system includes at least one lead and a signal processing circuit coupled to the lead. The signal processing circuit processes a signal representative of a respiratory activity. A controller coupled to the signal processing circuit analyzes the signal and when the signal indicates a need for respiratory therapy the controller outputs a controller signal. An output circuit coupled to the controller, for delivering a pulse in response to the controller signal, the pulse having an amplitude high enough to stimulate a phrenic nerve.

IMPLANTABLE AND RECHARGEABLE NEURAL STIMULATOR

One aspect of the present subject matter relates to an implantable medical device. An embodiment of the device comprises a rechargeable power supply adapted to be recharged through an ultrasound signal, a neural stimulator connected to the rechargeable power supply, and a controller connected to the rechargeable power supply. The neural stimulator is adapted to generate a neural stimulation signal for delivery to a neural stimulation target through an electrode. The controller is further connected to the neural stimulator to control the neural stimulator according to a neural stimulation protocol. Other aspects are provided herein. 1. A system for therapeutically stimulating a neural stimulation target of a human , comprising:an implantable medical device, wherein the implantable medical device includes a neural stimulator configured to deliver neural stimulation for use in stimulating the neural stimulation target, the implantable device including an ultrasound transducer configured to convert an ultrasound energy into an electrical energy,wherein the implantable medical device is configured to power the neural stimulator using the electrical energy converted from the ultrasound energy.2. The system of claim 1 , wherein the implantable medical device is remotely powered through the ultrasound energy.3. The system of claim 1 , wherein the ultrasound power signal includes data encoded within the ultrasound power signal claim 1 , wherein the implantable device is further configured to receive and process the data encoded in the ultrasound power signal.4. The system of claim 1 , further comprising an external device configured to send the ultrasound energy.5. The system of claim 1 , further comprising another implantable device configured to send the ultrasound energy.6. The system of claim 1 , wherein the implantable medical device further comprises:a blood pressure sensor configured to sense blood pressure; anda controller configured to control the neural stimulator ...

System and method for monitoring autonomic balance and physical activity

An implantable device monitors the balance between sympathetic tone and parasympathetic tone as a function of an activity level. Cardio-neurological healthy users exhibit a generally sympathetic tone in conjunction with heavy activity level and a generally parasympathetic tone in conjunction with periods of low activity level. Deviations from expected results are associated with a health problem. Measured conditions are stored and available for subsequent reporting to a remote programmer. Therapy delivered by an implantable device is determined as a function of the relationship between autonomic balance and activity level.

Neural stimulation to treat sleep apnea

A removable oral device is disclosed. The removable oral device comprises a mounting retainer configured to align with a set of teeth. An electrical stimulator is coupled to the mounting retainer. A single lead is employed that has a first and a second end and lacking a mechanical connection to the mounting retainer. A first and a second electrode are positioned along the single lead. The lead is disposed perpendicular to a longitudinal axis of a patient's tongue such that the first electrode is proximate a first hypoglossal nerve and the second electrode is proximate a second hypoglossal nerve.

Therapy system including cardiac rhythm therapy and neurostimulation capabilities

An implantable medical system that includes a cardiac therapy module and a neurostimulation therapy module may identify when neurostimulation electrodes have migrated toward a patient's heart. In some examples, the system may determine whether the neurostimulation electrodes have migrated toward the patient's heart based on a physiological response to an electrical signal delivered to the patient via the neurostimulation electrodes. In addition, in some examples, the system may determine whether the neurostimulation electrodes have migrated toward the patient's heart based on an electrical cardiac signal sensed via the neurostimulation electrodes.

MEDICAL LEAD FOR TREATING OBSTRUCTIVE SLEEP APNEA (OSA) WITH ELECTRICAL STIMULATION

A method of implanting a lead includes inserting a needle through tissue near a chin of a patient and through a tongue of the patient, inserting an introducer through an opening created by the needle, and inserting the lead through the introducer, the lead comprising an elongated member and one or more electrodes in a distal portion of the elongated member such that the one or more electrodes are implantable proximate to one or more motor points of a protrusor muscle within the tongue of the patient, wherein inserting the lead comprises inserting the lead to have a shape of one of a helix, a compound helix, a wave shape, or saw-tooth shape, or to have a loop in the lead.

Implantable and rechargeable neural stimulator

One aspect of the present subject matter relates to an implantable medical device. An embodiment of the device comprises a rechargeable power supply adapted to be recharged through an ultrasound signal, a neural stimulator connected to the rechargeable power supply, and a controller connected to the rechargeable power supply. The neural stimulator is adapted to generate a neural stimulation signal for delivery to a neural stimulation target through an electrode. The controller is further connected to the neural stimulator to control the neural stimulator according to a neural stimulation protocol. Other aspects are provided herein.

System and method for delivering myocardial and autonomic neural stimulation

Various aspects of the present subject matter provide an implantable medical device. In various embodiments, the device comprises a pulse generator, a lead, a sensor, and a controller. The pulse generator generates a baroreflex stimulation signal as part of a baroreflex therapy. The lead is adapted to be electrically connected to the pulse generator and to be intravascularly fed into a heart. The lead includes an electrode to be positioned in or proximate to the heart to deliver the baroreflex signal to a baroreceptor region in or proximate to the heart. The sensor senses a physiological parameter regarding an efficacy of the baroreflex therapy and provides a signal indicative of the efficacy. The controller is connected to the pulse generator to control the baroreflex stimulation signal and to the sensor to receive the signal indicative of the efficacy of the baroreflex therapy. Other aspects are provided herein.

THERAPY SYSTEM INCLUDING CARDIAC RHYTHM THERAPY AND NEUROSTIMULATION CAPABILITIES

An implantable medical system that includes a cardiac therapy module and a neurostimulation therapy module may identify when neurostimulation electrodes have migrated toward a patient's heart. In some examples, the system may determine whether the neurostimulation electrodes have migrated toward the patient's heart based on a physiological response to an electrical signal delivered to the patient via the neurostimulation electrodes. In addition, in some examples, the system may determine whether the neurostimulation electrodes have migrated toward the patient's heart based on an electrical cardiac signal sensed via the neurostimulation electrodes.

Connection verification apparatus, systems, and methods

A cardiac rhythm management apparatus and system may include a first contact to provide a connection signal, a second contact to sense a corresponding connection signal using a lead and an electrode coupled to the second contact, a measurement module capable of being communicatively coupled to the first and second contacts to measure a characteristic associated with the connection signal, a comparison module to determine whether the lead is of a preselected type, and an indicator module to indicate the comparison result. An article may cause a machine to implement a method which includes providing a connection signal from one contact, measuring a characteristic associated with a corresponding connection signal at another contact, and comparing the characteristic with a range of values to determine a comparison result. The method may also include indicating and recording the comparison result.

Syncope logbook and method of using same

Methods and systems are directed to acquiring and organizing information associated with at least one syncope event. A syncope event may be a suspected syncope event, a verified syncope event or a syncope event that is suspected and verified. Automated processes are used to collect information associated with at least one syncope event and organize the information as a syncope log entry. At least one of acquiring the information and organizing the information is performed at least in part implantably.

Apparatus and method for outputting heart sounds

An apparatus for outputting heart sounds includes an implantable system and an external system. The implantable system includes a sensor for generating sensed signals representing detected heart sounds, an interface circuit and a control circuit for receiving the sensed signals, generating data representing the heart sounds therefrom, and transmitting the data to the external system via the interface circuit. The external system includes an interface circuit for communicating with the implantable system, and a control circuit for receiving the data representing the heart sounds and for generating control signals that cause an output device to generate outputs representing the sounds. The implantable system may also include a sensor(s) for detecting cardiac electrical signals. In this case, outputs representing the cardiac electrical signals are also output.

CONNECTION VERIFICATION APPARATUS, SYSTEMS, AND METHODS

An apparatus, system, and method may operate to provide a connection signal using a first contact, measure a waveshape associated with a corresponding connection signal arising from the connection signal at a second contact connected to a first electrode using a lead, and provide a comparison result after determining whether the lead is a preselected lead type based on the waveshape.

Transvascular reshaping lead system

A system for selective activation of a nerve trunk using a transvascular reshaping lead is provided. One aspect of this disclosure relates to a system for spreading nerve bundles in a nerve trunk. The system includes a lead adapted to be chronically implanted in a blood vessel proximate a nerve trunk, and having an expandable portion adapted to be expanded to reshape the blood vessel to an elongated shape and to reshape the nerve trunk into an elongated shape to spread nerve bundles of the nerve trunk. The system also includes a plurality of electrodes and an implantable device coupled to the lead, where an electrical signal is delivered from the implanted medical device to one of the plurality of electrodes to transvascularly deliver neural stimulation from the electrode to at least one of the nerve bundles of the nerve trunk. Other aspects and embodiments are provided herein.

Medical lead for treating obstructive sleep apnea (OSA) with electrical stimulation

A lead for delivering electrical stimulation therapy is described. The lead includes an elongated member defining a longitudinal axis, one or more electrodes disposed at a distal end of the elongated member, a plurality of collars located along the longitudinal axis, and one or more fixation members. At least one of the fixation members is a bow-like member having a first connection point to a first collar of the plurality of collars and a second connection point to a second collar of the plurality of collars. The distal end of the elongated member is configured for insertion in a tongue of a patient such that the one or more electrodes are implanted proximate to one or more motor points of a protrusor muscle within the tongue of the patient and the bow-like member of the one or more fixation members is implanted within tissue of the tongue.

Baroreflex stimulation system to reduce hypertension

Various aspects of the present subject matter provide an implantable medical device. In various embodiments, the device comprises a pulse generator, a lead, a sensor, and a controller. The pulse generator generates a baroreflex stimulation signal as part of a baroreflex therapy. The lead is adapted to be electrically connected to the pulse generator and to be intravascularly fed into a heart. The lead includes an electrode to be positioned in or proximate to the heart to deliver the baroreflex signal to a baroreceptor region in or proximate to the heart. The sensor senses a physiological parameter regarding an efficacy of the baroreflex therapy and provides a signal indicative of the efficacy. The controller is connected to the pulse generator to control the baroreflex stimulation signal and to the sensor to receive the signal indicative of the efficacy of the baroreflex therapy. Other aspects are provided herein.

Medical electrical lead employing load bearing sleeve

A medical electrical lead employs a load bearing sleeve arrangement. A medical electrical lead includes an outer sleeve, having proximal and distal ends, and is formed of a first material. At least one electrical conductor is situated within the outer sleeve and extends between the proximal and distal ends of the outer sleeve. At least one electrode is electrically coupled to the electrical conductor. A load bearing sleeve extends between the proximal and distal ends of the outer sleeve. The load bearing sleeve is formed of a second material different from the first material. The load bearing sleeve offers resistance to axial loading forces applied to the lead. The load bearing sleeve can be coextensive with the outer sleeve or extend along at least the majority of the length of the outer sleeve.

SYSTEMS AND METHODS FOR DETECTING STROKES

A system for detecting strokes includes a sensor device configured to obtain physiological data from a patient, for example brain activity data. The sensor device can include electrodes configured to be disposed at the back of the patient's neck or base of the skull. The electrodes can detect electrical signals corresponding to brain activity in the P3, Pz, and/or P4 brain regions or other brain regions. A computing device communicatively coupled to the sensor device is configured to receive the physiological data and analyze it to indicate whether the patient has suffered a stroke. 1. A stroke detection system comprising:a sensor device configured to obtain physiological data from a patient, wherein the sensor device comprises a plurality of electrodes and is configured to be disposed above shoulders of the patient, and the physiological data comprises electrical brain activity data and electrical heart activity data of the patient sensed via the plurality of electrodes; and analyze the physiological data; and', 'based on the analysis, provide a patient stroke indicator., 'processing circuitry configured to2. The system of claim 1 , wherein the sensor device is configured to detect brain activity data corresponding to activity in at least one of the P3 claim 1 , Pz claim 1 , and P4 brain regions via the plurality of electrodes.3. The system of claim 1 , wherein the sensor device is configured to be disposed at or adjacent a rear portion of a neck or skull base of the patient.4. The system of claim 1 , wherein the sensor device comprises a housing configured to be implanted within the patient.5. The system of claim 4 , wherein the housing is configured to be implanted subcutaneously.6. The system of claim 1 , wherein the sensor device comprises a housing configured to be disposed over skin of the patient.7. The system of claim 6 , wherein the sensor device comprises one of a patch configured to be adhered to the patient or a garment configured to be worn by the ...

SYSTEMS AND METHODS FOR EVALUATING NEUROMODULATION THERAPY VIA HEMODYNAMIC RESPONSES

Systems and methods for evaluating neuromodulation via hemodynamic responses are disclosed herein. A system configured in accordance with embodiments of the present technology can include, for example, a neuromodulation catheter comprising an elongated shaft having a distal portion, and a plurality of electrodes spaced along a distal portion. The system can further include a controller communicatively coupled to the electrodes. The controller can be configured to apply first and second stimuli at and/or proximate to a target site within a blood vessel before and after delivering neuromodulation energy to the target site, and detect, via at least one of the electrodes, vessel impedance resulting from the first and second stimuli to determine a baseline impedance and a post-neuromodulation impedance. The controller can further be configured to assess the efficacy of the neuromodulation based, at least in part, on a comparison of the baseline impedance and the post-neuromodulation impedance ...

TRANSVASCULAR RESHAPING LEAD SYSTEM

A system for selective activation of a nerve trunk using a transvascular reshaping lead is provided. One aspect of this disclosure relates to a system for spreading nerve bundles in a nerve trunk. The system includes a lead adapted to be chronically implanted in a blood vessel proximate a nerve trunk, and having an expandable portion adapted to be expanded to reshape the blood vessel to an elongated shape and to reshape the nerve trunk into an elongated shape to spread nerve bundles of the nerve trunk. The system also includes a plurality of electrodes and an implantable device coupled to the lead, where an electrical signal is delivered from the implanted medical device to one of the plurality of electrodes to transvascularly deliver neural stimulation from the electrode to at least one of the nerve bundles of the nerve trunk. Other aspects and embodiments are provided herein.

SLEEP APNEA THERAPY

A system for sleep apnea treatment includes an implantable medical device (IMD) coupled to a first lead and a second lead, wherein the IMD comprises a processor and stimulation circuitry, and wherein the processor is configured to cause the stimulation circuitry of IMD to: transmit a first stimulation signal to the first lead to stimulate at least one of an ansa cervicalis, a glossopharyngeal nerve, tensor veli, levator veli, and digastric anterior of a patient, and transmit a second stimulation signal to the second lead to stimulate at least one a hypoglossal nerve or a phrenic nerve of the patient.

Obstructive and central sleep apnea combination therapy control

Apnea events may be detected based on a primary biomarker, e.g., respiration, in the one or more physiological signals. The apnea events may be characterized as one of an obstructive sleep apnea (OSA) event, a central sleep apnea (CSA) event, or a combination OSA/CSA event based on a secondary biomarker, e.g., a frequency spectrum or a morphology of the respirations in the one or more physiological signals. A first electrical stimulation may be provided to treat OSA in response to a first one or more of the apnea events being characterized as OSA events. A second electrical stimulation may be provided to treat CSA in response to a second one or more of apnea events being characterized as CSA events. A third electrical stimulation may be provided to treat combination OSA/CSA in response to a third one or more of the apnea events being characterized as combination OSA/CSA events.

TECHNIQUES FOR PLACING MEDICAL LEADS FOR ELECTRICAL STIMULATION OF NERVE TISSUE

This disclosure is directed to extra, intra, and transvascular medical lead placement techniques for arranging medical leads and electrical stimulation and/or sensing electrodes proximate nerve tissue within a patient.

Vascularly stabilized peripheral nerve cuff assembly

A vascularly stabilized peripheral nerve cuff assembly is provided. One aspect of this disclosure relates to an electrode assembly used in the delivery of neural stimulation therapy. The electrode assembly includes a body adapted to at least partially encompass a blood vessel and a nerve proximate to the blood vessel. The electrode assembly also includes at least one electrode along at least a portion of the body. The at least one electrode is adapted to be electrically connected to a neural stimulator. According to an embodiment, the electrode assembly includes a spacer within the body, the spacer having a first and second end, the first end secured to an inside surface of the body and the second end adapted to pass between the vessel and the nerve and to be secured to the inside surface of the body. Other aspects and embodiments are provided herein.

Drug delivery system for implantable medical device

A drug delivery system and method in which an implantable medical device communicates with and controls an external drug delivery device with low energy potential signals. The implantable device generates potential signals modulated with digitally encoded command information by operating a current source to cause corresponding electrical potentials that can be sensed at the skin surface by the external drug delivery device. The drug delivery device then demodulates the sensed potentials and decodes the digital data to extract command information therefrom to deliver a drug accordingly.

Cardiac rhythm management system and method

A system and method for cardiac rhythm management, which includes an electrode system having at least one electrode and control circuitry coupled to the electrode system from which a first cardiac signal is sensed. The control circuitry includes a pulse circuit to produce electrical pulses at a first value to be delivered to the electrode system in a first cardiac region. At least one cardiac signal is sensed from a second cardiac region, where the cardiac signal includes indications of cardiac depolarizations from the second cardiac region which occurs in direct reaction to the electrical pulses delivered to the first cardiac region. The first value of the electrical pulses are then modified by a pulse adjustment circuit when a cardiac depolarization which occurs in direct reaction to the electrical pulse delivered to the first cardiac region is detected from the second cardiac region.

NEURAL STIMULATION TO TREAT SLEEP APNEA

A removable oral device is disclosed. The removable oral device comprises a mounting retainer configured to align with a set of teeth. An electrical stimulator is coupled to the mounting retainer. A single lead is employed that has a first and a second end and lacking a mechanical connection to the mounting retainer. A first and a second electrode are positioned along the single lead. The lead is disposed perpendicular to a longitudinal axis of a patient's tongue such that the first electrode is proximate a first hypoglossal nerve and the second electrode is proximate a second hypoglossal nerve. 1. A dental system for treating obstructive sleep apnea , the system comprising:a removable mounting retainer configured to align with a set of teeth;an electrical stimulator coupled to the mounting retainer; anda lead comprising a lead body and one or more electrodes along the lead body, the one or more electrodes positioned to stimulate hypoglossal neural tissue to cause a tongue to move in response to the electrical stimulator wirelessly delivering electrical signals to the one or more electrodes.2. The device of wherein delivering electrical signals occurs without monitoring any phase of respiration.3. The device of wherein the lead having a longitudinal axis extending from a first and a second end claim 1 , the one or more electrodes comprising first and second electrodes at the first and second ends claim 1 , respectively the first electrode positioned proximate a first hypoglossal nerve and the second electrode positioned proximate a second hypoglossal nerve.4. The device of wherein the lead being curvilinear extending from a first and a second end claim 1 , the one or more electrodes comprising first and second electrodes at the first and second ends claim 1 , respectively the first electrode positioned proximate a first hypoglossal nerve and the second electrode positioned proximate a second hypoglossal nerve.5. The device of wherein the neural tissue comprises at ...

MEDICAL DEVICE TO PROVIDE BREATHING THERAPY

Medical devices and methods for providing breathing therapy (e.g., for treating heart failure, hypertension, etc.) may determine at least the inspiration phase of one or more breathing cycles based on the monitored physiological parameters and control delivery of a plurality of breathing therapy sessions (e.g., each of the breathing therapy sessions may be provided during a defined time period). Further, each of the plurality of breathing therapy sessions may include delivering stimulation after the start of the inspiration phase of each of a plurality of breathing cycles to prolong diaphragm contraction during the breathing cycle. 1. A method for providing breathing therapy , comprising:providing a plurality of breathing therapy sessions wherein each of the plurality of breathing therapy sessions comprises delivering stimulation during each of a plurality of breathing cycles to prolong diaphragm contraction during the breathing cycle and delivering cardiac pacing to the patient based on a predefined ratio of breathing rate to heart rate.2. The method of further comprising:monitoring one or more physiological parameters of a patient to determine a presence of a temporary or sustained elevated sympathetic tone based on at least an elevated blood pressure; andmonitoring respiration of a patient to determine at least an inspiration phase of one or more breathing cycles.3. The method of claim 2 , wherein the plurality of breathing therapy sessions upon determination of the presence of an elevated sympathetic tone claim 2 , wherein each of the breathing therapy sessions is provided during a defined time period claim 2 , and further wherein each of the plurality of breathing therapy sessions comprises delivering stimulation after the start of the inspiration phase of each of a plurality of breathing cycles to prolong diaphragm contraction during the breathing cycle.4. The method of claim 3 , wherein delivering stimulation comprises delivering at least one of phrenic nerve ...

UNIDIRECTIONAL NEURAL STIMULATION SYSTEMS, DEVICES AND METHODS

An embodiment relates to a method for delivering a unidirectional afferent nerve stimulation treatment. A test neural stimulation is delivered, and a physiologic response to the test neural stimulation is monitored. At least one neural stimulation parameter for the test neural stimulation is adjusted if the test neural stimulation does not elicit a desired physiologic response. If the test neural stimulation does elicit the desired physiologic response, at least one treatment parameter for a unidirectional afferent nerve stimulation is determined using the at least one neural stimulation parameter for the test neural stimulation that provided the desired physiologic response. The unidirectional afferent nerve stimulation is delivered using the at least one treatment parameter. 1. (canceled)2. An externally-controllable vagus nerve neurostimulator for treating chronic cardiac dysfunction , comprising:an implantable neurostimulator comprising:a pulse generator configured to deliver electrical therapeutic stimulation tuned to restore autonomic balance through continuously-cycling, intermittent and periodic electrical pulses simultaneously delivered at an intensity that avoids acute physiological side effects and with an unchanging cycle not triggered by physiological markers in both afferent and efferent directions of a cervical vagus nerve through a pair of helical electrodes via an electrically coupled nerve stimulation therapy lead; anda programmable switch configured to control the pulse generator in response to a remotely-applied magnetic signal.3. A neurostimulator according to claim 2 , wherein the pulse generator is further configured to suspend the electrical therapeutic stimulation for a fixed period of time in response to the magnetic signal.4. A neurostimulator according to claim 3 , wherein the programmable switch is further configured to recognize a plurality of the magnetic signals claim 3 , each magnetic signal corresponding to different durations of ...

Cardiac rhythm management system and method

A system and method for cardiac rhythm management, which includes an electrode system having at least one electrode and control circuitry coupled to the electrode system from which a first cardiac signal is sensed. The control circuitry includes a pulse circuit to produce electrical pulses at a first value to be delivered to the electrode system in a first cardiac region. At least one cardiac signal is sensed from a second cardiac region, where the cardiac signal includes indications of cardiac depolarizations from the second cardiac region which occurs in direct reaction to the electrical pulses delivered to the first cardiac region. The first value of the electrical pulses are then modified by a pulse adjustment circuit when a cardiac depolarization which occurs in direct reaction to the electrical pulse delivered to the first cardiac region is detected from the second cardiac region.

Dosing vagal nerve stimulation therapy in synchronization with transient effects

The present disclosure is directed to a method of using an implantable medical device. One embodiment of the present disclosure comprises delivering electrical stimulation proximate nerve tissue of a patient during a transient physiological effect period separated by a recovery period. The transient physiological effect period is when electrical stimulation has an increased level of efficacy and the recovery period is when additional electrical stimulation does not provide a beneficial physiological effect to the patient.

TECHNIQUES FOR PLACING MEDICAL LEADS FOR ELECTRICAL STIMULATION OF NERVE TISSUE

This disclosure is directed to extra, intra, and transvascular medical lead placement techniques for arranging medical leads and electrical stimulation and/or sensing electrodes proximate nerve tissue within a patient.

IMPEDANCE MEASUREMENT TO MONITOR ORGAN PERFUSION OR HEMODYNAMIC STATUS

A system and method for deliverying an ablation therapy that includes delivering the ablation therapy, delivering drive signals to establish a drive signal vector fields, determining impedance signals in response to the drive signals, determining a first impedance parameter in response to the first impedance signal and a second impedance parameter in response to the second impedance signal, determining whether there is a change in a hemodynamic status of the tissue subsequent to delivery of the ablation therapy in response to the first impedance parameter and the second impedance parameter, and adjusting delivery of the ablation therapy in response to determining whether there is a change in a hemodynamic status of the tissue. 1. A method for deliverying an ablation therapy to a tissue of a patient's body , comprising:delivering the ablation therapy to the tissue;delivering a first drive signal having a first frequency to establish a first drive signal vector field;determining a first impedance signal in response to the first drive signal;delivering a second drive signal having a second frequency different than the first frequency to establish a second drive signal vector;determining a second impedance signal in response to the second drive signal;determining a first impedance parameter in response to the first impedance signal and a second impedance parameter in response to the second impedance signal;determining whether there is a change in a hemodynamic status of the tissue subsequent to delivery of the ablation therapy in response to the first impedance parameter and the second impedance parameter; andadjusting delivery of the ablation therapy in response to determining whether there is a change in a hemodynamic status of the tissue.2. The method of claim 1 , wherein the first drive signal vector field and the second drive signal vector field each comprise an arterial volume and a venous volume corresponding to the tissue.3. The method of claim 1 , wherein ...

Systems and Methods for Evaluating Neuromodulation Therapy Via Hemodynamic Responses

Systems and methods for evaluating neuromodulation via hemodynamic responses are disclosed herein. A system configured in accordance with embodiments of the present technology can include, for example, a neuromodulation catheter comprising an elongated shaft having a distal portion, and a plurality of electrodes spaced along a distal portion. The system can further include a controller communicatively coupled to the electrodes. The controller can be configured to apply first and second stimuli at and/or proximate to a target site within a blood vessel before and after delivering neuromodulation energy to the target site, and detect, via at least one of the electrodes, vessel impedance resulting from the first and second stimuli to determine a baseline impedance and a post-neuromodulation impedance. The controller can further be configured to assess the efficacy of the neuromodulation based, at least in part, on a comparison of the baseline impedance and the post-neuromodulation impedance. 117-. (canceled)18. A system , comprising: an elongated shaft having a distal portion and a proximal portion, wherein the distal portion is configured to be positioned at a target site in a blood vessel of a human patient; and', 'a plurality of electrodes spaced along a distal portion of the shaft; and, 'a neuromodulation catheter comprising—'} apply a first stimulus at and/or proximate to the target site within the blood vessel;', 'detect, via at least one of the electrodes, vessel impedance resulting from the first stimulus to determine a baseline impedance;', 'deliver neuromodulation energy to the target site within the blood vessel of the human patient via the distal portion of the shaft;', 'apply a second stimulus at and/or proximate to the target site within the blood vessel after delivering the neuromodulation energy;', 'detect, via at least one of the electrodes, vessel impedance resulting from the second stimulus to determine a post-neuromodulation impedance; and', 'assess ...

Lead for stimulating the baroreceptors in the pulmonary artery

An apparatus includes a flexible lead body extending from a proximal end to a distal end, an expandable electrode coupled proximate the distal end, the expandable electrode having an expanded diameter dimensioned to abut a wall of a pulmonary artery, and an implantable pulse generator electrically coupled to the expandable electrode. The expandable electrode includes a plurality of electrode zones. The plurality of zones can be tested to determine which zone delivers the best baroreflex response. At least one of the electrode zones can be selected to deliver a stimulation signal based on the testing. The implantable pulse generator is adapted to deliver a baroreflex stimulation signal to a baroreceptor in the pulmonary artery via the electrode.

INTEGRATED SLEEP APNEA AND AT LEAST ONE OF CARDIAC MONITORING AND CARDIAC THERAPY

An implantable medical device (IMD) includes therapy delivery circuitry, sensing circuitry, and processing circuitry. The processing circuitry is configured to determine one or more sleep apnea therapy parameters, control the therapy delivery circuitry to deliver sleep apnea therapy via a first set of electrodes implantable within the patient in accordance with the one or more sleep apnea therapy parameters, and at least one of: (1) monitor a cardiac signal sensed with the sensing circuitry, or (2) determine one or more cardiac therapy parameters, and control the therapy delivery circuitry to deliver cardiac therapy via a second set of electrodes implantable within the patient in accordance with the one or more cardiac therapy parameters.

OBSTRUCTIVE SLEEP APNEA PATIENT PROGRAMMER FOR IMPLANTABLE DEVICES

An implantable neurostimulator system including an electrical lead having formed thereon a pair of bipolar electrodes, the electrical lead is configured for placement of the pair of bipolar electrodes proximate protrusor muscles of a patient. The system also includes a pulse generator electrically connected to the electrical lead and configured to deliver electrical energy to the pair of bipolar electrodes, the pulse generator having mounted therein a sensor configured to detect one or more physiological parameters, a memory, a control circuit, and a telemetry circuit. The system also including a communications telemetry module (CTM) in communication with the telemetry circuit and configured to receive a data collected by the sensor and data related to delivery of electrical energy to the bipolar electrodes, and an external programmer in communication with the CTM and configured to display a user interface the data collected by the sensor and data related to delivery of electrical energy ...

NEEDLE AND INTRODUCER USED IN LEAD PLACEMENT FOR OBSTRUCTIVE SLEEP APNEA TREATMENT

A system for treating obstructive sleep apnea (OSA) is described. The system may include a device having a size and shape selected to couple externally to a patient near a jaw of the patient. The device may be configured to receive at least one of a needle or an introducer for insertion into a tongue of the patient for lead placement of a lead for OSA treatment, and guide at least a portion of the at least one of the needle or introducer for insertion into the tongue of the patient. 1. A system for treating obstructive sleep apnea (OSA) , the system comprising: receive at least one of a needle or an introducer for insertion into a tongue of the patient for lead placement of a lead for OSA treatment; and', 'guide at least a portion of the at least one of the needle or introducer for insertion into the tongue of the patient., 'a device having a size and shape selected to couple externally to a patient near a jaw of the patient, wherein the device is configured to2. The system of claim 1 , further comprising at least one of the needle or the introducer claim 1 ,wherein the needle comprises a distal end configured to be inserted into the tongue of the patient to create an opening for the lead placement of the lead for OSA treatment, andwherein the introducer comprises a distal end for placement in the opening created by the needle and a proximal end for receiving the lead for OSA treatment.3. The system of claim 2 , wherein at least one of the needle or the introducer comprises one or more conductive portions configured to output stimulation signals to one or more motor points of a protrusor muscle within the tongue of the patient claim 2 , and wherein the device comprises a conductive layer that provides at least a partial current return path for the stimulation signals.4. The system of claim 3 , wherein the conductive layer comprises one or more silver chloride claim 3 , silver-silver chloride claim 3 , or a skin-electrode glue.5. The system of claim 3 , further ...

TECHNIQUES FOR PLACING MEDICAL LEADS FOR ELECTRICAL STIMULATION OF NERVE TISSUE

This disclosure is directed to extra, intra, and transvascular medical lead placement techniques for arranging medical leads and electrical stimulation and/or sensing electrodes proximate nerve tissue within a patient. 1. An implantable medical lead system configured to deliver electrical stimulation from within a lumen of a blood vessel within a patient to nerve tissue located adjacent to and outside of the blood vessel , the system comprising:a medical lead arranged within a lumen of the blood vessel;an electrode connected toward a distal end of the lead adjacent the nerve tissue; andan active fixation member connected toward a distal end of the lead adjacent the nerve tissue and configured to anchor the lead to a wall of the blood vessel lumen.2. The system of claim 1 , wherein the active fixation member comprises a helical wire configured to be screwed into tissue of the blood vessel wall.3. The system of claim 2 , wherein the helical fixation member has a length in the range from and including approximately 0.5 millimeters to and including approximately 2.5 millimeters.4. The system of claim 3 , wherein the length of the helical fixation member is in the range from and including approximately 1 millimeters to and including approximately 2 millimeters.5. The system of claim 2 , wherein a pitch of the helical fixation member is in the range from and including approximately 0.5842 millimeters to and including approximately 1.016 millimeters.6. The system of claim 1 , further comprising a catheter configured to be arranged within a lumen of the blood vessel adjacent the nerve tissue claim 1 , wherein the medical lead is advanceable from catheter to the wall of the blood vessel lumen.7. The system of claim 6 , wherein a distal end of the catheter is configured to direct the medical lead transversely toward the wall of the blood vessel lumen when the medical lead is advanced from the distal end of the catheter.8. The system of claim 6 , further comprising a ...

TREATMENT OF OBSTRUCTIVE SLEEP APNEA (OSA)

A system for treatment of obstructive sleep apnea (OSA) is described. The system includes an introducer needle having an elongated body. The introducer needle is configured to create an opening in a tongue of a patient for implantation of a lead for treating OSA. One or more electrically conductive areas are located on the elongated body. A medical device is configured to deliver a stimulation signal via the introducer needle through the one or more electrically conductive areas to the tongue of the patient to stimulate one or more motor points of a protrusor muscle within the tongue of the patient.

Medical electrical lead employing load bearing sleeve

A medical electrical lead employs a load bearing sleeve arrangement. A medical electrical lead includes an outer sleeve, having proximal and distal ends, and is formed of a first material. At least one electrical conductor is situated within the outer sleeve and extends between the proximal and distal ends of the outer sleeve. At least one electrode is electrically coupled to the electrical conductor. A load bearing sleeve extends between the proximal and distal ends of the outer sleeve. The load bearing sleeve is formed of a second material different from the first material. The load bearing sleeve offers resistance to axial loading forces applied to the lead. The load bearing sleeve can be coextensive with the outer sleeve or extend along at least the majority of the length of the outer sleeve.

TECHNIQUES FOR PLACING MEDICAL LEADS FOR ELECTRICAL STIMULATION OF NERVE TISSUE

This disclosure is directed to extra, intra, and transvascular medical lead placement techniques for arranging medical leads and electrical stimulation and/or sensing electrodes proximate nerve tissue within a patient.

LEAD BASED MEASUREMENTS FOR TONGUE MOVEMENT DETERMINATION

A system includes memory, and processing circuitry coupled to the memory, the processing circuitry configured to: determine at least one of: a cross-electrical signal measurement at a first electrode on a first lead implanted within a tongue of the patient based on a stimulation signal between a second electrode on the first lead or a second lead implanted within the tongue of the patient and a third electrode, or a strain measurement of at least one of the first lead or the second lead. The processing circuitry is configured to determine movement of the tongue based on at least one of the cross-electrical signal measurement or the strain measurement, and generate information indicative of the movement of the tongue.

Implantable cardiac device with dyspnea measurement

Cardiac monitoring and/or stimulation methods and systems employing dyspnea measurement. An implantable cardiac device may sense transthoracic impedance and determine a patient activity level. An index indicative of pulmonary function is implantably computed to detect an episode of dyspnea based on a change, trend, and/or value exceeding a threshold at a determined patient activity level. Trending one or more pulmonary function index values may be done to determine a patient's pulmonary function index profile, which may be used to adapt a cardiac therapy. A physician may be automatically alerted in response to a pulmonary function index value and/or a trend of the patient's pulmonary index being beyond a threshold. Computed pulmonary function index values and their associated patient's activity levels may be stored periodically in a memory and/or transmitted to a patient-external device.

Connection verification apparatus, systems, and methods

A cardiac rhythm management apparatus and system may include a first contact to provide a connection signal, a second contact to sense a corresponding connection signal using a lead and an electrode coupled to the second contact, a measurement module capable of being communicatively coupled to the first and second contacts to measure a characteristic associated with the connection signal, a comparison module to determine whether the lead is of a preselected type, and an indicator module to indicate the comparison result. An article may cause a machine to implement a method which includes providing a connection signal from one contact, measuring a characteristic associated with a corresponding connection signal at another contact, and comparing the characteristic with a range of values to determine a comparison result. The method may also include indicating and recording the comparison result.

Wireless ECG in implantable devices

An implantable medical device such as an implantable pacemaker or implantable cardioverter/defibrillator includes a programmable sensing circuit providing for sensing of a signal approximating a surface electrocardiogram (ECG) through implanted electrodes. With various electrode configurations, signals approximating various standard surface ECG signals are acquired without the need for attaching electrodes with cables onto the skin. The various electrode configurations include, but are not limited to, various combinations of intracardiac pacing electrodes, portions of the implantable medical device contacting tissue, and electrodes incorporated onto the surface of the implantable medical device.

Unidirectional neural stimulation systems, devices and methods

An embodiment relates to a method for delivering a unidirectional afferent nerve stimulation treatment. A test neural stimulation is delivered, and a physiologic response to the test neural stimulation is monitored. At least one neural stimulation parameter for the test neural stimulation is adjusted if the test neural stimulation does not elicit a desired physiologic response. If the test neural stimulation does elicit the desired physiologic response, at least one treatment parameter for a unidirectional afferent nerve stimulation is determined using the at least one neural stimulation parameter for the test neural stimulation that provided the desired physiologic response. The unidirectional afferent nerve stimulation is delivered using the at least one treatment parameter.

Single pass lead system

A single-pass endocardial lead electrode adapted for implantation in, on or about the heart and for connection to a system for monitoring or stimulating cardiac activity includes a lead body which is adapted for implantation within a single chamber of the heart, or multiple chambers of the heart. The lead includes a first distal end electrode which has a first electrical conducting surface. The lead body also has a second electrode which has a second electrical conducting surface. The first and second electrodes are either passively or actively attached to the wall of the heart. The lead body also includes a curved portion which facilitates the positioning of the second electrode. The main lead body alternatively includes a recess into which an atrial lead body and an active fixation element attached to one end can travel from a recessed position to a position for fixation to the wall of the heart. The active fixation element can also be moved by turning the terminal pin. The lead body ...

Unidirectional neural stimulation systems, devices and methods

An embodiment relates to a method for delivering a unidirectional afferent nerve stimulation treatment. A test neural stimulation is delivered, and a physiologic response to the test neural stimulation is monitored. At least one neural stimulation parameter for the test neural stimulation is adjusted if the test neural stimulation does not elicit a desired physiologic response. If the test neural stimulation does elicit the desired physiologic response, at least one treatment parameter for a unidirectional afferent nerve stimulation is determined using the at least one neural stimulation parameter for the test neural stimulation that provided the desired physiologic response. The unidirectional afferent nerve stimulation is delivered using the at least one treatment parameter.

Drug delivery system for implantable cardiac device

A drug delivery system incorporated into a cardiac device for delivering a dose of a drug to a patient upon detection of a particular medical condition. The cardiac device may be, for example, an implantable cardioverter/defibrillator, cardiac pacemaker, or combination device that communicates via a radio frequency link with a drug delivery device. The drug delivery device is preferably an electrically modulated transdermal drug delivery device for delivering the drug transdermally in accordance with a signal received from the cardiac device.

Coronary vein leads having pre-formed biased portions for fixation

A lead having a pre-formed biased portion is adapted for implantation with a body vessel and for connection to a signal generator. The lead is constructed and arranged so that when it is implanted, the electrodes are biased toward a vessel wall by the preformed biased portion, which operates to fixate the lead against the vessel wall.

NEEDLE AND INTRODUCER USED IN LEAD PLACEMENT FOR OBSTRUCTIVE SLEEP APNEA TREATMENT

A system for treating obstructive sleep apnea (OSA) is described. The system may include a locking device having a size and shape selected to couple to skin along a jaw of a patient. The locking device may be configured to receive at least one of a needle or an introducer for insertion into a tongue of the patient for lead placement of a lead for OSA treatment, and lock at least a portion of the at least one of the needle or introducer in place to reduce movement of the needle or introducer within the tongue.

IMPLANTABLE CARDIAC DEVICE WITH DYSPNEA MEASUREMENT

Cardiac monitoring and/or stimulation methods and systems employing dyspnea measurement. An implantable cardiac device may sense transthoracic impedance and determine a patient activity level. An index indicative of pulmonary function is implantably computed to detect an episode of dyspnea based on a change, trend, and/or value exceeding a threshold at a determined patient activity level. Trending one or more pulmonary function index values may be done to determine a patient's pulmonary function index profile, which may be used to adapt a cardiac therapy. A physician may be automatically alerted in response to a pulmonary function index value and/or a trend of the patient's pulmonary index being beyond a threshold. Computed pulmonary function index values and their associated patient's activity levels may be stored periodically in a memory and/or transmitted to a patient-external device. 1. (canceled)2. A system , comprising:a respiration sensor configured to sense respiration of a patient;an activity sensor configured to sense an activity level of the patient; determine a patient index based at least part on the sensed respiration of the patient;', 'detect a physiological condition based on the determined patient index being beyond a threshold, wherein the threshold is based at least in part on the sensed activity level of the patient; and', 'provide an output based, at least in part, on the detected physiological condition., 'a controller operatively coupled to the respiration sensor and the activity sensor, the controller configured to3. The system of claim 2 , wherein the controller is configured to determine the patient index based at least in part on a ratio of a respiratory rate value and a tidal volume value for the patient.4. The system of claim 2 , wherein the threshold is based on a profile developed by the controller using a plurality of previous patient index values and associated activity levels of the patient acquired over time.5. The system of claim ...

Pacemaker mode switching based upon atrial conduction time

A cardiac pacemaker is configured to estimate the intrinsic atrial conduction time from sensed signals detected by an atrial sensing channel. Atrial conduction delays have been found to be associated with the onset of atrial tachyarrhythmias. Upon detection of an atrial conduction time above a specified limit value, the pacemaker is programmed to switch from a normal pacing mode to an atrial pacing preference mode.

Cardiac rhythm management system for hypotension

A cardiac rhythm management system detects hypotension based on a measurement of thoracic impedance. It also provides therapy to treat the hypotension.

Wireless ECG in implantable devices

An implantable medical device such as an implantable pacemaker or implantable cardioverter/defibrillator includes a programmable sensing circuit providing for sensing of a signal approximating a surface electrocardiogram (ECG) through implanted electrodes. With various electrode configurations, signals approximating various standard surface ECG signals are acquired without the need for attaching electrodes with cables onto the skin. The various electrode configurations include, but are not limited to, various combinations of intracardiac pacing electrodes, portions of the implantable medical device contacting tissue, and electrodes incorporated onto the surface of the implantable medical device.

Syncope logbook and method of using same

Method and systems are directed to acquiring and organizing information associated with at least one syncope event. A syncope event may be a suspected syncope event, a verified syncope event or a syncope event that is suspected and verified. Automated processes are used to collect information associated with at least one syncope event and organize the information as a syncope log entry. At least one of acquiring the information and organizing the information is performed at least in part implantably.

Medical lead having a variable change in stiffness

According to one embodiment, the present invention includes an elongate implantable medical lead having a distal portion that is relatively flexible, a proximal portion that is relatively stiff, and a transition portion which has a variable transition stiffness. The transition stiffness varies over the length of the transition portion that generally decreases in a distal direction. The relatively stiff proximal portion of the lead gives the lead steerability while the gradual change in stiffness in the transition portion reduces the likelihood that the lead will prolapse when it is guided into a branch vein. The distal stiffness is less than the proximal stiffness giving the lead a safe end that is unlikely to puncture vascular walls and is able to maneuver around various tortuosities when the lead is implanted into a patient.

Medical lead for treating obstructive sleep apnea (OSA) with electrical stimulation

A method of implanting a lead includes inserting a needle through tissue near a chin of a patient and through a tongue of the patient, inserting an introducer through an opening created by the needle, and inserting the lead through the introducer, the lead comprising an elongated member and one or more electrodes in a distal portion of the elongated member such that the one or more electrodes are implantable proximate to one or more motor points of a protrusor muscle within the tongue of the patient, wherein inserting the lead comprises inserting the lead to have a shape of one of a helix, a compound helix, a wave shape, or saw-tooth shape, or to have a loop in the lead.

OBSTRUCTIVE AND CENTRAL SLEEP APNEA COMBINATION THERAPY CONTROL

Apnea events may be detected based on a primary biomarker, e.g., respiration, in the one or more physiological signals. The apnea events may be characterized as one of an obstructive sleep apnea (OSA) event, a central sleep apnea (CSA) event, or a combination OSA/CSA event based on a secondary biomarker, e.g., a frequency spectrum or a morphology of the respirations in the one or more physiological signals. A first electrical stimulation may be provided to treat OSA in response to a first one or more of the apnea events being characterized as OSA events. A second electrical stimulation may be provided to treat CSA in response to a second one or more of apnea events being characterized as CSA events. A third electrical stimulation may be provided to treat combination OSA/CSA in response to a third one or more of the apnea events being characterized as combination OSA/CSA events.

MEDICAL LEAD FOR TREATING OBSTRUCTIVE SLEEP APNEA (OSA) WITH ELECTRICAL STIMULATION

A lead for delivering electrical stimulation therapy is described. The lead includes an elongated member defining a longitudinal axis, one or more electrodes disposed at a distal end of the elongated member, a plurality of collars located along the longitudinal axis, and one or more fixation members. At least one of the fixation members is a bow-like member having a first connection point to a first collar of the plurality of collars and a second connection point to a second collar of the plurality of collars. The distal end of the elongated member is configured for insertion in a tongue of a patient such that the one or more electrodes are implanted proximate to one or more motor points of a protrusor muscle within the tongue of the patient and the bow-like member of the one or more fixation members is implanted within tissue of the tongue. 1. A lead for delivering electrical stimulation therapy , the lead comprising:an elongated member defining a longitudinal axis and comprising a proximal end and a distal end;one or more electrodes disposed at the distal end of the elongated member;a plurality of collars located along the longitudinal axis of the elongated member; andone or more fixation members, wherein at least one of the fixation members is a bow-like member having a first connection point to a first collar of the plurality of collars and a second connection point to a second collar of the plurality of collars,wherein the distal end of the elongated member is configured for insertion in a tongue of a patient such that the one or more electrodes are implanted proximate to one or more motor points of a protrusor muscle within the tongue of the patient and the bow-like member of the one or more fixation members is implanted within tissue of the tongue, and wherein the bow-like member, when deployed, defines a peak between the first connection point and the second connection point of the bow-like member, and wherein the peak is a point of the bow-like member that ...

Method and device for preventing plaque formation in coronary arteries

A method and device for preventing plaque build-up in a coronary artery includes providing an electrical field generating device, and generating an electrical field in the coronary artery to prevent plaque build-up in the coronary artery. The method further includes sensing the heart rhythm and generating the electrical field after a depolarization wave in the heart. The electrical field is generated by circuitry, in one embodiment implanted circuitry, connected to leads which are epicardially or intracardially positioned on the heart.

Implantable and rechargeable neural stimulator

One aspect of the present subject matter relates to an implantable medical device. An embodiment of the device comprises a rechargeable power supply adapted to be recharged through an ultrasound signal, a neural stimulator connected to the rechargeable power supply, and a controller connected to the rechargeable power supply. The neural stimulator is adapted to generate a neural stimulation signal for delivery to a neural stimulation target through an electrode. The controller is further connected to the neural stimulator to control the neural stimulator according to a neural stimulation protocol. Other aspects are provided herein.

IMPLANTABLE AND RECHARGEABLE NEURAL STIMULATOR

One aspect of the present subject matter relates to an implantable medical device. An embodiment of the device comprises a rechargeable power supply adapted to be recharged through an ultrasound signal, a neural stimulator connected to the rechargeable power supply, and a controller connected to the rechargeable power supply. The neural stimulator is adapted to generate a neural stimulation signal for delivery to a neural stimulation target through an electrode. The controller is further connected to the neural stimulator to control the neural stimulator according to a neural stimulation protocol. Other aspects are provided herein. 1. A system for therapeutically stimulating a neural stimulation target of a human , comprising: a rechargeable power supply adapted to be recharged through an ultrasound signal;', 'an electrode;', 'a neural stimulator connected to the rechargeable power supply, wherein the neural stimulator is configured to generate neural stimulation for delivery to the neural stimulation target through the electrode;', 'a controller connected to the rechargeable power supply, and further connected to the neural stimulator to control the neural stimulator; and', 'a communication module connected to the controller, wherein the communication module is configured to transmit and receive ultrasound communication signals used to communicate with the planet device., 'a planet device and an implantable satellite device, wherein the planet device and the implantable satellite device are configured to communicate with each other using ultrasound energy, the satellite device including2. The system of claim 1 , wherein the planet device is configured to deliver the ultrasound signal used to recharge the rechargeable power supply of the satellite device.3. The system of claim 1 , wherein the planet device is configured to communicate with the satellite device to control a neural stimulation therapy delivered by the satellite device according to a neural stimulation ...

System and method for therapy

Disclosed is a system for stimulation of a subject. The stimulation may be to provide therapy to treat the subject. Stimulation may be of selected muscle groups and/or portions.

Respiration signal measurement apparatus, systems, and methods

A cardiac rhythm management apparatus and system may include a first sensor to sense an atrial respiration signal, a second sensor to sense a ventricular respiration signal, and a measurement module capable of being communicatively coupled to the first and second sensors to monitor the atrial and ventricular respiration signals and to select a resulting signal as an indication of respiration. An article may cause a machine to implement a method which includes measuring a second signal responsive to a first signal, measuring a third signal responsive to a first signal, determining a respiration-to-cardiac ratio associated with each one of the second and third signals, and providing a resulting signal including a selected portion of a selected one of the second and third signals as an indication of respiration.

Drug delivery system for implantable medical device

A drug delivery system and method in which an implantable medical device communicates with and controls an external drug delivery device with low energy potential signals. The implantable device generates potential signals modulated with digitally encoded command information by operating a current source to cause corresponding electrical potentials that can be sensed at the skin surface by the external drug delivery device. The drug delivery device then demodulates the sensed potentials and decodes the digital data to extract command information therefrom to deliver a drug accordingly.

Drug delivery system for implantable medical device

A drug delivery system and method in which an implantable medical device communicates with and controls an external drug delivery device with low energy potential signals. The implantable device generates potential signals modulated with digitally encoded command information by operating a current source to cause corresponding electrical potentials that can be sensed at the skin surface by the external drug delivery device. The drug delivery device then demodulates the sensed potentials and decodes the digital data to extract command information therefrom to deliver a drug accordingly.

MEDICAL DEVICE TO PROVIDE BREATHING THERAPY

Medical devices and methods for providing breathing therapy (e.g., for treating heart failure, hypertension, etc.) may determine at least the inspiration phase of one or more breathing cycles based on the monitored physiological parameters and control delivery of a plurality of breathing therapy sessions (e.g., each of the breathing therapy sessions may be provided during a defined time period). Further, each of the plurality of breathing therapy sessions may include delivering stimulation after the start of the inspiration phase of each of a plurality of breathing cycles to prolong diaphragm contraction during the breathing cycle. 1. A medical device for providing breathing therapy comprising:monitoring apparatus configured to monitor one or more physiological parameters of a patient;a therapy delivery module configured to deliver electrical stimulation to a patient in which the presence of a temporary or sustained elevated sympathetic tone has been determined, wherein the elevated sympathetic tone is determined based at least on an elevated blood pressure; and determine at least the inspiration phase of one or more breathing cycles based on the monitored physiological parameters; and', 'control delivery of a plurality of breathing therapy sessions, wherein each of the breathing therapy sessions is provided during a defined time period, and further wherein each of the plurality of breathing therapy sessions comprises delivering stimulation after the start of the inspiration phase of each of a plurality of breathing cycles to prolong diaphragm contraction during the breathing cycle., 'a control module configured to2. The device of claim 1 , wherein the control module is further configured to determine the presence of the elevated sympathetic tone of a patient based on the monitored one or more physiological parameters of a patient.3. The device of claim 1 , wherein the therapy delivery module is configured to deliver at least one of phrenic nerve stimulation claim 1 ...

DETECTION OF SEIZURE AND STROKE

Devices, systems, and techniques are described for detecting stroke or seizure with a compact system. For example, a system includes a memory, a plurality of electrodes, and sensing circuitry configured to sense, via at least two electrodes of the plurality of electrodes, electrical signals from a patient, and generate, based on the electrical signals, physiological information. The system may also include processing circuitry configured to receive, from the sensing circuitry, the physiological information, determine, based on the physiological information, a seizure metric indicative of a seizure status of the patient and a stroke metric indicative of a stroke status of the patient, and store the seizure metric and the stroke metric in the memory. A housing may carry the plurality of electrodes and contain both of the sensing circuitry and the processing circuitry.

Absolute calibrated tissue oxygen saturation and total hemoglobin volume fraction

A medical device for monitoring a patient condition includes a sensor capable of being advanced transvascularly to be positioned along a volume of tissue, the sensor including a first combination of a light source and a light detector to emit light into a volume of tissue and to detect light scattered by the volume of tissue and to generate a first output signal corresponding to an intensity of the detected light. A control module is coupled to the light source to control the light source to emit light at least four spaced-apart light wavelengths, and a monitoring module is coupled to the light detector to receive the output signal and compute a measure of tissue oxygenation using the light detector output signal.

NEURAL STIMULATION TO TREAT SLEEP APNEA

A removable oral device is disclosed. The removable oral device comprises a mounting retainer configured to align with a set of teeth. An electrical stimulator is coupled to the mounting retainer. A single lead is employed that has a first and a second end and lacking a mechanical connection to the mounting retainer. A first and a second electrode are positioned along the single lead. The lead is disposed perpendicular to a longitudinal axis of a patient's tongue such that the first electrode is proximate a first hypoglossal nerve and the second electrode is proximate a second hypoglossal nerve.

Method and device for preventing plaque formation in coronary arteries

A method and device for preventing plaque build-up in a coronary artery includes providing an electrical field generating device, and generating an electrical field in the coronary artery to prevent plaque build-up in the coronary artery. The method further includes sensing the heart rhythm and generating the electrical field after a depolarization wave in the heart. The electrical field is generated by circuitry, in one embodiment implanted circuitry, connected to leads which are epicardially or intracardially positioned on the heart.

System and method for therapy

Disclosed is a system for stimulation of a subject. The stimulation may be to provide therapy to treat the subject. Stimulation may be of selected muscle groups and/or portions.

Systems and methods for evaluating neuromodulation therapy via hemodynamic responses

Systems and methods for evaluating neuromodulation via hemodynamic responses are disclosed herein. A system configured in accordance with embodiments of the present technology can include, for example, a neuromodulation catheter comprising an elongated shaft having a distal portion, and a plurality of electrodes spaced along a distal portion. The system can further include a controller communicatively coupled to the electrodes. The controller can be configured to apply first and second stimuli at and/or proximate to a target site within a blood vessel before and after delivering neuromodulation energy to the target site, and detect, via at least one of the electrodes, vessel impedance resulting from the first and second stimuli to determine a baseline impedance and a post-neuromodulation impedance. The controller can further be configured to assess the efficacy of the neuromodulation based, at least in part, on a comparison of the baseline impedance and the post-neuromodulation impedance ...

UNIDIRECTIONAL NEURAL STIMULATION SYSTEMS, DEVICES AND METHODS

An embodiment relates to a method for delivering a unidirectional afferent nerve stimulation treatment. A test neural stimulation is delivered, and a physiologic response to the test neural stimulation is monitored. At least one neural stimulation parameter for the test neural stimulation is adjusted if the test neural stimulation does not elicit a desired physiologic response. If the test neural stimulation does elicit the desired physiologic response, at least one treatment parameter for a unidirectional afferent nerve stimulation is determined using the at least one neural stimulation parameter for the test neural stimulation that provided the desired physiologic response. The unidirectional afferent nerve stimulation is delivered using the at least one treatment parameter.

WIRELESS ECG IN IMPLANTABLE DEVICES

An implantable medical device such as an implantable pacemaker or implantable cardioverter/defibrillator includes a programmable sensing circuit providing for sensing of a signal approximating a surface electrocardiogram (ECG) through implanted electrodes. With various electrode configurations, signals approximating various standard surface ECG signals are acquired without the need for attaching electrodes with cables onto the skin. The various electrode configurations include, but are not limited to, various combinations of intracardiac pacing electrodes, portions of the implantable medical device contacting tissue, and electrodes incorporated onto the surface of the implantable medical device. 1. An implantable medical device configured to be coupled to a plurality of electrodes including first electrodes suitable for sensing a first type cardiac signal and second electrodes suitable for sensing a second type cardiac signal , the implantable medical device comprising:a command receiver configured to receive an acquisition command;a sensing circuit configured to be programmed in response to the acquisition command to sense the first type cardiac signal, the sensing circuit including a frequency response programmable for at least a first pass band selectable for sensing the first type cardiac signal and a second pass band selectable for sensing the second type cardiac signal; anda sense interface configured to be programmed in response to the acquisition command to provide first electrical connections for sensing the first type cardiac signal, the first electrical connections connecting the sensing circuit to the first electrodes.2. The implantable medical device of claim 1 , further comprising a detector configured to detect a predetermined condition and produces the acquisition command in response to a detection of the predetermined condition.3. The implantable medical device of claim 2 , further comprising a detection timer coupled to the detector claim 2 , the ...

IMPEDANCE MEASUREMENT TO MONITOR ORGAN PERFUSION OR HEMODYNAMIC STATUS

An implantable medical device system and associated method deliver drive signals having different frequencies to establish vector fields comprising an arterial volume and a venous volume corresponding to targeted portion of a patient's body. Impedance signals are determined in response to drive signals having different frequencies. Impedance parameter values are determined over time. A change in the hemodynamic status of a targeted portion of the patient's body is identified in response to the impedance parameter values. 1. A method for monitoring a hemodynamic status of a portion of a patient's body , comprising:delivering a first drive signal having a first frequency to establish a first drive signal vector field comprising an arterial volume and a venous volume corresponding to targeted portion of a patient's body;determining a first impedance signal in response to the first drive signal;delivering a second drive signal having a second frequency different than the first frequency to establish a second drive signal vector field comprising an arterial volume and a venous volume;determining a second impedance signal in response to the second drive signal;determining a first plurality of values of an impedance parameter over time from the first impedance signal and a second plurality of values of an impedance parameter over time from the second impedance signal; andidentifying a change in a hemodynamic status of the targeted portion of the patient's body in response to the first plurality of values and the second plurality of values.2. The method of wherein identifying the change in hemodynamic status comprises determining a change in a first trend of the first plurality of values relative to a second trend of the second plurality of values.3. The method of claim 1 , further comprising generating a warning in response to identifying the change in the hemodynamic status.4. The method of claim 1 , further comprising adjusting a therapy delivered to the patient in ...

Apparatus and method for outputting heart sounds

An apparatus for outputting heart sounds includes an implantable system and an external system. The implantable system includes a sensor for generating sensed signals representing detected heart sounds, an interface circuit and a control circuit for receiving the sensed signals, generating data representing the heart sounds therefrom, and transmitting the data to the external system via the interface circuit. The external system includes an interface circuit for communicating with the implantable system, and a control circuit for receiving the data representing the heart sounds and for generating control signals that cause an output device to generate outputs representing the sounds. The implantable system may also include a sensor(s) for detecting cardiac electrical signals. In this case, outputs representing the cardiac electrical signals are also output.

CORONARY VEIN LEADS HAVING PRE-FORMED BIASED PORTIONS FOR FIXATION

A lead having a pre-formed biased portion is adapted for implantation with a body vessel and for connection to a signal generator. The lead is constructed and arranged so that when it is implanted, the electrodes are biased toward a vessel wall by the preformed biased portion, which operates to fixate the lead against the vessel wall. 1. An implantable medical lead for implantation within a body vessel , comprising:a lead body having a proximal end and an open distal end, and including a pre-formed biased portion between the proximal and distal ends, and an-unbiased portion extending distally from the pre-formed biased portion, wherein the pre-formed biased portion is adapted to fixate the lead against an interior wall of a body vessel upon implantation and includes a three-dimensional bias having a helical shape;a connector configured for coupling the lead to an implantable pulse generator;a plurality of electrodes on the lead body in the pre-formed biased portion;an electrode on the lead body in the un-biased portion;a first conductor extending within the lead body from the proximal end toward the distal end and coupled to the electrode in the un-biased portion;a plurality of second conductors extending within the lead body from the proximal end toward the distal end, each of the second conductors coupled to a respective one of the plurality of electrodes in the pre-formed biased portion; andan open lumen extending longitudinally through the distal end of the lead body.2. The lead of claim 1 , wherein the lead terminates in a distal tip claim 1 , and wherein the first conductor terminates proximal to the distal tip.3. The lead of claim 2 , further comprising an unbiased claim 2 , flexible tapered portion terminating at the distal tip of the lead.4. The lead of claim 1 , wherein the lead is an over the wire lead configured for use over a guidewire or stylet.5. The lead of claim 1 , wherein each of the electrodes in the pre-formed biased portion include a masked ...

System and method for delivering myocardial and autonomic neural stimulation

Various aspects of the present subject matter provide an implantable medical device. In various embodiments, the device comprises a pulse generator, a lead, a sensor, and a controller. The pulse generator generates a baroreflex stimulation signal as part of a baroreflex therapy. The lead is adapted to be electrically connected to the pulse generator and to be intravascularly fed into a heart. The lead includes an electrode to be positioned in or proximate to the heart to deliver the baroreflex signal to a baroreceptor region in or proximate to the heart. The sensor senses a physiological parameter regarding an efficacy of the baroreflex therapy and provides a signal indicative of the efficacy. The controller is connected to the pulse generator to control the baroreflex stimulation signal and to the sensor to receive the signal indicative of the efficacy of the baroreflex therapy. Other aspects are provided herein.

WIRELESS ECG IN IMPLANTABLE DEVICES

An implantable medical device such as an implantable pacemaker or implantable cardioverter/defibrillator includes a programmable sensing circuit providing for sensing of a signal approximating a surface electrocardiogram (ECG) through implanted electrodes. With various electrode configurations, signals approximating various standard surface ECG signals are acquired without the need for attaching electrodes with cables onto the skin. The various electrode configurations include, but are not limited to, various combinations of intracardiac pacing electrodes, portions of the implantable medical device contacting tissue, and electrodes incorporated onto the surface of the implantable medical device. 1. An implantable medical device configured to be coupled to a plurality of electrodes including first electrodes suitable for sensing a first type cardiac signal and second electrodes suitable for sensing a second type cardiac signal , the implantable medical device comprising:a command receiver configured to receive an acquisition command;a sensing circuit configured to be programmed in response to the acquisition command to sense the first type cardiac signal, the sensing circuit including a frequency response programmable for at least a first pass band selectable for sensing the first type cardiac signal and a second pass band selectable for sensing the second type cardiac signal; anda sense interface configured to be programmed in response to the acquisition command to provide first electrical connections for sensing the first type cardiac signal, the first electrical connections connecting the sensing circuit to the first electrodes.2. The implantable medical device of claim 1 , further comprising a detector configured to detect a predetermined condition and produces the acquisition command in response to a detection of the predetermined condition.3. The implantable medical device of claim 2 , further comprising a detection timer coupled to the detector claim 2 , the ...

TECHNIQUES FOR PLACING MEDICAL LEADS FOR ELECTRICAL STIMULATION OF NERVE TISSUE

This disclosure is directed to extra, intra, and transvascular medical lead placement techniques for arranging medical leads and electrical stimulation and/or sensing electrodes proximate nerve tissue within a patient. 1. An implantable medical lead system configured to deliver electrical stimulation to nerve tissue within a patient , the system comprising:an implantable medical lead comprising a distal portion configured for introduction into a sheath of tissue that contains the nerve tissue;an electrode electrically connected to the distal portion of the implantable medical lead; andan anchor connected to the medical lead and proximally offset from the electrode at least partially outside of the sheath to stabilize placement of the distal portion of the lead within the sheath.2. The system of further comprising a biasing member connected to the lead and configured to bias the electrode toward the nerve tissue.3. The system of claim 2 , wherein the biasing member comprises an expandable member.4. The system of claim 3 , wherein the expandable biasing member comprises one of a balloon or a stent.5. The system of claim 2 , wherein the biasing member comprises a spline.6. The system of further comprising a guide member along which the lead may be advanced.7. The system of claim 6 , wherein the guide member comprises one of a guidewire or a stylus.8. The system of claim 1 , wherein the anchor comprises one of a sutured or sutureless anchor.9. The system of claim 1 , wherein the anchor comprises a sleeve anchor configured to receive and stabilize the lead.10. The system of claim 9 , wherein the sleeve anchor comprises:a bore sized to receive the lead; andone or more tabs protruding generally away from the bore.11. The system of claim 10 , wherein the one or more tabs are configured to passively engage tissue of the patient to stabilize the placement of the lead.12. The system of claim 10 , wherein the one or more tabs are configured to be sutured to tissue of the ...

APPARATUS AND METHOD FOR OUTPUTTING HEART SOUNDS

An apparatus for outputting heart sounds includes an implantable system and an external system. The implantable system includes a sensor for generating sensed signals representing detected heart sounds, an interface circuit and a control circuit for receiving the sensed signals, generating data representing the heart sounds therefrom, and transmitting the data to the external system via the interface circuit. The external system includes an interface circuit for communicating with the implantable system, and a control circuit for receiving the data representing the heart sounds and for generating control signals that cause an output device to generate outputs representing the sounds. The implantable system may also include a sensor(s) for detecting cardiac electrical signals. In this case, outputs representing the cardiac electrical signals are also output. 1. (canceled)2. A system for acquiring and processing first data representative of heart sounds of a patient and second data representative of cardiac electrical signals of the patient using an implantable device , comprising: an interface circuit configured to communicate with the implantable device and to receive the first data and the second data from the implantable device;', 'a disassociation detector circuit configured to detect electrical-mechanical disassociation using a comparison between the first data and the second data; and', 'an output device configured to generate outputs representative of one or more of the heart sounds, the cardiac electrical signals, or the electrical-mechanical disassociation., 'an external system configured to receive the first data and the second date from the implantable device via telemetry, the external system including3. The system of claim 2 , comprising a controller circuit configured to process the first data including detecting a plurality of heart sound components from the first data claim 2 , and to process the second data including detecting a plurality of ...

IMPLANTABLE CARDIAC DEVICE WITH DYSPNEA MEASUREMENT

Cardiac monitoring and/or stimulation methods and systems employing dyspnea measurement. An implantable cardiac device may sense transthoracic impedance and determine a patient activity level. An index indicative of pulmonary function is implantably computed to detect an episode of dyspnea based on a change, trend, and/or value exceeding a threshold at a determined patient activity level. Trending one or more pulmonary function index values may be done to determine a patient's pulmonary function index profile, which may be used to adapt a cardiac therapy. A physician may be automatically alerted in response to a pulmonary function index value and/or a trend of the patient's pulmonary index being beyond a threshold. Computed pulmonary function index values and their associated patient's activity levels may be stored periodically in a memory and/or transmitted to a patient-external device. 1. An implantable cardiac device , comprising:a housing configured for implantation in a patient;an implantable sensor configured to sense transthoracic impedance;an implantable activity sensor configured to make an activity measurement indicative of patient activity;a memory provided in the housing; determine a patient pulmonary function index indicative of patient pulmonary function based at least part on the sensed transthoracic impedance;', 'detect a physiological condition based on the determined index being beyond a threshold, the threshold based at least in part on a plurality of patient pulmonary function index values and associated patient activity levels; and', 'provide an output based, at least in part, on the detected physiological condition., 'a controller provided in the housing and coupled to the respective sensors and the memory, the controller configured to2. The device according to claim 1 , wherein the controller is configured to determine the patient pulmonary function index based at least in part on a ratio of the multiple respiration parameters.3. The device ...

TECHNIQUES FOR PLACING MEDICAL LEADS FOR ELECTRICAL STIMULATION OF NERVE TISSUE

This disclosure is directed to extra, intra, and transvascular medical lead placement techniques for arranging medical leads and electrical stimulation and/or sensing electrodes proximate nerve tissue within a patient. 1. An implantable medical lead system configured to deliver electrical stimulation from within a lumen of a blood vessel within a patient to nerve tissue located adjacent to and outside of the blood vessel , the system comprising:a medical lead arranged within a lumen of the blood vessel;an electrode connected toward a distal end of the lead adjacent the nerve tissue; andan active fixation member connected toward a distal end of the lead adjacent the nerve tissue and configured to anchor the lead to a wall of the blood vessel lumen.2. The system of claim 1 , wherein the active fixation member comprises a helical wire configured to be screwed into tissue of the blood vessel wall.3. The system of claim 2 , wherein the helical fixation member has a length in the range from and including approximately 0.5 millimeters to and including approximately 2.5 millimeters.4. The system of claim 3 , wherein the length of the helical fixation member is in the range from and including approximately 1 millimeters to and including approximately 2 millimeters.5. The system of claim 2 , wherein a pitch of the helical fixation member is in the range from and including approximately 0.5842 millimeters to and including approximately 1.016 millimeters.6. The system of claim 1 , further comprising a catheter configured to be arranged within a lumen of the blood vessel adjacent the nerve tissue claim 1 , wherein the medical lead is advanceable from catheter to the wall of the blood vessel lumen.7. The system of claim 6 , wherein a distal end of the catheter is configured to direct the medical lead transversely toward the wall of the blood vessel lumen when the medical lead is advanced from the distal end of the catheter.8. The system of claim 6 , further comprising a ...

THERMAL STIMULATION AND SUBSEQUENT COOLING FOR FULLY IMPLANTABLE LVAD CONTROLLER

A method of cooling a mammal with an implantable blood pump. The method includes measuring a temperature of an internal controller, the internal controller being in communication with the implantable blood pump. an alert is generated if the temperature of the internal controller exceeds a predetermined temperature threshold. 1. A method of cooling a patient with an implantable blood pump , comprising:measuring a temperature of an internal controller, the internal controller being in communication with the implantable blood pump;generating an alert if the temperature of the internal controller exceeds a predetermined temperature threshold.2. The method of claim 1 , wherein the alert instructs the patient to place a heating pad on a body of the patient.3. The method of claim 2 , wherein the alert instructs the patient to place the heating pad on the back of a neck of the body of the patient.4. The method of claim 1 , wherein the alert instructs the patient to go to a hospital.5. The method of claim 1 , wherein the predetermined temperature threshold is 39 degrees Celsius.6. The method of claim 1 , wherein the predetermined temperature threshold is between 39 degrees Celsius and 43 degrees Celsius.7. The method of claim 1 , wherein the predetermined temperature threshold is 43 degrees Celsius.8. The method of claim 1 , wherein the method further includes communicating the measured temperature to an external controller in communication with the internal controller.9. The method of claim 8 , wherein the alert is generated by the external controller.10. The method of claim 1 , wherein the alert instructs the patient to thermally stimulate the back of a neck of the body of the patient.11. A system for cooling a patient with an implantable blood pump claim 1 , comprising:an internal controller configured to be in communication with the implantable blood pump;an external controller configured to be in communication with the internal controller, the external controller being ...

MEDICAL DEVICE TO PROVIDE BREATHING THERAPY

Medical devices and methods for providing breathing therapy (e.g., for treating heart failure, hypertension, etc.) may determine at least the inspiration phase of one or more breathing cycles based on the monitored physiological parameters and control delivery of a plurality of breathing therapy sessions (e.g., each of the breathing therapy sessions may be provided during a defined time period). Further, each of the plurality of breathing therapy sessions may include delivering stimulation after the start of the inspiration phase of each of a plurality of breathing cycles to prolong diaphragm contraction during the breathing cycle. 1. A method for providing breathing therapy , comprising:providing a plurality of breathing therapy sessions wherein each of the plurality of breathing therapy sessions comprises delivering stimulation during each of a plurality of breathing cycles to prolong diaphragm contraction during the breathing cycle and delivering cardiac pacing to the patient based on a predefined ratio of breathing rate to heart rate.2. The method of further comprising:monitoring one or more physiological parameters of a patient to determine a presence of a temporary or sustained elevated sympathetic tone based on at least an elevated blood pressure; andmonitoring respiration of a patient to determine at least an inspiration phase of one or more breathing cycles.3. The method of claim 2 , wherein the plurality of breathing therapy sessions upon determination of the presence of an elevated sympathetic tone claim 2 , wherein each of the breathing therapy sessions is provided during a defined time period claim 2 , and further wherein each of the plurality of breathing therapy sessions comprises delivering stimulation after the start of the inspiration phase of each of a plurality of breathing cycles to prolong diaphragm contraction during the breathing cycle.4. The method of claim 3 , wherein delivering stimulation comprises delivering at least one of phrenic nerve ...

DETECTION OF PATIENT CONDITIONS USING SIGNALS SENSED ON OR NEAR THE HEAD

A system comprises a sensor device and processing circuitry. The sensor device comprises a housing configured to be disposed above shoulders of a patient, a plurality of electrodes on the housing, a motion sensor, and sensing circuitry configured to sense a brain electrical signal and a cardiac electrical signal via the electrodes, and a motion signal via the motion sensor. The processing circuitry is configured to determine values over time of one or more parameters from the brain electrical signal, determine values over time of one or more parameters from the cardiac electrical signal, and generate at least one of a detection, prediction, or a classification a condition of the patient based on the values and the motion signal.

DETERMINING COMPOSITE SIGNALS FROM AT LEAST THREE ELECTRODES

In some examples, a device includes at least three electrodes a first pair of electrodes and a second pair of electrodes. The device also includes circuitry configured to generate a first cardiac signal based on a first differential signal received across the first pair, generate a first brain signal based on the first differential signal received across the first pair, generate a second cardiac signal based on a second differential signal received across the second pair, and generate a second brain signal based on the second differential signal received across the second pair. The circuitry is also configured to output a composite cardiac signal based on the first cardiac signal and the second cardiac signal and to output a composite brain signal based on the first brain signal and the second brain signal.

Apparatus and method for outputting heart sounds

An apparatus for outputting heart sounds includes an implantable system and an external system. The implantable system includes a sensor for generating sensed signals representing detected heart sounds, an interface circuit and a control circuit for receiving the sensed signals, generating data representing the heart sounds therefrom, and transmitting the data to the external system via the interface circuit. The external system includes an interface circuit for communicating with the implantable system, and a control circuit for receiving the data representing the heart sounds and for generating control signals that cause an output device to generate outputs representing the sounds. The implantable system may also include a sensor(s) for detecting cardiac electrical signals. in this case, outputs representing the cardiac electrical signals are also output.

Systems and Methods for Evaluating Neuromodulation Therapy Via Hemodynamic Responses

Systems and methods for evaluating neuromodulation via hemodynamic responses are disclosed herein. A system configured in accordance with embodiments of the present technology can include, for example, a neuromodulation catheter comprising an elongated shaft having a distal portion, and a plurality of electrodes spaced along a distal portion. The system can further include a controller communicatively coupled to the electrodes. The controller can be configured to apply first and second stimuli at and/or proximate to a target site within a blood vessel before and after delivering neuromodulation energy to the target site, and detect, via at least one of the electrodes, vessel impedance resulting from the first and second stimuli to determine a baseline impedance and a post-neuromodulation impedance. The controller can further be configured to assess the efficacy of the neuromodulation based, at least in part, on a comparison of the baseline impedance and the post-neuromodulation impedance. 1. A method of evaluating neuromodulation therapy , the method comprising:delivering a distal portion of a neuromodulation catheter to a target site within a blood vessel of a human patient, wherein the distal portion of the neuromodulation catheter comprises a plurality of electrodes spaced along a length thereof;applying a first stimulus at and/or proximate to the target site within the blood vessel;measuring, via at least one of the electrodes, vessel impedance resulting from the first stimulus to determine a baseline impedance;delivering neuromodulation energy to nerves at the target site within the blood vessel of the human patient via at least one energy delivery element;after delivering the neuromodulation energy, applying a second stimulus at and/or proximate to the target site within the blood vessel;measuring, via at least one of the electrodes, vessel impedance resulting from the second stimulus to determine a post-neuromodulation impedance; andcomparing the baseline ...

PERFORMING ONE OR MORE PULSE TRANSIT TIME MEASUREMENTS BASED ON AN ELECTROGRAM SIGNAL AND A PHOTOPLETHYSMOGRAPHY SIGNAL

This disclosure is directed to devices, systems, and techniques for monitoring a patient condition. In some examples, a medical device system includes processing circuitry configured to determine a plurality of pulse transit time (PTT) intervals, determine, based on an accelerometer signal, a posture of a patient from a plurality of postures corresponding to each PTT interval of the plurality of PTT intervals, classify each PTT interval of the plurality of PTT intervals based on the respective posture of the patient corresponding to the respective PTT interval, and monitor, based on the classified plurality of PTT intervals, a patient condition. 1. A medical device system comprising: a plurality of electrodes configured to collect an electrogram (EGM) signal of a patient, wherein the EGM signal includes a plurality of depolarizations; and', 'an accelerometer configured to collect an accelerometer signal that indicates which posture of a set of postures that the patient is occupying;, 'a medical device comprisinga wearable device configured to collect a photoplethysmography (PPG) signal of the patient, wherein the PPG signal includes a plurality of PPG features indicating the occurrence of a cardiac pulse; and determine a plurality of pulse transit time (PTT) intervals, wherein a PTT interval of the plurality of PTT intervals corresponds to each depolarization of the plurality of depolarizations, wherein each PTT interval of the plurality of PTT intervals represents an amount of time between the respective depolarization of the set of depolarizations and a PPG feature of the plurality of PPG features that occurs after the respective depolarization and before a subsequent depolarization of the plurality of depolarizations;', 'determine, based on the accelerometer signal, a posture of the patient from a plurality of postures corresponding to each PTT interval of the plurality of PTT intervals;', 'classify each PTT interval of the plurality of PTT intervals based on the ...

Implantable cardiac device with dyspnea measurement

Cardiac monitoring and/or stimulation methods and systems employing dyspnea measurement. An implantable cardiac device may sense transthoracic impedance and determine a patient activity level. An index indicative of pulmonary function is implantably computed to detect an episode of dyspnea based on a change, trend, and/or value exceeding a threshold at a determined patient activity level. Trending one or more pulmonary function index values may be done to determine a patient's pulmonary function index profile, which may be used to adapt a cardiac therapy. A physician may be automatically alerted in response to a pulmonary function index value and/or a trend of the patient's pulmonary index being beyond a threshold. Computed pulmonary function index values and their associated patient's activity levels may be stored periodically in a memory and/or transmitted to a patient-external device.

System and Method for Therapy

Disclosed is a system for stimulation of a subject. The stimulation may be to provide therapy to treat the subject. Stimulation may be of selected muscle groups and/or portions. 1. A method for activating a lingual muscle of a subject , comprising:recalling a first stimulation parameter configured to activate the lingual muscle of the subject;stimulating the subject per the recalled first stimulation parameter at a first time;receiving a signal respective of the subject during the stimulation of the subject at the first time;comparing the received signal to a predetermined signal; anddetermining a first efficacy of the stimulation at the first time based on the comparison of the received signal to the predetermined signal.2. The method of claim 1 , further comprising:recalling a second stimulation parameter configured to activate the lingual muscle of the subject;stimulating the subject per the recalled second stimulation parameter at a second time;receiving a second signal respective of the subject during the stimulation of the subject at the second time;comparing the received second signal to a predetermined signal;determining a second efficacy of the stimulation at the second time based on the comparison of the received signal to the predetermined signal.3. The method of claim 2 , further comprising:comparing the determined first efficacy and the second efficacy; andautomatically selecting for stimulation of the subject the recalled first stimulation parameter or the recalled second stimulation parameter for stimulation of the subject.4. The method of claim 3 , further comprising:providing a processor to execute instructions to automatically select for stimulation of the subject the recalled first stimulation parameter or the recalled second stimulation parameter for stimulation of the subject.5. The method of claim 4 , further comprising:providing the provided processor housed within an implantable device.6. The method of claim 5 , further comprising:implanting ...

System and Method for Therapy

Disclosed is a system for stimulation of a subject. The stimulation may be to provide therapy to treat the subject. Stimulation may be of selected muscle groups and/or portions.

System and Method for Therapy

Disclosed is a system for stimulation of a subject. The stimulation may be to provide therapy to treat the subject. Stimulation may be of selected muscle groups and/or portions. 1. A method of stimulating a subject , comprising:generating a first stimulation according to a first stimulation parameter for transmission through a first lead;generating a second stimulation according to a second stimulation parameter for transmission through a second lead;wherein the first lead is spaced laterally from the second lead;wherein the first stimulation parameter differs from the second stimulation parameter.2. The method of claim 1 ,wherein the first stimulation is greater in magnitude than the second stimulation.3. The method of claim 1 ,wherein the first stimulation is at a time different than the second stimulation.4. The method of claim 1 , wherein the first lead includes a first electrode and a second electrode and the second lead includes a third electrode and a fourth electrode;wherein the first stimulation is between the first electrode and the second electrode;wherein the second stimulation is between the third electrode and the fourth electrode.5. The method of claim 1 , further comprising:placing the first lead; andplacing the second lead.6. The method of claim 5 , wherein placing the second lead includes placing the second lead contralateral of the first lead.7. The method of claim 5 , wherein placing the first lead includes placing the first lead in a lateral side of a tongue of the subject;wherein placing the second lead includes placing the second lead contra-lateral of the first lead in the tongue of the subject.8. The method of claim 1 , wherein the first lead is spaced apart laterally from the second lead in a tongue of a subject.9. The method of claim 8 , wherein generating the first stimulation according to the first stimulation parameter includes providing a first stimulation wave form;wherein generating the second stimulation according to the second ...

OBSTRUCTIVE AND CENTRAL SLEEP APNEA COMBINATION THERAPY CONTROL

Apnea events may be detected based on a primary biomarker, e.g., respiration, in the one or more physiological signals. The apnea events may be characterized as one of an obstructive sleep apnea (OSA) event, a central sleep apnea (CSA) event, or a combination OSA/CSA event based on a secondary biomarker, e.g., a frequency spectrum or a morphology of the respirations in the one or more physiological signals. A first electrical stimulation may be provided to treat OSA in response to a first one or more of the apnea events being characterized as OSA events. A second electrical stimulation may be provided to treat CSA in response to a second one or more of apnea events being characterized as CSA events. A third electrical stimulation may be provided to treat combination OSA/CSA in response to a third one or more of the apnea events being characterized as combination OSA/CSA events. 1. A method comprising:receiving one or more physiological signals, each of the one or more physiological signals including respirations of a patient;detecting apnea events based on a primary biomarker in the one or more physiological signals;characterizing each of the apnea events as one of a normal event, OSA (obstructive sleep apnea) event, a CSA (central sleep apnea) event, or a combination OSA/CSA event based on a secondary biomarker in the one or more physiological signals;providing a first electrical stimulation configured to treat OSA in response to a first one or more of the apnea events being characterized as OSA events;providing a second electrical stimulation configured to treat CSA in response to a second one or more of apnea events being characterized as CSA events; andproviding a third electrical stimulation configured to treat combination OSA/CSA in response to a third one or more of the apnea events being characterized as combination OSA/CSA events.2. The method of claim 1 , further comprising providing one of the first claim 1 , the second or the third electrical stimulation ...

SYSTEM AND METHOD FOR IMPROVED OBSTRUCTIVE SLEEP APNEA DIAGNOSTIC FOR IMPLANTABLE DEVICES

A system and method of diagnosing sleep apnea including an implantable device with a sensor, a telemetry circuit and a memory, an external programmer in communication with the telemetry circuit and configured to receive data collected by the sensor and stored in the memory. The system and method include operation of a server, including a processor, in communication with the external programmer and storing an application including instructions that when executed by the processor executes steps of receiving the data collected by the sensor from the external programmer, analyzing the received data collected by the sensor, and transmitting to a remote computer an assessment of the received sensor data, wherein the assessment includes an evaluation of sleep apnea for the patient. 1. A method of assessing a patient for sleep apnea comprising:receiving sensor data from a device implanted in a patient for treatment of a heart related disease at an external programmer;transmitting the received sensor data to a remote server;analyzing the received data at the server; andtransmitting to a remote computer an assessment of the received sensor data, wherein the assessment includes an evaluation of sleep apnea for the patient.2. The method of claim 1 , further comprising receiving sensor data from an external sensor.3. The method of claim 1 , further comprising receiving self-reported data.4. The method of claim 1 , wherein the sensor data includes data indicative of the posture of the patient claim 1 , motion data of the patient claim 1 , electroencephalogram (EEG) data claim 1 , electrocardiogram (ECG) data claim 1 , Apnea Hypopnea Index (AHI) data or blood-oxygen saturation data.5. The method of claim 1 , wherein the sensor data includes data from one or more three-axis accelerometers.6. The method of claim 1 , wherein the sensor data includes respiration rate data claim 1 , heart rate data claim 1 , total sleep time data claim 1 , sleep efficiency data claim 1 , sleep stage ...

Method and apparatus for stimulation

A medical device system and method are disclosed for treating obstructive sleep apnea. The system includes a pulse generator and a medical electrical lead including multiple electrodes carried by a distal portion of an elongated lead body. The method includes advancing the distal portion within protrusor muscle tissue below the oral cavity and delivering electrical stimulation pulses via the electrodes to sustain a protruded state throughout a delivery time period to sustain a protruded state of a patient's tongue throughout the therapy delivery time period. The therapy delivery time period may span multiple respiration cycles.

EVALUATING STIMULATION EFICACY FOR TREATING SLEEP APNEA AND LINGUAL MUSCLE TONE SENSING SYSTEM FOR IMPROVED OSA THERAPY

A system and method of assessing therapy of an implantable neurostimulator (INS), the INS including a lead having at least one pair of bi-polar electrodes, and a pulse generator in electrical communication with the bi-polar electrodes, the pulse generator including a sensor, a memory, a control circuit, and a telemetry circuit. The system and method includes an external programmer in communication with the INS via the telemetry circuit, a server in communication with the external programmer and including thereon an application configured to receive sensor data from the INS from the external programmer and assess a quality of the sleep of a patient in which the INS is implanted based on the received sensor data, and a remote computer in communication with the server and configured to present an assessment of the quality of sleep of the patient. 1. An implantable neurostimulator (INS) comprising:an electrical lead having formed thereon at least a pair of bi-polar electrodes, wherein the electrical lead is configured for placement of the pair of bi-polar electrodes proximate protrusor muscles of a patient and configured to receive electromyography (EMG) signals;a pulse generator electrically connected to the electrical lead and configured to deliver electrical energy to the pair of bi-polar electrodes, the pulse generator having therein a sensor and a control circuit,wherein the sensor and control circuit are configured to receive the EMG signals and determine a tonal state of the protrusor muscles in which the lead is placed.2. The implantable neurostimulator of claim 1 , wherein the control circuit is in electrical communication with a therapy delivery circuit and causes the therapy delivery circuit to deliver electrical energy to the bi-polar electrodes upon a determination that the EMG signal is below a threshold value.3. The implantable neurostimulator of claim 1 , wherein the control circuit is in electrical communication with a therapy delivery circuit and ...

POSITION SENSITIVE LINGUAL MUSCLE SIMULATION SYSTEM FOR OBSTRUCTIVE SLEEP APNEA

An implantable neurostimulator (INS) and method of use, the INS including an electrical lead having formed thereon at least a pair of bi-polar electrodes, wherein the electrical lead is configured for placement of the pair of bi-polar electrodes proximate protrusor muscles of a patient, a pulse generator electrically connected to the electrical lead and configured to deliver electrical energy to the pair of bi-polar electrodes, the pulse generator having mounted therein a sensor and a control circuit, and the sensor is configured to generate signals representative of an orientation of the pulse generator and communicate the signals to the control circuit and the control circuit is configured to determine the orientation of the pulse generator and deliver electrical energy to the bi-polar electrodes when the determined orientation correlates to a pre-determined orientation. 1. An implantable neurostimulator (INS) comprising:an electrical lead having formed thereon at least a pair of bi-polar electrodes, wherein the electrical lead is configured for placement of the pair of bi-polar electrodes proximate protrusor muscles of a patient;a pulse generator electrically connected to the electrical lead and configured to deliver electrical energy to the pair of bi-polar electrodes, the pulse generator having mounted therein a sensor and a control circuit,wherein the sensor is configured to generate signals representative of an orientation of the pulse generator and communicate the signals to the control circuit and the control circuit is configured to determine the orientation of the pulse generator and deliver electrical energy to the bi-polar electrodes when the determined orientation correlates to a pre-determined orientation.2. The implantable neurostimulator of claim 1 , wherein the sensor is a three-axis accelerometer.3. The implantable neurostimulator of claim 1 , wherein the determined orientation is indicative a patient in which the INS is implanted is supine.4. The ...

TECHNIQUES FOR PLACING MEDICAL LEADS FOR ELECTRICAL STIMULATION OF NERVE TISSUE

This disclosure is directed to extra, intra, and transvascular medical lead placement techniques for arranging medical leads and electrical stimulation and/or sensing electrodes proximate nerve tissue within a patient. 121-. (canceled)22. A method of treating a human patient , the method comprising:positioning a lead having one or more electrodes adjacent to a target vagal nerve tissue site within the patient,wherein the lead is electrically coupled to an implantable neurostimulation module; anddelivering electrical stimulation to the target vagal nerve tissue via the one or more electrodes carried by the lead,wherein electrically stimulating the target vagal nerve tissue therapeutically treats one or more conditions of the patient.23. The method of wherein electrically stimulating the target vagal nerve tissue results in a therapeutically beneficial reduction in obesity of the patient.24. The method of wherein electrically stimulating the target vagal nerve tissue therapeutically treats a gastrointestinal condition of the patient.25. The method of wherein electrically stimulating the target vagal nerve tissue results in a therapeutically beneficial reduction in clinical symptoms of heart failure in the patient.26. The method of claim 22 , further comprising determining an efficacy of the vagal nerve tissue stimulation.27. The method of claim 26 , further comprising:comparing the efficacy of the vagal nerve tissue stimulation to a threshold efficacy; andrepositioning the lead and/or the one or more electrodes relative to the target vagal nerve tissue site if the efficacy of the vagal nerve tissue stimulation does not meet or exceed the threshold efficacy.28. The method of wherein positioning a lead having one or more electrodes adjacent to a target vagal nerve tissue site comprises intravascularly delivering the lead to the target site within the patient.29. The method of wherein positioning a lead having one or more electrodes adjacent to a target vagal nerve ...

TREATMENT OF OBSTRUCTIVE SLEEP APNEA (OSA)

A system for treatment of obstructive sleep apnea (OSA) is described. The system includes an introducer needle having an elongated body. The introducer needle is configured to create an opening in a tongue of a patient for implantation of a lead for treating OSA. One or more electrically conductive areas are located on the elongated body. A medical device is configured to deliver a stimulation signal via the introducer needle through the one or more electrically conductive areas to the tongue of the patient to stimulate one or more motor points of a protrusor muscle within the tongue of the patient.

Single pass lead system

A single-pass endocardial lead electrode adapted for implantation in, on or about the heart and for connection to a system for monitoring or stimulating cardiac activity includes a lead body which is adapted for implantation within a single chamber of the heart, or multiple chambers of the heart. The lead includes a first distal end electrode which has a first electrical conducting surface. The lead body also has a second electrode which has a second electrical conducting surface. The first and second electrodes are either passively or actively attached to the wall of the heart. The lead body also includes a curved portion which facilitates the positioning of the second electrode. The main lead body alternatively includes a recess into which an atrial lead body and an active fixation element attached to one end can travel from a recessed position to a position for fixation to the wall of the heart. The lead is attached to a pulse generator for producing pulses to the multiple sites within the heart.

Drug delivery system for implantable cardiac device

A drug delivery system incorporated into a cardiac device for delivering a dose of a drug to a patient upon detection of a particular medical condition. The cardiac device may be, for example, an implantable cardioverter/defibrillator, cardiac pacemaker, or combination device that communicates via a radio frequency link with a drug delivery device. The drug delivery device is preferably an electrically modulated transdermal drug delivery device for delivering the drug transdermally in accordance with a signal received from the cardiac device.

Apparatus and method for stabilizing an implantable lead

A method and system for stabilizing an implantable lead system employs a lead having one or more sensing, pacing, or shocking electrodes. A sleeve arrangement of the lead includes one or more first locations comprising a first material that substantially prevents or inhibits tissue in-growth between the first locations and cardiac tissue contacting the first locations. The sleeve arrangement further includes one or more adhesion sites provided at one or more of the first locations. The adhesion sites promote tissue in-growth or attachment between the adhesion sites and cardiac tissue contacting the adhesion sites. The cardiac tissue may represent tissue of a cardiac structure of the heart or coronary vasculature of the heart.

Stimulation lead for stimulating the baroreceptors in the pulmonary artery

An apparatus includes a flexible lead body extending from a proximal end to a distal end, the distal end having a biased portion having an outer diameter dimensioned to abut a wall of a pulmonary artery, an electrode coupled proximate the distal end, and an implantable pulse generator electrically coupled to the electrode. The implantable pulse generator is adapted to deliver a baroreflex stimulation signal to a baroreceptor in the pulmonary artery via the electrode.

System for selective activation of a nerve trunk using a transvascular reshaping lead

A system for selective activation of a nerve trunk using a transvascular reshaping lead is provided. One aspect of this disclosure relates to a system for spreading nerve bundles in a nerve trunk. The system includes a lead adapted to be chronically implanted in a blood vessel proximate a nerve trunk, and having an expandable portion adapted to be expanded to reshape the blood vessel to an elongated shape and to reshape the nerve trunk into an elongated shape to spread nerve bundles of the nerve trunk. The system also includes a plurality of electrodes and an implantable device coupled to the lead, where an electrical signal is delivered from the implanted medical device to one of the plurality of electrodes to transvascularly deliver neural stimulation from the electrode to at least one of the nerve bundles of the nerve trunk. Other aspects and embodiments are provided herein.

Vascularly stabilized peripheral nerve cuff assembly

A vascularly stabilized peripheral nerve cuff assembly is provided. One aspect of this disclosure relates to an electrode assembly used in the delivery of neural stimulation therapy. The electrode assembly includes a body adapted to at least partially encompass a blood vessel and a nerve proximate to the blood vessel. The electrode assembly also includes at least one electrode along at least a portion of the body. The at least one electrode is adapted to be electrically connected to a neural stimulator. According to an embodiment, the electrode assembly includes a spacer within the body, the spacer having a first and second end, the first end secured to an inside surface of the body and the second end adapted to pass between the vessel and the nerve and to be secured to the inside surface of the body. Other aspects and embodiments are provided herein.

Implantable cardiac device with dyspnea measurement

Cardiac monitoring and/or stimulation methods and systems employing dyspnea measurement. An implantable cardiac device may sense transthoracic impedance and determine a patient activity level. An index indicative of pulmonary function is implantably computed to detect an episode of dyspnea based on a change, trend, and/or value exceeding a threshold at a determined patient activity level. Trending one or more pulmonary function index values may be done to determine a patient's pulmonary function index profile, which may be used to adapt a cardiac therapy. A physician may be automatically alerted in response to a pulmonary function index value and/or a trend of the patient's pulmonary index being beyond a threshold. Computed pulmonary function index values and their associated patient's activity levels may be stored periodically in a memory and/or transmitted to a patient-external device.

Leads for pacing and/or sensing the heart from within the coronary veins

A lead for monitoring or stimulating cardiac activity is provided. The lead is adapted for implantation on or about the heart within the coronary vasculature and for connection to a signal generator. The lead body has one or more electrodes associated therewith. The lead is constructed and arranged so that when it is implanted, the electrodes are housed in the coronary vasculature and urged into intimate contact a vessel wall. A method for implanting the lead into the coronary vasculature is also provided, the method comprising the steps of inserting a stylet into the lead, inserting the lead into the coronary sinus, advancing the lead from the coronary sinus toward the toward the left atrium and into a coronary vein, removing the stylet, and sensing and pacing the heart. Alternatively, the method comprises placing a guide catheter into the coronary sinus, threading a guide wire into the coronary veins, pushing the lead over the guide wire and into the coronary sinus or the coronary vein, and sensing and pacing the heart via the lead in its implanted site in the coronary sinus or the coronary vein.

Left ventricular lead shapes

A lead for sensing and pacing a left ventricle of the heart includes a lead body having a proximal portion and a distal portion, a lumen extending through the lead body, a conductor extending through the lead body from the proximal end to the distal end and an electrode disposed on the distal portion of the lead body and electrically coupled to the conductor. A distal tip of the lead body is continuously deflectable upon advancement and withdrawal of a stylet through the lumen at the distal portion to access a selected branch of the coronary sinus. The distal tip of the lead body may be offset before or after continuously deflecting the distal tip.

Single pass lead system

A single-pass endocardial lead electrode adapted for implantation in, on or about the heart and for connection to a system for monitoring or stimulating cardiac activity includes a lead body which is adapted for implantation within a single chamber of the heart, or multiple chambers of the heart. The lead includes a first distal end electrode which has a first electrical conducting surface. The lead body also has a second electrode which has a second electrical conducting surface. The first and second electrodes are either passively or actively attached to the wall of the heart. The lead body also includes a curved portion which facilitates the positioning of the second electrode. The main lead body alternatively includes a recess into which an atrial lead body and an active fixation element attached to one end can travel from a recessed position to a position for fixation to the wall of the heart. The active fixation element can also be moved by turning the terminal pin. The lead body can also include multiple legs, each leg carrying an electrode. The lead is attached to a pulse generator for producing pulses to the multiple sites within the heart. A movement assembly for advancing a helix is also included within the legs and comprises an externally threaded collar which engages with an internally threaded housing or housing insert. The lead further includes a helical tip which has high impedance. The electrode has at least one features of the group: the helix having a coating of an insulating material on its surface, the helix having its surface beyond the distal end of the electrode and the distal end of the electrode having a porous conductive surface at a base of the helix, a porous conductive element at a base of the helix, and a porous conductive element at the end of the electrode having an insulating coating cover from 5-95% of the surface of the porous conductive element. The porous element may further provide a guiding mechanism for the helix as it ...

Cardiac rhythm management system and method

A system and method for cardiac rhythm management, which includes an electrode system having at least one electrode and control circuitry coupled to the electrode system from which a first cardiac signal is sensed. The control circuitry includes a pulse circuit to produce electrical pulses at a first value to be delivered to the electrode system in a first cardiac region. At least one cardiac signal is sensed from a second cardiac region, where the cardiac signal includes indications of cardiac depolarizations from the second cardiac region which occurs in direct reaction to the electrical pulses delivered to the first cardiac region. The first value of the electrical pulses are then modified by a pulse adjustment circuit when a cardiac depolarization which occurs in direct reaction to the electrical pulse delivered to the first cardiac region is detected from the second cardiac region.

Connection verification apparatus, system, and method

A cardiac rhythm management apparatus and system may include a first contact to provide a connection signal, a second contact to sense a corresponding connection signal using a lead and an electrode coupled to the second contact, a measurement module capable of being communicatively coupled to the first and second contacts to measure a characteristic associated with the corresponding connection signal, a comparison module to determine whether the lead is of a preselected type, and an indicator module to indicate the comparison result. An article may cause a machine to implement a method which includes providing a connection signal from one contact, measuring a characteristic associated with a corresponding connection signal at another contact, and comparing the characteristic with a range of values to determine a comparison result. The method may also include indicating and recording the comparison result.

Endocardial lead system

An endocardial lead (20) comprising an elongate body having a first defibrillation coil electrode (40), a second defibrillation coil electrode (44) and a first pacing/sensing electrode (42). The first defibrillation coil electrode has a first end at or near the distal end of the elongate body and a second end spaced longitudinally from the distal end. The first pacing/sensing electrode (42) is spaced longitudinally along the peripheral surface from the second end of the first defibrillation coil electrode and is disposed at a curved portion of the lead body. The second defibrillation coil electrode is spaced longitudinally along the peripheral surface from the first pacing/sensing electrode to afford positioning the first defibrillation coil longitudinally adjacent an apical location of the right ventricle (50) of a heart with the first pacing/sensing electrode within the right ventricle and the second defibrillation coil (44) within the right atrial chamber (52) or a major vein (54) leading to the right atrial chamber.

Double helix fes electrode

First and second electrical wires (10), (12) are wrapped helically around a polyprolene core (22). Along a single helical portion (A), a sheath (24) is placed over the spiral wound wires and core. In a double helix portion (B), the core with spiral wound wires is wrapped into an open helix. At an electrical stimulation portion (C), insulation is removed from the wires such that bare conductors (14), (16) are wrapped spirally around the core. The core with the spiral wrapped conductors is wrapped in an open helix. A plurality of barbs (32) are mechanically connected along the entire length of the exposed electrical conductor surface. The core extends beyond the end of the electrical conductor surface to facilitate insertion into a selected site with a cannula (64).

Therapy system including cardiac rhythm therapy and neurostimulation capabilities

An implantable medical system that includes a cardiac therapy module and a neurostimulation therapy module may identify when neurostimulation electrodes have migrated toward a patient's heart. In some examples, the system may determine whether the neurostimulation electrodes have migrated toward the patient's heart based on a physiological response to an electrical signal delivered to the patient via the neurostimulation electrodes. In addition, in some examples, the system may determine whether the neurostimulation electrodes have migrated toward the patient's heart based on an electrical cardiac signal sensed via the neurostimulation electrodes.

Therapy system including cardiac rhythm therapy and neurostimulation capabilities

An implantable medical system that includes a cardiac therapy module and a neurostimulation therapy module may identify when neurostimulation electrodes have migrated toward a patient's heart. In some examples, the system may determine whether the neurostimulation electrodes have migrated toward the patient's heart based on a physiological response to an electrical signal delivered to the patient via the neurostimulation electrodes. In addition, in some examples, the system may determine whether the neurostimulation electrodes have migrated toward the patient's heart based on an electrical cardiac signal sensed via the neurostimulation electrodes.

Implantable and rechargeable neural stimulator

One aspect of the present subject matter relates to an implantable medical device. An embodiment of the device comprises a rechargeable power supply adapted to be recharged through an ultrasound signal, a neural stimulator connected to the rechargeable power supply, and a controller connected to the rechargeable power supply. The neural stimulator is adapted to generate a neural stimulation signal for delivery to a neural stimulation target through an electrode. The controller is further connected to the neural stimulator to control the neural stimulator according to a neural stimulation protocol. Other aspects are provided herein.

Cardiac rhythm management system and method

A system and method for cardiac rhythm management, which includes an electrode system having at least one electrode and control circuitry coupled to the electrode system from which a first cardiac signal is sensed. The control circuitry includes a pulse circuit to produce electrical pulses at a first value to be delivered to the electrode system in a first cardiac region. At least one cardiac signal is sensed from a second cardiac region, where the cardiac signal includes indications of cardiac depolarizations from the second cardiac region which occurs in direct reaction to the electrical pulses delivered to the first cardiac region. The first value of the electrical pulses are then modified by a pulse adjustment circuit when a cardiac depolarization which occurs in direct reaction to the electrical pulse delivered to the first cardiac region is detected from the second cardiac region.

Subcutaneous electrode for stimulating skeletal musculature

Leads for pacing and/or sensing the heart from within the coronary veins

A lead (100) for monitoring or simulating cardiac activity is provided. The lead (100) is adapted for implantation on or about the heart within the coronary vasculature and for connection to a signal generator (140). The lead is constructed and arranged so that when it is implanted, the electrodes (122) are housed in the coronary vasculature and urged into intimate contact a vessel wall (128). The lead optionally includes a tapered, flexible lead body portion that is distal to a biased portion.

Absolute calibrated tissue oxygen saturation and total hemoglobin volume fraction

A medical device for monitoring a patient condition includes a first combination of a light source and a light detector to emit light into a volume of tissue, detect light scattered by the volume of tissue, and provide a first output signal corresponding to an intensity of the detected light. A control module is coupled to the light source to control the light source to emit light at least four spaced-apart light wavelengths, and a monitoring module is coupled to the light detector to receive the output signal, compute a measure of tissue oxygenation in response to the light detector output signal, and detect tissue hypoxia using the measure of tissue oxygenation.

Lead for stimulating the baroreceptors in the pulmonary artery

An apparatus includes a flexible lead body, an electrode coupled to the lead body, and an implantable pulse generator electrically coupled to the electrode. The implantable pulse generator is adapted to deliver a baroreflex stimulation signal to a baroreceptor in the pulmonary artery via the electrode. The apparatus includes means for passively fixating the electrode within the pulmonary artery.

Single pass lead having retractable, actively attached electrode for pacing and sensing

A single-pass endocardial lead electrode adapted for implantation on or about the heart and for connection to a system for monitoring or stimulating cardiac activity including a lead body with a circumferential outer surface. The lead includes a first distal end electrode which has a first electrical conducting surface which is for positioning within the ventricle of the heart. The lead body also has a second electrode which has a second electrical conducting surface adapted for positioning within the atrium of the heart. Both of the first and the second electrodes are adapted for positioning and fixation to the wall. An active fixation element is used as part of the second electrode. The lead body also includes a curved portion which facilitates the positioning and fixing of the second electrode. In another embodiment, the main lead body includes a recess into which an atrial lead body and the active fixation element attached to one end can travel from a recessed position to a position for fixation to the wall of the heart. The active fixation element which can also be moved by turning the terminal pin.

Techniques for placing medical leads for electrical stimulation of nerve tissue

This disclosure is directed to extra, intra, and transvascular medical lead placement techniques for arranging medical leads and electrical stimulation and/or sensing electrodes proximate nerve tissue within a patient. It discloses an implantable medical lead system configured to deliver electrical stimulation from within a lumen of a blood vessel within a patient to nerve tissue located adjacent to and outside of the blood vessel, the system comprising: a medical lead arranged within a lumen of the blood vessel; an electrode connected toward a distal end of the lead adjacent the nerve tissue; and an active fixation member connected toward a distal end of the lead adjacent the nerve tissue and configured to anchor the lead to a wall of the blood vessel lumen.

Unidirectional neural stimulation systems, devices and methods

An embodiment relates to a method for delivering a unidirectional afferent nerve stimulation treatment. A test neural stimulation is delivered, and a physiologic response to the test neural stimulation is monitored. At least one neural stimulation parameter for the test neural stimulation is adjusted if the test neural stimulation does not elicit a desired physiologic response. If the test neural stimulation does elicit the desired physiologic response, at least one treatment parameter for a unidirectional afferent nerve stimulation is determined using the at least one neural stimulation parameter for the test neural stimulation that provided the desired physiologic response. The unidirectional afferent nerve stimulation is delivered using the at least one treatment parameter.

Lead system

A single-pass endocardial lead electrode for implantation within a single chamber of the heart, or multiple chambers of the heart. The lead includes a first distal end electrode and a second electrode. The first and second electrodes are either passively or actively attached to the wall of the heart. The lead body also includes a curved portion which facilitates the positioning of the second electrode. The main lead body alternatively includes a recess into which an atrial lead body and an active fixation element attached to one end can travel from a recessed position to a position for fixation to the wall of the heart. The active fixation element can also be moved by turning the terminal pin. The lead body can also include multiple legs, each leg carrying an electrode. The lead is attached to a pulse generator for producing pulses to the multiple sites within the heart. A movement assembly for advancing a helix is also included within the legs and comprises an externally threaded collar which engages with an internally threaded housing or housing insert. The lead further includes a helical tip which has high impedance.

Lead for stimulating the baroreceptors in the pulmonary artery

An apparatus includes a flexible lead body, an electrode coupled to the lead body, and an implantable pulse generator electrically coupled to the electrode. The implantable pulse generator is adapted to deliver a baroreflex stimulation signal to a baroreceptor in the pulmonary artery via the electrode. The apparatus includes means for passively fixating the electrode within the pulmonary artery.

Unidirectional neural stimulation systems, devices and methods

An embodiment relates to a method for delivering a unidirectional afferent nerve stimulation treatment. A test neural stimulation is delivered, and a physiologic response to the test neural stimulation is monitored. At least one neural stimulation parameter for the test neural stimulation is adjusted if the test neural stimulation does not elicit a desired physiologic response. If the test neural stimulation does elicit the desired physiologic response, at least one treatment parameter for a unidirectional afferent nerve stimulation is determined using the at least one neural stimulation parameter for the test neural stimulation that provided the desired physiologic response. The unidirectional afferent nerve stimulation is delivered using the at least one treatment parameter.

Leads for pacing and/or sensing the heart from within the coronary veins

A lead for monitoring or stimulating cardiac activity is provided. The lead is adapted for implantation on or about the heart within the coronary vasculature and for connection to a signal generator. The lead body has one or more electrodes associated therewith. The lead is constructed and arranged so that when it is implanted, the electrodes are housed in the coronary vasculature and urged into intimate contact a vessel wall. A method for implanting the lead into the coronary vasculature is also provided, the method comprising the steps of inserting a stylet into the lead, inserting the lead into the coronary sinus, advancing the lead from the coronary sinus toward the toward the left atrium and into a coronary vein, removing the stylet, and sensing and pacing the heart. Alternatively, the method comprises placing a guide catheter into the coronary sinus, threading a guide wire into the coronary veins, pushing the lead over the guide wire and into the coronary sinus or the coronary vein, and sensing and pacing the heart via the lead in its implanted site in the coronary sinus or the coronary vein.

Implantable and rechargeable neural stimulator

One aspect of the present subject matter relates to an implantable medical device. An embodiment of the device comprises a rechargeable power supply adapted to be recharged through an ultrasound signal, a neural stimulator connected to the rechargeable power supply, and a controller connected to the rechargeable power supply. The neural stimulator is adapted to generate a neural stimulation signal for delivery to a neural stimulation target through an electrode. The controller is further connected to the neural stimulator to control the neural stimulator according to a neural stimulation protocol. Other aspects are provided herein.

System and method for monitoring autonomic balance and physical activity

An implantable device monitors the balance between sympathetic tone and parasympathetic tone as a function of an activity level. Cardio-neurological healthy users exhibit a generally sympathetic tone in conjunction with heavy activity level and a generally parasympathetic tone in conjunction with periods of low activity level. Deviations from expected results are associated with a health problem. Measured conditions are stored and available for subsequent reporting to a remote programmer. Therapy delivered by an implantable device is determined as a function of the relationship between autonomic balance and activity level.

Marking system for lead connector and header

A marking system to enable physicians to determine whether a connector of a lead is properly seated within the pulse generator.

Leads for pacing and/or sensing the heart from within the coronary veins

A lead for monitoring or stimulating cardiac activity is provided. The lead is adapted for implantation on or about the heart within the coronary vasculature and for connection to a signal generator. The lead body has one or more electrodes associated therewith. The lead is constructed and arranged so that when it is implanted, the electrodes are housed in the coronary vasculature and urged into intimate contact a vessel wall.

Cardiac rhythm management system and method

A system and method for cardiac rhythm management, which includes an electrode system having at least one electrode and control circuitry coupled to the electrode system from which a first cardiac signal is sensed. The control circuitry includes a pulse circuit to produce electrical pulses at a first value to be delivered to the electrode system in a first cardiac region. At least one cardiac signal is sensed from a second cardiac region, where the cardiac signal includes indications of cardiac depolarizations from the second cardiac region which occurs in direct reaction to the electrical pulses delivered to the first cardiac region. The first value of the electrical pulses are then modified by a pulse adjustment circuit when a cardiac depolarization which occurs in direct reaction to the electrical pulse delivered to the first cardiac region is detected from the second cardiac region.

Method and apparatus for reducing defibrillation threshold

An antitachyarrhythmia system uses vagal nerve stimulation in combination with one or more additional techniques to lower the defibrillation threshold (DFT). Examples of such additional techniques include using electrical shock waveforms each including a plurality of pulses and using defibrillation electrode configurations each including an electrode placed in the coronary sinus or coronary vein.

Performing one or more pulse transit time measurements based on an electrogram signal and a photoplethysmography signal

This disclosure is directed to devices, systems, and techniques for monitoring a patient condition. In some examples, a medical device system includes processing circuitry configured to determine a plurality of pulse transit time (PTT) intervals, determine, based on an accelerometer signal, a posture of a patient from a plurality of postures corresponding to each PTT interval of the plurality of PTT intervals, classify each PTT interval of the plurality of PTT intervals based on the respective posture of the patient corresponding to the respective PTT interval, and monitor, based on the classified plurality of PTT intervals, a patient condition.