Systems and methods for managing heart failure are described. The system receives physiological information including a first HS signal corresponding to paced ventricular contractions and a second HS signal corresponding to intrinsic ventricular contractions. The system detects worsening heart failure (WHF) using the received physiological information. A signal analyzer circuit can generate a paced HS metric from the first HS signal and a sensed HS metric from the second HS signal, and determine a concordance indicator between the paced and the sensed HS metrics. In response to the detected WHF, the system can use the concordance indicator to generate a therapy adjustment indicator for adjusting electrostimulation therapy, or a worsening cardiac contractility indicator indicating the detected WHF is attributed to degrading myocardial contractility.

The present invention relates to a medical device, in particular to an implantable medical device, comprising at least one implantable or non-implantable hemodynamic sensor configured for detecting hemodynamic cardiac signals, a controller configured for processing and analyzing the detected cardiac hemodynamic signals or signals derived from the detected cardiac hemodynamic signals by applying to said signals a Teager Energy Operator (TEO). The controller further comprises at least one algorithm configured to determine the need for a defibrillation operation by taking into account the at least one output hemodynamic signal. The present invention also provides a method and software for detecting or treating a ventricular fibrillation episode by taking into account cardiac hemodynamic signals.

A hermetically sealed feedthrough assembly for an active implantable medical device having an oxide-resistant electrical attachment for connection to an EMI filter, an EMI filter circuit board, an AIMD circuit board, or AIMD electronics. The oxide-resistant electrical attachment, including an oxide-resistant sputter layer 165 is disposed on the device side surface of the hermetic seal ferrule over which an ECA stripe is provided. The ECA stripe may comprise one of a thermal-setting electrically conductive adhesive, an electrically conductive polymer, an electrically conductive epoxy, an electrically conductive silicone, an electrically conductive polyimide, or a thermal-setting electrically conductive polyimide, such as those manufactured by Ablestick Corporation. The oxide-free electrical attachment between the ECA stripe and the filter or AIMD circuits may comprise one of gold, platinum, palladium, silver, iridium, rhenium, rhodium, tantalum, tungsten, niobium, zirconium, vanadium, and combinations or alloys thereof.

A method for monitoring health of a subject based on a physiological response to physical exertion, by processing circuitry of a medical device system, is described that includes detecting a plurality of exertion events of the subject based on a first sensed signal that varies as a function of movement of the subject. The method further includes determining a response of a physiological parameter of the subject to the exertion event for each of the detected exertion events based on second sensed signal that varies as a function of the physiological parameter. The method further includes determining that a change in the responses over time crosses threshold and generating an alert to a user based on the determination that the change crosses the threshold.

A method for monitoring health of a subject based on a physiological response to physical exertion, by processing circuitry of a medical device system, is described that includes detecting a plurality of exertion events of the subject based on a first sensed signal that varies as a function of movement of the subject. The method further includes determining a response of a physiological parameter of the subject to the exertion event for each of the detected exertion events based on second sensed signal that varies as a function of the physiological parameter. The method further includes determining that a change in the responses over time crosses threshold and generating an alert to a user based on the determination that the change crosses the threshold.

Subcutaneous implantable string shaped defibrillator for providing cardiac resynchronization therapy (CRT), including a flexible elongated body, at least two defibrillation leads, at least one sensor, at least two transition units and at least one epicardial lead, the defibrillation leads for providing at least one cardioversion defibrillation shock, the sensor being positioned on at least one of the defibrillation leads, for determining at least one metric of a heart, the transition units for respectively coupling the defibrillation leads to opposite ends of the elongated body, and the epicardial lead, coupled with the elongated body via at least one of the transition units, for providing at least one CRT pulse, the elongated body including a plurality of linked units, the linked units encapsulating at least one capacitor, at least one power source and a processor, wherein the processor provides at least one signal to the epicardial lead for providing the CRT pulse.

Disclosed is a delivery system for a component, for example, a splitting lead. A splitting lead can have a proximal portion to engage a controller and a distal portion to split apart into sub-portions that travel in multiple directions during implantation into a patient. The delivery system can include a handle and a component advancer to advance and removably engage a portion of the component. The component advancer can be coupled to the handle and advance the component into the patient by applying a force to the portion in response to actuation of the handle by the operator. Also, the delivery system can include an insertion tip with first and second ramps to facilitate advancement of first and second sub-portions into the patient in first and second directions. The leads may have various electrode configurations including, for example, wrapped or embedded electrodes, helical or elliptical coils, thin metallic plates, etc.

An object of the present invention is to provide a new electric device for defibrillation and a method for generating a defibrillation signal. The electric device for defibrillation includes an electrocardiogram waveform input unit; and an enable signal generating unit, wherein the electric device for defibrillation is configured to generate an enable signal from the enable signal generating unit after a peak of an event is surpassed and when or after condition 1 is satisfied, the event being estimated to be an R-wave of an electrocardiogram waveform, the electrocardiogram waveform being obtained from a human body and inputted from the electrocardiogram waveform input unit, and the condition 1 is that a differential value in a differentiated waveform generated based on the electrocardiogram waveform, which corresponds to the event estimated to be the R-wave, is a negative constant C.sub.3 value or less.

An implantable system includes an implantable medical device (IMD) and a non-transvenous lead that is configured to be implanted outside of a heart. The IMD includes an output configured to be connected at least to the lead, a current generator (CG) circuit configured to generate pacing pulses, a switching circuit coupled between the CG circuit and the output, one or more capacitors coupled in parallel with the CG circuit and the switching circuit, and a control circuit coupled to the CG circuit. The control circuit is configured to manage the CG circuit to generate the pacing pulses with a constant current at the output.

A method and medical device for detecting a cardiac event that includes sensing cardiac signals from a plurality of electrodes forming a first sensing vector sensing a first interval of the cardiac signal during a predetermined time period and a second sensing vector simultaneously sensing a second interval of the cardiac signal during the predetermined time period, identifying each of the first interval and the second interval as being one of shockable and not shockable in response to first processing of the first interval and the second interval and in response to second processing of one or both of the first interval and the second interval, the second processing being different from the first processing, and determining whether to deliver therapy for the cardiac event in response to identifying each of the first interval and the second interval as being one of shockable and not shockable in response to both the first processing and the second processing of the first interval and the second interval.