Several defibrillators, defibrillator architectures, defibrillator components and methods of operating defibrillators are described. In one aspect, a defibrillator (as for example an automated external defibrillator) that can be powered by a mobile communication device such as a smart cellular phone or a tablet computer is described. Utilizing a phone (or other mobile communication device) as the power supply for an external defibrillator allows the external defibrillator to be smaller and, in some circumstance, removes the need for a battery that stores sufficient energy for shock deliverywhich would need to be checked and/or replaced on a regular basis. Additionally, when desired, certain control functionality, computation, data processing, and user instructions can be handled/presented by the mobile communications device thereby further simplifying the defibrillator design and improving the user experience. This architecture takes advantage of the nearly ubiquitous availability of smart phones, tablet computers and other mobile communication devices.

Methods and apparatus for a three-stage atrial cardioversion therapy that treats atrial arrhythmias within pain tolerance thresholds of a patient. An implantable therapy generator adapted to generate and selectively deliver a three-stage atrial cardioversion therapy and at least two leads, each having at least one electrode adapted to be positioned proximate the atrium of the patient. The device is programmed for delivering a three-stage atrial cardioversion therapy via both a far-field configuration and a near-field configuration of the electrodes upon detection of an atrial arrhythmia. The three-stage atrial cardioversion therapy includes a first stage for unpinning of one or more singularities associated with an atrial arrhythmia, a second stage for anti-repinning of the one or more singularities, both of which are delivered via the far-field configuration of the electrodes, and a third stage for extinguishing of the one or more singularities delivered via the near-field configuration of the electrodes.

Methods and apparatus for a three-stage ventricular cardioversion and defibrillation therapy that treats ventricular tachycardia and fibrillation at low energy levels. An implantable therapy generator adapted to generate and selectively deliver a three-stage ventricular therapy and at least two leads operably each having at least one electrode adapted to be positioned proximate the ventricle of the patient. The device is programmed to deliver a three-stage therapy via both a far-field configuration and a near-field configuration of the electrodes upon detection of a ventricular arrhythmia. The three-stage therapy includes a first stage for unpinning of one or more singularities associated with the ventricular arrhythmia, a second stage for anti-repinning of the one or more singularities, both of which are delivered via the far-field configuration of the electrodes, and a third stage for extinguishing of the one or more singularities associated delivered via the near-field configuration of the electrodes.

Devices and methods are described for occluding the left atrial appendage (LAA). The device excludes the LAA from blood flow to prevent blood from clotting within the LAA and subsequently embolizing, particularly in patients with atrial fibrillation. The implantable device is delivered via transcatheter delivery into the LAA and secured within the LAA. The implant comprises an expandable and compliant frame and an expandable and conformable tubular foam body carried by the frame. The device may have a thromboresistant cover at a proximal end and a thromboresistant coating on the foam body. The frame may have recapture struts inclining radially outwardly in the distal direction from a central hub. The frame may have axially extending side wall struts, with adjacent pairs of side wall struts joined at one or more apexes. Anchors extend from the frame to engage tissue. The anchors can also be reversible to allow retraction of the anchors and repositioning or retrieval of the device.

Systems and methods for managing cardiac arrhythmias are discussed. A data management system receives a first detection algorithm including a detection criterion for detecting a cardiac arrhythmia. An arrhythmia detector detects arrhythmia episodes from a physiologic signal using a second detection algorithm that is different from and has a higher sensitivity for detecting the cardiac arrhythmia than the first detection algorithm. The arrhythmia detector assigns a detection indicator to each of the detected arrhythmia episodes. The detection indicator indicates a likelihood that the detected arrhythmia episode satisfies the detection criterion of the first detection algorithm. The system prioritizes the detected arrhythmia episodes according to the assigned detection indicators, and outputs the arrhythmia episodes to a user or a process according to the episode prioritization.

Ablation catheter comprising an elongate member with proximal and distal ends, wherein the distal end is arranged to apply a high energy electrical shock from a plurality of locations along the length of said distal end and wherein said distal end is curved. Preferably the distal end of the elongate member extends in a circle segment.

This document describes methods and materials for reducing incision sizes for improving the treatment of pathological conditions, including arrhythmias and trauma, using temperature modulation via implantable devices. For example, this document describes methods and devices for treating atrial and/or ventricular fibrillation by cooling the epicardium.

Disclosed herein are implantable medical devices and systems, and methods for used therewith, that selectively perform atrial overdrive pacing while an intrinsic atrial rate of a patient is within a specified range. Such a method can involve measuring intervals between a plurality of intrinsic atrial depolarizations that occur during a specified period, and classifying intrinsic atrial activity as stable or unstable based on the measured intervals. In response to classifying the intrinsic atrial activity as stable, atrial overdrive pacing is performed. In response to classifying the intrinsic atrial rate as unstable, atrial overdrive pacing is not performed (i.e., is abstained from being performed). Over time, effectiveness of performing atrial overdrive pacing using various different atrial interval shorting deltas are recorded in a log and updated, and the log is used to determine a preferred rate at which to perform atrial overdrive pacing for various different measured intervals.

A device includes a tissue conduction communication (TCC) transmitter that generates a TCC signal including a carrier signal having a peak-to-peak amplitude and a carrier frequency cycle length including a first polarity pulse for a first half of the carrier frequency cycle length and a second polarity pulse opposite the first polarity pulse for a second half of the carrier frequency cycle length. Each of the first polarity pulse and the second polarity pulse inject a half cycle charge into a TCC pathway. The TCC transmitter starts transmitting the TCC signal with a starting pulse having a net charge that is half of the half cycle charge and transmits alternating polarity pulses of the carrier signal consecutively following the starting pulse.

In alternative embodiments, provided are compositions, medical devices or products of manufacture, systems, diagnostic tools, and methods, including computer implemented methods, for predicting the response of patients with dyssynchronous heart failure (DHF) to cardiac resynchronization therapy (CRT), comprising: measuring or determining the fraction of the LV/septum performing negative work (MNW); and measuring or determining the coefficient of variation of external work density (COVW), wherein the MNW fraction performing negative work and coefficient of variation COVW (sd/mean) correlated strongly with observed reduction in end-systolic volume after CRT. In alternative embodiments, provided are products comprising a remote communication device for remotely and operably interacting with a programmable implantable cardioverter-defibrillator (ICD) or CRT-D including a defibrillator in case defibrillation is needed, an implantable defibrillator, a dual-chamber defibrillator or a single-chamber defibrillator, or a CRT-P where there is no defibrillator but the CRT-P has a pacing system alone without the defibrillator.