The present invention relates generally to implantable medical devices and more specifically to monitoring Signs of acute or chronic cardiac mechanical dysfunction Such as congestive heart failure (CHF) or cardiogenic shock and providing appropriate therapies.

All these disease processes lead to insufficient cardiac output to Sustain mild or moderate levels of exercise and proper function of other body organs, and progressive worsening eventually results in cardiogenic shock, arrhythmias, elec tromechanical dissociation, and death.

The dis closed PESP stimulator may be incorporated into a dual chamber (DDD) pacing System with or without physiologic rate control and with or without backup cardioversion/ defibrillation therapy capabilities or in a separate, Single purpose device.

These and other advantages and features of the present invention will be more readily understood from the follow ing detailed description of the preferred embodiments thereof, when considered in conjunction with the drawings, in which like reference numerals indicate identical Structures throughout the Several views, and wherein: FIG. 1 is a Schematic diagram depicting a multi-channel, atrial and bi-ventricular, monitoring/pacing IMD in which the present invention is preferably implemented; FIG. 2 is a simplified block diagram of one embodiment of IPG circuitry and associated leads employed in the System of FIG. 1 enabling selective therapy delivery and heart failure State monitoring in one or more heart chamber; FIG. 3 is a simplified block diagram of a Single monitor ing and pacing channel for deriving pressure, impedance and cardiac EGM signals employed in monitoring CHF and optionally pacing the heart and delivering PESP therapy in accordance with the present invention; FIGS. 4A and 4B constitute a flow chart depicting the monitoring and therapy delivery function of the IMD of FIGS. 1-3, measuring one or more of a group of parameters indicative of the State of heart failure employing cardiac EGM signals, blood pressure P and dP/dt signals and adjust ing electrical Stimulation therapies accordingly.

It will be appreciated from the following description that the monitor/therapy delivery IMD of the present invention may be utilized to obtain the aforementioned parameters as Stored patient data over a period of time and to deliver therapies for treating the heart failure.

Unfortunately, none of these patents provides a system for monitoring the effi ciency of the therapy in progress, either with respect to the proper positioning of the winding over the area to be treated or of the intensity of the magnetic field ...

FIG. 9 is an elevational view illustrating the applica Further in connection with the fabrication of the tor wrap of this invention in conjunction with an elec wrap 22, the preferred embodiment illustrated herein trostimulation component; also includes electromagnetic radiation shielding in the FIG. 10 is a plan view of an electrophoretic pharma form of a metalized material forming a substrate 38 ceutical delivery system for use with the apparatus of comprised of a layer of narrow gauge metal wire or this invention; and mesh in%bedded within the thermoplastic material.

The preferred power supply is an electrochemical The apparatus 20 is comprised of an applicator wrap cell such as a commercially available nickel cadmium 9 22, a portable operating console 24 that incorporates a volt rechargeable battery.

Velcro closure is utilized for securing the wrap 22 With regard to the electromagnetic field therapy, a against afflicted areas on the patient's body as for exam computerized chip distribution system monitors and ple as shown in FIG. 1.

Furthermore, the cores 32 can be imbedded in when inserted within the respective sockets 54, 55 com the thermoplastic material during the molding process plete two independent circuits for energizing alternat and thus secured in place by the surrounding thermo ing treatment coils 42.

The purpose a target area, further including a transverse substrate of of the electrophoresis is to utilize an electrical field to metalized electromagnetic radiation shielding material influence the transfer and metabolism of the drug me adjacent to said outer surface of said applicator wrap dium into the patient's body.

The description of this device, however, does not suggest any extension of the electromagnetic phenomenon in circum stances where PEMF stimulation can provide dramatic opportunities for the treatment of osteoarthritis, and muscu loskeletal pains including tendonitis, bursitis, and muscle spasms.

[0063] FIG. 41 shows a schematic view of a system includ ing a variation of a back applicator held on a patient's body by an ergonomic positioning element in the form of a shoulder harness, a sensor, and a logic controller.

In different variations, the coils may be movable manually by acting on a knob, lever, or similar type of actuator, or may be translated automatically by the logic controller in response to the input provided by the sensors.

[0123] In the second application, the powering coils may contain circuitry to determine the amount of resistance encountered by the applied magnetic field, or other electrical properties that may reflect the quality and degree of the mag netic coupling that is being achieved.

Alternatively, a sensor may be incorporated into the implantable device and commu nicate the degree and quality of the magnetic coupling exter nally via wireless communication, which may in tum provide feedback for the automatic or manual adjustment of the pow ering coil.

None had a history of knee or hip pathological conditions.

However, none of the following reports of magnetic stimulation of the vagus nerve were related to the treatment ofbronchoconstric(cid:173) tion.

However, none of the disclosures in these patents or patent applications for electrical stimulation of the vagus nerve at the ear are used to treat bronchoconstriction.

Seven of the animals (39%) demonstrated a small decrease in histamine transient and none of the animals dem(cid:173) onstrated an increase in histamine transient. Also, none of the animals achieved a significant (greater than 50%) ...

A conventional solu tion, placing earplugs in the patient’s ears, is undesirable because it is an additional step to perform in the therapeutic process and does not solve the problem of the noise caused by the device in the treatment facility (e.g., physicians office, hospital, etc.).

According to an embodiment, a ferrofluid chamber has a housing that is adapted to be coupled to a component that generates a magnetic field of Sufficient strength to stimulate anatomical tissue.

In the case of major depressive disorder, neurotransmitter dys regulation and abnormal glucose metabolism in the prefrontal cortex and the connected limbic structures may be a likely pathophysiology.

Repeated application of magnetic stimula tion to the prefrontal cortex may produce chronic changes in neurotransmitter concentrations and metabolism so that depression is alleviated.

Rather, the inventors have contemplated that the claimed Subject matter might also be embodied in other ways, to include different steps or elements similar to the ones described in this document, in conjunction with other present or future technologies.