Abstract: A medical device system and related methods of automatically adjusting control parameters of a medical device are disclosed. One method involves obtaining data pertaining to a physiological condition of a patient during operation of the medical device in accordance with the operating mode, determining a plurality of adjusted values for the control parameter based at least in part on the data, determining a respective cost associated with each respective adjusted value for the control parameter based at least in part on the data using a cost function, identifying, from among the plurality of adjusted values, an optimized value from among the plurality of adjusted values, wherein the optimized value has a minimum cost associated therewith from among the plurality of costs, and updating the control parameter at the medical device to the optimized value.

Abstract: One or more processors may be configured to detect whether a patient with diabetes is operating a vehicle based on one or more detected gestures. Based on the detection of operating the vehicle, the one or more processors may cause a patient device to output alerts according to a driving alert protocol. In another example, based on the detection of operating the vehicle, one or more processors may cause an insulin pump to operate according to a driving therapy protocol.

Abstract: Techniques related to temporary setpoint values are disclosed. The techniques may involve causing operation of a fluid delivery device in a closed-loop mode for automatically delivering fluid based on a difference between a first setpoint value and an analyte concentration value during operation of the fluid delivery device in the closed-loop mode. Additionally, the techniques may involve obtaining a second setpoint value. The second setpoint value may be a temporary setpoint value to be used for a period of time to regulate fluid delivery, and the second setpoint value may be greater than the first setpoint value. The techniques may further involve causing operation of the fluid delivery device for automatically reducing fluid delivery for the period of time based on the second setpoint value.

Abstract: Anchoring mechanisms for an implantable electrical medical lead that is positioned within a substernal space are disclosed. The anchoring mechanisms fixedly-position a distal portion of the lead, that is implanted in the substernal space.

Abstract: In some aspects, systems, devices, and techniques for programming a medical fluid delivery device are described. In one example, the disclosure relates to a system including a medical fluid delivery device configured to deliver a therapeutic agent to a patient, and a processor. The processor may be configured to receive a proposed therapy dosing program that defines a fluid therapy for delivery to a patient via a medical fluid delivery device for a first period of time, determine a total dosage over a second period of time, where the second period of time at least partially overlaps the first period of time, and compare the total dosage over the second period of time to a reference dosage.

Abstract: A user interface of a computing device for programming a medical device configured to review historical user session data while disconnected from the medical device. During a programming session, the user interface on the computing device may include features to control the functionality of the medical device as well as view and manipulate available data stored at the medical device. The user interface may interactively view screens and features and manipulate data using the programming user interface, e.g., as if the external programming device were in a live programming session with the medical device, but while disconnected from the medical device and not in a live programming session. As one example, the user interface of the external programming device may permit flexible, extensive manipulation and viewing of sensed signals, patient events, and operational information, such as patient adjustments made over time or coincident with particular signals or events.

Abstract: In some examples, a system includes a medical device comprising an elongate body configured to advance through layers of tissue of a patient, a lumen extending through the elongate body, a fluid line configured to supply fluid to the lumen, and a pressure sensor positioned within the lumen or the fluid line. The system may further include processing circuitry configured to receive, from the pressure sensor, a signal corresponding to the pressure of the fluid at each of a plurality of time points, determine, for each time point: a corresponding amplitude value of the signal, a difference between two amplitude values of the signal, an amplitude oscillation status of the signal, a position of the elongate body based on the difference and the amplitude oscillation status; and provide an indication of the position of the elongate body relative to the layers of tissue.

Abstract: Described here are patches and methods for measuring glucose in sweat (and tears and the like). In general, the patches comprise an adhesive layer adapted to bond to skin of an individual, a substrate layer disposed over the adhesive layer and comprising a glucose sensing complex including a chromogen that changes color in the presence of certain concentrations of glucose, and a cover. In typical embodiments, the substrate layer has elements formed to direct and accumulate sweat that migrates from the skin of the individual to the glucose sensing complex. Methods of using the invention can comprise cleaning the skin surface, collecting sweat in a patch comprising this microfluidic constellation of elements, and observing concentrations of glucose collected in the sweat, for example either visually, or by using a smartphone or other computer processing device.

Abstract: A tissue-removing catheter for removing tissue in a body lumen includes an elongate body and a tissue-removing element mounted on a distal end portion of the elongate body. The tissue-removing element is configured to remove the tissue as the tissue-removing element is rotated by the elongate body within the body lumen. An inner liner is received within the elongate body. The inner liner defines a guidewire lumen. The inner liner isolates an interior of the guidewire lumen from the elongate body and tissue-removing element such that rotational forces are not transferred from the elongate body and tissue-removing element to the interior of the guidewire lumen when the elongate body and tissue-removing element are rotated during removal of tissue from the body lumen.

Abstract: A continuous wire stent includes a wire bent into a waveform and spirally wrapped into a helix having a plurality of bands that form a hollow cylindrical shape. The waveform includes a plurality of waves, each wave including a first outer crown including a first intrados, a second outer crown including a second intrados facing the first intrados, a first mid-crown disposed between the first outer crown and the second outer crown, a second mid-crown disposed between the second outer crown and an outer crown of a next wave of the waveform, a first strut connecting the first outer crown to the first mid-crown, a second strut connecting the first mid-crown to the second outer crown, a third strut connecting the second outer crown to the second mid-crown, and a fourth strut connecting the second mid-crown to the outer crown in the next wave of the waveform.

Abstract: Embodiments hereof relate methods of delivering a valve prosthesis to an annulus of a native valve of a heart. A valve delivery system is introduced into a ventricle of the heart via a ventricular wall of the heart. The valve delivery system has a displacement component at the distal portion thereof. The valve prosthesis is in a delivery configuration and the displacement component is in a delivery state in which the displacement component has a first outer diameter. While the valve prosthesis is in the delivery configuration, the displacement component of the valve delivery system is radially expanded into an expanded state in which the displacement component has a second outer diameter greater than the first outer diameter. The valve delivery system is advanced towards the annulus of the native valve of the heart with the displacement component in the expanded state to displace chordae tendineae.

Abstract: A cryotreatment catheter for treating tissue. The catheter may include an outer elongate body, a balloon treatment element coupled to the distal portion of the elongate body with a plurality of balloon lobes radially arranged around the outer elongate body, an inner elongate body rotatably movable within the lumen of the outer elongate body, and a fluid delivery lumen located within the lumen of the outer elongate body and at least partially within the lumen of the inner elongate body. The fluid delivery lumen may be branched at a distal portion into a plurality of linear segments, each linear segment being in fluid communication with one of the plurality of balloon lobes. Each of the balloon lobes may be inflated independently of each other by the linear segments of the fluid delivery lumen.

Abstract: Surgical instruments with ultrasonic cutting and sensing capabilities, as well as related systems and methods, are disclosed herein. In one aspect, the present disclosure provides a surgical instrument including a housing; an ultrasonic transducer contained in the housing and capable of acting as an ultrasonic receiver; an output member at least partially received in the housing and configured to be driven by the ultrasonic transducer; a dissection head having an attachment portion configured to be selectively driven by the ultrasonic transducer; and a controller operable to initiate and stop the ultrasonic transducer according to an alternating duty cycle.

Abstract: Techniques for modeling therapy fields for therapy delivered by medical devices are described. Each therapy field model is based on a set of therapy parameters and represents where therapy will propagate from the therapy system delivering therapy according to the set of therapy parameters. Therapy field models may be useful in guiding the modification of therapy parameters. As one example, a processor compares an algorithmic model of a therapy field to a reference therapy field and adjusts at least one therapy parameter based on the comparison. As another example, a processor adjusts at least one therapy parameter to increase an operating efficiency of the therapy system while substantially maintaining the modeled therapy field.

Abstract: Embodiments of the invention provide amperometric analyte sensors having elements selected to optimize enzymatic activities associated with such sensors including polymers functionalized with enzymatic mediators as well as methods for making and using such sensors. While embodiments of the invention can be used in a variety of contexts, typical embodiments of the invention include glucose or ketone sensors used in the management of diabetes.

Abstract: A transcatheter valve prosthesis is disclosed that has a compressed, delivery configuration and an expanded configuration for deployment within a native heart valve. The valve prosthesis includes a self-expanding frame and a prosthetic valve component. The self-expanding frame includes a valve receiving portion defining an opening therethrough and first and second anchors at opposing ends of the valve receiving portion. The valve receiving portion is substantially planar and the first and second anchors are oriented substantially perpendicular to the valve receiving portion when the valve prosthesis is in the expanded configuration. The prosthetic valve component is disposed within the opening of the valve receiving portion and secured thereto.

Abstract: A stimulation electrode assembly configured to be positioned relative to a patient for an operative procedure is disclosed. An evoked stimulation response may be sensed by a sensor near a portion of a subject. The evoked response may be sensed by an electrode and determined with a monitoring system. The evoked response may additionally and/or alternatively be sensed with a motion sensor. A position sensor may be provided to measure or determine whether the sensor has moved during a procedure.

Abstract: A bipolar stimulation probe including a first electrode, a second electrode, a control module, and switches. The control module is configured to stimulate nerve tissue of a patient by generating (i) a first output signal indicative of a first pulse to be output from the first electrode, and (ii) a second output signal indicative of a second pulse to be output from the second electrode. The first pulse and the second pulse are monophasic. The switches are configured to output from the bipolar stimulation probe (i) the first pulse on the first electrode based on the first output signal, and (ii) the second pulse on the second electrode based on the second output signal.

Abstract: A blood glucose sensing system includes a sensor and a sensor electronics device. The sensor includes a plurality of electrodes. The sensor electronics device includes stabilization circuitry. The stabilization circuitry causes a first voltage to be applied to one of the electrodes for a first timeframe and causes a second voltage to be applied to one of the electrodes for a second timeframe. The stabilization circuitry repeats the application of the first voltage and the second voltage to continue the anodic—cathodic cycle. The sensor electronics device may include a power supply, a regulator, and a voltage application device, where the voltage application device receives a regulated voltage from the regulator, applies a first voltage to an electrode for the first timeframe, and applies a second voltage to an electrode for the second timeframe.