Abstract: Systems and processes for facilitating the removal of material with a robotically assisted tool with laser, irrigation capabilities, aspiration capabilities. Tool guidance systems that make use of vision technologies, including optical coherence tomography (OCT), white light imaging, and structured light imaging. Emulsification patterns optimized to minimize risk to the patient and reduce procedure time. Robotic tools with articulation capabilities that allow for precise control during capsulorhexis and emulsification procedures. Robotic instrument drive mechanisms combined with pumps, flow meters, and valves regulate and control irrigation and aspiration functionalities during robotic ophthalmologic procedures.

Abstract: A biostimulator, such as a leadless cardiac pacemaker, having a flexible circuit assembly, is described. The flexible circuit assembly is contained within an electronics compartment between a battery, a housing, and a header assembly of the biostimulator. The flexible circuit assembly includes a flexible substrate that folds into a stacked configuration in which an electrical connector and an electronic component of the flexible circuit assembly are enfolded by the flexible substrate. An aperture is located in a fold region of the flexible substrate to allow a feedthrough pin of the header assembly to pass through the folded structure into electrical contact with the electrical connector. The electronic component can be a processor to control delivery of a pacing impulse through the feedthrough pin to a pacing tip. Other embodiments are also described and claimed.

Abstract: A method of operating an implantable blood pump having a first stator, a second stator, and an impeller movably disposed there between. The method includes applying a first voltage waveform at first phase to the first stator to generate a magnetic field to rotate the impeller. A second voltage waveform is applied at a second phase shifted from the first phase to the second stator to rotate the impeller, the second voltage waveform is asymmetric to the first voltage waveform.

Abstract: A method, including receiving, from electrodes positioned within a heart, first signals from at least three of the electrodes indicating electrical activity in tissue with which the at least three of the electrodes engage, and second signals indicating locations of the at least three electrodes. The second signals are processed to compute the locations of the at least three electrodes and to determine a geometric center of the locations. Based on the signals, an electroanatomical map is generated for an area of the tissue including the geometric center, and an arrhythmia focus is determined in the map. A circle is presented, and within the circle, a region of the map is presented including the geometric center and the focus so that the geometric center on the map aligns with a center of the circle, the region within the circle indicating a spatial relationship between the geometric center and the focus.

Abstract: A medical device processor is configured to receive at least one cardiac electrical signal that is sensed during bilateral bundle branch pacing delivered from a bipolar electrode pair comprising an anode positioned along a first bundle branch and a cathode positioned along a second bundle branch opposite the first bundle branch, determine at least one feature from the first cardiac electrical signal, determine that the at least one feature meets first bundle branch capture criteria; and determine anodal bundle branch capture in response to the first bundle branch capture criteria being met.

Abstract: This document discusses, among other things, systems and methods for managing pain of a subject. A system includes a first sensor circuit to sense a first signal indicative of a functional state of the subject, a second sensor circuit to sense a second signal different from the first signal, and a controller circuit. The controller circuit may determine an operating mode of the second sensor circuit according to the sensed first signal, trigger the second senor circuit to sense the second signal under the determined operating mode, and generate a pain score using at least the second signal sensed under the determined operating mode. The pain score may be output to a patient or used for closed-loop control of a pain therapy.

Abstract: A system includes an interventional instrument and a control system. The control system is configured to: generate a graphical user interface (GUI) including an image of a target region for deploying the interventional instrument, wherein the target region includes a plurality of target points and is determined by a probabilistic collection of the plurality of target points, wherein a size of the target region is based at least in part on a location of a target structure within a patient anatomy; responsive to an engagement of the interventional instrument with tissue in the target region, update the GUI to include an engagement location marker; and responsive to the engagement of the interventional instrument, update the GUI to include an image of a revised target region.

Abstract: A biostimulator, such as a leadless cardiac pacemaker, having a flexible circuit assembly, is described. The flexible circuit assembly is contained within an electronics compartment between a battery, a housing, and a header assembly of the biostimulator. The flexible circuit assembly includes a flexible substrate that folds into a stacked configuration in which an electrical connector and an electronic component of the flexible circuit assembly are enfolded by the flexible substrate. An aperture is located in a fold region of the flexible substrate to allow a feedthrough pin of the header assembly to pass through the folded structure into electrical contact with the electrical connector. The electronic component can be a processor to control delivery of a pacing impulse through the feedthrough pin to a pacing tip. Other embodiments are also described and claimed.

Abstract: 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.

Abstract: An electrode lead may comprise a flexible circuit that includes a planar dielectric substrate including an elongated lead substrate portion having opposing ends, an electrode carrying substrate portion disposed on one end of the lead substrate portion, and a connector substrate portion disposed on the other end of the lead substrate portion, wherein the lead substrate portion is pre-shaped into a three-dimensional structure. The flexible circuit may further include an electrically conductive trace extending from the connector substrate portion to the electrode carrying substrate portion, a first window formed in the connector substrate portion to expose the electrically conductive trace to form a connector pad, and a second window formed in the electrode carrying substrate portion to expose the electrically conductive trace to form an electrode pad. The electrode lead may further comprise a lead connector that incorporates the connector substrate portion.

Abstract: An electrode lead may comprise a flexible circuit that includes a planar dielectric substrate including an elongated lead substrate portion having opposing ends, an electrode carrying substrate portion disposed on one end of the lead substrate portion, and a connector substrate portion disposed on the other end of the lead substrate portion, wherein the lead substrate portion is pre-shaped into a three-dimensional structure. The flexible circuit may further include an electrically conductive trace extending from the connector substrate portion to the electrode carrying substrate portion, a first window formed in the connector substrate portion to expose the electrically conductive trace to form a connector pad, and a second window formed in the electrode carrying substrate portion to expose the electrically conductive trace to form an electrode pad. The electrode lead may further comprise a lead connector that incorporates the connector substrate portion.

Abstract: A method comprising: at a training stage, training a machine learning algorithm on a training set comprising: (i) Heart Rate Variability (HRV) parameters extracted from temporal beat activity samples, wherein at least some of said samples include a representation of a Ventricular Fibrillation (VF) event, (ii) labels associated with one of: a first period of time immediately preceding a VF event in a temporal beat activity sample, a second period of time immediately preceding the first period of time in a temporal beat activity sample, and all other periods of time in a temporal beat activity sample; at an inference stage, receiving, as input, a target HRV parameters representing temporal beat activity in a subject; and applying said machine learning algorithm to said target HRV parameters, to predict an onset time of a VF event in said subject.

Abstract: An intramuscular stimulation needling device for chronic pain relief. The needling device can include a stepper motor, a needle, and a control unit. The needle can poke an affected muscle tissue and driven by a stepper motor in reciprocating manner. In each cycle, the needle moves a pre-determined distance forwardly in a first half cycle and retracts to original position in a second half cycle. The control unit can accelerate of the needle one or more times in the first half cycle at spaced intervals and decrease the velocity in the reverse pattern in the second half cycle.

Abstract: In embodiments, a wearable cardioverter defibrillator (WCD) system includes a support structure for wearing by an ambulatory patient. When worn, the support structure maintains electrodes on the patient's body. Different pairs of these electrodes define different channels, and different patient ECG signals can be sensed from the channels. The ECG signals can be analyzed to determine which one is the best to use, for the WCD system to make a shock/no shock decision. The analysis can be according to widths of the QRS complexes, consistency of the QRS complexes, or heart rate agreement statistics.

Abstract: A magnet arrangement for a hearing implant device is described. A magnet case is contained within an implantable device and has a central case axis of symmetry that is perpendicular to the outermost surface of the implantable device. The magnet case is configured to be freely rotatable within the implantable device about the case axis of symmetry. An implant magnet is contained within the magnet case and consists of a single cylindrical magnet having a central magnet axis of symmetry perpendicular to the case axis of symmetry. The implant magnet is configured to be freely rotatable within the magnet case about the magnet axis of symmetry.

Abstract: Apparatus for securing a therapy delivery device relative to a burr hole and method for making same. In one embodiment, the apparatus includes a base for seating in or near the burr hole. The apparatus may further include a stabilizer that may be engaged with the therapy delivery device. The stabilizer may include a surface coating or treatment operable to enhance frictional engagement with the therapy delivery device.

Abstract: Implantable medical systems enter an exposure mode of operation, either manually via a down linked programming instruction or by automatic detection by the implantable system of exposure to a magnetic disturbance. A controller then determines the appropriate exposure mode by considering various pieces of information including the device type including whether the device has defibrillation capability, pre-exposure mode of therapy including which chambers have been paced, and pre-exposure cardiac activity that is either intrinsic or paced rates. Additional considerations may include determining whether a sensed rate during the exposure mode is physiologic or artificially produced by the magnetic disturbance. When the sensed rate is physiologic, then the controller uses the sensed rate to trigger pacing and otherwise uses asynchronous pacing at a fixed rate.

Abstract: In some examples, a tether head assembly of a delivery system includes an inner retainer and an outer retainer that defines an aperture comprising a receptacle configured to receive an attachment member of a medical device, a passageway, and a groove. The inner retainer is movable within the groove between a second position in which the passageway is dimensioned to receive the attachment member and a first position in which the passageway is dimensioned to prevent passage of the attachment member. In some examples, a tether handle assembly defines a channel, a force transmitter within the channel, a slidable member partially received within a first end of the channel and a button partially received within a second end of the channel. Distally-directed force applied to the button may cause the force transmitter to apply proximally-directed force to the slidable member, moving the slidable member and an attached pull wire proximally.

Abstract: A system is provided that includes a first electrode configured to be located within a septal wall, and a second electrode configured to be located outside of the septal wall. The system also includes an impedance circuit configured to measure impedance along an impedance monitoring (IM) vector between the first and second electrodes. One or more processors are also provided that are configured to obtain impedance data indicative of an impedance along the IM vector with the first electrode located at different depths within the septal wall, the impedance data including a set of data values associated with different depths of the first electrode within the septal wall. The one or more processors are also configured to determine when the first electrode is located at a target depth within the septal wall based on the impedance data.

Abstract: A method for characterizing atrial fibrillation includes determining, by a processor of a computing device and based on heart data, an earliest activation time of a heart being monitored. The method also includes determining, by the processor and based on the heart data, a latest activation time of the heart. The method also includes modeling, by the processor, the earliest activation time and the latest activation time within one or more activation time maps. The method further includes identifying, by the processor, an atrial fibrillation driver based at least in part on the one or more activation time maps.