Abstract: A leadless pacing device may include a housing having a proximal end and a distal end, and a set of one or more electrodes supported by the housing. The housing may include a first portion and a second portion, with a guide wire port extending through the second portion. A guide wire lumen may extend through the second portion of the housing and the guide wire port may be located at a proximal end of the guide wire lumen. An exposed electrode may be located on a side of the housing that is opposite a side on which the guide wire port is located. The leadless pacing device may include a fixing member on the housing and extending radially from the housing. The leadless pacing device may further include a proximal member extending proximally from a proximal end of the housing. The proximal member may be elongated.

Abstract: A ventricularly implantable medical device that includes a sensing module that is configured to detect an atrial fiducial and identify an atrial contraction based at least on part on the detected atrial fiducial. Control circuitry in the implantable medical device is configured to deliver a ventricular pacing therapy to a patient's heart based at least in part on the identified atrial contraction, and can automatically switch or revert the ventricular pacing therapies on the fly.

Abstract: Systems and methods for dynamically controlling His-bundle pacing (HBP) according to an indication of a rate-related or intermittent atrioventricular (AV) block in a subject are disclosed. An exemplary medical system includes an AV conduction monitor to detect an indication of either a presence or an absence of intermittent or rate-related AV conduction disturbance using physiologic information of the subject. In the event that an intermittent or rate-related AV conduction disturbance is present, a control circuit provides a control signal to an electrostimulation circuit to deliver HBP pulses. If there is no indication of intermittent or rate-related AV conduction disturbance, or a previously detected intermittent or rate-related AV conduction disturbance has been terminated, the control circuit withholds or discontinues delivery of the HBP pulses to promote intrinsic ventricular conduction and activation.

Abstract: Systems and methods for dynamically controlling His-bundle pacing (HBP) according to an indication of a rate-related or intermittent atrioventricular (AV) block in a subject are disclosed. An exemplary medical system includes an AV conduction monitor to detect an indication of either a presence or an absence of intermittent or rate-related AV conduction disturbance using physiologic information of the subject. In the event that an intermittent or rate-related AV conduction disturbance is present, a control circuit provides a control signal to an electrostimulation circuit to deliver HBP pulses. If there is no indication of intermittent or rate-related AV conduction disturbance, or a previously detected intermittent or rate-related AV conduction disturbance has been terminated, the control circuit withholds or discontinues delivery of the HBP pulses to promote intrinsic ventricular conduction and activation.

Abstract: An electroporation ablation system for treating targeted tissue in a patient. The electroporation ablation system including an ablation catheter and an electroporation generator. The ablation catheter including a handle, a shaft having a distal end, and catheter electrodes situated at the distal end of the shaft and spatially arranged to generate electric fields in the targeted tissue in response to electrical pulses. The electroporation generator operatively coupled to the catheter electrodes and configured to deliver the electrical pulses in an irreversible electroporation pulse sequence that includes a preconditioning pulse sequence and an electroporation pulse sequence to one or more catheter electrodes. Wherein the preconditioning pulse sequence includes preconditioning electrical pulses configured to cause electrolysis near the targeted tissue and tetanizing skeletal muscle stimulation in the patient.

Abstract: A ventricularly implantable medical device that includes a sensing module that is configured to detect an artifact during ventricular filling and to identify an atrial event based at least on part on the detected artifact. Control circuitry of the implantable medical device is configured to deliver a ventricular pacing therapy to a patient's heart, wherein the ventricular pacing therapy is time dependent, at least in part, on the identified atrial event.

Abstract: An implantable leadless pacing device and delivery system may comprise an implantable leadless pacing device and a catheter configured to deliver the implantable leadless packing device to a target location. The implantable device may comprise a power source, circuitry operatively coupled to the power source, a housing at least partially enclosing the circuitry, a first electrode secured relative to and offset from a longitudinal axis of the housing and exposed exterior to the housing, and a fixation mechanism secured relative to the housing. The fixation mechanism may comprise at least one tine configured to move between an elongated delivery configuration and a curved deployed configuration and radially offset from the first electrode. The catheter may comprise a distal holding section defining a cavity configured to receive the implantable leadless pacing device.

Abstract: A medical device system has a medical device interface configured to download data from an implanted medical device. Memory stores electrode location identification rules and display definitions. Each of the display definitions correspond to possible electrode placement locations of the implanted medical device. Processing circuitry is configured to compare the downloaded data from the implanted medical device to the electrode location identification rules to identify one or more actual electrode placement locations of the possible electrode placement locations of the implanted medical device. A user output interface is in communication with the processing circuitry. The processing circuitry is configured to cause the output to display the one or more actual electrode placement locations.

Abstract: A system for ablation by electroporation including a catheter having electrodes, a display, and a controller. The controller is to generate, based on models of electric fields, graphical representations of the electric fields that can be produced using the electrodes, and overlay, on the display, the graphical representations of the electric fields and an anatomical map of a patient to aid in planning the ablation by electroporation, prior to delivering energy.

Abstract: A leadless cardiac pacemaker (LCP) that is configured for atrial placement may include a housing, two or more electrodes and a controller that is disposed within the housing and that is operably coupled to the two or more electrodes. The controller may be configured to sense activation of the atrium of the patient's heart via two or more of the electrodes and to deliver pacing therapy via two or more of the electrodes to a ventricle of the patient's heart by pacing the bundle of His in the patient's atrioventricular septum.

Abstract: A leadless pacing device may include a power supply providing a power supply voltage, a housing having a first end, a second end, and a side extending between the first end and the second end, and a set of electrodes supported by the housing and in communication with the power supply. The housing may be angled to follow a contour of a patient's heart when the housing is positioned within the coronary sinus of the patient's heart. In some cases, an angled portion of the housing may include a smooth-curve. In some cases, an angled portion of the housing may include a first portion of the housing and a second portion of the housing at an angle of less than one-hundred-eighty degrees with respect to the first portion of the housing. One or more of the electrodes may be exposed on a concave side of the angled housing.

Abstract: A medical device system has a medical device interface configured to download data from an implanted medical device. Memory stores electrode location identification rules and display definitions. Each of the display definitions correspond to possible electrode placement locations of the implanted medical device. Processing circuitry is configured to compare the downloaded data from the implanted medical device to the electrode location identification rules to identify one or more actual electrode placement locations of the possible electrode placement locations of the implanted medical device. A user output interface is in communication with the processing circuitry. The processing circuitry is configured to cause the output to display the one or more actual electrode placement locations.

Abstract: A leadless pacing device may include a housing having a proximal end and a distal end, and a set of one or more electrodes supported by the housing. The housing may include a first a distal extension extending distally from the distal end thereof. The distal extension may include a retractable and/or rotatable distal electrode. The distal electrode may be configured to be delivered to and pace at the Bundle of His. The leadless pacing device may be releasably coupled to an expandable anchor mechanism.

Abstract: Systems and methods for pacing cardiac conductive tissue are described. A medical system includes an electrostimulation circuit that may generate His-bundle pacing (HBP) pulses for delivery at or near the His bundle. In response to the delivery of the HBP pulse, the system senses a near-field cardiac activity representative of excitation of a para-Hisian myocardial tissue, and a far-field cardiac activity representative of excitation of the His bundle and a ventricle. The system classifies a tissue response to HBP into one of a plurality of capture types based on the sensed near-field and far-field cardiac activities. The system includes a control circuit to adjust one or more stimulation parameters based on the classified capture type. The electrostimulation circuit generates and delivers the HBP pulses according to the adjusted stimulation parameters to excite the His bundle.

Abstract: A leadless pacing device may include a housing having a proximal end and a distal end, and a set of one or more electrodes supported by the housing. The housing may include a first portion and a second portion, with a guide wire port extending through the second portion. A guide wire lumen may extend through the second portion of the housing and the guide wire port may be located at a proximal end of the guide wire lumen. An exposed electrode may be located on a side of the housing that is opposite a side on which the guide wire port is located. The leadless pacing device may include a fixing member on the housing and extending radially from the housing. The leadless pacing device may further include a proximal member extending proximally from a proximal end of the housing. The proximal member may be elongated.

Abstract: Systems and methods for pacing cardiac conductive tissue are described. A medical system includes electrostimulation circuit that may generate His-bundle pacing (HBP) pulses for delivery at or near the His bundle. A capture verification circuit may detect, from a far-field signal representing ventricular response to the HBP pulses, a His-bundle response representative of excitation of the His bundle directly resulting from the HBP pulses, and a myocardial response representative of excitation of the myocardium directly resulting from the HBP pulses. A control circuit may adjust one or more stimulation parameters based on the His-bundle response and myocardial response. The electrostimulation circuit may generate and deliver the HBP pulses according to the adjusted stimulation parameters to excite the His bundle.

Abstract: A ventricularly implantable medical device that includes a sensing module that is configured to gather information during a cardiac cycle and to identify a cardiac interval based at least on part on the gathered information. Control circuitry in the implantable medical device is configured to deliver a ventricular pacing therapy to a patient's heart, wherein the ventricular pacing therapy is time dependent, at least in part, on the identified cardiac interval.

Abstract: A ventricularly implantable medical device that includes a sensing module that is configured to identify a search window of time within a cardiac cycle to search for an atrial artifact. Control circuitry in the ventricular implantable medical device is configured to deliver a ventricular pacing therapy to a patient's heart, wherein the ventricular pacing therapy is time dependent, at least in part, on an atrial event identified in the search window of time.

Abstract: Systems and methods for pacing cardiac conductive tissue are described. A medical system includes an electrostimulation circuit to generate His-bundle pacing (HBP) pulses. A sensing circuit senses a physiologic signal, and detect a local His-bundle activation discrete from a pacing artifact of the HBP pulse. A control circuit verifies capture status in response to the HBP pulses. Based on the capture status, the control circuit determines one or more pacing thresholds including a selective HBP threshold representing a threshold strength to capture only the His bundle but not the local myocardium, and a non-selective HBP threshold representing a threshold strength to capture both the His bundle and the local myocardium. The electrostimulation circuit may deliver HBP pulses based on the selective and non-selective HBP thresholds.

Abstract: A leadless pacing device may include a housing having a proximal end and a distal end, and a set of one or more electrodes supported by the housing. The housing may include a first portion and a second portion, with a guide wire port extending through the second portion. A guide wire lumen may extend through the second portion of the housing and the guide wire port may be located at a proximal end of the guide wire lumen. An exposed electrode may be located on a side of the housing that is opposite a side on which the guide wire port is located. The leadless pacing device may include a fixing member on the housing and extending radially from the housing. The leadless pacing device may further include a proximal member extending proximally from a proximal end of the housing. The proximal member may be elongated.