Abstract: An example device includes an elongated housing, a first and second electrode, and signal generation circuitry. The housing can be implanted within a single first chamber of the heart. The first electrode extends distally from the distal end of the elongated housing. A distal end of the first electrode can penetrate into wall tissue of a second chamber of the heart. The second electrode, extending from the distal end of the elongated housing, is configured to flexibly maintain contact with the wall tissue of the first chamber without penetration of the wall tissue of the first chamber by the second electrode. Signal generation circuitry can be within the elongated housing and coupled to the first and second electrode. The signal generation circuitry can deliver cardiac pacing to the second chamber via the first electrode and the first chamber via the second electrode.

Abstract: A medical device having an elongate body with a proximal portion, a distal portion, and defining a lumen therethrough. The medical device has an expandable element coupled to the distal portion of the elongate body, the expandable element defining a proximal portion, a distal portion opposite the proximal portion and an intermediate portion disposed between the proximal portion and the distal portion. The expandable element also has an inner surface and an outer surface opposite the inner surface. The medical device has a plurality of cutting members, each cutting member being coupled with the outer surface of the expandable element, each cutting member having a proximal end and a distal end opposite the proximal end, the proximal end being proximate the proximal portion of the expandable element and the distal end being proximate to the intermediate portion of the expandable element.

Abstract: An interatrial shunting device including a tube and an anchoring assembly. The tube defines a first end opposite a second end, and a tube wall extending to and between the first and second ends. The tube wall is a solid body and defines a lumen of the tube, with the lumen being open at the first and second ends. The anchoring assembly is carried by the tube and is configured to secure the interatrial shunting device to a native atrial septum. The solid wall tube prevents tissue overgrowth across the atrial septum, and can have minimal exposure of the device in the left atrium to minimize stroke and other risks. In some examples, the anchoring assembly is configured to be self-transitionable from a delivery state to a deployed state.

Abstract: A medical device is configured to sense a cardiac electrical signal and determine from the cardiac electrical signal at least one of a maximum peak amplitude of a positive slope of the cardiac electrical signal and a maximum peak time interval from a pacing pulse to the maximum peak amplitude. The device is configured to determine a capture type of the pacing pulse based on at least one or both of the maximum peak amplitude and the maximum peak time interval.

Abstract: An implantable medical device system receives a cardiac electrical signal produced by a patient's heart and comprising atrial P-waves and delivers a His bundle pacing pulse to the patient's heart via a His pacing electrode vector. The system determines a timing of a sensed atrial P-wave relative to the His bundle pacing pulse and determines a type of capture of the His bundle pacing pulse in response to the determined timing of the atrial P-wave.

Abstract: An implantable medical device configured to deliver pacing therapy, the implantable medical device including a device body configured to position within a heart, where the device body comprises a proximal body portion and a distal body portion and defines a longitudinal axis extending through the proximal body portion and the distal body portion, the proximal body portion is configured to rotate around the longitudinal axis relative to distal body portion, and a leadlet mechanically coupled to the device body, where the leadlet mechanically supports an electrode configured to deliver pacing therapy, and where in response to the proximal body portion rotating relative to the distal body portion, the device body is configured to alter an extension length of the leadlet.

Abstract: Novel tools and techniques are provided for implementing intelligent assistance (“IA”) or extended intelligence (“EI”) ecosystem to placement procedures for cardiac implantable electronic device (“CIED”). In various embodiments, a computing system might analyze received one or more first layer input data (i.e., room content-based data) and received one or more second layer input data (i.e., patient and/or tool-based data), and might generate one or more recommendations for guiding a medical professional in performing a CIED placement procedure in a heart of the patient, based at least in part on the analysis, the generated one or more recommendations comprising 3D or 4D mapped guides toward, in, and around the heart of the patient. The computing system might then generate one or more XR images, based at least in part on the generated one or more recommendations, and might present the generated one or more XR images using a UX device.

Abstract: A medical device includes a motion sensor for producing a motion signal including cardiac event signals. The medical device generates a ventricular pacing pulse upon expiration of a pacing interval. The medical device determines a synchrony metric from the motion signal after a delivered ventricular pacing pulse and adjusts the pacing interval based on the synchrony metric.

Abstract: A pacemaker has a housing and a therapy delivery circuit enclosed by the housing for generating pacing pulses for delivery to a patient's heart. An electrically insulative distal member is coupled directly to the housing and at least one non-tissue piercing cathode electrode is coupled directly to the insulative distal member. A tissue piercing electrode extends away from the housing.

Abstract: A method for performing bronchial denervation, the method comprising an electromyography system having a cryoablation device with at least two recording electrodes. The electromyography system being configured to calculate a difference between a first electromyogram signal received from the first recording electrode and a second electromyogram signal received from the second recording electrode to generate a recorded electromyogram and compare the recorded electromyogram to a reference electromyogram.

Abstract: A pacemaker has a housing and a therapy delivery circuit enclosed by the housing for generating pacing pulses for delivery to a patient's heart. An electrically insulative distal member is coupled directly to the housing and at least one non-tissue piercing cathode electrode is coupled directly to the insulative distal member. A tissue piercing electrode extends away from the housing.

Abstract: A medical device includes a motion sensor for producing a motion signal including cardiac event signals. The medical device generates a ventricular pacing pulse upon expiration of a pacing interval. The medical device determines a synchrony metric from the motion signal after a delivered ventricular pacing pulse and adjusts the pacing interval based on the synchrony metric.

Abstract: A method of performing bronchial denervation of a bronchus having bronchial nerves along a portion thereof is provided. The method includes providing a cryoablation device having multiple electrodes capable of delivering electrical energy and measuring impedance. At least one bronchial nerve is stimulated with electrical energy. The electrical signals from the at least one bronchial nerve are recorded to provide a first value representative of nerve function. Cryogenic treatment energy is applied to form ice in the bronchus having a thickness to encapsulate the at least one bronchial nerve to cause a reduction in nerve function. The at least one bronchial nerve is restimulated with electrical energy. The electrical signals are recorded from the restimulated at least one bronchial nerve to provide a second value that represents diminished nerve function. The first value and the second value are compared to provide an assessment of the reduction in nerve function.

Abstract: VfA cardiac therapy uses an implantable medical device or system. The implantable medical device includes a tissue-piercing electrode implanted in the basal and/or septal region of the left ventricular myocardium of the patient's heart from the triangle of Koch region of the right atrium through the right atrial endocardium and central fibrous body. The device may include a right atrial electrode, a right atrial motion detector, or both. The device may be implanted completely within the patient's heart or may use one or more leads to implant electrodes in the patient's heart. The device may be used to provide cardiac therapy, including single or multiple chamber pacing, atrioventricular synchronous pacing, asynchronous pacing, triggered pacing, cardiac resynchronization pacing, or tachycardia-related therapy. A separate medical device may be used to provide some functionality for cardiac therapy, such as sensing, pacing, or shock therapy.

Abstract: A surgical method treats infections on a lead positioned at least partially within a patient's body. The surgical method includes uncoupling the lead from a pulse generator. The lead is then coupled to an ultrasound wave generator. Ultrasound waves are propagated from the ultrasound wave generator through the lead. Systems are disclosed.

Abstract: Devices, systems, and methods for treating pulmonary conditions, such as COPD and asthma, by denervating bronchial tissue using cryoablation. In one embodiment, a device for bronchial denervation comprises: an elongate body having a distal portion and a proximal portion opposite the distal portion; a treatment element at the distal portion of the elongate body; and a first recording electrode located distal to the treatment element and a second recording electrode located proximal to the treatment element, the first and second recording electrodes being configured to record electromyograms. In one embodiment, the device includes a fluid delivery element that is within the treatment element and that has a plurality of orifices aligned with an equatorial portion of the treatment element.

Abstract: A transseptal catheter delivery system includes an elongate first tubular member and an elongate second tubular member receivable within the first tubular member. The first tubular member includes an adjustable portion adjacent a distal end. The second tubular member is adapted to receive an instrument to be placed in the left ventricle, and includes a curved portion adjacent its distal end in a relaxed state. The adjustable portion is deflectable toward the atrial septum to guide a puncturing tool and/or guide insertion of the second tubular member through a septal puncture into the left atrium. Within the left atrium, the curved portion is oriented toward the left ventricle to guide insertion of a guide wire, and subsequently the second tubular member, into the left ventricle. Methods of transvenously accessing a left ventricle are also provided.

Abstract: A method includes locating the triangle of Koch region in the right atrium of a patient's heart; securing at least one electrode of an implantable lead or device to cardiac tissue from the triangle of Koch region to deliver ventricle-from-atrium (VfA) cardiac therapy; and testing the location or depth of the at least one electrode to configure VfA cardiac therapy. Locating the target implant region in the triangle of Koch region may include detecting an atrial slow pathway potential (ASP) or atrial pacing output.

Abstract: VfA cardiac therapy uses an implantable medical device or system. The implantable medical device includes a tissue-piercing electrode implanted in the basal and/or septal region of the left ventricular myocardium of the patient's heart from the triangle of Koch region of the right atrium through the right atrial endocardium and central fibrous body. The device may include a right atrial electrode, a right atrial motion detector, or both. The device may be implanted completely within the patient's heart or may use one or more leads to implant electrodes in the patient's heart. The device may be used to provide cardiac therapy, including single or multiple chamber pacing, atrioventricular synchronous pacing, asynchronous pacing, triggered pacing, cardiac resynchronization pacing, or tachycardia-related therapy. A separate medical device may be used to provide some functionality for cardiac therapy, such as sensing, pacing, or shock therapy.

Abstract: An adapter configured to electrically connect a test device to an implantable medical lead comprises a rotational electrical coupling. The rotational electrical coupling is configured to electrically connect a lead electrical connector to an adapter electrical connector. The rotational electrical coupling comprises a first conductive component configured to be electrically connected to the lead electrical connector and rotatable with a proximal portion of the implantable medical lead, and a second conductive component electrically connected to the first conductive component and the adapter electrical connector. The second conductive component may be rotationally fixed. The first and second conductive components may comprise graphite or another soft metal.