Abstract: A method for delivering physiological pacing includes selecting an electrode implant site for sensing cardiac signals, which is in proximity to the heart's intrinsic conduction system, where pacing stimulation results in a rhythm breaking out at an intrinsic location, and selected in response to a ratio of sensed P-wave amplitude to sensed R-wave amplitude.

Abstract: A medical fluid delivery system is provided including a steerable, guide catheter, a delivery catheter adapted for deployment at a targeted tissue site using the steerable guide catheter, the delivery catheter including a proximal port, a distal port, and a lumen extending between the proximal and distal ports; a distal fixation element coupled to the delivery catheter so as to position the distal port adjacent the targeted tissue site; and a flexible hollow needle adapted to be advanced through the delivery catheter lumen, the flexible needle including a tissue-piercing distal tip for extending from the distal port of the delivery catheter for advancement into the targeted tissue site and a proximal end for extending from the proximal port of the delivery catheter through which a medical fluid is delivered.

Abstract: This disclosure is directed to extra, intra, and transvascular medical lead placement techniques for arranging medical leads and electrical stimulation and/or sensing electrodes proximate nerve tissue within a patient.

Abstract: An implantable medical device (IMD) may include at least two separate lead connection assemblies, each with electrical connectors for connecting implantable leads to the IMD. In some examples, a IMD may include a first therapy module configured to generate a first electrical stimulation therapy and a second therapy module configured to generate a second electrical stimulation therapy for delivery to the patient. The IMD may include a first lead connection assembly including a first electrical connector electrically coupled to the first therapy module and a second lead connection assembly including a second electrical connector electrically coupled to the second therapy module. In some examples, the first and second lead connection assemblies are distributed around the outer perimeter of the IMD housing.

Abstract: A torque wrench for implantable medical devices is disclosed. The torque wrench comprises a first and a second component. The first component has first and second ends with a bore extending between the first and second ends of the first component. The first component includes a plurality of anti-rotation members extending from an inner surface of the bore at the second end of the first component. A second component includes a middle portion having a first and second ends. A drive shaft extends from the first end and a plurality of fingers extends from an exterior surface of the second end. The second component is received in the bore of the first component such that the fingers are interdigitate with the anti-rotation members.

Abstract: A therapy or monitoring system may implement one or more techniques to mitigate interference between operation of a charging device that charges a first implantable medical device (IMD) implanted in a patient and a second IMD implanted in the patient. In some examples, the techniques may include modifying an operating parameter of the charging device in response to receiving an indication that a second IMD is implanted in the patient. The techniques also may include modifying an operating parameter of the second IMD in response to detecting the presence or operation of the charging device.

Abstract: A catheter system for positioning of an instrument within a body. The catheter system includes a hub defining a lumen therethrough for passage of the instrument and an elongate tubular member defining a lumen therethrough. The lumen of the tubular member is in communication with the lumen of the hub. The system also includes a slitter member that is coupled to the hub. The slitter member is disposed to slit the tubular member. The slitter further includes a moveable member that is moveably coupled to the hub and that is coupled to the tubular member, the moveable member is operable to advance the elongate tubular member toward the slitter member as the moveable member is moved relative to the hub. The slitter member thereby slits the elongate tubular member.

Abstract: At least one storage component, for example a capacitor or a battery, of an implantable medical device includes two perimeter surfaces. Linear extensions of the two perimeter surfaces define a zone. An electrical connector, which is coupled to the storage component and includes at least one connection point for electrically connecting the storage component with at least one other component within the medical device, is contained within the zone defined by the linear extensions of the two perimeter surfaces.

Abstract: Electrical crosstalk between two implantable medical devices or two different therapy modules of a common implantable medical device may be evaluated, and, in some examples, mitigated. In some examples, one of the implantable medical devices or therapy modules delivers electrical stimulation to a nonmyocardial tissue site or a nonvascular cardiac tissue site, and the other implantable medical device or therapy module delivers cardiac rhythm management therapy to a heart of the patient.

Abstract: An electrode for an electrochemical cell in an implantable medical device is presented. The electrode comprises a current collector with electrode material disposed thereon. The current collector includes an asymmetric aperture pattern that uniformly dissipates heat during current flow through the current collector.

Abstract: A medical electrical lead that includes a lead body having a lead body lumen, an electrode head assembly fixedly engaged with the lead body and having an electrode head assembly lumen communicating with the lead body lumen, and a conductor extending within the lead body lumen and the electrode head assembly lumen. An insulating member extends through the electrode head assembly lumen and the lead body lumen to electrically isolate the conductor.

Abstract: An elongate medical electrical lead conductor includes a layer of hydrolytically stable polyimide formed thereover.

Abstract: Delivery of fusion pacing therapy to a later depolarizing ventricle (V2) of a heart of a patient may be timed based on the depolarization of the V2 during at least one prior cardiac cycle. In some examples, a V2 pacing pulse is delivered upon the expiration of a pacing interval that begins at detection of an atrial sense or pace event (AP/S). The pacing interval may be substantially equal to the duration of time between an AP/S and a V2 sensing event of at least one prior cardiac cycle decremented by an adjusted pre-excitation interval (PEI). In another example, the V2 pacing pulse is delivered at the expiration of a pacing interval that begins upon detection of a V2 sensing event of a prior cardiac cycle. The pacing interval may be substantially equal to a duration of time at least two subsequent V2 sensing events decremented by the adjusted PEI.

Abstract: An energy storage device includes a first conductor having a first surface and a second surface. The energy storage device also includes a second conductor and a separator assembly that encloses the first conductor and that is disposed between the first and second conductors. The separator assembly also includes a first portion that covers the first surface and a second portion that covers the second surface. The first and second portions are attached to one another, and at least one of the first and second portions includes a first sheet and a second sheet that are attached to one another. The first sheet includes a first material, and the second sheet includes a second material that is different from the first material.

Abstract: A lead connection assembly of an implantable medical device (IMD) may include at least two different types of electrical connectors. In some examples, the lead connection assembly may include first and second electrical connectors that have at least one of a different electrical contact arrangement, a different lead connection receptacle geometry or a different size than the first electrical connector. The first electrical connector may be electrically connected to a first therapy module that generates cardiac rhythm therapy that is delivered to a heart of a patient, and the second electrical connector may be electrically connected to a second therapy module that generates electrical stimulation that is delivered to a tissue site within the patient. The second electrical connector may be configured to be incompatible with a lead that delivers the cardiac rhythm therapy to the patient.

Abstract: A capacitor is presented that includes a housing, an electrode assembly, a liner, and a fill port. The liner is located between the housing and the electrode assembly. The liner includes a recessed portion. A fill port extends through the housing across from the recessed portion in the liner. A gap is formed between the recessed portion and the fill port.

Abstract: A method and system for use in selecting a cardiac pacing site includes sensors for tracking wall motion (e.g., sensors coupled to the right and left ventricular heart wall). The wall motion of one or more non-paced cardiac cycles is compared to the wall motion of one or more paced cardiac cycles to determine the effectiveness of one or more pacing sites. For example, image data may be generated to notify the user as to the effectiveness of the one or more pacing sites.

Abstract: A method for fabricating an implantable medical electrode includes roughening the electrode substrate, applying an adhesion layer, and depositing a valve metal oxide coating over the adhesion layer under conditions optimized to minimize electrode impedance and post-pulse polarization. The electrode substrate may be a variety of electrode metals or alloys including titanium, platinum, platinum-iridium, or niobium. The adhesion layer may be formed of titanium or zirconium. The valve metal oxide coating is a ruthenium oxide coating sputtered onto the adhesion layer under controlled target power, sputtering pressure, and sputter gas ratio setting optimized to minimize electrode impedance and post-pulse polarization.

Abstract: A constant current pacing apparatus and method for pacing uses, for example, H-bridge circuitry and a constant current source connected to the H-bridge circuitry.

Abstract: The present invention is directed to an interconnect for an implantable medical device. The interconnect includes a pad and a first layer introduced over the pad. At least one of the pad or the first layer comprise a negative coefficient of thermal expansion (CTE) material.