Abstract: This document discusses, among other things, systems and methods to receive physiologic information of a patient, to receive pulse pressure information from the patient different than the received physiologic information, and to determine an indication of atrial fibrillation (AF) using the received physiologic information and the received pulse pressure information.

Abstract: A medical device includes a hybrid circuitry assembly and a core circuitry support structure. The core circuitry support structure includes a frame defining a cavity configured to receive at least a portion of the hybrid circuitry assembly. An outer surface of the frame is shaped to correspond to an inside surface of a core assembly housing configured to enclose the hybrid circuitry assembly and the core circuitry support structure.

Abstract: Devices and circuits for reducing sizes of medical devices are disclosed. In one example, an implantable medical device (IMD) may include a housing, multiple electrodes outside of the housing, an energy storage device within the housing, and a circuit within the housing and connected to the energy storage device and the two or more electrodes. In some cases, the circuit may include two or more island sections, with each island section connected to at least one other island section by a ribbon section. Each island section may have two opposing major surfaces. A first island section and a second island section may be stacked within the housing such that one of the two major surfaces of the first island section faces one of the two opposing major surfaces of the second island section.

Abstract: A system and method for providing automatic setup of a remote patient care environment. Connectivity to a centralized server over a network connection is confirmed. Data reporting for a patient by one or more monitoring devices that are wirelessly connectable is induced through control provided through a user interface. Each of the devices is registered as the device attempts to establish a wireless connection and report the data conditioned on permission for access. Upon granting of the permission for access, the device is wirelessly connected and the data is subsequently received over the wireless connection.

Abstract: Implantable medical devices comprising electromagnetic interference shields which incorporate a dump resistor and various enhancements to control high voltage arcing. Included are embodiments in which a dump resistor is provided in a flexible shield having first and second conductive layers, where the resistor is provided in a layer between the conductive layers. In additional examples the design of plated through-holes is done to avoid the potential for arcing while maintaining close spacing.

Abstract: Systems and methods are provided for using information from a subject heart sound signal and information from a subject physiological pulsatile signal to identify subject systolic time intervals. An example system for identifying systolic time intervals includes a heart sound detector circuit, configured to detect a subject heart sound signal using an acoustic signal. The system can include a physiological signal sensing circuit configured to detect a physiological pulsatile signal, including at least one of a pulsatile cervical impedance signal or a pulsatile pulmonary artery pressure signal. A timing circuit can be configured to calculate a systolic time interval between a feature on the heart sound signal and a feature on the pulsatile signal. A subject physiologic diagnostic indication can be provided using information from the timing circuit about the systolic time interval.

Abstract: Various aspects relate to a device which, in various embodiments, comprises a header, a neural stimulator, a detector and a controller. The header includes at least one port to connect to at least one lead, and includes first and second channels for use to provide neural stimulation to first and second neural stimulation sites for a heart. The controller is connected to the detector and the neural stimulator to selectively deliver a therapy based on the feedback signal. A first therapy signal is delivered to the first neural stimulation site to selectively control contractility and a second therapy signal is delivered to the second neural stimulation site to selectively control one of a sinus rate and an AV conduction. Other aspects and embodiments are provided herein.

Abstract: Methods and devices detect context related to a patient when monitoring a physiological condition of the patient and/or when applying one or more modes of therapy. The context may be a patient context such as posture or an environmental context such as ambient conditions. The context may be used in various ways in relation to the physiological measurement, such as to control when the physiological measurements are made, to appropriately flag physiological measurements, to be recorded in association with the physiological measurements, and/or to correct the physiological measurements based on a reference context. A device such as a beacon transmitter is used in detecting the context and a measurement device such as an implantable cardiovascular device is used to capture the physiological measurements.

Abstract: Various aspects relate to a device which, in various embodiments, comprises a header, a neural stimulator, a detector and a controller. The header includes at least one port to connect to at least one lead, and includes first and second channels for use to provide neural stimulation to first and second neural stimulation sites for a heart. The controller is connected to the detector and the neural stimulator to selectively deliver a therapy based on the feedback signal. A first therapy signal is delivered to the first neural stimulation site to selectively control contractility and a second therapy signal is delivered to the second neural stimulation site to selectively control one of a sinus rate and an AV conduction. Other aspects and embodiments are provided herein.

Abstract: Systems and methods of acoustically interrogating a packaged medical implant such as an implantable sensor are disclosed. An illustrative system includes a sterilizable package including a package tray and a cover, a sensor module disposed within the package, and an acoustic coupling member disposed within an interior space of the package tray. An external interrogator located outside of the sealed package can be used to acoustically communicate with the sensor module.

Abstract: For a sampled signal, storing characteristic points generated based on parameters corresponding to curvature of the signal. The characteristic points include a time of occurrence of a lobe in a curvature series based on the signal and a corresponding amplitude of the signal. The characteristic points provide a compressed version of the sampled signal. The signal is reconstructed by establishing a function between a chronological sequence of characteristic points. For a repetitive signal, the stored data includes a code to indicate a time of reoccurrence of a previous cycle or data corresponding to differences between a previous cycle and a current cycle.

Abstract: A connector for connecting to an energy source such as a pulse generator for a cardiac stimulator system. The connector assembly includes a pin, at least one ring and a sleeve composed of an insulative hard polymer molded between the pin and ring such that the sleeve provides electrical insulation between the pin and ring and mechanically couples the pin and ring.

Abstract: A catheter for applying ablation energy to biological tissue having biological fluid flowing thereby includes a shaft having a distal-end region defining a tissue-contacting surface and a fluid-contacting surface. A plurality of band electrodes are positioned at the distal-end region of the shaft. A thermally conductive and non-electrically conductive surface covering, covers a portion of each of the band electrodes substantially coincident with the fluid-contacting surface. Each band electrode thereby has at least one masked portion substantially coincident with the fluid-contacting surface and at least one non-masked portion substantially coincident with the tissue-contacting surface. Ablation energy is transferred through the non-masked portion of the electrode. One or more thermal sensors are located in the non-masked portion of each of the band electrodes.

Abstract: A guide catheter employs a retractable inner sheath movably disposed within an open lumen of an outer sheath. The inner sheath includes a pre-formed distal end and an open lumen adapted to receive a payload. The inner sheath is translatable and rotatable relative to the outer sheath. The inner sheath conforms to the outer sheath shape until it is distally extended beyond the outer sheath. The outer sheath contains a steering tendon that can be used to adjustably deflect the outer sheath. The guide catheter further includes a proximally attached guide handle. A steering handle can be pivotably connected to the guide handle. The steering handle is connected to the steering tendon and can apply a tensile force to the steering tendon for adjustably deflecting the outer sheath. A catheter according to the present invention provides an improved system for locating and cannulating cardiac venous structures, particularly the coronary sinus via the right atrium.

Abstract: A tooless pulse generator to lead connection for an implantable cardiac stimulator includes first and second transversely extending slots formed in the header and intersecting the lead cavities formed therein. Fitted into the rectangular slots are first and second rectangular plates, each having an elongated hole therethrough. Leaf-type springs incorporated into the rectangular slots normally urge the two plates in opposite directions causing the apertures therein to be non-aligned. By squeezing on rubber buttons affixed to the ends of the respective plates and bonded to the header, the apertures formed through the plates can be brought into alignment, allowing the lead body and the proximal pin to be easily inserted through the aligned openings and into the connector block.