Abstract: Implantable leadless pacing devices and medical device systems including an implantable leadless pacing device are disclosed. An example implantable leadless pacing device may include a pacing capsule. The pacing capsule may include a housing. The housing may have a proximal region and a distal region. A first electrode may be disposed along the distal region. One or more anchoring members may be coupled to the distal region. The anchoring members may each include a region with a compound curve.

Abstract: Systems and methods for monitoring patient vasoactivity are discussed. An exemplary patient monitor system includes a sensor circuit configured to generate a heart sound (HS) metric using a HS signal sensed from a patient, and a vasoactivity monitor configured to monitor vasoactivity, such as degree of vasoconstriction or vasodilation, using the HS metric. The system can provide the monitored vasoactivity to a user to alert patient hemodynamic responses to vasoactive drugs, or initiate or adjust a vasoactive therapy according to the vasoactivity. The system may use the monitored vasoactivity to detect a medical condition such as worsening heart failure, pulmonary edema, or syncope.

Abstract: A connector apparatus for a medical device includes a cylindrical core of nonconductive material, a beam of conductive material, and a sleeve of conductive material. The cylindrical core includes an outside surface, an inside surface, a hollow center having a cross sectional area, and a slot opening in the cylindrical core extending from the outside surface to the inside surface. The beam is placed in the slot opening in the cylindrical core, wherein the beam reduces the cross-sectional area of the hollow center of the cylindrical core. The sleeve of conductive material is placed over the outside surface of the cylindrical core.

Abstract: A medical device includes a case and a core assembly. The core assembly includes operational circuitry enclosed within a core assembly housing. The medical device also includes a battery assembly, which includes a battery enclosed within a battery housing. The case includes the core assembly housing and the battery housing. A first electrode is coupled to, and electrically isolated from, the case; and a second electrode is electrically coupled to the case. The second electrode is electrically coupled to the operational circuitry via a sensing pathway that includes a portion of the case. The battery is electrically coupled to the operational circuitry via an energy supply pathway that includes the portion of the case.

Abstract: Embodiments of the present disclosure relate to implantable medical devices (IMDs). In an exemplary embodiment, an IMD comprises: a housing including a plurality of feedthroughs extending through the housing, a first electrode, a second electrode, and a biocompatible circuit board disposed around an outer surface of the housing. The biocompatible circuit board comprising a plurality of traces, wherein a first trace of the plurality of traces is coupled to the first electrode and a first feedthrough of the plurality of feedthroughs, and a second trace of the plurality of traces is coupled to the first electrode and a second feedthrough of the plurality of feedthroughs.

Abstract: Various aspects of the present subject matter provide an implantable medical device. In various embodiments, the device comprises a pulse generator, a first monitor and a controller. The pulse generator is adapted to generate a neural stimulation signal for a neural stimulation therapy. The neural stimulation signal has at least one adjustable parameter. The first monitor is adapted to detect an undesired effect. In some embodiments, the undesired effect is myocardial infarction. The controller is adapted to respond to the first monitor and automatically adjust the at least one adjustable parameter of the neural stimulation signal to avoid the undesired effect of the neural stimulation therapy. Other aspects are provided herein.

Abstract: Embodiments of the present disclosure relate to detecting implantable medical device orientation changes. In an exemplary embodiment, a medical device having a processor, comprises an acceleration sensor and memory. The acceleration sensor is configured to generate acceleration data that comprises a plurality of acceleration measurements. The memory comprises instructions that when executed by the processor, cause the processor to: obtain the acceleration data from the acceleration sensor; and determine, based on the acceleration data, that the medical device has flipped.

Abstract: An implantable antibacterial barrier device for an elongated medical device, the elongated medical device configured to extend from a first site, through a second site, to a third site. The implantable antibacterial barrier device includes a housing configured to be disposed at the first site, a working electrode configured to be disposed at the second site, and a reference electrode configured to be disposed at the first site. The housing includes barrier circuitry. The working electrode electrically is coupled to the barrier circuitry. The reference electrode is electrically coupled to the barrier circuitry. The barrier circuitry is configured to selectively maintain the working electrode at a negative electrical potential relative to the reference electrode to form an antibacterial barrier.

Abstract: A device for the active fixation of an implantable medical lead includes a housing, a tine assembly, an electrode, and a rotatable shaft. The housing includes a proximal end for connecting to the lead and a distal end opposite the proximal end. The housing defines a housing lumen extending between the proximal end and a recess adjacent to the distal end. The tine assembly is disposed within the housing lumen and includes at least one tine configured to self-bias from a linear configuration within the housing to a curved configuration outside of the housing. The electrode assembly is disposed at the distal end of the housing and includes a plurality of electrodes. The rotatable shaft extends through the housing lumen and is configured to engage the tine assembly such that rotation of the shaft transitions the at least one tine between the linear configuration and the curved configuration.

Abstract: Some method examples may include pacing a heart with cardiac paces, sensing a physiological signal for use in detecting pace-induced phrenic nerve stimulation, performing a baseline level determination process to identify a baseline level for the sensed physiological signal, and detecting pace-induced phrenic nerve stimulation using the sensed physiological signal and the calculated baseline level. Detecting pace-induced phrenic nerve stimulation may include sampling the sensed physiological signal during each of a plurality of cardiac cycles to provide sampled signals and calculating the baseline level for the physiological signal using the sampled signals. Sampling the sensed physiological signal may include sampling the signal during a time window defined using a pace time with each of the cardiac cycles to avoid cardiac components and phrenic nerve stimulation components in the sampled signal.

Abstract: Implantable leadless pacing devices and medical device systems including an implantable leadless pacing device are disclosed. An example implantable leadless pacing device may include a pacing capsule. The pacing capsule may include a housing. The housing may have a proximal region and a distal region. A first electrode may be disposed along the distal region. One or more anchoring members may be coupled to the distal region. The anchoring members may each include a region with a compound curve.

Abstract: Systems and methods for implantable medical devices and headers are described. In an example, an implantable medical device includes a device container including an electronic module within the device container. A modular header core includes a first core module including a first bore hole portion of a first bore hole, the first bore hole portion configured to couple a first electrical component with the electronic module. A second core module includes a second bore hole portion of a second bore hole different than the first bore hole, the second bore hole portion configured to couple a second electrical component with the electronic module. The first core module is detachably engaged with the second core module. A header shell is disposed around the modular header core and attached to the device container.

Abstract: Delivery devices, systems, and methods for delivering implantable leadless pacing devices are disclosed. An example delivery device may an outer tubular member and an inner tubular member slidably disposed within the lumen of the outer tubular member. A distal holding section may extend distally of a distal end of the inner tubular member and define a cavity therein for receiving an implantable leadless pacing device. The device may further include a hub portion including at least a first hub portion affixed adjacent to the proximal end of the outer tubular member and a second hub portion affixed adjacent to the proximal end of the inner tubular member. A first locking mechanism configured to releasably couple the outer tubular member and the inner tubular member may be disposed within the hub portion.

Abstract: An implantable medical device includes a polymer substrate and at least one nanofiber. The polymer substrate includes a surface portion extending into the polymer substrate from a surface of the substrate. The at least one nanofiber includes a first portion and a second portion. The first portion is interpenetrated with the surface portion of the substrate, and mechanically fixed to the substrate. The second portion projects from the surface of the substrate.

Abstract: Systems and methods for managing medical information storage and transmission are discussed. A data management system may include a receiver circuit to receive information about a physiological event sensed from a patient, and an event prioritizer circuit to assign a priority to the received information. A control circuit may perform data reduction of the received information according to the assigned priority. Data reduction at a higher reduction rate is performed on the received information if a lower priority is assigned than if a higher priority is assigned. The system may include an output circuit to output the received information to a user or a process, or to transmit the received information to an external device, according to the assigned priority.

Abstract: This document discusses, among other things, systems and methods to determine an alert state for each of a plurality of patients using received physiologic information, determine an event rate for the plurality of patients for a specific alert state, and adjust a composite HF risk determination for the plurality of patients using the determined event rate.

Abstract: Systems and methods for assessing a patient's risk of renal dysfunction are described. A system may include sensor circuits to sense physiological signals and processors to generate signal metrics from the physiological signals. The system may generate a primary renal risk indication using a first signal metric, and a secondary renal risk indication using at least a second signal metric. The system may generate a composite renal risk indication and estimate a glomerular filtration rate or a chronic kidney disease stage using at least the primary and secondary risk indications. The composite renal risk indication, which indicative of a degree of renal dysfunction, may be presented to a clinician, or provided to a detector for detecting worsening heart failure.

Abstract: This document discusses, among other things, systems and methods to determine an indication of discharge readiness for a patient using received physiologic information of the patient corresponding to hospitalization of the patient and received physiologic information of the patient corresponding to a time after hospitalization.

Abstract: Systems and methods for assessing a cardiac arrhythmia risk of a patient, such as a risk for developing atrial fibrillation, are disclosed. An exemplary medical-device system includes an arrhythmia predictor circuit configured to receive physiologic information of a patient, and in an absence of atrial tachyarrhythmia in the patient, determine a risk of the patient developing future atrial tachyarrhythmia using the physiologic information. In accordance with the arrhythmia risk indication, the system can generate an alert, or initiate more aggressive monitoring of a patient identified as having a high atrial tachyarrhythmia risk.

Abstract: An implantable medical device includes a first component including a first material, a second component including a second material, and a fiber matrix including a plurality of fibers. The fiber matrix joins the first component to the second component. The fiber matrix includes a first a first portion connected to the first component, and a second portion connected to the second component. The first portion of the fiber matrix is interpenetrated with, and mechanically fixed to, the first material. The first portion of the fiber matrix directly contacts the first material.