Abstract: Implantation of a cardiac stimulus system using an illuminating catheter system, and devices for such implantation. Multiple catheter systems for allowing for selective visualization of the internal thoracic vasculature are discussed and disclosed. A multiple lumen catheter may be used to selectively direct a contrast agent to a desired portion of the thoracic vasculature which may include the internal thoracic vein(s) and/or one or more intercostal veins.

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: 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: A mobile device, having a processor, includes an accelerometer configured to generate acceleration data, the acceleration data including a plurality of acceleration measurements. The mobile device also includes a memory having embodied thereon computer-executable instructions that are configured to, when executed by the processor, cause the processor to: obtain the acceleration data from the accelerometer; and generate, based on the acceleration data, heart sound data, the heart sound data including data associated with one or more heart sounds.

Abstract: An implantable cardiac monitor (ICM) may be configured to be deployed subcutaneous, submuscular, or substernal at a position that enables the ICM to detect cardiac activity. In some cases, the ICM includes a housing that includes a body portion and a tail portion. A first electrode may be disposed adjacent a first end of the body portion, a second electrode may be disposed adjacent a second end of the body portion and a third electrode may be disposed adjacent a tail end of the tail portion. A controller may be disposed within the housing and may be operably coupled to the first electrode, the second electrode and the third electrode. The controller may be configured to select a pair of the first electrode, the second electrode and the third electrode to use for sensing cardiac electrical activity and to communicate information about the sensed activity to a second medical device.

Abstract: A leadless pacing device may include a power supply for providing a power supply voltage, a housing having a first end and a second end with 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. When leadless pacing device is disposed within a coronary sinus of a patient's heart, the housing may facilitate blood flow across the housing. The housing may include fixing members extending radially outward from the side of the housing to engage a wall of the coronary sinus and expand the coronary sinus to allow blood to flow past the housing. In some cases, the housing may have a recess along a length thereof that allows blood to flow past the housing. The recess may include a groove, a flat feature, or other feature.

Abstract: Methods and/or device facilitating and selecting among multiple modes of filtering a cardiac electrical signal, in which one filtering mode includes additional high pass filtering of low frequency signals, relative to the other filtering mode. The selection filtering modes may include comparing sensed signal amplitude to one or more thresholds, using the multiple modes of filtering. In another example, an additional high pass filter is enabled, over and above a default or baseline filtering mode, and the detected cardiac signal is monitored for indications of possible undersensing, and/or for drops in amplitude toward a threshold, and the additional high pass filter may be disabled upon finding of possible undersensing or drop in signal amplitude.

Abstract: Delivery devices, systems, and methods for delivering implantable leadless pacing devices are disclosed. An example delivery device may include a proximal section including a deflection mechanism for deflecting the proximal section, and a distal holding section extending distally of a distal end of the proximal section and defining a cavity therein for receiving an implantable leadless pacing device. The delivery device may include more than one deflection mechanism for deflecting the proximal section at multiple deflection regions. The delivery device may include more than one tubular member that are translatable relative to one another, and the one or more tubular members may include fixed curve portions. The delivery device may include an atraumatic or bumper tip at the distal end of the holding section.

Abstract: Systems and methods to determine presence of an analyte using an implantable medical device are disclosed. In an embodiment, a medical system includes an implantable medical device, a light source, an optical sensor and a processor. The implantable medical device includes an indicator tag, which is responsive to an analyte. The light source is configured to emit light onto the indicator tag, where the emitted light comprises at least one wavelength of light, and where the indicator tag emanates light, in response to the emitted light, that corresponds to whether the indicator tag is exposed the analyte. The optical sensor is configured to receive at least a portion of the emanated light, which includes at least one wavelength of light. And, the processor is configured to determine whether the indicator tag is exposed to the analyte based on the received light.

Abstract: Implantation of a cardiac stimulus system using the intercostal veins. Superior, intercostal, and inferior access methods are discussed and disclosed. Superior access may be performed by entering the brachiocephalic vein from a jugular, subclavian, or other vein, and then accessing the internal thoracic vein, traversing a portion of the internal thoracic vein and then accessing an intercostal vein therefrom. Inferior access may be accomplished inferior to the lower rib margin via the superior epigastric vein, advancing superiorly into the internal thoracic vein and then accessing an intercostal vein therefrom. Intercostal access may include creating an opening in an intercostal space between two ribs and advancing a needle using ultrasound guidance to enter the intercostal vein directly.

Abstract: Methods and systems for use of the Q-wave to R-wave interval to guide placement of a leadless cardiac pacemaker are disclosed. An implant delivery device is equipped with sensing electrodes to sense R-wave onset in a ventricle of a patient's heart to allow placement at a location of last or latest onset of the R-wave. Guidance tools are provided to assist in determination of the Q-wave to R-wave interval during implantation. For a chronic system, a cooperative approach is disclosed in which an implantable medical device and a leadless cardiac pacemaker exchange data to determine Q-wave to R-wave intervals and enhance cardiac resynchronization therapy delivery by the leadless cardiac pacemaker.

Abstract: An electrical connector for detachably connecting an electrical lead to an implantable medical device includes a conductive housing and a plurality of spring contacts. The conductive housing extends from a proximal end to a distal end. The conductive housing has an interior surface forming a hollow cylinder. The plurality of spring contacts projects from the interior surface of the conductive housing and toward the proximal end. The plurality of spring contacts is at least partially contained within the conductive housing and configured to form an electrical connection to an electrical lead inserted within the conductive housing. The conductive housing and the plurality of spring contacts are integrally formed by an additive manufacturing process such that the electrical connector is a unitary structure.

Abstract: Extraction devices for extracting chronically implanted devices such as leadless cardiac pacemakers (LCP). In some cases, the extraction devices may be configured to cut or tear through at least some of the tissue ingrowth around and/or over the chronically implanted device such that a retrieval feature on the chronically implanted device may be grasped for removal of the chronically implanted device.

Abstract: Embodiments herein relate to optoelectronic interfaces for multimode analyte sensors for use with implantable medical devices. In an embodiment, an implantable medical device is included. The implantable medical device can include a first chemical sensor including an optical excitation assembly comprising a first visible spectrum emitter, a second visible spectrum emitter, and at least one of a near-infrared (NIR) emitter and an ultraviolet emitter. The first chemical sensor can also include an optical detection assembly including a colorimetric response detector, and a photoluminescent response detector. The first chemical sensor can also include a multimode sensing element including a colorimetric response element specific for a first chemical analyte, a photoluminescent response element specific for a second chemical analyte. Other embodiments are also included herein.

Abstract: An apparatus includes a battery stack including a plurality of alternating anodes and cathodes, wherein each of the anodes is positioned between first and second separators, and wherein a tab of the anode extends out from between the first and second separators, and an edge tape extending across a top of the first and second separators.

Abstract: Methods for implanting leads in the internal thoracic vein (ITV) of a patient may include first screening the patient to determine if various screening criteria are met. The screening criteria may include rib spacing, ITV location, and ITV diameter. When a predetermined parameter of at least one of the screening criteria is met, the implantation of one or more leads extending into the ITV and to a pulse generator are completed.

Abstract: Methods and devices for testing and configuring implantable medical device systems. A first medical device and a second medical device communicate with one another using test signals configured to provide data related to the quality of the communication signal to facilitate optimization of the communication approach. Some methods may be performed during surgery to implant one of the medical devices to ensure adequate communication availability.

Abstract: Systems and methods involve an intrathoracic cardiac stimulation device operable to provide autonomous cardiac sensing and energy delivery. The cardiac stimulation device includes a housing configured for intrathoracic placement relative to a patient's heart. A fixation arrangement of the housing is configured to affix the housing at an implant location within cardiac tissue or cardiac vasculature. An electrode arrangement supported by the housing is configured to sense cardiac activity and deliver stimulation energy to the cardiac tissue or cardiac vasculature. Energy delivery circuitry in the housing is coupled to the electrode arrangement. Detection circuitry is provided in the housing and coupled to the electrode arrangement. Communications circuitry may optionally be supported by the housing. A controller in the housing coordinates delivery of energy to the cardiac tissue or cardiac vasculature in accordance with an energy delivery protocol appropriate for the implant location.

Abstract: An apparatus comprises a respiration sensing circuit configured for coupling electrically to a plurality of electrodes and for sensing a respiration signal representative of respiration of a subject; a signal processing circuit electrically coupled to the respiration sensing circuit and configured to extract a respiration parameter from a sensed respiration signal and determine a signal performance metric for the sensed respiration signal using the respiration parameter; and a control circuit. The control circuit is configured to: initiate sensing of a plurality of respiration signals using different electrode combinations of the plurality of electrodes and determining of the signal performance metric for the sensed respiration signals; and enable an electrode combination from the plurality of electrodes and for use in monitoring respiration of the subject according to the signal performance metric.

Abstract: A system may include a leadless cardiac pacing device including a body, a proximal hub, and a helical fixation member opposite the proximal hub; and a first elongate shaft having a lumen extending from a distal end of the elongate shaft proximally into the elongate shaft and a transverse member extending transversely across the lumen. The proximal hub may include a transverse channel extending into the proximal hub, the transverse channel being configured to engage the transverse member.