Abstract: A capacitively loaded loop antenna for an implantable medical device is disclosed comprising a feed extending from a conductive surface of an implantable housing, a radiating element having a cross section larger than the feed, and a return coupling the radiating element to a conductive surface of the implantable housing. The radiating element can have a height above the top surface of the implantable housing, creating a capacitance between the radiating element and the conductive surface of the implantable housing configured to counteract the inductance of the capacitively loaded loop antenna.

Abstract: Systems and methods for detecting heart sound information from a subject's head are described. A system embodiment includes a headgear to be worn on the subject's head, and first and second sensors to sense respectively first and second physiologic signals each representing vibration, motion, or displacement conducted through patient body tissue. The sensed physiologic signals contain heart sound information. At least one of the first or the second sensor is included in the headgear, and placed at a head location to sense a physiologic signal indicative of heart sounds. The system includes a processor to generate a composite signal using the sensed first and second physiologic signals. The system may generate a heart sound metric using the composite signal, and detect a cardiac event such as an arrhythmia or worsening heart failure.

Abstract: Systems and methods to determine a composite respiration phase of a patient are disclosed, including a signal receiver circuit to receive first and second physiologic information of a patient, and an assessment circuit to determine first respiration phase information of the first physiologic information and to determine the composite respiration phase of the patient using the determined first respiration phase information and the second physiologic information.

Abstract: Systems and methods for detecting an arrhythmic event and storing physiological information associated with the detected arrhythmic event are described. A system may include a first detector to detect an arrhythmic event from a physiological signal sensed from a subject, and generate a confidence indicator indicating a confidence level of the detection of the arrhythmic event. If the confidence indicator indicates a relatively high confidence of arrhythmia detection, the system may provide the detected arrhythmic event to a first process for storing the detected arrhythmic event or generating an alert. If the confidence indicator indicates a relatively low confidence of arrhythmia detection, the system may provide the detected arrhythmic event to at least a second process including confirming or rejecting the detected arrhythmic event.

Abstract: Systems and methods for monitoring patients for risk of worsening heart failure (WHF) are discussed. A patient management system includes a sensor circuit to receive respiration measurements, and an input device to receive patient dyspnea descriptor indicating dyspnea symptom severity. The system includes a risk analyzer circuit to trend the respiration measurement over time, and to generate a WHF risk indicator using both the trended respiration measurement and the received dyspnea descriptor. A control circuit controls the receiver circuit to receive the dyspnea descriptor in response to the trended respiration measurement satisfying a specific condition. The system can present the WHF risk indicator to a user or a process, or deliver or adjust a HF therapy based on the WHF risk indicator.

Abstract: A leadless pacing device may include a housing having a proximal end and a distal end, and one or more electrodes supported by the housing. The housing may include a body portion and a header. A distal extension may extend distally from the header of the housing, the distal extension including one or more electrodes. The header may include a guide wire port and a guide wire lumen may extend from the guide wire port through the header of the housing and through the distal extension. A fixation member may extend from the header of the housing. The header may be formed from an over mold process.

Abstract: Systems and methods for classifying a cardiac arrhythmia are discussed. An exemplary system includes a correlator circuit to generate autocorrelation sequences using information of cardiac activity of a subject, including signal segments taken from a cardiac signal at respective elapsed time with respect to reference time. The correlator circuit can generate a correlation image using the autocorrelation sequences. The correlation image may be constructed by stacking the autocorrelation sequences according to the elapsed time of signal segments. An arrhythmia classifier circuit can classify the cardiac activity of the subject as one of arrhythmia types using the correlation image.

Abstract: A ventricularly implantable medical device that includes a sensing module that is configured to detect an atrial fiducial and identify an atrial contraction based at least on part on the detected atrial fiducial. Control circuitry in the implantable medical device is configured to deliver a ventricular pacing therapy to a patient's heart based at least in part on the identified atrial contraction, and can automatically switch or revert the ventricular pacing therapies on the fly.

Abstract: Systems and methods for detecting physiologic events in a patient are described herein. An embodiment of a medical system includes a memory circuit to store physiologic event episodes detected and recorded by a medical device. The system includes a control circuit to analyze the stored physiologic event episodes, and determine a presence of a target cardiac event under a plurality of detection settings. Using the determined presence of the target cardiac event from the stored physiologic event episodes, and user adjudication of the stored event episodes, the control circuit may select, from the plurality of detection settings, a detection setting to detect a subsequent target cardiac event. The control circuit may also prioritize the physiologic event episodes for storage in the memory circuit.

Abstract: A system and method for communication between an IMD and an external reader includes bringing a portion of a patient's body into contact with a device-body contact surface of an external reader. The reader transmits a first transdermal carrier wave from the contact surface into the patient's body, where the first carrier wave includes a request for communication with the IMD. The transdermal carrier waves are electrical conductive waves, optical waves, or acoustic waves. Upon detection of the first carrier wave, the IMD transmits a second transdermal carrier wave including a request for an access key from the reader and the reader replies by transmitting a third transdermal carrier wave including the access key back to the IMD. If the access key is valid, the IMD transmits information by radio frequency (RF) in an RF communication mode or a fourth transdermal carrier wave including data from the IMD.

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: A disposable pacemaker comprises a housing including a stylet port, a pulse generator printed circuit board assembly situated in the housing, and a pacing lead secured to the housing. The pacing lead includes a lumen aligned with the stylet port, such that the stylet port and the lumen of the pacing lead are configured to receive a stylet.

Abstract: A retention device for use with an implantable medical device (IMD) may comprise an elongate body including a configured to receive the lead of the IMD. The retention device may also include securing mechanisms coupled to the elongate body and configured to push against tissue of a patient. The securing mechanisms may also include linking elements coupled to the elongate body and a portion of the securing mechanisms.

Abstract: Improved devices, circuits and methods of operation in implantable stimulus systems. An implantable defibrillator may comprise a charging circuit using a transformer to store and build up energy on an HV capacitor or capacitor stack, with the HV capacitor in turn coupled to an H-bridge output circuit having low and high sides for issuing therapy. In the output current path, a current controlling circuitry is placed between the H-bridge and ground, allowing the greater flexibility in the selection of switching devices, and drivers for such devices, in the H-bridge circuit and/or enabling circuits between the H-bridge and the HV capacitor or other therapy circuit.

Abstract: This document discusses, among other things, systems and methods to detect an initial arrhythmia event indication and, after a threshold amount of detection window intervals detecting the initial arrhythmia event indication, adjust a set of arrhythmia parameters or at least one of a respective set of parameter thresholds to increase sensitivity of an extended arrhythmia event indication detection.

Abstract: Aspects of the present disclosure are directed toward apparatuses, methods, and systems comprising an introducer for facilitating subcutaneous implantation of a medical device. The introducer includes a housing, a tunneler extending from the housing, an inserter configured to move along a pathway to pass the medical device through the housing, a compartment configured to releasably hold and contain the medical device prior to the inserter moving the medical device, and a snap-feature integrally formed by the housing.

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 are described for subject rehospitalization management. In an example, multiple physiologic signals can be obtained from a subject using multiple sensors. In response to a hospitalization event, pre-hospitalization characteristics of the multiple physiologic signals can be identified. Post-hospitalization characteristics of the multiple physiologic signals can be identified, including characteristics that differ from their corresponding pre-hospitalization characteristics. Later subsequent physiologic signals can be further monitored after the hospitalization event, such as using the same multiple sensors, and subsequent physiologic signal characteristics can be identified. In an example, a heart failure diagnostic indication can be determined using information about the pre-hospitalization characteristics, the post-hospitalization characteristics, and the subsequent characteristics.

Abstract: Various aspects of the present subject matter provide an implantable medical device. In various embodiments, the device comprises a baroreflex stimulator and a controller. The baroreflex stimulator is adapted to generate a stimulation signal to stimulate a baroreflex. The controller is adapted to communicate with the baroreflex stimulator and implement a baroreflex stimulation protocol to vary an intensity of the baroreflex stimulation provided by the stimulation signal to abate baroreflex adaptation. According to various embodiments, the controller is adapted to implement the baroreflex stimulation protocol to periodically modulate the baroreflex stimulation to produce an effect that mimics an effect of pulsatile pressure. Other aspects are provided herein.

Abstract: A hospitalization management system including a heart failure analyzer that receives diagnostic data including at least sensor data representative of one or more physiological signals sensed from a hospitalized patient using one or more sensors and assesses risk of rehospitalization for the patient using the diagnostic data. The outcome of the risk assessment is used during and following the patient's hospitalization for reducing the risk of rehospitalization.