Abstract: Improved devices, circuits and methods of operation in implantable stimulus systems. An implantable defibrillator may comprise an H-bridge output circuit having low and high sides, with a current controlling circuit coupled to the high side of the H-bridge output circuit and a current monitoring circuit coupled to the low side of the H-bridge output circuit. A bootstrap design or a DC isolating circuit or circuit element may be used in the current controlling circuit.

Abstract: An implantable leadless cardiac pacing device and associated retrieval features. The implantable device includes a docking member extending from the proximal end of the housing of the implantable device including a covering surrounding at least a portion of the docking member configured to facilitate retrieval of the implantable leadless cardiac pacing device.

Abstract: Various aspects of the present disclosure are directed toward apparatuses, systems, and methods that include an implantable lead having a terminal pin, a conductor member configured to rotate in response to rotation of the terminal pin and a coupler arranged within configured to interface with the conductor member and having a rear bearing surface contacting the inner wall of a housing.

Abstract: Disclosed herein is an implantable medical device including a housing, a header, a connector port, and a collet assembly. The header can be arranged with the housing. The connector port can be arranged within the header and configured to couple an implantable lead to the header. The collet assembly can be arranged within the connector port and configured to frictionally engage a portion of the implantable lead and to secure the implantable lead with the header in response to insertion of the portion of the implantable lead into the connector port.

Abstract: Systems and methods for pacing cardiac conductive tissue are described. In an embodiment, a medical system includes an electrostimulation circuit to generate pacing pulses to stimulate a His bundle or a bunch branch. A sensing circuit senses a far-field ventricular activation, determines a cardiac synchrony indicator using the far-field ventricular activation in response to His bundle or bundle branch pacing, and verifies His-bundle capture status using the determined cardiac synchrony indicator. The system can determine a pacing threshold using the capture status under different stimulation strength values. The electrostimulation circuit can deliver stimulation pulses in accordance with the determined pacing threshold.

Abstract: A capacitor case sealed to retain electrolyte; a sintered anode disposed in the capacitor case, the sintered anode having a shape wherein the sintered anode includes a mating portion; a conductor coupled to the sintered anode, the conductor sealingly extending through the capacitor case to a terminal disposed on an exterior of the capacitor case; a sintered cathode disposed in the capacitor case, the sintered cathode having a shape that mates with the mating portion of the sintered anode such that the sintered cathode matingly fits in the mating portion of the sintered anode; a separator between the sintered anode and the sintered cathode; and a second terminal disposed on the exterior of the capacitor case and in electrical communication with the sintered cathode, with the terminal and the second terminal electrically isolated from one another.

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: An example of a system for monitoring and treating respiratory distress in a patient may include signal inputs, a signal processing circuit, and a respiratory distress analyzer. The signal inputs may be configured to receive patient condition signals indicative of autonomic balance of the patient. The signal processing circuit may be configured to process the patient condition signals and to generate patient condition parameters indicative of the autonomic balance using the processed patient condition signals. The respiratory distress analyzer may be configured to determine a state of the respiratory distress using the patient condition parameters, and may include a parameter analysis circuit configured to analyze the autonomic balance of the patient and to determine the state of the respiratory distress using an outcome of the analysis.

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: 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: 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: 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: 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: 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: 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 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 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.