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: 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: 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 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: 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.

Abstract: Implantable medical devices (IMD), such as but not limited to leadless cardiac pacemakers (LCP), subcutaneous implantable cardioverter defibrillators (SICD), transvenous implantable cardioverter defibrillators, neuro-stimulators (NS), implantable monitors (IM), may be configured to communicate with each other. In some cases, a first IMD may transmit instructions to a second IMD. In order to improve the chances of a successfully received transmission, the first IMD may transmit the instructions several times during a particular time frame, such as during a single heartbeat. If the second IMD receives the message more than once, the second IMD recognizes that the messages were redundant and acts accordingly.

Abstract: Various aspects of the present disclosure are directed toward introducer apparatuses, systems, and methods for positioning an implantable medical device within a patient. The introducer may include a housing having a proximal opening and a distal opening and configured to position the implantable medical device adjacent the distal opening prior to ejection and an ejection rod configured to pass through the proximal opening and eject the implantable medical device from the housing through the distal opening of the housing.

Abstract: An implantable medical electrical lead connectable to an electrical header of an implantable medical device includes a lead body extending from a proximal end to a distal end, a lead terminal disposed at the proximal end of the lead body and configured to couple the lead to the electrical header, and a lead boot disposed at the lead terminal. The lead boot includes a strain relief portion and a seal portion. The strain relief portion is formed of a first elastic polymer and the seal portion is formed of a second elastic polymer. The first elastic polymer is different from the second elastic polymer.

Abstract: Systems and methods for detecting cardiac arrhythmia are discussed. An exemplary medical-device system includes an arrhythmia detector circuit that receives physiologic information, including respiration and heart beat information a patient, and determines whether a respiratory sinus arrhythmia (RSA) is present or absent using the respiration and the heart beat information. An indication of the presence or absence of RSA may be stored in a memory. The arrhythmia detector circuit can detect an AT episode using the indication of RSA.

Abstract: A neurostimulation system provides for capture verification and stimulation intensity adjustment to ensure effectiveness of vagus nerve stimulation in modulating one or more target functions in a patient. In various embodiments, stimulation is applied to the vagus nerve, and evoked responses are detected to verify that the stimulation captures the vagus nerve and to adjust one or more stimulation parameters that control the stimulation intensity.

Abstract: Systems and methods for monitoring patients with multiple chronic diseases are described. A system may include a health status monitor that receives diagnostic data including physiological signals sensed from a patient. The system may produce at least a first risk indication of the patient developing a first disease and a second risk indication of the patient developing a different second disease. The system may detect the first and second diseases from the physiological signals, and generate a composite health status indicator using the detections of the first and second diseases and the first and second risk indications. An alert of worsening health status may be generated if the composite detection score exceeds an alert threshold.

Abstract: Delivery devices, systems, and methods for delivering implantable leadless pacing devices are disclosed. An example delivery device may include an outer tubular member including a lumen extending from a proximal end to a distal end thereof and an intermediate tubular member including a lumen extending from a proximal end to a distal end thereof. A distal holding section may be coupled to the intermediate tubular member and define a cavity therein for receiving a proximal implantable leadless pacing device and a distal implantable leadless pacing device in a linear arrangement. The distal holding section may have a proximal body portion and a distal body portion. The proximal body portion may be more flexible than the distal body portion. An inner tubular member including a lumen extending from a proximal end to a distal end thereof may be slidably disposed within the lumen of the intermediate tubular member.

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.

Abstract: Embodiments herein include implantable medical devices including chemical sensors with bioerodible masking layers to allow for staged activation of the sensors. In an embodiment, an implantable medical device includes a substrate defining wells and a first chemical sensor and a second chemical sensor disposed within separate wells of the substrate. The first chemical sensor and the second chemical sensor can be configured to detect one or more analytes. The device can include a first bioerodible masking layer disposed over the second chemical sensor, sealing off the second chemical sensor. The device can further include a protective planarization layer disposed over at least one of the first chemical sensor and the second chemical sensor such that the outermost surface of the medical device over the first sensor is flush with the outermost surface of the medical device over the second sensor. Other embodiments are also included herein.

Abstract: In an example, an apparatus is described that includes an implantable housing, a heart signal sensing circuit configured to sense intrinsic electrical heart signals, a ventricular tachyarrhythmia (VT) detector circuit, operatively coupled to the heart signal sensing circuit, the detector circuit operable to detect a VT based on the sensed heart signals, a processor configured to control delivery of an anti-tachyarrhythmia pacing (ATP) therapy based on the detected VT, and an energy delivery circuit configured to deliver the ATP therapy in response to the detected VT, wherein the apparatus does not include a shock circuit capable of delivering a therapeutically-effective cardioverting or defibrillating shock.

Abstract: This document discusses, among other things, systems and methods to receive cardiac electrical information and premature ventricular contraction (PVC) information of a subject, detect atrial fibrillation (AF) of the subject using the received cardiac electrical information, and adjust AF detection using the received PVC information.

Abstract: Delivery devices, systems, and methods for delivering implantable leadless pacing devices are disclosed. An example delivery device may include an intermediate tubular member and an inner tubular member slidably disposed within a lumen of the intermediate tubular member. A distal holding section may extend distally of a distal end of the intermediate tubular member and define a cavity therein for receiving an implantable leadless pacing device. The device may be configured to enable fluid flushing of the delivery device prior to use, to remove any air from within the device as well as providing the option of fluid flow during use of the delivery device.

Abstract: Systems and methods for managing heart failure are described. The system receives physiological information including a first HS signal corresponding to paced ventricular contractions and a second HS signal corresponding to intrinsic ventricular contractions. The system detects worsening heart failure (WHF) using the received physiological information. A signal analyzer circuit can generate a paced HS metric from the first HS signal and a sensed HS metric from the second HS signal, and determine a concordance indicator between the paced and the sensed HS metrics. In response to the detected WHF, the system can use the concordance indicator to generate a therapy adjustment indicator for adjusting electrostimulation therapy, or a worsening cardiac contractility indicator indicating the detected WHF is attributed to degrading myocardial contractility.