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: 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 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: 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: 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: 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: 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.

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: 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: 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: 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: 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: 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.