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: 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: 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: 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: 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: 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.

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: Embodiments of the present disclosure relate to heart sound measurements using mobile devices. In an embodiment, a medical system for monitoring heart sounds of a subject comprises a medical device configured to obtain, during a first sampling interval, a first physiological signal. The medical system further comprises a mobile device comprising an accelerator, wherein the accelerator is configured to obtain, during a second sampling interval, a second physiological signal. And, the medical system comprises an analysis component configured to extract heart sounds data from the second physiological signal.

Abstract: Systems and methods for treating a medical condition such as worsening heart failure (WHF) are described. A medical system may sense one or more physiological signals, and generate from the sensed physiological signals a signal metric trend indicating a progression of heart failure. A detector may detect a physiological event leading to WHF. A therapy control circuit may generate a therapy titration protocol using the generated signal metric trend. The therapy titration protocol includes a temporal profile of therapy dosage relative to a target dosage. The therapy control circuit may adjust the target dosage based on patient response. Therapies may be administered by a clinician or automatically delivered to the patient according to the therapy titration protocol.

Abstract: Systems and methods for monitoring patients with a chronic disease are described. A patient management system may sense physiological signals from a patient using one or more implantable or other ambulatory sensors, and generate from the physiological signals a chronobiological rhythm indicator (CRI) such as indicating a circadian rhythm. A reference CRI associated with a prior hospital admission event of the patient may be provided to the patient management system, which compares the CRI to the reference CRI and generates a readmission risk score indicating the patient's risk of subsequent hospital readmission due to a worsened condition of the chronic disease. The readmission risk score may be provided to a user or a process, or used to initiate or adjust a therapy delivered to the patient.

Abstract: Implantable devices and systems include one or more leads adapted to be emplaced in the internal thoracic vein (ITV) of a patient. The lead may include features to adapt the lead for such placement. An associated device for use with the lead may include operational circuitry adapted for use with a lead having an electrode for sensing and/or therapy purposes coupled thereto. Methods for implantation and use of such devices and systems are disclosed as well.

Abstract: Embodiments herein relate to sensor based authentication between an implantable medical device (IMD) and an external device. In an embodiment, the IMD includes a wireless communication module and an internal inertial measurement unit (IMU) capable of measuring vibrations, movement, or rotation. The IMD is configured to record an internal IMU signal from the internal IMU. The external device includes a wireless communication module and an external IMU. The external device is configured to record an external IMU signal from the external IMU. The system further includes a data processing system to receive a first level communication that can include the internal IMU signal, the external IMU signal, or both, compare data from the internal IMU signal with data from the external IMU signal, and authorize a second level communication based on results of the comparison step.

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: A medical device including a hybrid circuitry assembly, a core assembly housing having an inside surface, and a tag/getter assembly. The core assembly housing to enclose the hybrid circuitry assembly, and the tag/getter assembly to be situated adjacent the inside surface of the core assembly housing. The tag/getter assembly including an identification tag and a hydrogen getter.

Abstract: A bridge device includes a housing, a plurality of electrodes exposed outside of the housing such that at least two of the plurality of electrodes can be concurrently placed in contact with a patient's skin. A controller is disposed within the housing. A first communications module is operably coupled to the controller and to the at least two of the plurality of electrodes. The first communications module is configured to allow the controller to communicate with an implantable medical device via at least two of the plurality of electrodes using conducted communication. A second communications module is operably coupled to the controller and is configured to allow the controller to communicate with a remote device external to the patient.