Abstract: Systems and methods for detecting cardiac arrhythmias such as atrial tachyarrhythmia (AT) are discussed. An exemplary system includes a ventricular beat analyzer circuit to detect ventricular beats and assess ventricular activity, such as to evaluate a ventricular rate stability. The system includes an arrhythmia detector circuit to detect respective AT indications in distinct time periods using portions of received physiologic information during the distinct time periods. A control circuit can monitor the ventricular beats on a beat-by-beat basis, in response to the detected ventricular beats satisfying an instability condition, trigger AT detections during the distinct time periods and withhold AT detection in a subsequent time period if no AT is detected in the present time period. An AT characteristic may be generated using the detected AT indications. A therapy may be delivered in accordance with the AT characteristic.

Abstract: Described herein are systems and methods for classifying clinical episodes in order to more accurately generate alerts for those episodes that warrant them. In some embodiments, alerts are only generated for those episodes that are new or different from previous episodes, where the previous episodes have been found to be not significant enough to warrant an alert.

Abstract: This document discusses, among other things, systems and methods to receive physiologic information from a patient during different first and second pacing periods having respective, different first and second atrioventricular (AV) delays, determine first and second physiologic parameters using respective received physiologic information from the first and second pacing periods, and adjust the first AV delay using the determined first and second physiologic parameters, wherein the second AV delay is longer than the first AV delay.

Abstract: Systems and methods for rate-adaptive pacing are disclosed. In one illustrative embodiment, a medical device for delivering electrical stimulation to a heart may include a housing configured to be implanted on the heart or within a chamber of the heart, one or more electrodes connected to the housing, and a controller disposed within the housing. The controller may be configured to sense a first signal and determine a respiration rate based at least in part on the sensed first signal. In at least some embodiments, the controller may be further configured to adjust a rate of delivery of electrical stimulation by the medical device based at least in part on the determined respiration rate.

Abstract: Delivery devices, systems, and methods for delivering implantable leadless pacing devices are disclosed. An example delivery device may include a proximal section including a deflection mechanism for deflecting the proximal section, and a distal holding section extending distally of a distal end of the proximal section and defining a cavity therein for receiving an implantable leadless pacing device. The distal holding section may be structured to have portions that flex and bend while allowing the implantable device to be recaptured within the distal holding section.

Abstract: Various aspects of the present disclosure are directed toward apparatuses, systems, and methods that include a housing having a proximal portion including a proximal opening, distal portion including a distal opening, and an intermediate portion sized to contain a medical device; and an inserter having at least a portion comprising a greater width than at least one other portion of the inserter.

Abstract: New and alternative approaches to the monitoring of cardiac signal quality for external and/or implantable cardiac devices. In one example, signal quality is monitored continuously or in response to a triggering event or condition and, upon identification of a reduction in signal quality, a device may reconfigure its sensing state. In another example, one or more trends of signal quality are monitored by a device, either continuously or in response to a triggering event or condition, and sensing reconfiguration may be performed in response to identified trends and events. In yet another example, a device may use a looping data capture mode to track sensing data in multiple vectors while primarily relying on less than all sensing vectors to make decisions and, in response to a triggering event or condition, the looped data can be analyzed automatically, without waiting for additional data capture to reconfigure sensing upon identification of the triggering event or condition.

Abstract: An apparatus comprises a stimulus circuit, a recharge circuit, a switch circuit, and a control circuit. The stimulus circuit provides electrical cardiac pacing stimulation to multiple combinations of a plurality of electrodes, and the electrical stimulation is selectively applied at the first electrode of the electrode combinations. The recharge circuit includes a recharge capacitor electrically coupled to the second electrode of the electrode combinations, and the switch circuit selectively enables electrode combinations for electrical coupling to the stimulus circuit and the recharge circuit. The control circuit includes a pacing activation sub-circuit that selectively initiates delivery of the electrical stimulation using multiple electrode combinations, and enables simultaneous delivery of pacing recharge energy from the recharge capacitor to the second electrode of multiple electrode combinations.

Abstract: A retention device for use with an implantable medical device (IMD) are disclosed. An illustrative retention device 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 determine an indication of contractility of a heart of a patient using received physiologic information, and to determine blood pressure information of the patient using the heart sound information and the determined indication of contractility of the heart. The system can include an assessment circuit configured to determine an indication of contractility of a heart of the patient using first heart sound (S1) information of the patient, and to determine blood pressure information of the patient using second heart sound (S2) information of the patient and the determined indication of contractility of the heart.

Abstract: Aspects of the present disclosure are directed toward apparatuses, systems, and methods that may comprise a medical device having a header, a core assembly, and a scaffold assembly. The scaffold assembly may be configured to interface with the core assembly and position and support one or more circuit component relative to one or more other circuit components.

Abstract: A ventricularly implantable medical device that includes a sensing module that is configured to detect an artifact during ventricular filling and to identify an atrial event based at least on part on the detected artifact. Control circuitry of the implantable medical device is configured to deliver a ventricular pacing therapy to a patient's heart, wherein the ventricular pacing therapy is time dependent, at least in part, on the identified atrial event.

Abstract: Catheter and implantable leadless pacing devices, systems, and methods utilizing catheters and implantable leadless pacing devices are disclosed. An example catheter system may include a holding structure extending distally from a tubular member. An implantable device, such a leadless pacing device, may be located within a cavity of the holding structure and an electrical barrier may be located within the holding structure at a location between a proximal electrode and a distal electrode of the implantable device. The electrical barrier may inhibit electrical signals of the implantable device from traveling within the holding structure between the proximal electrode and the distal electrode of the implantable device. The holding structure may include one or more electrical ports adjacent the proximal end of the holding structure and adjacent or proximal of the proximal electrode of the implantable device.

Abstract: An illustrative anchoring mechanism is provided for attachment to an implantable subcutaneous lead to facilitate anchoring at the distal tip of the lead. The anchoring mechanism is attached to an opening in a distal portion of a subcutaneous lead prior to implantation. The anchoring mechanism may be designed to avoid covering the sensing electrode of the subcutaneous lead, to prevent interference with sensing. Use of such an apparatus may reduce the number of incisions needed to perform implantation.

Abstract: This document discusses, among other things, systems and methods to fabricate and operate an implantable medical device. The implantable medical device can include a housing portion defining an interior chamber. The implantable medical device can include a circuit in the interior chamber. The implantable medical device can include a first electronic component that is not in the interior chamber. The implantable medical device can include a substrate coupled to the housing, the substrate including a first via extending through the substrate, the first via electrically coupling the first electronic component to the circuit.

Abstract: Systems and methods for reconstructing heart sounds from heart sound samples taken under a sub-optimal condition, such as at a low sampling rate, are discussed. An exemplary system receives acceleration information from a patient sensed at a first sampling rate, and generate a heart sound ensemble of portions of acceleration information over multiple cardiac cycles. The system can reconstruct a heart sound segment to have a second sampling rate, higher than the first sampling rate, using the generated heart sound ensemble. A heart sound metric can be generated using the reconstructed heart sound segment, and used for detecting a cardiac event, such as a cardiac arrhythmia episode, or a worsening heart failure event.

Abstract: An example includes a capacitor case sealed to retain electrolyte, at least one anode disposed in the capacitor case, the at least one anode comprising a sintered portion disposed on a substrate, an anode conductor coupled to the substrate in electrical communication with the sintered portion, the anode conductor sealingly extending through the capacitor case to an anode terminal disposed on the exterior of the capacitor case with the anode terminal in electrical communication with the sintered portion, a second electrode disposed in the capacitor case, a separator disposed between the second electrode and the anode and a second electrode terminal disposed on an exterior of the capacitor case and in electrical communication with the second electrode, with the anode terminal and the second electrode terminal electrically isolated from one another.

Abstract: An implantable medical device may include a plurality of electrical components connected to form operational circuitry, a canister shaped for housing the operational circuitry, and a dampening layer configured to reduce internal motion between the operational circuitry and at least one of a plurality of additional component within the canister, the dampening layer selectively disposed over the operational circuitry but not over the at least one additional component, the dampening layer providing electrical isolation to the operational circuitry, the dampening layer comprising a moldable material in direct contact with an inner surface of the canister. Methods of manufacturing such a medical device are also disclosed.

Abstract: Implantable medical devices including interconnections having strain-relief structure. The interconnections can take the form of flexible circuits. Strain relief gaps and shapes are integrated in the interconnections to relieve forces in each of three dimensions. In some examples, the region of an interconnection which couples with a component of the implantable medical device is separated by a strain relief gap from a connection to a second component and/or a location where the flex bends around a corner.

Abstract: A system includes a sensor configured to sense first and second physiological signals produced by a source; and a processing device communicatively coupled to the sensor. The processing device is configured to: receive the first and second physiological signals; determine a first value of a signal characteristic; determine a second value of the signal characteristic; access a scaling map having scaling vectors, and each scaling vector having at least one signal characteristic correction value; determine a scaled first value and a scaled second value based on a first scaling vector and a second scaling vector, respectively; and predict a physiological event based on the scaled first value of the signal characteristic and the scaled second value of the signal characteristic.