Abstract: The present disclosure is directed to a shuttle apparatus for detachably joining a catheter to a guidewire so that the joined catheter, extending alongside the guidewire, is in sliding engagement with the guidewire without extending around the guidewire. The apparatus comprises a collar member sized for mounting in sliding engagement around a length of the guidewire, the collar member having a longitudinal axis that approximately aligns along the length, when mounted thereabout, the length being defined between a proximal-most point of the guidewire and a distal point of the guidewire, the distal point being offset proximally from a distal-most point of the guidewire. The apparatus further comprises a plug member coupled to the collar member, the plug member having a longitudinal axis, and the plug member being sized to fit within an opening of the catheter for detachable engagement therewith.

Abstract: Devices, systems, and methods for reverse irrigation of an ablation or treatment site. In one embodiment, a reverse irrigation device comprises at least one ablation electrode and at least one reverse irrigation port, the at least one reverse irrigation port being located at at least one of immediately proximate the at least one ablation electrode and on the at least one ablation electrode, the at least one reverse irrigation port being configured to be in fluid communication with a fluid removal component. A medical system may include an ablation system and a reverse irrigation system that are configured to operate synchronously such that the reverse irrigation system is activated to remove fluid from the ablation site during a period of time during which the ablation system is activated to deliver ablation energy through the at least one ablation electrode to the ablation site.

Abstract: Magnetic-based electronic valve readers for determining a location and orientation of magnets coupled to implantable medical devices to determine a setting of the device (e.g., setting of a fluid flow control valve of the medical device). The electronic valve readers include an orientation sensing mechanism that is provided and configured to enable the electronic valve reader to: 1) allow for internal offset calculation of an orientation change of the electronic valve reader during a reading process; and/or 2) during the reading process, provide an indication or warning to the clinician that the orientation of the electronic valve reader has changed to an extent at or exceeding a predetermined angular acceptance threshold or window. Systems including the disclosed electronic valve readers and methods of reading a setting of the device are also disclosed.

Abstract: Methods, systems, and devices for wireless signal transmission are described. A fractal antenna may be utilized to wirelessly communicate with a transmitter implanted within or located external to the patient. The fractal antenna may be implanted within the patient and may be coupled with a lead also implanted within the patient. The characteristics of the fractal antenna may allow for enhanced data transmission between the antenna and the transmitter while reducing the need for implanted wires to connect the transmitter and leads.

Abstract: In some examples, electrical stimulation is delivered to a patient such that selective termination of the stimulation causes a therapeutic effect in the patient after termination of the electrical stimulation to the patient. The electrical stimulation may be insufficient to produce a desired therapeutic effect in the patient during stimulation, but sufficient to induce a post-stimulation desired therapeutic effect following termination of the stimulation. In some examples, the electrical stimulation may be sub-threshold electrical stimulation. In some examples, the desired therapeutic effect may alleviate bladder dysfunction, bowel dysfunction, or other disorders. The stimulation may be selectively terminated in response to one or more therapy trigger events to induce the post-stimulation therapeutic effect.

Abstract: Devices, systems, and techniques are described for selecting an evoked compound action potential (ECAP) growth curve based on a posture of a patient. The ECAP growth curve defines a relationship between a parameter defining delivery of stimulation pulses delivered to the patient and a parameter of an ECAP signal of a nerve of a patient elicited by a stimulation pulse. In one example, a medical device detects a posture of a patient and selects an ECAP growth curve corresponding to the detected posture. The medical device selects, based on the ECAP growth curve corresponding to the detected posture and a characteristic of a detected ECAP signal, a value for a parameter for defining delivery of the stimulation pulses to the patient and controls delivery of the stimulation pulses according to the selected value for the parameter.

Abstract: In one example, a medical device includes a housing having a channel configured to receive an electrical lead. The medical device can further have a rotatable member having a longitudinal axis about which the rotatable member is configured to rotate. The rotatable member can have an outer surface having a first radius from the longitudinal axis. The rotatable member can also have a cam lobe extending farther from the longitudinal axis than the first radius of the outer surface. The cam lobe can have a substantially planar surface parallel to the longitudinal axis. The substantially planar surface of the cam lobe can be configured to retain the electrical lead within the channel. The medical device can further have a slider having a central portion substantially parallel with the cam lobe. The slider can further have a slider protrusion on the central portion of the slider.

Abstract: Programming a stimulator device to deliver a stimulation therapy at high-density parameter settings using a cathode-minimized electrode configuration determined to induce paresthesia over a patient pain pattern at low-density parameter settings.

Abstract: An electrosurgical system includes a radiofrequency (RF) generator having a controller configured to detect an occurrence of a vaporization point of target tissue and a vaporization duration between commencement of delivery of the RF energy and the occurrence of the vaporization point. The controller can apply the vaporization duration to adjust a parameter during subsequent electrode activation, such as RF power level, an electrode activation sequence, a distance between activated electrodes, and a number of activated electrodes. The controller can apply the vaporization duration to determine if whether a predetermined depth of effect has been reached for use in subsequent parameter adjustments.

Abstract: A bipolar electrosurgical device is disclosed that operates in a mechanical cutting mode and a hemostasis mode. The device includes a housing and a blade assembly extending from the housing. The blade assembly forms a cutting tip and cutting window at a distal end region to provide mechanical cutting of tissue and first and second electrode assemblies to provide electrical energy to tissue. The first electrode assembly includes an outer shaft defining a first electrode surface and the second electrode assembly includes an electrode body extending along and electrically isolated from an outer shaft and defining a U-shape in cross section.

Abstract: A system for treating obstructive sleep apnea (OSA) is described. The system may include a locking device having a size and shape selected to couple to skin along a jaw of a patient. The locking device may be configured to receive at least one of a needle or an introducer for insertion into a tongue of the patient for lead placement of a lead for OSA treatment, and lock at least a portion of the at least one of the needle or introducer in place to reduce movement of the needle or introducer within the tongue.

Abstract: In some examples, a tool for, e.g., creating a sub-sternal tunnel in a patient or other use, is described. The tool may include a handle and a tunneling shaft coupled to the handle. The tunneling shaft extends from a proximal end to a distal end, and at least a portion of the tunneling shaft extends in a curved orientation between the first end to the distal end. The distal end of the tunneling shaft includes a cutting tool having a sharp edge. The cutting tool is moveable from a recessed position in which the sharp edge of the cutting tool is recessed into the distal end of the tunneling shaft to a deployed position in which the sharp edge of the cutting tool extends beyond the distal end of the tunneling shaft in the deployed position, e.g., to cut pericardium, scar tissue, and/or connective tissue with the sharp edge.

Abstract: A method and medical device for adjusting a blanking period that includes sensing cardiac signals from a plurality of electrodes, the plurality of electrodes forming a plurality of sensing vectors, determining whether to adjust a blanking period during a first operating state, advancing from the first operating state to a second operating state in response to the sensed cardiac signals, determining, while in the second operating state, whether the blanking period was adjusted while in the first operating state, and adjusting the blanking period while in the second operating state in response to the blanking period being adjusted while in the first operating state.

Abstract: A medical delivery device for delivering a medical device includes a navigable elongated member, a deployment bay, and a compression mechanism. The deployment bay may be configured to house the medical device as the medical device is navigated to the target site. The deployment bay may be at a distal end of the delivery device and may include a distal opening through which the medical device may be deployed. The compression mechanism is configured to longitudinally compress in response to a predetermined force such that the elongated member and deployment bay are relatively closer together along a longitudinal axis of the delivery device.

Abstract: This invention pertains to systems and components useful for infusing medications such as insulin. Typically, the components are used to deliver insulin to a diabetic patient at a site of infusion over a period of time greater than 4 days. The system components typically comprise a cannula adapted for subcutaneous insertion into a diabetic patient. The system further comprises a fluid conduit adapted to deliver the insulin solution from a medication reservoir to the site of infusion and a depot in operable contact with the fluid conduit. The depot comprises selected materials including a site-loss mitigating agent (such as heparin) which inhibits inflammation at the site of infusion, and encapsulation of the cannula at the site of infusion. The site-loss mitigating agent is not premixed with the insulin, and instead is adapted to contact the insulin solution in the depot as the insulin solution flows from the medication reservoir to the site of infusion.

Abstract: An implantable medical lead for sacral modulation therapy is disclosed. The implantable medical lead includes a lead body having a distal portion. An electrode is electrically coupled to the lead body and configured to generate a stimulation field or to sense electrical fields. A fixation mechanism is coupled to the distal portion. The fixation mechanism is configured to anchor the implantable medical lead against an interior wall of a blood vessel. The electrode can effect the stimulation field from within the vessel to stimulate a selected sacral nerve or sense electrical signals such as muscle or nerve responses. Guided implantation of the medical lead or other medical leads through the body to a nerve of interest for neurostimulation via remote sensor is also disclosed.

Abstract: A method and implantable medical device system for delivering a cardiac pacing therapy that includes suspending delivery of the LV cardiac pacing therapy and sensing far-field cardiac signals via one or more far-field sensing vectors formed between a plurality of electrodes positioned on a single-pass coronary sinus lead. Far-field signal features are determined in response to the sensed far-field cardiac signals, a first offset interval and a second offset interval are determined in response to the determined far-field signal features, and an AV delay of the LV cardiac pacing therapy is adjusted in response to the determined first offset interval and second offset interval. Delivery of the LV cardiac pacing therapy having the adjusted AV delay is subsequently resumed.

Abstract: The techniques of this disclosure generally relate to an assembly including a single branch stent device and a modular stent device configured to be coupled to the single branch stent device. The single branch stent device includes a main body and a branch coupling extending radially from the main body. The modular stent device includes a main body configured to be coupled inside of the main body of the single branch stent device, a bypass gate extending distally from a distal end of the main body of the modular stent device, and an artery leg extending distally from the distal end of the main body of the modular stent device.

Abstract: Infusion systems, infusion devices, and related operating methods are provided. An exemplary method of alerting a user associated with an infusion device delivering fluid to the body of the user involves obtaining a measurement value for a physiological condition being influenced by the fluid, obtaining a current amount of active fluid in the body of the user, determining a homeostasis metric based at least in part on the current amount of active fluid and the measurement value for the physiological condition, and generating an alert based at least in part on the homeostasis metric.

Abstract: A surgical bur includes a body and a drill point. The body includes flutes and lands. Each of the flutes includes a cutting edge, a rake face, and a clearance surface. Each of the lands is convex-shaped and disposed between a pair of the flutes. The drill point includes axial relief surfaces. Each of the axial relief surfaces has a planar area, is distinct from the lands and borders (i) a distal portion of one of the cutting edges, (ii) one of the lands, and (iii) one of the clearance surfaces.