Abstract: A lead delivery apparatus and a method of delivering a medical lead to an anatomic target site. The method includes inserting a hydraulic plug into an internal delivery lumen of a delivery shaft, and coupling a medical lead to the hydraulic plug. Hydraulic pressure is applied to the hydraulic plug through the delivery lumen, thereby moving the hydraulic plug toward an anatomic target site, and advancing the medical lead toward the target site.

Abstract: A controller for an implantable blood pump, includes an accelerometer configured to measure at least one from the group consisting of position and movement of the controller. Processing circuitry is configured to control operation of the implantable blood pump, the processing circuitry being in communication with the accelerometer, the processing circuitry being configured to adjust a speed of the implantable blood pump if the measured at least one from the group consisting of position and movement deviates from a respective predetermined threshold.

Abstract: A medical system configured to aid a user in locating an access port of an implantable medical device, the medical system including an implantable port comprising a medicament chamber accessible through a septum, a localizer base operably coupled to the implantable port comprising an array of electromagnetic field emitting coils, an antenna array comprising a plurality of electromagnetic field sensing coils, and a user interface adapted to display data received from the antenna array to visually depict a relative position of the antenna array relative to the localizer base.

Abstract: In some examples, a tether head assembly of a delivery system includes an inner retainer and an outer retainer that defines an aperture comprising a receptacle configured to receive an attachment member of a medical device, a passageway, and a groove. The inner retainer is movable within the groove between a second position in which the passageway is dimensioned to receive the attachment member and a first position in which the passageway is dimensioned to prevent passage of the attachment member. In some examples, a tether handle assembly defines a channel, a force transmitter within the channel, a slidable member partially received within a first end of the channel and a button partially received within a second end of the channel. Distally-directed force applied to the button may cause the force transmitter to apply proximally-directed force to the slidable member, moving the slidable member and an attached pull wire proximally.

Abstract: In some examples, a system may include a plurality of electrodes, electrical stimulation circuitry, and a controller. The controller may be configured to select one or more parameters of therapy to be delivered to a brain of a patient and to control the electrical stimulation circuitry to deliver the therapy to the brain of the patient based on the selected parameters and via a first one or more electrodes of the plurality of electrodes. The parameters may be defined based on a first plurality of electrical signals sensed at a plurality of different positions within the brain of the patient when electrical stimulation is not delivered at each of the positions and a second plurality of electrical signals sensed at each of the plurality of different positions within the brain of the patient in response to electrical stimulation delivered at each of the positions at a plurality of different intensities.

Abstract: Aspects of the disclosure relate to devices and methods for preparing an existing, implanted prosthetic aortic valve for subsequent prosthetic aortic valve implantation. To prepare the existing valve, a valve preparation device is delivered to the valve and valve leaflets are severed either via mechanical cutting or electrodes so that the leaflets cannot obstruct a blood flow path once a prosthetic valve is subsequently implanted within the valve. Similarly, in alternate embodiments, devices and methods of the disclosure can be used for preparing a native aortic valve for delivery and implantation of a prosthetic valve.

Abstract: A system including a stimulation generator configured to delivery external stimulation to control or alleviate urinary or fecal incontinence. The system may also include sense electrodes configured to sense the presence of wetness. The system may provide closed loop therapy based on the presence of wetness.

Abstract: Deep Brain Stimulation (DBS) electrodes are positioned within (or adjacent to) white matter fiber tracts in a brain of patient. The DBS electrodes may be positioned near one or more stimulation sites within the white matter fiber tracts. The stimulation sites may be selected based on the disorder of the patient. In some examples, the stimulation sites may be selected based on one or more symptoms of the patient. In some examples, additional electrodes may be positioned in another area to collect bioelectrical brain signals. The area in which the additional electrodes are placed is an area that is different from the stimulation site but is targeted by stimulation therapy provided at the stimulation site.

Abstract: A wearable garment and an arrangement of electrodes configured to measure bioelectrical signals from a patient. The dry electrodes are free from adhesives to hold the electrodes in place on the patient's skin. The arrangement of the electrodes may be configured to limit noise and facilitate accurate signal sensing from the patient even with some amount of relative movement between the electrodes and the patient's skin. The wearable garment may be controllable to change the amount of compression based on the sensed signals from the electrodes, and from other sensors. The garment may maintain a comfortable level of compression until processing circuitry detects a signal of interest, such as a cardiac arrhythmia, irregular respiration, or some other signal. The processing circuitry may cause the wearable garment to increase compression to improve the contact between the electrodes and the patient's skin and improve reception of the measured signals.

Abstract: An example device for detecting one or more parameters of a cardiac signal is disclosed herein. The device includes one or more electrodes and sensing circuitry configured to sense a cardiac signal via the one or more electrodes. The device further includes processing circuitry configured to determine a representative signal based on the cardiac signal, the representative signal having a single polarity, and determine an end of a T-wave of the cardiac signal based on an area under the representative signal.

Abstract: An example device for detecting one or more parameters of a cardiac signal is disclosed herein. The device includes one or more electrodes and sensing circuitry configured to sense a cardiac signal via the one or more electrodes. The device further includes processing circuitry configured to determine an R-wave of the cardiac signal and determine whether the R-wave is noisy. Based on the R-wave being noisy, the processing circuitry is configured to determine whether the cardiac signal around a determined T-wave is noisy. Based on the cardiac signal around the determined T-wave not being noisy, the processing circuitry is configured to determine a QT interval or a corrected QT interval based on the determined T-wave and the determined R-wave.

Abstract: Examples of implantable medical leads or implantable medical systems with implantable medical leads to be anchored to a sacrum are disclosed. The implantable medical leads include a lead body having a distal portion. A fixation mechanism is coupled to the distal portion. An electrode array is mechanically coupled to the fixation mechanism. In one example, the electrode array is directly coupled to the fixation mechanism. The electrode array is electrically coupled to the lead body and configured to generate a stimulation field. The fixation mechanism is configured to anchor the implantable medical lead to a sacrum and effect the stimulation field in a foramen of the sacrum.

Abstract: A medical device delivery system can include a dilator including a tip having a taper in a distal direction, a coupler, and a flap that radially protrudes from the tip. The flap can be configured to bend against a body lumen to cover at least a portion of the delivery system when the dilator is tracked through the body lumen. A medical device delivery system can include a dilator including a tip having a lumen and a coupler having a lumen. The coupler can be configured to securely connect to the tip such that the lumen of the tip is aligned with the lumen of the coupler to allow a guide wire to pass therethrough. Methods for loading a medical device into a delivery catheter are also disclosed.

Abstract: Techniques for facilitating communication between an implantable medical device and an external device are provided. In one example, a method comprises broadcasting, via communication circuitry of an implantable device, a first set of advertisements at a first advertising rate according to a communication protocol. The method further comprises determining that detection circuitry of the implantable device detected voltage induced by an electromagnetic field at an interface between tissue of a patient and electrodes of the implantable device and in response to the detection of voltage induced by the electromagnetic field, broadcasting, via the communication circuitry, a second set of advertisements at a second advertising rate according to the communication protocol. The second advertising rate is greater than the first advertising rate.

Abstract: A method, system and device for implanting an electrode assembly of an implantable medical device in a patient's heart. Positioning one or more radiopaque markers in a coronary sinus of the patient's heart. Positioning, by using the one or more positioned radiopaque markers as a fluoroscopic visual reference, a distal tip of a delivery catheter within a right atrium of the patient's heart so that a distal opening of a lumen of the catheter is against a septal wall of the heart at a location between the ostium of the coronary sinus and the A-V nodal area of the right atrium, and so that the tip of the catheter is generally directed toward a left ventricle of the patient's heart. Advancing the electrode assembly through the lumen of the catheter and into the septal wall.

Abstract: In some examples, an assembly for a medical device. The assembly includes a first electrode comprising a first conductive tab, and a first current collector; a second electrode including a second conductive tab, a second current collector, a third current collector, and at least one connector connecting the second current collector to the third current collector, wherein the second current collector and the third current collector are folded over each other about the at least one connector, wherein the second conductive tab is coupled to the second current collector, and wherein the third current collector is electrically coupled to second conductive tab via the at least one connector and the second current collector; and a foil package being sealed over the first conductive tab and the second conductive tab to partially enclose the first electrode and second electrode.

Abstract: An implantable medical device system is configured to generate signals representing activity of a heart of a patient; determine, based on the signals, an intrinsic delay of the heart of the patient; determine whether the intrinsic delay is indicative of a first-degree heart block being present in the heart of the patient; determine a patient-specific timing regime for conduction system pacing based on whether the intrinsic delay is indicative of the first-degree heart block being present in the heart of the patient; and administer cardiac pacing to a native conduction system of the heart of the patient based on the timing regime.

Abstract: This disclosure is directed to devices, systems, and techniques for determining an efficacy of a treatment program. For example, a medical device system includes a medical device including one or more sensors configured to generate a signal that indicates a parameter of a patient. Additionally, the medical device system includes processing circuitry configured to receive data indicative of a user selection of a reference time; determine a plurality of parameter values of the parameter based on a portion of the signal corresponding to a period of time including the reference time. Additionally, the processing circuitry is configured to identify, based on a first set of parameter values, a reference parameter value, calculate a parameter change value, and determine, based on the parameter change value, whether an improvement or a worsening of the patient has occurred responsive to a treatment administered beginning at the reference time.

Abstract: Systems and methods are described herein for determining whether cardiac conduction system pacing therapy may be beneficial and/or determining how proximal or distal a cardiac conduction system block may be using external cardiac signals. To do so, one or more left-sided metrics of electrical heterogeneity information may be generated based on left-sided surrogate cardiac electrical measured using a plurality of left external electrodes.

Abstract: A medical device system is configured to guide implantation of a pacing electrode for left bundle branch pacing. The system includes a medical device having a processor configured to receive at least one cardiac electrical signal, determine a feature of the cardiac electrical signal, compare the feature to left bundle branch signal criteria, and determine a left bundle branch signal in response to the feature meeting the left bundle branch signal criteria. The system includes a display unit configured to generate a user feedback signal indicating advancement of a pacing electrode into a left portion of a ventricular septum in response to the processor determining the left bundle branch signal.