Abstract: An implantable medical device is configured determine a numerical value of a variable that is monitored by the implantable medical device and convert the numerical value to a data sequence of modulated electrical stimulation rate intervals. The implantable medical device delivers electrical stimulation pulses according to the data sequence of modulated stimulation rate intervals to cause a modulated rate of activation of excitable tissue of a patient corresponding to the modulated stimulation rate intervals. The modulated rate of activation is detectable by a rate monitor for demodulation to the numerical value of the monitored variable data value. In some examples, the implantable medical device is a pacemaker delivering cardiac pacing pulses according to modulated pacing rate intervals to cause a modulated heart rate of the patient detectable by a heart rate monitor for demodulation to the numerical value of the monitored variable.

Abstract: A system comprises processing circuitry and memory comprising program instructions that, when executed by the processing circuitry, cause the processing circuitry to: apply a first set of rules to first patient parameter data for a first determination of whether sudden cardiac arrest of a patient is detected; determine that a one or more context criteria of the first determination are satisfied; and in response to satisfaction of the context criteria, apply a second set of rules to second patient parameter data for a second determination of whether sudden cardiac arrest of the patient is detected. At least the second set of rules comprises a machine learning model, and the second patient parameter data comprises at least one patient parameter that is not included in the first patient parameter data.

Abstract: Various embodiments of a hermetic assembly and a method of forming such assembly are disclosed. The hermetic assembly includes a dielectric substrate having a first major surface and a second major surface, a patterned layer connected to the first major surface of the dielectric substrate by a laser bond, and a ferrule having a body and a flange extending from the body. The flange is welded to a welding portion of the patterned layer that is disposed between the flange and the first major surface of the dielectric substrate such that the ferrule is hermetically sealed to the dielectric substrate.

Abstract: Various embodiments of an electronic package and an implantable medical device that includes such package are disclosed. The electronic package includes a monolithic package substrate having a first major surface and a second major surface, an integrated circuit disposed in an active region of the package substrate, and a conductive via disposed through an inactive region of the package substrate and extending between the first major surface and the second major surface of the package substrate. The conductive via is separated from the active region by a portion of the inactive region of the substrate.

Abstract: An implantable medical device includes a plurality of electrodes to detect electrical activity, a motion detector to detect mechanical activity, and a controller to determine at least one electromechanical interval based on at least one of electrical activity and mechanical activity. The activity detected may be in response to delivering a pacing pulse according to an atrioventricular (AV) pacing interval using the second electrode. The electromechanical interval may be used to adjust the AV pacing interval. The electromechanical interval may be used to determine whether cardiac therapy is acceptable or whether atrial or ventricular remodeling is successful.

Abstract: An implantable medical device configured to monitor fluid in proximity to an implantable medical device for an inadvertent introduction of infusate into a pocket of tissue surrounding the implantable medical device during a refill procedure, the implantable medical device including a refillable infusate delivery system, the refillable infusate delivery system including a reservoir in fluid communication with an access port, and a conductivity sensor configured to monitor fluid in proximity to the conductivity sensor for an introduction of infusate into a pocket of tissue surrounding the implantable medical device, wherein the conductivity sensor comprises a pair of electrodes positioned on an external surface of the implantable medical device.

Abstract: Techniques for triggering the storage or transmission of cardiac electrogram (EGM) signals associated with a premature ventricular contractions (PVC) include sensing a cardiac EGM signal of a patient via a plurality of electrodes, detecting a premature ventricular contraction (PVC) within the cardiac EGM signal, determining whether PVC storage criteria is met, in response to a determination that the PVC storage criteria is met, storing a portion of the cardiac EGM signal associated with the PVC, and in response to a determination that the PVC storage criteria is not met, eschewing storing the portion of the cardiac EGM signal associated with the PVC.

Abstract: An example medical device includes a plurality of electrodes, therapy delivery circuitry, and processing circuitry configured to control the therapy delivery circuitry to deliver electrical stimulation to an intercostal nerve of a patient via at least two of the plurality of electrodes, wherein the electrical stimulation is delivered with stimulation parameters configured to suppress ventricular tachyarrhythmia of the patient, wherein the stimulation parameters comprise a stimulation frequency less than or equal to 40 hertz (Hz).

Abstract: This disclosure is directed to devices, systems, and techniques for monitoring a patient condition. In some examples, a medical device system includes a medical device comprising a set of sensors. Additionally, the medical device system includes processing circuitry configured to identify, based on at least one signal of the set of signals, a time of an event corresponding to the patient and set a time window based on the time of the event. Additionally, the processing circuitry is configured to save, to a fall risk database in a memory, a set of data including one or more signals of the set of signals so that the fall risk database may be analyzed in order to determine a fall risk score corresponding to the patient, wherein the set of data corresponds to the time window.

Abstract: Methods and systems for seamless adjustment of treatment are disclosed. A determination is made as to whether to intervene with a patient's treatment. Implanted device memory data is acquired over a pre-specified time period. Risk status is determined from the device memory data. Another external device memory data is acquired over a pre-specified time period. A determination is made as to whether to adjust treatment of the patient in response to the risk status, the data acquired from the implanted device memory and the external device memory data.

Abstract: An implantable access port including a port housing that defines a fill port cavity and includes a catheter fitting, a filter positioned within the port housing along a delivery flow pathway configured so that fluid injected into the fill port cavity passes through the filter prior to exiting through the catheter fitting, a one-way valve positioned within the port housing along an aspiration flow pathway configured to permit aspirated fluid to flow unfiltered from the catheter fitting to the fill port cavity and prevent injected fluid from flowing unfiltered from the fill port cavity to the catheter fitting, a port cover coupled to the port housing, and a pierceable septum positioned between the fill port cavity and the port cover configured to allow a needle to pierce through the pierceable septum to access the fill port cavity.

Abstract: A medical device is configured to produce a cardiac motion signal by sampling a signal produced by an axis of a motion sensor, starting a blanking period, suspending the sampling of the signal during at least a portion of the blanking period, and restarting the sampling of the signal at the sampling frequency before the blanking period has expired. The medical device may detect a cardiac event from the cardiac motion signal and generate a pacing pulse in response to detecting the cardiac event in some examples.

Abstract: An implantable medical device performs a method that includes detecting a cardiac event interval that is greater than a P-wave oversensing threshold interval. In response to detecting the cardiac event interval greater than the P-wave oversensing threshold interval, the device determines the amplitude of the sensed cardiac signal and withholds restarting a pacing interval in response to the amplitude satisfying P-wave oversensing criteria. A pacing pulse may be generated in response to the pacing interval expiring without sensing an intrinsic cardiac electrical event that is not detected as a P-wave oversensing event.

Abstract: Various embodiments of a feedthrough header assembly and a device including such assembly are disclosed. The assembly includes a header having an inner surface and an outer surface; a dielectric substrate having a first major surface and a second major surface, where the second major surface of the dielectric substrate is disposed adjacent to the inner surface of the header; and a patterned conductive layer disposed on the first major surface of the dielectric substrate, where the patterned conductive layer includes a first conductive portion and a second conductive portion electrically isolated from the first conductive portion. The assembly further includes a feedthrough pin electrically connected to the second conductive portion of the patterned conductive layer and disposed within a via that extends through the dielectric substrate and the header. The feedthrough pin extends beyond the outer surface of the header.

Abstract: A tool has an outer assembly, which includes a deployment tube, extending around, and moveable with respect to an inner assembly of the tool; the inner assembly includes a single pull wire and a distal member configured to engage an end of an implantable medical device. The deployment tube includes an articulating segment located just proximal to an enlarged distal-most portion, which contains the device and the distal member. Relatively soft and stiff sections of a composite sidewall define the articulating segment and extend alongside one another, such that, when the pull wire is actuated, the composite sidewall causes bending of the segment in two directions. A handle assembly of the tool includes a control member for the pull wire, and may further include a flushing subassembly that has a connector port located at an end of the handle assembly that is opposite a proximal port of the handle.

Abstract: A leadless neurostimulation device having a header unit including at least one primary electrode having a contact surface that defines an external surface of the leadless neurostimulation device, a housing including a secondary electrode positioned on the same side of the leadless neurostimulation device as the at least one primary electrode, and a anchor device including at least one suture point for securing the leadless neurostimulation device to patient tissue or at least one protrusion nub configured to create mechanical resistance that impedes relative movement between wherein the leadless neurostimulation device and the patient tissue when implanted, where the at least one primary electrode and the secondary electrode are configured to transmit an electrical stimulation signal therebetween to provide electrical stimulation therapy to a target nerve of a patient.

Abstract: An intracardiac ventricular pacemaker is configured to detect a ventricular diastolic event from a motion signal received by a pacemaker control circuit from a motion sensor. The control circuit starts an atrial refractory period having an expiration time set based on a time of the detection of the ventricular diastolic event. The control circuit detects an atrial systolic event from the motion signal after expiration of the atrial refractory period and controls a pulse generator of the pacemaker to deliver a pacing pulse to a ventricle of a patient's heart at a first atrioventricular pacing time interval after the atrial systolic event detection.

Abstract: Disclosed is a system for recharging a selected power source wirelessly, such as through a power transmission. The power source may be positioned within a subject and be charged wirelessly through the subject, such as tissue of the subject. A thermal transfer system is provided to transfer or transport thermal energy from a first position to a second position, such as away from the subject.

Abstract: A transcatheter heart valve delivery assembly includes a first shaft portion including a first wall surrounding a first chamber. A second shaft portion is attached to a distal end of the first shaft portion and includes a second wall surrounding a second chamber. A funnel portion is attached to a distal end of the second shaft portion and includes a funnel wall surrounding a funnel chamber. The funnel portion moves between a radially-compressed position, in which the funnel chamber includes a first diameter that is less than or equal to a diameter of the second chamber, and a radially-expanded position, in which the funnel chamber includes a second diameter that is greater than the first diameter. The funnel portion is biased into the radially-compressed position. Methods of recapturing a heart valve prosthesis are provided.

Abstract: Hemostatic springs and hemostatic seals comprising hemostatic springs facilitate introducing a surgical device into the vasculature of a patient during a surgical procedure. Each hemostatic spring comprises a radial array of spring segments positioned on a circular path about a central axis. Each hemostatic seal is configured to reduce an axial length of the hemostatic spring to constrict the radial array of spring segments to reduce a cross-sectional area of the central passage. Methods include axially inserting the surgical device into the hemostatic seal while compression from the hemostatic seal minimizes fluid leakage. Methods can further include reducing a frictional force of inserting the device into the hemostatic seal by reducing the axial compression to dilate the hemostatic spring.