Abstract: The temporal correlation between a bioelectrical brain signal of a patient and patient motion data, such as a signal indicative of patient motion or a patient posture indicator, is displayed by a display device. In some examples, the patient posture indicator comprises a graphical representation of at least a portion of a body of the patient. In some examples, the temporal correlation between a bioelectrical brain signal, a signal indicative of patient motion, and a signal indicative of cardiac activity of the patient is displayed by the display device.

Abstract: Posture-responsive therapy is delivered by the medical system based on posture state input from only one of multiple posture sensors at any given time. An example implantable medical system includes a first posture sensor and a second sensor. A processor controls therapy delivery to the patient based on at least one of a patient posture state or a patient activity level determined based on input from only one of the first or second posture sensors. In some examples, one of multiple posture sensors of an implantable posture-responsive medical system is used to automatically reorient another posture sensor (of the system), which has become disoriented. The disoriented posture sensor may be automatically reoriented for one or more posture states at a time.

Abstract: A method and medical device for determining a cardiac event that includes sensing a cardiac signal, determining a predetermined number of sensed cardiac events in response to the sensed cardiac signal, determining a plurality of sensed event windows in response to the predetermined number of the sensed cardiac events, determining, for each of the plurality of sensed event windows, whether a number of paced events is less than a paced event threshold, determining whether intervals within the sensed event windows having a number of paced events less than the paced event threshold are greater than an interval threshold, determining an interval difference factor for each of the plurality of windows having intervals less than the interval threshold, and determining the cardiac event in response to the interval difference factors determined for each of the plurality of windows.

Abstract: Disclosed is a method and system for navigating an instrument relative to a patient that can be near a field distorting feature. A localizer can generate an electromagnetic field that is sensed by a tracking device to determine a location of the tracking device with the sensed electromagnetic field. The system and related method can assist in determining whether a navigation field is distorted near a tracking device of the instrument.

Abstract: Heart valve delivery systems and methods of delivering and implanting heart valves using delivery catheters are disclosed. The delivery systems can include a handle assembly which can include a first control mechanism, a second control mechanism, and a decoupling mechanism. The delivery systems can also include a delivery catheter extending from the handle assembly. The delivery catheter can include an outer shaft, which can be controlled by the first control mechanism; a prosthesis containing capsule comprising a proximal capsule portion connected to the outer shaft, and a distal capsule portion releasably coupled to the proximal capsule portion. After deploying a valve prosthesis, the capsule can be closed by activating the decoupling mechanism in the handle to rapidly close the distal and proximal capsule portions together. The delivery system can also include a centering element to guide the distal and proximal capsule portions together.

Abstract: A medical therapy system to deliver a pre-bolus volume of medicant is disclosed. The medical therapy system includes an infusion pump that has a case containing a processor, memory, a drive mechanism, a reservoir, communication hardware and a sensor system. The infusion pump further includes a global positioning system (GPS) receiver to determine GPS coordinates of the infusion pump. The GPS receiver is coupled to the processor that executes stored program instructions to provide notification for confirmation to deliver a pre-bolus volume from the reservoir when the GPS coordinates of the infusion pump are within a specified proximity of GPS coordinates of a saved location.

Abstract: Implantable cardiac systems and methods for providing substernal pacing in an ICD system are described. In one example, an implantable cardiac system comprises an ICD system and an implantable leadless pacing device (LPD) communicatively coupled to the ICD system. The ICD system includes an ICD and an implantable defibrillation lead having a proximal portion coupled to the ICD and a distal portion having a defibrillation electrode configured to deliver a defibrillation shock to a heart of the patient. The LPD includes a housing, a first electrode on the housing, a second electrode on the housing, and a pulse generator within the housing and electrically coupled to the first electrode and the second electrode. The housing of the LPD is implanted substantially within an anterior mediastinum of the patient and the pulse generator is configured to deliver pacing pulses to a heart via the first and second electrodes.

Abstract: Implant tools and techniques for implantation of a medical lead, catheter or other implantable component are provided. The implant tools and techniques are particularly useful in implanting medical electrical leads in implant locations such as substernal spaces or subcutaneous locations. The implant tools include a sheath coupled to a sealing device. The sheath includes a continuous lumen that is in fluid communication with a passage of the sealing device. The lead is advanced through the passage and the lumen for placement of the distal end of the lead at the implant location.

Abstract: The disclosure describes devices and systems for determining alternative electrode combinations and power consumption for these alternative electrode combinations. In one example, a method includes identifying a set of one or more electrodes configured to deliver electrical stimulation therapy via a lead, determining, based on the set of one or more electrodes, one or more alternative electrode combinations for delivering electrical stimulation therapy, calculating, for each of the one or more alternative electrode combinations, a respective field similarity score with respect to the set of one or more electrodes, and outputting a representation of at least one of the one or more alternative electrode combinations for selection in at least partially defining electrical stimulation therapy, the representation comprising an indication of at least one of the respective power consumption values or the respective field similarity scores.

Abstract: A device includes (i) a housing defining an interior, wherein the interior has a blood compartment, a plasma compartment, and a fluid compartment; (ii) a first filter disposed in the interior of the housing, and (iii) a second filter disposed in the interior of the housing. The first filter separates at least a portion of the blood compartment from at least a portion of the plasma compartment. The first filter is configured to allow plasma components, but not cell components, of blood to pass through the first filter from the blood compartment to the plasma compartment. The second filter separates at least a portion of the plasma compartment from at least a portion of the fluid compartment. The second filter is configured to allow fluid and small molecules, but not larger components, to pass through the second filter from the plasma compartment to the fluid compartment. The device may include a sorbent in the plasma compartment to remove or reduce the concentration of selected components of the plasma.

Abstract: An implantable medical elongated member extends between a proximal end configured to be coupled to a medical device and a distal end. The implantable elongated member includes one or more fixation elements coupled to at least a middle portion and/or a proximal portion of the elongated member in order to substantially fix a position of the elongated member to tissue at one or more intermediate points between the proximal end and the distal end of the elongated member.

Abstract: A medical apparatus includes a guidewire and a fixator catheter. The fixator catheter comprises a tubular body with a distal portion and a proximal portion, and further includes a distal opening, a fixator secured to the distal portion, and a body opening arranged between the fixator and the proximal portion. The guidewire passes through the body opening and the distal opening of the fixator catheter. The fixator is movable between a compact configuration and an expanded configuration and, in the expanded condition, is capable of anchoring the guidewire and fixator catheter in a lumen of a blood vessel.

Abstract: The degassing system can include a degassing vessel and can utilize a vacuum pump and a fluid pump located downstream of the degassing vessel to control the pressure within the degassing vessel in order to control the concentration of gases in fluid exiting the degassing system. The degassing system can further comprise sensors in communication with the pumps to control the rate of flow and pressure through the degassing system. The degassing system may be placed in a dialysate flow path to remove dissolved gases including carbon dioxide from the dialysate.

Abstract: In general, the invention is directed to a system with a fail-safe mode for remote programming of medical devices, such as implantable medical devices (IMDs). During a remote programming session, an adverse event, such as a programming session failure, may prevent proper completion of a programming or result in improper programming due to data corruption or other factors. If a programming session is not completed correctly, the IMD is susceptible to improper operation, possibly exposing a patient to delivery of unnecessary or inappropriate therapies. A fail-safe mode reduces the likelihood of improper operation following a programming session failure. The fail-safe mode defines one or more fail-safe operations designed to preserve proper operation of the IMD. In some embodiments, the fail-safe operations include notifying a person concerning the failure of the programming session, modifying programming parameters within the implantable medical device, and delivering a therapy to a patient.

Abstract: Techniques for using multiple physiological parameters to provide an early warning for worsening heart failure are described. A medical device monitors a primary diagnostic parameter that is indicative of worsening heart failure, such as intrathoracic impedance or pressure, and one or more secondary diagnostic parameters. The medical device detects worsening heart failure in the patient based on the primary diagnostic parameter when an index that is changed over time based on the primary diagnostic parameter value is outside a range of values, termed the threshold zone. When the index is within the threshold zone, the medical device detects worsening heart failure in the patient based on the one or more secondary diagnostic parameters. Upon detecting worsening heart failure, the medical device may, for example, provide an alert that enables the patient to seek medical attention before experiencing a heart failure event.

Abstract: The inventions described in this patent application include i) a torqueable introducer sheath which is useable in conjunction with a transvascular passageway forming catheter to effect precise rotational control of the catheter; ii) an anchorable guide catheter which is useable in conjunction with an intravascular imaging catheter and a transvascular passageway-forming catheter to effect precise positioning and aiming of the passageway-forming catheter; iii) a passageway forming catheter having a torqueable proximal portion to facilitate precise rotational positioning of the distal portion of the catheter; iv) a deflectable-tipped passageway forming catheter, v) various markers and other apparatus useable in conjunction with any of the passageway-forming catheters to facilitate precise positioning and aiming of the catheter, and vi) an apparatus which may be formed within a catheter to prevent a member, apparatus of flow of material from being inadvertently advanced through a lumen of the catheter.

Abstract: A system and a method are disclosed that allow for generation of a model or reconstruction of a model of a subject based upon acquired image data. The image data can be acquired in a substantially mobile system that can be moved relative to a subject to allow for image acquisition from a plurality of orientations relative to the subject. The plurality of orientations can include a first and final orientation and a predetermined path along which an image data collector or detector can move to acquire an appropriate image data set to allow for the model of construction.

Abstract: Methods and apparatus are provided for thermally-induced renal neuromodulation. Thermally-induced renal neuromodulation may be achieved via direct and/or via indirect application of thermal energy to heat or cool neural fibers that contribute to renal function, or of vascular structures that feed or perfuse the neural fibers. In some embodiments, parameters of the neural fibers, of non-target tissue, or of the thermal energy delivery element, may be monitored via one or more sensors for controlling the thermally-induced neuromodulation. In some embodiments, protective elements may be provided to reduce a degree of thermal damage induced in the non-target tissues. In some embodiments, thermally-induced renal neuromodulation is achieved via delivery of a pulsed thermal therapy.

Abstract: Disclosed are systems and methods for the performance of kidney replacement therapy having or using a dialyzer, control components, a sorbent cartridge with at least two separate flow paths, and fluid reservoirs configured to be of a weight and size suitable to be worn or carried by an individual requiring treatment. The system for performing kidney replacement therapy has a controlled compliance dialysis circuit, where a control pump controls the bi-directional movement of fluid across a dialysis membrane. The dialysis circuit and an extracorporeal circuit for circulating blood are in fluid communication through the dialysis membrane. The flux of fluid moving between the extracorporeal circuit and the dialysis circuit is modified by the rate at which the control pump is operating such that a rate of ultrafiltration and convective clearance can be controlled.