Abstract: A programming-device user interface may include multiple levels of abstraction for programming treatment settings. A stimulation zone-programming interface may be at a highest level of abstraction and may include idealized stimulation zones. A field strength-programming interface may be at a middle level of abstraction and may include electromagnetic field-strength patterns generated by the stimulation zones, and/or electrode settings, and a depiction of how the electromagnetic fields interact with each other. An electrode-programming interface may be at a lowest level of abstraction and may depict treatment settings at an electrodes-view level. These interfaces may include a display of a stimulatable area of the patient's body. The display may include a depiction of leads and/or the underlying physiology, such as a depiction of a portion of a spine. Algorithms map treatment settings from one level of abstraction to settings at one or more other levels of abstraction.

Abstract: In some examples, the present disclosure relates to an implantable medical lead and medical device systems employing such leads for medical applications, such as, e.g., neural stimulation, deep brain stimulation, and/or sensing of bioelectrical signals. In one example, the lead includes a thin film configured to be secured to at least a portion of a carrier core, wherein the thin film has a distal end, a proximal end, and at least one electrode between the proximal end and the distal end; and at least one fixation element configured to secure the distal end of the thin film to the carrier core, wherein the fixation element comprises at least one of a distal extension portion of the thin film at least partially wrapped around the carrier core distal to the at least one electrode or a jacket tube located around the carrier core and the thin film.

Abstract: A method and apparatus for determining estimated remaining longevity for an implantable stimulator. A programmer processor is employed to acquire from the implantable stimulator a signal comprising data associated with the power source in the implantable stimulator and a date in which the stimulator was implanted. The programmer processor and the data are used to determine whether a pre-recommended replacement time threshold (pre-RRT) has been attained for replacing the implantable stimulator. The programmer processor is used to select an equation in which to calculate a recommended replacement time (RRT), the equation is selected in response to determining a time period that extends from the date in which the stimulator was implanted until a date in which the pre-RRT is attained.

Abstract: A method of treating cardiac tissue is provided, including positioning a first chamber of a medical device adjacent an atrial wall; directing a cryogenic coolant into the first chamber; anchoring the first chamber to the atrial wall through cryoadhesion; directing a distal portion of the medical device into the coronary sinus; and positioning a cardiac lead through at least a portion of the coronary sinus with the distal portion. The method may include measuring a temperature of the first chamber; removing the first chamber from the atrial wall once a predetermined threshold temperature of the first chamber is reached; anchoring a second chamber of the medical device to a portion of the coronary sinus; and/or perfusing blood flow through at least a portion of the second chamber.

Abstract: A method of placing an electrical lead of an implantable cardiac device inside a heart of a patient. The method includes securing a tool to an atrial appendage of the heart to hold onto the atrial appendage, piercing the atrial appendage, and creating an aperture in the atrial appendage while holding the atrial appendage with the tool. The method also includes moving a distal end of the electrical lead into the heart through the aperture in the atrial appendage and into a ventricle of the heart. Furthermore, the method includes coupling the distal end of the electrical lead to cardiac tissue in the ventricle and delivering an electrical signal to the cardiac tissue in the ventricle of the heart to maintain a predetermined heartbeat of the heart.

Abstract: A stent is formed from a wire having an outer member, a radiopaque core member disposed within a portion of the outer member, and an annular lumen between the radiopaque core member and the outer member. A substance is disposed in the annular lumen to be eluted through at least one opening disposed through the outer member. A plurality of radiopaque core members are disposed within portions of the outer member and are separated by lumens defined by the inner surface of the outer member. The lumens and annular lumens are in fluid communication with each other. In a method for making the stent, a composite wire including an outer member, an intermediate member, and a core member is shaped into a stent pattern and processed to remove the intermediate member and portions of the radiopaque core member, without damaging the outer member.

Abstract: A system and method control a pacing parameter in a closed-loop manner by determining a value of an EGM-based index corresponding an optimal electrical activation condition of a patient's heart and adjusting a pacing therapy to maintain the EGM-based index value. The closed loop control method performed by the system may establish a relationship between an EGM-based index and multiple settings of a pacing control parameter. Values of the EGM-based index are stored with corresponding setting shifts relative to a previously established optimal setting. A processor of an implantable medical device monitors the EGM-based index during cardiac pacing. Responsive to detecting an EGM-based index value corresponding to a non-optimal setting of the control parameter, the processor determines an adjustment of the control parameter from the stored index values and corresponding setting shifts.

Abstract: A stented valve including a stent structure having a generally tubular body portion, an interior area, a longitudinal axis, an first end, an second end, and an outer surface; at least one outflow barb extending from the outer surface of the stent adjacent to the first end of the stent structure and toward the second end of the stent structure; at least one inflow barb extending from the outer surface of the stent adjacent to the second end of the stent structure and toward the first end of the stent structure; and a valve structure attached within the interior area of the stent structure.

Abstract: Devices, systems, and techniques for monitoring the temperature of a device used to charge a rechargeable power source are disclosed. Implantable medical devices may include a rechargeable power source that can be transcutaneously charged. The temperature of an external charging device and/or an implantable medical device may be monitored to control the temperature exposure to patient tissue. In one example, a temperature sensor may sense a temperature of a portion of a device, wherein the portion is non-thermally coupled to the temperature sensor. A processor may then control charging of the rechargeable power source based on the sensed temperature.

Abstract: A method for manufacturing a medical device housing includes deforming an inner surface of a shield member to produce a seam area along the inner surface. The shield member has an inner surface and an outer surface spaced apart by a shield thickness. A seam seals the inner surface seam area of the shield member to a second shield member. The shield member inner surface has a bend extending to an interior edge of the seam.

Abstract: A method for passivating a biomaterial surface includes modifying proteinaceous material disposed at the biomaterial surface. The passivation may be effectuated by exposing the biomaterial surface to therapeutic electrical energy in the presence of blood or plasma.

Abstract: Techniques and systems for determining a head position of a patient and controlling delivery of electrical stimulation to a target stimulation site based on the determined head position are described. In some examples, movement of the head of the patient may result in movement of a lead, through which the electrical stimulation may be delivered, relative to the target stimulation site. Thus, controlling delivery of the electrical stimulation based on the head position may improve the efficiency and efficacy of the electrical stimulation therapy.

Abstract: A delivery system for delivering a therapeutic agent to a patient includes a catheter, a stop feature, a container and a bar. The catheter has a proximal end and a distal end and includes a body defining a lumen that extends to the distal end of the catheter. The stop feature is in proximity to the distal end of the catheter. The container is configured to house the therapeutic agent and is insertable and slidably disposable in the lumen of the catheter. The container is also configured to engage the stop feature of the catheter. The bar is slidably disposable in the lumen of the catheter. Sliding of the bar distally in the lumen forces the therapeutic agent out of the container and out of the lumen when the container is engaged with the stop feature. The stop feature is configured to inhibit the container from exiting the lumen.

Abstract: A system and method is provided to measure intrathoracic complex impedance and to identify and indicate disease conditions based on the impedance measurements. Multiple impedance vectors may be taken into account, and an optimal vector may be selected to provide the most useful impedance measurement for the identification and indication of disease conditions.

Abstract: A dilatation or fatigue tester for a stent-graft prosthesis includes a sample holder having a compressible member that defines a chamber for receiving a stent-graft prosthesis in an expanded state, a bearing assembly disposed to contact and act on an exterior surface of the compressible member of the sample holder, and an actuation assembly operably coupled to the bearing assembly for rotating the bearing assembly relative to the sample holder. Rotation of the bearing assembly cyclically compresses the compressible member of the sample holder to thereby provide cyclical radial loading and unloading of a stent-graft prosthesis received therein for simulating physiologic loading conditions of a stent-graft prosthesis within a vasculature due to a beating heart.

Abstract: An apparatus for subcutaneous lead guidance includes a flexible guide strap, a navigation catheter and a tunneling tool. The guide strap includes an upper layer having a plurality of retainer formations and a substrate attachable on a patient's skin extending between an incision and a target site. The navigation catheter is coupled to the upper layer via the retainer formations from a first end to a second end of the guide strap. The navigation catheter includes a plurality of position sensors for generating a subcutaneous navigation volume between the incision and the target site when the navigation catheter is coupled to a navigation system. The tunneling tool has a distal portion with a leading end and at least one position sensor on the distal portion for viewing digital representation of the distal portion in relation to the navigation volume on a display coupled to the navigation system.

Abstract: A medical device system and associated method predict a patient response to a cardiac therapy. The system includes for delivering cardiac pacing pulses to a patient's heart coupled to a cardiac sensing module and a cardiac pacing module for generating cardiac pacing pulses and controlling delivery of the pacing pulses at multiple pace parameter settings. An acoustical sensor obtains heart sound signals. A processor is enabled to receive the heart sound signals, derive a plurality of heart sound signal parameters from the heart sound signals, and determine a trend of each of the plurality of heart sound signal parameters with respect to the plurality of pace parameter settings. An external display is configured to present the trend of at least one heart sound parameter with respect to the plurality of pace parameter settings.

Abstract: Devices, systems and methods are disclosed for the ablation of tissue. Embodiments include an ablation catheter which has an array of ablation elements attached to a deployable carrier assembly. The carrier assembly can be constrained within the lumen of a catheter, and deployed to take on an expanded condition.

Abstract: Processes for manufacture and assembly of implantable medical devices are described. In particular, techniques are provided for nondestructive electrical isolation assessment of feedthrough assemblies of the implantable medical devices. The feedthrough assemblies may include an insulating structure, a plurality of terminal pins extending through the insulator and a ferrule having an inner lumen into which the insulating structure is disposed. One or more insulating seals may be disposed at the interface of the ferrule-to-insulating structure and/or the terminal pin-to-insulating structure. The electrical isolation assessments may be based on the dielectric properties of the components of the feedthrough assemblies, such as the insulating structure.

Abstract: A trackable medical instrument for use in a computer assisted image guided medical and surgical navigation systems that generate images during medical and surgical procedures, includes a guide member having an emitter array for being tracked by the system and a drive shaft contained within the guide member having a proximal and a distal end, the drive shaft being rotatable within the guide member while being fixable axially inside the guide member, the proximal end of the drive shaft having a first connector for interchangeably receiving at least one drive source, and the distal end having a second connector for interchangeably receiving at least one instrument tip.