Abstract: An implantable medical device is provided for sensing cardiac activity within a patient's body. The device comprises a canister, control circuitry disposed within the canister, and a lead assembly extending from the canister. At least one sense electrode is coupled to the circuitry and disposed on the lead assembly for sensing cardiac activity. At least one spacer is coupled between the lead assembly and the canister for maintaining a minimum predetermined distance between the at least one sense electrode and the canister.

Abstract: This disclosure provides techniques for bladder sensing. In accordance with the techniques described in this disclosure, a device may measure the impedance of a bladder, determine the posture of a patient, and determine a status of the bladder based on the impedance and posture.

Abstract: A prosthetic stented heart valve which includes a compressible and expandable stent structure having first and second opposite ends, an expanded outer periphery, and a compressed outer periphery that is at least slightly smaller than the expanded outer periphery when subjected to an external radial force. The valve further includes a valve segment comprising a dual-layer sheet formed into a generally tubular shape having at least one longitudinally extending seam, and a plurality of leaflets formed by attachment of an outer layer of the dual-layer sheet to an inner layer of the dual-layer sheet in a leaflet defining pattern. The valve segment is at least partially positioned within the stent structure. The valve may further include at least one opening in the outer layer of the dual-layer sheet that is spaced from both the first and second ends of the stent structure.

Abstract: Methods and apparatus are provided for monopolar neuromodulation, e.g., via a pulsed electric field. Such monopolar neuromodulation may effectuate irreversible electroporation or electrofusion, necrosis and/or inducement of apoptosis, alteration of gene expression, action potential attenuation or blockade, changes in cytokine up-regulation and other conditions in target neural fibers. In some embodiments, monopolar neuromodulation is applied to neural fibers that contribute to renal function. In some embodiments, such monopolar neuromodulation is performed bilaterally.

Abstract: Techniques for classification of a posture state of a patient using multiple posture state definitions, and for delivering therapy according to the patient's classified posture state. Detected parameter values describing a patient's posture state are compared to posture state definitions. This comparison is used to determine similarity values describing how similar the patient's posture state is to each of the posture states described by the posture state definitions. Weighting factors may be determined from the similarity values and used to weight therapy parameter values that are associated with each of the posture state definitions. The resulting weighted therapy parameter values may be used to derive a blended therapy parameter value for use in delivering therapy to the patient. The patient's posture state may be expressed in terms of a blending of the multiple posture state definitions.

Abstract: Methods and apparatus are provided for treatment of heart arrhythmia via renal neuromodulation. Such neuromodulation may effectuate irreversible electroporation or electrofusion, ablation, necrosis and/or inducement of apoptosis, alteration of gene expression, action potential attenuation or blockade, changes in cytokine up-regulation and other conditions in target neural fibers. In some embodiments, such neuromodulation is achieved through application of an electric field. In some embodiments, such neuromodulation is achieved through application of neuromodulatory agents, of thermal energy and/or of high intensity focused ultrasound. In some embodiments, such neuromodulation is performed in a bilateral fashion.

Abstract: This disclosure describes techniques implemented by a medical device, such as an implantable medical device (IMD). The IMD may be configured to detect a posture state of a patient, and deliver posture-responsive therapy. In particular, the IMD not only detects the posture state of a patient, but also detects timing associated with the detected posture state, such as the time of day, the day of the week, or a specific time of day associated with a specific day. In this way, the posture-responsive therapy delivered by the IMD may be dependent not only on the posture state of the patient, but also on the timing associated with the posture state. The same posture state, therefore, may result in different types of therapy to the patient if the same posture occurs at different times of the day.

Abstract: Systems and methods for removal of bacterial biofilm from a target site of a human patient includes a surgical instrument having an introducer for bodily insertion and maintaining an irrigation duct and a nozzle. A distal portion of the introducer is transitionable between a plurality of bend angles relative to a proximal portion thereof. In particular, the instrument is adapted to independently maintain the distal portion at each of the plurality of bend angles relative to the proximal portion. The nozzle is maintained relative to the distal portion of the introducer and is adapted to dispense pressurized irrigant from the irrigation duct toward a layer of bacterial biofilm.

Abstract: Neuromodulation systems with nerve monitoring assemblies and associated devices, systems, and methods are disclosed herein. A neuromodulation system configured in accordance with some embodiments of the present technology can include, for example, a generator, a nerve monitoring assembly configured to detect electroneurogram (ENG) signals, and a neuromodulation catheter. The neuromodulation catheter can include an elongated shaft with a distal portion and a proximal portion. The distal portion of the shaft can include an array of electrodes configured to detect nerve activity from within a blood vessel of a human. The proximal portion of the shaft can include at least one connector that operably couples the electrodes to the generator and to the nerve monitoring assembly.

Abstract: A reflectance optical perfusion sensor may include at least one light source and a plurality of detector elements arranged in a planar or nonplanar configuration, such as a three-dimensional array. The detector elements may sense light emitted by the at least one light source and reflected by a blood mass of a patient, such as blood within a blood vessel. In some examples, the detector elements may be arranged such that photodetection surfaces of at least two of the detector elements are nonparallel. In addition to or instead of the nonplanar arrangement of detector elements, an optical perfusion sensor may include a detector array including a plurality of detector elements at least partially surrounding a light source. Varying the location and orientations of detector elements may help increase a quantity of light emitted by the at least one light source and reflected toward the optical perfusion sensor by blood.

Abstract: A hybrid stent prosthesis including a biodegradable tubular body, a first non-biodegradable self-expanding ring coupled to a proximal end of the biodegradable body, and a second non-biodegradable self-expanding ring coupled to a distal end of the biodegradable body. The hybrid stent includes a mechanism for longitudinally compressing the tubular body to increase the radial or hoop strength thereof. The longitudinally compressing mechanism may be protruding elements coupled to and extending radially outward from the hybrid stent or elastomeric compression bands or tethers extending between the non-biodegradable rings. The compression bands may be pre-connected to both non-biodegradable rings prior to stent delivery, or may be connected to one non-biodegradable ring prior to insertion and connected to the other non-biodegradable ring in situ.

Abstract: Endovascular nerve monitoring devices and associated systems and methods are disclosed herein. A nerve monitoring system configured in accordance with a particular embodiment of the present technology can include a shaft having a proximal portion and a distal portion and a nerve monitoring assembly at the distal portion. The shaft is configured to locate the distal portion intravascularly at a treatment site. The nerve monitoring assembly can include a bipolar stimulation electrode array and a bipolar recording electrode array disposed distal to the bipolar stimulation electrode assembly.

Abstract: Medical device delivery assemblies are disclosed. The assembly may include a catheter-based delivery system. The assembly may include a pacing element to pace a patient's heart before, during, or after a procedure. The pacing element may be a detachable, implanting pacing element. The pacing element may be an implantable pacemaker and the implantable pacemaker may be disposed on a catheter-based delivery system. The assembly may include a prosthetic heart valve with one or more pacing elements on it. The pacing element may include a pacing strip or strips. These strips may be conductive or insulative. These strips may prevent, treat, or correct abnormal electrical communication in a heart.

Abstract: Image data can be obtained with an imaging device. A location of the imaging device relative to a subject can be determined. A location of an instrument can be tracked relative to the subject using a tracking system. Also, the tracked location of the instrument can be illustrated relative to the image data.

Abstract: Devices, systems, and methods for implanting radially expandable prostheses in the body lumens rely on tacking or anchoring the prostheses with separately introduced fasteners. The prostheses may be self-expanding or balloon expandable, and may include a single lumen or more than one lumen. After initial placement, a fastener applier system is introduced within the expanded prostheses to deploy a plurality of fasteners to at least one prosthesis end. The fasteners are usually helical fasteners which are releasably restrained on the fastener driver, and are delivered by rotation of the fastener driver. The fasteners may be applied singly, typically in circumferentially spaced-apart patterns about the interior of at least one end of the prosthesis. A lumen extension or lumens may be coupled to the prosthesis to extend the reach of the prosthesis within the implantation site. Fasteners may also be applied to the lumen extensions.

Abstract: Disclosed are a method and/or system for filtering sensor measurements. In one particular implementation, a sensor signal may be processed concurrently in a plurality of signal-filter paths. A particular signal-filter path may be selected to provide an output signal for obtaining a measurement based, at least in part, on a measurement of noise associated with the sensor signal.

Abstract: An infusion system is for infusing a fluid into the body of a patient. The infusion system includes at least one sensor for monitoring blood glucose concentration of the patient and an infusion device for delivering fluid to the patient. The sensor produces at least one sensor signal input. The infusion device uses the at least one sensor signal input and a derivative predicted algorithm to determine future blood glucose levels. The infusion device delivers fluid to the patient when future blood glucose levels are in a patient's target range. The infusion device is capable of suspending and resuming fluid delivery based on future blood glucose levels and a patient's low shutoff threshold. The infusion device suspends fluid delivery when future blood glucose levels falls below the low shutoff threshold. The infusion device resumes fluid delivery when a future blood glucose level is above the low shutoff threshold.

Abstract: Systems and methods for controllably variable fluid flow are disclosed that provide the ability to modify the effective cross-sectional area of the fluid delivery conduit available for fluid flow. Accordingly, selective control of these configurations allows fluid flow to be regulated as desired while the fluid delivery pressure remains the same. Additional configurations provided herein allow for the selective manipulation of a footprint or therapeutic pattern achievable with the medical device during a single procedure, negating the need for the removal and insertion of multiple devices to achieve the same variations in treatment geometry or characteristics.

Abstract: A guide device establishes a guide passage through a guide tube, through which an operative tool can be deployed into an interior body region for use. A steering assembly, in use, deflects or bends the distal end region of the guide tube, so that the operative tool can be placed in a desired orientation with respect to tissue. The steering assembly is desirable configured for single handed operation by the clinician. The steering assembly is also desirably configured to provide a mechanical advantage sufficient to translate relatively small increments of clinician control into relatively larger increments of guide tube deflection. In one arrangement, the steering assembly includes a rack and pinion linkage system. In another arrangement, the steering assembly includes a pivoting lever system.

Abstract: Various embodiments of a bioelectric sensor device for sensing bioelectric data from a human body are disclosed. The device can include a flexible substrate, a plurality of sensors arranged in a sensor array on a sensor array portion of the substrate, an electrically conductive network located on the substrate, and a plurality of lines of weakness formed in the sensor array portion of the substrate. In one or more embodiments, each line of weakness is configured to enhance separation of the sensor array portion of the substrate along a separation line that extends between at least two sensors of the plurality of sensors. The device can also include a left reference electrode proximate a distal end of a left reference electrode arm of the substrate and a right reference electrode proximate a distal end of a right reference electrode arm of the substrate.