Abstract: Catheter apparatuses, systems, and methods for cryogenically modulating neural structures of the renal plexus by intravascular access are disclosed herein. One aspect of the present application, for example, is directed to apparatuses, systems, and methods that incorporate a catheter treatment device comprising an elongated shaft. The elongated shaft is sized and configured to deliver a cryo-applicator to a renal artery via an intravascular path. Cryogenic renal neuromodulation may be achieved via application of cryogenic temperatures to modulate neural fibers that contribute to renal function, or of vascular structures that feed or perfuse the neural fibers.

Abstract: A method and apparatus for treating a nasal valve condition including surgically forming an access path to create a pocket on a side of the patient's nose. The pocket is positioned between a soft tissue layer and opposing surfaces of upper and lower cartilages of the nose. The pocket spans a junction between the upper and lower cartilages. An implant is placed through the access path into the pocket with a length oriented to span the junction. A delivery system for placement of the implant includes a surgical tool for forming the access path and for delivering the implant into the access path.

Abstract: A tool for remodeling a tissue annulus includes an elongate handle and a reshaping element on a distal end of the handle. The reshaping element may be directable between a first configuration to facilitate direction through a tissue annulus, and a second curved configuration to remodel tissue adjacent the tissue annulus. The tool may be used for treating a tissue annulus within a patient's heart, e.g., by introducing the reshaping element through the tissue annulus, and manipulating the tool to reshape the tissue annulus substantially to a contour of the reshaping element. The reshaping element may support the tissue while a prosthesis is secured to the tissue annulus, or the reshaping element may itself be secured to the tissue annulus and released from the tool.

Abstract: Systems and methods are described herein for determining whether anodal capture of the right ventricle is occurring when delivering left ventricular pacing with a cross-chamber pacing vector. The systems and methods may be measure cross-chamber sense times from left ventricular pacing and right ventricular pacing and compare the cross-chamber sense times to determine whether anodal capture of the right ventricle is occurring.

Abstract: Various techniques for measuring cardiac cycle length and pressure metrics based on pulmonary artery pressures are described. One example method described includes identifying a point within a derivative signal of a cardiovascular pressure signal without reference to electrical activity of a heart, initiating a time window from the identified point in the derivative signal, identifying a point within the cardiovascular signal within the time window, and determining at least one of a systolic pressure or diastolic pressure based on the identified point.

Abstract: Implantable medical devices having a metallic surface coated with a bioabsorbable primer polymer layer under a bioabsorbable drug polymer layer. Thus, in addition to the degradation of the drug polymer layer, there is degradation of the primer layer. The underlying metallic framework may or may not degrade depending on whether bioabsorbable or biostable metals are chosen.

Abstract: A method for the extraction and purification of urease from jack beans or other natural sources of urease. The method provides an efficient way to obtain purified urease from natural sources. The method can include defatting the natural sources of urease, extracting the urease from impurities, and further purification of the extracted urease.

Abstract: Arrays of planar solid state batteries are stacked in an aligned arrangement for subsequent separation into individual battery stacks. Prior to stacking, a redistribution layer (RDL) is formed over a surface of each wafer that contains an array; each RDL includes first and second groups of conductive traces, each of the first extending laterally from a corresponding positive battery contact, and each of the second extending laterally from a corresponding negative battery contact. Conductive vias, formed before or after stacking, ultimately couple together corresponding contacts of aligned batteries. If before, each via extends through a corresponding battery contact of each wafer and is coupled to a corresponding conductive layer that is included in another RDL formed over an opposite surface of each wafer. If after, each via extends through corresponding aligned conductive traces and, upon separation of individual battery stacks, becomes an exposed conductive channel of a corresponding battery stack.

Abstract: A medical device monitors a level of fluid accumulation, e.g., pulmonary edema, and one or more respiratory parameters of the patient to detect worsening heart failure. The medical device may use intrathoracic impedance measurements to monitor both the fluid accumulation and the one or more respiratory parameters. Respiration rate and volume, also referred to as the tidal volume, are examples of respiratory parameters. The medical device examines the one or more respiratory parameters after determining that the fluid accumulation indicates worsening heart failure. In this manner, the medical device uses the one or more respiratory parameters to confirm a determination of worsening heart failure that was made based on the fluid accumulation.

Abstract: In general, the invention is directed to a patient programmer for an implantable medical device. The patient programmer may include one or more of a variety of features that may enhance performance, support mobility and compactness, or promote patient convenience.

Abstract: A relatively compact implantable cardiac medical device includes a wireless communications module, which employs a directional antenna and which is adapted to receive input concerning ventricular wall motion. When the cardiac medical device is anchored to a ventricular wall, transmitter elements of the communications modules are only activated for communication during a detected period of reduced ventricular wall motion. The period of reduced ventricular wall motion may be defined as at least one time interval during which an axis of the directional antenna does not rotate out from a baseline orientation by more than 15 degrees. The communication may be conducted with an external programmer-type device, or with another implanted device, for example, located remote from the heart.

Abstract: In general, the disclosure is directed to a patient programmer for an implantable medical device. The patient programmer may include one or more of a variety of features that may enhance performance, support mobility and compactness, or promote patient convenience. The patient programmer includes an internal antenna mounted on a first circuit board and a display mounted on a second circuit board. The first circuit board includes a substantially contiguous ground plane layer that is interrupted by two or more gaps. The patient programmer may also include one or more of a variety of features that may enhance performance, support mobility and compactness, or promote patient convenience.

Abstract: A patient controls the delivery of therapy through volitional inputs that are detected by a biosignal within the brain. The volitional patient input may be directed towards performing a specific physical or mental activity, such as moving a muscle or performing a mathematical calculation. In one embodiment, a biosignal detection module monitors an electroencephalogram (EEG) signal from within the brain of the patient and determines whether the EEG signal includes the biosignal. In one embodiment, the biosignal detection module analyzes one or more frequency components of the EEG signal. In this manner, the patient may adjust therapy delivery by providing a volitional input that is detected by brain signals, wherein the volitional input may not require the interaction with another device, thereby eliminating the need for an external programmer to adjust therapy delivery. Example therapies include electrical stimulation, drug delivery, and delivery of sensory cues.

Abstract: A cardiac resynchronization pacemaker and a method of adjusting the pacemaker. The method includes deriving a vectorcardiogram from implanted electrodes (D-VCG), analyzing the D-VCG, deriving optimal CRT pacing parameters from the analysis of the D-VCG, and adjusting the CRT pacemaker according to the derived parameters. The pacemaker may include a processor configured to perform the method.

Abstract: Apparatus and methods configured to perform power regulation for an implantable device are presented. In an aspect, an implantable device can include a substrate that forms at least part of a body of the implantable device and a circuit disposed on or within the substrate. The circuit can include a high load power regulator configured to provide a first current level to components of the implantable device and a low load power regulator configured to provide a second current level to components of the implantable device, wherein the second current level is lower that the first current level. The circuit can also include a regulator switch configured to enable or disable current draw from the high load power regulator and the low load power regulator as a function of power state and associated power requirement of the components of the implantable device.

Abstract: A method for forming a wave form for a stent includes moving a first forming portion of a first forming member across an axis along which a formable material is provided in a first direction substantially perpendicular to the axis to engage and deform the formable material while engaging the formable material with a first forming portion of the second forming member. The method includes moving the first forming portion of the first forming member and the first forming portion of the second forming member across the axis in a second direction that is substantially opposite the first direction to draw and form the formable material over the first forming portion of the second forming member, disengaging the first forming member from the formable material, and rotating the first forming member to position a second forming portion of the first forming member to face the formable material.

Abstract: Various techniques for measuring cardiac cycle length and pressure metrics based on pulmonary artery pressures are described. One example method described includes identifying a point within a derivative signal of a cardiovascular pressure signal without reference to electrical activity of a heart, initiating a time window from the identified point in the derivative signal, identifying a point within the cardiovascular signal within the time window, and determining at least one of a systolic pressure or diastolic pressure based on the identified point.

Abstract: Cryotherapeutic systems with features that can facilitate pressure relief in the event of exhaust-passage blockage and associated devices, systems, and methods are disclosed herein. A cryotherapeutic system configured in accordance with a particular embodiment can include an elongated shaft having a distal portion and a pressure-relief portion proximal to the distal portion. The cryotherapeutic system can further include a supply lumen, an exhaust passage, and a balloon configured to receive refrigerant from the supply lumen and to exhaust refrigerant to the exhaust passage. The pressure-relief portion can be configured to release refrigerant from the exhaust passage when a pressure of refrigerant in the exhaust passage exceeds a threshold pressure less than a pressure rating of the balloon. The pressure-relief portion, for example, can include a rupture element configured to rupture at about the threshold pressure.

Abstract: Structures and methods relating to electrodes for incorporation into a feedthrough with a profile adapted for subcutaneous sensing of physiologic and cardiac signals. Electrode assemblies are adapted for integration with feedthroughs and provide reliable insulation from the implantable medical device housing. Various structures and manufacturing processes are implemented to provide a large sensing surface with a low profile. The subcutaneous sensing electrode assembly can provide a leadless sensing system and further enhances installation and follow-up procedures.

Abstract: A prosthetic valve assembly for use in replacing a deficient native valve comprises a replacement valve supported on an expandable valve support. If desired, one or more anchor may be used. The valve support, which entirely supports the valve annulus, valve leaflets, and valve commissure points, is configured to be collapsible for transluminal delivery and expandable to contact the anatomical annulus of the native valve when the assembly is properly positioned. The anchor engages the lumen wall when expanded and prevents substantial migration of the valve assembly when positioned in place. The prosthetic valve assembly is compressible about a catheter, and restrained from expanding by an outer sheath. The catheter may be inserted inside a lumen within the body, such as the femoral artery, and delivered to a desired location, such as the heart.