Abstract: A stent-graft delivery system includes an elongate shaft, a tip capture spindle disposed over the shaft, and a distal tip assembly coupled to the distal end of the shaft. At least one component of the delivery system constrains a stent of the stent-graft engaged with the tip capture spindle during delivery and partial-deployment of the stent-graft, and the at least one component is in a threaded relationship with the distal tip assembly. To fully deploy the stent-graft, the elongate shaft, having the distal tip assembly coupled thereto, is rotated to result in longitudinal movement of the at least one component and thereby release the stent from the tip capture spindle. The at least one component that longitudinally moves to fully deploy the stent-graft may be the tip capture spindle and/or a relatively short sleeve that extends over the tip capture spindle to the distal tip assembly.

Abstract: An implantable medical device includes two conductive enclosures that are attached together, wherein the first enclosure contains electronics, and the second enclosure contains a power source. The second enclosure, all or a portion of which is located outside the first enclosure, includes an inner layer, an outer layer, and a header plate, all of which are configured to provide redundant sealing for the power source. The inner and outer layers, formed by separate metal sheets nested one within the other, are preferably in direct mechanical and electrical contact. The first sheet, which forms the inner layer, approximately conforms to a profile of the power source, located therein, and the second sheet, which forms the outer layer, conforms to a profile of the first sheet. An insulative housing, which contains connector contacts of the device, is directly secured to the first and second conductive enclosures, for example, by mounting brackets.

Abstract: A tubular access sleeve and suction tool for accessing an anatomic surface or anatomic space and particularly the pericardium to access pericardial space and the epicardial surface of the heart in a minimally invasive manner are disclosed. A suction tool trunk extending through a suction tool lumen of the sleeve is coupled to suction pads at the ends elongated support arms. The suction pads can be retracted into a sleeve working lumen during advancement of the access sleeve through a passage and deployed from the tubular access sleeve lumen and disposed against the an outer tissue layer. Suction can be applied through suction tool lumens to suction ports of the suction pads that fix to the outer tissue layer so as to tension the outer tissue layer and/or pull the outer tissue layer away from an inner tissue layer so that the anatomic space can be accessed by instruments introduced through the working lumen to penetrate the outer tissue layer.

Abstract: The present invention provides an implantable medical device having at least two electrodes coupled to the device housing. The electrodes may be configured for sensing physiological signals such as cardiac signals and alternatively for providing an electrical stimulation therapy such as a pacing or defibrillation therapy. In accordance with aspects of the disclosure, the device housing provides a hermetic enclosure that includes a battery case hermetically coupled to a circuit assembly case. At least one of the at least two electrodes is coupled to an exterior surface of the battery case. The battery case is electrically insulated from the cathode and anode of the battery.

Abstract: Techniques and methods for determining the number and type of leads that are connected to an implantable medical device (IMD) system are disclosed. The IMD system is configured having at least two modes of operation, the modes of operation corresponding to the number and type of leads that are coupled to the IMD system. In accordance with aspects of the disclosure, one of the at least two modes may be selected based on the determination of the number and type of leads that are connected to the IMD system.

Abstract: Medical leads, such as medical electrical leads and medical neurological leads, that include a polymeric material that includes a silicone-urethane-containing polymer having improved hydrolytic stability.

Abstract: In one example, this disclosure is directed to a kit for intravascular implantation of an implantable medical device within a patient comprising an elongated outer sheath forming an inner lumen with a distal opening, the outer sheath sized to traverse a vasculature of the patient, and an elongated inner sheath with a stopper. The inner sheath further includes a tether configured to form a loop on a distal side of the stopper, the loop being configured to engage a looped element of the implantable medical device to couple the implantable medical device to the inner sheath. The stopper is slidable relative to the outer sheath. The tether is configured to release the looped element of the implantable medical device from the inner sheath by opening the tether loop when a portion of the stopper is located distally relative to the distal opening of the outer sheath.

Abstract: Methods and/or devices for sampling a patient's intrinsic AV conduction time during cardiac therapy that may, e.g., change the AV delays to values based on the AV delays themselves, previously-sampled intrinsic AV conduction times, and/or one or more other parameters directly related to AV delays to provide a time period during which to measure the patient's intrinsic AV conduction time.

Abstract: A medical system is provided, including a catheter body having a proximal portion and a distal portion; a shaft slidably disposed within a portion of the catheter body, the shaft defining a distal tip; a fluid injection tube coupled to the distal portion of the catheter body and the distal tip of the shaft, the fluid injection tube being transitionable from a first geometric configuration to a second geometric configuration; a membrane coupled to the shaft and enclosing at least a portion of the fluid injection tube therein; and a coolant source in fluid communication with the fluid injection tube. The first geometric configuration may be substantially linear, the second geometric configuration may be substantially helical, and the membrane may be tensioned across at least a portion of the fluid injection tube in the second geometric configuration.

Abstract: Methods and related apparatuses for sorbent recharging are provided. The methods and related apparatuses for recharging can recharge a specific rechargeable layer of a sorbent material such as zirconium phosphate in a sorbent cartridge. The methods and apparatuses include passing solutions containing combinations of acids, bases and salts through a module containing a rechargeable sorbent material such as zirconium phosphate in order to replace ions bound to the zirconium phosphate with hydrogen and sodium ions. The method allows for a customizable zirconium phosphate, with control over the ratios of sodium to hydrogen on the recharged zirconium phosphate.

Abstract: A customizable modular dialysate regeneration assembly with connectable sorbent packaging systems. The dialysate regeneration assembly can be customized based on patient parameters or dialysis session parameters. A processor can be included that can determine the correct amount of each sorbent material necessary for a given patient and a given dialysis session.

Abstract: A sorbent pouch for use in sorbent dialysis. The sorbent pouch allows for fluid to freely pass into and through the sorbent materials, while keeping the sorbent materials inside the sorbent pouch.

Abstract: An apparatus and method for replenishing urease in a sorbent cartridge for use in sorbent dialysis using urease pouches. The sorbent cartridge is configured to allow insertion of a urease pouch or injection of a urease solution into the sorbent cartridge containing a urease pouch. The sorbent module can also comprise other, rechargeable, sorbent materials for removing toxins other than urea from spent dialysate.

Abstract: Embodiments of the invention provide amperometric analyte sensors having multiple related structural elements (e.g. sensor arrays comprising a working, counter and reference electrode) and algorithms designed for use with such sensors. While embodiments of the innovation can be used in a variety of contexts, typical embodiments of the invention include glucose sensors used in the management of diabetes.

Abstract: In some examples, an IMD provides CRT data that indicates an amount of time that CRT was not delivered by the IMD, such as the % CRT. In some examples, a CRT loss diagnosis module apportions the amount of time that CRT was not delivered amongst predetermined reasons for loss of CRT based on the CRT data and sensed cardiac data from the IMD. An external computing device may present a representation of the apportionment to a user, e.g., a clinician. The external computing device may also analyze the apportionment, and recommend programming changes for the delivery of CRT by the IMD based on the analysis.

Abstract: A method and system for detecting microbubble formation during a radiofrequency ablation procedure. The method includes measuring an impedance of a pair of electrodes, at least one electrode in the pair of electrodes being coupled to a treatment assembly of a medical device. Radiofrequency ablation energy is transmitted between the pair of electrodes. The transmission of radiofrequency ablation energy between the pair of electrodes is terminated when after a predetermined period of time the measured impedance in either of the electrodes in the pair of electrodes is a predetermined percentage above a measured minimum impedance and a measured power is above a predetermined power threshold. An alert is generated indicating at least one of the formation and release of microbubbles proximate the pair of electrodes.

Abstract: Implantable medical leads include a shield that is guarded at a termination by having a first portion and second portion of the shield, where the first portion is between a termination of the shield at the second portion and an inner insulation layer surrounding the filars. The first portion may reduce the coupling of RF energy from the termination of the shield at the second portion to the filars. The first and second portions may be part of a continuous shield, where the first and second portions are separated by an inversion of the shield. The first and second portions may instead be separate pieces. The first portion may be noninverted residing between the termination at the second portion and inner layers, or the first portion may be inverted to create first and second sub-portions. The shield termination at the second portion is between the first and second sub-portions.

Abstract: A system to generate a navigation field relative to an implanted device is disclosed. The system can include a small and/or thin localizer array positioned in the implanted device. A power management scheme and circuits can be provided to conserve and resource power in the implanted device.

Abstract: An inner subassembly of a delivery system assembly extends within a lumen of an elongate outer tube of the assembly, and includes a flared distal end, which is preferably configured to conform to a proximal end of an implantable medical device; a distal-most portion of the outer tube is sized to contain both the flared distal end and an entirety of the medical device. The inner subassembly includes a core, an elongate pull-wire, extending along the core, and a sheath surrounding the pull-wire and the core; the sheath includes a slot opening that allows the pull-wire to pass laterally therethrough. The assembly preferably has a pre-formed curvature along a length of the sheath, and the slot opening extends along the pre-formed curvature. The outer tube is longitudinally moveable relative to the inner subassembly, for example, to deploy the medical device.

Abstract: Examples for delivering electrical stimulation to a patient via a medical device to manage or treat rapid eye movement behavior disorder (RBD) are described. In one example, a method comprises determining a patient is in a rapid eye movement (REM) sleep stage, and delivering electrical stimulation therapy to the patient based on the determination that the patient is in the REM sleep stage, where the electrical stimulation therapy is delivered to inhibit movement of the patient during the REM sleep stage. In some examples, the electrical stimulation therapy may be delivered to the brain of the patient.