Abstract: An implantable cardiac monitoring device includes first and second arms, pivotably attached to one another; electronic circuitry and an associated power source of the device are hermetically sealed in a housing formed by one of the arms. A first electrode is carried by the first arm, a second electrode by the second arm, and a third electrode by one of the two arms. The device further includes a tether element, preferably a strut, pivotably attached between the arms and movable between a folded state and an expanded state. When the strut is in the folded state, the device, in a relatively compact form, can be inserted through a relatively small incision and into subcutaneous tissue, after which, the strut is moved to the expanded state where ends of the arms are spaced apart from one another and supported by the strut, and the three electrodes form dual sensing vectors.

Abstract: A programmer allows a clinician to identify combinations of electrodes from within an electrode set implanted in a patient that enable delivery of desirable neurostimulation therapy by an implantable medical device. The programmer executes an electrode combination search algorithm to select combinations of electrodes to test in a non-random order. According to algorithms consistent with the invention, the programmer may first identify a position of a first cathode for subsequent combinations, and then select electrodes from the set to test with the first cathode as anodes or additional cathodes based on the proximity of the electrodes to the first cathode. The programmer may store information for each combination tested, and the information may facilitate the identification of desirable electrode combinations by the clinician. The clinician may create neurostimulation therapy programs that include identified desirable program combinations.

Abstract: A surgical cutting instrument including an outer tube having a bearing sleeve disposed within a lumen thereof, along with an inner wire assembly extending through the outer tube and the bearing sleeve. A cutting tip is connected to the inner wire assembly distal the outer tube. Conversely, a coupling chuck is connected to a proximal section of the inner wire assembly, with a housing maintaining the outer tube and the coupling chuck. When mounted to a motor, the inner wire assembly is rotated to effectuate a surgical cutting procedure at the cutting tip, with the bearing sleeve supporting the inner wire assembly relative to the outer tube during rotation.

Abstract: The disclosure describes an elongated housing, e.g., a catheter, configured to be inserted into a lumen of a patient to diagnose or treat a patient. The elongated housing includes a scope channel that accepts a cystoscope and a viewing window at the distal end of the elongated housing. The user may use the cystoscope to view tissue adjacent to the viewing window. The viewing window may take up at least 10 percent of the length of the elongated housing to allow the user to identify a large area of tissue in the lumen without moving the elongated housing with respect to the tissue. Once the user identifies the target tissue, the user may position the elongated housing graduations on the viewing window and the proximal end of the elongated housing. An ablation needle electrode may be extended into the target tissue to deliver ablation therapy to the target tissue.

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.

Abstract: Catheter apparatuses, systems, and methods for achieving renal neuromodulation by intravascular access are disclosed herein. One aspect of the present technology, for example, is directed to a treatment device having a direct heating element configured to be delivered to a renal blood vessel. The treatment device is selectively transformable between a delivery or low-profile state and a deployed state. The direct heating element is housed within an occlusion element which is sized and shaped so that the direct heating element contacts an interior wall of the occlusion element, an outer wall of which is simultaneously in contact with the inner wall of a renal blood vessel when the treatment assembly is in the deployed state. The direct heating element is configured to apply thermal energy to heat neural fibers that contribute to renal function.

Abstract: A device that may be used as an automatic voiding diary detects urinary and/or fecal voiding events and records voiding information indicative of the voiding events without the need for significant patient interaction. The device includes a microphone that captures internal and/or external sounds that are associated with voiding events and generates an electrical signal based the sounds. The device processes the electrical signal to determine whether the signal is indicative of the occurrence of a voiding event (i.e., the device detects voiding events) by, for example, comparing the electrical signal to a signal template or comparing an amplitude of the signal to a threshold. The device may be a device implanted within the patient or an external device that can be carried or attached to the body or clothing of the patient.

Abstract: Embodiments include heart monitoring systems, apparatus, and methods adapted to detect myocardial ischemia. An apparatus includes at least one first-tier sensor/analyzer adapted to sense a first input related to cardiac function, and to produce a first-tier trigger signal when the first input indicates myocardial ischemia. In an embodiment, a first-tier sensor/analyzer includes an ECG sensor/analyzer. In another embodiment, a first-tier sensor/analyzer includes a patient activator. An apparatus further includes at least one second-tier sensor/analyzer adapted to sense a second input related to cardiac function, and to produce a second-tier trigger signal when the second input indicates myocardial ischemia. In an embodiment, a second-tier sensor-analyzer includes a heart sound sensor/analyzer. A triggering element is adapted to produce a response-invoking signal in response to the first-tier trigger signal and the second-tier trigger signal.

Abstract: The disclosure is directed to a deep brain stimulation (DBS) lead having a distal end for providing therapeutic electrical stimulation to tissue in a stimulation target area of a patient's brain, comprising an array of one or more stimulation elements and sensing elements located at the distal end of the lead; each of the one or more stimulation elements is capable of providing electrical stimulation to the brain tissue in the target area; and each of the one or more sensing elements is capable of detecting electrical signals produced by nerve cells within the brain; wherein after the first implantation of the lead into the brain along a trajectory that is pre-determined by non-surgical procedures, the array of stimulation and sensing elements is capable of facilitating the location of the target area and the determination for each of the stimulation elements of the required stimulation parameters needed to provide the therapeutic stimulation to the brain tissue in the stimulation target area, without requiri

Abstract: The disclosure is directed to transmitting power source usage information regarding a power source of an implantable medical device (IMD) to a remote networking device via a network. The IMD operates on power supplied by a power source, such as a battery, within the housing of the IMD. The use of the power source may be monitored remotely in order to maintain therapy. Power source usage information may include power source recharge patterns such as frequency of recharging events, length of recharging events, period between recharging events, discharge state of the power source, and degree of coupling between primary and secondary coils during recharging. The IMD, or an external device used with the IMD, may generate, store, and transmit the power source usage information to the remote networking device. Action requests may be transmitted from the remote networking device via the network based upon the power source usage information.

Abstract: An volume of a patient can be mapped with a system operable to identify a plurality of locations and save a plurality of locations of a mapping instrument. The mapping instrument can include one or more electrodes that can sense a voltage that can be correlated to a three dimensional location of the electrode at the time of the sensing or measurement. Therefore, a map of a volume can be determined based upon the sensing of the plurality of points without the use of other imaging devices. An implantable medical device can then be navigated relative to the mapping data.

Abstract: Devices, systems, and techniques for generating an encryption key using detected motion from a device. In one example, a method may include receiving movement information indicative of motion detected by a first device during a period of time in which the first device and a second device were bumped together, determining a set of values that represent at least one characteristic of the movement information, and generating, based on the set of values, an encryption key for at least one of encrypting and decrypting data communicated between the first device and the second device. In some examples, the first device may include a sensor configured to detect each time the first device is bumped with the second device during the period of time. The first and second devices may be an implantable medical device and a programmer for the implantable medical device.

Abstract: A power converter comprises a first die and a second die. Each die comprises a semiconductor substrate comprising a junction for converting nuclear radiation particles to electrical energy, the junction of each semiconductor substrate comprising a first side and a second side, a first electrode comprising a nuclear radiation-emitting radioisotope deposited on the semiconductor substrate, the first electrode being electrically connected to the first side of the junction, and a second electrode deposited on the semiconductor substrate, the second electrode being electrically connected to the second side. A bond is formed between one of the first electrode or the second electrode of the first die and one of the first electrode or the second electrode of the second die, wherein the bond forms an electrical contact between the bonded electrodes.

Abstract: Helical push wire electrodes are provided. The electrodes may create a continuous helical lesion. One or more electrodes may wind around a support section and create a set of helixes having fixed ends and hitches. Pushing or pulling an end of the electrode transforms the electrodes between a delivery configuration and a deployed configuration such that the set of helixes expand or contract axially. Different portions of the electrodes may be surrounded by sleeves. The sleeves may regulate how the wires transform and provide insulation. Various insulation configurations of the electrodes may provide creations of discrete lesions, efficient energy delivery and reduced power consumption.

Abstract: Methods for preparing sterilized baclofen solutions include adjusting the pH to below a desired pH, and steam sterilizing the solution with adjusted pH, which results in the solution having the desired pH. Such solutions may also have low concentrations of 4-CPP. Injectable baclofen solutions having greater than 2 mg/mL baclofen include between 5 mM and 25 mM of a phosphate or sulfate species. The solution has an ionic strength equivalent of about 1.5 M NaCl. The present application also provides baclofen formulations for use in treating spasticity, brain injury, cerebral palsy, spinal cord injury, cervical injury, multiple sclerosis, thoracic injury, or withdrawal symptoms.

Abstract: The invention relates to a system for testing heart valve leaflets. The system includes a leaflet support assembly with a support post for receiving and supporting a leaflet to be tested, the post being disposed in a target region of the support assembly. The system also has a transmitter assembly that includes a light source and is configured and arranged to direct light from the light source onto the target region. The system further includes a receiver assembly that has an image sensor configured and arranged to sense an image of the target region and generate image information indicative of the sensed image, such as leaflet droop.

Abstract: A navigation system generally determines a location of a portion of a first medical instrument relative to a patient. The navigation system generally includes a multi-configuration tracking array that extends from the first medical instrument. A plurality of tracking devices can be positioned on the multi-configuration tracking array. At least one of the tracking devices changes to define at least a first condition and a second condition. A tracking system detects the tracking devices and relates a change between the first condition and the second condition with a change between at least a first instrument configuration and a second instrument configuration.

Abstract: A medical device and associated method classify candidate pacing electrode sites for delivering pacing pulses to a patient's heart. A first morphology template is established and stored in memory of the device. A processor is configured to determine a cardiac signal morphology in response to delivering pacing pulses at a candidate pacing site in a first heart chamber. The processor compares the determined cardiac signal morphology to the first morphology template. The pacing site in the first heart chamber is classified in response to the comparing of the determined cardiac signal morphology and the first morphology template.

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: A brain condition can be tracked based on identification of co-activation of two antagonistic networks of a patient's brain. Various embodiments concerns methods and devices for sensing one or more signals indicative of brain activity, detecting one or more episodes of default mode network activation based on the one or more signals, detecting one or more episodes of salience network activation based on the one or more signals, and identifying one or more episodes of temporal co-activation of the default mode network and the salience network based on the detected one or more episodes of default mode network activation and the one or more episodes of salience network activation. The brain condition can be tracked and treated based on the identification of the one or more episodes of co-activation.