Abstract: A system and method select a pacing site for a cardiac pacing therapy. A change from a baseline mechanical activity is extracted from a signal of mechanical heart activity during pacing at each one of multiple pacing sites along a heart chamber. A change from a baseline electrical activity is extracted from a signal of electrical heart activity during pacing at each of the of pacing sites. The pacing sites are sorted in a first order based upon the changes in mechanical heart activity and in a second order based upon the changes in electrical heart activity. A pacing site is selected from the multiple pacing sites as a common pacing site between the first order and the second order.

Abstract: Disclosed is a method and system for navigating an instrument relative to a subject. A reference device can be associated with the subject. The reference device can be moved while maintaining or allowing registration with an image space.

Abstract: A medical device system performs a method for determining presence of scar tissue through an implanted lead having an electrode for cardiac pacing and sensing. A sensing module senses heart activity with the electrode to produce a unipolar electrogram (EGM) waveform. A processor receives the unipolar EGM waveform and extracts two or more features representative of heart activity at the electrode. Scar tissue is identified at the site of the first electrode based upon at least two of the extracted features indicating scar tissue.

Abstract: A medical device system performs a method determining presence of scar tissue. Torso-surface potential signals are received by a processor from multiple electrodes distributed on a torso of a patient. The processor extracts features of the potential signal from each electrode and stores values of the features in a non-transitory storage medium. The processor determines a scar indicator index for each of the electrodes from the stored features and identifies which ones of the electrodes have an affirmative scar indicator index. An overall scar burden index is determined as a proportion of the electrodes with an affirmative scar indicator index.

Abstract: A medical device and associated method convert an analog signal using an adaptable number of comparisons between the analog signal and a reference signal. The medical device includes an analog-to-digital (A/D) converter for receiving an analog signal. The A/D converter has a full scale range and a total number of bits spanning the full scale range. The A/D converter converts the analog signal to a digital signal over conversion cycles using an adaptable number of comparisons. For at least one of the conversion cycles, the adaptable number of comparisons is less than the total number of comparisons required to convert the analog signal over the full scale range of the A/D converter.

Abstract: An implantable cardioverter defibrillator (ICD) senses ventricular depolarizations (R-waves) in an electrogram signal to detect a ventricular tachycardia or fibrillation episodes. The EGM signal is also monitored in real time for characteristics that uniquely identify instances of T-wave oversensing. The ICD determines whether detection of a tachycardia or fibrillation episode is appropriate based upon counts of each of the unique characteristics evidencing T-wave oversensing.

Abstract: Effective treatments of pain for extended periods of time are provided. The treatments include the administration of one or more drug depots intraspinally wherein the drug depots include an effective amount of a benzodiazepine, such as midazolam, formulated within a polyorthoester. By administration of one or more drug depots, one can relieve pain caused by diverse sources, including but not limited to chronic pelvic pain syndromes, spinal disc herniation (i.e. sciatica), spondilothesis, stenosis, discongenic back pain and joint pain, as well as pain that is incidental to surgery. In some embodiments, the relief can be for at least twenty-five days, at least fifty days, at least one hundred days or at least one hundred and thirty-five days.

Abstract: This disclosure describes techniques for estimating an amount of charge on a power source. A processor may determine an uncertainty value associated with a first charge level of a power source and an uncertainty value associated with a second charge level of the power source. Based on the uncertainties, the processor may adjust the first charge level to generate an adjusted charge level. The processor may further adjust the adjusted charge level based on the behavior of the power source.

Abstract: An apparatus for delivering a fluid includes a housing, an inlet in the housing for receiving the fluid, and an outlet in the housing for discharging the fluid. A piston channel is provided within the housing through which the fluid flows from the inlet to the outlet. An actuator is positioned within the housing and is moveable between a retracted position and a forward position, the actuator defining a piston chamber for storing fluid received through the inlet when the actuator is in the retracted position and for driving the fluid stored in the piston chamber toward the outlet when the actuator transitions from the retracted position to the forward position. The actuator includes an armature and a piston coupled to the armature and moveable within the piston channel. The piston channel wall is provided with a groove for conducting fluid from the inlet to the outlet.

Abstract: Analyte sensors having antioxidant protection are disclosed. By combining antioxidant and/or scavenger agents into polymer matrices that contain sensor moieties, the sensor moieties are protected from reactive oxygen species. Also disclosed are methods of making analyte sensors and methods of inhibiting oxidative degradation of sensing components in hydrated, polymerized analyte sensor systems.

Abstract: A tube-positioning system for loading tubing into a peristaltic pump includes a shell configured to slidably fit onto, and be releasably secured relative to, an exterior housing of a peristaltic pump. A pair of guides protrude from an upper portion of opposite side walls of the shell with each guide configured to releasably mount a first tube segment to extend between the guides.

Abstract: This disclosure describes antenna structures for use with implantable medical devices (IMDs). The IMD may include a housing that hermetically encloses electronic components of the IMD and a fixation mechanism that attaches the IMD to a target location within a patient, such as a wall of a vessel. The fixation mechanism may function as a radiating element of an antenna of the IMD. The fixation mechanism may be attached to a housing of the IMD with two different members. One member may be an anchoring structure that mechanically anchors the fixation mechanism to the housing. The second member may be a connector that electrically connects the fixation mechanism to the housing such that the fixation mechanism is configured to transmit and/or receive communication signals with other implantable or external devices.

Abstract: Drug loading of polymeric materials can be adjusted by selection of materials and/or adjusting processing steps in formation of an implantable drug-loaded device.

Abstract: The accuracy of data processing operations in implantable medical devices is improved through reductions in errors associated with data acquisition, reading, and transmission. In one embodiment, two or more circuit modules of the device are operated at different clock speeds and a voting scheme is utilized to obtain a valid data value from one of the modules. The disclosure describes methods, devices and systems that utilize the voting schemes to eliminate errors induced by race conditions in obtaining the valid data values by obtaining a plurality of data samples during operation of the circuit modules at the different clock speeds and selecting from among the data samples the valid data value.

Abstract: A system and method are described for delivering an implantable medical device in a patient and through a catheter. The delivery catheter comprises telemetry means for communicatively coupling the implantable medical device with an external instrumentation during implantation.

Abstract: According to some methods, for example, preprogrammed in a microprocessor element of an implantable cardiac pacing system, at least one of a number of periodic pacing threshold searches includes steps to reduce an evoked response amplitude threshold for evoked response signal detection. The reduction may be to a minimum value measurable above zero, for example, as determined by establishing a ‘noise floor’. Alternately, amplitudes of test pacing pulses and corresponding post pulse signals are collected and reviewed to search for a break, to determine a lower value to which the evoked response threshold may be adjusted without detecting noise. Subsequent to reducing the threshold, if no evoked response signal is detected for a test pulse applied at or above a predetermined maximum desirable pulse energy, an operational pacing pulse energy is set to greater than or equal to the maximum desirable in conjunction with a reduction in pacing rate.

Abstract: Activation of an enzyme in a bodily fluid is detected based on the amount of cleavage of a substrate for the enzyme. The substrate is tagged with two fluorescent dyes—a donor and an acceptor. The tagged substrate is presented to the bodily fluid. A device emits energy at a first wavelength into the bodily fluid, and detects energy at second and third wavelengths emitted by the dyes in response to the energy at the first wavelength. Prior to enzymatic cleavage of the substrate, the acceptor emits energy at the third wavelength in response to energy at the second wavelength received through fluorescent resonant energy transfer (FRET) from the donor. After enzymatic cleavage of the substrate, the donor emits energy at the second wavelength. The device can determine the concentration of activated enzyme within the bodily fluid based on the relative intensities of energy at the second and third wavelengths.

Abstract: Methods, devices and assemblies for anchoring implanted medical electrical leads employed in the stimulating and/or sensing of signals in tissue are disclosed. The devices include a lead anchoring clip having a central hub portion, an anchoring portion for coupling to tissue and a lead engagement mechanism that couples the clip to a medical electrical lead.

Abstract: An electromagnetic receiver assembly is included in a navigation element for a therapy delivery system. If the system is modular, the navigation element may be an insertable module thereof and/or include a lumen to receive another insertable module.