Abstract: Devices, systems and methods are disclosed for the ablation of tissue. A steerable ablation catheter can include one or more ablation elements at its distal end and one or more ablation elements fixedly attached to its shaft. The distal end of the ablation catheter can be deflected to assume a number of different deflection geometries in at least one direction along the shaft. One feature of the ablation catheter is that its shaft can comprise materials of differing durometers or stiffnesses attached together at a joint. Methods associated with use of the ablation catheter are also covered.

Abstract: A medical method is provided, including a medical device having a distal assembly including at least one electrode and at least one treatment element, the medical device generating information regarding at least one of a physiological measurement and an operational parameter of the medical device; a plurality of surface electrodes affixable to a skin of the patient, wherein the surface electrodes are in electrical communication with the distal assembly to obtain position information of the medical device; and a processor pairing the position information and the at least one of a physiological measurement and an operational parameter of the medical device.

Abstract: Techniques for performing a lead integrity test during a suspected tachyarrhythmia are described. An implantable medical device (IMD) may perform the test prior to delivering a therapeutic shock to treat the suspected tachyarrhythmia and, in some cases, may withhold the shock based on the test. In some examples, the IMD measures an impedance of a lead a plurality of times during the suspected tachyarrhythmia. In some examples, the IMD measures the impedance a plurality of times between two sensed events of the suspected tachyarrhythmia. The IMD or another device may determine a variability of, or otherwise compare, the measured impedances to evaluate the integrity of the lead. Instead of or in addition to withholding a shock, the IMD or another device may change a sensing or stimulation vector of the IMD, or provide an alert to a user, if the integrity test indicates a possible lead integrity issue.

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 connectors, systems, and methods in which one or more catheters are attached to a connector. In the illustrated embodiment, the catheter is retained relative to the connector by inward radial compression between an outer surface of a hollow connector pin inserted into the catheter, and a clamping arm that pivots relative to the connector pin and pushes against an outer surface of the catheter. One or more sleeves may slide over the clamping arm to bias the clamping arm radially inwardly.

Abstract: A prosthesis for implantation at a native semilunar valve includes a prosthetic distal valve, which includes a pliant material configured to collapse inwardly towards a longitudinal axis of the prosthesis during diastole, and to open outwardly during systole, and a distal fixation member configured to be positioned in a downstream artery of the subject. The apparatus also includes a proximal fixation member coupled to the distal fixation member, and configured to be positioned at least partially on a ventricular side of the native semilunar valve. The proximal fixation member is shaped so as to define a lattice that is shaped so as to define an intermediary portion that is coupled to the pliant material of the valve and diverges outwardly from the longitudinal axis, and a distal portion that is distal to the intermediary portion and diverges outwardly from the intermediary portion of the lattice. Other embodiments are also described.

Abstract: This disclosure relates to implantable medical devices (IMDs); in particular, to medical electrical leads having an integrated sensor disposed in a hermetic package and said sensor package accommodates a torque coil and an elongated cable conductor extending therethrough. The integrated sensor can include a pressure sensor, an accelerometer, and the like. The coil and the cable can couple to pacing and sensing electrode coupled to the lead distal to the sensor package. The sensor package is compact, substantially circular in cross section and robust, in that the overall design promote mechanical stability.

Abstract: Methods and apparatus for delivery of substances or apparatus to target sites located outside blood vessels within the body of a human or animal patient. A vessel wall penetrating catheter is inserted into the vasculature, positioned and oriented within a blood vessel near the target extravascular site and a penetrator is advanced from the catheter so as to penetrate outwardly through the wall of the blood vessel in the direction of the target site. Thereafter, a delivery catheter is passed through a lumen of the penetrator to the target site. A desired substance or apparatus is then delivered to or obtained from the target site. In some applications, the penetrator may be retracted into the vessel wall penetrating catheter and the vessel wall penetrating catheter may be removed, leaving the delivery catheter in place for chronic or continuous delivery of substance(s) to and/or obtaining of information or samples from the target site.

Abstract: An implantable medical device that includes a body that includes a proximal end portion configured to be at least partially received by an apparatus, and a distal end portion; a stimulating electrical element at the distal end portion of the body; a stimulating contact at the proximal end portion of the body, wherein the stimulating contact is positioned such that, when received by the apparatus, at least a portion of the apparatus is capable of electrically coupling to the stimulating contact; a stimulating conductor that electrically couples the stimulating electrical element to the stimulating contact; a conductive body, wherein the conductive body is not utilized for application of stimulation; a conductive body contact, wherein the conductive body is electrically connected to the conductive body contact. Systems that include devices are also disclosed.

Abstract: A system and method is provided to measure intrathoracic complex impedance and to identify and indicate disease conditions based on the impedance measurements. Multiple impedance vectors may be taken into account, and an optimal vector may be selected to provide the most useful impedance measurement for the identification and indication of disease conditions.

Abstract: Methods and apparatus are provided for bilateral renal neuromodulation, e.g., via a pulsed electric field, via a stimulation electric field, via localized drug delivery, via high frequency ultrasound, via thermal techniques, etc. Such 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, neuromodulation is applied to neural fibers that contribute to renal function. In some embodiments, such neuromodulation is performed in a bilateral fashion. Bilateral renal neuromodulation may provide enhanced therapeutic effect in some patients as compared to renal neuromodulation performed unilaterally, i.e., as compared to renal neuromodulation performed on neural tissue innervating a single kidney.

Abstract: A feedthrough includes a sheet having a hole, where the sheet includes a first material that is a ceramic comprising alumina. The feedthrough further includes a second material substantially filling the hole. The second material is different than the first material and includes platinum and an additive that includes alumina. The first and second materials have a co-fired bond therebetween that hermetically seals the hole.

Abstract: An implantable medical device delivers neurostimulation therapy to a patient according to a parameter set. A parameter set may consist of a number of programs that are delivered substantially simultaneously. When programming the implantable medical device for the patient, a clinician programmer may maintain a session log for the patient that includes a listing of programs delivered to the patient and rating information provided by a clinician and the patient for programs of the list. The listing may be ordered according to the rating information in order to facilitate the selection of programs for a parameter set. A program library that may include particularly effective programs organized according to a directory structure may be stored in a memory. One or both of the implantable medical device and a patient programmer may store usage information that provides an objective assessment of therapy use by the patient, and allows a clinician to later improve the therapy based on the usage information.

Abstract: Devices, systems, and techniques for ramping one or more parameter values of electrical stimulation are disclosed. An implantable medical device may increase or decrease a parameter value, e.g., amplitude or pulse width, over time to reach a target value of the parameter. In one example, a memory may be configured to store a plurality of amplitude ramp schedules. At least one processor may be configured to obtain a stimulation parameter set that at least partially defines an electrical stimulation therapy, select one of the plurality of amplitude ramp schedules based on a signal frequency of the stimulation parameter set, and increase an amplitude of the electrical stimulation therapy during a ramp period defined by the selected amplitude ramp schedule.

Abstract: A battery comprises a battery case forming a substantially sealed enclosure and an electrode stack within the enclosure. The electrode stack includes a first set of electrode elements and a second set of electrode elements. The electrode elements in the second set alternate with the electrode elements in the first set within the electrode stack. A conductive tab extends from each of the electrode elements in the first and second sets, wherein each of the conductive tabs in the first set forms an aperture, wherein the apertures are coincident with each other. The battery further comprises a feedthrough including a feedthrough pin extending through the battery case and through each of the coincident apertures, wherein the feedthrough pin serves as a positive terminal for the battery.

Abstract: A 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: A system and method for a procedure that can be performed on any appropriate subject. Procedures can include assembling any appropriate work piece or installing members into a work piece, such as an airframe, autoframe, etc. Regardless of the subject, generally the procedure can have a selected result that is efficacious. The efficacious result may be the desired or best result for the procedure. The system and method can be used in confirming a selected result that can be efficacious.

Abstract: A medical lead screening connector includes a housing, a plurality of lead receptor channels disposed within the housing, a cover hingedly attached to the housing, and a base element rotationally attached to the housing. Each lead receptor channel includes at least two lead receptor contacts. A conductor cable is attached to and extends away from the housing. The base element is configured to reel in the conductor cable upon rotation of the base element.

Abstract: A device for delivering fluid to a user includes a housing, a drive motor assembly in the housing, other internal components in the housing, and a keypad external to the housing. The device includes a number of features and elements that enhance its operation, manufacturability, reliability, and user-friendliness. These features and elements include a shock absorbing element for a battery of the device, a keypad actuator layer that overlies a keypad assembly and forms a water resistant seal with the housing, and an offset element for a piezoelectric speaker that is located inside the housing.

Abstract: A system for determining a location of an instrument within an anatomy is provided. The system can include a first instrument, which can define at least one lumen. The system can further include a second instrument, which can be received through the at least one lumen. The system can include at least one electrode, which can be coupled to a distal end of the first instrument. The electrode can be responsive to electrical activity to generate at least one signal. The system can include a sensing unit, which can be in contact with the anatomy to sense electrical activity within the anatomy at a location near the instrument. The sensing unit can be in communication with the electrode to receive the signal. The system can further include a control module that can determine, based on the sensed electrical activity and the signal, the location of the first instrument.