Abstract: Techniques for modeling therapy fields for therapy delivered by medical devices are described. Each therapy field model is based on a set of therapy parameters and represents where therapy will propagate from the therapy system delivering therapy according to the set of therapy parameters. Therapy field models may be useful in guiding the modification of therapy parameters. As one example, a processor compares an algorithmic model of a therapy field to a reference therapy field and adjusts at least one therapy parameter based on the comparison. As another example, a processor adjusts at least one therapy parameter to increase an operating efficiency of the therapy system while substantially maintaining the modeled therapy field.

Abstract: A portable medical device is provided with an internal accelerometer device. The medical device includes a circuit board, the accelerometer device, and a response module coupled to the accelerometer device. The accelerometer device is mechanically and electrically coupled to the circuit board, and it includes a plurality of mass-supporting arms for a plurality of electrically distinct sensor electrodes, piezoelectric material for the mass-supporting arm, and a proof mass supported by the mass-supporting arms. Each of the mass-supporting arms has one of the sensor electrodes located thereon. Acceleration of the proof mass causes deflection of the piezoelectric material, which generates respective sensor signals at one or more of the sensor electrodes. The response module is configured to initiate an acceleration-dependent operation of the portable medical device in response to generated sensor signals present at the sensor electrodes.

Abstract: A method for adjusting delivery of a therapeutic fluid to a patient suffering from or at risk of pulmonary arterial hypertension includes introducing the therapeutic fluid to a patient via a catheter at a predetermined rate. The catheter is positioned to deliver the fluid to the right ventricle or the pulmonary artery. The catheter a one-way valve configured to allow the fluid to flow from the catheter to the target location. The method further includes monitoring pressure of the target location by monitoring internal catheter pressure, and adjusting the rate at which the therapeutic fluid is introduced to the catheter based on the monitored pressure. The rate at which the fluid is introduced to the catheter is increased if internal catheter pressure increases, and the rate at which the fluid is introduced to the catheter is decreased if the internal catheter pressure decreases.

Abstract: Medical leads include a lumen body at an end of the lead, and the lumen body includes multiple filar lumens. The lumen body is joined to a lead body, and electrical connectors are longitudinally spaced along the lumen body. Filars within the filar lumens are directed through filar passageways within the lumen body to attach to the electrical connectors on the lumen body. The filar passageways may be aligned with the filar lumens, and slots within the electrical connectors may be aligned with the filar passageways to facilitate assembly. The lumen body may provide additional stiffness to the end of the lead where the lumen body is located to facilitate lead insertion into the medical device. The filar lumens of the lumen body may have a longitudinally straight configuration so that the portions of filars within the filar lumens are held in a longitudinally straight configuration.

Abstract: Systems and methods are provided for modulating the autonomic nervous system by the electrical stimulation of the neuro-muscular system of a patient, and include an implantable electrical system for gastrointestinal stimulation which incorporates a heart rate sensor to indicate the neurovegetative patient condition, to initiate and terminate stimulation at specific locations, and an algorithm to automatically control electrical stimulation frequency, interval, amplitude, or a combination of such parameters for adaptive treatment of obesity, anorexia, other eating disorders, diseases related with the so called “metabolic syndrome” (e.g., impaired glucose tolerance and diabetes type 2, GERD, systemic hypertension, early arterovascular degeneration, early senility, and the like), and disorders related to a pathologic inbalance of the autonomic nervous system.

Abstract: A method for identifying oversensing in implantable medical devices (IMDs), such as implantable cardioverter defibrillators (ICDs), is described. A near-field electrogram signal and a far-field electrogram signal are obtained via a near-field electrode pair and a far-field electrode pair. The near-field electrogram signal is compared to the far-field electrogram signal and a determination of whether oversensing exists is made based on the comparison. In some instances, a scheduled therapy is withheld in response to determining that oversensing exists.

Abstract: A delivery system having an improved handle allowing operation of the delivery system with one hand while maintaining accuracy in delivery and deployment of a prosthesis in a body lumen. The delivery system includes a sheath and a handle. The handle includes a slide shaft having a threaded outer surface, and a hub assembly coupled to the sheath. The hub assembly includes an inner slider having a thread tooth pivot support, a thread tooth pivotably mounted to the thread tooth pivot support, a distal sleeve having a thread tooth press member pressing on the thread tooth, and a proximal sleeve. Motion of the distal sleeve relative to the inner slider pivots the thread tooth on the thread tooth pivot support to engage and disengage the hub assembly with the threaded outer surface. The distal sleeve is rotatably coupled to the proximal sleeve, and the proximal sleeve is prevented from rotating to provide a stable grip to allow operation of the catheter with one hand.

Abstract: A medical device delivers a therapy to a patient. Posture events are identified, e.g., a posture of the patient is periodically determined and/or posture transitions by the patient are identified, and each determined posture event is associated with a current therapy parameter set. A value of at least one posture metric is determined for each of a plurality of therapy parameter sets based on the posture events associated with that therapy parameter set. A list of the therapy parameter sets is presented to a user, such as a clinician, for evaluation of the relative efficacy of the therapy parameter sets. The list may be ordered according to the one or more posture metric values to aid in evaluation of the therapy parameter sets. Where values are determined for a plurality of posture metrics, the list may be ordered according to the one of the posture metrics selected by the user.

Abstract: Systems and methods of removing bacterial biofilm from a target site using a biofilm removal endoscope. The endoscope has an insertion portion including an imaging channel terminating at a viewing window and an irrigation channel terminating at a nozzle. The imaging and irrigation channels are permanently affixed relative to one another. The insertion portion is inserted into the patient, with a working end thereof being disposed proximate the target site. The target site is imaged and a flow of fluid is dispensed via the nozzle to mechanically remove bacterial biofilm from the target site.

Abstract: The present invention provides systems and methods for the repair, removal, and/or replacement of heart valves. The methods comprise introducing a delivery system into the heart, wherein a prosthesis is disposed on the delivery member attached to the delivery system, advancing the prosthesis to the target site, and disengaging the prosthesis from the delivery member at the target site for implantation. The present invention also provides implant systems for delivering a prosthesis to a target site in or near the heart. In one embodiment of the present invention, the implant system comprises a delivery system, an access system, and a prosthesis.

Abstract: An imaging apparatus and related method comprising a detector located a distance from a source and positioned to receive a beam of radiation in a trajectory; a detector positioner that translates the detector to an alternate position in a direction that is substantially normal to the trajectory; and a beam positioner that alters the trajectory of the radiation beam to direct the beam onto the detector located at the alternate position.

Abstract: A capacitor for an implantable medical device is presented. The capacitor includes an anode, a cathode, a separator therebetween, and an electrolyte over the anode, cathode, and separator. The electrolyte includes ingredients comprising acetic acid, ammonium acetate, phosphoric acid, and tetaethylene glycol dimethyl ether. The capacitor has an operating voltage ninety percent or greater of its formation voltage.

Abstract: Infusion catheter systems and methods are described herein that incorporate flow restrictors to balance flow to multiple target sites serviced by delivery catheters. Fluids may be delivered to the target sites using multiple separate delivery catheters or through multiple separate lumens located in the same delivery catheter. Flow balancing may be performed between multiple catheters that are fed from a single fluid source, between multiple separate lumens in a single delivery catheter that are also fed from a single fluid source. Multiple catheters may be fluidly connected to one or more flow restrictors housed within an anchor or in another embodiment, a catheter may be fluidly connected to a restrictor housed in one anchor and another catheter fluidly connected to a second anchor wherein each of the restrictors is also fluidly connected to a single fluid source.

Abstract: A powered screwdriver system includes an electric ratchet. In accordance with one aspect, the powered screwdriver system includes a driver housing and includes a motor disposed within the housing. A working end provides a rotational output and is mechanically coupled to the rotor. A power source provides power to the motor. A controller receives signals representative of a motor condition and, based on the received signals, controls the motor in a manner providing the electric ratchet.

Abstract: A shield located within an implantable medical lead may be terminated in various ways at a metal connector. The shield may be terminated by various joints including butt, scarf, lap, or other joints between insulation layers surrounding the lead and an insulation extension. The shield may terminate with a physical and electrical connection to a single metal connector. The shield may terminate with a physical and electrical connection by passing between an overlapping pair of inner and outer metal connectors. The metal connectors may include features such as teeth or threads that penetrate the insulation layers of the lead. The shield may terminate with a physical and electrical connection by exiting a jacket of a lead adjacent to a metal connector and lapping onto the metal connector.

Abstract: A method of delivering therapy to a target site. The method includes (a) obtaining a base image of the target site, (b) injecting a dose of a mix of a therapeutic agent and a contrast agent into a first injection location at the target site via a needle passing through a catheter, (c) collecting sequential fluoroscopic images of a contrast agent dispersion cloud at the first injection location, (d) determining a contrast agent dispersion area from the sequential fluoroscopic images, (e) determining a therapeutic agent dispersion area from the contrast agent dispersion area, (f) marking the therapeutic agent dispersion area on the base image of the target site, and (g) repeating (b) through (f) until the target site is substantially covered with overlapping therapeutic agent dispersion areas corresponding to a plurality of injections at a plurality of injection locations at the target site.

Abstract: Chronic wounds may be treated by debriding necrotic and other devitalized tissue from the wound, and applying to the wound an extracellular polymeric substance solvating system comprising a metal ion sequestering agent, surfactant and buffering agent. The solvating system disrupts biofilms which may be present in the wound and aids or enables the resumption of normal healing.

Abstract: This disclosure is directed toward techniques for classifying a tachycardia as supraventricular tachycardia or ventricular tachycardia. A method comprises detecting a tachycardia based on at least one value of a cardiac interval, delivering vagal stimulation in response to the detection of the tachycardia, sensing a physiological parameter other than the cardiac interval during or subsequent to delivering the vagal stimulation, and classifying the tachycardia as supraventricular or ventricular based on the sensed physiological parameter. In some examples, the method includes sensing a response of a physiological parameter other than cardiac rate to the vagal stimulation, such as pressure or a morphological characteristic of the cardiac electrical waveform. The method may include providing an indication to a user based on the classification of supraventricular tachycardia, or delivery of appropriate electrical therapy based on the classification of ventricular tachycardia or ventricular fibrillation.

Abstract: Techniques for controlling therapy delivery based on the relative orientation and/or motion of a device accelerometer and a lead accelerometer are described. In one embodiment, a therapy system includes an electrical stimulator and a lead. The electrical stimulator comprises a processor that controls delivery of a therapy to a target stimulation site in a patient and a device accelerometer coupled to the electrical stimulator. The lead is coupled to the electrical stimulator to deliver the therapy from the electrical stimulator to the target stimulation site in the patient, and includes a lead accelerometer. The processor compares signals from the accelerometers, and controls delivery of the therapy to the patient based on the comparison. In this manner, the processor may adjust stimulation to, for example, address movement of electrodes relative to target tissue when a patient changes postures.

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.