Abstract: Thrombectomy catheters are presented that have curved tip portions. A suction lumen extends from at or near the proximal end of the catheter to a suction port at or near the tip portion of the catheter. The curves of the thrombectomy catheter can be selected to place a suction port at or near a vessel wall for the more effective removal of thrombus resulting from directing the suction in the direction of the thrombus. In some embodiments, the tip portion of the catheter can be transitioned from a first configuration for delivery of the catheter into the vessel to a second more curved configuration with a desired design for application of suction. The catheter can be moved in a circumferential and/or lateral direction to cover selected portions of the inner vessel wall. In some embodiments, a partially occlusive structure can be used to reduce and/or redirect flow within the vessel to improve performance of the thrombectomy.

Abstract: A surgical cutting instrument including two coaxially arranged tubular members. The first tubular member has a cutting tip and is co-axially disposed within the second tubular member, which in turn has a cutting window to expose the cutting tip to tissue and bone through the cutting window. Movement of the tubular members with respect to each other debrides soft tissue and thin bone presented to the cutting window. The second (outer) tubular member has one or more features which contribute to reduced clogging of the cutting tip as a whole.

Abstract: Polarization signals, which represent voltages measured at a pacemaker electrode, are not constant and may drift. Polarization signal drift, which often precedes undesirable pace polarization artifacts, is more significant when the pacemaker is inhibited from providing an electrical stimulation to the patient's heart. The present invention provides an implantable system and methods for stabilization of a polarization signal. Electrical pulses may be applied to stabilize a polarization signal. In one implementation of the invention, polarization signal stabilization may be used as part of process to terminate tachycardia.

Abstract: A guiding accessory, for use in conjunction with a guidewire and a catheter of an implant system, facilitates passage of an elongate and flexible conductor of a relatively compact therapy delivery device to an implant site, for example, within the cardiac venous system, when a therapy generator of the device is held within a distal portion of the catheter, and the catheter, device and guiding accessory are advanced along the guidewire. The guiding accessory includes a helically extending wall that forms a lumen within which the device conductor and guidewire extend. After advancing the catheter, guiding accessory and device to the implant site, the helically extending wall is unwound from around the device conductor, for removal, preferably, by pulling proximally on a tension line, which is attached to a proximal end of the wall.

Abstract: The disclosure describes a user interface that may be used to control ablation therapy and monitor ablation therapy progress in systems that utilize wet electrode ablation techniques. The user interface presents a virtual electrode depth icon to a user that indicates the size of a lesion that may be created with the selected virtual electrode depth. The virtual electrode depth may be changed by the user according to the ablation therapy most appropriate for a patient, and the user may interact with the user interface to define the virtual electrode depth. In this manner, the user interface may be a touchscreen or other input device such as a mouse, pointing device, or keyboard. The user interface may also provide a thermometer icon that represents a patient temperature, a timer icon that represents a remaining time for therapy, and other representations of therapy progress.

Abstract: At least one of a medical device, such as an implantable medical device, and a programming device determines values for one or more metrics that indicate the quality of a patient's sleep. Sleep efficiency, sleep latency, and time spent in deeper sleep states are example sleep quality metrics for which values may be determined. In some embodiments, determined sleep quality metric values are associated with a current therapy parameter set. In some embodiments, a programming device presents sleep quality information to a user based on determined sleep quality metric values. A clinician, for example, may use the sleep quality information presented by the programming device to evaluate the effectiveness of therapy delivered to the patient by the medical device, to adjust the therapy delivered by the medical device, or to prescribe a therapy not delivered by the medical device in order to improve the quality of the patient's sleep.

Abstract: Techniques relate to operating a medical device by classifying a detected posture state of a patient. This classification may be performed by comparing the detected posture state of the patient to posture state definitions available within the system. Each definition may be described in terms of a parameter (e.g., vector) indicative of a direction in three-dimensional space. The posture state definitions may be calibrated by automatically estimating values for these parameters, thereby eliminating the need for the patient to assume each posture state during the calibration process to capture actual parameter values. According to another aspect, the estimated parameter values may be updated as the patient assumes various postures during a daily routine. For instance, estimated vectors initially used to calibrate the posture state definitions may be changed over time to more closely represent posture states the patient actually assumes, and to further adapt to changes in a patient's condition.

Abstract: A medical device system for comparing a cardiopulmonary signal to a brain signal. In one embodiment of the invention, a medical device system is provided that includes a brain monitoring element, respiratory monitoring element and a processor. The processor is configured to receive a brain signal from the brain monitoring element and a respiratory signal from the respiratory monitoring element. The processor is further configured to compare the brain signal to the respiratory signal. Methods of comparing a brain signal to a cardiopulmonary signal are also provided.

Abstract: A contrast agent can be infused into a subject and a determination can be made of a VOD and/or a concentration gradient of the contrast agent in the VOD. The contrast agent can be infused in the subject using selected parameters. A correlation to a selected material can be made to determine parameters for infusion the selected material.

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 delivery system for use with a prosthetic heart valve having a stent frame to which a valve structure is attached includes a shaft assembly including a distal end, an intermediate portion, and a first coupling structure disposed near the distal end and configured to be coupled to a distal end of the prosthetic heart valve via a first tether. A sheath assembly defines a lumen sized to slidably receive the shaft assembly. The delivery system is configured to transition from a loaded state in which the sheath assembly encompasses the prosthetic heart valve to a deployed state in which the sheath assembly is withdrawn from the prosthetic heart valve. The first coupling structure is configured to be manipulated in a first direction to provide a controlled expansion or contraction of the distal end of the prosthetic heart valve.

Abstract: A combination material can be infused into a subject and a determination can be made of a VOD and/or a convection gradient of a liquid material portion in the VOD. The combination material can be infused in the subject using selected parameters. A correlation of data relating to the liquid material can be made to a selected material to determine parameters for infusion the selected material.

Abstract: A medical device includes a first substrate, a second substrate, a control module, and an energy storage device. The first substrate includes at least one of a first semiconductor material and a first insulating material. The second substrate includes at least one of a second semiconductor material and a second insulating material. The second substrate is bonded to the first substrate such that the first and second substrates define an enclosed cavity between the first and second substrates. The control module is disposed within the enclosed cavity. The control module is configured to at least one of determine a physiological parameter of a patient and deliver electrical stimulation to the patient. The energy storage device is disposed within the cavity and is configured to supply power to the control module.

Abstract: A transseptal sheath defining a sheath lumen, a proximal end, and a distal end. A valve disposed within the sheath lumen proximate the distal end. The transseptal sheath defining at least one port along a portion of its periphery proximate the valve.

Abstract: A method and apparatus for optimizing a computer assisted procedure is provided. A method and apparatus for performing a procedure is also provided. Data can be accessed and processed to optimize and perform a procedure. The data can be augmented or supplemented with patient specific data.

Abstract: A surgical apparatus and method according to which a cable assembly is connected to a handpiece and includes a sensing element, and a member adapted to move relative to the sensing element to control the operation of a motor in the handpiece.

Abstract: Devices, systems and methods are disclosed for the ablation of tissue. Embodiments include an ablation catheter that has an array of ablation elements attached to a deployable carrier assembly. The carrier assembly can be constrained within the lumen of a catheter, and deployed to take on an expanded condition. The carrier assembly includes multiple electrodes that are configured to ablate tissue at low power. Systems include an interface unit with a visual display that provides a visual representation of the geometry of the ablation elements and/or provides selection means for selecting an icon provided on the display.

Abstract: A surgical access device including a lower portion having a central opening spaced from a lower portion outer wall, an upper portion adjacent to the lower portion and having a central opening spaced from an upper portion outer wall, and at least one flange portion extending outwardly from the upper and lower portions. The device can further include a gap extending from the central openings of the lower and upper portions and through their outer walls.

Abstract: Embodiments of close loop optimization of atrio-ventricular (A-V) delay interval and/or inter-ventricular (V-V) timing are disclosed. An implantable medical device includes a housing that supports a processing means adapted for implantation in a patient. There can be two or more electrodes electrically coupled to the processing means where the two or more electrodes can be used for sensing a patient's cardiac signals, which include a far-field EGM. The processing means can determine a width of a P-wave from the sensed far-field EGM. Also included can be a means for delivering an adapted cardiac pacing therapy based upon the width of the P-wave, including revised A-V delay and/or V-V temporal intervals.

Abstract: Operating techniques and methodologies for a body area network of medical devices are provided. One technique relates to an intelligent channel hopping scheme that detects loss of wireless synchronization on an initial wireless channel, thereafter obtains a measure of quality for the initial wireless channel, and then selects a new wireless channel when the obtained measure of quality fails to satisfy a threshold criteria. Another operating technique dynamically adapts an ordered list of available wireless channels in accordance with a quality measure of the available wireless channels. Thus, when quality degradation associated with a first wireless channel is detected, the ordered list can be updated to indicate a lower preference for the first wireless channel and to indicate a higher preference for a second wireless channel that does not suffer from quality degradation.