Abstract: An elastic percutaneous elastic introducer sheath is disclosed which can locally expand and reduce to accommodate a transcatheter medical device. The elastic introducer sheath includes a non-circumferentially continuous wire structure, a liner, and a jacket.

Abstract: A method and apparatus for treatment of cardiac and renal diseases associated with the elevated sympathetic renal nerve activity by implanting a device to block the renal nerve signals to and from the kidney. The device can be a drug pump or a drug eluding implant for targeted delivery of a nerve-blocking agent to the periarterial space of the renal artery.

Abstract: This disclosure describes a chopper stabilized instrumentation amplifier. The amplifier is configured to achieve stable measurements at low frequency with very low power consumption. The instrumentation amplifier uses a differential architecture and a mixer amplifier to substantially eliminate noise and offset from an output signal produced by the amplifier. Dynamic limitations, i.e., glitching, that result from chopper stabilization at low power are substantially eliminated through a combination of chopping at low impedance nodes within the mixer amplifier and feedback. The signal path of the amplifier operates as a continuous time system, providing minimal aliasing of noise or external signals entering the signal pathway at the chop frequency or its harmonics. The amplifier can be used in a low power system, such as an implantable medical device, to provide a stable, low-noise output signal.

Abstract: A method of detecting a fault condition within an implantable medical pump comprises delivering therapeutic fluid using a medical pump comprising an actuation mechanism configured to be energized to provide a pump stroke, detecting a property associated with energizing the actuation mechanism, and determining whether the property associated with energizing the actuation mechanism indicates that a fault condition exists with the medical pump.

Abstract: A heart valve prosthesis configured for placement at a mitral valve in the heart is disclosed that includes a stent-like support structure for supporting a prosthetic mitral valve. The support structure is configured to have a low ventricular profile with only a short length thereof protruding into the left ventricle when deployed in vivo. The support structure includes an upstream section that is outwardly expandable to sit against the atrial wall so as to at least partially anchor the prosthesis therein and a downstream section to which the prosthetic mitral valve is coupled that extends between the left atria and ventricle through the native mitral valve. The low-ventricular profile of the prosthesis is achieved by shaping the support structure such that the downstream section extends within and overlaps with the upstream section at given regions around the circumference of the support structure in an expanded configuration.

Abstract: An implantable medical device is provided having circuitry to control operation of the implantable medical device and a receiver configured to receive communication signals on an allocated band of a plurality of communication channels separated in frequency by a channel spacing. The receiver includes an oscillator and a signal source configured to apply a quench signal to the oscillator. The quench signal has a frequency corresponding to the channel spacing. The receiver is enabled to receive on all of the plurality of communication channels simultaneously by applying the quench signal.

Abstract: A valve prosthesis comprises a valve fixation device that comprises a plurality of struts that run in a direction substantially parallel to the longitudinal axis; a first circumferential row of cells coupled to the plurality of struts; and a second circumferential row of cells coupled to the plurality of struts. The valve fixation device is compressible to a compressed state for delivery to an implantation site, and expandable to an expanded state for deployment at the implantation site. The plurality of struts are substantially rigid such that the plurality of struts do not change dimensions between the compressed state and the expanded state. The valve prosthesis also comprises a valve comprising a plurality of leaflets and a plurality of commissures. The valve is coupled to the valve fixation device such that the plurality of commissures are radially aligned with respective struts of the plurality of struts.

Abstract: Methods include monitoring indicators of blood pH or blood electrolyte levels during a blood fluid removal session and adjusting concentrations of pH buffers or electrolytes in dialysate or replacement fluid used during the session based on the monitored indicators. Blood fluid removal systems may employ sensors that monitor blood pH or electrolyte levels to adjust the fluid parameters during a blood fluid removal session.

Abstract: An attachment mechanism for coupling a stent to a delivery system is disclosed. The delivery system includes an inner shaft assembly. The attachment mechanism is configured to pivot relative to the inner shaft assembly of the delivery system in order to release the stent from the delivery system upon retraction of a delivery sheath capsule compressively containing the stent.

Abstract: Methods for treating polycystic kidney disease with therapeutic renal neuromodulation and associated systems and methods are disclosed herein. One aspect of the present technology is directed to methods that at least partially inhibit sympathetic neural activity in nerves proximate a renal artery of a kidney of a patient. One or more measurable physiological parameter corresponding to the polycystic kidney disease can thereby be reduced. Moreover, central sympathetic drive in the patient can be reduced in a manner that treats the patient for the polycystic kidney disease. Renal sympathetic nerve activity can be modulated along the afferent and/or efferent pathway. The modulation can be achieved, for example, using an intravascularly positioned catheter carrying a neuromodulation assembly, e.g., a neuromodulation assembly configured to cryotherapeutically cool the renal nerve or to deliver an energy field to the renal nerve.

Abstract: In general, the disclosure is directed to an implantable neurostimulator and system capable of providing adaptive neurostimulation therapy to alleviate incontinence. The neurostimulator operates according to a set of stimulation parameters stored in memory. During operation, information is obtained from the patient, the implanted neurostimulator, one or more implanted sensors, or some combination thereof. A processor analyzes the information to automatically generate proposed adjustments to the stimulation parameters applied by the neurostimulator. The adjustments provide an adaptive neurostimulation therapy that supports or enhances therapeutic efficacy based on the information.

Abstract: A method for loading a prosthesis onto a delivery system includes passing a distal end of a delivery system through a first open end and a second open end of a reducing member. The method includes seating the prosthesis in a piston member of a cap by contacting a first end of the prosthesis with a first surface of the piston member and by contacting a portion of a side of the prosthesis with at least one side wall extending from the periphery of the first surface. Additionally, the method includes inserting the distal end of the delivery system into a center of the prosthesis and an opening defined by the piston member. And the method includes advancing the cap towards a reducing member such that a portion of the prosthesis seated in the piston member advances along an inner surface of the conical wall of the reducing member.

Abstract: An extensible implantable electrical lead includes a lead body having a proximal region and a distal region. The lead body is formed of a polymeric material that is extensible between a first length and a second length. A first plurality of electrical conductors are disposed within the lead body and extend between the proximal region and the distal region. The first plurality of electrical conductors are each electrically insulated and spaced apart from each other and form a side-by-side co-planar first sigmoidal pattern between the proximal region and the distal region.

Abstract: Techniques for minimizing interference between the first and second medical devices or between the different therapy modules of a common medical device are described herein. In some examples, a medical device may include shunt-current mitigation circuitry and/or at least one clamping structure that helps minimize or even eliminate shunt-current that feeds into a first therapy module of the medical device via one or more electrodes electrically connected to the first therapy module. The shunt-current may be generated by the delivery of electrical stimulation by a second therapy module. The second therapy module may be enclosed in a common housing with the first therapy module or may be separate, e.g., a part of a separate medical device.

Abstract: Infusion systems, infusion devices, and related operating methods are provided. An exemplary method of operating an infusion device capable of delivering fluid to a user involves determining one or more signal characteristics associated with a subset of the measurements corresponding to a monitoring period, determining a reliability metric for the monitoring period based on the one or more signal characteristics, and providing indication of a maintenance condition when the reliability metric violates a threshold.

Abstract: Infusion systems, infusion devices, and related operating methods are provided. An exemplary method of operating an infusion device involves obtaining a filtered measurement indicative of a physiological condition of a user, determining a metric indicative of a characteristic of the filtered measurement based at least in part on one or more derivative metrics associated with the filtered measurement, and determining an output measurement indicative of the physiological condition of the user based at least in part on the filtered measurement, the metric, and a previous output measurement.

Abstract: Infusion systems, infusion devices, and related operating methods are provided. An exemplary method of operating an infusion device capable of delivering fluid to a user involves obtaining one or more uncalibrated measurements indicative of the physiological condition, obtaining one or more reference measurements of the physiological condition, determining a raw calibration factor based on a relationship between the one or more uncalibrated measurements and the one or more reference measurements corresponding to the respective uncalibrated measurements of the one or more uncalibrated measurements, and determining an adjusted calibration factor based at least in part on an expected calibration factor and the raw calibration factor, wherein operation of the infusion device to deliver the fluid is influenced by the adjusted calibration factor.

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: A system and method for decompensation prediction of a heart failure patient with one or more injectable detecting systems communicating wirelessly with a remote monitoring system. The system includes one or more injectable detecting systems having a plurality of sensors that provide an indication of at least one physiological event of a patient, a wireless communication device coupled to the one or more injectable detecting systems and configured to transfer patient data directly or indirectly from the one or more injectable detecting systems to a remote monitoring system, and a remote monitoring system coupled to the wireless communication device, the remote monitoring system using processed data to determine heart failure status and predict impending decompensation of the patient.

Abstract: The disclosure relates generally to wireless communication with an implantable medical device. An implantable medical device (IMD) may initiate the establishment of a communication session by sending a wakeup communication to an external device with which the IMD desires to communicate. The external device may operate in low power state (sometimes referred to as a sleep state or a low current state) in which the external device occasionally powers up telemetry circuitry to monitor for the wakeup communication from the IMD. Upon receiving the wakeup communication, the external device transitions from the low power state to a high power state to establish the communication session with the IMD. Operating the external device in the low power state when no communication session is established reduces the amount of power consumed by the external device when no telemetry is occurring, thus enabling the external device to be powered by a battery.