Abstract: Methods and apparatus are provided for pulsed electric field (PEF) neuromodulation via an intra-to-extravascular approach, e.g., to effectuate irreversible electroporation or electrofusion, necrosis and/or inducement of apoptosis, alteration of gene expression, changes in cytokine upregulation and other conditions in target neural fibers. In some embodiments, an apparatus includes an intravascular catheter having one or more electrodes configured for intra-to-extravascular placement across a wall of patient's vessel into proximity with target neural fibers. With the electrode(s) passing from an intravascular position to an extravascular position prior to delivery of the PEF, a magnitude of applied voltage or energy delivered via the electrode(s) and necessary to achieve desired neuromodulation may be reduced relative to an intravascular PEF system having one or more electrodes positioned solely intravascularly.

Abstract: A method of delivering and deploying a valve prosthesis includes delivering the valve prosthesis disposed in a delivery catheter to a native valve, proximally retracting a delivery catheter tube of the delivery catheter such that three engagement arms of a support of the valve prosthesis are released from the delivery catheter tube and flare outwardly while an inflow frame portion of the support remains within a distal portion of the delivery catheter, and distally advancing the distal portion of the delivery catheter such that the inflow frame portion is released from the distal portion.

Abstract: Aspects of the present disclosure are directed to an implantable medical device including a housing containing components therein configured for delivering neurostimulation therapy, and an anchoring feature included with the housing. The implantable medical device also includes a lead having an electrode. In one aspect, the implantable medical device may include a guidewire passageway configured to allow the lead of implantable medical device to be introduced over a guidewire.

Abstract: Techniques for remote monitoring of a patient and corresponding medical device(s) are described. The remote monitoring comprises determining identification data and identifying implantable medical device (IMD) information, initiating an imaging device and determining an imaging program, receiving one or more frames of image data including image(s) of an implantation site, identifying an abnormality at the implantation site, triggering a supplemental image capture mode, receiving one or more supplemental images of the implantation site, and outputting the one or more supplemental images of the implantation site.

Abstract: A method and system for identifying an implant in an x-ray image of an anatomy shown on a display screen. The method includes: displaying the image including an artifact of the implant; prompting a user to enter parameters of the implant; displaying a rendering of the implant over the image; prompting the user to position the rendering on the artifact at an accurate position corresponding to an actual position of the implant; alerting the user when the rendering is at an inaccurate position; prompting the user to reposition the rendering from the inaccurate position to the accurate position; alerting the user when the rendering is maneuvered by the user to the accurate position; and after the rendering has been maneuvered to the accurate position by the user, reconstructing the x-ray image to replace the artifact with the rendering affixed in the accurate position.

Abstract: A surgical bur is disclosed having cutting and trailing edges and associated flutes and lands. Each flute includes a cutting edge. Each of the trailing edges relatives in a selected dimension to a preceding cutting edge.

Abstract: Provided herein are methods, devices and compositions for assessing neuromodulation efficacy based on changes in the level of one or more biomarkers in plasma or urine collected from a human subject following a renal neuromodulation procedure.

Abstract: Techniques for remote monitoring of a patient and corresponding medical device(s) are described. The remote monitoring comprises identifying a first set of images that represent a particular location of a body of a patient in which at least one component of an implantable medical device (IMD) coincides, determining a projection of alteration characteristics of the particular location of the body, identifying a second set of images, determining a second set of alteration characteristics, comparing the second set of alteration characteristics to the projection, and identifying a potential abnormality at the particular location of the body.

Abstract: Catheter apparatuses, systems, and methods for achieving renal neuromodulation by intravascular access are disclosed herein. One aspect of the present technology, for example, is directed to a treatment device having a multi-electrode array configured to be delivered to a renal blood vessel. The array is selectively transformable between a delivery or low-profile state (e.g., a generally straight shape) and a deployed state (e.g., a radially expanded, generally helical shape). The multi-electrode array is sized and shaped so that the electrodes or energy delivery elements contact an interior wall of the renal blood vessel when the array is in the deployed (e.g., helical) state. The electrodes or energy delivery elements are configured for direct and/or indirect application of thermal and/or electrical energy to heat or otherwise electrically modulate neural fibers that contribute to renal function or of vascular structures that feed or perfuse the neural fibers.

Abstract: A catheter may include an elongate body including a proximal portion including a proximal end, and a distal tip portion. The distal tip portion may include an inner liner and a marker band circumferentially surrounding the inner liner. The distal tip portion also may include an outer jacket circumferentially surrounding a first portion of the inner liner and ending proximal of a proximal end of the marker band; and a tip outer jacket circumferentially surrounding a second portion of the inner liner and the marker band. The tip outer jacket extends distally past the marker band distal end to a distal tip of the elongate body, and a proximal end of the tip outer jacket may be laterally adjacent to a distal end of the outer jacket.

Abstract: An implantable electrical stimulation medical system is disclosed. The system includes an implantable medical device having electrical circuitry configured to perform electrical stimulation, a nonstandard implantable medical lead, and an adapter matrix. The adapter matrix electrically interfaces with the electrical circuitry and the nonstandard implantable medical lead to provide electrical stimulation from the implantable medical device to the nonstandard implantable medical lead.

Abstract: An intracardiac ventricular pacemaker having a motion sensor, a pulse generator and a control circuit coupled to the pulse generator and the motion sensor is configured to identify a ventricular systolic event, detect a ventricular passive filling event signal from the motion signal, and determine a time interval from the ventricular systolic event to the ventricular passive filling event. The pacemaker establishes a minimum pacing interval based on the time interval.

Abstract: Techniques and devices for implementing the techniques for adjusting atrial arrhythmia detection based on analysis of one or more P-wave sensing windows associated with one or more R-waves. An implantable medical device may determine signal characteristics of the cardiac signal within the P-wave sensing window, determine whether the cardiac signal within the sensing window corresponds to a P-wave based on the determined signal characteristics, determine a signal to noise ratio of the cardiac signal within the sensing window, update the arrhythmia score when the P-wave is identified in the sensing window and the determined signal to noise ratio satisfies a signal to noise threshold.

Abstract: The disclosure is directed to programming implantable stimulators to deliver stimulation energy via one or more implantable leads having complex electrode array geometries. The disclosure also contemplates guided programming to select electrode combinations and parameter values to support efficacy. The techniques may be applied to a programming interface associated with a clinician programmer, a patient programmer, or both. A user interface permits a user to view electrodes from different perspectives relative to the lead. For example, the user interface provides a side view of a lead and a cross-sectional view of the lead. The user interface may include an axial control medium to select and/or view electrodes at different axial positions along the length of a lead, and a rotational control medium to select and/or view electrodes at different angular positions around a circumference of the lead.

Abstract: A fixation mechanism of an implantable medical device is formed by a plurality of tines fixedly mounted around a perimeter of a distal end of the device. Each tine may be said to include a first segment fixedly attached to the device, a second segment extending from the first segment, and a third segment, to which the second segment extends. When the device is loaded in a lumen of a delivery tool and a rounded free distal end of each tine engages a sidewall that defines the lumen, to hold the tines in a spring-loaded condition, the first segment of each tine, which has a spring-biased pre-formed curvature, becomes relatively straightened, and the third segment of each tine, which is terminated by the free distal end, extends away from the axis of the device at an acute angle in a range from about 45 degrees to about 75 degrees.

Abstract: A ventricular pacemaker is configured to determine a ventricular rate interval by determining at least one ventricular event interval between two consecutive ventricular events and determine a rate smoothing ventricular pacing interval based on the ventricular rate interval. The pacemaker is further configured to detect an atrial event from a sensor signal and deliver a ventricular pacing pulse in response to detecting the atrial event from the sensor signal. The pacemaker may start the rate smoothing ventricular pacing interval to schedule a next pacing pulse to be delivered upon expiration of the rate smoothing ventricular pacing interval.

Abstract: Neuromodulation cryotherapeutic devices and associated systems and methods are disclosed herein. A cryotherapeutic device configured in accordance with a particular embodiment of the present technology can include an elongated shaft having distal portion and a supply lumen along at least a portion of the shaft. The shaft can be configured to locate the distal portion intravascularly at a treatment site proximate a renal artery or renal ostium. The supply lumen can be configured to receive a liquid refrigerant. The cryotherapeutic device can further include a cooling assembly at the distal portion of the shaft. The cooling assembly can include an applicator in fluid communication with the supply lumen and configured to deliver cryotherapeutic cooling to nerves proximate the target site when the cooling assembly is in a deployed state.

Abstract: An apparatus having a foil pack defining a device enclosure and a fluid conduit defining a fluid channel. The device enclosure may be configured to hold an energy storage device such as a battery or capacitor. The fluid conduit defines a fluid channel configured to allow a flow from the device enclosure through a test port defined by the fluid conduit. The apparatus is configured to establish a vacuum in the device enclosure when a vacuum is established in the fluid channel (e.g., during leak testing of the device enclosure). A scaffolding within the fluid conduit is configured to configured to resist a collapse of the fluid channel when the vacuum is established in the fluid channel.

Abstract: Disclosed is a system and method for operating an assembly, such as a powered drill assembly. The assembly may be operated to provide feedback to the user regarding a selected position and/or condition of the powered drill system. The powered drill system may be used to power or drive a selected tool, such as a resection or grinding tool.

Abstract: Devices, methods, and systems for prosthesis delivery to patient vasculature are provided. A prosthesis delivery device provided herein delivers a prosthesis to the vasculature of a patient and permits an operator to deploy the prosthesis using a single action mechanism to deploy the prosthesis at a standard deployment rate and a dual action mechanism to deploy the prosthesis at an accelerated deployment rate. Deploying the prosthesis at an accelerated deployment rate results in alterations to the deployed prosthesis structure because the prosthesis is deployed with increased axial compression that results in the prosthesis having increased radial force.