Abstract: A valve prosthesis includes a support and a prosthetic valve coupled to the support. The support includes three engagement arms that meet one another at three respective junctures. The engagement arms are shaped so as to define three peak complexes at the three respective junctures and three troughs, each trough disposed between two of the peak complexes. The support further includes three support arms, each support arm having a first end coupled to a respective engagement arm between a respective trough of the respective engagement arm and a first one of the three respective junctures and a second end coupled to the respective engagement arm between the respective trough and a second one of the three respective junctures.

Abstract: Devices, systems, and methods used to register medical image data with anatomical positions are disclosed. The image data is captured by an imaging system over a period of time. The positions are determined by a tracking system over the period of time. The positions are averaged to determine an average position of the anatomy, which is then used for registration of the image data with the anatomy. Registration based on the average position can then be used to enhance the quality of 3D images of the anatomy, as well as to improve navigation for a surgical procedure.

Abstract: A medical system includes an implantable medical device that carries a first electrode on a distal end of the implantable medical device and a return electrode. The implantable medical device is configured to be positioned within a heart. The implantable medical device further includes a leadlet including a proximal end and a distal end. The proximal end is attached to the implantable medical device, and the distal end is configured to penetrate tissue of the heart. The leadlet carries a second electrode, and a body of the leadlet between the proximal end and the distal end is configured to flex when the distal end is implanted in the tissue of the heart. The implantable medical device further includes a fixation device attached to the implantable medical device. The fixation device is configured to affix the distal end of the implantable medical device to the heart.

Abstract: Systems, methods, and devices for reconstructing an image is provided. An imaging device may be oriented at one or more poses and an image may be received at each of the one or more poses to form a set of images. Pose information may be received at each of the one or more poses. The set of images and the pose information may be inputted into a reconstruction model to generate a three-dimensional representation of the one or more anatomical elements.

Abstract: Techniques are disclosed for monitoring a patient for the occurrence of a cardiac arrhythmia. A computing system generates sample probability values by applying a machine learning model to sample patient data. The machine learning model determines a respective probability value that indicates a probability that the cardiac arrhythmia occurred during each respective temporal window. The computing system outputs a user interface comprising graphical data based on the sample probability values and receives, via the user interface, an indication of user input to select a probability threshold for a patient. The computing system receives patient data for the patient and applies the machine learning model to the patient data to determine a current probability value. In response to the determination that the current probability exceeds the probability threshold for the patient, the computing system generates an alert indicating the patient has likely experienced the occurrence of the cardiac arrhythmia.

Abstract: A method and device apparatus to deliver a pacing therapy capable of remodeling a patient's heart over a period of time that includes monitoring one or more parameters in response to a delivered cardiac remodeling pacing, determining whether the cardiac remodeling pacing has an effect on cardiac normalization in response to the monitoring, and adjusting the cardiac remodeling pacing in response to the determined effect on cardiac normalization. The method and device may also perform short-term monitoring of one or more parameters in response to the delivered cardiac remodeling pacing, monitor one or more long-term parameter indicative of a long-term effect of the delivered cardiac remodeling pacing, determine the long-term effect of the delivered cardiac remodeling pacing on cardiac normalization in response to the monitoring, and adjust the cardiac remodeling pacing in response to one or both of the short-term monitoring and the determined long-term effect on cardiac normalization.

Abstract: A surgical access system includes a cannula, a mapping spacer, and a trocar. The cannula includes a proximal base and an elongated cannula body extending distally therefrom. The mapping spacer is configured to releasably engage the proximal base and includes first and second uprights defining a slot therebetween. The trocar includes a proximal handle and an elongated trocar body extending distally therefrom to a distal cutting tip. The elongated trocar body is insertable through the mapping spacer and cannula. In a first orientation of the trocar relative to the mapping spacer, the proximal handle is configured to abut the first and second uprights to inhibit extension of the distal cutting tip from the proximal base beyond an initial position. In a second orientation of the trocar, the proximal handle is slidable through the slot to enable extension of the distal cutting tip distally towards an extended position.

Abstract: A diagnostic Electrochemical Impedance Spectroscopy (EIS) procedure is applied to measure values of impedance-related parameters for one or more sensing electrodes. The parameters may include real impedance, imaginary impedance, impedance magnitude, and/or phase angle. The measured values of the impedance-related parameters are then used in performing sensor diagnostics, calculating a highly-reliable fused sensor glucose value based on signals from a plurality of redundant sensing electrodes, calibrating sensors, detecting interferents within close proximity of one or more sensing electrodes, and testing surface area characteristics of electroplated electrodes. Advantageously, impedance-related parameters can be defined that are substantially glucose-independent over specific ranges of frequencies. An Application Specific Integrated Circuit (ASIC) enables implementation of the EIS-based diagnostics, fusion algorithms, and other processes based on measurement of EIS-based parameters.

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: A surgical method treats infections on a lead positioned at least partially within a patient's body. The surgical method includes uncoupling the lead from a pulse generator. The lead is then coupled to an ultrasound wave generator. Ultrasound waves are propagated from the ultrasound wave generator through the lead. Systems are disclosed.

Abstract: An implantable medical device is configured determine a numerical value of a variable that is monitored by the implantable medical device and convert the numerical value to a data sequence of modulated electrical stimulation rate intervals. The implantable medical device delivers electrical stimulation pulses according to the data sequence of modulated stimulation rate intervals to cause a modulated rate of activation of excitable tissue of a patient corresponding to the modulated stimulation rate intervals. The modulated rate of activation is detectable by a rate monitor for demodulation to the numerical value of the monitored variable data value. In some examples, the implantable medical device is a pacemaker delivering cardiac pacing pulses according to modulated pacing rate intervals to cause a modulated heart rate of the patient detectable by a heart rate monitor for demodulation to the numerical value of the monitored variable.

Abstract: Various embodiments of a hermetic assembly and a method of forming such assembly are disclosed. The hermetic assembly includes a dielectric substrate having a first major surface and a second major surface, a patterned layer connected to the first major surface of the dielectric substrate by a laser bond, and a ferrule having a body and a flange extending from the body. The flange is welded to a welding portion of the patterned layer that is disposed between the flange and the first major surface of the dielectric substrate such that the ferrule is hermetically sealed to the dielectric substrate.

Abstract: A system comprises processing circuitry and memory comprising program instructions that, when executed by the processing circuitry, cause the processing circuitry to: apply a first set of rules to first patient parameter data for a first determination of whether sudden cardiac arrest of a patient is detected; determine that a one or more context criteria of the first determination are satisfied; and in response to satisfaction of the context criteria, apply a second set of rules to second patient parameter data for a second determination of whether sudden cardiac arrest of the patient is detected. At least the second set of rules comprises a machine learning model, and the second patient parameter data comprises at least one patient parameter that is not included in the first patient parameter data.

Abstract: An example catheter includes an elongate member having a wall defining a longitudinally extending lumen, a fixation member disposed on an exterior surface of the wall of a distal portion of the elongate member, a pull wire extending axially through the wall of the elongate member and coupled to the fixation member, and a member portion encasing at least a portion of the fixation member, where the fixation member is shaped to engage the distal member in response to a pull force applied to the pull wire to cause the elongate member to deflect from an initial configuration to a deflected configuration.

Abstract: An embodiment of a sensor device includes a base substrate, a circuit pattern formed overlying the interior surface of the substrate, a physiological characteristic sensor element on the exterior surface of the substrate, conductive plug elements located in vias formed through the substrate, each conductive plug element having one end coupled to a sensor electrode, and having another end coupled to the circuit pattern, a multilayer component stack carried on the substrate and connected to the circuit pattern, the stack including features and components to provide processing and wireless communication functionality for sensor data obtained in association with operation of the sensor device, and an enclosure structure coupled to the substrate to enclose the interior surface of the substrate, the circuit pattern, and the stack.

Abstract: A telescoping catheter including an elongated tubular member having a proximal end, a distal end, and a passageway extending between the proximal end and the distal end. The tubular member includes a first tubular segment and a second tubular segment. The first tubular segment and the second tubular segment are slidable relative to one another to vary a length of the tubular member. The first tubular segment includes a first connector mateable with a second connector of the second tubular segment to selectively maintain the first and second tubular segments in an extended position. The second tubular segment includes a second proximal end that is mateable with a handle.

Abstract: A valve prosthesis and methods for implanting the prosthesis are provided. The prosthesis generally includes a self-expanding frame and two or more engagement arms. A valve prosthesis is sutured to the self-expanding frame. Each engagement arm corresponds to a native mitral valve leaflet. At least one engagement arm immobilizes the native leaflets, and holds the native leaflets close to the main frame. The prosthetic mitral valve frame also includes two or more anchor attachment points. Each anchor attachment point is attached to one or more anchors that help attach the valve prosthesis to the heart.

Abstract: An implantable medical device includes a plurality of electrodes to detect electrical activity, a motion detector to detect mechanical activity, and a controller to determine at least one electromechanical interval based on at least one of electrical activity and mechanical activity. The activity detected may be in response to delivering a pacing pulse according to an atrioventricular (AV) pacing interval using the second electrode. The electromechanical interval may be used to adjust the AV pacing interval. The electromechanical interval may be used to determine whether cardiac therapy is acceptable or whether atrial or ventricular remodeling is successful.

Abstract: Various embodiments of an electronic package and an implantable medical device that includes such package are disclosed. The electronic package includes a monolithic package substrate having a first major surface and a second major surface, an integrated circuit disposed in an active region of the package substrate, and a conductive via disposed through an inactive region of the package substrate and extending between the first major surface and the second major surface of the package substrate. The conductive via is separated from the active region by a portion of the inactive region of the substrate.

Abstract: An implantable medical device configured to monitor fluid in proximity to an implantable medical device for an inadvertent introduction of infusate into a pocket of tissue surrounding the implantable medical device during a refill procedure, the implantable medical device including a refillable infusate delivery system, the refillable infusate delivery system including a reservoir in fluid communication with an access port, and a conductivity sensor configured to monitor fluid in proximity to the conductivity sensor for an introduction of infusate into a pocket of tissue surrounding the implantable medical device, wherein the conductivity sensor comprises a pair of electrodes positioned on an external surface of the implantable medical device.