Abstract: Devices, systems, and methods may manage therapy delivery to a patient based on one or more physiological markers. In some examples, a method includes detecting a physiological marker that occurs prior in time to a dysfunctional phase of a physiological cycle, wherein a dysfunctional state of the physiological cycle occurs during the dysfunctional phase without treatment, responsive to detecting the physiological marker, initiating a first phase of the physiological cycle having a duration of time. The method may also include, responsive to the first phase elapsing, controlling a therapy delivery module to deliver neurostimulation therapy during a second phase that begins prior to the dysfunctional phase, wherein the neurostimulation therapy is configured to treat the dysfunctional state.

Abstract: This disclosure is directed to devices, systems, and techniques for monitoring a patient condition. In some examples, a medical device system includes processing circuitry configured to determine a plurality of pulse transit time (PTT) intervals, determine, based on an accelerometer signal, a posture of a patient from a plurality of postures corresponding to each PTT interval of the plurality of PTT intervals, classify each PTT interval of the plurality of PTT intervals based on the respective posture of the patient corresponding to the respective PTT interval, and monitor, based on the classified plurality of PTT intervals, a patient condition.

Abstract: Disclosed is a system that includes pressure sensors to assist in monitoring pressure at a selected location. Pressure sensors may be applied to or incorporated into catheters and/or shunts positioned within a patient. A monitoring system may then receive signals from the pressure sensors to monitor pressure at the location over time.

Abstract: A system for a physiological characteristic sensor deployed with a sensor inserter includes an adhesive skin patch coupled to the physiological characteristic sensor. The adhesive patch is to couple the physiological characteristic sensor to an anatomy. The system includes a gravity resistance system coupled to the adhesive patch and to be coupled to the sensor inserter. The gravity resistance system maintains the adhesive patch substantially perpendicular to a longitudinal axis of the sensor inserter prior to deployment of the physiological characteristic sensor and the gravity resistance system is to be removable from the sensor inserter by the adhesive patch upon deployment of the physiological characteristic sensor.

Abstract: A tethering assembly for securing a medical device includes a shaft and a wire that extends in sliding engagement within a proximal lumen, a channel, and a distal receptacle of the shaft. A retainer zone of the shaft, through which the channel extends, stops a transition segment of the wire, which extends between a proximal and a distal segment of the wire, from moving into the shaft receptacle, thereby restraining a distal-most tip of the wire from moving through a distal-most opening of the receptacle. When a projecting member of the device has entered a secure zone of the receptacle, via movement through the distal-most opening and a tapering passageway thereof, the distal-most tip of the wire, which may be spring-biased, can move distally into the passageway so that the tip blocks the projecting member from moving distally, back through the passageway.

Abstract: A method of estimating a heart rate of a patient having an implantable blood pump including, during operation of the blood pump continuously detecting a plurality of cardiac cycles, each of the plurality of cardiac cycles including a length; sorting the plurality of cardiac cycles according to the length; filtering the plurality of cardiac cycles between one of a group consisting of including a reliable condition and at least one unreliable condition; continuously estimating a heart rate according to the length of the plurality of cardiac cycles and the reliable condition; and if the at least one unreliable condition is detected, modifying the estimated heart rate based on information associated with the detected at least one unreliable condition.

Abstract: Devices, systems, and techniques are configured for identifying stimulation parameter values based on electrical stimulation that induces dyskinesia for the patient. For example, a method may include controlling, by processing circuitry, a medical device to deliver electrical stimulation to a portion of a brain of a patient, receiving, by the processing circuitry, information representative of an electrical signal sensed from the brain after delivery of the electrical stimulation, determining, by the processing circuitry and from the information representative of the electrical signal, a peak in a spectral power of the electrical signal at a second frequency lower than a first frequency of the electrical stimulation, and responsive to determining the peak in the spectral power of the electrical signal at the second frequency, performing, by the processing circuitry, an action.

Abstract: A trial stimulation system includes a disposable trial electrical stimulator that, in some examples, is sterilized for a single use in a stimulation trial of one patient. Additionally, systems for securing a disposable trial stimulator to the body of a patient are described, which may function to improve the durability of the system during the trial period and reduce the risk of damage or malfunction to the system due to lead/electrode dislocation and/or off-label uses like showering or bathing with the trial stimulator still secured to the body.

Abstract: A catheter used for percutaneous endovascular procedures is described. The catheter is configured to be used for engagement and treatment of obstructive lesions in a patient's vasculature. The catheter includes a tube having a leading edge that is configured to score or cut a lesion in a vasculature. The tube may be an expandable outer tube, and placed around an inflatable inner tube, such that inflation of the inner tube expands the outer tube. Expansion of the inner tube may connect or laterally lock the inner tube to the outer tube, allowing both tubes to move in unison through the vasculature. The leading edge can score or cut lesions as it moves in the vasculature.

Abstract: An implantable medical device system includes an extracardiac sensing device and an intracardiac pacemaker. The sensing device senses a P-wave attendant to an atrial depolarization of the heart via housing-based electrodes carried by the sensing device when the sensing device is implanted outside the cardiovascular system and sends a trigger signal to the intracardiac pacemaker in response to sensing the P-wave. The intracardiac pacemaker detects the trigger signal and schedules a ventricular pacing pulse in response to the detected trigger signal.

Abstract: A medical device is configured to deliver a series of electrical stimulation pulses including opposing polarity pulses. The medical device delivers a charge balancing pulse by modifying every nth pulse of the electrical stimulation pulses to reduce a net charge delivered over the series of electrical stimulation pulses. In some examples, the medical device may be an implantable medical device that is coupled to an extra-cardiovascular lead for delivering the cardiac pacing pulses.

Abstract: Devices, systems, and techniques are described for use in recharging a power source of a cranially mounted implantable medical device. In one example, a wearable medical device includes a flexible body configured to cover at least a portion of a scalp of a head of a patient. A securing member is connected to the flexible body and configured to extend around a circumference of the head to stabilize the flexible body with respect to the scalp of the patient. A fixation member is configured to mount to a location of the flexible body and couple the flexible body to a recharge coil that is configured to recharge the power source of the cranially-mountable implantable medical device.

Abstract: A method and system is disclosed for acquiring image data of a subject. The image data can be collected with an imaging system with at least two different energy characteristics. The image data can be reconstructed using reconstruction techniques.

Abstract: An adaptor assembly for coupling a cutting tool to a drill drive chuck such that driven rotation of the drive chuck is transferred to the cutting tool by the adaptor assembly. The adaptor assembly includes a rod, a collet and an enclosure. A proximal region of the rod provides an adaptor male coupling portion configured to engage a drill drive chuck. A leading of the collet provides an adaptor female coupling portion configured to engage a surgical cutting tool tang. Further, the rod and the collet form complementary engagement features for coupling to one another. The enclosure rotatably maintains the collet. Upon final assembly of the rod to the collet, rotation of the rod is transferred to the collet. During use, the adaptor assembly can facilitate coupling of a cutting tool to a powered handpiece under circumstances where the cutting tool is otherwise incompatible with the powered handpiece.

Abstract: A guide extension catheter assembly including a guide extension catheter and a support device. The guide extension catheter includes a shaft and a tubular member. The support device includes a push member and a shuttle member. The guide extension catheter assembly is configured to selectively provide a delivery state in which at least a portion of the shuttle member is disposed within the lumen, a leading end of the shuttle member is distal a distal end of the tubular member, and the shuttle member is directly, physically connected to the tubular member. In the delivery state, a longitudinal distal force applied to the push member is transferred to the tubular member as a longitudinal distal force via the shuttle member. The guide extension catheter assemblies of the present disclosure can promote a two stage guide extension catheter deployment.

Abstract: A method and system is disclosed for acquiring image data of a subject. The image data can be collected with an imaging system in a selected manner and/or motion. More than one projection may be combined to generate and create a selected view of the subject.

Abstract: Methods of compressing a stented prosthetic heart valve are disclosed. The method including inserting a stented prosthetic heart valve having a self-expandable stent frame into a container, initiating a cooling element in the container, transferring heat through a thermal conductor to cool an interior of the container, reducing a temperature of the self-expandable stent frame while located within the container to a critical temperature of not greater than 8° C., and compressing an outer diameter of the stented prosthetic heart valve while the stented prosthetic heart valve is at the critical temperature.

Abstract: Methods, systems, and devices for enhancing the efficiency and efficacy of energy delivery and tissue mapping. One system includes a treatment element having a plurality of electrodes and an energy generator that is configured to deliver electric energy pulses to the electrodes in a variety of patterns. For example, electrodes may be arranged in closely spaced pairs. The energy generator may deliver mapping energy to each electrode in each pair individually to map tissue and may deliver ablation energy to the electrodes in each pair together, such that each pair is treated like a single electrode, to deliver ablation energy, such as bipolar ablation energy between adjacent pairs. One system includes at least one concave electrode, the configuration of which concentrates the energy and drives it deeper into the tissue. One system includes neutral electrodes between active electrodes, the energy generator selectively coupling the neutral electrodes to alter the ablation pattern.

Abstract: An improved assembly for securing an implantable medical device for retrieval from an implant site includes a plurality of snares, wherein distal openings of a first snare carrier lumen and a second snare carrier lumen have a pre-set offset established therebetween. First and second snare shafts, to which first and second snare loops are coupled, respectively, extend within the corresponding snare carrier lumens such that each loop is located in proximity to the corresponding distal opening of the lumen. The pre-set offset allows an operator to simultaneously position the snare loops around the device; and, when the operator retracts the snare shafts to collapse the snare loops until the loops fit snuggly around the device, the pre-set offset can help to align the device for retrieval.