Abstract: A heart valve therapy system includes a delivery device and a stented valve. The delivery device includes an outer sheath, an inner shaft, an optional hub assembly, and a plurality of tethers. In a delivery state, a stent frame of the prosthesis is crimped over the inner shaft and maintained in a compressed condition by the outer sheath. The tethers are connected to the stent frame. In a partial deployment state, the outer sheath is at least partially withdrawn, allowing the stent frame to self-expand. Tension in the tethers prevents the stent frame from rapidly expanding and optionally allowing recapture. Upon completion of the stent frame expansion, the tethers are withdrawn.

Abstract: A system includes an inflow loading assembly configured to compress an inflow portion of the implantable medical device as the implantable medical device is advanced through the inflow loading assembly. The system also includes an outflow loading assembly removably coupled to the inflow loading assembly. The outflow loading assembly is configured to partially compress an outflow portion of the implantable medical device during coupling to the inflow loading assembly. The inflow loading assembly includes one or more biasing features that are configured to asymmetrically compress the inflow portion of the implantable medical device.

Abstract: An implantable medical device system is configured to sense cardiac events in response to a cardiac electrical signal crossing a cardiac event sensing threshold. A control circuit is configured to determine a drop time interval based on a heart rate and control a sensing circuit to hold the cardiac event sensing threshold at a threshold value during the drop time interval.

Abstract: Systems, devices, and techniques are described for adjusting electrical stimulation based on detected ECAPs. In one example, a medical device includes processing circuitry configured to control stimulation circuitry to deliver a first electrical stimulation pulse and sensing circuitry to detect, after delivery of the first electrical stimulation pulse, an ECAP signal. The processing circuitry may be configured to determine a characteristic value of the ECAP signal, determine an ECAP differential value that indicates whether the characteristic value of the ECAP signal is one of greater than a selected ECAP characteristic value or less than the selected ECAP characteristic value, determine, based on the ECAP differential value, a gain value, determine, based on the gain value, a parameter value that at least partially defines a second electrical stimulation pulse, and control the stimulation circuitry to deliver the second electrical stimulation pulse according to the parameter value.

Abstract: A delivery system for delivery of a radially expandable device to an implantation site in a patient, the delivery system including an elongated tubular member comprising a distal tip and an outer surface, first and second balloon portions spaced proximally from each other and the distal tip along a length of the tubular member, an annular space between the first and second balloon portions, a plurality of clip deployment tubes extendably moveable relative to the outer surface of the tubular member, and a plurality of clips, wherein each clip is moveable within a length of one of the clip deployment tubes between a retracted position and a deployed position.

Abstract: An example medical device includes an optical sensor, processing circuitry, an antenna, and a power source. The optical sensor includes a light source; a reference optical beacon having a first fluorophore that emits a first fluorescence proportional to a first concentration of a substance proximate the beacon; a test optical beacon having a reagent substrate that reacts with an analyte to produce the substance and a second fluorophore that emits a second fluorescence proportional to a second concentration of the substance proximate the test beacon; and a photodetector to detect the first and second fluorescence. The processing circuitry determines a difference between the first and second fluorescence, which is indicative of the concentration of the analyte. The antenna and power source enable the medical device to operate completely within a biological system for continuous analyte monitoring.

Abstract: A medicine administration and tracking system includes a delivery device configured to deliver a plurality of doses of medicine over a plurality of days and a computing device configured to receive dose information for each dose. The computing device includes a software application operable to cause the computing device to retrieve the dose information for all doses within a pre-determined period of days, categorize each dose within the pre-determined period of days into one of a plurality of time blocks throughout a 24-hour timeframe, determine a time of interest based on a time block of the plurality of time blocks having the least amount of doses categorized therein, and select a physiological parameter reading from a plurality of physiological parameter readings as a physiological parameter reading of interest based on a proximity of a time of the physiological parameter reading to the determined time of interest.

Abstract: A medical device includes a sensor to observe a characteristic of an anatomy, and a sensor base coupled to the sensor. The medical device includes a coupling system to couple the sensor base to the anatomy. The coupling system includes a first adhesive member and a second adhesive member. The first adhesive member is coupled to the sensor base and the second adhesive member is to couple to the anatomy. The second adhesive member includes at least one cut-out to direct moisture to an ambient environment surrounding the medical device.

Abstract: This disclosure describes implantable medical leads and medical device systems utilizing the leads. In some examples, an implantable medical lead comprises a first defibrillation electrode and a second defibrillation electrode, the first and second defibrillation electrodes configured to deliver anti-tachyarrhythmia shocks, and a pace electrode disposed between the first defibrillation electrode and the second defibrillation electrode, the pace electrode configured to deliver a pacing pulse that generates an electric field proximate to the pace electrode. The implantable medical lead further comprises a shield disposed between the first defibrillation electrode and the second defibrillation electrode and over a portion of an outer surface of the pace electrode, wherein the shield is configured to impede the electric field in a direction from the pace electrode away from a heart.

Abstract: An intracardiac ventricular pacemaker having a motion sensor is configured to produce a motion signal including an atrial systolic event and a ventricular diastolic event indicating a passive ventricular filling phase, set a detection threshold to a first amplitude during an expected time interval of the ventricular diastolic event and to a second amplitude lower than the first amplitude after an expected time interval of the ventricular diastolic event. The pacemaker is configured to detect the atrial systolic event in response to the motion signal crossing the detection threshold and set an atrioventricular pacing interval in response to detecting the atrial systolic event.

Abstract: An expandable introducer includes a hub having a distal end and a proximal end, and a sheath coupled to the hub and extending distally therefrom, the sheath defining a central lumen. The sheath is configured to radially expand from a radially unexpanded, folded state having a first diameter and to a radially expanded, unfolded state having a second diameter larger than the first diameter in response to a device passing through the central lumen. A wall of the sheath includes a thick wall region having a first wall thickness and a thin wall region having a second wall thickness smaller than the first wall thickness, wherein the thick wall region includes a coil embedded within the wall of the sheath.

Abstract: A system including a self-expanding prosthesis configured to foreshorten during deployment thereof and a delivery device configured to percutaneously deliver the self-expanding prosthesis. The delivery device includes a handle having an actuator thereon, an outer sheath including a proximal end coupled to the handle and a pusher shaft slidingly disposed within the outer sheath. The pusher shaft has a proximal end coupled to the handle and a distal end configured to releasably couple to the self-expanding prosthesis such that the self-expanding prosthesis axially moves therewith. The inner shaft has a distal portion of the inner shaft that is configured to receive a self-expanding prosthesis thereon. The outer sheath and the pusher shaft are configured to simultaneously move in opposing axial directions via actuation of the actuator on the handle to compensate for the foreshortening of the self-expanding prosthesis during deployment.

Abstract: Disclosed herein are different disposable assemblies for the same reusable assembly. The different disposable assemblies include a first disposable assembly and a second disposable assembly. The first disposable assembly may be configured to be operatively coupled to the reusable assembly to deliver fluid, and the second disposable assembly may be configured to be operatively coupled to the reusable assembly to deliver fluid when the first disposable assembly is not operatively coupled to the reusable assembly. The first disposable assembly may have a first set of one or more characteristics, and the second disposable assembly may have a second set of one or more characteristics that is different from the first set of one or more characteristics.

Abstract: This disclosure is directed to techniques for detecting and mitigating inaccurate sensing in a medical system. In some examples, one or more sensors of the medical system may include at least one electrode configured to sense an impedance of a portion of a patient's body proximate to the electrode and processing circuitry of the medical system may detect an inaccuracy in the data corresponding to the one or more patient physiological parameters based upon data including at least the sensed impedance of the portion of the patient body; correct at least a portion of the inaccuracy in the data corresponding to the one or more patient physiological parameters; and generate, for display on a display device, output data indicating the inaccuracy in the data corresponding to the one or more patient physiological parameters.

Abstract: Extravascular implant tools that utilize a bore-in mechanism to safely access extravascular locations and implant techniques utilizing these tools are described. The bore-in mechanism may include a handle and a helix extending from the handle. The bore-in mechanism is used, for example, in conjunction with a tunneling tool to traverse the diaphragmatic attachments to access a substernal location. The tunneling tool may be an open channel tunneling tool or a conventional tunneling tool (e.g., metal rod).

Abstract: An implantable medical device (IMD) includes a body, a fixation component, and an interface assembly. The body extends from a proximal portion to a distal portion along a longitudinal axis. The fixation component includes a penetrator tine. The penetrator tine includes an incisive distal end configured to penetrate a tissue to fix the IMD to the tissue. The electrode interface assembly includes a proximal section and a distal section. The proximal section is attached to and extends distally from the distal portion of the body along the longitudinal axis. The distal section extends from the proximal section of the electrode interface assembly and defines a non-incisive distal end. The distal end of the electrode interface assembly is configured to contact the tissue to control a depth of tissue penetration of the penetrator tine.

Abstract: In some examples, a processor determines a patient state based on activity of a bioelectrical brain signal of a patient in one or more frequency sub-bands of a frequency band of interest. For example, a processor may determine a patient state based on the power level of a bioelectrical brain signal of the patient in one or more frequency sub-bands of a frequency band, or based on a spectral pattern of a bioelectrical brain signal in a frequency band, such as a shift in a power distribution between sub-bands, a change in the peak frequency within one or more sub-bands, a pattern of the power distribution over one or more frequency sub-bands, or a width or a variability of one or more sub-bands exhibiting a relatively high or low level of activity.

Abstract: A device, such as an IMD, having a tissue conductance communication (TCC) transmitter controls a drive signal circuit and a polarity switching circuit by a controller of the TCC transmitter to generate an alternating current (AC) ramp on signal having a peak amplitude that is stepped up from a starting peak-to-peak amplitude to an ending peak-to-peak amplitude according to a step increment and step up interval. The TCC transmitter is further controlled to transmit the AC ramp on signal from the drive signal circuit and the polarity switching circuit via a coupling capacitor coupled to a transmitting electrode vector coupleable to the IMD. After the AC ramp on signal, the TCC transmitter transmits at least one TCC signal to a receiving device.

Abstract: An insertion set system includes a base configured to be secured to a patient, and a flexible tubing on the base. The flexible tubing has a distal end portion forming a cannula to be inserted into the patient. An inserter having a needle is received by the base. The needle has a channel in which the distal end portion of the flexible tubing is received. The needle is able to slide relative to the flexible tubing, to selectively withdraw the needle off of the distal end portion of the flexible tubing. The base may include a passage for fluid flow arranged transverse to the axial dimension of the distal end portion of the flexible tubing.