Abstract: Various embodiments of an electronics module and an implantable medical device that includes such module are disclosed. The module includes a feedthrough header assembly having a conductive header that includes a conductive inner surface, an outer surface, and a contact disposed on the inner surface and electrically connected to the header; and a feedthrough pin disposed within a via that extends through the header. The module further includes an electronic layer having a substrate and an electronic component disposed on or within the substrate. The electronic component is electrically connected to the contact of the conductive header such that the electronic component is electrically connected to the header. A major surface of the substrate of the electronic layer faces the conductive inner surface of the header without any intervening nonconductive layers disposed between the major surface of the substrate and the conductive inner surface of the header.

Abstract: A sleeve for a medical lead includes a tubular body having a first open end and a second open end, a tubular wall extending between the first and second ends and defining a hollow center, and a longitudinal axis extending through the hollow center. A first pocket is disposed in the tubular wall and having a curved transverse cross section and a first access opening at the first open end of the tubular body. A medical lead system includes a medical lead and the sleeve configured to slide over the medical lead and be adjacent to the electrode region.

Abstract: A dry valve crimping and loading system includes packaging, a crimper disposed in the packaging, and a dry valve prosthesis disposed within a crimper chamber of the crimper. The crimper chamber has a first volume in an expanded state a second volume in a collapsed state, wherein the first volume is greater than the second volume. The crimper is configured to transition the dry valve prosthesis from an uncompressed state to a compressed state when the crimper chamber transitions from the expanded state to the collapsed state to expel the glycerol from the dry valve prosthesis as the crimper transitions the dry valve prosthesis from the uncompressed state to the compressed state.

Abstract: Prosthetic heart valves each includes a link extending along a link axis and an axial frame. The axial frame includes a plurality of struts comprising a plurality of inner struts pivotally attached to a plurality of outer struts at a plurality of pivot nodes. A first pivot node of the plurality of pivot can be attached to the link and a second pivot node of the plurality of pivot nodes can move relative to the link along the link axis. Methods of radially expanding a prosthetic heart valve can comprise radially expanding the radially expandable frame from a radially retracted orientation to a radially expanded orientation while the second pivot node axially translates relative to the link.

Abstract: A heart valve prosthesis includes a frame defining a central lumen, a valve assembly disposed within the central lumen of the frame, and a plurality of gripper pads. The gripper pads are configured to engage lacerated leaflets of a previously implanted heart valve prosthesis. The gripper pads are configured to separate from each other to separate the lacerated leaflets when the heart valve prosthesis radially expands from a radially compressed configuration to a radially expanded configuration.

Abstract: An implantable medical device that includes a memory, stimulation circuitry configured to deliver electrical stimulation to a patient, and processing circuitry operably coupled to the memory. The processing circuitry is configured to: control the stimulation circuitry to output electrical stimulation therapy to a patient via a first electrode combination and control the stimulation circuitry to output a notification stimulation via a second electrode combination and interleaved with the electrical stimulation therapy. The notification stimulation may include an intensity above a perception level of the patient, and the second electrode combination may include an electrode disposed at an implant site of the implantable medical device.

Abstract: Systems and methods are described herein related to the evaluation and adjustment of left bundle branch (LBB) pacing therapy. Evaluation of the LBB pacing therapy may utilize electrical activity monitored from a plurality of external electrodes. The electrical activity may be used to provided one or more metrics of dispersion of surrogate cardiac electrical activation times, which may then be used to evaluate, and potentially adjust the LBB pacing therapy.

Abstract: An implantable medical device has a therapy module configured to generate a composite pacing pulse including a series of at least two individual pulses. The therapy module is configured to generate the composite pacing pulse by generating a first pulse of the at least two individual pulses by selectively coupling a first portion of a plurality of capacitors to an output signal line and generate a second pulse of the at least two individual pulses by selectively coupling a second portion of the plurality of capacitors to the output signal line.

Abstract: Disclosed is a system for recharging a selected power source wirelessly, such as through a power transmission. The power source may be positioned within a subject and be charged wirelessly through the subject, such as tissue of the subject. A thermal transfer system is provided to transfer or transport thermal energy from a first position to a second position, such as away from the subject.

Abstract: An oxygenator apparatus for use in an extracorporeal circuit. The apparatus includes a housing and a membrane assembly disposed within the housing. The membrane assembly includes a first plurality of gas exchange elements disposed in a first zone and a second plurality of gas exchange elements disposed in a second zone. The second zone is arranged concentrically around the first zone. The first and second plurality of gas exchange elements are fluidly open along a body and fluidly separated along a distal end. The first zone is configured to be fluidly coupled to an oxygen source and the second zone is configured to be fluidly coupled to a negative pressure source. A blood flow path includes a generally radial flow through the first zone to add oxygen to the blood and the second zone to separate gaseous micro emboli from the blood through the plurality of gas exchange elements.

Abstract: A medical device, such as an extra-cardiovascular implantable cardioverter defibrillator (ICD), senses R-waves from a first cardiac electrical signal by a first sensing channel and stores a time segment of a second cardiac electrical signal acquired by a second sensing channel in response to each sensed R-wave. The ICD determines morphology match scores from the stored time segments of the second cardiac electrical signal and, based on the morphology match scores, withholds detection of a tachyarrhythmia episode. In some examples, the ICD detects T-wave oversensing based on the morphology match scores and withholds detection of a tachyarrhythmia episode in response to detecting the T-wave oversensing.

Abstract: A guide wire system configured to guide a medical device (e.g., a medical lead) to a target area within a patient. The guide wire system may be configured to penetrate and pass through a tissue wall in the patient to guide the medical device to the target area. The guide wire system includes a support section configured to expand to substantially maintain a position relative to the tissue wall. The guide wire system includes a pull wire configured to cause the support portion to expand. The expanded support section may provide counter-traction to a distal force on the tissue wall exerted by a medical device during, for example, fixation of the medical device to the target area, or other stages of an implantation. The support section is configured to re-establish an initial configuration for proximal withdrawal from the tissue wall.

Abstract: An implantable medical device (IMD) automatically determines at least a portion of the parameters and, in some instances all of the parameters, of an exposure operating mode based on stored information regarding sensed physiological events or therapy provided over a predetermined period of time. The IMD may configure itself to operate in accordance with the automatically determined parameters of the exposure operating mode in response to detecting a disruptive energy field. Alternatively, the IMD may provide the automatically determined parameters of the exposure operating mode to a physician as suggested or recommended parameters for the exposure operating mode. In other instances, the automatically determined parameters may be compared to parameters received manually via telemetry and, if differences exist or occur, a physician or patient may be notified and/or the manual parameters may be overridden by the automatically determined parameters.

Abstract: A medical system for treating incontinence includes an implantable medical device (IMD) implantable proximate to a tibial nerve of a patient comprising therapy delivery circuitry configured to provide electrical stimulation therapy proximate the tibial nerve of the patient for treating incontinence, and processing circuitry configured to: during an implant period, determine a set of stimulation parameters to control the therapy delivery circuitry, during an induction period after the implant period, initiate electrical stimulation therapy according to the set of stimulation parameters, during a first maintenance period, determine an adjustment to the set of stimulation parameters as first maintenance period stimulation parameters to reduce the electrical stimulation therapy from the induction period, and during a second maintenance period, determine an adjustment to the set of stimulation parameters as second maintenance period stimulation parameters to reduce the electrical stimulation therapy from the first

Abstract: An extra-cardiovascular implantable cardioverter defibrillator senses R-waves from a first cardiac electrical signal by a first sensing channel and stores a time segment of a second cardiac electrical signal in response to each sensed R-wave. The ICD determines intervals between successively sensed R-waves and, in response to at least a predetermined number of the intervals being less than a tachyarrhythmia detection interval, analyzes at least a portion of the time segment of the second cardiac electrical signal corresponding to a most recent one of the sensed R-waves to confirm the most recent one of the R-waves. The ICD updates an unconfirmed beat count in response to the most recent one of the R-waves not being confirmed and withholds detection of a tachyarrhythmia episode in response to the unconfirmed beat count being equal to or greater than a rejection threshold.

Abstract: A medical device is configured to receive sensed cardiac event data including a value of a feature determined from each one of a plurality of cardiac events sensed from a cardiac signal according to a first setting of a sensing control parameter. The medical device is configured to classify each value of the feature of each one of the sensed cardiac events as either a predicted sensed event or a predicted undersensed event according to a second setting of the sensing control parameter that is less sensitive to sensing cardiac events than the first setting. The medical device is configured to determine a predicted sensed event interval between each consecutive pair of the predicted sensed events and predict that an arrhythmia is detected or not detected based on the predicted sensed event intervals.

Abstract: Various fixation techniques for implantable medical device (IMDs) are described. In one example, an assembly comprises an IMD; and a set of active fixation tines attached to the IMD. The active fixation tines in the set are deployable from a spring-loaded position in which distal ends of the active fixation tines point away from the IMD to a hooked position in which the active fixation tines bend back towards the IMD. The active fixation tines are configured to secure the IMD to a patient tissue when deployed while the distal ends of the active fixation tines are positioned adjacent to the patient tissue.

Abstract: This disclosure is directed to devices, systems, and techniques for wirelessly charging a medical device. A charging device may receive a request to wirelessly charge a medical device. The charging device may, in response to receiving the request, physically move within wireless charging range of the medical device. The charging device may, in response to determining that the charging device is within the wireless charging range of the medical device, wirelessly transmit power to the medical device to wirelessly charge the medical device.

Abstract: An implantable medical device system delivers a pacing pulse to a patient's heart and starts a first pacing interval corresponding to a pacing rate in response to the delivered pacing pulse. The system charges a holding capacitor to a pacing voltage amplitude during the first pacing interval. The system detects an increased intrinsic heart rate that is at least a threshold rate faster than the current pacing rate from a cardiac electrical signal received by a sensing circuit of the implantable medical device. The system starts a second pacing interval in response to an intrinsic cardiac event sensed from the cardiac electrical signal and withholds charging of the holding capacitor for at least a portion of the second pacing interval in response to detecting the increased intrinsic heart rate.