Abstract: An implantable infusate spread promoting system configured to enable improved dispersion of delivered infusate. The system including an implantable device configured to enable infusate delivery within a body of a patient, and an implantable manually actuatable flushing pump configured to remove and re-inject a quantity of fluid with each actuation to promote improved dispersion of the delivered infusate.

Abstract: An external coil system for a transcutaneous energy transfer system (TETS), the external coil being configured to transfer energy sufficient to power and implantable blood pump. The system includes a housing containing the external coil, the housing includes a thermal insulating base, the external coil being partially disposed within the thermal insulating base and a thermally conductive plastic, the external coil being partially disposed within the thermally conductive plastic.

Abstract: A controller for an implantable blood pump includes processing circuitry configured to initiate a suction response algorithm if a combination of a number of detected suction events multiplied by a suction event variable and a number of non-suction events multiplied by a non-suction event variable exceed a predetermined threshold.

Abstract: Devices, systems, and techniques for controlling electrical stimulation therapy are described. In one example, a system may be configured to deliver electrical stimulation therapy to a patient, the electrical stimulation therapy comprising a plurality of therapy pulses at a predetermined pulse frequency over a period of time and deliver, over the period of time, a plurality of control pulses interleaved with at least some therapy pulses of the plurality of therapy pulses. The system may also be configured to sense, after one or more control pulses and prior to an immediately subsequent therapy pulse of the plurality of therapy pulses, a respective evoked compound action potential (ECAP), adjust, based on at least one respective ECAP, one or more parameter values that at least partially defines the plurality of therapy pulses, and deliver the electrical stimulation therapy to the patient according to the adjusted one or more parameter values.

Abstract: Far field telemetry communications are conducted during recharge sessions between an external device and an implantable medical device. The two devices may not have been previously paired together for far field telemetry and may have been paired with other devices for far field telemetry during previous recharge sessions and/or programming sessions. Embodiments provide for temporary bonding of the two devices for far field telemetry during the recharge session. The implantable medical device of the recharge session may maintain a programming bond with an external device other than the external device conducting the recharge session. Safeguards against establishment of inadvertent programming sessions between the external device that has conducted a recharge session and implantable medical devices that may or may not be bonded to that external device are provided.

Abstract: Techniques for evaluating cardiac electrical dyssynchrony are described. In some examples, an activation time is determined for each of a plurality of torso-surface potential signals. The dispersion or sequence of these activation times may be analyzed or presented to provide variety of indications of the electrical dyssynchrony of the heart of the patient. In some examples, the locations of the electrodes of the set of electrodes, and thus the locations at which the torso-surface potential signals were sensed, may be projected on the surface of a model torso that includes a model heart. The inverse problem of electrocardiography be solved to determine electrical activation times for regions of the model heart based on the torso-surface potential signals sensed from the patient.

Abstract: A surgical device configured to surround an implantable medical device that includes a collagen membrane and a coating embedded in the membrane, the coating including at least one active pharmaceutical ingredient.

Abstract: Prosthetic heart valves each includes a link extending along an axial direction 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 in the axial direction. 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: An advancer includes an advancer hub and an advancer shaft extending distally from the advancer hub. The advancer shaft includes a proximal end, a distal end, and a lumen extending from the proximal end to the distal end. The advancer shaft is configured to be disposed around an outer shaft of a delivery catheter, and includes a split line configured to enable splitting the shaft to enable removal of the shaft from the outer shaft. The advancer hub configured to be mounted on the outer shaft of the delivery catheter, and includes a parting line to enable splitting of the advancer hub.

Abstract: A medical system includes techniques for adjusting the cycling of electrical stimulation therapy delivered by a medical device based on user input. The disclosure describes techniques to iteratively adjust the duration that stimulation is delivered and not delivered based on user input indicative of patient's symptoms.

Abstract: This disclosure is directed to devices, systems, and techniques for controlling electrical stimulation therapy. In some examples, a medical device includes stimulation generation circuitry configured to deliver a first stimulation pulse to a patient, sensing circuitry configured to sense the first stimulation pulse, and processing circuitry. The processing circuitry is configured to determine that a value of a characteristic of the sensed first stimulation pulse exceeds a target stimulation pulse value and responsive to determining that the value of the characteristic of the sensed first stimulation pulse exceeds the target stimulation pulse value, change a first value of a parameter to a second value of the parameter that at least partially defines a second stimulation pulse deliverable by the stimulation generation circuitry after the first stimulation pulse was sensed.

Abstract: Devices, systems, and methods for more efficiently ablating tissue with pulsed field ablation energy while minimizing collateral injury to non-target tissue. In one embodiment, a system for ablating tissue at a treatment site comprises: an energy delivery device; and a control unit including: a source of impedance-modifying fluid in fluid communication with the energy delivery device; an energy generator in electrical communication with the energy delivery device, the energy generator being configured to transmit energy to the energy delivery device and the energy delivery device being configured to deliver energy to the treatment site; and processing circuitry configured to control delivery of the impedance-modifying fluid from the energy delivery device to the treatment site. In one embodiment, a method for ablating tissue comprises delivering an impedance-modifying fluid to a treatment site and delivering pulsed field ablation energy to the treatment site.

Abstract: Implantable medical electrical leads having electrodes arranged such that a defibrillation coil electrode and a pace/sense electrode(s) are concurrently positioned substantially over the ventricle when implanted as described. The leads include an elongated lead body having a distal portion and a proximal end, a connector at the proximal end of the lead body, a defibrillation electrode located along the distal portion of the lead body, wherein the defibrillation electrode includes a first electrode segment and a second electrode segment proximal to the first electrode segment by a distance. The leads may include at least one pace/sense electrode, which in some instances, is located between the first defibrillation electrode segment and the second defibrillation electrode segment.

Abstract: Systems, devices, and techniques are described for determining a posture state of a patient based on detected evoked compound action potentials (ECAPs). In one example, a medical device includes stimulation circuitry configured to deliver electrical stimulation and sensing circuitry configured to sense a plurality of evoked compound action potential (ECAP) signals. The medical device also includes processing circuitry configured to control the stimulation circuitry to deliver a plurality of electrical stimulation pulses having different amplitude values, control the sensing circuitry to detect, after delivery of each electrical stimulation pulse of the plurality of electrical stimulation pulses, a respective ECAP signal of the plurality of ECAP signals, and determine, based on the plurality of ECAP signals, a posture state of the patient.

Abstract: In some examples, a feedthrough assembly for a medical device may include a ferrule. The ferrule defines an aperture extending through the ferrule from an outer end surface defined by the ferrule to an end inner end surface defined by the ferrule. The aperture includes a first portion having a first diameter and a second portion having a second diameter less than the first diameter. The aperture defines a longitudinal axis extending therethrough and the ferrule defines a ledge between the first and second portions of the aperture that extends radially inward toward the longitudinal axis. The feedthrough assembly further may include a conductive pin within the aperture and an insulating member surrounding at least a portion of the pin. The insulating member may electrically insulate the conductive pin from the ferrule, and the ledge and a surface of the insulating member adjacent the ledge may define a space therebetween.

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: Anchors for securing a medical device relative to a body portal, wherein the anchors may accommodate most any implantation trajectory through the portal. Such anchors may further secure the device along any such trajectory without imparting undesirable biasing forces that may shift the device from its intended implanted location. In some embodiments, the anchor is configured as a burr hole anchor including a spherical member contained in a socket of the anchor such that orientation of the spherical member is permitted about three mutually perpendicular axes.

Abstract: Devices, systems, and techniques are disclosed for determining an orientation of an implanted medical lead. For example, a system may include processing circuitry configured to receive image data representing a lead implanted within a patient, identify, from the image data, at least one hypointensive portion, identify, from the image data, at least one hyperintensive portion, determine, based on the at least one hypointensive portion and the at least one hyperintensive portion, an orientation of the lead within the patient, and output the orientation of the lead.

Abstract: An implantable medical device (IMD) includes a drug reservoir located within a reservoir chamber of the IMD that includes a first side and a second side directly opposite the first side defining a reservoir volume there between. The IMD further includes and a volume sensor system including an ultrasound transmitter within the reservoir chamber and positioned to transmit an ultrasound signal toward the second side at an angle relative to the second side and a plurality of ultrasound sensors adjacent to at least one of the first side or second side of the drug reservoir with each sensor positioned to selectively receive the signal from the transmitter at different reservoir volume levels to indicate a current volume capacity of the drug reservoir.

Abstract: Systems and methods for manufacturing elongate medical devices including internal components embedded between multiple jacket layers. The system including a heating cartridge, a heating element, a filament handling system, a substrate handling system, and a controller to feed and melt each of the filaments for forming the multiple jacket layers. The system may include a single heating cartridge adapted to make multiple passes to form a first and second jacket or multiple heating cartridges that sequentially form a first and second jacket.