Abstract: Peripheral nerve field stimulation (PNFS) may be controlled based on detected physiological effects of the PNFS, which may be an efferent response to the PNFS. In some examples, a closed-loop therapy system may include a sensing module that senses a physiological parameter of the patient, which may be indicative of the patient's response to the PNFS. Based on a signal generated by the sensing module, the PNFS may be activated, deactivated or modified. Example physiological parameters of the patient include heart rate, respiratory rate, electrodermal activity, muscle activity, blood flow rate, sweat gland activity, pilomotor reflex, or thermal activity of the patient's body. In some examples, a patient pain state may be detected based on a signal generated by the sensing module, and therapy may be controlled based on the detection of the pain state.

Abstract: Techniques for minimizing rate of depletion of a non-rechargeable power source, to extend the operational lifetime of an implantable medical device that includes the non-rechargeable power source, by enforcing operational-mode-specific communication protocols whereby inter-device communication between the implantable medical device and another implantable medical device is such that level of power draw from the non-rechargeable power source by the implantable medical device is less than level of power draw from the rechargeable power source by the another implantable medical device for the implantable medical devices to engage in communication with each other.

Abstract: Techniques for remote monitoring of a patient and corresponding medical device(s) are described. The remote monitoring comprises providing an interactive session configured to allow a user to navigate a plurality of sub sessions, determining a first set of data items in accordance with a first subsession, the first set of data items including the image data, determining a second set of data items in accordance with a second subsession of the interactive session, determining, based at least in part on the first set of data items and the second set of data items, an abnormality, and outputting a post-implant report of the interactive session.

Abstract: Seals used within lead bores of implantable medical devices for creating a seal to implantable medical leads inserted into the lead bores include a cylinder that engages the lead body. The length of contact of the cylinder to the lead body is at least 0.010? long while average contact pressure is no greater than (10 pounds per inch)/(contact length). Adequate electrical isolation is achieved, even when a debris particle is present between the inner cylinder and the lead body while insertion force remains acceptable.

Abstract: A method and medical device for determining sensing vectors that includes sensing cardiac signals from a plurality of electrodes, the plurality of electrodes forming a plurality of sensing vectors, determining a sensing vector metric in response to the sensed cardiac signals, determining a morphology metric associated with a morphology of the sensed cardiac signals, determining vector selection metrics in response to the determined sensing vector metric and the determined morphology setting, and selecting a sensing vector of the plurality of sensing vectors in response to the determined vector selection metrics.

Abstract: The present disclosure relates generally to pacing of the cardiac conduction system of a patient, and more particularly, to providing adaptive cardiac conducting system pacing therapy and to determining selective or non-selective capture of the cardiac conduction system by cardiac conduction system pacing therapy. The adaptive cardiac conduction system pacing therapy may adjust AV delay and VV delay based on various signals and metrics and may switch between cardiac conduction system pacing therapy exclusively and cardiac conduction system pacing therapy in combination with traditional left ventricular pacing therapy.

Abstract: Far field telemetry operations are conducted between an external device and an implantable medical device while power is being transferred to the implantable medical device for purposes of recharging a battery of the implantable medical device. The far field operations may include exchanging recharge information that has been collected by the implantable medical device which allows the external device to exercise control over the recharge process. The far field operations may include suspending far field telemetry communications for periods of time while power continues to be transferred where suspending far field telemetry communications may include powering down far field telemetry communication circuits of the implantable medical device for periods of time which may conserve energy. The far field operations may further include transferring programming instructions to the implantable medical device.

Abstract: An extra-cardiovascular implantable cardioverter defibrillator (ICD) system receives a cardiac electrical signal by an electrical sensing circuit via an extra-cardiovascular sensing electrode vector and senses cardiac events from the cardiac electrical signal. The ICD system detects tachycardia from the cardiac electrical signal and determines a tachycardia cycle length from the cardiac electrical signal. The ICD system determines an ATP interval based on the tachycardia cycle length and sets an extended ATP interval that is longer than the ATP interval. The ICD delivers ATP pulses to a patient's heart via an extra-cardiovascular pacing electrode vector different than the sensing electrode vector. The ATP pulses include a leading ATP pulse delivered at the extended ATP interval after a cardiac event is sensed from the cardiac electrical signal and a second ATP pulse delivered at the ATP interval following the leading ATP pulse.

Abstract: A pacemaker having a motion sensor delivers atrial-synchronized ventricular pacing by detecting events from a signal produced by the motion sensor and delivering ventricular pacing pulses at a rate that tracks the rate of the detected events. The pacemaker is configured to confirm atrial tracking of the ventricular pacing pulses by determining if detected events from the motion sensor signal are atrial events. The pacemaker is configured to adjust a control parameter used for detecting events from the motion sensor signal if atrial tracking is not confirmed.

Abstract: A method for deploying a medical device such as a heart valve to a desired location in a blood vessel comprising first deploying a tubular filter adjacent to at least one tributary vessel location with a filter deployment member, disengaging said deployment member and removing it, inserting an expandable sheath into the blood vessel, passing a medical device through said sheath to deploy its removing said sheath and removing said filter.

Abstract: Various embodiments of an electrical component and a method of forming such component are disclosed. The electrical component includes a substrate having a first major surface, a second major surface, and a cavity disposed in the substrate. The cavity extends between the first major surface and the second major surface. The electrical component also includes an anode electrode that includes a conductive foil layer disposed on the second major surface of the substrate and over the cavity. Tantalum material is disposed within the cavity and includes tantalum particles. A dielectric layer is disposed on the tantalum particles, and an electrolyte cathode layer is disposed on the dielectric layer. The electrical component also includes a cathode electrode disposed over the cavity.

Abstract: A hemostasis device includes a valve, the valve being sized and configured to be disposed entirely within a handle of a medical device, the valve including a rim, the rim being sized and configured to seal with a lumen of the handle of the medical device.

Abstract: Techniques for estimating the temperature of an external portion of a medical device are described. In an example, processing circuitry may determine a temperature sensed by at least one temperature sensor of an internal portion of the device, and determine, based on an algorithm that incorporates the temperature of the internal portion of the device, an estimated temperature of a second portion of the device, wherein the algorithm is representative of an estimated temperature difference between the first portion of the device and the second portion of the device based at least in part on a dynamic transfer function that operates in a time-domain.

Abstract: A health care system acquires data determines whether a patient is at risk of hypervolemia or hypovolemia. The method comprises (a) acquiring from a device memory a patient's absolute intrathoracic impedance data over a pre-specified time period, (b) determining a running average of the intrathoracic impedance data over the pre-specified time period, and (c) determining by the system whether the running average of the intrathoracic impedance data over the pre-specified time period exceeds one of a first and second range, the first range being a higher value boundary of intrathoracic electrical impedance and the second range being a lower value boundary of intrathoracic electrical impedance.

Abstract: A biocompatible medical device may include an electrochemical sensor including a common reference electrode; at least one counter electrode; and a work electrode platform comprising a plurality of respective work electrodes, each respective work electrode electrically coupled to the common reference electrode and comprising a respective reagent substrate configured to react with a respective analyte to produce a respective signal indicative of a concentration of the respective analyte; and processing circuitry operatively coupled to the electrochemical sensor, and configured to receive from the electrochemical sensor a plurality of signals from the plurality of respective work electrodes; identify the respective signal corresponding to a respective selected work electrode; and process the identified signal to determine the concentration of the respective analyte associated with the respective selected work electrode.

Abstract: A device, system, and method for optically evaluating and treating or ablating tissue. Specifically, device, system, and method allow for the optical and/or electrical evaluation of tissue at the same location(s) at which ablation or treatment or ablation energy is delivered. This allows for a more accurate evaluation of lesion formation and tissue condition before, during, and/or after a treatment or ablation procedure. In one embodiment, a device for performing a medical procedure includes an elongate body including a proximal portion, a distal portion having a distal end, and a longitudinal axis, and a distal tip electrode at the elongate body distal end, the tip electrode being optically transparent and electrically conductive. The device may also include optical windows in the elongate body aligned with one or more transparent lateral electrodes for optically interrogating tissue and/or for delivering treatment or ablation energy to tissue.

Abstract: An implantable access port including a port housing that defines a fill port cavity and includes a catheter fitting, a filter positioned within the port housing along a delivery flow pathway configured so that fluid injected into the fill port cavity passes through the filter prior to exiting through the catheter fitting, a one-way valve positioned within the port housing along an aspiration flow pathway configured to permit aspirated fluid to flow unfiltered from the catheter fitting to the fill port cavity and prevent injected fluid from flowing unfiltered from the fill port cavity to the catheter fitting, a port cover coupled to the port housing, and a pierceable septum positioned between the fill port cavity and the port cover configured to allow a needle to pierce through the pierceable septum to access the fill port cavity.

Abstract: Various embodiments of a sealed package and a method of forming such package are disclosed. The package can include a non-conductive substrate that includes a cavity disposed in a first major surface. A cover layer can be disposed over the cavity and attached to the first major surface of the non-conductive substrate to form a sealed enclosure. The sealed package can also include a feedthrough that includes a via between a recessed surface of the cavity and a second major surface of the substrate, and a conductive material disposed in the via. An external contact can be disposed over the via on the second major surface of the non-conductive substrate, where the external contact is electrically connected to the conductive material disposed in the via. The sealed package can also include an electronic device disposed within the sealed enclosure that is electrically connected to the external contact.

Abstract: Intrathecal drug delivery pumps can aspirate cerebrospinal fluid (CSF) when the drug reservoir is empty or at other times to maintain a continuous or cyclic fluid flow through the pump and the delivery catheter. This addresses the potential need for continuous infusion to maintain an un-occluded fluid pathway to the intrathecal space by providing an “active port” that aspirates and expels CSF to keep fluid flow going without infusing a drug or requiring saline to fill the pump. If drug refill visits are missed, CSF could be used to keep the pump mechanism functional rather than having it run dry requiring replacement or requiring saline injections to keep the pump mechanism functioning. In addition, by having the pump aspirate CSF into the body of the pump, it would be possible to monitor biomarkers using systems in the fluid pathway and pressure differences for possible issues related to CSF management.

Abstract: This disclosure describes methods, systems, and devices configured to determine a timing of a future bladder related event of a patient. For example, a system includes processing circuitry configured to identify a timing of a plurality of bladder related events of a patient, determine, based on the timing of the plurality of bladder related events of the patient, a probability to experience a bladder related event function for the patient, the probability to experience a bladder related event function indicating a probability that the patient will experience a bladder related event at an elapsed time after a previous bladder related event, predict, based on the probability to experience a bladder related event function, a timing of a future bladder related event, and control delivery of a therapy to the patient based on the predicted timing of the future bladder related event.