Abstract: A medical device for providing electrical stimulation to a brain of a patient includes one or more processors. The one or more processors are configured to determine a first set of parameters of a first electrical signal that is delivered via a first electrode configured to apply electrical stimulation to a first region of the brain and to determine a second set of parameters of a second electrical signal based on the first set of parameters. The second electrical signal is delivered via a second electrode configured to apply electrical stimulation to a second region of the brain. The one or more processors are further configured to deliver, with the first electrode, the first electrical signal having the first set of parameters and to deliver, with the second electrode, the second electrical signal having the second set of parameters.

Abstract: In some examples, the disclosure relates to a medical device such as an implantable medical lead. The medical lead may include: a lead body including an electrically conductive lead wire; an electrical contact on a proximal portion of the lead body, the electrical contact including a contact substrate; and an electrode on a distal portion of the lead body, the electrode including an electrode substrate, wherein the electrode substrate is electrically coupled to the contact substrate via the electrically conductive lead wire, wherein the lead wire is formed of a composition comprising titanium or titanium alloys, wherein the electrode substrate is formed of a first beta-titanium alloy, and wherein the contact substrate is formed of a second beta-titanium alloy.

Abstract: Medical devices that provide for selected curve deflection in multiple planes such that three-dimensional shapes can be formed in the medical devices by placing a pull wire extending through the catheter in tension, as well as methods of manufacturing and using the medical devices. The medical devices may include selected portions in which the location of the pull wire changes circumferentially and/or radially to provide for the selected curve deflection. The medical devices may include, in addition to, or in place of changes in pull wire location, selected portions having exhibiting changes in rigidity to provide for the selected curve deflection.

Abstract: An implantable medical device system capable of sensing cardiac electrical signals includes a sensing circuit, a therapy delivery circuit and a control circuit. The sensing circuit is configured to receive a cardiac electrical signal and sense a cardiac event in response to the signal crossing a cardiac event sensing threshold. The therapy delivery circuit is configured to deliver an electrical stimulation therapy to a patient's heart via the electrodes coupled to the implantable medical device. The control circuit is configured to control the sensing circuit to set a starting value of the cardiac event sensing threshold and hold the starting value constant for a sense delay interval. The control circuit is further configured to detect an arrhythmia based on cardiac events sensed by the sensing circuit and control the therapy delivery circuit to deliver the electrical stimulation therapy in response to detecting the arrhythmia.

Abstract: A medical system including a device head configured to be positioned in an atrium of a heart, an implantable medical device configured to be positioned within a vena cava of the heart, and a lead extending from the device head to the implantable medical device. A fixation element coupled to the device head is configured to engage tissues within the atrium. The device head includes an electrode configured to deliver therapy and/or sensing signals to tissues within the atrium using stimulation signals received from processing circuitry within the implantable medical device. The medical system may include a delivery catheter configured to allow delivery of the device head to the atrium.

Abstract: Systems, devices, methods, and techniques are described for using evoked compound action potential (ECAP) signals to determine an implant location for a lead. An example method includes receiving first information representative of a first evoked compound action potential (ECAP) signal sensed in response to a first control stimulus delivered to a first location adjacent to a spinal cord of a patient. The method also includes receiving, second information representative of a second ECAP signal in response to a second control stimulus delivered to a second location adjacent to the spinal cord of the patient. Additionally, the method includes outputting a first indication of the first information representative of the first ECAP signal and a second indication of the second information representative of the second ECAP signal.

Abstract: In some examples, a battery assembly for an implantable medical device. The battery assembly may include an electrode stack comprising a plurality of electrode plates, wherein the plurality of electrode plates comprises a first electrode plate including a first tab extending from the first electrode plate and a second electrode plate including a second tab extending from the second electrode plate; a spacer between the first tab and the second tab; and a rivet extending through the first tab, second tab, and spacer, wherein the rivet is configured to mechanically attach the first tab, second tab, and spacer to each other.

Abstract: The disclosure describes capturing the cardiac tissue using current steering techniques with a multi-pole cardiac lead implanted near the cardiac tissue. The techniques may include current-controlled sources in an IMD to provide current regulation to the pacing pulses allowing direct stimulation through multiple electrode contacts with known current delivery to the tissue. This current steering technique may use a delivery current source coupled to a delivery electrode and a receiving current source coupled to a receiving electrode to steer the current to the desired tissue to be stimulated. In some examples, different electrode pairs may be paced sequentially or together. In other examples, two or more electrodes may be considered the “delivery electrodes” and two or more electrodes may be considered the “receiving electrodes.” In some examples a current-controlled source in the IMD may be implemented using a source degeneration circuit.

Abstract: An implantable neurostimulation system including an implantable neurostimulation device having one or more electrodes configured to deliver electrical energy to a patient according to a prescribed dosing pattern for the treatment of one or more physiological conditions and an external programmer configured to wirelessly communicate with the implantable neurostimulation device, the external programmer including a user interface enabling a clinician to define an irregular dosing pattern, such that a dose pattern during each day of a calendar month is individually programmable.

Abstract: A medical device is configured to sense a cardiac electrical signal and detect an atrial tachyarrhythmia based on the sensed cardiac electrical signal. The medical device is configured to determine that far field oversensing criteria are met by the cardiac electrical signal during the detected atrial tachyarrhythmia. The medical device may detect termination of the detected atrial tachyarrhythmia in response to the far field oversensing criteria being met.

Abstract: The present disclosure relates to delivery devices for transcatheter stented prosthesis loading, delivery and implantation. The delivery devices provide a loaded delivery state in which the stented prosthesis is loaded and compressed over the delivery device. The compression of the stented prosthesis can be adjusted with one or more elongate tension members, which extend around the stented prosthesis and proximately to an actuation and release assembly that can be provided as part of a handle assembly. The delivery device can be manipulated to adjust tension in the tension members to permit the stented prosthesis to compress, self-expand, and ultimately release from the shaft assembly. In some embodiments, the tension in one or more tension members is adjusted with one or more actuation and release assemblies.

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: The present disclosure is directed to an implantable medical device including a housing having a generally planar portion, and a piezoelectric transducer disposed within the housing, wherein a receiving face of the piezoelectric transducer is arranged at an oblique angle with respect to a poling axis of the piezoelectric transducer, and an electrode to deliver a neurostimulation therapy. The implantable medical device is configured to receive energy signals from an external device and transduce the received energy signals into electrical power.

Abstract: A method of delivering a pacing lead may include locating a potential implantation site adjacent to or within the triangle of Koch region of a patient's heart. The method may include advancing a pacing lead to the potential implantation site. The pacing lead has an elongate body and a fixation element coupled to a distal portion and attachable to the right-atrial endocardium adjacent to or within the triangle of Koch region. The method may include implanting the pacing lead at the potential implantation site to or sense electrical activity of the left ventricle in the basal and/or septal region of the left ventricular myocardium of the patient's heart. The pacing lead may include a lumen configured to receive a guide wire. A sheath of a delivery system used to deliver the pacing lead may include two or more curves to facilitate implanting the pacing lead at the implantation site.

Abstract: A method for rotationally aligning a valve prosthesis using imaging identifiers includes delivering the valve prosthesis in a collapsed configuration in a catheter to a vicinity of a functioning native heart valve of a heart of the subject using a retrograde approach, generating an image of the functioning native heart valve and the valve prosthesis, rotationally aligning engagement arms of the valve prosthesis with sinuses of the functioning native heart valve using at least one of the imaging identifiers of the heart valve prosthesis visible in the image.

Abstract: A medical device is configured to sense an electrical signal and determine that signal to noise criteria are met based on electrical signal segments stored in response to sensed electrophysiological events. The medical device is configured to determine an increased gain signal segment from one of the stored electrical signal segments in response to determining that the signal to noise criteria are met. The medical device determines a noise metric from the increased gain signal segment. The stored electrical signal segment associated with the increased gain signal segment may be classified as a noise segment in response to the noise metric meeting noise detection criteria.

Abstract: A leadless neurostimulation device including a header unit having at least one primary electrode having a contact surface that defines an external surface on a side of the device, an outer housing that forms a side of the header unit opposite of the contact surface of the primary electrode, and a dielectric mount that receives at least a portion of the primary electrode and at least partially surrounds the primary electrode, the dielectric mount being configured to electrically insulate the primary electrode from the outer housing, the dielectric mount being received and fixed within a recessed portion of the outer housing, and a housing having a secondary electrode positioned on the same side of the leadless neurostimulation device as the primary electrode, the primary electrode and the secondary electrode being configured to transmit an electrical stimulation signal therebetween to provide electrical stimulation therapy to a tibial nerve of a patient.

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: 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 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.