Abstract: Aspects of the disclosure provide a cardiac implant delivery device including catheter having a distal end and a telescoping capsule assembly secured to the distal end. The capsule assembly can include a distal capsule and a proximal capsule. Other embodiments include additional capsules positioned between the proximal and distal capsules. The capsule assembly has a loaded arrangement and a deployed arrangement. As the capsule assembly transitions from the loaded arrangement fully covering the implant to the deployed arrangement, the proximal capsule and any intermediate capsules move distally in the direction of the distal capsule to unsheathe the implant. In various embodiments, the cardiac implant is a prosthetic heart valve. Methods of delivering a cardiac implant are also disclosed. Various methods include methods of delivering a replacement tricuspid heart valve.

Abstract: A medical device comprises therapy delivery circuitry and processing circuitry. The therapy delivery circuitry is configured to deliver anti-tachycardia pacing (ATP) therapy to a heart of a patient. The ATP therapy includes one or more pulse trains and each of the one or more pulse trains includes a plurality of pacing pulses. The processing circuitry is configured to, for at least one of the plurality of pacing pulses of at least one of the one or more pulse trains, determine at least one latency metric of an evoked response of the heart to the pacing pulse. The processing circuitry is further configured to modify the ATP therapy based on the at least one latency metric.

Abstract: A method for battery management, the method including determining an amount of charge Qchg delivered to the battery during a portion of a charging cycle. The method can also include measuring state of charge (SoCfull) of the battery subsequent to the charging cycle, and determining an amount of charge Qdsg produced by the battery during a discharging cycle of the battery to a depth of discharge (DoD) threshold. The method can also include measuring state of charge (SoCempty) of the battery subsequent to discharging the battery. The method can include determining total battery capacity based on the values determined in previous operations. Apparatuses and systems for battery management are also described.

Abstract: In a medical device system, a computer apparatus is configured to receive body surface electrical signals from an electrode apparatus including multiple external electrodes. The computing apparatus generates electrical dyssynchrony data from the body surface electrical signals during delivery of His bundle pacing pulses and identifies effective His bundle capture based on the electrical dyssynchrony data. The computing apparatus generates an indication of His bundle capture in response to identifying the effective His bundle capture.

Abstract: Aspects of the disclosure are generally related to systems, devices and methods for transcatheter delivery and deployment of an implant, such as a prosthetic valve. Aspects of the disclosure include methods of loading the implant to the delivery device having a capsule assembly for sheathing the implant. The capsule assembly can include separable proximal and distal segments. Such methods of loading can include utilizing a collar and a funnel to guide the proximal segment over the implant and adjacent the distal segment to compress and fully sheathe the implant for delivery.

Abstract: Aspects of the present disclosure are directed to an implantable medical device including a housing containing components therein configured for delivering neurostimulation therapy, and an anchoring feature included with the housing. The implantable medical device also includes a lead having an electrode. In one aspect, the implantable medical device may include a guidewire passageway configured to allow the lead of implantable medical device to be introduced over a guidewire.

Abstract: Techniques for remote monitoring of a patient and corresponding medical device(s) are described. The remote monitoring comprises determining identification data and identifying implantable medical device (IMD) information, initiating an imaging device and determining an imaging program, receiving one or more frames of image data including image(s) of an implantation site, identifying an abnormality at the implantation site, triggering a supplemental image capture mode, receiving one or more supplemental images of the implantation site, and outputting the one or more supplemental images of the implantation site.

Abstract: An implantable electrical stimulation medical system is disclosed. The system includes an implantable medical device having electrical circuitry configured to perform electrical stimulation, a nonstandard implantable medical lead, and an adapter matrix. The adapter matrix electrically interfaces with the electrical circuitry and the nonstandard implantable medical lead to provide electrical stimulation from the implantable medical device to the nonstandard implantable medical lead.

Abstract: Techniques for remote monitoring of a patient and corresponding medical device(s) are described. The remote monitoring comprises identifying a first set of images that represent a particular location of a body of a patient in which at least one component of an implantable medical device (IMD) coincides, determining a projection of alteration characteristics of the particular location of the body, identifying a second set of images, determining a second set of alteration characteristics, comparing the second set of alteration characteristics to the projection, and identifying a potential abnormality at the particular location of the body.

Abstract: A fixation mechanism of an implantable medical device is formed by a plurality of tines fixedly mounted around a perimeter of a distal end of the device. Each tine may be said to include a first segment fixedly attached to the device, a second segment extending from the first segment, and a third segment, to which the second segment extends. When the device is loaded in a lumen of a delivery tool and a rounded free distal end of each tine engages a sidewall that defines the lumen, to hold the tines in a spring-loaded condition, the first segment of each tine, which has a spring-biased pre-formed curvature, becomes relatively straightened, and the third segment of each tine, which is terminated by the free distal end, extends away from the axis of the device at an acute angle in a range from about 45 degrees to about 75 degrees.

Abstract: The disclosure is directed to programming implantable stimulators to deliver stimulation energy via one or more implantable leads having complex electrode array geometries. The disclosure also contemplates guided programming to select electrode combinations and parameter values to support efficacy. The techniques may be applied to a programming interface associated with a clinician programmer, a patient programmer, or both. A user interface permits a user to view electrodes from different perspectives relative to the lead. For example, the user interface provides a side view of a lead and a cross-sectional view of the lead. The user interface may include an axial control medium to select and/or view electrodes at different axial positions along the length of a lead, and a rotational control medium to select and/or view electrodes at different angular positions around a circumference of the lead.

Abstract: Techniques and devices for implementing the techniques for adjusting atrial arrhythmia detection based on analysis of one or more P-wave sensing windows associated with one or more R-waves. An implantable medical device may determine signal characteristics of the cardiac signal within the P-wave sensing window, determine whether the cardiac signal within the sensing window corresponds to a P-wave based on the determined signal characteristics, determine a signal to noise ratio of the cardiac signal within the sensing window, update the arrhythmia score when the P-wave is identified in the sensing window and the determined signal to noise ratio satisfies a signal to noise threshold.

Abstract: An intracardiac ventricular pacemaker having a motion sensor, a pulse generator and a control circuit coupled to the pulse generator and the motion sensor is configured to identify a ventricular systolic event, detect a ventricular passive filling event signal from the motion signal, and determine a time interval from the ventricular systolic event to the ventricular passive filling event. The pacemaker establishes a minimum pacing interval based on the time interval.

Abstract: A ventricular pacemaker is configured to determine a ventricular rate interval by determining at least one ventricular event interval between two consecutive ventricular events and determine a rate smoothing ventricular pacing interval based on the ventricular rate interval. The pacemaker is further configured to detect an atrial event from a sensor signal and deliver a ventricular pacing pulse in response to detecting the atrial event from the sensor signal. The pacemaker may start the rate smoothing ventricular pacing interval to schedule a next pacing pulse to be delivered upon expiration of the rate smoothing ventricular pacing interval.

Abstract: Techniques are disclosed for monitoring a patient for the occurrence of a cardiac arrhythmia. A computing system generates sample probability values by applying a machine learning model to sample patient data. The machine learning model determines a respective probability value that indicates a probability that the cardiac arrhythmia occurred during each respective temporal window. The computing system outputs a user interface comprising graphical data based on the sample probability values and receives, via the user interface, an indication of user input to select a probability threshold for a patient. The computing system receives patient data for the patient and applies the machine learning model to the patient data to determine a current probability value. In response to the determination that the current probability exceeds the probability threshold for the patient, the computing system generates an alert indicating the patient has likely experienced the occurrence of the cardiac arrhythmia.

Abstract: An apparatus having a foil pack defining a device enclosure and a fluid conduit defining a fluid channel. The device enclosure may be configured to hold an energy storage device such as a battery or capacitor. The fluid conduit defines a fluid channel configured to allow a flow from the device enclosure through a test port defined by the fluid conduit. The apparatus is configured to establish a vacuum in the device enclosure when a vacuum is established in the fluid channel (e.g., during leak testing of the device enclosure). A scaffolding within the fluid conduit is configured to configured to resist a collapse of the fluid channel when the vacuum is established in the fluid channel.

Abstract: A medical system includes an implantable medical device that carries a first electrode on a distal end of the implantable medical device and a return electrode. The implantable medical device is configured to be positioned within a heart. The implantable medical device further includes a leadlet including a proximal end and a distal end. The proximal end is attached to the implantable medical device, and the distal end is configured to penetrate tissue of the heart. The leadlet carries a second electrode, and a body of the leadlet between the proximal end and the distal end is configured to flex when the distal end is implanted in the tissue of the heart. The implantable medical device further includes a fixation device attached to the implantable medical device. The fixation device is configured to affix the distal end of the implantable medical device to the heart.

Abstract: A method and device apparatus to deliver a pacing therapy capable of remodeling a patient's heart over a period of time that includes monitoring one or more parameters in response to a delivered cardiac remodeling pacing, determining whether the cardiac remodeling pacing has an effect on cardiac normalization in response to the monitoring, and adjusting the cardiac remodeling pacing in response to the determined effect on cardiac normalization. The method and device may also perform short-term monitoring of one or more parameters in response to the delivered cardiac remodeling pacing, monitor one or more long-term parameter indicative of a long-term effect of the delivered cardiac remodeling pacing, determine the long-term effect of the delivered cardiac remodeling pacing on cardiac normalization in response to the monitoring, and adjust the cardiac remodeling pacing in response to one or both of the short-term monitoring and the determined long-term effect on cardiac normalization.

Abstract: A surgical method treats infections on a lead positioned at least partially within a patient's body. The surgical method includes uncoupling the lead from a pulse generator. The lead is then coupled to an ultrasound wave generator. Ultrasound waves are propagated from the ultrasound wave generator through the lead. Systems are disclosed.

Abstract: A system comprises processing circuitry and memory comprising program instructions that, when executed by the processing circuitry, cause the processing circuitry to: apply a first set of rules to first patient parameter data for a first determination of whether sudden cardiac arrest of a patient is detected; determine that a one or more context criteria of the first determination are satisfied; and in response to satisfaction of the context criteria, apply a second set of rules to second patient parameter data for a second determination of whether sudden cardiac arrest of the patient is detected. At least the second set of rules comprises a machine learning model, and the second patient parameter data comprises at least one patient parameter that is not included in the first patient parameter data.