Abstract: A leadless cardiac pacemaker comprises a hermetic housing, a power source disposed in the housing, at least two electrodes supported by the housing, a semiconductor temperature sensor disposed in the housing, and a controller disposed in the housing and configured to deliver energy from the power source to the electrodes to stimulate the heart based upon temperature information from the temperature sensor. In some embodiments, the sensor can be configured to sense temperature information within a predetermined range of less than 20 degrees C. The temperature sensor can be disposed in the housing but not bonded to the housing.

Abstract: Systems and methods are provided for bridging a bi-directional communication link between an external device and an implantable medical device (IMD). The systems and methods establish a first bi-directional communication link between an external device and a wireless bridge device according to a wireless protocol, and establish a second bi-directional communication link between the wireless bridge device and an IMD concurrently with the first bi-direction communication link according to the wireless protocol. The systems and methods further receive a data packet from the external device at the wireless bridge device. The data packet is received during the communication interval. The systems and methods further transmit the data packet from the wireless bridge device to the IMD during the communication interval.

Abstract: Provided herein are implantable systems, and methods for use therewith, for monitoring a patient's arterial blood pressure while a patient's heart is being paced. A signal (e.g., PPG or IPG signal) indicative of changes in arterial blood volume remote from the patient's heart is obtained using a sensor or electrodes that are implanted remote from the patient's heart. One or more metrics indicative of pulse arrival time (PAT) are determined, where each metric can be determined by determining a time from a paced cardiac event to one or more predetermined features of the signal indicative of changes in arterial blood volume. Based on at the metric(s) indicative of PAT, arterial blood pressure is estimated, which can include determining values indicative of systolic blood pressure, diastolic blood pressure, pulse pressure and/or mean arterial blood pressure, and/or changes in such values.

Abstract: A cardiac pacing system comprising one or more leadless cardiac pacemakers configured for implantation in electrical contact with a cardiac chamber and configured to perform cardiac pacing functions in combination with a co-implanted implantable cardioverter-defibrillator (ICD). The leadless cardiac pacemaker comprises at least two leadless electrodes configured for delivering cardiac pacing pulses, sensing evoked and/or natural cardiac electrical signals, and bidirectionally communicating with the co-implanted ICD.

Abstract: A method is provided for a bridge device to interface between an external device and an implantable medical device (“IMD”), the bridge device includes a system on a chip (“SoC”) having a memory, an input/output interface, a standard wireless computer network (“SWCN”) controller and a bridge controller integrated into a single integrated circuit (“IC”). The method includes configuring the bridge controller to convert data between a Medical Implant Communication Service (MICS) protocol and a SWCN protocol, coupling a MICS controller to the SoC, and configuring the MICS controller to manage operation of a first transceiver based on the MICS protocol. The method includes configuring the SWCN controller to manage operation of a second transceiver based on the SWCN protocol, communicating between the bridge device and an IMD utilizing the first transceiver, and communicating between the bridge device and an external device utilizing the second transceiver.

Abstract: Methods, devices and systems are provided for selecting one or more left ventricular multi-electrode pacing site(s). The methods, devices and systems measure arrival times of LV activation events for corresponding LV sensing sites, where the arrival times each correspond to a conduction time from an intrinsic ventricular event or delivery of a pacing pulse until sensing of the corresponding LV activation event. Site-to-site (STS) relative delays are calculated as differences between the arrival times associated with adjacent LV sensing sites. The STS relative delays represent STS arrival delays for corresponding combinations of the adjacent LV sensing sites. An LV electrode combination is identified that is associated with at least one of the STS relative delays that satisfy selection criteria, where the LV electrode combination corresponds to a target tissue region exhibiting a select degree of non-uniformity.

Abstract: The device includes radio frequency (RF) communication components installed within a case of the device and an antenna with an inverted E shape mounted within a header of the device. The antenna has three branches extending from a main arm: a capacitive branch connecting one end of the main arm to the case; an RF signal feed branch connecting a middle portion of the main arm to the internal RF components of the device via a feedthrough; and an inductive branch connecting the opposing (far) end of the main arm to the case to provide a shunt to ground.

Abstract: The present disclosure provides a cardiac pacing system. The cardiac pacing system includes a right atrial ring electrode, a right atrial tip electrode, a right ventricle ring electrode, and a pacing integrated circuit (IC) including a first pace output node electrically coupled to the right atrial ring electrode, a pace return node electrically coupled to the right atrial tip electrode, and a second pace output node electrically coupled to the right ventricle ring electrode, wherein the pacing IC has a fast discharge configuration that facilitates reducing or eliminating a DC rectification current generated from RF interference during a fast discharge phase.

Abstract: Techniques are provided for use with an implantable cardiac stimulation device equipped with a multi-pole left ventricular (LV) lead and a right ventricular (RV) lead for identifying suitable pacing vectors. In one example, RV-LV delay times are measured while using different electrodes of the LV lead as cathodes for sensing. The LV electrode having the longest RV-LV delay time is identified and LV capture thresholds and diaphragmatic stimulation thresholds are measured for pacing vectors that employ that LV electrode as a cathode. Assuming at least one vector employing the selected LV electrode is found to have acceptable thresholds, the vector is selected for use in delivering pacing therapy with the selected LV electrode. If none of the pacing vectors employing the selected LV electrode has acceptable thresholds, another LV electrode is selected and the procedure is repeated. Examples with a multi-pole RV lead are also described.

Abstract: Described herein are methods, devices, and systems for treating human anemia. The methods, devices, and systems generally include monitoring a patients hemoglobin level and at least one of autonomic balance and inflammatory state to determine the etiology of the anemic state, modulating at least one of a sympathetic or parasympathetic nerve based on the cause of the anemia, monitoring for changes in the patients cardiac activity and state of inflammation, and hemoglobin level. An external neurostimulation system is describes, and well as a chronic implantable system. A method for treating a patient for anemia in conjunction with a renal denervation ablation catheter is also disclosed.

Abstract: In accordance with one embodiment, a leadless implantable medical device (LIMD), compromises a hermetic housing that has a distal portion and proximal portion. An electrode is proximate to the distal portion. An electronics package is disposed in the housing, in which the electronics package is configured to generate and deliver stimulation signals to the electrode. A fixation mechanism is disposed on the distal portion of the housing. A torque mechanism is disposed on the proximal portion of the housing. The torque mechanism has a tool engagement element movably coupled to the housing. The tool engagement element has a rotational force applied thereto during implant. The torque mechanism includes a torque limiter that maintains a fixed relation between the tool engagement element and the housing when in an engaged state. The torque limiter changes from the engaged state to a disengaged state when the rotational force exceeds a predetermined torque limit.

Abstract: Systems and associated methods are provided for automatically identifying a problem with sensing heart activity. In use, a plurality of heartbeats is sensed utilizing an implantable medical device. Further, data associated with the heartbeats is collected and stored. To this end, a problem with the sensing of the heartbeats (e.g., oversensing, undersensing, etc.) may be automatically identified and corrected, utilizing the data.

Abstract: A system and method for controlling non-paresthesia stimulation of nervous tissue of a patient. The method delivers a non-paresthesia stimulation waveform, senses sensory action potential (SAP) signals from the nervous tissue of interest, and analyzes the SAP signals to obtain SAP activity data for at least one of an SAP C-fiber component or an SAP A-delta fiber component. The method determines whether the SAP activity data satisfies a criteria of interest and adjusts at least one of the therapy parameters to change the non-paresthesia stimulation waveform when the SAP activity data does not satisfy the criteria of interest.

Abstract: A system and method for delivering coupled burst and tonic stimulation of nervous tissue is provided. The system and method includes providing a lead with at least one stimulation electrode configured to be implanted at a target position proximate to nervous tissue of interest. The system and method further includes coupling the lead to an implantable pulse generator (IPG). The method delivers a first current pulse configured as a tonic stimulation waveform to the at least one electrode. The tonic stimulation waveform is configured to excite A-beta fibers of the nervous tissue. After a tonic-burst delay, the IPG delivers second current pulses configured as a burst stimulation waveform to at least one electrode. The burst stimulation waveform is configured to excite C-fibers of the nervous tissue.

Abstract: A method is provided for establishing a communication session with an implantable medical device (“IMD”). The method includes configuring an IMD and an external device to communicate with one another through a protocol that utilizes a dedicated advertisement channel. The advertisement period and the scan period of the protocol are independent of one another such that the advertisement and scan periods at least partially overlap intermittently after a number of cycles. When the external device detects one of the advertisement notices, the method includes establishing a communications link between the external device and the IMD.

Abstract: Techniques are provided for use with a pulmonary artery pressure (PAP) monitor having an implantable PAP sensor. In one example, a PAP signal is sensed that is representative of beat-by-beat variations in PAP occurring during individual cardiac cycles of the patient. The PAP monitor detects peaks within the PAP signal corresponding to valvular regurgitation within the heart, then detects mitral regurgitation (MR) based on the peaks. In other examples, the PAP monitor optimizes pacing parameters based on the PAP signal and corresponding electrical cardiac signals. Examples are provided where the PAP monitor is an external system and other examples are provided where the PAP monitor is a component of an implantable cardiac rhythm management device.

Abstract: The present disclosure provides systems and methods for estimating a change in an intracardiac distance between systole and diastole. A system includes a pacing electrode configured to generate a pacing pulse, a sensing electrode configured to measure an electrical artifact corresponding to the pacing pulse, and a computing device communicatively coupled to the pacing electrode and the sensing electrode, the computing device configured to determine a first amplitude of a first electrical artifact measured at the sensing electrode during systole, determine a second amplitude of a second electrical artifact measured at the sensing electrode during diastole, and calculate a mechanical index based on the first amplitude and the second amplitude, wherein the mechanical index is representative of the change in the intracardiac distance.

Abstract: In accordance with an embodiment, apparatuses and methods are provided for coordinating operation between leadless pacemakers (LPs) located in different chambers of the heart. A method includes configuring a local LP to receive communications from a remote LP through conductive communication over first and second channels, maintaining the first channel active for at least a portion of a time when the second channel is inactive to listen for event messages from the remote LP, detecting an incoming signal at the local LP over the first channel, determining whether the incoming signal received over the first channel corresponds to an LP wakeup notice, when the incoming signal corresponds to the LP wakeup notice, activating the second channel at the local LP, and receiving an event message over the second channel from the remote LP.

Abstract: Described herein are implantable systems and devices, and methods for use therewith, that can be used to monitor and treat heart failure (HF). Such implantable systems preferably includes a lead having at least two electrodes implantable in a patient's left ventricular (LV) chamber. A plurality of different sensing vectors are used to obtain a plurality of IEGMs each of which is indicative of an evoked response at a corresponding different region of the LV chamber. For each of the IEGMs, there is a determination of one or more evoked response metrics indicative of a localized cardiac function at the corresponding region of the LV chamber. The evoke response metrics can be, e.g., paced depolarization integral (PDI) and/or maximum upward slope of an R-wave, but are not limited thereto.

Abstract: An implantable medical device includes a pressure input, an excitation source, a detector module, and a processor. The pressure input is configured to be joined to a pressure sensor located proximate to a cardiac chamber of the heart. The pressure input receives pressure measurements representative of a pressure in the cardiac chamber. The excitation source is configured to deliver stimulation pulses to the heart. The detector module communicates with the pressure sensor to receive and compare the pressure measurements to a pressure threshold. The processor instructs the excitation source to deliver the stimulation pulses at a pressure-based rate based on the comparison of the pressure measurements to the pressure threshold.