Abstract: Described herein are methods, devices, and systems that improve arrhythmia episode detection specificity, such as, but not limited to, atrial fibrillation (AF) episode detection specificity. Such a method can include obtaining an ordered list of R-R intervals within a window leading up to a detection of a potential arrhythmia episode, determining a measure of a dominant repeated R-R interval pattern within the window, and comparing the measure of the dominant repeated R-R interval pattern to a pattern threshold. If the measure of the dominant repeated R-R interval pattern is below the pattern threshold, that is indicative of a regularly irregular pattern being present, and there is a determination that the detection of the potential arrhythmia episode does not correspond to an actual arrhythmia episode. Such embodiments can beneficially be used to significantly reduce the number of false positive arrhythmia detections.

Abstract: A system and method for designating between types of activation by a pulse generator configured to deliver a left ventricular (LV) pacing pulse at an LV pacing site as part of a cardiac resynchronization therapy (CRT) are provided. The system includes a sensing channel configured to collect cardiac activity (CA) signals along at least one sensing vector extending through a septal wall between the LV and right ventricle (RV). The CA signals are indicative of one or more beats and include a pre-LV pacing segment indicative of cardiac activity preceding the LV pacing pulse and a post-LV pacing segment indicative of cardiac activity following the LV pacing pulse. The system includes memory to store program instructions. One or more processors are configured to implement the program instructions to analyze the pre-LV pacing segment to identify a first myocardium activation (MA) characteristic of interest (COI).

Abstract: An implantable system including an atrial leadless pacemaker (aLP) and a ventricular leadless pacemaker (vLP), and methods for use therewith, are configured or used to terminate a pacemaker mediated tachycardia (PMT). In an embodiment, in response to the aLP detecting a PMT, the aLP initiates a PMT PA interval, and the aLP does not inform the vLP, via an i2i communication, of an atrial sensed event that caused the PMT to be detected, thereby preventing the vLP from initiating a PV interval during the PMT PA interval. The aLP selectively terminates the PMT PA interval. Additionally, the aLP informs the vLP, via an i2i communication, of an intrinsic atrial event being detected during the PMT PA interval, or of an atrial paced event being performed in response to the PMT PA interval expiring without an intrinsic atrial event being detected during the PMT PA interval.

Abstract: A method of manufacturing a filtered feedthrough assembly for use with an implantable medical device. The method may include gold brazing an insulator to a flange at first braze joint, and gold brazing a plurality of feedthrough wire to the insulator at second braze joints. The method may further include applying a first non-conductive epoxy to the first braze joint, and applying a second non-conductive epoxy to the second braze joint. The method may further include grit blasting a face of the flange, applying a conductive epoxy to the face of the flange, and attaching an EMI filter to the conductive epoxy such that it is grounded to the flange via the conductive epoxy and not via the first braze joint or the second braze joints.

Abstract: Embodiments described herein relate to implantable medical devices (IMDs) and methods for use therewith. Such a method includes using an accelerometer of an IMD (e.g., a leadless pacemaker) to produce one or more accelerometer outputs indicative of the orientation of the IMD. The method can also include controlling communication pulse parameter(s) of one or more communication pulses (produced by pulse generator(s)) based on accelerator output(s) indicative of the orientation of the IMD. The communication pulse parameter(s) that is/are controlled can be, e.g., communication pulse amplitude, communication pulse width, communication pulse timing, and/or communication pulse morphology. Such embodiments can be used to improve conductive communications between IMDs whose orientation relative to one another may change over time, e.g., due to changes in posture and/or due to cardiac motion over a cardiac cycle.

Abstract: An implantable lead includes a lead body, electrical conductors, and a lead anchor. The lead body includes an electrode segment configured to be positioned along a pericardial membrane of a heart and including a plurality of electrodes configured to at least one of sense electrical signals from the heart or deliver therapy to the heart. The electrical conductors extend through the lead body between distal and proximal ends of the lead body, and are configured to electrically couple the electrodes to a pulse generator. The lead anchor is configured to be secured to a chest wall. The electrical conductors extend through the lead anchor, and the electrode segment extends from the lead anchor to the pericardial membrane. The electrode segment includes a transition portion that is configured to extend a depth into a mediastinum and a contoured portion to extend alongside and curve about the pericardial membrane.

Abstract: Described herein are methods, devices, and systems that monitor heart rate and/or for arrhythmic episodes based on sensed intervals that can include true R-R intervals as well as over-sensed R-R intervals. True R-R intervals are initially identified from an ordered list of the sensed intervals by comparing individual sensed intervals to a sum of an immediately preceding two intervals, and/or an immediately following two intervals. True R-R intervals are also identified by comparing sensed intervals to a mean or median of durations of sensed intervals already identified as true R-R intervals. Individual intervals in a remaining ordered list of sensed intervals (from which true R-R intervals have been removed) are classified as either a short interval or a long interval, and over-sensed R-R intervals are identified based on the results thereof. Such embodiments can be used, e.g., to reduce the reporting of and/or inappropriate responses to false positive tachycardia detections.

Abstract: A cathode subassembly for use in an electrolytic capacitor may include a first separator sheet including a surface having first and second regions, where the second region extends from a perimeter of the first region to a first peripheral edge of the first sheet, a second peripheral edge of a second sheet is substantially aligned with the first peripheral edge, a conductive foil is sandwiched between the first and second sheets and disposed within the first region, the first and second sheets are adhered to each other in a sealing region extending from the second region to a region of a surface of the second sheet facing the second region, and the first sheet includes at least one first recess portion at the first peripheral edge aligned with at least one second recess portion at the second peripheral edge of the second sheet.

Abstract: Computer implemented methods and systems for detecting arrhythmias in cardiac activity are provided. The method is under control of one or more processors configured with specific executable instructions. The method obtains a far field cardiac activity (CA) data set that includes far field CA signals for beats. The method applies a feature enhancement function to the CA signals to form an enhanced feature in the CA data set. The method calculates an adaptive sensitivity level and sensitivity limit based on the enhanced feature from one or more beats within the CA data set and automatically iteratively analyzes a beat segment of interest by comparing the beat segment of interest to the current sensitivity level to determine whether one or more R-waves are present within the beat segment of interest.

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: Implantable medical devices (IMDs) described herein, and methods for use therewith described herein, reduce how often an IMD accepts a false message and/or reduce adverse effects of an IMD accepting a false message. Such IMDs can be leadless pacemakers (LPs), or implantable cardio defibrillators (ICDs), but are not limited thereto. Such embodiments can be used help multiple IMDs (e.g., multiple LPs) implanted within a same patient maintain synchronous operation, such as synchronous multi-chamber pacing.

Abstract: Described herein are implantable medical devices and systems, and methods for use therewith, for reducing T-wave oversensing and arrythmia undersensing that occur due to inappropriate filtering of a signal indicative of cardiac electrical activity. A method includes obtaining a signal indicative of cardiac electrical activity, and using a first bandpass filter to produce a first filtered version thereof, using a second bandpass filter to produce a second filtered version thereof, wherein the first bandpass filter passes frequencies within a first frequency range, and the second bandpass filter passes frequencies within a second frequency range that is wider than the first frequency range. The method also includes selectively changing from using the first filtered version of the signal to monitor for a VS event, to using the second filtered version of the signal to monitor for a VS event, based on first criteria, and vice versa, based on second criteria.

Abstract: A method for managing power during communication with an implantable medical device, including establishing a communications link, utilizing a power corresponding to a session start power, to initiate a current session between an implantable medical device (IMD) and external device. A telemetry break condition of the communications link is monitored during the current session. The power utilized by the IMD is adjusted between low and high power levels, during the current session based on the telemetry break condition. The number of sessions is counted, including the current session and one or more prior sessions, in which the IMD utilized the higher power level, and a level for the session start power to be utilized to initiate a next session following the current session is adaptively learned based on the counting of the number of sessions.

Abstract: A medical tool includes a rotation mechanism that further includes a warning feature. The warning feature provides an indication when the rotation mechanism has achieved a number of rotations.

Abstract: Described herein are methods, devices, and systems that identify ventricular sensed (VS) events from a signal indicative of cardiac electrical activity, such a far-field EGM or ECG signal, and monitor for an arrythmia and/or perform arrythmia discrimination based on the VS events. Beneficially, such embodiments reduce the probability of double-counting of R-wave, or more generally, of oversensing VS events, and thereby provide for improved arrythmia detection and arrythmia discrimination.

Abstract: A computer implemented method and system is provided for managing neural stimulation therapy. The method comprises under control of one or more processors configured with program instructions. The method delivers a series of candidate stimulation waveforms having varied stimulation intensities to at least one electrode located proximate to nervous tissue of interest. A parameter defines the candidate stimulation waveforms is changed to vary the stimulation intensity. The method identifies a first candidate stimulation waveform that induces a paresthesia-abatement effect, while continuing to induce a select analgesic effect. The method further identifies a second candidate stimulation waveform that does not induce the select analgesic effect. The method sets a stimulation therapy based on the first and second candidate stimulation waveforms.

Abstract: Described herein are methods, devices and systems for efficiently storing data for sensed biological signals. A sensed biological signal, or an amplitude and/or filtered version thereof, is provided to an N-bit ADC of an IMD to produce an N-bit data value indicative of an amplitude of the biological signal at a point in time. One of a plurality of chords of a compression curve is selected, based on a magnitude of the N-bit data value, and used to produce an M-bit data value, which is a compressed version of the N-bit data value, wherein M<N. The M-bit data value is stored as an M-bit data slice within memory of the IMD, and can be expanded to a reproduced N-bit data value after being uploaded to a non-implanted device or system.

Abstract: A resistance weld shielding control system includes a computer that is executed to control a fixture to receive and hold at least one part to be welded. The computer also controls one or more electrodes to apply electrical energy to the part for welding the at least one part, and controls a gas delivery system to direct an inert gas onto the part for shielding the part from the ambient atmosphere via a nozzle. The nozzle is configured in the fixture such that the fixture holds the nozzle in a fixed physical relationship to the part.

Abstract: An implantable medical device (IMD) and method are provided. The IMD includes a sensing channel configured to obtain biological signals indicative of biological behavior of an anatomy of interest over a period of time. The biological behavior has a feature of interest that repeats over time. The biological signals have clinically relevant (CR) segments that include information related to the feature of interest. The biological signals have non-clinically relevant (NCR) segments that do not include information related to the feature of interest. At least one of circuitry or a processor are configured to compare the biological signals to an amplitude window to distinguish the CR segments from the NCR segments, save to memory the CR segments and delete the NCR segments, save to memory time information indicative of a duration of the NCR segments that were deleted and to form a lossy compressed data set for the biological signals.

Abstract: A leafless biostimulator, such as a leadless pacemaker, includes a housing sized and configured to be implanted within a heart of a patient and includes both primary and secondary fixation features. The primary fixation feature is adapted to rotate to fix the leadless biostimulator to a wall of the heart during initial implantation. Once the leadless biostimulator is implanted, the secondary fixation feature is adapted to resist counter-rotation of the leadless biostimulator. The primary fixation feature may include a fixation helix configured to affix the housing to the heart by rotating in a screwing direction. The secondary fixation feature may include an apex to engage the heart to resist unscrewing of the primary fixation feature.