Abstract: Methods and systems for terminating a pacemaker mediated tachycardia (PMT) are described herein. During a period that a PMT is not detected, an implantable system delivers an atrial pacing pulse to an atrial cardiac chamber in response to a PA interval expiring without an intrinsic atrial event being detected during the PA interval. The systems performs atrial sensing to thereby monitor for intrinsic atrial events in the atrial cardiac chamber, performs ventricular sensing to thereby monitor for intrinsic ventricular events in a ventricular cardiac chamber, and detects the PMT. Additionally, the system, in response to the PMT being detected, initiates a PMT PA interval that is shorter than the PA interval that the system would otherwise use for atrial pacing if the PMT was not detected.

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 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: Devices and methods for improving conductive communication are described herein. One of the devices involved in the conductive communication can be an external device while the other device is an IMD, or both of the devices can be IMDs. In certain embodiments, a preferred conductive communication vector for use is identified based on obtained information indicative of the at least one of a physical or physiologic state of the patient within which an IMD is implanted.

Abstract: Devices and methods for improving conductive communication are described herein. One of the devices involved in the conductive communication can be an external device while the other device is an IMD, or both of the devices can be IMDs. In certain embodiments, each of at least three different conductive communication vectors are used to produce a respective bitstream, and a valid bit stream is selected or produced based on the at least three bitstreams. Message data included in and/or decoded from the valid bitstream is then stored and/or used.

Abstract: Computer implemented methods and systems are provided that comprise, under control of one or more processors of a medical device, where the one or more processors are configured with specific executable instructions. The methods and systems include sensing circuitry configured to define a sensing channel to collect biological signals, memory configured to store program instructions, a processor configured to implement the program instructions to at least one of analyze the biological signals, manage storage of the biological signals or deliver a therapy, and communication circuitry configured to wirelessly communicate with at least one other implantable or external device, the communication circuitry configured to transition between a sleep state, a partial awake state and a fully awake state.

Abstract: A system and method have at least one implantable lead comprising a right ventricular (RV) electrode and one or more left ventricular (LV) electrodes, at least one processor, and a memory coupled to the at least one processor. The memory stores program instructions.

Abstract: A device for loading a leadless pacemaker onto a catheter-based delivery system includes a distal portion and a proximal portion. The distal portion includes a retention feature configured to receive the leadless pacemaker. The proximal portion is proximal the distal portion and includes a funneling structure opening toward the retention feature. The distal and proximal portions of the device are configured such that, when a distal end of the catheter-based delivery system is brought towards the proximal portion of the loading device and the leadless pacemaker is retained by the retention feature, the funneling structure guides features of the distal end of the catheter-based delivery system through an opening in an attachment feature located at a proximal end of the leadless pacemaker.

Abstract: Systems, devices, and methods are disclosed herein, wherein a first implantable medical device (IMD) uses normal conductive communication to transmit message(s) intended for a second IMD, during a first period of time that a first trigger event is not detected. The first IMD, in response to detecting the first trigger event, starts a timer or counter and transitions to using boosted conductive communication to transmit one or more messages intended for the second IMD during a second period of time. In response to the first IMD either detecting a second trigger event, or detecting based on the timer or counter that a specified amount of time or cardiac cycles elapsed since the timer or counter was started, the first IMD transitions back to using normal conductive communication to transmit one or more messages intended for the second IMD during a third period of time. Other embodiments are also disclosed herein.

Abstract: For use by an implantable system including a first and second leadless pacemakers (LPs) implanted, respectively, in first and second cardiac chambers, a method comprises storing, within memory of the first LP, a paced activation morphology template corresponding to far-field signal components expected to be present in an EGM sensed by the first LP when a pacing pulse delivered to the second cardiac chamber by the second LP captures the second cardiac chamber. The method also includes the first LP comparing a morphology of a portion of an EGM sensed by the first LP to the paced activation morphology template to determine whether a match therebetween is detected, and determining whether capture of the second cardiac chamber occurred or failed to occur, based on whether the first LP detects a match between the morphology of the portion of the EGM and the paced activation morphology template.

Abstract: Systems and methods for improving conducted i2i communication between first and second implantable medical device (IMDs) are described, wherein at least one of the IMDs comprises a leadless pacemaker (LP). Respective information is stored within each of the first and second IMDs that specifies a primary communication window (PCW) for performing the conducted communication with one another when using a primary conducted communication protocol (PCCP), and also specifies an alternate communication window (ACW) for performing the conducted communication with one another when using an alternate conducted communication protocol (ACCP). At least one of the first and second IMDs monitors quality metric of the conducted communication therebetween while the PCCP is being used, and in response to the quality metric falling below a corresponding threshold, the first and second IMDs perform conducted i2i communication with one another in accordance with the ACCP during the ACW of one or more cardiac cycles.

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: An implantable medical device includes a header body and a septum assembly. The header body includes a first welding surface and a septum bore extending inwardly from an outer surface to an inner cavity. The septum assembly is at least partially disposed within the septum bore of the header assembly and includes a septum configured to allow insertion of a tool through the septum into the inner cavity and to otherwise provide a seal. The septum assembly further includes a retainer within which at least a portion of the septum is retained. The retainer includes a welding feature coupled to the retainer body, the welding feature providing a second welding surface. The retainer is coupled to the header body by welding the first welding surface to the second welding surface.

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: Described herein is a fully-differential receiver for use with an implantable medical device (IMD) and configured to receive conducted communication signals that are transmitted by another IMD or an external device. The fully-differential receiver includes a fully-differential preamplifier, a fully-differential buffer, a first comparator, a second comparator, and an AC coupling network coupled between differential outputs of the fully-differential buffer and a coupled together differential pair of inputs of the first and second comparators. A differential pair of inputs of the fully-differential receiver comprise the differential pair of inputs of the fully-differential preamplifier, and a differential pair of outputs of the fully-differential receiver comprise a first output of the first comparator and a second output of the second comparator. In order to conserve power, the fully-differential receiver is selectively changed from operating in a first mode to operating in a second mode, and vice versa.

Abstract: Delivery of implantable active agent delivery components includes implanting a distal lead end of a lead into tissue at an implantation site. A delivery stylet is then inserted through a lead lumen of the lead. The delivery stylet includes a stylet body having a distal stylet end and an active agent delivery component detachably coupled to the distal stylet end. The active agent delivery component is inserted into the tissue at the implantation site by extending the distal stylet end of the delivery stylet from a distal lead end of the lead such that the active agent delivery component is inserted into the tissue at the implantation site. The active agent delivery component is then detached within the tissue at the implantation site and the delivery stylet may be retracted and removed from the lead lumen.

Abstract: A device includes an electrode stack including a plurality of conductive anodes, a plurality of conductive cathodes, a plurality of separators arranged between the conductive anodes and the conductive cathodes, and a dielectric material disposed on a surface of each of the conductive anodes. The stack has a top surface, a bottom surface, and an edge extending between the top surface and the bottom surface. A continuous electrically insulating film overlies the edge, peripheral portions of the top surface and peripheral portions of the bottom surface so that a central portion of the top surface and a central portion of the bottom surface are exposed. An electrolyte is disposed between the conductive anodes and the conductive cathodes.

Abstract: A leadless biostimulator has a housing including an electronics compartment, an electronics assembly mounted in the electronics compartment, a proximal electrode that disposed on and/or integrated into the housing, and an electrical feedthrough assembly. The electrical feedthrough assembly includes a distal electrode and a flange. The flange is mounted on the housing. The distal electrode is electrically isolated from the flange by an insulator and configured to be placed in contact with target tissue to which a pacing impulse is to be transmitted by the leadless biostimulator. A mount is mounted on the flange and thereby mounted on the electrical feedthrough assembly. A fixation element is mounted on the mount and configured to facilitate fixation of the leadless biostimulator to tissue of a patient.

Abstract: Catheter-based delivery systems for delivery and retrieval of a leadless pacemaker include features to facilitate improved manipulation of the catheter and improved capture and docking functionality of leadless pacemakers. Such functionality includes mechanisms directed to deflecting and locking a deflectable catheter, maintaining tension on a retrieval feature, protection from anti-rotation, and improved docking cap and drive gear assemblies.

Abstract: Catheter-based delivery systems for delivery and retrieval of a leadless pacemaker include features to facilitate improved manipulation of the catheter and improved capture and docking functionality of leadless pacemakers. Such functionality includes mechanisms directed to deflecting and locking a deflectable catheter, maintaining tension on a retrieval feature, protection from anti-rotation, and improved docking cap and drive gear assemblies.