Abstract: A neurostimulation (NS) lead configured to provide NS therapy to nervous tissue. The NS lead includes a lead body having an active side and a posterior side that face in generally opposite directions. The NS lead includes an array of electrodes provided on the active side and configured to face the nervous tissue and provide the NS therapy to the nervous tissue. The NS lead also includes a non-planar contour formed in the active side. The non-planar contour includes a plurality of slopes that form a morphological feature. The morphological feature is one of a projection or a depression that extends along a designated path on the active side.

Abstract: Improved pliable print rollers for high speed drink can printing machines increase the pliable roller life five- to ten-fold at comparable ink thickness and machine speed. The improved performance results from the selection of materials utilized including a combination of elastomers, and in some case an essentially oil-free composition, and an associated manufacturing process not previously utilized to create pliable print rollers for high speed drink can printing machines. In particular a particular embodiment, the composition includes a combination of elastomers (e.g., 75% polyisoprene and 25% polybutadiene), a filler (e.g., silica), a curing agent (e.g., peroxided), and other additives (e.g., pigment, antioxidant, antiozonant) with little or no oil added as a softener. An illustrative composition including 150 parts by weight contains 100 parts elastomer, 35 parts filler, 4 parts curing agent, and 11 parts other additives (i.e., zero parts oil softener).

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: A chamber or vasculature of a heart may be accessed via the pericardial space of the heart. Initially, the pericardial space may be accessed via a transmyocardial approach or a subxiphoid approach. A lead or other implantable apparatus may thus be routed into the pericardial space, through myocardial tissue and into the chamber or vasculature. The lead or other apparatus may be used to sense activity in or provide therapy to the heart.

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: 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: 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.

Abstract: An implantable medical device (IMD) is configured to be implanted within a patient. The IMD may include a controller configured to adjust a communication frequency, a housing formed of an electrically common material, and an insulating cover coupled to the housing. The insulating cover may include one or both of at least one opening or at least one thinned area over portions of the housing. Multiple sub-electrodes are formed in the housing through the opening(s) or the thinned area(s).

Abstract: A system and method for using an implantable cardiac stimulation device to monitor a patient for the progress of an existing condition and/or early detection of an emerging condition based, at least in part, on measuring and evaluating the timing characteristics of the patient's atrial activity. The atrial timing characteristics are used as indicators or predictors of conditions of interest, such as heart failure (HF) and atrial fibrillation (AF). In certain implementations, the system can determine discriminating indicators of a predominant underlying cause of a condition, such as between vagal and non-vagal AF, as an indicator of a suggested therapy. The system can store data corresponding to the observed atrial timing for trending analysis as well as transmit data for offline analysis, such as via an external device.

Abstract: In accordance with an embodiment, a system and method is provided for providing communications between first and second implantable medical devices (IMDs). The system comprises a first implantable medical device (IMD) configured to transmit a first event message during or preceding a first cardiac cycle, and a second IMD configured to receive the first event message, wherein receipt of the first event message configures the second IMD to generate pacing pulses for only a predetermined number (“n”) of consecutive cardiac cycles, wherein n is an integer equal to or greater than 2.

Abstract: An exemplary method includes performing a capture threshold assessment using a bipolar electrode configuration, deciding if capture occurred for a maximum energy value of the capture threshold assessment and, if capture did not occur, then performing a lead impedance test for the lead associated with the bipolar electrode configuration. Such a test may aim to detect an insulation defect and/or a conductor defect. Other exemplary methods, devices, systems, etc., are also disclosed.

Abstract: Systems and methods for closed loop spinal cord stimulation are provided. The systems and methods position a first electrode proximate to a dorsal column. The first electrode is electrically coupled to an implantable pulse generator (IPG). The systems and methods further program the IPG to deliver excitation pulses to the first electrode based on a stimulation level. The excitation pulses are emitted from the first electrode. The systems and methods further position a second electrode proximate to a dorsal root. The second electrode is electrically coupled to the IPG. The systems and methods further measure at the second electrode a first evoked potential waveforms resulting from the excitation pulses.

Abstract: A leadless cardiac pacemaker that does not require a separate hermetic housing surrounding the battery and electronics compartments is provided. The cardiac pacemaker can include a battery disposed in a battery housing and a set of electronics disposed in an electronics housing. In some embodiments, the battery housing and the electronics housing can comprise an external surface of the pacemaker. The pacemaker can include a first set of welds separating the battery from the set of electronics, and a second set of welds separating the set of electronics and the battery from an exterior of the housing. Various embodiments for achieving dual-redundant welds are also provided.

Abstract: A wireless implantable system is provided that is externally powered and comprises of a closed-loop feedback for treating both patients with obstructive and central sleep apnea. A method is provided for treating sleep apnea using an implantable device. The method comprises sensing an inspiration (IN) signal representative of inspiration experienced by a patient from a respiratory surrogate signal and sensing a respiratory effort (RE) signal representative of an amount of effort exerted by the patient during respiration.

Abstract: The present disclosure provides neurostimulation methods and system for deep brain stimulation. A neurostimulation system for deep brain stimulation includes a burr hole plug including a cover and a base, and at least one deep brain stimulation (DBS) lead extending through an aperture defined through the base, the at least one DBS lead including at least one DBS electrode configured to apply stimulation to a subject. The system further includes an implantable pulse generator (IPG), an extension electrically coupling the IPG to the at least one DBS lead, and an indifferent electrode positioned proximate the at least one DBS electrode to facilitate reducing an area between the indifferent electrode and the at least one DBS electrode.

Abstract: Systems and methods to control non-paresthesia stimulation of nerve tissue of a patient are herein disclosed. The systems and methods deliver a non-paresthesia stimulation waveform to at least one electrode proximate to target nerve fibers, and define an analysis window that is positioned to occur at an intermediate point within at least one of a first burst or an inter-burst delay. Additionally, the systems and methods, during the analysis window, measure evoked potential (EP) signals from the target nerve fibers. The systems and methods also analyze the EP signals to obtain activity data for select nerve fiber components, and adjust at least one therapy parameter to change the non-paresthesia stimulation waveform based on the activity data.

Abstract: Systems and methods are provided for maintaining a bi-directional communication link between an external device and an implantable medical device (IMD). The systems and methods receive a connection request from an external device at the IMD. The communication request includes one or more communication link parameters based on a wireless protocol, defining a first communication interval. The systems and methods establish a bi-directional communication link between the external device and the IMD based on the one or more communication link parameters, and receive, during the first communication interval, a data packet from the external device along a first data channel, the data packet including an adjusted communication link parameter. The adjusted communication link parameter include a second communication interval.