Abstract: A method and system for displaying a three dimensional visualization of cardiac motion. The method and system obtain point specific (PS) motion data for a plurality of map points. The PS motion data indicates an amount of motion that occurred at the corresponding map point on a wall of the heart during at least one cardiac cycle. The method and system determine three dimensional (3D) positions of the map points during the cardiac cycle based on the PS motion data and select a set of 3D positions based on a frame rate. The method and system further generate 3D visualizations for each selected set of 3D positions.

Abstract: The present disclosure provides systems and methods for neurostimulation. The method includes applying electrical stimulation to a patient using a paddle lead that includes a plurality of electrodes, acquiring evoked response data using at least some of the plurality of electrodes, wherein the evoked response data is indicative of a patient response to the electrical stimulation, transmitting the evoked response data to a computing device, and processing the evoked response data using the computing device to facilitate monitoring the applied electrical stimulation.

Abstract: An exemplary method for optimizing pacing configuration includes providing distances between electrodes of a series of three or more ventricular electrodes associated with a ventricle; selecting a ventricular electrode from the series; delivering energy to the ventricle via the selected ventricular electrode, the energy sufficient to cause an evoked response; acquiring signals of cardiac electrical activity associated with the evoked response via non-selected ventricular electrodes of the series; based on signals of cardiac electrical activity acquired via the non-selected ventricular electrodes and the distances, determining conduction velocities; based on the conduction velocities, deciding if the selected ventricular electrode is an optimal electrode for delivery of a cardiac pacing therapy; and, if the selected ventricular electrode comprises an optimal electrode for delivery of the cardiac pacing therapy, calling for delivery of the cardiac pacing therapy using the selected ventricular electrode.

Abstract: A method and system are provided for characterizing motion data. The method and system obtain point specific (PS) motion data for a plurality of map points. The PS motion data indicates an amount of motion that occurred at the corresponding map point on a wall of the heart during at least one cardiac cycle. The method and system, calculate mechanical activation times (MAT) for the map points, identifying a group of neighbor map points for a current map point, and modifying the MAT corresponding to the current map point based on the MATs corresponding to at least a portion of the group of neighboring map points. Further, the method and system repeat the identifying and modifying operations for at least a subset of the map points.

Abstract: A cathode element is formed as a continuous single element with a plurality of cathode leaves connected by cathode bridges. An anode element is similarly formed as a continuous single element with a plurality of anode leaves connected by anode bridges. The cathode element and anode element can be aligned and interleaved at spaces between adjacent leaves. The resulting battery pre-stack can then be folded along its bridges in alternating directions to form a battery stack whose layers alternate between an anode and cathode, and which requires minimal components and minimal or no welds.

Abstract: In a cardiac pacing system, a leadless cardiac pacemaker is configured for implantation in electrical contact with a cardiac chamber and configured for leadless pacing.

Abstract: Methods, systems and devices efficiently identify cardiac resynchronization therapy (CRT) pacing parameter set(s) that provide improved hemodynamic response relative to an initial CRT pacing parameter set, wherein each CRT pacing parameter set includes at least two CRT pacing parameters. User input(s) are accepted that specify a maximum amount of time and/or parameter sets that can be used to perform testing, and specify relative importance of parameters within the sets. Based on the accepted user input(s), there is a determination of how many different variations of each of the CRT pacing parameters can be tested, and based on this determination different CRT pacing parameter sets are selected and tested to obtain a hemodynamic response measure corresponding to each of the different sets tested. Additionally, one or more of the tested CRT pacing parameter sets, if any, that provide improved hemodynamic response relative to the initial CRT pacing parameter set is/are identified.

Abstract: An RF protection circuit mitigates potentially adverse effects that may otherwise result from electromagnetic interference (e.g., due to MRI scanning of a patient having an implanted medical device). The RF protection circuit may comprise a voltage divider that is deployed across a pair of cardiac electrodes that are coupled to internal circuitry of the implantable medical device. Each leg of the voltage divider may be referenced to a ground of the internal circuit, whereby the different legs are deployed in parallel across different circuits of the internal circuitry. In this way, when an EMI-induced (e.g., MRI-induced) signal appears across the cardiac electrodes, the voltages appearing across these circuits and the currents flowing through these circuits may be reduced. The RF protection circuit may be used in an implantable medical device that employs a relatively low capacitance feedthrough to reduce EMI-induced (e.g., MRI-induced) current flow in a cardiac lead.

Abstract: A method and system for characterizing an accessibility of potential left ventricular stimulus sites in connection with surgical planning for transvenous implant of a cardiac medical lead in or near a heart of a patient are provided. The method and system include obtaining image data representative of a coronary venous system for the heart of the patient to receive the lead. The method and system generate a venous map, based on the image data, representative of venous pathways for the heart of the patient. The method and system analyze the venous map to identify pathway features of interest (PFOI) within at least one select region of the venous pathways. The method and system assign scores to the PFOI based on at least one of predetermined feature-complexity relations or physician-entered complexity updates. The method and system display treatment planning information to a user based on the scores.

Abstract: Implementations described and claimed herein provide controlled access into the intra-pericardial space. In one implementation, a medical device comprises an outer sheath, an inner sheath, and a nose shaft. The outer sheath comprises a proximal end, a distal end, and a lumen extending between the proximal end and the distal end. The inner sheath extends through the lumen of the outer sheath and comprises a distal portion adapted to pierce the pericardial sac. The nose shaft is adapted to displace relative to a distal edge of the distal portion of the inner sheath. Displacing the distal portion of the inner sheath relative to the outer sheath until the nose shaft displaces relative to the distal edge provides controlled penetration into the intra-pericardial space.

Abstract: Medical device including a lift tool having a distal end configured to removably engage an anatomic layer. The lift tool includes a shaft lumen that extends longitudinally through the lift tool and through the distal end. The shaft lumen is configured to receive an elongated insert device that is movable through the shaft lumen and through the distal end. The medical device also includes a locking mechanism that is coupled to the lift tool. The locking mechanism includes a locking member that is selectively movable with respect to the insert device between a released position and an engaged position. The locking member engages the insert device when in the engaged position to hold the insert device at a fixed position with respect to the lift tool and permits the insert device to move through the shaft lumen when in the released position.

Abstract: A method of manufacturing an implantable medical lead is disclosed herein. The method may include: providing a lead body including a proximal end, a distal end, and an electrode near the distal end; provide a conductor extending between the proximal and distal ends; providing a crimp including a ribbon-like member and extending the ribbon-like member around the conductor; and mechanically and electrically connecting the ribbon-like member to the electrode.

Abstract: Methods and systems are provided to deliver a neural stimulation therapy to treat apnea episodes. The methods and systems detect a respiratory pattern of a patient and identify a type associated with the respiratory pattern. A sleep stage is detected that the patient is experiencing and the method and system identify when the sleep stage warrants therapy. When the respiratory pattern corresponds to an apnea episode (AE) and the sleep stage warrants therapy, the methods and systems deliver an apnea episode terminating neuro-stimulation (AET-NS) therapy configured to terminate the AE. A type of AE therapy that is delivered may be based on the sleep stage that was detected. The methods and systems may determine whether the AET-NS therapy successfully terminated the AE, and, if not, adjust the AET-NS therapy and deliver a new AET-NS therapy.

Abstract: Techniques are provided for use by an implantable medical device or diagnostic sensor for detecting and discriminating euvolemia, hypervolemia and hypovolemia. In one example, the device detects a pressure signal within the patient representative of changes in cardiac pressure overall several cardiac cycles. The device generates separate time-domain and frequency-domain representations of the pressure signal and then discriminates among euvolemia, hypervolemia and hypovolemia within the patient based on an analysis of the time-domain and the frequency-domain representations of the signal. Depending upon the capabilities of the device, suitable warnings may be generated to alert the patient or caregiver. Diuretics or other medications can be titrated to address abnormal fluid conditions such as a fluid overload during hypervolemia. Techniques for detecting a pressure alternans pattern indicative of imminent decompensation are also described.

Abstract: Evaluation of an implanted electrical lead condition includes comparing electrogram template features with test electrogram features. The evaluating also includes determining the implanted electrical lead condition based solely on the electrogram comparison. The compared test electrogram features and template electrogram features may be atrial amplitudes and ventricular amplitudes. The sensing may be with a quad polar lead. The compared test electrogram features and electrogram template features may account for different patient postures and/or may account for respiration modulation.

Abstract: Methods and systems described herein are especially useful wherein monitoring for atrial fibrillation (AF) is based on RR interval variability as measured from an electrocardiogram (ECG) signal. An activity threshold, which can be patient specific, is obtained. Patient activity is monitored. Based on the monitored patient activity and the activity threshold, there is a determination of when it is likely that AF monitoring based on RR interval variability is adversely affected by patient activity. When it has been determined that it is likely that AF monitoring based on RR interval variability is adversely affected by patient activity, whether and/or how AF monitoring is performed is modified.

Abstract: A method and system are provided to measure cardiac motion data using a cardiovascular navigation system. The method and system position a patient reference sensor (PRS) on a patient, wherein the PRS determines a position of the patient relative to a reference point. The method and system determine a reference orientation matrix based on an orientation of the PRS relative to a reference point and determining a normalization time based on an electrical signal. The method and system obtain point specific (PS) motion data for a plurality of map points. The PS motion data indicates a three dimensional trajectory that occurs at the corresponding map point on a wall of a heart of the patient during at least one cardiac cycle. Further the method and system compensate the PS motion data based on the PRS.

Abstract: An exemplary system includes a programmer configured to instruct an implantable device and a qualification module with instructions to call for tests performed by an implantable device configured for delivery of CRT, to receive results from the tests, to analyze the results and to decide, based on the analysis, if the patient qualifies for automatic, implantable device-based optimization of one or more CRT parameters and, only if the patient qualifies for automatic, implantable device-based optimization of one or more CRT parameters, presenting a graphical user interface that comprises a selectable control to enable an algorithm of an implantable device to automatically optimize at least one of the one or more cardiac resynchronization therapy parameters. Other exemplary methods, devices, systems, etc., are also disclosed.

Abstract: A system of non-linear feedback control for spinal cord stimulation is provided. The system comprises a lead adapted to be implanted within an epidural space of a dorsal column of a patients spine, and a pulse generator (PG) electrically coupled to the lead. The PG is configured to deliver spinal cord stimulation (SCS) therapy. The system also comprises a sensing circuitry configured to sense an evoked compound action potential (ECAP) response that propagates along the neural pathway. The system also comprises a processor programmed to operation, in response to instructions stored on a non-transient computer-readable medium, to obtain a baseline ECAP response when the lead and spinal cord tissue properties are in baseline states; analyze ECAP responses relative to the baseline ECAP response to obtain an ECAP feedback difference indicative of a change in at least one of the baseline state of the lead and the baseline state of the spinal cord tissue properties.

Abstract: A method and system are provided for analyzing motion data collected by a cardiovascular navigation system to determine a level of dyssynchrony exhibited by a heart. The method and system comprise obtaining a motion data (MD) set that includes a plurality of map point specific motion data (PSMD) collections of motion data. The motion data in each PSMD collection includes information indicating an amount and direction of motion that occurred at a corresponding map point on a wall of the heart during a select period of time, such as during at least one cardiac cycle. The method and system divide the PSMD collections of data into sectors which may be associated with corresponding phases of the cardiac cycle, and analyze the sectors of the PSMD collections to determine at least one of a slope, a magnitude and a direction of motion at the corresponding map point of the wall of the heart during the associated sector.