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 intervals within the signal corresponding to the durations of cardiac cycles, then detects cardiac rhythm irregularities based on the intervals. For example, the PAP monitor can detect and distinguish atrial fibrillation, ventricular fibrillation and ventricular tachycardia based on the stability of the intervals of the PAP signal along with other information such as ventricular rate. The PAP monitor can also detect and distinguish premature contractions based on durations of the intervals. Examples where the PAP monitor is a component of an implantable cardiac rhythm management device (CRMD) are also provided.

Abstract: A method and system are provided that provide feedback regarding lead stability for a candidate target vessel, and provide guidance on a type of lead to be used. The method and system utilize a surgical navigation system and information regarding patient anatomy to predict lead stability within the patient anatomy. The method and system provide patient-specific force measurements for one or more vessels of a patient.

Abstract: A system and method for confirming arrhythmias in an implantable cardiac stimulation device senses electrical events in an intracardiac signal and identifies a potential arrhythmia based on the electrical events. The electrical events may be depolarization events occurring in a heart, such as R-waves or P-waves. The electrical events are high pass filtered and analyzed to confirm or reject the electrical events. The confirmed electrical events are then analyzed to determine whether the electrical events indicate a heart arrhythmia. A therapy may then be applied to the heart for treating the arrhythmia.

Abstract: A bioelectric battery may be used to power implantable devices. The bioelectric battery may have an anode electrode and a cathode electrode separated by an insulating member comprising a tube having a first end and a second end, wherein said anode is inserted into said first end of said tube and said cathode surrounds said tube such that the tube provides a support for the cathode electrode. The bioelectric battery may also have a membrane surrounding the cathode to reduce tissue encapsulation. Alternatively, an anode electrode, a cathode electrode surrounding the cathode electrode, a permeable membrane surrounding the cathode electrode. An electrolyte is disposed within the permeable membrane and a mesh surrounds the permeable membrane. In an alternative embodiment, a pacemaker housing acts as a cathode electrode for a bioelectric battery and an anode electrode is attached to the housing with an insulative adhesive.

Abstract: A method for operating an implantable medical device (IMD) implanted within a patient may include scanning for a wakeup request signal from an external programmer over a first frequency band at a first power level, switching to communication over a second frequency band at a second power level after the IMD detects the wakeup request signal, wherein the switching operation initiates an initial data exchange session during a common connected time period between the IMD and the external programmer, and cycling between the first and second power levels during the common connected time period based on whether data is being exchanged between the external programmer and the IMD.

Abstract: An intra-pericardial medical device is provided that comprises a lead body having a proximal portion, a distal end portion, and an intermediate portion extending between the proximal portion and the distal end portions. An intra-pericardial medical device further includes the control logic housed with the lead body and an energy source housed within the lead body. A stimulus conductor is included and extends along the lead body. An electrode is joined to the stimulus conduct near the distal end portion, where the electrode configured to deliver stimulus pulses. A telemetry conductor is provided within the lead and extends from the proximal portion and along the intermediate portion of the lead body. The telemetry conductor is wound into a series of coil groups to form inductive loops for at least one of receiving and transmitting radio frequency (RF) energy.

Abstract: An apparatus and method for characterizing a region of interest (ROI) including measuring position and orientation data within the ROI; and generating a geometric data set to include one or more of: length, bifurcation location, angle and curvature characteristics of the ROI. Also, sequentially taking an image of a tool within the ROI; comparing tool dimensions with ROI dimensions; and estimating diameter, length, take-off angle, and/or tortuosity characteristics based on the comparisons.

Abstract: Systems and methods for determining whether there is a correlation between arrhythmias and myocardial ischemic episodes are provided. An implantable system (e.g., a monitor, pacemaker or ICD) is used to monitor for arrhythmias and to monitor for myocardial ischemic episodes. When such events are detected by the implantable system, the implantable system stores (e.g., in its memory) data indicative of the detected arrhythmias and data indicative of the detected myocardial ischemic episodes. Then, for each detected arrhythmia, a determination is made based on the data, whether there was a myocardial ischemic episode detected within a specified temporal proximity of (e.g., within a specified amount of time of) the arrhythmia. Where a myocardial ischemic episode occurred within the specified temporal proximity of an arrhythmia, data for the two events can be linked.

Abstract: Systems and methods are provided for initiating a bi-directional communication link with an implantable medical device. The systems and methods configure an implantable medical device (IMD) to detect activation fields from a triggering device when the triggering device is positioned proximate to the IMD, and to identify a field characterization of the activation field. The systems and methods further configure the IMD to establish a bi-directional communication link with an external device through a select communication initialization mode form a plurality of communication initialization modes defined by a wireless protocol in response to the field characterization of the activation field.

Abstract: In an implantable medical device for monitoring glucose concentration in the blood, a blood-glucose concentration analysis is performed using correlations of blood-glucose concentration with measures of metabolic oxygen consumption including oxymetric, and/or temperature. Analysis of electrocardiographic data is used in a parallel method to detect and/or confirm the onset and/or existence and/or extent of hypoglycemia and/or hyperglycemia. Blood-glucose concentration calculation is enhanced by using the combination of the oxygen metabolism analysis and electrocardiographic analysis.

Abstract: A leadless intra-cardiac medical device senses cardiac activity from multiple chambers and applies cardiac stimulation to at least one cardiac chamber and/or generates a cardiac diagnostic indication. The leadless device may be implanted in a local cardiac chamber (e.g., the right ventricle) and detect near-field signals from that chamber as well as far-field signals from an adjacent chamber (e.g., the right atrium).

Abstract: A battery includes a case having a lid. A feed-through assembly provides an electrical connection through the lid. Feed-through insulation is disposed over the feed-through assembly. An insulation layer is disposed over the inner surface of the lid and the feed-through assembly. The insulation layer comprises an aperture configured to accommodate the feed-through assembly and to form a compression joint with the feed-through insulation disposed over the feed-through assembly.

Abstract: The invention relates to leadless cardiac pacemakers (LBS), and elements and methods by which they affix to the heart. The invention relates particularly to a secondary fixation of leadless pacemakers which also include a primary fixation. Secondary fixation elements for LBS's may passively engage structures within the heart. Some passive secondary fixation elements entangle or engage within intraventricular structure such as trabeculae carneae. Other passive secondary fixation elements may engage or snag heart structures at sites upstream from the chamber where the LBS is primarily affixed. Still other embodiments of passive secondary fixation elements may include expandable structures.

Abstract: A method for patterning a metal substrate includes a series of surface treatments to control tunnel initiation at a micron or sub-micron level. In particular, the series of surface treatments include forming a hydration layer which acts as a mask while etching the surface of the metal substrate. The hydration layer mask enables control of the tunnel initiation on a micron or sub-micron level because the etching does not undercut the interface between the metal substrate and the hydration layer. As a result, the tunnels can be initiated in an orthogonal direction and closer together, thereby increasing the tunnel density.

Abstract: Methods, systems and devices described herein can be used for automatically adjusting one or more cardiac resynchronization therapy (CRT) pacing parameters (and more generally stimulation parameters), to achieve a long term reduction in left ventricular (LV) diastolic pressure (and more generally, preload) of a heart failure (HF) patient. A reduction in LV diastolic pressure is indicative of a reduction in preload (the force of blood the fills the left ventricle), which is typically indicative of an improvement in a patient's HF condition. In accordance with certain embodiments, when a set of stimulation parameters is tested, the set is tested for a period that is sufficiently long enough to allow the patient's compensatory mechanisms to react to the set of stimulation parameters and achieve a substantially steady-state LV diastolic pressure corresponding to the using the set of stimulation parameters.

Abstract: A leadless implantable medical device (LIMD) includes a housing formed from a battery and an end cap. A proximal end of the end cap forms an LIMD proximal end and a distal end of the battery case forms an LIMD distal end. A non-conductive coupler mechanically secures a terminal end of the battery case to a mating end of the end cap, while maintaining the battery case and end cap electrically separated. A first electrode projects from the proximal end of the end cap. An intra-cardiac (IC) device extension projects from the distal end of the battery case. The extension includes a second electrode that is electrically connected to the battery case. The second electrode is located remote from the LIMD distal end. An electronics module is located within an internal cavity of the end cap and communicates with the first and second electrodes.

Abstract: A leadless intra-cardiac medical device is configured to be implanted entirely within a heart of a patient. The device includes an intra-cardiac extension and a housing. The intra-cardiac extension includes a loop body having at least one loop segment retaining at least one coil group that is configured to one or both of receive and transmit radio frequency (RF) energy, wherein the loop body is configured to extend into a first chamber of the heart. The housing is in electrical communication within the loop body, and includes a transceiver, control logic and an energy source. The housing is configured to be securely attached to an interior wall portion of a second chamber of the heart, wherein the transceiver is configured to communicate with an external device through the RF energy.

Abstract: Pacing related timing is determined for an implantable medical device (IMD) by pacing at an RV pacing site, a first LV pacing site and a second LV pacing site in accordance with a first site, a second site and a third site pacing order, and further in accordance with a first inter-electrode pacing delay between pacing at the first site and pacing at the second site and a second inter-electrode pacing delay between pacing at the second site and pacing at the third site. At least one of a sensed event or a paced event is detected for at each of the second site and the third site. The first inter-electrode pacing delay and the second inter-electrode pacing delay are adjusted to avoid sensed events in favor of paced events at each of the second site and the third site. An atrio-ventricular delay may also be adjusted to avoid sensed events or lack of capture due to possible fusion at the first site, in favor of paced events at the first site.

Abstract: A method for performing deep brain stimulation (DBS) therapy may include determining a location of a target area of a brain, forming a burr hole through a skull of a patient based on the location the target area, positioning one or more reference members on or within the brain through the burr hole, and acquiring at least one image of the brain having the one or more reference members with at least one imaging sub-system.

Abstract: An implantable physiologic sensor assembly is configured to be implanted within a patient. The assembly includes a module that houses an internal operative chamber, and a flexible pressure-detecting member connected to the module. The module and the pressure-detecting member are separated before implantation into the patient. At least a first end of the pressure-detecting member is configured to be inserted into an artery of the patient and a second end of the pressure-detecting member is connected to the module. The module is configured to be subcutaneously positioned within the patient.