Abstract: A leadless cardiac pacemaker having a radial fixation mechanism is provided. The cardiac pacemaker can include fixation mechanism separate from a pacing electrode and having a diameter equal to or less than the outer diameter of the pacemaker. The fixation mechanism can allow the pacemaker to be inserted into tissue with less than 2 rotations of the pacemaker to place the pacing electrode in contact with the tissue. In some embodiments, the fixation mechanism can comprise a plurality of hooks or protrusions positioned near a distal portion of the pacemaker. The fixation mechanism(s) can be configured to penetrate the endocardium of the patient and reside mostly within the myocardium. Methods of delivering the leadless cardiac pacemaker into the heart are also provided.

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: Patient tissues are imaged using, e.g., a real-time fluoroscopic imaging system, along with a lead system being implanted. Parameters representative of lead placement efficacy—such as capture thresholds, phrenic nerve stimulation thresholds, impedance values or screw-in tip mechanical resistance values—are measured at candidate implant locations. Localization parameters identifying the candidate implant locations are also measured. In one example, a display is generated substantially in real-time showing: images of the tissues of the patient and the lead system being implanted; candidate locations of the electrodes; and parameters representative of lead placement efficacy at the candidate locations. In this manner, the implanting clinician can readily view capture thresholds and other helpful parameters at various candidate locations along with actual real-time images of the tissues of the patient and the lead system being implanted.

Abstract: Techniques are provided for configuring filters for reducing heating within pacing/sensing leads of a pacemaker or implantable cardioverter-defibrillator that might occur due to induced currents during a magnetic resonance imaging (MRI) procedure or in the presence of other sources of strong radio frequency (RF) fields. In particular, techniques are provided for selecting inductors and capacitors for use in LC filters while taking into account the tolerances of the component devices, as well as the target impedance of the components and the particular RF frequencies to be filtered.

Abstract: Embodiments of the present invention concern the timing of sending one or more commands to control circuitry of a multi-electrode lead (MEL). In one embodiment, the one or more commands are sent to control circuitry within the MEL during a predetermined portion of a cardiac pacing cycle to avoid potential problems of prior systems that were not synchronized with the cardiac pacing cycle. In one embodiment, the one or more commands are sent when cardiac tissue is refractory from a cardiac pacing pulse, to prevent the command(s) from potentially undesirably stimulating cardiac tissue. The command sending can occur such that the one or more commands are sent between instances when sensing circuitry of the implantable cardiac stimulation device is being used to obtain one or more signals indicative of cardiac electrical activity, to prevent interference between the one or more commands with the signals indicative of cardiac electrical activity that are sensed.

Abstract: A system may include a target implantable medical device (IMD) and an external device configured to selectively communicate with the target IMD. The external device may include a communication module configured to communicate with the target IMD, a response analysis module configured to receive and analyze a target response signal from the target IMD and other response signals from other IMDS, and a power adjustment module configured to receive one or more power-adjustment request signals from the response analysis module. The power adjustment module is configured to adaptively adjust a power of a transmission request over a first frequency band based on the one or more power-adjustment request signals until the response analysis module receives only the target response signal from the target IMD.

Abstract: A leadless cardiac pacemaker configured for implantation in electrical contact with a left ventricular cardiac chamber and configured for leadless triggered left-ventricular pacing for cardiac resynchronization therapy (CRT) in response to conducted signals from a pulse generator.

Abstract: Techniques are provided for updating a morphology template used to discriminate abnormal cardiac rhythms. In one example, a non-weighted candidate morphology template is generated based on far-field R-wave morphology. A weighted candidate morphology template is generated based on an ensemble average of the non-weighted candidate morphology template and a previous (i.e. active) morphology template. The previous morphology template is then selectively updated based on a comparison of additional R-waves against both the non-weighted and the weighted candidate templates. Thereafter, abnormal cardiac rhythms such as ventricular tachycardia and supraventricular tachycardia are discriminated using the updated morphology template based on newly-detected far-field R-waves. These techniques provide a method for updating the morphology discrimination template in response to long-term changes in morphology due to cardiac remodeling or cardiac disease progression.

Abstract: Systems, devices and methods described herein can be used to monitor and treat cardiovascular disease, and more specifically, can be used to determine heart rate (HR), determine respiration rate (RR) and classify cardiac rhythms based on atrial intracardiac electrogram (IEGM) and atrial pressure (AP) signals. The atrial IEGM and AP signals are subject to spectrum transforms to obtain an atrial IEGM frequency spectrum and an AP frequency spectrum. Based on peaks in the atrial IEGM and AP frequency spectrums measures of HR and RR are determined, and arrhythmias are detected and/or arrhythmia discrimination is performed.

Abstract: A leadless implantable medical device (IMD) may include an electrode, a housing, and an energy transfer component. The housing retains a pulse generator configured to provide stimulation energy for delivery to a tissue of interest, a power supply, a memory storing programmable instructions, and a processor communicatively coupled to the memory. The processor is responsive to the programmable instructions to control operation of the leadless IMD. The electrode is securely affixed to the tissue of interest. The housing includes first and second body portions mated to one another at a detachable interface. The electrode is coupled to the second body portion. The energy transfer component is distributed between the first and second body portions and is configured to convey at least one of stimulation energy or sensed signals across the detachable interface when the first and second body portions are mated to one another.

Abstract: A cardiac pacing system comprises multiple leadless cardiac pacemakers configured for implantation in electrical contact with a cardiac chamber and configured for multi-chamber cardiac pacing. The individual leadless cardiac pacemakers comprise at least two leadless electrodes configured for delivering cardiac pacing pulses, sensing evoked and/or natural cardiac electrical signals, and communicating bidirectionally among the leadless cardiac pacemaker plurality.

Abstract: An implantable lead is provided that comprises a lead body configured to be implanted in a patient, the lead body having a distal end and a proximal end, and a lumen extending between the distal and proximal ends; a connector assembly provided at the proximal end of the lead body, the connector assembly configured to connect to an implantable medical device; an electrode provided along the lead body, the electrode configured to at least one of deliver stimulating pulses and sense electrical activity, the electrode having a length extending between a proximal end and a distal end of the electrode; a conductor cable located within the lead body and extending at least partially along a length of the lead body; and an connection node electrically connecting the cable to the electrode at an intermediate point along the length of the electrode. The connection node is disposed at a position intermediate between the proximal and distal ends of the electrode.

Abstract: Devices, systems, and methods for communicating with an implantable medical device are disclosed. A communication device may include an input/output interface configured to communicate with a wireless communication device, a communication interface configured to communicate with a remote system, a detector configured to detect when the wireless communication device is within a range of the non-implantable communication device, wherein communication between the wireless interface and the wireless communication device is initiated upon detection by the detector that the wireless communication device is within the range of the non-implantable communication device, and a processor configured to perform an analysis of data received from the wireless communication device via the input/output interface and associated with the implantable medical device. The communication device may include a user interface configured to receive data input by a user.

Abstract: Provided herein are implantable systems, and methods for use therewith, for characterizing a tachycardia and/or selecting treatment for a tachycardia using results of a dominant frequency analysis. One or more electrogram (EGM) signal(s) indicative of cardiac electrical activity are obtained. For at least one of the EGM signal(s) a dominant frequency (DF) analysis is performed, and the results of the DF analysis are used to characterize a tachycardia and/or to select treatment for a tachycardia.

Abstract: A delivery system for implanting a leadless cardiac pacemaker into a patient is provided. The cardiac pacemaker can include a docking or delivery feature having a through-hole disposed on or near a proximal end of the pacemaker for attachment to the delivery system. In some embodiments, the delivery catheter can include first and second tethers configured to engage the delivery feature of the pacemaker. The tethers, when partially aligned, can have a cross-sectional diameter larger than the through-hole of the delivery feature, and when un-aligned, can have a cross-sectional diameter smaller than the through-hole of the delivery feature. Methods of delivering the leadless cardiac pacemaker with the delivery system are also provided.

Abstract: A method and system are provided for characterizing chamber specific function. The method and system comprise collecting cardiac signals associated with asynchronous timing between first and second chambers of the heart; collecting dynamic impedance (DI) data along a chamber-specific function (CSF) vector to form a DI data set, the DI data set collected during a collection window that is temporally aligned based on a timing feature of interest (FOI); repeating the collection operations over multiple cardiac cycles (CC) to obtain an ensemble of DI data sets; and combining the ensemble of DI data sets to form a composite DI data set that is coupled to a chamber functional mechanic of interest (FMOI) associated with the first chamber and decoupled from functional mechanics associated with the second chamber; and analyzing the composite DI data set to obtain a CSF indicator associated with the chamber FMOI of the first chamber.

Abstract: A system and method enables precise detection of the time of occurrence of a cardiac event of a heart. The method includes the steps of sensing electrical activity of the heart to generate an electrogram signal including the cardiac event, storing the electrogram signal, correlating the electrogram signal with an electrogram template, and identifying the time of occurrence of the cardiac event based upon the correlation.

Abstract: A distributed leadless implantable system is provided that comprises first and second leadless implantable medical devices (LIMD) configured to be implanted entirely within first and second chambers of the heart. Each of the first and second LIMDs comprises a housing having a proximal end configured to engage local tissue of interest in a local chamber, electrodes located along the housing and cardiac sensing circuitry configured to detect intrinsic and paced cardiac events occurring in a near field associated with the local chamber.

Abstract: A system and method for simultaneous burst and tonic stimulation of nerve 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 nerve tissue of interest. The system and method further includes coupling the lead to an implantable pulse generator (IPG). The IPG generates current pulses that are delivered through blocking capacitors to the stimulation electrodes. The system and method further provides programming the IPG to deliver a first series of current pulses configured as a tonic stimulation waveform to the stimulation electrodes and to deliver a second series of current pulses configured as a burst stimulation waveform to the stimulation electrodes. The tonic and burst stimulation waveforms each include at least two current pulses with different amplitude polarities.

Abstract: A system and method are provided for initiating a secured bi-directional communication session with an implantable medical device. The system and method include configuring a pulse generator (PG) device and an external device to establish a communication link there between through a wireless protocol with a defined bonding procedure. The system and method also include transmitting a static identification and dynamic seed from the PG device through a dedicated advertisement channel to the external device and generating a passkey from a pre-defined algorithm based on the dynamic seed and a static identification. Further, the system and method include starting the defined bonding procedure.