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: A dual band antenna mounted to a case of an implantable medical device (IMD) for implant within a patient is provided. The dual band antenna includes a first antenna sub-structure (FAS) and a second antenna sub-structure (SAS) each separately tuned to match a corresponding first and second resonant frequency, by adjusting at least one of relative lengths of the FAS and SAS, a capacitance of the FAS, a location of the SAS relative to the FAS and a cross-sectional area of conducting elements forming the components of the antenna. The FAS is formed as an inverted E-shaped antenna having three branches. The first branch of the antenna is capacitive, a second branch provides a radio frequency signal feed and a third branch provides a shunt to ground. The SAS is formed as a mono-pole antenna that is formed integral with, and extends from, the FAS.

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: A catheter system for retrieving a leadless cardiac pacemaker from a patient is provided. The cardiac pacemaker can include a docking or retrieval feature configured to be grasped by the catheter system. In some embodiments, the retrieval catheter can include a snare configured to engage the retrieval feature of the pacemaker. The retrieval catheter can include a torque shaft selectively connectable to a docking cap and be configured to apply rotational torque to a pacemaker to be retrieved. Methods of delivering the leadless cardiac pacemaker with the delivery system are also provided.

Abstract: An exemplary method includes positioning a lead in a patient where the lead has a longitudinal axis that extends from a proximal end to a distal end and where the lead includes an electrode with an electrical center offset from the longitudinal axis of the lead body; measuring electrical potential in a three-dimensional potential field using the electrode; and based on the measuring and the offset of the electrical center, determining lead roll about the longitudinal axis of the lead body where lead roll may be used for correction of field heterogeneity, placement or navigation of the lead or physiological monitoring (e.g., cardiac function, respiration, etc.). Various other methods, devices, systems, etc., are also disclosed.

Abstract: An exemplary method includes positioning a lead in a patient where the lead has a longitudinal axis that extends from a proximal end to a distal end and where the lead includes an electrode with an electrical center offset from the longitudinal axis of the lead body; measuring electrical potential in a three-dimensional potential field using the electrode; and based on the measuring and the offset of the electrical center, determining lead roll about the longitudinal axis of the lead body where lead roll may be used for correction of field heterogeneity, placement or navigation of the lead or physiological monitoring (e.g., cardiac function, respiration, etc.). Various other methods, devices, systems, etc., are also disclosed.

Abstract: Techniques are provided for controlling spinal cord stimulation (SCS) or other forms of neurostimulation. In one example, SCS treatment is delivered to a patient and nerve impulse firing signals are sensed along the spinal cord following the SCS treatment. The nerve impulse signals are analyzed to determine whether the signals are associated with effective SCS and then the delivery of additional SCS is controlled to improve SCS efficacy. For example, the nerve impulse signals can be analyzed to determine whether the signals are consistent with a positive patient mood associated with pain mitigation and, if not, SCS control parameters are adjusted to improve the efficacy of the SCS in reducing pain. In other examples, heart rate variability (HRV) is also used to control SCS. Still further, adjustments may be made to SCS control parameters to improve antiarrhythmic or sympatholytic effects associated with SCS. Techniques employing baseline/target calibration procedures are also described.

Abstract: A level shifter shifts the level of an input signal from a second voltage domain to a first voltage domain. To accommodate different input signal levels (e.g., including sub-threshold input signal levels) that may arise due to changes in the supply voltage for the second voltage domain, current for a latch circuit of the level shifter is limited based on the supply voltage for the second voltage domain. In this way, a drive circuit of the level shifter that controls the latch circuit based on the input signal is able to initiate a change of state of the latch circuit over a wide range of input signal levels.

Abstract: In one example, a leadless implantable medical device (LIMD) generates a cathodal stimulation pulse with anodal recharge for delivery to patient heart tissues using the tip electrode and the anode electrode. The LIMD then verifies capture of the cathodal stimulation pulse and, if capture is not verified, delivers a cathodal backup stimulation pulse with anodal recharge using the tip electrode and the anode electrode. Automatic capture verification is thereby provided within an LIMD to allow for a reduction in the magnitude of stimulation pulses and to extend the lifetime of the device. In one particular example, the anode is a middle portion of a cylindrical case with a surface area sufficient to prevent anodal stimulation. Other portions of the case are coated with an electrically insulating material to render those portions substantially electrically inert. A voltage halver may be used to further reduce power consumption.

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: 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: Techniques are provided for estimating electrical conduction delays with the heart of a patient based on measured immittance values. In one example, impedance or admittance values are measured within the heart of a patient by a pacemaker or other implantable medical device, then used by the device to estimate cardiac electrical conduction delays. A first set of predetermined conversion factors may be used to convert the measured immittance values into conduction delay values. In some examples, the device then uses the estimated conduction delay values to estimate LAP or other cardiac pressure values. A second set of predetermined conversion factors may be used to convert the estimated conduction delays into pressure values. Techniques are also described for adaptively adjusting pacing parameters based on estimated LAP.

Abstract: Disclosed herein is an implantable medical device including an antimicrobial layer. The antimicrobial layer may include a first distinct size of silver nanoparticles, a second distinct size of silver nanoparticles, and a third distinct size of silver nanoparticles. The antimicrobial layer extends over a surface of the implantable medical device, and, in some instances, the surface of the implantable medical device may serve as a substrate on which the antimicrobial layer is deposited.

Abstract: Dynamically switching between different external RF transceivers for communication with an implantable medical device maintains high communication quality in the face of interference, fading, detuning, or other adverse wireless communication conditions. Quality information associated with communications between an implantable medical device and different external devices is monitored to select one of these external devices to conduct subsequent communication with the implantable medical device. This monitoring is conducted on a repeated basis such that communication is switched to a different RF transceiver whenever such an RF transceiver is able to achieve a higher quality communication than the currently selected RF transceiver. In some embodiments, RF transceivers are deployed in different devices. For example, one or more RF transceivers may be deployed at a portable programmer (e.g., in the form of a computer tablet) and one or more other RF transceivers may be deployed at an associated base station.

Abstract: An implantable active fixation lead includes an outer sheath, a protector member having a peripheral surface extending between its distal and proximal end surfaces with a helical groove formed in the peripheral surface, and a fixation helix integral with the outer sheath. The fixation helix includes a tip end engageable with body tissue and slidably engaged with the helical groove for relative translation and rotation. A longitudinal force on the lead firmly engages the protector member's distal end surface with the body tissue. With the fixation helix initially retracted proximally of the protector member's distal end surface and disengaged from the body tissue, upon application of torque to the outer sheath, the distal end surface of the protector member is moved proximally with respect to the fixation helix which, simultaneously, is extended distally beyond the distal end surface of the protector member to an extended position into engagement with the body tissue.

Abstract: An implantable system acquires intracardiac impedance with an implantable lead system. In one implementation, the system generates frequency-rich, low energy, multi-phasic waveforms that provide a net-zero charge and a net-zero voltage. When applied to bodily tissues, current pulses or voltage pulses having the multi-phasic waveform provide increased specificity and sensitivity in probing tissue. The effects of the applied pulses are sensed as a corresponding waveform. The waveforms of the applied and sensed pulses can be integrated to obtain corresponding area values that represent the current and voltage across a spectrum of frequencies. These areas can be compared to obtain a reliable impedance value for the tissue. Frequency response, phase delay, and response to modulated pulse width can also be measured to determine a relative capacitance of the tissue, indicative of infarcted tissue, blood to tissue ratio, degree of edema, and other physiological parameters.

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: Exemplary methods are described for providing responsive vascular control with or without cardiac pacing. An implantable device with responsive vascular and cardiac controllers interprets physiological conditions and responds with an appropriate degree of vascular therapy applied as electrical pulses to a sympathetic nerve. In one implementation, an implantable device is programmed to deliver the vascular therapy in response to low blood pressure or orthostatic hypotension. The device may stimulate the greater splanchnic nerve, to effect therapeutic vasoconstriction. The vascular therapy is dynamically adjusted as the condition improves. In one implementation to benefit impaired physical mobility, vascular therapy comprises vasoconstriction and is timed to coincide with a recurring segment of the cardiac cycle. The vasoconstriction assists circulation and venous return in the lower limbs of inactive and bedridden individuals.

Abstract: A method and system are provided to analyze valve related timing and monitor heart failure. The method and system comprise collecting cardiac signals associated with an atrial chamber of interest; collecting dynamic impedance (DI) data along an atria-function focused (AFF) vector to form a DI data set, the DI data set including information corresponding to a mechanical function (MF) of a valve associated with the atrial chamber of interest; identifying, from the cardiac signals, an intra-atrial conduction timing (IACT) associated with the atrial chamber of interest; estimating an MF landmark at which the mechanical function of the valve occurs based on the DI data set; analyzing a timing delay between the MF landmark and the IACT; and adjusting a therapy, based on the timing delay, to encourage atrial contribution to ventricular filling.

Abstract: Various embodiments of the present invention are directed to, or are for use with, an implantable system including a lead having multiple electrodes implantable in a patient's left ventricular (LV) chamber. In accordance with an embodiment, the patient's LV chamber is paced at first and second sites within the LV chamber using a programmed LV1-LV2 delay, wherein the LV1-LV2 delay is a programmed delay between when first and second pacing pulses are to be delivered respectively at the first and second sites within the LV chamber. Evoked responses to the first and second pacing pulses are monitored for, and one or more LV pacing parameter is/are adjusted and/or one or more backup pulse is/are delivered based on results of the monitoring.