Abstract: Techniques are provided for controlling and delivering spinal cord stimulation (SCS) or other forms of neurostimulation. In one example, neurostimulation pulses are generated wherein successive pulses alternate in polarity so that a pair of electrodes alternate as cathodes. Each pulse has a cathodic amplitude sufficient to achieve cathodic capture of tissues adjacent the particular electrode used as the cathode for the pulse. The neurostimulation pulses are delivered to patient tissues using the electrodes to alternatingly capture tissues adjacent opposing electrodes via cathodic capture to achieve a distributed virtual stimulation cathode. Various pulse energy savings techniques are also set forth that exploit the distributed virtual stimulation cathode.

Abstract: The device includes radio frequency (RF) communication components installed within a case of the device and an antenna with an inverted E shape mounted within a header of the device. The antenna has three branches extending from a main horizontal arm: a capacitive branch connecting one end of the main arm to the case via a capacitive load; an RF signal feed branch connecting a middle portion of the main arm to the internal RF components of the device via a feedthrough; and an inductive branch connecting the opposing (far) end of the main arm to the case to provide a shunt to ground. The E-shaped configuration and the provision of capacitive loading allows for cancellation of inductance to bring the antenna into resonance and to provide optimal radiation efficiency as well as to provide for impedance with no reactive component.

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 IMD periodically transmitting advertisement notices over the dedicated advertisement channel according to the protocol. The advertisement notices being transmitted periodically at an advertisement period over multiple cycles. The method further includes repeatedly scanning the advertisement channel, by the external device, for select scanning intervals in search of the advertisement notices, the scanning operation being repeated periodically at a scan period over the multiple cycles. The advertisement period and the scan period are independent of one another such that the advertisement and scan periods at least partially overlap intermittently after a number of cycles.

Abstract: A neurostimulation lead including an elongated lead body having a distal end and a proximal base. The lead body may have an elastic property such that the lead body is capable of flexing between different geometries. The lead may also include electrodes positioned along the lead body. The lead body may be configured to be straightened into a substantially linear geometry for delivering the lead body into an epidural space and may be biased such that the lead body is configured to have a wave-like geometry when disposed within the epidural space. The lead body may form first and second lateral segments that are joined by a corresponding linking portion when in the wave-like geometry.

Abstract: Methods and systems are provided to control a configuration of a neural stimulation (NS) system having an NS device coupled to an NS lead. The methods and systems change between configurations of the NS system and collect cardiac signals from a patient that are representative of cardiac rhythms experienced by the patient over a period of time and in connection with multiple NS configurations. The methods and systems derive, from the cardiac signals, characteristic values for at least one physiologic characteristic indicative of at least one of normal and abnormal cardiac rhythms in connection with the multiple NS configurations; and select, from the multiple NS configurations, an NS operating configuration to be used by the NS system based on the characteristic values.

Abstract: Described herein are implantable cardiac stimulation devices, and methods for use therewith. A pacing channel of such a device includes a pace output terminal, a pulse generator and at least two pace return electrode terminals. The pace output terminal is coupleable to an electrode for use as an anode. The pulse generator is configured to selectively output an electrical stimulation pulse to the pace output terminal. Each of the pace return electrode terminals is coupleable to a separate one of at least two further electrodes for use as a cathode. Switching circuitry selectively couples any one of the pace return electrode terminals of the pacing channel to the pace return capacitor of the pacing channel at a time, thereby enabling the pace return capacitor to be shared by at least two of the pace return electrode terminals of the pacing channel. Additional embodiments are also disclosed herein.

Abstract: A method and system for selecting at least one left ventricular (LV) pacing site for an implantable medical device equipped for cardiac stimulus pacing using a multi-pole LV lead are provided. The method and system include sensing LV activation events at multiple LV sensing sites. The arrival times of the LV activation events for corresponding LV sensing sites are measured. The method and system further include calculating differences between the arrival times for combinations of the LV sensing sites to obtain inter-site arrival delays between the combinations of the LV sensing sites. When at least one of the inter-site arrival delays exceeds a threshold, the method and system include designating the LV sensing site from the corresponding combination that has a later arrival time as a first LV pacing site from which to deliver LV pacing pulses using the implantable medical device.

Abstract: Implantable systems, and methods for use therewith, are provided for monitoring for an impending myocardial infarction. A signal indicative of changes in arterial blood volume is obtained. Such a signal can be a photoplethysmography signal or an impedance plethysmography signal. For each of a plurality of periods of time, a metric indicative of the areas under the curve of the signal or number of inflections in the signal is determined. An impending myocardial infarction is monitored for based on changes in the metric indicative of the area under the curve of the signal or number of inflections in the signal, and an alert and/or therapy is triggered in response to an impending myocardial infarction being predicted.

Abstract: Methods, systems and devices are provided for monitoring respiratory disorders based on monitored factors of a photoplethysmography (PPG) signal that is representative of peripheral blood volume. The monitored factors can be respiratory effort as well as respiratory rate and/or blood oxygen saturation level. The systems and devices may or may not be implanted in a patient.

Abstract: An implantable medical device, comprised of at least one lead configured to be located proximate to a heart, the at least one lead including electrodes, at least a portion of the electrodes configured to sense cardiac activity. A therapy module configured to control delivery of pacing pulses in accordance with a therapy timing and based on the cardiac sensed activity sensed. Cardiac impedance (CI) sensor circuitry configured to be coupled to at least a first combination of the electrodes to sense cardiac impedance (CI), the CI sensor circuitry generating an impedance data stream associated with a corresponding CI sensing vector.

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: A leadless intra-cardiac medical device (LIMD) includes an electrode assembly configured to be anchored within a first wall portion of a first chamber of a heart. The electrode assembly includes an electrode main body having a first securing helix, an electrode wire segment extending from the body, and a first segment-terminating contact positioned on the electrode wire segment. The device further includes a housing assembly configured to be anchored within a second wall portion of a second chamber of the heart. The housing assembly includes a body having a second securing helix, a housing wire segment extending from the body, and a second segment-terminating contact positioned on the housing wire segment. The device also includes a connector block that electrically connects the electrode wire segment to the housing wire segment by retaining the first and second segment-terminating contacts.

Abstract: A leadless cardiac pacemaker comprises a housing, a plurality of electrodes coupled to an outer surface of the housing, and a pulse delivery system hermetically contained within the housing and electrically coupled to the electrode plurality, the pulse delivery system configured for sourcing energy internal to the housing, generating and delivering electrical pulses to the electrode plurality. The pacemaker further comprises an anti-unscrewing feature disposed on either a fixation device of the pacemaker or on the housing itself. The anti-unscrewing feature can be configured to prevent the fixation device from disengaging the wall of the heart.

Abstract: A medical device configured to be secured to an individual may include a housing containing one or more electrical components, and one or more leads electrically connected to the housing. Each lead may include an insulating jacket that surrounds a central core including one or more conductors, and at least one pressure-resisting member integrally formed with one or both of the insulating jacket or the central core. The pressure-resisting member is configured to resist one or more forces exerted into the central core. For example, the pressure-resisting member may include one or more of a suture-anchoring member or a lead-strengthening member.

Abstract: An exemplary embodiment includes acquiring an electroneurogram of the right carotid sinus nerve or the left carotid sinus nerve, analyzing the electroneurogram for at least one of chemosensory information and barosensory information and calling for one or more therapeutic actions based at least in part on the analyzing. Therapeutic actions may aim to treat conditions such as sleep apnea, an increase in metabolic demand, hypoglycemia, hypertension, renal failure, and congestive heart failure. Other exemplary methods, devices, systems, etc., are also disclosed.

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: 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: Described herein are implantable systems and devices, and methods for use therewith, that can be used to perform arrhythmia discrimination. A plurality of different sensing vectors are used to obtain a plurality of different IEGMs, each of which is indicative of cardiac electrical activity at a different ventricular region. The plurality of different IEGMs can include, e.g., an IEGM indicative of cardiac electrical activity at a first region of the patient's left ventricular (LV) chamber and an IEGM indicative of cardiac electrical activity at a second region of the patient's LV chamber. Additionally, the plurality of different IEGMs can further include an IEGM indicative of cardiac electrical activity at a region of a patient's right ventricular (RV) chamber. For each of the IEGMs, there is a determination of a corresponding localized R-R interval stability metric indicative of the R-R interval stability at the corresponding ventricular region. This can include, e.g.

Abstract: Techniques are provided for use by an implantable medical device for assessing and controlling concurrent anodal/cathodal capture. In one example, the device delivers bipolar pacing stimulus while sensing a bipolar intracardiac electrogram (IEGM) and while adjusting a magnitude of the pacing stimulus. The device analyzes the bipolar IEGM signals to detect an indication of activation representative of concurrent anodal and cathodal capture. Preferably, the pulse magnitude is set relative to the anodal/cathodal capture threshold based upon clinician programming in response to the needs of the patient. In this manner, concurrent anodal and cathodal capture can be selectively activated or deactivated based on clinician instructions received from a device programmer or other external programming device. Techniques exploiting both bipolar and unipolar IEGM signals to assess and control concurrent anodal/cathodal capture are also described.

Abstract: An epicardial lead is passively fixed in a pericardial space by a passive fixation member. The passive fixation member extends from a distal portion of an epicardial lead and acts against a pericardial layer and an epicardial layer to hold the lead in place. The epicardial lead may include an electrode that is connected to a conductor that extends from a distal portion of the lead. In some embodiments the epicardial lead includes a material that promotes fibrosis to fix the lead to heart tissue. The passive fixation member may include a shocking coil.