Abstract: A method and system for differential analysis of cardiac events are provided that include monitoring cardiac signals from a heart to detect deviations indicative of at least one of ischemia and myocardial infarction (MI). The method and system also monitor physiologic surrogate signals associated with pain to detect chest pain. Additionally, the method and system include characterizing a cardiac event exhibited by the heart based on whether the cardiac event occurs in a presence of at least one of the ischemia, IM, and chest pain.

Abstract: An implantable medical lead includes a longitudinally extending body, an electrical conductor, an electrical component and a weld. The longitudinally extending body includes a distal end, a proximal end, and paddle region near the distal end. The electrical conductor extends through the body between the proximal end and the paddle region. The electrical component is on the paddle region and includes a sacrificial feature defined in a wall of the electrical component. The sacrificial feature includes a region that continues from the wall of the electrical component and a side that is isolated from the wall of the electrical component via a void defined in the wall of the electrical component. The weld is formed at least in part from at least a portion of the sacrificial feature. The weld operably couples the electrical component to the electrical conductor.

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: 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: An implantable medical lead may include a longitudinally extending body, an electrical conductor, an electrical component, and a weld. The longitudinally extending body includes a distal end and a proximal end. The electrical conductor extends through the body between the proximal end and the distal end. The electrical component is on the body and includes a sacrificial feature defined in a wall of the electrical component. The sacrificial feature includes a region that continues from the wall of the electrical component and a side that is isolated from the wall of the electrical component via a void defined in the wall of the electrical component. The weld is formed at least in part from at least a portion of the sacrificial feature. The weld operably couples the electrical component to the electrical conductor.

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: 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: Certain embodiments of the present disclosure provide an externally-secured medical device (ESMD) configured to be securely affixed to skin of a patient. The ESMD may include at least one pad configured to be directly secured to the skin of the patient. The pad(s) may include at least one electrode configured to direct therapeutic energy into the skin of the patient toward an internal organ. An adhesion component is provided on a patient-engaging surface of the at least one pad configured to securely affix the at least one pad in a persistent and enduring manner to the skin of the patient. The at least one pad is directly secured to the skin of the patient through the adhesion component.

Abstract: A method and system for deriving effectiveness of medical treatment of a patient are provided that include collecting patient state (PS) data from at least one of an implantable medical device (IMD) or an external medical device (EMD) over a collection interval. The collected PS data relates to a physiologic characteristic (PC) of the patient. The PS data is transferred to a database that is remote from the patient to form a patient state data (PSD) history. The patient undergoes a pivotal medical event (PME) during the collection interval. The PS data within the PSD history is analyzed before and after the PME to propose a treatment therapy (TT). Following delivery of the TT, the collecting and transferring operations are repeated to obtain post-treatment PS data and form a post-treatment PSD history. An effectiveness indicator (EI) of the TT is derived based on at least the post-treatment PSD history.

Abstract: Stimulation of a patient's nervous system is controlled based on cardiovascular risk assessment performed by an implantable medical device. For example, an implantable medical device may monitor cardiac electrical activity to detect changes in the ST segment. Upon detection of a certain change in the ST segment, the implantable medical device controls the application of spinal cord stimulation and/or other neurostimulation to cardiac-related sections of the patient's nervous system. In some embodiments, the implantable medical device communicates with a separate neurostimulation device to control the neurostimulation. In some embodiments, the implantable medical device delivers the neurostimulation.

Abstract: A method and system are provided for removing, from an implant chamber of a heart, a leadless implantable medical device (LIMD) having a distal end and a proximal end. The distal end is configured to be actively secured to tissue in the implant chamber of the heart. The proximal end is configured to be coupled to a distal end of an indwelling retrieval mechanism (IRM). The IRM extends from the heart along a vessel, the IRM having a proximal end configured to be anchored at a temporary anchor site. The method comprises detaching the IRM from the anchor site, loading a retrieval tool over the proximal end of the IRM and along the body of the IRM. The retrieval tool has a lumen therein that receives the IRM as the retrieval tool re-enters the vessel, thereby allowing the retrieval tool to engage the LIMD.

Abstract: Leadless neurostimulation (NS) device including a device body and electrodes positioned along an active side of the device body. The electrodes form a multi-electrode array that is configured to interface with nervous tissue of a patient and supply electrical pulses to the nervous tissue. The NS device also includes an electronic sub-system that is coupled to the device body. The electronic sub-system includes switching circuitry, a power source, and an inductive coil that is operably coupled to the power source. The inductive coil is configured to receive electrical power through inductive coupling with an external coil. The device body, including the inductive coil coupled thereto, is sized and shaped to be disposed within an epidural space of a patient.

Abstract: An implantable lead assembly includes an elongated body, a bobbin, and a conductor. The elongated body includes a distal end having an electrode and a proximal end having a header connector portion for coupling the elongated body with an implantable medical device. The bobbin is disposed in the elongated body. The conductor is disposed in the elongated body and is electrically coupled with the header connector portion and the electrode. The conductor is wound around the bobbin to form first and second inductive coils that are axially separated from each other by an inter-coil gap formed from the bobbin. The first and second inductive coils have different self resonant frequencies.

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: Stimulation of a patient's nervous system is controlled based on cardiovascular risk assessment performed by an implantable medical device. For example, an implantable medical device may monitor cardiac electrical activity to detect changes in the ST segment. Upon detection of a certain change in the ST segment, the implantable medical device controls the application of spinal cord stimulation and/or other neurostimulation to cardiac-related sections of the patient's nervous system. In some embodiments, the implantable medical device communicates with a separate neurostimulation device to control the neurostimulation. In some embodiments, the implantable medical device delivers the neurostimulation.

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 coupled/paired stimulus pulse is delivered to the heart at an inter-pulse interval following one of i) detection of an intrinsic depolarization or ii) delivery of a primary stimulus pulse. Capture resulting from the coupled/paired stimulus pulse is sensed for. In response to capture by a coupled/paired stimulus pulse, the inter-pulse interval is incrementally decreased by a first amount until there is no capture by a coupled/paired stimulus pulse. In response to no capture by a coupled/paired stimulus pulse, the inter-pulse interval is incrementally increased by a second amount greater than the first amount, until capture by a coupled/paired stimulus pulse is detected. Once capture is again detected, paired/coupled pacing is delivered at the inter-pulse interval which resulted in capture for a predetermined period of time or until loss of capture occurs.

Abstract: A lead implantation tool is used for the implantation of active fixation medical leads. The tool may be configured to operably couple to a lead connector end of an implantable cardiac electrotherapy lead including an active fixation helix tip and wherein the lead connector end includes a contact pin proximally extending from the lead connector end. The tool may include a feature configured to couple to the contact pin and a first mechanism configured to convert linear movement into rotational movement of the contact pin relative to the lead connector end. The tool may further include a second mechanism that causes a stylet extending through the tool and into the contact pin to at least one of distally and proximally displace within the contact pin.

Abstract: Various techniques are provided for use with an implantable medical device for exploiting near-field impedance/admittance. Examples include techniques for assessing heart chamber disequilibrium, detecting chamber volumes and pressures, calibrating near-field-based left atrial pressure (LAP) estimation procedures and for assessing the recovery from injury at the electrode-tissue interface. In one particular example, the implantable device assesses the degree of concordance between the left ventricle (LV) and the right ventricle (RV) by quantifying a degree of scatter between LV and RV near-field admittance values. An increase in RV admittance is indicative of RV failure, an increase in LV admittance is indicative of LV failure, and an increase in both LV and RV admittance is indicative of biventricular failure.

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.