Abstract: A method of manufacturing an implantable medical lead is disclosed herein. The method may include: providing a lead body including a proximal end, a distal end, and an electrode near the distal end; provide a conductor extending between the proximal and distal ends; providing a crimp including a ribbon-like member and extending the ribbon-like member around the conductor; and mechanically and electrically connecting the ribbon-like member to the electrode.

Abstract: A method of manufacturing an implantable medical lead is disclosed herein. The method may include: providing a lead body including a proximal end, a distal end, and an electrode near the distal end; provide a conductor extending between the proximal and distal ends; providing a crimp including a ribbon-like member and extending the ribbon-like member around the conductor; and mechanically and electrically connecting the ribbon-like member to the electrode.

Abstract: A new model is provided for understanding and exploiting impedance or admittance values measured by implantable medical devices, such as pacemakers or cardiac resynchronization devices (CRTs.) The device measures impedance along vectors extending through tissues of the patient between various pairs of electrodes. The device then converts the vector-based impedance measurements into near-field individual electrode-based impedance values. This is accomplished, in at least some examples, by converting the vector-based impedance measurements into a set of linear equations to be solved while ignoring far-field contributions to the impedance measurements. The device solves the linear equations to determine the near-field impedance values for the individual electrodes, which are representative of the impedance of tissues in the vicinity of the electrodes.

Abstract: Methods and systems are provided for discriminating heart arrhythmias. The methods and systems include identifying an arrhythmia, recording a predetermined number of beats during the arrhythmia as a base arrhythmia (BA) beats; delivering anti-tachy pacing (ATP) therapy to at least one chamber of the heart. After delivering the ATP therapy, the methods and system record at least one return beat representing cardiac activity following the ATP therapy, determines whether the return beat originated in a reference chamber of the heart, compares a morphology of the return beat to a morphology of the BA beat; and declares a VT or SVT based on the comparing operation.

Abstract: An intra-cardiac implantable medical device (IIMD) system may include a housing and an intra-cardiac (IC) device extension. The housing may be configured to be implanted entirely within a local chamber of the heart. The housing includes a base configured to be secured to the local chamber. The IC device extension may include a proximal end, a distal end, and an extension body extending there between. The proximal end may be coupled to the housing and configured to be located in the local chamber. The extension body may include an IE orientation segment connected to a chamber transition segment that is sufficient in length to extend from the local chamber into an adjacent chamber. The IE orientation segment is configured to be lodged within the adjacent chamber in order to stabilize the system within heart.

Abstract: A method of manufacturing an implantable medical lead is disclosed herein. The method may include: providing a lead body including a proximal end, a distal end, and an electrode near the distal end; provide a conductor extending between the proximal and distal ends; providing a crimp including a ribbon-like member and extending the ribbon-like member around the conductor; and mechanically and electrically connecting the ribbon-like member to the electrode.

Abstract: A medical device includes pacing circuitry configured to deliver during a cardiac cycle a first pacing pulse to a first site using a first electrode as a cathode electrode for the first pacing pulse and to deliver a second pacing pulse to a second site using a second electrode as a cathode electrode for the second pacing pulse. Sensing circuitry is configured to generate a differential signal between cardiac electrical activity sensed at the first electrode and cardiac electrical activity sensed at the second electrode. Capture circuitry discriminates between single site capture and multi-site capture based on the differential signal.

Abstract: Embodiments of the present invention relate to implantable systems, and method for use therein, that can detect myocardial ischemic events. In accordance with specific embodiments of the present invention, short-term fluctuations in cardiac intervals that follow premature ventricular contractions (PVCs) are monitored. This allows myocardial ischemic events to be detected based on these monitored fluctuations. The cardiac intervals for which fluctuations are being monitored can be, for example, RR intervals. Alternatively, or additionally, short-term fluctuations in other types of cardiac intervals may be monitored. Such other cardiac intervals include, for example, PR intervals, PP intervals, QT intervals and RT intervals.

Abstract: A sealed mule shoe assembly for use in directional drilling, comprising an outer mule shoe and an inner housing for containing a directional measurement tool which is slidably insertable in the outer mule shoe. The mule shoe assembly advantageously has half-moon mating surfaces which advantageously allow use circumferential seals to thereby prevent ingress of abrasive materials into the landing area between the outer mule shoe and the inner housing, thereby greatly prolonging the life of the mule shoe assembly. Such seals further make use of hydrostatic forces downhole which cause locking landed engagement of the inner tool within the outer mule shoe. Cup seals or a check valve are used to allow escape of fluid when the inner tool is inserted within the outer mule shoe, and similarly prevent ingress of abrasive fluids and drill cuttings into the area of landed engagement.

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: An implantable pulse generator includes a header, a can, a grouped array feedthru, and an inline array feedthru board. The feedthru includes a header side, a can side and a grouped array of feedthru wires extending through the feedthru. A first end of each feedthru wire is electrically coupled to a lead connector block. The inline array feedthru board includes a grouped array of first electrical contact holes and an inline array of conductor wires. The grouped array of first electrical contact holes receives therein second ends of the feedthru wires. The inline array of conductor wires projects from a side of the board opposite the feedthru. Each first electrical contact hole is in electrical communication with a respective conductor wire. Each conductor wire is in electrical contact with at least a portion of an electrical connection region of an electronic substrate housed within the can.

Abstract: The invention is directed towards measuring current of injury (COI) during lead fixation. A baseline waveform is sensed from a lead while the lead is in a pre-fixation position. The baseline waveform represents an interface between the lead and tissue proximate a lead prior to active fixation. Cardiac signals are then sensed when the lead is in a post-fixation position. The post-fixation waveform represents an interface between the lead and the tissue once the lead is actively attached to the tissue. A COI is calculated based on an automatic comparison of the baseline and post-fixation waveforms. A COI feature of interest is identified in the baseline and post-fixation waveforms and a COI index, a COI area, a COI differential and/or a COI ratio is calculated based on the COI feature of interest in the baseline and post-fixation waveforms.

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: Time delays between a feature of a signal indicative of electrical activity of a patient's heart and a feature of a plethysmograph signal indicative of changes in arterial blood volume are used to arrange the operation of an implantable device, such as a pacemaker. Shorter time delays between the feature of the signal indicative of electrical activity of a patient's heart and the feature of the plethysmograph signal indicative of changes in arterial blood volume are indicative of larger cardiac stroke volumes. The time delay can be used to select a pacing site or combination of pacing sites and/or to select a pacing interval set.

Abstract: Methods and systems are provided for discriminating heart arrhythmias. The methods and systems include identifying an arrhythmia, recording a predetermined number of beats during the arrhythmia as a base arrhythmia (BA) beats; delivering anti-tachy pacing (ATP) therapy to at least one chamber of the heart. After delivering the ATP therapy, the methods and system record at least one return beat representing cardiac activity following the ATP therapy, determines whether the return beat originated in a reference chamber of the heart, compares a morphology of the return beat to a morphology of the BA beat; and declares a VT or SVT based on the comparing operation.

Abstract: Disclosed herein are a variety of implantable medical leads for coupling to an implantable pulse generator and targeted stimulation of the lateral and posterior basal left ventricular region of a patient heart. As one example, the lead may include a tubular body including proximal section, an intermediate section and a distal section. The intermediate section biases into a generally S-shaped or sinusoidal-shaped configuration when the intermediate section is in a free or non-restricted state. The proximal section proximally extends from the intermediate section to a proximal end configured to electrically couple to the implantable pulse generator. The distal section biases into a generally straight linear shaped configuration when the distal section is in a free or non-restricted state.

Abstract: Techniques are provided for use with an implantable cardiac rhythm management (CRMD) system equipped to deliver neurostimulation to acupuncture sites within anterior regions of the neck, thorax or abdomen of the patient. Parameters associated with the health of the patient are detected, such as parameters indicative of arrhythmia, heart failure and hypertension.

Abstract: Techniques are provided for use with an implantable medical device for evaluating mechanical cardiac dyssynchrony based impedance (Z) measured along different vectors between an electrode in the right ventricle (RV) and various electrodes of a multi-pole left ventricle (LV) lead.

Abstract: A method for operating an implantable medical device includes delivering a plurality of pacing pulses to an atria of a patient's heart and monitoring intrinsic atrial activity to detect intrinsic atrial contractions between one or more of the plurality of pacing pulses. The method further includes detecting atrial undersensing as a function of the detection of intrinsic atrial contractions.

Abstract: An intra-cardiac implantable medical device (IIMD) and method of implant are provided. The IIMD comprises a housing configured to be implanted entirely within a coronary sinus (CS) of the heart. The IIMD has at least one intra-cardiac device extension (ICDE).