Abstract: The disclosure relates in some aspects to an implantable pressure sensor and a method of measuring pressure. In some embodiments pressure may be measured through the use of an implantable lead incorporating one or more pressure sensors. In some aspects a pressure sensor is implemented in a micro-electromechanical system (“MEMS”) that employs direct mechanical sensing. A biocompatible material is attached to one or more portions of the MEMS sensor to facilitate implant in a body of a patient. The MEMS sensor may thus be incorporated into an implantable lead for measuring blood pressure in, for example, one or more chambers of the patient's heart.

Abstract: A bioelectric battery may be used to power implantable devices. The bioelectric battery may have an anode electrode and a cathode electrode separated by an insulating member comprising a tube having a first end and a second end, wherein said anode is inserted into said first end of said tube and said cathode surrounds said tube such that the tube provides a support for the cathode electrode. The bioelectric battery may also have a membrane surrounding the cathode to reduce tissue encapsulation. Alternatively, an anode electrode, a cathode electrode surrounding the cathode electrode, a permeable membrane surrounding the cathode electrode. An electrolyte is disposed within the permeable membrane and a mesh surrounds the permeable membrane. In an alternative embodiment, a pacemaker housing acts as a cathode electrode for a bioelectric battery and an anode electrode is attached to the housing with an insulative adhesive.

Abstract: The implantable medical device includes high-voltage components (such as defibrillation shock generation components) operative to generate high-voltage pulses for delivery to tissues of the patient while using the case or housing of the device as a stimulation electrode. The device also includes low-voltage Medical Implant Communication Service (MICS) or Medical Device Radiocommunications Service (MedRadio) components operative to generate low-power signals for communicating with an external device via radio frequencies while using the case as part of an antenna. A conductive noise shield is mounted within the case of the device and interposed between the high-voltage components and the case, with the shield configured to attenuate electrical interference between the high-voltage components and the case to facilitate radio-frequency communication between the low-voltage MICS/MedRadio components and the external device, which use the case as part of the antenna.

Abstract: Neuromodulation for controlling hypertension and other cardio-renal disorders of a patient is disclosed. A neuromodulation device is configured to be delivered to a patient's body and to apply an electric activation to decrease renal sympathetic hyperactivity of the patient based on monitored blood pressure of the patient, substantially without thermal energization of the patient's body by applying the electric activation. The electric activation may also depend on monitored blood volume of the patient. A feedback control module may be used to provide feedback control information for adjusting the electric activation based on the monitored blood pressure and volume of the patient.

Abstract: A lead assembly of an implantable medical device includes an elongated body, electrodes on the body, and a tracking sensor located in the body. The body extends between a connector end and a leading end and has conductors disposed in the body. The connector end of the body includes terminals coupled with the conductors. The electrodes disposed on the body can be located at or near an anatomy of interest in a patient and are conductively coupled with the terminals of the body by the conductors. The electrodes are configured to sense electric activity of the anatomy of interest and/or deliver stimulus pulses to the anatomy of interest. The tracking sensor is conductively coupled with the terminals of the body by the conductors. The tracking sensor generates an electric position signal representative of a position of the tracking sensor in the heart when the body is in the patient.

Abstract: Adaptively creating a table of optimal, patient-specific atrioventricular (AV) delays for a an implantable medical device (IMD) begins as the IMD detects the patient entering a target heart rates within a defined range of elevated heart rates. On detection, the device begins testing AV delays by pacing the heart at a number of different AV delays. The IMD selects the optimal AV delay based on a comparison of measurements of cardiac output obtained during each delay's test pacing period. The optimal AV delay corresponds to the one which resulted in the highest cardiac output. The device selects this optimal AV delay and stores it in an AV delay table on the device. The process continues as the device detects the patient entering the other target heart rates in order to complete the table.

Abstract: Provided herein are implantable systems, and methods for use therewith, for monitoring a patient's pre-ejection interval (PEI). A signal indicative of cardiac electrical activity and a signal indicative of changes in arterial blood volume are obtained. One or more predetermined features of the signal indicative of cardiac electrical activity and the signal indicative of changes in arterial blood volume are detected. The patient's PEI is determined by determining an interval between the predetermined feature of the signal indicative of cardiac electrical activity and the predetermined feature of the signal indicative of changes in arterial blood volume.

Abstract: A high Q self-resonant inductor and method for manufacturing the same is disclosed herein for use in an implantable medical lead. The method of manufacture includes depositing a first conductive material over an elongated ceramic member and removing portions of the conductive material to leave a continuous helical metallic pattern on an elongated ceramic structure. The helical metallic pattern has a first terminal end located at a proximal end of the elongated ceramic member and a second terminal end located at a distal end of the ceramic member. The method also includes covering the helical metallic pattern with a ceramic material to form a first ceramic layer and forming vias in the ceramic material. At least one electrode is coupled to the helical metallic pattern through the vias in the ceramic material.

Abstract: In accordance with an embodiment, an implantable lead assembly is provided comprised of an elongated body including a distal end, a proximal end having a header connector portion for coupling the elongated body with an implantable medical device, and an intermediate segment located between the distal and proximal ends. An intermediate electrode is disposed at the intermediate segment along the elongated body. A conductor is disposed in the elongated body and electrically coupled with the header connector portion and the intermediate electrode. The conductor wound within the intermediate segment to form first and second inductive coils that are axially separated from each other by an inter-coil gap, wherein the first and second inductive coils have different self-resonant frequencies.

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: Methods for monitoring a patient's level of B-type natriuretic peptide (BNP), and implantable cardiac systems capable of performing such methods, are provided. A ventricle is paced for a period of time to provoke a ventricular evoked response, and a ventricular intracardiac electrogram (IEGM) indicative of the ventricular evoked response is obtained. Based on the ventricular IEGM, there is a determination of at least one ventricular evoked response metric (e.g., ventricular evoked response peak-to-peak amplitude, ventricular evoked response area and/or ventricular evoked response maximum slope), and the patient's level of BNP is monitored based on determined ventricular evoked response metric(s). Based on the monitored level's of BNP, the patients heart failure (HF) condition and/or risks and/or occurrences of certain events (e.g., an acute HF exacerbation and/or an acute myocardial infarction) can be monitored.

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: Disclosed herein is an implantable pulse generator feedthru configured to make generally planar electrical contact with an electrical component housed within a can of an implantable pulse generator. The feedthru may include a feedthru housing including a header side and a can side, a core within the feedthru housing, a generally planar electrically conductive interface adjacent the can side, and a feedthru wire extending through the core. The feedthru wire may include an interface end and a header end, wherein the header end extends from the header side and the interface end is at least one of generally flush with the generally planar interface and generally recessed relative to the generally planar interface.

Abstract: In a possible implementation, a method for cardiac testing is provided which includes measuring test data associated with cardiac events and storing the test data in an intracardiac stimulation device. The method further includes acquiring event electrograms corresponding with the test data and storing the event electrograms corresponding with the test data in the intracardiac stimulation device. In a possible implementation, marker data is stored associating event electrograms with measured test data, which may identify the event electrograms used for measuring the test data and/or identify when adjacent event electrograms are not contiguous. In some implementations, the test data may be measured and stored in an out-of-clinic test, and the test data and the corresponding event electrograms may be later retrieved from the intracardiac stimulation device and presented on a visual display.

Abstract: A method for hermetically sealing electronic circuitry within a housing of an implantable medical device is provided. The method comprises assembling the housing having an interior cavity, joining a feed-through assembly to the housing, and joining a back-fill member to the feed-through housing. The back fill member has an opening there through communicating with the interior cavity of the housing. The housing is back-filled with an inert gas through the opening in the back-fill member, and the interior cavity is hermetically sealed by closing the opening through the back-fill member with a sealing element. The sealing element and back-fill member are formed of different first and second materials, respectively.

Abstract: A wireless communication threshold for an implantable medical device is automatically adapted in an attempt to maintain optimum signal detection sensitivity. In some aspects, a threshold level may be adapted to account for current environmental conditions, implant conditions, device conditions, or other conditions that may affect the reception of wireless signals at the device. In some aspects, the determination of an optimum level for the threshold involves a tradeoff relating to effectively detecting target signals while avoiding detection of noise and/or interference. In some aspects, adaptation of a threshold may be based on maximum energy levels associated with one or more sets of RF energy sample data. In some aspects, adaptation of a threshold may be based on the number of false wakeups that occur during a period of time.

Abstract: Disclosed herein is an implantable medical lead configured to receive a stylet. The lead may include a tubular body and a structure. The tubular body may include a distal end and a proximal end. The body may be configured to receive the stylet. The structure longitudinally may extend through the body between the distal end and the proximal end. The structure may be anchored within the body such that a tensile force arising within the body by the stylet being extended through the body causes the tensile force to be substantially carried by the structure.

Abstract: An implantable lead is provided that comprises a lead body and a header assembly. The lead body has a distal end and a proximal end. The lead body is configured to be implanted in a patient. The header assembly is provided at the distal end of the lead body and includes an internal chamber and a tissue engaging end. An electrode is provided on the header assembly. The electrode is configured to deliver a stimulating pulse. A resonant inductor is located within the chamber in the header assembly. An electrically floating heat spreader is provided on the header assembly. The heat spreader is located proximate to the resonant inductor and is positioned on the header assembly to cover at least a portion of the resonant inductor. The heat spreader is thermally coupled to the resonant inductor to convey thermal energy away from the header assembly.

Abstract: A guide wire is heated by application of electricity to change the stiffness of at least a portion of the guide wire. That portion of the guide wire may thus be selectively softened wherever that portion needs to be bent to facilitate routing the guide wire through curves or obstacles in a desired path.

Abstract: Techniques are provided for discriminating episodes of cardiac ischemia indicated based on shifts in ST segment elevation from false detections due to atrial fibrillation (AF) or other confounding factors such as premature ventricular contractions (PVCs.) In an example for use with a single-chamber device, in response to a possible ischemic event, the single-chamber device assesses ventricular stability based an examination of ventricular intracardiac electrogram (IEGM) signals. If the ventricular IEGM is unstable due to paroxysmal AF or frequent PVCs, the ischemic event is rejected as a false detection. Otherwise, the device responds to the event by, for example, generating warning signals, recording diagnostic data or controlling device therapy. The stability discrimination techniques are particularly advantageous for use within single-chamber devices that lack automatic mode switching but are also beneficial within at least some dual-chamber devices or multi-chamber systems.