Abstract: Methods, systems, and devices that detect arrhythmic episodes and perform arrhythmia discrimination are described. Such a system includes a leadless pacemaker (LP) that senses a near-field electrogram (NF-EGM), and a non-vascular implantable cardioverter defibrillator (NV-ICD) that senses a far-field electrogram (FF-EGM). The LP determines cardiac activity information based on the NF-EGM and optionally also based on paced cardiac events caused by the LP.

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: Computer implemented methods, devices and systems for monitoring a trend in heart failure (HF) progression are provided. The method comprises sensing left ventricular (LV) activation events at multiple LV sensing sites along a multi-electrode LV lead. The activation events are generated in response to an intrinsic or paced ventricular event. The method implements program instructions on one or more processors for automatically determining a conduction pattern (CP) across the LV sensing sites based on the LV activation events, identifying morphologies (MP) for cardiac signals associated with the LV activation events and repeating the sensing, determining and identifying operations, at select intervals, to build a CP collection and an MP collection. The method calculates an HF trend based on the CP collection and MP collection and classifies a patient condition based on the HF trend to form an HF assessment.

Abstract: A method of manufacturing an aluminum electrolytic capacitor includes impregnating an aluminum electrolytic capacitor with a first electrolyte to form a first impregnated capacitor, aging the first impregnated capacitor using a first aging process to form a first aged capacitor, impregnating the first aged capacitor with a second electrolyte to form a second impregnated capacitor, the second electrolyte being different from the first electrolyte, aging the second impregnated capacitor using a final aging process to form a final aged capacitor, and impregnating the final aged capacitor with a third electrolyte.

Abstract: A computer implemented method for detecting arrhythmias in cardiac activity including obtaining far field cardiac activity (CA) signals for a series of beats. For at least a portion of the beats, the one or more processors perform, on a beat by beat basis: a) identifying first and second feature of interests (FOI) from a segment of the CA signal that corresponds to a current beat; and b) classifying the current beat into one of first and second groups. The method also includes designating one of the first and second groups to be a primary group based on a relation between the first and second groups, and for the beats in the primary group, selecting one of the first and second FOIs as the R-wave FOI. The method also includes rejecting an arrhythmia detection based on the P-waves detected.

Abstract: Methods, systems, and devices that are used for improving cardiac resynchronization therapy (CRT) are described herein. Such a method can include, for each set of pacing parameters, of a plurality of sets of pacing parameters, performing CRT using a set of pacing parameters and simultaneously therewith sensing a plurality of intracardiac electrograms (IEGMs) using different combinations of implanted electrodes. Additionally, for each set of pacing parameters, of the plurality of sets of pacing parameters, the method includes producing a respective reconstructed multi-lead surface electrocardiogram (ECG) based on the plurality of IEGMs that were sensed while CRT was performed using the set of pacing parameters. The method also includes analyzing the reconstructed multi-lead surface ECGs that were produced for the plurality of sets of pacing parameters, and based on results thereof, identifying a set of pacing parameters to be use for further CRT.

Abstract: Certain embodiments of the present technology described herein relate to detecting atrial oversensing in a His intracardiac electrogram (His IEGM), characterizing atrial oversensing, determining when atrial oversensing is likely to occur, and or reducing the chance of atrial oversensing occurring. Some such embodiments characterize and/or avoid atrial oversensing within a His IEGM. Other embodiments of the present technology described herein relate to determining whether atrial capture occurs in response to His bundle pacing (HBP). Still other embodiments of the present technology described herein relate to determining whether AV node capture occurs in response to HBP.

Abstract: Systems and methods for an implantable medical device which utilizes a patch antenna for communicating with an external device. The implantable medical device includes a housing, a header, and a patch antenna formed using an RF plate and a ground plate, which may be or include a metal surface of the housing. Also, a material of the header forms a dielectric of the patch antenna.

Abstract: Systems, methods, and devices are provided for determining an early battery depletion (EBD) condition of an implantable medical device that includes a memory storing program instructions and a processor executing the program instructions. Circuitry is electrically coupled to the processor, and the circuitry and processor perform one or more tasks related to at least one of collecting signals indicative of physiologic activity, analyzing collected signals, delivering therapy, or communicating with an external device. A battery supplies energy to the circuitry and processor. A monitoring circuit coupled to the battery measures actual energy usage from the battery representing at least one of a current draw from the battery during corresponding tasks or a voltage measurement across the battery. Circuitry and processor calculate projected energy usage from the battery in connection with the corresponding tasks, and determine when an EBD condition exists based on projected energy usage and actual energy usage.

Abstract: Implantable medical devices (IMDs) described herein, and methods for use therewith described herein, reduce how often an IMD accepts a false message and/or reduce adverse effects of an IMD accepting a false message. Such IMDs can be leadless pacemakers (LPs), or implantable cardio defibrillators (ICDs), but are not limited thereto. Such embodiments can be used help multiple IMDs (e.g., multiple LPs) implanted within a same patient maintain synchronous operation, such as synchronous multi-chamber pacing.

Abstract: A method and device for managing establishment of a communications link between an external instrument (EI) and an implantable medical device (IMD) are provided. The method stores, in a memory in at least one of the IMD or the EI, a base scanning schedule that defines a pattern for scanning windows over a scanning state. The method enters the scanning state during which a receiver scans for advertisement notices during the scanning windows. At least a portion of the scanning windows are grouped in a first segment of the scanning state. The method stores, in the memory, a scan reset pattern for restarting the scanning state. Further, the method automatically restarts the scanning state based on the scan reset pattern to form a pseudo-scanning schedule that differs from the base scanning schedule and establishes a communication session between the IMD and the EI.

Abstract: A biostimulator, such as a leadless cardiac pacemaker, including a fixation element to engage tissue and one or more backstop elements to resist back-out from the tissue, is described. The fixation element can be mounted on a housing of the biostimulator such that a helix of the fixation element extends distally to a leading point. The leading point can be located on a distal face of the helix at a position that is proximal from a center of the distal face. The backstop elements can include non-metallic filaments, such as sutures, or can include a pinch point of the biostimulator. The backstop features can grip the tissue to prevent unscrewing of the fixation element. Other embodiments are also described and claimed.

Abstract: Computer implemented methods and systems for detecting noise in cardiac activity are provided. The method and system obtain a far field cardiac activity (CA) data set that includes far field CA signals for a series of beats, overlay a segment of the CA signals with a noise search window, and identify turns in the segment of the CA signals. The method and system determine whether the turns exhibit a turn characteristic that exceed a turn characteristic threshold, declare the segment of the CA signals as a noise segment based on the determining operation, shift the noise search window to a next segment of the CA signal and repeat the identifying, determining and declaring operations; and modify the CA signals based on the declaring the noise segments.

Abstract: A method and device for dynamic device based AV delay adjustment are provided. The method provides electrodes that are configured to be located proximate to an atrial (A) site and a right ventricular (RV) site. The method utilizes one or more processors, in an implantable medical device (IMD), for detecting an atrial paced (Ap) event or atrial sensed (As) event. The method determines a measured AV interval corresponding to an interval between the Ap event or the As event and a ventricular sensed event and calculates a percentage-based (PB) offset based on the measured AV interval. The method automatically dynamically adjusting an AV delay, utilized by the IMD, based on the measured AV interval and the PB offset and manages a pacing therapy, utilized by the IMD, based on the AV delay after the adjusting operation.

Abstract: A method of forming a brazed joint is described. The method includes pressing a non-molybdenum component, such as a cross pin of a battery case assembly, against a molybdenum component, such as a terminal pin of the battery case assembly, and applying one or more electrical pulses to form an interface liquid layer between the components that cools to form the brazed joint. At least one of the electrical pulses has a constant voltage over a pulse time. A contact resistance between the components can decrease during the pulse time, and thus, the constant voltage can cause an uncontrolled electrical current of the electrical pulse to increase. The increasing electrical current heats the components sufficiently to form the interface liquid layer having a predetermined thickness that provides a required bend strength. Removal of surface oxides provide consistent mechanical strength for this joint. Other embodiments are also described and claimed.

Abstract: Fabricating an electrode for use in a capacitor includes cutting an electrode precursor from a sheet of material. The electrode precursor is exposed to steam so as to form a steamed electrode precursor. A capacitor is fabricated and includes an electrode generated from the steamed electrode precursor.

Abstract: A method for controlling an adaptive pacing therapy that includes utilizing one or more processors to perform measuring an atrial-ventricular (AV) interval corresponding to an interval between an atrial paced (Ap) event or an atrial sensed (As) event and a sensed ventricular (Vs) event, setting an AV delay based on the AV interval, and measuring an S1 heart sound characteristic of interest (COI) while utilizing the AV delay in connection with delivering a pacing therapy by the IMD. The one or more processors also perform adjusting the AV delay, repeating the measuring, and adjusting to obtain a collection of S1 heart sound COIs and corresponding AV delays, selecting one of the AV delays, that corresponds to a select one of the S1 heart sound COIs, as a resultant AV delay, and managing the pacing therapy, utilized by the IMD, based on the resultant AV delay.

Abstract: A method for managing power during communication with an implantable medical device, including establishing a communications link, utilizing a power corresponding to a session start power, to initiate a current session between an implantable medical device (IMD) and external device. A telemetry break condition of the communications link is monitored during the current session. The power utilized by the IMD is adjusted between low and high power levels, during the current session based on the telemetry break condition. The number of sessions is counted, including the current session and one or more prior sessions, in which the IMD utilized the higher power level, and a level for the session start power to be utilized to initiate a next session following the current session is adaptively learned based on the counting of the number of sessions.

Abstract: Catheter-based delivery systems for delivery and retrieval of a leadless pacemaker include features to facilitate improved manipulation of the catheter and improved capture and docking functionality of leadless pacemakers. Such functionality includes mechanisms directed to deflecting and locking a deflectable catheter, maintaining tension on a retrieval feature, protection from anti-rotation, and improved docking cap and drive gear assemblies.

Abstract: Computer implemented methods and systems for monitoring cardiac activity (CA) signals, for a series of beats, over first and second sensing channels having different first and second detection thresholds, respectively. The methods and systems also include analyzing the CA signals over the first and second sensing channels utilizing the first and second detection thresholds, respectively, during an event prediction window to detect a presence of sensed events. The methods and systems also include determining amplitudes of the sensed events detected. The methods and systems also include calculating at least one of an amplitude distribution or amplitude trend for the sensed events detected over the first and second channels and adjusting at least one of the first or second detection thresholds based on the at least one of the amplitude distribution or amplitude trend.