Abstract: A medical instrument includes an instrument shaft with exit holes near a distal end of the shaft, a tool coupled to the distal end of the shaft, and a backend. The backend may include a mechanism that manipulates a drive element that extends through the shaft and couples to the tool, a fluid inlet, and a fluid channel assembly providing fluid communication between the fluid inlet and the proximal end of the shaft. Cleaning fluid is directed into the fluid inlet, through the fluid channel assembly, and into the shaft. A chassis or other structural piece of the backend may form part of the fluid channel assembly.

Abstract: A method of manufacturing an implantable lead including a cuff is disclosed. The method includes partially curing a first silicone electrode cover, embedding electrodes within the first silicone electrode cover, partially curing a second silicone electrode cover, placing the first silicone electrode in a face-to-face relationship with the second silicone electrode cover to form an assembly, forming the assembly into a desired shape against a shim, placing an assembly within a canister to control an outer expansion, and curing the assembly.

Abstract: A neuroprosthetic system for substituting a sensory modality of a mammal by electrical stimulation of a region of the cerebral cortex corresponding to the neural modality to be substituted. The system includes at least one sensor for generating a sensed data feed by sensing a neural modality to be substituted, an electrode unit including a plurality of three-dimensional arrays of flexible electrode shafts for implantation of a region of the cerebral cortex, a rigid electrode support structure for guiding the flexible electrode shafts into the region of the cerebral cortex and for retraction after implantation, a driving unit for electrically driving the electrode, a recording unit, and a processing unit for analysing sensed data feed for providing stimulation patterns for electrically driving groups of electrical contacts of the electrode unit corresponding to subsets of locations in the region of the cerebral cortex, for substituting the sensory modality.

Abstract: The embodiment discloses an electrode array including a housing; a plurality of first contact electrodes exposed to an outside of the housing; a plurality of second contact electrodes exposed to the outside of the housing; a first wire group disposed inside the housing and electrically connected to the first contact electrodes; and a second wire group disposed inside the housing and electrically connected to the second contact electrodes, the plurality of first contact electrodes and the first wire group being disposed on different planes within the housing.

Abstract: An implantable medical device includes an electrode and an insulative material secured to the electrode via an adhesive. The electrode includes a metal substrate and a metal coating. The metal substrate includes a connection segment and an active segment along a length of the metal substrate. The metal coating is disposed on an outer surface of the metal substrate along the connection segment and the active segment. The insulative material surrounds the connection segment of the metal substrate without surrounding the active segment, and the adhesive adheres to the metal coating on the connection segment.

Abstract: Systems, methods, devices, and techniques for estimating a heart disease prediction of a mammal. An electrocardiogram (ECG) procedure is performed on a mammal, and a computer system obtains ECG data that describes results of the ECG over a period of time. The system provides a predictive input that is based on the ECG data to a predictive model, such as a neural network or other machine-learning model. In response, the predictive model processes the input to generate an estimated heart disease predictive characteristic of the mammal. The system outputs the estimated heart disease prediction of the mammal for presentation to a user.

Abstract: Methods and systems for facilitating the determining and setting of stimulation parameters for programming an electrical stimulation system are disclosed. The disclosed systems and methods use algorithms to identify patient-specific metrics to use as feedback variables for optimizing stimulation parameters for a patient. The patient-specific metric(s) are determined by ranking a plurality of clinical indicators for the patient with and without the presence of a medical intervention to determine which clinical indicators respond most strongly to the medical intervention. The clinical indicators that respond most strongly can be used as the patient-specific metric for optimizing stimulation, or a composite patient-specific metric may be derived as a mathematical combination of a plurality of clinical indicators that respond well to the intervention.

Abstract: The present invention is directed to a method for inducing an immune response in a subject, including a step of activating neurons in the mesolimbic network of the subject by applying a neurofeedback.

Abstract: A delivery device for delivering a pacing lead to the His bundle of a patient's heart includes an elongated sheath having a distal end, and a plurality of mapping electrodes positioned at the distal end. The distal end of the sheath may have a distal end face, and the mapping electrodes may include two electrodes that diametrically oppose one another at a position exposed on or spaced from the distal end face. The sheath includes a plurality of flexible sections spaced apart from one another, and a pull wire that causes the sheath to deflect from a substantially straight configuration to a dual hinged curved configuration that maneuvers and positions the electrodes in the vicinity of the bundle of His. The sheath may include a PTFE liner having axially oriented, platelet-like fibril features that enable the sheath to be split along its length from a proximal end to the distal end.

Abstract: Embodiments of the invention provide apparatus, systems and methods for stimulating tissue in the urinary tract to initiate or facilitate urination. One embodiment provides an external urinary sphincter stimulation (EUSS) catheter for stimulating the external urinary sphincter (EUS), where the EUSS catheter includes nerve stimulation electrodes (NSES) for delivering current to nerves within or around the EUS in order to relax the EUS prior to urination. Other embodiments provide a system for stimulating the EUS including the EUSS catheter and a controller operatively coupled to the EUSS catheter, where the controller includes a pulse generator for delivering current to the NSES. Other embodiments provide methods for positioning the EUSS catheter in the patient's body including in the EUS using a urethral approach. Embodiments of the invention are particularly useful for initiating and/or controlling urination for patients who have lost the ability to voluntarily urinate due to neurogenic bladder dysfunction.

Abstract: This disclosure is directed to devices, systems, and techniques for controlling electrical stimulation therapy. In some examples, a medical device includes stimulation generation circuitry configured to deliver a first stimulation pulse to a patient, sensing circuitry configured to sense the first stimulation pulse, and processing circuitry. The processing circuitry is configured to determine that a value of a characteristic of the sensed first stimulation pulse exceeds a target stimulation pulse value and responsive to determining that the value of the characteristic of the sensed first stimulation pulse exceeds the target stimulation pulse value, change a first value of a parameter to a second value of the parameter that at least partially defines a second stimulation pulse deliverable by the stimulation generation circuitry after the first stimulation pulse was sensed.

Abstract: A WCD system is configured to monitor various characteristics of the WCD system including about the patient. The WCD system is further configured to transmit a notification of a notifiable event to responders that are outside a local area of the patient, and to silence the notification for any responder(s) that are inside the local area of the patient.

Abstract: Systems, methods, devices, and techniques for estimating an ejection-fraction characteristic of a mammal. An electrocardiogram (ECG) procedure is performed on a mammal, and a computer system obtains ECG data that describes results of the ECG over a period of time. The system provides a predictive input that is based on the ECG data to an ejection-fraction predictive model, such as a neural network or other machine-learning model. In response, the ejection-fraction predictive model processes the input to generate an estimated ejection-fraction characteristic of the mammal. The system outputs the estimated ejection-fraction characteristic of the mammal for presentation to a user.

Abstract: Systems, methods, devices, and techniques for estimating a heart disease prediction of a mammal. An electrocardiogram (ECG) procedure is performed on a mammal, and a computer system obtains ECG data that describes results of the ECG over a period of time. The system provides a predictive input that is based on the ECG data to a predictive model, such as a neural network or other machine-learning model. In response, the predictive model processes the input to generate an estimated heart disease predictive characteristic of the mammal. The system outputs the estimated heart disease prediction of the mammal for presentation to a user.

Abstract: Electrical stimulation of neural activity in the neural innervation of the spleen that is associated with neurovascular bundles provides a useful way to treat acute medical conditions, such as trauma, hemorrhaging and shock.

Abstract: Provided herein is a computing system for optimizing a waveform, in communication with an implantable pulse generator, and including a computing device including a memory device and a processor communicatively coupled to the memory device. The processor is configured to: retrieve historical waveform data associated with a plurality of waveforms used in therapeutic sessions for a plurality of patients, the historical waveform data including a plurality of waveform parameters; analyzing the historical waveform data to determine preferred waveform parameters; determining that a patient is starting a new therapeutic session using the patient therapeutic device; displaying each of the preferred waveform parameters; prompting the user to accept or modify the displayed waveform parameters; optimizing the waveform parameters for the therapeutic session; and transmitting the optimized waveform parameters to the patient therapeutic device to start the therapeutic session.

Abstract: This disclosure relates to implantable neuro stimulation devices with a feedback loop to control an amount of energy delivered into a neural tissue based on a measured evoked neural response. Stimulation electrodes deliver stimulation energy to neural tissue. A microprocessor performs closed-loop control of the stimulation energy based on a feedback signal that is indicative of an evoked neural response. A supervisor is connected to the feedback signal and detects malfunction of the stimulator based on the feedback signal. The supervisor is also connected to the stimulator to provide a status signal to the stimulator and changes the status signal to indicate malfunction upon detecting malfunction based on the feedback signal. The microprocessor adjusts the control of the stimulation energy in response to the status signal from the supervisor indicating malfunction.

Abstract: A catheter including a catheter shaft and a mapping balloon configured for navigation within a body. The mapping balloon can be coupled to the catheter shaft, such as at a distal end of the catheter shaft. The mapping balloon can have an exterior surface including a plurality of predefined fold locations configured to allow the mapping balloon to be adjusted between a collapsed configuration and an expanded configuration. In the collapsed configuration, the mapping balloon can include a first dimension, and in the expanded configuration the mapping balloon can have a second dimension. The second dimension can be greater than the first dimension. A plurality of electrodes can be located along the exterior surface of the mapping balloon to communicate electrical signals with an electronic control unit.

Abstract: Methods and systems for using sensed evoked neural responses for informing aspects of neurostimulation therapy are disclosed. Electrical signals may be recorded during the provision of electrical stimulation to a patient's neural tissue. The electrical signals may be processed and analyzed using one or more classification criteria to determine if the electrical signals contain a neural response of interest. Examples of such neural responses include evoked neural responses that are oscillatory and/or resonant in nature. If the electrical signals include such responses of interest, one or more features may be extracted from the signals and used as biomarkers for informing aspects of neurostimulation therapy, such as directing lead placement, optimizing stimulation parameters, closed-loop feedback control of stimulation, and the like. Various methods and systems described herein are particularly relevant in the context of multi-site stimulation paradigms, such as coordinated reset neuromodulation.

Abstract: The disclosed invention relates to an improved system and method for treatment of soft tissue, e.g., for treatment of a snoring condition. The system can include a laser source; a hand piece; and a device for directing radiation emitted by the laser source to a treatment area (e.g., an oral treatment area). In some cases, the handpiece can include an optical element (e.g., a lens) mounted within a replaceable cartridge and adapted to modulate a laser beam such that it is non-ablative, prior to its delivery to a treatment region. In various embodiments, the system includes a CO2 laser capable of performing treatment in a more efficient manner than conventional techniques.