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: 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: 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: 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: 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: 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.

Abstract: An electrode pad with a defibrillation circuit and a separate ECG tracing circuit. The electrode pad includes a foam base layer, first and second conductive layers, and a hydrogel layer. The foam base layer has a first side and the first conductive layer is centrally located on the base layer. The first conductive layer has a first circuit configured to provide a defibrillation current. The second conductive layer extends at least partially around the first conductive layer on the first side of the base layer. The second conductive layer has a separate second circuit configured to receive an electrical signal. The hydrogel layer covers the first and second conductive layers on the first side of the base layer. The electrode pad additionally includes an electrical connector attached to the first and second conductive layers. The electrical connector is configured for providing a voltage to the first and second conductive layers.

Abstract: A cardiac device comprises a first anchoring element configured to be attached to a first side of a tissue wall, a second anchoring element configured to be attached to a second side of the tissue wall, and a cinching device. The cinching device is configured to attach to the first anchoring element and the second anchoring element and apply force to the first anchoring element to move the first anchoring element towards the second anchoring element and at least partially compress the tissue wall.

Abstract: Systems and techniques are disclosed to establish programming of an implantable electrical neurostimulation device for treating pain of a human subject, through the use and adjustment of analgesic stimulation parameters based on trust dynamics and trust measurements. In an example, the system to establish programming of the neurostimulation device performs operations that: determine a trust measurement value that is derived from results of at least one commitment made with a human subject, via observable interactions; determine a modification of at least one neurostimulation programming parameter, based on the trust measurement value; and to cause the implantable neurostimulation device to implement the modification of the at least one neurostimulation programming parameter. Further examples are provided to produce and track the trust measurement value, as well as identify a pain susceptibility value and determine a receptiveness to analgesic effects based on these and other trust dynamics.

Abstract: A method for processing a cardiac signal represented as a function of time includes providing a number n of different threshold levels Ni, with i=1 to n and n being greater than or equal to three; detecting, from a given time T and per threshold level Ni, at least two successive intersections of the cardiac signal with the threshold level Ni, considering a crossing per increasing and/or decreasing value of the cardiac signal with the threshold level Ni; and determining at least one statistical parameter for the cardiac signal from the intersections of the cardiac signal with the at least three different threshold levels Ni. The method may be implemented by a subcutaneous active implantable medical device having a control circuit configured to process a cardiac signal.

Abstract: Provided is a method of monitoring a heart rate of an open circulatory system aquatic organism including water fleas, zebrafish, brine shrimp, and the method of evaluating individual response by real time measurement of a heart rate of an aquatic organism and the individual response evaluation apparatus by real time measurement of a heart rate of an aquatic organism according to the present invention may effectively fix the aquatic organism for real time measurement of the heart rate of an aquatic organism, and may measure the heart rate using digital holography to display the heart rate while configuring a data format to allow the corresponding data to be stored for a long time, thereby treating a compound for inducing an individual response, securing a heart rate change in real time by image processing, and then effectively determining the presence or absence of harmfulness due to induction of the individual response.

Abstract: A modified nerve cuff electrode is designed to enhance the stability of neural recording and/or nerve stimulation. Any nerve cuff electrode includes a nerve cuff and a plurality of electrodes within the nerve cuff. While traditional nerve cuff electrodes have every one of the plurality of electrode contacts on the inner surface of the nerve cuff, in the modified nerve cuff electrode each of an inner surface and an outer surface of the nerve cuff has at least one electrode contact. The at least one electrode contact on the outer surface can be electrically isolated from the peripheral nerve to provide a stable reference or ground during recording or a stable pathway for a return current during stimulation to enhance the stability of the recording or the stimulation.

Abstract: A surgical instrument with improved end-effector gripping force. The instrument comprises a shaft, which may be inserted into a body of a patient. The articulated end-effector is mounted on the distal extremity of the instrument shaft and comprises a plurality of links interconnected by a plurality of joints, whose movements are remotely actuated by the surgeon's hands. This remote actuation is accomplished through mechanical transmission, mainly along flexible elements, which are able to deliver motion from a set of actuation elements, placed at a proximal extremity of the shaft, to the instrument's articulated end-effector. The articulated end-effector further comprises one or more cam-and-follower mechanisms that are able to amplify the force transmitted by the flexible elements so that the actuation force at the instrument jaws is maximized and the tension on the transmission elements minimized, thus increasing the fatigue resistance and life of the instrument.

Abstract: The present invention relates to an implantable nerve stimulation device, which includes: a body part which is formed of a metal that ultrasonic waves can be transmitted, and includes a stimulation surface and a charging surface facing each other; a header part which is made of a non-metal and is located at one end of the body part; a cover which includes a stimulation electrode, a hinge part rotatably coupled to one side of the stimulation surface, and a coupling part detachably coupled to the other side of the stimulation surface, is positioned above the stimulation surface to interpose a nerve between the electrode and the stimulation surface; and power generation elements which are located inside the body part and are electrically connected to the electrode.