Abstract: Systems and methods for dynamically controlling His-bundle pacing (HBP) according to an indication of a rate-related or intermittent atrioventricular (AV) block in a subject are disclosed. An exemplary medical system includes an AV conduction monitor to detect an indication of either a presence or an absence of intermittent or rate-related AV conduction disturbance using physiologic information of the subject. In the event that an intermittent or rate-related AV conduction disturbance is present, a control circuit provides a control signal to an electrostimulation circuit to deliver HBP pulses. If there is no indication of intermittent or rate-related AV conduction disturbance, or a previously detected intermittent or rate-related AV conduction disturbance has been terminated, the control circuit withholds or discontinues delivery of the HBP pulses to promote intrinsic ventricular conduction and activation.

Abstract: In one aspect, a photoplethysmograph system to measure a user's heart rate includes one or more light-emitting diodes (LED) that provide a constantly-on light signal during a measurement period. The one or more light-emitting diodes are in optical contact with an epidermal surface of the user. The one or more light-emitting diodes emit a light signal into the tissue of the user, and wherein the tissue contains a pulsating blood flow. A light-intensity sensor circuit converts the reflected LED light from the tissue into a second signal that is proportional to a reflected light intensity. The second signal includes a voltage or current signal. A computer-processing module calculates the user's beat-to-beat heart rate from the second current signal.

Abstract: A system and method for neural-network-based atrial fibrillation detection with the aid of a digital computer are provided. Electrocardiography (ECG) features and annotated patterns of the features are maintained in a database, at least some of the patterns associated with atrial fibrillation. A classifier is trained based on the annotated patterns, the classifier implemented by a convolutional neural network. A representation of an ECG signal recorded by one or more ambulatory monitors is received. ECG features in the representation falling within each of the temporal windows are detected. The trained classifier is used to identify patterns of the ECG features. At least one matrix with weights for the patterns are generated. A value indicative of whether portions of the representation are associated the patient experiencing atrial fibrillation is calculated. That one or more of the portions are associated with the patient experiencing atrial fibrillation is determined.

Abstract: A method to treat a patient having a pelvic floor dysfunction by establishing a neurostimulator having a processor and a signal generator to generate a stimulation signal. The processor is set to one or more parameters effective in the treating of the patient's pelvic dysfunction when the stimulation signal is applied to a saphenous nerve of the patient. The neurostimulator is configured to provide the stimulation signal to a stimulator in accordance with a stimulation protocol. At least one stimulator is positioned next to a portion of the saphenous nerve of at least one lower limb of a patient. The processor is operationally activated to provide the stimulation signal to the stimulator for treatment of the patient.

Abstract: Methods, systems, and apparatus for detecting configuration for a patient worn sensor assembly are described. In one aspect a method includes receiving, by a computer system, sensor assembly data for a particular sensor assembly, accessing, by the computer system, sensor assembly identifier information defining a plurality of sensor assembly identifiers, where each sensor assembly identifier is associated with a respective sensor assembly, identifying, by the computer system and based on the sensor assembly data, a particular sensor assembly identifier for the particular sensor assembly, and determining, by the computer system, configuration information for the particular sensor assembly based on the particular sensor assembly identifier.

Abstract: An implantable pump system is provided, suitable for use as a left ventricular assist device (LVAD) system, having an implantable pump, a battery, a controller, and a programmer. The implantable pump includes a flexible membrane coupled to an actuator assembly via a skirt that extends toward the inlet of the pump and curves to guide blood toward the outlet. The actuator assembly is magnetically engagable with electromagnetic coils, so that when the electromagnetic coils are energized, the actuator assembly causes wavelike undulations to propagate along the flexible membrane to propel blood from the inlet, across the skirt, and through the outlet of the implantable pump. The controller may be programmed by a programmer to operate at frequencies and duty cycles that mimic physiologic flow rates and pulsatility while operating in an efficient manner that avoids thrombus formation, hemolysis and/or platelet activation.

Abstract: An electrical stimulation system includes a sheath that includes conductive points that are operative to facilitate electrical stimulation to a bodily portion of a user. Drive-sense circuits (DSCs) generate electrical stimulation signals based on reference signals and provide those electrical stimulation signals via electrodes to the conductive points of the sheath. The electrical stimulation signal is coupled into respective locations of the bodily portion of the user that are in proximity to or in contact with the conductive points of the sheath. In addition, the DSCs sense, via the conductive points of the sheath and via the electrodes, changes of the electrical stimulation signals based on coupling of them into the respective locations of the bodily portion of the user. The DSCs provide digital signals that are representative of the changes of the electrical stimulation signals to one or more processing modules that includes and/or is coupled to memory.

Abstract: A method for anatomical diagnosis includes measuring, using a catheter that includes a position sensor and an electrode, over multiple cycles of a beating heart, electrical activity and mechanical motion at a plurality of locations contacted by the catheter on a heart wall within a chamber of the heart. Based on the measured mechanical motion, a magnitude of a mechanical strain is computed over the cycles at the locations. In one embodiment, the computed strain is used in identifying a group of the locations at which the magnitude of the mechanical strain is below a predefined strain threshold and a voltage of the electrical activity is below a predefined voltage threshold as a locus of scar tissue. In another embodiment, a pathological condition of the heart is identified based on a characteristic of the mechanical strain computed over the left ventricle during the diastolic phase.

Abstract: Apparatus is provided for facilitating percutaneous delivery of an implant to a target site of a body of a subject. The apparatus includes a delivery tool that includes a needle that defines a lumen through which the implant passes. The needle has a proximal end and a distal end, and defines a triple-grind bevel at the distal end. The triple-grind bevel defines a primary grind and two side-grinds. The side-grinds do not extend to meet each other to define a point at a distal-most part of the needle. Other embodiments are also described.

Abstract: An ophthalmic device for treating an eye includes a laser source, a scanner system and an application head with a focusing optic and a patient interface for docking the application head onto the eye. Moreover, the ophthalmic device includes a measurement system for optically capturing eye structures when the application head is docked to the eye and a circuit which is configured to determine reference structures of the eye, which are arranged in ring-shaped fashion about the center axis of the anterior chamber of the eye, from the captured eye structures and to arrange a defined three-dimensional treatment model with respect to these reference structures in order to process a three-dimensional treatment pattern in accordance with the arranged three-dimensional treatment model in the eye.

Abstract: Electrical current can be delivered to the skin to treat hyperhidrosis or other conditions using wearable and non-wearable devices. Wearable devices to deliver electrical current can include an inner assembly that carries one or more electrodes and an outer assembly that can be worn over the inner assembly. Contact between electrodes and the user's skin can be promoted using suction, support components, or filler materials. Non-wearable devices can be grasped by a user or otherwise placed into contact with a treatment site for delivery of electrical current to the user's skin. Electrode lay-out for wearable and non-wearable devices can be optimized for current density distribution across the electrode.

Abstract: Systems, devices, and methods for tracking and determining the motion of a cardiac implant is disclosed. The motion of the implant is determined by transmitting acoustic energy to a tissue location using an acoustic controller-transmitter comprising an array of acoustic transducers; wherein the implant is configured to convert the transmitted acoustic energy to electrical energy; and the tracking is achieved by determining the electrical energy delivered to the tissue throughout one or more cardiac cycles in order to create a motion profile of the cardiac implant.

Abstract: In some examples, a coil electrode assembly includes a coil electrode including a plurality of windings and extending from an electrode proximal end to an electrode distal end, the coil electrode defining an electrode lumen from the electrode proximal end to the electrode distal end. The coil electrode assembly further includes an insulative tube extending within the lumen of the coil electrode such that the coil electrode extends along an outer surface of the insulative tube. The coil electrode is partially embedded within the insulative tube when the insulative tube is in an expanded state to maintain a spacing between the windings.

Abstract: A leadless pacemaker device for providing an intra-cardiac pacing includes processing circuitry configured to generate ventricular pacing signals for stimulating ventricular activity at a ventricular pacing rate, a first sensor configuration receiving a first sense signal, and a second sensor configuration receiving a second sense signal. The processing circuitry derives, in a first sensing state, atrial events from the first sense signal for controlling the ventricular pacing rate based on the atrial events. The processing circuitry switches, based on at least one switching criterion, from the first sensing state to a second sensing state in which the processing circuitry derives atrial events from the second sense signal. The second sense signal is received by the second sensor configuration for detection of atrial events and the second sensor configuration is a motion sensor or a sound sensor. A method for operating the pacemaker device is also provided.

Abstract: Various embodiments provide a wellness tracking device with a base plate that may be utilized as a combination electrode by a variety of sensors. The base plate may be a multi-material electrode that includes a conductor and a transparent or semi-transparent material to enable optical sensing. In certain embodiments, the base plate supports a plurality of different sensors, which may selectively utilize the base plate as an electrode.

Abstract: A medical device includes a motion sensor for producing a motion signal including cardiac event signals. The medical device generates a ventricular pacing pulse upon expiration of a pacing interval. The medical device determines a synchrony metric from the motion signal after a delivered ventricular pacing pulse and adjusts the pacing interval based on the synchrony metric.

Abstract: Systems and methods make possible the placement of one or more electrode leads in a tissue region for providing functional and/or therapeutic stimulation to tissue. The systems and methods are adapted to provide the relief of pain.

Abstract: The invention relates mainly to an optical guide for diffusing a light radiation through a surface, which is essentially characterized in that it includes a base (3,31) comprising or able to hold at least one diffusion rod (2, 2a; 35a, 35b, 35c) whose lower diffusion end (7, 7a; 38a, 38b, 38c) protrudes from said base (3) and is intended to be applied on or near said surface, and whose upper collecting end (6,6a; 37a, 37b, 37c) is intended to be located near and opposite a power supplied light source (36a, 36b, 36c), and in that the diffusion rod (2, 2a; 35a, 35b, 35c) comprises a material able to transmit light from its collecting end (6,6a; 37a, 37b, 37c) up to its diffusion end (7, 7a; 38a, 38b, 38c). The invention also relates to an irradiation module and to an irradiation device adapted to the transcranial and/or transcutaneous irradiation by light radiation.

Abstract: A method for determining and responding in real-time to an increased risk of death relating to a patient with epilepsy is provided. The method includes receiving cardiac data and determining a cardiac index based upon the cardiac data. The method includes determining an increased risk of death associated with epilepsy if the indices are extreme, issuing a warning of the increased risk of death and logging information related to the increased risk of death. Also presented is a second method for determining and responding in real-time to an increased risk of death relating to a patient with epilepsy comprising receiving at least one of arousal data, responsiveness data or awareness data and determining an arousal index, a responsiveness index or an awareness index, where the indices are based on arousal data, responsiveness data or awareness data respectively.

Abstract: A garment includes a fabric base layer and at least one side-emitting optical fiber retained to or integrated with the fabric base layer. The fabric base layer can stretch in the grain and cross grain direction of the fabric base layer. The at least one side-emitting optical fiber is located in at least one light-emitting zone to be located over a targeted body area of the person wearing the garment, and is configured to receive light from a light source and in the at least one light-emitting zone is configured to project light having a therapeutic wavelength toward the targeted body area.