Abstract: An ambulatory medical device configured to analyze heart rates in different operating modes includes a plurality of ECG sensing electrodes, a plurality of therapy electrodes and at least one processor configured to in a default operating mode, perform a default heart rate calculation for determining a heart rate of the patient for use in detecting a cardiac arrhythmia condition of the patient. The at least one processor is configured to change a device operating mode from a default mode based on detecting patient activity to an activity operating mode, and in the activity operating mode, perform a different heart rate calculation from the default heart rate calculation for determining the heart rate for use in detecting the cardiac arrhythmia condition of the patient during the activity operating mode. The at least one processor is configured to deliver the treatment in response to detecting the cardiac arrhythmia condition.

Abstract: A method of processing of electrocardiogram includes the steps of providing an electrocardiogram comprising signals in at least two channels; selecting at least two frequency ranges of the signal in each of the said at least two channels; calculating an envelope for the signal in each frequency range in each channel; dividing the calculated envelope of the signal in each frequency range in each channel into QRS complex segment envelopes; and computing an average or median envelope as an average or mean of QRS complex segment envelopes for each frequency range in each channel.

Abstract: An implantable system for treating a heart contains a processor, a memory unit, a treatment unit including a treatment electrode, and a detection unit for detecting a cardiac event requiring treatment. The memory unit includes a computer-readable program, which prompts the processor to perform the following steps: a) detecting by way of the detection unit whether a cardiac event to be treated has occurred in the heart; b) if a cardiac event to be treated has occurred, determining a position of the treatment electrode or determining a variable correlating with this position; and c) comparing the position of the treatment electrode or the variable correlating with the position to a reference variable, and carrying out, or not carrying out a cardiac treatment by way of the treatment unit and the treatment electrode as a function of the position of the treatment electrode or the variable correlating with the position.

Abstract: An intracardiac ventricular pacemaker includes a pulse generator for delivering ventricular pacing pulses, an impedance sensing circuit, and a control circuit in communication with the pulse generator and the impedance sensing circuit. The pacemaker is configured to produce an intraventricular impedance signal, detect an atrial systolic event using the intraventricular impedance signal, set an atrioventricular pacing interval in response to detecting the atrial systolic event, and deliver a ventricular pacing pulse in response to the atrioventricular pacing interval expiring.

Abstract: A system for marking cardiac time intervals from heart valve signals includes a non-invasive sensor unit for capturing electrical signals and composite vibration objects, a memory containing computer instructions, and one or more processors coupled to the memory. The one or more processors causes the one or more processors to perform operations including separating a plurality of individual heart vibration events into heart valve signals from the composite vibration objects, and marking cardiac time interval from the heart valve signals by detecting individual heartbeats using at least one or more of a PCA algorithm or deep learning.

Abstract: Cardiac Output (CO) has traditionally been difficult, dangerous, and expensive to obtain. Surrogate measures such as pulse rate and blood pressure have therefore been used to permit an estimate of CO. MEMS technology, evolutionary computation, and time-frequency signal analysis techniques provide a technology to non-invasively estimate CO, based on precordial (chest wall) motions. The technology detects a ventricular contraction time point, and stroke volume, from chest wall motion measurements. As CO is the product of heart rate and stroke volume, these algorithms permit continuous, beat to beat CO assessment. Nontraditional Wavelet analysis can be used to extract features from chest acceleration. A learning tool is preferable to define the packets which best correlate to contraction time and stroke volume.

Abstract: Disclosed is a system including an electrode and a stylet configured to steer the electrode towards its intended position during implantation, and a method for such system's use. An electrode is provided having regions with varied flexibility. A stylet having bends that are indexed to specific regions of flexibility of the electrode may be inserted into the electrode, and upon minimal radial and/or longitudinal movement of the stylet within the electrode, will cause the magnitude of the angle to which the lead is bent to either increase or decrease so as to aid the operator in placement of the electrode.

Abstract: Techniques for switching an implantable medical device (IMD) from a first mode to a second mode in relation to signals obtained from internal sensors are described. The internal sensors may include a temperature sensor and a biosensor. In some examples, processing circuitry of the IMD may make a first preliminary determination that the IMD is implanted based on a first signal from the temperature sensor. In response to the first preliminary determination being that the IMD is implanted, the processing circuitry may make a second preliminary determination that the IMD is implanted based on a second signal from the biosensor. The processing circuitry may switch the IMD from a first mode to a second mode based on both the first preliminary determination and the second preliminary determination being that the IMD is implanted.

Abstract: Devices, systems and methods provide forms of asymptomatic diaphragmatic stimulation (ADS) therapy that affect pressures within the intrathoracic cavity, including: 1) dual-pulse ADS therapy, during which a first ADS pulse is delivered during a diastolic phase of a cardiac cycle and a second ADS pulse is delivered during a systolic phase, 2) paired-pulse ADS therapy, during which a first ADS pulse is delivered, closely followed by a second ADS pulse, with the second ADS pulse functioning to extend or enhance a phase of a transient, partial contraction of the diaphragm, and 3) multiple-pulse ADS therapy, during which a stream of ADS pulses is delivered, wherein the time between pulses is based on heart rate. Devices, systems and methods also monitor electromyography (EMG) activity of the diaphragm relative to baseline activity to assess the health of a diaphragm subject to ADS therapy and to adjust ADS therapy parameters or sensing parameters.

Abstract: A medical device senses cardiac electrical signals including T-waves attendant to ventricular myocardial repolarizations and detects a T-wave template condition associated with non-pathological changes in T-wave morphology. The device generates a T-wave template from T-waves sensed by the sensing circuit during the T-wave template condition. After generating the T-wave template, the device acquires a T-wave signal from the cardiac electrical signal and compares the acquired T-wave signal to the T-wave template. The device detects a pathological event in response to the acquired T-wave signal not matching the T-wave template.

Abstract: Provided are a system and method of generating an aggregated stability map of one or more rotational sources associated with a heart rhythm disorder. In accordance therewith, a plurality of rotational area profile maps is accessed for a plurality of analysis intervals. Each of the profile maps includes rotation intensity values for a plurality of locations associated with rotation of the one or more rotational sources. An aggregated stability map is generated based on the profile maps, wherein the stability map includes a plurality of locations. Each location includes a rotation intensity value based at least on a filter number of highest rotation intensity values from corresponding locations of the profile maps, the filter number being automatically determined from a plurality of filter numbers such that the plurality of profile maps as filtered includes a predetermined number of rotation intensity values in excess of a threshold intensity value.

Abstract: Blood pump devices having improved rotary seals for sealing a bearing assembly supporting a rotor provided herein. Such rotary seals are particularly suited for use in blood pump devices that include rotors having cantilevered supported through a sealed mechanical bearing disposed outside a blood flow path of the device to avoid thrombus formation caused by blood contact with the bearing. The rotary seal can include a first and second face seal that are preloaded with a deflectable compliance member incorporated into the pump housing or a pair of magnets. Such rotary seals can instead or further utilize tight fitment between components or a bio-absorbable fill material to seal an interface between the rotor shaft and pump housing to seal the bearing assembly from fluid flowing through the pump.

Abstract: Techniques are disclosed for using a rate of wireless telemetry of an implantable medical device (IMD) to estimate a remaining longevity of a power source of the IMD. For example, the IMD sets a timer indicative of a remaining power capacity of the power source until a recommended replacement time (RRT) threshold. The IMD determines a power consumption of the IMD due to telemetry and updates, based on the power consumption of the IMD due to telemetry, the timer indicative of the remaining power capacity of the power source. The IMD determines, based on expiration of the timer indicative of the remaining power capacity of the power source, that the power source has reached the RRT threshold. In some examples, the IMD may output, to an external device and for display to a user, an indication that the power source has reached the RRT threshold.

Abstract: A method and a system for measuring a main electrically evoked compound action potential is described. The system may comprise a cochlea implant system which includes an electrode array, and where the electrode array includes at least a stimulator electrode, a first recording electrode and a second recording electrode, and where the first recording electrode is arranged closer to the stimulator electrode than the second recording electrode, a processor electrically in communication with the cochlea implant system.

Abstract: An active implantable medical device for neurostimulation therapy is disclosed. The device produces stimulation pulse sequences generated continuously in succession during activity periods separated by intermediate inactivity periods during which no stimulation is issued. An input signal, provided by a physiological sensor, representative of cardiac activity and/or of the patient's hemodynamic status is received by circuitry. The circuitry further provides for dynamic control of the neurostimulation therapy, wherein the length of activity periods is modulated based on the current value level of the control parameter compared to a threshold. The duration of the next period of inactivity is calculated by the circuitry at the end of each activity period to maintain a constant duty cycle ratio between periods of activity and periods of inactivity.

Abstract: Systems and methods for recording bipolar electrogram signals by dynamically selecting electrode pairs. For a particular electrode of interest, a reference electrode is identified as the physically closest electrode to the electrode of interest that satisfies at least one selection criterion indicative of an absence of concurrent electrical activation.

Abstract: A terminal tool includes a main body, an electrical connector body, and an electrical connector. The main body includes a distal clamping section and a shaft. The shaft includes a window and a first lumen extending through the shaft for receiving a terminal end of an implantable lead. The electrical connector body includes a second lumen and is independently rotatable with respect to the main body. The shaft at least partially extends through the second lumen. The electrical connector is coupled to the electrical connector body and extends at least partially through the window of the shaft.

Abstract: Recovery circuitry for passively recovering charge from capacitances at electrodes in an Implantable Pulse Generator (IPG) is disclosed. The passive recovery circuitry includes passive recovery switches intervening between each electrode node and a common reference voltage, and each switch is in series with a variable resistance that may be selected based on differing use models of the IPG. The passive recovery switches may also be controlled in different modes. For example, in a first mode, the only recovery switches closed after a stimulation pulse are those associated with electrodes used to provide stimulation. In a second mode, all recovery switches are closed after a stimulation pulse, regardless of the electrodes used to provide stimulation. In a third mode, all recovery switches are closed continuously, which can provide protection when the IPG is in certain environments (e.g., MRI), and which can also be used during stimulation therapy itself.

Abstract: Systems and methods for treating cognitive dysfunction and/or depression using transcutaneous auricular neurostimulation therapy may include positioning a wearable neurostimulation device about the ear of the patient, connecting the wearable neurostimulation device, to a pulse generator, and delivering a first series of stimulation pulses to at least one first electrode, the first series being configured to increase monoamine neurotransmitter availability, and delivering a second series of stimulation pulses to at least one second electrode, the second series being configured to upregulate opioid receptor agonists.

Abstract: Implantable cardioverter device (ICD) systems capable of delivering a multi-vector defibrillation shock, and methods for use therewith, are described herein. Such an ICD system can include a defibrillation charge capacitor, a charge circuit, first, second, and third electrodes, switches, a controller, and first, second and third filters. The defibrillation charge capacitor is coupled between a first voltage rail and a second voltage rail. The first filter is coupled between the first and second electrodes, and the second filter is coupled between the second and third electrodes, so that the first and second filters can shunt EMI signals. The third filter is coupled between the first and third electrodes and configured to provide for electrical symmetry when the first, second, and third electrodes are used to deliver a multi-vector defibrillation shock. Such filters, which can be implemented using capacitors, can be used to make the ICD system MRI compatible.