Abstract: Embodiments of the present disclosure are configured to assess the severity of a blockage in a vessel and, in particular, a stenosis in a blood vessel. In some particular embodiments, the devices, systems, and methods of the present disclosure are configured to assess the severity of a stenosis in the coronary arteries by monitoring fluid flow. In some embodiments, the devices, systems, and methods of the present disclosure include a flow-sensing element within a distal portion of an intravascular device that is mounted at an oblique angle with respect to a central longitudinal axis of the intravascular device. The angled flow-sensing element can be oriented away from a vessel wall and towards the center of the vessel lumen through rotation of the intravascular device.

Abstract: An implantable medical device (IMD) has a housing enclosing an electronic circuit. The housing includes a first housing portion, a second housing portion and a joint coupling the first housing portion to the second housing portion. A polymer seal is positioned in the joint in various embodiments. Other embodiments of an IMD housing are disclosed.

Abstract: Methods for therapeutic renal denervation are disclosed herein. One aspect of the present application, for example, is directed to methods that block, reduce and/or inhibit renal sympathetic nerve activity to achieve a reduction in central sympathetic tone. Renal sympathetic nerve activity may be altered or modulated along the afferent and/or efferent pathway. The achieved reduction in central sympathetic tone may carry several therapeutic benefits across many disease states.

Abstract: A method and system is described for ensuring a state of an active implantable medical device based on the presence and persistence of a magnetic field. The output of a magnetic field sensor is monitored. The active implantable medical device is maintained in a first state, for so long as the presence of a magnetic field is detected by the magnetic field sensor, until a first interval is surpassed. If the first interval is surpassed, then a determination is made as to whether a second interval has been surpassed. If it is determined that the second interval has not been surpassed, then the active implantable medical device is transitioned into a second state. If it is determined that the second interval has been surpassed, then it is ensured that the active implantable medical device is in a predetermined one of the first and second states.

Abstract: Methods and apparatus are provided for bilateral renal neuromodulation, e.g., via a pulsed electric field, via a stimulation electric field, via localized drug delivery, via high frequency ultrasound, via thermal techniques, etc. Such neuromodulation may effectuate irreversible electroporation or electrofusion, necrosis and/or inducement of apoptosis, alteration of gene expression, action potential attenuation or blockade, changes in cytokine up-regulation and other conditions in target neural fibers. In some embodiments, neuromodulation is applied to neural fibers that contribute to renal function. In some embodiments, such neuromodulation is performed in a bilateral fashion. Bilateral renal neuromodulation may provide enhanced therapeutic effect in some patients as compared to renal neuromodulation performed unilaterally, i.e., as compared to renal neuromodulation performed on neural tissue innervating a single kidney.

Abstract: Methods and apparatus are provided for treating hypertension, e.g., via a pulsed electric field, via a stimulation electric field, via localized drug delivery, via high frequency ultrasound, via thermal techniques, etc. Such neuromodulation may effectuate irreversible electroporation or electrofusion, necrosis and/or inducement of apoptosis, alteration of gene expression, action potential attenuation or blockade, changes in cytokine up-regulation and other conditions in target neural fibers. In some embodiments, neuromodulation is applied to neural fibers that contribute to renal function. In some embodiments, such neuromodulation is performed in a bilateral fashion. Bilateral renal neuromodulation may provide enhanced therapeutic effect in some patients as compared to renal neuromodulation performed unilaterally, i.e., as compared to renal neuromodulation performed on neural tissue innervating a single kidney.

Abstract: A method and apparatus for treatment of heart failure, hypertension and renal failure by stimulating the renal nerve. The goal of therapy is to reduce sympathetic activity of the renal nerve. Therapy is accomplished by at least partially blocking the nerve with drug infusion or electrostimulation. Apparatus can be permanently implanted or catheter based.

Abstract: A cardiac rhythm management system provides an increase in pacing rate as a combination of responses to three characteristics of a relative-temperature signal: a dip, a positive slope, and a positive magnitude. The relative-temperature signal is the difference between a short-term and a long-term temperature average. A dip produces a limited and temporary rate increase having a first proportionality. A positive slope produces a rate increase with a second proportionality. A positive magnitude produces a rate increase with a third proportionality. The dip response seeds the slope response to provide a seamless and immediate rate transition after a dip. The cardiac rhythm management system limits and filters the sum of the rate increases to provide a sensor indicated rate, which is used to stimulate the heart.

Abstract: An implantable medical device includes a housing, a power source and an operational circuit that is coupled to the power source. The operational circuit includes a first electrode terminal and a second electrode terminal, an output circuit configured to deliver an electrical stimulation therapy through the first and second electrode terminals and a control circuit configured to evaluate an electrical parameter associated with the output circuit and to control generation of the electrical stimulation therapy responsive to a result of the evaluated parameter. Among other things, the implantable medical device may modify a parameter of the therapy delivery in response to a result of the evaluation.

Abstract: A hand-held device for electrically powered skin treatment is disclosed. The device includes a first outer electrode, a second outer electrode, and a plurality of rechargeable batteries. The plurality of batteries are disposed in a compartment where the compartment is covered by a shell-like housing cover and where an outside of the housing cover is a section of an exterior area of a device housing. The compartment is covered by a removable compartment cover where an inner side of the compartment cover is directed toward the plurality of batteries in the compartment and where a connector socket with at least two poles is disposed on an outer side of the compartment cover. The compartment cover is located within the housing cover. A charging circuit is coupled to the plurality of batteries.

Abstract: Methods and apparatus are provided for monopolar neuromodulation, e.g., via a pulsed electric field. Such monopolar neuromodulation may effectuate irreversible electroporation or electrofusion, necrosis and/or inducement of apoptosis, alteration of gene expression, action potential attenuation or blockade, changes in cytokine up-regulation and other conditions in target neural fibers. In some embodiments, monopolar neuromodulation is applied to neural fibers that contribute to renal function. In some embodiments, such monopolar neuromodulation is performed bilaterally.

Abstract: Methods and apparatus are provided for intravascularly-induced neuromodulation using a pulsed electric field, e.g., to effectuate irreversible electroporation or electrofusion, necrosis and/or inducement of apoptosis, alteration of gene expression, changes in cytokine upregulation, etc., in target neural fibers. In some embodiments, the intravascular PEF system comprises a catheter having a pair of bipolar electrodes for delivering the PEF, with a first electrode positioned on a first side of an impedance-altering element and a second electrode positioned on an opposing side of the impedance-altering element. A length of the electrodes, as well as a separation distance between the first and second electrodes, may be specified such that, with the impedance-altering element deployed in a manner that locally increases impedance within a patient's vessel, e.g.

Abstract: Devices and methods are described for the treatment of heart conditions such as heart failure with preserved ejection fraction, including diastolic heart failure, by performing a pericardial modification procedure. Intraoperative test procedures for assessing the efficacy of the pericardial modification procedure are also described.

Abstract: Herein is described a device and methods-of-use to treat multiple possible causes of sudden neurological dysfunction related to cardiac, cerebrovascular, or brain electrical abnormalities. The device can be employed so as to treat cardiac dysfunction such as arrhythmia and subsequently related dysfunction of the central nervous system such as stroke and seizure. Alternatively, the device can be employed so as to treat cardiac dysfunction simultaneous with treatment of dysfunction of the central nervous system. Finally, the device can be employed so as to augment the effectiveness of treating cardiac dysfunction, namely the restoration of cardiac output and blood flow to the brain, by dilating the arteries of the brain.

Abstract: An external medical device generates a drive signal inductively coupled to an implantable coil from an external coil. A regulator module coupled to the implantable coil generates an output signal in response to the inductively coupled signal and a feedback signal correlated to an amplitude of the inductively coupled signal. A signal generator receives the output signal for generating a therapeutic electrical stimulation signal. The control module adjusts the drive signal in response to the feedback signal to control the electrical stimulation signal.

Abstract: This document provides methods and materials involved in detecting and delivering neurochemical signals, electrophysiological signals, ions, or combinations thereof within a mammal. For example, systems that can include one or more implantable devices containing probes configured to detect neurochemical signals (e.g., neurotransmitter concentrations), electrical signals, ions, or combinations thereof and one or more implantable devices containing electrodes and/or microfluidic delivery components configured to deliver neurochemical signals (e.g., neurotransmitters), electrical signals, ions, or combinations thereof to one or more locations within a mammal are provided.

Abstract: Systems and methods for detecting atrial tachyarrhythmias such as atrial fibrillation (AF) are disclosed. A medical system can sense a heart rate (HR) output and a hemodynamic status output. An AF detector circuit automatically determines a first detection criterion and a different second detection criterion. The first detection criterion can be more sensitive to the presence of the AF episode than the second detection criterion, and the second detection criterion can be more specific to the AF episode than the first detection criterion. The AF detector circuit detects an AF onset event using the first detection criterion and at least one of the heart rate output or the hemodynamic status output, and detects an AF termination event using the second detection criterion and at least one of the heart rate output or the hemodynamic status output.

Abstract: A lead anchor includes a flexible housing having a first end and a second end opposite to the first end, the flexible housing defining a lead lumen forming a continuous passageway through the flexible housing. The lead anchor also includes a compressible retention ring disposed within the flexible housing and around a portion of the lead lumen. The retention ring defines an uncompressed position in which the retention ring has an elongate shape, with a major axis and a minor axis, to hold a portion of a lead received within the lead lumen. The retention ring further defines a compressed position achieved by compressing opposite ends of the major axis of the retention ring to transition the retention ring to a more circular shape that allows the lead to slidingly pass through the retention ring. Upon release of the compression, the retention ring returns to the uncompressed position.

Abstract: A non-transitory computer readable medium stores instructions that, when executed by at least one processor, cause the at least one processor to perform a method that includes computing a transfer matrix representing a relative influence that each respective electrode location for measuring electrical potentials on a patient's body has on an estimation of electrical potentials for locations on a surface of interest prior to the measuring of electrical potentials at the respective electrode locations and receiving electrical potential measurements measured via a plurality of electrodes at respective electrode locations on the patient's body. The method also includes computing the estimation of electrical potentials for the locations on the surface of interest based at least in part on the received electrical potential measurements and the computed transfer matrix and generating image data representing the estimation of electrical potentials.

Abstract: Drug eluting implants for targeted delivery of a nerve blocking agent to inhibit neural traffic along renal nerves of a human patient.