Abstract: Disclosed herein are methods of delivering current to a target tissue using a medical instrument, wherein the medical instrument is configured to track and deliver a predetermined current time amount. Also disclosed herein are methods and a system of monitoring for usage of a hemorrhoid treatment instrument and invoicing for such usage.

Abstract: A connecting element for connecting a blood pump or a cannula to a heart, the connecting element including a sealing element, which is designed to at least temporarily close an opening formed in the cardiac wall and to be opened via insertion of a preferably cylindrical object in the direction of an axis of the opening.

Abstract: Methods and devices are provided utilizing an end effector having three jaws movably coupled thereto for grasping and/or dissecting tissue. In one embodiment, each of the three jaws are movable between an open position in which the distal ends of the three jaws are spaced apart from one another, and a closed position in which the distal ends directly contact one another. The jaws can define an opening therebetween when the jaws are in the closed position.

Abstract: A burr hole plug comprises a plug base configured for being mounted around a burr hole. The plug base includes an aperture through which an elongated medical device exiting the burr hole may pass. The plug base is configured to accommodate a variety of cranium forms without requiring deformation of the plug base. A plug base holding tool is used to secure the plug base to the cranium, wherein the tool aligns fasteners with the plug base for insertion through the plug base and into the cranium. The burr hole plug further comprises a retainer configured for being mounted within the aperture of the plug base to secure the medical device. The retainer includes a clamping mechanism that secures the elongated medical device in the burr hole plug, wherein the movement of the clamping mechanism is controlled to prevent skewing of the clamping mechanism.

Abstract: The present invention is directed toward a detection architecture for use in implantable cardiac rhythm devices. The detection architecture of the present invention provides methods and devices for discriminating between arrhythmias. Moreover, by exploiting the enhanced specificity in the origin of the identified arrhythmia, the detection architecture can better discriminate between rhythms appropriate for device therapy and those that are not.

Abstract: A multi-mode electrosurgical apparatus for use in cold plasma applications, electrosurgical cutting, electrosurgical coagulation and mechanical cutting is provided. The electrosurgical apparatus includes a housing having a passage extending therethrough, an electrically conducting tube being disposed in the passage of the housing; an insulating outer tube disposed around the electrically conducting tube coupled to the housing, the electrically conducting tube being movable along a longitudinal axis of the housing and outer tube; an electrically conducting blade coupled to the distal end of the electrically conducting tube, and a transformer assembly disposed on a proximal end of the housing, the transformer assembly including a first transformer and a first switch for selectively coupling the first transformer and an external second transformer to the electrically conducting tube for providing electrosurgical energy thereto.

Abstract: In a subcutaneous implantable cardioverter/defibrillator, cardiac arrhythmias are detected to determine necessary therapeutic action. Cardiac signal information is sensed from far field electrodes implanted in a patient. The sensed cardiac signal information is then amplified and filtered. Parameters such as rate, QRS pulse width, cardiac QRS slew rate, amplitude and stability measures of these parameters from the filtered cardiac signal information are measured, processed and integrated to determine if the cardioverter/defibrillator needs to initiate therapeutic action.

Abstract: An implantable neurostimulator system for treating movement disorders includes a sensor, a detection subsystem capable of identifying episodes of a movement disorder by analyzing a signal received from the sensor, and a therapy subsystem capable of supplying therapeutic electrical stimulation to treat the movement disorder. The system treats movement disorders by detecting physiological conditions characteristic of an episode of symptoms of the movement disorder and selectively initiating therapy when such conditions are detected.

Abstract: A hermetically sealed filtered feedthrough assembly for an AIMD includes an insulator hermetically sealed to a conductive ferrule or housing. A conductor is hermetically sealed and disposed through the insulator in non-conductive relation to the conductive ferrule or housing between a body fluid side and a device side. A feedthrough capacitor is disposed on the device side. A first low impedance electrical connection is between a first end metallization of the capacitor and the conductor. A second low impedance electrical connection is between a second end metallization of the capacitor and the ferrule or housing. The second low impedance electrical connection includes an oxide-resistant metal addition attached directly to the ferrule or housing and an electrical connection coupling the second end metallization electrically and physically directly to the oxide-resistant metal addition.

Abstract: A method and apparatus are disclosed for treating mitral regurgitation with electrical stimulation. By providing pacing stimulation to a region of the left ventricle in proximity to the mitral valve apparatus in a manner which pre-excites the region during early ventricular systole, a beneficial effect is obtained which can prevent or reduce the extent of mitral regurgitation.

Abstract: A method of treating a metabolic condition in a patient, comprising: determining a target non-immediate effect of a therapy relating to treatment of a metabolic condition; and applying an electric field to an abdominal cavity of the patient in a manner designed to at least approach said target.

Abstract: A processor-based method for use with an active implantable medical device for cardiac pacing, resynchronization, and/or defibrillation includes forming a plurality of first and second endocardial acceleration vectors using a plurality of endocardial acceleration signals acquired using stimulation to cause capture and a spontaneous rhythm of the patient in the absence of ventricular pacing, respectively. An at least two dimension space is created using the first and second endocardial acceleration vectors, including two subspaces corresponding to the presence and absence of capture, respectively. Ventricular capture is tested for after acquiring a new endocardial acceleration signal. The testing includes forming a new endocardial acceleration signal based on the new vector. Presence or absence of capture is determined for the new signal based on the position of the new vector relative to the two subspaces.

Abstract: A method of treating a patient for ventricular tachycardia using a wearable defibrillator includes monitoring the patient for a predetermined condition via one or more electrodes on the defibrillator, sending a message to the patient in response to the predetermined condition, activating the defibrillator so that the defibrillator delivers defibrillation energy to the patient, and storing at least one of the results of the monitoring, sending and activating steps in a memory on the defibrillator. The method also includes downloading information stored in the memory of the defibrillator to a base station having an external interface, and transmitting the information downloaded from the memory of the base station to an external location via the external interface of the base station.

Abstract: Symmetrical and asymmetrical snares are used for endoscopically controlled methods by which tumors in hollow organs of the gastrointestinal tract can be ensnared and RF-surgically removed from the organ wall for diagnostic and/or therapeutic purposes. These snares are characterized in that one of the two snare portions, in the case of asymmetrical snares the longer of the two snare portions, is completely electrically insulated or is made from electrically non-conductive material and that the other of the two snare portions is made from electrically conductive material and its surface is not electrically insulated. In one embodiment, the asymmetrical snare is characterized in that the long snare portion is so much flexurally stiffer than the short snare portion that it tensions the short snare portion like the string of a bow.

Abstract: A system for electrically stimulating a first cochlear implant includes (a) an electrode contact simultaneously transmitting a first electrical stimulus from stimulation hardware to a first ear fitted with the first cochlear implant and a second stimulus from the stimulation hardware to a second ear, the second stimulus being one of electrical and acoustical; (b) a component establishing a plurality of frequency-to-electrode maps used to determine the first electrical stimulus; (c) a user-interface component permitting a user to adjust the frequency-to-electrode maps and receive the corresponding auditory stimulation in the first cochlear implant; (d) a component storing the frequency-to-electrode maps; and (e) a display component displaying a visual representation of multiple frequency-to-electrode maps to facilitate a comparison between the frequency-to-electrode maps in making a determination by a user of a most desired frequency-to-electrode map.

Abstract: A surgical instrument can include a shaft having a proximal end and a distal end, and a wrist coupled to the distal end of the shaft and configured to articulate in multiple degrees of freedom coupled to the distal end of the shaft. The surgical instrument can further include an end effector supported by the wrist, wherein the end effector includes a cutting element and jaws configured to grip tissue and fuse tissue via electrosurgical energy. The surgical instrument can be configured for use with a teleoperated robotic surgical system that can include a patient side console configured to interface to actuate the surgical instrument and a surgeon side console configured to receive inputs from a surgeon to control the actuation of the surgical instrument.

Abstract: An irrigation catheter includes a handle, a catheter sheath with at least one ablation electrode proximal the distal end of the catheter sheath and a stylet for deflecting the distal end of the catheter sheath. The ablation electrode includes at least one irrigation opening in it. The irrigation catheter further includes a fluid-carrying formation formed on the catheter sheath under the ablation electrode. The fluid-carrying formation is in fluid communication with the irrigation lumen of the catheter sheath so that fluid is conveyed from the irrigation lumen to the irrigation opening.

Abstract: A neurostimulation system includes a neural stimulation lead having a proximal portion and a distal portion and including a plurality of electrodes along the distal portion. The plurality of electrodes are configured for positioning proximate a portion of the autonomic nervous system. A neural stimulation circuit, coupled to the plurality of electrodes, delivers neural stimulation pulses to the plurality of electrodes. A processor and controller is configured to control the neural stimulation circuit to deliver first neural stimulation pulses to each of a plurality of electrode configurations. Each electrode configuration includes one or more of the plurality of electrodes. The processor and controller is further configured to receive information related to motor fiber activity that is induced in response to delivery of the first neural stimulation pulses to each of the plurality of electrode configurations and to identify the electrode configurations that induce the motor fiber activity.

Abstract: A T-wave offset point of an ECG signal is provided. In accordance with various example embodiments, a location of a QRS complex in the ECG signal is identified and used to determine a first time window of the ECG signal in which to search for a T-wave offset point. The T-wave offset point is identified within the first time window, and the identified T-wave offset point is provided as an output based upon a noise characteristic of the ECG signal in a second time window that includes at least a portion of the T-wave.

Abstract: By incorporating magnetic field-inducing position determination coils (PDCs) in an external charger, it is possible to determine the position of an implantable device by actively inducing magnetic fields using the PDCs and sensing the reflected magnetic field from the implant. In one embodiment, the PDCs are driven by an AC power source with a frequency equal to the charging coil. In another embodiment, the PDCs are driven by an AC power source at a frequency different from that of the charging coil. By comparing the relative reflected magnetic field strengths at each of the PDCs, the position of the implant relative to the external charger can be determined. Audio and/or visual feedback can then be communicated to the patient to allow the patient to improve the alignment of the charger.