Abstract: An implantable medical device (IMD) includes a housing that is configured to be positioned at least in part in a chamber of a heart, and in some cases, in a right ventricle (RV) proximate an RV facing side of the ventricular septum of the heart. When so provided, an RV electrode may be fixed relative to the housing to be proximate the RV facing side of the ventricular septum. An LV electrode may be spaced a distance from the RV electrode and the housing such that the LV electrode is positioned at least partially within the ventricular septum. An LV electrode position adjustment assembly may be used to adjust the depth at which the LV electrode is positioned within the ventricular septum.

Abstract: A device configured to deliver and deploy an implantable medical device (IMD) includes a handle assembly and a shaft extending distally therefrom. A device containment housing configured to accommodate the IMD is coupled to the distal region of the shaft. At least one of the shaft and device containment housing includes a compressible region that is configured to compress by an amount that is related to an applied force. The device may include a first position indicator and a second position indicator. An applied force causes the compressible region to compress by an amount that is related to the applied force, causing a change in distance between the first position indicator and the second position indicator and thus providing an indication of the applied force.

Abstract: Systems and methods for cardiac pacing are described in this document. A medical system includes an electrostimulation circuit to generate His-bundle pacing (HBP) pulses to capture a His bundle, and LV pacing (LVP) pulses to capture a left ventricle. A sensing circuit may sense a cardiac activity, such as an atrial or an LV cardiac electrical activity. The system includes a control circuit controlling the delivery of HBP and LVP pulses. The HBP and LVP may be delivered concurrently or sequentially. In an example, the LVP pulses may be delivered based on a His-bundle capture status in response to the HBP pulse. The system may adjust one or more His-bundle stimulation parameters based on the His-bundle capture status.

Abstract: A ventricular implantable medical device that is configured to detect an atrial timing fiducial from the ventricle. The ventricular implantable medical is configured to deliver a ventricular pacing therapy to the ventricle based on the detected atrial timing fiducial. If the ventricular implantable medical device temporarily fails to detect atrial activity because of noise, posture, patient activity or for any other reason, an atrial implantable medical device may be configured to communicate atrial events to the ventricular implantable medical device and the ventricular implantable medical device may synchronize the ventricular pacing therapy with the atrium activity based on those communications.

Abstract: A leadless pacing device may include a housing having a proximal end and a distal end, and a set of one or more electrodes supported by the housing. The housing may include a first a distal extension extending distally from the distal end thereof. One or more electrodes may be supported by the distal extension. The leadless pacing device may be releasably coupled to an expandable anchor mechanism.

Abstract: A leadless pacing device may include a housing having a proximal end and a distal end, and a set of one or more electrodes supported by the housing. The housing may include a first a distal extension extending distally from the distal end thereof. The distal extension may include a retractable and/or rotatable distal electrode. The distal electrode may be configured to be delivered to and pace at the Bundle of His. The leadless pacing device may be releasably coupled to an expandable anchor mechanism.

Abstract: A medical device system has a medical device interface configured to download data from an implanted medical device. Memory stores electrode location identification rules and display definitions. Each of the display definitions correspond to possible electrode placement locations of the implanted medical device. Processing circuitry is configured to compare the downloaded data from the implanted medical device to the electrode location identification rules to identify one or more actual electrode placement locations of the possible electrode placement locations of the implanted medical device. A user output interface is in communication with the processing circuitry. The processing circuitry is configured to cause the output to display the one or more actual electrode placement locations.

Abstract: A ventricularly implantable medical device that includes a sensing module that is configured to detect an artifact during ventricular filling and to identify an atrial event based at least on part on the detected artifact. Control circuitry of the implantable medical device is configured to deliver a ventricular pacing therapy to a patient's heart, wherein the ventricular pacing therapy is time dependent, at least in part, on the identified atrial event.

Abstract: A ventricularly implantable medical device that includes a sensing module that is configured to identify a search window of time within a cardiac cycle to search for an atrial artifact. Control circuitry in the ventricular implantable medical device is configured to deliver a ventricular pacing therapy to a patient's heart, wherein the ventricular pacing therapy is time dependent, at least in part, on an atrial event identified in the search window of time.

Abstract: A ventricularly implantable medical device that includes a sensing module that is configured to detect an atrial fiducial and identify an atrial contraction based at least on part on the detected atrial fiducial. Control circuitry in the implantable medical device is configured to deliver a ventricular pacing therapy to a patient's heart based at least in part on the identified atrial contraction, and can automatically switch or revert the ventricular pacing therapies on the fly.

Abstract: A ventricularly implantable medical device that includes a sensing module that is configured to gather information during a cardiac cycle and to identify a cardiac interval based at least on part on the gathered information. Control circuitry in the implantable medical device is configured to deliver a ventricular pacing therapy to a patient's heart, wherein the ventricular pacing therapy is time dependent, at least in part, on the identified cardiac interval.

Abstract: A leadless cardiac pacemaker (LCP) that is configured for atrial placement may include a housing, two or more electrodes and a controller that is disposed within the housing and that is operably coupled to the two or more electrodes. The controller may be configured to sense activation of the atrium of the patient's heart via two or more of the electrodes and to deliver pacing therapy via two or more of the electrodes to a ventricle of the patient's heart by pacing the bundle of His in the patient's atrioventricular septum.

Abstract: Systems and methods for pacing cardiac conductive tissue are described. A medical system includes electrostimulation circuit that may generate His-bundle pacing (HBP) pulses for delivery at or near the His bundle. A capture verification circuit may detect, from a far-field signal representing ventricular response to the HBP pulses, a His-bundle response representative of excitation of the His bundle directly resulting from the HBP pulses, and a myocardial response representative of excitation of the myocardium directly resulting from the HBP pulses. A control circuit may adjust one or more stimulation parameters based on the His-bundle response and myocardial response. The electrostimulation circuit may generate and deliver the HBP pulses according to the adjusted stimulation parameters to excite the His bundle.

Abstract: Systems and methods for pacing cardiac conductive tissue are described. A medical system includes an electrostimulation circuit to generate His-bundle pacing (HBP) pulses for delivery at or near a His bundle of the heart. A control circuit may time the delivery of the HBP pulses within a tissue refractory period subsequent to an intrinsic His-bundle activation of a first His-bundle portion. Based on an evoked His-bundle activation of a second His-bundle portion, the system may determine whether correction of intra-Hisian block has occurred. The system additionally includes a threshold test circuit to determine an individualized pacing threshold representing minimal energy to excite the His bundle and to correct the cardiac conduction abnormality.

Abstract: Systems and methods for pacing cardiac conductive tissue are described. A medical system includes an electrostimulation circuit that may generate His-bundle pacing (HBP) pulses for delivery at or near the His bundle. In response to the delivery of the HBP pulse, the system senses a near-field cardiac activity representative of excitation of a para-Hisian myocardial tissue, and a far-field cardiac activity representative of excitation of the His bundle and a ventricle. The system classifies a tissue response to HBP into one of a plurality of capture types based on the sensed near-field and far-field cardiac activities. The system includes a control circuit to adjust one or more stimulation parameters based on the classified capture type. The electrostimulation circuit generates and delivers the HBP pulses according to the adjusted stimulation parameters to excite the His bundle.

Abstract: An endoprosthesis includes a stent having an inner surface defining a lumen and an outer surface; and a polymeric cover on the outer surface of the stent. The polymeric cover includes a base and adhesion elements. When the endoprosthesis is expanded to the expanded state in a lumen defined by a vessel wall, the adhesion elements create an interlock between the vessel wall and the endoprosthesis.

Abstract: Systems, methods, and devices for determining occurrences of a tamponade condition are disclosed. One exemplary method includes monitoring an accelerometer signal of a leadless cardiac pacemaker attached to a heart wall, determining if a tamponade condition of the patient's heart is indicated based at least in part on the monitored accelerometer signal, and in response to determining that the tamponade condition is indicated, providing a notification of the tamponade condition for use by a physician to take corrective action.

Abstract: Systems, devices, and methods for determining occurrences of myocardial infarctions are disclosed. In one embodiment, a method of sensing for an occurrence of a myocardial infarction may include sensing a baseline accelerometer signal during a baseline, determining a baseline template based on one or more characteristics of the baseline accelerometer signal, and storing the baseline template in a memory. The method may further include sensing an accelerometer signal during a test period subsequent to the baseline, determining a test template based on one or more characteristics of the accelerometer signal during the test period, and comparing the baseline template with the test template, and based on the comparison, determining if a myocardial infarction occurred in the patient's heart. If it is determined that a myocardial infarction occurred in the patient's heart, the method may further include displaying an indication on a display that a myocardial infarction occurred.

Abstract: Systems, methods, and devices for detecting dislodgment of an implantable device are disclosed. In one example, a method for determining a dislodgement status may comprise collecting, by the implantable device operating in a first operating mode, a first number of accelerometer signal samples during a cardiac cycle of the heart and using the first number of accelerometer signal samples to determine a first patient parameter and collecting, by the implantable device operating in a second operating mode, a second number of accelerometer signal samples during a cardiac cycle of the heart and using the second number of accelerometer signal samples to determine a dislodgment status of the implantable device, wherein the first number is smaller than the second number. In some further embodiments, the method may further include providing a notification of the dislodgment status to a remote device that is remote from the implantable medical device.

Abstract: An implantable pacing device for delivering ventricular pacing may be configured to intermittently and variably reduce the AV delay interval used in an atrial triggered pacing mode in a manner that simulates exercise. The device may be programmed to intermittently switch to and from a variably shortened AV delay mode according to defined entry and exit conditions.