Abstract: An implantable medical device (IMD) may include a housing having a proximal end and a distal end and a set of one or more electrodes connected to but spaced apart from the housing. The IMD may further include a controller disposed within the housing, wherein the controller is configured to sense cardiac electrical signals, and deliver electrical stimulation pulses via the first set of one or more electrodes. In some embodiments, a first portion of the housing is configured to be disposed at least partly within a coronary sinus of a patient's heart and a second portion of the housing is configured to be disposed at least partly within a right atrium of the patient's heart.

Abstract: A subcutaneous implantable cardioverter-defibrillator (S-ICD) comprising shocking electrodes configured to reduce the defibrillation threshold. The S-ICD may include a canister housing a source of electrical energy, a capacitor, and operational circuitry that senses heart rhythms and an electrode and lead assembly. The electrode and lead assembly may comprise a lead, at least one sensing electrode, and at least one shocking electrode. The at least one shocking electrode may extend over a length in the range of 50 to 110 millimeters and a width in the range of 1 to 40 millimeters.

Abstract: Systems and methods for treating cardiac arrhythmias are disclosed. In one embodiment, an SICD comprises two or more electrodes, a charge storage device, and a controller operatively coupled to two or more of the electrodes and the charge storage device. In some embodiments, the controller is configured to monitor cardiac activity of the heart of the patient, detect an occurrence of a cardiac arrhythmia based on the cardiac activity, and determine a type of the detected cardiac arrhythmia from two or more types of cardiac arrhythmias. If the determined type of cardiac arrhythmia is one of a first set of cardiac arrhythmia types, the controller sends an instruction for reception by an LCP to initiate the application of ATP therapy by the LCP. If the determined type of cardiac arrhythmia is not one of the first set cardiac arrhythmia types, the controller does not send the instruction.

Abstract: Methods and devices for testing and configuring implantable medical device systems. A first medical device and a second medical device communicate with one another using test signals configured to provide data related to the quality of the communication signal to facilitate optimization of the communication approach. Some methods may be performed during surgery to implant one of the medical devices to ensure adequate communication availability.

Abstract: Systems and methods for treating cardiac arrhythmias are disclosed. In one embodiment, an SICD comprises two or more electrodes, a charge storage device, and a controller operatively coupled to two or more of the electrodes and the charge storage device. In some embodiments, the controller is configured to monitor cardiac activity of the heart of the patient, detect an occurrence of a cardiac arrhythmia based on the cardiac activity, and determine a type of the detected cardiac arrhythmia from two or more types of cardiac arrhythmias. If the determined type of cardiac arrhythmia is one of a first set of cardiac arrhythmia types, the controller sends an instruction for reception by an LCP to initiate the application of ATP therapy by the LCP. If the determined type of cardiac arrhythmia is not one of the first set cardiac arrhythmia types, the controller does not send the instruction.

Abstract: Methods and devices for testing and configuring implantable medical device systems. A first medical device and a second medical device communicate with one another using test signals configured to provide data related to the quality of the communication signal to facilitate optimization of the communication approach. Some methods may be performed during surgery to implant one of the medical devices to ensure adequate communication availability.

Abstract: Systems and methods for managing communication strategies between implanted medical devices. Methods include temporal optimization relative to one or more identified conditions in the body. A selected characteristic, such as a signal representative or linked to a biological function, is assessed to determine its likely impact on communication capabilities, and one or more communication strategies may be developed to optimize intra-body communication.

Abstract: Systems and methods for managing communication strategies between implanted medical devices. Methods include temporal optimization relative to one or more identified conditions in the body. A selected characteristic, such as a signal representative or linked to a biological function, is assessed to determine its likely impact on communication capabilities, and one or more communication strategies may be developed to optimize intra-body communication.

Abstract: Delivery devices, systems, and methods for delivering implantable leadless pacing devices are disclosed. An example delivery device may include a tubular member and a distal holding section extending distally of a distal end of the tubular member and defining a cavity therein for receiving an implantable leadless pacing device. The delivery device may facilitate vascular delivery of the pacing device to a left side of a patient's heart. In one example, a distal tip portion may extend distal of the distal holding section and may be actuated between a closed and an opened position. When in the closed position, the distal tip portion may have a tip that can puncture or engage an opening in a septum between a left atrium and a right atrium of a patient's heart. Actuating the distal tip portion to an opened position may be utilized to dilate the puncture or opening in the septum.

Abstract: Catheter and implantable leadless pacing devices, systems, and methods utilizing catheters and implantable leadless pacing devices are disclosed. An example catheter system may include a holding structure extending distally from a tubular member. An implantable device, such as a leadless pacing device, may be located within a cavity of the holding structure. The holding structure may include one or more electrical ports adjacent the proximal end of the holding structure and adjacent or proximal of the proximal end of the implantable device. The electrical ports may provide a conductive pathway extending through the distal structure to allow electrical signals to pass through the distal structure to and/or from the implantable device.

Abstract: Systems, methods and implantable devices configured to provide cardiac resynchronization therapy and/or bradycardia pacing therapy. A first device located in the heart of the patient is configured to receive a communication from a second device and deliver a pacing therapy in response to or in accordance with the received communication. A second device located elsewhere is configured to determine an atrial event has occurred and communicate to the first device to trigger the pacing therapy. The second device may be configured for sensing the atrial event by the use of vector selection and atrial event windowing, among other enhancements. Exception cases are discussed and handled as well.

Abstract: A subcutaneous implantable cardioverter-defibrillator (S-ICD) comprising shocking electrodes configured to reduce the defibrillation threshold. The S-ICD may include a canister housing a source of electrical energy, a capacitor, and operational circuitry that senses heart rhythms and an electrode and lead assembly. The electrode and lead assembly may comprise a lead, at least one sensing electrode, and at least one shocking electrode. The at least one shocking electrode may extend over a length in the range of 50 to 110 millimeters and a width in the range of 1 to 40 millimeters.

Abstract: Tunneling tools and systems comprising electrodes and tunneling tool. In some examples the tunneling tools have a width that is greater than thickness, or may have enlarged portions to allow tunneling of a space. The tunneling tools may have expandable dissection portions including expandable balloons, linkages and/or springs in different examples. Systems may include tunneling tools with a lumen for receiving a lead having an electrode in a collapsed configuration, where the electrode is designed to expand once placed in a patient, with the tunneling tool designed to create a space in which the electrode can expand.

Abstract: An implantable medical device (IMD) may include a housing having a proximal end and a distal end and a set of one or more electrodes connected to but spaced apart from the housing. The IMD may further include a controller disposed within the housing, wherein the controller is configured to sense cardiac electrical signals, and deliver electrical stimulation pulses via the first set of one or more electrodes. In some embodiments, a first portion of the housing is configured to be disposed at least partly within a coronary sinus of a patient's heart and a second portion of the housing is configured to be disposed at least partly within a right atrium of the patient's heart.

Abstract: Systems and methods for treating cardiac arrhythmias are disclosed. In one embodiment, an SICD comprises two or more electrodes, a charge storage device, and a controller operatively coupled to two or more of the electrodes and the charge storage device. In some embodiments, the controller is configured to monitor cardiac activity of the heart of the patient, detect an occurrence of a cardiac arrhythmia based on the cardiac activity, and determine a type of the detected cardiac arrhythmia from two or more types of cardiac arrhythmias. If the determined type of cardiac arrhythmia is one of a first set of cardiac arrhythmia types, the controller sends an instruction for reception by an LCP to initiate the application of ATP therapy by the LCP. If the determined type of cardiac arrhythmia is not one of the first set cardiac arrhythmia types, the controller does not send the instruction.

Abstract: Medical device systems and methods with multiple communication modes. An example medical device system may include a first medical device and a second medical device communicatively coupled to the first medical device. The first medical device may be configured to communicate information to the second medical device in a first communication mode. The first medical device may further be configured to communicate information to the second medical device in a second communication mode after determining that one or more of the communication pulses captured the heart of the patient.

Abstract: An implantable medical device (IMD) may include a housing having a proximal end and a distal end and a set of one or more electrodes connected to but spaced apart from the housing. The IMD may further include a controller disposed within the housing, wherein the controller is configured to sense cardiac electrical signals, and deliver electrical stimulation pulses via the first set of one or more electrodes. In some embodiments, a first portion of the housing is configured to be disposed at least partly within a coronary sinus of a patient's heart and a second portion of the housing is configured to be disposed at least partly within a right atrium of the patient's heart.

Abstract: Systems and methods for treating cardiac arrhythmias are disclosed. In one embodiment, an SICD comprises two or more electrodes, a charge storage device, and a controller operatively coupled to two or more of the electrodes and the charge storage device. In some embodiments, the controller is configured to monitor cardiac activity of the heart of the patient, detect an occurrence of a cardiac arrhythmia based on the cardiac activity, and determine a type of the detected cardiac arrhythmia from two or more types of cardiac arrhythmias. If the determined type of cardiac arrhythmia is one of a first set of cardiac arrhythmia types, the controller sends an instruction for reception by an LCP to initiate the application of ATP therapy by the LCP. If the determined type of cardiac arrhythmia is not one of the first set cardiac arrhythmia types, the controller does not send the instruction.

Abstract: Medical device systems and methods with multiple communication modes. An example medical device system may include a first medical device and a second medical device communicatively coupled to the first medical device. The first medical device may be configured to communicate information to the second medical device in a first communication mode. The first medical device may further be configured to communicate information to the second medical device in a second communication mode after determining that one or more of the communication pulses captured the heart of the patient.

Abstract: Medical device systems and methods with multiple communication modes. An example medical device system may include a first medical device and a second medical device communicatively coupled to the first medical device. The first medical device may be configured to communicate information to the second medical device in a first communication mode. The first medical device may further be configured to communicate information to the second medical device in a second communication mode after determining that one or more of the communication pulses captured the heart of the patient.