Abstract: Medical devices and methods for making and using medical devices are disclosed. An example medical device may include an implantable medical device. The implantable medical device may include an implantable pacing member having a housing and a lead input. A lead may be coupled to the lead input. The lead may be designed to extend along a pericardial space, epicardium, or both and engage a heart chamber. A passageway may be defined along a portion of the length of the lead.

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 devices and methods for making and using medical devices are disclosed. An example medical device may include an implantable medical device. The implantable medical device may include an implantable pacing member having a housing and a lead input. A lead may be coupled to the lead input. The lead may be designed to extend along a pericardial space, epicardium, or both and engage a heart chamber. A passageway may be defined along a portion of the length of the lead.

Abstract: A system for sensing electrical cardiac activity and for providing therapy to a patient's heart. The system may include a first implantable device implanted within a patient and a second implantable device implanted near or within the heart of the patient. In some cases, the first implantable device may at least partially power the second implantable device by periodically recharging a rechargeable battery or other power source within the second implantable device. In some cases, the first implantable device may at least partially power the second implantable device by periodically, intermittently or continuously transmitting energy that may be stored by a battery, capacitor or other power storage device within the second implantable device.

Abstract: Methods and systems for use of the Q-wave to R-wave interval to guide placement of a leadless cardiac pacemaker are disclosed. An implant delivery device is equipped with sensing electrodes to sense R-wave onset in a ventricle of a patient's heart to allow placement at a location of last or latest onset of the R-wave. Guidance tools are provided to assist in determination of the Q-wave to R-wave interval during implantation. For a chronic system, a cooperative approach is disclosed in which an implantable medical device and a leadless cardiac pacemaker exchange data to determine Q-wave to R-wave intervals and enhance cardiac resynchronization therapy delivery by the leadless cardiac pacemaker.

Abstract: IMD devices and treatment methods are discussed and disclosed. An IMD having a lead adapted for placement in an internal thoracic vein (ITV) of a patient may be employed to facilitate atrial sensing. Devices may be used to communicate with one another, such communication configured to allow pacing therapy to a heart of a patient.

Abstract: An implantable leadless pacing device and delivery system may comprise an implantable leadless pacing device and a catheter configured to deliver the implantable leadless packing device to a target location. The implantable device may comprise a power source, circuitry operatively coupled to the power source, a housing at least partially enclosing the circuitry, a first electrode secured relative to and offset from a longitudinal axis of the housing and exposed exterior to the housing, and a fixation mechanism secured relative to the housing. The fixation mechanism may comprise at least one tine configured to move between an elongated delivery configuration and a curved deployed configuration and radially offset from the first electrode. The catheter may comprise a distal holding section defining a cavity configured to receive the implantable leadless pacing device.

Abstract: Implantable medical devices (IMD), such as but not limited to leadless cardiac pacemakers (LCP), subcutaneous implantable cardioverter defibrillators (SICD), transvenous implantable cardioverter defibrillators, neuro-stimulators (NS), implantable monitors (IM), may be configured to communicate with each other. In some cases, a first IMD may transmit instructions to a second IMD. In order to improve the chances of a successfully received transmission, the first IMD may transmit the instructions several times during a particular time frame, such as during a single heartbeat. If the second IMD receives the message more than once, the second IMD recognizes that the messages were redundant and acts accordingly.

Abstract: Methods and systems in which a first medical device provides patient status details to a second medical device. Patient status details may include one or more of patient posture and/or patient activity level, or other indications of patient status. The second medical device, in response to information about patient status and changes in patient status, uses a sensing configuration management function to respond to and accommodate the change in patient status. In an example, a first medical device monitors patient posture and communicates information related to patient posture to a second medical device, which then tailors sensing configurations to the patient posture.

Abstract: Implantable medical devices (IMD), such as but not limited to leadless cardiac pacemakers (LCP), neuro-stimulators (NS), and/or implantable monitors (IM), may be configured to communicate using more than one mode of communication and/or more than one communication vector. In some cases, the implantable medical device may be configured to switch between communication modes, vectors, and/or communication paths, which may help improve communication reliability and/or communication speed between devices.

Abstract: Implantable medical device (IMD) such as leadless cardiac pacemakers may include a rechargeable power source. In some cases, the IMD may include a plurality of receiving coils that may capture a non-radiative near-field energy and then convert the near-field energy into electrical energy that may be used to recharge the rechargeable power source. Accordingly, since the rechargeable power source does not have to maintain sufficient energy stores in a single charge for the entire expected life of the IMD, the power source itself and thus the IMD, may be made smaller while still meeting device longevity expectations.

Abstract: An implantable medical device (IMD) with an inductive coil for wireless communication and/or power transfer. The inductive coil may be disposed about a housing of the IMD. The housing may include a magnetically permeable material that is configured to operate as a flux concentrator for concentrating non-radiative near-field energy through the inductive coil. In some cases, the near-field energy may be captured and converted into electrical energy that may be used to recharge a rechargeable power source of the IMD.

Abstract: Near-field energy transmitters for charging a rechargeable power source of an implantable medical device (IMD). In some cases, the transmitter may include an output driver that may drive a transmit coil such that near-field energy is transmitted to the IMD at a determined frequency. In some cases, the IMD may include a receiving coil that may capture the near-field energy and then convert the near-field energy into electrical energy that may be used to recharge the rechargeable power source. Since the rechargeable power source does not have to maintain sufficient energy stores in a single charge for the entire expected life of the IMD, the power source itself and thus the IMD may be made smaller while still meeting device longevity requirements.

Abstract: An implantable medical device (IMD) may be deployed within a patient's right atrium at a location near a right atrial appendage of the patient's heart in order to pace the patient's heart and/or to sense electrical activity within the patient's heart. In some cases, an IMD may be implanted within the right atrial appendage. The IMD may include an expandable anchoring mechanism configured to secure the IMD in place.

Abstract: A delivery and deployment device may include a handle assembly and a shaft extending distally from the handle assembly. A device containment housing may be coupled to a distal region of the shaft and may extend distally therefrom. The distal containment housing may be configured to accommodate at least a portion of the IMD therein. The IMD may, for example, be a leadless pacemaker, a lead, a neurostimulation device, a sensor or any other suitable IMD. A plurality of electrodes may be distributed about an exterior surface of the device containment housing such that at least some of the plurality of electrodes may be positioned to test a potential IMD deployment location before deploying the IMD.

Abstract: An implantable medical device (IMD) that includes a housing, a first electrode secured relative to the housing, a second electrode secured relative to the housing, and a gyroscope secured relative to the housing. The IMD may include circuitry in the housing in communication with the first electrode, the second electrode, and the gyroscope. The circuitry may be configured to determine and store a plurality of torsion data measurements, from which a representation of a twist profile may be determined.

Abstract: Methods, systems and devices for providing cardiac resynchronization therapy (CRT) to a patient using a leadless cardiac pacemaker (LCP) and an extracardiac device (ED). The system is configured to identify atrial events to use as timing markers for the LCP to deliver CRT, and further to determine whether the timing markers are incorrectly sensed and to make adjustment or call for re-initialization as needed.

Abstract: An implantable cardiac monitor (ICM) may be configured to be deployed subcutaneous, submuscular, or substernal at a position that enables the ICM to detect cardiac activity. In some cases, the ICM includes a housing that includes a body portion and a tail portion. A first electrode may be disposed adjacent a first end of the body portion, a second electrode may be disposed adjacent a second end of the body portion and a third electrode may be disposed adjacent a tail end of the tail portion. A controller may be disposed within the housing and may be operably coupled to the first electrode, the second electrode and the third electrode. The controller may be configured to select a pair of the first electrode, the second electrode and the third electrode to use for sensing cardiac electrical activity and to communicate information about the sensed activity to a second medical device.

Abstract: Systems and methods for monitoring patients with cardiac diseases are described. A system may include an accelerometer sensor for sensing an epicardial or endocardial acceleration (EA) signal. The accelerometer may be included in a leadless or a lead-based medical device. The system may additionally include a companion device in communication with the medical device via a wireless communication link. The companion device may sense a cardiac signal such as a heart sound signal, and may use the cardiac signal and the EA signal transmitted from the medical device to generate a diastolic function indicator indicating the diastolic function of the heart. The system may provide the diastolic function indicator to a user or a process, or to detect worsening of heart failure based on the diastolic function indicator.

Abstract: Systems and methods for conducted communication are described. In one embodiment, a method of communicating with a medical device implanted within a patient comprises receiving, at a medical device via electrodes connected to the patient, a conducted communication signal, wherein the conducted communication signal comprises a signal component and a noise component. The method may further comprise adjusting, by the medical device, a receive threshold based at least in part on an amplitude of the received conducted communication signal so as to reduce an amplitude of the noise component of the conducted communication signal.