Abstract: A device for generating a plurality of output voltages from a single input energy supply source is described. The device includes a switched capacitor voltage converter that provides each of the output voltages having different supply ratios. The supply ratio is defined as a function of the input voltage provided to the switched capacitor voltage converter by the energy supply source. The switched capacitor voltage converter includes a plurality of capacitors selectively coupled to a plurality of switches that dynamically configure the capacitors into a plurality of stacked configurations. Switching between the plurality of stacked configurations may be controlled based on predetermined criteria.

Abstract: Various techniques are described for periodically performing a calibration routine to calibrate a low-power system clock within an implantable medical device (IMD) based on a high accuracy reference clock also included in the IMD. The system clock is powered continuously, and the reference clock is only powered on during the calibration routine. The techniques include determining a clock error of the system clock based on a difference between frequencies of the system clock and the reference clock over a fixed number of clock cycles, and adjusting a trim value of the system clock to compensate for the clock error. Calibrating the system clock with a delta-sigma loop, for example, reduces the clock error over time. This allows accurate adjustment of the system clock to compensate for errors due to trim resolution, circuit noise and temperature.

Abstract: Techniques and systems for monitoring cardiac arrhythmias and delivering electrical stimulation therapy using a subcutaneous implantable cardioverter defibrillator (SICD) and a leadless pacing device (LPD) are described. For example, the SICD may detect a tachyarrhythmia within a first electrical signal from a heart and determine, based on the tachyarrhythmia, to deliver anti-tachyarrhythmia shock therapy to the patient to treat the detected arrhythmia. The LPD may receive communication from the SICD requesting the LPD deliver anti-tachycardia pacing to the heart and determine, based on a second electrical signal from the heart sensed by the LPD, whether to deliver anti-tachycardia pacing (ATP) to the heart. In this manner, the SICD and LPD may communicate to coordinate ATP and/or cardioversion/defibrillation therapy. In another example, the LPD may be configured to deliver post-shock pacing after detecting delivery of anti-tachyarrhythmia shock therapy.

Abstract: A method and apparatus for determining estimated remaining longevity for an implantable stimulator. The device employs pre-calculated numbers of days for various combinations conditions of device usage parameters to determine remaining device longevity based upon identified actual conditions of device usage and employs the determined longevity to change longevity indicator states in the device. While between longevity state changes, the device the identified conditions of device usage and adjusts the determined longevity if the conditions of use change significantly. The indicator states may correspond to one or more of Recommended Replacement Time (RRT), Elective Replacement Indicator (ERI) or End of Service (EOS).

Abstract: The present invention provides an implantable medical device having at least two electrodes coupled to the device housing. The electrodes may be configured for sensing physiological signals such as cardiac signals and alternatively for providing an electrical stimulation therapy such as a pacing or defibrillation therapy. In accordance with aspects of the disclosure, the device housing provides a hermetic enclosure that includes a first housing section that is hermetically coupled to a second housing section. At least one of the at least two electrodes is coupled to an exterior surface of the first housing section that encloses the battery components of the device. The first housing section is electrically insulated from the cathode and anode of the battery.

Abstract: A device for generating a plurality of output voltages from a single input energy supply source is described. The device includes a switched capacitor voltage converter that provides each of the output voltages having different supply ratios. The supply ratio is defined as a function of the input voltage provided to the switched capacitor voltage converter by the energy supply source. The switched capacitor voltage converter includes a plurality of capacitors selectively coupled to a plurality of switches that dynamically configure the capacitors into a plurality of stacked configurations. Switching between the plurality of stacked configurations may be controlled based on predetermined criteria.

Abstract: The present invention provides an implantable medical device having at least two electrodes coupled to the device housing. The electrodes may be configured for sensing physiological signals such as cardiac signals and alternatively for providing an electrical stimulation therapy such as a pacing or defibrillation therapy. In accordance with aspects of the disclosure, the device housing provides a hermetic enclosure that includes a first housing section that is hermetically coupled to a second housing section. At least one of the at least two electrodes is coupled to an exterior surface of the first housing section that encloses the battery components of the device. The first housing section is electrically insulated from the cathode and anode of the battery.

Abstract: A method of generating at least one recommended replacement time signal for a battery is provided. The method includes measuring a plurality of associated unloaded and loaded battery voltages. A delta voltage for each associated unloaded and loaded battery voltage is then determined. A select number of delta voltages are averaged. A minimum delta voltage is determined from a plurality of the averaged delta voltages. At least one recommended replacement time signal for the battery is generated with the use of the minimum delta voltage when at least one averaged delta voltage is detected that has at least reached a replacement threshold.

Abstract: The present invention provides an implantable medical device having at least two electrodes coupled to the device housing. The electrodes may be configured for sensing physiological signals such as cardiac signals and alternatively for providing an electrical stimulation therapy such as a pacing or defibrillation therapy. In accordance with aspects of the disclosure, the device housing provides a hermetic enclosure that includes a battery case hermetically coupled to a circuit assembly case. At least one of the at least two electrodes is coupled to an exterior surface of the battery case. The battery case is electrically insulated from the cathode and anode of the battery.

Abstract: Various techniques are described for periodically performing a calibration routine to calibrate a low-power system clock within an implantable medical device (IMD) based on a high accuracy reference clock also included in the IMD. The system clock is powered continuously, and the reference clock is only powered on during the calibration routine. The techniques include determining a clock error of the system clock based on a difference between frequencies of the system clock and the reference clock over a fixed number of clock cycles, and adjusting a trim value of the system clock to compensate for the clock error. Calibrating the system clock with a delta-sigma loop, for example, reduces the clock error over time. This allows accurate adjustment of the system clock to compensate for errors due to trim resolution, circuit noise and temperature.

Abstract: A device for generating a plurality of output voltages from a single input energy supply source is described. The device includes a switched capacitor voltage converter that provides each of the output voltages having different supply ratios. The supply ratio is defined as a function of the input voltage provided to the switched capacitor voltage converter by the energy supply source. The switched capacitor voltage converter includes a plurality of capacitors selectively coupled to a plurality of switches that dynamically configure the capacitors into a plurality of stacked configurations. Switching between the plurality of stacked configurations may be controlled based on predetermined criteria.

Abstract: Techniques are disclosed for generating a plurality of output voltages from a single input power source. The techniques include implementing a switched capacitor voltage converter to provide at least two output voltages having different supply ratios. The supply ratio is defined as a function of the input voltage provided to the switched capacitor voltage converter by the power source. The switched capacitor voltage converter includes a plurality of capacitors selectively coupled to a plurality of switches to define at least a first and a second mode with each of the modes having a plurality of configurations. In accordance with aspects of the disclosure, the techniques include coupling the plurality of capacitors to define the first or second mode based on predetermined criteria.

Abstract: Apparatus and methods configured to perform power regulation for an implantable device are presented. In an aspect, an implantable device can include a substrate that forms at least part of a body of the implantable device and a circuit disposed on or within the substrate. The circuit can include a high load power regulator configured to provide a first current level to components of the implantable device and a low load power regulator configured to provide a second current level to components of the implantable device, wherein the second current level is lower that the first current level. The circuit can also include a regulator switch configured to enable or disable current draw from the high load power regulator and the low load power regulator as a function of power state and associated power requirement of the components of the implantable device.

Abstract: Various techniques are described for periodically performing a calibration routine to calibrate a low-power system clock within an implantable medical device (IMD) based on a high accuracy reference clock also included in the IMD. The system clock is powered continuously, and the reference clock is only powered on during the calibration routine. The techniques include determining a clock error of the system clock based on a difference between frequencies of the system clock and the reference clock over a fixed number of clock cycles, and adjusting a trim value of the system clock to compensate for the clock error. Calibrating the system clock with a delta-sigma loop, for example, reduces the clock error over time. This allows accurate adjustment of the system clock to compensate for errors due to trim resolution, circuit noise and temperature.

Abstract: A medical device communication system includes a receiver adapted to receive radio frequency (RF) signals and configured to operate in a first mode to poll for an RF signal for a first time interval to detect an element of a valid input signal during the first time interval. In response to detecting the element of a valid input signal in the first time interval, the receiver operates in a second mode to poll for the RF signal for a second time interval to analyze the RF signal over the second time interval to detect a valid modulation of the RF signal. In response to detecting a valid modulation of the RF signal during the second time interval, the receiver is enabled to establish a communication session with a transmitting device.

Abstract: Techniques and systems for monitoring cardiac arrhythmias and delivering electrical stimulation therapy using a subcutaneous implantable cardioverter defibrillator (SICD) and a leadless pacing device (LPD) are described. For example, the SICD may detect a tachyarrhythmia within a first electrical signal from a heart and determine, based on the tachyarrhythmia, to deliver anti-tachyarrhythmia shock therapy to the patient to treat the detected arrhythmia. The LPD may receive communication from the SICD requesting the LPD deliver anti-tachycardia pacing to the heart and determine, based on a second electrical signal from the heart sensed by the LPD, whether to deliver anti-tachycardia pacing (ATP) to the heart. In this manner, the SICD and LPD may communicate to coordinate ATP and/or cardioversion/defibrillation therapy. In another example, the LPD may be configured to deliver post-shock pacing after detecting delivery of anti-tachyarrhythmia shock therapy.

Abstract: Electrical crosstalk between two implantable medical devices or two different therapy modules of a common implantable medical device may be evaluated, and, in some examples, mitigated. In some examples, one of the implantable medical devices or therapy modules delivers electrical stimulation to a nonmyocardial tissue site or a nonvascular cardiac tissue site, and the other implantable medical device or therapy module delivers cardiac rhythm management therapy to a heart of the patient.

Abstract: An implantable medical sensor system provides signals representative of a magnitude of moment fraction applied to a sensor module at a selected site. A sensor module includes a first transducer producing a first signal having an associated first response to pressure and strain applied to the sensor module and a second transducer producing a second signal having an associated second response to pressure and strain applied to the sensor module. A moment fraction is computed in response to the first signal and the second signal. In various embodiments, the moment fraction is used to guide positioning of the sensor module, indicate a need for repositioning the sensor module, report loading of the sensor module during normal operation for use as sensor design information and in setting sensor calibration ranges.

Abstract: A medical device communication system includes a receiver adapted to receive radio frequency (RF) signals and configured to operate in a first mode to poll for an RF signal for a first time interval to detect an element of a valid input signal during the first time interval. In response to detecting the element of a valid input signal in the first time interval, the receiver operates in a second mode to poll for the RF signal for a second time interval to analyze the RF signal over the second time interval to detect a valid modulation of the RF signal. In response to detecting a valid modulation of the RF signal during the second time interval, the receiver is enabled to establish a communication session with a transmitting device.

Abstract: Electrical crosstalk between two implantable medical devices or two different therapy modules of a common implantable medical device may be evaluated, and, in some examples, mitigated. In some examples, one of the implantable medical devices or therapy modules delivers electrical stimulation to a nonmyocardial tissue site or a nonvascular cardiac tissue site, and the other implantable medical device or therapy module delivers cardiac rhythm management therapy to a heart of the patient.