Abstract: Systems and methods for monitoring and evaluating the function of a prosthetic heart valve (PHV) implanted in a patient are discussed. An exemplary medical-device system can receive heart sounds information including vibrational or acoustic information generated by an implanted PHV, and generate an indicator of function of the PHV using a HS metric of received acceleration information. An alert of PHV dysfunction can be presented to a system user. The PHV function may be monitored during a valve replacement procedure to assist in position adjustment of the prosthetic value, or after the valve replacement procedure to assess patient progress in recovery. According to some embodiments, the system can generate a risk indicator indicating patient natural valve function and a need for heart valve repair or replacement.

Abstract: An implantable medical device (IMD) is configured with a pressure sensor. The IMD includes a housing, a pressure sensor and a fluid filled cavity. The housing has a diaphragm that is exposed to the environment outside of the housing. The pressure sensor has a pressure sensor diaphragm that is responsive to a pressure applied to the pressure sensor diaphragm and provides a pressure sensor output signal that is representative of the pressure applied to the pressure sensor diaphragm. The fluid filled cavity is in fluid communication with both the diaphragm of the housing and the pressure sensor diaphragm of the pressure sensor. The fluid filled cavity is configured to communicate a measure related to the pressure applied by the environment to the diaphragm of the housing to the pressure sensor diaphragm of the pressure sensor.

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 apparatus includes a housing including a bore and a housing groove within the bore and located on an inner surface of the housing; and a coil spring located within the housing and mounted within the housing groove, wherein the housing groove has a non-uniform radius such that the coil spring defines zones of relative low contact force and zones of relative high contact force.

Abstract: An implantable leadless cardiac pacing device and associated delivery and retrieval devices. The implantable device includes a docking member extending from the proximal end of the housing of the implantable device configured to engage with the delivery and/or retrieval device to facilitate delivery and/or retrieval of the implantable leadless cardiac pacing device.

Abstract: Delivery devices, systems, and methods for delivering an implantable leadless pacing device having an outer peripheral surface are disclosed. An example delivery device may include a proximal section including a distal end, and a distal holding section extending distally of a distal end of the proximal section. The distal holding section defines a cavity therein for receiving the implantable leadless pacing device, and may be configured to apply a holding force to the implantable leadless pacing device. In some cases, the distal holding section may be configured to apply a compressive force to the outer peripheral surface of the leadless pacing device when the leadless pacing device is disposed in the cavity.

Abstract: At least one of a first medical device and a second medical device may be implanted within a patient while the second medical device may optionally be proximate but external to the patient. At least one of the medical devices has an antenna having at least two electrodes and at least one of the medical devices has an antenna having at least three electrodes. The medical devices can communicate via conducted communication through the patient's tissue between a first pair of electrodes and a second pair of electrodes. At least one of the pairs of electrodes can be selected in accordance with the signal strength of the communication vector between the first and second pairs of electrodes.

Abstract: Methods and devices for configuring the use of a motion sensor in an implantable cardiac device. The electrical signals of the patient's heart are observed and may be correlated to the physical motion of the heart as detected by the motion sensor of the implantable cardiac device in order to facilitate temporal configuration of motion sensor data collection that avoids detecting cardiac motion in favor of overall motion of the patient.

Abstract: A system may include an input device configured to receive a signal indicative of elevated glucose in a patient, and an electrical stimulator configured to electrically stimulate at least one skeletal muscle. The system may further include a controller operably connected to the electrical stimulator. The controller may be configured for delivering a glucose therapy in response to the signal by controlling the electrical stimulator. The system may be configured to deliver the therapy in combination with other glucose therapies, and the therapy may be titrated based on a sensed parameter or patient feedback.

Abstract: Embodiments of the present disclosure relate to heart sound measurements using mobile devices. In an embodiment, a medical system for monitoring heart sounds of a subject comprises a medical device configured to obtain, during a first sampling interval, a first physiological signal. The medical system further comprises a mobile device comprising an accelerator, wherein the accelerator is configured to obtain, during a second sampling interval, a second physiological signal. And, the medical system comprises an analysis component configured to extract heart sounds data from the second physiological signal.

Abstract: A system for recharging an implantable medical device having a rechargeable battery while the implantable medical device is implanted within a patient includes a recharge energy source configured to be disposed exterior to the patient and a recharging bridge configured to be implanted within the patient. The recharging bridge is configured to facilitate energy transfer from the recharge energy source to the implantable medical device.

Abstract: Cardiac activity of the heart can be sensed using, for example, one or more leadless cardiac pacemakers (LCPs) that are implanted in a close proximity to the heart. Sensing cardiac activity by the one or more leadless cardiac pacemakers (LCPs) can help the system in determining an occurrence of cardiac arrhythmia. For treatment purposes, electrical stimulation therapy, for example anti-tachyarrhythmia pacing (ATP) therapy, can be delivered by at least one of the devices of the system. Such therapy can help treat the detected cardiac arrhythmia. In some instances, one of the leadless cardiac pacemakers can instruct one or more of the other devices to assist in providing pacing therapy. In some instances, one of the leadless cardiac pacemakers can instruct one or more of the other devices to temporarily stop providing therapy or to simply shut down while another device provides therapy.

Abstract: A leadless cardiac pacemaker (LCP) is configured to sense cardiac activity and to pace a patient's heart and is disposable within a ventricle of the patient's heart. The LCP may include a housing, a first electrode and a second electrode that are secured relative to the housing and are spaced apart. A controller is disposed within the housing and is operably coupled to the first electrode and the second electrode such that the controller is capable of receiving, via the first electrode and the second electrode, electrical cardiac signals of the heart. The LCP may include a pressure sensor and/or an accelerometer. The controller may determine an atrial contraction timing fiducial based at least in part upon two or more of a signal from the pressure sensor, a signal from the accelerometer representing, and an electrical cardiac signal.

Abstract: This document discusses, among other things, apparatus, systems, or methods to efficiently collect heart sound data, including detecting first heart sound information of a heart of a patient using a heart sound sensor in a first, low-power operational mode, and detecting second heart sound information of the heart using the heart sound sensor in a separate second, high-power operational mode. The operational mode of the heart sound sensor can be controlled using physiologic information from the patient, including heart sound information, information about a heart rate of the patient, or other physiologic information from the patient that indicates worsening heart failure.

Abstract: An implantable medical device (IMD) includes a tap sensor configured to detect an impact event occurring on the surface of the patient's body. The tap sensor is configured to determine whether the impact event (which may be, for example, a tap of a finger or hand upon a surface of the body) likely is a communication directed at the tap sensor. In response to determining that the impact event likely is a communication directed at the tap sensor, the IMD is configured to transition from a first state to a second state.

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: Systems, devices, and methods for monitoring and assessing blood glucose level in a patient are discussed. An exemplary system receives physiologic information from a patient using an ambulatory medical device. The physiologic information is correlated to, and different from, a direct glucose level measurement. The system determines a glucose index indicative of an abnormal blood glucose level using the received physiologic information by the two or more physiologic sensors. The system may use the glucose index to initiate or adjust a therapy, or to trigger a glucose sensor, separate from the two or more physiologic sensors, to directly measure blood glucose concentration.

Abstract: Systems, devices, and methods for pacing a heart of a patient are disclosed. A device may include a leadless cardiac pacemaker (LCP) that includes a power supply, a pair of electrodes, and a controller operably connected to the electrodes and the power supply. The controller may identify a capture threshold by setting a pace amplitude at a power supply voltage of the power supply and deliver pacing stimulation pulses with different pulse widths to identify the capture threshold. The LCP may then deliver pacing stimulation pulses based, at least in part, on a pulse amplitude and pulse width associated with the capture threshold, and also adding a capture margin. In some cases, the pulse amplitude may change over time and the LCP may adjust a pulse width along a strength-duration curve to account for the pulse amplitude change and maintain a capture threshold and capture margin.

Abstract: A medical system includes a physiological monitoring system configured to sense a physiological signal and record physiological signal data indicative of the patient's physiological state. The physiological monitoring system including a controller, a storage device, at least one sensor operatively coupled to the controller, and a first communication component. The system includes a mobile device configured to facilitate sensor placement, the mobile device comprising a controller, a display device, and a second communication component configured to facilitate communication between the physiological monitoring system and the mobile device. The controller of the mobile device is configured to provide a graphical user interface (GUI) on the display device, the GUI including information about a proper placement of the at least one sensor, wherein the proper placement is determined based on the physiological signal data.

Abstract: Embodiments disclosed herein relate to devices and methods for monitoring one or more physiological parameters of a subject. In an embodiment, a wearable device comprises a substrate configured to attached to a subject's skin. The substrate comprises a middle portion arranged between two end portions, wherein the middle portion is more flexible than at least one of the end portions. The wearable device also comprises a physiological sensor arranged on the middle portion. The physiological sensor is configured to sense a physiological signal of the subject when the wearable device is attached to the subject's skin. And, the wearable device comprises one or more electrical components arranged on at least one of the end portions, wherein at least one of the one or more electrical components is coupled to the physiological sensor.