Abstract: A medical system includes an implantable medical device (IMD) configured to detect an arrhythmia in a patient; and an external device comprising processing circuitry and configured to receive from the IMD an indication that the IMD has detected the arrhythmia in die patient; generate an output indicating that the IMD has detected the arrhythmia; receive an input from a user; and in response to the input from the user, transmitting to the IMD a command to cause the IMD to modify a therapy plan determined by the IMD.

Abstract: The technology disclosed herein relates to, in part, an assembly having a handle and a tunneling shaft coupled to the handle. The tunneling shaft extends from the handle to a distal end, where a portion of the tunneling shaft extends in a curved orientation between the handle and the distal end. An optical window is disposed at the distal end of the tunneling shaft. An insertion pathway extends through the handle and the tunneling shaft to the optical window. A constriction mechanism is coupled to the handle and defines a portion of the insertion pathway. The constriction mechanism is configured to selectively constrict the insertion pathway. An endoscope is configured to be inserted in the handle to the optical window along the insertion pathway.

Abstract: An implantable medical lead includes a first defibrillation electrode and a second defibrillation electrode. The implantable medical lead further includes a pacing electrode configured to deliver a pacing pulse that generates an electric field proximate to the pacing electrode. The implantable medical lead further includes a shield disposed over a portion of an outer surface of the pacing electrode and extending laterally away from the pacing electrode. The shield is configured to impede the electric field in a direction from the pacing electrode away from a heart. The implantable medical lead further includes a conductive surface disposed on the shield and electrically coupled to the pacing electrode.

Abstract: In some examples, a medical device includes an elongated structure configured to extend from an access point of a patient through an intercostal space within the patient. The medical device may further include a plurality of electrodes comprising a first subset of electrodes and a second subset of electrodes, where at least the first subset of electrodes is carried on a distal portion of the elongated structure. The first subset of electrodes of the plurality of electrodes may be configured to deliver electrical therapy to a heart of the patient or sense cardiac activity. The second subset of electrodes of the plurality of electrodes may be configured to deliver energy to tissue proximate a ribcage of the patient to reduce a sensation in one or more intercostal nerves.

Abstract: Systems, devices, and methods for performing respiratory-based cardiac remodeling pacing therapy are described in this disclosure. A patent's respiration may be monitored, and the lower pacing limit for the cardiac remodeling pacing and support pacing therapy delivered to a patient may be adjusted based on the monitored respiration to achieve or restore respiratory sinus arrhythmia.

Abstract: Implantable medical systems enter an exposure mode of operation, either manually via a down linked programming instruction or by automatic detection by the implantable system of exposure to a magnetic disturbance. A controller then determines the appropriate exposure mode by considering various pieces of information including the device type including whether the device has defibrillation capability, pre-exposure mode of therapy including which chambers have been paced, and pre-exposure cardiac activity that is either intrinsic or paced rates. Additional considerations may include determining whether a sensed rate during the exposure mode is physiologic or artificially produced by the magnetic disturbance. When the sensed rate is physiologic, then the controller uses the sensed rate to trigger pacing and otherwise uses asynchronous pacing at a fixed rate.

Abstract: Implantable medical systems enter an exposure mode of operation, either manually via a down linked programming instruction or by automatic detection by the implantable system of exposure to a magnetic disturbance. A controller then determines the appropriate exposure mode by considering various pieces of information including the device type including whether the device has defibrillation capability, pre-exposure mode of therapy including which chambers have been paced, and pre-exposure cardiac activity that is either intrinsic or paced rates. Additional considerations may include determining whether a sensed rate during the exposure mode is physiologic or artificially produced by the magnetic disturbance. When the sensed rate is physiologic, then the controller uses the sensed rate to trigger pacing and otherwise uses asynchronous pacing at a fixed rate.

Abstract: Implantable medical systems enter an exposure mode of operation, either manually via a down linked programming instruction or by automatic detection by the implantable system of exposure to a magnetic disturbance. A controller then determines the appropriate exposure mode by considering various pieces of information including the device type including whether the device has defibrillation capability, pre-exposure mode of therapy including which chambers have been paced, and pre-exposure cardiac activity that is either intrinsic or paced rates. Additional considerations may include determining whether a sensed rate during the exposure mode is physiologic or artificially produced by the magnetic disturbance. When the sensed rate is physiologic, then the controller uses the sensed rate to trigger pacing and otherwise uses asynchronous pacing at a fixed rate.

Abstract: A lower pacing rate limit is utilized by pacing devices to initiate pacing in response to a patient's intrinsic rate being less than the lower pacing rate limit. Illustrative systems, devices, and methods may obtain rate modification information related to a patient such as physical characteristics, diagnostic parameters, pathologies, device characteristics of a pacing device implanted in the patient, and patient-reported information. The rate modification information may be used to determine lower pacing rate limit based thereon.

Abstract: Implantable medical systems enter an exposure mode of operation, either manually via a down linked programming instruction or by automatic detection by the implantable system of exposure to a magnetic disturbance. A controller then determines the appropriate exposure mode by considering various pieces of information including the device type including whether the device has defibrillation capability, pre-exposure mode of therapy including which chambers have been paced, and pre-exposure cardiac activity that is either intrinsic or paced rates. Additional considerations may include determining whether a sensed rate during the exposure mode is physiologic or artificially produced by the magnetic disturbance. When the sensed rate is physiologic, then the controller uses the sensed rate to trigger pacing and otherwise uses asynchronous pacing at a fixed rate.

Abstract: Implantable medical devices automatically switch from a normal mode of operation to an exposure mode of operation and back to the normal mode of operation. The implantable medical devices may utilize hysteresis timers in order to determine if entry and/or exit criteria for the exposure mode are met. The implantable medical devices may utilize additional considerations for entry to the exposure mode such as a confirmation counter or a moving buffer of sensor values. The implantable medical devices may utilize additional considerations for exiting the exposure mode of operation and returning to the normal mode, such as total time in the exposure mode, patient position, and high voltage source charge time in the case of devices with defibrillation capabilities.

Abstract: This disclosure describes systems, devices and techniques for improving the longevity of battery life in a device. An example first device includes communication circuitry configured to communicate with a second device and processing circuitry configured to determine an expected amount of data to be transmitted by the second device to the first device. The processing circuitry is configured to determine that the expected amount of data to be transmitted by the second device to the first device is greater than or equal to a predetermined data threshold and based on the expected amount of data to be transmitted being greater than or equal to the predetermined data threshold, determine that a predetermined restriction is met. The processing circuitry is configured to, based on the predetermined restriction being met, control the communication circuitry to transmit an instruction to the second device.

Abstract: Techniques are disclosed for using a rate of wireless telemetry of an implantable medical device (IMD) to estimate a remaining longevity of a power source of the IMD. For example, the IMD sets a timer indicative of a remaining power capacity of the power source until a recommended replacement time (RRT) threshold. The IMD determines a power consumption of the IMD due to telemetry and updates, based on the power consumption of the IMD due to telemetry, the timer indicative of the remaining power capacity of the power source. The IMD determines, based on expiration of the timer indicative of the remaining power capacity of the power source, that the power source has reached the RRT threshold. In some examples, the IMD may output, to an external device and for display to a user, an indication that the power source has reached the RRT threshold.

Abstract: Implantable medical systems enter an exposure mode of operation, either manually via a down linked programming instruction or by automatic detection by the implantable system of exposure to a magnetic disturbance. A controller then determines the appropriate exposure mode by considering various pieces of information including the device type including whether the device has defibrillation capability, pre-exposure mode of therapy including which chambers have been paced, and pre-exposure cardiac activity that is either intrinsic or paced rates. Additional considerations may include determining whether a sensed rate during the exposure mode is physiologic or artificially produced by the magnetic disturbance. When the sensed rate is physiologic, then the controller uses the sensed rate to trigger pacing and otherwise uses asynchronous pacing at a fixed rate.

Abstract: Implantable medical systems enter an exposure mode of operation, either manually via a down linked programming instruction or by automatic detection by the implantable system of exposure to a magnetic disturbance. A controller then determines the appropriate exposure mode by considering various pieces of information including the device type including whether the device has defibrillation capability, pre-exposure mode of therapy including which chambers have been paced, and pre-exposure cardiac activity that is either intrinsic or paced rates. Additional considerations may include determining whether a sensed rate during the exposure mode is physiologic or artificially produced by the magnetic disturbance. When the sensed rate is physiologic, then the controller uses the sensed rate to trigger pacing and otherwise uses asynchronous pacing at a fixed rate.

Abstract: Techniques are disclosed for using a rate of wireless telemetry of an implantable medical device (IMD) to estimate a remaining longevity of a power source of the IMD. For example, the IMD sets a timer indicative of a remaining power capacity of the power source until a recommended replacement time (RRT) threshold. The IMD determines a power consumption of the IMD due to telemetry and updates, based on the power consumption of the IMD due to telemetry, the timer indicative of the remaining power capacity of the power source. The IMD determines, based on expiration of the timer indicative of the remaining power capacity of the power source, that the power source has reached the RRT threshold. In some examples, the IMD may output, to an external device and for display to a user, an indication that the power source has reached the RRT threshold.

Abstract: Implantable medical systems enter an exposure mode of operation, either manually via a down linked programming instruction or by automatic detection by the implantable system of exposure to a magnetic disturbance. A controller then determines the appropriate exposure mode by considering various pieces of information including the device type including whether the device has defibrillation capability, pre-exposure mode of therapy including which chambers have been paced, and pre-exposure cardiac activity that is either intrinsic or paced rates. Additional considerations may include determining whether a sensed rate during the exposure mode is physiologic or artificially produced by the magnetic disturbance. When the sensed rate is physiologic, then the controller uses the sensed rate to trigger pacing and otherwise uses asynchronous pacing at a fixed rate.

Abstract: Implantable medical systems enter an exposure mode of operation, either manually via a down linked programming instruction or by automatic detection by the implantable system of exposure to a magnetic disturbance. A controller then determines the appropriate exposure mode by considering various pieces of information including the device type including whether the device has defibrillation capability, pre-exposure mode of therapy including which chambers have been paced, and pre-exposure cardiac activity that is either intrinsic or paced rates. Additional considerations may include determining whether a sensed rate during the exposure mode is physiologic or artificially produced by the magnetic disturbance. When the sensed rate is physiologic, then the controller uses the sensed rate to trigger pacing and otherwise uses asynchronous pacing at a fixed rate.

Abstract: Techniques for facilitating authorized telemetry with an implantable device are provided. In one embodiment, for example, a method includes comparing, by a first device having a processor, first electronic information with second electronic information. The first electronic information is indicative of a first motion of a second device external to a body in which the implantable device is located, and the second electronic information is indicative of a second motion of the implantable device. The method also includes determining whether a defined level of correlation exists between the first electronic information and the second electronic information, and initiating a telemetry session between the second device and the implantable device based on a determination that the defined level of correlation exists between the first electronic information and the second electronic information.

Abstract: Implantable medical systems enter an exposure mode of operation, either manually via a down linked programming instruction or by automatic detection by the implantable system of exposure to a magnetic disturbance. A controller then determines the appropriate exposure mode by considering various pieces of information including the device type including whether the device has defibrillation capability, pre-exposure mode of therapy including which chambers have been paced, and pre-exposure cardiac activity that is either intrinsic or paced rates. Additional considerations may include determining whether a sensed rate during the exposure mode is physiologic or artificially produced by the magnetic disturbance. When the sensed rate is physiologic, then the controller uses the sensed rate to trigger pacing and otherwise uses asynchronous pacing at a fixed rate.