Abstract: An example system includes an implantable medical device (IMD) that includes a housing configured for subcutaneous implantation proximate a lymphatic element of a patient; and a plurality of electrodes configured to sense an impedance signal indicative of one or more physiological parameters of the lymphatic element; and processing circuitry configured to: determine the one or more physiological parameters of the lymphatic element based on the impedance signal; determine a peripheral edema status of the patient based on the one or more physiological parameters; and output an indication of the peripheral edema status.

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: An implantable medical device (IMD) comprises a plurality of deep tines configured to be advanced into a septum of a heart of a patient in different directions that are not parallel to a longitudinal axis of the implantable medical device, wherein each deep tine of the plurality of deep tines is configured to deliver cardiac pacing to cardiac tissue distal to a chamber of the heart in which the IMD is implanted, and one or more shallow electrodes engageable with the septum, wherein the one or more shallow electrodes are configured to deliver cardiac pacing to the chamber of the heart in which the IMD is implanted.

Abstract: A tethering assembly for securing a medical device includes a shaft and a wire that extends in sliding engagement within a proximal lumen, a channel, and a distal receptacle of the shaft. A retainer zone of the shaft, through which the channel extends, stops a transition segment of the wire, which extends between a proximal and a distal segment of the wire, from moving into the shaft receptacle, thereby restraining a distal-most tip of the wire from moving through a distal-most opening of the receptacle. When a projecting member of the device has entered a secure zone of the receptacle, via movement through the distal-most opening and a tapering passageway thereof, the distal-most tip of the wire, which may be spring-biased, can move distally into the passageway so that the tip blocks the projecting member from moving distally, back through the passageway.

Abstract: This disclosure is directed to systems and techniques for detecting change in patient health based upon patient data. In one example, a medical system comprising processing circuitry communicably coupled to a glucose sensor and configured to generate continuous glucose sensor measurements of a patient. The processing circuitry is further configured to: extract at least one feature from the continuous glucose sensor measurements over at least one time period, wherein the at least one feature comprises one or more of an amount of time within a pre-determined glucose level range, a number of hypoglycemia events, a number of hyperglycemia events, or one or more statistical metrics corresponding to the continuous glucose sensor measurements; apply a machine learning model to the at least one extracted feature to produce data indicative of a risk of a cardiovascular event; and generate output data based on the risk of the cardiovascular event.

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: An implantable medical device (IMD) comprises a plurality of deep tines configured to be advanced into a septum of a heart of a patient in different directions that are not parallel to a longitudinal axis of the implantable medical device, wherein each deep tine of the plurality of deep tines is configured to deliver cardiac pacing to cardiac tissue distal to a chamber of the heart in which the IMD is implanted, and one or more shallow electrodes engageable with the septum, wherein the one or more shallow electrodes are configured to deliver cardiac pacing to the chamber of the heart in which the IMD is implanted.

Abstract: A method of cooling a mammal with an implantable blood pump. The method includes measuring a temperature of an internal controller, the internal controller being in communication with the implantable blood pump. An alert is generated if the temperature of the internal controller exceeds a predetermined temperature threshold. The internal controller and implantable blood pump may be implanted at different locations in the patient.

Abstract: A tethering assembly for securing a medical device includes a shaft and a wire that extends in sliding engagement within a proximal lumen, a channel, and a distal receptacle of the shaft. A retainer zone of the shaft, through which the channel extends, stops a transition segment of the wire, which extends between a proximal and a distal segment of the wire, from moving into the shaft receptacle, thereby restraining a distal-most tip of the wire from moving through a distal-most opening of the receptacle. When a projecting member of the device has entered a secure zone of the receptacle, via movement through the distal-most opening and a tapering passageway thereof, the distal-most tip of the wire, which may be spring-biased, can move distally into the passageway so that the tip blocks the projecting member from moving distally, back through the passageway.

Abstract: This disclosure is directed to systems and techniques for detecting change in patient health based upon patient data. In one example, a medical system comprising processing circuitry communicably coupled to a glucose sensor and configured to generate continuous glucose sensor measurements of a patient. The processing circuitry is further configured to: extract at least one feature from the continuous glucose sensor measurements over at least one time period, wherein the at least one feature comprises one or more of an amount of time within a pre-determined glucose level range, a number of hypoglycemia events, a number of hyperglycemia events, or one or more statistical metrics corresponding to the continuous glucose sensor measurements; apply a machine learning model to the at least one extracted feature to produce data indicative of a risk of a cardiovascular event; and generate output data based on the risk of the cardiovascular event.

Abstract: A method of cooling a mammal with an implantable blood pump. The method includes measuring a temperature of an internal controller, the internal controller being in communication with the implantable blood pump. an alert is generated if the temperature of the internal controller exceeds a predetermined temperature threshold.

Abstract: A fixation mechanism of an implantable medical device is formed by a plurality of tines fixedly mounted around a perimeter of a distal end of the device. Each tine may be said to include a first segment fixedly attached to the device, a second segment extending from the first segment, and a third segment, to which the second segment extends. When the device is loaded in a lumen of a delivery tool and a rounded free distal end of each tine engages a sidewall that defines the lumen, to hold the tines in a spring-loaded condition, the first segment of each tine, which has a spring-biased pre-formed curvature, becomes relatively straightened, and the third segment of each tine, which is terminated by the free distal end, extends away from the axis of the device at an acute angle in a range from about 45 degrees to about 75 degrees.

Abstract: A relatively compact implantable medical device includes a fixation member formed by a plurality of fingers mounted around a perimeter of a distal end of a housing of the device; each finger is elastically deformable from a relaxed condition to an extended condition, to accommodate delivery of the device to a target implant site, and from the relaxed condition to a compressed condition, to accommodate wedging of the fingers between opposing tissue surfaces at the target implant site, wherein the compressed fingers hold a cardiac pacing electrode of the device in intimate tissue contact for the delivery of pacing stimulation to the site. Each fixation finger is preferably configured to prevent penetration thereof within the tissue when the fingers are compressed and wedged between the opposing tissue surfaces. The pacing electrode may be mounted on a pacing extension, which extends distally from the distal end of the device housing.

Abstract: A fixation mechanism of an implantable medical device is formed by a plurality of tines fixedly mounted around a perimeter of a distal end of the device. Each tine may be said to include a first segment fixedly attached to the device, a second segment extending from the first segment, and a third segment, to which the second segment extends. When the device is loaded in a lumen of a delivery tool and a rounded free distal end of each tine engages a sidewall that defines the lumen, to hold the tines in a spring-loaded condition, the first segment of each tine, which has a spring-biased pre-formed curvature, becomes relatively straightened, and the third segment of each tine, which is terminated by the free distal end, extends away from the axis of the device at an acute angle in a range from about 45 degrees to about 75 degrees.

Abstract: A relatively compact implantable medical device includes a fixation member formed by a plurality of fingers mounted around a perimeter of a distal end of a housing of the device; each finger is elastically deformable from a relaxed condition to an extended condition, to accommodate delivery of the device to a target implant site, and from the relaxed condition to a compressed condition, to accommodate wedging of the fingers between opposing tissue surfaces at the target implant site, wherein the compressed fingers hold a cardiac pacing electrode of the device in intimate tissue contact for the delivery of pacing stimulation to the site. Each fixation finger is preferably configured to prevent penetration thereof within the tissue when the fingers are compressed and wedged between the opposing tissue surfaces. The pacing electrode may be mounted on a pacing extension, which extends distally from the distal end of the device housing.

Abstract: An example fixation component for an implantable medical device (IMD) includes a base and a plurality of tines configured be deployed with a target deployment stiffness to engage tissue a target implant site while maintaining a target deflection stiffness after deployment. The base defines a longitudinal axis of the fixation component and is fixedly attached near the distal end of the IMD. Each tine is spaced apart from one another around a perimeter of the distal end of the IMD and extend from the base. A shape of each tine is selected to control each of the target deployment stiffness and target deflection stiffness.

Abstract: An implantable medical device (IMD) comprises a plurality of deep tines configured to be advanced into a septum of a heart of a patient in different directions that are not parallel to a longitudinal axis of the implantable medical device, wherein each deep tine of the plurality of deep tines is configured to deliver cardiac pacing to cardiac tissue distal to a chamber of the heart in which the IMD is implanted, and one or more shallow electrodes engageable with the septum, wherein the one or more shallow electrodes are configured to deliver cardiac pacing to the chamber of the heart in which the IMD is implanted.

Abstract: A controller for an implantable medical device including a housing sized and configured to be received within a patient, the housing having a thermally conductive shell defining an exterior surface. At least a portion of the exterior surface of the thermally conductive shell defines at least one from the group consisting of a plurality of corrugations and a plurality of protuberances.

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.