Abstract: Devices, systems, and techniques are described for selecting parameters for electrical stimulation therapy. For example, device may include processing circuitry configured to determine a first window of time to sense a physiological signal, determine, based on the first window of time, a second window of time for delivering electrical stimulations, and determine, based on a duration of the second window of time, a number of stimulation pulses deliverable during the second window of time at one or more pulse frequencies. The processing circuitry may then output, based on the number of stimulation pulses deliverable during the second window of time, at least one selectable stimulation parameter that at least partially defines the electrical stimulation, wherein the second window of time is adjacent to the first window of time.

Abstract: A method and system for determining a location of a treatment element relative to an anatomical feature and for estimating contact between the treatment element and the anatomical feature in the context of a navigation system. The system may include a medical device including at least one treatment element and at least one navigation electrode and a navigation system in communication with the one or more navigation electrodes, the navigation system including a processing unit. The processing unit may be programmed to determine a plurality of points that define a surface geometry of the at least one treatment element, calculate a distance between each of the points and a closest point on the anatomical feature, and estimate the likelihood of contact between the points.

Abstract: A method and system for controlling flow of refrigerant through a medical device are disclosed. According to one aspect, a system for delivering refrigerant to an expansion cavity portion of the medical device comprises a first path and a second path in communication with the expansion cavity portion. The system also includes a first PID controller in communication with a first proportional valve in the first path, the first PID controller being configured to operate the first proportional valve based on a pressure measurement in the first path; and a second PID controller in communication with a second proportional valve in the second path, the second controller being configured to operate the second proportional valve based on a pressure measurement in the second path or in the expansion cavity portion.

Abstract: A method and system for determining a target location for a medical device having complex geometry relative to an anatomical feature, and for navigating and positioning the medical device at the target location. The system may include a medical device including a treatment element having a centroid, one or more navigation electrodes, and a longitudinal axis and a navigation system in communication with the one or more navigation electrodes, the navigation system including a processing unit. The processing unit may be programmed to define a plane that approximates a surface of the anatomical feature, define a centroid of the anatomical feature, define a vector that is normal to the plane and extends away from the centroid of the anatomical feature, and determine a target location for the treatment element of the medical device based on the vector to assist the user in placing the device for treatment.

Abstract: A method and system for determining a target location for a medical device having complex geometry relative to an anatomical feature, and for navigating and positioning the medical device at the target location. The system may include a medical device including a treatment element having a centroid, one or more navigation electrodes, and a longitudinal axis and a navigation system in communication with the one or more navigation electrodes, the navigation system including a processing unit. The processing unit may be programmed to define a plane that approximates a surface of the anatomical feature, define a centroid of the anatomical feature, define a vector that is normal to the plane and extends away from the centroid of the anatomical feature, and determine a target location for the treatment element of the medical device based on the vector to assist the user in placing the device for treatment.

Abstract: A medical system configured to estimate a volume of infusate within an implantable medical device, the system including an implantable medical device comprising a fluid reservoir, and an external programmer in communication with the implantable medical device, the external programmer comprising a processor configured to estimate a distribution of refill intervals based on actual infusion data including patient initiated infusions.

Abstract: A medical device with closed-loop responsive stimulation may include techniques to mitigate the impact on the therapy output of noise coupled into the medical device. A medical device according to this disclosure may determine the presence of noise and alter the closed loop policy to provide the necessary therapy to the patient and avoid prolonged under stimulation caused by the noise. The medical device may continue therapy while testing for noise. When the device determines the noise level no longer affects the output therapy, the device may return the closed loop policy to a no-noise mode of operation. The medical device may also include techniques to mitigate the impact of manual adjustment while the medical device is subject to noise or is responding to changes in the patient's physiological signals.

Abstract: A medical device with closed-loop responsive stimulation may include techniques to mitigate the impact on the therapy output of noise coupled into the medical device. A medical device according to this disclosure may determine the presence of noise and alter the closed loop policy to provide the necessary therapy to the patient and avoid prolonged under stimulation caused by the noise. The medical device may continue therapy, while testing for noise. When the device determines the noise level no longer affects the output therapy, the device may return the closed loop policy to a no-noise mode of operation. The medical device may also include techniques to mitigate the impact of manual adjustment while the medical device is subject to noise or is responding to changes in the patient's physiological signals.

Abstract: Devices, systems, and techniques for calibrating posture state definitions are described. In one example, a system includes a memory configured to store a plurality of posture state definitions defining a plurality of posture states. The system may also include processing circuitry configured to receive a request to update the plurality of posture state definitions, responsive to receiving the request, and obtain sensor data for one posture state of the plurality of posture states, wherein the sensor data generated while a patient is in the one posture state. The processing circuitry may also determine a difference between the sensor data and a posture state definition of the posture state definitions corresponding to the one posture state, update, based on the difference, the plurality of posture state definitions, and store the updated plurality of posture state definitions in the memory.

Abstract: A medical device with closed-loop responsive stimulation may include techniques to mitigate the impact on the therapy output of noise coupled into the medical device. A medical device according to this disclosure may determine the presence of noise and alter the closed loop policy to provide the necessary therapy to the patient and avoid prolonged under stimulation caused by the noise. The medical device may continue therapy while testing for noise. When the device determines the noise level no longer affects the output therapy, the device may return the closed loop policy to a no-noise mode of operation. The medical device may also include techniques to mitigate the impact of manual adjustment while the medical device is subject to noise or is responding to changes in the patient's physiological signals.

Abstract: A medical device with closed-loop responsive stimulation may include techniques to mitigate the impact on the therapy output of noise coupled into the medical device. A medical device according to this disclosure may determine the presence of noise and alter the closed loop policy to provide the necessary therapy to the patient and avoid prolonged under stimulation caused by the noise. The medical device may continue therapy, while testing for noise. When the device determines the noise level no longer affects the output therapy, the device may return the closed loop policy to a no-noise mode of operation. The medical device may also include techniques to mitigate the impact of manual adjustment while the medical device is subject to noise or is responding to changes in the patient's physiological signals.

Abstract: A method and system for automatic location of a target treatment structure, such as a pulmonary vein ostium, from an anatomical image. The method includes calculating a most likely path of blood flow through a pulmonary vein based on a cross-sectional area minimization technique and calculating pulmonary vein geometry as a function of length. For example, a pulmonary vein ostium may be located by analyzing a change in pulmonary vein dimensional size or other anatomical factors, such as absolute size. The method may also include determining tissue thickness at the pulmonary vein ostium or other treatment size for treatment dose optimization. The method may be an algorithm performed by a processing unit of a navigation system or other component of a medical system.

Abstract: A method and system for determining a location of a treatment element relative to an anatomical feature and for estimating contact between the treatment element and the anatomical feature in the context of a navigation system. The system may include a medical device including at least one treatment element and at least one navigation electrode and a navigation system in communication with the one or more navigation electrodes, the navigation system including a processing unit. The processing unit may be programmed to determine a plurality of points that define a surface geometry of the at least one treatment element, calculate a distance between each of the points and a closest point on the anatomical feature, and estimate the likelihood of contact between the points.

Abstract: Embodiments disclosed herein relate to systems and methods for detecting faults in leads and automatically reconfiguring a stimulation pattern of the leads based on a detected fault.

Abstract: A method and system for determining a location of a treatment element relative to an anatomical feature and for estimating contact between the treatment element and the anatomical feature in the context of a navigation system. The system may include a medical device including at least one treatment element and at least one navigation electrode and a navigation system in communication with the one or more navigation electrodes, the navigation system including a processing unit. The processing unit may be programmed to determine a plurality of points that define a surface geometry of the at least one treatment element, calculate a distance between each of the points and a closest point on the anatomical feature, and estimate the likelihood of contact between the points.

Abstract: A device, system, and method for performing a variety of treatment procedures safely with a single treatment device. For example, a system is provided that includes a treatment device with a highly conformable balloon that is inflated at a constant pressure and that remains “soft” during use, which enhances balloon-tissue contact, treatment efficacy, and patient safety. In one embodiment, a system for ablating tissue comprises: a treatment device including a highly conformable balloon; a control unit including a fluid supply reservoir in fluid communication with the highly conformable balloon, the control unit being configured to deliver fluid from the fluid supply reservoir to the highly conformable balloon such that the highly conformable balloon is maintained at a balloon pressure of between 0.2 psig and 3.0 psig.

Abstract: A method of monitoring a patient for phrenic nerve collateral damage during a cardiac ablation procedure. The method includes measuring at least one from the group consisting of compound motor action potential (CMAP) and accelerometer signals in response to stimulating of the phrenic nerve. Real-time data is displayed on a display, the real-time data including the at least one from the group consisting of the measured CMAP and accelerometer signals. Long-term trend data is simultaneously displayed on the display, the long-term trend data being associated with the measured at least one from the group consisting of CMAP and accelerometer signals.

Abstract: In situations in which an implantable medical device (e.g., a subcutaneous ICD) is co-implanted with a leadless pacing device (LPD), it may be important that the subcutaneous ICD knows when the LPD is delivering pacing, such as anti-tachycardia pacing (ATP). Techniques are described herein for detecting, with the ICD and based on the sensed electrical signal, pacing pulses and adjusting operation to account for the detected pulses, e.g., blanking the sensed electrical signal or modifying a tachyarrhythmia detection algorithm. In one example, the ICD includes a first pace pulse detector configured to obtain a sensed electrical signal and analyze the sensed electrical signal to detect a first type of pulses having a first set of characteristics and a second pace pulse detector configured to obtain the sensed electrical signal and analyze the sensed electrical signal to detect a second type of pulses having a second set of characteristics.

Abstract: A device, system, and method for performing a variety of treatment procedures safely with a single treatment device. For example, a system is provided that includes a treatment device with a highly conformable balloon that is inflated at a constant pressure and that remains “soft” during use, which enhances balloon-tissue contact, treatment efficacy, and patient safety. In one embodiment, a system for ablating tissue comprises: a treatment device including a highly conformable balloon; a control unit including a fluid supply reservoir in fluid communication with the highly conformable balloon, the control unit being configured to deliver fluid from the fluid supply reservoir to the highly conformable balloon such that the highly conformable balloon is maintained at a balloon pressure of between 0.2 psig and 3.0 psig.

Abstract: A medical system for monitoring pressure may comprise a medical device with an expandable element, at least one pressure sensor in communication with the expandable element and a control unit. The control unit may include a fluid source in fluid communication with the expandable element and circulation of the fluid within the expandable element may inflate the expandable element. A processing circuitry may be configured to monitor a pressure within the expandable element based on signals received from the at least one pressure sensor for a first period of time and circulation of the fluid within the expandable element for a second period of time.