Abstract: A pacemaker has a housing and a therapy delivery circuit enclosed by the housing for generating pacing pulses for delivery to a patient's heart. An electrically insulative distal member is coupled directly to the housing and at least one non-tissue piercing cathode electrode is coupled directly to the insulative distal member. A tissue piercing electrode extends away from the housing.

Abstract: VfA cardiac therapy uses an implantable medical device or system. The implantable medical device includes a tissue-piercing electrode implanted in the basal and/or septal region of the left ventricular myocardium of the patient's heart from the triangle of Koch region of the right atrium through the right atrial endocardium and central fibrous body. The device may include a right atrial electrode, a right atrial motion detector, or both. The device may be implanted completely within the patient's heart or may use one or more leads to implant electrodes in the patient's heart. The device may be used to provide cardiac therapy, including single or multiple chamber pacing, atrioventricular synchronous pacing, asynchronous pacing, triggered pacing, cardiac resynchronization pacing, or tachycardia-related therapy. A separate medical device may be used to provide some functionality for cardiac therapy, such as sensing, pacing, or shock therapy.

Abstract: A method of treating or preventing ARDS includes advancing a cryogenic treatment element into a target bronchus of a mammal and exchanging cryogenic energy between the target bronchus and the cryogenic treatment element for a predetermined period of time until a target temperature of the target bronchus is reached to cause neuropraxia of nerves within the target bronchus.

Abstract: An implantable medical device delivery system includes a delivery catheter including an elongated body with a first portion defining a first lumen and a second portion defining a second lumen. An angle is defined between a first axis and a second axis defined by the first and second portions, respectively. The second axis points toward the left ventricular (LV) apex of the patient's heart when the first axis points into the CS. The first portion or an elongated element may extend into the CS to anchor the delivery catheter to the orientation of the CS.

Abstract: A method of creating a shunt between a right atrium and a left atrium of a mammalian heart including puncturing an atrial septum between the right atrium and the left atrium to create a shunt. An ablation device having balloon is advanced at least partially through the shunt. The balloon is inflated and configured to thermally isolate the atrial septum from blood within the left atrium and the right atrium. Ablation energy is delivered to ablate the atrial septum.

Abstract: A deflectable shaft catheter may include a handle extending laterally from a hub of the catheter to form an acute angle therewith, wherein the handle contains a wire controller and a guide that rotates in plane with the angle. A spring biased slider of the wire controller, for the aforementioned handle, or an in-line handle sans the guide, may include first and second parts between which a proximal end of the wire extends and bends into a bore formed in the first part. Alternately, the slider includes an elastomeric core sandwiched between first and second parts thereof. The slider may further include a cavity in which a spring member biases the proximal end of the wire toward a distal end of the cavity, but only forces the wire to the cavity distal end, if a predetermined spring force of the member is greater than an opposing force along the wire.

Abstract: A method of creating a shunt between a right atrium and a left atrium of a mammalian heart including puncturing an atrial septum between the right atrium and the left atrium to create a shunt. An ablation device having balloon is advanced at least partially through the shunt. The balloon is inflated and configured to thermally isolate the atrial septum from blood within the left atrium and the right atrium. Ablation energy is delivered to ablate the atrial septum.

Abstract: An implantable medical lead having an elongated lead body extending from a proximal end to a distal end, at least one conductor extending within the lead body from the proximal end to the distal end, and a fixation member having a proximal end and a distal end, the proximal end of the electrode configured to be electrically coupled to the distal end of the lead body.

Abstract: VfA cardiac therapy uses an implantable medical device or system. The implantable medical device includes a tissue-piercing electrode implanted in the basal and/or septal region of the left ventricular myocardium of the patient's heart from the triangle of Koch region of the right atrium through the right atrial endocardium and central fibrous body. The device may include a right atrial electrode, a right atrial motion detector, or both. The device may be implanted completely within the patient's heart or may use one or more leads to implant electrodes in the patient's heart. The device may be used to provide cardiac therapy, including single or multiple chamber pacing, atrioventricular synchronous pacing, asynchronous pacing, triggered pacing, cardiac resynchronization pacing, or tachycardia-related therapy. A separate medical device may be used to provide some functionality for cardiac therapy, such as sensing, pacing, or shock therapy.

Abstract: Systems, devices, and methods may be used to deliver and provide cardiac pacing therapy to a patient. Leads or leadlets carrying one or more left ventricular electrodes may be positioned in or near the interventricular septum to sense and pace left ventricular signals of the patient's heart. In one example, a leadlet including one or more left ventricular electrodes may extend in the coronary sinus from a leadless implantable medical device located in the right atrium.

Abstract: An implantable lead system may include an adjustable lead assembly. The lead assembly may include a fixation member and an implantable lead slidably coupled to and rotatable relative to the fixation member. The implantable lead system may include a telescoping delivery system. The delivery system may include an outer catheter and an inner catheter slidably coupled to and rotatable relative to the outer catheter. The lead assembly may be implanted in a cardiac septal wall through the delivery assembly.

Abstract: A method includes locating the triangle of Koch region in the right atrium of a patient's heart; securing at least one electrode of an implantable lead or device to cardiac tissue from the triangle of Koch region to deliver ventricle-from-atrium (VfA) cardiac therapy; and testing the location or depth of the at least one electrode to configure VfA cardiac therapy. Locating the target implant region in the triangle of Koch region may include detecting an atrial slow pathway potential (ASP) or atrial pacing output.

Abstract: A system and method of positioning an atrial pacing lead for delivery of a cardiac pacing therapy that includes sensing electrical activity of tissue of a patient from a plurality of external electrodes and determining a distribution of bi-atrial activation in response to the sensed electrical activity. A target site for delivering the atrial pacing therapy is adjusted based on a change in bi-atrial dyssynchrony that is determined in response to the determined distribution of bi-atrial activation, and placement of the atrial pacing lead for delivery of the atrial pacing therapy is determined in response to the adjusting.

Abstract: A medical device is configured to sense a cardiac electrical signal and determine from the cardiac electrical signal at least one of a maximum peak amplitude of a positive slope of the cardiac electrical signal and a maximum peak time interval from a pacing pulse to the maximum peak amplitude. The device is configured to determine a capture type of the pacing pulse based on at least one or both of the maximum peak amplitude and the maximum peak time interval.

Abstract: Cardiac electrical heterogeneity information may be used to determine whether one or more His bundle paced settings for His bundle pacing therapy are acceptable for His bundle pacing. Cardiac electrical heterogeneity information may be generated during His bundle pacing, and the evaluation against baseline information and/or other information to determine whether the His bundle paced settings are acceptable.

Abstract: A medical device includes a motion sensor for producing a motion signal including cardiac event signals. The medical device generates a ventricular pacing pulse upon expiration of a pacing interval. The medical device determines a synchrony metric from the motion signal after a delivered ventricular pacing pulse and adjusts the pacing interval based on the synchrony metric.

Abstract: An implantable medical device delivery system includes a delivery catheter including an elongated body with a first portion defining a first lumen and a second portion defining a second lumen. An angle is defined between a first axis and a second axis defined by the first and second portions, respectively. The second axis points toward the left ventricular (LV) apex of the patient's heart when the first axis points into the CS. The first portion or an elongated element may extend into the CS to anchor the delivery catheter to the orientation of the CS.

Abstract: A microwave ablation device including a catheter having an inner tube defining an inflow lumen therethrough and an outflow lumen between the inner tube and an inner surface of the catheter, a balloon in fluid communication with the inflow and outflow lumens, a microwave ablation antenna insertable into one of the inflow or outflow lumens, and a temperature sensor for detecting the temperature of at least one of a fluid circulating in the catheter or an airway wall against which a portion of the catheter is positioned.

Abstract: Cardiac electrical heterogeneity information may be used to determine whether one or more ventricle from atrium (VfA) paced settings for VfA pacing therapy are acceptable. Cardiac electrical heterogeneity information may be generated during VfA pacing, and then evaluated to determine whether the VfA paced settings are acceptable.

Abstract: An IMD system receives a near field His bundle electrical signal produced by a patient's heart via a first sensing electrode vector and a far field cardiac electrical signal via a second sensing electrode vector different than the first sensing electrode vector. The IMD system generates His bundle pacing pulses delivered to the patient's heart via a His pacing electrode vector and determines a type of cardiac capture evoked by a His bundle pacing pulse.