A method for controlling charging a power source of an implantable medical device (IMD) in a patient including determining a power being delivered to a primary coil of an external charging device for recharging, determining an estimated power delivered to the IMD power source an estimated heat generated by the primary coil based on a resistance of the primary coil determined as function of at least one of a recharge frequency, a temperature of the primary coil, and a current supplied to the primary coil, calculating an estimated heat generated by the IMD by subtracting the estimated heat generated by the primary coil and the estimated power delivered stored by the rechargeable power source from the power being delivered to a primary coil; and controlling based on the heat generated by the IMD, the power being delivered by the primary coil of the external charging device.
A61N 1/372 - Arrangements in connection with the implantation of stimulators
H02J 50/10 - Circuit arrangements or systems for wireless supply or distribution of electric power using inductive coupling
H02J 50/80 - Circuit arrangements or systems for wireless supply or distribution of electric power involving the exchange of data, concerning supply or distribution of electric power, between transmitting devices and receiving devices
2.
SYSTEM AND METHOD FOR INTERACTING WITH AN IMPLANTABLE MEDICAL DEVICE
One example of a system includes a local user system to interact with an implantable medical device and a local input device communicatively coupled to the local user system to generate local events. To operate the local user system, the local user system is to receive local events from the local input device and remote events from a remote user system communicatively coupled to the local user system via a medical device remote access system. The local user system is to process a local event and ignore a remote event in response to receiving a local event and a remote event simultaneously.
A61B 5/00 - Measuring for diagnostic purposes ; Identification of persons
A61N 1/372 - Arrangements in connection with the implantation of stimulators
G16H 40/63 - ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices for local operation
G16H 40/67 - ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices for remote operation
G16Z 99/00 - Subject matter not provided for in other main groups of this subclass
An example medical device includes a device housing configured to be implantable within a patient, the device housing including an internal surface in contact with a voltaic cell of the battery, and a battery external to the device housing and comprising a battery housing configured to be hermetically sealed. The battery is configured to provide electrical power to an electrical component housed within the device housing, and the battery housing is configured to be attached to the device housing. The battery housing includes an internal surface in contact with a voltaic cell of the battery, and an external surface in contact with the biocompatible electrical insulator. an external surface in contact with the biocompatible electrical insulator.
C08G 61/10 - Macromolecular compounds containing only carbon atoms in the main chain of the macromolecule, e.g. polyxylylenes only aromatic carbon atoms, e.g. polyphenylenes
H01M 50/233 - Mountings; Secondary casings or frames; Racks, modules or packs; Suspension devices; Shock absorbers; Transport or carrying devices; Holders characterised by physical properties of casings or racks, e.g. dimensions
H01M 50/247 - Mountings; Secondary casings or frames; Racks, modules or packs; Suspension devices; Shock absorbers; Transport or carrying devices; Holders specially adapted for portable devices, e.g. mobile phones, computers, hand tools or pacemakers
H01M 50/296 - Mountings; Secondary casings or frames; Racks, modules or packs; Suspension devices; Shock absorbers; Transport or carrying devices; Holders characterised by terminals of battery packs
4.
LOCAL FIELD POTENTIAL (LFP) SENSING FOR NEUROSTIMULATION CONTROL
A system may be configured to sense local field potentials (LFPs) from electrodes placed in epidural space near the spine of a patient. The system may be configured to analyze the sensed LFPs and determine a change in a state of the patient, such as a physiological state of the patient. The system may use such analysis to update and/or suggest parameters for delivery of electrical stimulation therapy. The system may further be configured to analyze LFPs in a frequency domain by applying a wavelet transform or other transform to sensed LFPs.
An implantable cardiac defibrillator (ICD) system includes an ICD implanted subcutaneously in a patient, a defibrillation lead having a proximal portion coupled to the ICD and a distal portion having a defibrillation electrode configured to deliver a defibrillation or cardioversion shock to a heart of the patient, and a pacing lead that includes a distal portion having one or more electrodes and a proximal portion coupled to the ICD. The distal portion of the pacing lead is implanted at least partially along a posterior side of a sternum of the patient within the anterior mediastinum. The ICD is configured to provide pacing pulses to the heart of the patient via the pacing lead and provide defibrillation shocks to the patient via the defibrillation lead. As such, the implantable cardiac system provides pacing from the substernal space for an extravascular ICD system.
An example system includes electrodes configured to deliver the electrical stimulation to a patient, and a device comprising processing circuitry configured to determine, for a patient, a loading dose of electric stimulation. The processing circuitry is also configured to cause electrical stimulation circuitry' to deliver, during a first time period, the loading dose to the patient, receive patient feedback representing a response of the patient to the loading dose, determine, based on patient feedback, a maintenance dose of electrical stimulation, and cause the electrical stimulation circuitry to deliver, and during a second time period that is after the first time period, a maintenance dose of electrical stimulation. Delivering the maintenance dose of electrical stimulation consumes less power than delivering the loading dose of electrical stimulation.
In some examples, a method for controlling delivery of cardiac therapy and cardiac sensing by a medical device system including electrodes for delivering the cardiac therapy may include storing, in a memory of the medical device system, a respective value for each of a plurality of cardiac therapy and/or sensing parameters and, in association with each of a plurality of heart position states, a respective modification of at least one of the cardiac therapy and/or sensing parameters. Such a method also may include determining a current one of the plurality of heart position states of the patient, modifying the at least one cardiac therapy and/or sensing parameter value according to the modification associated with the current heart position state, and controlling the delivery of the cardiac therapy and/or cardiac sensing according to the modified at least one cardiac therapy and/or sensing parameter value.
Medical devices including a balloon-actuated sheath are provided. The medical devices include a tubular body, a tooltip, a balloon, and a tubular sheath translatably coupled to the balloon. Medical devices including a balloon-actuated distal cap are provided. The medical devices include a tubular body, a tooltip, a balloon, and a distal cap translatably coupled to the balloon. When air is pushed into one end of the medical device, the balloon may inflate, translating the tubular sheath or distal cap along a longitudinal axis from a retracted position to an extended position. When in the extended position, the tubular sheath at least partially surrounds the tooltip. When in the extended position, the distal cap at least partially opens fluid communication between the tooltip and the environment.
A system comprising processing circuitry configured to receive a wirelessly-transmitted message from a medical device, the message indicating that the medical device detected an acute health event of the patient. In response to the message, the processing circuitry is configured to determine a location of the patient, determine an alert area based on the location of the patient, and control transmission of an alert of the acute heath event of the patient to any one or more computing devices of one or more potential responders within the alert area.
An analyte sensor apparatus for detecting an analyte in a target environment includes a plurality of electrodes and a controller. The plurality of electrodes may be configured to provide a plurality of electrode signals based on a target environment. The plurality of electrodes may include one or more working electrodes, a first reference electrode, and a second reference electrode. The one or more working electrodes may be configured to provide an analyte signal based on a presence of an analyte in the target environment. The first reference electrode may be configured to provide a first baseline signal of the target environment. The second reference electrode may include a different type of electrode than the first reference electrode. The second reference electrode may be configured to provide a second baseline signal of the target environment. The controller may be operatively coupled to the plurality of electrodes.
In some examples, a system includes processing circuitry configured to receive a first set of information, the first set of information comprising information of actual therapy delivered to a patient over a plurality of instances of therapy delivery. The processing circuitry may determine, based upon the first set of information, a therapy usage pattern. The processing circuitry may determine a modification to a programmed therapy schedule based on the therapy usage pattern. The processing circuitry may generate for output the modification to the programmed therapy schedule.
Electrochemical cells and methods of preventing overheating of the same are disclosed. An electrochemical cell may include a cathode and an anode. The anode may include a lithium alloy. The anode may be configured to reduce a maximum rate of ion transfer between the anode and the cathode in response to an occurrence of a fault condition. The lithium alloy may comprise at least 70 weight percent lithium to 99 weight percent lithium.
Techniques related to classifying a posture state of a living body are disclosed. One aspect relates to sensing at least one signal indicative of a posture state of a living body. Posture state detection logic classifies the living body as being in a posture state based on the at least one signal, wherein this classification may take into account at least one of posture and activity state of the living body. The posture state detection logic further determines whether the living body is classified in the posture state for at least a predetermined period of time. Response logic is described that initiates a response as a result of the body being classified in the posture state only after the living body has maintained the classified posture state for at least the predetermined period of time. This response may involve a change in therapy, such as neurostimulation therapy, that is delivered to the living body.
An implantable medical lead includes a lead body extending from a proximal end to a distal end. The lead body includes an inner insulation layer and an outer insulation layer. The lead further includes a sleeve mechanically supported by the lead body at the distal end of the lead body. The lead further includes an uninsulated conductor coil. The uninsulated conductor coil includes a first portion having a first inner diameter, and a second portion having a second inner diameter and extending distally from the outer insulation layer. The first portion is positioned between the inner insulation layer and the outer insulation layer. The second inner diameter is greater than the first inner diameter. An outer surface of the second portion is exposed.
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.
A61N 1/05 - Electrodes for implantation or insertion into the body, e.g. heart electrode
B21D 39/02 - Application of procedures in order to connect objects or parts, e.g. coating with sheet metal otherwise than by plating; Tube expanders of sheet metal by folding, e.g. connecting edges of a sheet to form a cylinder
Example techniques, devices, and systems are described herein. An example device includes stimulation generation circuitry, sensing circuitry, and processing circuitry. The processing circuitry is configured to control the stimulation generation circuitry to generate a first stimulation signal having a first stimulation recharge parameter for delivery to target anatomy and receive from the sensing circuitry a sensed evoked response signal. The processing circuitry is configured to analyze the sensed evoked response signal for one or more artifacts and adjust, based on the one or more artifacts, the first stimulation recharge parameter to determine a second stimulation recharge parameter. The processing circuitry is also configured to control the stimulation generation circuitry to generate a second stimulation signal having the second stimulation recharge parameter for delivery to the target anatomy.
An example medical device for aspirating material from a patient includes a flow switch including an anvil, an actuator, and a surface feature on at least one of the anvil and actuator. The flow switch is configured to move the actuator away from the anvil create a flow path for the aspiration of the material and to move the actuator toward the anvil to reduce the flow path by creating at least one channel defined by the surface feature.
A61M 1/00 - Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
A leadless neurostimulation device including a header unit having at least one primary electrode having a contact surface that defines an external surface on a side of the device, an outer housing that forms a side of the header unit opposite of the contact surface of the primary electrode, and a dielectric mount that receives at least a portion of the primary electrode and at least partially surrounds the primary electrode, the dielectric mount being configured to electrically insulate the primary electrode from the outer housing, the dielectric mount being received and fixed within a recessed portion of the outer housing, and a housing having a secondary electrode positioned on the same side of the leadless neurostimulation device as the primary electrode, the primary electrode and the secondary electrode being configured to transmit an electrical stimulation signal therebetween to provide electrical stimulation therapy to a tibial nerve of a patient.
Devices, systems, and techniques are described that use electric field imaging (often referred to as the sensed stimulation artifact representative of a delivered stimulus) as an informative feedback signal to provide closed loop control of electrical stimulation therapy. In some examples, the electric field imaging may be used in combination with other feedback signals, such as ECAP do monitor and adjust the delivered electrical stimulation therapy.
Broad cerebrospinal fluid (CSF) distribution of an agent is achievable by delivering the agent in a liquid formulation to the CSF at flow rates less than 500 microliters per hour, such as between about 2 microliters per hour and about 100 microliters per hour.
A61B 17/12 - Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels or umbilical cord
A fixation component includes tines extending from a base portion of the fixation component. Each tine is elastically deformable between a pre-set position and an open position. Each tine includes a hook segment extending from a proximal end near the base portion to a distal end. Each tine also includes a distal segment extending from the distal end of the hook segment to a tissue-piercing tip. When positioned in the pre-set position, the hook segment extends along a pre-set curvature that encloses an angle between 135 degrees and 270 degrees, and the distal segment extends away from a longitudinal axis of the fixation component.
A medical device lead connector includes electrically conducting contact rings spaced apart by an electrically insulating ring and in axial alignment. The electrically conducting contact ring and the insulating ring having an interface bond on an atomic level.
A61N 1/05 - Electrodes for implantation or insertion into the body, e.g. heart electrode
A61N 1/375 - Constructional arrangements, e.g. casings
B23K 20/02 - Non-electric welding by applying impact or other pressure, with or without the application of heat, e.g. cladding or plating by means of a press
H01R 13/187 - Pins, blades or sockets having separate spring member for producing or increasing contact pressure the spring member being in the socket
H01R 24/58 - Contacts spaced along longitudinal axis of engagement
H01R 43/02 - Apparatus or processes specially adapted for manufacturing, assembling, maintaining, or repairing of line connectors or current collectors or for joining electric conductors for soldered or welded connections
24.
METHODS OF PREPARING BALLOON EXPANDABLE CATHETERS FOR CARDIAC AND VASCULAR INTERVENTIONS
Methods for purging a balloon catheter of air. An inflation fluid is inserted into a balloon and an inflation lumen of a balloon catheter. The inflation lumen is in fluid communication with the balloon. The balloon catheter is positioned in an inverted orientation with a distal end thereof disposed below a proximal end thereof. The distal end of the balloon catheter includes a balloon. A vibration source is positioned in direct contact with an outer surface of the balloon catheter. The balloon catheter is vibrated via the vibration source. A vacuum is applied or pulled on the inflation lumen of the balloon catheter. The steps of vibrating the balloon catheter and applying the vacuum are performed simultaneously.
Example devices and techniques are described herein for determining a relative state-of-charge of a battery. An example device includes memory, a battery, a temperature sensor and processing circuitry coupled to the memory and the temperature sensor. The temperature sensor may be configured to sense a battery temperature. The processing circuitry may be configured to estimate an end-of-discharge state-of-charge of the battery. The processing circuitry may be configured to estimate a remaining capacity of the battery. The processing circuitry may be configured to estimate a full charge capacity of the battery. The processing circuitry may be configured to estimate a relative state-of-charge of the battery and generate a representation of the estimate of the relative state-of-charge of the battery for output.
G01R 31/396 - Acquisition or processing of data for testing or for monitoring individual cells or groups of cells within a battery
G01R 31/367 - Software therefor, e.g. for battery testing using modelling or look-up tables
G01R 31/3842 - Arrangements for monitoring battery or accumulator variables, e.g. SoC combining voltage and current measurements
H01M 10/42 - Methods or arrangements for servicing or maintenance of secondary cells or secondary half-cells
H01M 10/48 - Accumulators combined with arrangements for measuring, testing or indicating the condition of cells, e.g. the level or density of the electrolyte
H02J 7/00 - Circuit arrangements for charging or depolarising batteries or for supplying loads from batteries
26.
DIRECTIONAL CONTROL OF MULTI-COIL ARRAY FOR APPLICATIONS IN RECHARGE SYSTEMS
A system that includes a power transmitting antenna (124) with a coiled conductor defined by a first axis and a second axis perpendicular to the first axis, where a single plane comprises the first axis and the second axis. The system includes a support layer (140, 142) comprising: a substantially planar top surface and a substantially planar bottom surface opposite the substantially planar top surface arranged parallel to the plane. The support layer also comprises a material with a predetermined resiliency. The support layer is configured to support a mass of a user and maintain a predetermined spacing between the plane of the power transmitting antenna and the user during compression of the material from the mass of the user.
H02J 50/40 - Circuit arrangements or systems for wireless supply or distribution of electric power using two or more transmitting or receiving devices
H02J 50/00 - Circuit arrangements or systems for wireless supply or distribution of electric power
H02J 50/10 - Circuit arrangements or systems for wireless supply or distribution of electric power using inductive coupling
H02J 50/80 - Circuit arrangements or systems for wireless supply or distribution of electric power involving the exchange of data, concerning supply or distribution of electric power, between transmitting devices and receiving devices
Systems, devices, and techniques for adjusting electrical stimulation based on sensed ECAP signals. For example, processing circuitry is configured to control delivery of a first train of electrical stimulation pulses at a first frequency to a first target tissue and control delivery of a second train of electrical stimulation pulses at a second frequency to a second target tissue different from the first target tissue. The processing circuitry can also receive an ECAP signal elicited by a pulse of the second train of electrical stimulation pulses, adjust, based on the ECAP signal, a first value of a parameter that at least partially defines the first tram of electrical stimulation pulses to a second value, and, responsive to adjusting the first value of the parameter to the second value, control delivery of subsequent pulses of the first tram of electrical stimulation pulses according to the second value of the parameter.
An apparatus for fastening around a cranial burr hole includes a substantially flat core and a shell encapsulating a ring portion of the core. The shell defines an orifice substantially centered within the ring portion, and has a contoured lower surface to match the cranial curvature. Pliable arms of the core extend laterally from the ring portion, each being terminated by a fastener member. A central portion of a placement tool for the apparatus has a lower part configured to extend through the apparatus orifice, and an upper part from which first and second arms of the tool extend laterally. Each tool arm is terminated with a receptacle to hold a bone screw, and, when the tool central portion lower part extends through the apparatus orifice, each receptacle aligns with a corresponding fastener member, and lower openings of the receptacles are generally oriented along the contoured lower surface.
A61N 1/05 - Electrodes for implantation or insertion into the body, e.g. heart electrode
A61B 90/11 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis with guides for needles or instruments, e.g. arcuate slides or ball joints
A61M 25/04 - Holding devices, e.g. on the body in the body, e.g. expansible
A method comprises identifying P-waves within a cardiac signal stored by a medical device for a cardiac episode detected by the medical device, and calculating a gain factor for display of the cardiac signal based on the identified P-waves.
A medical device is configured to sense a cardiac signal that includes far field ventricular event signals and determine a ventricular activity metric from the sensed cardiac signal. The ventricular activity metric may be representative of a ventricular rate or an atrioventricular time interval. The medical device is configured to determine an atrioventricular synchrony metric based on the ventricular activity metric and generate an output based on the atrioventricular synchrony metric. The device may include a memory configured to store data corresponding to the atrioventricular synchrony metric.
A61N 1/365 - Heart stimulators controlled by a physiological parameter, e.g. by heart potential
A61N 1/368 - Heart stimulators controlled by a physiological parameter, e.g. by heart potential comprising more than one electrode co-operating with different heart regions
Systems and methods for sampling a fluid is provided. The system may include a port implanted in a patient and a catheter implanted in the patient and in fluid communication with the port. The catheter may enable fluid sampling from the patient and delivery of the fluid sample via the port.
A61B 10/00 - Other methods or instruments for diagnosis, e.g. for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
A transcatheter heart valve prosthesis and a method of assembling the transcatheter heart valve prosthesis are disclosed. The heart valve prosthesis includes a valve-skirt assembly having an inner skirt, a frame, an outer wrap backing and an outer wrap. The method includes: tacking the valve-skirt assembly within the frame; attaching the inner skirt below commissure posts of the frame; attaching commissures of the valve component to the commissure posts; attaching a plurality of outer wrap backings to the inner skirt; attaching the outer wrap backings and the inner skirt to the frame; attaching tissue bumpers to struts in an outflow section of the frame; attaching an outer wrap and the inner skirt to the frame; attaching the outer wrap to the inner skirt proximate inflow edges thereof; and attaching the outer wrap to the inner skirt and to the outer wrap backings proximate respective outflow edges thereof.
A medical device is configured to detect an atrial tachyarrhythmia episode. The device senses a cardiac signal, identifies R-waves in the cardiac signal attendant ventricular depolarizations and determines classification factors from the R-waves identified over a predetermined time period. The device classifies the predetermined time period as one of unclassified, atrial tachyarrhythmia and non-atrial tachyarrhythmia by comparing the determined classification factors to classification criteria. A classification criterion is adjusted from a first classification criterion to a second classification criterion after at least one time period being classified as atrial tachyarrhythmia. An atrial tachyarrhythmia episode is detected by the device in response to at least one subsequent time period being classified as atrial tachyarrhythmia based on the adjusted classification criterion.
An example medical device includes processing circuitry configured to determine an electrode impedance value for each of one or more electrodes of a lead coupled to the medical device, identify one or more of the electrodes having electrode impedance values that are greater than electrode impedance values of other electrodes of the lead, from the identified one or more electrodes, determine a recommendation of electrodes to use for sensing a signal, and output information indicative of the recommendation.
Systems, apparatus, methods and computer-readable storage media facilitating trusted pairing between an implantable medical device (IMD) and an external device are provided. In one embodiment, an IMD includes a housing configured to be implanted within a patient, a memory and circuitry within the housing and a processor that executes executable components stored in the memory. The executable components can include: a communication component configured to initiate establishing a telemetry connection with an external device in accordance with a first telemetry protocol based on reception of a request, from the external device, to establish the telemetry connection with the IMD using the first telemetry protocol; and a validation component configured to restrict establishment of the telemetry connection with the external device in accordance with the first telemetry protocol based on reception of validation information from the external device, wherein provision of the validation information is excluded from the first telemetry protocol.
H04W 4/80 - Services using short range communication, e.g. near-field communication [NFC], radio-frequency identification [RFID] or low energy communication
A medical device includes a motion sensor configured to produce a motion signal and a control circuit configured to set sensing control parameters and sense atrial events from the motion signal during ventricular cycles according to the sensing control parameters. In some examples, the control circuit is configured to determine a feature of the motion signal for at least some ventricular cycles, determine a metric of the motion signal based on the determined features, and adjust at least one of the sensing control parameters based on the metric.
A61N 1/375 - Constructional arrangements, e.g. casings
G16H 20/30 - ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to physical therapies or activities, e.g. physiotherapy, acupressure or exercising
G16H 40/67 - ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices for remote operation
G16H 50/30 - ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for individual health risk assessment
A medical device includes wake circuitry and telemetry circuitry. The wake circuitry is configured to receive a first set of data from a device associated with the medical device, where the first set of data is received at a frequency band. The wake circuitry is configured to output a set of pulses based on the first set of data. The wake circuitry is configured to detect a data pattern using the set of pulses. The wake circuitry is configured to output an activation signal in response to a determination that the data pattern satisfies a data pattern requirement. The telemetry circuitry is configured to output a second set of data in response to receiving the activation signal. The second set of data is transmitted at the frequency band. The telemetry circuitry is configured to establish a communication session with the device using the second set of data.
Systems, devices, and techniques for adjusting electrical stimulation based on a posture state of a patient are described. For example, processing circuitry is configured to receive an input from a user adjusting an informed stimulation parameter that at least partially defines a plurality of informed pulses, determine a ratio of a first value of an informed stimulation parameter to a first value of a control stimulation parameter that at least partially defines a plurality of control pulses, change, according to the input, the first value of the informed stimulation parameter to a second value of the informed stimulation parameter, and change, based on the input and the ratio, the first value of the control stimulation parameter to a second value of the control stimulation parameter. The processing circuitry' can then control delivery of the adjusted control pulses and informed pulses.
A61N 1/36 - Applying electric currents by contact electrodes alternating or intermittent currents for stimulation, e.g. heart pace-makers
A61B 5/00 - Measuring for diagnostic purposes ; Identification of persons
A61B 5/388 - Nerve conduction study, e.g. detecting action potential of peripheral nerves
A61N 1/372 - Arrangements in connection with the implantation of stimulators
G16H 40/63 - ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices for local operation
A pair of cooperating catheters, chosen from an inner catheter and two possible outer catheters, are used together to provide rapid access to the Left heart for diagnostic or therapeutic interventions. The pair of catheters can be used to carry out an electrographic determination of the location of the Fossa Ovalis on the septum. Features on the Catheter system permit quick and reliable confirmation of the catheter location via echo or x-rays. Once across the septum the inner catheter is removed from the outer catheter and a standard intervention may be carried out through the lumen of the outer catheter.
A system and method for detecting and verifying bradycardia/asystole episodes includes sensing an electrogram (EGM) signal. The EGM signal is compared to a primary threshold to sense events in the EGM signal, and at least one of a bradycardia or an asystole is detected based on the comparison. In response to detecting at least one of a bradycardia or an asystole, the EGM signal is compared to a secondary threshold to sense events under-sensed by the primary threshold. The validity of the bradycardia or the asystole is determined based on the detected under-sensed events.
An example implantable medical device includes a stimulating lead includes receive one or more signals indicative of one or more physiologic parameters; deliver electrical therapy to stimulate a muscle wrapped around a heart via one or more electrodes of a stimulating lead; and adjust an amount of the electrical therapy delivered, via the stimulating electrodes, based on the one or more physiologic parameters.
A method for ablating tissue by applying at least one pulse train of pulsed-field energy. The method includes delivering a pulse train of energy having a predetermined frequency to cardiac tissue, the pulse train including at least 60 pulses, an inter-phase delay between 0 μs and 5 μs, an inter-pulse delay of at least 5 μs, and a pulse width of 5 μs.
A61B 18/12 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
A61N 1/32 - Applying electric currents by contact electrodes alternating or intermittent currents
43.
ADAPTIVE DEEP BRAIN STIMULATION USING MOVEMENT DESYNCHRONIZATION
Techniques are disclosed for delivering electrical stimulation therapy to a patient. In one example, a medical system delivers electrical stimulation therapy to a tissue of the patient via electrodes. The medical system determines a first change of a first sensed signal of the patient to movement by the patient and a second change of a second sensed signal of the patient to the movement by the patient. Based on the first change and the second change, the medical system selects one of the first sensed signal and the second sensed signal of the patient for controlling the electrical stimulation therapy. The medical system adjusts a level of at least one parameter of the electrical stimulation therapy based on the selected one of the first sensed signal and the second sensed signal.
A method for determining a patient's likelihood of experiencing a thromboembolic event when receiving an implantable blood contacting medical device. The method includes extracting a sample of blood from the patient. The sample of blood is exposed to a metal, metal alloy, or ceramic in a test tube. The sample of the blood is agitated in the test tube. A thromboembolic marker for the sample in the test tube is measured. If the thromboembolic marker for the sample in the test tube is higher than a predetermined thromboembolic marker threshold, it is determined that the patient is likely to experience the thromboembolic event when receiving the blood contacting implantable medical device.
A method for processing patient data includes prompting a patient to complete a survey based on one or more of data received from an implantable medical device, a first time from an enrollment in a study related to the implantable medical device, a second time since a last survey, a medical event, or a detection of the patient in a geofenced area. The method may further include receiving input from the patient in response to the survey, and sending the input from the patient to a database.
G16H 10/20 - ICT specially adapted for the handling or processing of patient-related medical or healthcare data for electronic clinical trials or questionnaires
Delivery devices and methods for delivering a prosthetic heart valve. The delivery device includes an inner shaft assembly with a valve retainer, an outer shaft assembly, a handle assembly and an axial force adjustment assembly. The outer shaft assembly includes a capsule containing the prosthetic valve in a loaded state. The handle assembly is coupled to a proximal region of the outer shaft assembly. The axial force adjustment assembly connects a proximal section of the inner shaft assembly to the handle assembly, and is configured to selectively move the proximal section relative to the handle assembly. The axial force adjustment assembly can include an actuator member and a driver member. The driver member directly interfaces with the inner shaft assembly, and a force applied to the actuator member is transferred onto the proximal section via the driver member. A sensor for sensing tension and/or compression in the inner shaft assembly can be provided.
A61F 2/95 - Instruments specially adapted for placement or removal of stents or stent-grafts
A61F 2/966 - Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod
47.
TRANSCATHETER DELIVERY SYSTEM AND METHOD WITH CONTROLLED EXPANSION AND CONTRACTION OF PROSTHETIC HEART VALVE
A delivery system for use with a prosthetic heart valve having a stent frame to which a valve structure is attached, includes a shaft assembly including a distal end and a coupling structure disposed near the distal end and configured to be coupled to a distal end of the prosthetic heart valve. The system includes a sheath assembly defining a lumen sized to slidably receive the shaft assembly. The delivery system is configured to transition from a loaded state in which the sheath assembly encompasses the prosthetic heart valve to a deployed state in which the sheath assembly is withdrawn from the prosthetic heart valve. The coupling structure is configured to provide a controlled expansion or contraction of the distal end of the prosthetic heart valve based on longitudinal movement of the distal end of the shaft assembly.
In some examples, a processor is configured determine whether efficacy of therapy delivered by a medical device to the patient may have changed and generate a notification based on the determination. For example, a processor may be configured to determine whether a bioelectrical brain signal indicative of activity of a brain of a patient includes a biomarker that indicates efficacy of therapy delivered by a medical device to the patient may have changed, and generate notification based on determining the bioelectrical brain signal includes the biomarker. In some examples, the processor modifies the therapy delivered to the patient prior to generating the notification.
This disclosure describes an implantable medical electrical lead and an ICD system utilizing the lead. The lead includes a lead body defining a proximal end and a distal portion, wherein at least a part of the distal portion of the lead body defines an undulating configuration. The lead includes a defibrillation electrode that includes a plurality of defibrillation electrode segments disposed along the undulating configuration spaced apart from one another by a distance. The lead also includes at least one electrode disposed between adjacent sections of the plurality of defibrillation sections. The at least one electrode is configured to deliver a pacing pulse to the heart and/or sense cardiac electrical activity of the heart.
Some examples include a lithium-ion battery including an electrode assembly, a battery case, and an insulator. The electrode assembly includes a plurality of stacked electrodes. The battery case includes a cover and a housing. The housing includes a bottom, a perimeter side, and an open top. The cover is configured to extend across the open top. The cover and the housing form an interior enclosure to house the electrode assemble with the cover and the housing sealingly coupled at the lip. The insulator includes a body and a profiled portion. The body being generally planar and the profiled portion extending from the body at an angle. The body is disposed between the electrode assembly and the cover of the battery case. The profiled portion extends between the electrode assembly and the lip of the housing. The insulator is to provide a barrier between the electrode assembly and the sealed lip.
H01M 10/0585 - Construction or manufacture of accumulators having only flat construction elements, i.e. flat positive electrodes, flat negative electrodes and flat separators
H01M 10/0525 - Rocking-chair batteries, i.e. batteries with lithium insertion or intercalation in both electrodes; Lithium-ion batteries
H01M 50/474 - Spacing elements inside cells other than separators, membranes or diaphragms; Manufacturing processes thereof characterised by their position inside the cells
H01M 50/103 - Primary casings, jackets or wrappings of a single cell or a single battery characterised by their shape or physical structure prismatic or rectangular
In some examples, determining a heart failure status using a medical device comprising one or more sensors includes determining a first value of a heart beat variability metric of a patient while an activity state of a patient satisfies an inactivity criterion based on a signal received from the one or more sensors, and determining, within a predetermined period of time after further determining that the activity state of the patient no longer satisfies the inactivity criterion, a second value of the heart beat variability metric while the activity state of the patient no longer satisfies the inactivity criterion based on the signal. A difference between the first value of the heart beat variability metric and the second value of the heart beat variability metric may be determined and the heart failure status of the patient may be determined based on the difference.
A medical device processor is configured to receive a first cardiac electrical signal sensed from a first sensing electrode vector, receive a second cardiac electrical signal sensed from a second sensing electrode vector different than the first sensing electrode vector, and construct a third cardiac electrical signal from the first cardiac electrical signal and the second cardiac electrical signal. In some examples, the system determines sensed cardiac events according to at least one setting of a cardiac event sensing threshold control parameter from at least the third cardiac electrical signal and may determine at least one acceptable setting of a sensing control parameter based on the determined sensed cardiac events. The processor may generate an output representative of the determined sensed cardiac events.
Methods, systems, and devices are configured delivering one or more sequences of different pulse trains to a patient. For example, a system includes processing circuitry configured to control stimulation circuitry to deliver a sequence of a plurality of trains of electrical stimulation pulses, wherein each train of the plurality of trains of electrical stimulation pulses comprises respective pulses at least partially defined by a unique parameter variation pattern of a plurality of parameter variation patterns, and control the stimulation circuitry to repeatedly deliver the sequence of the plurality of trains of electrical stimulation pulses.
Systems, devices, and techniques are described for adjusting electrical stimulation based on detected ECAPs. In one example, a medical device includes processing circuitry configured to control stimulation circuitry to deliver a first electrical stimulation pulse and sensing circuitry to detect, after delivery of the first electrical stimulation pulse, an ECAP signal. The processing circuitry may be configured to determine a characteristic value of the ECAP signal, determine an ECAP differential value that indicates whether the characteristic value of the ECAP signal is one of greater than a selected ECAP characteristic value or less than the selected ECAP characteristic value, determine, based on the ECAP differential value, a gain value, determine, based on the gain value, a parameter value that at least partially defines a second electrical stimulation pulse, and control the stimulation circuitry to deliver the second electrical stimulation pulse according to the parameter value.
Techniques are disclosed for delivering electrical stimulation therapy to a patient. In one example, a medical system delivers electrical stimulation therapy to a tissue of the patient via electrodes. The medical system determines a first change of a first sensed signal of the patient to movement by the patient and a second change of a second sensed signal of the patient to the movement by the patient. Based on the first change and the second change, the medical system selects one of the first sensed signal and the second sensed signal of the patient for controlling the electrical stimulation therapy. The medical system adjusts a level of at least one parameter of the electrical stimulation therapy based on the selected one of the first sensed signal and the second sensed signal.
Systems, devices, methods, and techniques are described for using evoked compound action potential (ECAP) signals to monitor lead position and/or detect lead migration. An example system includes sensing circuitry configured to sense an ECAP signal, and processing circuitry. The processing circuitry controls the sensing circuitry to detect, after delivery of an electrical stimulation pulse, a current ECAP signal, and determines one or more characteristics of the current ECAP signal. The processing circuitry also compares the one or more characteristics of the current ECAP signal to corresponding one or more characteristics of a baseline ECAP signal, and determines, based on the comparison, a migration state of the electrodes delivering the electrical stimulation pulse. Additionally, the processing circuitry outputs, based on the migration state, an alert indicative of migration of the electrodes.
Subcutaneous implantation tools and methods of implanting a subcutaneous device using the same. The tool may include a tool body having a longitudinally extending recess having a distal opening and having a tunneler at a distal end of the tool body extending from the distal opening of the recess. The tool may include a plunger slidably fitting within at least a portion of the tool body recess. The recess may be configured to receive an implantable device and the tunneler preferably extends distally from the recess at a position laterally displaced from the device when the device is so located in the recess. Movement of the plunger distally within the recess advances the device distally out of the recess and alongside of and exterior to the tunneler.
A crimper for altering an implantable medical device from an uncompressed state to a compressed state. The crimper includes a plurality of crimper elements that define a crimper channel, each of the crimper elements including a non-planar surface that forms a portion of the crimper channel. Each non-planar surface is configured to apply non-uniform radial compression along a length of the implantable medical device during operation of the crimper when altering the implantable medical device from the uncompressed state to the compressed state. The crimper also includes handle configured to operate the crimper. Actuation of the handle decreases a volume of the crimper chamber to transition the implantable medical device from the uncompressed state to the compressed state.
A recapturable external LAA exclusion clip system includes a clip comprising first and second clip struts, at least one of the struts having a connector interface comprising a first portion of a lock, and a delivery device comprising a handle and an end effector. The handle comprises jaw and lock controls. The end effector is connected to the handle and comprises a clevis and first and second jaws. The jaws are connected to the clevis and operatively connected to the jaw control to actively articulate at least one of the jaws with respect to the other. At least one of the jaws has a connector comprising a second portion of the lock operatively connected to the lock control to removably lock with the first portion of the lock. The first and second portions of the lock have a locked state and are configured to unlock the locked state upon actuation of the lock control.
A61B 17/128 - Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels or umbilical cord for applying or removing clamps or clips
60.
MEDICAL DEVICE AND METHOD FOR TACHYARRYTHMIA DETECTION
A medical device is configured to determine time intervals between consecutive cardiac events sensed from a cardiac electrical signal, increase a value of a tachyarrhythmia interval count in response to each of the determine time intervals detected as a tachyarrhythmia interval. The device is further configured to detect normal sinus rhythm events and the decrease the value of the tachyarrhythmia interval count in response to a threshold number of detected normal sinus rhythm events.
This disclosure is directed to techniques for recording and recognizing physiological parameter patterns associated with symptoms. A medical device system includes a medical device including an accelerometer configured to collect an accelerometer signal that indicates one or more patient movements that occur during a cough. Additionally, the medical device system includes processing circuitry configured to: determine whether the accelerometer signal satisfies a set of criteria corresponding to a cough pattern comprising a smooth increase from a baseline, then a sharp decrease, a peak within the sharp decrease, then a gradual return to the baseline; and identify a cough based on the determination that the accelerometer signal satisfies the set of criteria.
A system comprises processing circuitry configured to receive parametric data for a plurality of parameters of a patient. The parametric data is generated by one or more sensing devices of the patient based on physiological signals of the patient sensed by the one or more sensing devices. The plurality of parameters comprise AF burden. The processing circuitry is configured to derive one or more features based on the parametric data for the plurality of parameters, wherein the one or more features comprise at least one AF burden pattern feature, apply the one or more features to a model, and determine a risk level of a health event for the patient based on the application of the one or more features to the model.
G16H 50/30 - ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for individual health risk assessment
A61B 5/11 - Measuring movement of the entire body or parts thereof, e.g. head or hand tremor or mobility of a limb
A61B 5/00 - Measuring for diagnostic purposes ; Identification of persons
63.
MEDICAL DEVICE SYSTEM FOR CLASSIFICATION AND PREDICTION OF MEDICAL EVENTS USING TIME-BETWEEN-EVENT VALUES
A computing system including a memory, processing circuitry coupled to the memory, and communications circuitry. The processing circuitry is configured to determine a time-between-event (TBE) value for a first plurality of events detected by a computing device, determine a classification condition based on the determined TBE value and reference data stored in the memory, the reference data comprising information corresponding to prior detected events, based on a determined change in the TBE value, apply the classification condition to apply a to a plurality of detected events, wherein the plurality of detected events comprises the first plurality of events and the second plurality of events, and determine whether one or more of the plurality of detected events satisfies the classification condition. The communications circuitry is configured to communicate to another device via a network that the one or more of the plurality of detected events satisfies the classification condition.
G16H 80/00 - ICT specially adapted for facilitating communication between medical practitioners or patients, e.g. for collaborative diagnosis, therapy or health monitoring
G16H 40/67 - ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices for remote operation
G16H 50/30 - ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for individual health risk assessment
64.
SYNCHRONIZATION OF ANTI-TACHYCARDIA PACING IN AN EXTRA-CARDIOVASCULAR IMPLANTABLE SYSTEM
An extra-cardiovascular implantable cardioverter defibrillator (ICD) system receives a cardiac electrical signal by an electrical sensing circuit via an extra-cardiovascular sensing electrode vector and senses cardiac events from the cardiac electrical signal. The ICD system detects tachycardia from the cardiac electrical signal and determines a tachycardia cycle length from the cardiac electrical signal. The ICD system determines an ATP interval based on the tachycardia cycle length and sets an extended ATP interval that is longer than the ATP interval. The ICD delivers ATP pulses to a patient's heart via an extra-cardiovascular pacing electrode vector different than the sensing electrode vector. The ATP pulses include a leading ATP pulse delivered at the extended ATP interval after a cardiac event is sensed from the cardiac electrical signal and a second ATP pulse delivered at the ATP interval following the leading ATP pulse.
Systems and methods of generating atrial electrical heterogeneity using electrical activity monitored using a plurality of external electrodes are described herein. The atrial electrical heterogeneity may include P-wave electrical heterogeneity. The atrial electrical heterogeneity generated from electrical activity monitored during atrial pacing therapy may be used to evaluate and adjust atrial pacing therapy. The atrial electrical heterogeneity generated from electrical activity monitored during intrinsic activation may be used to evaluate a patient's cardiac condition.
Medical devices that provide stimulation therapy that is adjusted based on sensed physiological signals compensate for drifting of those physiological signal values that can lead to stimulation control reaching limits and becoming less effective. The medical devices determine average values of the physiological signals and use those average values to compute adjusted physiological signal threshold(s). The adjusted threshold(s) bring the physiological signals closer to or within the threshold(s) to allow the stimulation adjustments to be made within stimulation limits that can influence the physiological signal to continue to be within the threshold(s) and provide more effective therapy.
A catheter includes a control handle and a catheter shaft coupled to the control handle and extending from the control handle. The catheter shaft has a proximal end coupled to the control handle and a distal end located opposite the proximal end. The catheter also includes a pull wire band coupled to the catheter shaft. At least a portion of the pull wire band is exposed to an environment outside of the catheter shaft. The catheter also includes a pull wire extending from the control handle and through the catheter shaft to the pull wire band.
An example receptacle connector for a catheter for performing pulsed field ablation (PFA). The receptacle connector includes a first side to receive electrical signals; a second side, opposite to the first side, to transfer the electrical signals to a plurality of electrodes; a surface on the first side; and a plurality of groups of pins extending from the surface. Each of the groups of pins includes at least one pin to electrically connect to a power source to receive the electrical signals, and an interlocking wall surrounding the at least one pin.
Subcutaneous implantation tools and methods of implanting a subcutaneous device using the same. The tool may include a tool body having a longitudinally extending recess having a distal opening and having a tunneler at a distal end of the tool body extending from the distal opening of the recess. The tool may include a plunger slidably fitting within at least a portion of the tool body recess. The recess may be configured to receive an implantable device and the tunneler preferably extends distally from the recess at a position laterally displaced from the device when the device is so located in the recess. Movement of the plunger distally within the recess advances the device distally out of the recess and alongside of and exterior to the tunneler.
An example method includes obtaining, by processing circuitry, at least one first electrical stimulation parameter of an electrical stimulation program that defines an electrical stimulation therapy deliverable to a patient and determining an electrical characteristic of a stimulation system configured to deliver the electrical stimulation therapy according to the electrical stimulation program. The method further includes determining, based on the electrical characteristic and the at least one first electrical stimulation parameter, a maximum selectable value for a second electrical stimulation parameter of the electrical stimulation program and outputting, for display by a user interface, the maximum selectable value.
Devices, systems, and techniques are described for selecting an evoked compound action potential (ECAP) growth curve based on a posture of a patient. The ECAP growth curve defines a relationship between a parameter defining delivery of stimulation pulses delivered to the patient and a parameter of an ECAP signal of a nerve of a patient elicited by a stimulation pulse. In one example, a medical device detects a posture of a patient and selects an ECAP growth curve corresponding to the detected posture. The medical device selects, based on the ECAP growth curve corresponding to the detected posture and a characteristic of a detected ECAP signal, a value for a parameter for defining delivery of the stimulation pulses to the patient and controls delivery of the stimulation pulses according to the selected value for the parameter.
A medical device is configured to receive sensed cardiac event data including a value of a feature determined from each one of a plurality of cardiac events sensed from a cardiac signal according to a first setting of a sensing control parameter. The medical device is configured to classify each value of the feature of each one of the sensed cardiac events as either a predicted sensed event or a predicted undersensed event according to a second setting of the sensing control parameter that is less sensitive to sensing cardiac events than the first setting. The medical device is configured to determine a predicted sensed event interval between each consecutive pair of the predicted sensed events and predict that an arrhythmia is detected or not detected based on the predicted sensed event intervals.
The present disclosure relates generally to pacing of the cardiac conduction system of a patient, and more particularly, to providing adaptive cardiac conducting system pacing therapy and to determining selective or non-selective capture of the cardiac conduction system by cardiac conduction system pacing therapy. The adaptive cardiac conduction system pacing therapy may adjust AV delay and VV delay based on various signals and metrics and may switch between cardiac conduction system pacing therapy exclusively and cardiac conduction system pacing therapy in combination with traditional left ventricular pacing therapy.
A61N 1/368 - Heart stimulators controlled by a physiological parameter, e.g. by heart potential comprising more than one electrode co-operating with different heart regions
A61N 1/375 - Constructional arrangements, e.g. casings
Novel tools and techniques are provided for implementing an imaging discovery utility for augmenting clinical image management. In some embodiments, in response to receiving a request for a first medical image file(s) from a requesting device, a non-relational (“NoSQL”) data management system (“DMS”) may access a NoSQL database containing, inter alia, a plurality of medical image files that are mirrored copies of a plurality of medical image files stored in a relational (“SQL”) database, the medical image files each being organized in an image-centric hierarchy with image data being at a top level and patient information associated with the image data being at a lower level. Based on a successful search of the NoSQL database based on search terms in the request, the NoSQL DMS may identify a corresponding second medical image(s) in the SQL database, and may retrieve and send (to the requesting device) the identified second medical image(s).
Techniques that include applying machine learning models to episode data, including a cardiac electrogram, stored by a medical device are disclosed. In some examples, based on the application of one or more machine learning models to the episode data, processing circuitry derives, for each of a plurality of arrhythmia type classifications, class activation data indicating varying likelihoods of the classification over a period of time associated with the episode. The processing circuitry may display a graph of the varying likelihoods of the arrhythmia type classifications over the period of time. In some examples, processing circuitry may use arrhythmia type likelihoods and depolarization likelihoods to identify depolarizations, e.g., QRS complexes, during the episode.
G16H 50/20 - ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for computer-aided diagnosis, e.g. based on medical expert systems
A stented valve including a generally tubular stent structure that has a longitudinal axis, first and second opposite ends, a plurality of commissure support structures spaced from the first and second ends and extending generally parallel to the longitudinal axis, at least one structural wire positioned between each two adjacent commissure support structures, and at least one wing portion extending from two adjacent commissure support structures and toward one of the first and second ends of the stent structure. The stented valve further includes a valve structure attached within the generally tubular stent structure to the commissure support structures.
Devices, systems, and methods for occluding body lumens are disclosed herein. According to some embodiments, the present technology includes an embolization device configured to be positioned within a body lumen of a patient. The embolization device can comprise an elongated primary structure formed of a coiled wire, where the primary structure forms a secondary structure when unconstrained in which the primary structure forms an anchor portion and a trailing portion. The anchor portion can be configured to anchor the embolization device at the treatment site, and the trailing portion can be configured to fill space in the body lumen to reduce or block flow into or through the body lumen. The primary structure can have a stiffening feature along at least a portion of the anchor portion.
A61B 17/12 - Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels or umbilical cord
78.
ALIGNMENT GARMENT FOR USE WITH A FULLY IMPLANTABLE SYSTEM
An alignment vest for holding an external coil in a predetermined location. The alignment vest may comprise at least one attachment mechanism for holding the external coil in the predetermined location. The alignment vest may also comprise a panel having a fastening mechanism and a plurality of straps, the front panel being secured to at least one of the plurality of straps.
A61M 60/875 - Energy supply devices; Converters therefor specially adapted for wireless or transcutaneous energy transfer [TET], e.g. inductive charging specially adapted for optimising alignment of external and implantable coils
A61M 60/178 - Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient’s body implantable in, on, or around the heart drawing blood from a ventricle and returning the blood to the arterial system via a cannula external to the ventricle, e.g. left or right ventricular assist devices
Methods of and systems for ablating cardiac tissue is disclosed. One example method includes monitoring an electrical signal of a heart of a patient. The electrical signal represents the heart beating. The method further includes determining, with an electronic processor and based on the electrical signal, an end-diastolic time period at an end of a diastolic time period during which diastole of the heart has occurred during a previous cardiac cycle. The method further includes determining, with the electronic processor and based on the electrical signal, that another cardiac cycle has begun. The method further includes causing, with the electronic processor, an electrode to deliver pulsed field ablation (PFA) energy to the heart during at least a portion of a time in which the end-diastolic time period of the another cardiac cycle is expected to occur.
A transseptal system includes a needle, a guidewire, a handle, and a dilator. The handle defines a needle passage to slidably receive the needle, and a guidewire passage to slidably receive the guidewire. The dilator defines a lumen having a distal region and a proximal region. The dilator is coupled to the handle such that the lumen is open to the needle passage and the guidewire passage. The proximal region of the lumen is sized to simultaneously receive the needle body and the guidewire. The distal region is sized to slidably receive one of the needle and the guidewire on an individual basis. A transseptal puncture and access procedure can be performed, including puncturing tissue with the needle followed by immediate advancement of the guidewire into the accessed area, eliminating the need for multiple instrument exchanges during the procedure.
A locking mechanism for a connector to an implantable controller includes a housing of the implantable controller defining a housing bore sized to receive the connector. A set screw is releasably coupled to the housing and disposed at an oblique angle with respect to the housing, the set screw being configured to engage at least a portion of the connector when the set screw is fully inserted within the housing to lock the connector within the housing.
An electrosurgical device configured to harvest RF energy to provide power to one or more loads. The electrosurgical device including a distal portion having two electrodes configured to introduce electrical current into tissue and a proximal portion coupled to an electrical connector. The electrical connector is configured to provide a treatment signal and a continuous signal to an energy harvesting assembly housed within the electrosurgical device. The energy harvesting assembly includes a transformer configured to isolate and reduce the treatment signal to a lower voltage, an AC-DC converter configured to convert the AC signal to DC, and a DC-DC regulator configured to output a fixed voltage. The one or more loads can be electrically coupled to the energy harvesting assembly such that the one or more loads are powered by the fixed voltage.
Examples for controlling electrical stimulation therapy are described. One example includes delivering a pulse train at a frequency to a patient, the pulse train comprising a plurality of first pulses at least partially interleaved with a plurality of second pulses, wherein the plurality of first pulses are configured to facilitate sensing elicited electrical signals, each pulse of the plurality of first pulses having an active first phase and active second phase. Each pulse of the plurality of second pulses may include an active first phase and a passive second phase. Additionally, or alternatively, the plurality of second pulses may alternate between a cathodic active first phase and an anodic active first phase according to a ratio. At least one pulse of the plurality' of second pulses may have an interphase interval that is longer than an interphase interval of at least one pulse of the plurality of first pulses.
A charging device is described. One example of a charging device described herein includes at least one coil contained in a housing, where the at least one coil wirelessly transfers energy to an implantable medical device. The charging device may further include a coil manipulator that adjusts a configuration of the at least one coil within the housing.
H02J 50/90 - Circuit arrangements or systems for wireless supply or distribution of electric power involving detection or optimisation of position, e.g. alignment
H02J 50/00 - Circuit arrangements or systems for wireless supply or distribution of electric power
H02J 50/80 - Circuit arrangements or systems for wireless supply or distribution of electric power involving the exchange of data, concerning supply or distribution of electric power, between transmitting devices and receiving devices
H02J 50/40 - Circuit arrangements or systems for wireless supply or distribution of electric power using two or more transmitting or receiving devices
H02J 50/23 - Circuit arrangements or systems for wireless supply or distribution of electric power using microwaves or radio frequency waves characterised by the type of transmitting antennas, e.g. directional array antennas or Yagi antennas
An additive manufacturing system for producing a medical catheter or lead and a method thereof. The system including a heating cartridge defining an interior volume and at least one filament port. The system also including a heating element thermally coupled to the heating cartridge to heat the interior volume, a filament handling system to feed at least one filament through the at least one filament port, and a substrate handling system. The substrate handling system including a clamp to secure a portion of a substrate to be moved relative to the heating cartridge to apply a jacket to the substrate. In one or more embodiments, a subassembly is positioned on the substrate and has an electrode ring. The jacket printed to cover at least a portion of the subassembly and spaced apart from the electrode ring.
B29C 64/118 - Processes of additive manufacturing using only liquids or viscous materials, e.g. depositing a continuous bead of viscous material using filamentary material being melted, e.g. fused deposition modelling [FDM]
B29C 64/40 - Structures for supporting 3D objects during manufacture and intended to be sacrificed after completion thereof
Valve delivery catheter assemblies including components that limit trauma to the expanded prosthetic valve and body channels as the distal tip of the catheter is withdrawn through the expanded valve and thereafter from the body. Catheter assemblies according to the present invention can include a handle assembly, an introducer sheath, and a distal tip assembly. The handle assembly can include a fixed main handle and two or more rotating handles that allow a user to control the distal tip assembly of the catheter. A safety button can be included on the handle assembly to allow for precise and consistent positioning of the prosthetic valve in the body. A valve retaining mechanism can be included to assist in retaining the prosthetic valve prior to deployment.
A61F 2/966 - Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod
Systems and methods that automatically adjust, or adapt, stimulation waveforms delivered to brain structures. Closed loop system embodiments can automatically be re-configured into a more suitable closed loop control system in response to measures of control system performance. Measures can be internal performance characteristics of the adaptive control system or external inputs provided by another subsystem. As these measures change in time, the robust adaptive system changes in response.
An alignment garment for holding an external coil in a predetermined location. The alignment garment may comprise an attachment mechanism for holding the external coil in the predetermined location. The alignment garment may also have a plurality of straps with a first strap in the plurality of straps being secured to the attachment mechanism and a second strap of the plurality of straps being secured to the attachment mechanism.
A61M 60/875 - Energy supply devices; Converters therefor specially adapted for wireless or transcutaneous energy transfer [TET], e.g. inductive charging specially adapted for optimising alignment of external and implantable coils
A system includes a medical device for implanting in a valve of a subject, the implantable medical device having a self-expanding frame; and a holder configured to retain the frame of the implantable medical device in a constricted configuration and to control expansion of the frame. The holder has a controllably constrictable and expandable loop, wherein the loop is disposed about at least a portion of the self-expanding frame such that constriction or expansion of the first loop controls constriction or expansion of the frame.
In some examples, a medical system includes a medical device. The medical device may include a housing configured to be implanted in a target site of a patient, a light emitter configured to emit a signal configured to cause a fluorescent marker to emit a fluoresced signal into the target site, and a light detector that may be configured to detect the fluoresced signal. The medical system may include processing circuitry configured to determine a characteristic of the fluorescent marker based on the emitted signal and the fluoresced signal. The characteristic of the fluorescent marker may be indicative of a presence of a compound in the patient, and the processing circuitry may be configured to track the presence of the compound of the patient based on the characteristic of the fluorescent marker.
A61B 5/1459 - Measuring characteristics of blood in vivo, e.g. gas concentration, pH-value using optical sensors, e.g. spectral photometrical oximeters invasive, e.g. introduced into the body by a catheter
A61B 5/145 - Measuring characteristics of blood in vivo, e.g. gas concentration, pH-value
A61B 5/00 - Measuring for diagnostic purposes ; Identification of persons
A61B 5/0205 - Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
A61B 5/1473 - Measuring characteristics of blood in vivo, e.g. gas concentration, pH-value using chemical or electrochemical methods, e.g. by polarographic means invasive, e.g. introduced into the body by a catheter
Example devices and techniques for improving signal quality of a sensed evoked response signal include processing circuitry communicatively coupled to stimulation generation circuitry and sensing circuitry. The processing circuitry is configured to control the stimulation generation circuitry to generate a stimulation signal and receive from the sensing circuitry the sensed evoked response signal. The processing circuitry is configured to determine that a characteristic value of at least one of the artifact or the sensed evoked response signal meets a threshold and automatically change, based on the determination that the characteristic value of the at least one of an artifact in the sensed evoked response signal or the sensed evoked response signal meets the threshold, at least one sensing parameter.
An example system includes telemetry circuitry configured for communication between a medical device and an external device associated with the medical device and processing circuitry. The processing circuitry is configured to receive, with the telemetry circuitry, an advertisement from the medical device. The advertisement includes connection parameters for a potential communication session with the medical device and an indication that the medical device is connected by an established communication session between the medical device and a connected device. The processing circuitry is further configured to identify the connected device using the indication of the advertisement, initiate a communication session between the telemetry circuitry and the connected device, and output, with the telemetry circuitry and using the communication session between the telemetry circuitry and the connected device, a request for information from the medical device.
Systems, apparatus, methods and non-transitory computer readable media facilitating telemetry data communication security between an implantable device and an external clinician device are provided. An implantable device can include a security component configured to generate security information based on reception of a clinician telemetry session request from the clinician device via a first telemetry communication protocol. The security information can include a session identifier and a first session key, and the clinician telemetry session request can include a clinician device identifier associated with the clinician device. The implantable device can further include a communication component configured to establish a clinician telemetry session with the clinician device using a second telemetry communication protocol based on determining that a connection request, received via the second telemetry communication protocol, was transmitted by the clinician device based on inclusion of the clinician device in the connection request.
H04Q 9/00 - Arrangements in telecontrol or telemetry systems for selectively calling a substation from a main station, in which substation desired apparatus is selected for applying a control signal thereto or for obtaining measured values therefrom
Systems and methods for controlling and optimizing closed-loop neuromodulation therapies are provided. The system may include a pulse generator configured to generate an electrical signal that may be transmitted to a plurality of a electrodes. The plurality of electrodes may include at least one stimulating electrode and at least one recording electrode. The at least one stimulating electrode may be configured to stimulate an anatomical element based on the electrical signal and the at least one recording electrode configured to record a physiological response.
An example implantable neurostimulator includes a battery configured to provide power to the implantable neurostimulator, a battery switch configured to open or close, and a plurality of firmware modules. At least two of the plurality of firmware modules are configured to generate and transmit one or more respective requests. The implantable neurostimulator also includes power domain firmware configured to receive the one or more respective requests, determine whether to open in response to the one or more respective requests, and control the battery switch to open in response to the determination.
A medical system includes a generator configured to generate pulsed electric field (PEF) energy. A medical device is in electrical communication with the generator and has a plurality of electrodes configured to deliver the PEF energy to a target tissue to create electroporated regions in the target tissue. A delivery element tracking system is in communication with the generator and the medical device. The tracking system has processing circuitry configured to: measure a position of at least one of the plurality of electrodes prior to delivery of PEF energy to the target tissue with respect to the target tissue and correlate a PEF field distribution based on the delivery of PEF energy to the target tissue to determine or modify at least one metric of a therapeutic effect from the PEF delivery at positions other than the measured location of the plurality of electrodes.
A61B 5/00 - Measuring for diagnostic purposes ; Identification of persons
A61B 18/12 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
98.
APPLICATION OF NON-THERAPEUTIC WAVEFORMS WITH GRADIENT SENSING TO PREDICT PULSED FIELD ABLATION (PFA) FIELDS
A method and a pulsed electric field (PEF) ablation instrument are provided. According to one aspect, a method in a PFA generator includes receiving electrical responses for each of at least one non-therapeutic waveform. The process also includes determining an electric field distribution based at least in part on the received electrical responses. The process further includes selecting a non-therapeutic waveform that produces an electric field distribution that satisfies criteria. The process also includes mapping the selected non-therapeutic waveform to an ablative waveform.
Various embodiments of an integrated circuit package are disclosed. The package includes an integrated circuit having an integrated circuit contact disposed on a first major surface of the integrated circuit; a first passivation layer disposed on the first major surface of the integrated circuit and over the integrated circuit contact; and a redistribution layer disposed on the first passivation layer. The redistribution layer includes a conductive trace and a shield region that define a plane of the redistribution layer. The package further includes a second passivation layer disposed on the redistribution layer, and a patterned conductive layer disposed on the second passivation layer and including a conductive trace. A portion of the shield region of the redistribution layer is disposed between the conductive trace of the patterned conductive layer and the integrated circuit along an axis that is substantially orthogonal to the first major surface of the integrated circuit.
H01L 23/552 - Protection against radiation, e.g. light
H01L 23/528 - Layout of the interconnection structure
H01L 21/768 - Applying interconnections to be used for carrying current between separate components within a device
H01L 23/522 - Arrangements for conducting electric current within the device in operation from one component to another including external interconnections consisting of a multilayer structure of conductive and insulating layers inseparably formed on the semiconductor body
Various embodiments of an electrical component and a method of forming such component are disclosed. The electrical component includes a substrate having a first major surface, a second major surface, and a cavity disposed in the substrate. The cavity extends between the first major surface and the second major surface. The electrical component also includes an anode electrode that includes a conductive foil layer disposed on the second major surface of the substrate and over the cavity. Tantalum material is disposed within the cavity and includes tantalum particles. A dielectric layer is disposed on the tantalum particles, and an electrolyte cathode layer is disposed on the dielectric layer. The electrical component also includes a cathode electrode disposed over the cavity.
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