Medical devices including a balloon-actuated sheath are provided. The medical devices include a tubular body, a tooltip (130), a balloon (120), and a tubular sheath (140) 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.
A61N 1/05 - Electrodes for implantation or insertion into the body, e.g. heart electrode
A61B 90/00 - 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
2.
STABLE REFERENCE FOR SENSOR APPARATUS USING TWO REFERENCE ELECTRODES
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. The reference baseline signal is based on the combination of first baseline signal and second baseline signals. The analyte level of the target environment is based on the analyte signal and the reference baseline signal.
A61B 5/1468 - Measuring characteristics of blood in vivo, e.g. gas concentration, pH-value using chemical or electrochemical methods, e.g. by polarographic means
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.
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.
Systems and methods for evaluating a proposed valve-in-valve procedure for a patient in which a replacement transcatheter aortic valve will be deployed within a first bioprosthetic aortic valve. The methods include selecting predetermined benchmark measurements of a valve-in-valve combination. Images of anatomy of the patient are received. Anatomical measurements of the first bioprosthetic valve are obtained from the received images. The predetermined benchmark measurements and the anatomical measurements are reviewed. Based, at least in part, upon the review, risks of a valve-in-valve procedure for the patient are evaluated. The methods of the present disclosure can be used on baseline scans of a patient without a first bioprosthetic valve implanted; under these circumstances, dimensions of the first valve are determined by benchmark measurements. Where methods of the present disclosure are used on post-first implant scans, then the dimensions of the first valve are determined from the post-implant scans.
A system comprises one or more implantable monitoring devices configured to continuously sense a plurality of physiological signals of a subject and collect parameter data of the subject based on the sensed physiological signals. At least one monitoring device of the one or more monitoring devices comprises a housing configured for subcutaneous implantation in the subject and a plurality of electrodes positioned on the housing. The at least one monitoring device is configured to continuously sense at least one physiological signal of the plurality of physiological signals via the plurality of electrodes. The system further comprises processing circuitry configured to determine a mental state of the subject based on at least one of the sensed physiological signals or the parameter data.
This disclosure describes a system comprising an electrical lead, an implantable medical device, wherein the electrical lead is configured to be electrically connected to the implantable medical device, and wherein the implantable medical device is configured to deliver an electrical therapy to tissue of a patient via the electrical lead, and an expandable member configured to be disposed over the implantable medical device and an excess portion of the electrical lead. The expandable member comprises a first portion defining an inner volume configured to retain the implantable medical device and the excess portion of the electrical lead, and a second portion connected to a proximal end of the first portion, the second portion configured to be disposed over at least a part of the first portion of the expandable member, wherein the expandable member is configured to control a length of the electrical lead within vasculature of the patient..
Adaptive cardiac conduction system pacing therapy for multi-chamber devices may monitor electrical activity of a patient's heart and select a cardiac conduction system pacing therapy pacing mode based on the monitored electrical activity. For instance, one or more metrics such as P-wave-to-R-wave interval and QRS complex width may be determined based on the monitored electrical activity, and one of an inhibited pacing mode, a ventricular fusion pacing mode, an atrioventricular synchronous pacing mode, and an atrial fibrillation pacing mode may be selected based on the determined one or more metrics.
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
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 to 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
A61M 39/28 - Clamping means for squeezing flexible tubes, e.g. roller clamps
A system including an implantable medical device (IMD) configured to deliver an anti-tachycardia pacing (ATP) therapy to a patient and an external device including: communications circuitry configured to communicate with the IMD; and processing circuitry configured to: receive, via the communications circuitry, a request to connect from the IMD, determine whether the IMD is connected to the external device, and based on a determination that the IMD is connected to the external device, transmit instructions, via the communications circuitry, to the IMD to deliver the ATP therapy to the patient.
In some examples, an implantable medical device includes a device body extending from a proximal portion to a distal portion along a longitudinal axis, a fixation component, and an electrode interface assembly. The fixation component includes a penetrator tine extending away from the distal portion of the device body and configured to penetrate a tissue. The electrode interface assembly includes a leadlet extending away from the distal portion of the device body, an elongated body extending away from the distal portion of the device body the elongated body defining a recess and a groove, wherein the groove is configured to receive the leadlet, and an electrode extending from the elongated body and disposed within the recess.
An electrochemical cells and methods of making the same are disclosed. An electrochemical cell may include a cell housing and a cell core disposed in the cell housing. The cell body may extend along a longitudinal axis from a distal end to a proximal end. The cell core may include a cathode electrode, an anode electrode, and a separator disposed between the cathode electrode and the anode electrode. The cathode electrode may define a plurality of cathode windings around the longitudinal axis. Each cathode winding may include a porous conductive strip and a cathode active material disposed on the porous conductive strip. The anode electrode may be disposed around the cathode electrode.
H01M 4/74 - Meshes or woven material; Expanded metal
H01M 10/04 - Construction or manufacture in general
H01M 10/0525 - Rocking-chair batteries, i.e. batteries with lithium insertion or intercalation in both electrodes; Lithium-ion batteries
H01M 10/0587 - Construction or manufacture of accumulators having only wound construction elements, i.e. wound positive electrodes, wound negative electrodes and wound separators
13.
MEDICAL DEVICE AND METHOD FOR DETERMINING RISK OF A CARDIAC EVENT
A medical device is configured to receive up to two cardiac electrical signals. For each cardiac cycle of multiple cardiac cycles, the device may derive a T-wave loop in at least two dimensions using one or two of the up to two cardiac electrical signals. The medical device may determine a repolarization measurement representative of each T-wave loop and determine a change in the repolarization measurement from a previously determined repolarization measurement. The device may determine a metric of the determined changes in the repolarization measurements.
Adaptive cardiac conduction system pacing therapy may monitor electrical activity of a patient's heart and select a cardiac conduction system pacing therapy pacing mode based on the monitored electrical activity. For instance, one or more metrics such as P- wave-to-R-wave interval and QRS complex width may be determined based on the monitored electrical activity, and one of an inhibited pacing mode, a ventricular fusion pacing mode, an atrioventricular synchronous pacing mode, and an atrial fibrillation pacing mode may be selected based on the determined one or more metrics.
A61B 5/366 - Detecting abnormal QRS complex, e.g. widening
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
A61B 5/00 - Measuring for diagnostic purposes ; Identification of persons
A61N 1/375 - Constructional arrangements, e.g. casings
This disclosure describes a system comprising an electrical lead, an implantable medical device, wherein the electrical lead is configured to be electrically connected to the implantable medical device, and the implantable medical device is configured to deliver an electrical therapy to tissue of a patient via the electrical lead, and an expandable member configured to be disposed over the implantable medical device and an excess portion of the electrical lead, wherein the expandable member is configured to control movement of the electrical lead within vasculature of the patient.
A system including an electrical lead, an implantable medical device, wherein the electrical lead is configured to be electrically connected to the implantable medical device, and the implantable medical device is configured to deliver an electrical therapy to tissue of a patient via the electrical lead, a sheath configured to be at least partially disposed within vasculature of the patient and configured to receive the electrical lead such that a distal portion of the electrical lead is placed within the vasculature through the sheath, and a lead management device connected to the implantable medical device and the sheath, wherein the lead management device is configured to secure an excess portion of the electrical lead, and wherein the lead management device is configured to control movement of the electrical lead within the vasculature of the patient.
An example medical device includes a memory; and processing circuitry coupled to the memory, the processing circuitry is configured to: receive, from one or more electrodes coupled to the medical device, a cardiac signal; determine a risk of noise being greater than or equal to a noise risk threshold or an active amount of the noise being greater than or equal to an active noise threshold; and in response to determining the risk of noise is greater than or equal to the noise risk threshold or the active amount of noise is greater than or equal to the active noise threshold, activate a filter to filter the noise from the cardiac signal.
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 31/36 - Arrangements for testing, measuring or monitoring the electrical condition of accumulators or electric batteries, e.g. capacity or state of charge [SoC]
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
A capsule of a delivery system for a transcatheter heart valve prosthesis includes markers for rotationally orienting the capsule within a native valve. The capsule includes markers that are sized and located on the capsule such that when viewed in a cusp overlap viewing angle image, the markers indicate whether the capsule is in a desired rotational orientation. Methods for rotationally aligning a capsule of a delivery system containing a transcatheter heart valve prosthesis within a native valve are also provided.
A computing device comprises communication circuitry configured to wirelessly communicate with a sensor device, one or more output devices, and processing circuitry. The processing circuitry is configured to receive episode data for an acute health event detected by the sensor device via the communication circuitry, the episode data transmitted by the sensor device in response to detecting the acute health event. The processing circuitry is configured to apply one or more machine learning models to each segment of a plurality of segments of the episode data to determine a respective classification of a plurality of predetermined classifications for each segment of the plurality of segments, determine a classification of the acute health event from the plurality of predetermined classifications based on the respective classifications of the plurality of segments, and determine whether to control the one or more output devices to output an alarm based on the classification.
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 computing device comprises communication circuitry configured to wirelessly communicate with a sensor device on a patient or implanted within the patient, one or more output devices, and processing circuitry. The processing circuitry is configured to receive episode data for an acute health event detected by the sensor device via the communication circuitry, the episode data transmitted by the sensor device in response to detecting the acute health event, determine an alarm context in response to receiving the episode data, configure an alarm for the acute health event based on the alarm context, and control the one or more output devices to output the alarm configured based on the alarm context.
A system comprises a cloud computing system, a computing device, and a sensor device. The sensor device is configured to sense an electrocardiogram of the patient, detect a ventricular tachyarrhythmia based on sensed electrocardiogram, and wirelessly communicate with the computing device in response to the detection of the ventricular tachyarrhythmia. Based on the wireless communication from the sensor device, the computing device is configured to at least one of output a local alarm or transmit an alert to an emergency medical service via the cloud computing system. Processing circuitry of at least one of the sensor device, the computing device, or the cloud computing system is configured to determine QT intervals based on the electrocardiogram, and transmit a message indicating QT prolongation of the patient to a clinician based on a determination that the QT intervals satisfy one or more QT prolongation criteria.
A computing device comprises communication circuitry configured to wirelessly communicate with a sensor device on a patient or implanted within the patient, one or more output devices, and processing circuitry. The processing circuitry is configured to receive episode data for an acute health event detected by the sensor device via the communication circuitry, the episode data transmitted by the sensor device in response to detecting the acute health event. The processing circuitry is configured to classify the acute health event as one of a plurality of classifications by at least applying one or more machine learning models to each segment of a plurality of segments of the episode data, and applying one or more non¬ machine learning rules to each segment of the plurality of segments. The processing circuitry is configured to determine whether to control the one or more output devices to output an alarm based on the classification.
A61B 5/29 - Invasive for permanent or long-term implantation
A61B 5/00 - Measuring for diagnostic purposes ; Identification of persons
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
A61B 5/33 - Heart-related electrical modalities, e.g. electrocardiography [ECG] specially adapted for cooperation with other devices
24.
IDENTIFYING EJECTION FRACTION USING A SINGLE LEAD CARDIAC ELECTROGRAM SENSED BY A MEDICAL DEVICE
An example system for determining reduced ejection fraction includes two or more electrodes forming a single lead configured to capture a cardiac electrogram (EGM) signal of a patient, circuitry configured to: convert the EGM signal to a time -frequency domain using a continuous wavelet transform; and apply the converted EGM signal to a convolutional neural network to determine one or more of an amount of ejection fraction or a classification of ejection fraction.
A61B 5/02 - Measuring pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography; Heart catheters for measuring blood pressure
A61B 5/00 - Measuring for diagnostic purposes ; Identification of persons
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
25.
MULTI-MODALITY BALLOON CATHETER INCLUDING LITHOTRIPSY BALLOON
A multi-modality catheter is configured to treat a calcified lesion of a body lumen. The multi-modality catheter includes an integrated intravascular lithotripsy balloon and second treatment balloon. The intravascular lithotripsy balloon includes a shock wave emitter to produce a shock wave for modifying the calcified lesion. The second treatment balloon is configured to treat the calcified lesion.
A medical system including an implantable medical device (IMD) configured to position within a heart of a patient. The IMD is configured to receive imparted forces from a tissue wall of a beating heart when a fixation element of the IMD is implanted in the tissue wall. The IMD includes a motion sensor configured to sense the motion of the IMD produced by forces imparted to the IMD from the tissue wall. Processing circuitry is configured to compare the motion sensed with a representative cardiac activity. The processing circuitry is configured to assess the engagement of the fixation element and the tissue wall based on the comparison. The processing circuitry may be configured to assess the engagement as a clinician causes the fixation element to engage the tissue wall.
A lithotripsy balloon catheter may include a shock wave emitter that is selectively movable longitudinally within the balloon to adjust a longitudinal position of the shock wave emitter relative to the balloon. A lithotripsy balloon catheter may include a unipolar electrode that produces an electrical arc when a voltage is applied to the unipolar electrode thereby creating a shock wave within the balloon. A grounding conductor for the shock wave emitter may be coupled to the proximal end portion of the catheter body and configured to be connected to ground. A lithotripsy balloon catheter may include a unipolar electrode in communication with an electrical source of energy and configured to deliver energy from the electrical energy source to the fluid in the balloon thereby creating a shock wave within the balloon. Ceramic insulation may be disposed on the unipolar electrode to focus energy at a tip of the unipolar electrode.
A medical device system includes a medical device comprising one or more electrodes and configured to generate electrical cardiac data based on a cardiac signal sensed from a patient via the one or more electrodes, a memory configured to store a machine learning model and a plurality of sets of training data, and processing circuitry in communication with the memory. The processing circuitry is configured to apply the machine learning model to the electrical cardiac data to determine a value of a metric of left ventricular (LV) dysfunction. The machine learning model is trained based on the plurality of sets of training data. Each set of training data of the plurality of sets of training data includes a set of training electrical cardiac data and information indicating one or more values of the metric of LV dysfunction corresponding to the set of training electrical cardiac data.
A61B 5/02 - Measuring pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography; Heart catheters for measuring blood pressure
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
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
The present disclosure relates to surrogate left ventricular activation times (110, 107, 107A) that is representative of, or correlates to, left ventricular activation times for use in determining left bundle branch (LBB) (8a) capture and LBB pacing configuration. The surrogate left ventricular activation times (110, 107, 107A) may be determined, or measured, from electrical activity monitored from one or more implanted electrodes (40, 42, 44, 46, 48, 50, 58, 61, 62, 64, 66) such as, for example, a LBB pacing electrode or an electrode located in the right ventricle (28).
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
In some examples, the disclosure relates to system, devices, and techniques for delivering electrical stimulation therapy to treat patient disorders. In one example, the disclosure is directed to a method including controlling, using processing circuitry, the delivery of an electrical stimulation therapy to a patient via a medical device, wherein the electrical stimulation therapy includes a plurality of bi-phasic pulses, each pulse of the bi- phasic pulses including a first phase followed by a second phase, and wherein the plurality of bi-phasic pulses are configured to reduce or block transmission of neural activity along nerve fibers.
A loading system for loading a heart valve prosthesis into a delivery system includes a loading cone, a loading ring, and a valve seat. The loading cone includes a passageway extending therethrough, with the passageway including a tapered portion. The loading ring is configured to be coupled to the loading cone. The valve seat is configured to be coupled to the loading ring. The valve seat is rotatable relative to the loading ring when the valve seat and the loading ring are coupled together. The valve seat is configured to receive the heart valve prosthesis.
Systems and methods for treating Inflammatory Bowel Disease (IBD) using neuromodulation are described herein. For example, IBD can be treated by delivering an electrical signal to one or more sacral nerves of a patient via an implanted signal delivery device positioned proximate one or more of the patient's sacral nerves. In some embodiments, the electrical signal can modulate neural activity in the patient, which may in turn reduce inflammation in the patient by altering an imbalance between the patient's sympathetic nervous system and parasympathetic nervous system, and/or modifying a threshold for an inflammatory response in the gastrointestinal system.
Techniques are described for facilitating multi-party adjudication of cardiac episodes. An example system includes memory storing instructions and processing circuitry configured to execute those instructions to receive episode data of a cardiac episode from a medical device. The processing circuitry is configured to determine a region of the episode data based on input from a primary adjudicator and to display a notification to a secondary adjudicator. The processing circuitry is further configured to display the region of episode data to the secondary adjudicator and to receive and transmit input from the secondary adjudicator.
G16H 10/00 - ICT specially adapted for the handling or processing of patient-related medical or healthcare data
G16H 10/60 - ICT specially adapted for the handling or processing of patient-related medical or healthcare data for patient-specific data, e.g. for electronic patient records
G16H 15/00 - ICT specially adapted for medical reports, e.g. generation or transmission thereof
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 50/20 - 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
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
G16H 80/00 - ICT specially adapted for facilitating communication between medical practitioners or patients, e.g. for collaborative diagnosis, therapy or health monitoring
34.
HEALTH EVENT PREDICTION AND PATIENT FEEDBACK SYSTEM
A medical device system includes a memory; and processing circuitry in communication with the memory. The processing circuitry is configured to receive parametric data for a plurality of parameters of a patient, determine, based on the parametric data, an atrial fibrillation (AF) burden of the patient over a period of time, wherein the AF burden of the patient over the period of time includes a pattern of increased AF burden; output, for display by a user device, a request to identify whether the patient engaged in each patient behavior of a set of patient behaviors during the period of time; and determine, based on receiving a response indicating that the patient engaged in one or more patient behaviors of the set of patient behaviors, a suggestion to change at least a subset of the one or more patient behaviors to attenuate the pattern of increased AF burden.
An example system includes a memory; and processing circuitry coupled to the memory and configured to: receive electrocardiogram (ECG) data of a patient, wherein the ECG 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; obtain a plurality of heartbeat intervals from the ECG data; sample a plurality of points for each respective heartbeat interval of the plurality of intervals; determine a slow-moving average for each sample point parameter of respective heartbeat intervals during a. first period of time; determine a fast-moving average for each sample point parameter of respective heartbeat intervals during a second period of time, determine a difference between the slow -moving average and the fast-moving average for each sample point parameter; and determine a risk level of a health event for the patient based on the determined differences.
A61B 5/0245 - Measuring pulse rate or heart rate using sensing means generating electric signals
A61B 5/0538 - Measuring electrical impedance or conductance of a portion of the body invasively, e.g. using a catheter
A61B 5/08 - Measuring devices for evaluating the respiratory organs
A61B 5/11 - Measuring movement of the entire body or parts thereof, e.g. head or hand tremor or mobility of a limb
A61B 5/1455 - Measuring characteristics of blood in vivo, e.g. gas concentration, pH-value using optical sensors, e.g. spectral photometrical oximeters
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.
An adjustable rotational connector is configured to establish electrical communication between an implantable medical lead and a cable of an external testing device while allowing rotation of the implantable medical lead relative to the cable. The coupling includes a pin that is electrically conductive. An adjustable socket is positioned within the pin and is configured to receive lead connectors of different sizes. A bearing is configured to facilitate rotation of the pin relative to the cable. An actuatable element surrounds at least a portion of the adjustable socket. The actuatable element is configured to transition between a first and second position relative to the adjustable socket to allow the adjustable socket to receive and secure the lead connector of the implantable medical lead in the adjustable socket.
A61N 1/375 - Constructional arrangements, e.g. casings
A61N 1/05 - Electrodes for implantation or insertion into the body, e.g. heart electrode
H01R 13/62 - Means for facilitating engagement or disengagement of coupling parts or for holding them in engagement
F16L 37/12 - Couplings of the quick-acting type in which the connection between abutting or axially-overlapping ends is maintained by locking members using hooks, pawls, or other movable or insertable locking members
38.
METHODS FOR PREDICTING PROSTHETIC VALVE OUTFLOW TRACT OBSTRUCTION
Systems and methods for evaluating a subject having indications for receiving a prosthetic valve, such as a prosthetic mitral valve. Images of the subject's native annulus are obtained and assessed. A candidate prosthetic valve is selected based upon the assessment. An implant model of the candidate prosthetic valve is selected from a library of different implant models based upon the native annulus assessment. A virtual implant representation is generated by applying the selected implant model to the obtained images. An area of the neo-VOT of the virtual implant representation is reviewed. Whether or not the candidate prosthetic valve is appropriate for the subject is evaluated based upon the review.
A fixation device comprising a first elongated body extending distally from a distal end of an implantable medical device and a second elongated body extending distally from the distal end of the implantable medical device. The first elongated body comprises a helix having one or more coils, wherein a distal end of the helix is configured to penetrate into tissue of a patient. The second elongated body is configured to flexibly maintain contact with the tissue without penetrating the tissue, and wherein the second elongated body is disposed on the distal end at a separation angle away from an electrode disposed on the distal end of the implantable medical device, wherein the separation angle comprises an angle between the electrode and the second end of the second elongated body.
A fixation device comprising: a first elongated body configured to extend distally from a distal end of an implantable medical device, the first elongated body comprising: a distal end configured to penetrate into tissue of a patient; and a helix having one or more coils; and an anti-rotation feature defined by the one or more coils, the anti-rotation feature configured to resist rotation of the helix within the tissue, wherein the anti-rotation feature comprises a varying pitch of the helix, the varying pitch resulting at least in part from an undulating configuration of the one or more coils of the helix.
Techniques for classifying a health condition of a patient are described. An example technique may include utilizing a probability model that uses various diagnostic states of physiological parameters, which may include fluid retention and temperature, to determine a classification of a health condition of the patient. The probability model may determine a probability score indicating a likelihood of the classification of the health condition being correct. The probability model may output the classification of the health condition and the probability score.
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
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
42.
INTRA-LUMINAL MEDICAL DEVICE WITH EVOKED BIOPOTENTIAL SENSING CAPABILITY
Sensing an evoked response to electrical stimulation of target tissue of a patient in conjunction with an intra-luminal electrode. The intra-luminal electrode may be implanted in a blood vessel or similar lumen proximal to the target tissue and the sensed signals and/or delivered stimulation may pass through the blood vessel, or other lumen, walls. In some examples the evoked response may be an evoked compound action potential (ECAP), which may also be evoked resonant neural activity (ERNA). The electrical stimulation may elicit a measurable response indicative of a thought pattern or neural state that would otherwise be undetectable using a non-evoked biopotential.
An implantable medical device (IMD) with electrodes near tissue of a patient and a rechargeable energy storage device. Power receiving circuitry receives electrical energy a wireless power transmitting device. The power receiving circuitry includes one or more secondary coils arranged to efficiently receive the wireless power when the primary coil is at any angle relative to the IMD. The IMD includes a non-conductive, hermetically sealed housing that encloses the device circuitry, including the rechargeable energy storage device, power receiving circuitry, processing circuitry, electrical stimulation circuitry and other components to perform the functions of the IMD.
A leadless implantable medical device (IMD) with electrodes near tissue of a patient and a rechargeable energy storage device. Power receiving circuitry receives electrical energy a wireless power transmitting device. The power receiving circuitry includes one or more secondary coils arranged to efficiently receive the wireless power when the primary coil is at any angle relative to the IMD. The IMD includes a non-conductive, hermetically sealed housing that encloses the device circuitry, including the rechargeable energy storage device, power receiving circuitry, processing circuitry, electrical stimulation circuitry and other components to perform the functions of the IMD. The housing may include one or more conductive ferrules which may provide the hermetic seal for the housing as well as act as an electrode to sense bioelectrical signals and/or deliver electrical stimulation therapy.
This disclosure describes a system including a needle configured to percutaneously insert into skin and form a path for inserting a lead, the needle including a pointed distal end for percutaneously inserting the needle for placement near a hypoglossal nerve of a patient, and an elongated body comprising an inner lumen, wherein the elongated body defines one or more openings connecting an outer surface of the elongated body to the inner lumen. The lead may be configured to be disposed within the inner lumen of the elongated body and may include a shaft and one or more electrodes disposed on the shaft, configured to be placed near the hypoglossal nerve, and configured to stimulate the hypoglossal nerve for treating obstructive sleep apnea (OSA), wherein locations of the one or more electrodes on the shaft at least partially correspond to the one or more openings of the needle.
An example implantable medical electrical lead includes a lead body defining a proximal portion and a distal portion, wherein at least a part of the distal portion of the lead body defines a three-dimensional undulating configuration; a. proximal end of the distal portion disposed adjacent to the three-dimensional undulating configuration; a first defibrillation electrode and a second defibrillation electrode disposed along the three-dimensional undulating configuration spaced apart from one another; and a pacing electrode disposed between the first defibrillation electrode and the second defibrillation electrode. The first defibrillation electrode is disposed between the proximal end and the pacing electrode. A first portion of tire first defibrillation electrode, a first portion of the second defibrillation electrode, and the pacing electrode are disposed along a plane. A second portion of the first defibrillation electrode adjacent to the pacing electrode arcs orthogonally to the plane.
Devices, systems, and techniques for determining medical lead placement are described. In one example, a system includes sensing circuitry configured to detect, via a lead, a bioelectric signal of the patient, wherein the lead comprises one or more electrodes, and wherein the lead is configured to be located in an epidural space of a patient and displaced laterally from a dorsal horn of the patient. Additionally, the system includes processing circuitry configured to determine, based on the bioelectric signal, a proximity of each electrode of the one or more electrodes to a dorsal root of the patient; and output information indicative of the proximity of each electrode of the one or more electrodes to the dorsal root.
Techniques are disclosed detecting atrioventricular (AV) block. A computing device receives cardiac electrogram data of a patient sensed by a medical device for an episode of bradycardia or pause. The computing device identifies a plurality of heartbeats within the cardiac electrogram data. For each of the plurality of heartbeats, the computing device determines a R-R interval and whether a P-wave is detectable cardiac electrogram data. Responsive to determining that the P-wave is detectable, the computing device determines a P-R interval. The computing device determines, based on the cardiac electrogram data, whether AV block has occurred during the episode. Responsive to determining that AV block has occurred, the computing device outputs a report including: an indication that AV block has occurred and at least one of the R-R intervals or the P-R intervals that coincide with the AV block.
Devices, systems and techniques to measure changes in pulse transit time (PTT) and, in some cases, determine pulse wave velocity (PWV), in a blood vessel to support continuous ambulatory monitoring of PTT and/or PWV. Each heartbeat creates a pressure wave that propagates along the arterial system. A pressure wave may travel faster along a rigid artery when compared to a more flexible artery. In this manner, PTT may be an indirect indicator of blood vessel flexibility and patient health.
A61B 5/00 - Measuring for diagnostic purposes ; Identification of persons
A61B 5/02 - Measuring pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography; Heart catheters for measuring blood pressure
A61B 5/021 - Measuring pressure in heart or blood vessels
A61B 5/0285 - Measuring phase velocity of blood waves
50.
DISCRIMINATING BETWEEN LEFT BUNDLE BRANCH AREA PACING AND VENTRICULAR SEPTAL PACING
Processing circuitry (50) of a medical system is configured to determine a ventricular activation time metric and determine, based on the ventricular activation time metric, whether ventricular capture includes left bundle branch area pacing or septal pacing. The processing circuitry (50) is further configured to modify a magnitude of the ventricular pacing in response to the ventricular capture including septal pacing.
Systems, circuit arrangements, and circuit operation that determine the state of charge of a battery used to provide power to an electrically powered device. The example circuit arrangement of this disclosure may include a selectable sense resistor circuit, a voltage-controlled oscillator (VCO) with a programmable gain preamplifier, an integrator, and a comparator configured to sample the sense resistor measurement and determine an amount of charge from the battery per unit time. The circuit operation may also include slow chop technique to cancel residual input referred offset, where "slow" refers to a chop period that is much longer than the clock period and sample period. By counting the total charge amount used by the electrically powered device and knowing the initial battery charge level at the beginning of life for the battery, the system of this disclosure may determine the state of charge of the battery.
G01R 19/165 - Indicating that current or voltage is either above or below a predetermined value or within or outside a predetermined range of values
G01R 31/3832 - Arrangements for monitoring battery or accumulator variables, e.g. SoC using current integration without measurement of battery voltage
G01R 1/20 - Modifications of basic electric elements for use in electric measuring instruments; Structural combinations of such elements with such instruments
The present disclosure relates generally to pacing of the cardiac conduction system and/or to the left ventricular septum of a patient, and more particularly, to providing cardiac conducting system and/or left ventricular septal pacing according to an advanced pacing delay during atrial fibrillation. The advanced pacing delay may be determined in various ways either during atrial fibrillation or not during atrial fibrillation.
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
A valve prosthesis includes a self-expanding frame and a prosthetic valve coupled to an interior of the frame. The frame includes a plurality of endcrowns at a first end thereof, and a first paddle connected to a first endcrown by a first stem. The first end of the frame is collapsible to a collapsed configuration when a restraining force is applied to the first paddle and to the endcrowns, is configured to expand from the collapsed configuration to a partially deployed configuration when the restraining force is removed from the endcrowns but is still applied to the first paddle, and is configured to expand to a fully deployed configuration when the restraining force is removed from the endcrowns and from the first paddle. A first vale of a lateral dimension of the first end in the partially deployed configuration is at least 70 percent of a second value of the lateral dimension of the first end in the fully deployed configuration.
A processing circuitry is configured to discharge capacitors to a discharge voltage level, such as by repeatedly discharging the capacitors when coupled in series and partially recharging one or more capacitors of the capacitors when coupled in parallel until the voltage across the capacitors coupled in series is approximately equal to the discharge voltage level. To discharge the capacitors, the processing circuitry is configured to discharge the capacitors when coupled in series to respective intermediate threshold voltage levels of a plurality of intermediate threshold voltage levels, and to partially recharge the one or more capacitors, the processing circuitry is configured to, in response to a voltage across the capacitors coupled in series reaching the respective intermediate threshold voltage levels, charge the one or more capacitors to respective intermediate common voltage levels of a plurality of intermediate common voltage levels when coupled in parallel.
H02M 3/18 - Conversion of dc power input into dc power output without intermediate conversion into ac by dynamic converters using capacitors or batteries which are alternately charged and discharged, e.g. charged in parallel and discharged in series
55.
CARDIAC MONITORING DEVICE WITH BIOCOMPATIBLE ELECTRICAL INSULATOR
An example implantable medical device includes a housing configured to house processing circuitry configured to control functioning of the implantable medical device. The housing includes an electrically conductive portion defining a cavity configured to receive the processing circuitry and a dielectric cover configured to cover the cavity and enclose the processing circuitry within the cavity. The implantable medical device further includes an electrode positioned on an outer surface of the dielectric cover and connected to the processing circuitry, the processing circuitry being further configured to monitor a physiological parameter of a patient via the electrode, and the implantable medical device further includes a biocompatible electrical insulator disposed on an outer surface of at least one of the electrically conductive portion or the dielectric cover, the biocompatible electrical insulator being configured to not be disposed on the electrode.
Devices, systems, and techniques are described for switching between electrical stimulation having a bipolar electrode combination and electrical stimulation having a unipolar electrode combination. In one example, processing circuitry is configured to receive a first stimulation parameter set comprising a bipolar electrode combination that defines a first electrical stimulation, estimate a volume of neural activation (VNA) corresponding to the first stimulation parameter set, determine, based on the first VNA, a second stimulation parameter set comprising a unipolar electrode combination that defines a second electrical stimulation, and control an implantable medical device to deliver the second electrical stimulation instead of the first electrical stimulation.
An implant tool system includes an implantable medical device. The implantable medical device includes a zone visual marker positioned on an exterior surface of the device. The zone visual marker includes a distal end of the zone visual marker. The distal end of the zone visual marker aligning with the proximal end of an introducer indicates when to withdraw the introducer. The zone visual marker further includes a proximal end of the zone visual marker. The proximal end of the zone visual marker aligning with the proximal end of the introducer indicates when to inflate a balloon carried by the device and affix the distal end of the implantable medical device to the target site via a fixation mechanism.
A61N 1/05 - Electrodes for implantation or insertion into the body, e.g. heart electrode
A61B 90/00 - 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
Systems, devices, and techniques are described for analyzing ECAP signals to determine threshold for therapy. In one example, a system includes processing circuitry configured to receive a maximum amplitude value for a plurality of stimulation pulses, control stimulation generation circuitry to begin delivery of the plurality of stimulation pulses at an initial amplitude value less than the maximum amplitude value and iteratively increase a subsequent amplitude value of a next stimulation pulse of the plurality of stimulation pulses up to the maximum amplitude value, receive, for each stimulation pulse of the plurality of stimulation pulses, ECAP signal information, determine, from the ECAP signal information, ECAP characteristic values, and determine, based on the ECAP characteristic values and during the delivery of the stimulation pulses with iteratively increasing amplitude values, at least one threshold from which one or more stimulation parameter values for subsequent stimulation pulses are determined.
Systems, devices, and techniques are described for determining stimulation parameter values based on a latency determined from an evoked compound action potential (ECAP). In one example, processing circuitry is configured to control delivery of a first burst of pulses, each pulse of the first burst of pulses defined by a first parameter set, control delivery of a stimulation pulse defined by a second parameter set; receive information representative of an ECAP signal elicited by the stimulation pulse, determine an ECAP characteristic of the ECAP signal, the ECAP characteristic indicative of a latency of one of more nerve fibers activated by the stimulation pulse, determine, based on the ECAP characteristic, one or more parameter values of the first parameter set to generate a third parameter set for a second burst of pulses, and control delivery of the second burst of pulses according to the third parameter set.
Prosthetic heart valves include a stent having an inner surface and an outer surface. A skirt is connected to and spans a circumference of the inner surface. A valve structure is secured to the skirt. The valve structure includes a plurality of leaflets, with adjoining leaflets attached to the skirt next to one another to form commissures. Each leaflet has a free edge that is suspended from the respective commissures associated with the leaflet, with the free edges combining to define an area of coaptation. The valve structure is arranged to define an inflow region opposite an outflow region. The prosthetic heart valve has a compressed arrangement and an expanded arrangement. In various embodiments, the skirt is sized to fully sheathe the leaflets in both the compressed arrangement and the expanded arrangement.
A medical device (50) is configured to obtain, by processing circuitry of the medical device (50), at least a first electrocardiogram (ECG) signal. The processing circuitry may determine a ventricular activation time (VAT) using the first ECG signal for each one of multiple pacing pulses and detect a threshold difference between a first VAT associated with a first pacing pulse of the plurality of pacing pulses and a second VAT associated with a second pacing pulse of the plurality of pacing pulses. The medical device (50) may be configured to display the determined VATs.
A medical device includes one or more accelerometers; a sensor configured to monitor a physiological parameter of a patient; a memory; and processing circuitry configured to receive, from the one or more accelerometers, an accelerometer signal indicative of an amount of movement of the patient; determine, based on the accelerometer signal, that the patient is in an active period; determine, based on the accelerometer signal, that the active period has ended; and cause the sensor to transition from a low-power state to a high-power state in response to determining that the active period has ended.
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.
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
A61B 5/0538 - Measuring electrical impedance or conductance of a portion of the body invasively, e.g. using a catheter
A61B 5/318 - Heart-related electrical modalities, e.g. electrocardiography [ECG]
A medical device is configured to sense a first cardiac signal and a second cardiac signal and determine a quantitative relationship of a first feature of the first cardiac signal and a second feature of the second cardiac signal. The medical device is configured to confirm a sensed cardiac event signal and/or reject an oversensed signal based on the quantitative relationship.
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
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
Various embodiments of an implantable medical device are disclosed. The device includes a housing having a first major surface and a second major surface, electronic components disposed within the housing, and an electrode disposed on the first major surface of the housing and electrically connected to the electronic components. The device further includes a surround having a body that includes a first major surface, a second major surface, and an opening disposed in the first major surface of the body. The surround is adapted to receive within the body at least a portion of the housing. Further, the surround also includes a fixation component disposed on or through the body of the surround and adapted to attach the surround to tissue of a patient. The electrode extends through the opening of the body of the surround and is adapted to be in contact with the tissue of the patient.
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 tire 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.
A61B 90/30 - Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure
A61B 90/00 - 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
An example computer-implemented method includes determining a location of a probe relative to patient anatomy, in which the probe includes an emitter adapted to deliver energy. The method also includes computing a virtual spatial projection of an energy field for the emitter based on the location of the probe and at least one operating parameter for the emitter. The method also includes generating guidance for performing an intervention with the probe based on the virtual spatial projection.
This disclosure describes a method including outputting, by a computing system through a lead electrode on a distal portion of an implantable medical lead within vasculature of a patient, an electrical signal, wherein the implantable medical lead further includes an expandable member in an expanded state while the electrical signal is outputted, wherein the expanded expandable member is configured, to directionally-impede the electrical signal. The method may further include sensing, through each of a plurality of surface electrodes positioned on the patient, the electrical signal, determining, for each respective surface electrode of the plurality of surface electrodes, a value of the sensed electrical signal corresponding to an impedance between the respective surface electrode and the lead electrode, and determining a position and an orientation of the distal portion of the implantable medical lead within the vasculature of the patient based on the determined values of the sensed electrical signal.
Therapeutic electrical pulse delivery systems and therapeutic pulse generators are disclosed. The therapeutic electrical pulse delivery system may include a power source, a pulse generator, and a controller. The pulse generator may be operatively coupled to the power source. The pulse generator may include one or more capacitors. Each of the one or more capacitors may include a first electrode, a second electrode, and a dielectric disposed between the first electrode and the second electrode. The dielectric may include a crystalline dielectric including carbon. The controller may include one or more processors and may be operatively coupled to the power source or the pulse generator. The controller may be configured to charge the one or more capacitors of the pulse generator using the power source and cause the pulse generator to deliver a therapeutic electrical pulse using the charged one or more capacitors.
A medical device system includes an implantable medical lead including a lead body defining a proximal end and a distal portion, and at least a part of the distal portion of the lead body defines an undulating configuration. The medical device system also includes an introducer tool defining a lumen configured to receive the distal portion, and the introducer tool is configured to limit rotation of the distal portion within the lumen.
Various embodiments of an integrated circuit package (20) are disclosed. The package includes an integrated circuit (22) having an integrated circuit contact (28) disposed on a first major surface (24) of the integrated circuit; a first passivation layer (30) disposed on the first major surface of the integrated circuit and over the integrated circuit contact; and a redistribution layer (32) disposed on the first passivation layer. The redistribution layer includes a conductive trace (34) and a shield region (36) that define a plane of the redistribution layer. The package further includes a second passivation layer (38) disposed on the redistribution layer, and a patterned conductive layer (40) disposed on the second passivation layer and including a conductive trace (42). 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 23/522 - 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
H01L 23/552 - Protection against radiation, e.g. light
H01L 23/556 - Protection against radiation, e.g. light against alpha rays
A61N 1/375 - Constructional arrangements, e.g. casings
73.
SYSTEMS AND METHODS FOR CONTROLLING AND OPTIMIZING CLOSED-LOOP NEUROMODULATION THERAPY
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.
A method and a pulsed electric field (PEF) ablation instrument are provided. According to one aspect, a method in a PF A 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.
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
A61B 5/00 - Measuring for diagnostic purposes ; Identification of persons
75.
DELIVERY SYSTEM IMPLANT CINCH AND RELEASE MECHANISM
In some examples, a medical system includes a prosthetic device configured to expand radially outward to position a valve assembly to control blood flow through an annulus of a heart valve. The prosthetic device includes a cinch member configured to control a device perimeter defined by the prosthetic device. In some examples, the cinch member defines a closed loop substantially around a valve axis of the prosthetic device. In examples, the prosthetic device includes an outer support configured to expand to engage the annulus of the heart valve. In examples, the outer support defines the perimeter. The medical system may include an engagement device configured to cause the cinch member to control the device perimeter when the prosthetic device is positioned within a chamber of a heart of a patient.
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
76.
DELIVERY DEVICE HAVING STABILITY TUBE WITH COMPRESSIBLE REGION
Transcatheter prosthetic heart valve delivery devices including an inner shaft assembly having a coupling structure configured to selectively engage a prosthetic heart valve, a delivery sheath assembly having a capsule and slidably disposed over the inner shaft assembly, and an outer stability tube coaxially received over the delivery sheath assembly and having a compressible region. As the capsule is retracted, the capsule contacts a distal end of the outer stability tube and, with further proximal retraction of the capsule, force is applied by capsule to the distal end of the outer stability tube and eventually overcomes a biasing force of the compressible region, which causes the outer stability tube to retract along with the capsule allowing the outer stability tube to be longer and provider greater stability than if the compressible region were not present.
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
A delivery catheter system is provided with a catheter assembly including an elongate catheter body having a distal tip portion and a capsule distal to the distal tip portion, said capsule comprising a capsule body capable of containing all or part of a deliverable prosthesis. The system further includes a locating member comprising a first portion connected to the capsule body, and an annular second portion extending from the first portion and configured for contacting a valve annulus. The annular second portion is moveable from a collapsed state, in which the second annular portion is at least partially retained within a sheath, to a deployed state in which the second annular portion extends radially outwardly from the capsule body.
A medical system configured to impart a torque to a medical device within a patient. The medical system includes a driver including a driver body supporting a torque coupler. A snare is configured to engage the medical device. The torque coupler is configured to receive the medical device within a coupler volume. The snare and/or the torque coupler are configured to exert forces on the medical device such that the torque coupler imparts a torque to a retrieval structure of the medical device, causing rotation of the medical device. In examples, the medical device includes an attachment member configured to engage or disengage tissue when the medical device rotates. The medical system may include a delivery catheter configured to deliver and/or retrieve the torque coupler, snare, and/or the medical device.
A medical device may be configured to determine heart rates of the patient based on the cardiac signal sensed during a first period. The medical device may detect one or more sleep apnea episodes of the patient occurring during the first period. The medical device may determine whether one or more verification conditions are satisfied. Responsive to determining that the one or more verification conditions are satisfied, the medical device may measure impedances of the patient during a second period subsequent to the first period, and use impedance to the measured impedances to detect one or more sleep apnea episodes of the patient occurring during the second period.
An assembly including a transcatheter valve prosthesis and a crimping accessory. The transcatheter valve prosthesis including a stent and a valve component including at least one leaflet secured to the stent. The valve prosthesis includes a crimped having a crimped configuration for delivery and an expanded configuration. The crimping accessory assists in transitioning the valve prosthesis into the crimped configuration. In a first embodiment, the crimping accessory includes a conduit having a vacuum port configured to use suction force to move at least one leaflet radially inward. In a second embodiment, the crimping accessory includes a plurality of rods or graspers configured to contact and hold the at least one leaflet and to place a radially inward force as to move the least one leaflet radially inwards. Once each of the embodiments applies a force, the valve prosthesis is partially radially compressed into the crimped configuration.
An electrochemical cells and methods of making the same are disclosed. An electrochemical cell may include a cell housing and a cell core. The cell housing may define a tubular cell body extending along a longitudinal axis from a distal end to a proximal end. The cell core may be disposed in the cell housing. The cell core may include a winding core extending along the longitudinal axis, a cathode, an anode, a plurality of inner windings, and a plurality of outer windings. The plurality of inner windings may be coiled around the winding core and define an inner diameter. The plurality of outer windings may be coiled around the plurality of inner windings and define an outer diameter.
H01M 10/04 - Construction or manufacture in general
H01M 10/0587 - Construction or manufacture of accumulators having only wound construction elements, i.e. wound positive electrodes, wound negative electrodes and wound separators
H01M 4/70 - Carriers or collectors characterised by shape or form
H01M 50/107 - Primary casings, jackets or wrappings of a single cell or a single battery characterised by their shape or physical structure having curved cross-section, e.g. round or elliptic
H01M 50/528 - Fixed electrical connections, i.e. not intended for disconnection
82.
METHOD AND APPARATUS FOR ESTABLISHING ATRIAL SYNCHRONOUS VENTRICULAR PACING CONTROL PARAMETERS
A medical device includes processing circuitry configured to receive a cardiac motion signal and at least one cardiac electrical signal sensed over a signal episode. The processing circuitry is configured to determine that a P-wave of the at least one cardiac electrical signal occurs in a diastolic period of a cardiac cycle of the signal episode. In response to the P-wave being in the diastolic period of the cardiac cycle, the medical device may determine a feature of the cardiac motion signal sensed during the cardiac cycle and, based on the determined feature, establish a control parameter used for controlling delivery of atrial synchronous ventricular pacing.
A medical device includes a motion sensor configured to sense a motion signal. The medical device includes a control circuit configured to determine if the motion signal sensed over a motion metric time interval meets oversensing criteria when a cardiac electrical event signal is received during the motion metric time interval.
A shuttle apparatus configured to detachably engage a delivery system for an implantable medical device. The shuttle apparatus includes a distal portion having a generally semiconical introducer member with a proximal base and a distal apex, a proximal portion having a hollow, generally frustoconical plug member with a base adjacent to the base of the introducer member, and a collar member with a distal end on the introducer member and a proximal end on the plug member, wherein the proximal end of the collar member includes a cantilevered arm.
An example implantable medical device includes a housing configured to house control circuitry that is configured to control functioning of the implantable medical device, an electrode positioned on an outer surface of the housing and connected to the control circuitry. The control circuitry is configured to monitor a physiological parameter of a patient via the electrode. The implantable medical device also includes an absorbable antibacterial layer disposed on the housing. The implantable medical device including the absorbable antibacterial layer is configured to be received within an implantation tool and delivered out of the implantation tool and into a patient.
A funnel crimper includes a body having a tapered portion, an extended outflow portion, and a tissue compressor. The tissue compressor is configured to apply a radially inward force to tissue of a prosthetic valve of a transcatheter heart valve prosthesis disposed on an inner surface of a frame of the transcatheter heart valve prosthesis as the transcatheter heart valve prosthesis is advanced through a lumen of the funnel crimper. The tissue compressor may be a ring of relatively soft material extending into the lumen of the funnel crimper or pressurized fluid applied radially inward to the lumen of the funnel crimper.
Various embodiments of a medical lead system are disclosed. The lead system includes a lead body that includes a lumen that extends along the lead body between an inlet adjacent to a proximal end of the lead body and an outlet adjacent to a distal end of the lead body; a fixation member; and a distal balloon connected to an exterior surface of the distal end of the lead body and fluidly connected to the outlet of the lumen. The medical lead system further includes a pressure sensor fluidly connected to the inlet of the lumen of the lead body and configured to sense a pressure within an interior volume of the distal balloon and communicate a signal indicative of the pressure to a clinician. The fixation member is further configured to extend distal to the distal balloon when the distal balloon is in an inflated configuration.
A medical system configured to impart a torque to a medical device within a patient. The medical system includes a driver including a driver body supporting a head section. The medical system includes a snare configured to engage the medical device. In examples, the head section defines a protrusion configured to insert into a device recess or a device slot of the implantable medical device to transfer the torque to the medical device. In examples, the a snare surface of the snare is configured to engage the medical device to transfer the torque to the medical device. In examples, the medical device includes an attachment member configured to engage or disengage tissue when the medical device rotates. The medical system may include a delivery catheter configured to deliver and/or retrieve the head section, intermediate member, and medical device.
Systems, devices and methods for maintaining coronary access after implanting a prosthetic heart valve and/or a transcatheter prosthetic heart valve replacement procedure. Systems of the present disclosure include a support structure and a valve structure. The support structure includes inner and outer frame members that define at least one auxiliary passageway. Upon final implantation, the valve structure is connected to the inner frame member, and the auxiliary passageway provides for passage of an auxiliary access device. In some embodiments, the inner frame member is formed or provided by a stent otherwise maintaining the valve structure. In other embodiments, the valve structure is secured to a stent of a prosthetic heart valve that is implanted separately from the support structure.
A method including collecting, by a computing system, heart rate data of a patient from a medical device of the patient; determining, by the computing system, one or more heart rate variability features based on the heart rate data; applying, by the computing system, a model to the heart rate variability features and one or more clinical features of the patient; predicting, by the computing system, an effect of a medical procedure on the patient based on the application of the model to the heart rate variability features and the one or more clinical features; and outputting, by the computing system, the predicted effect of the medical procedure to a display device.
Disclosed is a system to plan and position an implant in a subject. The planned position may be based upon various features and structures identified in a group of subjects for a current subject. The implant may then be positioned in a selected position which may be identified as an optimal position for the selected current subject.
This disclosure includes example medical device systems, and techniques for communicating between medical devices. An example medical device includes memory configured to store parameters for therapy delivery for a patient, communication circuitry, electrical signal generation circuitry, and processing circuitry. The processing circuitry is configured to control the electrical signal generation circuitry to deliver a first electrical signal to an anatomy of the patient. The processing circuitry is configured to, based on the electrical signal generation circuitry delivering the first electrical signal, control the communication circuitry to communicate with another medical device.
Ventricle-from-atrium (VfA) devices, systems, and methods may be configured to detect a tachyarrhythmia. For instance, an atrial event rate may be compared to a ventricular rate to determine whether a patient's heart is undergoing a tachyarrhythmia. Further, it may be determined whether the tachyarrhythmia is a supraventricular tachycardia or ventricular tachycardia prior to delivering therapy to treat the tachyarrhythmia.
A medical device, and methods of manufacturing the same, including a fixation element having varied cross-sectional dimension. The device including a body portion and the fixation element coupled to a distal body end and extending therefrom. The fixation element is configured to affix the body portion to a wall of a heart. The fixation element defines a helical shape extending between a distal fixation end and a proximal fixation end along a direction of a helical axis. The fixation element defines a proximal fixation section proximate the proximal fixation end, a distal fixation section proximate the distal fixation end, and a middle fixation section located between the proximal and distal fixation sections. A cross-sectional dimension of the middle fixation section is smaller than a cross-sectional dimension of the proximal fixation section.
Ventricle-from-atrium (VfA) devices, systems, and methods may be configured to monitor a single channel of cardiac electrical activity using one or both of a right atrial electrode positionable within the right atrium to sense electrical activity in the right atrium and a tissue-piercing electrode implantable in one or more of the basal region, septal region, and basal-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 to sense electrical activity in one or more of the basal region, septal region, and basal-septal region of the left ventricular myocardium. Various processing, windowing, and thresholding may be used to identify atrial events and ventricular events within the single channel of cardiac electrical activity.
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
Transcatheter heart valve prostheses include a valve support, a prosthetic valve mounted within the valve support, and an anchoring frame at least partially surrounding the valve support. The anchoring frame and the valve support are attached to each other at respective inflow ends thereof. The anchoring frame includes a fixation portion configured to securely fix the anchoring frame to tissue at a native heart valve, an integration region configured to integrate the anchoring frame with the valve support, and a lateral portion extending between the fixation portion and the integration region. A brim is coupled to and extends radially outwardly from the anchoring frame at a transition between the lateral portion and the fixation portion.
A heart valve prosthesis includes an inner stent, an outer stent at least partially surrounding the inner stent, and a prosthetic valve operatively coupled to the inner stent. The outer stent includes a plurality of struts and nodes defining open cells of the outer stent, and a plurality of cleats. The plurality of cleats includes first strut cleats extending radially outwardly and proximally from first struts of a first row of the plurality of struts with the heart valve prosthesis in a radially expanded configuration.
A medical device system includes a memory configured to store a cardiac signal sensed following delivery of a ventricular conduction system pacing pulse. The medical device system includes processing circuitry configured to determine a capture type classification of the ventricular conduction system pacing pulse and generate an output based on the capture type classification. The medical device system may include a user interface configured to present a representation of the capture type classification associated with the delivered ventricular conduction system pacing pulse.
Aspects of the disclosure include transcatheter delivery devices for delivery and deployment of a cardiac prosthesis, such as a prosthetic heart valve. Various embodiments include a one or two part capsule for maintaining the prosthesis during delivery. Embodiments include a flexible capsule that can deflect, either automatically or in response to contact with the anatomy, to reduce a delivery depth within a ventricle necessary to fully unsheathe the prosthesis, which increases the patient population and valve locations suitable for prosthesis delivery with the delivery device.
A system for closed-loop therapy includes memory configured to store a. first set of one or more parameters for a. first set of therapeutic electrical stimulation signals. The system includes processing circuitry configured to determine one or more local field potential (LFP) measurements of an LFP that is intrinsically generated, cause stimulation generation circuitry to deliver one or more electrical stimulation signals, determine one or more evoked resonant neural activity (ERNA) signals that are evoked by delivery' of respective ones of the electrical stimulation signals, determine a second set of one or more parameters for a second set of therapeutic electrical stimulation signals based on the one or more evoked signals and the one or more LFP measurements, and cause the stimulation generation circuitry- to deliver the second set of the one or more therapeutic electrical stimulation signals.
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