Abstract:
A leadless pulse generator is disclosed herein. The leadless pulse generator has a body, a helical anchor, an electrode, and a sleeve. The body includes a distal end and a proximal end opposite the distal end. The helical anchor distally extends from the distal end. The electrode is at the distal end. The sleeve distally extends from the distal end and has a proximal face and a distal face opposite the proximal face. The proximal face is adjacent the body. The sleeve coaxially extends about the helical anchor and further has a biased state wherein the distal face is near a distal tip of the helical anchor. The sleeve is configured to compress such that the distal face displaces proximally towards the proximal face upon the distal face being forced against the cardiac tissue in the course of the helical anchor screwing into the cardiac tissue.
Abstract:
In accordance with an embodiment, a system and method is provided for providing communications between first and second implantable medical devices (IMDs). The system comprises a first implantable medical device (IMD) configured to transmit a first event message during or preceding a first cardiac cycle, and a second IMD configured to receive the first event message, wherein receipt of the first event message configures the second IMD to generate pacing pulses for only a predetermined number (“n”) of consecutive cardiac cycles, wherein n is an integer equal to or greater than 2. The method comprises transmitting a first event message during or preceding a first cardiac cycle from the first IMD, receiving the first event message at the second IMD, in response to receiving the first event message, arming the second IMD to generate a pacing pulse for a second cardiac cycle, and arming the second IMD to generate a pacing pulse for only a predetermined number of consecutive cardiac cycles immediately subsequent to the second cardiac cycle.
Abstract:
A cardiac rhythm management system provides an increase in pacing rate as a combination of responses to three characteristics of a relative-temperature signal: a dip, a positive slope, and a positive magnitude. The relative-temperature signal is the difference between a short-term and a long-term temperature average. A dip produces a limited and temporary rate increase having a first proportionality. A positive slope produces a rate increase with a second proportionality. A positive magnitude produces a rate increase with a third proportionality. The dip response seeds the slope response to provide a seamless and immediate rate transition after a dip. The cardiac rhythm management system limits and filters the sum of the rate increases to provide a sensor indicated rate, which is used to stimulate the heart.
Abstract:
A leadless biostimulator includes a housing, and distal and proximal electrodes disposed on or integrated into the housing. The distal electrode includes an electrode body and an electrode tip mounted on a distal end of the electrode body, wherein the electrode tip is electrically conductive and configured to be placed in contact with a stimulation site. The electrode tip includes a distal tip end facing a surrounding environment and opposite a proximal tip end. The electrode tip defines a tip hole extending through the electrode tip along a longitudinal axis of the housing from the distal tip end to the proximal tip end. The tip hole comprises a through hole having a first diameter at the distal tip end and a second diameter at the proximal tip end of the tip electrode, wherein the first diameter of the tip hole is less than the second diameter of the tip hole.
Abstract:
External devices, methods for use therewith, and systems including an external device and an implantable medical device (IMD) are described. A method includes receiving at the external device, using each of first, second, and third subsets of at least three external electrodes, conductive communication pulses transmitted by the IMD, and determining, for each subset of the external electrodes, a respective metric indicative of power and/or quality of the conductive communication pulses received from the IMD using the subset of external electrodes. The method further includes identifying, based on results of the determining, a preferred one of the first, second, and third subsets of the at least three external electrodes, and using the preferred one of the first, second, and third subsets of the at least three external electrodes to receive further conductive communication pulses transmitted by the IMD.
Abstract:
A biostimulator, such as a leadless cardiac pacemaker, including a fixation element to engage tissue and one or more backstop elements to resist back-out from the tissue, is described. The fixation element can be mounted on a housing of the biostimulator such that a helix of the fixation element extends distally to a leading point. The leading point can be located on a distal face of the helix at a position that is proximal from a center of the distal face. The backstop elements can include non-metallic filaments, such as sutures, or can include a pinch point of the biostimulator. The backstop features can grip the tissue to prevent unscrewing of the fixation element. Other embodiments are also described and claimed.
Abstract:
Methods, systems, and devices that detect arrhythmic episodes and perform arrhythmia discrimination are described. Such a system includes a leadless pacemaker (LP) that senses a near-field electrogram (NF-EGM), and a non-vascular implantable cardioverter defibrillator (NV-ICD) that senses a far-field electrogram (FF-EGM). The LP determines cardiac activity information based on the NF-EGM and optionally also based on paced cardiac events caused by the LP. The LP monitors for specific pacemaker condition(s), sends i2i message(s) including the cardiac activity information to the NV-ICD when at least one of the specific pacemaker condition(s) is detected by the LP, and does not send i2i message(s) including the cardiac activity information to the NV-ICD when the LP detects none of the specific pacemaker condition(s) After the NV-ICD receives the i2i message(s) transmitted by the LP, the NV-ICD can detect an arrhythmic episode and/or perform arrhythmia discrimination based on the cardiac activity information included therein.
Abstract:
A leadless biostimulator has a housing including an electronics compartment, an electronics assembly mounted in the electronics compartment, a proximal electrode that disposed on and/or integrated into the housing, and an electrical feedthrough assembly. The electrical feedthrough assembly includes a distal electrode and a flange. The flange is mounted on the housing. The distal electrode is electrically isolated from the flange by an insulator and configured to be placed in contact with target tissue to which a pacing impulse is to be transmitted by the leadless biostimulator. A mount is mounted on the flange and thereby mounted on the electrical feedthrough assembly. A fixation element is mounted on the mount and configured to facilitate fixation of the leadless biostimulator to tissue of a patient.
Abstract:
Described herein are methods, devices, and systems that enable a remote non-implantable device (RNID) to send commands to a leadless pacemaker (LP) implanted within a patient. The RNID provide commands to a local non-implantable device (LNID) over one or more communication networks, and the LNID sends the commands to a second implantable device (SID) by transmitting radio frequency (RF) communication signals, which include the commands, using an antenna of the LNID. After receiving the commands from the LNID, by receiving RF communication signals that include the commands using an antenna of the SID, the SID transmits conductive communication signals, which include the commands, using electrodes of the SID. The LP receives the commands from the SID by receiving the conductive communication signals, which include the commands, using electrodes of the LP, and the LP performs command responses based on the commands that originated from the RNID.
Abstract:
A biostimulator, such as a leadless cardiac pacemaker, including an electrical feedthrough assembly mounted on a housing, is described. An electronics compartment of the housing can contain an electronics assembly to generate a pacing impulse, and the electrical feedthrough assembly can include an electrode tip to deliver the pacing impulse to a target tissue. A monolithically formed electrode body can have a pin integrated with a cup. The pin can be electrically connected to the electronics assembly, and the cup can be electrically connected to the electrode tip. Accordingly, the biostimulator can transmit the pacing impulse through the monolithic pin and cup to the target tissue. The cup can hold a filler having a therapeutic agent for delivery to the target tissue and may include retention elements for maintaining the filler at a predetermined location within the cup.