Pacesetter

An implantable biostimulator (104, 200, 302) has a housing (106, 212, 402, 502, 602), one or more fixation elements (210, 304, 418, 510, 610) at a distal end of the housing (106, 212, 402, 502, 602), and one or more electrode probes (208, 306, 406, 506). The housing (106, 212, 402, 502, 602)includes an electronics compartment containing pacing circuitry. The one or more electrode probes (208, 306, 406, 506)are coupled to the pacing circuitry. The one or more electrode probes (208, 306, 406, 506)are extendable from the distal end of the housing (106, 212, 402, 502, 602). The one or more electrode probes (208, 306, 406, 506) have depth control to a controlled depth of extension.

Devices (106, 109) and methods for improving conductive communication are described herein. One of the devices (106, 109) involved in the conductive communication can be an external device while the other device is an IMD, or both of the devices can be IMDs. In certain embodiments, conductive communication is performed using a first timing scheme that specifies when conductive communication pulses are transmitted relative to one or more cardiac events. A quality metric of the conductive communication is monitored, when the first timing scheme is being used to perform the conductive communication. In response to detecting the quality metric being below a corresponding threshold, when the first timing scheme is being used to perform the conductive communication, the invention changes to using a second timing scheme to perform the conductive communication.

An apparatus comprises an accelerometer (125) and at least one processor (104). The accelerometer (125), alone or in combination with the at least one processor (104), used to determine an activity level of a patient and a posture of the patient. The at least one processor (104) configured to classify the patient as being asleep in response to both (i) the posture of the patient being recumbent or reclined for at least a sleep latency duration, and (ii) the activity level of the patient not exceeding an activity threshold for at least the sleep latency duration. The at least one processor (104) is also configured to, after the patient has been classified as being asleep, classify the patient as being awake in response to at least one of (iii) the posture of the patient being upright for at least an awake latency duration, or (iv) the activity level of the patient exceeding the activity threshold for at least the awake latency duration.

A biostimulator transport system (202) comprises a catheter, a universal joint (2102) having a ball and socket type mechanism (2302) including a ball (2104) mounted within a socket (2106) at a distal tip of the catheter, wherein the ball (2104) includes a central channel, and a central shaft (2202) extending through the central channel to a biostimulator coupling (410).

A method comprises a first implantable medical device, IMD1, (102a, 102b, 104, 106) generating a first series of bits that are to be communicated from the IMD1 (102a, 102b, 104, 106) to a second implantable medical device, IMD2 (102a, 102b, 104, 106). The IMD1 (102a, 102b, 104, 106) encodes each bit of the first series of bits as either a first pseudo noise pulse sequence corresponding to a first bit value of the first series, or a second pseudo noise pulse sequence corresponding to a second bit value of the first series, to thereby produce an encoded series of bits. The first pseudo noise pulse sequence and the second pseudo noise pulse sequence are orthogonal to one another. The IMD1 (102a, 102b, 104, 106) transmits the encoded series of bits using conductive communication.

An implantable medical device (IMD) (200) is provided that can include electronic circuitry (212), a first sensor (270) configured to detect a magnetic field in an environment of the IMD (200), and a second sensor (110, 112, 114, 234) configured to obtain environmental data. The IMD (200) includes one or more processors (264), and a memory (252) coupled to the one or more processors (264). The memory (252) stores program instructions, wherein the program instructions are executable by the one or more processors (264) to discriminate between a first magnet mode and a second magnet mode based on the environmental data and switch the mode of operation with the electronic circuitry (212) based on discriminating between the first magnet mode and the second magnet mode.

An implantable lead (400) is described that includes a header coupling (200), a helix shaft (302), and a fixation helix (106). The header coupling (200) extends from a proximal end (204) to a distal end (206) thereof, and defines a central lumen (208) from the proximal end (204) to the distal end (206). The header coupling (200) includes a base section (212) and a distal tube section (214) extending from the base section (212) to the distal end (206). The helix shaft (302) includes a proximal shank (306) that extends into the central lumen (208) of the header coupling (200) through a distal opening (210) of the distal tube section (214). The fixation helix (106) is mounted to a distal segment (304) of the helix shaft (302) and is configured to penetrate tissue of a patient. A surface (222) of the header coupling (200) directly engages and is fixedly secured to a surface (312) of the helix shaft (302), forming a sealed joint (308) that seals the central lumen (208) of the header coupling (200) and prevents fluid from migrating past the distal end (206).

A system (100) and computer readable medium for use during an implant procedure during which a delivery system (100) is being used to implant a leadless pacemaker (LP) (102a, 102b) within a patient may, while the delivery system (100) is being used to position the LP (102a, 102b) at a potential implant site within the patient: receive, from the LP (102a, 102b), data comprising one or more pacing impedance measurements and at least one measurement obtained by the LP (102a, 102b) other than pacing impedance; provide the data to a model (950) that is produced prior to the implant procedure based on data collected from other LPs implanted in other patients; and use the model (950) to output an indication of whether the LP (102a, 102b) should be chronically implanted at the potential implant site.

An attachment device (250) for coupling a biostimulator (200) to a delivery system (100) includes a case (502), a tether dock (504), and a filament (506). The case (502) has a wall (516), a first end (512), and a second end (514) opposite the first end (512). The wall (516) defines a passage (508) and a slot (510). The passage (508) extends between the first end (512) and the second end (514). The slot (510) extends through the wall (516) such that the passage (508) is accessible through the slot (510). The tether dock (504) extends from second end (514) of the case (502). The tether dock (504) defines a groove (524) extending therethrough. The filament (506) has a fixed end (526) and free end (528). The fixed end (526) is attached to the first end (521) of the case (502). The free end (528) includes a bulb (530) that is selectively receivable in the passage (508) of the case (502) through the slot (510).

A biostimulator (100) includes a housing (302) having a longitudinal axis (304) and containing an electronics compartment (306). A pacing element (108) is coupled to the housing (302). The pacing element (108) includes a flexible conductor (410) extending along the longitudinal axis (304). A fixation element mount (311) is mounted on the housing (302). The fixation element mount (311) includes a distal mount end (430). A fixation element (106) is mounted on the fixation element mount (311). The fixation element (106) extends about the longitudinal axis (304). A radiopaque marker (502) has a distal marker end (504) longitudinally aligned with the distal mount end (430) of the fixation element mount (311). Other embodiments are also described and claimed.