An apparatus includes an interface and a processor. The interface is configured to receive one or more magnetic-positioning signals from one or more position sensors coupled to one or more body-surface patches attached to a body of a patient, the magnetic-positioning signals indicative of respective positions of the position sensors. The processor is configured to (i) detect an inadvertent stimulation of a phrenic nerve of the patient, which occurs due to cardiac pacing applied by an intra-cardiac electrode in a heart of the patient, (ii) estimate, based on the magnetic-positioning signals, a motion of one or more of the body-surface patches occurring during the detected stimulation of the phrenic nerve, (iii) estimate, based on the estimated motion of the body-surface patches, a distance between the pacing electrode and the phrenic nerve, and (iv) send an output derived from the estimated distance to the output device.

Systems and methods involve an intrathoracic cardiac stimulation device operable to provide autonomous cardiac sensing and energy delivery. The cardiac stimulation device includes a housing configured for intrathoracic placement relative to a patient's heart. A fixation arrangement of the housing is configured to affix the housing at an implant location within cardiac tissue or cardiac vasculature. An electrode arrangement supported by the housing is configured to sense cardiac activity and deliver stimulation energy to the cardiac tissue or cardiac vasculature. Energy delivery circuitry in the housing is coupled to the electrode arrangement. Detection circuitry is provided in the housing and coupled to the electrode arrangement. Communications circuitry may optionally be supported by the housing. A controller in the housing coordinates delivery of energy to the cardiac tissue or cardiac vasculature in accordance with an energy delivery protocol appropriate for the implant location.

A cardiac defibrillation system that includes a pulse generator to generate therapeutic electrical pulses and at least one lead inserted through an intercostal space in the region of a cardiac notch of the left lung of a patient, the lead having a distal end configured to transmit the therapeutic electrical pulses generated by the pulse generator to defibrillate the heart of the patient.

Transcardiac diaphragmatic stimulation includes detecting a cardiac event based on signals sensed through a cardiac event sensor located in or on a region of a heart in proximity to a diaphragm, and delivering an ADS therapy through an ADS therapy mechanism that is located in proximity with the region of the heart, to induce a contraction of the diaphragm without inducing a contraction of the heart. The cardiac event sensor may be located a) on an interior surface of a cardiac wall that abuts the diaphragm, or 2) on an exterior surface of the heart, between a cardiac wall and the diaphragm. The ADS therapy mechanism may be located: a) on an interior surface of a cardiac wall that abuts the diaphragm, 2) on a superior surface of the diaphragm that abuts a cardiac wall, or 3) on an inferior surface of the diaphragm at a region of the diaphragm that abuts the heart.

Embodiments of the present disclosure include a medical device, comprising an elongate shaft extending along a shaft longitudinal axis and comprising a shaft proximal portion and a shaft distal portion. A navigational assembly is connected to the shaft distal portion and extends along the shaft longitudinal axis. The navigational assembly includes a navigational electrode positioning feature and a magnetic position sensor positioning feature.

An epicardial pacer wire management device can include a spool defining a recessed region that encompasses the spool. The recessed region can receive a portion of a pacer wire. The device can further include a connector attached to the spool, and the connector can be electrically coupled with an exposed tip of the pacer wire. The device can further include an electrical port attached to the spool that can communicate with a pacing control unit. The device may include an electrical communication line electrically coupled between the connector and the electrical port.

In some examples, a system can be used for delivering cardiac resynchronization therapy (CRT). The system may include a pacing device configured to be implanted within a patient. The pacing device can include a plurality of electrodes, signal generation circuitry configured to deliver ventricular pacing via the plurality of electrodes, and a sensor configured to produce a signal that indicates mechanical activity of the heart. Processing circuitry can be configured to identify one or more features of a cardiac contraction within the signal, and determine whether the contraction was a fusion beat based on the one or more features.

A method, system and device for monitoring and treating conditions of a mammalian heart, among which may include bradyarrhythmias, tachyarrhythmias and heart failure, the device being configured as a pacemaker that harvests energy as it implements the pacemaker functions to treat and monitor conditions of the heart. The pacemaker has a case, electrical circuitry sealed within the case, an electrode that is electrically coupled to the electrical circuitry, and embodiments may include a microelectromechanical system (MEMS) for harvesting and converting the kinematic energy of the heart into electrical energy. Embodiments provide receivers at locations of the heart which sense heart activity and are controlled with pacing circuitry to deliver electrical impulses at locations and time intervals to replicate the contractions of a normal functioning heart. Further embodiments provide a multi-part pacemaker where case-connectable electrode part may be implanted separately from the case part.

Steering engagement catheter devices, systems, and methods of using the same for accessing a tissue, including internal and external tissues of a heart, are disclosed. In at least one embodiment, a steering engagement catheter is provided, comprising an elongated tube having a proximal end, a distal end, and a first wall positioned circumferentially along a length of the elongated tube, the elongated tube configured such that a delivery catheter is capable of at least partial insertion into the elongated tube, at least one steering wire having a proximal end and a distal end, the distal end of the at least one steering wire coupled to the first wall of the elongated tube at or near the distal end of the elongated tube, and a controller operably coupled to the at least one steering wire at or near the proximal end of the at least one steering wire.

The present invention provides advancements in the art of cardiac pacemakers. The invention provides a pacemaker system that comprises at least one pacemaker and that is, to a large extent, self-controlled, allows for long-term implantation in a patient, and minimizes current inconveniences and problems associated with battery life. The invention further includes a mechanism in which at least two pacemakers are implanted in a patient, and in which the pacemakers communicate with each other at the time of a given pacing or respiratory event, without any required external input, and adjust pacing parameters to respond to the patient's need for blood flow. The invention further provides a design for a pacemaker in which the pacemaker electrode is connected to the pacemaker body by a lead that is configured to allow the pacemaker to lie parallel to the epicardial surface and to reduce stress on the pacemaker and heart tissue.