Methods and apparatuses for use in medical procedures are disclosed. Some implementations may include a medical procedure guide that can overlay portions of anatomy of a patient. The guide may include alignment markings to facilitate proper placement, procedure markings to facilitate determination of a position at which to commence a medical procedure, and/or imaging markers incorporated within the guide to facilitate commencement or completion of the medical procedure in conjunction with imaging.

This catheter has: a shaft (10) has a first side hole (31) and a second side hole (32) in a wall (12); an insertion member (20) disposed in the lumen (11) of the shaft (10); a first electrode (41) provided on outer side of the first side hole (31); and a first wire (51) that is electrically connected to the first electrode (41) through the first side hole (31) and extents in the lumen (11) of the shaft (10) but outside the insertion member (20), wherein the first wire (51) has a first position (61) and a second position (62) inside the shaft (10), and the second position (62) of the first wire (51) is located at a position deviated from the first position (61) by 45 degrees or more in a circumferential direction of the insertion member (20).

A medical device processor is configured to receive a first cardiac electrical signal sensed from a first sensing electrode vector, receive a second cardiac electrical signal sensed from a second sensing electrode vector different than the first sensing electrode vector, and construct a third cardiac electrical signal from the first cardiac electrical signal and the second cardiac electrical signal. In some examples, the system determines sensed cardiac events according to at least one setting of a cardiac event sensing threshold control parameter from at least the third cardiac electrical signal and may determine at least one acceptable setting of a sensing control parameter based on the determined sensed cardiac events. The processor may generate an output representative of the determined sensed cardiac events.

This document discusses, among other things, systems and methods for monitoring a patient at risk of epilepsy. A system comprises a sensor circuit that senses from the patient at least first and second physiological or functional signals. A wellness detector circuit can detect an epileptic event using the sensed physiological or functional signals, or additionally classify the epileptic event into one of epileptic seizure types. The system can generate a wellness indicator based on a trend of the physiological or functional signal during the detected epileptic event. The wellness indicator indicates an impact of the detected epileptic event on the health status of the patient. The system includes an output unit configured to output the detection of the epileptic event or the wellness indicator to a user or a process.

Systems and methods for ambulatory detection of medical events such as cardiac arrhythmia are described herein. An embodiment of an arrhythmia detection system may include a detection criterion circuit that determines a patient-specific detection criterion using a baseline cardiac characteristic when the patient is free of cardiac arrhythmias. The detection criterion circuit generates a patient-specific threshold of a signal metric by adjusting a population-based threshold of the signal metric, where the manner and the amount of adjustment is based on information about patient baseline cardiac characteristic. The arrhythmia detection system detects an arrhythmia episode using a physiologic signal sensed from the patient and the patient-specific arrhythmia detection threshold.

Techniques are disclosed for detecting arrhythmia episodes for a patient. A medical device may receive one or more sensor values indicative of motion of a patient. The medical device may determine, based at least in part on the one or more sensor values, an activity level of the patient. The medical device may determine a heart rate threshold for triggering detection of an arrhythmia episode based at least in part on the activity level of the patient. The medical device may determine whether to trigger detection of the arrhythmia episode for the patient based at least in part on comparing a heart rate of the patient with the heart rate threshold. The medical device may, in response to triggering detection of the arrhythmia episode, collect information associated with the arrhythmia episode.

Techniques are described for discriminating SVT and, in particular, rapidly conducting AF. The techniques include detecting an onset of a fast rate of ventricular events sensed from a cardiac electrical signal and detecting a pause in the fast rate of ventricular sensed events. A threshold number of ventricular event intervals required to detect a ventricular tachyarrhythmia is detected with each of the threshold number of ventricular event intervals being less than a tachyarrhythmia detection interval. Detection of the ventricular tachyarrhythmia and an electrical stimulation therapy for treating the ventricular tachyarrhythmia are withheld in response to at least the pause being detected.

Electrotherapy waveform and pulse generation and delivery systems, methods and devices are described, such as for generation and delivery of defibrillation or pacing electrotherapeutic waveforms to patients, using open or closed loop current control. An example system includes a power supply, a therapeutic current control network and a controller. A therapeutic current control network may include at least one current control switch and a resonant tank. During delivery of an electrotherapeutic waveform to a patient with optional closed loop current control, the controller may compare a signal associated with a determined or estimated current provided to the patient with a signal associated with a reference waveform. Based at least in part on the comparison, the controller may adjust operation of the at least one current control switch of the therapeutic current control network in adjusting delivery of the electrotherapeutic waveform to the patient to correspond with the reference waveform. The system may utilize one or more of soft switching, wide bandgap materials and a bidirectional power supply.

Methods and systems for alleviating disorders and complications associated with autonomic nervous system dysfunction. The approach generally includes measuring heart rate signals from a subject to measure heart rate variability and determine a heart rate variability threshold, determining that the subject is experiencing autonomic nervous system dysfunction, and alerting the subject to stimulate the auricular branch of the vagus nerve with an ear device.

A wearable cardioverter defibrillator (WCD) system includes a support structure having an adjustable fastening assembly to fasten portions of the support structure together to fit the support structure on a patient. The adjustable fastening assembly enables the patient wearing the support structure to adjust the fit of the support structure without unfastening the portions from each other. The adjustable fastening assembly may also enable the patient to adjust the fit of the support structure while wearing clothing over the support structure and without having to adjust the clothing to view or access the adjustable fastening assembly.