An implantable medical device includes an electrode and an insulative material secured to the electrode via an adhesive. The electrode includes a metal substrate and a metal coating. The metal substrate includes a connection segment and an active segment along a length of the metal substrate. The metal coating is disposed on an outer surface of the metal substrate along the connection segment and the active segment. The insulative material surrounds the connection segment of the metal substrate without surrounding the active segment, and the adhesive adheres to the metal coating on the connection segment.

An implantable medical device system is configured to sense cardiac events in response to a cardiac electrical signal crossing a cardiac event sensing threshold. A control circuit is configured to determine a drop time interval based on a heart rate and control a sensing circuit to hold the cardiac event sensing threshold at a threshold value during the drop time interval.

An implantable medical device system receives a cardiac electrical signal produced by a patient's heart and comprising atrial P-waves and delivers a His bundle pacing pulse to the patient's heart via a His pacing electrode vector. The system determines a timing of a sensed atrial P-wave relative to the His bundle pacing pulse and determines a type of capture of the His bundle pacing pulse in response to the determined timing of the atrial P-wave.

Systems and methods include differential diagnosis for acute heart failure to provide treatment to a patient including determining whether the patient has cardiac volume overload, determining whether the patient has decreased abdominal venous system volume, and providing the appropriate treatment in response to the determinations. A multi-sensor system may be used to determine cardiac volume and abdominal venous system volume. Fluid redistribution treatment may be provided when cardiac volume overload is accompanied by a decrease in abdominal venous system volume. Fluid accumulation treatment may be provided when cardiac volume overload is not accompanied by a decrease in abdominal venous system volume.

Semi-autonomous vehicle apparatus which is controlled by a plurality of control sources includes a vehicle which may function autonomously and apparatus for control of the vehicle by either an onboard driver or a driver not situated onboard. The vehicle may also be controlled by an off-vehicle computational device. Hierarchy setting apparatus determines which one or combination of the possible control entities take priority. Persons using the apparatus are identified by either a password or, preferably by providing identification based on a biologic feature. Management of impaired vehicle operators is provided for.

Techniques are disclosed for using feature delineation to reduce the impact of machine learning cardiac arrhythmia detection on power consumption of medical devices. In one example, a medical device performs feature-based delineation of cardiac electrogram data sensed from a patient to obtain cardiac features indicative of an episode of arrhythmia in the patient. The medical device determines whether the cardiac features satisfy threshold criteria for application of a machine learning model for verifying the feature-based delineation of the cardiac electrogram data. In response to determining that the cardiac features satisfy the threshold criteria, the medical device applies the machine learning model to the sensed cardiac electrogram data to verify that the episode of arrhythmia has occurred or determine a classification of the episode of arrhythmia.

The present invention relates to a medical device, in particular to an implantable medical device, comprising at least one implantable or non-implantable hemodynamic sensor configured for detecting hemodynamic cardiac signals, a controller configured for processing and analyzing the detected cardiac hemodynamic signals or signals derived from the detected cardiac hemodynamic signals by applying to said signals a Teager Energy Operator (TEO). The controller further comprises at least one algorithm configured to determine the need for a defibrillation operation by taking into account the at least one output hemodynamic signal. The present invention also provides a method and software for detecting or treating a ventricular fibrillation episode by taking into account cardiac hemodynamic signals.

A hermetically sealed feedthrough assembly for an active implantable medical device having an oxide-resistant electrical attachment for connection to an EMI filter, an EMI filter circuit board, an AIMD circuit board, or AIMD electronics. The oxide-resistant electrical attachment, including an oxide-resistant sputter layer 165 is disposed on the device side surface of the hermetic seal ferrule over which an ECA stripe is provided. The ECA stripe may comprise one of a thermal-setting electrically conductive adhesive, an electrically conductive polymer, an electrically conductive epoxy, an electrically conductive silicone, an electrically conductive polyimide, or a thermal-setting electrically conductive polyimide, such as those manufactured by Ablestick Corporation. The oxide-free electrical attachment between the ECA stripe and the filter or AIMD circuits may comprise one of gold, platinum, palladium, silver, iridium, rhenium, rhodium, tantalum, tungsten, niobium, zirconium, vanadium, and combinations or alloys thereof.

Systems, methods, and devices to facilitate insertion of certain leads with electrode(s) into patients are described. Leads can be implanted to work in conjunction with a cardiac pacemaker or cardiac defibrillator. A lead for cardiac therapy may be inserted into an intercostal space associated with the cardiac notch of a patient. Devices for delivery may include, for example, a delivery system coupled with an electrical lead and having a handle, a component advancer and insertion tips. The handle is configured to be actuated by an operator and the component advancer is configured to advance an electrical lead into the patient. The insertion tips can be configured to close around the electrical lead within the component advancer, to push through biological tissue, and to open to enable the lead to advance into the patient. The electrical lead can also be maintained in a particular orientation during the advancement into the patient.

A system and a method include an implantable medical device (IMD) having one or more inputs configured to receive one or more sensed signals from one or more electrodes. A plurality of filters are configured to filter the one or more sensed signals and output a plurality of filtered signals. Memory is configured to store program instructions. A processor, when executing the program instructions, is configured to receive the plurality of filtered signals, and analyze the plurality of filtered signals to determine a desired one of the plurality of filters.