Implantable devices and systems include one or more leads adapted to be emplaced in the internal thoracic vein (ITV) of a patient. The lead may include features to adapt the lead for such placement. An associated device for use with the lead may include operational circuitry adapted for use with a lead having an electrode for sensing and/or therapy purposes coupled thereto. Methods for implantation and use of such devices and systems are disclosed as well.

Disclosed herein is an implantable electronic device for use with an implantable medical lead. The implantable electronic device includes a housing and a header connector assembly coupled to the housing and adapted to receive the proximal lead end of the implantable medical lead. The header connector assembly includes a connector assembly including a connector, a feedthrough extending through the housing, and a conductor coupling the feedthrough to the connector. The conductor includes a first conductor segment and a second conductor segment offset from the first conductor segment and each of the first conductor segment and the second conductor segment are resistance welded to the connector.

A subcutaneous cardiac defibrillation system implantable comprising a housing and a subcutaneous implantable lead comprising a proximal end connected to the housing and a distal free end. The subcutaneous implantable lead comprises at least one defibrillation electrode and at least three detection electrodes. The first detection electrode and the second detection electrode form a first dipole, and the third detection electrode and the first detection electrode, or the third detection electrode and the second detection electrode, or the housing and one of said detection electrodes, form a second dipole. The defibrillation electrode is positioned between the second detection electrode and the third detection electrode, the first dipole is positioned between the housing and the defibrillation electrode, the third electrode is positioned between the free distal end of the lead and the defibrillation electrode, and the length of the first dipole is shorter than the length of the second dipole.

A bridge device includes a housing, a plurality of electrodes exposed outside of the housing such that at least two of the plurality of electrodes can be concurrently placed in contact with a patient's skin. A controller is disposed within the housing. A first communications module is operably coupled to the controller and to the at least two of the plurality of electrodes. The first communications module is configured to allow the controller to communicate with an implantable medical device via at least two of the plurality of electrodes using conducted communication. A second communications module is operably coupled to the controller and is configured to allow the controller to communicate with a remote device external to the patient.

Various aspects of the present disclosure are directed toward apparatuses, systems and methods for connecting a lead to an implantable medical device. The apparatuses, systems and methods may include a clamp arranged within a connector port configured to secure the lead with a header in response to frictional engagement between a portion of the implantable lead and the clamp.

Devices for assisting with the functioning of a tricuspid valve of a heart include a shaft, a flow optimizer, and an anchoring mechanism. A tilting mechanism can be configured to tilt the shaft relative to a central axis of the anchoring mechanism. Leaflets (e.g., multi-layer leaflets) of the flow optimizer can include a membrane and a rim, and the rim can have a higher stiffness than the membrane. A delivery system can be configured to deliver the device and adjust the position of the flow optimizer with respect to the anchoring mechanism.

A system and methods of maintaining communication with a medical device for exchange of information, instructions, and programs, in a highly reliable manner. Apparatus and methods for accomplishing this task include: 1) The inclusion of a locating device in the system, in close proximity to an implanted device, but which does not drain the implanted device battery. The locating device may be implanted or external to the body. 2) The use of motion detection and global positioning system devices to locate elements within a communicating system for the medical device; 3) The assessment of received signal quality by elements of the system; 4) The use of a notification system for a device user who is moving out of range of communications; and 5) Documenting the absolute and functional integrity of instructions received by the medical device.

Systems and methods for monitoring physiologic response to Valsalva maneuver (VM) are disclosed. An exemplary patient monitor may detect a natural incidence of a VM session occurred in an ambulatory setting using a heart sound (HS) signal sensed from the patient. The patient monitor may include a physiologic response analyzer to sense patient physiologic response during the detected VM session, and generate a cardiovascular or autonomic function indicator based on the sensed physiologic response to the VM. Using the physiologic response to the VM, the system may detect a target physiologic event using the sensed physiologic response to the VM.

In some examples, a medical device system includes an electrode. The medical device system may include impedance measurement circuitry coupled to the electrode, the impedance measurement circuitry may be configured to generate an impedance signal indicating impedance proximate to the electrode. The medical device system may include processing circuitry that may be configured to identify a first component of the impedance signal. The first component of the impedance signal may be correlated to a cardiac event. The processing circuitry may be configured to determine that the cardiac event occurred based on the identification of the first component of the impedance signal.

A method and device for managing establishment of a communications link between an external instrument (EI) and an implantable medical device (IMD) are provided. The method stores, in a memory in at least one of the IMD or the EI, a base scanning schedule that defines a pattern for scanning windows over a scanning state. The method enters the scanning state during which a receiver scans for advertisement notices during the scanning windows. At least a portion of the scanning windows are grouped in a first segment of the scanning state. The method stores, in the memory, a scan reset pattern for restarting the scanning state. Further, the method automatically restarts the scanning state based on the scan reset pattern to form a pseudo-scanning schedule that differs from the base scanning schedule and establishes a communication session between the IMD and the EI.