A device, such as an IMD, having a tissue conductance communication (TCC) transmitter controls a drive signal circuit and a polarity switching circuit by a controller of the TCC transmitter to generate an alternating current (AC) ramp on signal having a peak amplitude that is stepped up from a starting peak-to-peak amplitude to an ending peak-to-peak amplitude according to a step increment and step up interval. The TCC transmitter is further controlled to transmit the AC ramp on signal from the drive signal circuit and the polarity switching circuit via a coupling capacitor coupled to a transmitting electrode vector coupleable to the IMD. After the AC ramp on signal, the TCC transmitter transmits at least one TCC signal to a receiving device.

A subcutaneously implantable device is implantable into a body of a patient, and includes a prong and an electrode. The prong has a contact portion at or adjacent to a distal end thereof that is configured to contact an organ, a nerve, and/or a tissue of the patient. The prong is constructed to apply pressure to the organ, the nerve, and/or the tissue so as to maintain contact between the contact portion and the organ, the nerve, and/or the tissue without fixing the contact portion to the organ, the nerve, and/or the tissue. The electrode is provided at the contact portion of the prong, is configured to contact the organ, the nerve, and/or the tissue, and is electrically coupled or couplable with circuitry that is configured to provide monitoring, therapeutic, and/or diagnostic capabilities with respect to the organ, the nerve, and/or the tissue.

A lead extraction tool includes a lever for enhanced mechanical advantage. A belt of the tool which causes rotation of a cutter on an end of a sheath can be driven both when a trigger of the handheld tool is squeezed and when the trigger is relaxed. A pair of winged engagers are carried upon a pedestal which moves with the trigger, with a driver coupled to a portion of the trigger causing a rear winged engager or a front winged engager to engage the belt, both when squeezing the trigger and when relaxing the trigger.

An implantable medical device (IMD) is provided and includes electrodes configured to be located in or about a heart. The electrodes include a bipolar electrode combination that define a bipolar sensing vector. The electrodes include a unipolar electrode combination that define a unipolar sensing vector. The IMD includes sensing circuitry configured to define a first sensing channel coupled to the bipolar electrode combination and a second sensing channel coupled to the unipolar electrode combination. The IMD includes memory to store program instructions and one or more processors configured to implement the program instructions to collect cardiac activity (CA) signals over the first and second sensing channels for a series of beats, identify a sensed interval delta (SID) from the CA signals for at least a portion of the series of beats, the SID representing a timing interval between i) a COI in the CA signals collected over the first sensing channel and ii) the same COI in the CA signals collected over the second sensing channel; and designate the series of beats to correspond to be a polymorphic ventricular tachycardia (PVT) or a monomorphic ventricular tachycardia (MVT) based on the SID.

A medical device, such as an extra-cardiovascular implantable cardioverter defibrillator (ICD), senses R-waves from a first cardiac electrical signal by a first sensing channel and stores a time segment of a second cardiac electrical signal acquired by a second sensing channel in response to each sensed R-wave. The ICD determines morphology match scores from the stored time segments of the second cardiac electrical signal and, based on the morphology match scores, withholds detection of a tachyarrhythmia episode. In some examples, the ICD detects T-wave oversensing based on the morphology match scores and withholds detection of a tachyarrhythmia episode in response to detecting the T-wave oversensing.

A capacitor and a method of processing an anode metal foil are presented. The method includes electrochemically etching the metal foil to form a plurality of tunnels. Next, the etched metal foil is disposed within a widening solution to widen the plurality of tunnels. Exposed surfaces of the etched metal foil are then oxidized. The method includes removing a section of the etched metal foil, where the section of the etched metal foil includes exposed metal along an edge. The section of the etched metal foil is placed into a bath comprising water to form a hydration layer over the exposed metal on the section of the etched metal foil. The method also includes assembling the section of the etched metal foil having the hydration layer as an anode within a capacitor.

A medical device is configured to deliver anti-tachycardia pacing (ATP) in the presence of T-wave alternans. The device is configured to detect a ventricular tachyarrhythmia from a cardiac electrical signal received by the medical device. In response to the detected ventricular tachyarrhythmia, the device delivers a plurality of ATP pulses at alternating time intervals. The alternating time intervals comprise at least a first ATP time interval separating a first pair of the ATP pulses and a second ATP time interval different than the first ATP time interval. The second ATP time interval consecutively follows the first ATP time interval and separates a second pair of the ATP pulses.

In some examples, a system may be used for delivering cardiac therapy or cardiac sensing. The system may include an in implantable medical device including a housing configured to be implanted on or within a heart of a patient, a fixation element configured to attach the housing to the heart; and a sensor configured to produce a signal that indicates motion of the implantable medical device. Processing circuitry may be configured to identify one or more impingements between the housing and another structure, such as a tissue of the heart, based on the signal from the sensor and provide an indication of the one or more impingements to a user.

The capsule comprises a tubular body and a front-end unit with an helical screw for anchoring the capsule to a wall of a patient's organ. The front-end unit is mobile in relative axial rotation with respect to the tubular body. A disengageable frictional coupling member allows this relative rotation when, for implantation, the tubular body receives an external rotational stress, and that until a predetermined limit torque triggering the disengagement. At explantation, this disengagement is prevented to allow a joint rotation of the tubular body and of the front-end unit and the unscrewing of the helical screw. It is provided for that purpose two conjugated plates facing each other, with flat surfaces such as circular sectors offset in opposite directions with respect to a radial reference plane, in such a way as to form steps providing an anti-disengagement abutment function.

Devices and methods are described for occluding the left atrial appendage (LAA). The device excludes the LAA from blood flow to prevent blood from clotting within the LAA and subsequently embolizing, particularly in patients with atrial fibrillation. The implantable device is delivered via transcatheter delivery into the LAA and secured within the LAA. The implant comprises an expandable and compliant frame and an expandable and conformable tubular foam body. The device may have a thromboresistant cover at a proximal end. The frame may have recapture struts inclining radially outwardly from a central hub. The frame may have axially extending side wall struts, with adjacent pairs of side wall struts joined at one or more apexes. Anchors extend from the frame and into the foam to engage tissue.