VfA cardiac therapy uses an implantable medical device or system. The implantable medical device includes a tissue-piercing electrode implanted in the basal and/or septal region of the left ventricular myocardium of the patient's heart from the triangle of Koch region of the right atrium through the right atrial endocardium and central fibrous body. The device may include a right atrial electrode, a right atrial motion detector, or both. The device may be implanted completely within the patient's heart or may use one or more leads to implant electrodes in the patient's heart. The device may be used to provide cardiac therapy, including single or multiple chamber pacing, atrioventricular synchronous pacing, asynchronous pacing, triggered pacing, cardiac resynchronization pacing, or tachycardia-related therapy. A separate medical device may be used to provide some functionality for cardiac therapy, such as sensing, pacing, or shock therapy.

An intracardiac ventricular pacemaker is configured to detect an atrial mechanical event from a motion sensor signal received by an atrial event detector circuit of the pacemaker. The motion sensor signal is responsive the motion of blood flowing in the ventricle. A pacing pulse is scheduled at an expiration of a pacing interval set by a pace timing circuit in response to detecting the atrial mechanical event. An atrial-synchronized ventricular pacing pulse is delivered upon expiration of the pacing interval.

The present technology is generally directed to medical implants, such as stimulation assemblies for stimulating heart tissue. In some embodiments, a stimulation assembly includes a body, circuitry positioned at least partially within the body, an electrode coupled to the body, and a hook mechanism coupled to the body. The stimulation assembly can be implanted at cardiac tissue of a patient such that the electrode electrically contacts the tissue. The circuitry can be configured to receive acoustic energy and convert the acoustic energy to electrical energy, and the electrode can deliver the electrical energy to the tissue to stimulate the tissue. The hook mechanism can be configured to engage the tissue to pull the tissue and the electrode toward and into engagement with one another.

A retractable screw-type stimulation or defibrillation intracardiac lead is disclosed. According to one embodiment, the lead comprises a flexible hollow sheath (12) having at its distal end a lead head (10) and a connector (66) at its proximal end. The connector comprises a pin (62) connected to a lead head electrode (18). The lead head comprises a tubular body (28), at least one electrode (18, 20) for stimulation or defibrillation, a moving element translationally and rotationally moving within the tubular body in a helical motion, and an anchoring screw (24) axially moving with respect to the tubular body, and a deployment mechanism (22) to deploy the anchoring screw out of the tubular body (28). The lead is a co-radial type, and the moving element (26) secured to the anchoring screw is connected to the tubular body (28) by a helical guide (46) and a coupling finger (56) protruding between two successive turns of the helical guide (46) for transforming a rotary movement imparted to the lead body in a deployment or retraction movement of the moving element (26). The helical guide (46) is resiliently compressible, with a free end (52) with a flat area (54) facing a flange (38) in vis-à-vis, so as to pinch the coupling finger (56) and to perform the function of a clutch limiting the torque transmitted to the anchoring screw by the rotation of the lead body, even in case of continuation of this rotation.

Implantable medical devices such as leadless cardiac pacemakers (LCP) may be configured to be delivered to a target location within the heart over a guide wire. In some cases, using a guide wire for delivery facilitates placement of devices in regions not otherwise easily reached. An LCP may include a housing and a wire lumen disposed relative to the housing. The wire lumen may be configured to allow the LCP to slide over a guide wire. In some cases, the guide wire may include a guide wire electrode that may be used to test potential implantation sites.

An implantable medical device (IMD) may include an outer housing having a titanium outer surface, the titanium outer surface including a plurality of titanium atoms. A tissue growth-inhibiting layer may extend over the titanium outer surface. In some cases, the tissue growth-inhibiting layer may include a plurality of polyethylene glycol molecules, at least some of the plurality of polyethylene glycol molecules covalently bonded via an ether bond to one of the plurality of titanium atoms.

An active implantable medical device is disclosed herein having a radio-opaque marker. The radio-opaque marker can be formed within an exterior wall of the device or within recesses on the outside of the exterior wall. The implantable medical device can be a leadless pacemaker. The shape of the radio-opaque marker can be designed to facilitate visualization and identification of the location, orientation, and rotation of the implanted medical device by conventional fluoroscopy. Methods of use are also disclosed.

Embodiments of the invention provide methods for the detection and treatment of atrial fibrillation (AF) and related conditions. One embodiment provides a method comprising measuring electrical activity of the heart using electrodes arranged on the heart surface to define an area for detecting aberrant electrical activity (AEA) and then using the measured electrical activity (MEA) to detect foci of AEA causing AF. A pacing signal may then be sent to the foci to prevent AF onset. Atrial wall motion characteristics (WMC) may be sensed using an accelerometer placed on the heart and used with MEA to detect AF. The WMC may be used to monitor effectiveness of the pacing signal in preventing AF and/or returning the heart to normal sinus rhythm (NSR). Also, upon AF detection, a cardioversion signal may be sent to the atria using the electrodes to depolorize an atrial area causing AF and return the heart to NSR.

A biostimulator, such as a leadless cardiac pacemaker, having a flexible circuit assembly, is described. The flexible circuit assembly is contained within an electronics compartment between a battery, a housing, and a header assembly of the biostimulator. The flexible circuit assembly includes a flexible substrate that folds into a stacked configuration in which an electrical connector and an electronic component of the flexible circuit assembly are enfolded by the flexible substrate. An aperture is located in a fold region of the flexible substrate to allow a feedthrough pin of the header assembly to pass through the folded structure into electrical contact with the electrical connector. The electronic component can be a processor to control delivery of a pacing impulse through the feedthrough pin to a pacing tip. Other embodiments are also described and claimed.

A wireless electrostimulation system can comprise a wireless energy transmission source, and an implantable cardiovascular wireless electrostimulation node. A receiver circuit comprising an inductive antenna can be configured to capture magnetic energy to generate a tissue electrostimulation. A tissue electrostimulation circuit, coupled to the receiver circuit, can be configured to deliver energy captured by the receiver circuit as a tissue electrostimulation waveform. Delivery of tissue electrostimulation can be initiated by a therapy control unit.