In one embodiment, a method for operating a system for management of implantable medical devices (IMDs), comprises: conducting communications sessions with a plurality of clinician programmer devices, wherein some of the communication sessions occur white the plurality of clinician programmer devices are engaged in respective programming sessions with IMDs; conducting communications sessions with a plurality of patient controller devices, wherein the communication sessions with the patient controller devices include communication of data pertaining to offline programming of IMDs; reconciling programming session data received from the plurality of clinician programmer devices with programming session data received from patient controller devices to identify instances of unauthorized IMD programming; and distributing revocation data to patient controller devices to be downloaded to corresponding IMDs, wherein the revocation data identifies cryptographic keys that are no longer trusted.

In one embodiment, a WCD is described. The WCD includes a support structure configured to be worn by a patient and a processor coupled to the support structure. The WCD also includes an energy storage module configured to store an electrical charge and in communication with the processor. The WCD also includes a discharge circuit coupled to the energy storage module, the discharge circuit in communication with the processor and configured to discharge the stored electrical charge through a body of the patient. The processor is configured to detect an event at the WCD, classify the detected event, and determine an alarm onset time of the detected event based at least in part on the event classification. The processor is further configured to issue the alarm after the alarm onset time.

Provided herein are methods of treating a patient comprising providing a medical apparatus comprising an external system and an implantable system, implanting the implantable system, and delivering at least one of power or data to the implantable system with the external system. The external system comprises: at least one external antenna configured to transmit a first transmission signal to the implantable system; an external transmitter configured to drive the at least one external antenna; an external power supply; and an external controller. The implantable system comprises: at least one implantable antenna configured to receive the first transmission signal from the first external device; an implantable receiver; at least one implantable functional element configured to interface with the patient; an implantable controller; an implantable energy storage assembly; and an implantable housing surrounding at least the implantable controller and the implantable receiver. Medical apparatus are also provided.

A method of cardiac signal processing including: receiving measurements from at least two electrodes positioned within the heart; determining, using the measurements, relative positioning of the at least two electrodes relative to each other; evaluating suitability of the relative positioning of the at least two electrodes for measurement of cardiac activity to determine which cardiac cycles should receive cardiac contractility modulation stimulation.

An ambulatory medical device includes two or more response mechanisms; a memory storing an active operation mode parameter identifying an active operation mode from a plurality of operation modes; a controller connected with the two or more response mechanisms; and a therapy manager component executable by the controller and configured to identify the active operation mode, detect a physiological parameter indicative of a health disorder of the patient, request that the patient change the state of one of the two or more response mechanisms in response to detection of the physiological parameter, monitor the state of each of the two or more response mechanisms within a first predetermined period, and delay therapy to the patient in response to detection of a first change in the state of one of the two or more response mechanisms within the predetermined period and identification of a first mode as the active operation mode.

Provided herein are methods of treating a patient comprising providing a medical apparatus comprising an external system and an implantable system, implanting the implantable system, and delivering at least one of power or data to the implantable system with the external system. The external system comprises: at least one external antenna configured to transmit a first transmission signal to the implantable system; an external transmitter configured to drive the at least one external antenna; an external power supply; and an external controller. The implantable system comprises: at least one implantable antenna configured to receive the first transmission signal from the first external device; an implantable receiver; at least one implantable functional element configured to interface with the patient; an implantable controller; an implantable energy storage assembly; and an implantable housing surrounding at least the implantable controller and the implantable receiver. Medical apparatus are also provided.

Systems, devices, and methods for electroporation ablation therapy are disclosed in the context of esophageal ablation. An ablation device may include a first catheter defining a longitudinal axis and a lumen therethrough. A balloon may be coupled to the first catheter. The balloon may be configured to transition between a deflated configuration and an inflated configuration. A second catheter may extend from a distal end of the first catheter lumen. A set of splines including electrodes formed on a surface of each of the splines may couple to the distal end of the first catheter lumen and a distal portion of the second catheter. The second catheter may be configured for translation along the longitudinal axis to transition the set of splines between a first configuration and a second configuration.

This document discusses, among other things, systems and methods related to a flexible circuit buzzer apparatus, such as a buzzer apparatus for use in an implantable medical device. In an example, the buzzer apparatus can include a flexible circuit having a first dielectric layer. A conductive layer can be disposed on the first dielectric layer. A hole can be formed in the first dielectric layer, the conductive layer, or both. A buzzer including a first contact can be located proximate to the hole. A conductive via can be plated or deposited in the hole. At least the first contact can be electrically coupled to the conductive layer by the conductive via.

A prosthetic hearing implant kit is disclosed. The prosthetic hearing implant kit comprises internal components configured to be implanted in a recipient and comprises an internal coil; external components configured to be worn by the recipient and comprises an external coil adapted to be inductively coupled with said internal coil; and an alert system having a second external coil and adapted to receive an external alarm and to transmit signals to said implanted components via said external coil for providing the recipient with a corresponding alarm indication.

A system for lead integrity monitoring includes an implantable medical device (IMD) having a housing enclosing a control circuit; and a lead, having a first sensor. The lead is coupled to the housing and electrically coupled to the control circuit. The system also includes at least one processing device configured to identify a first lead failure alert based on a first set of information; obtain a second set of information generated by a second sensor; perform an evaluation of the first set of information in the context of the second set of information; and confirm or cancel the first lead failure alert based on the evaluation.