Implantable medical device with recharge coil

Description

TECHNICAL FIELD

The disclosure relates generally to implantable medical devices, and more particularly to implantable medical devices that have a power source that may be wirelessly recharged from a remote location.

BACKGROUND

Implantable medical devices are commonly used to perform a variety of functions, such as to monitor one or more conditions and/or delivery therapy to a patient. In some cases, an implantable medical device may deliver neurostimulation therapy to a patient. In some cases, an implantable medical device may simply monitor one or more conditions, such as pressure, acceleration, cardiac events, and may communicate the detected conditions or events to another device, such as another implantable medical device or an external programmer.

In some cases, an implantable medical device may be configured to deliver pacing and/or defibrillation therapy to a patient. Such implantable medical devices may treat patients suffering from various heart conditions that may result in a reduced ability of the heart to deliver sufficient amounts of blood to a patient's body. In some cases, heart conditions may lead to rapid, irregular, and/or inefficient heart contractions. To help alleviate some of these conditions, various devices (e.g., pacemakers, defibrillators, etc.) may be implanted into a patient's body. When so provided, such devices can monitor and provide therapy, such as electrical stimulation therapy, to the patient's heart to help the heart operate in a more normal, efficient and/or safe manner. In some cases, a patient may have multiple implanted devices that cooperate to monitor and/or provide therapy to the patient's heart.

In some cases, implantable medical devices must be relatively small. For example, leadless cardiac pacemakers are typically relatively small because they are often placed within the heart. Due to their relatively small size, a large fraction of the internal space of such implantable medical devices may be consumed by a battery or other power source. As the battery life determines the potential useful life expectancy of the implantable medical device, there is a desire to make the batteries as large as possible within the confines of the available space.

What would be desirable is an implantable medical device that has recharge capability for recharging a rechargeable power source of the implantable medical device. This may give the implantable medical device a longer useful life expectancy and/or may not require as much battery space permitting a significantly smaller device size. A smaller device size may make the device more easily deliverable and implantable in the body, allow the device to be implantable in smaller and more confined spaces in the body, and/or may make the device less expensive to produce.

SUMMARY

The disclosure is directed to implantable medical that provide a long lasting power source often within a smaller device housing. While a leadless cardiac pacemaker is used as an example implantable medical device, the disclosure may be applied to any suitable implantable medical device including, for example, neuro-stimulators, diagnostic devices including those that do not deliver therapy, and/or any other suitable implantable medical device as desired.

In some cases, the disclosure pertains to implantable medical devices (IMD) such as leadless cardiac pacemakers (LCP) that include a rechargeable power source such as a rechargeable battery, a rechargeable capacitor or a rechargeable supercapacitor. In some cases, the IMD may include a plurality of receiving coils that may capture a non-radiative near-field energy and then convert the near-field energy into electrical energy that may be used to recharge the rechargeable power source. Accordingly, since the rechargeable power source does not have to maintain sufficient energy stores in a single charge for the entire expected life of the IMD, the power source itself and thus the IMD may be made smaller while still meeting device longevity expectations.

In an example of the disclosure, an implantable medical device (IMD) may be configured to be implanted within a patient and may include a housing configured for trans-catheter deployment. A plurality of electrodes may be exposed external to the housing. Therapeutic circuitry may be disposed within the housing and operatively coupled to the plurality of electrodes and configured to sense one or more signals via one or more of the plurality of electrodes and/or to stimulate tissue via one or more of the plurality of electrodes. A rechargeable power source may be disposed within the housing and configured to power the therapeutic circuitry. A plurality of receiving coils configured to receive non-radiative near-field energy through the patient's body, wherein each of the plurality of receiving coils has a primary capture axis along which a maximum amount of non-radiative near-field energy is captured, and wherein at least one of the plurality of receiving coils has a primary capture axis that is non-parallel with the primary capture axis of another one of the plurality of receiving coils. Charging circuitry may be operatively coupled with the plurality of receiving coils and the rechargeable power source, the charging circuitry may be configured to use the non-radiative near-field energy received via the plurality of receiving coils to charge the rechargeable power source.

Alternatively or additionally to any of the embodiments above, at least two of the plurality of receiving coils may be operatively coupled in a power summation configuration.

Alternatively or additionally to any of the embodiments above, at least one of the plurality of receiving coils may be disposed outside the housing.

Alternatively or additionally to any of the embodiments above, at least one of the plurality of receiving coils may be disposed within the housing.

Alternatively or additionally to any of the embodiments above, a ratio of a length of the at least one of the plurality of receiving coils to a diameter of the at least one of the plurality of receiving coils may be greater than or equal to 3 to 1 and the at least one of the plurality of receiving coils may have a ferrite core.

Alternatively or additionally to any of the embodiments above, the charging circuitry may be further configured to select one of the plurality of receiving coils and to receive non-radiative near-field energy using the selected receiving coil, monitor the non-radiative near-field energy received via the selected receiving coil and detect a predetermined condition, and in response to detecting the predetermined condition, select a different one of the plurality of receiving coils and receive non-radiative near-field energy using the different one of the plurality of receiving coils.

Alternatively or additionally to any of the embodiments above, at least one of the plurality of receiving coils may be non-planar and form a three-dimensional surface.

the applied magnetic field may have a frequency that is greater than or equal to 10 kHz and less than or equal to 100 MHz.

Alternatively or additionally to any of the embodiments above, the plurality of receiving coils may be further configured to establish an inductive communication link with an external device.

Alternatively or additionally to any of the embodiments above, the IMD may be a leadless cardiac pacemaker (LCP).

Alternatively or additionally to any of the embodiments above, one of the plurality of electrodes may be carried by a first remote electrode unit that is remote from but tethered relative to the housing and may include a fixation structure for fixing the first remote electrode unit at a first location in the patient, and the first remote electrode unit may carry one of the plurality of receiving coils. Furthermore, another one of the plurality of electrodes may be carried by a second remote electrode unit that is remote from but tethered relative to the housing and may include a fixation structure for fixing the second remote electrode unit at a second location in the patient, and the second remote electrode unit may carry another one of the plurality of receiving coils.

In another example of the disclosure, an implantable medical device (IMD) may be configured to be implanted within a patient's body and may include one or more sensors. Circuitry may be operatively coupled to the one or more sensors. A rechargeable power source may power the circuitry. A plurality of receiving coils may be configured to receive non-radiative near-field energy through the patient's body, the plurality of receiving coils may be operatively coupled in a power summing configuration, wherein each of the plurality of receiving coils may have a primary capture axis along which a maximum amount of non-radiative near-field energy is captured, and wherein at least one of the plurality of receiving coils may have a primary capture axis that is non-parallel with the primary capture axis of another one of the plurality of receiving coils. Charging circuitry may be operatively coupled with the plurality of receiving coils and the rechargeable power source, and may be configured to use the non-radiative near-field energy received via the plurality of receiving coils to charge the rechargeable power source.

Alternatively or additionally to any of the embodiments above, at least one of the plurality of receiving coils may have a ferrite core.

Alternatively or additionally to any of the embodiments above, a ratio of a length of at least one of the plurality of receiving coils to a diameter of the at least one of the plurality of receiving coils may be greater than or equal to 2 to 1.

Alternatively or additionally to any of the embodiments above, the IMD may further comprise a flexible substrate that may be configured to conform to a surface (e.g. endocardial, epicardial, septal, free wall) of the patient's heart, and the one or more sensors, the circuitry, the rechargeable power source, the plurality of receiving coils and the charging circuitry may be mounted to the flexible substrate.

Alternatively or additionally to any of the embodiments above, the IMD may further comprise a flexible substrate that may be configured to conform to a surface of a patient, and at least two of the plurality of receiving coils may be fixed to the flexible substrate.

In another example of the disclosure, an implantable medical device (IMD) may be configured to be implanted within a patient's body and may include a housing configured for trans-catheter deployment. A plurality of electrodes may be exposed external to the housing. Therapeutic circuitry may be disposed within the housing and may be operatively coupled to the plurality of electrodes and configured to sense one or more signals via one or more of the plurality of electrodes and/or to stimulate tissue via one or more of the plurality of electrodes. A rechargeable power source may be disposed within the housing and may be configured to power the therapeutic circuitry. A plurality of receiving coils may be disposed outside the housing and may be operatively coupled to the rechargeable power source, and may be configured to receive non-radiative near-field energy through the patient's body, and move from a pre-deployment compressed state to an expanded post-deployment state, wherein in the post-deployment state of each of the plurality of receiving coils may have a primary capture axis along which a maximum amount of non-radiative near-field energy is captured, and wherein at least one of the plurality of receiving coils may have a primary capture axis that is non-parallel with the primary capture axis of another one of the plurality of receiving coils. Charging circuitry may be operatively coupled with the plurality of receiving coils and the rechargeable power source, and may be configured to use the non-radiative near-field energy received via the plurality of receiving coils to charge the rechargeable power source.

Alternatively or additionally to any of the embodiments above, at least two of the plurality of receiving coils may be operatively coupled in a power summation configuration.

Alternatively or additionally to any of the embodiments above, a maximum outer dimension of at least one of the plurality of receiving coils may be less than 1/10 of the wavelength of an applied magnetic field supplying the non-radiative near-field energy, and wherein the applied magnetic field supplying the non-radiative near-field energy may have a frequency that is greater than or equal to 10 kHz and less than or equal to 100 MHz.

Alternatively or additionally to any of the embodiments above, the IMD is a leadless cardiac pacemaker (LCP).

The above summary of some illustrative embodiments is not intended to describe each disclosed embodiment or every implementation of the present disclosure. The Figures and Description which follow more particularly exemplify these and other illustrative embodiments.

BRIEF DESCRIPTION OF THE FIGURES

The disclosure may be more completely understood in consideration of the following description in connection with the accompanying drawings, in which:

FIG. 1 is a schematic block diagram of an illustrative LCP in accordance with an example of the disclosure;

FIG. 2 is a schematic block diagram of another illustrative medical device that may be used in conjunction with the LCP of FIG. 1;

FIG. 3 is a schematic diagram of an exemplary medical system that includes multiple LCPs and/or other devices in communication with one another;

FIG. 4 is a schematic diagram of a system including an LCP and another medical device, in accordance with an example of the disclosure;

FIG. 5 is a side view of an illustrative implantable leadless cardiac device;

FIG. 6 is a schematic diagram of a patient including a rechargeable implantable medical device system;

FIG. 7 is a schematic of an illustrative circuit for a coupled inductor system;

FIG. 8 is a schematic of an illustrative coupled inductor power summation system;

FIG. 9 is a schematic diagram of an illustrative implantable medical device (IMD) according to an example of the disclosure;

FIG. 10 is a schematic diagram of another illustrative IMD according to an example of the disclosure;

FIG. 11 is a schematic diagram of another illustrative IMD according to an example of the disclosure;

FIG. 12 is a cross-sectional side view of an illustrative IMD according to an example of the disclosure;

FIG. 13 is a cross-sectional side view of another illustrative IMD according to an example of the disclosure;

FIG. 14 is a cross-sectional side view of another illustrative IMD according to an example of the disclosure;

FIG. 15 is a cross-sectional side view of another illustrative IMD according to an example of the disclosure;

FIG. 16A-16D is an illustrative delivery device that may be used to deliver an illustrative IMD in a chamber of a heart according to an example of the disclosure; and

FIG. 17A-17D is an illustrative delivery device that may be used to deliver an illustrative IMD in a chamber of a heart according to an example of the disclosure.

While the disclosure is amenable to various modifications and alternative forms, specifics thereof have been shown by way of example in the drawings and will be described in detail. It should be understood, however, that the intention is not to limit the disclosure to the particular embodiments described. On the contrary, the intention is to cover all modifications, equivalents, and alternatives falling within the spirit and scope of the disclosure.

DESCRIPTION

For the following defined terms, these definitions shall be applied, unless a different definition is given in the claims or elsewhere in this specification.

All numeric values are herein assumed to be modified by the term “about,” whether or not explicitly indicated. The term “about” generally refers to a range of numbers that one of skill in the art would consider equivalent to the recited value (i.e., having the same function or result). In many instances, the terms “about” may include numbers that are rounded to the nearest significant figure.

The recitation of numerical ranges by endpoints includes all numbers within that range (e.g. 1 to 5 includes 1, 1.5, 2, 2.75, 3, 3.80, 4, and 5).

As used in this specification and the appended claims, the singular forms “a”, “an”, and “the” include plural referents unless the content clearly dictates otherwise. As used in this specification and the appended claims, the term “or” is generally employed in its sense including “and/or” unless the content clearly dictates otherwise.

It is noted that references in the specification to “an embodiment”, “some embodiments”, “other embodiments”, etc., indicate that the embodiment described may include one or more particular features, structures, and/or characteristics. However, such recitations do not necessarily mean that all embodiments include the particular features, structures, and/or characteristics. Additionally, when particular features, structures, and/or characteristics are described in connection with one embodiment, it should be understood that such features, structures, and/or characteristics may also be used connection with other embodiments whether or not explicitly described unless clearly stated to the contrary.

The following description should be read with reference to the drawings in which similar structures in different drawings are numbered the same. The drawings, which are not necessarily to scale, depict illustrative embodiments and are not intended to limit the scope of the disclosure.

FIG. 1 depicts an illustrative leadless cardiac pacemaker (LCP) that may be implanted into a patient and may operate to deliver appropriate therapy to the heart, such as to deliver anti-tachycardia pacing (ATP) therapy, cardiac resynchronization therapy (CRT), bradycardia therapy, and/or the like. While a leadless cardiac pacemaker (LCP) is used as an example implantable medical device, it is contemplated that the concepts disclosed herein can be applied to any suitable implantable medical device (a therapeutic device, a diagnostic device, a cardiac stimulator, a neural stimulator). As can be seen in FIG. 1, the LCP 100 may be a compact device with all components housed within or directly on a housing 120. In some cases, the LCP 100 may be considered as being an example of an implantable medical device (IMD). In the example shown in FIG. 1, the LCP 100 may include a communication module 102, a pulse generator module 104, an electrical sensing module 106, a mechanical sensing module 108, a processing module 110, a battery 112, and an electrode arrangement 114. The LCP 100 may include more or less modules, depending on the application.

The communication module 102 may be configured to communicate with devices such as sensors, other medical devices such as an SICD, and/or the like, that are located externally to the LCP 100. Such devices may be located either external or internal to the patient's body. Irrespective of the location, external devices (i.e. external to the LCP 100 but not necessarily external to the patient's body) can communicate with the LCP 100 via communication module 102 to accomplish one or more desired functions. For example, the LCP 100 may communicate information, such as sensed electrical signals, data, instructions, messages, R-wave detection markers, etc., to an external medical device (e.g. SICD and/or programmer) through the communication module 102. The external medical device may use the communicated signals, data, instructions, messages, R-wave detection markers, etc., to perform various functions, such as determining occurrences of arrhythmias, delivering electrical stimulation therapy, storing received data, and/or performing any other suitable function. The LCP 100 may additionally receive information such as signals, data, instructions and/or messages from the external medical device through the communication module 102, and the LCP 100 may use the received signals, data, instructions and/or messages to perform various functions, such as determining occurrences of arrhythmias, delivering electrical stimulation therapy, storing received data, and/or performing any other suitable function. The communication module 102 may be configured to use one or more methods for communicating with external devices. For example, the communication module 102 may communicate via radiofrequency (RF) signals, inductive coupling, optical signals, acoustic signals, conducted communication signals, and/or any other signals suitable for communication.

In the example shown in FIG. 1, the pulse generator module 104 may be electrically connected to the electrodes 114. In some examples, the LCP 100 may additionally include electrodes 114′. In such examples, the pulse generator 104 may also be electrically connected to the electrodes 114′. The pulse generator module 104 may be configured to generate electrical stimulation signals. For example, the pulse generator module 104 may generate and deliver electrical stimulation signals by using energy stored in the battery 112 within the LCP 100 and deliver the generated electrical stimulation signals via the electrodes 114 and/or 114′. Alternatively, or additionally, the pulse generator 104 may include one or more capacitors, and the pulse generator 104 may charge the one or more capacitors by drawing energy from the battery 112. The pulse generator 104 may then use the energy of the one or more capacitors to deliver the generated electrical stimulation signals via the electrodes 114 and/or 114′. In at least some examples, the pulse generator 104 of the LCP 100 may include switching circuitry to selectively connect one or more of the electrodes 114 and/or 114′ to the pulse generator 104 in order to select which of the electrodes 114/114′ (and/or other electrodes) the pulse generator 104 delivers the electrical stimulation therapy. The pulse generator module 104 may generate and deliver electrical stimulation signals with particular features or in particular sequences in order to provide one or multiple of a number of different stimulation therapies. For example, the pulse generator module 104 may be configured to generate electrical stimulation signals to provide electrical stimulation therapy to combat bradycardia, tachycardia, cardiac synchronization, bradycardia arrhythmias, tachycardia arrhythmias, fibrillation arrhythmias, cardiac synchronization arrhythmias and/or to produce any other suitable electrical stimulation therapy. Some more common electrical stimulation therapies include anti-tachycardia pacing (ATP) therapy, cardiac resynchronization therapy (CRT), and cardioversion/defibrillation therapy. In some cases, the pulse generator 104 may provide a controllable pulse energy. In some cases, the pulse generator 104 may allow the controller to control the pulse voltage, pulse width, pulse shape or morphology, and/or any other suitable pulse characteristic.

In some examples, the LCP 100 may include an electrical sensing module 106, and in some cases, a mechanical sensing module 108. The electrical sensing module 106 may be configured to sense the cardiac electrical activity of the heart. For example, the electrical sensing module 106 may be connected to the electrodes 114/114′, and the electrical sensing module 106 may be configured to receive cardiac electrical signals conducted through the electrodes 114/114′. The cardiac electrical signals may represent local information from the chamber in which the LCP 100 is implanted. For instance, if the LCP 100 is implanted within a ventricle of the heart (e.g. RV, LV), cardiac electrical signals sensed by the LCP 100 through the electrodes 114/114′ may represent ventricular cardiac electrical signals. In some cases, the LCP 100 may be configured to detect cardiac electrical signals from other chambers (e.g. far field), such as the P-wave from the atrium.

The mechanical sensing module 108 may include one or more sensors, such as an accelerometer, a pressure sensor, a heart sound sensor, a blood-oxygen sensor, a chemical sensor, a temperature sensor, a flow sensor and/or any other suitable sensors that are configured to measure one or more mechanical/chemical parameters of the patient. Both the electrical sensing module 106 and the mechanical sensing module 108 may be connected to a processing module 110, which may provide signals representative of the sensed mechanical parameters. Although described with respect to FIG. 1 as separate sensing modules, in some cases, the electrical sensing module 106 and the mechanical sensing module 108 may be combined into a single sensing module, as desired.

The electrodes 114/114′ can be secured relative to the housing 120 but exposed to the tissue and/or blood surrounding the LCP 100. In some cases, the electrodes 114 may be generally disposed on either end of the LCP 100 and may be in electrical communication with one or more of the modules 102, 104, 106, 108, and 110. The electrodes 114/114′ may be supported by the housing 120, although in some examples, the electrodes 114/114′ may be connected to the housing 120 through short connecting wires such that the electrodes 114/114′ are not directly secured relative to the housing 120. In examples where the LCP 100 includes one or more electrodes 114′, the electrodes 114′ may in some cases be disposed on the sides of the LCP 100, which may increase the number of electrodes by which the LCP 100 may sense cardiac electrical activity, deliver electrical stimulation and/or communicate with an external medical device. The electrodes 114/114′ can be made up of one or more biocompatible conductive materials such as various metals or alloys that are known to be safe for implantation within a human body. In some instances, the electrodes 114/114′ connected to the LCP 100 may have an insulative portion that electrically isolates the electrodes 114/114′ from adjacent electrodes, the housing 120, and/or other parts of the LCP 100. In some cases, one or more of the electrodes 114/114′ may be provided on a tail (not shown) that extends away from the housing 120.

The processing module 110 can be configured to control the operation of the LCP 100. For example, the processing module 110 may be configured to receive electrical signals from the electrical sensing module 106 and/or the mechanical sensing module 108. Based on the received signals, the processing module 110 may determine, for example, abnormalities in the operation of the heart H. Based on any determined abnormalities, the processing module 110 may control the pulse generator module 104 to generate and deliver electrical stimulation in accordance with one or more therapies to treat the determined abnormalities. The processing module 110 may further receive information from the communication module 102. In some examples, the processing module 110 may use such received information to help determine whether an abnormality is occurring, determine a type of abnormality, and/or to take particular action in response to the information. The processing module 110 may additionally control the communication module 102 to send/receive information to/from other devices.

In some examples, the processing module 110 may include a pre-programmed chip, such as a very-large-scale integration (VLSI) chip and/or an application specific integrated circuit (ASIC). In such embodiments, the chip may be pre-programmed with control logic in order to control the operation of the LCP 100. By using a pre-programmed chip, the processing module 110 may use less power than other programmable circuits (e.g. general purpose programmable microprocessors) while still being able to maintain basic functionality, thereby potentially increasing the battery life of the LCP 100. In other examples, the processing module 110 may include a programmable microprocessor. Such a programmable microprocessor may allow a user to modify the control logic of the LCP 100 even after implantation, thereby allowing for greater flexibility of the LCP 100 than when using a pre-programmed ASIC. In some examples, the processing module 110 may further include a memory, and the processing module 110 may store information on and read information from the memory. In other examples, the LCP 100 may include a separate memory (not shown) that is in communication with the processing module 110, such that the processing module 110 may read and write information to and from the separate memory.

The battery 112 may provide power to the LCP 100 for its operations. In some instances, the battery 112 may a rechargeable battery, which may help increase the useable lifespan of the LCP 100. In still other examples, the battery 112 may be some other type of power source, as desired.

To implant the LCP 100 inside a patient's body, an operator (e.g., a physician, clinician, etc.), may fix the LCP 100 to the cardiac tissue of the patient's heart. To facilitate fixation, the LCP 100 may include one or more anchors 116. The anchor 116 may include any one of a number of fixation or anchoring mechanisms. For example, the anchor 116 may include one or more pins, staples, threads, screws, helix, tines, and/or the like. In some examples, although not shown, the anchor 116 may include threads on its external surface that may run along at least a partial length of the anchor 116. The threads may provide friction between the cardiac tissue and the anchor to help fix the anchor 116 within the cardiac tissue. In other examples, the anchor 116 may include other structures such as barbs, spikes, or the like to facilitate engagement with the surrounding cardiac tissue.

FIG. 2 depicts an example of another or second medical device (MD) 200, which may be used in conjunction with the LCP 100 (FIG. 1) in order to detect and/or treat cardiac abnormalities. In some cases, the MD 200 may be considered as an example of the IMD and/or the LCP. In the example shown, the MD 200 may include a communication module 202, a pulse generator module 204, an electrical sensing module 206, a mechanical sensing module 208, a processing module 210, and a battery 218. Each of these modules may be similar to the modules 102, 104, 106, 108, and 110 of LCP 100. Additionally, the battery 218 may be similar to the battery 112 of the LCP 100. In some examples, however, the MD 200 may have a larger volume within the housing 220. In such examples, the MD 200 may include a larger battery and/or a larger processing module 210 capable of handling more complex operations than the processing module 110 of the LCP 100.

While it is contemplated that the MD 200 may be another leadless device such as shown in FIG. 1, in some instances the MD 200 may include leads such as leads 212. The leads 212 may include electrical wires that conduct electrical signals between the electrodes 214 and one or more modules located within the housing 220. In some cases, the leads 212 may be connected to and extend away from the housing 220 of the MD 200. In some examples, the leads 212 are implanted on, within, or adjacent to a heart of a patient. The leads 212 may contain one or more electrodes 214 positioned at various locations on the leads 212, and in some cases at various distances from the housing 220. Some leads 212 may only include a single electrode 214, while other leads 212 may include multiple electrodes 214. Generally, the electrodes 214 are positioned on the leads 212 such that when the leads 212 are implanted within the patient, one or more of the electrodes 214 are positioned to perform a desired function. In some cases, the one or more of the electrodes 214 may be in contact with the patient's cardiac tissue. In some cases, the one or more of the electrodes 214 may be positioned subcutaneously and outside of the patient's heart. In some cases, the electrodes 214 may conduct intrinsically generated electrical signals to the leads 212, e.g. signals representative of intrinsic cardiac electrical activity. The leads 212 may, in turn, conduct the received electrical signals to one or more of the modules 202, 204, 206, and 208 of the MD 200. In some cases, the MD 200 may generate electrical stimulation signals, and the leads 212 may conduct the generated electrical stimulation signals to the electrodes 214. The electrodes 214 may then conduct the electrical signals and delivery the signals to the patient's heart (either directly or indirectly).

The mechanical sensing module 208, as with the mechanical sensing module 108, may contain or be electrically connected to one or more sensors, such as accelerometers, acoustic sensors, blood pressure sensors, heart sound sensors, blood-oxygen sensors, and/or other sensors which are configured to measure one or more mechanical/chemical parameters of the heart and/or patient. In some examples, one or more of the sensors may be located on the leads 212, but this is not required. In some examples, one or more of the sensors may be located in the housing 220.

While not required, in some examples, the MD 200 may be an implantable medical device. In such examples, the housing 220 of the MD 200 may be implanted in, for example, a transthoracic region of the patient. The housing 220 may generally include any of a number of known materials that are safe for implantation in a human body and may, when implanted, hermetically seal the various components of the MD 200 from fluids and tissues of the patient's body.

In some cases, the MD 200 may be an implantable cardiac pacemaker (ICP). In this example, the MD 200 may have one or more leads, for example the leads 212, which are implanted on or within the patient's heart. The one or more leads 212 may include one or more electrodes 214 that are in contact with cardiac tissue and/or blood of the patient's heart. The MD 200 may be configured to sense intrinsically generated cardiac electrical signals and determine, for example, one or more cardiac arrhythmias based on analysis of the sensed signals. The MD 200 may be configured to deliver CRT, ATP therapy, bradycardia therapy, and/or other therapy types via the leads 212 implanted within the heart. In some examples, the MD 200 may additionally be configured provide defibrillation therapy.

In some instances, the MD 200 may be an implantable cardioverter-defibrillator (ICD). In such examples, the MD 200 may include one or more leads implanted within a patient's heart. The MD 200 may also be configured to sense cardiac electrical signals, determine occurrences of tachyarrhythmias based on the sensed signals, and may be configured to deliver defibrillation therapy in response to determining an occurrence of a tachyarrhythmia. In other examples, the MD 200 may be a subcutaneous implantable cardioverter-defibrillator (S-ICD). In examples where the MD 200 is an S-ICD, one of the leads 212 may be a subcutaneously implanted lead. In at least some examples where the MD 200 is an S-ICD, the MD 200 may include only a single lead which is implanted subcutaneously, but this is not required. In some instances, the lead(s) may have one or more electrodes that are placed subcutaneously and outside of the chest cavity. In other examples, the lead(s) may have one or more electrodes that are placed inside of the chest cavity, such as just interior of the sternum but outside of the heart H.

In some examples, the MD 200 may not be an implantable medical device. Rather, the MD 200 may be a device external to the patient's body, and may include skin-electrodes that are placed on a patient's body. In such examples, the MD 200 may be able to sense surface electrical signals (e.g. cardiac electrical signals that are generated by the heart or electrical signals generated by a device implanted within a patient's body and conducted through the body to the skin). In such examples, the MD 200 may be configured to deliver various types of electrical stimulation therapy, including, for example, defibrillation therapy.

FIG. 3 illustrates an example of a medical device system and a communication pathway through which multiple medical devices 302, 304, 306, and/or 310 may communicate. In the example shown, the medical device system 300 may include LCPs 302 and 304, external medical device 306, and other sensors/devices 310. The external device 306 may be any of the devices described previously with respect to the MD 200. Other sensors/devices 310 may also be any of the devices described previously with respect to the MD 200. In some instances, other sensors/devices 310 may include a sensor, such as an accelerometer, an acoustic sensor, a blood pressure sensor, or the like. In some cases, other sensors/devices 310 may include an external programmer device that may be used to program one or more devices of the system 300.

Various devices of the system 300 may communicate via communication pathway 308. For example, the LCPs 302 and/or 304 may sense intrinsic cardiac electrical signals and may communicate such signals to one or more other devices 302/304, 306, and 310 of the system 300 via communication pathway 308. In one example, one or more of the devices 302/304 may receive such signals and, based on the received signals, determine an occurrence of an arrhythmia. In some cases, the device or devices 302/304 may communicate such determinations to one or more other devices 306 and 310 of the system 300. In some cases, one or more of the devices 302/304, 306, and 310 of the system 300 may take action based on the communicated determination of an arrhythmia, such as by delivering a suitable electrical stimulation to the heart of the patient. It is contemplated that the communication pathway 308 may communicate using RF signals, inductive coupling, optical signals, acoustic signals, or any other signals suitable for communication. Additionally, in at least some examples, device communication pathway 308 may include multiple signal types. For instance, other sensors/device 310 may communicate with the external device 306 using a first signal type (e.g. RF communication) but communicate with the LCPs 302/304 using a second signal type (e.g. conducted communication). Further, in some examples, communication between devices may be limited. For instance, as described above, in some examples, the LCPs 302/304 may communicate with the external device 306 only through other sensors/devices 310, where the LCPs 302/304 send signals to other sensors/devices 310, and other sensors/devices 310 relay the received signals to the external device 306.

In some cases, the communication pathway 308 may include conducted communication. Accordingly, devices of the system 300 may have components that allow for such conducted communication. For instance, the devices of system 300 may be configured to transmit conducted communication signals (e.g. current and/or voltage pulses) into the patient's body via one or more electrodes of a transmitting device, and may receive the conducted communication signals (e.g. pulses) via one or more electrodes of a receiving device. The patient's body may “conduct” the conducted communication signals (e.g. pulses) from the one or more electrodes of the transmitting device to the electrodes of the receiving device in the system 300. In such examples, the delivered conducted communication signals (e.g. pulses) may differ from pacing or other therapy signals. For example, the devices of the system 300 may deliver electrical communication pulses at an amplitude/pulse width that is sub-capture threshold to the heart. Although, in some cases, the amplitude/pulse width of the delivered electrical communication pulses may be above the capture threshold of the heart, but may be delivered during a blanking period of the heart (e.g. refractory period) and/or may be incorporated in or modulated onto a pacing pulse, if desired.

Delivered electrical communication pulses may be modulated in any suitable manner to encode communicated information. In some cases, the communication pulses may be pulse width modulated or amplitude modulated. Alternatively, or in addition, the time between pulses may be modulated to encode desired information. In some cases, conducted communication pulses may be voltage pulses, current pulses, biphasic voltage pulses, biphasic current pulses, or any other suitable electrical pulse as desired.

FIG. 4 shows an illustrative medical device system. In FIG. 4, an LCP 402 is shown fixed to the interior of the left ventricle of the heart 410, and a pulse generator 406 is shown coupled to a lead 412 having one or more electrodes 408a-408c. In some cases, the pulse generator 406 may be part of a subcutaneous implantable cardioverter-defibrillator (S-ICD), and the one or more electrodes 408a-408c may be positioned subcutaneously. In some cases, the one or more electrodes 408a-408c may be placed inside of the chest cavity but outside of the heart, such as just interior of the sternum.

In some cases, the LCP 402 may communicate with the subcutaneous implantable cardioverter-defibrillator (S-ICD). In some cases, the lead 412 and/or pulse generator 406 may include an accelerometer 414 that may, for example, be configured to sense vibrations that may be indicative of heart sounds.

In some cases, the LCP 402 may be in the right ventricle, right atrium, left ventricle or left atrium of the heart, as desired. In some cases, more than one LCP 402 may be implanted. For example, one LCP may be implanted in the right ventricle and another may be implanted in the right atrium. In another example, one LCP may be implanted in the right ventricle and another may be implanted in the left ventricle. In yet another example, one LCP may be implanted in each of the chambers of the heart.

FIG. 5 is a side view of an illustrative implantable leadless cardiac pacemaker (LCP) 610. The LCP 610 may be similar in form and function to the LCP 100 described above. The LCP 610 may include any of the modules and/or structural features described above with respect to the LCP 100 described above. The LCP 610 may include a shell or housing 612 having a proximal end 614 and a distal end 616. The illustrative LCP 610 includes a first electrode 620 secured relative to the housing 612 and positioned adjacent to the distal end 616 of the housing 612 and a second electrode 622 secured relative to the housing 612 and positioned adjacent to the proximal end 614 of the housing 612. The electrodes 620, 622 may be sensing and/or pacing electrodes to provide electro-therapy and/or sensing capabilities. The first electrode 620 may be capable of being positioned against or may otherwise contact the cardiac tissue of the heart while the second electrode 622 may be spaced away from the first electrode 620. The first and/or second electrodes 620, 622 may be exposed to the environment outside the housing 612 (e.g. to blood and/or tissue).

In some cases, the LCP 610 may include a pulse generator (e.g., electrical circuitry) and a power source (e.g., a battery, supercapacitor and/or other power source) within the housing 612 to provide electrical signals to the electrodes 620, 622 to control the pacing/sensing electrodes 620, 622. While not explicitly shown, the LCP 610 may also include, a communications module, an electrical sensing module, a mechanical sensing module, and/or a processing module, and the associated circuitry, similar in form and function to the modules 102, 106, 108, 110 described above. The various modules and electrical circuitry may be disposed within the housing 612. Electrical connections between the pulse generator and the electrodes 620, 622 may allow electrical stimulation to heart tissue and/or sense a physiological condition.

In the example shown, the LCP 610 includes a fixation mechanism 624 proximate the distal end 616 of the housing 612. The fixation mechanism 624 is configured to attach the LCP 610 to a wall of the heart H, or otherwise anchor the LCP 610 to the anatomy of the patient. In some instances, the fixation mechanism 624 may include one or more, or a plurality of hooks or tines 626 anchored into the cardiac tissue of the heart H to attach the LCP 610 to a tissue wall. In other instances, the fixation mechanism 624 may include one or more, or a plurality of passive tines, configured to entangle with trabeculae within the chamber of the heart H and/or a helical fixation anchor configured to be screwed into a tissue wall to anchor the LCP 610 to the heart H. These are just examples.

The LCP 610 may further include a docking member 630 proximate the proximal end 614 of the housing 612. The docking member 630 may be configured to facilitate delivery and/or retrieval of the LCP 610. For example, the docking member 630 may extend from the proximal end 614 of the housing 612 along a longitudinal axis of the housing 612. The docking member 630 may include a head portion 632 and a neck portion 634 extending between the housing 612 and the head portion 632. The head portion 632 may be an enlarged portion relative to the neck portion 634. For example, the head portion 632 may have a radial dimension from the longitudinal axis of the LCP 610 that is greater than a radial dimension of the neck portion 634 from the longitudinal axis of the LCP 610. In some cases, the docking member 630 may further include a tether retention structure 636 extending from or recessed within the head portion 632. The tether retention structure 636 may define an opening 638 configured to receive a tether or other anchoring mechanism therethrough. While the retention structure 636 is shown as having a generally “U-shaped” configuration, the retention structure 636 may take any shape that provides an enclosed perimeter surrounding the opening 638 such that a tether may be securably and releasably passed (e.g. looped) through the opening 638. In some cases, the retention structure 636 may extend though the head portion 632, along the neck portion 634, and to or into the proximal end 614 of the housing 612. The docking member 630 may be configured to facilitate delivery of the LCP 610 to the intracardiac site and/or retrieval of the LCP 610 from the intracardiac site. While this describes one example docking member 630, it is contemplated that the docking member 630, when provided, can have any suitable configuration.

It is contemplated that the LCP 610 may include one or more pressure sensors 640 coupled to or formed within the housing 612 such that the pressure sensor(s) is exposed to the environment outside the housing 612 to measure blood pressure within the heart. For example, if the LCP 610 is placed in the left ventricle, the pressure sensor(s) 640 may measure the pressure within the left ventricle. If the LCP 610 is placed in another portion of the heart (such as one of the atriums or the right ventricle), the pressures sensor(s) may measure the pressure within that portion of the heart. The pressure sensor(s) 640 may include a MEMS device, such as a MEMS device with a pressure diaphragm and piezoresistors on the diaphragm, a piezoelectric sensor, a capacitor-Micro-machined Ultrasonic Transducer (cMUT), a condenser, a micro-monometer, or any other suitable sensor adapted for measuring cardiac pressure. The pressures sensor(s) 640 may be part of a mechanical sensing module described herein. It is contemplated that the pressure measurements obtained from the pressures sensor(s) 640 may be used to generate a pressure curve over cardiac cycles. The pressure readings may be taken in combination with impedance measurements (e.g. the impedance between electrodes 620 and 622) to generate a pressure-impedance loop for one or more cardiac cycles as will be described in more detail below. The impedance may be a surrogate for chamber volume, and thus the pressure-impedance loop may be representative for a pressure-volume loop for the heart H.

In some embodiments, the LCP 610 may be configured to measure impedance between the electrodes 620, 622. More generally, the impedance may be measured between other electrode pairs, such as the additional electrodes 114′ described above. In some cases, the impedance may be measure between two spaced LCP's, such as two LCP's implanted within the same chamber (e.g. LV) of the heart H, or two LCP's implanted in different chambers of the heart H (e.g. RV and LV). The processing module of the LCP 610 and/or external support devices may derive a measure of cardiac volume from intracardiac impedance measurements made between the electrodes 620, 622 (or other electrodes). Primarily due to the difference in the resistivity of blood and the resistivity of the cardiac tissue of the heart H, the impedance measurement may vary during a cardiac cycle as the volume of blood (and thus the volume of the chamber) surrounding the LCP changes. In some cases, the measure of cardiac volume may be a relative measure, rather than an actual measure. In some cases, the intracardiac impedance may be correlated to an actual measure of cardiac volume via a calibration process, sometimes performed during implantation of the LCP(s). During the calibration process, the actual cardiac volume may be determined using fluoroscopy or the like, and the measured impedance may be correlated to the actual cardiac volume.

In some cases, the LCP 610 may be provided with energy delivery circuitry operatively coupled to the first electrode 620 and the second electrode 622 for causing a current to flow between the first electrode 620 and the second electrode 622 in order to determine the impedance between the two electrodes 620, 622 (or other electrode pair). It is contemplated that the energy delivery circuitry may also be configured to deliver pacing pulses via the first and/or second electrodes 620, 622. The LCP 610 may further include detection circuitry operatively coupled to the first electrode 620 and the second electrode 622 for detecting an electrical signal received between the first electrode 620 and the second electrode 622. In some instances, the detection circuitry may be configured to detect cardiac signals received between the first electrode 620 and the second electrode 622.

When the energy delivery circuitry delivers a current between the first electrode 620 and the second electrode 622, the detection circuitry may measure a resulting voltage between the first electrode 620 and the second electrode 622 (or between a third and fourth electrode separate from the first electrode 620 and the second electrode 622, not shown) to determine the impedance. When the energy delivery circuitry delivers a voltage between the first electrode 620 and the second electrode 622, the detection circuitry may measure a resulting current between the first electrode 620 and the second electrode 622 (or between a third and fourth electrode separate from the first electrode 620 and the second electrode 622) to determine the impedance.

FIG. 6 provides a highly schematic illustration of a patient 700 having an implantable medical device 702 implanted within the patient 700. While the implantable medical device 702 is shown as being in or near the patient's chest, it will be appreciated that this is merely illustrative, as the implantable medical device 702, depending on functionality, may be implanted in other locations within the patient 700. A transmitter 704 is shown exterior to the patient 700. In some cases, the transmitter 704 may be configured to transmit reactive near-field energy that is of a wavelength (or frequency, as wavelength and frequency are related by the numerical speed of light) and intensity that can safety pass into the patient 700 to the implantable medical device 702 without causing excessive tissue heating and/or other potentially damaging effects to the patient 700.

The transmitter 704 may take any of a variety of forms. For example, while shown schematically as a box in FIG. 6, the transmitter 704 may be sized and configured for the patient 700 to periodically wear about their neck on a lanyard or in a shirt pocket, which would place the transmitter 704 proximate their chest, at about the same vertical and horizontal position as the implantable medical device 702 within the patient's chest. In some cases, for example, the transmitter 704 may be built into the back of a chair that the patient 700 would periodically sit in to recharge the implantable medical device 702. The chair may be in the patient's home, for a daily recharge, for example, or may be at a remote location such as a medical clinic, for a patient 700 having a longer recharge schedule. As another example, the transmitter 704 may be built into a bed such that the transmitter 704 may at least partially recharge the implantable medical device 702 each evening when the patient 700 sleeps. In some cases, the transmitter 704 may be configured to only transmit once per week, or once per month, for example, depending on the power requirements of the implantable medical device 702. In some cases, the transmitter 704 and the implantable medical device 702 may communicate with each other. When so provided, the implantable medical device 702 may report its current battery recharge level to the transmitter 704, and if the current battery recharge level is below a threshold, the transmitter 704 may transmit power to the implantable medical device 702. These are just examples.

It will be appreciated that the implantable medical device 702 may be configured to periodically or continuously receive near-field energy at a wavelength and intensity that is safe for the patient 700 and that the implantable medical device 702 may use to recharge a rechargeable power source within the implantable medical device 702. The near-field energy may be received at a rate that exceeds a rate at which power is being drawn from the rechargeable battery and consumed by various components within the implantable medical device 702.

FIG. 7 provides an illustrative circuit for a coupled inductor system 800. Inductive coupling is the near-field wireless transmission of electrical energy between a source 802 and a device 804. In some cases, the source 802 may transfer power from a source inductor 806 to a device inductor 808 by a magnetic field. The system 800, therefore, may act as a transformer. In some cases, a signal generator 810 may generate an alternating current (AC) through the source inductor 806 and create an oscillating magnetic field. The magnetic field may pass through the device inductor 808 and induce an alternating electromagnetic force (EMF), which creates an alternating current (AC) in the device 804. The induced AC may either drive a load 812 directly, or may be rectified to direct current (DC) by a rectifier (not shown) in the device 804, which may then drive the load 812.

In some cases, the power transferred may increase with frequency and mutual inductance between the source inductor 806 and the device inductor 808, which may depend on their geometry (e.g. orientation, size, shape, etc.) and the distance between them. For example, if the source inductor 806 and the device inductor 808 are on the same axis (i.e., a primary capture axis) and close together so a large percentage of the magnetic flux from the source inductor 806 passes through the device inductor 808, the transfer of power may approach 100%. The greater the separation between the coils, the more the magnetic field from the source inductor 806 may not interact with the device inductor 808, and the transfer of power may decrease.

In some cases, the source inductor 806 and/or the device inductor 808 may be fitted with magnetic cores. A magnetic core can be a piece of magnetic material with a high magnetic permeability used to confine and guide magnetic fields in electrical, electromechanical and magnetic devices such as electromagnets, transformers, generators, inductors, and other magnetic assemblies. In some cases, the magnetic core may be made of ferromagnetic metal such as iron, or ferromagnetic compounds such as ferrites. The high permeability, relative to the surrounding atmosphere, may cause the magnetic field lines to be concentrated in the ferrite core. In some cases, the use of the ferrite core can concentrate the strength and increase the effect of magnetic fields produced by electric currents through the source inductor 806. The magnetic field may also be confined and guided, using the ferrite cores, and may improve coupling, thus, improving the transfer of power.

In some cases, the system may achieve resonant inductive coupling. In this case, the source 802 can be tuned to resonant at the same frequency as the device 804. In some cases, the source 802 can include the source inductor 806 connected to a capacitor 814 as shown. A similar capacitor may be included in the device 804. A resonance between the source inductor 806 circuit and the device inductor 808 circuit can increase the coupling and power transfer between the devices. In some cases, when the system 800 achieves resonant inductive coupling, the source 802 and the device 804 may interact with each other more strongly than they do with non-resonant objects and power losses due to absorption in stray nearby objects may be reduced and/or negligible.

As discussed above, the power transfer efficiency may depend on the geometry (e.g. orientation, size, shape, etc.) of the source inductor 806 and the device inductor 808 (e.g., the direction of their primary capture axis) and the distance between them. In addition, in some cases, the impedance of a device may vary (e.g., due to aging of the circuitry of an IMD, due to the location of deployment of an IMD within a patient, etc.) and change the resonant frequency of the device. As a result, it may be difficult to achieve resonant inductive coupling over all conditions. To compensate for this, and in some cases, the source 802 and/or device 804 may include a tuning circuit that can be used to actively tune the resonance frequency of the source inductor circuit and/or device inductor circuit to help keep the devices in resonance. In some embodiments coupled inductor system 800 also provides an inductive mode of communication to support a communication pathway such as the communication pathway 308 shown in FIG. 3. The inductive communication link may be provided when the coupled inductor system 800 is not being utilized for transmission of electrical energy to recharge rechargeable power source 712. Alternatively the inductive communication link may be provided when the coupled inductor system 800 is being utilized for transmission of electrical energy to recharge rechargeable power source 712 via modulation of an transfer energy parameter (e.g. amplitude, frequency, phase, pulse width, etc.).

FIG. 8 provides an illustrative coupled inductor power summation system 900. In some cases, the power summation system 900 may be used to increase the overall power transferred from a source 902 to a device 904 by using two receiving inductors to capture the magnetic field induced by the source 902 and then power summing the captured energy. In some cases, a signal generator 906 may generate an AC through the source inductor 908 and create an oscillating magnetic field 910. Part of the source induced magnetic field 910 may pass through each of the two (or more) device inductors 912 and 914, which may induce an alternating EMF in the device inductors 912 and 914, and thus an AC in each of the device inductors 912 and 914. The AC produced by each of the device inductors 912 and 914 may be independently rectified by non-linear elements 918 and 920 (e.g., rectifying diodes), respectively, and the rectified currents may be summed together. The sum of the rectified currents may increase the total power delivered to the device load 916 relative to a system that has a single receiving device.

In this configuration, the power summation system 900 may reduce or avoid the power transfer inefficiencies caused by inductor geometries, the distance between the inductors, the changes in resonant frequency, and/or other factors. For example, in some cases, the magnetic field 910 may not pass directly through the device inductors 912 and 914. For instance, the direction of the primary capture axis of the device inductors 912 and 914 may not be completely aligned with the primary transfer axis of the source inductor 908. In such a case, when the primary capture axis of the device inductor 912 is aligned with the primary capture axis of the device inductor 914, and each receives the same component of the magnetic field 910, the two device inductors 912 and 914 may double the energy captured relative to a system with only a single device coil. When the primary capture axis of the device inductor 912 is miss-aligned with the primary capture axis of the device inductor 914, and each receives a different component of the magnetic field 910, one of the device inductors 912 and 914 may capture energy that is not captured by the other of the device inductors 912 and 914. This may help capture a more consistent power level, particularly when the orientation between the source inductors 908 and the device inductors 912, and 914 is unknown or is changing over time.

Rather than having the device inductors 912 and 914 in a power summing configuration as shown in FIG. 8, it is contemplated that a switching circuit (not shown) may be used to individually select the device inductors 912 and 914. For example, the magnetic field 910 may pass directly through or almost directly through the device inductor 912 and may barely pass or not pass through the device inductor 914 (e.g., the direction of the primary capture axis of the device inductor 914 may not align with the primary transfer axis of the source inductor 908, there is a substantial distance between the device inductor 914 and the source inductor 908, etc.). In this case, the power contributed from the device inductor 914 may be negligible. The power summation system 900 may select only the device inductor 912 to inductively couple with the source inductor 908 and the power delivered to the device load 916 may be from the AC created by the alternating EMF in the device inductor 912. In some cases, the power summation system 900 may sample the AC created by each of the device inductors 912 and 914, and determine which of the coils to select. In some cases, the power summation system 900 may include a posture sensor and may select the coils based, at least in part, on the posture of the patient. In some cases, the power summation system 900 may include a respiration sensor and may select the coils based, at least in part, on a respiration parameter (e.g. respiration phase) of the patient. In some cases, the power summation system 900 may include an ECG sensor and may select the coils based, at least in part, on a cardiac (e.g. cardiac phase) of the patient. These are just examples.

In some cases, the source inductor 908 and/or the device inductors 912, and 914 may be fitted with ferrite cores. In these cases, the magnetic field created by the source inductor 908 may be increased, confined, and guided through the device inductors 912 and 914. As a result, the coupling between the source inductor 908 and the device inductors 912 and 914 may be improved, which may improve the overall transfer of power.

FIG. 9 provides an illustrative but non-limiting example of at least some of the components within the implantable medical device 702. In some cases, the implantable medical device 702 may include a device housing 706 that may encompass a receiving coil 708, charging circuitry 710, and a rechargeable power source 712. In various embodiments, the implantable medical device 702 may also include receiving coils 714 and 716. In certain embodiments, the receiving coils 714 and 716 may be external to the device housing 706.

The receiving coils 708, 714, and 716 may be any of a variety of different types of antennas. When considering the electromagnetic regions around a transmitting antenna, there are three categories, namely, (1) reactive near-field; (2) radiated near-field and (3) radiated far-field. The “Inductive” charging system of the present disclosure is intended to operate in the reactive near-field region. In inductive power systems, power is typically transferred over short distances by magnetic fields using inductive coupling between coils of wire, such as receiving coils 708, 714, and 716, or by electric fields using capacitive coupling between electrodes. In radiative power systems (e.g. radiated near-field and radiated far-field), power is typically transmitted by beams of electromagnetic (EM) energy. Radiative power systems can often transport energy for longer distances, but the ability of a receiving antenna to capture sufficient energy can be challenging, particular for applications where the size of the receiving antenna is limited.

In some cases, the transmitter 704 (FIG. 6) and implantable medical device 702 may inductively transfer power between about 10 kHz and 100 MHz within the patient's body. When so provided, the system operates in the reactive near-field (as in inductive charging system). In some cases, the transmitter 704 may transmit the near-field energy such that multiple implanted receiving coils (i.e., receiving coils 708, 714, and 716) may simultaneously or sequentially capture the near-field energy and provide it to the charging circuitry 710.

In some cases, the charging circuitry 710 may be configured to convert the received near-field energy into a form that may be used to recharge the rechargeable power source 712. In some instances, the charging circuitry 710 may function to recharge the rechargeable power source 712, and the implantable medical device 702 may include other circuitry (not shown) to provide other functions ascribed to the implantable medical device 702. In some cases, the charging circuitry 710 may provide power directly to circuitry (not shown) of the implantable medical device 702, such as sensing circuitry, therapy delivery circuitry, communication circuitry, and/or any other suitable circuitry.

The rechargeable power source 712 may include any type of rechargeable battery. In some cases, the rechargeable power source 712 may include a supercapacitor. The rechargeable power source 712 may take a three dimensional shape that facilitates incorporation of the rechargeable power source into the device housing 706. As will be appreciated, in some cases the device housing 706 may have a cylindrical or substantially cylindrical shape, in which case the rechargeable power source 712 may have a cylindrical or annular profile, such as a button battery or an elongated (in length) battery having a substantially cylindrical shape, but this is not required. In some cases, device housing 706 may be rigid; in some cases it may be flexible. It is recognized that there are possible tradeoffs in rechargeable battery shape and dimensions relative to performance, so these issues should be considered in designing the rechargeable power source 712 for a particular use. While FIG. 9 schematically shows a single rechargeable power source 712, in some cases there may be two, three or more distinct rechargeable power sources 712, each electrically coupled with the charging circuitry 710. For example, in some cases there may be performance advantages in having multiple rechargeable power sources 712. In some instances, there may be packaging advantages to having multiple (and smaller) rechargeable power sources 712. In some cases, rechargeable power source 712 may include more than one type of rechargeable power sources (e.g. both a rechargeable battery and a super capacitor).

FIG. 10 provides a schematic view of an illustrative IMD 1102 that may be configured to be implanted within a patient such as the patient 700 (FIG. 6). In some cases, electrodes 1110a-1110b may be exposed external to a housing 1118 and may be operably coupled to therapeutic circuitry 1108. While two electrodes are illustrated, it will be appreciated that in some instances the IMD 1102 may include three, four or more distinct electrodes. Depending on the intended functionality of the IMD 1102, the electrodes 1110a-1110b may be used for sensing and/or pacing the patient's heart. In some instances, for example, the IMD 1102 may be a leadless cardiac pacemaker (LCP), an implantable monitoring device or an implantable sensor. In some cases, the electrodes 1110a-1110b may be used for communicating with other implanted devices and/or with external devices. In some cases, communication with other implanted devices may include conductive communication, but this is not required. Rechargeable power source 1106 may be disposed within the housing 1118 and may be configured to power the IMD 1102, including the therapeutic circuitry 1108.

According to various embodiments, the housing 1118 may be configured for trans-catheter deployment. In some cases, this means that the housing 1118 has overall dimensions that enable the IMD 1102 to fit within a catheter or similar device for delivering the IMD 1102 via a vascular approach. In some cases, the housing 1118 may have an overall length of perhaps about five centimeters or less, or perhaps about three centimeters or less, and/or an overall width of perhaps about 2 centimeters or less, or perhaps about 1 centimeter or less.

In various embodiments, receiving coil 1112 may be disposed within the housing 1118 and receiving coils 1114 and 1116 may be disposed outside the housing 1118. In some cases, receiving coils 1112, 1114, and 1116 may all be within the housing 1118, or the receiving coils 1112, 1114, and 1116 may all be outside of the housing. These are just examples.

In certain embodiments, the receiving coils 1112, 1114, and 1116 may be configured to receive near-field energy. The charging circuitry 1104 may be operably coupled with the receiving coils 1112, 1114, and 1116 and the rechargeable power source 1106. In some cases, the charging circuitry 1104 may be configured to charge the rechargeable power source 1106 using the near-field energy received by the receiving coils 1112, 1114, and 1116. In some cases, the receiving coils 1112, 1114, and 1116 may be configured to receive sufficient near field energy from a wavelength band of near-field energy transmitted from outside the patient 700 (FIG. 6) to recharge the rechargeable power source 1106 at a rate faster than the rechargeable power source 1106 is depleted by powering the IMD 1102 when the wavelength band of near-field energy is transmitted at an intensity that does not cause heat damage to the patient 700. In some cases, the housing 1118 has a substantially cylindrical profile and the receiving coil 1112 may be conformed to the substantially cylindrical profile of an inner surface of an inner cavity defined by the housing 1118.

In some cases, the charging circuitry 1104 and the therapeutic circuitry 1108 may be located on distinct circuit boards or may be manifested within distinct integrated circuits (ICs). In some cases, the charging circuitry 1104 and the therapeutic circuitry 1108, while shown as distinct elements, may be combined within a single IC or on a single circuit board. In some cases, the therapeutic circuitry 1108 may be operatively coupled to the electrodes 1110a and 1110b. In some instances, the therapeutic circuitry 1108 may be configured to sense one or more signals via the electrodes 1110a and 1110b (or additional electrodes) and/or to stimulate tissue via the electrodes 1110a and 1110b. In some cases, the therapeutic circuitry 1108 may pace, or stimulate tissue, at least partly in response to the one or more sensed signals.

FIG. 11 provides a schematic view of another illustrative IMD 1202 that may be configured to be implanted within a patient such as the patient 700 (FIG. 6). In some cases, electrodes 1210 and 1212 may be remote from a housing 1220 of the IMD 1202 and may be operably coupled to therapeutic circuitry 1208. While two electrodes are illustrated, it will be appreciated that in some instances the IMD 1202 may include three, four or more distinct electrodes. Depending on the intended functionality of the IMD 1202, the electrodes 1210 and 1212 may be used for sensing and/or pacing the patient's heart. In some instances, for example, the IMD 1202 may be an LCP, an implantable monitoring device or an implantable sensor. In some cases, the electrodes 1210 and 1212 may be used for communicating with other implanted devices and/or with external devices. In some cases, communication with other implanted devices may include conductive communication, but this is not required.

In some cases, the electrodes 1210 and 1212 may include receiving coils 1214 and 1216, and in some cases another receiving coil 1218 may be disposed within the housing 1220. In certain embodiments, the receiving coils 1214, 1216, and 1218 may be configured to receive near-field energy. The charging circuitry 1204 may be operably coupled with the receiving coils 1214, 1216, and 1218 and the rechargeable power source 1206. In some cases, the charging circuitry 1204 may be configured to charge the rechargeable power source 1206 using the near-field energy received by the receiving coils 1214, 1216, and 1218. In some cases, the receiving coils 1214, 1216, and 1218 may be configured to receive sufficient near-field energy from a wavelength band of near-field energy transmitted from outside the patient 700 (FIG. 6) to recharge the rechargeable power source 1206 at a rate faster than the rechargeable power source 1206 is depleted by powering the IMD 1202 when the wavelength band of near-field energy is transmitted at an intensity that does not cause heat damage to the patient 700. In some cases, the housing 1220 has a substantially cylindrical profile and the receiving coil 1218, if present, may be conformed to the substantially cylindrical profile of an inner surface of an inner cavity defined by the housing 1220, but this is not required. In some cases, the rechargeable power source 1206 may be disposed within the housing 1220 and may be configured to power the IMD 1202, including the therapeutic circuitry 1208.

In some cases, the charging circuitry 1204 and the therapeutic circuitry 1208 may be located on distinct circuit boards or be manifested within distinct integrated circuits (ICs). In some cases, the charging circuitry 1204 and the therapeutic circuitry 1208, while shown as distinct elements, may be combined within a single IC or on a single circuit board. In some cases, the therapeutic circuitry 1208 may be operatively coupled to the electrodes 1210 and 1212. In some instances, the therapeutic circuitry 1208 may be configured to sense one or more signals via the electrodes 1210 and 1212 (or additional electrodes) and/or to stimulate tissue via the electrodes 1210 and 1212. In some cases, the therapeutic circuitry 1208 may pace, or stimulate tissue, at least partly in response to the one or more sensed signals.

According to various embodiments, the housing 1220 may be configured for trans-catheter deployment. In some cases, this means that the housing 1220 has overall dimensions that enable the IMD 1202 to fit within a catheter or similar device for delivering the IMD 1202 via a vascular approach. In some cases, the housing 1220 may have an overall length of perhaps about five centimeters or less, or perhaps about three centimeters or less, and/or an overall width of perhaps about 2 centimeters or less, or perhaps about 1 centimeter or less.

FIG. 12 illustrates an example of another illustrative IMD 1300 (e.g., a leadless cardiac pacemaker (LCP)) implanted in a chamber of a heart H, such as the left ventricle LV. A cross-sectional view of the illustrative implantable medical device 1300 is shown in FIG. 12. The IMD 1300 may include a shell or housing 1302 having a proximal end 1304 and a distal end 1306. The IMD 1300 may include a first electrode 1308 positioned adjacent to the distal end 1306 of the housing 1302 and a second electrode 1310 positioned adjacent to the proximal end 1304 of the housing 1302. The electrodes 1308, 1310 may be sensing and/or pacing electrodes to provide electro-therapy and/or sensing capabilities. The first electrode 1308 may be capable of being positioned against or may otherwise in contact with the cardiac tissue of the heart H while the second electrode 1310 may be spaced away from the first electrode 1308, and in some cases spaced away from the cardiac tissue.

The illustrative IMD 1300 may include a pulse generator (e.g., therapeutic circuitry 1312), and a rechargeable power source 1314 (e.g., a rechargeable battery) within the housing 1302 to provide electrical signals to the electrodes 1308, 1310 and thus control the pacing/sensing electrodes 1308, 1310. Electrical communication between the therapeutic circuitry 1312 and the electrodes 1308, 1310 may provide electrical stimulation to heart tissue and/or sense a physiological condition.

The illustrative IMD 1300 may include a fixation mechanism 1316 proximate the distal end 1306 of the housing 1302 configured to attach the implantable device 1300 to a tissue wall of the heart H, or otherwise anchor the IMD 1300 to the anatomy of the patient. As shown in FIG. 12, in some instances, the fixation mechanism 1316 may include one or more, or a plurality of hooks or tines anchored into the cardiac tissue of the heart H to attach the implantable device 1300 to a tissue wall. In other instances, the fixation mechanism 1316 may include one or more, or a plurality of passive tines, configured to entangle with trabeculae within the chamber of the heart H and/or a helical fixation anchor configured to be screwed into a tissue wall to anchor the IMD 1300 to the heart H.

The illustrative IMD 1300 may include a docking member 1318 proximate the proximal end 1304 of the housing 1302 configured to facilitate delivery and/or retrieval of the IMD 1300. For example, the docking member 1318 may extend from the proximal end 1304 of the housing 1302 along a longitudinal axis of the housing 1302. The docking member 1318 may include a head portion 1320 and a neck portion 1322 extending between the housing 1302 and the head portion 1320. The head portion 1320 may be an enlarged portion relative to the neck portion 1322. For example, the head portion 1320 may have a radial dimension from the longitudinal axis of the IMD 1300 which is greater than a radial dimension of the neck portion 1322 from the longitudinal axis of the IMD 1300. The docking member 1318 may further include a tether retention structure 1324 extending from the head portion 1320. The tether retention structure 1324 may define an opening 1326 configured to receive a tether or other anchoring mechanism therethrough. While the retention structure 1324 is shown as having a generally “U-shaped” configuration, the retention structure 1324 may take any shape which provides an enclosed perimeter surrounding the opening 1326 such that a tether may be securably and releasably passed (e.g. looped) through the opening 1326. The retention structure 1324 may extend though the head portion 1320, along the neck portion 1322, and to or into the proximal end 1304 of the housing 1302. The docking member 1318 may be configured to facilitate delivery of the IMD 1300 to the intracardiac site and/or retrieval of the IMD 1300 from the intracardiac site. Other docking members 1318 are contemplated.

In some cases, the IMD 1300 may include receiving coils 1328, 1330, 1332, and 1334 configured to receive a non-radiative near-field energy through a patient's body. The receiving coils may include fixation mechanisms 1344, 1346, and 1348 similar to the fixation mechanism 1316.

The receiving coils 1328, 1330, 1332, and 1334 are used in an “inductive” charging systems that operates in the non-radiative near-field region. In inductive power systems, power is typically transferred over short distances by magnetic fields (i.e. magnetic field 1340) using inductive coupling between coils of wire, such as source coil 1338 and receiving coils 1328, 1330, 1332, and 1334. In some cases, a source 1336 may apply the magnetic field 1340 that operates at a frequency greater than or equal to 10 kHz and less than or equal to 100 MHz. When so provided, the source 1336 and the IMD 1300 may operate in the non-radiative near-field energy region. In addition, in some instances, a ratio between the frequency of operation of the applied magnetic field and a dimension of the receiving coils 1328, 1330, 1332, and 1334 may affect a generated radiated field. For example, when an outer dimension of receiving coils 1328, 1330, 1332, and 1334 is less than 1/10 of the wavelength of the applied magnetic field, the radiated field may be minimized.

In some cases, as shown in FIG. 12, the receiving coils 1328, 1330, and 1332 may be disposed outside the housing 1302 and tethered relative to the housing 1302 (e.g., using the tether retention structure 1324). Furthermore, the receiving coil 1334, if present, may be disposed within the housing 1302. In some cases, a signal generator circuitry 1341 may generate an AC through the source coil 1338 and create an oscillating magnetic field 1340. The magnetic field 1340 may pass through the receiving coils 1328, 1330, 1332, and 1334 and induce an alternating EMF, which creates an alternating current. The receiving coils 1328, 1330, 1332, and 1334 may be operatively coupled to charging circuitry 1342 and pass the induced AC to the charging circuitry 1342. In certain embodiments, the charging circuitry 1342 may also be operatively coupled with the rechargeable power source 1314. In some cases, the charging circuitry 1342 may be configured to charge the rechargeable power source 1314 using the AC received from the receiving coils 1328, 1330, 1332, and 1334. In some cases, the receiving coils 1328, 1330, 1332, and 1334 may be configured to receive sufficient near-field energy from the magnetic field 1340 transmitted from the source 1336 to recharge the rechargeable power source 1314, at a rate faster than the rechargeable power source 1314 is depleted powering the IMD 1300, when the magnetic field 1340 is transmitted at an intensity that does not cause heat damage to the patient 700. In some cases, the charging circuitry 1342 may use power summing to sum the power from each of the receiving coils 1328, 1330, 1332, and 1334. In some cases, the charging circuitry 1342 may including a switching circuit to selectively select one or more of the receiving coils 1328, 1330, 1332, and 1334 to charge the rechargeable power source 1314.

In some cases, the charging circuitry 1342 may monitor the magnetic field 1340 and detect the power delivered to the rechargeable power source 1314. In some cases, the charging circuitry 1342 may detect that the power delivered has decreased due to the primary capture axis of the receiving coil 1328 no longer aligning with the primary transfer axis of the source coil 1338. The charging circuitry 1342 may also detect that the primary capture axis of the receiving coil 1332 is in closer alignment with the primary transfer axis of the source coil 1338. As a result, the charging circuitry 1342 may select the receiving coil 1332 to inductively couple with the source coil 1338 and the power delivered to the rechargeable power source 1314 will be from the AC created by the alternating EMF in the receiving coil 1332. This is just one example of the use of a switching circuit.

In some cases, one or more of the receiving coils 1328, 1330, 1332, and 1334 may be fitted with a ferrite core (not shown). The permeability, relative to the surrounding environment, may cause the magnetic field 1340 to be concentrated in the ferrite core. In some cases, the use of the ferrite core can concentrate the strength and increase the effect of the magnetic field 1340 produced. The magnetic field 1340 may also be confined and guided, using the ferrite cores, and may improve coupling, thus, improving the transfer of power. In some cases, to increase the benefits of a ferrite core, the diameter of the receiving coils 1328, 1330, 1332, and 1334 may be relatively small compared to their lengths. For example, to benefit from the ferrite cores, a ratio between the length of the receiving coils 1328, 1330, 1332, and 1334 and their diameters may be 3 to 1 or greater. In another example, to benefit from the ferrite cores, the ratio between the length of the receiving coils 1328, 1330, 1332, and 1334 and their diameters may be 10 to 1 or greater. In some cases, the receiving coils 1328, 1330, 1332, and 1334 may be spaced from one another and may each may have a primary capture axis that is not-aligned with the primary capture axis of at least one other receiving coil.

In some cases, the source coil 1338 may be resonantly inductively coupled to one or more of the receiving coils 1328, 1330, 1332, and 1334. For example, the source 1336 may be tuned such that the source coil 1338 resonates at the same frequency as one or more of the receiving coils 1328, 1330, 1332, and 1334, in some cases, the resonance between the source coil 1338 and one or more of the receiving coils 1328, 1330, 1332, and 1334 may increase the power transferred. In some cases, when the source 1336 and the MD 1300 achieve resonant inductive coupling, the source 1336 and the IM D 1300 may interact with each other more strongly than they do with non-resonant objects and power losses due to absorption in stray nearby objects may be reduced or negligible.

FIG. 13 illustrates another example IMD 1400 (e.g., a leadless cardiac pacemaker (LCP)) implanted in a chamber of a heart H, such as the left ventricle LV. The IMD 1400 may include a housing 1402, electrodes 1408 and 1410, receiving coils 1428, 1430, 1432, and 1434, fixation mechanisms 1416, 1444, 1446, and 1448, a docking member 1418, a tether retention structure 1424, therapeutic circuitry 1412, a rechargeable power source 1414, and charging circuitry 1442. The configuration and operation the IMD 1400 and its elements may be similar to the configuration and operation of the IMD 1300 and its elements described with respect to FIG. 12. In some cases, as seen in FIG. 13, the IMD 1400 may also include remote electrodes 1450, 1452, and 1454 disposed outside the housing 1402 of the IMD 1400 and tethered relative to the housing 1402 (e.g., using the tether retention structure 1424). The remote electrodes 1450, 1452, and 1454 may be sensing and/or pacing electrodes to provide electro-therapy and/or sensing capabilities. In some cases, the electrodes 1450, 1452, and 1454 may be capable of being positioned against or may otherwise contact the cardiac tissue of the heart H. The IMD 1400 may also include a pulse generator (e.g., the therapeutic circuitry 1412), and the rechargeable power source 1414 (e.g., a rechargeable battery) within the housing 1402 operatively coupled to the electrodes 1450, 1452, and 1454 to provide electrical signals to the electrodes 1450, 1452, and 1454 and thus control the pacing/sensing electrodes 1450, 1452, and 1454. Electrical communication between the therapeutic circuitry 1412 and the electrodes 1450, 1452, and 1454 may provide electrical stimulation to heart tissue and/or sense a physiological condition.

The remote electrodes 1450, 1452, and 1454 may include fixation mechanisms 1444, 1446, and 1448 proximate a distal end of an electrode housing 1456, 1458, and 1460 configured to attach the remote electrodes 1450, 1452, and 1454 to a tissue wall of the heart H, or otherwise anchor the remote electrodes 1450, 1452, and 1454 to the anatomy of the patient. As shown in FIG. 13, in some instances, the fixation mechanisms 14441446, and 1448 may include one or more, or a plurality of hooks or tines anchored into the cardiac tissue of the heart H to attach the remote electrodes 1450, 1452, and 1454 to a tissue wall. In other instances, the fixation mechanisms 1444, 1446, and 1448 may include one or more, or a plurality of passive tines, configured to entangle with trabeculae within the chamber of the heart H and/or a helical fixation anchor configured to be screwed into a tissue wall to anchor the remote electrodes 1450, 1452, and 1454 to the heart H.

In some cases, one or more of the remote electrodes 1450, 1452, and 1454 may also include a receiving coil, such as receiving coils 1428, 1430, and 1432. As previously stated, the receiving coils 1428, 1430, and 1432 may be configured to operate similar to the receiving coils 1328, 1330, 1332, as described with respect to FIG. 12.

FIG. 14 illustrates another example an IMD 1500 (e.g., a leadless cardiac pacemaker (LCP)) implanted in a chamber of a heart H, such as the left ventricle LV. The IMD 1500 may include a housing 1502, electrodes 1508 and 1510, receiving coils 1528, 1530, and 1532, fixation mechanism 1516, a docking member 1518, a tether retention structure 1524, therapeutic circuitry 1512, a rechargeable power source 1514, and charging circuitry 1542. The configuration and operation the IMD 1500 and its elements may be similar to the configuration and operation of the IMD 1300 and its elements described with respect to FIG. 12. In some cases, as seen in FIG. 14, the IMD 1500 may include the receiving coils 1528, 1530, and 1532 disposed outside the housing 1502, and may be configured to move from a pre-deployment, compressed state, to an expanded post-deployment state. For example, the receiving coils 1528, 1530, and 1532 may be attached to a distal end of the housing 1502 of the IMD in any suitable manner, which may include hinges, screws, pins and/or any other suitable fastener so that joints 1560, 1562, and 1564 are formed at a distal end of the receiving coils 1528, 1530, and 1532. In some cases, the joints 1560, 1562, and 1564 may be configured to pivot so that a proximal end of the receiving coils 1528, 1530, and 1532 move, retract, or compress towards the housing 1502 to a closed position. In some cases, the joints 1560, 1562, and 1564 may be further configured to pivot so that the proximal end of the receiving coils 1528, 1530, and 1532 move, expand, or swing away from the housing 1502 to an open position.

For another example, the receiving coils 1528, 1530, and 1532 may be attached to a proximal end of the housing 1502 of the IMD in any suitable manner, which may include hinges, screws, pins and/or any other suitable fastener so that joints 1560, 1562, and 1564 are formed at a proximal end of the receiving coils 1528, 1530, and 1532. In some cases, the joints 1560, 1562, and 1564 may be configured to pivot so that a distal end of the receiving coils 1528, 1530, and 1532 move, retract, or compress towards the housing 1502 to a closed position. In some cases, the joints 1560, 1562, and 1564 may be further configured to pivot so that the distal end of the receiving coils 1528, 1530, and 1532 move, expand, or swing away from the housing 1502 to an open position.

In the open position, the receiving coils 1528, 1530, and 1532 may each have a primary capture axis along which a maximum amount of non-radiative near-field energy is captured. As discussed herein, a transfer of power may increase when a primary transfer axis of a source coil (i.e., source coil 1538) of a source (i.e., source 1536) is at least partially aligned with a primary capture axis of one or more of the receiving coils 1528, 1530, and 1532. Furthermore, the primary transfer axis of the source coil 1538 may change during a given time. Therefore, in some cases, the IMD 1500 may be configured such that the primary capture axis of one or more of the receiving coils 1528, 1530, and 1532 may be non-parallel with the primary capture axis of another one of the receiving coils 1528, 1530, and 1532. In this configuration, the IMD 1500 may have a greater chance of one of the primary receiving axis of the receiving coils 1528, 1530, and 1532 being at least partially aligned with the primary transfer axis of the source coil 1538 so as to increase the power transfer efficiency. In some cases, two or more of the receiving coils 1528, 1530, and 1532 may be at least partially aligned with the primary transfer axis of the source coil 1538. In some cases, the receiving coils 1528, 1530, and 1532 are orientated to be orthogonal or substantially orthogonal to each other.

In some cases, the receiving coils 1528, 1530, and 1532 may be in the closed state before and during deployment of the IMD 1500, and in the open state after deployment of the IMD 1500. For example, the IMD 1500 may initially be located in a holding section of a delivery catheter. In the holding section, the receiving coils 1528, 1530, and 1532 may be compressed or retracted by an inner-wall of the holding section of the delivery catheter. Once the holding section has been positioned adjacent to cardiac tissue at a desired implantation site, the IMD 1500 may be distally advanced out of the holding section of the delivery catheter. During this process, the fixation mechanism 1516 may engage the heart tissue, and the delivery catheter, including the holding section, can be proximally retracted. Once, the holding section has been retracted, the inner-wall may no longer compress or retract the receiving coils 1528, 1530, and 1532, allowing the receiving coils 1528, 1530, and 1532 to open. In some cases, the receiving coils 1528, 1530, and 1532 may include a shape memory alloy such as Nitinol that is biases the receiving coils 1528, 1530, and 1532 toward the open position.

As discussed herein, in some cases, the source 1536 may apply a magnetic field 1540 that operates at a frequency greater than or equal to 10 kHz and less than or equal to 100 MHz. When so provided, the source 1536 and the IMD 1500 may operate in the non-radiative near-field energy region. In addition, in some instances, a ratio between the frequency of operation of the applied magnetic field and a maximum dimension of the receiving coils 1528, 1530, and 1532, may affect a generated radiated field. For example, when a maximum outer dimension of receiving coils 1528, 1530, and 1532, is less than 1/10 of the wavelength of the applied magnetic field, the radiated field may be minimized, which in this instance may be desirable.

Also discussed herein, in some cases, the receiving coils 1528, 1530, and 1532 may be in a power summation configuration. As discussed with respect to FIG. 8, a power summation configuration may be used to increase the overall power transferred from the source 1536 to the IMD 1500. For example, the source 1536 may transmit the near-field energy such that the receiving coils 1528, 1530, and 1532 may simultaneously or sequentially capture the near-field energy and transfer it to the charging circuitry 1542. In some cases, the magnetic field 1540 may pass through at least two of the receiving coils 1528, 1530, and 1532. The alternating current (AC) created from the alternating EMF from the induced receiving coils may combine using a non-linear circuit element (e.g. diodes) and increase the total power delivered to the rechargeable power source 1514. In this configuration, the 1500 may increase the power transfer efficiencies to help overcome the receiving coils 1528, 1530, and 1532 spatial geometries (e.g., misalignment of their primary capture axes with the transfer axis of the source coil 1538), the distance between the source coil 1538 and the receiving coils 1528, 1530, and 1532, changes in resonant frequency and/or other factors.

The receiving coils 1528, 1530, and 1532 may be any of a variety of different types of receiving coils. Although flat (winged) coils are shown, the receiving coils 1528, 1530, and 1532 may take on many other shapes and configurations. Moreover, although three coils are shown, it will be appreciated that in some instances, the IMD 1500 may include one, two, four or more distinct receiving coils. In some cases, the receiving coils 1528, 1530, and 1532 may be made of shaped-formed materials such as nitinol. In some cases, the receiving coils 1528, 1530, and 1532 may be conformal to the myocardium of the heart when in the open position. In some cases, the receiving coils 1528, 1530, and 1532 may be stiff. In some cases, the receiving coils 1528, 1530, and 1532 may contain both endothialization-promoting and anti-thrombotic coatings (e.g., Dacron sock, PEG, etc.). In some cases, the receiving coils 1528, 1530, and 1532 may have localized strain-relief added that may reduce wear-out (e.g., use of meandering interconnect at the joints). In some cases, the receiving coils 1528, 1530, and 1532 may contain ferrite materials that may improve the local magnetic flux. In some cases, a substrate of the receiving coils 1528, 1530, and 1532 may incorporate ferrous material such that the local flux density may be increased. In some cases, the receiving coils 1528, 1530, and 1532 may be a part of the housing 1502 and open up after deployment. In some cases, the receiving coils 1528, 1530, and 1532 may be used for inductive communication. In some cases, the receiving coils 1528, 1530, and 1532 may be used for acoustic energy transfer. In some cases, the receiving coils 1528, 1530, and 1532 may have their own resonance capacitor and rectifier to provide localized rectification. In some cases, the receiving coils 1528, 1530, and 1532 could be a single-coil compound that covers three distinct planes. In some cases, the receiving coils 1528, 1530, and 1532 may be used for capacitive recharge. In some cases, the receiving coils 1528, 1530, and 1532 may be rod shaped and serially co-aligned during catheter delivery to reduce the diametric space taken up in the holding section of the delivery catheter.

FIG. 15 illustrates another example an IMD 1600 (e.g., an implantable cardiac pacemaker) implanted in a chamber of a heart H, such as the left ventricle LV. Although configured differently, the IMD 1600 and its elements may operate similar to IMD 1300 and its elements. For instance, in some cases, the IMD 1600 may include electrodes 1602, 1604, 1606, and 1608 operably coupled to therapeutic circuitry 1622. While four electrodes are illustrated, it will be appreciated that in some instances the IMD 1600 may include one, two, three, five or more distinct electrodes and/or sensors. Depending on the intended functionality of the IMD 1600, the electrodes 1602, 1604, 1606, and 1608 may be used for sensing and/or pacing the patient's heart. In some instances, for example, the IMD 1600 may be a monitoring device or an implantable sensor. In some cases, the electrodes 1602, 1604, 1606, and 1608 may be used for communicating with other implanted devices and/or with external devices. In some cases, communication with other implanted devices may include conductive communication, but this is not required. The IMD 1600 may also include a rechargeable power source 1612 and may be configured to power the IMD 1600, including therapeutic circuitry 1622.

According to various embodiments, the IMD 1600 may be configured for trans-catheter deployment. In some cases, this means that the IMD 1600 has pre-deployment dimensions that enable the IMD 1600 to fit within a delivery catheter or similar device for delivering the IMD 1600 via a vascular approach.

In various embodiments, the IMD 1600 may also include receiving coils 1614, 1616, 1618, and 1620. In certain embodiments, the receiving coils 1614, 1616, 1618, and 1620 may be configured to receive near-field energy. The charging circuitry 1610 may be operably coupled with the receiving coils 1614, 1616, 1618, and 1620 and the rechargeable power source 1612. In some cases, the charging circuitry 1610 may be configured to charge the rechargeable power source 1612 using the near-field energy received by the receiving coils 1614, 1616, 1618, and 1620. In some cases, the receiving coils 1614, 1616, 1618, and 1620 may be configured to receive sufficient near-field energy from a wavelength band of near-field energy transmitted from outside the patient 700 (FIG. 6) to recharge the rechargeable power source 1612 at a rate faster than the rechargeable power source 1612 is depleted by powering the IMD 1600 when the wavelength band of near-field energy is transmitted at an intensity that does not cause heat damage to the patient 700.

In some cases, the charging circuitry 1610 and the therapeutic circuitry 1622 may be located on distinct circuit boards or be manifested within distinct integrated circuits (ICs). In some cases, the charging circuitry 1610 and the therapeutic circuitry 1622, while shown as distinct elements, may be combined within a single IC or on a single circuit board. In some cases, the therapeutic circuitry 1622 may be operatively coupled to the electrodes 1602, 1604, 1606, and 1608. In some instances, the therapeutic circuitry 1622 may be configured to sense one or more signals via the electrodes 1602, 1604, 1606, and 1608 (or additional electrodes) and/or to stimulate tissue via the electrodes 1602, 1604, 1606, and 1608. In some cases, the therapeutic circuitry 1622 may pace, or stimulate tissue, at least partly in response to the one or more sensed signals.

In some cases, the receiving coils 1614, 1616, 1618, and 1620 may be in a power summation configuration. As discussed with respect to FIG. 8, a power summation configuration may be used to increase the overall power transferred from a source 1636 to the IMD 1600. For example, the source 1636 may transmit the near-field energy such that the receiving coils 1614, 1616, 1618, and 1620 may simultaneously or sequentially capture the near-field energy and transfer it to the charging circuitry 1610. In some cases, the magnetic field 1640 may pass through at least two of the receiving coils 1614, 1616, 1618, and 1620. The alternating current (AC) created from the alternating EMF from the induced receiving coils may combine using a non-linear circuit element (e.g. diodes) and increase the total power delivered to the rechargeable power source 1612. In this configuration, the IMD 1600 may increase the power transfer efficiencies to help overcome the receiving coils 1614, 1616, 1618, and 1620 spatial geometries (e.g., misalignment of their primary capture axes with the transfer axis of a source coil 1638), the distance between the source coil 1638 and the receiving coils 1614, 1616, 1618, and 1620, changes in resonant frequency and/or other factors.

In some cases, the receiving coils 1614, 1616, 1618, and 1620 may be fitted with a ferrite core (not shown). The permeability, relative to the surrounding environment, may cause a magnetic field 1640 to be concentrated in the ferrite core. In some cases, the use of the ferrite core can concentrate the strength and increase the effect of the magnetic field 1640 produced. The magnetic field 1640 may also be confined and guided, using the ferrite cores, and may improve coupling, thus, improving the transfer of power. In some cases, to increase the benefits of a ferrite core, the diameter of the receiving coils 1614, 1616, 1618, and 1620 should be relatively small compared to their lengths. For example, to benefit from the ferrite cores, a ratio between the length of the receiving coils 1614, 1616, 1618, and 1620 and their diameters may be greater than or equal to 2 to 1. In another example, to benefit from the ferrite cores, the ratio between the length of the receiving coils 1614, 1616, 1618, and 1620 and their diameters may be greater than or equal to 10 to 1.

In some cases, the IMD 1600 may include a flexible substrate 1650. In certain embodiments, the flexible substrate 1650 may be configured to expand from a delivery state to a deployed state and conform to an inner surface of the heart H. In some cases, the flexible substrate 1650 may comprise a flex circuit with the receiving coils 1614, 1616, 1618, and 1620, the therapeutic circuitry 1622, the charging circuitry 1610, and the rechargeable power source 1612. In some cases, the flexible substrate 1650 may have one or more tines, barbs or other fixation elements that help fix the flexible substrate 1650 in place on the inner surface of the heart H.

FIG. 16A is a view of an illustrative delivery device 1700 (e.g., a catheter) that may be used to deliver an IMD 1702 (e.g., a leadless cardiac pacemaker (LCP)) in a chamber of a heart H, such as the left ventricle LV or right ventricle RV. The delivery device 1700 may include a distal holding section 1712 that may define a cavity 1714 for slidably receiving the IMD 1702, and may include a distal opening 1716 for slidable insertion and/or extraction of the IMD 1702 into and/or out of the cavity 1714. In some cases, receiving coils 1706, 1708, and 1710 may be disposed outside a housing 1704 of the IMD 1702 and tethered relative to the housing 1704 (e.g., using a tether retention structure 1724).

In some cases, a distal end 1718 of the distal holding section 1712 may be placed next to and in contact with a wall 1720 of the chamber of heart H and deployment of the IMD 1702 can begin. FIG. 16B is a view of an implantable IMD 1702 in the delivery device 1700. As the IMD 1702 is pushed distally, fixation mechanisms 1722 may engage the heart tissue of the heart chamber wall 1720. The IMD 1702 may be distally advanced out of the distal holding section 1712 to deploy the fixation mechanisms 1722 from the distal holding section 1712 and engage the fixation mechanisms 1722 in the heart tissue.

Once the fixation mechanisms 1722 have sufficiently engaged the heart wall 1720, as shown in FIG. 16C, the remainder of the IMD 1702 (e.g., the receiving coils 1706, 1708, and 1710) may be expelled from the distal holding section 1712 and the delivery device 1700 may be retracted. In some cases, the inductive coupling between a source coil (not shown) and the receiving coils 1706, 1708, and 1710 may depend on their geometry (e.g. orientation, size, shape, etc.) and the distance between them. For example, when the source coil is aligned with one or more of the receiving coils 1706, 1708, and 1710 such that a magnetic field (not shown) flows directly or nearly directly through one or more of the receiving coils 1706, 1708, and 1710, the power transfer efficiency may increase. In addition, the power transfer efficiency may increase when one or more of the receiving coils 1706, 1708, and 1710 are close enough to the source coil such that the magnetic field reaches one or more of the receiving coils 1706, 1708, and 1710 before the magnetic field has diverged substantially.

In some cases, the receiving coils 1706, 1708, and 1710 may include fixation mechanisms 1726, 1728, and 1730 configured to engage the heart tissue of the chamber wall 1720 and secure each of the receiving coils 1706, 1708, and 1710 to a corresponding location along the chamber wall 1720. As shown in FIG. 16D, as the delivery device is retracted, the receiving coils 1706, 1708, and 1710 may each be guided and fixed to implantation locations that are spaced from one another such that the receiving coils 1706, 1708, and 1710 have primary capture axes that are not parallel, and in some case, orthogonal. When so provided, the IMD 1702 may have a greater chance that a primary capture axis of the receiving coils 1706, 1708, and 1710 substantially aligns with the primary transfer axis of the source coil such that the magnetic field flows directly or nearly directly through one or more of the receiving coils 1706, 1708, and 1710.

FIG. 17A is a view of an illustrative delivery device 1800 (e.g., a catheter) that may be used to deliver an IMD 1802 (e.g., a leadless cardiac pacemaker (LCP)) in a chamber of a heart H, such as the left ventricle LV or the right ventricle RV. The delivery device 1800 may include a distal holding section 1812 that may define a cavity 1814 for slidably receiving the IMD 1802, and may include a distal opening 1816 for slidable insertion and/or extraction of the IMD 1802 into and/or out of the cavity 1814. In some cases, the IMD 1802 may include the receiving coils 1806, 1808, and 1810 disposed outside a housing 1804 and configured to move from a pre-deployment, compressed state, to an expanded post-deployment state. For example, the receiving coils 1806, 1808, and 1810 may be attached to a distal end (or proximal end) of the housing 1804 by any suitable mechanism such as hinges, screws, pins and/or any other suitable fastener or joint so that joints 1830, 1832, and 1834 are formed at a distal end (or proximal end) of the receiving coils 1806, 1808, and 1810. In some cases, the joints 1830, 1832, and 1834 may be configured to pivot so that a proximal end (or distal end) of the receiving coils 1806, 1808, and 1810 move, retract, or compress towards the housing 1804 to a closed position. In some cases, the joints 1830, 1832, and 1834 may be further configured to pivot so that the proximal end (or distal end) of the receiving coils 1806, 1808, and 1810 move, expand, or swing away from the housing 1804 to an open position. These are just some examples.

In some cases, a distal end 1818 of the distal holding section 1812 may be placed next to and in contact with a wall 1820 of the chamber of heart H and deployment of the IMD 1802 can begin. FIG. 17B is a view of an implanted IMD 1802 by the delivery device 1800. As the IMD 1802 is pushed distally, fixation mechanisms 1822 engage the heart tissue of the chamber wall 1820. The IMD 1802 may be distally advanced out of the distal holding section 1812 to deploy the fixation mechanisms 1822 from the distal holding section 1812 and engage the fixation mechanisms 1822 in the heart tissue.

Once the fixation mechanisms 1822 have sufficiently engaged the heart wall 1820, as shown in FIG. 17C, the remainder of the IMD 1802 may be expelled from the distal holding section 1812 and the delivery device 1800 may be retracted. In some cases, the receiving coils 1806, 1808, and 1810 may be compressed or retracted by an inner-wall 1824 of the distal holding section 1812. Once the distal holding section 1812 has been retracted, the inner-wall 1824 may no longer compress or retract the receiving coils 1806, 1808, and 1810, allowing the receiving coils 1806, 1808, and 1810 to open, sometimes in an umbrella-like manner.

As shown in FIG. 17D, in the open position, the receiving coils 1806, 1808, and 1810 may each have a primary capture axis along which a maximum amount of non-radiative near-field energy is captured. As discussed herein, a transfer of power may increase when a primary transfer axis of a source coil (not shown) is aligned with a primary capture axis of one or more of the receiving coils 1806, 1808, and 1810. Furthermore, the primary transfer axis of the source coil may change during a given time relative to the primal)) axis of the receiving coils 1806, 1808, and 1810. Therefore, in some cases, the IMD 1802 may be configured such that the primary capture axis of one or more of the receiving coils 1806, 1808, and 1810 may be non-parallel with the primary capture axis of another one of the receiving coils 1806, 1808, and 1810, and in some cases orthogonal. In this configuration, the IMD 1802 may have a greater chance of a primary receiving axis of the receiving coils 1806, 1808, and 1810 substantially aligning with the primary transfer axis of the source coil and may increase the power transfer efficiency.

It should be understood that this disclosure is, in many respects, only illustrative. Changes may be made in details, particularly in matters of shape, size, and arrangement of steps without exceeding the scope of the disclosure. This may include, to the extent that it is appropriate, the use of any of the features of one example embodiment being used in other embodiments.

Claims

1. An implantable medical device (IMD) configured to be implanted within a patient, the IMD comprising: a housing configured for trans-catheter deployment, the housing having a housing exterior;a plurality of electrodes exposed external to the housing;therapeutic circuitry disposed within the housing, the therapeutic circuitry operatively coupled to the plurality of electrodes and configured to sense one or more signals via one or more of the plurality of electrodes and/or to stimulate tissue via one or more of the plurality of electrodes;a rechargeable power source disposed within the housing and configured to power the therapeutic circuitry;a plurality of receiving coils configured to receive non-radiative near-field energy through the patient's body, wherein each of the plurality of receiving coils has a primary capture axis along which a maximum amount of non-radiative near-field energy is captured, and wherein at least one of the plurality of receiving coils has a primary capture axis that is non-parallel with the primary capture axis of another one of the plurality of receiving coils, and wherein each of the plurality of receiving coils have an attached end that is secured to the housing exterior and an unattached end that is able to pivot away from and/or towards the housing exterior; andcharging circuitry operatively coupled with the plurality of receiving coils and the rechargeable power source, the charging circuitry configured to use the non-radiative near-field energy received via the plurality of receiving coils to charge the rechargeable power source.
2. The IMD of claim 1, wherein at least two of the plurality of receiving coils are operatively coupled in a power summation configuration.
3. The IMD of claim 1, wherein at least one of the plurality of receiving coils is disposed outside the housing.
4. The IMD of claim 1, wherein the charging circuitry is further configured to: select one of the plurality of receiving coils and to receive non-radiative near-field energy using the selected receiving coil;monitor the non-radiative near-field energy received via the selected receiving coil and detect a predetermined condition; andin response to detecting the predetermined condition, select a different one of the plurality of receiving coils and receive non-radiative near-field energy using the different one of the plurality of receiving coils.
5. The IMD of claim 1, wherein at least one of the plurality of receiving coils are non-planar and form a three-dimensional surface.
6. The IMD of claim 1, wherein the plurality of receiving coils are further configured to establish an inductive communication link with an external device.
7. The IMD of claim 1, wherein the IMD is a leadless cardiac pacemaker (LCP).
8. The IMD of claim 1, wherein the IMD has a proximal end and a distal end, and wherein the attached end of each of the plurality of receiving coils comprises a distal end of each of the plurality of receiving coils and the unattached end of each of the plurality of receiving coils comprises a proximal end of each of the plurality of receiving coils.
9. The IMD of claim 1, wherein the IMD has a proximal end and a distal end, and wherein the attached end of each of the plurality of receiving coils comprises a proximal end of each of the plurality of receiving coils and the unattached end of each of the plurality of receiving coils comprises a distal end of each of the plurality of receiving coils.
10. An implantable medical device (IMD) configured to be implanted within a patient's body, the IMD comprising: one or more sensors;circuitry operatively coupled to the one or more sensors;a rechargeable power source for powering the circuitry;a plurality of receiving coils configured to receive non-radiative near-field energy through the patient's body, the plurality of receiving coils operatively coupled in a power summing configuration, wherein each of the plurality of receiving coils has a primary capture axis along which a maximum amount of non-radiative near-field energy is captured, and wherein at least one of the plurality of receiving coils has a primary capture axis that is non-parallel with the primary capture axis of another one of the plurality of receiving coils, and wherein each of the plurality of receiving coils have an attached end that is secured to the housing and an opposing unattached end; andcharging circuitry operatively coupled with the plurality of receiving coils and the rechargeable power source, the charging circuitry configured to use the non-radiative near-field energy received via the plurality of receiving coils to charge the rechargeable power source.
11. The IMD of claim 10, wherein the IMD has a proximal end and a distal end, and wherein the attached end of each of the plurality of receiving coils comprises a distal end of each of the plurality of receiving coils and the unattached end of each of the plurality of receiving coils comprises a proximal end of each of the plurality of receiving coils.
12. The IMD of claim 10, wherein the IMD has a proximal end and a distal end, and wherein the attached end of each of the plurality of receiving coils comprises a proximal end of each of the plurality of receiving coils and the unattached end of each of the plurality of receiving coils comprises a distal end of each of the plurality of receiving coils.
13. An implantable medical device (IMD) configured to be implanted within a patient's body, the IMD comprising: a housing configured for trans-catheter deployment;a plurality of electrodes exposed external to the housing;therapeutic circuitry disposed within the housing, the therapeutic circuitry operatively coupled to the plurality of electrodes and configured to sense one or more signals via one or more of the plurality of electrodes and/or to stimulate tissue via one or more of the plurality of electrodes;a rechargeable power source disposed within the housing and configured to power the therapeutic circuitry;a plurality of receiving coils disposed outside the housing, each operatively coupled to the rechargeable power source and each having an attached end secured to the housing and an unattached end, and wherein the plurality of receiving coils are configured to: receive non-radiative near-field energy through the patient's body, andmove from a pre-deployment compressed state in which the attached end and the unattached end of each of the plurality of receiving coils are proximate the housing to an expanded post-deployment state in which the attached end of each of the plurality of receiving coils remains proximate the housing but the unattached end of each of the plurality of receiving coils are moved away from the housing, wherein in the post-deployment state of each of the plurality of receiving coils has a primary capture axis along which a maximum amount of non-radiative near-field energy is captured, and wherein at least one of the plurality of receiving coils has a primary capture axis that is non-parallel with the primary capture axis of another one of the plurality of receiving coils; andcharging circuitry operatively coupled with the plurality of receiving coils and the rechargeable power source, the charging circuitry configured to use the non-radiative near-field energy received via the plurality of receiving coils to charge the rechargeable power source.
14. The IMD of claim 13, wherein at least two of the plurality of receiving coils are operatively coupled in a power summation configuration.
15. The IMD of claim 13, wherein the IMD is a leadless cardiac pacemaker (LCP).
16. The IMD of claim 13, wherein the IMD has a proximal end and a distal end, and wherein the attached end of each of the plurality of receiving coils comprises a distal end of each of the plurality of receiving coils and the unattached end of each of the plurality of receiving coils comprises a proximal end of each of the plurality of receiving coils.
17. The IMD of claim 13, wherein the IMD has a proximal end and a distal end, and wherein the attached end of each of the plurality of receiving coils comprises a proximal end of each of the plurality of receiving coils and the unattached end of each of the plurality of receiving coils comprises a distal end of each of the plurality of receiving coils.

CROSS REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of U.S. Provisional Patent Application Ser. No. 62/424,930 filed on Nov. 21, 2016, the disclosure of which is incorporated herein by reference.

US Referenced Citations (1128)

Number	Name	Date	Kind
3835864	Rasor et al.	Sep 1974	A
3943936	Rasor et al.	Mar 1976	A
4142530	Wittkampf	Mar 1979	A
4151513	Menken et al.	Apr 1979	A
4157720	Greatbatch	Jun 1979	A
RE30366	Rasor et al.	Aug 1980	E
4243045	Maas	Jan 1981	A
4250884	Hartlaub et al.	Feb 1981	A
4256115	Bilitch	Mar 1981	A
4263919	Levin	Apr 1981	A
4310000	Lindemans	Jan 1982	A
4312354	Walters	Jan 1982	A
4323081	Wiebusch	Apr 1982	A
4357946	Dutcher et al.	Nov 1982	A
4365639	Goldreyer	Dec 1982	A
4440173	Hudziak et al.	Apr 1984	A
4476868	Thompson	Oct 1984	A
4522208	Buffet	Jun 1985	A
4537200	Widrow	Aug 1985	A
4556063	Thompson et al.	Dec 1985	A
4562841	Brockway et al.	Jan 1986	A
4593702	Kepski et al.	Jun 1986	A
4593955	Leiber	Jun 1986	A
4630611	King	Dec 1986	A
4635639	Hakala et al.	Jan 1987	A
4674508	DeCote	Jun 1987	A
4712554	Garson	Dec 1987	A
4729376	DeCote	Mar 1988	A
4754753	King	Jul 1988	A
4759366	Callaghan	Jul 1988	A
4776338	Lekholm et al.	Oct 1988	A
4787389	Tarjan	Nov 1988	A
4793353	Borkan	Dec 1988	A
4819662	Heil et al.	Apr 1989	A
4858610	Callaghan et al.	Aug 1989	A
4886064	Strandberg	Dec 1989	A
4887609	Cole, Jr.	Dec 1989	A
4928688	Mower	May 1990	A
4967746	Vandegriff	Nov 1990	A
4987897	Funke	Jan 1991	A
4989602	Sholder et al.	Feb 1991	A
5012806	De Bellis	May 1991	A
5036849	Hauck et al.	Aug 1991	A
5040534	Mann et al.	Aug 1991	A
5058581	Silvian	Oct 1991	A
5078134	Heilman et al.	Jan 1992	A
5109845	Yuuchi et al.	May 1992	A
5113859	Funke	May 1992	A
5113869	Nappholz et al.	May 1992	A
5117824	Keimel et al.	Jun 1992	A
5127401	Grevious et al.	Jul 1992	A
5133353	Hauser	Jul 1992	A
5144950	Stoop et al.	Sep 1992	A
5170784	Ramon et al.	Dec 1992	A
5179945	Van Hofwegen et al.	Jan 1993	A
5193539	Schulman et al.	Mar 1993	A
5193540	Schulman et al.	Mar 1993	A
5241961	Henry	Sep 1993	A
5243977	Trabucco et al.	Sep 1993	A
5259387	dePinto	Nov 1993	A
5269326	Verrier	Dec 1993	A
5284136	Hauck et al.	Feb 1994	A
5300107	Stokes et al.	Apr 1994	A
5301677	Hsung	Apr 1994	A
5305760	McKown et al.	Apr 1994	A
5312439	Loeb	May 1994	A
5313953	Yomtov et al.	May 1994	A
5314459	Swanson et al.	May 1994	A
5318597	Hauck et al.	Jun 1994	A
5324316	Schulman et al.	Jun 1994	A
5331966	Bennett et al.	Jul 1994	A
5334222	Salo et al.	Aug 1994	A
5342408	Decoriolis et al.	Aug 1994	A
5370667	Alt	Dec 1994	A
5372606	Lang et al.	Dec 1994	A
5376106	Stahmann et al.	Dec 1994	A
5383915	Adams	Jan 1995	A
5388578	Yomtov et al.	Feb 1995	A
5404877	Nolan et al.	Apr 1995	A
5405367	Schulman et al.	Apr 1995	A
5411031	Yomtov	May 1995	A
5411525	Swanson et al.	May 1995	A
5411535	Fujii et al.	May 1995	A
5456691	Snell	Oct 1995	A
5458622	Alt	Oct 1995	A
5466246	Silvian	Nov 1995	A
5468254	Hahn et al.	Nov 1995	A
5472453	Alt	Dec 1995	A
5522866	Fernald	Jun 1996	A
5540727	Tockman et al.	Jul 1996	A
5545186	Olson et al.	Aug 1996	A
5545202	Dahl et al.	Aug 1996	A
5571146	Jones et al.	Nov 1996	A
5591214	Lu	Jan 1997	A
5620466	Haefner et al.	Apr 1997	A
5634938	Swanson et al.	Jun 1997	A
5649968	Alt et al.	Jul 1997	A
5662688	Haefner et al.	Sep 1997	A
5674259	Gray	Oct 1997	A
5683426	Greenhut et al.	Nov 1997	A
5683432	Goedeke et al.	Nov 1997	A
5706823	Wodlinger	Jan 1998	A
5709215	Perttu et al.	Jan 1998	A
5720770	Nappholz et al.	Feb 1998	A
5728154	Crossett et al.	Mar 1998	A
5741314	Daly et al.	Apr 1998	A
5741315	Lee et al.	Apr 1998	A
5752976	Duffin et al.	May 1998	A
5752977	Grevious et al.	May 1998	A
5755736	Gillberg et al.	May 1998	A
5759199	Snell et al.	Jun 1998	A
5774501	Halpern et al.	Jun 1998	A
5792195	Carlson et al.	Aug 1998	A
5792202	Rueter	Aug 1998	A
5792203	Schroeppel	Aug 1998	A
5792205	Alt et al.	Aug 1998	A
5792208	Gray	Aug 1998	A
5814089	Stokes et al.	Sep 1998	A
5827216	Igo et al.	Oct 1998	A
5836985	Goyal et al.	Nov 1998	A
5836987	Baumann et al.	Nov 1998	A
5842977	Lesho et al.	Dec 1998	A
5855593	Olson et al.	Jan 1999	A
5873894	Vandegriff et al.	Feb 1999	A
5891184	Lee et al.	Apr 1999	A
5897586	Molina	Apr 1999	A
5899876	Flower	May 1999	A
5899928	Sholder et al.	May 1999	A
5919214	Ciciarelli et al.	Jul 1999	A
5935078	Feierbach	Aug 1999	A
5941906	Barreras et al.	Aug 1999	A
5944744	Paul et al.	Aug 1999	A
5954757	Gray	Sep 1999	A
5978713	Prutchi et al.	Nov 1999	A
5991660	Goyal	Nov 1999	A
5991661	Park et al.	Nov 1999	A
5999848	Gord et al.	Dec 1999	A
5999857	Weijand et al.	Dec 1999	A
6016445	Baura	Jan 2000	A
6026320	Carlson et al.	Feb 2000	A
6029085	Olson et al.	Feb 2000	A
6041250	dePinto	Mar 2000	A
6044298	Salo et al.	Mar 2000	A
6044300	Gray	Mar 2000	A
6055454	Heemels	Apr 2000	A
6073050	Griffith	Jun 2000	A
6076016	Feierbach	Jun 2000	A
6077236	Cunningham	Jun 2000	A
6080187	Alt et al.	Jun 2000	A
6083248	Thompson	Jul 2000	A
6106551	Crossett et al.	Aug 2000	A
6115636	Ryan	Sep 2000	A
6128526	Stadler et al.	Oct 2000	A
6141581	Olson et al.	Oct 2000	A
6141588	Cox et al.	Oct 2000	A
6141592	Pauly	Oct 2000	A
6144879	Gray	Nov 2000	A
6162195	Igo et al.	Dec 2000	A
6164284	Schulman et al.	Dec 2000	A
6167310	Grevious	Dec 2000	A
6201993	Kruse et al.	Mar 2001	B1
6208894	Schulman et al.	Mar 2001	B1
6211799	Post et al.	Apr 2001	B1
6221011	Bardy	Apr 2001	B1
6240316	Richmond et al.	May 2001	B1
6240317	Villaseca et al.	May 2001	B1
6256534	Dahl	Jul 2001	B1
6259947	Olson et al.	Jul 2001	B1
6266558	Gozani et al.	Jul 2001	B1
6266567	Ishikawa et al.	Jul 2001	B1
6270457	Bardy	Aug 2001	B1
6272377	Sweeney et al.	Aug 2001	B1
6273856	Sun et al.	Aug 2001	B1
6277072	Bardy	Aug 2001	B1
6280380	Bardy	Aug 2001	B1
6285907	Kramer et al.	Sep 2001	B1
6292698	Duffin et al.	Sep 2001	B1
6295473	Rosar	Sep 2001	B1
6297943	Carson	Oct 2001	B1
6298271	Weijand	Oct 2001	B1
6307751	Bodony et al.	Oct 2001	B1
6312378	Bardy	Nov 2001	B1
6315721	Schulman et al.	Nov 2001	B2
6336903	Bardy	Jan 2002	B1
6345202	Richmond et al.	Feb 2002	B2
6351667	Godie	Feb 2002	B1
6351669	Hartley et al.	Feb 2002	B1
6353759	Hartley et al.	Mar 2002	B1
6358203	Bardy	Mar 2002	B2
6361780	Ley et al.	Mar 2002	B1
6368284	Bardy	Apr 2002	B1
6371922	Baumann et al.	Apr 2002	B1
6398728	Bardy	Jun 2002	B1
6400982	Sweeney et al.	Jun 2002	B2
6400990	Silvian	Jun 2002	B1
6408208	Sun	Jun 2002	B1
6409674	Brockway et al.	Jun 2002	B1
6411848	Kramer et al.	Jun 2002	B2
6424865	Ding	Jul 2002	B1
6434429	Kraus et al.	Aug 2002	B1
6438410	Hsu et al.	Aug 2002	B2
6438417	Rockwell et al.	Aug 2002	B1
6438421	Stahmann et al.	Aug 2002	B1
6440066	Bardy	Aug 2002	B1
6441747	Khair et al.	Aug 2002	B1
6442426	Kroll	Aug 2002	B1
6442432	Lee	Aug 2002	B2
6443891	Grevious	Sep 2002	B1
6445953	Bulkes et al.	Sep 2002	B1
6453200	Koslar	Sep 2002	B1
6459929	Hopper et al.	Oct 2002	B1
6470215	Kraus et al.	Oct 2002	B1
6471645	Warkentin et al.	Oct 2002	B1
6480745	Nelson et al.	Nov 2002	B2
6487443	Olson et al.	Nov 2002	B2
6490487	Kraus et al.	Dec 2002	B1
6498951	Larson et al.	Dec 2002	B1
6507755	Gozani et al.	Jan 2003	B1
6507759	Prutchi et al.	Jan 2003	B1
6512940	Brabec et al.	Jan 2003	B1
6522915	Ceballos et al.	Feb 2003	B1
6526311	Begemann	Feb 2003	B2
6539253	Thompson et al.	Mar 2003	B2
6542775	Ding et al.	Apr 2003	B2
6553258	Stahmann et al.	Apr 2003	B2
6561975	Pool et al.	May 2003	B1
6564807	Schulman et al.	May 2003	B1
6574506	Kramer et al.	Jun 2003	B2
6584351	Ekwall	Jun 2003	B1
6584352	Combs et al.	Jun 2003	B2
6597948	Rockwell et al.	Jul 2003	B1
6597951	Kramer et al.	Jul 2003	B2
6622046	Fraley et al.	Sep 2003	B2
6628985	Sweeney et al.	Sep 2003	B2
6647292	Bardy et al.	Nov 2003	B1
6666844	Igo et al.	Dec 2003	B1
6689117	Sweeney et al.	Feb 2004	B2
6690959	Thompson	Feb 2004	B2
6694189	Begemann	Feb 2004	B2
6704602	Berg et al.	Mar 2004	B2
6718212	Parry et al.	Apr 2004	B2
6721597	Bardy et al.	Apr 2004	B1
6738670	Almendinger et al.	May 2004	B1
6746797	Benson et al.	Jun 2004	B2
6749566	Russ	Jun 2004	B2
6758810	Lebel et al.	Jul 2004	B2
6763269	Cox	Jul 2004	B2
6778860	Ostroff et al.	Aug 2004	B2
6788971	Sloman et al.	Sep 2004	B1
6788974	Bardy et al.	Sep 2004	B2
6804558	Haller et al.	Oct 2004	B2
6807442	Myklebust et al.	Oct 2004	B1
6847844	Sun et al.	Jan 2005	B2
6871095	Stahmann et al.	Mar 2005	B2
6878112	Linberg et al.	Apr 2005	B2
6885889	Chinchoy	Apr 2005	B2
6892094	Dusdigian et al.	May 2005	B2
6897788	Khair et al.	May 2005	B2
6904315	Panken et al.	Jun 2005	B2
6922592	Thompson et al.	Jul 2005	B2
6931282	Esler	Aug 2005	B2
6934585	Schloss et al.	Aug 2005	B1
6957107	Rogers et al.	Oct 2005	B2
6978176	Lattouf	Dec 2005	B2
6985773	Von Arx et al.	Jan 2006	B2
6990375	Kloss et al.	Jan 2006	B2
7001366	Ballard	Feb 2006	B2
7003350	Denker et al.	Feb 2006	B2
7006864	Echt et al.	Feb 2006	B2
7013178	Reinke et al.	Mar 2006	B2
7027871	Burnes et al.	Apr 2006	B2
7050849	Echt et al.	May 2006	B2
7060031	Webb et al.	Jun 2006	B2
7063693	Guenst	Jun 2006	B2
7082336	Ransbury et al.	Jul 2006	B2
7085606	Flach et al.	Aug 2006	B2
7092758	Sun et al.	Aug 2006	B2
7110824	Amundson et al.	Sep 2006	B2
7120504	Osypka	Oct 2006	B2
7130681	Gebhardt et al.	Oct 2006	B2
7139613	Reinke et al.	Nov 2006	B2
7142912	Wagner et al.	Nov 2006	B2
7146225	Guenst et al.	Dec 2006	B2
7146226	Lau et al.	Dec 2006	B2
7149581	Goedeke	Dec 2006	B2
7149588	Lau et al.	Dec 2006	B2
7158839	Lau	Jan 2007	B2
7162307	Patrias	Jan 2007	B2
7164952	Lau et al.	Jan 2007	B2
7177700	Cox	Feb 2007	B1
7181505	Haller et al.	Feb 2007	B2
7184830	Echt et al.	Feb 2007	B2
7186214	Ness	Mar 2007	B2
7191015	Lamson et al.	Mar 2007	B2
7200437	Nabutovsky et al.	Apr 2007	B1
7200439	Zdeblick et al.	Apr 2007	B2
7206423	Feng et al.	Apr 2007	B1
7209785	Kim et al.	Apr 2007	B2
7209790	Thompson et al.	Apr 2007	B2
7211884	Davis et al.	May 2007	B1
7212871	Morgan	May 2007	B1
7226440	Gelfand et al.	Jun 2007	B2
7228183	Sun et al.	Jun 2007	B2
7236821	Cates et al.	Jun 2007	B2
7236829	Farazi et al.	Jun 2007	B1
7254448	Almendinger et al.	Aug 2007	B2
7260436	Kilgore et al.	Aug 2007	B2
7270669	Sra	Sep 2007	B1
7272448	Morgan et al.	Sep 2007	B1
7277755	Falkenberg et al.	Oct 2007	B1
7280872	Mosesov et al.	Oct 2007	B1
7288096	Chin	Oct 2007	B2
7289847	Gill et al.	Oct 2007	B1
7289852	Helfinstine et al.	Oct 2007	B2
7289853	Campbell et al.	Oct 2007	B1
7289855	Nghiem et al.	Oct 2007	B2
7302294	Kamath et al.	Nov 2007	B2
7305266	Kroll	Dec 2007	B1
7310556	Bulkes	Dec 2007	B2
7319905	Morgan et al.	Jan 2008	B1
7333853	Mazar et al.	Feb 2008	B2
7336994	Hettrick et al.	Feb 2008	B2
7347819	Lebel et al.	Mar 2008	B2
7366572	Heruth et al.	Apr 2008	B2
7373207	Lattouf	May 2008	B2
7384403	Sherman	Jun 2008	B2
7386342	Falkenberg et al.	Jun 2008	B1
7392090	Sweeney et al.	Jun 2008	B2
7406105	Delmain et al.	Jul 2008	B2
7406349	Seeberger et al.	Jul 2008	B2
7410497	Hastings et al.	Aug 2008	B2
7425200	Brockway et al.	Sep 2008	B2
7433739	Salys et al.	Oct 2008	B1
7496409	Greenhut et al.	Feb 2009	B2
7496410	Heil	Feb 2009	B2
7502652	Gaunt et al.	Mar 2009	B2
7512448	Malick et al.	Mar 2009	B2
7515969	Tockman et al.	Apr 2009	B2
7526342	Chin et al.	Apr 2009	B2
7529589	Williams et al.	May 2009	B2
7532933	Hastings et al.	May 2009	B2
7536222	Bardy et al.	May 2009	B2
7536224	Ritscher et al.	May 2009	B2
7539541	Dulles et al.	May 2009	B2
7544197	Kelsch et al.	Jun 2009	B2
7558631	Cowan et al.	Jul 2009	B2
7565195	Kroll et al.	Jul 2009	B1
7584002	Burnes et al.	Sep 2009	B2
7590455	Heruth et al.	Sep 2009	B2
7606621	Brisken et al.	Oct 2009	B2
7610088	Chinchoy	Oct 2009	B2
7610092	Cowan et al.	Oct 2009	B2
7610099	Almendinger et al.	Oct 2009	B2
7610104	Kaplan et al.	Oct 2009	B2
7616991	Mann et al.	Nov 2009	B2
7617001	Penner et al.	Nov 2009	B2
7617007	Williams et al.	Nov 2009	B2
7630767	Poore et al.	Dec 2009	B1
7634313	Kroll et al.	Dec 2009	B1
7637867	Zdeblick	Dec 2009	B2
7640060	Zdeblick	Dec 2009	B2
7647109	Hastings et al.	Jan 2010	B2
7650186	Hastings et al.	Jan 2010	B2
7657311	Bardy et al.	Feb 2010	B2
7668596	Von Arx et al.	Feb 2010	B2
7682316	Anderson et al.	Mar 2010	B2
7691047	Ferrari	Apr 2010	B2
7702392	Echt et al.	Apr 2010	B2
7713194	Zdeblick	May 2010	B2
7713195	Zdeblick	May 2010	B2
7729783	Michels et al.	Jun 2010	B2
7734333	Ghanem et al.	Jun 2010	B2
7734343	Ransbury et al.	Jun 2010	B2
7738958	Zdeblick et al.	Jun 2010	B2
7738964	Von Arx et al.	Jun 2010	B2
7742812	Ghanem et al.	Jun 2010	B2
7742816	Masoud et al.	Jun 2010	B2
7742822	Masoud et al.	Jun 2010	B2
7743151	Vallapureddy et al.	Jun 2010	B2
7747335	Williams	Jun 2010	B2
7751881	Cowan et al.	Jul 2010	B2
7758521	Morris et al.	Jul 2010	B2
7761150	Ghanem et al.	Jul 2010	B2
7761164	Verhoef et al.	Jul 2010	B2
7765001	Echt et al.	Jul 2010	B2
7769452	Ghanem et al.	Aug 2010	B2
7783362	Whitehurst et al.	Aug 2010	B2
7792588	Harding	Sep 2010	B2
7797059	Bomzin et al.	Sep 2010	B1
7801596	Fischell et al.	Sep 2010	B2
7809438	Echt et al.	Oct 2010	B2
7840281	Kveen et al.	Nov 2010	B2
7844331	Li et al.	Nov 2010	B2
7844348	Swoyer et al.	Nov 2010	B2
7846088	Ness	Dec 2010	B2
7848815	Brisken et al.	Dec 2010	B2
7848823	Drasler et al.	Dec 2010	B2
7860455	Fukumoto et al.	Dec 2010	B2
7871433	Lattouf	Jan 2011	B2
7877136	Moffitt et al.	Jan 2011	B1
7877142	Moaddeb et al.	Jan 2011	B2
7881786	Jackson	Feb 2011	B2
7881798	Miesel et al.	Feb 2011	B2
7881810	Chitre et al.	Feb 2011	B1
7890173	Brisken et al.	Feb 2011	B2
7890181	Denzene et al.	Feb 2011	B2
7890192	Kelsch et al.	Feb 2011	B1
7894885	Bartal et al.	Feb 2011	B2
7894894	Stadler et al.	Feb 2011	B2
7894907	Cowan et al.	Feb 2011	B2
7894910	Cowan et al.	Feb 2011	B2
7894915	Chitre et al.	Feb 2011	B1
7899537	Kroll et al.	Mar 2011	B1
7899541	Cowan et al.	Mar 2011	B2
7899542	Cowan et al.	Mar 2011	B2
7899554	Williams et al.	Mar 2011	B2
7901360	Yang et al.	Mar 2011	B1
7904170	Harding	Mar 2011	B2
7907993	Ghanem et al.	Mar 2011	B2
7920928	Yang et al.	Apr 2011	B1
7925343	Min et al.	Apr 2011	B1
7930022	Zhang et al.	Apr 2011	B2
7930040	Kelsch et al.	Apr 2011	B1
7937135	Ghanem et al.	May 2011	B2
7937148	Jacobson	May 2011	B2
7937161	Hastings et al.	May 2011	B2
7941214	Kleckner et al.	May 2011	B2
7945333	Jacobson	May 2011	B2
7946997	Hübinette	May 2011	B2
7949404	Hill	May 2011	B2
7949405	Feher	May 2011	B2
7953486	Daum et al.	May 2011	B2
7953493	Fowler et al.	May 2011	B2
7962202	Bhunia	Jun 2011	B2
7974702	Fain et al.	Jul 2011	B1
7979136	Young et al.	Jul 2011	B2
7983753	Severin	Jul 2011	B2
7991467	Markowitz et al.	Aug 2011	B2
7991471	Ghanem et al.	Aug 2011	B2
7996087	Cowan et al.	Aug 2011	B2
8000791	Sunagawa et al.	Aug 2011	B2
8000807	Morris et al.	Aug 2011	B2
8001975	DiSilvestro et al.	Aug 2011	B2
8002700	Ferek-Petric et al.	Aug 2011	B2
8010209	Jacobson	Aug 2011	B2
8019419	Panescu et al.	Sep 2011	B1
8019434	Quiles et al.	Sep 2011	B2
8027727	Freeberg	Sep 2011	B2
8027729	Sunagawa et al.	Sep 2011	B2
8032219	Neumann et al.	Oct 2011	B2
8036743	Savage et al.	Oct 2011	B2
8046079	Bange et al.	Oct 2011	B2
8046080	Von Arx et al.	Oct 2011	B2
8050297	Delmain et al.	Nov 2011	B2
8050759	Stegemann et al.	Nov 2011	B2
8050774	Kveen et al.	Nov 2011	B2
8055345	Li et al.	Nov 2011	B2
8055350	Roberts	Nov 2011	B2
8060212	Rios et al.	Nov 2011	B1
8065018	Haubrich et al.	Nov 2011	B2
8073542	Doerr	Dec 2011	B2
8078278	Penner	Dec 2011	B2
8078283	Cowan et al.	Dec 2011	B2
8095123	Gray	Jan 2012	B2
8102789	Rosar et al.	Jan 2012	B2
8103359	Reddy	Jan 2012	B2
8103361	Moser	Jan 2012	B2
8112148	Giftakis et al.	Feb 2012	B2
8114021	Robertson et al.	Feb 2012	B2
8121680	Falkenberg et al.	Feb 2012	B2
8123684	Zdeblick	Feb 2012	B2
8126545	Flach et al.	Feb 2012	B2
8131334	Lu et al.	Mar 2012	B2
8140161	Willerton et al.	Mar 2012	B2
8150521	Crowley et al.	Apr 2012	B2
8160672	Kim et al.	Apr 2012	B2
8160702	Mann et al.	Apr 2012	B2
8160704	Freeberg	Apr 2012	B2
8165694	Carbanaru et al.	Apr 2012	B2
8175715	Cox	May 2012	B1
8180451	Hickman et al.	May 2012	B2
8185213	Kveen et al.	May 2012	B2
8187161	Li et al.	May 2012	B2
8195293	Limousin et al.	Jun 2012	B2
8204595	Pianca et al.	Jun 2012	B2
8204605	Hastings et al.	Jun 2012	B2
8209014	Doerr	Jun 2012	B2
8214043	Matos	Jul 2012	B2
8224244	Kim et al.	Jul 2012	B2
8229556	Li	Jul 2012	B2
8233985	Bulkes et al.	Jul 2012	B2
8265748	Liu et al.	Sep 2012	B2
8265757	Mass et al.	Sep 2012	B2
8262578	Bharmi et al.	Oct 2012	B1
8280521	Haubrich et al.	Oct 2012	B2
8285387	Utsi et al.	Oct 2012	B2
8290598	Boon et al.	Oct 2012	B2
8290600	Hastings et al.	Oct 2012	B2
8295939	Jacobson	Oct 2012	B2
8301254	Mosesov et al.	Oct 2012	B2
8315701	Cowan et al.	Nov 2012	B2
8315708	Berthelsdorf et al.	Nov 2012	B2
8321021	Kisker et al.	Nov 2012	B2
8321036	Brockway et al.	Nov 2012	B2
8332036	Hastings et al.	Dec 2012	B2
8335563	Stessman	Dec 2012	B2
8335568	Heruth et al.	Dec 2012	B2
8340750	Prakash et al.	Dec 2012	B2
8340780	Hastings et al.	Dec 2012	B2
8352025	Jacobson	Jan 2013	B2
8352028	Wenger	Jan 2013	B2
8352038	Mao et al.	Jan 2013	B2
8359098	Lund et al.	Jan 2013	B2
8364261	Stubbs et al.	Jan 2013	B2
8364276	Willis	Jan 2013	B2
8369959	Meskens	Feb 2013	B2
8369962	Abrahamson	Feb 2013	B2
8380320	Spital	Feb 2013	B2
8386051	Rys	Feb 2013	B2
8391981	Mosesov	Mar 2013	B2
8391990	Smith et al.	Mar 2013	B2
8406874	Liu et al.	Mar 2013	B2
8406879	Shuros et al.	Mar 2013	B2
8406886	Gaunt et al.	Mar 2013	B2
8412352	Griswold et al.	Apr 2013	B2
8417340	Goossen	Apr 2013	B2
8417341	Freeberg	Apr 2013	B2
8423149	Hennig	Apr 2013	B2
8428722	Verhoef et al.	Apr 2013	B2
8433402	Ruben et al.	Apr 2013	B2
8433409	Johnson et al.	Apr 2013	B2
8433420	Bange et al.	Apr 2013	B2
8447412	Dal Molin et al.	May 2013	B2
8452413	Young et al.	May 2013	B2
8457740	Osche	Jun 2013	B2
8457742	Jacobson	Jun 2013	B2
8457744	Janzig et al.	Jun 2013	B2
8457761	Wariar	Jun 2013	B2
8478407	Demmer et al.	Jul 2013	B2
8478408	Hastings et al.	Jul 2013	B2
8478431	Griswold et al.	Jul 2013	B2
8494632	Sun et al.	Jul 2013	B2
8504156	Bonner et al.	Aug 2013	B2
8509910	Sowder et al.	Aug 2013	B2
8515559	Roberts et al.	Aug 2013	B2
8525340	Eckhardt et al.	Sep 2013	B2
8527068	Ostroff	Sep 2013	B2
8532790	Griswold	Sep 2013	B2
8538526	Stahmann et al.	Sep 2013	B2
8541131	Lund et al.	Sep 2013	B2
8543205	Ostroff	Sep 2013	B2
8547248	Zdeblick et al.	Oct 2013	B2
8548605	Ollivier	Oct 2013	B2
8554333	Wu et al.	Oct 2013	B2
8565882	Mates	Oct 2013	B2
8565897	Regnier et al.	Oct 2013	B2
8571678	Wang	Oct 2013	B2
8577327	Makdissi et al.	Nov 2013	B2
8588926	Moore et al.	Nov 2013	B2
8612002	Faltys et al.	Dec 2013	B2
8615310	Khairkhahan et al.	Dec 2013	B2
8626280	Allavatam et al.	Jan 2014	B2
8626294	Sheldon et al.	Jan 2014	B2
8634908	Cowan	Jan 2014	B2
8634912	Bomzin et al.	Jan 2014	B2
8634919	Hou et al.	Jan 2014	B1
8639335	Peichel et al.	Jan 2014	B2
8644934	Hastings et al.	Feb 2014	B2
8649859	Smith et al.	Feb 2014	B2
8670842	Bornzin et al.	Mar 2014	B1
8676319	Knoll	Mar 2014	B2
8676335	Katoozi et al.	Mar 2014	B2
8700173	Edlund	Apr 2014	B2
8700181	Bornzin et al.	Apr 2014	B2
8705599	dal Molin et al.	Apr 2014	B2
8718766	Wahlberg	May 2014	B2
8718773	Willis et al.	May 2014	B2
8725260	Shuros et al.	May 2014	B2
8738133	Shuros et al.	May 2014	B2
8738147	Hastings et al.	May 2014	B2
8744555	Allavatam et al.	Jun 2014	B2
8744572	Greenhut et al.	Jun 2014	B1
8747314	Stahmann et al.	Jun 2014	B2
8755884	Demmer et al.	Jun 2014	B2
8758365	Bonner et al.	Jun 2014	B2
8768483	Schmitt et al.	Jul 2014	B2
8774572	Hamamoto	Jul 2014	B2
8781605	Bomzin et al.	Jul 2014	B2
8788035	Jacobson	Jul 2014	B2
8788053	Jacobson	Jul 2014	B2
8798740	Samade et al.	Aug 2014	B2
8798745	Jacobson	Aug 2014	B2
8798762	Fain et al.	Aug 2014	B2
8798770	Reddy	Aug 2014	B2
8805505	Roberts	Aug 2014	B1
8805528	Corndorf	Aug 2014	B2
8812109	Blomqvist et al.	Aug 2014	B2
8818504	Bodner et al.	Aug 2014	B2
8827913	Havel et al.	Sep 2014	B2
8831747	Min et al.	Sep 2014	B1
8855789	Jacobson	Oct 2014	B2
8868186	Kroll	Oct 2014	B2
8886339	Faltys et al.	Nov 2014	B2
8903473	Rogers et al.	Dec 2014	B2
8903500	Smith et al.	Dec 2014	B2
8903513	Ollivier	Dec 2014	B2
8909336	Navarro-Paredes et al.	Dec 2014	B2
8914131	Bornzin et al.	Dec 2014	B2
8923795	Makdissi et al.	Dec 2014	B2
8923963	Bonner et al.	Dec 2014	B2
8938300	Rosero	Jan 2015	B2
8942806	Sheldon et al.	Jan 2015	B2
8958892	Khairkhahan et al.	Feb 2015	B2
8977358	Ewert et al.	Mar 2015	B2
8989873	Locsin	Mar 2015	B2
8996109	Karst et al.	Mar 2015	B2
9002467	Smith et al.	Apr 2015	B2
9008776	Cowan et al.	Apr 2015	B2
9008777	Dianaty et al.	Apr 2015	B2
9014818	Deterre et al.	Apr 2015	B2
9017341	Bomzin et al.	Apr 2015	B2
9020611	Khairkhahan et al.	Apr 2015	B2
9037262	Regnier et al.	May 2015	B2
9042984	Demmer et al.	May 2015	B2
9072911	Hastings et al.	Jul 2015	B2
9072913	Jacobson	Jul 2015	B2
9155882	Grubac et al.	Oct 2015	B2
9168372	Fain	Oct 2015	B2
9168380	Greenhut et al.	Oct 2015	B1
9168383	Jacobson et al.	Oct 2015	B2
9180285	Moore et al.	Nov 2015	B2
9192774	Jacobson	Nov 2015	B2
9205225	Khairkhahan et al.	Dec 2015	B2
9216285	Boling et al.	Dec 2015	B1
9216293	Berthiaume et al.	Dec 2015	B2
9216298	Jacobson	Dec 2015	B2
9227077	Jacobson	Jan 2016	B2
9238145	Wenzel et al.	Jan 2016	B2
9242102	Khairkhahan et al.	Jan 2016	B2
9242113	Smith et al.	Jan 2016	B2
9248300	Rys et al.	Feb 2016	B2
9265436	Min et al.	Feb 2016	B2
9265962	Dianaty et al.	Feb 2016	B2
9272155	Ostroff	Mar 2016	B2
9278218	Karst et al.	Mar 2016	B2
9278229	Reinke et al.	Mar 2016	B1
9283381	Grubac et al.	Mar 2016	B2
9283382	Berthiaume et al.	Mar 2016	B2
9289612	Sambelashvili et al.	Mar 2016	B1
9302115	Molin et al.	Apr 2016	B2
9333364	Echt et al.	May 2016	B2
9358387	Suwito et al.	Jun 2016	B2
9358400	Jacobson	Jun 2016	B2
9364675	Deterre et al.	Jun 2016	B2
9370663	Moulder	Jun 2016	B2
9375580	Bonner et al.	Jun 2016	B2
9375581	Baru et al.	Jun 2016	B2
9381365	Kibler et al.	Jul 2016	B2
9393424	Demmer et al.	Jul 2016	B2
9393436	Doerr	Jul 2016	B2
9399139	Demmer et al.	Jul 2016	B2
9399140	Cho et al.	Jul 2016	B2
9409033	Jacobson	Aug 2016	B2
9427594	Bornzin et al.	Aug 2016	B1
9433368	Stahmann et al.	Sep 2016	B2
9433780	Regnier et al.	Sep 2016	B2
9457193	Klimovitch et al.	Oct 2016	B2
9492668	Sheldon et al.	Nov 2016	B2
9492669	Demmer et al.	Nov 2016	B2
9492674	Schmidt et al.	Nov 2016	B2
9492677	Greenhut et al.	Nov 2016	B2
9511233	Sambelashvili	Dec 2016	B2
9511236	Varady et al.	Dec 2016	B2
9511237	Deterre et al.	Dec 2016	B2
9522276	Shen et al.	Dec 2016	B2
9522280	Fishler et al.	Dec 2016	B2
9526522	Wood et al.	Dec 2016	B2
9526891	Eggen et al.	Dec 2016	B2
9526909	Stahmann et al.	Dec 2016	B2
9533163	Klimovitch et al.	Jan 2017	B2
9561382	Persson et al.	Feb 2017	B2
9566012	Greenhut et al.	Feb 2017	B2
9636511	Carney et al.	May 2017	B2
9669223	Auricchio et al.	Jun 2017	B2
9687654	Sheldon et al.	Jun 2017	B2
9687655	Pertijs et al.	Jun 2017	B2
9687659	Von Arx et al.	Jun 2017	B2
9694186	Carney et al.	Jul 2017	B2
9782594	Stahmann et al.	Oct 2017	B2
9782601	Ludwig	Oct 2017	B2
9789317	Greenhut et al.	Oct 2017	B2
9789319	Sambelashvili	Oct 2017	B2
9808617	Ostroff et al.	Nov 2017	B2
9808628	Sheldon et al.	Nov 2017	B2
9808631	Maile et al.	Nov 2017	B2
9808632	Reinke et al.	Nov 2017	B2
9808633	Bonner et al.	Nov 2017	B2
9808637	Sharma et al.	Nov 2017	B2
20020032470	Linberg	Mar 2002	A1
20020035376	Bardy et al.	Mar 2002	A1
20020035377	Bardy et al.	Mar 2002	A1
20020035378	Bardy et al.	Mar 2002	A1
20020035380	Rissmann et al.	Mar 2002	A1
20020035381	Bardy et al.	Mar 2002	A1
20020042629	Bardy et al.	Apr 2002	A1
20020042630	Bardy et al.	Apr 2002	A1
20020042634	Bardy et al.	Apr 2002	A1
20020049475	Bardy et al.	Apr 2002	A1
20020052636	Bardy et al.	May 2002	A1
20020068958	Bardy et al.	Jun 2002	A1
20020072773	Bardy et al.	Jun 2002	A1
20020082665	Haller et al.	Jun 2002	A1
20020091414	Bardy et al.	Jul 2002	A1
20020095196	Linberg	Jul 2002	A1
20020099423	Berg et al.	Jul 2002	A1
20020103510	Bardy et al.	Aug 2002	A1
20020107545	Rissmann et al.	Aug 2002	A1
20020107546	Ostroff et al.	Aug 2002	A1
20020107547	Erlinger et al.	Aug 2002	A1
20020107548	Bardy et al.	Aug 2002	A1
20020107549	Bardy et al.	Aug 2002	A1
20020107559	Sanders et al.	Aug 2002	A1
20020120299	Ostroff et al.	Aug 2002	A1
20020173830	Starkweather et al.	Nov 2002	A1
20020193846	Pool et al.	Dec 2002	A1
20030009203	Lebel et al.	Jan 2003	A1
20030028082	Thompson	Feb 2003	A1
20030040779	Engmark et al.	Feb 2003	A1
20030041866	Linberg et al.	Mar 2003	A1
20030045805	Sheldon et al.	Mar 2003	A1
20030088278	Bardy et al.	May 2003	A1
20030097153	Bardy et al.	May 2003	A1
20030105497	Zhu et al.	Jun 2003	A1
20030114908	Flach	Jun 2003	A1
20030144701	Mehra et al.	Jul 2003	A1
20030187460	Chin et al.	Oct 2003	A1
20030187461	Chin	Oct 2003	A1
20040024435	Leckrone et al.	Feb 2004	A1
20040068302	Rodgers et al.	Apr 2004	A1
20040087938	Leckrone et al.	May 2004	A1
20040088035	Guenst et al.	May 2004	A1
20040102830	Williams	May 2004	A1
20040127959	Amundson et al.	Jul 2004	A1
20040133242	Chapman et al.	Jul 2004	A1
20040147969	Mann et al.	Jul 2004	A1
20040147973	Hauser	Jul 2004	A1
20040167558	Igo et al.	Aug 2004	A1
20040167587	Thompson	Aug 2004	A1
20040172071	Bardy et al.	Sep 2004	A1
20040172077	Chinchoy	Sep 2004	A1
20040172104	Berg et al.	Sep 2004	A1
20040176817	Wahlstrand et al.	Sep 2004	A1
20040176818	Wahlstrand et al.	Sep 2004	A1
20040176830	Fang	Sep 2004	A1
20040186529	Bardy et al.	Sep 2004	A1
20040204673	Flaherty	Oct 2004	A1
20040210292	Bardy et al.	Oct 2004	A1
20040210293	Bardy et al.	Oct 2004	A1
20040210294	Bardy et al.	Oct 2004	A1
20040215308	Bardy et al.	Oct 2004	A1
20040220624	Ritscher et al.	Nov 2004	A1
20040220626	Wagner	Nov 2004	A1
20040220639	Mulligan et al.	Nov 2004	A1
20040249431	Ransbury et al.	Dec 2004	A1
20040260348	Bakken et al.	Dec 2004	A1
20040267303	Guenst	Dec 2004	A1
20050061320	Lee et al.	Mar 2005	A1
20050070962	Echt et al.	Mar 2005	A1
20050102003	Grabek et al.	May 2005	A1
20050149138	Min et al.	Jul 2005	A1
20050165466	Morris et al.	Jul 2005	A1
20050182465	Ness	Aug 2005	A1
20050203410	Jenkins	Sep 2005	A1
20050283208	Von Arx et al.	Dec 2005	A1
20050288743	Ahn et al.	Dec 2005	A1
20060042830	Maghribi et al.	Mar 2006	A1
20060052829	Sun et al.	Mar 2006	A1
20060052830	Spinelli et al.	Mar 2006	A1
20060064135	Brockway	Mar 2006	A1
20060064149	Belacazar et al.	Mar 2006	A1
20060085039	Hastings et al.	Apr 2006	A1
20060085041	Hastings et al.	Apr 2006	A1
20060085042	Hastings et al.	Apr 2006	A1
20060095078	Tronnes	May 2006	A1
20060106442	Richardson et al.	May 2006	A1
20060116746	Chin	Jun 2006	A1
20060135999	Bodner et al.	Jun 2006	A1
20060136004	Cowan et al.	Jun 2006	A1
20060161061	Echt et al.	Jul 2006	A1
20060200002	Guenst	Sep 2006	A1
20060206151	Lu	Sep 2006	A1
20060212079	Routh et al.	Sep 2006	A1
20060241701	Markowitz et al.	Oct 2006	A1
20060241705	Neumann et al.	Oct 2006	A1
20060247672	Vidlund et al.	Nov 2006	A1
20060259088	Pastore et al.	Nov 2006	A1
20060265018	Smith et al.	Nov 2006	A1
20070004979	Wojciechowicz et al.	Jan 2007	A1
20070016098	Kim et al.	Jan 2007	A1
20070027508	Cowan	Feb 2007	A1
20070078490	Cowan et al.	Apr 2007	A1
20070088394	Jacobson	Apr 2007	A1
20070088396	Jacobson	Apr 2007	A1
20070088397	Jacobson	Apr 2007	A1
20070088398	Jacobson	Apr 2007	A1
20070088405	Jacobson	Apr 2007	A1
20070135882	Drasler et al.	Jun 2007	A1
20070135883	Drasler et al.	Jun 2007	A1
20070150037	Hastings et al.	Jun 2007	A1
20070150038	Hastings et al.	Jun 2007	A1
20070156190	Cinbis	Jul 2007	A1
20070196456	Stevens	Aug 2007	A1
20070219525	Gelfand et al.	Sep 2007	A1
20070219590	Hastings et al.	Sep 2007	A1
20070225545	Ferrari	Sep 2007	A1
20070233206	Frikart et al.	Oct 2007	A1
20070239244	Morgan et al.	Oct 2007	A1
20070255376	Michels et al.	Nov 2007	A1
20070276444	Gelbart et al.	Nov 2007	A1
20070293900	Sheldon et al.	Dec 2007	A1
20070293904	Gelbart et al.	Dec 2007	A1
20080004663	Jorgenson	Jan 2008	A1
20080021505	Hastings et al.	Jan 2008	A1
20080021519	De Geest et al.	Jan 2008	A1
20080021532	Kveen et al.	Jan 2008	A1
20080065183	Whitehurst et al.	Mar 2008	A1
20080065185	Worley	Mar 2008	A1
20080071318	Brooke et al.	Mar 2008	A1
20080109054	Hastings et al.	May 2008	A1
20080119911	Rosero	May 2008	A1
20080130670	Kim et al.	Jun 2008	A1
20080154139	Shuros et al.	Jun 2008	A1
20080154322	Jackson et al.	Jun 2008	A1
20080228234	Stancer	Sep 2008	A1
20080234771	Chinchoy et al.	Sep 2008	A1
20080243217	Wildon	Oct 2008	A1
20080269814	Rosero	Oct 2008	A1
20080269825	Chinchoy et al.	Oct 2008	A1
20080275518	Ghanem et al.	Nov 2008	A1
20080275519	Ghanem et al.	Nov 2008	A1
20080288039	Reddy	Nov 2008	A1
20080294208	Willis et al.	Nov 2008	A1
20080294210	Rosero	Nov 2008	A1
20080306359	Zdeblick et al.	Dec 2008	A1
20090018599	Hastings et al.	Jan 2009	A1
20090024180	Kisker et al.	Jan 2009	A1
20090036941	Corbucci	Feb 2009	A1
20090048646	Katoozi et al.	Feb 2009	A1
20090062895	Stahmann et al.	Mar 2009	A1
20090082827	Kveen et al.	Mar 2009	A1
20090082828	Ostroff	Mar 2009	A1
20090088813	Brockway et al.	Apr 2009	A1
20090131907	Chin et al.	May 2009	A1
20090135886	Robertson et al.	May 2009	A1
20090143835	Pastore et al.	Jun 2009	A1
20090171408	Solem	Jul 2009	A1
20090171414	Kelly et al.	Jul 2009	A1
20090204163	Shuros et al.	Aug 2009	A1
20090204170	Hastings et al.	Aug 2009	A1
20090210024	M	Aug 2009	A1
20090216292	Pless et al.	Aug 2009	A1
20090234407	Hastings et al.	Sep 2009	A1
20090234411	Sambelashvili et al.	Sep 2009	A1
20090266573	Engmark et al.	Oct 2009	A1
20090275998	Burnes et al.	Nov 2009	A1
20090275999	Burnes et al.	Nov 2009	A1
20090299447	Jensen et al.	Dec 2009	A1
20100013668	Kantervik	Jan 2010	A1
20100016911	Willis et al.	Jan 2010	A1
20100023085	Wu et al.	Jan 2010	A1
20100030061	Canfield et al.	Feb 2010	A1
20100030327	Chatel	Feb 2010	A1
20100042108	Hibino	Feb 2010	A1
20100056871	Govari et al.	Mar 2010	A1
20100063375	Kassab et al.	Mar 2010	A1
20100063562	Cowan et al.	Mar 2010	A1
20100094367	Sen	Apr 2010	A1
20100114209	Krause et al.	May 2010	A1
20100114214	Morelli et al.	May 2010	A1
20100125281	Jacobson et al.	May 2010	A1
20100168761	Kassab et al.	Jul 2010	A1
20100168819	Freeberg	Jul 2010	A1
20100198288	Ostroff	Aug 2010	A1
20100198304	Wang	Aug 2010	A1
20100217367	Belson	Aug 2010	A1
20100228308	Cowan et al.	Sep 2010	A1
20100234906	Koh	Sep 2010	A1
20100234924	Willis	Sep 2010	A1
20100241185	Mahapatra et al.	Sep 2010	A1
20100249729	Morris et al.	Sep 2010	A1
20100286744	Echt et al.	Nov 2010	A1
20100312309	Harding	Dec 2010	A1
20110022113	Zdeblick et al.	Jan 2011	A1
20110071586	Jacobson	Mar 2011	A1
20110077708	Ostroff	Mar 2011	A1
20110112600	Cowan et al.	May 2011	A1
20110118588	Komblau et al.	May 2011	A1
20110118810	Cowan et al.	May 2011	A1
20110137187	Yang et al.	Jun 2011	A1
20110144720	Cowan et al.	Jun 2011	A1
20110152970	Jollota et al.	Jun 2011	A1
20110160558	Rassatt et al.	Jun 2011	A1
20110160565	Stubbs et al.	Jun 2011	A1
20110160801	Markowitz et al.	Jun 2011	A1
20110160806	Lyden et al.	Jun 2011	A1
20110166620	Cowan et al.	Jul 2011	A1
20110166621	Cowan et al.	Jul 2011	A1
20110184491	Kivi	Jul 2011	A1
20110190835	Brockway et al.	Aug 2011	A1
20110208260	Jacobson	Aug 2011	A1
20110218587	Jacobson	Sep 2011	A1
20110230734	Fain et al.	Sep 2011	A1
20110237967	Moore et al.	Sep 2011	A1
20110245890	Brisben et al.	Oct 2011	A1
20110251660	Griswold	Oct 2011	A1
20110251662	Griswold et al.	Oct 2011	A1
20110270099	Ruben et al.	Nov 2011	A1
20110270339	Murray, III et al.	Nov 2011	A1
20110270340	Pellegrini et al.	Nov 2011	A1
20110276102	Cohen	Nov 2011	A1
20110282423	Jacobson	Nov 2011	A1
20120004527	Thompson et al.	Jan 2012	A1
20120029323	Zhao	Feb 2012	A1
20120041508	Rousso et al.	Feb 2012	A1
20120059433	Cowan et al.	Mar 2012	A1
20120059436	Fontaine et al.	Mar 2012	A1
20120065500	Rogers et al.	Mar 2012	A1
20120078322	Dal Molin et al.	Mar 2012	A1
20120089198	Ostroff	Apr 2012	A1
20120093245	Makdissi et al.	Apr 2012	A1
20120095521	Hintz	Apr 2012	A1
20120095539	Khairkhahan et al.	Apr 2012	A1
20120101540	O'Brien et al.	Apr 2012	A1
20120101553	Reddy	Apr 2012	A1
20120109148	Bonner et al.	May 2012	A1
20120109149	Bonner et al.	May 2012	A1
20120109236	Jacobson et al.	May 2012	A1
20120109259	Bond et al.	May 2012	A1
20120116489	Khairkhahan et al.	May 2012	A1
20120150251	Giftakis et al.	Jun 2012	A1
20120158111	Khairkhahan et al.	Jun 2012	A1
20120165827	Khairkhahan et al.	Jun 2012	A1
20120172690	Anderson et al.	Jul 2012	A1
20120172891	Lee	Jul 2012	A1
20120172892	Grubac et al.	Jul 2012	A1
20120172942	Berg	Jul 2012	A1
20120197350	Roberts et al.	Aug 2012	A1
20120197373	Khairkhahan et al.	Aug 2012	A1
20120215285	Tahmasian et al.	Aug 2012	A1
20120232565	Kveen et al.	Sep 2012	A1
20120277600	Greenhut	Nov 2012	A1
20120277606	Ellingson et al.	Nov 2012	A1
20120283795	Stancer et al.	Nov 2012	A1
20120283807	Deterre et al.	Nov 2012	A1
20120290025	Keimel	Nov 2012	A1
20120296381	Mates	Nov 2012	A1
20120303082	Dong et al.	Nov 2012	A1
20120316613	Keefe et al.	Dec 2012	A1
20130012151	Hankins	Jan 2013	A1
20130023975	Locsin	Jan 2013	A1
20130035748	Bonner et al.	Feb 2013	A1
20130041422	Jacobson	Feb 2013	A1
20130053908	Smith et al.	Feb 2013	A1
20130053915	Holmstrom et al.	Feb 2013	A1
20130053921	Bonner et al.	Feb 2013	A1
20130060298	Splett et al.	Mar 2013	A1
20130066169	Rys et al.	Mar 2013	A1
20130072770	Rao et al.	Mar 2013	A1
20130079798	Tran et al.	Mar 2013	A1
20130079861	Reinert et al.	Mar 2013	A1
20130085350	Schugt et al.	Apr 2013	A1
20130085403	Gunderson et al.	Apr 2013	A1
20130085550	Polefko et al.	Apr 2013	A1
20130096649	Martin et al.	Apr 2013	A1
20130103047	Steingisser et al.	Apr 2013	A1
20130103109	Jacobson	Apr 2013	A1
20130110008	Bourget et al.	May 2013	A1
20130110127	Bornzin et al.	May 2013	A1
20130110192	Tran et al.	May 2013	A1
20130110219	Bornzin et al.	May 2013	A1
20130116529	Min et al.	May 2013	A1
20130116738	Samade et al.	May 2013	A1
20130116740	Bornzin et al.	May 2013	A1
20130116741	Bornzin et al.	May 2013	A1
20130123872	Bornzin et al.	May 2013	A1
20130123875	Varady et al.	May 2013	A1
20130131591	Berthiaume et al.	May 2013	A1
20130131693	Berthiaume et al.	May 2013	A1
20130138006	Bornzin et al.	May 2013	A1
20130150695	Biela et al.	Jun 2013	A1
20130150911	Perschbacher et al.	Jun 2013	A1
20130150912	Perschbacher et al.	Jun 2013	A1
20130184776	Shuros et al.	Jul 2013	A1
20130196703	Masoud et al.	Aug 2013	A1
20130197609	Moore et al.	Aug 2013	A1
20130231710	Jacobson	Sep 2013	A1
20130238072	Deterre et al.	Sep 2013	A1
20130238073	Makdissi et al.	Sep 2013	A1
20130253342	Griswold et al.	Sep 2013	A1
20130253343	Waldhauser et al.	Sep 2013	A1
20130253344	Griswold et al.	Sep 2013	A1
20130253345	Griswold et al.	Sep 2013	A1
20130253346	Griswold et al.	Sep 2013	A1
20130253347	Griswold et al.	Sep 2013	A1
20130261497	Pertijs et al.	Oct 2013	A1
20130265144	Banna et al.	Oct 2013	A1
20130268042	Hastings et al.	Oct 2013	A1
20130274828	Willis	Oct 2013	A1
20130274847	Ostroff	Oct 2013	A1
20130282070	Cowan et al.	Oct 2013	A1
20130282073	Cowan et al.	Oct 2013	A1
20130296727	Sullivan et al.	Nov 2013	A1
20130303872	Taff et al.	Nov 2013	A1
20130324825	Ostroff et al.	Dec 2013	A1
20130325081	Karst et al.	Dec 2013	A1
20130345770	Dianaty et al.	Dec 2013	A1
20140012344	Hastings et al.	Jan 2014	A1
20140018876	Ostroff	Jan 2014	A1
20140018877	Demmer et al.	Jan 2014	A1
20140031836	Ollivier	Jan 2014	A1
20140039570	Carroll et al.	Feb 2014	A1
20140039591	Drasler et al.	Feb 2014	A1
20140043146	Makdissi et al.	Feb 2014	A1
20140046395	Regnier et al.	Feb 2014	A1
20140046420	Moore et al.	Feb 2014	A1
20140058240	Mothilal et al.	Feb 2014	A1
20140058494	Ostroff et al.	Feb 2014	A1
20140074114	Khairkhahan et al.	Mar 2014	A1
20140074186	Faltys et al.	Mar 2014	A1
20140094891	Pare et al.	Apr 2014	A1
20140100627	Min	Apr 2014	A1
20140107723	Hou et al.	Apr 2014	A1
20140121719	Bonner et al.	May 2014	A1
20140121720	Bonner et al.	May 2014	A1
20140121722	Sheldon et al.	May 2014	A1
20140128935	Kumar et al.	May 2014	A1
20140135865	Hastings et al.	May 2014	A1
20140142648	Smith et al.	May 2014	A1
20140148675	Nordstrom et al.	May 2014	A1
20140148815	Wenzel et al.	May 2014	A1
20140155950	Hastings et al.	Jun 2014	A1
20140169162	Romano et al.	Jun 2014	A1
20140172060	Bomzin et al.	Jun 2014	A1
20140180306	Grubac et al.	Jun 2014	A1
20140180366	Edlund	Jun 2014	A1
20140207149	Hastings et al.	Jul 2014	A1
20140207210	Willis et al.	Jul 2014	A1
20140214104	Greenhut et al.	Jul 2014	A1
20140222098	Baru et al.	Aug 2014	A1
20140222109	Moulder	Aug 2014	A1
20140228913	Molin et al.	Aug 2014	A1
20140236172	Hastings et al.	Aug 2014	A1
20140243848	Auricchio et al.	Aug 2014	A1
20140255298	Cole et al.	Sep 2014	A1
20140257324	Fain	Sep 2014	A1
20140257422	Herken	Sep 2014	A1
20140257444	Cole et al.	Sep 2014	A1
20140276929	Foster et al.	Sep 2014	A1
20140309706	Jacobson	Oct 2014	A1
20140379041	Foster	Dec 2014	A1
20150025612	Haasl et al.	Jan 2015	A1
20150039041	Smith et al.	Feb 2015	A1
20150051609	Schmidt et al.	Feb 2015	A1
20150051610	Schmidt et al.	Feb 2015	A1
20150051611	Schmidt et al.	Feb 2015	A1
20150051612	Schmidt et al.	Feb 2015	A1
20150051613	Schmidt et al.	Feb 2015	A1
20150051614	Schmidt et al.	Feb 2015	A1
20150051615	Schmidt et al.	Feb 2015	A1
20150051616	Haasl et al.	Feb 2015	A1
20150051682	Schmidt et al.	Feb 2015	A1
20150057520	Foster et al.	Feb 2015	A1
20150057558	Stahmann et al.	Feb 2015	A1
20150057721	Stahmann et al.	Feb 2015	A1
20150088155	Stahmann et al.	Mar 2015	A1
20150105836	Bonner et al.	Apr 2015	A1
20150157861	Aghassian	Jun 2015	A1
20150173655	Demmer et al.	Jun 2015	A1
20150190638	Smith et al.	Jul 2015	A1
20150196756	Stahmann et al.	Jul 2015	A1
20150196757	Stahmann et al.	Jul 2015	A1
20150196758	Stahmann et al.	Jul 2015	A1
20150196769	Stahmann et al.	Jul 2015	A1
20150217119	Nikolski et al.	Aug 2015	A1
20150221898	Chi et al.	Aug 2015	A1
20150224315	Stahmann	Aug 2015	A1
20150224320	Stahmann	Aug 2015	A1
20150258345	Smith et al.	Sep 2015	A1
20150290468	Zhang	Oct 2015	A1
20150297905	Greenhut et al.	Oct 2015	A1
20150297907	Zhang	Oct 2015	A1
20150305637	Greenhut et al.	Oct 2015	A1
20150305638	Zhang	Oct 2015	A1
20150305639	Greenhut et al.	Oct 2015	A1
20150305640	Reinke et al.	Oct 2015	A1
20150305641	Stadler et al.	Oct 2015	A1
20150305642	Reinke et al.	Oct 2015	A1
20150306374	Seifert et al.	Oct 2015	A1
20150306375	Marshall et al.	Oct 2015	A1
20150306406	Crutchfield et al.	Oct 2015	A1
20150306407	Crutchfield et al.	Oct 2015	A1
20150306408	Greenhut et al.	Oct 2015	A1
20150321016	O'Brien et al.	Nov 2015	A1
20150328459	Chin et al.	Nov 2015	A1
20160015322	Anderson et al.	Jan 2016	A1
20160023000	Cho et al.	Jan 2016	A1
20160030757	Jacobson	Feb 2016	A1
20160033177	Barot et al.	Feb 2016	A1
20160121127	Klimovitch et al.	May 2016	A1
20160121128	Fishier et al.	May 2016	A1
20160121129	Persson et al.	May 2016	A1
20160213919	Suwito et al.	Jul 2016	A1
20160213937	Reinke et al.	Jul 2016	A1
20160213939	Carney et al.	Jul 2016	A1
20160228026	Jackson	Aug 2016	A1
20160317825	Jacobson	Nov 2016	A1
20160367823	Cowan et al.	Dec 2016	A1
20170001003	Pivonka	Jan 2017	A1
20170014629	Ghosh et al.	Jan 2017	A1
20170035315	Jackson	Feb 2017	A1
20170043173	Sharma et al.	Feb 2017	A1
20170043174	Greenhut et al.	Feb 2017	A1
20170189681	Anderson	Jul 2017	A1
20170281261	Shuros et al.	Oct 2017	A1
20170281952	Shuros et al.	Oct 2017	A1
20170281953	Min et al.	Oct 2017	A1
20170281955	Maile et al.	Oct 2017	A1
20170312531	Sawchuk	Nov 2017	A1

Foreign Referenced Citations (44)

Number	Date	Country
2008279789	Oct 2011	AU
2008329620	May 2014	AU
2014203793	Jul 2014	AU
1003904	Jan 1977	CA
202933393	May 2013	CN
0362611	Apr 1990	EP
503823	Sep 1992	EP
1702648	Sep 2006	EP
1904166	Jun 2011	EP
2433675	Jan 2013	EP
2441491	Jan 2013	EP
2452721	Nov 2013	EP
1948296	Jan 2014	EP
2662113	Jan 2014	EP
2471452	Dec 2014	EP
2760541	May 2016	EP
2833966	May 2016	EP
2000051373	Feb 2000	JP
2002502640	Jan 2002	JP
2004512105	Apr 2004	JP
2005508208	Mar 2005	JP
2005245215	Sep 2005	JP
2008540040	Nov 2008	JP
5199867	Feb 2013	JP
9500202	Jan 1995	WO
9636134	Nov 1996	WO
9724981	Jul 1997	WO
9826840	Jun 1998	WO
9939767	Aug 1999	WO
0234330	Jan 2003	WO
02098282	May 2003	WO
2005000206	Apr 2005	WO
2005042089	May 2005	WO
2006065394	Jun 2006	WO
2006086435	Aug 2006	WO
2006113659	Oct 2006	WO
2006124833	May 2007	WO
2007075974	Jul 2007	WO
2009006531	Jan 2009	WO
2012054102	Apr 2012	WO
2013080038	Jun 2013	WO
2013098644	Aug 2013	WO
2013184787	Dec 2013	WO
2014120769	Aug 2014	WO

Non-Patent Literature Citations (8)

Entry
US 8,886,318 B2, 11/2014, Jacobson et al. (withdrawn)
Electromagnetic Radiation: Field Memo. United States Department of Labor Occupational Safety and Health Administration, May 20, 1990, https://www.osha.gov/SLTC/radiofrequencyradiation/electromagnetic_fieldmemo/electromagnetic.html#section 6. Accessed Oct. 29, 2019.
Hachisuka et al., “Development and Performance Analysis of an Intra-Body Communication Device,” The 12th International Conference on Solid State Sensors, Actuators and Microsystems, vol. 4A1.3, pp. 1722-1725, 2003.
Seyedi et al., “A Survey on Intrabody Communications for Body Area Network Application,” IEEE Transactions on Biomedical Engineering,vol. 60(8): 2067-2079, 2013.
Wegmüller, “Intra-Body Communication for Biomedical Sensor Networks,” Diss. ETH, No. 17323, 1-173, 2007.
Notification of Transmittal of the International Search Report and the Written Opinion of the International Searching Authority, or the Declaration, dated Jan. 29, 2016, 15 pages.
Spickler et al., “Totally Self-Contained Intracardiac Pacemaker,” Journal of Electrocardiology, vol. 3(3&4): 324-331, 1970.
“Instructions for Use System 1, Leadless Cardiac Pacemaker (LCP) and Delivery Catheter,” Nanostim Leadless Pacemakers, pp. 1-28, 2013.

Related Publications (1)

	Number	Date	Country
	20180140850 A1	May 2018	US

Provisional Applications (1)

	Number	Date	Country
	62424930	Nov 2016	US

Implantable medical device with recharge coil

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