A blog about what is new (and old) in the world of active implantable medical devices 

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Enopace Receives Additional $5M Investment for Development of Stimulator for Treatment of Heart Failure

Enopace's implantable device

From Patent Application Publication: US 2011/0137370 A1

Sorin recently announced a $5 million investment in Israeli startup Enopace Biomedical, which is developing an endovascular neurostimulation system for heart failure.  Back in October 2011 Sorin invested $7 million to finance the initial clinical studies of Enopace’s technology as well as ongoing product development.

Very scant details are available besides that it is developing a neuromodulation system to treat patients with congestive heart failure. According to the company, its technology consists of a minimally invasive, implantable neurostimulation device that increases cardiac efficiency by reducing left ventricular workload.

From Enopace’s patent applications, it seems that Enopace’s device consists of a stimulation unit that is placed within the aorta close to the heart, and which is driven wirelessly from a coil that is placed within a vein closeby to the artery. The transmitting coil is in turn driven from an implanted control unit that is implanted subcutaneously.

Israeli business news website “Globes” interviewed Enopace’s CEO Amir Dagan, and reported in February 2013:

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Neuromodulation Startup NeuroTronik Raises $13.1M for Development of System for Treating Acute Heart Failure Syndrome

NeuroTronik Neuromodulation www.implantable-device.comNeuroTronik, a recent spin-off from Synecor, a Chapel Hill business accelerator, announced that it has raised $13.1M for the development of a neuromodulation system intended for the treatment of acute heart failure syndrome.

Douglas Reed, a partner in the VC group backing NeuroTronik said that the device aims to shorten hospital stays and reduce the need of patients to return to the hospital a few weeks later.  According to Reed:

“It’s a way of stimulating the heart to increase the pumping effectiveness, the effectiveness of the contractions, so it improves cardiac function while the device is in place.”

 

 
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EnteroMedics Submits PMA of the Maestro VBLOC System for Treatment of Obesity

EnteroMedics  reported that it has submitted its pre-market approval application for FDA review of its Maestro Rechargeable System’s VBLOC vagal blocking therapy as a treatment for obesity

This is an important step for an implantable device company that faced very tough times in 2009 after its US clinical trial failed to meet a critical effectiveness goal. EnteroMedics conducted a pivotal trial, and believes that the data are positive, leading it to submit the PMA application.

According to the press release, EnteroMedics president & CEO Mark Knudson said that “the Maestro System is a unique, neuroscience-based approach to the treatment of this epidemic disease, one which offers the potential to fill a significant gap in the obesity treatment spectrum. In the hundreds of patients treated to date, in addition to showing clinically meaningful weight loss, VBLOC Therapy has demonstrated an excellent benefit-to-risk profile; a criterion identified by the Agency as central to the review and approvability of new obesity treatment devices.”

 

 
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NeuroPace Raises $18M of Planned $50M

Image Credit: NeuroPace

NeuroPace is a privately-held company in Mountain View, CA. Their RNS® implantable stimulator, along with depth leads and cortical strip leads are designed for the treatment of medically refractory partial epilepsy.

Unlike Cyberonics’ VNS IPGs, the RNS neurostimulator is designed to detect abnormal electrical activity in the brain and respond by delivering electrical stimulation to normalize brain activity before the patient experiences seizure symptoms. The neurostimulator is implanted in the cranium and connected to one or two leads that are implanted near the patient’s seizure focus.

NeuroPace recently disclosed that it has raised about $18 million of a planned $50 million in new funding. NeuroPace has raised about $180 million since it was founded in 1997.

 

 

 
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Proposed Microgravity Testing of AIMDs

 

With the popularization of space tourism, I would hereby like to propose the addition of a clause to 45502-1 to be titled “Protection of the active implantable medical device from microgravity conditions“.  I propose the following language:

The implantable parts of an ACTIVE IMPLANTABLE MEDICAL DEVICE shall be designed and constructed so that no irreversible change will be caused by exposure to microgravity conditions.

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TYRX receives FDA Approval for Fully Resorbable AIGISRx R Antibacterial IPG Envelope

Tyrx IPG antimicrobial pouch David Prytchi www.implantable-device.com

AIGISRx® is an Antibacterial Envelope that is made from knitted polypropylene mesh substrate, coated with a polyarylate bioresorbable polymer containing two antimicrobial antibiotics, minocycline and rifampin. AIGISRx is a dual component (resorbable and non-resorbable), sterile prosthesis designed to reduce infection and to stabilize the implantable pacemaker or defibrillator when implanted in the body.

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Aleva Neurotherapeutic’s Ultra-Flexible Electrode Arrays for DBS

Aleva DBS electrode array www.implantable-device.com David Prutchi PhD

Miniature, ultra-flexible electrode (credit: EPFL)

Aleva Neurotherapeutics is a spinoff of the Swiss Federal Institute of Technology (EPFL) Microsystems Laboratory.   Aleva is developing unique microfabricated devices to more specifically target deep-brain stimulation.

kurtzweilai.net recently published an interesting blog about the technology.  From the post:

“Miniature, ultra-flexible electrodes could be the answer to more successful treatment for Parkinson’s diseases, according to Professor Philippe Renaud of the École Polytechnique Fédérale de Lausanne (EPFL) in Switzerland.

He has developed soft arrays of miniature electrodes in his Microsystems Laboratory that open new possibilities for more accurate and local deep brain stimulation (DBS).

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Mainstay Medical’s Reactiv8 to Treat LBP Caused by Arthrogenic Muscle Inhibition

logo_mainstay1[1]

Mainstay Medical was founded in 2008 by entrepreneur Dr. Danny Sachs. The company’s ReActiv8 neurostimulator is intended to treat chronic low back pain caused by arthrogenic muscle inhibition.  This is a neuroprotective condition in which the brain reflexively attempts to limit motor stimulation and movement in muscles surrounding a joint in response to damage or injury to the joint. In patients with this type of back pain, an initial injury triggers this reflexive inhibition, and the brain tries to limit painful movement by altering nerve transmissions to the deep stabilizing muscles of the spine, causing a loss of motor control, an unstable spine, and greater susceptibility to reinjury.

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Neuros Medical’s Altius™ High Frequency Electrical Nerve Block™ Pain Therapy

Neuros Medical Altius www.implantable-device.com David Prutchi PhD

Neuros Medical, a Cleveland, Ohio based neuromodulation company, developed the Altius implantable system to deliver Electrical Nerve Block therapy for the treatment of chronic pain in a variety of applications including neuroma/residual limb pain, chronic post surgical pain, and chronic migraine.

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Medtronic Issues Urgent Class-I Recall Notifications for the SynchroMed® Implantable Infusion System

SynchroMed-II[1]

Medtronic’s press release:

MINNEAPOLIS – June 26, 2013 – In June 2013, Medtronic, Inc. (NYSE: MDT) initiated four medical device notifications to customers worldwide about the SynchroMed® Implantable Infusion System. These notifications provide clinicians with information to help identify and manage issues that impact the safe and reliable delivery of therapy using the SynchroMed Implantable Infusion System.

The United States Food and Drug Administration (FDA) has classified three of these notifications as Class I recalls.The fourth notification is an update to a 2011 action related to pump refill which was previously classified by the FDA as a Class I recall.

Patients are encouraged to maintain regular follow-up appointments with their physicians; however, if they experience a change or return of symptoms or hear a device alarm, they should contact their physician immediately. No action is required of physicians beyond the recommendations provided in the notifications.

Medtronic’s intrathecal drug delivery systems are used to treat chronic, intractable pain and severe spasticity of cerebral or spinal origin. These notifications do not involve Medtronic external insulin pumps for diabetes.

Specifically, the Neuromodulation business of Medtronic has initiated the following field corrective actions:

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St Jude Receives CE Mark for Quadra Assura MP™ Multipoint CRT-D

SJM_QuadraAssuraMPSt. Jude Medical today announced CE Mark approval of its next-generation quadripolar device, the Quadra Assura MP™ cardiac resynchronization therapy defibrillator (CRT-D). The device features MultiPoint™ Pacing (MPP) technology that enables physicians to pace multiple locations on the left side of the heart. This gives the clinician more choices to best optimize cardiac resynchronization therapy (CRT) pacing to meet individual patient needs.

According to the press release:

The Quadra Assura MP CRT-D is designed to work with the Quartet™ Lead, which has four electrodes to offer maximum flexibility for different pacing configurations. The new MPP capability allows physicians to program simultaneous or sequential delivery of two left ventricular (LV) pulses per pacing cycle, rather than the standard single pacing pulse. The capability to deliver two LV pulses per cycle allows physicians to tailor CRT pacing for each patient, potentially leading to more effective outcomes compared to single site pacing, which may be particularly beneficial in patients not responding to traditional bi-ventricular pacing therapy.

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Sorin Launches Reply 200 Pacemakers with Sleep Apnea Monitoring

Sorin Reply 200 with apnea monitor David Prutchi PhD www.implantable-device.comSorin announced today CE mark approval and the European commercial launch of the REPLY ™ 200 family of pacemakers featuring Sleep Apnea Monitoring (SAM).  According to the press release:

Sleep apnea is highly prevalent and vastly undiagnosed in pacemaker patients. It increases the mortality risk and the risk of common cardiovascular co-morbidities such as hypertension, atrial fibrillation (AF) and heart failure (HF). Moreover, sleep apnea complicates the management of common cardiovascular co-morbidities.

The REPLY 200 SR and DR pacemakers automatically screen patients for the risk of severe sleep apnea using a highly reliable sensor that measures ventilation. The Respiratory Disturbance Index (RDI), calculated and reported by the pacemaker, has been validated against polysomnography, the gold standard method used to diagnose sleep apnea.

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Boston Scientific Begins Patient Enrollment in U.S. Clinical Trial of Vercise™ DBS for Parkinson’s Disease, Presents EU Data

Boston Scientific Vercise DBS System www.implantable-device.com David Prutchi, Ph.D.

Image Credit: Boston Scientific

Boston Scientific announced today the first implantation of its Vercise™ DBS System as part of the INTREPID clinical trial. INTREPID is a prospective, multi-center, double-blinded, randomized, controlled study to evaluate the safety and effectiveness of motor function and overall quality of life in patients with the Vercise DBS System for the treatment of Parkinson’s disease.  According to the press release:

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Implantabe Preterm Labor Monitor

implantable premature labor monitor David Prutchi PhD www.implantable-device.comNot new, but recently came across while researching some information about related devices…

The NASA Tech Briefs of May 1999 described a device that telemeters pressure changes to detect intrauterine contractions.  According to the brief:

A biotelemetric system for monitoring key physiological parameters of a fetus and its uterine environment is undergoing development. The main purpose of the monitoring is to detect preterm labor in order to enable timely treatment. At the present stage of development, the system monitors pressure changes and temperature. The pressure changes serve as direct indications of intrauterine contractions that could be associated with the onset of preterm labor. Future versions of the system are expected to monitor additional parameters, including pH and the heart rate of the fetus.

 

 
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IEEE Summer School on Implantable Devices – Bogotá, Colombia (July 9 – 12, 2013)

IEEE Summer School Implantable Devices David Prutchi PhD Bogota ColombiaI have been honored with an invitation to present at the  Fourth IEEE CASS Summer School on Wearable and Implantable Biomedical Circuits and Systems in Bogotá, Colombia (July 9 – 12, 2013).

I will be giving two 1 hour and 20 minute talks on “A Practical Perspective on Developing Novel Commercial Active Implantable Medical Devices”.  Unlike other commercial devices, developing medical implantable devices takes place in a heavily regulated environment which requires decisive proof of the devices’ safety and efficacy. Costs, schedules, and clinical strategies must be planned accordingly to achieve a successful exit. This two-part lecture will focus on the practical technical and business-oriented aspects of planning and executing the development of implantable medical devices intended for a commercial application.

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