Abstract: Systems, devices and methods described herein can be used to monitor and treat cardiovascular disease, and more specifically, can be used to determine heart rate (HR), determine respiration rate (RR) and classify cardiac rhythms based on atrial intracardiac electrogram (IEGM) and atrial pressure (AP) signals. The atrial IEGM and AP signals are subject to spectrum transforms to obtain an atrial IEGM frequency spectrum and an AP frequency spectrum. Based on peaks in the atrial IEGM and AP frequency spectrums measures of HR and RR are determined, and arrhythmias are detected and/or arrhythmia discrimination is performed.

Abstract: A method and system are provided for characterizing cardiac function. The method and system comprise collecting cardiac signals associated with electrical or mechanical behavior of a heart over at least one cardiac cycle; identifying a timing feature of interest (FOI) from the cardiac signals; collecting dynamic impedance (DI) data over at least one cardiac cycle (CC), designated by the timing FOI, along at least one of i) a venous return (VR) vector or ii) a right ventricular function (RVF) vector; and analyzing at least one morphologic characteristic from the DI data based on at least one of i) a VR-DI correlation metric to obtain a VR indicator associated with the CC or ii) a RVF-DI correlation metric to obtain a RVF indicator associated with CC.

Abstract: An implantable medical lead includes a longitudinally extending body, an electrical conductor, an electrical component and a weld. The longitudinally extending body includes a distal end, a proximal end, and paddle region near the distal end. The electrical conductor extends through the body between the proximal end and the paddle region. The electrical component is on the paddle region and includes a sacrificial feature defined in a wall of the electrical component. The sacrificial feature includes a region that continues from the wall of the electrical component and a side that is isolated from the wall of the electrical component via a void defined in the wall of the electrical component. The weld is formed at least in part from at least a portion of the sacrificial feature. The weld operably couples the electrical component to the electrical conductor.

Abstract: An apparatus and method for gathering bodily fluid dynamic pressure measurements including placing a delivery tool in a region of interest (ROI), wherein the delivery tool includes a sensor, wherein the sensor is positioned in a substantially perpendicular direction to a flow direction of the ROI; measuring a sensor displacement for a time period; and determining a pressure measurement in the ROI using the sensor displacement.

Abstract: Implantable systems, and methods for use therewith, enable the monitoring of a patient's electromechanical delay (EMD) and arterial blood pressure. Paced cardiac events are caused by delivering sufficient pacing stimulation to cause capture. A cardiogenic impedance (CI) signal, indicative of cardiac contractile activity in response to the pacing stimulation being delivered, is obtained. One or more predetermined features of the CI signal are detected, and a value indicative of the patient's EMD is determined by determining a time between a delivered pacing stimulation and at least one of the detected one or more features of the CI signal. The value indicative of EMD can be used to more accurately determine metrics indicative of pulse arrival time (PAT), which can be used to estimate arterial blood pressure.

Abstract: Systems and methods for determining whether there is a correlation between arrhythmias and myocardial ischemic episodes are provided. An implantable system (e.g., a monitor, pacemaker or ICD) is used to monitor for arrhythmias and to monitor for myocardial ischemic episodes. When such events are detected by the implantable system, the implantable system stores (e.g., in its memory) data indicative of the detected arrhythmias and data indicative of the detected myocardial ischemic episodes. Then, for each detected arrhythmia, a determination is made based on the data, whether there was a myocardial ischemic episode detected within a specified temporal proximity of (e.g., within a specified amount of time of) the arrhythmia. Where a myocardial ischemic episode occurred within the specified temporal proximity of an arrhythmia, data for the two events can be linked.

Abstract: An exemplary includes acquiring an electroneurogram of the right carotid sinus nerve or the left carotid sinus nerve, analyzing the electroneurogram for at least one of chemosensory information and barosensory information and calling for one or more therapeutic actions based at least in part on the analyzing. Therapeutic actions may aim to treat conditions such as sleep apnea, an increase in metabolic demand, hypoglycemia, hypertension, renal failure, and congestive heart failure. Other exemplary methods, devices, systems, etc., are also disclosed.

Abstract: A method for detecting potential failures by a lead of an implantable medical device is provided. The method includes sensing a first signal over a first channel between a first combination of electrodes on the lead and sensing a second signal from a second channel between a second combination of electrodes on the lead. The method determines whether at least one of the first and second signals is representative of a potential failure in the lead and identifies a failure and the electrode associated with the failure based on which of the first and second sensed signals is representative of the potential failure. Optionally, when the first and second sensed signals are both representative of the potential failure, the method further includes determining whether the first and second sensed signals are correlated with one another. When the first and second sensed signals are correlated, the method declares an electrode common to both of the first and second combinations to be associated with the failure.

Abstract: A leadless implantable medical device (LIMD) is provided with dual chamber sensing functionality, without leads, despite the fact that the entire device is located in one chamber. In one embodiment, the LIMD senses local activity in the right atrium (RA) and local activity in the right ventricle (RV), even though it is entirely located in the RA. The sensing electrodes enable sensing in different chambers of the heart while reducing cross talk interference and thus provide accurate tracking of myocardial contraction in multiple chambers.

Abstract: Provided herein are implantable systems that include an implantable photoplethysmography (PPG) sensor, which can be used to obtain an arterial PPG waveform. In an embodiment, a metric of a terminal portion of an arterial PPG waveform is determined, and a metric of an initial portion of the arterial PPG waveform is determined, and a surrogate of mean arterial pressure is determined based on the metric of the terminal portion and the metric of the initial portion. In another embodiment, a surrogate of diastolic pressure is determined based on a metric of a terminal portion of an arterial PPG waveform. In a further embodiment, a surrogate of cardiac afterload is determined based on a metric of a terminal portion of an arterial PPG waveform.

Abstract: An exemplary includes acquiring an electroneurogram of the right carotid sinus nerve or the left carotid sinus nerve, analyzing the electroneurogram for at least one of chemosensory information and barosensory information and calling for one or more therapeutic actions based at least in part on the analyzing. Therapeutic actions may aim to treat conditions such as sleep apnea, an increase in metabolic demand, hypoglycemia, hypertension, renal failure, and congestive heart failure. Other exemplary methods, devices, systems, etc., are also disclosed.

Abstract: Methods for monitoring a patient's level of B-type natriuretic peptide (BNP), and implantable cardiac systems capable of performing such methods, are provided. A ventricle is paced for a period of time to provoke a ventricular evoked response, and a ventricular intracardiac electrogram (IEGM) indicative of the ventricular evoked response is obtained. Based on the ventricular IEGM, there is a determination of at least one ventricular evoked response metric (e.g., ventricular evoked response peak-to-peak amplitude, ventricular evoked response area and/or ventricular evoked response maximum slope), and the patient's level of BNP is monitored based on determined ventricular evoked response metric(s). Based on the monitored level's of BNP, the patients heart failure (HF) condition and/or risks and/or occurrences of certain events (e.g., an acute HF exacerbation and/or an acute myocardial infarction) can be monitored.

Abstract: A method for operating an implantable medical device includes delivering a plurality of pacing pulses to an atria of a patient's heart and monitoring intrinsic atrial activity to detect intrinsic atrial contractions between one or more of the plurality of pacing pulses. The method further includes detecting atrial undersensing as a function of the detection of intrinsic atrial contractions.

Abstract: Disclosed herein is a method of assembling an implantable medical lead configured to receive a stylet. The lead is provided with a tubular insulation layer, an electrode is disposed on the tubular insulation layer, an electrical conductor is routed through the tubular insulation layer, and a stylet stop is inserted into a distal end of the tubular insulation layer. The electrical conductor is directly and mechanically connected to the stylet stop and is in electrical communication with the electrode.

Abstract: Disclosed herein is an implantable medical lead configured to receive a stylet. The lead may include a tubular body and a structure. The tubular body may include a distal end and a proximal end. The body may be configured to receive the stylet. The structure longitudinally may extend through the body between the distal end and the proximal end. The structure may be anchored within the body such that a tensile force arising within the body by the stylet being extended through the body causes the tensile force to be substantially carried by the structure.