Abstract: Implantable devices having motion sensors. In some examples the a configuration is generated for the implantable device to use the motion sensor in an energy preserving mode in which one or more axis of detection of the motion sensor is disabled or ignored. In some examples the motion sensor outputs along multiple axes are analyzed to determine which axes best correspond to certain patient parameters including patient motion/activity and/or cardiac contractility. In other examples the output of the motion sensor is observed across patient movements or postures to develop conversion parameters to determine a patient standard frame of reference relative to outputs of the motion sensor of an implanted device.

Abstract: Systems, devices, and methods for pacing a heart of a patient are disclosed. A device may include a leadless cardiac pacemaker (LCP) that includes a power supply, a pair of electrodes, and a controller operably connected to the electrodes and the power supply. The controller may identify a capture threshold by setting a pace amplitude at a power supply voltage of the power supply and deliver pacing stimulation pulses with different pulse widths to identify the capture threshold. The LCP may then deliver pacing stimulation pulses based, at least in part, on a pulse amplitude and pulse width associated with the capture threshold, and also adding a capture margin. In some cases, the pulse amplitude may change over time and the LCP may adjust a pulse width along a strength-duration curve to account for the pulse amplitude change and maintain a capture threshold and capture margin.

Abstract: An implantable medical device (IMD) may include a sensor for providing a sensor output signal and a sense channel configured to receive the sensor output signal from the sensor. The sense channel may be configured to process the sensor output signal and output a sense channel output signal. The sense channel may have an adjustable performance level, wherein for a higher performance level the sense channel consumes more power than for a lower performance level. A controller may be configured to adjust the performance level of the sense channel to achieve more performance and more power consumption when a higher degree of sense channel performance is desired and to achieve less performance and less power consumption when a higher degree of performance is not desired.

Abstract: Methods and devices for configuring the use of a motion sensor in an implantable cardiac device. The electrical signals of the patient's heart are observed and may be correlated to the physical motion of the heart as detected by the motion sensor of the implantable cardiac device in order to facilitate temporal configuration of motion sensor data collection that avoids detecting cardiac motion in favor of overall motion of the patient.

Abstract: A medical device includes a case and a core assembly. The core assembly includes operational circuitry enclosed within a core assembly housing. The medical device also includes a battery assembly, which includes a battery enclosed within a battery housing. The case includes the core assembly housing and the battery housing. A first electrode is coupled to, and electrically isolated from, the case; and a second electrode is electrically coupled to the case. The second electrode is electrically coupled to the operational circuitry via a sensing pathway that includes a portion of the case. The battery is electrically coupled to the operational circuitry via an energy supply pathway that includes the portion of the case.

Abstract: Systems and methods for monitoring patients with respiratory diseases are described. A system may include a sensor circuit configured to sense one or more physiological signals indicative of respiratory sounds, and a spectral analyzer to generate first and second spectral contents at respective first and second frequency bands. The system may produce a respiratory anomaly indicator using the first and second spectral contents, or additionally with other physiological parameters. The system may detect an onset or progression of a target respiratory condition such as asthma or chronic obstructive pulmonary disease using the respiratory anomaly indicator, or to trigger or adjust a therapy.

Abstract: Systems and methods for monitoring patients with respiratory diseases are described. A system may include a sensor circuit to sense a respiration signal and at least one hemodynamic signal. The system may detect a specified respiratory phase from the respiration signal, and generate from the hemodynamic signal one or more signal metrics that are correlative to at least one of a systolic blood pressure, a blood volume, or a cardiac dimension. The system may detect a restrictive or obstructive respiratory condition when the hemodynamic signal metric indicates hemodynamic deterioration during a specified respiratory phase. The system may additionally classify the detected restrictive or obstructive respiratory condition into one of two or more categories, and deliver a therapy based on the detection or the classification.

Abstract: Implantable medical devices comprising electromagnetic interference shields which incorporate a dump resistor and various enhancements to control high voltage arcing. Included are embodiments in which a dump resistor is provided in a flexible shield having first and second conductive layers, where the resistor is provided in a layer between the conductive layers. In additional examples the design of plated through-holes is done to avoid the potential for arcing while maintaining close spacing.

Abstract: A medical system for providing a defibrillation therapy to a patient includes a cardiac monitoring device (CMD) configured to sense and record physiological data indicative of the patient's cardiac function. The CMD includes a communication component. The system also includes an external therapy device configured to deliver defibrillation therapy, and configured to be positioned external to and supported by the patient. The external therapy device includes an external therapy device communication component. The CMD communication component and the external therapy device communication component are configured to operatively couple the CMD and the external therapy device to one another, so as to work as a system to detect and treat fibrillation.

Abstract: An implantable medical device (IMD) includes a core assembly having a housing with circuitry disposed therein. The IMD also includes an integrated electrode/antenna assembly. The integrated electrode/antenna assembly includes an electrode component and an antenna component.

Abstract: Implantable devices having motion sensors. In some examples the a configuration is generated for the implantable device to use the motion sensor in an energy preserving mode in which one or more axis of detection of the motion sensor is disabled or ignored. In some examples the motion sensor outputs along multiple axes are analyzed to determine which axes best correspond to certain patient parameters including patient motion/activity and/or cardiac contractility. In other examples the output of the motion sensor is observed across patient movements or postures to develop conversion parameters to determine a patient standard frame of reference relative to outputs of the motion sensor of an implanted device.

Abstract: Methods and devices for configuring the use of a motion sensor in an implantable cardiac device. The electrical signals of the patient's heart are observed and may be correlated to the physical motion of the heart as detected by the motion sensor of the implantable cardiac device in order to facilitate temporal configuration of motion sensor data collection that avoids detecting cardiac motion in favor of overall motion of the patient.

Abstract: A system includes a pulse generator including a can electrode and a lead couplable to the pulse generator, the lead including a distal coil electrode and a proximal coil electrode, wherein both of the coil electrodes are electrically uncoupled from the can electrode such that a unipolar sensing vector is provided between at least one of the coil electrodes and the can electrode.

Abstract: Implantable medical devices comprising electromagnetic interference shields which incorporate a dump resistor and various enhancements to control high voltage arcing. Included are embodiments in which a dump resistor is provided in a flexible shield having first and second conductive layers, where the resistor is provided in a layer between the conductive layers. In additional examples the design of plated through-holes is done to avoid the potential for arcing while maintaining close spacing.

Abstract: An implantable medical device (IMD) may include multiple power supply circuits and an electrostimulation therapy output circuit configured to, in response to a control signal specifying an electrostimulation therapy, controllably connect any one or more of the first or second power supply circuits to any one or more of a first electrostimulation output node or a second electrostimulation output node to deliver an electrostimulation. In an embodiment, the IMD may include an electrostimulation therapy return circuit configured to establish a return path for the electrostimulation delivered via one or more of the first electrostimulation output node or the second electrostimulation output node.

Abstract: An implantable cardiac rhythm management (CRM) device includes a sensing and detection circuit that senses at least one cardiac signal and detects cardiac electrical events from the sensed estimation. The sensed cardiac signal is filtered to produce a filtered cardiac signal having a signal frequency band and a noise signal having a noise frequency band. The noise frequency band is substantially different from the signal frequency band. A dynamic noise floor is produced based on the noise signal and used as the minimum value for the detection threshold. A cardiac electrical is detected when the amplitude of the filtered cardiac signal exceeds the detection threshold.

Abstract: An implantable medical device can include an integrated circuit comprising an electrostatic discharge (ESD) protection circuit. The ESD protection circuit can include an active circuit, a first passive circuit, and a second passive circuit. For example, at least one of the first or second passive circuits can include an array of capacitors in a series configuration, a parallel configuration, or a combination of series and parallel configurations. The first and second passive circuits can be configured to establish a specified time constant, and, in response to an applied ESD, the first and second passive circuits can provide a control signal to active circuit to switch the active circuit from a substantially non-conductive mode to a substantially conductive mode.

Abstract: An integrated circuit for an implantable medical device can include a substrate, a first capacitor, and an electrostatic discharge (ESD) protection circuit. The first capacitor can include an electrically conductive lower polysilicon terminal and an electrically conductive upper polysilicon terminal that can be separated from the lower polysilicon terminal by a first capacitor dielectric material. The ESD protection circuit can include an ESD shunt transistor and a second capacitor. The ESD shunt transistor can be configured to be normally off, but can be configured to turn on and conduct between first and second power supply rails in response to an ESD event exceeding a specified ESD event threshold value. The second capacitor can includes a first substrate terminal and an electrically conductive second polysilicon terminal that can be separated from the first substrate terminal by a second capacitor dielectric material.

Abstract: An implantable cardiac rhythm management (CRM) device includes a sensing and detection circuit that senses at least one cardiac signal and detects cardiac electrical events from the sensed cardiac signal using a detection threshold that is adjusted based on a dynamic noise estimation. The sensed cardiac signal is filtered to produce a filtered cardiac signal having a signal frequency band and a noise signal having a noise frequency band. The noise frequency band is substantially different from the signal frequency band. A dynamic noise floor is produced based on the noise signal and used as the minimum value for the detection threshold. A cardiac electrical is detected when the amplitude of the filtered cardiac signal exceeds the detection threshold.

Abstract: An implantable cardiac rhythm management (CRM) device includes a sensing and detection circuit that senses at least one cardiac signal and detects cardiac electrical events from the sensed cardiac signal using a detection threshold that is adjusted based on a dynamic noise estimation. The sensed cardiac signal is filtered to produce a filtered cardiac signal having a signal frequency band and a noise signal having a noise frequency band. The noise frequency band is substantially different from the signal frequency band. A dynamic noise floor is produced based on the noise signal and used as the minimum value for the detection threshold. A cardiac electrical is detected when the amplitude of the filtered cardiac signal exceeds the detection threshold.