Abstract: Devices, systems, and techniques are disclosed for verifying the occurrence of an acute health event. An example device includes communication circuitry configured to receive a communication indicative of an acute health event of a patient and memory communicatively coupled to the communication circuitry and being configured to store the indication of the acute health event. The device includes processing circuitry communicatively coupled to the communication circuitry and the memory. The processing circuitry is configured to, in response to the communication, verify the acute health event and based on the verification of the acute health event, send an alert regarding the acute health event.

Abstract: A medical device processor is configured to receive at least one cardiac electrical signal that is sensed during bilateral bundle branch pacing delivered from a bipolar electrode pair comprising an anode positioned along a first bundle branch and a cathode positioned along a second bundle branch opposite the first bundle branch, determine at least one feature from the first cardiac electrical signal, determine that the at least one feature meets first bundle branch capture criteria; and determine anodal bundle branch capture in response to the first bundle branch capture criteria being met.

Abstract: The control module of a first pacemaker included in an implantable medical device system including the first pacemaker and a second pacemaker is configured to set a pacing escape interval in response to a far field pacing pulse sensed by the first pacemaker. The far field pacing pulse is a pacing pulse delivered by the second pacemaker. The pacing escape interval is allowed to continue without restarting the in response to a far field intrinsic event sensed by the first pacemaker during the pacing escape interval. The first pacemaker delivers a cardiac pacing pulse to the heart upon expiration of the pacing escape interval.

Abstract: An adapter configured to electrically connect a test device to an implantable medical lead comprises a rotational electrical coupling. The rotational electrical coupling is configured to electrically connect a lead electrical connector to an adapter electrical connector. The rotational electrical coupling comprises a first conductive component configured to be electrically connected to the lead electrical connector and rotatable with a proximal portion of the implantable medical lead, and a second conductive component electrically connected to the first conductive component and the adapter electrical connector. The second conductive component may be rotationally fixed. The first and second conductive components may comprise graphite or another soft metal.

Abstract: Implantable medical systems enter an exposure mode of operation, either manually via a down linked programming instruction or by automatic detection by the implantable system of exposure to a magnetic disturbance. A controller then determines the appropriate exposure mode by considering various pieces of information including the device type including whether the device has defibrillation capability, pre-exposure mode of therapy including which chambers have been paced, and pre-exposure cardiac activity that is either intrinsic or paced rates. Additional considerations may include determining whether a sensed rate during the exposure mode is physiologic or artificially produced by the magnetic disturbance. When the sensed rate is physiologic, then the controller uses the sensed rate to trigger pacing and otherwise uses asynchronous pacing at a fixed rate.

Abstract: A medical device system is configured to guide implantation of a pacing electrode for left bundle branch pacing. The system includes a medical device having a processor configured to receive at least one cardiac electrical signal, determine a feature of the cardiac electrical signal, compare the feature to left bundle branch signal criteria, and determine a left bundle branch signal in response to the feature meeting the left bundle branch signal criteria. The system includes a display unit configured to generate a user feedback signal indicating advancement of a pacing electrode into a left portion of a ventricular septum in response to the processor determining the left bundle branch signal.

Abstract: A medical device is configured to set a post-atrial time interval in response to an atrial event and generate an event time signal in response to a ventricular electrical signal crossing an R-wave sensing threshold during the post-atrial time interval. The device accumulates oversensing evidence in response to the event time signal and adjusts a ventricular sensing control parameter based on the accumulated oversensing evidence in some examples.

Abstract: Techniques for minimizing rate of depletion of a non-rechargeable power source, to extend the operational lifetime of an implantable medical device that includes the non-rechargeable power source, by enforcing operational-mode-specific communication protocols whereby inter-device communication between the implantable medical device and another implantable medical device is such that level of power draw from the non-rechargeable power source by the implantable medical device is less than level of power draw from the rechargeable power source by the another implantable medical device for the implantable medical devices to engage in communication with each other.

Abstract: A pacemaker having a motion sensor delivers atrial-synchronized ventricular pacing by detecting events from a signal produced by the motion sensor and delivering ventricular pacing pulses at a rate that tracks the rate of the detected events. The pacemaker is configured to confirm atrial tracking of the ventricular pacing pulses by determining if detected events from the motion sensor signal are atrial events. The pacemaker is configured to adjust a control parameter used for detecting events from the motion sensor signal if atrial tracking is not confirmed.

Abstract: Implantable medical systems enter an exposure mode of operation, either manually via a down linked programming instruction or by automatic detection by the implantable system of exposure to a magnetic disturbance. A controller then determines the appropriate exposure mode by considering various pieces of information including the device type including whether the device has defibrillation capability, pre-exposure mode of therapy including which chambers have been paced, and pre-exposure cardiac activity that is either intrinsic or paced rates. Additional considerations may include determining whether a sensed rate during the exposure mode is physiologic or artificially produced by the magnetic disturbance. When the sensed rate is physiologic, then the controller uses the sensed rate to trigger pacing and otherwise uses asynchronous pacing at a fixed rate.

Abstract: A medical device is configured to set a post-atrial time interval in response to an atrial event and generate an event time signal in response to a ventricular electrical signal crossing an R-wave sensing threshold during the post-atrial time interval. The device accumulates oversensing evidence in response to the event time signal and adjusts a ventricular sensing control parameter based on the accumulated oversensing evidence in some examples.

Abstract: An example medical device system includes memory configured to store information relating to an occurrence of a cardiac event in a patient and processing circuitry configured to determine the occurrence of the cardiac event in the patient. The processing circuitry is configured to determine at least one of a fall of the patient, a slumping posture of the patient, or a change from an upright posture to a non-upright posture of the patient and that the cardiac event is associated therewith in time. The processing circuitry is configured to, in response to determining that the cardiac event and the at least one of the fall of the patient, the slumping posture of the patient, or the change from the upright posture to the non-upright posture of the patient are associated in time, modulate a response to the cardiac event.

Abstract: A medical device and method conserve electrical power used in monitoring cardiac arrhythmias. The device includes a sensing circuit configured to sense a cardiac signal, a power source and a control circuit having a processor powered by the power source. The control circuit is configured to operate in a normal state by waking up the processor to analyze the cardiac electrical signal for determining a state of an arrhythmia. The control circuit switches from the normal state to a power saving state that includes waking up the processor at a lower rate than during the normal state.

Abstract: Systems, devices, and methods may be used to deliver and provide cardiac pacing therapy to a patient. Leads or leadlets carrying one or more left ventricular electrodes may be positioned in or near the interventricular septum to sense and pace left ventricular signals of the patient's heart. In one example, a leadlet including one or more left ventricular electrodes may extend in the coronary sinus from a leadless implantable medical device located in the right atrium.

Abstract: A pacemaker having a motion sensor delivers atrial-synchronized ventricular pacing by detecting events from a signal produced by the motion sensor and delivering ventricular pacing pulses at a rate that tracks the rate of the detected events. The pacemaker is configured to confirm atrial tracking of the ventricular pacing pulses by determining if detected events from the motion sensor signal are atrial events. The pacemaker is configured to adjust a control parameter used for detecting events from the motion sensor signal if atrial tracking is not confirmed.

Abstract: Techniques for minimizing rate of depletion of a non-rechargeable power source, to extend the operational lifetime of an implantable medical device that includes the non-rechargeable power source, by enforcing operational-mode-specific communication protocols whereby inter-device communication between the implantable medical device and another implantable medical device is such that level of power draw from the non-rechargeable power source by the implantable medical device is less than level of power draw from the rechargeable power source by the another implantable medical device for the implantable medical devices to engage in communication with each other.

Abstract: An intracardiac ventricular pacemaker is configured to operate in in a selected one of an atrial-tracking ventricular pacing mode and a non-atrial tracking ventricular pacing mode. A control circuit of the pacemaker determines at least one motion signal metric from the motion signal, compares the at least one motion signal metric to pacing mode switching criteria, and, responsive to the pacing mode switching criteria being satisfied, switches from the selected one of the non-atrial tracking pacing mode and the atrial tracking pacing mode to the other one of the non-atrial tracking pacing mode and the atrial tracking pacing mode for controlling ventricular pacing pulses delivered by the pacemaker.

Abstract: Implantable medical systems enter an exposure mode of operation, either manually via a down linked programming instruction or by automatic detection by the implantable system of exposure to a magnetic disturbance. A controller then determines the appropriate exposure mode by considering various pieces of information including the device type including whether the device has defibrillation capability, pre-exposure mode of therapy including which chambers have been paced, and pre-exposure cardiac activity that is either intrinsic or paced rates. Additional considerations may include determining whether a sensed rate during the exposure mode is physiologic or artificially produced by the magnetic disturbance. When the sensed rate is physiologic, then the controller uses the sensed rate to trigger pacing and otherwise uses asynchronous pacing at a fixed rate.

Abstract: A ventricular pacemaker is configured to determine a ventricular rate interval by determining at least one ventricular event interval between two consecutive ventricular events and determine a rate smoothing ventricular pacing interval based on the ventricular rate interval. The pacemaker is further configured to detect an atrial event from a sensor signal and deliver a ventricular pacing pulse in response to detecting the atrial event from the sensor signal. The pacemaker may start the rate smoothing ventricular pacing interval to schedule a next pacing pulse to be delivered upon expiration of the rate smoothing ventricular pacing interval.

Abstract: An implantable medical device includes an electrically conductive first housing, a conductive feedthrough extending through the first housing, electronic circuitry positioned within the first housing, a device electrode, and a second housing. The electronic circuitry is electrically coupled to the first housing and the feedthrough, and senses electrical signals of a patient and/or delivers electrical stimulation therapy to the patient via the first housing and the feedthrough. The device electrode is configured to electrically connect with tissue and/or a fluid at a target site in the patient. A lead connector is configured to connect to a proximal end of an implantable medical lead. The lead connector includes a first connector contact electrically coupled to the feedthrough and a second connector contact electrically coupled to the first housing.