Abstract: Systems and methods for assessing a cardiac arrhythmia risk of a patient, such as a risk for developing atrial fibrillation, are disclosed. An exemplary medical-device system includes a risk stratifier circuit configured to, in an absence of prior and present atrial arrhythmia, determine a composite risk of the patient developing a future atrial arrhythmia using a trained machine-learning model and a plurality of features of physiological information sensed from the patient and an arrhythmia monitor circuit configured to adjust an arrhythmia monitoring parameter based at least in part on the composite risk and to detect an atrial arrhythmia event using the adjusted arrhythmia monitoring parameter.

Abstract: An apparatus comprises a magnetic field detection circuit, a cardiac signal sensing circuit, a memory circuit, a control circuit, and an arrhythmia detection circuit. The cardiac signal sensing circuit generates a cardiac signal representative of cardiac activity of a subject when coupled to sensing electrodes. The control circuit is operatively coupled to the magnetic field detection circuit; the cardiac signal sensing circuit, and the memory circuit. The control circuit stores cardiac signal data determined using the sensed cardiac signal, receives an indication of magnetic field detection by the magnetic field detection circuit, stores data obtained using the sensed cardiac signal during the magnetic field detection, and stores an identifier indicating the magnetic field detection in association with the data. The arrhythmia detection circuit processes the cardiac signal data to detect a cardiac arrhythmia event and confirm the cardiac arrhythmia event according to the magnetic field indication.

Abstract: This document discusses, among other things, systems and methods to receive cardiac electrical information of a subject, detect a premature ventricular contraction (PVC) event in a first detection window using the received cardiac electrical information, determine a count of detected PVC events in the first detection window, remove cardiac electrical information associated with the detected PVC event from the first detection window based on the determined count of detected PVC events, and detect an indication of atrial fibrillation of the subject for the first detection window using remaining cardiac electrical information in the first detection window.

Abstract: Systems and methods for monitoring patients with multiple chronic diseases are described. A system may include a health status monitor that receives diagnostic data including physiological signals sensed from a patient. The system may produce at least a first risk indication of the patient developing a first disease and a second risk indication of the patient developing a different second disease. The system may detect the first and second diseases from the physiological signals, and generate a composite health status indicator using the detections of the first and second diseases and the first and second risk indications. An alert of worsening health status may be generated if the composite detection score exceeds an alert threshold.

Abstract: Systems and methods for detecting cardiac arrhythmia are discussed. An exemplary arrhythmia detection system can receive physiologic information of the patient, measure a first signal metric using a first portion of the received physiologic information, and determine an arrhythmia detection duration using a comparison between the measured first signal metric and a reference signal metric value. The system includes an arrhythmia detector to detect an AT episode using a second portion of the physiologic information corresponding to the determined arrhythmia detection duration.

Abstract: Embodiments of the present disclosure relate to implantable medical device (IMD) enclosures. In an exemplary embodiment, an IMD comprises: a housing comprising an open end and a header defining a cavity and comprising at least one conduit through a wall of the header, wherein the header is formed from a non-conductive material. Further, the IMD comprises a coupling member comprising a flange, wherein the flange is configured to be received by the open end of the housing and wherein the flange and the open end of the housing at least partially overlap along an axial direction of the IMD when the flange is received by the open end. Additionally, the IMD comprises an electrode arranged on an outer surface of the header and a feedthrough coupled to the electrode and extending through the conduit of the header, wherein the feedthrough is configured to be coupled to internal circuitry housed within the IMD. Further, the IMD comprises a ring forming a hermetic seal between the coupling member and the header.

Abstract: Systems and methods for monitoring heart failure (HF) status in a patient are discussed. An exemplary system includes a gait analyzer circuit than can receive gait or balance information, and generate a gait feature such as gait speed or a gait pattern. The system includes a HF detector circuit that can detect patient HF status, or to predict patient risk of a future worsening heart failure (WHF) event, using the gait feature. In some examples, the system may trigger sensing physiologic information according to the detected gait, and detect patient HF status using the sensed physiologic information. The system can initiate or adjust a heart failure therapy according to the HF status or the WHF risk.

Abstract: Embodiments of the present disclosure relate to imaging a body part using sounds. In embodiments, a system comprises a motion sensor and a processing device communicatively coupled to the motion sensor. The motion sensor is configured to sense an acceleration wave produced by a sound emitted by a source and generate acceleration measurements in response to sensing the acceleration wave, wherein the source is associated with the body part of a subject. The processing device is configured to receive the acceleration measurements and determine a location of the source using a location of the motion sensor and the acceleration measurements. In addition, the processing device is configured to image the body part of the subject using the determined location of the source and the acceleration measurements.

Abstract: A medical device includes a processor, an acceleration sensor, and memory. The acceleration sensor is configured to generate acceleration data that comprises a plurality of acceleration measurements. The memory comprises instructions that when executed by the processor, cause the processor to: obtain the acceleration data from the acceleration sensor; and determine, based on the acceleration data, that the medical device has flipped.

Abstract: Embodiments herein relate to implantable medical devices including a power subunit with a first biocompatible electrically conductive shell configured for direct contact with an in vivo environment. In some embodiments a lithium anode can be disposed within the first biocompatible electrically conductive shell in direct electrical communication with a feedthrough pin, wherein the feedthrough pin is electrically isolated from the first biocompatible electrically conductive shell. A cathode can also be disposed within the first biocompatible electrically conductive shell and can be in direct electrical communication with the first biocompatible electrically conductive shell. The first biocompatible electrically conductive shell has a positive electrical potential. The implantable medical device further includes an electronics control subunit with a control circuit disposed within a second biocompatible electrically conductive shell. Other embodiments are included herein.

Abstract: Systems and methods for monitoring and treating patients with heart failure are discussed. The system can store in a memory stimulation parameters, including stimulation timing parameters for a plurality of heart rate ranges. The system includes a plurality of timers with respective durations for the plurality of heart rate ranges. A stimulation control circuit can identify a target heart range in which a detected heart rate falls, and measure an atrioventricular (AV) conduction characteristic value in response to the timer for the target heart range being expired at the detected heart rate. The stimulation control circuit can update a stimulation parameter corresponding to the target heart rate range using the measured AV conduction characteristic. The updated stimulation parameter can be used in cardiac stimulation.

Abstract: This document discusses, among other things, systems and methods to receive physiologic information from a patient and to generate a heart failure status using the received physiologic information. Based on the received physiologic information, the generated heart failure status can be classified into at least one of a set of predetermined phenotype clusters.

Abstract: Systems and methods for managing cardiac arrhythmias are discussed. A data management system receives a first detection algorithm including a detection criterion for detecting a cardiac arrhythmia. An arrhythmia detector detects arrhythmia episodes from a physiologic signal using a second detection algorithm that is different from and has a higher sensitivity for detecting the cardiac arrhythmia than the first detection algorithm. The arrhythmia detector assigns a detection indicator to each of the detected arrhythmia episodes. The detection indicator indicates a likelihood that the detected arrhythmia episode satisfies the detection criterion of the first detection algorithm. The system prioritizes the detected arrhythmia episodes according to the assigned detection indicators, and outputs the arrhythmia episodes to a user or a process according to the episode prioritization.

Abstract: Systems, devices and methods for determining sensing quality changes and drops in an implantable medical device, remotely and/or within the device itself. A cardiac implantable medical device tracks, over time, a number of counters, the contents of which are communicated to a processor which may be part of a remote monitoring device or which may be a customer service center that receives data from remote monitoring devices and/or programmers. Counter data is analyzed to identify changes in sensing quality and/or to provide information useful for clinical investigations, system integrity checking, or device reprogramming.

Abstract: Systems and methods are described for subject rehospitalization management. In an example, multiple physiologic signals can be obtained from a subject using multiple sensors. In response to a hospitalization event, pre-hospitalization characteristics of the multiple physiologic signals can be identified. Post-hospitalization characteristics of the multiple physiologic signals can be identified, including characteristics that differ from their corresponding pre-hospitalization characteristics. Later subsequent physiologic signals can be further monitored after the hospitalization event, such as using the same multiple sensors, and subsequent physiologic signal characteristics can be identified. In an example, a heart failure diagnostic indication can be determined using information about the pre-hospitalization characteristics, the post-hospitalization characteristics, and the subsequent characteristics.

Abstract: Systems and methods are disclosed to determine, in response to a detected atrial sense event in a first cardiac cycle, a ventricular blanking period for the first cardiac cycle and to detect a ventricular sense event in the first cardiac cycle using the received electrical information following the determined ventricular blanking period.

Abstract: Medical devices and methods for making and using medical devices are disclosed. An example medical device may include an implantable medical device. The implantable medical device may include an implantable pacing member having a housing and a lead input. A lead may be coupled to the lead input. The lead may be designed to extend along a pericardial space, epicardium, or both and engage a heart chamber. A passageway may be defined along a portion of the length of the lead.

Abstract: Disclosed herein is an implantable medical device including a housing, a header, a connector port, and a collet assembly. The header can be arranged with the housing. The connector port can be arranged within the header and configured to couple an implantable lead to the header. The collet assembly can be arranged within the connector port and configured to frictionally engage a portion of the implantable lead and to secure the implantable lead with the header in response to insertion of the portion of the implantable lead into the connector port.

Abstract: Systems and methods for cardiac pacing are described in this document. A medical system includes an electrostimulation circuit to generate His-bundle pacing (HBP) pulses to capture a His bundle, and LV pacing (LVP) pulses to capture a left ventricle. A sensing circuit may sense a cardiac activity, such as an atrial or an LV cardiac electrical activity. The system includes a control circuit controlling the delivery of HBP and LVP pulses. The HBP and LVP may be delivered concurrently or sequentially. In an example, the LVP pulses may be delivered based on a His-bundle capture status in response to the HBP pulse. The system may adjust one or more His-bundle stimulation parameters based on the His-bundle capture status.

Abstract: Embodiments herein relate to body vibration analysis systems and methods. In an embodiment, a body vibration analysis system is included having a first light source configured to illuminate a surface of the body from a first angle with a first set of lighted features and a second light source configured to illuminate a surface of the body from a second angle with a second set of lighted features, wherein the second set of lighted features are optically distinguishable from the first set of lighted features. The system further includes a camera configured to detect light reflected from the surface of the body and a control circuit configured to receive an input from the camera and assess spatial vibration as a function of location on the surface of the body. Other embodiments are also included herein.