Abstract: An apparatus comprises a cardiac signal sensing circuit configured for coupling electrically to a plurality of electrodes and to sense intrinsic cardiac activation at three or more locations within a subject's body using the electrodes; a stimulus circuit configured for coupling to the plurality of electrodes; a signal processing circuit electrically coupled to the cardiac signal sensing circuit and configured to determine a baseline intrinsic activation vector according to the sensed intrinsic cardiac activation; and a control circuit electrically coupled to the cardiac signal sensing circuit and stimulus circuit and configured to: initiate delivery of electrical pacing therapy using initial pacing parameters determined according to the baseline intrinsic activation vector; initiate sensing of a paced activation vector; and adjust one or more pacing therapy parameters according to the paced activation vector.

Abstract: An implantable leadless cardiac pacing device and associated delivery and retrieval devices. The implantable device includes a docking member extending from the proximal end of the housing of the implantable device configured to engage with the delivery and/or retrieval device to facilitate delivery and/or retrieval of the implantable leadless cardiac pacing device.

Abstract: Delivery devices, systems, and methods for delivering an implantable leadless pacing device having an outer peripheral surface are disclosed. An example delivery device may include a proximal section including a distal end, and a distal holding section extending distally of a distal end of the proximal section. The distal holding section defines a cavity therein for receiving the implantable leadless pacing device, and may be configured to apply a holding force to the implantable leadless pacing device. In some cases, the distal holding section may be configured to apply a compressive force to the outer peripheral surface of the leadless pacing device when the leadless pacing device is disposed in the cavity.

Abstract: Catheter and implantable leadless pacing devices, systems, and methods utilizing catheters and implantable leadless pacing devices are disclosed. An example catheter system may include a holding structure extending distally from a tubular member. An implantable device, such as a leadless pacing device, may be located within a cavity of the holding structure. The holding structure may include one or more electrical ports adjacent the proximal end of the holding structure and adjacent or proximal of the proximal end of the implantable device. The electrical ports may provide a conductive pathway extending through the distal structure to allow electrical signals to pass through the distal structure to and/or from the implantable device.

Abstract: At least one of a first medical device and a second medical device may be implanted within a patient while the second medical device may optionally be proximate but external to the patient. At least one of the medical devices has an antenna having at least two electrodes and at least one of the medical devices has an antenna having at least three electrodes. The medical devices can communicate via conducted communication through the patient's tissue between a first pair of electrodes and a second pair of electrodes. At least one of the pairs of electrodes can be selected in accordance with the signal strength of the communication vector between the first and second pairs of electrodes.

Abstract: Embodiments herein include implantable medical systems, devices and methods including chemical sensors. In an embodiment, an implantable medical device system includes a chemical sensor; a fluid state sensor such as a posture sensor; an activity sensor; and/or a respiration sensor. The implantable medical device system can further include normalization circuitry receiving data from the chemical sensor and the fluid state sensor and normalizing the chemical sensor data based on data from the fluid state sensor. In an embodiment, a method of operating an implantable medical device system is included. The method can include measuring the amount of a chemical analyte using a chemical sensor, measuring the fluid status in a patient using a fluid state sensor, and normalizing the measured amount of the chemical analyte as indicated by the chemical sensor using normalization circuitry based on data from the fluid state sensor. Other embodiments are also included herein.

Abstract: A leadless pacing device may include a housing, a distal extension extending distally of a distal end of the housing, one or more electrodes supported by the housing, a distal electrode supported by the distal extension, and a processing module located within an interior space of the housing and electrically coupled to the one or more electrodes supported by the housing and the distal electrode supported by the distal extension. The housing may be positioned within a coronary sinus and the distal extension may be positioned within a vessel extending from the coronary sinus. The processing module may determine whether cardiac events occurred based on near-field signals and/or far-field signals sensed using the one or more electrodes supported by the housing and the distal electrode. The processing module may generate cardiac stimulation pulses based on the determination of whether a cardiac event occurred and where it occurred.

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: 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: This document discusses, among other things, apparatus, systems, and methods to determine a first atrial fibrillation (AF) indication using received information about a heart over a first period, to cluster depolarization information about the heart over the first period, and to discriminate between an atrial fibrillation (AF) event and a non-AF event in the first period using the determined first AF indication the clustered depolarization information.

Abstract: An apparatus includes a sensing circuit configured to generate a sensed physiological signal that includes physiological information of a subject, a detection circuit, and a control circuit. The detection circuit detects a physiological condition of a subject using the physiological signal. The control circuit stores sampled values of a segment of the physiological signal in temporary memory storage; and stores the sampled values in non-temporary storage in response to receiving an indication of continued detection of the physiological condition.

Abstract: According to various method embodiments, a person is indicated for a therapy to treat a cardiovascular disease, and the therapy is delivered to the person to treat the cardiovascular disease. Delivering the therapy includes delivering a vagal stimulation therapy (VST) to a vagus nerve of the person at a therapeutically-effective intensity for the cardiovascular disease that is below an upper boundary at which upper boundary the VST would lower an intrinsic heart rate during the VST.

Abstract: A system for recharging an implantable medical device having a rechargeable battery while the implantable medical device is implanted within a patient includes a recharge energy source configured to be disposed exterior to the patient and a recharging bridge configured to be implanted within the patient. The recharging bridge is configured to facilitate energy transfer from the recharge energy source to the implantable medical device.

Abstract: A leadless cardiac pacemaker (LCP) is configured to sense cardiac activity and to pace a patient's heart and is disposable within a ventricle of the patient's heart. The LCP may include a housing, a first electrode and a second electrode that are secured relative to the housing and are spaced apart. A controller is disposed within the housing and is operably coupled to the first electrode and the second electrode such that the controller is capable of receiving, via the first electrode and the second electrode, electrical cardiac signals of the heart. The LCP may include a pressure sensor and/or an accelerometer. The controller may determine an atrial contraction timing fiducial based at least in part upon two or more of a signal from the pressure sensor, a signal from the accelerometer representing, and an electrical cardiac signal.

Abstract: This document discusses, among other things, systems and methods to adjust arrhythmia detection using physiological information of a patient, including detecting a candidate cardiac event about a threshold, displaying the detected candidate cardiac event to a user, receiving user information about the detected candidate cardiac event, and adjusting an arrhythmia detection threshold based upon the received user information.

Abstract: An implantable device, such as a pacer, defibrillator, or other cardiac rhythm management device, can include one or more MRI Safe components. In an example, the implantable device includes a battery including a first electrode and a second electrode separate from the first electrode. The second electrode includes a first surface and a second surface. The second electrode includes a slot through the second electrode from the first surface toward the second surface. The slot extends from a perimeter of the second electrode to an interior of the second electrode. The slot is configured to at least partially segment a surface area of the second electrode to reduce a radial current loop size in the second electrode.

Abstract: Implantable medical device systems and methods of use including an implantable first medical device having a lead with a transducer thereon and an implantable second medical device having a receiver for receiving energy emitted by the transducer. The lead may be placed in an internal thoracic vein, and other locations may be used as well. The implantable second medical device may be placed in or on the heart or an associated blood vessel.

Abstract: Systems and methods for evaluating electrostimulation of a heart are disclosed. A system can comprise an electrostimulation circuit that can deliver multi-site electrostimulation, including pacing at two or more sites of the heart during the same cardiac cycle. The system can comprise a heart sound sensor circuit configured to sense a heart sound (HS) signal during multi-site stimulation. The heart sound sensor circuit can also sense HS signals in response to uni-site stimulation at a specified site capturing at least a portion of the heart. The system can comprise a pacing analyzer circuit that uses the HS signals during the multi-site stimulation and during the uni-site stimulation to determine a capture status indication that indicates whether the multi-site stimulation captures the two or more sites of the heart, and can be one of a full capture indication, a partial capture indication, or a loss of capture indication.

Abstract: In various method embodiments for operating an implantable neural stimulator to deliver a neural stimulation therapy to an autonomic neural target, the method comprises using the implantable neural stimulator to deliver the neural stimulation therapy to the autonomic neural target, and evaluating an evoked response to the neural stimulation bursts. The neural stimulation therapy includes a plurality of neural stimulation bursts where each neural stimulation burst includes a plurality of neural stimulation pulses and successive neural stimulation bursts are separated by a time without neural stimulation pulses. Evaluating the evoked response includes sensing the evoked response to the neural stimulation bursts where sensing the evoked response includes sensing at least one physiological parameter affected by the neural stimulation bursts, comparing the sensed evoked response against a baseline, and determining if the evoked response substantially returns to the baseline between neural stimulation bursts.

Abstract: The disclosure pertains to percutaneously deliverable bioabsorbable closure devices for an ostium of a left atrial appendage which devices promote endothelialization across the ostium and then are bioabsorbed to leave little or no foreign residue, methods of manufacturing such bioabsorbable closure devices, and the use thereof.