Abstract: Systems and methods described herein improve visibility of P-waves of an EGM or ECG signal segment to be displayed on a display screen. There is a determination of whether relatively small features, including the P-waves, of the ECG or EGM signal segment would be difficult to visualize if an original signal segment range of the ECG or EGM signal segment were caused to be displayed on the display screen. In response to determining that the relatively small features of the ECG or EGM signal segment would be difficult to visualize, a portion of the EGM or ECG signal segment is displayed on the display screen in a manner that magnifies the P-waves of the EGM or ECG signal segment compared to if an entirety of the EGM or ECG signal segment within the original signal segment range were instead caused to be displayed on the display screen.

Abstract: Described herein are methods, devices, and systems that use electrogram (EGM) or electrocardiogram (ECG) data for sleep apnea detection. An apparatus and method detect potential apnea events (an apnea or hypopnea event) using a signal indicative of cardiac electrical activity of a patient's heart, such as an EGM or ECG. Described herein are also methods, devices, and systems for classifying a patient as being asleep or awake, which can be used to selectively enable and disable sleep apnea detection monitoring, as well as in other manners.

Abstract: A method and device for dynamic device based AV delay adjustment are provided. The method provides electrodes that are configured to be located proximate to an atrial (A) site and a right ventricular (RV) site. The method utilizes one or more processors, in an implantable medical device (IMD), for detecting an atrial paced (Ap) event or atrial sensed (As) event. The method determines a measured AV interval corresponding to an interval between the Ap event or the As event and a ventricular sensed event and calculates a percentage-based (PB) offset based on the measured AV interval. The method automatically dynamically adjusting an AV delay, utilized by the IMD, based on the measured AV interval and the PB offset and manages a pacing therapy, utilized by the IMD, based on the AV delay after the adjusting operation.

Abstract: A method and system for managing delivery of a respiration gated defibrillation shock from a subcutaneous implantable medical device (S-IMD) having one or more extra vascular electrodes. The method and system sense cardiac events of a heart. Additionally, the method and system utilize one or more processors to declare a shockable arrhythmia based on the cardiac events, obtain a respiration proxy signal indicative of respiration, track a respiration state related (RSR) characteristic from the respiration proxy signal, gate delivery of a high voltage (HV) shock based on occurrence of a respiration-gated (RG) trigger in connection with the RSR characteristic, and deliver the HV shock along a shocking vector between extra vascular electrodes based on the RG trigger to time delivering of the HV shock to occur during the select state within the respiration cycle.

Abstract: Methods and systems are provided for a rate adaptive bi-ventricular fusion pacing. The methods and systems deliver a first pulse at a left ventricular (LV) lead and a second pulse at a right ventricular (RV) lead based on a paced atrio-ventricular (AV) delay. The first pulse timed to be delivered concurrently with an intrinsic ventricular conduction. The methods and systems further repeat the delivery of the first pulse and the second pulse for a predetermined number of cycles. Additionally, the methods and systems measure an intrinsic AV conduction interval, and adjust the paced AV delay based on the intrinsic AV conduction interval and a negative hysteresis delta.

Abstract: Described herein are apparatuses and methods to detect tachycardias and selectively reject false tachycardia detections due to T-wave oversensing or noise. An apparatus includes electrodes, a sensing circuit coupled to at least two of the electrodes and configured to sense a signal indicative of cardiac electrical activity, and a smoothing filter configured to filter to the sensed signal indicative of cardiac electrical activity to thereby produce a filtered signal indicative of cardiac electrical activity. The apparatus produces a difference signal indicative of cardiac electrical activity by determining a difference between the sensed and filtered signals indicative of cardiac electrical activity. The apparatus also includes at least one processor configured to detect a tachycardia, or to determine whether or not to reject a tachycardia detection, based on the difference signal. The smoothing filter and/or difference circuitry can be implemented by the at least one processor, and/or other circuitry.

Abstract: Described herein are methods, devices, and systems that enable a remote non-implantable device (RNID) to send commands to a leadless pacemaker (LP) implanted within a patient. The RNID provide commands to a local non-implantable device (LNID) over one or more communication networks, and the LNID sends the commands to a second implantable device (SID) by transmitting radio frequency (RF) communication signals, which include the commands, using an antenna of the LNID. After receiving the commands from the LNID, by receiving RF communication signals that include the commands using an antenna of the SID, the SID transmits conductive communication signals, which include the commands, using electrodes of the SID. The LP receives the commands from the SID by receiving the conductive communication signals, which include the commands, using electrodes of the LP, and the LP performs command responses based on the commands that originated from the RNID.

Abstract: A system for verifying a candidate pathologic episode of a patient is provided that includes an accelerometer configured to be implanted in the patient. The accelerometer is configured to obtain accelerometer data along at least one axis. The system also includes a memory configured to store program instructions, and one or more processors that, when executing the program instructions, are configured to obtain accelerometer data. The one or more processors are also configured to determine a plurality of control three-dimensional point vectors related to the accelerometer data, and obtain a biological signal and identify a candidate pathologic episode based on the biological signal. The one or more processors are also configured to analyze the plurality of control three-dimensional point vectors to identify a physical action experienced by the patient, and verify the candidate pathologic episode based on the physical action.

Abstract: Systems, methods, and devices are provided for determining an early battery depletion (EBD) condition of an implantable medical device that includes a memory storing program instructions and a processor executing the program instructions. Circuitry is electrically coupled to the processor, and the circuitry and processor perform one or more tasks related to at least one of collecting signals indictive of physiologic activity, analyzing collected signals, delivering therapy, or communicating with an external device. A battery supplies energy to the circuitry and processor. A monitoring circuit coupled to the battery measures actual energy usage from the battery representing at least one of a current draw from the battery during corresponding tasks or a voltage measurement across the battery. Circuitry and processor calculate projected energy usage from the battery in connection with the corresponding tasks, and determine when an EBD condition exists based on projected energy usage and actual energy usage.

Abstract: A system and method for use during an implant procedure during which a delivery system is being used to implant a leadless pacemaker (LP) within a patient may, while the delivery system is being used to position the LP at a potential implant site within the patient: receive, from the LP, data comprising one or more pacing impedance measurements and at least one measurement obtained by the LP other than pacing impedance; provide the data to a model that is produced prior to the implant procedure based on data collected from other patients; and use the model to output an indication of whether the LP should be chronically implanted at the potential implant site.

Abstract: Described herein are apparatuses and methods for classifying a patient as being asleep or awake. Such an apparatus can include an accelerometer and a processor. The accelerometer, alone or in combination with the processor, is used to determine an activity level of the patient and a posture of the patient. The processor is configured to classify the patient as being asleep in response to both (i) the posture of the patient being recumbent or reclined for at least a sleep latency duration, and (ii) the activity level of the patient not exceeding an activity threshold for at least the sleep latency duration; and classify the patient as being awake in response to at least one of (iii) the posture of the patient being upright for at least an awake latency duration, or (iv) the activity level of the patient exceeding the activity threshold for at least the awake latency duration.

Abstract: Described herein is an ED configured to wirelessly communicate with an IMD, a method for use by the ED, a system including the ED and the IMD, and a method for use by such a system. While a wireless connection is being established between the ED and the IMD, the ED receive an IMD anchor point transmitted by the IMD, and the ED stores the IMD anchor point and an ED anchor point. Thereafter, time stamps of signal data and the stored anchor points are used to synchronize the display of different physiologic signals, at least one of which is displayed based on signal data obtained from the IMD via the wireless connection, and another of which is obtained by the ED not using the wireless connection. Such embodiments enable the synchronized co-display of such physiologic signals even in noisy environments where the wireless connection is relatively poor.

Abstract: Systems and methods described herein improve visibility of features (e.g., P-waves) of a physiologic signal segment (e.g., an EGM or ECG signal segment) to be displayed within a display band having a specified height between an upper and a lower boundary of the display band. The physiologic signal segment is divided into sub-segments, for each of which a sub-segment minimum peak amplitude and maximum peak amplitude are determined. Based thereon, a new minimum peak amplitude and a new maximum peak amplitude are determined and used to determine a new display range. A portion of the physiologic signal segment that is within the new display range is caused to be display, within the display band having the specified height, such that the upper boundary of the display band corresponds to the new maximum peak amplitude, and the lower boundary of the display band corresponds to the new minimum peak amplitude.

Abstract: A leadless biostimulator, such as a leadless pacemaker, including a header assembly having a monolithic controlled release device (MCRD) for therapeutic agent elution, is described. The MCRD is in fluid communication with a space between an insulator and an electrode of the header assembly to elute therapeutic agent into the space when the leadless biostimulator is implanted. The therapeutic agent can elute through the space around the electrode to provide controlled elution of the therapeutic agent to a surrounding environment. The electrode can extend longitudinally through the insulator cavity to a distal tip that provides a stable surface area and controlled impedance for pacing a target tissue. Other embodiments are also described and claimed.

Abstract: Described herein are implantable medical devices (IMDs), and methods for use therewith. In certain embodiments, a controller of an IMD controls when a pacing capacitor of the IMD is charged using a first voltage, when the pacing capacitor is being charged using a second voltage, and when the pacing capacitor is discharged to deliver a pacing pulse between anode and cathode electrodes of, or electrically coupled to, the IMD. By selectively charging the pacing capacitor for a portion of a charge duration using the second voltage, that is greater in magnitude than the first voltage that is used for delivering the pacing pulse, a magnitude of a polarization artifact superimposed on an evoked response within a cardiac electrical signal, sensed using a sensing circuit of the IMD, is reduced compared to if the pacing capacitor were instead charged using the first voltage for the entire charge duration.

Abstract: Dual chamber leadless pacemaker systems comprising an aLP and a vLP, and methods for use therewith, are disclosed. Such systems and methods can detect and terminate pacemaker mediated tachycardia (PMT) even when the implant-to-implant (i2i) communication from the vLP to aLP (V2A) is compromised. The vLP monitors for PMT in response to reception of an i2i communication from the aLP indicating compromised V2A i2i communication and initiates, following detection of a PMT, initiate a PMT PV interval in response to reception of an i2i communication from the aLP indicating an atrial sensed event. The PMT PV interval is shorter than a PV interval that the vLP would otherwise use for ventricular pacing if PMT was not detected. The vLP also delivers a ventricular pacing pulse to the ventricular cardiac chamber in response to the PMT PV interval expiring without an intrinsic ventricular event being detected during the PMT PV interval.

Abstract: A lead for an implantable medical device (IMD) includes an electrode having a plurality of brick segments that are discrete and mechanically connected to one another in a line. The brick segments are electrically conductive and electrically connected to one another. The brick segments are configured to be powered by a pulse generator of the IMD to deliver high-voltage shocks for defibrillation therapy.

Abstract: Described herein are leadless pacemakers (LPs) and methods for use therewith. In certain embodiments an LP stores a polarization artifacts template or a capture plus polarization artifacts template in memory of the LP. The LP uses the stored template when performing autocapture and/or other types of capture detection to mitigate adverse effects of electrode polarization. Such embodiments are especially useful where the LP is an atrial LP, but can also be used to other types of LPs, such as a ventricular LP.

Abstract: Systems and methods for an implantable medical device which utilizes a patch antenna for communicating with an external device. The implantable medical device includes a housing, a header, and a patch antenna formed using an RF plate and a ground plate, which may be or include a metal surface of the housing. Also, a material of the header forms a dielectric of the patch antenna.

Abstract: A leadless biostimulator, such as a leadless cardiac pacemaker, having a header assembly that includes overmolded components, is described. The header assembly includes a helix mount overmolded on a flange of an electrical feedthrough assembly. A fixation element is mounted on the helix mount. The overmolded helix mount fills a recess in an outer surface of the flange to robustly join the header assembly components. The electrical feedthrough assembly includes an electrode contained within the flange to deliver electrical impulses to a target anatomy, and an insulator that separates the electrode from the flange. The overmolded helix mount can conform or adhere to the outer surfaces of the flange and the insulator to electrically isolate the electrode from the flange. Other embodiments are also described and claimed.