Abstract: A method includes controlling a cardiac pacing rate of an implantable medical device to control a heart rate of a patient and detecting inhalation and exhalation of the patient. The method further includes determining that the patient is in a resting state, and, in response to determining that the patient is in the resting state, incrementally increasing the pacing rate while exhalation of the patient is detected and incrementally decreasing the pacing rate while inhalation of the patient is detected.

Abstract: A method includes controlling a cardiac pacing rate of an implantable medical device (IMD) to control a heart rate of a patient and determining that the patient is in a resting state. The method further includes modifying the pacing rate of the IMD for N cardiac cycles in response to determining that the patient is in the resting state. N is an integer greater than 1. Modifying the pacing rate includes incrementally increasing the pacing rate for a first portion of the N cardiac cycles, and incrementally decreasing the pacing rate for a second portion of the N cardiac cycles.

Abstract: In a method and apparatus for supplying wireless energy to a medical device (100) implanted in a patient, wireless energy is transmitted from an external energy source (104) located outside a patient and is received by an internal energy receiver (102) located inside the patient, for directly or indirectly supplying received energy to the medical device. An energy balance is determined between the energy sent by the external energy source and energy received by the internal energy receiver, and the transmission of wireless energy is then controlled based on the determined energy balance. The energy balance thus provides an accurate indication of the correct amount of energy needed, which is sufficient to operate the medical device properly, but without causing undue temperature rise.

Abstract: In a method and apparatus for supplying wireless energy to a medical device (100) implanted in a patient, wireless energy is transmitted from an external energy source (104) located outside a patient and is received by an internal energy receiver (102) located inside the patient, for directly or indirectly supplying received energy to the medical device. An energy balance is determined between the energy received by the internal energy receiver and the energy used for the medical device, and the transmission of wireless energy is then controlled based on the determined energy balance. The energy balance thus provides an accurate indication of the correct amount of energy needed, which is sufficient to operate the medical device properly, but without causing undue temperature rise.

Abstract: Techniques are provided for use by implantable medical devices for controlling ventricular pacing. In one example, optimal atrio-ventricular and interventricular pacing delay values are determined for pacing the heart of the patient based, in part, on a measured inter-atrial conduction delay. Atrio-ventricular conduction delays are then measured within the patient. The atrio-ventricular pacing delays are compared with the measured atrio-ventricular conduction delays. If the atrio-ventricular pacing delays are less than the measured atrio-ventricular conduction delays, biventricular pacing is delivered using the atrio-ventricular pacing delay and the interventricular pacing delay.

Abstract: A medical device and associated method obtaining cardiac event intervals corresponding to a tachycardia interval. Evidence of a rhythm breaking point is obtained in response to sensing a cardiac event having a morphology corresponding to a supraventricular beat. A non-treatable rhythm is detected in response to the plurality of cardiac event intervals and the evidence of the rhythm breaking point.

Abstract: Systems and methods are provided in the disclosure for estimating a risk of arrhythmia in a patient using electrocardiographic analysis. In certain aspects, a method of estimating a risk of arrhythmia in a patient is provided. The method comprises receiving electrocardiographic signals of the patient from a plurality of leads over a plurality of heart beats, averaging the electrocardiographic signals to produce an averaged electrocardiographic signal, and determining deflections in the averaged electrocardiographic signal, wherein each deflection has an amplitude and a duration. The method further comprises determining a significance of each deflection based on whether the amplitude of that deflection exceeds a threshold, and estimating a risk of arrhythmia in the patient based on at least one of a number, the amplitudes, and the durations of the significant deflections within a portion of the averaged electrocardiographic signal.

Abstract: The disclosure is directed towards posture-responsive therapy. To avoid interruptions in effective therapy, an implantable medical device may include a posture state module that detects the posture state of the patient and automatically adjusts therapy parameter values according to the detected posture state. A system may include a posture state module that records a current posture of a patient, a user interface that receives a therapy adjustment, a processor that associates a posture that the posture state module recorded when the user interface received the therapy adjustment with the therapy adjustment, determines whether the posture falls within a defined posture state, compares the therapy adjustment to therapy information associated with the defined posture state, and updates the set of posture state definitions based on the determination and comparison.

Abstract: NMES systems and methods for stimulating muscle tissue, and in some embodiments deep muscle tissue. The impedance near the surface of the skin is controllably increased to increase the percentage of energy delivered to a subject that stimulates muscle tissue.

Abstract: An implantable medical device that measures respiration parameters based on transthoracic impedance signals, and converts transthoracic impedance signals into a time series of digital values which is filtered with morphological operators to separate the signal into a respiratory component and a cardiac component. Metrics are generated based on the filtered impedance values such as respiratory rate, I/E ratio, tidal volume and minute ventilation.

Abstract: A pacemaker initiates and times a monitoring interval in response to an event such as a therapy delivery to a patient. The monitoring interval is specified to include a duration of an anticipated acute response to the event, such as vagal surge. One or more physiological parameters indicative of the acute response are detected during the monitoring interval for analyzing therapeutic effect of the event. In various embodiments, one or more pacing parameters are adjusted for a response interval specified to include the duration of the anticipated acute response to allow for the analysis and maximization of the therapeutic effect. In various embodiments, the event includes a session of pacing therapy delivered according to an intermittent cardiac stress augmentation pacing protocol, and the therapeutic effect is analyzed to adjust that protocol.

Abstract: The disclosure includes methods and systems for treating cardiac arrhythmias. Some methods for treating an abnormal heart rhythm include determining a change in a sinus node cycle length of a heart of a patient between a time prior to the abnormal heart rhythm and a time during the abnormal heart rhythm; when the change is within a first range, delivering a first therapy to the patient for treating the abnormal heart rhythm; and when the change is within a second range, delivering a second therapy to the patient for treating the abnormal heart rhythm, wherein the first therapy is different from the second therapy. In some embodiments, the first therapy may include shock therapy and the second therapy may include anti-tachycardia pacing.

Abstract: A medical device and associated method for discriminating cardiac events includes determining whether a cardiac evidence counter is greater than a predetermined detection threshold, advancing from a concerned state to a convinced state in response to the evidence counter being greater than the predetermined detection threshold, determining whether a reduction in the cardiac evidence counter occurs while in the convinced state, determining whether one of a first rate corresponding to the first sensing vector and a second rate corresponding to the second sensing vector is less than a predetermined rate limit, and determining whether to advance from the convinced state to one of a therapy delivery state, the concerned state and the unconcerned state in response to determining whether one of the first rate and the second rate is less than a predetermined rate limit.

Abstract: Defibrillator lead designs and methods for manufacturing a lead including attachment between a fibrosis-limiting material covering, a shocking coil electrode, and an implantable lead body are disclosed herein. The shocking coil electrode includes at least one treated portion. The fibrosis limiting material includes a selectively modified portion that is disposed over the at least one treated portion.

Abstract: A medical device and associated method for discriminating cardiac events includes determining whether a cardiac evidence counter is greater than a predetermined detection threshold, determining whether to advance from a current state to a next state in response to the evidence counter being greater than the predetermined detection threshold, determining whether advancing from a previous state to the current state occurred while in one of a low variability mode and a high variability mode during the previous state, and determining whether to advance from the current state to a previous state in response to determining whether advancing from a previous state to the current state occurred while operating in one of a low variability mode and a high variability mode during the previous state.

Abstract: Cardioprotective pre-excitation pacing may be applied to stress or de-stress a particular myocardial region delivering of pacing pulses in a manner that causes a dyssynchronous contraction. Such dyssynchronous contractions are responsible for the desired cardioprotective effects of pre-excitation pacing but may also be hazardous. Described herein is a method and system that uses measures of a patient's physiological response to ventricular dyssynchrony to control the duty cycles of intermittent pre-excitation pacing.

Abstract: An implantable medical device that includes an optical sensor for providing a signal corresponding to light attenuation by a volume of blood perfused tissue, a control module coupled to the optical sensor controlling the light emitted by the optical sensor, a monitoring module receiving an optical sensor output signal and measuring light attenuation, a tissue electrode for stimulating the volume of blood perfused tissue, a pulse generator coupled to the tissue electrode for delivering electrical stimulation to the volume of blood-perfused tissue, and a processor coupled to the cardiac electrode and the monitoring module and configured to detect an arrhythmia in response to the depolarization signals, compute a tissue oxygenation measurement and control the pulse generator to deliver electrical stimulation to the volume of blood-perfused tissue in response to detecting the arrhythmia, and detect a hemodynamic status of the arrhythmia in response to at least one of a detected rate of tissue oxygenation decline

Abstract: Systems and methods for pacing the heart using resynchronization pacing delays that achieve improvement of cardiac function are described. An early activation pacing interval is calculated based on an optimal AV delay and an atrial to early ventricular activation interval between an atrial event and early activation of a ventricular depolarization. The early activation pacing interval for the ventricle is calculated by subtracting the measured AVEA from the calculated optimal AV delay. The early activation pacing interval is initiated responsive to sensing early activation of the ventricle and pacing is delivered relative to expiration of the early activation pacing interval.

Abstract: A medical device and associated method for monitoring a patient's heart rhythm sense cardiac events and detect a sudden change in the heart rhythm in response to the sensed cardiac events. Detecting the sudden change includes determining a variability of intervals between the sensed cardiac events and switching between a low variability mode of operation and a high variability mode of operation in response to the variability of intervals. During the low variability mode, detecting the sudden change includes detecting an increase in the rate of cardiac events. During the high variability mode, detecting the sudden change includes detecting a sudden decrease in the variability of the cardiac event intervals. A concerning cardiac rhythm is detected in response to detecting the sudden change.

Abstract: Heart monitor for detecting ectopic beats in an input electrocardiogram signal that includes an electrocardiogram signal input and a morphological signal analyzer connected to the electrocardiogram signal input, the analyzer being adapted to generate a first time series of values representing the input electrocardiogram signal, a second signal analyzer adapted to generate generating a modified time series of values representing a trend of values of the first time series and a comparison stage being adapted to compare the first time series with the modified time series to thus detect ectopic beats.