Abstract: An example of a system may include a stimulator and at least one controller. The stimulator may be configured to deliver nerve stimulation to capture a first set of axons in a nerve and to deliver depletion block stimulation to capture a second set of axons in the nerve, where the second set is a subset of the first. The depletion block stimulation may include a series of pulses at a depletion pulse frequency within a range between about 100 Hz to about 1 kHz, and the nerve stimulation may include a series of pulses at a stimulation pulse frequency within a range of about 0.25 Hz to about 50 Hz. At least a portion of the nerve stimulation and at least a portion of the depletion block stimulation may be delivered to be effective in providing a nerve block while delivering nerve stimulation.

Abstract: Systems and methods for pacing cardiac conductive tissue are described. A medical system includes an electrostimulation circuit to generate His-bundle pacing (HBP) pulses. A sensing circuit senses a physiologic signal, and detect a local His-bundle activation discrete from a pacing artifact of the HBP pulse. A control circuit verifies capture status in response to the HBP pulses. Based on the capture status, the control circuit determines one or more pacing thresholds including a selective HBP threshold representing a threshold strength to capture only the His bundle but not the local myocardium, and a non-selective HBP threshold representing a threshold strength to capture both the His bundle and the local myocardium. The electrostimulation circuit may deliver HBP pulses based on the selective and non-selective HBP thresholds.

Abstract: An example of a method embodiment may include receiving a user programmable neural stimulation (NS) dose for an intermittent neural stimulation (INS) therapy, and delivering the INS therapy with the user programmable NS dose to an autonomic neural target of a patient. Delivering the INS therapy may include delivering NS bursts, and delivering the NS bursts may include delivering a number of NS pulses per cardiac cycle during a portion of the cardiac cycles and not delivering NS pulses during a remaining portion of the cardiac cycles. The method may further include sensing cardiac events within the cardiac cycles, and controlling delivery of the user programmable NS dose of INS therapy using the sensed cardiac events to time delivery of the number of NS pulses per cardiac cycle to provide the user programmable NS dose. The user programmable NS dose may determine the number of NS pulses per cardiac cycle.

Abstract: A neurostimulation system provides for capture verification and stimulation intensity adjustment to ensure effectiveness of vagus nerve stimulation in modulating one or more target functions in a patient. In various embodiments, stimulation is applied to the vagus nerve, and evoked responses are detected to verify that the stimulation captures the vagus nerve and to adjust one or more stimulation parameters that control the stimulation intensity.

Abstract: A neurostimulation system delivers neurostimulation to a patient using one or more primary parameters and one or more secondary parameters. The one or more primary parameters are controlled for maintaining efficacy of the neurostimulation. The one or more secondary parameters are adjusted for preventing the patient from developing neural accommodation. In various embodiments, values for the one or more secondary parameters are varied during the delivery of the neurostimulation for prevention of neural accommodation that may result from a constant or periodic pattern of stimulation pulses.

Abstract: Systems and methods for managing heart failure are described. The system receives physiological information including a first HS signal corresponding to paced ventricular contractions and a second HS signal corresponding to intrinsic ventricular contractions. The system detects worsening heart failure (WHF) using the received physiological information. A signal analyzer circuit can generate a paced HS metric from the first HS signal and a sensed HS metric from the second HS signal, and determine a concordance indicator between the paced and the sensed HS metrics. In response to the detected WHF, the system can use the concordance indicator to generate a therapy adjustment indicator for adjusting electrostimulation therapy, or a worsening cardiac contractility indicator indicating the detected WHF is attributed to degrading myocardial contractility.

Abstract: A neurostimulation system provides for capture verification and stimulation intensity adjustment to ensure effectiveness of vagus nerve stimulation in modulating one or more target functions in a patient. In various embodiments, stimulation is applied to the vagus nerve, and evoked responses are detected to verify that the stimulation captures the vagus nerve and to adjust one or more stimulation parameters that control the stimulation intensity.

Abstract: An example of a system may include a depletion block neural stimulator and a depletion block controller. The depletion block neural stimulator may be configured to deliver a depletion block stimulation to a nerve. The depletion block stimulation may include a series of pulses at a pulse frequency within a range between about 100 Hz to about 1000 Hz. The depletion block controller may be configured to communicate with the depletion block neural stimulator and control the depletion block stimulation. The depletion block controller may be configured to receive a start depletion block signal and respond to the received start depletion block signal by initiating the delivery of the depletion block stimulation to the nerve, and the depletion block controller may be configured to receive a stop depletion block signal and respond to the received stop depletion block signal by terminating the delivery of the depletion block stimulation to the nerve.

Abstract: Systems and methods for managing machine-generated medical events detected from one or more patients are described herein. A medical event management system includes an event analyzer circuit to detect a medical event using physiological data from a patient-triggered episode acquired from a medical device. The event analyzer circuit determines a confidence score of the medical event detection, and generates an alignment indicator indicating a degree of concordance between the detected medical event and the information about the patient-triggered episode. The system assigns priority information to the patient-triggered episode using the generated alignment indicator and the confidence score of the detection. An output circuit can output the received physiological information to a user or a process according to the assigned priority information.

Abstract: An apparatus comprises a stimulus circuit, a switch circuit, and a control circuit. The stimulus circuit is configured to provide electrical pulse stimulation to the plurality of electrodes. The switch circuit is configured to electrically couple different combinations of the electrodes to the stimulus circuit. The control circuit is to configure a stimulation vector that includes a first vector electrode and a plurality of other electrodes electrically coupled together to form a second combined vector electrode. The control circuit includes a capture detection sub-circuit configured to determine individual capture stimulation thresholds between the first vector electrode and each single electrode of the combined vector electrode. The control circuit is configured to determine a capture stimulation threshold of the stimulation vector using the determined individual capture thresholds.

Abstract: Systems and methods for monitoring and treating patients with heart failure (HF) are discussed. The system may sense cardiac signals, and receives information about patient physiological or functional conditions. A stimulation parameter table that includes recommended values of atrioventricular delay (AVD) or other timing parameters maybe created at a multitude of patient physiological or functional conditions. The system may periodically reassess patient physiological or functional conditions. A therapy programmer circuit may dynamically switch between left ventricular-only pacing and biventricular pacing, or switch between single site pacing and multisite pacing based on the patient condition. The therapy programmer circuit may adjust AVD and other timing parameters using the cardiac signal input and the stored stimulation parameter table. A HF therapy may be delivered according to the determined stimulation site, stimulation mode, and the stimulation timing.

Abstract: Systems and methods for monitoring and treating patients with heart failure (HF) are discussed. The system may sense cardiac signals, and receives information about patient physiological or functional conditions. A stimulation parameter table that includes recommended values of atrioventricular delay (AVD) or other timing parameters maybe created at a multitude of patient physiological or functional conditions. The system may periodically reassess patient physiological or functional conditions. A therapy programmer circuit may dynamically switch between left ventricular-only pacing and biventricular pacing, or switch between single site pacing and multisite pacing based on the patient condition. The therapy programmer circuit may adjust AVD and other timing parameters using the cardiac signal input and the stored stimulation parameter table. A HF therapy may be delivered according to the determined stimulation site, stimulation mode, and the stimulation timing.

Abstract: Systems and methods for monitoring and treating patients with heart failure (HF) are discussed. The system may sense cardiac signals, and receives information about patient physiological or functional conditions. A stimulation parameter table that includes recommended values of atrioventricular delay (AVD) or other timing parameters maybe created at a multitude of patient physiological or functional conditions. The system may periodically reassess patient physiological or functional conditions. A therapy programmer circuit may dynamically switch between left ventricular-only pacing and biventricular pacing, or switch between single site pacing and multisite pacing based on the patient condition. The therapy programmer circuit may adjust AVD and other timing parameters using the cardiac signal input and the stored stimulation parameter table. A HF therapy may be delivered according to the determined stimulation site, stimulation mode, and the stimulation timing.

Abstract: Systems and methods for monitoring patient for syncope are discussed. A syncope monitor system can detect a precipitating event associated with a syncope onset, and acquire hemodynamic data in response to the detection of the precipitating event. A syncope analyzer circuit may generate temporal profiles of one or more hemodynamic parameters using the hemodynamic data. The syncope analyzer may use the temporal profiles to detect a syncopal event and to classify the syncopal event into one of a plurality of syncope categories. The detection and classification information may be output to a user or a process.

Abstract: This document discusses, among other things, systems and methods to receive physiologic information of a patient, to receive pulse pressure information from the patient different than the received physiologic information, and to determine an indication of atrial fibrillation (AF) using the received physiologic information and the received pulse pressure information.

Abstract: An example of a method performed by an implantable medical device (IMD) to deliver a therapy to a patient may include delivering the therapy to the patient, detecting a trigger that is controlled by the patient or a caregiver to the patient, and determining if at least one feature of the IMD for responding to a trigger is enabled. The IMD may be configured to allow the patient or the caregiver to the patient to enable the at least one feature. The method may further include, when the at least one feature is enabled, automatically implementing the at least one enabled feature in response to the detected trigger, including automatically suspending the therapy in response to the detected trigger and automatically restoring the therapy after a defined period after the detected trigger.

Abstract: This document discusses, among other things, systems and methods for managing pain of a subject. A system may include a motion sensor configured to sense at least one functional signal indicative a physical state of the subject. The at least one functional signal may include at least one motor activity signal or at least one sleep state signal. A pain analyzer circuit may extract, from the functional signal, signal metrics indicative of subject motor control or kinetics, and generate a pain score using the signal metrics. The pain score may be output to a user or a process. The system may additionally include an electrostimulator to generate and deliver a closed-loop pain therapy according to the pain score.

Abstract: According to an embodiment of a method performed by an implantable medical device to deliver a neural stimulation therapy to a patient, a lower dose of the neural stimulation therapy is delivered to the patient. The dose of the neural stimulation therapy is automatically increased from the lower dose to a higher dose, and the higher dose of the neural stimulation therapy is delivered to the patient. A trigger that is controlled by the patient is detected, and the dose of the neural stimulation therapy is automatically returned from the higher dose back to the lower dose in response to detecting the trigger.

Abstract: Methods and systems for selecting electrical stimulation parameters for an electrical stimulation device implanted in a patient can use an iterative process for identifying electrodes for stimulation, as well as suitable stimulation parameters. The process begins with an initial set of electrode combinations to identify regions of the nerve or other tissue for stimulation. This leads to selection of other electrode combinations to test, followed by the selection of multiple electrode groups (which can include three or more electrodes) for stimulation.

Abstract: This document discusses, among other things, systems and methods for monitoring a patient at risk of epilepsy. A system comprises a sensor circuit that senses from the patient at least first and second physiological or functional signals. A wellness detector circuit can detect an epileptic event using the sensed physiological or functional signals, or additionally classify the epileptic event into one of epileptic seizure types. The system can generate a wellness indicator based on a trend of the physiological or functional signal during the detected epileptic event. The wellness indicator indicates an impact of the detected epileptic event on the health status of the patient. The system includes an output unit configured to output the detection of the epileptic event or the wellness indicator to a user or a process.