Abstract: A system is provided that includes a first electrode configured to be located within a septal wall, and a second electrode configured to be located outside of the septal wall. The system also includes an impedance circuit configured to measure impedance along an impedance monitoring (IM) vector between the first and second electrodes. One or more processors are also provided that are configured to obtain impedance data indicative of an impedance along the IM vector with the first electrode located at different depths within the septal wall, the impedance data including a set of data values associated with different depths of the first electrode within the septal wall. The one or more processors are also configured to determine when the first electrode is located at a target depth within the septal wall based on the impedance data.

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 for controlling an adaptive pacing therapy that includes utilizing one or more processors to perform measuring an atrial-ventricular (AV) interval corresponding to an interval between an atrial paced (Ap) event or an atrial sensed (As) event and a sensed ventricular (Vs) event, setting an AV delay based on the AV interval, and measuring an S1 heart sound characteristic of interest (COI) while utilizing the AV delay in connection with delivering a pacing therapy by the IMD. The one or more processors also perform adjusting the AV delay, repeating the measuring, and adjusting to obtain a collection of S1 heart sound COIs and corresponding AV delays, selecting one of the AV delays, that corresponds to a select one of the S1 heart sound COIs, as a resultant AV delay, and managing the pacing therapy, utilized by the IMD, based on the resultant AV delay.

Abstract: Computer implemented methods, devices and systems for monitoring a trend in heart failure (HF) progression are provided. The method comprises sensing left ventricular (LV) activation events at multiple LV sensing sites along a multi-electrode LV lead. The activation events are generated in response to an intrinsic or paced ventricular event. The method implements program instructions on one or more processors for automatically determining a conduction pattern (CP) across the LV sensing sites based on the LV activation events, identifying morphologies (MP) for cardiac signals associated with the LV activation events and repeating the sensing, determining and identifying operations, at select intervals, to build a CP collection and an MP collection. The method calculates an HF trend based on the CP collection and MP collection and classifies a patient condition based on the HF trend to form an HF assessment.

Abstract: System and methods are provided herein and include a HIS electrode configured to be located proximate to a HIS bundle and to at least partially define a HIS sensing vector. They system includes memory to store program instructions and cardiac activity (CA) signals for a series of beats utilizing a candidate sensing configuration. The candidate sensing configuration is defined by i) the HIS sensing vector and ii) a sensing channel that utilizes sensing circuitry configured to operate based on one or more sensing settings to detect near field and far field activity. The system includes one or more processors that, when executing the program instructions, are configured to analyze the CA signals to obtain an atrial (A) feature of interest (FOI) and a ventricular (V) FOI for the corresponding beats within the series of beats and identify a V-A FOI relation between the A FOIs and the V FOIs across the series of beats.

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 for controlling an adaptive pacing therapy that includes utilizing one or more processors to perform measuring an atrial-ventricular (AV) interval corresponding to an interval between an atrial paced (Ap) event or an atrial sensed (As) event and a sensed ventricular (Vs) event, setting an AV delay based on the AV interval, and measuring an S1 heart sound characteristic of interest (COI) while utilizing the AV delay in connection with delivering a pacing therapy by the IMD. The one or more processors also perform adjusting the AV delay, repeating the measuring, and adjusting to obtain a collection of S1 heart sound COIs and corresponding AV delays, selecting one of the AV delays, that corresponds to a select one of the S1 heart sound COIs, as a resultant AV delay, and managing the pacing therapy, utilized by the IMD, based on the resultant AV delay.

Abstract: System and methods are provided herein and include a HIS electrode configured to be located proximate to a HIS bundle and to at least partially define a HIS sensing vector. They system includes memory to store program instructions and cardiac activity (CA) signals for a series of beats utilizing a candidate sensing configuration. The candidate sensing configuration is defined by i) the HIS sensing vector and ii) a sensing channel that utilizes sensing circuitry configured to operate based on one or more sensing settings to detect near field and far field activity. The system includes one or more processors that, when executing the program instructions, are configured to analyze the CA signals to obtain an atrial (A) feature of interest (FOI) and a ventricular (V) FOI for the corresponding beats within the series of beats and identify a V-A FOI relation between the A FOIs and the V FOIs across the series of beats.

Abstract: An implantable medical device (IMD) is provided and includes electrodes configured to be located in or about a heart. The electrodes include a bipolar electrode combination that define a bipolar sensing vector. The electrodes include a unipolar electrode combination that define a unipolar sensing vector. The IMD includes sensing circuitry configured to define a first sensing channel coupled to the bipolar electrode combination and a second sensing channel coupled to the unipolar electrode combination.

Abstract: Computer implemented methods and implantable medical devices (IMD) are provided that obtain cardiac activity (CA) signals for a cardiac beat and compare the CA signals to a sensitivity level to detect a sensed event. One or more processors are configured to change the sensitivity level, utilized by the sensing circuitry, over the cardiac beat based on an adaptive sensitivity profile. The adaptive sensitivity profile has a maximum sensitivity limit (MSL). The process determines whether a characteristic of interest (COI) from a candidate event satisfies criteria relative to the COI for a collection of prior sensed events, declares the candidate event to be a valid sensed event or a false sensed event based on the determine operation; and adjusts the maximum sensitivity limit based on when the COI from the candidate event satisfies the criteria to provide adaptive sensing of CA signals.

Abstract: A system and method for designating between types of activation by a pulse generator configured to deliver a left ventricular (LV) pacing pulse at an LV pacing site as part of a cardiac resynchronization therapy (CRT) are provided. The system includes a sensing channel configured to collect cardiac activity (CA) signals along at least one sensing vector extending through a septal wall between the LV and right ventricle (RV). The CA signals are indicative of one or more beats and include a pre-LV pacing segment indicative of cardiac activity preceding the LV pacing pulse and a post-LV pacing segment indicative of cardiac activity following the LV pacing pulse. The system includes memory to store program instructions. One or more processors are configured to implement the program instructions to analyze the pre-LV pacing segment to identify a first myocardium activation (MA) characteristic of interest (COI).

Abstract: The signal quality of an electrophysiological signal can be determined from information regarding proximal stability of an electrophysiology catheter at the time the signal is acquired and temporal stability of the electrophysiological signal. The proximal stability information can include a distance between the electrophysiology catheter and an anatomical surface, a velocity of the electrophysiology catheter, and/or contact force between the electrophysiology catheter and the anatomical surface. Graphical representations of signal quality scores can be output to a display in order to enable visualization thereof by a practitioner.

Abstract: A system is provided that includes a first electrode configured to be located within a septal wall, and a second electrode configured to be located outside of the septal wall. The system also includes an impedance circuit configured to measure impedance along an impedance monitoring (IM) vector between the first and second electrodes. One or more processors are also provided that are configured to obtain impedance data indicative of an impedance along the IM vector with the first electrode located at different depths within the septal wall, the impedance data including a set of data values associated with different depths of the first electrode within the septal wall. The one or more processors are also configured to determine when the first electrode is located at a target depth within the septal wall based on the impedance data.

Abstract: A system and method for monitoring heart function based on heart sounds (HS) is provided. The system includes electrodes configured to sense electrical cardiac activity (CA) signals over a period of time. An HS sensor is configured to sense HS signals over the period of time. The system includes memory to store specific executable instructions and includes one or more processors that, when executing the specific executable instructions, is configured to: identify a characteristic of interest (COI) of a heartbeat from the CA signals. The processors overlay a HS search window onto an HS segment of the HS signals based on the COI from the CA signals and calculate a center of mass (COM) for at least one of S1 or S2 HS based on the HS segment of the HS signals within the search window to obtain a corresponding at least one of S1 COM or S2 COM.

Abstract: A leadless implantable medical device (IMD) and method of using same are provided. The IMD comprises: a housing, a fixation element, electrodes configured to sense electrical cardiac activity (CA) signals over a period of time, an HS sensor configured to sense HS signals over the period of time, memory to store specific executable instructions, and one or more processors. The one or more processors and method: identify a characteristic of interest (COI) of a heartbeat from the CA signals, calculate a center of mass (COM) for at least one HS based on the HS signals to obtain a corresponding at least one HS COM, and calculate at least one of a therapy-related (TR) delay or a sensing-related (SR) blanking interval (BI) based on the at least one HS COM.

Abstract: Computer implemented methods, devices and systems for monitoring a trend in heart failure (HF) progression are provided. The method comprises sensing left ventricular (LV) activation events at multiple LV sensing sites along a multi-electrode LV lead. The activation events are generated in response to an intrinsic or paced ventricular event. The method implements program instructions on one or more processors for automatically determining a conduction pattern (CP) across the LV sensing sites based on the LV activation events, identifying morphologies (MP) for cardiac signals associated with the LV activation events and repeating the sensing, determining and identifying operations, at select intervals, to build a CP collection and an MP collection. The method calculates an HF trend based on the CP collection and MP collection and classifies a patient condition based on the HF trend to form an HF assessment.

Abstract: A system and method have at least one implantable lead comprising a right ventricular (RV) electrode and one or more left ventricular (LV) electrodes, at least one processor, and a memory coupled to the at least one processor. The memory stores program instructions.

Abstract: An electrophysiology map of a portion of a patient's anatomy can be visualized using an electroanatomical mapping system. The system receives a plurality of electrophysiology data points (e.g., an electrophysiology map), which includes a plurality of electrophysiology signals. The system then creates a distribution (e.g., a histogram) for one or more characteristics of the plurality of electrophysiology signals (e.g., dominant cycle length, regular cycle length, peak-to-peak voltage, fractionation, conduction velocity, or the like). The system then analyzes the distribution to determine a display convention (e.g., a range and scale) for a graphical representation of the characteristic based on, for example, a best-fit shape of the distribution, a skew of the distribution, a range of the distribution, and/or a most dominant value of the distribution. The graphical representation can then be output according to the display convention.

Abstract: Systems and methods for resolving catheter rendering issues are provided. A system includes a catheter including a plurality of electrodes and a plurality of catheter pins, each catheter pin corresponding to an associated electrode. The system further includes a mapping system communicatively coupled to the catheter, the mapping system including a pin box including a plurality of sockets, a display device configured to render the catheter, and an electronic control unit (ECU). The ECU is configured to determine that the catheter is being rendered incorrectly on the display device, determine a number of electrodes that are being rendered incorrectly on the display device, identify at least one particular electrode of the plurality of electrodes that is being rendered incorrectly on the display device, and attempt to resolve the incorrect rendering of the catheter based on the determined number of electrodes and the at least one particular electrode.

Abstract: A system is provided for controlling a left univentricular (LUV) pacing therapy using an implantable medical device (IMD). The system also includes one or more processors configured to determine an atrial-ventricular (AV) conduction interval (ARRV) between the A site and a first RV sensed event at the RV site, determine an inter-ventricular (VV) conduction interval (RLV-RRV) between a paced event at the LV site and a second RV sensed event at the RV site, and set a ventricular refractory period (VRP) based on at least one of the AV conduction interval or the VV conduction interval and a predetermined offset. The one or more processors are also configured to blank signals over the RV sensing channel during the VRP.