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 system may include an input device configured to receive a signal indicative of elevated glucose in a patient, and an electrical stimulator configured to electrically stimulate at least one skeletal muscle. The system may further include a controller operably connected to the electrical stimulator. The controller may be configured for delivering a glucose therapy in response to the signal by controlling the electrical stimulator. The system may be configured to deliver the therapy in combination with other glucose therapies, and the therapy may be titrated based on a sensed parameter or patient feedback.

Abstract: The current technology relates to a shock deferral unit that is portable by an ambulatory patient. The shock deferral unit has a bi-directional communication device configured to receive a notification of an impending shock from a defibrillator and configured to send an instruction to defer the impending shock to the defibrillator. An authentication interface is configured to receive authentication data from a user. A user instruction interface is configured to receive the instruction to defer the impending shock from the user. An authentication device is configured to authenticate the user based on the authentication data and instruct the bi-directional communication device to send the instruction to defer a shock upon authentication and receipt of the instruction to defer the shock.

Abstract: Cardiac activity of the heart can be sensed using, for example, one or more leadless cardiac pacemakers (LCPs) that are implanted in a close proximity to the heart. Sensing cardiac activity by the one or more leadless cardiac pacemakers (LCPs) can help the system in determining an occurrence of cardiac arrhythmia. For treatment purposes, electrical stimulation therapy, for example anti-tachyarrhythmia pacing (ATP) therapy, can be delivered by at least one of the devices of the system. Such therapy can help treat the detected cardiac arrhythmia. In some instances, one of the leadless cardiac pacemakers can instruct one or more of the other devices to assist in providing pacing therapy. In some instances, one of the leadless cardiac pacemakers can instruct one or more of the other devices to temporarily stop providing therapy or to simply shut down while another device provides therapy.

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: Implantable medical device (IMD) such as leadless cardiac pacemakers may include a rechargeable power source. In some cases, the IMD may include a plurality of receiving coils that may capture a non-radiative near-field energy and then convert the near-field energy into electrical energy that may be used to recharge the rechargeable power source. Accordingly, since the rechargeable power source does not have to maintain sufficient energy stores in a single charge for the entire expected life of the IMD, the power source itself and thus the IMD, may be made smaller while still meeting device longevity expectations.

Abstract: Embodiments of the present disclosure relate to monitoring one or more physiological parameters of a subject using a multilayer wearable device. In an embodiment, a multilayer wearable device is configured to be attached to a subject. The multilayer wearable device comprises a substrate having multiple layers including a first portion connected to a second portion. The first portion has a first side and a second, opposite side. And the second portion has a first side and a second, opposite side. The first side of the first portion is configured to be attached to the subject and the second portion is arranged on top of the first portion such that the first side of the second portion is disposed adjacent the second side of the first portion. And, the wearable device includes one or more electrical components configured to sense a physiological parameter of the subject.

Abstract: Embodiments disclosed herein relate to devices and methods for monitoring one or more physiological parameters of a subject. In an embodiment, a wearable device comprises a substrate configured to attached to a subject's skin. The substrate comprises a middle portion arranged between two end portions, wherein the middle portion is more flexible than at least one of the end portions. The wearable device also comprises a physiological sensor arranged on the middle portion. The physiological sensor is configured to sense a physiological signal of the subject when the wearable device is attached to the subject's skin. And, the wearable device comprises one or more electrical components arranged on at least one of the end portions, wherein at least one of the one or more electrical components is coupled to the physiological sensor.

Abstract: Cardiac activity of the heart can be sensed using, for example, one or more leadless cardiac pacemakers (LCPs) that are implanted in a close proximity to the heart. Sensing cardiac activity by the one or more leadless cardiac pacemakers (LCPs) can help the system in determining an occurrence of cardiac arrhythmia. For treatment purposes, electrical stimulation therapy, for example anti-tachyarrhythmia pacing (ATP) therapy, can be delivered by at least one of the devices of the system. Such therapy can help treat the detected cardiac arrhythmia. In some instances, one of the leadless cardiac pacemakers can instruct one or more of the other devices to assist in providing pacing therapy. In some instances, one of the leadless cardiac pacemakers can instruct one or more of the other devices to temporarily stop providing therapy or to simply shut down while another device provides therapy.

Abstract: The current technology relates to a shock deferral unit that is portable by an ambulatory patient. The shock deferral unit has a bi-directional communication device configured to receive a notification of an impending shock from a defibrillator and configured to send an instruction to defer the impending shock to the defibrillator. An authentication interface is configured to receive authentication data from a user. A user instruction interface is configured to receive the instruction to defer the impending shock from the user. An authentication device is configured to authenticate the user based on the authentication data and instruct the bi-directional communication device to send the instruction to defer a shock upon authentication and receipt of the instruction to defer the shock.

Abstract: Systems and methods for managing machine-generated alerts of a medical event such as worsening heart failure (WHF) are described. A patient management system includes a patient database of information about a correspondence between a plurality of alert thresholds (ATHs) and corresponding clinical outcome indicators (COIs) for a plurality of patients. A control circuit can query the patient database for a matching patient that meets specific query criteria compared to a target patient, retrieve an ATH-COI correspondence associated with the matching patient, and determine the alert threshold using a user input of a COI and the retrieved ATH-COI correspondence. A medical event detector detects the medical event using physiological signals sensed from the target patient and the determined alert threshold.

Abstract: Various aspects of the present subject matter relate to an implantable device. Various device embodiments comprise at least one port to connect to at least one lead with at least electrode, stimulation circuitry connected to the at least one port and adapted to provide at least one neural stimulation therapy to at least one neural stimulation target using the at least one electrode, sensing circuitry connected to the at least one port and adapted to provide a sensed signal, and a controller connected to the stimulation circuitry to provide the at least one neural stimulation therapy and to the sensing circuitry to receive the sensed signal. In response to a triggering event, the controller is adapted to switch between at least two modes. Other aspects and embodiments are provided herein.

Abstract: A hospitalization management system including a heart failure analyzer that receives diagnostic data including at least sensor data representative of one or more physiological signals sensed from a hospitalized patient using one or more sensors and assesses risk of rehospitalization for the patient using the diagnostic data. The outcome of the risk assessment is used during and following the patient's hospitalization for reducing the risk of rehospitalization.

Abstract: This document discusses, among other things, systems and methods to determine a blood pressure measurement of a subject, such as a systolic blood pressure of a subject, a diastolic blood pressure of the subject, or both, using received heart sound information and plethysmography information of the subject. The system can include a signal receiver circuit configured to receive the heart sound information and plethysmography information of the subject, and an assessment circuit configured to determine the systolic and diastolic blood pressure of the subject using the received heart sound information and the plethysmography information of the subject.

Abstract: An implantable medical device (IMD) that includes a housing, a first electrode secured relative to the housing, a second electrode secured relative to the housing, and a gyroscope secured relative to the housing. The IMD may include circuitry in the housing in communication with the first electrode, the second electrode, and the gyroscope. The circuitry may be configured to determine and store a plurality of torsion data measurements, from which a representation of a twist profile may be determined.

Abstract: A cardiac rhythm management system includes a first implantable device such as a defibrillator and a second implantable device such as a leadless cardiac pacemaker. A programmer is configured to receive and display heart data emanating from the implantable defibrillator and from the leadless cardiac pacemaker. The heart data emanating from the leadless cardiac pacemaker is displayed in temporal alignment with the heart data emanating from the implantable defibrillator.

Abstract: Various aspects of the present subject matter relate to an implantable device. Various device embodiments comprise at least one port to connect to at least one lead with at least electrode, stimulation circuitry connected to the at least one port and adapted to provide at least one neural stimulation therapy to at least one neural stimulation target using the at least one electrode, sensing circuitry connected to the at least one port and adapted to provide a sensed signal, and a controller connected to the stimulation circuitry to provide the at least one neural stimulation therapy and to the sensing circuitry to receive the sensed signal. In response to a triggering event, the controller is adapted to switch between at least two modes. Other aspects and embodiments are provided herein.

Abstract: A leadless cardiac pacemaker (LCP) configured to sense cardiac activity and to pace a patient's heart. The LCP may include a housing, a first electrode secured relative to the housing, a second electrode secured relative to the housing, and a pressure sensor secured relative to the housing and coupled to the environment outside of the housing. The LCP may further include circuitry in the housing in communication with the first electrode, the second electrode, and the pressure sensor. The circuitry may be configured to determine and store a plurality of impedance-pressure data pairs, from which a representation of a pressure-volume loop may be determined.

Abstract: This document discusses, among other things, using a pressure sensor to detect body sound information of a patient, such as cardiac murmurs, respiratory sounds, etc.