Abstract: A method and apparatus for optimizing and assessing the response to extra-systolic stimulation (ESS) are provided. An optimization/monitoring parameter is calculated as a function of potentiation ratio, PR, and recirculation fraction, RF, derived from measurements of myocardial contractile function during and after ESS. PR may be computed as the ratio of the contractile function on post-extra-systolic beats during ESS to baseline contractile function. RF may be computed as the slope of a linear regression performed on a plot of the contractile function for a post-extra-systolic beat versus the contractile function for the previous post-extra-systolic beat after ESS is ceased. The ESI resulting in a maximum optimization/monitoring parameter, preferably computed as the product of PR and RF, is determined as the optimal ESI. The operating ESI may be automatically adjusted, and/or PR and RF data may be stored for monitoring purposes.

Abstract: Neurostimulation to mitigate lung wetness is delivered to a patient based on a sensed parameter indicative of lung wetness. The neurostimulation is configured to at least one of increase parasympathetic activity or decrease sympathetic activity within the patient. In some examples, a patient response to the neurostimulation therapy may be detected to modify the neurostimulation therapy. The patient response may include, for example, changes in the contractility of a heart of the patient, changes in the heart rate, heart rate variability or blood pressure of the patient, changes in a bladder size of the patient, changes in bladder functional activity of the patient, changes in urine flow, changes in lung function, changes in lung composition, or changes in the nerve activity of the patient.

Abstract: The above-described methods and apparatus are believed to be of particular benefit for patients suffering heart failure including cardiac dysfunction, chronic HF, and the like and all variants as described herein and including those known to those of skill in the art to which the invention is directed. It will understood that the present invention offers the possibility of monitoring and therapy of a wide variety of acute and chronic cardiac dysfunctions. The current invention provides systems and methods for delivering therapy for cardiac hemodynamic dysfunction via the innervated myocardial substrate receives one or more discrete pulses of electrical stimulation during the refractory period of said innervated myocardial substrate.

Abstract: An implantable medical device (IMD) may include at least two separate lead connection assemblies, each with electrical connectors for connecting implantable leads to the IMD. In some examples, a IMD may include a first therapy module configured to generate a first electrical stimulation therapy and a second therapy module configured to generate a second electrical stimulation therapy for delivery to the patient. The IMD may include a first lead connection assembly including a first electrical connector electrically coupled to the first therapy module and a second lead connection assembly including a second electrical connector electrically coupled to the second therapy module. In some examples, the first and second lead connection assemblies are distributed around the outer perimeter of the IMD housing.

Abstract: Determining an optimal atrioventricular interval is of interest for proper delivery of cardiac resynchronization therapy. Although device optimization is gradually and more frequently being performed through a referral process with which the patient undergoes an echocardiographic optimization, the decision of whether to optimize or not is still generally reserved for the implanting physician. Recent abstracts have suggested a formulaic approach for setting A-V interval based on intrinsic electrical sensing, that may possess considerable appeal to clinicians versus a patient average nominal A-V setting of 100 ms. The present invention presents a methods of setting nominal device settings based on entering patient cardiac demographics to determine what A-V setting may be appropriate. The data is based on retrospective analysis of the MIRACLE trial to determine what major factors determined baseline A-V settings.

Abstract: An implantable medical device system and corresponding method to monitor blood pressure by transforming a measured pressure signal to estimate a blood pressure metric or waveform corresponding to a target site. An implantable sensor generates a signal corresponding to blood pressure at a first arterial branch location and a processor receiving the signal applies a transfer function to the signal to derive a blood pressure metric or waveform at a target site.

Abstract: Electrical crosstalk between two implantable medical devices or two different therapy modules of a common implantable medical device may be evaluated, and, in some examples, mitigated. In some examples, one of the implantable medical devices or therapy modules delivers electrical stimulation to a nonmyocardial tissue site or a nonvascular cardiac tissue site, and the other implantable medical device or therapy module delivers cardiac rhythm management therapy to a heart of the patient.

Abstract: A first implantable medical device (IMD) implanted within a patient may communicate with a second IMD implanted within the patient by encoding information in an electrical stimulation signal. The delivery of the electrical stimulation signal may provide therapeutic benefits to the patient. The second IMD may sense the electrical stimulation signal, which may be presented as an artifact in a sensed cardiac signal, and process the sensed signal to retrieve the encoded information. The second IMD may modify its operation based on the received therapy information. Crosstalk between the first and second IMDs may be reduced using various techniques described herein. For example, the first IMD may generate the electrical stimulation signal to include a spread spectrum energy distribution or a predetermined signal signature. The second IMD may effectively remove a least some of the signal artifact in a sensed cardiac signal based on the predetermined signal signature.

Abstract: Electrical crosstalk between two implantable medical devices or two different therapy modules of a common implantable medical device may be evaluated, and, in some examples, mitigated. In some examples, one of the implantable medical devices or therapy modules delivers electrical stimulation to a nonmyocardial tissue site or a nonvascular cardiac tissue site, and the other implantable medical device or therapy module delivers cardiac rhythm management therapy to a heart of the patient.

Abstract: A lead connection assembly of an implantable medical device (IMD) may include at least two different types of electrical connectors. In some examples, the lead connection assembly may include first and second electrical connectors that have at least one of a different electrical contact arrangement, a different lead connection receptacle geometry or a different size than the first electrical connector. The first electrical connector may be electrically connected to a first therapy module that generates cardiac rhythm therapy that is delivered to a heart of a patient, and the second electrical connector may be electrically connected to a second therapy module that generates electrical stimulation that is delivered to a tissue site within the patient. The second electrical connector may be configured to be incompatible with a lead that delivers the cardiac rhythm therapy to the patient.

Abstract: A therapy or monitoring system may implement one or more techniques to mitigate interference between operation of a charging device that charges a first implantable medical device (IMD) implanted in a patient and a second IMD implanted in the patient. In some examples, the techniques may include modifying an operating parameter of the charging device in response to receiving an indication that a second IMD is implanted in the patient. The techniques also may include modifying an operating parameter of the second IMD in response to detecting the presence or operation of the charging device.

Abstract: Electrical crosstalk between two implantable medical devices or two different therapy modules of a common implantable medical device may be evaluated, and, in some examples, mitigated. In some examples, one of the implantable medical devices or therapy modules delivers electrical stimulation to a nonmyocardial tissue site or a nonvascular cardiac tissue site, and the other implantable medical device or therapy module delivers cardiac rhythm management therapy to a heart of the patient.

Abstract: Electrical crosstalk between two implantable medical devices or two different therapy modules of a common implantable medical device may be evaluated, and, in some examples, mitigated. In some examples, one of the implantable medical devices or therapy modules delivers electrical stimulation to a nonmyocardial tissue site or a nonvascular cardiac tissue site, and the other implantable medical device or therapy module delivers cardiac rhythm management therapy to a heart of the patient.

Abstract: Electrical crosstalk between two implantable medical devices or two different therapy modules of a common implantable medical device may be evaluated, and, in some examples, mitigated. In some examples, one of the implantable medical devices or therapy modules delivers electrical stimulation to a nonmyocardial tissue site or a nonvascular cardiac tissue site, and the other implantable medical device or therapy module delivers cardiac rhythm management therapy to a heart of the patient.

Abstract: Techniques for minimizing interference between the first and second medical devices or between the different therapy modules of a common medical device are described herein. In some examples, a medical device may include shunt-current mitigation circuitry and/or at least one clamping structure that helps minimize or even eliminate shunt-current that feeds into a first therapy module of the medical device via one or more electrodes electrically connected to the first therapy module. The shunt-current may be generated by the delivery of electrical stimulation by a second therapy module. The second therapy module may be enclosed in a common housing with the first therapy module or may be separate, e.g., a part of a separate medical device.

Abstract: Electrical crosstalk between two implantable medical devices or two different therapy modules of a common implantable medical device may be evaluated, and, in some examples, mitigated. In some examples, one of the implantable medical devices or therapy modules delivers electrical stimulation to a nonmyocardial tissue site or a nonvascular cardiac tissue site, and the other implantable medical device or therapy module delivers cardiac rhythm management therapy to a heart of the patient.

Abstract: Electrical crosstalk between two implantable medical devices or two different therapy modules of a common implantable medical device may be evaluated, and, in some examples, mitigated. In some examples, one of the implantable medical devices or therapy modules delivers electrical stimulation to a nonmyocardial tissue site or a nonvascular cardiac tissue site, and the other implantable medical device or therapy module delivers cardiac rhythm management therapy to a heart of the patient.

Abstract: A therapy or monitoring system may implement one or more techniques to mitigate interference between operation of a charging device that charges a first implantable medical device (IMD) implanted in a patient and a second IMD implanted in the patient. In some examples, the techniques may include modifying an operating parameter of the charging device in response to receiving an indication that a second IMD is implanted in the patient. The techniques also may include modifying an operating parameter of the second IMD in response to detecting the presence or operation of the charging device.

Abstract: Electrical crosstalk between two implantable medical devices or two different therapy modules of a common implantable medical device may be evaluated, and, in some examples, mitigated. In some examples, one of the implantable medical devices or therapy modules delivers electrical stimulation to a nonmyocardial tissue site or a nonvascular cardiac tissue site, and the other implantable medical device or therapy module delivers cardiac rhythm management therapy to a heart of the patient.

Abstract: Electrical crosstalk between two implantable medical devices or two different therapy modules of a common implantable medical device may be evaluated, and, in some examples, mitigated. In some examples, one of the implantable medical devices or therapy modules delivers electrical stimulation to a nonmyocardial tissue site or a nonvascular cardiac tissue site, and the other implantable medical device or therapy module delivers cardiac rhythm management therapy to a heart of the patient.