Abstract: Systems and methods are described herein for generating surrogate cardiac electrical activation times from electrical activity monitored by a plurality of external electrodes. Surrogate cardiac electrical activation times that should be corrected may be identified, or determined, according to one or more metrics, and then such surrogate cardiac electrical activation times may be corrected according to various criterion.

Abstract: A method for monitoring a cardiovascular pressure in a patient includes measuring, by pressure sensing circuitry of an implantable pressure sensing device, the cardiovascular pressure of the patient. The method further includes transmitting, via wireless communication circuitry of the implantable pressure sensing device, the measured cardiovascular pressure to another device. The method further includes determining, by processing circuitry of the other device, whether a posture of the patient at a time of the measured cardiovascular pressure was a target posture for cardiovascular pressure measurements. The method further includes determining, by the processing circuitry of the other device, whether to store or discard the transmitted cardiovascular pressure based on determining whether the posture was the target posture.

Abstract: A medical device and method conserve electrical power used in monitoring cardiac arrhythmias. The device includes a sensing circuit configured to sense a cardiac signal, a power source and a control circuit having a processor powered by the power source. The control circuit is configured to operate in a normal state by waking up the processor to analyze the cardiac electrical signal for determining a state of an arrhythmia. The control circuit switches from the normal state to a power saving state that includes waking up the processor at a lower rate than during the normal state.

Abstract: Systems, apparatus, methods and non-transitory computer readable media facilitating telemetry data communication security between an implantable device and an external clinician device are provided. An implantable device can include a security component configured to generate security information based on reception of a clinician telemetry session request from the clinician device via a first telemetry communication protocol. The security information can include a session identifier and a first session key, and the clinician telemetry session request can include a clinician device identifier associated with the clinician device.

Abstract: An implantable device and associated method for delivering multi-site pacing therapy is disclosed. The device comprises a set of electrodes including a first ventricular electrode and a second ventricular electrode, spatially separated from one another and all coupled to an implantable pulse generator. The device comprises a processor configured for selecting a first cathode and a first anode from the set of electrodes to form a first pacing vector at a first pacing site along a heart chamber and selecting a second cathode and a second anode from the set of electrodes to form a second pacing vector at a second pacing site along the same heart chamber. The pulse generator is configured to deliver first pacing pulses to the first pacing vector and delivering second pacing pulses to the second pacing vector. The pulse generator generates a recharging current for recharging a first coupling capacitor over a first recharge time period in response to the first pacing pulses.

Abstract: In some examples, determining an estimated remaining longevity of a power source of an implantable medical device comprises determining values of one or more parameters of the power source and one or more operational parameters of the implantable medical device; calculating, based on at least some of the determined parameter values, a first estimated duration until one of the determined parameters of the power source reaches a pre-recommended replacement time (pre-RRT) threshold and adding a timer duration to determine a first estimated longevity value; calculating, based on at least some of the determined parameter values, a second estimated duration until one of the determined parameters of the power source reaches a recommended replacement time (RRT) backup threshold as a second estimated longevity value; determining the estimated remaining longevity based on the two estimated longevity values; and indicating the determined estimated remaining longevity.

Abstract: An implantable medical device includes an activity sensor, a pulse generator, and a control module. The control module is configured to determine activity metrics from the activity signal and determine an activity metric value at a predetermined percentile of the activity metrics. The control module sets a lower pacing rate set point based on the activity metric value at the predetermined percentile.

Abstract: Systems, apparatus, methods and non-transitory computer readable media facilitating telemetry data communication security between an implantable device and an external clinician device are provided. An implantable device can include a security component configured to generate security information based on reception of a clinician telemetry session request from the clinician device via a first telemetry communication protocol. The security information can include a session identifier and a first session key, and the clinician telemetry session request can include a clinician device identifier associated with the clinician device.

Abstract: An implantable medical device includes an activity sensor, a pulse generator, and a control module. The control module is configured to determine activity metrics from the activity signal and determine an activity metric value at a predetermined percentile of the activity metrics. The control module sets a lower pacing rate set point based on the activity metric value at the predetermined percentile.

Abstract: A cardiac stimulation system and associated capture management method are provided in which capture and device longevity are improved. The device determines a series of capture thresholds. Capture threshold is the minimum pulse level (pulse energy or pulse amplitude or pulse width) that captures the heart. Each determination requires delivery of pacing pulses at several (at least two) known levels (pulse energy, pulse amplitude and/or pulse width) over time. The individual determined capture thresholds are combined into a set and the variability of the set is used to set the safety margin. The greater the variability in the capture thresholds, the bigger the safety margin.

Abstract: Systems, apparatus, methods and computer-readable storage media facilitating management of operation of an implantable medical device (“IMD”) using a number of communication modes are provided. An IMD is configured to operate in a disabled mode wherein radio frequency (RF) telemetry communication is disabled, or operate in a first advertising mode using the RF telemetry communication. The IMD receives a clinician session request from a clinician device via an induction telemetry protocol while operating in the disabled mode or the first advertising mode, and transitions to operating from the disabled mode or the first advertising mode to operating in a second advertising mode based on receiving the clinician session request. From the second advertising mode, the IMD can establish a clinician telemetry session with the clinician device using the RF telemetry communication and a unique security mechanism facilitated by an identifier for the clinician device included in the clinician session request.

Abstract: A cardiac stimulation system and associated capture management method are provided in which capture and device longevity are improved. The device determines a series of capture thresholds. Capture threshold is the minimum pulse level (pulse energy or pulse amplitude or pulse width) that captures the heart. Each determination requires delivery of pacing pulses at several (at least two) known levels (pulse energy, pulse amplitude and/or pulse width) over time. The individual determined capture thresholds are combined into a set and the variability of the set is used to set the safety margin. The greater the variability in the capture thresholds, the bigger the safety margin.

Abstract: Systems, devices disclosed provide example methods comprising determining that a triggering event has occurred based on statuses for a set of physiological parameters associated with the patient, the physiological parameters indicative of the patient engaging in a patient initiated physical activity, generating a trigger output signal in response to the determination that the triggering event has occurred, wirelessly transmitting the trigger output signal to a pressure sensing device implanted in a vessel of the patient, triggering, based on receiving the trigger output signal, the pressure sensing device to sense a cardiovascular pressure of the patient; and transmitting, by the pressure sensing device, a wireless signal comprising data corresponding to the sensed cardiovascular pressure of the patient.

Abstract: In some examples, determining an estimated remaining longevity of a power source of an implantable medical device comprises determining values of one or more parameters of the power source and one or more operational parameters of the implantable medical device; calculating, based on at least some of the determined parameter values, a first estimated duration until one of the determined parameters of the power source reaches a pre-recommended replacement time (pre-RRT) threshold and adding a timer duration to determine a first estimated longevity value; calculating, based on at least some of the determined parameter values, a second estimated duration until one of the determined parameters of the power source reaches a recommended replacement time (RRT) backup threshold as a second estimated longevity value; determining the estimated remaining longevity based on the two estimated longevity values; and indicating the determined estimated remaining longevity.

Abstract: A method and device for detecting phrenic nerve stimulation (PNS) in, or using, a cardiac medical device. A test signal sensitive to contraction of a diaphragm of a patient may be sensed and signal artifacts of the test signal within each of a first window of the test signal prior to a predetermined cardiac signal and a second window of the test signal subsequent to the predetermined cardiac signal may be determined. The PNS beat criteria may be evaluated, for example, using the test signal, which may be a heart sounds signal.

Abstract: Systems, apparatus, methods and computer-readable storage media facilitating management of operation of an implantable medical device (“IMD”) using a number of communication modes are provided. An IMD is configured to operate in a disabled mode wherein radio frequency (RF) telemetry communication is disabled, or operate in a first advertising mode using the RF telemetry communication. The IMD receives a clinician session request from a clinician device via an induction telemetry protocol while operating in the disabled mode or the first advertising mode, and transitions to operating from the disabled mode or the first advertising mode to operating in a second advertising mode based on receiving the clinician session request. From the second advertising mode, the IMD can establish a clinician telemetry session with the clinician device using the RF telemetry communication and a unique security mechanism facilitated by an identifier for the clinician device included in the clinician session request.

Abstract: A method of operation of a medical device system for determining prospective heart failure hospitalization risk. The method includes measuring one or more data observations via one or more electrodes of an implanted medical device disposed in a patient's body. The data observations are stored into memory of the implantable medical device of a patient. The data observations are transmitted to an external device. The processor of the external device parses the data observations into one or more evaluation periods. Using the number of observations in one or more evaluation periods, a look up table, stored into memory of the external device, is accessed. The look up table associates prospective heart failure hospitalization risk with the data observations noted in the evaluation period. One or more embodiments involve a weighted prospective heart failure hospitalization risk for the set of evaluation periods. The prospective heart failure hospitalization is then displayed on the graphical user interface.

Abstract: An implantable device and associated method for delivering multi-site pacing therapy is disclosed. The device comprises a set of electrodes including a first ventricular electrode and a second ventricular electrode, spatially separated from one another and all coupled to an implantable pulse generator. The device comprises a processor configured for selecting a first cathode and a first anode from the set of electrodes to form a first pacing vector at a first pacing site along a heart chamber and selecting a second cathode and a second anode from the set of electrodes to form a second pacing vector at a second pacing site along the same heart chamber. The pulse generator is configured to deliver first pacing pulses to the first pacing vector and delivering second pacing pulses to the second pacing vector. The pulse generator generates a recharging current for recharging a first coupling capacitor over a first recharge time period in response to the first pacing pulses.

Abstract: Systems and methods are described herein for generating surrogate cardiac electrical activation times from electrical activity monitored by a plurality of external electrodes. Surrogate cardiac electrical activation times that should be corrected may be identified, or determined, according to one or more metrics, and then such surrogate cardiac electrical activation times may be corrected according to various criterion.

Abstract: Systems and methods are described herein for selection of a cardiac cycle, or heartbeat, from a plurality of cardiac cycles monitored over time. The cardiac cycle may be selected using various metrics including a single-cycle metric and a cycle-series metric. Further, the selected cardiac cycle may be used for further cardiac analysis (for example, to generate electrical activation times).