Abstract: A medical device system including a pacemaker implantable in an atrial chamber of a patient's heart is configured to sense near field atrial events from a cardiac signal received by a sensing module of the pacemaker and to sense far field ventricular events. The pacemaker is configured to establish an atrial lower rate interval to control a rate of delivery of atrial pacing pulses, determine a rate of the far field ventricular events sensed by the sensing module, determine an atrial event rate, compare the rate of the sensed far field ventricular events to the atrial event rate, and adjust the atrial lower rate interval in response to the comparison.

Abstract: A medical device system including an pacemaker implantable in a chamber of a patient's heart is configured to sense near field events from a cardiac electrical signal, establish a lower rate interval to control a rate of delivery of pacing pulses and schedule a first pacing pulse by starting a pacing escape interval set equal to the lower rate interval. The pacemaker withholds the scheduled pacing pulse in response to sensing a near-field event during the pacing escape interval and schedules a next pacing pulse to be delivered at the lower rate interval from a time that the pacing escape interval is scheduled to expire.

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: Cardiac pacing methods for an implantable single chamber pacing system, establish an offset rate for pacing at a predetermined decrement from either a baseline rate (i.e. dictated by a rate response sensor), or an intrinsic rate. Pacing maintains the offset rate until x of y successive events are paced events, at which time the offset rate is switched to the baseline rate for pacing over a predetermined period of time. Following the period, if an intrinsic event is not immediately detected, within the interval of the offset rate, the rate is switched back to baseline for pacing over an increased period of time. Some methods establish a preference rate, between the offset and baseline rates, wherein an additional criterion, for switching from the offset rate to the baseline rate, is established with respect to the preference rate.

Abstract: The disclosure herein relates generally to methods for treating heart conditions using vagal stimulation, and further to systems and devices for performing such treatment. Such methods may include monitoring physiological parameters of a patient, detecting cardiac conditions, and delivering vagal stimulation (e.g., electrical stimulation to the vagus nerve or neurons having parasympathetic function) to the patient to treat the detected cardiac conditions.

Abstract: The disclosure herein relates generally to methods for treating heart conditions using vagal stimulation, and further to systems and devices for performing such treatment. Such methods may include monitoring physiological parameters of a patient, detecting cardiac conditions, and delivering vagal stimulation (e.g., electrical stimulation to the vagus nerve or neurons having parasympathetic function) to the patient to treat the detected cardiac conditions.

Abstract: A medical device system and method for determining pacing threshold data that includes a cardiac capture sensor, a phrenic nerve stimulation sensor, a pulse generator selectively coupled to a plurality of electrode vectors to deliver a phrenic nerve stimulation pulse, and a processor coupled to the cardiac capture sensor, the phrenic nerve stimulation sensor and the pulse generator and configured to deliver the phrenic nerve stimulation pulse along the plurality of electrode vectors, determine, for each vector of the plurality of vectors, whether phrenic nerve stimulation is detected in response to the delivered phrenic nerve stimulation, deliver a pacing pulse along only the vectors of the plurality of vectors that phrenic nerve stimulation is determined not to be detected, and determine pacing capture thresholds in response to the delivered pacing pulse.

Abstract: A medical device system and method for determining pacing threshold data that includes a cardiac capture sensor, a phrenic nerve stimulation sensor, a pulse generator selectively coupled to a plurality of electrode vectors to deliver a pacing stimulation pulse, and a processor coupled to the cardiac capture sensor, the phrenic nerve stimulation sensor and the pulse generator and configured to deliver the pacing simulation pulse along the plurality of electrode vectors, determine, for each vector of the plurality of vectors, a pacing capture threshold in response to the delivered pacing pulse, deliver a phrenic nerve stimulation pulse along only the vectors of the plurality of vectors that the determined pacing capture threshold is less than a predetermined pacing capture threshold limit, and determine whether phrenic nerve stimulation is detected in response to the delivered phrenic nerve stimulation pulse.

Abstract: A method of stimulation therapy and an apparatus for providing the therapy which addresses cardiac dysfunction including heart failure. The therapy employs atrial pacing pulses delivered to a heart after the atrial refractory period and timed so that they will not cause a ventricular contraction. These atrial pacing are timed to achieve beneficial effects on myocardial mechanics (efficacy) while maintaining an extremely low level of risk of arrhythmia induction. These methods may be employed individually or in combinations in an external or implantable ESS therapy delivery device.

Abstract: Cardiac pacing methods for an implantable single chamber pacing system, establish an offset rate for pacing at a predetermined decrement from either a baseline rate (i.e. dictated by a rate response sensor), or an intrinsic rate. Pacing maintains the offset rate until x of y successive events are paced events, at which time the offset rate is switched to the baseline rate for pacing over a predetermined period of time. Following the period, if an intrinsic event is not immediately detected, within the interval of the offset rate, the rate is switched back to baseline for pacing over an increased period of time. Some methods establish a preference rate, between the offset and baseline rates, wherein an additional criterion, for switching from the offset rate to the baseline rate, is established with respect to the preference rate.

Abstract: Devices, systems, and techniques for transitioning between different drug delivery sources or different drug concentrations may account for diffusion and mixing of drug within the fluid. In one example, a method may include determining a flow rate for a fluid to be delivered to a patient via a drug pump and a catheter in fluid communication with a reservoir of the drug pump. The fluid includes a drug. The method also includes determining a concentration profile of the drug delivered via the catheter, wherein the concentration profile identifies a volume of delivered fluid needed to achieve a target transition dose of the drug. The method further includes determining, by a processor and based on the flow rate and the concentration profile, an initial delivery period required to achieve the target transition dose by delivering the fluid at the flow rate.

Abstract: Cardiac pacing methods for an implantable single chamber pacing system, establish an offset rate for pacing at a predetermined decrement from either a baseline rate (i.e. dictated by a rate response sensor), or an intrinsic rate. Pacing maintains the offset rate until x of y successive events are paced events, at which time the offset rate is switched to the baseline rate for pacing over a predetermined period of time. Following the period, if an intrinsic event is not immediately detected, within the interval of the offset rate, the rate is switched back to baseline for pacing over an increased period of time. Some methods establish a preference rate, between the offset and baseline rates, wherein an additional criterion, for switching from the offset rate to the baseline rate, is established with respect to the preference rate.

Abstract: The disclosure herein relates generally to methods for treating heart conditions using vagal stimulation, and further to systems and devices for performing such treatment. Such methods may include monitoring physiological parameters of a patient, detecting cardiac conditions, and delivering vagal stimulation (e.g., electrical stimulation to the vagus nerve or neurons having parasympathetic function) to the patient to treat the detected cardiac conditions.

Abstract: The disclosure herein relates generally to methods for treating heart conditions using vagal stimulation, and further to systems and devices for performing such treatment. Such methods may include monitoring physiological parameters of a patient, detecting cardiac conditions, and delivering vagal stimulation (e.g., electrical stimulation to the vagus nerve or neurons having parasympathetic function) to the patient to treat the detected cardiac conditions.

Abstract: The disclosure herein relates generally to methods for treating heart conditions using vagal stimulation, and further to systems and devices for performing such treatment. Such methods may include monitoring physiological parameters of a patient, detecting cardiac conditions, and delivering vagal stimulation (e.g., electrical stimulation to the vagus nerve or neurons having parasympathetic function) to the patient to treat the detected cardiac conditions.

Abstract: Various techniques for facilitating selection of a pacing vector for pacing a chamber of a heart are described. One example method described includes, for each of a plurality of vectors, delivering a pacing pulse to capture a first heart chamber, determining a first time interval between the pacing pulse and a sensed event in a second heart chamber, determining a capture detection window in response to the determined first time interval, and enabling a capture detection module to iteratively decrease a pacing pulse magnitude delivered in the first heart chamber until an event in the second heart chamber is not sensed during the determined capture detection window.

Abstract: Cardiac pacing methods for an implantable single chamber pacing system, establish an offset rate for pacing at a predetermined decrement from either a baseline rate (i.e. dictated by a rate response sensor), or an intrinsic rate. Pacing maintains the offset rate until x of y successive events are paced events, at which time the offset rate is switched to the baseline rate for pacing over a predetermined period of time. Following the period, if an intrinsic event is not immediately detected, within the interval of the offset rate, the rate is switched back to baseline for pacing over an increased period of time. Some methods establish a preference rate, between the offset and baseline rates, wherein an additional criterion, for switching from the offset rate to the baseline rate, is established with respect to the preference rate.

Abstract: The invention provides methods and apparatus for determining in a non-tracking pacing mode (e.g., DDI/R, VVI/R) whether a ventricular pacing stimulus is capturing a paced ventricle, including some or all of the following aspects. For example, increasing a ventricular pacing rate a nominal amount to an overdrive pacing rate higher than a most recent heart rate and evaluating a conduction interval from a first pacing ventricle to a second sensing ventricle and then continuing to monitor the underlying rate to ensure that a threshold testing pacing rate will not exceed a predetermined minimum interval and providing pacing stimulation to the first ventricle and sensing the second ventricle to determine whether the pacing stimulation to the first ventricle was one of sub-threshold and supra-threshold. The methods and apparatus are especially useful in conjunction with ensuring actual delivery of a ventricular pacing regime (e.g., cardiac resynchronization therapy or “CRT”).

Abstract: The present disclosure is directed to generating and displaying an electrogram (EGM) summary for use by physicians or other clinicians. An implantable medical device (IMD) transmits EGM signal data for a number of cardiac episodes to an external computing device. The external computing device selects a subset of the cardiac episodes for which information or images are displayed to the user. In various examples, cardiac episodes may be selected for display based at least in part on a retrospective analysis classification of the cardiac episode.

Abstract: Various techniques for facilitating selection of a pacing vector for pacing a chamber of a heart are described. One example method described includes, for each of a plurality of vectors, delivering a pacing pulse to capture a first heart chamber, determining a first time interval between the pacing pulse and a sensed event in a second heart chamber, determining a capture detection window in response to the determined first time interval, and enabling a capture detection module to iteratively decrease a pacing pulse magnitude delivered in the first heart chamber until an event in the second heart chamber is not sensed during the determined capture detection window.