Abstract: Embodiments herein relate to systems for tracking and maintaining the integrity of patient device data over extended periods of time. In a first aspect, a medical device system is included having an implantable device that can include a control circuit, a communication circuit, and one or more sensors. The system can also include an external device including a control circuit and a communication circuit. The external device can be configured to receive patient data from the implantable device and execute a hashing operation on units of received patient device data and one or more previous digest packets to create new digest packets. The external device can be configured to store the new digest packets and forward digest packets onto another device of the medical device system when requested to allow patient data to be authenticated. Other embodiments are also included herein.

Abstract: New and alternative approaches to the monitoring of cardiac signal quality for external and/or implantable cardiac devices. In one example, signal quality is monitored continuously or in response to a triggering event or condition and, upon identification of a reduction in signal quality, a device may reconfigure its sensing state. In another example, one or more trends of signal quality are monitored by a device, either continuously or in response to a triggering event or condition, and sensing reconfiguration may be performed in response to identified trends and events. In yet another example, a device may use a looping data capture mode to track sensing data in multiple vectors while primarily relying on less than all sensing vectors to make decisions and, in response to a triggering event or condition, the looped data can be analyzed automatically, without waiting for additional data capture to reconfigure sensing upon identification of the triggering event or condition.

Abstract: Catheter and implantable leadless pacing devices, systems, and methods utilizing catheters and implantable leadless pacing devices are disclosed. An example catheter system may include a holding structure extending distally from a tubular member. An implantable device, such a leadless pacing device, may be located within a cavity of the holding structure and an electrical barrier may be located within the holding structure at a location between a proximal electrode and a distal electrode of the implantable device. The electrical barrier may inhibit electrical signals of the implantable device from traveling within the holding structure between the proximal electrode and the distal electrode of the implantable device. The holding structure may include one or more electrical ports adjacent the proximal end of the holding structure and adjacent or proximal of the proximal electrode of the implantable device.

Abstract: Catheter and implantable leadless pacing devices, systems, and methods utilizing catheters and implantable leadless pacing devices are disclosed. An example catheter system may include a holding structure extending distally from a tubular member. An implantable device, such a leadless pacing device, may be located within a cavity of the holding structure and an electrical barrier may be located within the holding structure at a location between a proximal electrode and a distal electrode of the implantable device. The electrical barrier may inhibit electrical signals of the implantable device from traveling within the holding structure between the proximal electrode and the distal electrode of the implantable device. The holding structure may include one or more electrical ports adjacent the proximal end of the holding structure and adjacent or proximal of the proximal electrode of the implantable device.

Abstract: Methods and devices for combining multiple signals from multiple sensing vectors for use in wearable or implantable cardiac devices. Signals from multiple vectors may be combined using weighting factors and/or by conversion to different coordinate systems than the original inputs, which may or may not be normalized to patient anatomy. Signals from multiple sensing vectors may be combined prior to or after several analytical steps or processes including before or after filtering, and before or after cardiac cycle detection. Cardiac cycle detection information may be combined across multiple sensing vectors before or after analysis of individual vectors for noise or overdetection. Cardiac cycle detection information may also be combined across multiple sensing vectors to identify noise and/or overdetection.

Abstract: New and alternative approaches to the monitoring of cardiac signal quality for external and/or implantable cardiac devices. In one example, signal quality is monitored continuously or in response to a triggering event or condition and, upon identification of a reduction in signal quality, a device may reconfigure its sensing state. In another example, one or more trends of signal quality are monitored by a device, either continuously or in response to a triggering event or condition, and sensing reconfiguration may be performed in response to identified trends and events. In yet another example, a device may use a looping data capture mode to track sensing data in multiple vectors while primarily relying on less than all sensing vectors to make decisions and, in response to a triggering event or condition, the looped data can be analyzed automatically, without waiting for additional data capture to reconfigure sensing upon identification of the triggering event or condition.

Abstract: Methods and devices for combining multiple signals from multiple sensing vectors for use in wearable or implantable cardiac devices. A preferred sensing configuration may be selected at a given point in time, for example under clinical conditions. Signal quality for the preferred sensing configuration is then monitored, and if the signal quality degrades under selected conditions, re-analysis may be performed to select a different sensing vector configuration for at least temporary use. If signal quality increases for the preferred sensing configuration, temporary use of the different sensing vector configuration may cease and reversion to the preferred sensing configuration takes place if certain conditions are met. The conditions for reversion may depend in part of a history of sensing signal quality for the preferred sensing configuration.

Abstract: Methods and devices for combining multiple signals from multiple sensing vectors for use in wearable or implantable cardiac devices. Signals from multiple vectors may be combined using weighting factors and/or by conversion to different coordinate systems than the original inputs, which may or may not be normalized to patient anatomy. Signals from multiple sensing vectors may be combined prior to or after several analytical steps or processes including before or after filtering, and before or after cardiac cycle detection. Cardiac cycle detection information may be combined across multiple sensing vectors before or after analysis of individual vectors for noise or overdetection. Cardiac cycle detection information may also be combined across multiple sensing vectors to identify noise and/or overdetection.

Abstract: New and alternative approaches to the monitoring of cardiac signal quality for external and/or implantable cardiac devices. In one example, signal quality is monitored continuously or in response to a triggering event or condition and, upon identification of a reduction in signal quality, a device may reconfigure its sensing state. In another example, one or more trends of signal quality are monitored by a device, either continuously or in response to a triggering event or condition, and sensing reconfiguration may be performed in response to identified trends and events. In yet another example, a device may use a looping data capture mode to track sensing data in multiple vectors while primarily relying on less than all sensing vectors to make decisions and, in response to a triggering event or condition, the looped data can be analyzed automatically, without waiting for additional data capture to reconfigure sensing upon identification of the triggering event or condition.

Abstract: Catheter and implantable leadless pacing devices, systems, and methods utilizing catheters and implantable leadless pacing devices are disclosed. An example catheter system may include a holding structure extending distally from a tubular member. An implantable device, such a leadless pacing device, may be located within a cavity of the holding structure and an electrical barrier may be located within the holding structure at a location between a proximal electrode and a distal electrode of the implantable device. The electrical barrier may inhibit electrical signals of the implantable device from traveling within the holding structure between the proximal electrode and the distal electrode of the implantable device. The holding structure may include one or more electrical ports adjacent the proximal end of the holding structure and adjacent or proximal of the proximal electrode of the implantable device.

Abstract: Methods and devices for combining multiple signals from multiple sensing vectors for use in wearable or implantable cardiac devices. A preferred sensing configuration may be selected at a given point in time, for example under clinical conditions. Signal quality for the preferred sensing configuration is then monitored, and if the signal quality degrades under selected conditions, re-analysis may be performed to select a different sensing vector configuration for at least temporary use. If signal quality increases for the preferred sensing configuration, temporary use of the different sensing vector configuration may cease and reversion to the preferred sensing configuration takes place if certain conditions are met. The conditions for reversion may depend in part of a history of sensing signal quality for the preferred sensing configuration.

Abstract: Methods and devices for combining multiple signals from multiple sensing vectors for use in wearable or implantable cardiac devices. Signals from multiple vectors may be combined using weighting factors and/or by conversion to different coordinate systems than the original inputs, which may or may not be normalized to patient anatomy. Signals from multiple sensing vectors may be combined prior to or after several analytical steps or processes including before or after filtering, and before or after cardiac cycle detection. Cardiac cycle detection information may be combined across multiple sensing vectors before or after analysis of individual vectors for noise or overdetection. Cardiac cycle detection information may also be combined across multiple sensing vectors to identify noise and/or overdetection.

Abstract: Methods and devices for combining multiple signals from multiple sensing vectors for use in wearable or implantable cardiac devices. Signals from multiple vectors may be combined using weighting factors and/or by conversion to different coordinate systems than the original inputs, which may or may not be normalized to patient anatomy. Signals from multiple sensing vectors may be combined prior to or after several analytical steps or processes including before or after filtering, and before or after cardiac cycle detection. Cardiac cycle detection information may be combined across multiple sensing vectors before or after analysis of individual vectors for noise or overdetection. Cardiac cycle detection information may also be combined across multiple sensing vectors to identify noise and/or overdetection.

Abstract: New and alternative approaches to the monitoring of cardiac signal quality for external and/or implantable cardiac devices. In one example, signal quality is monitored continuously or in response to a triggering event or condition and, upon identification of a reduction in signal quality, a device may reconfigure its sensing state. In another example, one or more trends of signal quality are monitored by a device, either continuously or in response to a triggering event or condition, and sensing reconfiguration may be performed in response to identified trends and events. In yet another example, a device may use a looping data capture mode to track sensing data in multiple vectors while primarily relying on less than all sensing vectors to make decisions and, in response to a triggering event or condition, the looped data can be analyzed automatically, without waiting for additional data capture to reconfigure sensing upon identification of the triggering event or condition.

Abstract: Energy delivered from an implantable medical device to stimulate tissue within a patient's body is controlled. An electrical signal used to stimulate the tissue is changed from a first energy state to a second energy state during a magnetic resonance imaging (MRI) scan. The energy delivered is maintained at the second energy state after the MRI scan. A capture threshold of the tissue is then measured, and the energy delivered to the tissue is adjusted based on the measured capture threshold of the tissue.

Abstract: A method and system for providing an indication of delivery of a neural stimulation therapy is disclosed. In an example, a method may include identifying current timing of an intermittent neural stimulation (INS) programmed in an implantable medical device (IMD) where the programmed INS includes alternating stimulation ON and stimulation OFF times and a timing for delivering stimulation bursts of a plurality of stimulation pulses during the stimulation burst ON times. An indication of the current timing of the INS may be provided using an INS indicator of an external device.

Abstract: A method and system for providing an indication of delivery of a neural stimulation therapy is disclosed. In an example, a method may include identifying current timing of an intermittent neural stimulation (INS) programmed in an implantable medical device (IMD) where the programmed INS includes alternating stimulation ON and stimulation OFF times and a timing for delivering stimulation bursts of a plurality of stimulation pulses during the stimulation burst ON times. An indication of the current timing of the INS may be provided using an INS indicator of an external device.

Abstract: Energy delivered from an implantable medical device to stimulate tissue within a patient's body is controlled. An electrical signal used to stimulate the tissue is changed from a first energy state to a second energy state during a magnetic resonance imaging (MRI) scan. The energy delivered is maintained at the second energy state after the MRI scan. A capture threshold of the tissue is then measured, and the energy delivered to the tissue is adjusted based on the measured capture threshold of the tissue.

Abstract: Energy delivered from an implantable medical device to stimulate tissue within a patient's body is controlled. An electrical signal used to stimulate the tissue is changed from a first energy state to a second energy state during a magnetic resonance imaging (MRI) scan. The energy delivered is maintained at the second energy state after the MRI scan. A capture threshold of the tissue is then measured, and the energy delivered to the tissue is adjusted based on the measured capture threshold of the tissue.

Abstract: Energy delivered from an implantable medical device to stimulate tissue within a patient's body is controlled. An electrical signal used to stimulate the tissue is changed from a first energy state to a second energy state during a magnetic resonance imaging (MRI) scan. The energy delivered is maintained at the second energy state after the MRI scan. A capture threshold of the tissue is then measured, and the energy delivered to the tissue is adjusted based on the measured capture threshold of the tissue.