Abstract: This document discusses, among other things, systems and methods to generate a first pacing waveform during a first pacing period and a second pacing waveform during a second pacing period, and alternate the first and second pacing periods to provide pacing-based hypertension therapy to a heart of a patient to reduce patient blood pressure, wherein the first pacing waveform has a first atrioventricular (AV) delay and the second pacing waveform has a second AV delay longer than the first AV delay. Physiologic information can be received from the patient, and one of the first or second pacing period for delivery to the patient can be determined using the received physiologic information.

Abstract: This document discusses, among other things, systems and methods to generate a first pacing waveform during a first pacing period and a second pacing waveform during a second pacing period, to alternate first and second pacing periods to provide pacing-based hypertension therapy to a heart of a patient to reduce patient blood pressure, and to determine an increased pacing rate for the first pacing waveform during the first pacing period using the first AV delay, wherein the first pacing waveform has a first atrioventricular (AV) delay and the second pacing waveform has a second AV delay longer than the first AV delay.

Abstract: Approaches to rank potential left ventricular (LV) pacing vectors are described. Early elimination tests are performed to determine the viability of LV cathode electrodes. Some LV cathodes are eliminated from further testing based on the early elimination tests. LV cathodes identified as viable cathodes are tested further. Viable LV cathode electrodes are tested for hemodynamic efficacy. Cardiac capture and phrenic nerve activation thresholds are then measured for potential LV pacing vectors comprising a viable LV cathode electrode and an anode electrode. The potential LV pacing vectors are ranked based on one or more of the hemodynamic efficacy of the LV cathodes, the cardiac capture thresholds, and the phrenic nerve activation thresholds.

Abstract: Systems and methods for managing machine-generated medical events detected from one or more patients are described herein. A medical event management system includes an event analyzer circuit to detect a medical event using physiological data from a patient-triggered episode acquired from a medical device. The event analyzer circuit determines a confidence score of the medical event detection, and generates an alignment indicator indicating a degree of concordance between the detected medical event and the information about the patient-triggered episode. The system assigns priority information to the patient-triggered episode using the generated alignment indicator and the confidence score of the detection. An output circuit can output the received physiological information to a user or a process according to the assigned priority information.

Abstract: A ventricularly implantable medical device that includes a sensing module that is configured to gather information during a cardiac cycle and to identify a cardiac interval based at least on part on the gathered information. Control circuitry in the implantable medical device is configured to deliver a ventricular pacing therapy to a patient's heart, wherein the ventricular pacing therapy is time dependent, at least in part, on the identified cardiac interval.

Abstract: A ventricularly implantable medical device that includes a sensing module that is configured to identify a search window of time within a cardiac cycle to search for an atrial artifact. Control circuitry in the ventricular implantable medical device is configured to deliver a ventricular pacing therapy to a patient's heart, wherein the ventricular pacing therapy is time dependent, at least in part, on an atrial event identified in the search window of time.

Abstract: Methods and/or device facilitating and selecting among multiple modes of filtering a cardiac electrical signal, in which one filtering mode includes additional high pass filtering of low frequency signals, relative to the other filtering mode. The selection filtering modes may include comparing sensed signal amplitude to one or more thresholds, using the multiple modes of filtering. In another example, an additional high pass filter is enabled, over and above a default or baseline filtering mode, and the detected cardiac signal is monitored for indications of possible undersensing, and/or for drops in amplitude toward a threshold, and the additional high pass filter may be disabled upon finding of possible undersensing or drop in signal amplitude.

Abstract: Various system embodiments comprise a stimulator adapted to deliver a stimulation signal for a heart failure therapy, a number of sensors adapted to provide at least a first measurement of a heart failure status and a second measurement of the heart failure status, and a controller. The controller is connected to the stimulator and to the number of sensors. The controller is adapted to use the first and second measurements to create a heart failure status index, and control the stimulator to modulate the signal using the index. Other aspects and embodiments are provided herein.

Abstract: Methods and/or device facilitating and selecting among multiple modes of filtering a cardiac electrical signal, in which one filtering mode includes additional high pass filtering of low frequency signals, relative to the other filtering mode. The selection filtering modes may include comparing sensed signal amplitude to one or more thresholds, using the multiple modes of filtering. In another example, an additional high pass filter is enabled, over and above a default or baseline filtering mode, and the detected cardiac signal is monitored for indications of possible undersensing, and/or for drops in amplitude toward a threshold, and the additional high pass filter may be disabled upon finding of possible undersensing or drop in signal amplitude.

Abstract: Systems and methods for classifying a cardiac arrhythmia are discussed. An exemplary system includes a correlator circuit to generate autocorrelation sequences using information of cardiac activity of a subject, including signal segments taken from a cardiac signal at respective elapsed time with respect to reference time. The correlator circuit can generate a correlation image using the autocorrelation sequences. The correlation image may be constructed by stacking the autocorrelation sequences according to the elapsed time of signal segments. An arrhythmia classifier circuit can classify the cardiac activity of the subject as one of arrhythmia types using the correlation image.

Abstract: Methods and devices adapted for cardiac signal analysis. A method or device has accessible to it more than one approach to cardiac cycle rate analysis and is adapted to monitor sensing signal quality. In response to an apparent reduction in signal quality or other trigger, the method or device checks whether an arrhythmia or an actual drop in signal quality is occurring prior to modifying sensing configurations or parameters.

Abstract: Methods, systems and devices for providing cardiac resynchronization therapy (CRT) to a patient using a leadless cardiac pacemaker (LCP) and an extracardiac device (ED). The LCP is configured to deliver pacing therapy at a pacing interval. Illustratively, the ED may be configured to analyze the cardiac cycle including a portion preceding the pacing therapy delivery for one or several cardiac cycles, and determine whether an interval from the P-wave to the pace therapy in the cardiac cycle(s) is in a desired range. In an example, if the P-wave to pace interval is outside the desired range, the ED communicates to the LCP to adjust the pacing interval.

Abstract: This document discusses, among other things, systems and methods to determine a response curve between received cardiac electrical information from a subject, such as a time of a P wave, and received cardiac acceleration information of the subject, such as a time of a first heart sound (S1) or a second heart sound (S2), to a set of stimulation signals provided to the subject at different AVD intervals. In certain examples, one or more cardiac resynchronization therapy (CRT) parameters can be determined for the subject using the determined response curve.

Abstract: This document discusses, among other things, systems and methods to determine a response between received cardiac electrical information from a subject, such as a time of a P wave, and received cardiac acceleration information of the subject, such as a time of a first heart sound (S1) or a second heart sound (S2), across a set of stimulation signals provided to the subject at different AVD intervals, and determining one or more cardiac resynchronization therapy (CRT) parameters using an inflection point of the determined response.

Abstract: Methods, systems and devices for providing cardiac resynchronization therapy (CRT) to a patient using a leadless cardiac pacemaker (LCP) and an extracardiac device (ED). The LCP is configured to deliver pacing therapy at a pacing interval. Illustratively, the ED may be configured to analyze the cardiac cycle including a portion preceding the pacing therapy delivery for one or several cardiac cycles, and determine whether an interval from the P-wave to the pace therapy in the cardiac cycle(s) is in a desired range. In an example, if the P-wave to pace interval is outside the desired range, the ED communicates to the LCP to adjust the pacing interval.

Abstract: A delivery and deployment device may include a handle assembly and a shaft extending distally from the handle assembly. A device containment housing may be coupled to a distal region of the shaft and may extend distally therefrom. The distal containment housing may be configured to accommodate at least a portion of the IMD therein. The IMD may, for example, be a leadless pacemaker, a lead, a neurostimulation device, a sensor or any other suitable IMD. A plurality of electrodes may be distributed about an exterior surface of the device containment housing such that at least some of the plurality of electrodes may be positioned to test a potential IMD deployment location before deploying the IMD.

Abstract: Systems and methods for detecting cardiac arrhythmias such as an atrial fibrillation (AF) are described herein. The AF detection system includes a sensor circuit to sense a physiological signal, a heartbeat processor to recognize a plurality of beat patterns using cycle length of two more consecutive cardiac cycles. The beat patterns can be indicative of temporal relationship between the consecutive cardiac cycles. The heartbeat processor may generate a repetitiveness indictor based on a statistical measurement of various beat patterns. The AF detection system includes an arrhythmia detector to detect an episode of AF based on the repetitiveness indictor, and to discriminate the AF from other arrhythmias of atrio-ventricular conduction abnormalities.

Abstract: A system and method to sense heart sounds with one or more implantable medical devices according to one or more signal processing parameters. The method alters one or more of the parameters as a function of one or more physiologic triggering events. The method then senses heart sounds with the one or more implantable medical devices according to at least the one or more altered signal processing parameters.

Abstract: This document discusses, among other things, systems and methods to adjust arrhythmia detection using physiological information of a patient, including detecting a candidate cardiac event about a threshold, displaying the detected candidate cardiac event to a user, receiving user information about the detected candidate cardiac event, and adjusting an arrhythmia detection threshold based upon the received user information.

Abstract: An apparatus includes a cardiac signal sensing circuit configured to generate a sensed cardiac signal representative of electrical cardiac activity of a subject, a buffer memory and a pause detection circuit. The pause detection circuit is configured to: identify ventricular depolarization in the cardiac signal or the sampled cardiac signal; detect a candidate pause episode using the cardiac signal in which delay in ventricular depolarization exceeds a specified delay threshold; identify noise events in a stored cardiac signal; and discard the cardiac signal of the candidate pause episode when a number of noise events satisfies a specified noise event number threshold, otherwise store the cardiac signal of the candidate pause episode as a bradycardia pause episode.