Abstract: A medical system configured to monitor physiological symptoms of a patient to detect a current or imminent arrhythmia in a heart of a patient. The medical system is configured to deliver pacing signals to the conduction system of the heart in response to the current or imminent arrhythmia. In examples, the pacing signals are configured to cause high-rate conduction system pacing of the heart. In examples, if the arrhythmia continues or another arrhythmia is detected, the medical system is configured to cause a defibrillation element to deliver a shock to the heart of the patient. In examples, the medical system is configured to deliver a relatively low energy shock following the conduction system pacing.

Abstract: A system comprises processing circuitry and memory comprising program instructions that, when executed by the processing circuitry, cause the processing circuitry to: apply a first set of rules to first patient parameter data for a first determination of whether sudden cardiac arrest of a patient is detected; determine that a one or more context criteria of the first determination are satisfied; and in response to satisfaction of the context criteria, apply a second set of rules to second patient parameter data for a second determination of whether sudden cardiac arrest of the patient is detected. At least the second set of rules comprises a machine learning model, and the second patient parameter data comprises at least one patient parameter that is not included in the first patient parameter data.

Abstract: A system comprises processing circuitry and memory comprising program instructions that, when executed by the processing circuitry, cause the processing circuitry to: apply a first set of rules to first patient parameter data for a first determination of whether sudden cardiac arrest of a patient is detected; determine that a one or more context criteria of the first determination are satisfied; and in response to satisfaction of the context criteria, apply a second set of rules to second patient parameter data for a second determination of whether sudden cardiac arrest of the patient is detected. At least the second set of rules comprises a machine learning model, and the second patient parameter data comprises at least one patient parameter that is not included in the first patient parameter data.

Abstract: Implantable medical electrical leads having electrodes arranged such that a defibrillation coil electrode and a pace/sense electrode(s) are concurrently positioned substantially over the ventricle when implanted as described. The leads include an elongated lead body having a distal portion and a proximal end, a connector at the proximal end of the lead body, a defibrillation electrode located along the distal portion of the lead body, wherein the defibrillation electrode includes a first electrode segment and a second electrode segment proximal to the first electrode segment by a distance. The leads may include at least one pace/sense electrode, which in some instances, is located between the first defibrillation electrode segment and the second defibrillation electrode segment.

Abstract: Implantable medical electrical leads having electrodes arranged such that a defibrillation coil electrode and a pace/sense electrode(s) are concurrently positioned substantially over the ventricle when implanted as described. The leads include an elongated lead body having a distal portion and a proximal end, a connector at the proximal end of the lead body, a defibrillation electrode located along the distal portion of the lead body, wherein the defibrillation electrode includes a first electrode segment and a second electrode segment proximal to the first electrode segment by a distance. The leads may include at least one pace/sense electrode, which in some instances, is located between the first defibrillation electrode segment and the second defibrillation electrode segment.

Abstract: A cardiac medical system, such as an implantable cardioverter defibrillator (ICD) system, receives a cardiac electrical signal by and senses cardiac events when the signal crosses an R-wave sensing threshold. The system determines at least one sensed event parameter from the cardiac electrical signal for consecutive cardiac events sensed by the sensing circuit and compares the sensed event parameters to P-wave oversensing criteria. The system detects P-wave oversensing in response to the sensed event parameters meeting the P-wave oversensing criteria; and adjusts at least one of an R-wave sensing control parameter or a therapy delivery control parameter in response to detecting the P-wave oversensing.

Abstract: Devices, systems, and techniques for detecting a sudden cardiac event based on respiratory parameter information. A method includes receiving periodic respiratory parameter information, where the respiratory parameter information includes respiratory effort of a patient; and determining, by the processing circuitry and based on the respiratory parameter information, whether a sudden cardiac arrest of the patient is detected.

Abstract: Techniques are disclosed for a multi-tier system for delivering therapy to a patient. In one example, a first device senses parametric data for a patient and determines, based on a first analysis of the parametric data, that the patient is experiencing a treatable event. In response, the first device establishes wireless communication with a second device and transmits the parametric data to the second device. The second device verifies, based on a second analysis of the parametric data, whether the patient is experiencing the treatable event. The second device selects, based on the second analysis of the parametric data, an instruction for responding to the treatable event and transmits the instruction for responding to the treatable event to the first device. In some examples, in response to receiving the instruction, the first device aborts delivery of therapy for the treatable event or proceeds with delivering therapy for the treatable event.

Abstract: Implantable medical electrical leads having electrodes arranged such that a defibrillation coil electrode and a pace/sense electrode(s) are concurrently positioned substantially over the ventricle when implanted as described. The leads include an elongated lead body having a distal portion and a proximal end, a connector at the proximal end of the lead body, a defibrillation electrode located along the distal portion of the lead body, wherein the defibrillation electrode includes a first electrode segment and a second electrode segment proximal to the first electrode segment by a distance. The leads may include at least one pace/sense electrode, which in some instances, is located between the first defibrillation electrode segment and the second defibrillation electrode segment.

Abstract: A cardiac medical system, such as an implantable cardioverter defibrillator (ICD) system, receives a cardiac electrical signal by and senses cardiac events when the signal crosses an R-wave sensing threshold. The system determines at least one sensed event parameter from the cardiac electrical signal for consecutive cardiac events sensed by the sensing circuit and compares the sensed event parameters to P-wave oversensing criteria. The system detects P-wave oversensing in response to the sensed event parameters meeting the P-wave oversensing criteria; and adjusts at least one of an R-wave sensing control parameter or a therapy delivery control parameter in response to detecting the P-wave oversensing.

Abstract: Devices, systems, and techniques are disclosed for verifying the occurrence of an acute health event. An example device includes communication circuitry configured to receive a communication indicative of an acute health event of a patient and memory communicatively coupled to the communication circuitry and being configured to store the indication of the acute health event. The device includes processing circuitry communicatively coupled to the communication circuitry and the memory. The processing circuitry is configured to, in response to the communication, verify the acute health event and based on the verification of the acute health event, send an alert regarding the acute health event.

Abstract: An implantable cardiac defibrillator (ICD) system includes an ICD implanted subcutaneously in a patient, a defibrillation lead having a proximal portion coupled to the ICD and a distal portion having a defibrillation electrode configured to deliver a defibrillation or cardioversion shock to a heart of the patient, and a pacing lead that includes a distal portion having one or more electrodes and a proximal portion coupled to the ICD. The distal portion of the pacing lead is implanted at least partially along a posterior side of a sternum of the patient within the anterior mediastinum. The ICD is configured to provide pacing pulses to the heart of the patient via the pacing lead and provide defibrillation shocks to the patient via the defibrillation lead. As such, the implantable cardiac system provides pacing from the substernal space for an extravascular ICD system.

Abstract: A wearable garment and an arrangement of electrodes configured to measure bioelectrical signals from a patient. The dry electrodes are free from adhesives to hold the electrodes in place on the patient's skin. The arrangement of the electrodes may be configured to limit noise and facilitate accurate signal sensing from the patient even with some amount of relative movement between the electrodes and the patient's skin. The wearable garment may be controllable to change the amount of compression based on the sensed signals from the electrodes, and from other sensors. The garment may maintain a comfortable level of compression until processing circuitry detects a signal of interest, such as a cardiac arrhythmia, irregular respiration, or some other signal. The processing circuitry may cause the wearable garment to increase compression to improve the contact between the electrodes and the patient's skin and improve reception of the measured signals.

Abstract: An implantable cardiac defibrillator (ICD) system includes an ICD implanted subcutaneously in a patient, a defibrillation lead having a proximal portion coupled to the ICD and a distal portion having a defibrillation electrode configured to deliver a defibrillation or cardioversion shock to a heart of the patient, and a pacing lead that includes a distal portion having one or more electrodes and a proximal portion coupled to the ICD. The distal portion of the pacing lead is implanted at least partially along a posterior side of a sternum of the patient within the anterior mediastinum. The ICD is configured to provide pacing pulses to the heart of the patient via the pacing lead and provide defibrillation shocks to the patient via the defibrillation lead. As such, the implantable cardiac system provides pacing from the substernal space for an extravascular ICD system.

Abstract: Implantable medical electrical leads having electrodes arranged such that a defibrillation coil electrode and a pace/sense electrode(s) are concurrently positioned substantially over the ventricle when implanted as described. The leads include an elongated lead body having a distal portion and a proximal end, a connector at the proximal end of the lead body, a defibrillation electrode located along the distal portion of the lead body, wherein the defibrillation electrode includes a first electrode segment and a second electrode segment proximal to the first electrode segment by a distance. The leads may include at least one pace/sense electrode, which in some instances, is located between the first defibrillation electrode segment and the second defibrillation electrode segment.

Abstract: An example device of a patient includes an antenna configured to wirelessly receive communication from a medical device; and processing circuitry coupled to the antenna and configured to: determine that the received communication indicates that a patient is experiencing an acute health event; in response to the determination, determine one or more physical states of the patient based on sensed data from one or more sensors; confirm that the patient is not experiencing the acute health event based on the determined one or more physical states; and output information based on the confirmation that the patient is not experiencing the acute health event.

Abstract: An example device of a patient includes an antenna configured to wirelessly receive communication from a medical device; and processing circuitry coupled to the antenna and configured to: determine that the received communication indicates that a patient is experiencing an acute health event; in response to the determination, determine one or more physical states of the patient based on sensed data from one or more sensors; confirm that the patient is not experiencing the acute health event based on the determined one or more physical states; and output information based on the confirmation that the patient is not experiencing the acute health event.

Abstract: Implantable medical electrical leads having electrodes arranged such that a defibrillation coil electrode and a pace/sense electrode(s) are concurrently positioned substantially over the ventricle when implanted as described. The leads include an elongated lead body having a distal portion and a proximal end, a connector at the proximal end of the lead body, a defibrillation electrode located along the distal portion of the lead body, wherein the defibrillation electrode includes a first electrode segment and a second electrode segment proximal to the first electrode segment by a distance. The leads may include at least one pace/sense electrode, which in some instances, is located between the first defibrillation electrode segment and the second defibrillation electrode segment.

Abstract: Implantable leadless cardiac pacing systems and methods for providing substernal pacing using the leadless cardiac pacing systems are described. In one embodiment, an implantable leadless cardiac pacing system includes a housing, a first electrode on the housing, a second electrode on the housing, and a pulse generator within the housing and electrically coupled to the first electrode and the second electrode. The housing is implanted substantially within an anterior mediastinum of a patient and the pulse generator is configured to deliver pacing pulses to a heart of the patient via a therapy vector formed between the first and second electrodes.

Abstract: Implantable medical electrical leads having electrodes arranged such that a defibrillation coil electrode and a pace/sense electrode(s) are concurrently positioned substantially over the ventricle when implanted as described. The leads include an elongated lead body having a distal portion and a proximal end, a connector at the proximal end of the lead body, a defibrillation electrode located along the distal portion of the lead body, wherein the defibrillation electrode includes a first electrode segment and a second electrode segment proximal to the first electrode segment by a distance. The leads may include at least one pace/sense electrode, which in some instances, is located between the first defibrillation electrode segment and the second defibrillation electrode segment.