Abstract: In some examples, a system can be used for delivering cardiac resynchronization therapy (CRT). The system may include a pacing device configured to be implanted within a patient. The pacing device can include a plurality of electrodes, signal generation circuitry configured to deliver ventricular pacing via the plurality of electrodes, and a sensor configured to produce a signal that indicates mechanical activity of the heart. Processing circuitry can be configured to identify one or more features of a cardiac contraction within the signal, and determine whether the contraction was a fusion beat based on the one or more features.

Abstract: Techniques for using multiple physiological parameters to provide an early warning for worsening heart failure are described. A medical device monitors a primary diagnostic parameter that is indicative of worsening heart failure, such as intrathoracic impedance or pressure, and one or more secondary diagnostic parameters. The medical device detects worsening heart failure in the patient based on the primary diagnostic parameter when an index that is changed over time based on the primary diagnostic parameter value is outside a range of values, termed the threshold zone. When the index is within the threshold zone, the medical device detects worsening heart failure in the patient based on the one or more secondary diagnostic parameters. Upon detecting worsening heart failure, the medical device may, for example, provide an alert that enables the patient to seek medical attention before experiencing a heart failure event.

Abstract: A medical device processor is configured to receive at least one cardiac electrical signal that is sensed during bilateral bundle branch pacing delivered from a bipolar electrode pair comprising an anode positioned along a first bundle branch and a cathode positioned along a second bundle branch opposite the first bundle branch, determine at least one feature from the first cardiac electrical signal, determine that the at least one feature meets first bundle branch capture criteria; and determine anodal bundle branch capture in response to the first bundle branch capture criteria being met.

Abstract: A system comprising processing circuitry configured to receive a wirelessly-transmitted message from a medical device, the message indicating that the medical device detected an acute health event of the patient. In response to the message, the processing circuitry is configured to determine a location of the patient, determine an alert area based on the location of the patient, and control transmission of an alert of the acute heath event of the patient to any one or more computing devices of one or more potential responders within the alert area.

Abstract: The present disclosure pertains to cardiac pacing methods and systems, and, more particularly, to cardiac resynchronization therapy (CRT). In particular, the present disclosure pertains to determining whether a patient is experiencing atrial fibrillation (AF). If the patient is experiencing AF, the efficacy of CRT is determined. A signal is sensed in response to a ventricular pacing stimulus. Through signal processing, a number of features are parsed from the signal and a determination is made as to whether the ventricular pacing stimulus evoked a response from the ventricle.

Abstract: An implantable medical device system is configured to generate signals representing activity of a heart of a patient; determine, based on the signals, an intrinsic delay of the heart of the patient; determine whether the intrinsic delay is indicative of a first-degree heart block being present in the heart of the patient; determine a patient-specific timing regime for conduction system pacing based on whether the intrinsic delay is indicative of the first-degree heart block being present in the heart of the patient; and administer cardiac pacing to a native conduction system of the heart of the patient based on the timing regime.

Abstract: A medical device system is configured to guide implantation of a pacing electrode for left bundle branch pacing. The system includes a medical device having a processor configured to receive at least one cardiac electrical signal, determine a feature of the cardiac electrical signal, compare the feature to left bundle branch signal criteria, and determine a left bundle branch signal in response to the feature meeting the left bundle branch signal criteria. The system includes a display unit configured to generate a user feedback signal indicating advancement of a pacing electrode into a left portion of a ventricular septum in response to the processor determining the left bundle branch signal.

Abstract: Techniques for detecting infections in a patient in relation to temperature values obtained from implantable temperature sensors are described. An example implantable temperature sensor may be included within a housing of an implantable medical device (IMD). In some examples, the temperature sensor may determine a plurality of temperature values over time. Processing circuitry of the IMD or of an external device may smooth the temperature values and apply an infection detection model to the smoothened temperature signal to determine an infection status of the patient.

Abstract: An implantable medical device comprises a sensing module configured to obtain electrical signals from one or more electrodes and a control module configured to process the electrical signals from the sensing module in accordance with a tachyarrhythmia detection algorithm to monitor for a tachyarrhythmia. The control module detects initiation of a pacing train delivered by a second implantable medical device, determines a type of the detected pacing train, and modifies the tachyarrhythmia detection algorithm based on the type of the detected pacing train.

Abstract: An implantable medical device system and method for delivering cardiac resynchronization therapy (CRT) pacing that includes determining capture associated with the delivered CRT pacing is ineffective in response to the delivered CRT pacing. A reason for capture being ineffective is determined and a safety margin is adjusted if the determined reason for capture being ineffective is loss of capture and a left ventricle (LV) pre-excitation is adjusted if the determined reason for capture being ineffective is delayed LV depolarization. Monitoring for a change in effective cardiac resynchronization therapy is used to confirm that the adjustment of the CRT pacing was effective in resolving the ineffective capture.

Abstract: A controller for an implantable blood pump, having processing circuitry configured to control an operating speed of an impeller of the implantable blood pump. The processing circuitry being further configured to control activation and deactivation of a sleep mode. During the sleep mode the processing circuitry being configured to measure a level of suction by detecting suction during a predetermined time interval, recording the time at which suction occurred during the predetermined time interval, and generating a graph demonstrating the measured level of suction. The measured level of suction being a percentage of time the implantable blood pump experienced suction during the predetermined time interval. The processing circuitry being configured to reduce the operating speed of the impeller if the measured level of suction exceeds a predetermined threshold.

Abstract: A method and medical device for detecting a cardiac event that includes sensing cardiac signals from a plurality of electrodes, the plurality of electrodes forming a first sensing vector and a second sensing vector, identifying the cardiac event as one of a shockable event and a non-shockable event in response to first processing of a first interval sensed along the first sensing vector during a predetermined sensing window and a second interval simultaneously sensed along the second sensing vector, performing second processing of the first interval and the second interval, different from the first processing, in response to the cardiac event being identified as a shockable event, and determining whether to delay identifying the cardiac event being shockable in response to the second processing of the first interval and the second interval.

Abstract: A method of detecting hypertension in a patient having an implantable blood pump, the method includes operating the implantable blood pump at a first pump set speed during a first period of time. A first flow rate minimum during a cardiac cycle of the patient is measured. during the first period of time. The first pump set speed is reduced by at least 200 rpm during a second period of time after the first period of time to a second pump set speed, the second period of time being less than the first period of time. A second flow rate minimum is measured during a cardiac cycle during the second period of time. If the second flow rate minimum decreases during the second period of time at the second pump set speed by more than a predetermined amount, an alert is generated indicating a presence of hypertension.

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: A method of detecting hypertension in a patient having an implantable blood pump, the method includes operating the implantable blood pump at a first pump set speed during a first period of time. A first flow rate minimum during a cardiac cycle of the patient is measured during the first period of time. The first pump set speed is reduced by at least 200 rpm during a second period of time after the first period of time to a second pump set speed, the second period of time being less than the first period of time. A second flow rate minimum is measured during a cardiac cycle during the second period of time. If the second flow rate minimum decreases during the second period of time at the second pump set speed by more than a predetermined amount, an alert is generated indicating a presence of hypertension.

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: In some examples, a system may be used for delivering cardiac therapy or cardiac sensing. The system may include an in implantable medical device including a housing configured to be implanted on or within a heart of a patient, a fixation element configured to attach the housing to the heart; and a sensor configured to produce a signal that indicates motion of the implantable medical device. Processing circuitry may be configured to identify one or more impingements between the housing and another structure, such as a tissue of the heart, based on the signal from the sensor and provide an indication of the one or more impingements to a user.

Abstract: A method and medical device for detecting a cardiac event that includes sensing cardiac signals from a plurality of electrodes, the plurality of electrodes forming a first sensing vector and a second sensing vector, identifying the cardiac event as one of a shockable event and a non-shockable event in response to first processing of a first interval sensed along the first sensing vector during a predetermined sensing window and a second interval simultaneously sensed along the second sensing vector, performing second processing of the first interval and the second interval, different from the first processing, in response to the cardiac event being identified as a shockable event, and determining whether to delay identifying the cardiac event being shockable in response to the second processing of the first interval and the second interval.

Abstract: A medical device is configured to sense at least one cardiac electrical signal and generate pacing pulses according to a first pacing therapy by generating pacing pulses for delivery to a first combination of ventricular pacing sites including at least one ventricular conduction system pacing site. The medical device may be configured to determine a ventricular conduction condition based on a QRS signal feature of the sensed cardiac signal during the first pacing therapy. The medical device may change to a second pacing therapy different than the first pacing therapy based on the determined ventricular conduction condition.

Abstract: An extra-cardiovascular implantable cardioverter defibrillator senses R-waves from a first cardiac electrical signal by a first sensing channel and stores a time segment of a second cardiac electrical signal in response to each sensed R-wave. The ICD determines intervals between successively sensed R-waves and, in response to at least a predetermined number of the intervals being less than a tachyarrhythmia detection interval, analyzes at least a portion of the time segment of the second cardiac electrical signal corresponding to a most recent one of the sensed R-waves to confirm the most recent one of the R-waves. The ICD updates an unconfirmed beat count in response to the most recent one of the R-waves not being confirmed and withholds detection of a tachyarrhythmia episode in response to the unconfirmed beat count being equal to or greater than a rejection threshold.