Abstract: Techniques are provided for use with a pulmonary artery pressure (PAP) monitor having an implantable PAP sensor. In one example, a PAP signal is sensed that is representative of beat-by-beat variations in PAP occurring during individual cardiac cycles of the patient. The PAP monitor detects peaks within the PAP signal corresponding to valvular regurgitation within the heart, then detects mitral regurgitation (MR) based on the peaks. In other examples, the PAP monitor optimizes pacing parameters based on the PAP signal and corresponding electrical cardiac signals. Examples are provided where the PAP monitor is an external system and other examples are provided where the PAP monitor is a component of an implantable cardiac rhythm management device.

Abstract: Techniques are provided for use with a pulmonary artery pressure (PAP) monitor having an implantable PAP sensor. In one example, a PAP signal is sensed that is representative of beat-by-beat variations in PAP occurring during individual cardiac cycles of the patient. The PAP monitor detects intervals within the signal corresponding to the durations of cardiac cycles, then detects cardiac rhythm irregularities based on the intervals. For example, the PAP monitor can detect and distinguish atrial fibrillation, ventricular fibrillation and ventricular tachycardia based on the stability of the intervals of the PAP signal along with other information such as ventricular rate. The PAP monitor can also detect and distinguish premature contractions based on durations of the intervals. Examples where the PAP monitor is a component of an implantable cardiac rhythm management device (CRMD) are also provided.

Abstract: Techniques are provided for use with a pulmonary artery pressure (PAP) monitor having an implantable PAP sensor. In one example, a PAP signal is sensed that is representative of beat-by-beat variations in PAP occurring during individual cardiac cycles of the patient. The PAP monitor detects peaks within the PAP signal corresponding to valvular regurgitation within the heart, then detects mitral regurgitation (MR) based on the peaks. In other examples, the PAP monitor optimizes pacing parameters based on the PAP signal and corresponding electrical cardiac signals. Examples are provided where the PAP monitor is an external system and other examples are provided where the PAP monitor is a component of an implantable cardiac rhythm management device.

Abstract: Techniques are provided for use with a pulmonary artery pressure (PAP) monitor having an implantable PAP sensor. In one example, a PAP signal is sensed that is representative of beat-by-beat variations in PAP occurring during individual cardiac cycles of the patient. The PAP monitor detects intervals within the signal corresponding to the durations of cardiac cycles, then detects cardiac rhythm irregularities based on the intervals. For example, the PAP monitor can detect and distinguish atrial fibrillation, ventricular fibrillation and ventricular tachycardia based on the stability of the intervals of the PAP signal along with other information such as ventricular rate. The PAP monitor can also detect and distinguish premature contractions based on durations of the intervals. Examples where the PAP monitor is a component of an implantable cardiac rhythm management device (CRMD) are also provided.

Abstract: An exemplary method includes, based on metrics available as input to a chronic phase optimization algorithm for selecting an optimal electrode configuration for delivery of a cardiac pacing therapy, executing the chronic phase optimization algorithm during an acute phase to select an optimal electrode configuration for delivery of a cardiac pacing therapy; during the acute phase, acquiring position information with respect to time for electrodes implanted in a body; determining one or more acute phase metrics based on the acquired position information; and validating the chronic phase optimization algorithm based at least in part on the one or more acute phase metrics.

Abstract: A biventricular pacing system is provided which includes an automatic capture verification system for verifying capture of left ventricular pacing pulses on a beat by beat basis. A loss of capture recovery system delivers a backup safety pulse in the event of loss of capture detected in either the right or left ventricle. An automatic stimulation threshold search system is provided for measuring the capture threshold of both left and right ventricles based on various triggers. An automatic output regulation system for both the left and right ventricular channels is provided to set the pacing amplitude to levels sufficient to ensure capture plus a safety margin. A left ventricular automatic stimulation threshold search is triggered upon detection of any loss of capture in the left ventricle and periodically based on a number of different triggers.

Abstract: Techniques for improving the specificity of automatic mode switching (AMS) are provided to prevent inappropriate mode switching and to ensure that mode switching is performed when needed. In one example, improved techniques for calculating a filtered rate interval (FARI) are provided, which help avoid inappropriate mode switching within devices that employ FARI in connection with the determination of the atrial rate. Also, techniques are provided for detecting atrial tachycardia and for distinguishing between a true tachycardia and a false tachycardia (such as pacemaker mediated tachycardia). The techniques described herein for detecting atrial tachycardia and for distinguishing between true and false tachycardia are advantageously employed in connection with AMS but may be used in other circumstances as well. Techniques employed in conjunction with dynamic atrial overdrive (DAO) pacing are also discussed.