Abstract: Systems and methods are described herein for evaluation and adjustment cardiac therapy. The systems and methods may initially evaluate a first pacing parameter while other pacing parameters are fixed to, for example, nominal values, and determine an effective setting for the first pacing parameter. Then, a second pacing parameter may be evaluated while the first pacing parameter is fixed to the previously-determined effective setting. Each evaluation may not test every possible setting for the pacing parameters, and instead, may utilize various processes to limit the settings to a subset of settings to test.

Abstract: Systems and methods are described herein for evaluation and configuration cardiac therapy. The systems and methods may monitor electrical activity using a plurality of external electrodes and may utilize multiple-electrode cardiac metrics such as electrical heterogeneity information, single-electrode cardiac metrics, and vectorcardiographic metrics to determine and select one or more paced settings from a plurality of different paced settings.

Abstract: Systems and methods are described herein for use in synchronizing electrical activity monitored by a plurality of external electrodes with supplemental cardiac data for use in evaluating a patient's cardiac condition and configuring cardiac therapy. The supplemental cardiac data may include one or more markers indicative of the occurrence of cardiac events and/or data representative of representative of at least one of cardiac electrical signals, cardiac sounds, cardiac pressures, blood flow, and an estimated instantaneous flow waveform provided by a left ventricular assist device.

Abstract: Systems, methods, and devices are described herein for evaluation of patient's cardiac condition based on monitored electrical activity from a plurality of external electrodes. Various information such as electrical heterogeneity information may be generated based on the monitored electrical activity, which may be further analyzed to evaluate the patient's cardiac condition. The systems, methods, and devices may provide an indication of whether the patient may benefit from cardiac therapy based on the evaluation of the patient's cardiac condition.

Abstract: Systems, interfaces, and methods are described herein for evaluation and adjustment cardiac therapy. The systems, interfaces, and methods may utilize, or include, a graphical user interface to display various information with respect to a plurality of external electrodes and electrical activity monitored using such external electrodes and to allow a user to adjust what information to display.

Abstract: A method includes determining whether electrical activity is indicative of atrial fibrillation, determining whether mechanical activity is indicative of atrial fibrillation, and adjusting a pacing parameter or mode based on whether the electrical activity and the mechanical activity are indicative of atrial fibrillation. The electrical activity may be detected based on a far-field measurement. The method may be performed using a leadless implantable medical device.

Abstract: Systems and methods are described herein for generating surrogate cardiac electrical activation times from electrical activity monitored by a plurality of external electrodes. Surrogate cardiac electrical activation times that should be corrected may be identified, or determined, according to one or more metrics, and then such surrogate cardiac electrical activation times may be corrected according to various criterion.

Abstract: A system and method of positioning an atrial pacing lead for delivery of a cardiac pacing therapy that includes sensing electrical activity of tissue of a patient from a plurality of external electrodes and determining a distribution of bi-atrial activation in response to the sensed electrical activity. A target site for delivering the atrial pacing therapy is adjusted based on a change in bi-atrial dyssynchrony that is determined in response to the determined distribution of bi-atrial activation, and placement of the atrial pacing lead for delivery of the atrial pacing therapy is determined in response to the adjusting.

Abstract: An implantable medical system may provide atrioventricular synchronous pacing using the ventricular septal wall. The system may include a ventricular electrode coupled to an intracardiac housing or a first medical lead implantable in the ventricular septal wall of the patient's heart to deliver cardiac therapy to or sense electrical activity of the left ventricle of the patient's heart and a right atrial electrode coupled to a leadlet or second medical lead to deliver cardiac therapy to or sense electrical activity of the right atrium of the patient's heart. A right ventricular electrode may be coupled to the intracardiac housing or the first medical lead and implantable in the ventricular septal wall of the patient's heart to deliver cardiac therapy to or sense electrical activity of the right ventricle of the patient's heart.

Abstract: Methods and/or devices may be configured to estimate right ventricular-timings from left ventricular (LV) sensing times for adaptive cardiac therapy using DDD/VDD LV pacing without using a right ventricular (RV) lead. One embodiment employs a subcutaneous device (SD) in a patient and a leadless pacing device (LPD) coupled to a patient's heart. Heart activity including atrial and ventricular events are sensed from the patient's heart using the SD. Left ventricular events (LVS) are sensed using the LPD. The SD is used to determine whether cardiac resynchronization pacing therapy (CRT pacing) is appropriate based upon the heart activity sensed by the SD. The SD is further configured to determine timing of CRT pacing pulses for delivery to cardiac tissue through the LPD.

Abstract: A method and system for delivering a cardiac pacing therapy that includes a cardiac signal being sensed via electrodes of an atrial lead, and an occurrence of one of an intrinsic and a paced atrial depolarization event of a current cardiac cycle being determined in response to the sensed cardiac signal. A first pacing therapy is delivered during the current cardiac cycle in response to the determined occurrence of the depolarization event, and an amplitude of the cardiac signal within the current cardiac cycle subsequent to the delivered first pacing therapy is compared to a predetermined amplitude threshold. A second pacing therapy is delivered, via a left ventricular lead, within the same cardiac cycle and subsequent to the delivered first pacing therapy in response to the amplitude not being more negative than the predetermined amplitude threshold and is not delivered in response to the amplitude being more negative than the predetermined amplitude threshold.

Abstract: Systems and methods may monitor electrical activity of a patient's heart using electrodes during delivery of cardiac conduction system pacing therapy, generate electrical heterogeneity information (EHI) based on the monitored electrical activity during delivery of cardiac conduction system pacing therapy, and determine whether the cardiac conduction system pacing therapy would benefit from supplemental cardiac pacing therapy based on the generated EHI.

Abstract: Systems and methods may monitor electrical activity of a patient's heart using electrodes during delivery of cardiac therapy and determine a degree of posterior left bundle branch engagement based on the monitored electrical activity. The systems and methods may adjust the cardiac therapy based on the degree of posterior left bundle branch engagement.

Abstract: Cardiac electrical heterogeneity information may be used to determine whether one or more His bundle paced settings for His bundle pacing therapy are acceptable for His bundle pacing. Cardiac electrical heterogeneity information may be generated during His bundle pacing, and the evaluation against baseline information and/or other information to determine whether the His bundle paced settings are acceptable.

Abstract: Systems, methods, and devices are described herein for determining cardiac conduction system capture of ventricle from atrium (VfA) therapy. VfA therapy may be delivered at a plurality of different A-V delays while electrical activity of the patient is monitored. The electrical activity may then be utilized to determine whether the cardiac conduction system of the patient has been captured by the VfA therapy.

Abstract: Systems, methods, and devices are described herein for evaluation, adjustment, and delivery of adaptive cardiac therapy. The systems, methods, and devices may utilize electrical heterogeneity information to determine and/or select one or more pacing settings and pacing type or configurations for a plurality of different heart rates. The adaptive cardiac therapy may deliver cardiac therapy at selected pacing settings such as, for example, A-V and/or V-V intervals, according to a presently measured heart rate and switch between left ventricular-only or biventricular cardiac pacing therapy also according to the presently measured heart rate.

Abstract: The exemplary systems and methods may be configured for use in the determination of ectopic beat-compensated electrical heterogeneity information. Electrical activity can be monitored by a plurality of external electrodes. Ectopic beat information can be detected. Ectopic beat-compensated electrical heterogeneity information can be generated based on the monitored electrical activity and the detected ectopic beat information.

Abstract: Cardiac electrical heterogeneity information may be used to determine whether one or more ventricle from atrium (VfA) paced settings for VfA pacing therapy are acceptable. Cardiac electrical heterogeneity information may be generated during VfA pacing, and then evaluated to determine whether the VfA paced settings are acceptable.

Abstract: Methods and systems of evaluating cardiac pacing in candidate patients for cardiac resynchronization therapy and cardiac resynchronization therapy patients are disclosed. The methods and systems disclosed allow treatments to be personalized to patients by measuring the extent of tissue capture from cardiac pacing under various therapy parameter conditions. Systems and methods of optimizing right ventricle only cardiac pacing are also disclosed.

Abstract: An implantable medical device includes a plurality of electrodes to detect electrical activity, a motion detector to detect mechanical activity, and a controller to determine at least one electromechanical interval based on at least one of electrical activity and mechanical activity. The activity detected may be in response to delivering a pacing pulse according to an atrioventricular (AV) pacing interval using the second electrode. The electromechanical interval may be used to adjust the AV pacing interval. The electromechanical interval may be used to determine whether cardiac therapy is acceptable or whether atrial or ventricular remodeling is successful.