Abstract: An implantable device and associated method for delivering a multi-site pacing therapy includes electrodes for sensing cardiac signals and delivering cardiac pacing pulses to a first pacing site along a heart chamber and a therapy delivery module for delivering cardiac pacing pulses to a patient's heart via the electrodes. A sensing module measures an activation time at multiple pacing electrode sites along the heart chamber in response to delivering pacing pulses at the first pacing site. A controller is configured to identify a second pacing site from the plurality of pacing electrode sites in response to the activation times measured during pacing at the first site.

Abstract: A medical device system and associated method for controlling a cardiac rhythm management therapy detect extracardiac stimulation. Cardiac pacing pulses are delivered, and a cardiac electrical signal comprising myocardial depolarization and repolarization signals is acquired. A processor is configured to, responsive to the cardiac electrical signal, detect extracardiac capture due to the cardiac pacing pulse.

Abstract: A system and method for controlling respiration depth or respiration rate is provided. A bipolar pair of a plurality of electrodes is selected in a location for stimulating a phrenic nerve. Electrical stimulation is delivered through a medical electrical lead electrode proximate phrenic nerve tissue. Modulating respiration is elicited in response to electrical stimulation of the phrenic nerve.

Abstract: A medical device and associated method detect ischemia using stimulation delivered to induce respiration. A spontaneous breathing response to the stimulation-induced respiration is determined. Ischemia is detected in response to the spontaneous breathing response. The spontaneous breathing response is measured as a response to adjusting a parameter controlling the stimulation.

Abstract: A system and method for delivering a nerve stimulation therapy determines whether a cardiac EGM signal can be sensed by a bipolar pair of electrodes selected from a number of electrodes positioned for stimulating a nerve. In response to not being able to sense a cardiac signal using the bipolar pair, stimulation of the nerve using a selected pair of the electrodes is enabled.

Abstract: An implantable device and associated method for delivering a multi-site pacing therapy includes electrodes for sensing cardiac signals and delivering cardiac pacing pulses. Electrodes positioned at first and second selected pacing sites are used to deliver pacing pulses to a first heart chamber using a bipole comprising the first electrode and the second electrode. A controller is configured to determine if anodal and cathodal capture can be achieved during pacing using the bipole. Responsive to anodal and cathodal capture being achieved, the controller selects a multi-site pacing configuration comprising the bipole for singly pacing the first and second pacing sites.

Abstract: A medical device and associated method control the delivery of a cardiac pacing therapy by selecting first and second pacing sites along a first ventricle of a patient's heart and delivering the pacing therapy by pacing the first ventricle using the first pacing site during the periods of a first ventricular pacing mode and using the second pacing site during periods of a second ventricular pacing mode. In one embodiment, the device determines activation times at multiple sites along a ventricle in response to pacing pulses being delivered to the opposite ventricle. A first pacing site is selected in response to the activation time determination. The device delivers the pacing therapy by pacing the first ventricle using the first pacing site during periods of the first ventricular pacing mode.

Abstract: An implantable device and associated method detect anodal capture during electrical stimulation. A first pacing pulse is delivered using a first cathode and a first anode. A second pacing pulse is delivered using the first cathode and a second anode. A first response to the first pacing pulse and a second response to the second pacing pulse are measured. Anodal capture of the first pacing pulse at the first anode is detected in response to a first difference between the first response and the second response.

Abstract: Pulseless electrical activity (PEA) is reduced or eliminated. A medical electrical lead is implanted to deliver high voltage therapy to a fibrillating heart. Another medical electrical lead delivers electrical stimulation through an electrode proximate phrenic nerve tissue in response to the delivery of high voltage therapy to the fibrillating heart.

Abstract: An implantable device and associated method discriminate between cathodal and anodal capture during electrical stimulation. A control response to a pacing pulse delivered using a candidate cathode electrode and a universal anode and responses to bipolar pacing pulses delivered using candidate bipoles including the candidate cathode are measured. Responsive to the control response meeting a threshold response, the control response is classified as normal and each of the responses for the candidate bipoles are compared to the control response. The responses for the candidate bipoles are each classified based on the comparison.

Abstract: A method includes estimating a cardiac signal of a patient, estimating a length of a cardiac refractory period based in part on the cardiac signal and selectively adjusting the length of phrenic nerve electrical stimulation to be delivered to the patient based on the estimated length of the cardiac refractory period. In some examples the method includes delivering phrenic nerve stimulation for approximately the entire refractory period. The phrenic nerve stimulation may be used to treat a variety of breathing disorders.

Abstract: A system and associated method deliver a respiration therapy. Stimulation pulses are delivered to activate a right portion of a patient's diaphragm and to activate a left portion of a patient's diaphragm. A control processor determines dyssynchrony of a respiratory response to the stimulation pulses and adjusts a stimulation control parameter controlling the delivering of the stimulation pulses in response to dyssynchrony of the respiratory response.

Abstract: A medical device and associated method control the delivery of a cardiac pacing therapy by selecting first and second pacing sites along a first ventricle of a patient's heart and delivering the pacing therapy by pacing the first ventricle using the first pacing site during the periods of a first ventricular pacing mode and using the second pacing site during periods of a second ventricular pacing mode. In one embodiment, the device determines activation times at multiple sites along a ventricle in response to pacing pulses being delivered to the opposite ventricle. A first pacing site is selected in response to the activation time determination. The device delivers the pacing therapy by pacing the first ventricle using the first pacing site during periods of the first ventricular pacing mode.

Abstract: An implantable device and associated method for delivering a multi-site pacing therapy includes electrodes for sensing cardiac signals and delivering cardiac pacing pulses to a first pacing site along a heart chamber and a therapy delivery module for delivering cardiac pacing pulses to a patient's heart via the electrodes. A sensing module measures an activation time at multiple pacing electrode sites along the heart chamber in response to delivering pacing pulses at the first pacing site. A controller is configured to identify a second pacing site from the plurality of pacing electrode sites in response to the activation times measured during pacing at the first site.

Abstract: An implantable device and associated method for delivering a multi-site pacing therapy includes electrodes for sensing cardiac signals and delivering cardiac pacing pulses. Electrodes positioned at first and second selected pacing sites are used to deliver pacing pulses to a first heart chamber using a bipole comprising the first electrode and the second electrode. A controller is configured to determine if anodal and cathodal capture can be achieved during pacing using the bipole.

Abstract: A medical device system and associated method for controlling a cardiac rhythm management therapy detect extracardiac stimulation. Cardiac pacing pulses are delivered, and a cardiac electrical signal comprising myocardial depolarization and repolarization signals is acquired. A processor is configured to, responsive to the cardiac electrical signal, detect extracardiac capture due to the cardiac pacing pulse.

Abstract: Techniques are described for detecting conduction abnormalities in a heart of a patient. In particular, an IMD may be configured to obtain electrical signals corresponding to cardiac activity of the heart of the patient and periodically analyze a most recent electrical signal of the obtained electrical signals to detect an electrical conduction abnormality of the heart. The IMD adjusts a frequency at which the most recent electrical signal is analyzed based on at least one physiological parameter of the patient. For example, the IMD may increase the frequency at which the most recent electrical signal is analyzed when a heart rate parameter has significantly changed and the number of detected premature ventricular contractions (PVCs) is greater than or equal to a threshold number. In this manner, the most recent electrical signal is analyzed at a higher frequency in situations in which conduction abnormalities are more likely.

Abstract: A system and associated method deliver a respiration therapy. Stimulation pulses are delivered to activate a right portion of a patient's diaphragm and to activate a left portion of a patient's diaphragm. A control processor determines dyssynchrony of a respiratory response to the stimulation pulses and adjusts a stimulation control parameter controlling the delivering of the stimulation pulses in response to dyssynchrony of the respiratory response.

Abstract: A medical device and associated method detect ischemia using stimulation delivered to induce respiration. A spontaneous breathing response to the stimulation-induced respiration is determined. Ischemia is detected in response to the spontaneous breathing response. The spontaneous breathing response is measured as a response to adjusting a parameter controlling the stimulation.

Abstract: An implantable device and associated method discriminate between cathodal and anodal capture during electrical stimulation. A control response to a pacing pulse delivered using a candidate cathode electrode and a universal anode and responses to bipolar pacing pulses delivered using candidate bipoles including the candidate cathode are measured. Responsive to the control response meeting a threshold response, the control response is classified as normal and each of the responses for the candidate bipoles are compared to the control response. The responses for the candidate bipoles are each classified based on the comparison.