Abstract: Systems, methods and implantable devices configured to provide cardiac resynchronization therapy and/or bradycardia pacing therapy. A first device located in the heart of the patient is configured to receive a communication from a second device and deliver a pacing therapy in response to or in accordance with the received communication. A second device located elsewhere is configured to determine an atrial event has occurred and communicate to the first device to trigger the pacing therapy. The second device may be configured for sensing the atrial event by the use of vector selection and atrial event windowing, among other enhancements. Exception cases are discussed and handled as well.

Abstract: Various aspects of the present subject matter relate to an implantable device. Various device embodiments comprise at least one port to connect to at least one lead with at least electrode, stimulation circuitry connected to the at least one port and adapted to provide at least one neural stimulation therapy to at least one neural stimulation target using the at least one electrode, sensing circuitry connected to the at least one port and adapted to provide a sensed signal, and a controller connected to the stimulation circuitry to provide the at least one neural stimulation therapy and to the sensing circuitry to receive the sensed signal. In response to a triggering event, the controller is adapted to switch between at least two modes. Other aspects and embodiments are provided herein.

Abstract: An apparatus comprises a stimulus circuit, a recharge circuit, a switch circuit, and a control circuit. The stimulus circuit provides electrical cardiac pacing stimulation to multiple combinations of a plurality of electrodes, and the electrical stimulation is selectively applied at the first electrode of the electrode combinations. The recharge circuit includes a recharge capacitor electrically coupled to the second electrode of the electrode combinations, and the switch circuit selectively enables electrode combinations for electrical coupling to the stimulus circuit and the recharge circuit. The control circuit includes a pacing activation sub-circuit that selectively initiates delivery of the electrical stimulation using multiple electrode combinations, and enables simultaneous delivery of pacing recharge energy from the recharge capacitor to the second electrode of multiple electrode combinations.

Abstract: Systems and methods for treating cardiac arrhythmias. One example medical device system for delivering electrical stimulation therapy to a heart of a patient may comprise a leadless cardiac pacemaker (LCP) implanted within a heart of a patient and configured to determine occurrences of cardiac arrhythmias, a medical device configured to determine occurrences of cardiac arrhythmias and to deliver defibrillation shock therapy to the patient, wherein the LCP and the medical device are spaced from one another and communicatively coupled, and wherein after the LCP determines an occurrence of a cardiac arrhythmia, the LCP is configured to modify the defibrillation shock therapy of the medical device.

Abstract: Systems and methods for coordinating treatment of abnormal heart activity using multiple implanted devices within a patient. In one example, abnormal heart activity may be sensed by a medical device system. One of the devices of the system may determine to deliver anti-tachycardia pacing therapy to the heart of the patient, and may communicate an instruction to another of the devices of the medical device system to deliver anti-tachycardia pacing (ATP) therapy to the heart. The receiving medical device may then deliver ATP therapy to the heart of the patient.

Abstract: A bridge device includes a housing, a plurality of electrodes exposed outside of the housing such that at least two of the plurality of electrodes can be concurrently placed in contact with a patient's skin. A controller is disposed within the housing. A first communications module is operably coupled to the controller and to the at least two of the plurality of electrodes. The first communications module is configured to allow the controller to communicate with an implantable medical device via at least two of the plurality of electrodes using conducted communication. A second communications module is operably coupled to the controller and is configured to allow the controller to communicate with a remote device external to the patient.

Abstract: A ventricularly implantable medical device that includes a sensing module that is configured to detect an atrial fiducial and identify an atrial contraction based at least on part on the detected atrial fiducial. Control circuitry in the implantable medical device is configured to deliver a ventricular pacing therapy to a patient's heart based at least in part on the identified atrial contraction, and can automatically switch or revert the ventricular pacing therapies on the fly.

Abstract: A ventricularly implantable medical device that includes a sensing module that is configured to detect an artifact during ventricular filling and to identify an atrial event based at least on part on the detected artifact. Control circuitry of the implantable medical device is configured to deliver a ventricular pacing therapy to a patient's heart, wherein the ventricular pacing therapy is time dependent, at least in part, on the identified atrial event.

Abstract: A ventricularly implantable medical device that includes a sensing module that is configured to identify a search window of time within a cardiac cycle to search for an atrial artifact. Control circuitry in the ventricular implantable medical device is configured to deliver a ventricular pacing therapy to a patient's heart, wherein the ventricular pacing therapy is time dependent, at least in part, on an atrial event identified in the search window of time.

Abstract: An implantable medical device (IMD) with a receiving coil for wireless power transfer. The receiving coil may be disposed about a flux concentrator located in a housing of the IMD. The flux concentrator may concentrate non-radiative near-field energy through the receiving coil. In some cases, the near-field energy may be captured and converted into electrical energy that may be used to recharge a rechargeable power source of the IMD.

Abstract: An implantable medical device (IMD) is configured with a pressure sensor. The IMD includes a housing and a diaphragm that is exposed to the environment outside of the housing. The diaphragm is configured to transmit a pressure from the environment outside of the housing to a piezoelectric membrane. In response, the piezoelectric membrane generates a voltage and/or a current, which is representative of a pressure change applied to the housing diaphragm. In some cases, only changes in pressure over time are used, not absolute or gauge pressures.

Abstract: An apparatus comprises a stimulus circuit, a switch circuit, and a control circuit. The stimulus circuit is configured to provide electrical pulse stimulation to the plurality of electrodes. The switch circuit is configured to electrically couple different combinations of the electrodes to the stimulus circuit. The control circuit is to configure a stimulation vector that includes a first vector electrode and a plurality of other electrodes electrically coupled together to form a second combined vector electrode. The control circuit includes a capture detection sub-circuit configured to determine individual capture stimulation thresholds between the first vector electrode and each single electrode of the combined vector electrode. The control circuit is configured to determine a capture stimulation threshold of the stimulation vector using the determined individual capture thresholds.

Abstract: Systems, devices, and methods for adjusting functionality of an implantable medical device based on posture are disclosed. In some instances, a method for operating a leadless cardiac pacemaker implanted into a patient, where the patient has two or more predefined behavioral states, may include detecting a change in the behavioral state of the patient, and in response, changing a sampling rate of a sensor signal generated by a sensor of the leadless cardiac pacemaker. In some embodiments, the method may further include using the sampled sensor signal to determine an updated pacing rate of the leadless cardiac pacemaker and providing pacing to the patient at the updated pacing rate.

Abstract: Systems and methods for managing communication strategies between implanted medical devices. Methods include temporal optimization relative to one or more identified conditions in the body. A selected characteristic, such as a signal representative or linked to a biological function, is assessed to determine its likely impact on communication capabilities, and one or more communication strategies may be developed to optimize intra-body communication.

Abstract: At least one of a first medical device and a second medical device may be implanted within a patient while the second medical device may optionally be proximate but external to the patient. At least one of the medical devices has an antenna having at least two electrodes and at least one of the medical devices has an antenna having at least three electrodes. The medical devices can communicate via conducted communication through the patient's tissue between a first pair of electrodes and a second pair of electrodes. At least one of the pairs of electrodes can be selected in accordance with the signal strength of the communication vector between the first and second pairs of electrodes.

Abstract: An implantable medical device includes a rechargeable battery and a battery recharging assembly. The battery recharging assembly includes an energy receiver for capturing energy from an externally applied charging field, a battery charging circuit that is operably coupled to the rechargeable battery for recharging the rechargeable battery, and a demodulator that is operably coupled to the energy receiver and the battery charging circuit. The demodulator demodulates the energy captured by the energy receiver and delivers demodulated energy to the battery charging circuit to be used to charge the rechargeable battery. The IMD includes a controller that is configured to control operation of at least part of the IMD.

Abstract: A system for recharging an implantable medical device having a rechargeable battery while the implantable medical device is implanted within a patient includes a recharge energy source configured to be disposed exterior to the patient and a recharging bridge configured to be implanted within the patient. The recharging bridge is configured to facilitate energy transfer from the recharge energy source to the implantable medical device.

Abstract: A system for sensing electrical cardiac activity and for providing therapy to a patient's heart. The system may include a first implantable device implanted within a patient and a second implantable device implanted near or within the heart of the patient. In some cases, the first implantable device may at least partially power the second implantable device by periodically recharging a rechargeable battery or other power source within the second implantable device. In some cases, the first implantable device may at least partially power the second implantable device by periodically, intermittently or continuously transmitting energy that may be stored by a battery, capacitor or other power storage device within the second implantable device.

Abstract: Systems and methods for managing communication strategies between implanted medical devices. Methods include temporal optimization relative to one or more identified conditions in the body. A selected characteristic, such as a signal representative or linked to a biological function, is assessed to determine its likely impact on communication capabilities, and one or more communication strategies may be developed to optimize intra-body communication.

Abstract: Methods and devices for configuring the use of a motion sensor in an implantable cardiac device. The electrical signals of the patient's heart are observed and may be correlated to the physical motion of the heart as detected by the motion sensor of the implantable cardiac device in order to facilitate temporal configuration of motion sensor data collection that avoids detecting cardiac motion in favor of overall motion of the patient.