Abstract: Methods, devices and program products are provided for determining an early battery depletion condition for a battery powered device. The method determines a charge consumption drawn externally from a battery cell by the device for a select period of time, obtains a measured cell voltage for the battery cell of the medical device, calculates a projected cell voltage based on the charge consumption and usage conditions, and declares an early depletion condition based on a relation between the measured and projected cell voltages.

Abstract: Implantable cardiac stimulation devices configured to deliver more than one pacing pulse per cardiac cycle, and methods for use therewith, are described herein. A method can include delivering a first pacing pulse using a first pair of electrodes. Thereafter, between delivery of the first pacing pulse and delivery of second pacing pulse using a second (different) pair of electrodes, one or more voltage characteristics are measured at each of a plurality of different nodes within the cardiac stimulation device. A preferred pair of nodes for use during a fast discharge phase are identified based on the measured voltage characteristic(s). Switches within the implantable cardiac stimulation device are controlled so that the pair of nodes, identified as being the preferred pair of nodes that are to be used for performing the fast discharge phase, are used for performing the fast discharge phase to thereby achieve charge neutrality in an improved manner.

Abstract: An implantable medical device is provided that comprises a pulse generator circuit that times delivery of ventricular pacing pulses based on a base intracardiac interval (ICI). A processor is provided that has memory storing program instructions and storing atrial and ventricular events over multiple cardiac cycles and that is responsive to execution of the program instructions. The processor adjusts the base ICI by an ICI adjustment, during one or more of the multiple cardiac cycles, to promote intrinsic heart activity. The processor further counts a number of the cardiac cycles in which the ICI adjustments occurred in conjunction with arrhythmias to identify an excessive adjustment count and modifies the ICI adjustment to utilize a new ICI adjustment based on the excessive adjustment count.

Abstract: Methods and systems are provided to manage display of cardiac signals. The methods and systems receive a first data steam along a first communications path conveyed with first throughput and receiving a second data stream along a second communications path transmitted with second throughput. The first and second throughputs are asynchronous with respect to one another. The first and second data streams carry cardiac signals sensed by external and implanted electrodes, respectively, for one or more common events. The methods and systems store data from the first and second data streams in first and second memory buffers. The methods and systems synchronize the data stored in the first and second memory buffers with one another by performing at least one of: temporally offsetting activation of the storing operation for the first and second data streams with respect to one another; or managing an amount of the data maintained in at least one of the first memory buffer or the second memory buffer.

Abstract: A method, system and external instrument are provided. The method initiates a communication link between an external instrument (EI) and an implantable medical device (IMD), established a first connection interval for conveying data packets between the EI and IMD and monitors a connection criteria that includes at least one of a data throughput requirement. A battery indicator or link condition of the communications link is between the IMD and EI. The method further changes from the first connection interval to a second connection interval based on the connection criteria.

Abstract: Example electronic devices, including but not limited to implantable medical devices, and methods employing dynamic announcing for creation of wireless communication connections are disclosed herein. In an example, an electronic device includes a wireless communication interface to transmit announcement signals for creating a wireless communication connection with the external device. The electronic device also includes a sensor to detect a characteristic of an environment external to the electronic device, and a control circuit including an announcement timing control module to dynamically control timing of the announcement signals based on the detected characteristic.

Abstract: The present disclosure provides systems and methods for automatically determining pace and sense configurations for an implantable cardiac device. A method of operating an implantable cardiac device includes automatically determining, during a detection phase, a pace and sense configuration for the implantable cardiac device based on a plurality of first impedance measurements. The method further includes confirming, during a confirmation phase, the pace and sense configuration based on a plurality of second impedance measurements, and operating the implantable cardiac device in accordance with the pace and sense configuration.

Abstract: An implantable medical device is provided that comprises a pulse generator circuit that times delivery of ventricular pacing pulses based on a base intracardiac interval (ICI). A processor is provided that has memory storing program instructions and storing atrial and ventricular events over multiple cardiac cycles and that is responsive to execution of the program instructions. The processor adjusts the base ICI by an ICI adjustment, during one or more of the multiple cardiac cycles, to promote intrinsic heart activity. The processor further counts a number of the cardiac cycles in which the ICI adjustments occurred in conjunction with arrhythmias to identify an excessive adjustment count and modifies the ICI adjustment to utilize a new ICI adjustment based on the excessive adjustment count.

Abstract: An exemplary method includes performing a capture threshold assessment using a bipolar electrode configuration, deciding if capture occurred for a maximum energy value of the capture threshold assessment and, if capture did not occur, then performing a lead impedance test for the lead associated with the bipolar electrode configuration. Such a test may aim to detect an insulation defect and/or a conductor defect. Other exemplary methods, devices, systems, etc., are also disclosed.

Abstract: An exemplary method includes performing a capture threshold assessment using a bipolar electrode configuration, deciding if capture occurred for a maximum energy value of the capture threshold assessment and, if capture did not occur, then performing a lead impedance test for the lead associated with the bipolar electrode configuration. Such a test may aim to detect an insulation defect and/or a conductor defect. Other exemplary methods, devices, systems, etc., are also disclosed.

Abstract: An exemplary method includes performing a capture threshold assessment using a bipolar electrode configuration, deciding if capture occurred for a maximum energy value of the capture threshold assessment and, if capture did not occur, then performing a lead impedance test for the lead associated with the bipolar electrode configuration. Such a test may aim to detect an insulation defect and/or a conductor defect. Other exemplary methods, devices, systems, etc., are also disclosed.

Abstract: An exemplary method includes performing a capture threshold assessment using a bipolar electrode configuration, deciding if capture occurred for a maximum energy value of the capture threshold assessment and, if capture did not occur, then performing a lead impedance test for the lead associated with the bipolar electrode configuration. Such a test may aim to detect an insulation defect and/or a conductor defect. Other exemplary methods, devices, systems, etc., are also disclosed.

Abstract: An exemplary method includes performing a capture threshold assessment using a bipolar electrode configuration, deciding if capture occurred for a maximum energy value of the capture threshold assessment and, if capture did not occur, then performing a lead impedance test for the lead associated with the bipolar electrode configuration. Such a test may aim to detect an insulation defect and/or a conductor defect. Other exemplary methods, devices, systems, etc., are also disclosed.

Abstract: Techniques are provided for use with an implantable medical device for detecting breaches in lead insulation or other lead failures. In one example, bipolar impedance is measured along single-lead vectors (i.e. intra-lead vectors) of a right atrial (RA) lead and a right ventricular (RV) leads. Impedance is also measured along various cross-lead vectors (i.e. inter-lead vectors) between electrodes of the two leads. A derived impedance value is then determined from a combination of the measured impedance values, wherein the derived impedance is sensitive to a shunt impedance arising from a breach within the RV lead. A lead breach is then detected relatively early based on the derived impedance by detecting a significant deviation in derived impedance over time. Unipolar impedance measurements are used to confirm the breach.

Abstract: An implantable medical device is provided for detecting transportless ventricular rhythm of a heart lacking atrial transport and comprises a housing, sensors configured to be located proximate to a heart, a sensing module to sense cardiac signals representative of a rhythm originating from the heart and a rhythm detection module. The rhythm detection module determines a change in AV association and identifies a potential ventricular complex with loss of atrial transport (VCLAT) based on the change in AV association.

Abstract: An implantable medical device is provided for detecting transportless ventricular rhythm of a heart lacking atrial transport and comprises a housing, sensors configured to be located proximate to a heart, a sensing module to sense cardiac signals representative of a rhythm originating from the heart and a rhythm detection module. The rhythm detection module determines a change in AV association and identifies a potential ventricular complex with loss of atrial transport (VCLAT) based on the change in AV association.

Abstract: Techniques are provided for use with an implantable medical device for detecting breaches in lead insulation or other lead failures. In one example, bipolar impedance is measured along single-lead vectors (i.e. intra-lead vectors) of a right atrial (RA) lead and a right ventricular (RV) leads. Impedance is also measured along various cross-lead vectors (i.e. inter-lead vectors) between electrodes of the two leads. A derived impedance value is then determined from a combination of the measured impedance values, wherein the derived impedance is sensitive to a shunt impedance arising from a breach within the RV lead. A lead breach is then detected relatively early based on the derived impedance by detecting a significant deviation in derived impedance over time. Unipolar impedance measurements are used to confirm the breach.

Abstract: An implantable medical device is provided for detecting transportless ventricular rhythm of a heart lacking atrial transport and comprises a housing, sensors configured to be located proximate to a heart, a sensing module to sense cardiac signals representative of a rhythm originating from the heart and a rhythm detection module. The rhythm detection module determines a change in AV association and identifies a potential ventricular complex with loss of atrial transport (VCLAT) based on the change in AV association.

Abstract: An exemplary method includes performing a capture threshold assessment using a bipolar electrode configuration, deciding if capture occurred for a maximum energy value of the capture threshold assessment and, if capture did not occur, then performing a lead impedance test for the lead associated with the bipolar electrode configuration. Such a test may aim to detect an insulation defect and/or a conductor defect. Other exemplary methods, devices, systems, etc., are also disclosed.

Abstract: An implantable cardiac stimulation device provides measurement of intrinsic heart activity metrics while sustaining pacing of the heart. The device includes a pulse generator that delivers pacing pulses to a first chamber of corresponding chambers of a heart, and a sensing circuit that senses a conducted evoked response of a second chamber of the corresponding chambers of the heart in response to the pacing pulse to provide an electrical signal representing the conducted evoked response. The device further includes a measuring circuit that measures a metric of the electrical signal to approximate a corresponding metric of an intrinsic electrical feature of the second chamber.