Abstract: Various techniques for measuring cardiac cycle length and pressure metrics based on pulmonary artery pressures are described. One example method described includes identifying a point within a derivative signal of a cardiovascular pressure signal without reference to electrical activity of a heart, initiating a time window from the identified point in the derivative signal, identifying a point within the cardiovascular signal within the time window, and determining at least one of a systolic pressure or diastolic pressure based on the identified point.

Abstract: A leadless pacing device (LPD) includes a motion sensor configured to generate a motion signal as a function of heart movement. The LPD is configured to analyze the motion signal within an atrial contraction detection window that begins an atrial contraction detection delay period after activation of the ventricle, and detect a contraction of an atrium of the heart based on the analysis of the motion signal within the atrial contraction detection window. If the LPD does not detect a ventricular depolarization subsequent to the atrial contraction, e.g., with an atrio-ventricular (AV) interval beginning when the atrial contraction was detected, the LPD delivers a ventricular pacing pulse.

Abstract: Provided is a method, system and/or apparatus for determining prospective heart failure event risk. Acquired from a device memory are a heart failure patient's current and preceding risk assessment periods. Counting detected data observations in the current risk assessment period for a current risk assessment total amount and counting detected data observations in the preceding risk assessment period for a preceding risk assessment period total amount. Associating the current risk assessment and preceding risk assessment total amounts with a lookup table to acquire prospective risk of heart failure (HF) event for the preceding risk assessment period and the current risk assessment period. Employing weighted sums of the prospective risk of the HF event for the preceding risk assessment period and the current risk assessment period to calculate a weighted prospective risk of the HF event for a patient. Displaying on a graphical user interface the weighted prospective risk of the HF event for the patient.

Abstract: Medical devices and methods for providing breathing therapy (e.g., for treating heart failure, hypertension, etc.) may determine at least the inspiration phase of one or more breathing cycles based on the monitored physiological parameters and control delivery of a plurality of breathing therapy sessions (e.g., each of the breathing therapy sessions may be provided during a defined time period). Further, each of the plurality of breathing therapy sessions may include delivering stimulation after the start of the inspiration phase of each of a plurality of breathing cycles to prolong diaphragm contraction during the breathing cycle.

Abstract: An implantable medical system is configured to coordinate ventricular pacing with intrinsic depolarizations of another chamber. The implantable medical system includes a leadless pacing device implanted on or within the ventricle. Another implantable medical device is configured to sense an intrinsic depolarization the other chamber of the heart of the patient, and in response to the intrinsic depolarization of the other chamber, deliver an electrical pulse. The leadless pacing device is configured to detect the electrical pulse delivered by the other implantable medical device and, in response to detecting the electrical pulse delivered by the other implantable medical device, deliver a pacing pulse to the ventricle via at least a first electrode in coordination with the intrinsic depolarization of the other chamber.

Abstract: Various techniques for measuring cardiac cycle length and pressure metrics based on pulmonary artery pressures are described. One example method described includes identifying a point within a derivative signal of a cardiovascular pressure signal without reference to electrical activity of a heart, initiating a time window from the identified point in the derivative signal, identifying a point within the cardiovascular signal within the time window, and determining at least one of a systolic pressure or diastolic pressure based on the identified point.

Abstract: A leadless pacing device (LPD) includes a motion sensor configured to generate a motion signal as a function of heart movement. The LPD is configured to analyze the motion signal within an atrial contraction detection window that begins an atrial contraction detection delay period after activation of the ventricle, and detect a contraction of an atrium of the heart based on the analysis of the motion signal within the atrial contraction detection window. If the LPD does not detect a ventricular depolarization subsequent to the atrial contraction, e.g., with an atrio-ventricular (AV) interval beginning when the atrial contraction was detected, the LPD delivers a ventricular pacing pulse.

Abstract: Various techniques for measuring cardiac cycle length and pressure metrics based on pulmonary artery pressures are described. One example method described includes identifying a point within a derivative signal of a cardiovascular pressure signal without reference to electrical activity of a heart, initiating a time window from the identified point in the derivative signal, identifying a point within the cardiovascular signal within the time window, and determining at least one of a systolic pressure or diastolic pressure based on the identified point.

Abstract: A medical device system including at least a first implantable medical device and a second implantable medical device is configured to establish by a control module of the first implantable medical device whether the second implantable medical device is present in a patient and self-configure an operating mode of the control module in response to establishing that the second implantable medical device is present.

Abstract: Methods and devices for determining optimal Atrial to Ventricular (AV) pacing intervals and Ventricular to Ventricular (VV) delay intervals in order to optimize cardiac output. Impedance, preferably sub-threshold impedance, is measured across the heart at selected cardiac cycle times as a measure of chamber expansion or contraction. One embodiment measures impedance over a long AV interval to obtain the minimum impedance, indicative of maximum ventricular expansion, in order to set the AV interval. Another embodiment measures impedance change over a cycle and varies the AV pace interval in a binary search to converge on the AV interval causing maximum impedance change indicative of maximum ventricular output. Another method varies the right ventricle to left ventricle (VV) interval to converge on an impedance maximum indicative of minimum cardiac volume at end systole. Another embodiment varies the VV interval to maximize impedance change.

Abstract: The present invention provides an apparatus for detecting and monitoring obstructive sleep apnea. The apparatus measures sinus tachycardia and a change in the atrial-ventricular conduction, and includes a controller for receiving the measurement of the sinus tachycardia and the change in the atrial-ventricular conduction to detect obstructive sleep apnea based upon the sinus tachycardia and the change in the atrial-ventricular conduction.

Abstract: Medical devices and methods for providing breathing therapy (e.g., for treating heart failure, hypertension, etc.) may determine at least the inspiration phase of one or more breathing cycles based on the monitored physiological parameters and control delivery of a plurality of breathing therapy sessions (e.g., each of the breathing therapy sessions may be provided during a defined time period). Further, each of the plurality of breathing therapy sessions may include delivering stimulation after the start of the inspiration phase of each of a plurality of breathing cycles to prolong diaphragm contraction during the breathing cycle.

Abstract: Techniques for estimating a cardiac chamber or vascular pressure based upon impedance are described. A device or system may measure an impedance between at least two electrodes implanted within or proximate to a cardiovascular system. The device or system may estimate a pressure of an element of the cardiovascular system based on a relationship between impedance and volume of the element, and based on a empirical relationship between the volume and the pressure. The device or system may also estimate the dimension of the element based on the impedance-volume relationship, or other characteristics based on the impedance. Because the impedance measurements may be obtained, in some examples, by using electrodes and leads implanted within the cardiovascular system and coupled to an implantable medical device, a practical estimation of a cardiovascular pressure can be obtained on a chronic basis without requiring the use other invasive sensors, such as micronanometer transducers.

Abstract: A medical device and associated method for delivery of a cardiac therapy that includes determining a first impedance signal along a thoracic electrode vector extending within a portion of a thoracic cavity, determining a second impedance signal along an extra-thoracic electrode vector extending outside the thoracic cavity, comparing first amplitude measurements corresponding to the first impedance signals and second amplitude measurements corresponding to the second impedance signals, comparing first slope measurements corresponding to the first impedance signals and second slope measurements corresponding to the second impedance signals, and determining delivery of the cardiac therapy in response to the comparing.

Abstract: An implantable cardioverter defibrillator evaluates the hemodynamic stability of an arrhythmia to determine whether or not to defibrillate. The device obtains cardiac pressure and cardiac impedance data and evaluates a phase relationship between these parameters. Hemodynamically stable rhythms will result in an out of phase relationship.

Abstract: An implantable medical device system and method provide physiological variable monitoring for use in patient management. A target value for a physiological variable and formulations for computing metrics of the physiological variable are stored. Values of the physiological variable are determined from a sensed physiological signal and are used to compute a selected metric. The metric is compared to the stored target value.

Abstract: A medical device and associated method for delivery of a cardiac therapy that includes determining a first impedance signal along a thoracic electrode vector extending within a portion of a thoracic cavity, determining a second impedance signal along an extra-thoracic electrode vector extending outside the thoracic cavity, comparing first amplitude measurements corresponding to the first impedance signals and second amplitude measurements corresponding to the second impedance signals, comparing first slope measurements corresponding to the first impedance signals and second slope measurements corresponding to the second impedance signals, and determining delivery of the cardiac therapy in response to the comparing.

Abstract: A medical device and associated method for monitoring a fluid status of a patient that includes determining a first impedance signal along an electrode vector comprising a portion of a thoracic cavity, determining a second impedance signal along an extra-thoracic electrode vector, and determining a fluid status measurement in response to the determined first impedance signal and the determined second impedance signal

Abstract: An implantable medical device and associated method detect obstructed inspiration by monitoring an blood pressure signal. A respiration signal is monitored and a phase of respiratory inspiration is detected from the respiration signal. A trend in the pressure signal is measured during the inspiration phase. Obstructed inspiration for the inspiration phase is detected in response to the measured the trend.

Abstract: Apparatus using one or more modes of statistical analysis with one or more monitored parameters of a patient's heart to identify and/or assess arrhythmias. Through use of the one or more modes of statistical analysis, a medical professional can be aided during evaluation of patient data for diagnosis of the patient. At least one of the monitored parameters may include one or more values used representatively for storage intervals of a selected length. As such, for each storage interval, a value may be determined for the one monitored parameter occurring at an upper percentile and a lower percentile. In addition, a median value may be determined for the one monitored parameter for each storage interval. Over a plurality of the storage intervals, these determined values can be used in one or more modes of statistical analysis to better identify and assess the arrhythmias.