Abstract: A system and method for providing a universal wrap that can apply a thermal pack to many different regions of a patient's body. The universal wrap is provided in a standardized form. The medical provider is provided with options to modify the standardized form in order to adapt the wrap to many different applications.

Abstract: A method of modifying cardiac tissue behavior, comprising applying a therapeutically effective electric field having an effect of modifying protein activation levels of at least one protein, and repeatedly applying the field at time intervals timed to increase the activation levels of the at least one protein beyond an activation level achieved by natural and/or paced excitation of the muscle without the application, to an extent about at least as high as a decay of the activation between applications of the field.

Abstract: In some examples, controlling delivery of therapy includes using an implantable medical device comprising at least one electrode. Processing circuitry of a system comprising the device may receive, from an application running on a patient personal device, a patient request entered by the patient into the application. The processing circuitry may further determine, based on the patient request, a requested value of a therapy parameter, compare the requested value to information stored in a memory of the medical device system, the information indicating one or more allowable values of the therapy parameter, determine that the requested value is one of the allowable values based on the comparison of the requested value of the therapy parameter to the one or more allowable values, and control the implantable medical device to deliver cardiac pacing via the at least one electrode according to the requested value for a period of time.

Abstract: Devices and methods provide for the sensing of physiological signals by providing a stimulation waveform that includes a stimulation pulse followed by an active recharge pulse to clear the charge in capacitors within the stimulation path. The active recharge pulse is followed by a period of passive recharge and then a period of no recharge. Non-neurological sources of artifacts within the sensed physiological signal may be handled by providing a brief period of passive recharge followed by a lengthy period of no recharge, which is made possible by the use of the active recharge pulse prior to the passive recharge. The period of no recharge removes any low impedance path to ground from the stimulation electrodes, which allows an amplifier of the sensing circuit to provide common mode rejection of non-neurological signals, such as cardiac signals, present at the sensing electrodes.

Abstract: The disclosure relates to a device including a circuit for adjusting the energy of the stimulation pulses, independently controlling the pulse width and the voltage of each stimulation pulse. An iterative search algorithm for determining the optimum energy includes changing both the pulse width and voltage at each new pulse delivered, by setting a high energy value and a low energy value, and delivering a stimulation pulse with the low energy value. A capture test is then carried out. In the presence of a capture, a current iteration is complete and a new iteration is done with the current low energy as a new high energy value. In the absence of capture, the algorithm is terminated with selection of the last energy value that produced the capture as the value of optimum energy.

Abstract: An implantable medical device system receives a cardiac electrical signal produced by a patient's heart and comprising atrial P-waves and delivers a His bundle pacing pulse to the patient's heart via a His pacing electrode vector. The system determines a timing of a sensed atrial P-wave relative to the His bundle pacing pulse and determines a type of capture of the His bundle pacing pulse in response to the determined timing of the atrial P-wave.

Abstract: Disclosed herein are apparatuses and methods for treating neurological disorders by electro-stimulation. The apparatus for treating neurological disorders includes at least one electrode implantable in the brain of a patient, and a processing and stimulation device connected to the at least one electrode. The processing and stimulation device may include a stimulation module configured to generate a stimulation signal to be sent to the at least one electrode, and an acquisition module that measures cerebral activity coming from the brain of the patient. The acquisition module may have a front-end block configured to amplify the potential difference of its input signals (V1a, V2a) and to filter a stimulus artifact and may include a multi-stage fully-differential switched capacitor circuit (e.g., an integrated circuit) configured for discrete-time signal processing.

Abstract: In an example, an implantable medical device (IMD) includes a hold capacitor configured to deliver an electrical therapy pulse, and charge pump circuitry configured to transfer energy from the battery to the hold capacitor. In this example, the charge pump circuitry comprises a plurality of capacitors, and switching circuitry configured to put the charge pump circuitry into a K-factor mode selected from a group of K-factor modes by opening and closing a combination of switches connected to the plurality of capacitors.

Abstract: Disclosed are apparatus and methods that provide the ability to electrical stimulate a physical system, and actively eliminate interference with signal acquisition (artifacts) that arises from the stimulation. The technique implemented in the circuits and methods for eliminating interference connects a discharge path to a physical interface to the system to remove charge that is built-up during stimulation. By placing the discharge path in a feedback loop that includes a recording preamplifier and AC-coupling circuitry, the physical interface is brought back to its pre-stimulation offset voltage. The disclosed apparatus and methods may be used with piezoelectric transducers, ultrasound devices, optical diodes, and polarizable and non-polarizable electrodes. The disclosed apparatus can be employed in implantable devices, in vitro or in vivo setups with vertebrate and invertebrate neural tissue, muscle fibers, pancreatic islet cells, osteoblasts, osteoclasts, bacteria, algae, fungi, protists, and plants.

Abstract: In some examples, determining an estimated remaining longevity of a power source of an implantable medical device comprises determining values of one or more parameters of the power source and one or more operational parameters of the implantable medical device; calculating, based on at least some of the determined parameter values, a first estimated duration until one of the determined parameters of the power source reaches a pre-recommended replacement time (pre-RRT) threshold and adding a timer duration to determine a first estimated longevity value; calculating, based on at least some of the determined parameter values, a second estimated duration until one of the determined parameters of the power source reaches a recommended replacement time (RRT) backup threshold as a second estimated longevity value; determining the estimated remaining longevity based on the two estimated longevity values; and indicating the determined estimated remaining longevity.

Abstract: A pacing system, which is particularly suitable for implantable leadless pacemakers, applies passively-balanced voltage-based pacing pulses, and periodically performs capture verification (evoked response detection) by following a pacing pulse with a current-based active balancing pulse, and then measuring any evoked response provoked by the pacing pulse. The active balancing pulse reduces residual charge on the electrodes used for pulsing, and thereby reduces polarization artifacts that could obscure measurement of the evoked response at the electrodes. The amplitude and pulse width of the active balancing current pulse are defined by measurements made in a few preceding pulses. The pacemaker preferably detects indicia of cardiac contractility, and performs capture verification only when contractility indicates that the patient is physically inactive and emotionally stable.

Abstract: Digital-to-analog converter (master DAC) circuitry is disclosed that is programmable to set a controlled slew rate for pulses that are otherwise defined as having sharp amplitude transitions. For example, when producing a biphasic pulse, the constant amplitude and duration of first and second pulses phases can be defined and provided to the DAC in traditional fashion. Slew rate control signals control a slew rate DAC within the master DAC, which prescribes a slew rate that will appear at sharp transitions of the defined biphasic pulses, i.e., at the beginning of the first phase, at the transition from the first to the second phase, and at the end of the second phase. The slew rate can vary with the duration or frequency of the pulses, with lower slew rates used with longer durations and/or lower frequencies, and with higher slew rates used with shorter durations and/or higher frequencies.

Abstract: Techniques and devices for implementing the techniques for adjusting atrial arrhythmia detection based on analysis of one or more P-wave sensing windows associated with one or more R-waves. An implantable medical device may determine signal characteristics of the cardiac signal within the P-wave sensing window, determine whether the cardiac signal within the sensing window corresponds to a P-wave based on the determined signal characteristics, determine a signal to noise ratio of the cardiac signal within the sensing window, update the arrhythmia score when the P wave is identified in the sensing window and the determined signal to noise ratio satisfies a signal to noise threshold.

Abstract: Devices and methods provide for the sensing of physiological signals by providing a stimulation waveform that includes a stimulation pulse followed by an active recharge pulse to clear the charge in capacitors within the stimulation path. The active recharge pulse is followed by a period of passive recharge and then a period of no recharge. Non-neurological sources of artifacts within the sensed physiological signal may be handled by providing a brief period of passive recharge followed by a lengthy period of no recharge, which is made possible by the use of the active recharge pulse prior to the passive recharge. The period of no recharge removes any low impedance path to ground from the stimulation electrodes, which allows an amplifier of the sensing circuit to provide common mode rejection of non-neurological signals, such as cardiac signals, present at the sensing electrodes.

Abstract: In some examples, an implantable medical device determines that another medical device delivered an anti-tachyarrhythmia shock, and delivers post-shock pacing in response to the determination. The implantable medical device may be configured to both detect the delivery of the shock in a sensed electrical signal and, if delivery of the shock is not detected, determine that the shock was delivered based on detection of asystole of the heart. The asystole may be detected based on the sensed electrical signal. In some examples, an implantable medical device is configured to revert from a post-shock pacing mode to a baseline pacing mode by iteratively testing a plurality of decreasing values of pacing pulse magnitude until loss of capture is detected. The implantable medical device may update a baseline value of the pacing pulse magnitude for the baseline mode based on the detection of loss of capture.

Abstract: Methods and devices for tying management of an implantable medical device to the activities of a primary care physician are described, including access control, simplified parameter optimization, support for tuning a device in response to the effects of other treatments in parallel, and support for helping a primary physician and a patient work together to tune device configuration to the activity and performance needs of the patient. In some embodiments, a medical device is self-configuring in a device parameter domain, based on inputs provided in a patient performance domain. The self-configuring of the medical device is based, for example, on an automatically applied transformation of inputs derived from patient performance domain observations into changes in the configuration of the medical device which affect technical parameters of its operation.

Abstract: A gait modulation system including: (a) a sensor device including a sensor adapted for associating with at least one lower limb of the patient, the sensor for transducing at least one parameter related to a gait of the patient, so as to obtain gait data related to the gait, and (b) a muscle stimulator including: (i) an electrical stimulation circuit, the circuit adapted to supply an electrical stimulation output to an electrode array for performing functional electrical stimulation of at least one muscle of the lower limb, and (ii) a microprocessor, operatively connected to the at least one sensor, the microprocessor adapted for: receiving a stream of gait information based on the gait data; processing the gait information, and controlling the stimulation output based on the processing of the gait information, and wherein the microprocessor is further adapted to identify a failure in the stream of gait information, and to consequently control the electrical stimulation circuit to deliver a fail-safe stimulati

Abstract: The disclosure relates to a device including a circuit for adjusting the energy of the stimulation pulses, independently controlling the pulse width and the voltage of each stimulation pulse. An iterative search algorithm for determining the optimum energy includes changing both the pulse width and voltage at each new pulse delivered, by setting a high energy value and a low energy value, and delivering a stimulation pulse with the low energy value. A capture test is then carried out. In the presence of a capture, a current iteration is complete and a new iteration is done with the current low energy as a new high energy value. In the absence of capture, the algorithm is terminated with selection of the last energy value that produced the capture as the value of optimum energy.

Abstract: The electrosurgical systems and methods of the present disclosure monitor power dosage delivered to tissue being treated with improved speed and accuracy. The electrosurgical systems include an output stage, sensors, analog all-pass filters, an analog multiplier, an average power calculation circuit, and a controller. The output stage generates electrosurgical energy to treat tissue. The plurality of sensors sense voltage and current waveforms of the generated electrosurgical energy. The plurality of analog all-pass filters filter the sensed voltage and current waveforms. The plurality of analog all-pass filter may have lagging or leading phase. The analog multiplier multiplies the filtered voltage and current waveforms to obtain a real power waveform. The average power calculation circuit calculates a real average power based on the real power waveform. The controller then generates a control signal to control the output stage based on the real average power.

Abstract: A system and method for operating an electronic computing device that is capable of invoking a battery saver mode may monitor an amount of power remaining in a battery of the electronic computing device, and generate an alert when the remaining amount of power in the battery available for continued operation of the device is at or below a predetermined threshold. The alert may include a notification of the estimated power remaining and an option to enable the battery saver mode. The alert may include a notification of the estimated power remaining and that battery saver mode has been enabled, and an option to disable the battery saver mode. The alert may include a notification of the estimated power remaining, and an option to customize the parameters of the battery saver mode by adjusting operation of various features and applications of the device.

Abstract: Example implantable cardiac stimulation devices, pulse generators, and methods providing enhanced cardiac pacing energy are disclosed herein. In an example, an implantable cardiac stimulation device may include a pulse generator having a pacing output node providing cardiac pacing pulses to be applied to a heart of a patient. The pulse generator may include a pulse voltage regulator that receives a pacing signal and generates cardiac pacing pulses at an output of the pulse voltage regulator according to the pacing signal. The pulse voltage regulator may receive a supply voltage to generate cardiac pacing pulses at the supply voltage, gated by the pacing signal.

Abstract: A positionally sensitive spinal cord stimulation apparatus and method using near-infrared (NIR) reflectometry are provided for automatic adjustments of spinal cord stimulation. The system comprises an electrode assembly with an integrated optical fiber sensor for sensing spinal cord position. The integrated optical fiber sensor, comprising a set of optical elements for emitting light from a set of IR emitters and for collecting reflected light into a set of IR photodetectors, determines a set of measured optical intensities. As the spinal cord changes position, the angles of incidence for light from the IR emitter and the measured optical intensities change. Electrode pulse characteristics are adjusted in real time, based on the set of measured optical intensities, to minimize changes in stimulation perceived by the patient during motion.

Abstract: The disclosure relates to systems and methods for cardiac rhythm management. In some cases, a system may include a pulse generator for generating pacing pulses for stimulating a heart of a patient; a memory; and a sensor configured to sense a response to a unwanted stimulation and to produce a corresponding sensor signal. A processing circuit may receive the sensor signal for a time after one or more pacing pulses, and may derive a time-frequency representation of the sensor signal based on the received sensor signal. The processing circuit may use the time-frequency representation of the sensor signal to help identify unwanted stimulation. Once unwanted stimulation is detected, the processing circuit may change the pacing pulses to help reduce or eliminate the unwanted stimulation.

Abstract: A chronically implanted medical device, connected to a medical electrical lead that includes a sensor, is used to detect diastolic dysfunction. A LV accelerometer signal is sensed through the sensor. Based on the LV accelerometer signal, a determination is made as to whether diastolic dysfunction data exists.

Abstract: According to various method embodiments, a person is indicated for a therapy to treat a cardiovascular disease, and the therapy is delivered to the person to treat the cardiovascular disease. Delivering the therapy includes delivering a vagal stimulation therapy (VST) to a vagus nerve of the person at a therapeutically-effective intensity for the cardiovascular disease that is below an upper boundary at which upper boundary the VST would lower an intrinsic heart rate during the VST.

Abstract: Methods and systems described herein are especially useful wherein monitoring for atrial fibrillation (AF) is based on RR interval variability as measured from an electrocardiogram (ECG) signal. An activity threshold, which can be patient specific, is obtained. Patient activity is monitored. Based on the monitored patient activity and the activity threshold, there is a determination of when it is likely that AF monitoring based on RR interval variability is adversely affected by patient activity. When it has been determined that it is likely that AF monitoring based on RR interval variability is adversely affected by patient activity, whether and/or how AF monitoring is performed is modified.

Abstract: Various aspects of the present subject matter relate to a method. According to various method embodiments, cardiac activity is detected, and neural stimulation is synchronized with a reference event in the detected cardiac activity. Neural stimulation is titrated based on a detected response to the neural stimulation. Other aspects and embodiments are provided herein.

Abstract: In an example, a system includes a cardiac pulse generator configured to generate cardiac paces to pace the heart, a sensor configured to sense a physiological signal for use in detecting pace-induced phrenic nerve stimulation where the pace-induced phrenic nerve stimulation is phrenic nerve stimulation induced by electrical cardiac pace signals, and a phrenic nerve stimulation detector configured to analyze the sensed physiological signal to detect PS beats where the PS beats are cardiac paces that induce phrenic nerve stimulation. The detector may be configured to correlate signal data for sensed beat signals to a PS template to detect PS beats, or may be configured to analyze morphological features of sensed beat signals to detect PS beats, or may be configured to detect PS beats using a combination that both correlates signal data for sensed beat signals to a PS template and analyzes morphological features of sensed beat signals.

Abstract: An implantable electrode array including a carrier on which plural electrodes are disposed. Also disposed on the carrier is an array antenna over which signals are wirelessly received. A tether is connected to the carrier. A tether antenna is attached to the tether. After the electrode array is implanted, during a trial period instructions and power are transmitted to the array antenna over the tether antenna. If the trial is successful, the tether is disconnected from the electrode array. If the trial is not successful and extraction of the array is necessary, extraction is accomplished by pulling on the tether. Electrode array removal may be facilitated by the pulling of the array into an extraction tube disposed over the tether.

Abstract: Techniques are provided for controlling spinal cord stimulation (SCS) or other forms of neurostimulation. Far-field cardiac electrical signals are sensed using a lead of the SCS device and neurostimulation is selectively delivering using a set of adjustable SCS control parameters. Parameters representative of cardiac rhythm are derived from the far-field cardiac electrical signals. The parameters representative of cardiac rhythm are correlated with SCS control parameters to thereby map neurostimulation control settings to cardiac rhythm parameters. The delivery of further neurostimulation is then controlled based on the mapping of neurostimulation control settings to cardiac rhythm parameters to, for example, address any cardiovascular disorders detected based on the far-field cardiac signals. In this manner, a closed loop control system is provided to automatically adjust SCS control parameters to respond to changes in cardiac rhythm such as changes associated with ischemia, arrhythmia or heart failure.

Abstract: An electronic system activatable by electrical power is described. The system is useful for influencing cellular functions or malfunctions in a warm-blooded mammalian subject. The system includes one or more controllable low energy HF (High Frequency) carrier signal generator circuits, one or more data processors for receiving control information, one or more amplitude modulation control generators and one or more amplitude modulation frequency control generators. The amplitude modulation frequency control generators are adapted to accurately control the frequency of the amplitude modulations to within an accuracy of at least 1000 ppm, most preferably to within about 1 ppm, relative to one or more determined or predetermined reference amplitude modulation frequencies.

Abstract: A method of modifying the force of contraction of at least a portion of a heart chamber, including providing a subject having a heart, comprising at least a portion having an activation, and applying a non-excitatory electric field having a given duration, at a delay after the activation, to the portion, which causes the force of contraction to be increased by a least 5%.

Abstract: In an example of a method, the method includes testing for phrenic nerve stimulation (PS) threshold. If PS beats are detected at the pacing output level, analyzing the detected PS beats using criteria to determine if the pacing output level can be declared to be the PS threshold. If the pacing output level cannot be declared to be the PS threshold based on the analysis of the PS beat at the pacing output level, performing a PS beat confirmation procedure. The PS beat confirmation procedure may include delivering additional cardiac paces at the pacing output level to generate additional PS beats, and analyzing the detected PS beats using other criteria to determine if the pacing output level can be confirmed as the PS threshold.

Abstract: Cardioprotective pre-excitation pacing may be applied to stress or de-stress a particular myocardial region delivering of pacing pulses in a manner that causes a dyssynchronous contraction. Such dyssynchronous contractions are responsible for the desired cardioprotective effects of pre-excitation pacing. A method and device for applying reverse hysteresis and mode switching to the delivery of such cardioprotective pacing are described.

Abstract: A cardiac rhythm management (CRM) device can extract ventilation information from thoracic impedance or other information, and adjust a delivery rate of the CRM therapy. A tidal volume of a patient is measured and used to adjust a ventilation rate response factor. The measured tidal volume can optionally be adjusted using a ventilation rate dependent adjustment factor. The ventilation rate response factor can also be adjusted using a maximum voluntary ventilation (MVV), an age predicted maximum heart rate, a resting heart rate, and a resting ventilation determined for the patient. In various examples, a global ventilation sensor rate response factor (for a population) can be programmed into the CRM device, and automatically tailored to be appropriate for a particular patient.

Abstract: Techniques are provided for use with implantable devices equipped with programmable voltage multipliers (including voltage dividers.) Candidate pulse widths are determined for selected voltage multipliers and stimulation vectors. Each candidate pulse width corresponds to a lowest pulse energy sufficient to achieve capture within the tissues of the patient (subject to a safety margin) using the selected vector and using the corresponding voltage multiplier. As such, a candidate pulse width represents a preferred or optimal pulse width, at least insofar as energy consumption is concerned. However, depending upon the capabilities of the device, the candidate pulse width might not be achievable. Accordingly, for each programmable vector, the system determines a lowest “operable” voltage multiplier sufficient to generate a pulse at a candidate pulse width subject to the capabilities of the device.

Abstract: Various aspects relate to a method. In various embodiments, a therapy of a first therapy type is delivered, and it is identified whether a therapy of a second therapy type is present to affect the therapy of the first therapy type. Delivery of the therapy is controlled based on the presence of the therapy of the second therapy type. Some embodiments deliver the therapy of the first type using one set of parameters in the presence of a therapy of a second type, and deliver the therapy of the first type using another set of parameters when the therapy of the second type is not present. In various embodiments, one of the therapy types includes a cardiac rhythm management therapy, and the other includes a neural stimulation therapy. Other aspects and embodiments are provided herein.

Abstract: A release mechanism (100, 100a) for releasing a medical implant (105) from an insertion device (110), comprising a body (10) having a proximal end (12) and a distal end (14), wherein between the proximal end and the distal end (12, 14) an actuator (16, 16a) is provided, wherein for generating a selective relative displacement between the first and second insertion elements (72; 74) of the insertion device (110), the actuator (16, 16a) has a first and at least a second direction of motion (18; 20), wherein in the first direction of motion (18), the first and second insertion elements (72; 74) can be displaced relative to one another in the longitudinal direction (18), and wherein in the at least second direction of motion (20), the actuator (16, 16a) effects a movement transversely to the longitudinal direction (18).

Abstract: Electrical energy delivery tissue site validation systems and methods can determine an indication of a tissue type at a tissue site. This information can be used to enable or inhibit electrical energy delivery to the tissue site. The tissue type at the tissue site can be determined such as by delivering a test electrical energy and sensing a responsive electrical energy. An electrical connectivity to the tissue site can also be determined, such as by using a sensed intrinsic electrical signal at the tissue site. Tissue type information may be communicated externally, such as to allow user confirmation or override of the determined indication of tissue type at the tissue site, such as by a physician, user, or other operator.

Abstract: The invention relates to electrodes of a novel type in a heart stimulator functioning on energy produced by a piezoelectric effect. A variant of the electrodes is formed by the presence of a ferromagnetic material. The device constituting the heart stimulator has a small overall volume, weighs less than traditional stimulators, poses less risk of infection and clotting and much less risk of mechanical failure. Use of the device containing electrodes composed of materials capable of producing a piezoelectric effect and, if appropriate, also containing a ferromagnetic material, and also a directional probe comprising an electromagnet.

Abstract: A cardiac medical device and associated method control delivery of dual chamber burst pacing pulses in response to detecting tachycardia. A number of cardiac cycles occurring in a first cardiac chamber are identified subsequent to the dual chamber pacing pulses. The number of sensed intrinsic events occurring in a second cardiac chamber during the first chamber cardiac cycles is determined as a number of second chamber events. The tachycardia episode is classified in response to the number of second chamber events.

Abstract: An implantable medical device detects a strong static magnetic field associated with an MRI imaging instrument and operates in a safekeeping operating mode. The device includes an electronic circuit for the detection/stimulation of a cardiac activity, a weak field sensor detecting the presence of a first magnetic field of a permanent magnet being located in proximity to the device, a strong field sensor detecting the presence of a second magnetic field of an MRI imaging instrument during the course of an MRI examination.

Abstract: Various system embodiments comprise a myocardial stimulator, at least one sensor adapted for use in detecting heart rate to determine heart rate turbulence (HRT), and a controller connected to the myocardial stimulator and the at least one sensor. The myocardial stimulator is adapted to deliver pacing pulses through at least one electrode to provide cardiac pacing. The controller is adapted to intermittently deliver a sequence of stress-inducing pacing pulses adapted to increase sympathetic tone during the stress-inducing pacing. The controller is further adapted to determine HRT from the detected heart rate to assess cardiac stress to the stress-inducing pacing pulses, and adjust at least one parameter of the stress-inducing pacing pulses to adjust cardiac stress if the cardiac stress to the stress-inducing pacing pulses is undesirable.

Abstract: A new pacemaker apparatus for treating the physiological electric conduction of the heart that includes a conduction abnormality in a ventricle. The pacemaker includes a pulse generator and a pacing electrode located in the heart, the pulse generator providing pacing signals to the pacing electrode. The pacemaker further includes a signal generation circuit that generates electrical signals from heart-related feedback signals that indicate that the pacing electrode is delivering the pacing signals in a region at or near the His bundle of the heart. The combination of the pulse generator and the signal generation circuit indicates that the pacing electrode is delivering the pacing signals in the region, at or near the His bundle of the heart, to electrically bypass the conduction abnormality of the heart in the ventricle.

Abstract: Cardioprotective pre-excitation pacing may be applied to stress or de-stress a particular myocardial region delivering of pacing pulses in a manner that causes a dyssynchronous contraction. Such dyssynchronous contractions are responsible for the desired cardioprotective effects of pre-excitation pacing but may also be hazardous. Described herein is a method and system that uses measures of a patient's heart rate or exertion level to control the duty cycles of intermittent pre-excitation pacing.

Abstract: Methods, systems and devices efficiently identify cardiac resynchronization therapy (CRT) pacing parameter set(s) that provide improved hemodynamic response relative to an initial CRT pacing parameter set, wherein each CRT pacing parameter set includes at least two CRT pacing parameters. User input(s) are accepted that specify a maximum amount of time and/or parameter sets that can be used to perform testing, and specify relative importance of parameters within the sets. Based on the accepted user input(s), there is a determination of how many different variations of each of the CRT pacing parameters can be tested, and based on this determination different CRT pacing parameter sets are selected and tested to obtain a hemodynamic response measure corresponding to each of the different sets tested. Additionally, one or more of the tested CRT pacing parameter sets, if any, that provide improved hemodynamic response relative to the initial CRT pacing parameter set is/are identified.

Abstract: According to some embodiments, the present invention provides a device, system, and methods for treating a plurality of conditions in a patient, where the device, system, and methods provide a stimulation signal for each condition, wherein each stimulation signal has one or more of polarity, direction, and pulse patterns selected for the respective condition. According to some embodiments, the conditions comprise congestive heart failure and stroke.

Abstract: The disclosure herein relates generally to methods for treating heart conditions using vagal stimulation, and further to systems and devices for performing such treatment. Such methods may include monitoring physiological parameters of a patient, detecting cardiac conditions, and delivering vagal stimulation (e.g., electrical stimulation to the vagus nerve or neurons having parasympathetic function) to the patient to treat the detected cardiac conditions.

Abstract: Methods, apparatus, and systems are provided to stimulate multiple sites in a heart. A controller senses electrical activity associated with sinus rhythm of the heart. A signal generator is configured to generate an electrical signal for stimulating the heart. Based on the electrical signal, a distributor circuit then distributes the stimulating signals, such as pacing pulses, to a heart. The distributor circuit may vary the delay time between stimulating signals, inhibit a stimulating signal, trigger application of a stimulating signal, or vary the characteristics, such as the pulse width and amplitude, of a stimulating signal.

Abstract: Embodiments of close loop optimization of atrio-ventricular (A-V) delay interval and/or inter-ventricular (V-V) timing are disclosed. An implantable medical device includes a housing that supports a processing means adapted for implantation in a patient. There can be two or more electrodes electrically coupled to the processing means where the two or more electrodes can be used for sensing a patient's cardiac signals, which include a far-field EGM. The processing means can determine a width of a P-wave from the sensed far-field EGM. Also included can be a means for delivering an adapted cardiac pacing therapy based upon the width of the P-wave, including revised A-V delay and/or V-V temporal intervals.