Abstract: Systems and methods for managing machine-generated medical events detected from one or more patients are described herein. A medical event management system includes an event analyzer circuit to detect a medical event using physiological data from a patient-triggered episode acquired from a medical device. The event analyzer circuit determines a confidence score of the medical event detection, and generates an alignment indicator indicating a degree of concordance between the detected medical event and the information about the patient-triggered episode. The system assigns priority information to the patient-triggered episode using the generated alignment indicator and the confidence score of the detection. An output circuit can output the received physiological information to a user or a process according to the assigned priority information.

Abstract: A method of monitoring respiration with an acoustic measurement device, the acoustic measurement device having a sound transducer, the sound transducer configured to measure sound associated with airflow through a mammalian trachea, the method includes correlating the measured sound into a measurement of tidal volume and generating at least one from the group consisting of an alert and an alarm if the measured tidal volume falls outside of a predetermined range.

Abstract: An implantable device for providing electrical stimulation of cervical vagus nerves for treatment of chronic cardiac dysfunction is provided. A stimulation therapy lead includes helical electrodes configured to conform to an outer diameter of a cervical vagus nerve sheath, and a set of connector pins electrically connected to the helical electrodes. A neurostimulator includes an electrical receptacle into which the connector pins are securely and electrically coupled. The neurostimulator also includes a pulse generator configured to therapeutically stimulate the vagus nerve through the helical electrodes in alternating cycles of stimuli application and stimuli inhibition that are tuned to both efferently activate the heart's intrinsic nervous system and afferently activate the patient's central reflexes by triggering bi-directional action potentials.

Abstract: An earphone includes a loudspeaker, a microphone, a housing supporting the loudspeaker and microphone, and an ear tip surrounding the housing and configured to acoustically couple both the loudspeaker and the microphone to an ear canal of a user, and to acoustically close the entrance to the user's ear canal. A processor receives input audio signals from the microphone, detects peaks having a frequency of around 1 Hz in the input audio signals, based on the detected peaks, computes an instantaneous heart rate, measures a frequency of an oscillation within the instantaneous heart rate, and based on the frequency of the oscillation, computes a rate of respiration.

Abstract: The invention provides a body-worn monitor that measures a patient's vital signs (e.g. blood pressure, SpO2, heart rate, respiratory rate, and temperature) while simultaneously characterizing their activity state (e.g. resting, walking, convulsing, falling). The body-worn monitor processes this information to minimize corruption of the vital signs by motion-related artifacts. A software framework generates alarms/alerts based on threshold values that are either preset or determined in real time. The framework additionally includes a series of ‘heuristic’ rules that take the patient's activity state and motion into account, and process the vital signs accordingly. These rules, for example, indicate that a walking patient is likely breathing and has a regular heart rate, even if their motion-corrupted vital signs suggest otherwise.

Abstract: A device comprising a three-dimensional polymeric element and an electronic element integrated with the polymeric element is disclosed. The electronic element is made up of one or more electrode(s) each individually connectable to a measuring device and/or a controller, and each independently having a thin electrically-isolating layer deposited thereon such that the electrode is exposed to an environment surrounding the electrode at one or more pre-determined locations over the electrode. The device can include cells and/or tissue and/or a therapeutically active agent incorporated within the polymeric material. Processes of fabricating the device, systems for operating the device and methods utilizing same are also disclosed.

Abstract: Systems and methods for controlling blood pressure by controlling atrial pressure and atrial stretch are disclosed. In some embodiments, a stimulation circuit may be configured to deliver a stimulation pulse to at least one cardiac chamber of a heart of a patient, and at least one controller may be configured to execute delivery of one or more stimulation patterns of stimulation pulses to the at least one cardiac chamber, wherein at least one of the stimulation pulses stimulates the heart such that an atrial pressure resulting from atrial contraction of an atrium overlaps in time a passive pressure build-up of the atrium, such that an atrial pressure of the atrium resulting from the stimulation is a combination of the atrial pressure resulting from atrial contraction and the passive pressure build-up and is higher than an atrial pressure of the atrium would be without the stimulation, and such that the blood pressure of the patient is reduced.

Abstract: Various system embodiments comprise a stimulator adapted to deliver a stimulation signal for a heart failure therapy, a number of sensors adapted to provide at least a first measurement of a heart failure status and a second measurement of the heart failure status, and a controller. The controller is connected to the stimulator and to the number of sensors. The controller is adapted to use the first and second measurements to create a heart failure status index, and control the stimulator to modulate the signal using the index. Other aspects and embodiments are provided herein.

Abstract: Methods and/or devices may be configured to estimate right ventricular-timings from left ventricular (LV) sensing times for adaptive cardiac therapy using DDD/VDD LV pacing without using a right ventricular (RV) lead. One embodiment employs a subcutaneous device (SD) in a patient and a leadless pacing device (LPD) coupled to a patient's heart. Heart activity including atrial and ventricular events are sensed from the patient's heart using the SD. Left ventricular events (LVS) are sensed using the LPD. The SD is used to determine whether cardiac resynchronization pacing therapy (CRT pacing) is appropriate based upon the heart activity sensed by the SD. The SD is further configured to determine timing of CRT pacing pulses for delivery to cardiac tissue through the LPD.

Abstract: A leadless cardiac pacemaker (LCP) is configured to sense cardiac activity and to pace a patient's heart and is disposable within a ventricle of the patient's heart. The LCP MAY include a housing, a first electrode and a second electrode that are secured relative to the housing and are spaced apart. A controller is disposed within the housing and is operably coupled to the first electrode and the second electrode such that the controller is capable of receiving, via the first electrode and the second electrode, electrical cardiac signals of the heart. The LCP may include a pressure sensor and/or an accelerometer. The controller may determine a pace time within a cardiac cycle based at least in part upon an indication of metabolic demand.

Abstract: Described is a system for biofeedback, the system including one or more processors and a memory, the memory being a non-transitory computer-readable medium having executable instructions encoded thereon, such that upon execution of the instructions, the one or more processors perform operations including using a first biometric sensor during performance of a current task, acquiring first biometric data, and producing a first biometric value by assessing the first biometric data. The one or more processors further perform operations including determining a first relevance based on a first significance of a first correlation between the first biometric value and the current task, and controlling a device based on the first relevance and the first biometric value.

Abstract: A device and method for detecting biological information without being affected by sudden-onset signal even when sudden-onset large vibration is caused while driving a vehicle or the like. Peak input and output values of a variable delay device are detected, and the difference between the values is determined by a subtractor. The difference is compared to a predetermined threshold to obtain a positive or negative output as an up/down selection output for an up/down counter. The output of the up/down counter is sent to a variable delay device with a clock generated based on an inputted peak signal of biological information to obtain a variable delay amount corresponding to one cycle of the biological information. When the subtractor output exceeds the predetermined threshold, a predetermined output voltage is generated, and an amplifier connected to the variable delay device is controlled so that the gain of the amplifier becomes zero.

Abstract: A system for processing cardiac activation information associated with a complex rhythm disorder identifies a location of the heart rhythm disorder by determining activations within cardiac signals obtained at neighboring locations of the heart and arranging the activations to identify an activation trail. The activation trail may define a rotational pattern or radially emanating pattern corresponding to an approximate core of the heart rhythm disorder.

Abstract: Disclosed herein are methods, systems, and apparatus for treating a medical condition of a patient, involving detecting a physiological cycle or cycles of the patient and applying an electrical signal to a portion of the patient's vagus nerve through an electrode at a selected point in the physiological cycle(s). The physiological cycle can be the cardiac and/or respiratory cycle. The selected point can be a point in the cardiac cycle correlated with increased afferent conduction on the vagus nerve, such as a point from about 10 msec to about 800 msec after an R-wave of the patient's ECG, optionally during inspiration by the patient. The selected point can be a point in the cardiac cycle when said applying increases heart rate variability, such as a point from about 10 msec to about 800 msec after an R-wave of the patient's ECG, optionally during expiration by the patient.

Abstract: Intermittent delivery of ventricular pacing pulses synchronized to occur during an atrial diastole time period can be used to provide atrial stretch therapy and augment the production and release of atrial natriuretic hormone.

Abstract: Receiver-stimulator with folded or rolled up assembly of piezoelectric components, causing the receiver-stimulator to operate with a high degree of isotropy are disclosed. The receiver-stimulator comprises piezoelectric components, rectifier circuitry, and at least two stimulation electrodes. Isotropy allows the receiver-stimulator to be implanted with less concern regarding the orientation relative the transmitted acoustic field from an acoustic energy source.

Abstract: Electrode structures for transvascular nerve stimulation combine electrodes with an electrically-insulating backing layer. The backing layer increases the electrical impedance of electrical paths through blood in a lumen of a blood vessel and consequently increases the flow of electrical current through surrounding tissues. The electrode structures may be applied to stimulate nerves such as the phrenic, vagus, trigeminal, obturator or other nerves.

Abstract: An example method for controlling delivery of electrical stimulation therapy includes maintaining, by one or more processors of a medical device configured to deliver electrical stimulation to a patient, a counter tied to a clock used by the medical device to deliver the electrical stimulation to the patient; and obtaining, by the one or more processors, one or more representations of sensed electrical signals for the patient that are referenced to counts of the counter. In this example, the method also includes identifying, based on the one or more representations of the sensed electrical signals for the patient, a count of the counter at which stimulation is to be delivered to the patient; and delivering, by the medical device and to the patient, electrical stimulation based on the identified count of the counter.

Abstract: An implantable medical device (IMD) is configured with a pressure sensor. The IMD includes a housing, a pressure sensor and a fluid filled cavity. The housing has a diaphragm that is exposed to the environment outside of the housing. The pressure sensor has a pressure sensor diaphragm that is responsive to a pressure applied to the pressure sensor diaphragm and provides a pressure sensor output signal that is representative of the pressure applied to the pressure sensor diaphragm. The fluid filled cavity is in fluid communication with both the diaphragm of the housing and the pressure sensor diaphragm of the pressure sensor. The fluid filled cavity is configured to communicate a measure related to the pressure applied by the environment to the diaphragm of the housing to the pressure sensor diaphragm of the pressure sensor.

Abstract: Cardiac therapy devices in the form of pacemakers and/or defibrillators including one or more leads with electrodes implanted in a vein in a posterior position in combination with one or more leads with electrodes implanted in an anterior position. The posterior position may be chosen from one or more of the azygos, hemiazygos, accessory hemiazygos, or posterior intercostal veins. The anterior position may be chosen from the internal thoracic vein, an anterior intercostal vein, or an anterior subcutaneous location. In other examples, sensors are placed for use by a cardiac monitoring or therapy system in one or more of the internal thoracic vein, the azygos vein, the hemiazygos vein, the accessory hemiazygos vein, and/or an anterior or posterior intercostal vein.

Abstract: Systems and methods for stimulation of neurological tissue apply a stimulation waveform that is derived by a developed genetic algorithm (GA), which may be coupled to a computational model of extracellular stimulation of a mammalian myelinated axon. The waveform is optimized for energy efficiency.

Abstract: An implantable monitoring device is disclosed for monitoring a patient's heart rate variability over time. The device includes a cardiac electrogram amplifier, a sensing electrode coupled to an input of the amplifier, timing circuitry, processing circuitry and a memory. The timing circuitry defines successive shorter time periods during each monitoring period. The processing circuitry relies upon electrogram activity that occurs during rest periods that extend as long as T1, all of which is stored into memory. Active periods are not considered as part of the heart rate variability calculation. The processing circuitry calculates median intervals between depolarizations of the patient's heart sensed by the amplifier during the shorter time periods and calculates a standard deviation of the median intervals during T2, a longer monitoring period.

Abstract: An apparatus comprises a cardiac signal sensing circuit configured for coupling electrically to a plurality of electrodes and to sense intrinsic cardiac activation at three or more locations within a subject's body using the electrodes; a stimulus circuit configured for coupling to the plurality of electrodes; a signal processing circuit electrically coupled to the cardiac signal sensing circuit and configured to determine a baseline intrinsic activation vector according to the sensed intrinsic cardiac activation; and a control circuit electrically coupled to the cardiac signal sensing circuit and stimulus circuit and configured to: initiate delivery of electrical pacing therapy using initial pacing parameters determined according to the baseline intrinsic activation vector; initiate sensing of a paced activation vector; and adjust one or more pacing therapy parameters according to the paced activation vector.

Abstract: A leadless pacing device may include a housing, a distal extension extending distally of a distal end of the housing, one or more electrodes supported by the housing, a distal electrode supported by the distal extension, and a processing module located within an interior space of the housing and electrically coupled to the one or more electrodes supported by the housing and the distal electrode supported by the distal extension. The housing may be positioned within a coronary sinus and the distal extension may be positioned within a vessel extending from the coronary sinus. The processing module may determine whether cardiac events occurred based on near-field signals and/or far-field signals sensed using the one or more electrodes supported by the housing and the distal electrode. The processing module may generate cardiac stimulation pulses based on the determination of whether a cardiac event occurred and where it occurred.

Abstract: Systems, methods, and computer program product embodiments are disclosed for performing electrophysiology (EP) signal processing. An embodiment includes an electrocardiogram (ECG) circuit board configured to process an ECG signal. The embodiment further includes a plurality of intracardiac (IC) circuit boards, each configured to process a corresponding IC signal. The embodiment further includes a communications interface communicatively coupled to a remote device, and a processor, coupled to the ECG circuit board, the plurality of IC circuit boards, and the communications interface. The processor is configured to receive, via the communications interface, feedback from the remote device. The processor is further configured to control, via the communication interface, the remote device based on the ECG signal, the IC signals, or the feedback from the remote device.

Abstract: A method and system for delivering cardiac pacing therapy that includes sensing electrical activity of tissue of a patient from a plurality of external electrodes during delivery of a non-ambulatory pacing therapy from a pacing device and determining an optimal electromechanical (EM) response time from an optimal electrical activation determined from electrical heterogeneity information obtained during non-ambulatory pacing therapy. During delivery of subsequent ambulatory pacing, the pacing sensing an EM signal from an EM sensor of the pacing device, determines a current EM response time in response to the sensed EM signal, and adjusting a pacing parameter setting of the ambulatory pacing therapy in response to comparing the current EM response time to the optimal EM response time.

Abstract: Detecting dislodgement of a ventricular lead coupled to an implantable medical device comprises sensing a near-field cardiac EGM via a first electrode of the ventricular lead and a far-field cardiac EGM via a second electrode of the ventricular lead, identifying, R-waves in the near-field cardiac EGM and the far-field cardiac EGM. determining a near-field value of one or more R-wave amplitude metrics based on amplitudes of R-waves identified in the near-field cardiac EGM and a far-field value of the one or more R-wave amplitude metrics based on amplitudes of R-waves identified in the far-field cardiac EGM, detecting dislodgement of the ventricular lead based on at least one of the near-field value or the far-field value of the one or more R-wave amplitude metrics; and providing a lead dislodgment alert in response to detecting the dislodgement of the ventricular lead.

Abstract: A method and system are provided for controlling an adaptive pacing therapy using an implantable medical device (IMD). The method provides electrodes that are configured to be located proximate to an atrial (A) site, left ventricular (LV) site and right ventricular (RV) site of the heart. The method utilizes one or more processors to perform obtaining an intra-atrial conduction interval (IACI-LVPROX) between an atrial event and intrinsic conduction at an LV site that is proximal to a sinoatrial (SA) node and obtaining timing of a first heart sound S1. The processors determine whether the S1 occurs after the IACI-LVPROX, and calculates an S1-conduction lag ?S1_C between the IACI-LVPROX and the first heart sound S1. The processors set an atrial-ventricular pacing (AV) delay based on the IACI-LVPROX and the ?S1_C. The processors deliver a pacing therapy based on the AV delay.

Abstract: In some examples, the disclosure describes an implantable medical device comprising a plurality of electrodes, sensing circuitry configured to sense a physiological electrical signal via the plurality of electrodes, and communication circuitry configured to transmit and/or receive a transconductance communication signal via the plurality of electrodes, wherein at least one electrode of the plurality of electrodes comprises a lower-capacitance portion and a higher-capacitance portion.

Abstract: An air-conditioning control system provides an appropriate environment in accordance with a stress level of a person in a room and a use of a space in which the person stays. A deriver derives heartbeat-related parameters based on a body movement of the person. A determiner determines a stress level of the person at a current moment, based on the heartbeat-related parameters. A receiver receives a use of the space for the person. A CPU for appliance control (i) selects a heartbeat-related parameter to be changed, depending on the received use and the heartbeat-related parameters, and (ii) controls operation of the air conditioner to change the selected heartbeat-related parameter to be changed.

Abstract: Decision support technology is provided for use with patients who may experience respiratory deterioration. A mechanism is provided to determine whether a patient is experiencing (or is likely to experience at a future time) an autoimmune inflammatory event, which may include performing a spectral analysis on a time series of nocturnal or axillary temperatures for the patient to determine a spectrum slope or intercept. The time series may be demeaned, detrended, and apodized before performing the spectral analysis. A comparison of the slope or intercept with a baseline value is used to determine an indication of the patient's likely condition or future condition regarding the autoimmune inflammatory event. Based on the comparison, an intervening action may be invoked, such as alerting a caregiver, providing a recommendation or modified treatment, or determining and recommending a tailored prescription of medicine for the patient.

Abstract: Methods and devices are provided comprising an implantable lead having electrodes configured to be located proximate to a heart, the electrodes defining a sensing vector through a region of interest in the heart. The method and system collect an intra-cardiac electrogram (EGM) signal associated with an event of interest and determining an global amplitude characteristic (GAC) and a global slope characteristic (GSC) from the EGM signal under control of one or more processors within an implantable medical device (IMD). A QRS start time is defined, within the EGM signal, based on the GSC and determining a local amplitude characteristic (LAC) for a segment of the EGM signal within a search window of the GAC under control of one or more processors within an implantable medical device (IMD) A QRS end time is defined, within the EGM signal, based on the LAC; and calculating a QRS duration based on the QRS start time and QRS end time under control of one or more processors within an implantable medical device (IMD).

Abstract: In some example embodiments, there may be provided a method. The method may include receiving three-dimensional image data representative of a heart; receiving electrical data representative of an electrophysiology of the heart; and generating, based on the received three-dimensional image data and the received electrical data, a computational model of the heart. Related systems and articles of manufacture may also be provided.

Abstract: Some embodiments of the present disclosure discuss an apparatus comprising a transceiver configured to generate and/or receive radio frequency (RF) electromagnetic signals, one or more antennae configured to radiate the generated RF electromagnetic signals toward a surface and to output signals corresponding to received reflections of the RF electromagnetic signals, and a processing circuitry configured to process the received reflections and/or the output signals so as to determine change in position of the apparatus with respect to the surface. The apparatus may be incorporated into a wearable garment and/or an adhesive patch, and it may be attached to an outer surface of a human or an animal body.

Abstract: Automated generation of graphical displays of industrial process data tags including three trend charts for each data tag. The displays include trend charts for the time-weighted average, the minimum value, and the maximum value over a predetermined time period. Altering the transparency of the trend charts for the minimum value and maximum value enables displaying data for multiple tags on a single chart.

Abstract: An intracardiac ventricular pacemaker is configured to detect a ventricular diastolic event from a motion signal received by a pacemaker control circuit from a motion sensor. The control circuit starts an atrial refractory period having an expiration time set based on a time of the detection of the ventricular diastolic event. The control circuit detects an atrial systolic event from the motion signal after expiration of the atrial refractory period and controls a pulse generator of the pacemaker to deliver a pacing pulse to a ventricle of a patient's heart at a first atrioventricular pacing time interval after the atrial systolic event detection.

Abstract: The invention provides methods related to improving heart function.

Abstract: An implantable medical device includes an activity sensor, a pulse generator, and a control module. The control module is configured to determine activity metrics from the activity signal and determine an activity metric value at a predetermined percentile of the activity metrics. The control module sets a lower pacing rate set point based on the activity metric value at the predetermined percentile.

Abstract: A medical device and associated method evaluate vectors of a multi-dimensional accelerometer by receiving a signal from the accelerometer for each of the vectors and determining a metric from the signal for each of the vectors during a first sensing condition and during a second sensing condition. The difference between the metrics determined for the first sensing condition and the second sensing condition for each of the vectors is determined. One of the vectors is selected, based upon the determined differences, for monitoring the patient.

Abstract: A processor acquires image data from a medical imaging system. The processor generates a first model from the image data. The processor generates a computational model which includes cardiac electrophysiology and cardiac mechanics estimated from the first model. The processor performs tests on the computational model to determine outcomes for therapies. The processor overlays the outcome on an interventional image. Using interventional imaging, the first heart model may be updated/overlaid during the therapy to visualize its effect on a patient's heart.

Abstract: A patient suffering from congestive heart failure is at increased risk of cardiac arrhythmogenesis during sleep, particularly if experiencing central sleep apnea as a co-morbidity. Low intensity peripheral neurostimulation therapies that target imbalance of the autonomic nervous system have been shown to improve clinical outcomes. Thus, bi-directional autonomic regulation therapy is delivered to the cervical vagus nerve at an intensity that is insufficient to elicit pathological or acute physiological side effects and without the requirement of an enabling physiological feature or triggering physiological marker. The patient's physiology is monitored to identify periods of sleep. In one embodiment, upon sensing a condition indicative of tachyarrhythmia following a period of bradycardia, as naturally occurs during sleep, an enhanced “boost” dose of bi-directional neural stimulation intended to “break” the tachyarrhythmic condition is delivered.

Abstract: Systems, devices, and methods for pacing a heart of a patient are disclosed. An illustrative method may include determining a motion level of the patient using a motion sensor of an implantable medical device secured relative to a patient's heart, and setting a pacing rate based at least in part on the patient's motion level. The patient's motion level may be determined by, for example, comparing the motion level sensed by the motion sensor during a current heart beat to a motion level associated with one or more previous heart beats. Noise may occur in the motion level measurements during those heart beats that transition between an intrinsically initiated heart beat and pace initiated heart beat. Various techniques may be applied to the motion level measurements to help reduce the effect of such noise.

Abstract: Some systems and methods may facilitate selection of a vector for delivering electrical stimulation to a patient's heart. One method may include displaying a plurality of vectors on a display screen wherein each vector represents a different combination of three or more electro-stimulation electrodes, determining an electrical impedance for each of the plurality of vectors, displaying on the display screen the electrical impedance for each of the plurality of vectors, receiving a selection of a set of the plurality of vectors, determining, for each of the vectors in the set of vectors, a capture threshold, displaying on the display screen the capture threshold for each of the vectors in the set of vectors, receiving a selection of a vector from the set of vectors for delivery of electrical stimulation to the patient's heart, and programming the electro-stimulation device electrical stimulation to the patient's heart via the selected vector.

Abstract: An example method includes performing amplitude-based detection to determine location of R-peaks for a plurality of electrograms. The method also includes performing wavelet-based detection to determine location of R-peaks for the plurality of electrograms. The method also includes adjusting the location of the R-peaks determined by the wavelet-based detection of R-peaks based on the location of R-peaks determined by the amplitude-based detection of R-peaks. The method also includes storing, in memory, R-peak location data to specify R-peak locations for the plurality of electrograms based on the adjusting.

Abstract: An exemplary method for optimizing pacing configuration includes providing distances between electrodes of a series of three or more ventricular electrodes associated with a ventricle; selecting a ventricular electrode from the series; delivering energy to the ventricle via the selected ventricular electrode, the energy sufficient to cause an evoked response; acquiring signals of cardiac electrical activity associated with the evoked response via non-selected ventricular electrodes of the series; based on signals of cardiac electrical activity acquired via the non-selected ventricular electrodes and the distances, determining conduction velocities; based on the conduction velocities, deciding if the selected ventricular electrode is an optimal electrode for delivery of a cardiac pacing therapy; and, if the selected ventricular electrode comprises an optimal electrode for delivery of the cardiac pacing therapy, calling for delivery of the cardiac pacing therapy using the selected ventricular electrode.

Abstract: In some examples, processing circuitry of a medical device system determines, for each of a plurality of periods, a plurality of heart rates of a patient based on a cardiac electrogram signal, and identifies a first subset of the plurality of heart rates as nighttime heart rates and a second subset of the plurality of heart rates as resting heart rates. The processing circuitry determines a representative nighttime heart rate based on the first subset of the plurality of heart rates, determines a representative resting heart rate based on the second subset of the plurality of heart rates, and determines a nocturnal dip base on the representative nighttime heart rate and the representative resting heart rate.

Abstract: The present disclosure provides systems and methods for integrating cardiac resynchronization therapy (CRT) and temporary induced dyssynchrony (TID) therapy. An implantable cardiac device includes one or more pulse generators coupled to a plurality of electrodes, and a controller communicatively coupled to the one or more pulse generators and configured to cause the one or more pulse generators to apply a combination of CRT and TID therapy to a patient's heart via the plurality of electrodes in accordance with at least one protocol.

Abstract: A cardiac pacing system having a pulse generator for generating therapeutic electric pulses, a lead electrically coupled with the pulse generator having an electrode, a first sensor configured to monitor a physiological characteristic of a patient, a second sensor configured to monitor a second physiological characteristic of a patient and a controller. The controller can determine a pacing vector based on variables including a signal received from the second sensor, and cause the pulse generator to deliver the therapeutic electrical pulses according to the determined pacing vector. The controller can also modify pacing characteristics based on variables including a signal received from the second sensor.

Abstract: An active implantable medical device includes a VNS pulse bursts generator for stimulation of the vagus nerve according to several selectable configurations. The device may further include a sensor of the current activity level of the patient. The generator is controlled on the activity signal via a classifier determining the of class the current level of activity among a plurality of classes of activity. A controller selects a configuration of VNS therapy depending on the class of activity thus determined. Limits of the activity classes are dynamically changeable by a calibration module that conducts a historical analysis of the successive current activity levels over a predetermined analysis period. The calibration module can prepare a histogram of the historical analysis, and can define the limits of the activity classes depending on the outcome of the historical analysis and the histogram.

Abstract: Computer implemented methods and systems are provided for automatically determining capture thresholds for an implantable medical device equipped for cardiac stimulus pacing using a multi-pole left ventricular (LV) lead. The methods and systems measures a base capture threshold for a base pacing vector utilizing stimulation pulses varied over at least a portion of an outer test range. The base pacing vector is defined by a first LV electrode provided on the LV lead and a second electrode located remote from an LV chamber. The methods and systems designate a secondary pacing vector that includes the first LV electrode and a neighbor LV electrode provided on the LV lead. The methods and systems further define an inner test range having secondary limits based on the base capture threshold, wherein at least one of the limits for the inner test range differs from a corresponding limit for the outer test range.