Abstract: Described herein are methods, devices, and systems for treating human anemia. The methods, devices, and systems generally include monitoring a patient's hemoglobin level and at least one of autonomic balance and inflammatory state to determine the etiology of the anemic state, modulating at least one of a sympathetic or parasympathetic nerve based on the cause of the anemia, monitoring for changes in the patient's cardiac activity and state of inflammation, and hemoglobin level. An external neurostimulation system is describes, and well as a chronic implantable system. A method for treating a patient for anemia in conjunction with a renal denervation ablation catheter is also disclosed.

Abstract: An implantable neurostimulator-implemented method for managing tachyarrhythmias through vagus nerve stimulation is provided. An implantable neurostimulator, including a pulse generator, is configured to deliver electrical therapeutic stimulation in a manner that results in creation and propagation (in both afferent and efferent directions) of action potentials within neuronal fibers of a patient's cervical vagus nerve. Operating modes of the pulse generator are stored. A maintenance dose of the electrical therapeutic stimulation is delivered to the vagus nerve via the pulse generator to restore cardiac autonomic balance through continuously-cycling, intermittent and periodic electrical pulses. A restorative dose of the electrical therapeutic stimulation is delivered to prevent initiation of or disrupt tachyarrhythmia through periodic electrical pulses delivered at higher intensity than the maintenance dose.

Abstract: A system for controlling a position of a patient's tongue includes attaching at least one electrode to the patient's Hypoglossal nerve and applying an electric signal through the electrode to at least one targeted motor efferent located within the Hypoglossal nerve to stimulate at least one muscle of the tongue. The system may also include the use of more than one contact to target more than one motor efferent and stimulating more than one muscle. The stimulation load to maintain the position of the tongue may be shared by each muscle. The position of the patient's tongue may be controlled in order to prevent obstructive sleep apnea.

Abstract: A method of reducing renal hypertension applied for electrically stimulating a target zone of an organism having a symptom of renal hypertension by using an electronic stimulation device. The electronic stimulation device comprises at least one electronic stimulation unit. The electronic stimulation unit includes at least one first electrode and at least one second electrode. The method includes the following steps. The electrical stimulation unit is placed near the target zone. The electrical stimulation unit generates an electrical stimulation signal and the electrical stimulation signal is introduced to the target zone so as to stimulate the target zone. An electric field is generated between the first electrode and the second electrode and covers the target zone. The strength of the electric field ranges from 100 V/m to 1000 V/m.

Abstract: The invention relates to an active implantable medical device. The device includes a VNS pulse generator, an activity sensor for detecting a patient's current activity level, and a processor. The processor is configured to collect the electrical activity of the heart, such as a current intrinsic heart rate of the patient. The processor further calculates values of a reference heart rate based on the patient's current activity level. A first histogram is constructed from the reference heart rate values, and a second histogram is constructed from the intrinsic heart rate values. An index representative of the patient's condition is derived by comparing the first and second histograms.

Abstract: Systems and methods are provided for delivering neurostimulation therapies to patients for treating chronic heart failure. A neural fulcrum zone is identified and ongoing neurostimulation therapy is delivered within the neural fulcrum zone. The implanted stimulation device includes a physiological sensor for monitoring the patient's response to the neurostimulation therapy on an ambulatory basis over extended periods of time and a control system for adjusting stimulation parameters to maintain stimulation in the neural fulcrum zone based on detected changes in the physiological response to stimulation.

Abstract: A handheld device measures all vital signs and some hemodynamic parameters from the human body and transmits measured information wirelessly to a web-based system, where the information can be analyzed by a clinician to help diagnose a patient. The system utilizes our discovery that bio-impedance signals used to determine vital signs and hemodynamic parameters can be measured over a conduction pathway extending from the patient's wrist to a location on their thoracic cavity, e.g. their chest or navel. The device's form factor can include re-usable electrode materials to reduce costs. Measurements made by the handheld device, which use the belly button as a ‘fiducial’ marker, facilitate consistent, daily measurements, thereby reducing positioning errors that reduce accuracy of standard impedance measurements. In this and other ways, the handheld device provides an effective tool for characterizing patients with chronic diseases, such as heart failure, renal disease, and hypertension.

Abstract: A remote control system detects a directional signal at an alerting sensor package; activates an appliance to accept a control signal in response to the directional signal; accepts the control signal at the appliance from a muscle sensor package; and adjusts operation of the appliance in response to the control signal.

Abstract: An apparatus for treating a heart of a patient includes a first lead and at least a second lead for pacing the heart adapted to be in electrical communication with the heart. The apparatus includes a microcontroller in communication with the first and second leads which triggers the first lead at either different times or the same time from when the microcontroller triggers the second lead. Alternatively, the apparatus includes a microcontroller in communication with the first and second leads that determines heart volume, including stroke volume, end-systolic volume, and calculated values including ejection fraction, from admittance from signals from the first and second leads and uses the admittance as feedback to control heart volume ejected, as measured by stroke volume, calculated values such as ejection fraction, and control end-systolic volume, with respect to the first and second leads. A method for treating the heart of a patient.

Abstract: A method of detecting an early onset of neurocardiogenic syncope in a patient uses respiratory functions as a predictor of the syncope. According to the method, at least one sample of baseline minute ventilation, tidal volume and respiratory rate of the patient is obtained. The detection unit is set to detect an increase in tidal volume and in minute ventilation over a predetermined respiratory period. The detecting unit also detects any rate of change in respiratory rate and sends a signal to a microprocessor to determine whether the increase in minute ventilation is a sole function of increased tidal volume. The impending syncope is diagnosed if variance in respiratory rate is less than 25% in relation to the sampled baseline during the predetermined period of time.

Abstract: A system and method for cardiac resynchronization therapy (“CRT”) in which a model of baseline cardiac electrical activity, such as a model of global baseline cardiac electrical activity derived from various surface electrocardiograph (“ECG”) signals, is utilized to automatically adjust pacing control parameters of a cardiac implantable electrical device (“CIED”) are provided. The baseline model is compared to CRT response patterns using modified pacing control parameters in an iterative fashion, based on a patient-specific response pattern phenotype determination, until ventricular electrical asynchrony is minimized. The pacing control parameters resulting in the minimum ventricular electrical asynchrony are used to generate final control parameters for CRT.

Abstract: An implantable neurostimulator-implemented method for managing tachyarrhythmias upon a patient's awakening from sleep through vagus nerve stimulation is provided. An implantable neurostimulator, including a pulse generator, is configured to deliver electrical therapeutic stimulation in a manner that results in creation and propagation (in both afferent and efferent directions) of action potentials within neuronal fibers comprising the cervical vagus nerve of a patient. Operating modes of the pulse generator are stored. An enhanced dose of the electrical therapeutic stimulation is parametrically defined and tuned to prevent initiation of or disrupt tachyarrhythmia upon the patient's awakening from a sleep state through at least one of continuously-cycling, intermittent and periodic ON-OFF cycles of electrical pulses. Other operating modes, including a maintenance dose and a restorative dose are defined.

Abstract: In a method of preventing the formation of alternans in the heart of a patient, the heart is paced to control the TR interval of each heartbeat. The method may be performed using a heart monitoring and pacing device that includes a processor, memory, an electrocardiogram (ECG) sensing circuit, and a pulse generator. In the method, a heartbeat rate of the heart is detected and comparted to a threshold value stored in the memory. The heart is paced using the pulse generator to force the TR period of a limited number of heartbeats toward a targeted TR period, which is stored in the memory.

Abstract: A device and process generates an alarm during a machine-assisted ventilation of a patient. A minute volume is measured and a median of the minute volume and a lower critical limit value of the minute volume and a time delay are determined and are recorded in a control device. A reference signal is determined as a function of the lower critical limit value for the minute volume and the time delay based on the median of the minute volume. From the reference signal an alarm limit value located below the lower critical limit value as well as a value for a maximum tolerated duration of apnea of the patient are derivable. An alarm signal is generated both during an undershooting of the lower critical limit value over a period of time that is longer than the established time delay and during an undershooting of the alarm limit value.

Abstract: The invention consists of a device and method for the prediction of left ventricular ejection fraction (EF) and other cardiac hemodynamic parameters using systolic time intervals in patients with narrow QRS, right bundle branch block, left bundle branch block, right ventricular and/or left ventricular cardiac pacing and in the presence of arrhythmia, such as atrial fibrillation. The device has three inputs: the ECG, a peripheral pulse and a phonocardiogram. Timing parameters are obtained from these signals to calculate a systolic function index, used for the prediction of ejection fraction. Given the invention's features it would be now possible to assess cardiac performance and specifically left ventricular ejection fraction in ambulatory patients as well as during invasive procedures such as the implant of cardiac rhythm management devices.

Abstract: A method for reducing spasticity applied with an electrical stimulation device to electrically stimulate a target zone of an organism suffering from spasticity. The electrical stimulation device comprises at least one electrical stimulation unit. The electrical stimulation unit includes at least one first electrode and at least one second electrode. The method includes the following steps. The electrical stimulation unit is placed near the target zone. The electrical stimulation unit generates an electrical stimulation signal and the electrical stimulation signal is introduced to the target zone so as to stimulate the target zone. An electric field is generated between the first electrode and the second electrode and covers the target zone. The strength of the electric field ranges from 100 V/m to 1000 V/m.

Abstract: Systems and methods for diagnosing one or more respiration distress manifestations by implantably recognizing their occurrence and evaluating information about the same to provide an indication of present or impending worsening heart failure are discussed. Using information produced by an implantable respiration sensor circuit and an implantable physiological sensor circuit, such as at least one of a physical activity sensor circuit or a posture sensor circuit, an implantable or external processor circuit may detect a respiration disturbance and an associated subsequent arousal from stable state occurrence and thereafter evaluate over time arousal from stable state occurrences to provide the indication of present or impending worsening heart failure. In one example, information about a fluid level within a subject is used in determining the indication of worsening heart failure.

Abstract: Systems and methods for reducing ventricle filling volume are disclosed. In some embodiments, a stimulation circuit may be used to stimulate a patient's heart to reduce ventricle filling volume or even blood pressure. When the heart is stimulated at a consistent rate to reduce blood pressure, the cardiovascular system may over time adapt to the stimulation and revert back to the higher blood pressure. In some embodiments, the stimulation pattern may be configured to be inconsistent such that the adaptation response of the heart is reduced or even prevented. In some embodiments, a stimulation circuit may be used to stimulate a patient's heart to cause at least a portion of an atrial contraction to occur while the atrioventricular valve is closed. Such an atrial contraction may deposit less blood into the corresponding ventricle than when the atrioventricular valve is opened throughout an atrial contraction.

Abstract: A spinal cord stimulation device having a stimulation unit for generation and delivery of stimulation pulses, a control unit for controlling the stimulation unit with respect to stimulation intensity and an autonomic nervous system (“ANS”) sensing unit that is configured to generate ANS indicating signals that represent an increased sympathetic tone or an increased parasympathetic tone, respectively. The control unit is configured to control the intensity of respective stimulation pulses depending on a respective ANS indicating signal as generated by said ANS sensing unit.

Abstract: A medical device includes a housing configured for implantation within a body of a patient. Detection circuitry is disposed in the housing and coupled to an electrode arrangement. The detection circuitry is configured to sense a cardiac electrical signal from the patient. A processor is coupled to the detection circuitry and configured to compute a first measure of heart rate variability (HRV) using the cardiac electrical signal, and compute a second measure of HRV using the cardiac electrical signal, the second measure of HRV differing from the first measure of HRV. The processor is also configured to produce an index of patient status derived from a ratio of the first and second measures of HRV, such that the index is a normalized HRV metric personalized to the patient. The processor or a remote system can use the index to assess acute and chronic changes in patient status.

Abstract: An oral care implement (1) comprising: an electrode pair with an impedance formed therebetween when electrified; a frequency generator, electrically connected to the electrode pair, for applying a voltage with at least two different frequencies between the electrode pair; an impedance measurement unit, electrically coupled to the electrode pair, for measuring impedance values between the electrode pair at least at the different frequencies; and a contact determination unit, in communication with the impedance measurement unit, wherein the contact determination unit comprises a memory for storing a function, wherein the function correlates impedance values of a defined oral area at the different frequencies, and wherein the contact determination unit comprises a processor for processing the measured impedance values to the stored function so as to determine contact information of the electrode pair with the defined oral area.

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: A device includes a pulse generator coupled to a neurostimulation lead placed around the nerve and a set of electrodes individually connected to the generator by a splitter circuit controlled to preferentially stimulate certain regions of the nerve relative to other regions. The device performing an iterative search of an optimal configuration operating by selection of a plurality of different stimulation configurations, storing of a cardiac physiological parameter measured for each selected stimulation configuration, and designation as optimal stimulation configuration of the one of said selected different stimulation configurations, depending on at least the stored values of the physiological parameter measured for different electrode configurations.

Abstract: The present disclosure may take the form of a method of optimizing CRT wherein candidate pacing settings are administered at a candidate lead implantation site. Such a method may comprise: determining a navigation sensor path at a measurement site for each candidate pacing setting at the candidate lead implantation site; and identifying which navigation sensor path corresponds to a most efficient cardiac tissue displacement.

Abstract: A leadless implantable medical device comprises a first electrode configured to deliver electrical pacing energy, a second electrode configured to sense intrinsic electrical cardiac activity, and a third electrode configurable to both deliver electrical pacing energy and sense intrinsic electrical cardiac activity. The first and third electrodes are used for delivering electrical pacing energy and the second and third electrodes are used to sense intrinsic electrical cardiac activity. None of the first, second and third electrodes are incorporated into a lead.

Abstract: An intra cardiac device is disclosed. The device comprises means for transforming kinetic energy from heart tissue movement into electrical energy in use, from which electrical energy information in respect of heart function is obtainable. Furthermore, a system is disclosed, comprising one such intra cardiac device and at least one receiver, wherein the intra cardiac device comprises means of communication, through which said at least one device communicates with the receiver(s) wirelessly. In this way energy from heart movement provides self contained intra cardiac devices for conveniently monitoring or stimulating a patient's heart.

Abstract: Dislodgement of a defibrillation lead from the right ventricle to the right atrium is a rare complication associated with implantable cardioverter-defibrillators. However, such dislodgement deserves attention out of proportion to its low incidence because of the possibility to cause fatal proarrhythmia. Various embodiments are directed to algorithms for detecting lead dislodgement, including a primary algorithm that operates during baseline rhythm and a secondary algorithm that operates during detection of ventricular tachycardia or ventricular fibrillation to identify lead dislodgement during atrial fibrillation.

Abstract: In one embodiment of the invention, an interactive vital signs scanning method is disclosed including concurrently scanning for a plurality of vital signs with a portable vital signs scanner; detecting movement of the portable vital signs scanner during the scanning for the plurality of vital signs; and determining a measure of quality of the scanning for the plurality of vital signs with the portable vital signs scanner. In another embodiment, a method of improving the quality of vital signs data is disclosed including concurrently sensing data from a plurality of vital signs sensors over a period of time with a portable vital signs scanner; determining a plurality of vital sign values for a respective plurality of vital signs in response to the sensed data from the plurality of vital signs sensors over the period of time; and fusing at least two vital sign values of the plurality of vital sign values for the respective plurality of vital signs.

Abstract: Cardiac dyssynchrony of a patient may be evaluated based on electrical activity of a heart of the patient and corresponding chest wall motion of the patient sensed via an external accelerometer. In one example, an acceleration signal indicative of the chest wall motion is generated by an external accelerometer positioned on the chest wall of the patient. A processor of a diagnostic device integrates the acceleration signal to generate a velocity signal and temporally correlates the velocity signal and an electrical cardiac signal. The processor determines a time delay between a deflection of the electrical cardiac signal indicating ventricular electrical activation and a subsequent greatest peak of the velocity signal. The time delay may indicate a degree of electromechanical delay of the left ventricle. In some examples, the processor generates an output indicative of a cardiac dyssynchrony status based on the time delay.

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 an 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: An electronic stimulation device for electrically stimulating at least one dorsal root ganglion with relative low pain sensations without generating relative much sensations of paresthesia comprises at least one electronic stimulation unit. The electronic stimulation unit includes at least one first electrode and at least one second electrode, and it delivers a high-frequency electrical stimulation signal to impel the first electrode and the second electrode to generate an electric field. The range of the electric field covers the dorsal root ganglion, and the electric field strength ranges from 100 V/m to 1000 V/m.

Abstract: An electronic stimulation device for electrically stimulating at least one dorsal root ganglion with relative low pain sensations without generating relative much sensations of paresthesia comprises at least one electronic stimulation unit. The electronic stimulation unit includes at least one first electrode and at least one second electrode, and it delivers a high-frequency electrical stimulation signal to impel the first electrode and the second electrode to generate an electric field. The frequency of the high-frequency electrical stimulation signal ranges from 200 kHz to 1000 kHz.

Abstract: An apparatus for coupling to a plurality of electrodes implantable at a plurality of tissue sites of a heart chamber of a subject. The apparatus including a stimulus circuit configured to provide an electrical cardiac pacing stimulation to the plurality of electrodes, a switching circuit configured to select electrodes of the plurality of electrodes for electrical coupling to the stimulus circuit, and a control circuit including a heart rate sub-circuit configured to determine heart rate; and a pacing site activation sub-circuit configured to selectively change which electrodes of the plurality of electrodes are used to provide the electrical cardiac pacing stimulation therapy according to the determined heart rate.

Abstract: Systems and methods for efficiently determining one or more parameters for vectors of a multi-electrode implantable medical device, and for identifying one or more suitable vectors for sensing cardiac electrical data and/or delivering electrical stimulation therapy based on one or more of the determined parameters. Reducing the time required to determine the one or more parameters for each vector can help reduce procedure time for implanting and/or configuring an implantable medical device, which can reduce costs and/or improved patient comfort.

Abstract: The invention relates to improved cardiac pacemakers and methods of use thereof. In particular the cardiac pacemakers are useful for normalizing heart rates over resting heart rates in order to condition the heart to improve overall cardiac output.

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: Pacing parameters may be adjusted to increase the cardiac output of a patient's heart while a patient is awake and/or active and the demand placed on the heart may be greatest, and to decrease or hemodynamic efficiency while a patient is at rest so that the heart itself has time to rest before the next period of higher demand for efficiency begins. This may aid in lessening the strain placed on the heart by making the heart work hard when needed such as when the patient is active, and by permitting the heart to “rest” when the patient is relatively inactive.

Abstract: A system and method for effectively communicating information using at least one mode of communication is described, in which information recipients proximate to a communications device within a pre-determined space and during a pre-determined time period are identified, from whom physiological state information is obtained that, when coupled with other characteristics information, is used to select from a plurality of information elements at least one information element to better target the information elements. The information element is then provided to the communications device so that it may be provided to the information recipients in the pre-determined space in a manner that is sensed by the information recipients.

Abstract: A reader device includes an array of antenna coils configured to electromagnetically couple with devices implanted beneath or within skin of a human body. An implanted device can include a loop antenna or other means configured to couple with at least one antenna coil of the reader device to receive radio frequency energy from the reader device. The antenna coil array is configured to mount to the skin surface to improve the coupling between the implanted device and coils of the array. Further, the reader device is configured to select two or more antenna coils of the array and to operate the selected antenna coils to emit radio frequency power at respective amplitudes and relative phases to provide radio frequency power to the implanted device while increasing efficiency of the power transfer and reducing the exposure of the skin to radio frequency energy.

Abstract: A system for controlling a position of a patient's tongue includes attaching at least one electrode to the patient's Hypoglossal nerve and applying an electric signal through the electrode to at least one targeted motor efferent located within the Hypoglossal nerve to stimulate at least one muscle of the tongue. The system may also include the use of more than one contact to target more than one motor efferent and stimulating more than one muscle. The stimulation load to maintain the position of the tongue may be shared by each muscle. The position of the patient's tongue may be controlled in order to prevent obstructive sleep apnea.

Abstract: Various techniques are disclosed for quickly and efficiently determining cardiac pacing vectors that minimize phrenic nerve stimulation.

Abstract: A system and method control a pacing parameter in a closed-loop manner by determining a value of an EGM-based index corresponding an optimal electrical activation condition of a patient's heart and adjusting a pacing therapy to maintain the EGM-based index value. The closed loop control method performed by the system may establish a relationship between an EGM-based index and multiple settings of a pacing control parameter. Values of the EGM-based index are stored with corresponding setting shifts relative to a previously established optimal setting. A processor of an implantable medical device monitors the EGM-based index during cardiac pacing. Responsive to detecting an EGM-based index value corresponding to a non-optimal setting of the control parameter, the processor determines an adjustment of the control parameter from the stored index values and corresponding setting shifts.

Abstract: A system and method for controlling non-paresthesia stimulation of nervous tissue of a patient. The method delivers a non-paresthesia stimulation waveform, senses sensory action potential (SAP) signals from the nervous tissue of interest, and analyzes the SAP signals to obtain SAP activity data for at least one of an SAP C-fiber component or an SAP A-delta fiber component. The method determines whether the SAP activity data satisfies a criteria of interest and adjusts at least one of the therapy parameters to change the non-paresthesia stimulation waveform when the SAP activity data does not satisfy the criteria of interest.

Abstract: The disclosure is directed towards posture-responsive therapy. To avoid interruptions in effective therapy, an implantable medical device may include a posture state module that detects the posture state of the patient and automatically adjusts therapy parameter values according to the detected posture state. A system may include a memory that stores a set of pre-established posture state definitions for delivery of posture state-responsive therapy to a patient, an external programmer comprising a user interface that receives a request from a user to update the set of pre-established posture state definitions, and a processor that updates the set of pre-established posture state definitions in response to the request.

Abstract: Techniques are provided for use with a pulmonary artery pressure (PAP) monitor having an implantable PAP sensor. In one example, a PAP signal is sensed that is representative of beat-by-beat variations in PAP occurring during individual cardiac cycles of the patient. The PAP monitor detects peaks within the PAP signal corresponding to valvular regurgitation within the heart, then detects mitral regurgitation (MR) based on the peaks. In other examples, the PAP monitor optimizes pacing parameters based on the PAP signal and corresponding electrical cardiac signals. Examples are provided where the PAP monitor is an external system and other examples are provided where the PAP monitor is a component of an implantable cardiac rhythm management device.

Abstract: The present disclosure provides systems and methods for estimating a change in an intracardiac distance between systole and diastole. A system includes a pacing electrode configured to generate a pacing pulse, a sensing electrode configured to measure an electrical artifact corresponding to the pacing pulse, and a computing device communicatively coupled to the pacing electrode and the sensing electrode, the computing device configured to determine a first amplitude of a first electrical artifact measured at the sensing electrode during systole, determine a second amplitude of a second electrical artifact measured at the sensing electrode during diastole, and calculate a mechanical index based on the first amplitude and the second amplitude, wherein the mechanical index is representative of the change in the intracardiac distance.

Abstract: Described herein are implantable systems and devices, and methods for use therewith, that can be used to monitor and treat heart failure (HF). Such implantable systems preferably includes a lead having at least two electrodes implantable in a patient's left ventricular (LV) chamber. A plurality of different sensing vectors are used to obtain a plurality of IEGMs each of which is indicative of an evoked response at a corresponding different region of the LV chamber. For each of the IEGMs, there is a determination of one or more evoked response metrics indicative of a localized cardiac function at the corresponding region of the LV chamber. The evoke response metrics can be, e.g., paced depolarization integral (PDI) and/or maximum upward slope of an R-wave, but are not limited thereto.

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

Abstract: In some examples, this disclosure describes techniques for assessing hemodynamic intolerance of ventricular pacing. A method comprises sensing a parameter indicative of autonomic tone during a first period in which a medical device delivers ventricular pacing to a patient, sensing the parameter indicative of autonomic tone during a second period in which the medical device does not deliver ventricular pacing to the patient, and assessing a level of change in autonomic tone in the patient induced by ventricular pacing based on values of the sensed parameter during the first and second periods.

Abstract: A system for providing electrical stimulation of cervical vagus nerves for treatment of chronic cardiac dysfunction with bounded titration is provided. The system includes a patient-operable external controller to transmit a plurality of unique signals. The system further includes an implantable neurostimulator, which includes a recordable memory storing an autotitration operating mode that includes a maximum stimulation intensity and is configured to increase an intensity of the delivered electrical therapeutic stimulation up to a level not exceeding the maximum stimulation intensity upon receipt of one of the unique signals.