Abstract: A recharging system for recharging batteries or providing power to an implantable device includes an electric coil adapted to be coupled to the implantable device, the electric coil defining a coil interior and a coil exterior. A magnetic component is coupled to the electric coil and adapted to at least partially surround the implantable device. A mechanical actuator is attached to the magnetic component, the mechanical actuator converting compression motion into motion of the magnetic component relative to the electric coil.

Abstract: Some aspects relate to systems, devices, and methods of delivering rate responsive pacing therapy. The method includes monitoring activity information related to an activity level of a patient and delivering rate responsive pacing (RRP) to the patient at a pacing rate corresponding to a RRP profile. The RRP profile may be used to generate the pacing rate based on the activity information and may be adjusted based on the monitored activity information.

Abstract: Techniques related to classifying a posture state of a living body are disclosed. One aspect relates to sensing at least one signal indicative of a posture state of a living body. Posture state detection logic classifies the living body as being in a posture state based on the at least one signal, wherein this classification may take into account at least one of posture and activity state of the living body. The posture state detection logic further determines whether the living body is classified in the posture state for at least a predetermined period of time. Response logic is described that initiates a response as a result of the body being classified in the posture state only after the living body has maintained the classified posture state for at least the predetermined period of time. This response may involve a change in therapy, such as neurostimulation therapy, that is delivered to the living body.

Abstract: Embodiments of the present disclosure include a system for determining an error associated with an electrode disposed on a medical device. The system comprises a processor and a memory storing instructions on a non-transitory computer-readable medium. The instructions are executable by the processor to receive an electrode signal from the electrode disposed on the medical device. The instructions are further executable by the processor to receive a plurality of other electrode signals from a plurality of other electrodes disposed on the medical device. The instructions are further executable by the processor to determine that the electrode signal received from the electrode disposed on the medical device is an outlier in relation to the plurality of other electrode signals from the plurality of other electrodes disposed on the medical device, based on a comparison between the electrode signal and the plurality of other electrode signals.

Abstract: Systems, methods, and devices are described herein for evaluation, adjustment, and delivery of adaptive cardiac therapy. The systems, methods, and devices may utilize electrical heterogeneity information to determine and/or select one or more pacing settings and pacing type or configurations for a plurality of different heart rates. The adaptive cardiac therapy may deliver cardiac therapy at selected pacing settings such as, for example, A-V and/or V-V intervals, according to a presently measured heart rate and switch between left ventricular-only or biventricular cardiac pacing therapy also according to the presently measured heart rate.

Abstract: Systems and methods for monitoring chronic over-pacing (COP) to the heart are discussed herein. In an embodiment, a system includes a receiver circuit to receive information about pacing rates of a plurality of paced heart beats, and a pacing analyzer circuit to generate a pacing rate distribution using pacing rates of the plurality of the paced heart beats. The pacing rate distribution includes a pacing rate histogram. The pacing analyzer circuit may recognize a morphological pattern from the pacing rate distribution, and detect a COP indication using the extracted feature. A programmer circuit adjusts one or more therapy parameters in response to the detected. COP indication.

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 class of 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: A wearable medical includes a walking detector module with a motion sensor that is configured to detect when the patient is walking or running. In embodiments, a parameter (referred to herein as a “Bouncy” parameter) is determined from Y-axis acceleration measurements. In some embodiments, the Bouncy parameter is a measurement of the AC component of the Y-axis accelerometer signal. This detection can be used by the medical device to determine how and/or whether to provide treatment to the patient wearing the medical device. For example, when used in a WCD, the walking detector can prevent “false alarms” because a walking patient is generally conscious and not in need of a shock.

Abstract: Embodiments described herein relate to implantable medical devices (IMDs) and methods for use therewith. Such a method includes using an accelerometer of an IMD (e.g., a leadless pacemaker) to produce one or more accelerometer outputs indicative of the orientation of the IMD. The method can also include controlling communication pulse parameter(s) of one or more communication pulses (produced by pulse generator(s)) based on accelerometer output(s) indicative of the orientation of the IMD. The communication pulse parameter(s) that is/are controlled can be, e.g., communication pulse amplitude, communication pulse width, communication pulse timing, and/or communication pulse morphology. Such embodiments can be used to improve conductive communications between IMDs whose orientation relative to one another may change over time, e.g., due to changes in posture and/or due to cardiac motion over a cardiac cycle.

Abstract: Device and method for removing artifacts in physiological measurements. The method can comprise the steps of obtaining a physiological signal of a user; obtaining corresponding motion data representative of motion of the user; determining whether the physiological signal is distorted; and if the physiological signal is determined to be distorted, identifying a noise reference and filtering the physiological signal with the noise reference.

Abstract: A device and method for analyzing of a disturbed pattern of pulse wave front results in a non-invasive, real-time diagnostic tool of arterial vascular performance on both a global and regional scale. The device provides a single number quantifying how well the arterial tree as a whole is coupled to receive and distribute a stroke volume of a single heartbeat. Changing heart rate, contractility, volume status, and afterload will change stroke volume and ejection time. Different vasculatures with different properties (e.g., size and intrinsic stiffness) will be best matched for different stroke volumes and ejection times to provide optimal coupling. The device will allow finding the optimal set of parameters for individual patient.

Abstract: A device for measuring a ventricular-arterial coupling of a subject includes first and second inputs. The first input receives signals from a plurality of electrocardiogram sensors that are coupled to the subject at a plurality of first locations. The second input receives signals from a plurality of photoplethysmogram sensors that are coupled to the subject at a plurality of second locations. The second locations are selected from the group consisting of a head of the subject, an arm of the subject, and a leg of the subject. The signals received from the electrocardiogram sensors and the signals received from the photoplethysmogram sensors are received simultaneously. The device also includes a monitor configured to display the signals from the electrocardiogram sensors and the signals from the photoplethysmogram sensors.

Abstract: Various exemplary embodiments provide an electronic device configured to include one or more sensor modules, at least one memory, a display, and a first processor or second processor operatively coupled to the one or more sensor modules, the at least one memory, and/or the display, wherein the first processor is configured to acquire sensor data from at least one sensor module among the one or more sensor modules, calculate a difference between at least two data points in the acquired sensor data, determine user's activity information based on at least one of a period of the sensor data, a magnitude of the difference, and a change amount of the difference, and deliver the user's activity information to the second processor, and wherein the second processor is configured to display, on the display, a user interface related to the user's activity information delivered from the first processor. Other exemplary embodiments are also possible.

Abstract: A notification system is provided that provides notification of patient events such as movement and/or incontinence. The notification system provides for a plurality of different pressure sensor pads as well as an incontinence pad to be used in association with a single monitor.

Abstract: This disclosure relates to methods, devices, and systems for delivering and adjusting stimulation therapy. In one example, a method comprising delivering, by a stimulation electrode, electrical stimulation as a candidate therapy to a patient according to a set of candidate therapy parameters, the stimulation electrode located in proximity to the dorsal column of a patient; sensing, by a sensing electrode, an electrically evoked compound action potential (eECAP) signal in response to the delivery of the electrical stimulation; and classifying, by a processor, the sensed eECAP signal generated in response to the application of the candidate therapy relative to an eECAP baseline is disclosed.

Abstract: The present disclosure relates to cardiac evoked response detection and, more particularly, reducing polarization effects in order to detect an evoked response following delivery of a stimulation pulse. An implantable medical device (IMD) is configured to deliver a ventricular pacing pulse. A signal is sensed in response to the ventricular pacing stimulus. A window is placed over the sensed signal to obtain a set of data from the signal after a paced event. The set of data extracted from the sensed signal comprises a maximum amplitude, a maximum time associated with the maximum amplitude, a minimum amplitude, and a minimum time associated with the minimum amplitude. Responsive to processing the extracted data, the window is delayed to avoid polarization effects. A determination is then made as to whether the ventricular pacing stimulus is capturing the paced ventricle in response to determining whether the maximum time is greater than the minimum time.

Abstract: The present invention is generally directed to methods, systems, and computer program products for coordinating musculoskeletal and cardiovascular hemodynamics. In some embodiments, a heart pacing signal causes heart contractions to occur with an essentially constant time relationship with respect to rhythmic musculoskeletal activity. In other embodiments, prompts (e.g., audio, graphical, etc.) are provided to a user to assist them in timing of their rhythmic musculoskeletal activity relative to timing of their cardiovascular cycle. In further embodiments, accurately indicating a heart condition during a cardiac stress test is increased.

Abstract: Techniques for detecting a value of a sensed patient parameter, and automatically delivering therapy to a patient according to therapy information previously associated with the detected value, are described. In exemplary embodiments, a medical device receives a therapy adjustment from the patient. In response to the adjustment, the medical device associates a sensed value of a patient parameter with therapy information determined based on the adjustment. Whenever the parameter value is subsequently detected, the medical device delivers therapy according to the associated therapy information. In this manner, the medical device may “learn” to automatically adjust therapy in the manner desired by the patient as the sensed parameter of the patient changes. Exemplary patient parameters that may be sensed for performance of the described techniques include posture, activity, heart rate, electromyography (EMG), an electroencephalogram (EEG), an electrocardiogram (ECG), temperature, respiration rate, and pH.

Abstract: A multifunctional invasive cardiovascular diagnostic measurement host is disclosed that interfaces a variety of sensor devices, such as guide wire-mounted pressure sensors, flow sensors, temperature sensors, etc, and provides a multi-Mode graphical user interface providing a plurality of displays in accordance with the various types of sensors and measurements rendered by the sensors.

Abstract: There is provided a biological rhythm disturbance degree calculating device, including a physiological index time series data acquiring unit which acquires time series data of a physiological index calculated from a biomedical signal of a subject, a calculation period deciding unit which decides a calculation period which is a time length corresponding to substantially a half of a cycle with which daily-life physiological index time series data calculated from the biomedical signal measured in daily life fluctuates, a calculating unit which calculates, during the calculation period, a phase shift amount between inspected physiological index time series data calculated from the biomedical signal measured during an inspection and the daily-life physiological index time series data, and a disturbance degree deciding unit which decides a disturbance degree of a biological rhythm during the inspection of the subject based on the phase shift amount.

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: Some method examples may include pacing a heart with cardiac paces, sensing a physiological signal for use in detecting pace-induced phrenic nerve stimulation, performing a baseline level determination process to identify a baseline level for the sensed physiological signal, and detecting pace-induced phrenic nerve stimulation using the sensed physiological signal and the calculated baseline level. Detecting pace-induced phrenic nerve stimulation may include sampling the sensed physiological signal during each of a plurality of cardiac cycles to provide sampled signals and calculating the baseline level for the physiological signal using the sampled signals. Sampling the sensed physiological signal may include sampling the signal during a time window defined using a pace time with each of the cardiac cycles to avoid cardiac components and phrenic nerve stimulation components in the sampled signal.

Abstract: A wrist-worn athletic performance monitoring system, including an analysis processor, configured to execute an activity recognition processes to recognize a sport or activity being performed by an athlete, and a sampling rate processor, configured to determine a sampling rate at which an analysis processor is to sample data from an accelerometer. The sampling rate processor may determine the sampling rate such that the analysis processor uses a low amount of electrical energy while still being able to carry out an activity classification process to classify an activity being performed.

Abstract: An implantable medical device system includes a pacemaker and an implantable cardioverter defibrillator (ICD). The pacemaker is configured to confirm a hemodynamically unstable rhythm based on an activity metric determined from an activity sensor signal after detecting a ventricular tachyarrhythmia and withhold anti-tachycardia pacing (ATP) pulses in response to confirming the hemodynamically unstable rhythm. The pacemaker may deliver ATP when a hemodynamically unstable rhythm is not confirmed based on the activity metric. The ICD is configured to detect the ATP and withhold a shock therapy in response to detecting the ATP in some examples.

Abstract: Hat, helmet, and other headgear apparatus includes dry electrophysiological electrodes and, optionally, other physiological and/or environmental sensors to measure signals such as ECG from the head of a subject. Methods of use of such apparatus to provide fitness, health, or other measured or derived, estimated, or predicted metrics are also disclosed.

Abstract: Disclosed is an integrated circuit comprising a substrate (10) carrying a plurality of circuit elements; a metallization stack (12, 14, 16) interconnecting said circuit elements, said metallization stack comprising a patterned upper metallization layer comprising a first metal portion (20) and a second metal portion (21); a passivation stack (24, 26, 28) covering the metallization stack; a gas sensor including a sensing material portion (32, 74) on the passivation stack; a first conductive portion (38) extending through the passivation stack connecting a first region of the sensing material portion to the first metal portion; and a second conductive portion (40) extending through the passivation stack connecting a second region of the sensing material portion to the second metal portion. A method of manufacturing such an IC is also disclosed.

Abstract: A wearable therapeutic device includes a garment configured to be worn on a torso of a patient. The garment has an anterior portion and a posterior portion. The garment is configured to house at least one defibrillator component, a first therapy electrode disposed in the anterior portion of the garment, a second therapy electrode disposed in the posterior portion of the garment, and an alarm module configured to alert the patient of an impending defibrillation shock from the at least one defibrillator component to be delivered by at least one of the first therapy electrode and the second therapy electrode. The first therapy electrode and the second therapy electrode are configured to be electrically coupled to the at least one defibrillator component. At least one of the first therapy electrode and the second therapy electrode is at least one of woven into the garment and comprises a textile material.

Abstract: Systems, devices, and methods for adjusting functionality of an implantable medical device based on posture are disclosed. In some instances, a method for operating a leadless cardiac pacemaker implanted into a patient, where the patient has two or more predefined behavioral states, may include detecting a change in the behavioral state of the patient, and in response, changing a sampling rate of a sensor signal generated by a sensor of the leadless cardiac pacemaker. In some embodiments, the method may further include using the sampled sensor signal to determine an updated pacing rate of the leadless cardiac pacemaker and providing pacing to the patient at the updated pacing rate.

Abstract: The invention provides a multi-sensor system that uses an algorithm based on adaptive filtering to monitor a patient's respiratory rate. The system features a first sensor which is selected from the group consisting of an impedance pneumography sensor, an ECG sensor, a PPG sensor, * and a motion sensor (e.g., an accelerometer) configured to attach to the patient's torso and measure therefrom a motion signal. The system further comprises (iii) a processing system, configured to operably connect to the first and motion sensors, and to determine a respiration rate value by applying filter parameters obtained from the first sensor signals to the motion sensor signals.

Abstract: A monitoring system has biomechanical sensors, physiological sensors and a controller which receive sensory inputs from the sensors to provide output signals for the output device, and it detects from the sensory inputs risk of a syncopal event The bio-mechanical sensors include sensors arranged to allow the processor to detect a user postures and posture transitions. The processor operates a finite state machine, in which there is a state corresponding to each of a plurality of user physical postures and to each of a plurality of transitions between said postures, and the processor determines a relevant state depending on the sensory inputs. A device output may be muscle stimulation to prevent syncope, and there are stimulation permissions associated with the finite state machine states.

Abstract: A Medical Device Application (MDA) is disclosed for an external device (e.g., a cell phone) that can communicate with an Implantable Medical Device (IMD). The MDA receives data logged in the IMD, processes that data in manners reviewable by an IMD patient, and that can control the IMD based on such processed data. The MDA can use the logged data to adjust IMD therapy based on patient activity or posture, and allows a patient to learn optimal therapy settings for particular activities. The MDA can also use the logged data to allow a patient to review details about IMD battery performance, whether such battery is primary or rechargeable, and to control stimulation parameters based on that performance. The MDA also allows a patient to enter medicine dose information, to review the relationship between medicinal therapy and IMD therapy, and to adjust IMD therapy based on the dosing information.

Abstract: Implantable devices having motion sensors. In some examples the a configuration is generated for the implantable device to use the motion sensor in an energy preserving mode in which one or more axis of detection of the motion sensor is disabled or ignored. In some examples the motion sensor outputs along multiple axes are analyzed to determine which axes best correspond to certain patient parameters including patient motion/activity and/or cardiac contractility. In other examples the output of the motion sensor is observed across patient movements or postures to develop conversion parameters to determine a patient standard frame of reference relative to outputs of the motion sensor of an implanted device.

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 user interface that receives user input linking a plurality of posture states of a patient, and selecting a set of therapy parameter values for delivery of therapy to the patient for each of a linked posture states, a processor that defines the therapy to be delivered to the patient for each of the linked posture states based on the selection, and an implantable medical device that delivers the therapy to the patient for each of the linked posture states based on the selection.

Abstract: The present invention is generally directed to methods, systems, and computer program products for coordinating musculoskeletal and cardiovascular hemodynamics. In some embodiments, a heart pacing signal causes heart contractions to occur with an essentially constant time relationship with respect to rhythmic musculoskeletal activity. In other embodiments, prompts (e.g., audio, graphical, etc.) are provided to a user to assist them in timing of their rhythmic musculoskeletal activity relative to timing of their cardiovascular cycle. In further embodiments, accurately indicating a heart condition during a cardiac stress test is increased.

Abstract: A medical device provides stimulation therapy to a patient based on a set of therapy parameters. One or more therapy parameters may be automatically adjusted based on acceleration forces detected by a sensor, the acceleration forces being applied to the patient. In some examples, adjustments to one or more therapy parameter may be made based on an algorithm. The algorithm may be defined by acceleration and therapy parameter value pairs associated with opposite patient positions.

Abstract: A physiological response to activity (PRA) during a subject's activities of daily living (ADL) can be used, such as to generate useful diagnostic information about the subject. This can involve using a template, such as an impulse response template. The technique can be used with an implantable or other ambulatory medical monitoring or therapy device, such as a cardiac function management device, or with a local or remote external interface device.

Abstract: Techniques for remotely calibrating an implanted patient sensor with a remote networking device are described. In some embodiments, the sensor is a component of an implantable medical device (IMD). The remote networking device communicates with the IMD via a network to which the IMD and/or external programmer is connected. The IMD may transmit sensor information to the remote networking device when the IMD detects a problem with the sensor or when the patient indicates that therapy is not correctly selected for different activities. New calibration settings may be remotely generated by directly interrogating the sensor and/or communicating with the patient in order to associate sensor output with patient activities, motions, or postures.

Abstract: A leadless cardiac pacemaker comprises a hermetic housing, a power source disposed in the housing, at least two electrodes supported by the housing, a semiconductor temperature sensor disposed in the housing, and a controller disposed in the housing and configured to deliver energy from the power source to the electrodes to stimulate the heart based upon temperature information from the temperature sensor. In some embodiments, the sensor can be configured to sense temperature information within a predetermined range of less than 20 degrees C. The temperature sensor can be disposed in the housing but not bonded to the housing.

Abstract: One embodiment provides a method for allocating assignments based on workload and physiological stress. The method comprises maintaining a queue of logged-in service representatives, and, in response to receiving a service request for a new assignment, scanning the queue to determine a subset of potential service representatives to assign the new assignment to. A corresponding workload level of each service representative of the subset is the smallest among all service representatives of the queue. For each service representative of the subset, a corresponding anxiety level is determined based on physiological sensor data captured by a wearable tracking device attached to the service representative. The new assignment is assigned to a service representative of the subset, the service representative having a corresponding anxiety level that is the smallest among all service representatives of the subset.

Abstract: An active implantable medical device for cardiac resynchronization includes implantable electrodes configured to detect atrial and ventricular events and to apply electrical pulses to a plurality of stimulation sites of the right and left ventricles, where a first combination of stimulation sites define an original pacing configuration and a second combination of stimulation sites define a changed pacing configuration. A sensing device is configured to measure a peak to peak amplitude of the first peak of endocardial acceleration for each cardiac cycle. A processing circuit is configured to change the pacing configuration from the original pacing configuration to the changed pacing configuration, measure one of a set of values in the changed pacing configuration, and change the pacing configuration from the changed pacing configuration to the original pacing configuration.

Abstract: The present invention is generally directed to methods, systems, and computer program products for coordinating musculoskeletal and cardiovascular hemodynamics. In some embodiments, a heart pacing signal causes heart contractions to occur with an essentially constant time relationship with respect to rhythmic musculoskeletal activity. In other embodiments, prompts (e.g., audio, graphical, etc.) are provided to a user to assist them in timing of their rhythmic musculoskeletal activity relative to timing of their cardiovascular cycle. In further embodiments, accurately indicating a heart condition during a cardiac stress test is increased.

Abstract: Per the disclosure subcutaneously implantable medical devices (IMDs) with rate responsive implantable pulse generator (IPG) capability that also include dual patient activity sensors are adaptively controlled. One of the activity sensors uses multiple electrodes adapted to acquire electrocardiographic signals and signals from non-cardiac muscle tissue (myopotentially-based signals). The signals from the electrode-based activity sensor are used to confirm and/or override the patient-activity sensor signals from the other non-myopotentially-based patient activity sensor. The electrodes are directly mechanically coupled to the housing of the IMD and electrically coupled to circuitry that filters, processes, and interprets both the patient activity sensor signals.

Abstract: A method, electrical tissue stimulation system, and programmer for providing therapy to a patient are provided. Electrodes are placed adjacent tissue (e.g., spinal cord tissue) of the patient, electrical stimulation energy is delivered from the electrodes to the tissue in accordance with a defined waveform, and a pulse shape of the defined waveform is modified, thereby changing the characteristics of the electrical stimulation energy delivered from the electrode(s) to the tissue. The pulse shape may be modified by selecting one of a plurality of different pulse shape types or by adjusting a time constant of the pulse shape.

Abstract: A neural stimulation system automatically corrects or adjusts the stimulus magnitude (stimulation energy) in order to maintain a comfortable and effective stimulation therapy. Because the changes in impedance associated with the electrode-tissue interface can indicate obstruction of current flow and positional lead displacement, lead impedance can indicate the quantity of electrical stimulation energy that should be delivered to the target neural tissue to provide corrective adjustment. Hence, a change in impedance or morphology of an impedance curve may be used in a feedback loop to indicate that the stimulation energy needs to be adjusted and the system can effectively auto correct the magnitude of stimulation energy to maintain a desired therapeutic effect.

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. A ratio of measured optical intensities in combination with a total measured optical intensity is used to interpolate a set of electrode stimulation settings from a calibration table. Electrode pulse characteristics are adjusted in real time to minimize changes in stimulation perceived by the patient during motion.

Abstract: Improved techniques and systems for utilizing a portable electronic device to monitor, process, present and manage data captured by a remote sensor during a physical activity session are disclosed. The portable electronic device offers a convenient user interface that can be visual and/or audio based customized to a particular application, user-friendly and/or dynamic. The portable electronic device can pertain to a personal media device and thus also provide media playback.

Abstract: An implantable cardiac stimulator includes at least one first sensing unit for detecting intrinsic cardiac activities of a first ventricle, at least one ventricular stimulation unit for stimulating a second ventricle, and a stimulation control unit connected to the first sensing unit. The stimulation unit processed output signals of the first sensing unit and generates control signals for the stimulation units. The stimulation control unit derives a current intrinsic RR interval from detected ventricular intrinsic cardiac activities R of the first ventricle, and to determine from the RR interval a delay interval ?, which begins with a ventricular event of the first ventricle and at the end of which the stimulation control unit triggers a stimulation of the second ventricle (unless it is suppressed).

Abstract: An implantable cardiac device includes a sensor for sensing patient activity and detecting phrenic nerve activation. A first filter channel attenuates first frequencies of the sensor signal to produce a first filtered output. A second filter channel attenuates second frequencies of the accelerometer signal to produce a second filtered output. Patient activity is evaluated using the first filtered output and phrenic nerve activation caused by cardiac pacing is detected using the second filtered output.

Abstract: Methods, systems and computer program products for cardiac pacing are provided. For pacing using biventricular synchronization in a patient, a first stimulation signal is applied to a first region of a heart of the patient at a first time and a second stimulation signal applied to a second region of the heart of the patient at a second time to provide biventricular synchronization stimulation of the heart. Cardiac function of the patient associated with application of the first and the second stimulation signals is sensed and a timing relationship of the first stimulation signal to the second stimulation signal is adjusted based on the sensed cardiac function.

Abstract: Devices and methods for sleep detection involve the use of an adjustable threshold for detecting sleep onset and termination. A method for detecting sleep includes adjusting a sleep threshold associated with a first sleep-related signal using a second sleep-related signal. The first sleep-related signal is compared to the adjusted threshold and sleep is detected based on the comparison. The sleep-related signals may be derived from implantable or external sensors. Additional sleep-related signals may be used to confirm the sleep condition. A sleep detector device implementing a sleep detection method may be a component of an implantable pulse generator such as a pacemaker or defibrillator.