Abstract: A method of selecting a combination of electrodes for use in neurostimulation includes testing combinations of electrodes in an electrode array to identify an atrial capture. The atrial capture is indicated by at least one effect on an atrium. The method includes excluding electrodes with the atrial capture to result in remaining electrodes of the electrode array, testing combinations of the remaining electrodes of the electrode array for effect on cardiac contractility and/or relaxation, and selecting a combination of electrodes from the remaining electrodes. The selected combination has both a desired effect on cardiac contractility and/or relaxation and does not have an undesired side effect.

Abstract: The present disclosure is associated with monitoring health of a patient. An example electromagnetic-evoked acoustic device includes an electromagnetic component to emit energy toward tissue of a patient to cause the energy to be absorbed by the tissue; an ultrasound transmission component to transmit acoustic energy toward the tissue to cause a biological response from the tissue; and an ultrasound sensing component to sense the biological response from the tissue to permit a status of the tissue to be determined, wherein the biological response is sensed based on the energy absorbed by the tissue during the biological response.

Abstract: Systems and methods for His bundle pacing and classifying response to pacing impulses include applying, using a pulse generator, an impulse through a stimulating electrode to induce a response from a patient heart. A response to the impulse is measured using at least one sensing electrode and frequency characteristics of the response are analyzed to determine whether His bundle capture has occurred and, if so, what type of capture has occurred. To facilitate analysis, the response measured from the patient heart may also be filtered to pass or stop frequencies indicative of certain capture types.

Abstract: An example system includes memory configured to store a plurality of lead impedances (LeadZs) and processing circuitry communicatively coupled to the memory. The processing circuitry is configured to determine a first sensed LeadZ, and determine a second sensed LeadZ. The processing circuitry is configured to determine a first difference between the first sensed LeadZ and the second sensed LeadZ, and determine a parameter based at least in part on the first difference. The first sensed LeadZ and the second sensed LeadZ are sensed during a same first cardiac cycle or adjacent cardiac cycles of a heart that is receiving pacing.

Abstract: An apparatus for determining heart transplant rejection of a heart in a patient includes at least two electrodes adapted to be sewn into the heart that span the left ventricle. The apparatus includes a voltage generator adapted to be inserted in the patient which generates a voltage to the two electrodes and senses the resulting voltage from the two electrodes. A method for determining heart transplant rejection of a heart in a patient. A pacemaker for a patient (including bi-ventricular pacing and AICDs). The pacemaker includes an RV lead having four electrodes adapted to be inserted into the RV apex. The pacemaker includes a voltage generator which generates a voltage signal to the electrodes and senses the instantaneous voltage along the length of the RV and determines the real and imaginary components to remove the myocardial components of the septum and RV free wall to determine absolute RV blood volume. The pacemaker includes a battery connected to the voltage generator.

Abstract: Implantable medical devices include a first sensor for detecting a magnetic field that indicates an exposure mode of operation is appropriate. The implantable medical devices include a second sensor for detecting whether an MRI characteristic is present that indicates whether MRI or non-MRI post exposure diagnostics and other actions should be implemented and may also indicate whether the exposure mode should be MRI or non-MRI specific. An MRI post exposure diagnostic may perform pacing capture threshold tests and the post exposure pacing amplitude output may be kept at a higher than normal level. The second sensor may be an overvoltage clamp circuit of a telemetry coil that indicates whether an overvoltage condition on the telemetry coil is occurring to indicate whether an MRI characteristic is present. The second sensor may be a second threshold magnetic sensor, an accelerometer, or a microphone to indicate whether an MRI characteristic is present.

Abstract: A radio frequency (RF) ablation system is disclosed including signal generator circuitry and control circuitry. The signal generator circuitry is configured to generate a plurality of RF ablation current signals each having a respective phase and a respective amplitude. The control circuitry is configured to reduce crosstalk between a first RF ablation signal of the plurality of RF ablation current signals and a second RF ablation signal of the plurality of RF ablation current signals by adjusting the respective phase of the first RF ablation signal in relation to the respective phase of the second RF ablation signal such that the respective phase of the first RF ablation signal is different than the respective phase of the second RF ablation signal.

Abstract: A method for detecting, in a real-time manner, a presence or an absence of a an anomaly in or a cyber attack onto a medical apparatus comprises the steps of capturing, with an antenna, one or more emissions of electromagnetic energy from the processing devices within medical apparatus; converting, with a receiver coupled to the antenna, the one or more emissions from an analog to a digital form; generating, with a controller, a digital signal in a time domain; converting, the digital signal from the time domain to a frequency domain, the digital signal containing a signature of cross modulation products from the non-linear attachments; processing, in the frequency domain, the signature of cross modulation products to determine mixing characteristics of the cross modulation products; and detecting, based on the mixing characteristics, the absence or the presence of the anomaly or the cyber attack.

Abstract: A transfer device for a differential bus system. The transfer device includes a first bus connection and a second bus connection for connection to a transfer medium of the differential bus system, a transmitting device that is connected and/or connectable to the first bus connection and the second bus connection, and an impedance adaptation circuit that is designed to influence an impedance at the first bus connection and/or at the second bus connection.

Abstract: A system for assisting a rescuer in performing cardio-pulmonary resuscitation (CPR) on a patient includes: a proximity sensor configured to be positioned at a location corresponding to a location of a rescuer's hand when delivering compressions to a patient's chest, the proximity sensor configured to produce a signal indicative of the rescuer's hands being released from the patient's chest; a medical device operatively coupled with the proximity sensor and configured to provide resuscitative treatment to the patient; and a controller communicatively coupled with the medical device and the proximity sensor. The controller is configured to: determine, based upon the signal from the proximity sensor, if the rescuer's hands have been released from the patient's chest, and trigger an action by the medical device in response to a determination that the rescuer's hands have been released from the patient's chest.

Abstract: An apparatus for monitoring a patient post operation having electrically conducting leads which are adapted to extend from inside the patient. The leads having electrodes adapted to communicate with a heart of the patient and apply electrical signals to the heart. The electrodes providing cardiac signals to the computer in response to the electrical signals so the computer can determine in real time at least one of heart volume, end diastolic heart volume, end systolic heart volume, stroke volume, change in heart volume, change in stroke volume, contractility, respiration rate or tidal volume regarding the patient.

Abstract: An implantable medical device has a therapy module configured to generate a composite pacing pulse including a series of at least two individual pulses. The therapy module is configured to generate the composite pacing pulse by generating a first pulse of the at least two individual pulses by selectively coupling a first portion of a plurality of capacitors to an output signal line and generate a second pulse of the at least two individual pulses by selectively coupling a second portion of the plurality of capacitors to the output signal line.

Abstract: Techniques for switching an implantable medical device (IMD) from a first mode to a second mode in relation to signals obtained from internal sensors are described. The internal sensors may include a temperature sensor and a biosensor. In some examples, processing circuitry of the IMD may make a first preliminary determination that the IMD is implanted based on a first signal from the temperature sensor. In response to the first preliminary determination being that the IMD is implanted, the processing circuitry may make a second preliminary determination that the IMD is implanted based on a second signal from the biosensor. The processing circuitry may switch the IMD from a first mode to a second mode based on both the first preliminary determination and the second preliminary determination being that the IMD is implanted.

Abstract: A medical device is configured to deliver therapeutic electrical stimulation pulses by generating frequency modulated electrical stimulation pulse signals. The medical device includes a pulse signal source and a modulator. The pulse signal source generates an electrical stimulation pulse signal having a pulse width. The modulator may include a high frequency modulator configured to modulate a frequency of the pulse signal from a starting frequency down to a minimum frequency during the pulse width. The modulator may include a low frequency bias generator to modulate the offset of the pulse signal between a minimum offset and a maximum offset in other examples.

Abstract: Ventricle-from-atrium (VfA) cardiac therapy may utilize a tissue-piercing electrode implanted in the left ventricular myocardium of the patient's heart from the right atrium through the right atrial endocardium and central fibrous body. The exemplary devices and methods may determine whether the tissue-piercing electrode is achieving effective left ventricular capture. Additionally, one or more pacing parameters, or paced settings, may be adjusted in view of the effective left ventricular capture determination.

Abstract: An extra-cardiovascular implantable cardioverter defibrillator (ICD) having a low voltage therapy module and a high voltage therapy module is configured to select, by a control module of the ICD, a pacing output configuration from at least a low-voltage pacing output configuration of the low voltage therapy module and a high-voltage pacing output configuration of the high voltage therapy module. The high voltage therapy module includes a high voltage capacitor having a first capacitance and the low voltage therapy module includes a plurality of low voltage capacitors each having up to a second capacitance that is less than the first capacitance. The ICD control module controls a respective one of the low voltage therapy module or the high voltage therapy module to deliver extra-cardiovascular pacing pulses in the selected pacing output configuration via extra-cardiovascular electrodes coupled to the ICD.

Abstract: For use by an implantable system including a first and second leadless pacemakers (LPs) implanted, respectively, in first and second cardiac chambers, a method comprises storing, within memory of the first LP, a paced activation morphology template corresponding to far-field signal components expected to be present in an EGM sensed by the first LP when a pacing pulse delivered to the second cardiac chamber by the second LP captures the second cardiac chamber. The method also includes the first LP comparing a morphology of a portion of an EGM sensed by the first LP to the paced activation morphology template to determine whether a match therebetween is detected, and determining whether capture of the second cardiac chamber occurred or failed to occur, based on whether the first LP detects a match between the morphology of the portion of the EGM and the paced activation morphology template.

Abstract: Methods and systems for using sensed evoked neural responses for informing aspects of neurostimulation therapy are disclosed. Electrical signals may be recorded during the provision of electrical stimulation to a patient's neural tissue. The electrical signals may be processed and analyzed using one or more classification criteria to determine if the electrical signals contain a neural response of interest. Examples of such neural responses include evoked neural responses that are oscillatory and/or resonant in nature. If the electrical signals include such responses of interest, one or more features may be extracted from the signals and used as biomarkers for informing aspects of neurostimulation therapy, such as directing lead placement, optimizing stimulation parameters, closed-loop feedback control of stimulation, and the like. Various methods and systems described herein are particularly relevant in the context of multi-site stimulation paradigms, such as coordinated reset neuromodulation.

Abstract: A system includes a signal generator, configured to pass a generated signal, which has two different generated frequencies, through a circuit including a bidirectional semiconductor device. The system further includes a processor, configured to identify, while the generated signal is passed through the circuit, a derived frequency, which derives from the generated frequencies, on the circuit, and to generate, in response to identifying the derived frequency, an output indicating that a property of the bidirectional semiconductor device is asymmetric. Other embodiments are also described.

Abstract: In some examples of selecting a target therapy delivery site for treating a patient condition, a relatively high frequency electrical stimulation signal is delivered to at least two areas within a first region (e.g., an anterior nucleus of the thalamus) of a brain of a patient, and changes in brain activity (e.g., as indicated by bioelectrical brain signals) within a second region (e.g., a hippocampus) of the brain of the patient in response to the delivered stimulation are determined. The target therapy delivery site, an electrode combination, or both, may be selected based on the changes in brain activity.

Abstract: Methods and systems can facilitate identifying effective electrodes and other stimulation parameters, as well as determining whether to use cathodic and anodic stimulation. Alternately, the methods and systems may identify effective electrodes and other stimulation parameters based on preferential stimulation of different types of neural elements. These methods and systems can further facilitate programming an electrical stimulation system for stimulating patient tissue.

Abstract: The present invention provides a circuitry of a biopotential acquisition system, where the circuitry includes an input node, an ETI transmitter, a capacitor and an ETI receiver. The input node is configured to receive an input signal from an electrode of the biopotential acquisition system. The ETI transmitter is configured to generate a transmitter signal. A first node of the capacitor is coupled to the ETI transmitter, and a second node of the capacitor is coupled to the input node. The ETI receiver is coupled to the input node, and is configured to receive the transmitter signal via the capacitor to generate an ETI.

Abstract: A method for identifying reversible cardiac dyssynchrony (RCD) of a patient and treating the RCD measures an event relating to a rapid increase in the rate of pressure increase within the left ventricle. The method calculates a first time delay between the event and a first reference time. If the first time delay is longer than a set fraction of electrical activation of the heart, then the presence of cardiac dyssynchrony in the patient is identified. Pacing is applied to the heart, and a second time delay between the event following pacing and a second reference time following pacing is calculated. If the second time delay is shorter than the first time delay, the method identifies a shortening of a delay to onset of myocardial synergy, OoS, thereby identifying the presence of RCD in the patient. Treatment of the RCD is performed.

Abstract: The present invention involves approaches for selecting one or more electrode combinations.

Abstract: An implantable medical device for stimulating a human or animal heart. In operation, the device performs the following steps: a) sensing an atrial electric signal a the first detection unit; b) sensing an electric signal at the His bundle with a second detection unit upon termination of a first time period starting upon sensing the atrial electric signal with the first detection unit and/or starting upon applying a stimulation pulse, wherein the first time period lies in a range of from 10 ms to 100 ms; c) classifying the electric signal sensed with the second detection unit as His bundle activity signal or as ventricular activity signal.

Abstract: An implantable medical device for stimulating a human/animal heart, comprising a housing, a processor, a memory unit, a stimulation unit configured to stimulate the His bundle, and a detection unit configured to detect an electrical signal at the His bundle. The device performs: a) stimulating the His bundle with a stimulation pulse delivered by the stimulation unit; b) measuring an electric signal at the His bundle with the detection unit upon termination of a first period of time starting upon delivering of the stimulation pulse, wherein the first period of time is from 35 ms to 500 ms; c) measuring an impedance of the same heart with the detection unit upon termination of a second period of time starting upon delivering of the stimulation pulse, wherein the second period of time is equal to or longer than the first period of time and is from 50 ms to 500 ms.

Abstract: Techniques for scheduled tests for endpoint agents are disclosed.

Abstract: Certain embodiments of the present technology described herein relate to detecting atrial oversensing in a His intracardiac electrogram (His IEGM), characterizing atrial oversensing, determining when atrial oversensing is likely to occur, and or reducing the chance of atrial oversensing occurring. Some such embodiments characterize and/or avoid atrial oversensing within a His IEGM. Other embodiments of the present technology described herein relate to determining whether atrial capture occurs in response to His bundle pacing (HBP). Still other embodiments of the present technology described herein relate to determining whether AV node capture occurs in response to HBP.

Abstract: Systems, methods, and devices are described herein for determining cardiac conduction system capture of ventricle from atrium (VfA) therapy. VfA therapy may be delivered at a plurality of different A-V delays while electrical activity of the patient is monitored. The electrical activity may then be utilized to determine whether the cardiac conduction system of the patient has been captured by the VfA therapy.

Abstract: A system and method for designating between types of activation by a pulse generator configured to deliver a left ventricular (LV) pacing pulse at an LV pacing site as part of a cardiac resynchronization therapy (CRT) are provided. The system includes a sensing channel configured to collect cardiac activity (CA) signals along at least one sensing vector extending through a septal wall between the LV and right ventricle (RV). The CA signals are indicative of one or more beats and include a pre-LV pacing segment indicative of cardiac activity preceding the LV pacing pulse and a post-LV pacing segment indicative of cardiac activity following the LV pacing pulse. The system includes memory to store program instructions. One or more processors are configured to implement the program instructions to analyze the pre-LV pacing segment to identify a first myocardium activation (MA) characteristic of interest (COI).

Abstract: Differential charge-balancing can be used in high-frequency neural stimulation. For example, a neural stimulation apparatus can have first and second electrodes configured to be coupled proximate to a nerve fiber to implement a neural stimulation procedure. A neural stimulation circuit can be electrically coupled to the first and second electrodes. The neural stimulation circuit can apply stimulation currents to the nerve fiber through the first and second electrodes during a first stimulation phase of the neural stimulation procedure. The neural stimulation circuit can also apply a modified stimulation current to the nerve fiber through the first electrode during a second stimulation phase of the neural stimulation procedure. The modified stimulation current can be generated based on a difference between (i) a voltage at the first electrode, and (ii) a reference voltage derived from voltages on the first and second electrodes.

Abstract: An example device includes an elongated housing, a first and second electrode, and signal generation circuitry. The housing can be implanted within a single first chamber of the heart. The first electrode extends distally from the distal end of the elongated housing. A distal end of the first electrode can penetrate into wall tissue of a second chamber of the heart. The second electrode, extending from the distal end of the elongated housing, is configured to flexibly maintain contact with the wall tissue of the first chamber without penetration of the wall tissue of the first chamber by the second electrode. Signal generation circuitry can be within the elongated housing and coupled to the first and second electrode. The signal generation circuitry can deliver cardiac pacing to the second chamber via the first electrode and the first chamber via the second electrode.

Abstract: A system for encouraging therapeutic psychosocial activity of a patient comprising a master control system having a processor for operating system software, one or more portable communication devices in communication with the master control system, a testing device having testing input software that operates to transmit information to the master control system, wherein the master control system operates to transmit an information request to the one or more portable communication devices to direct the testing input software to create a window on a display screen informing the patient information has been requested, and the testing device operates to collect and transmit test information in response to the information request.

Abstract: A method and system for assessing lesion formation in tissue is provided. The system includes an electronic control unit (ECU). The ECU is configured to acquire values for first and second components of a complex impedance between the electrode and the tissue, and to calculate an index responsive to the first and second values. The ECU is further configured to process the ECI to assess lesion formation in the tissue.

Abstract: Techniques for switching an implantable medical device (IMD) from a first mode to a second mode in relation to signals obtained from internal sensors are described. The internal sensors may include a temperature sensor and a biosensor. In some examples, processing circuitry of the IMD may make a first preliminary determination that the IMD is implanted based on a first signal from the temperature sensor. In response to the first preliminary determination being that the IMD is implanted, the processing circuitry may make a second preliminary determination that the IMD is implanted based on a second signal from the biosensor. The processing circuitry may switch the IMD from a first mode to a second mode based on both the first preliminary determination and the second preliminary determination being that the IMD is implanted.

Abstract: A cardiac stimulation system and associated capture management method are provided in which capture and device longevity are improved. The device determines a series of capture thresholds. Capture threshold is the minimum pulse level (pulse energy or pulse amplitude or pulse width) that captures the heart. Each determination requires delivery of pacing pulses at several (at least two) known levels (pulse energy, pulse amplitude and/or pulse width) over time. The individual determined capture thresholds are combined into a set and the variability of the set is used to set the safety margin. The greater the variability in the capture thresholds, the bigger the safety margin.

Abstract: The disclosure describes various aspects of an automated external defibrillator (AED) system, including shock generating electronics, a battery configured for providing power to the shock generating electronics, power management circuitry configured for managing the shock generating electronics and the battery, at least one environmental sensor configured for monitoring environmental conditions in which the AED system is placed, and a controller configured for controlling the power management circuitry and the at least one environmental sensor. The at least one environmental sensor includes a temperature sensor configured for providing a temperature measurement, and the controller is further configured for adjusting operations of the power management circuitry in accordance with the temperature measurement provided by the temperature sensor. The disclosure further describes associated methods of using the AED system.

Abstract: Techniques are disclosed for using a rate of wireless telemetry of an implantable medical device (IMD) to estimate a remaining longevity of a power source of the IMD. For example, the IMD sets a timer indicative of a remaining power capacity of the power source until a recommended replacement time (RRT) threshold. The IMD determines a power consumption of the IMD due to telemetry and updates, based on the power consumption of the IMD due to telemetry, the timer indicative of the remaining power capacity of the power source. The IMD determines, based on expiration of the timer indicative of the remaining power capacity of the power source, that the power source has reached the RRT threshold. In some examples, the IMD may output, to an external device and for display to a user, an indication that the power source has reached the RRT threshold.

Abstract: Systems and methods for His bundle pacing and classifying response to pacing impulses include applying, using a pulse generator, an impulse through a stimulating electrode to induce a response from a patient heart. A response to the impulse is measured using at least one sensing electrode and time-domain based characteristics of the response are analyzed to determine whether His bundle capture has occurred and, if so, what type of capture has occurred.

Abstract: The disclosure describes an enhancement to lead monitoring techniques, which uses a sensing integrity counter (SIC). The techniques of this disclosure may enhance lead monitoring techniques by detecting possible sensing issues based on a significant increase in periodic, e.g., daily, SIC counts relative to previous periods. Some issues with sensing cardiac signals via implantable cardiac leads can result in an implantable medical device (IMD) measuring very short intervals between what appears to be sensed heart beats. Examples of issues include insulation breach, conductor fracture, or poor electrical connection, which may cause noise that appears to be an R-wave. The IMD may detect the noise, along with actual R-waves, and determine that there are relatively short (e.g., less than a threshold) intervals between the “R-waves.” A significant increase in the number or frequency of very short intervals between R-waves may indicate the date/time of a significant sensing issue.

Abstract: A method of generating an electrophysiology map of a portion of a patient's anatomy using an electroanatomical mapping system, includes defining a plurality of inclusion criteria, collecting a plurality of electrophysiology data points, each being associated with inclusion data, and identifying those electrophysiology data points that have inclusion data satisfying the inclusion criteria. The inclusion criteria can then be automatically adjusted to drive the number of electrophysiology data points having inclusion data satisfying the inclusion criteria towards a target number. A graphical representation of the electrophysiology map can be rendered using the final set of electrophysiology data points.

Abstract: An exemplary monitoring system 1) monitors evoked responses that occur in response to acoustic stimulation during an insertion procedure in which a lead that is communicatively coupled to a cochlear implant is inserted into a cochlea of a patient, the monitoring comprising using an intracochlear electrode disposed on the lead to measure a first and a second evoked response at a first and a second insertion depth within the cochlea, the second insertion depth nearer to an apex of the cochlea than the first insertion depth, 2) determines that a change between the first evoked response measured at the first insertion depth and the second evoked response measured at the second insertion depth is greater than a predetermined threshold, and 3) determines, based on the determination that the change is greater than the predetermined threshold, that cochlear trauma has likely occurred at the second insertion depth.

Abstract: The present disclosure relates generally to pacing of cardiac tissue, and more particularly to adjusting delivery of His bundle or bundle branch pacing in a cardiac pacing system to achieve synchronized ventricular activation. A leadless pacing device (LPD) may include a plurality of electrodes comprising a bundle pacing electrode leadlessly connected to the housing, which may be implanted proximate to or in the His bundle or bundle branch of the patient's heart. An electrical pulse generator may generate and deliver electrical His-bundle or bundle-branch stimulation pulses using the bundle pacing electrode based on sensing one or both of an atrial event and a ventricular event. The LPD may receive communication from another implantable device, such as a subcutaneously implanted device, and deliver His-bundle or bundle-branch pacing in response to the communication.

Abstract: A medical device system and associated method predict a patient response to a cardiac therapy. The system includes for delivering cardiac pacing pulses to a patient's heart coupled to a cardiac sensing module and a cardiac pacing module for generating cardiac pacing pulses and controlling delivery of the pacing pulses at multiple pace parameter settings. An acoustical sensor obtains heart sound signals. A processor is enabled to receive the heart sound signals, derive a plurality of heart sound signal parameters from the heart sound signals, and determine a trend of each of the plurality of heart sound signal parameters with respect to the plurality of pace parameter settings. An external display is configured to present the trend of at least one heart sound parameter with respect to the plurality of pace parameter settings.

Abstract: Described herein is an implantable medical device (IMD) that wirelessly communicates another IMD, and methods for use therewith. Such a method can include receiving one or more implant-to-implant (i2i) communication signals from the other IMD using a communication receiver of the IMD, measuring a strength of at least one of the one or more received i2i communication signals or a surrogate thereof, and updating a strength metric based on the measured strength or surrogate thereof. The method further includes determining, based on the updated strength metric, whether to increase, decrease, or maintain the sensitivity of the communication receiver of the IMD, and responding accordingly such that the sensitivity is sometimes increased, sometimes decreased, and sometimes maintained. The method can also include selectively causing a transmitter of the IMD to transmit an i2i communication signal to the other IMD requesting that the other IMD adjust its transmission strength.

Abstract: Ventricle-from-atrium (VfA) cardiac therapy may utilize a tissue-piercing electrode implanted in the left ventricular myocardium of the patient's heart from the right atrium through the right atrial endocardium and central fibrous body. The exemplary devices and methods may determine whether the tissue-piercing electrode is achieving effective left ventricular capture. Additionally, one or more pacing parameters, or paced settings, may be adjusted in view of the effective left ventricular capture determination.

Abstract: An intracardiac ventricular pacemaker having a motion sensor, a pulse generator and a control circuit coupled to the pulse generator and the motion sensor is configured to identify a ventricular systolic event, detect a ventricular passive filling event signal from the motion signal, and determine a time interval from the ventricular systolic event to the ventricular passive filling event. The pacemaker establishes a minimum pacing interval based on the time interval.

Abstract: A method for analyzing a condition of a heart, comprises receiving a plurality of electric signals, which are acquired by non-invasive measurement on the skin of a person or animal, each signal representing electrical activity in a respective region of the heart of the person or animal; calculating a derivative value of each signal at a plurality of time instances; selecting a plurality of the calculated derivative values of a first signal and determining a first point in time of a first event based on the selected derivative values; selecting a plurality of the calculated derivative values of a second signal and determining a second point in time of a second event, corresponding to the first event, based on the selected derivative values of the second signal, and calculating at least one measure based on a difference of the first point in time and the second point in time.

Abstract: In some examples of selecting a target therapy delivery site for treating a patient condition, a relatively high frequency electrical stimulation signal is delivered to at least two areas within a first region (e.g., an anterior nucleus of the thalamus) of a brain of a patient, and changes in brain activity (e.g., as indicated by bioelectrical brain signals) within a second region (e.g., a hippocampus) of the brain of the patient in response to the delivered stimulation are determined. The target therapy delivery site, an electrode combination, or both, may be selected based on the changes in brain activity.

Abstract: Systems and methods for pacing cardiac conductive tissue are described. A medical system includes an electrostimulation circuit to generate His-bundle pacing (HBP) pulses. A sensing circuit senses a physiologic signal, and detect a local His-bundle activation discrete from a pacing artifact of the HBP pulse. A control circuit verifies capture status in response to the HBP pulses. Based on the capture status, the control circuit determines one or more pacing thresholds including a selective HBP threshold representing a threshold strength to capture only the His bundle but not the local myocardium, and a non-selective HBP threshold representing a threshold strength to capture both the His bundle and the local myocardium. The electrostimulation circuit may deliver HBP pulses based on the selective and non-selective HBP thresholds.