Abstract: Systems and methods for communication between an implantable medical device and an external device. Data blocks are generated and transmitted between the implantable device and the external device. The data blocks include a first flag indicating whether the data block is a first data block in a message and when the data block is a subsequent data block in a multiple data block message. When the first flag indicates that the data block is a first data block in a message, the data block also contains a device ID, a command token, and message content. When the first flag indicates that the data block is a subsequent data block in a multiple data block message, the data block contains additional message content that is appended to message content from a previously received data block.

Abstract: An implantable neuromodulation device includes a plurality of electrical terminals configured for being respectively coupled to a plurality of electrodes; analog output circuitry configured for delivering electrical modulation energy to the electrical terminals in accordance with programming data from a first external control device; a low-speed telemetry system configured for receiving the programming data; a high-speed telemetry system configured for receiving non-programming data from a second external control device; and memory configured for storing the programming data and the non-programming data. The low-speed telemetry system has a data transfer rate in the range of 2-800 kbits/sec, and the high-speed telemetry system has a data transfer rate in the range of 1-50 Mbits/sec. The high-speed telemetry system may have a greater telemetry range than the low-speed telemetry system.

Abstract: Systems and methods for communication between an implantable medical device and an external device. Data blocks are generated and transmitted between the implantable device and the external device. The data blocks include a first flag indicating whether the data block is a first data block in a message and when the data block is a subsequent data block in a multiple data block message. When the first flag indicates that the data block is a first data block in a message, the data block also contains a device ID, a command token, and message content. When the first flag indicates that the data block is a subsequent data block in a multiple data block message, the data block contains additional message content that is appended to message content from a previously received data block.

Abstract: Certain implementations may include systems, methods, and apparatus for wirelessly transmitting data and power across inductive links using pulse delay modulation (PDM). According to an example implementation, a method is provided that includes generating a power carrier signal; generating a data waveform from a series of binary bits, the data waveform including a series of pulses in synchronization with the power carrier signal; transmitting, from one or more transmitting (Tx) coils of an inductive link, the power carrier signal and the data waveform; receiving, by one or more receiving (Rx) coils of the inductive link, an interference signal, the interference signal based at least in part on a superposition of the transmitted power carrier signal and the transmitted data waveform; determining zero crossings of the received interference signal; determining delays associated with the zero crossings; and determining the data packet based at least in part on the delays.

Abstract: Two LC circuits (each with its own coil) are used in either or both of an external controller or an implanted medical device to extend the range at which the two devices can communicate. Only one of the LC circuits (i.e., one of the coils) is used when the device is transmitting, while both LC circuits (i.e., both coils) are used when the device is receiving. When receiving, the LC circuits are preferably connected in series. The series connection of the LC circuits does not affect the resonant frequency, and thus this resonant frequency is the same for both transmission and reception despite the different LC circuits used. Switching circuitry is controlled to disconnect one of the LC circuits when the device is transmitting, and to connect the LC circuits in series during reception.

Abstract: A fluid reservoir for use in a remotely adjustable gastric banding system comprises a housing and a flexible reservoir pouch positioned within the housing. The flexible reservoir pouch is coupled to an inflatable portion of a gastric band via flexible tubing. A pump coupled to the flexible reservoir pouch facilitates filling and draining the inflatable portion of the gastric band. The pump may be located within or outside of the housing. A receiving coil may be coupled to the housing, and the receiving coil forms a loop around the housing. The receiving coil receives radio frequency signals to drive the pump. A circuit board may be disposed in the housing for driving the pump to move the fluid between the flexible reservoir pouch and the inflatable portion of the gastric band. A portion of the circuit board may be a flexible circuit board to allow the housing to flex.

Abstract: An external controller/charger system for an implantable medical device is disclosed, in which the external controller/charger system provides automatic switching between telemetry and charging without any manual intervention by the patient. The external controller/charger system includes an external controller which houses a telemetry coil and an external charging coil coupled to the external controller. Normally, a charging session is carried out using the external charging coil, and a telemetry session is carried out using the telemetry coil. However, when a patient requests to carry out telemetry during a charging session, the external charging coil is used instead of the internal telemetry coil.

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

Abstract: In a method and apparatus for supplying wireless energy to a medical device (100) implanted in a patient, wireless energy is transmitted from an external energy source (104) located outside a patient and is received by an internal energy receiver (102) located inside the patient, for directly or indirectly supplying received energy to the medical device. An energy balance is determined between the energy received by the internal energy receiver and the energy used for the medical device, and the transmission of wireless energy is then controlled based on the determined energy balance. The energy balance thus provides an accurate indication of the correct amount of energy needed, which is sufficient to operate the medical device properly, but without causing undue temperature rise.

Abstract: Techniques, apparatuses, and systems for interfacing multiple sensors with a biological system can include amplifying signals from respective sensors associated with an external device; modulating the amplified signals based on respective different frequency values; and summing the modulated signals to produce an output signal to stimulate a biological system.

Abstract: This document discusses, among other things, apparatus, systems, and methods for transvascularly stimulation of a nerve or nerve trunk. In an example, an apparatus is configured to transvascularly stimulate a nerve trunk through a blood vessel. The apparatus includes an expandable electrode that is chronically implantable in a blood vessel proximate a nerve trunk. The expandable electrode is configured to abut a predetermined surface area of the vessel wall along a predetermined length of the vessel. An electrical lead is coupled to the expandable electrode. An implantable pulse generator is coupled to the lead and configured to deliver an electrical stimulation signal to the electrode through the lead. in an example method, an electrical signal is delivered from an implanted medical device to an electrode chronically implanted in a blood vessel proximate a nerve trunk to transvascularly deliver neural stimulation from the electrode to the nerve trunk.

Abstract: A system and method for modifying the parameters of an implantable medical device includes an implantable medical device that communicates with a remote control device that, in turn, communicates through the browser of a computer or any other device capable of using mark-up language protocol. The computer optionally communicates with other computers and/or devices through a network.

Abstract: Implant devices described herein may be adapted to communicate with other devices via an antenna array. The antenna array may be configured to minimize radiation to surrounding tissue and/or maximize signal power in a direction of device(s) with which the implant device communicates.

Abstract: This document discusses, among other things, a modular antitachyarrhythmia therapy system. In an example, a modular antitachyarrhythmia system includes at least two separate modules that coordinate delivery an antitachyarrhythmia therapy, such as defibrillation therapy. In another example, a modular antitachyarrhythmia therapy system includes a sensing module, an analysis module, and a therapy module.

Abstract: Devices and systems provide for proximity based selection of an implantable medical device for far field communication with an external device. By using a proximity communication that is limited to the IMD of interest during the selection process, the external device can eliminate those IMDs that are in range of far field communications but are able to receive the proximity communication. Thus, information may be shared via a proximity communication that is validated via a far field communication, or shared via a far field communication as a challenge and then validated via a proximity communication. The proximity communication may be used to initially limit the number of devices that respond to a discovery request and then subsequently used to select the intended implantable medical device as well as automatically select the appropriate therapy application corresponding to the selected IMD.

Abstract: A system and method involve transceiving successive first and second synchronization signals defining endpoints of a frame. A digital signal is transceived by a modulating time interval between portions of the first and second synchronization signals. A first data pulse is transceived during the frame. A relative position in the frame of the first data pulse represents a first analog signal.

Abstract: An antenna for an implantable medical device (IMD) is provided including a monolithic structure derived from a plurality of discrete dielectric layers having an antenna embedded within the plurality of dielectric layers. The antenna includes antenna portions formed within different layers of the monolithic structure with at least one conductive via formed to extend through the dielectric layers in order to provide a conductive pathway between the portions of the antenna formed on different layers, such that an antenna is formed that extends between different vertical layers. The dielectric layers may comprise layers of ceramic material that can be co-fired together with the antenna to form a hermetically sealed monolithic antenna structure. The antenna embedded within the monolithic structure can be arranged to have a substantially spiral, helical, fractal, meandering or planer serpentine spiral shape.

Abstract: The present disclosure involves a medical system. The medical system includes a medical device configured to deliver a medical therapy to a patient and store an electronic patient record that includes visual identification information of the patient. The medical system includes a clinician programmer configured to program the medical device. The clinician programmer includes a display screen. The clinician programmer includes a transceiver configured to conduct electronic communication with external devices. The clinician programmer includes a memory storage configured to store machine-readable code. The clinician programmer includes a computer processor configured to execute the machine-readable code to: establish an electronic communication with the medical device via the transceiver; and display the electronic patient record, including the visual identification information of the patient, on the display screen after the electronic communication has been established.

Abstract: A computer-implemented method is presented for synchronizing time between two handheld medical devices that interoperate with each other. The method includes: determining a first time as measured by a first clock residing in the first medical device; determining a second time as measured by a second clock residing in a second medical device; evaluating whether the first clock is synchronized with the second clock; determining whether at least one of the first clock and the second clock was set manually by a user; and setting time of the first clock in accordance with the second time when the second clock was set manually by the user.

Abstract: Disclosed is a remote controller for an implantable medical device having stored contraindication information, which includes information which a patient or clinician might wish to review when assessing the compatibility of a given therapeutic or diagnostic technique or activity with the patient's implant. The stored contraindication information is available through a display of the remote controller or via a wired, wireless, or portable drive connection with an external device. By storing contraindication information with the implant's remote controller, patient and clinician can more easily determine the safety of a particular therapeutic or diagnostic technique or physical activity with the patient's implant, perhaps without the need to contact the manufacturer's service representative.

Abstract: An RF telemetry receiver circuit for active implantable medical devices. The baseband binary signal (Db) is doubly modulated by a low frequency carrier (Fm) and by a high frequency carrier (Fc). The receiver circuit is a semi-passive non heterodyne circuit, devoid of a local oscillator and mixer. It comprises an antenna (104), a passive bandpass filter (108) centered on the high-frequency carrier (Fc), a passive envelope detector (120-126) and a, digital demodulator (116). The envelope detector comprises a first diode circuit (120) of non-coherent detection, an active bandpass filter (122) centered on a frequency (2.Fm) twice the low frequency carrier and having a bandwidth (2.Db) twice the baseband bandwidth, and a second diode circuit (124) of non-coherent detection, outputting a baseband signal applied to the digital demodulation stage (116).

Abstract: Systems and methods are described for adjusting the operation of implantable stimulation devices used to provide medical monitoring and treatment. Several hierarchical algorithms are described which operate according to conditionally obtaining a patient response to an alert signal. In one such strategy semi-automatic therapy adjustment occurs by automatically issuing patient alert messages when selected operations are to occur, and using a patient's response to the alert message that is provided within a selected time limit in order to contingently adjust therapy. Methods are also described for resolving conflicts which may occur when time information and sensed data information each indicate different patient states are occurring. Although treatment of neural and cardiac disorders is emphasized, the techniques can be applied to the monitoring and treatment of any medical disorder with an implanted device.

Abstract: The present technology is directed generally to a lead anchor for positioning and securing spinal cord modulation leads and associated systems and methods. In at least some contexts, the lead anchor includes a central lumen surrounded by a restriction feature. The restriction feature can interface with a tightening screw or other actuator and can be configured to provide a radial compressive fit around the lead body. In some embodiments, the clamp can be disengaged upon twisting or other unlocking motion to release the lead.

Abstract: A medical transceiver device for radio-based communication with an implantable medical device has circuitry for transmitting radio-frequency signals to, and/or receiving radio-frequency signals from, the implantable medical device, first and second electrically conductive structures, and an antenna feed network operatively interconnected between the circuitry and the first and second conductive structures. Each of the first and second conductive structures is operable as a transmitting and/or receiving antenna for the radio-frequency signals. The first and second conductive structures emit and/or receive radio waves of different polarizations, and the first and second conductive structures are disposed adjacent each other at a single location in space, thereby providing spatial diversity that is independent of the polarization diversity.

Abstract: Devices, systems and methods for delivering and positioning an implantable medical device and for evaluating an acoustic communication link are disclosed. An illustrative system includes a catheter adapted to contain an implantable device with a biosensor and an acoustic transducer configured to transmit an acoustic signal, and an implant assist device in acoustic communication with the implantable device via an acoustic communication link. The implant assist device includes an acoustic transducer adapted to receive the acoustic signal transmitted by the implantable medical device, and control/processing circuitry configured to evaluate a performance of the acoustic link.

Abstract: A method for defining connections between a plurality of lead bodies and a plurality of output ports of a neurostimulator, and an external control device for performing the method are disclosed. The external control device includes a user interface and control circuitry. The method includes displaying the lead bodies and the output ports of the neurostimulator; selecting a first one of the lead bodies; dragging a connector from the first lead body to a first one of the output ports of the neurostimulator; and dropping the connector onto the first output port of the neurostimulator, thereby defining a connection between the first lead body and the first output port of the neurostimulator. In another embodiment, a method includes defining the connection between the first lead body and the first output port, and graphically displaying the connection between the first lead body and the first output port of the neurostimulator.

Abstract: A bio-medical communication system includes a bio-medical unit and a communication device. The bio-medical unit is implantable in and/or affixable to a host body and includes a power harvesting module, a communication module, and a functional module. The communication device is operable to: set-up a communication with the bio-medical unit; wirelessly communicate the at least one of upstream data signal and downstream data signal with the bio-medical unit; convert the upstream data signal into an upstream wide area network (WAN) signal and/or a downstream WAN signal into the downstream data signal; and transmit or receive at least one of the upstream and downstream WAN signals.

Abstract: An intravascularly-deliverable electrode assembly can be used to provide electrostimulation. The electrode assembly can include an electrostimulation circuit located in a housing, two or more elongate members coupled to the housing and configured to anchor the housing to a heart, the two or more elongate members including two or more electrodes electrically coupled to the electrostimulation circuit and controllably addressable by the electrostimulation circuit for delivery of an electrostimulation to the heart. The two or more elongate members can be sized and shaped for intravascular delivery to the heart in a first configuration, and in response to a user actuation, the two or more elongate members can move to a second configuration that is expanded relative to the first configuration to securely anchor the intravascularly-deliverable electrode assembly to the heart. Circuitry within the electrode assembly can coordinate electrostimulation, such as for delivery to sites near each electrode.

Abstract: Systems and methods permit remotely-monitored rehabilitation of a patient. A system can comprise a patient monitor configured to monitor a patient's physiological data. The patient monitor can monitor using a first monitoring mode. A patient communication device can be configured to present, to the patient, an option to perform an exercise regimen, and to receive a response indicating whether the patient will perform the exercise regimen. A configuration module coupled to the patient communication device can be configured to activate a second monitoring mode when the response indicates that the patient will perform the exercise regimen. When the exercise regimen is complete, the first monitoring mode can be re-established. When the response indicates that the patient will not perform the exercise regimen, the response can be recorded as a negative response, and the option to perform the exercise regimen can be presented again.

Abstract: This document discusses, among other things, a modular antitachyarrhythmia therapy system. In an example, a modular antitachyarrhythmia system includes at least two separate modules that coordinate delivery an antitachyarrhythmia therapy, such as a defibrillation therapy. In another example, a modular antitachyarrhythmia therapy system includes a sensing module, an analysis module, and a therapy module.

Abstract: The present invention is directed to an implantable medical device and a method for power management for power efficient use of RF telemetry during, for example, conditions where long periods of continuous monitoring of the device and the patient is desired such as during MRI procedures. A protocol module adapted to, at receipt of a low power protocol indication, activate and use a low power protocol for communication between the device and external units. The protocol module is capable of switching between different communication protocols including a low power communication protocol and a default RF communication protocol depending on, for example, whether continuous long-term monitoring of the patient is performed.

Abstract: An apparatus comprises a medical device configured for implantation into a living organism. The medical device comprises processing circuitry, a memory and interface circuitry configured for communication with a monitoring device. The medical device is configured to receive a request for access from the monitoring device, to measure a physiological value of the living organism, to perform a pairing protocol with the monitoring device, the pairing protocol comprising a secure channel set-up phase followed by an authentication phase, and to permit access by the monitoring device responsive to a successful pairing in accordance with the pairing protocol, the successful pairing being based at least in part on a determination that a physiological value supplied by the monitoring device substantially matches the measured physiological value. The medical device performs the secure channel set-up phase before sending the measured physiological value to the monitoring device.

Abstract: A telemetry head for communication with an implantable medical device comprises a telemetry antenna and a shield substantially surrounding at least a portion of the antenna, the shield having a coating comprising a ferromagnetic material applied to at least a portion of the shield, wherein the coating is configured to shield at least the portion of the telemetry antenna from electromagnetic interference fields while permitting telemetry signals to pass through the coating.

Abstract: A leadless pacemaker for pacing a heart of a human includes a hermetic housing and at least two electrodes on or near the hermetic housing. The at least two electrodes are configured to deliver energy to stimulate the heart and to transfer information to or from at least one external device.

Abstract: Implantable leadless cardiac pacing systems and methods for providing substernal pacing using the leadless cardiac pacing systems are described. In one embodiment, an implantable leadless cardiac pacing system includes a housing, a first electrode on the housing, a second electrode on the housing, and a pulse generator within the housing and electrically coupled to the first electrode and the second electrode. The housing is implanted substantially within an anterior mediastinum of a patient and the pulse generator is configured to deliver pacing pulses to a heart of the patient via a therapy vector formed between the first and second electrodes.

Abstract: An implanted coil supplies energy or control signals to, or provides information from, a medical device implanted in a human or animal patient. Preferably, the coil is implanted subcutaneously in the patient at a location suitable for easy access to the coil. The implanted coil is wound from a wire that is formed into a plurality of smaller diameter coils connected in series and positioned perpendicular to the larger implanted coil. Preferably, the wire used to form the implanted coil is a helically-shaped wire that is very resilient, and, thus, capable of handling even extreme movements of a patient in whom it is implanted without the risk of breaking.

Abstract: In general, the disclosure is related to characterization of implanted electrical stimulation electrode arrays using post-implant imaging. The electrode arrays may be carried by implanted leads. Characterization of implanted electrode arrays may include identification of the type or types of leads implanted within a patient and/or determination of positions of the implanted leads or electrodes carried by the leads relative to one another or relative to anatomical structures within the patient. In addition, the disclosure relates to techniques for specifying or modifying patient therapy parameters based on the characterization of the implanted electrode arrays.

Abstract: Disclosed is a system having an implanted component and external component which are configured to provide a test of wireless communication in order to assess the success or failure of such communication and to store attributes related to such test in a memory log. To provide the communication test the implantable and external components can attempt wireless communication according to communication test parameters which relate to number of times to retry communication, duration of sending communication test signals, durations of waiting for communication test signals and the schedule of the communication tests. The schedule of tests may be periodic or may change over time in order to become more or less frequent according to a programmable schedule that may also decrease if the communication tests are successful and indicate patient compliance in keeping the external components close by.

Abstract: A delivery system for implanting a biostimulation device comprising a stylet extending along an axis from knob end to a threaded end configured to engage an internally threaded nut of the biostimulation device and a catheter tube configured to axially contain the stylet. The catheter tube comprises a feature that engages a corresponding feature on the biostimulation device whereby the stylet can be rotated relative to the catheter tube for disengagement of the stylet threaded end from the biostimulation device threaded end.

Abstract: A system and method for contactless power transfer in implantable devices for charging rechargeable batteries disposed within the implantable devices are provided. The system includes a first coil electrically couplable to a power source, wherein the first coil is configured to produce a magnetic field. The system further includes a second coil electrically coupled to the rechargeable battery disposed within the implantable device and configured to receive power from the first coil via the magnetic field and to transfer the power to the rechargeable battery. The system also includes a field focusing element disposed between the first coil and the second coil and configured as a self resonant coil having a standing wave current distribution to focus the magnetic field onto the second coil and enhance the coupling between the first coil and the second coil.

Abstract: A particular method of providing power to an implantable medical device includes providing a first signal to a primary coil that is inductively coupled to a secondary coil of an implantable medical device. The method also include determining a first alignment difference between a voltage corresponding to the first signal and at least one of a current corresponding to the first signal and a component voltage at a component of a primary coil circuit. The method further includes determining a frequency sweep range based on the first alignment difference. The method also includes performing a frequency sweep over the frequency sweep range.

Abstract: A method and system is presented for an implantable wireless power receiver for use with a medical stimulation or monitoring device. The receiver receives transmitted energy through one or more non-inductive antenna(s), utilizes microelectronics to perform rectification of the received signal for generation of a DC power supply to power an implantable device, and may also utilize microelectronics to provide parameter settings to the device, or stimulating or other waveforms to a tissue.

Abstract: An electronic medical monitoring and treatment apparatus allows a victim of a medical emergency person access to a medical professional (MP) who can monitor, diagnose and treat the person from a remote site. The apparatus includes a cardiac medical monitoring and treatment device (MMTD) coupled to an electronic adapter designed to communicate with a local, first transmitting/receiving (T/R) device which, in turn, is adapted to electronically communicate with a remote, second transmitting/receiving (T/R) device used by the MP. The MMTD may comprise a cardiac treatment circuit for effecting cardiac pacing and/or defibrillation and a cardiac signal circuit for receiving cardiac signals. The cardiac signals are (1) transmitted from the signal circuit to the second T/R device for evaluation by the MP, (2) the MP may transmit a control signal to the treatment circuit, and (3), in response thereto, the treatment circuit may generate one or more electrical pulses for treatment of the person.

Abstract: In one embodiment, a method of programming an IPG comprises providing one or several GUI screens on the programmer device, the GUI screens comprising a master amplitude GUI control for controlling amplitudes for stimsets of a stimulation program and one or several balancing GUI controls for controlling amplitudes of each stimset of the stimulation program; communicating one or several commands from the programmer device to the IPG to change the amplitude of all stimsets of the stimulation program in response to manipulation of the master amplitude GUI control, wherein the amplitude of each stimulation set is automatically calculated by a level selected through the master amplitude GUI control and one or several calibration parameters for the respective stimulation set; and automatically recalculating the one or several calibration parameters for a respective stimulation set in response to manipulation of one of the balancing GUI controls and storing the recalculated calibration parameters.

Abstract: The invention relates to a therapy system and a therapy device having at least one data communication interface which can operate in various data transmission modes and cooperates with a data communication control unit. The data communication interface can change from one data transmission mode to another without interruption of an existing data link. The change is controlled by the data communication control unit as a function of predefined selection criteria.

Abstract: Systems and methods are described for adjusting the operation of implantable stimulation devices used to provide medical monitoring and treatment. Several hierarchical algorithms are described which operate according to conditionally obtaining a patient response to an alert signal. In one such strategy semi-automatic therapy adjustment occurs by automatically issuing patient alert messages when selected operations are to occur, and using a patient's response to the alert message that is provided within a selected time limit in order to contingently adjust therapy. Methods are also described for resolving conflicts which may occur when time information and sensed data information each indicate different patient states are occurring. Although treatment of neural and cardiac disorders is emphasized, the techniques can be applied to the monitoring and treatment of any medical disorder with an implanted device.

Abstract: For supplying energy to a medical implant (100) in a patient's body a receiver (102) cooperates with an external energizer (104) so that energy is wirelessly transferred. A feedback communication system (109) sends feedback information from the receiver to the energizer, the feedback information being related to the transfer of energy to the receiver. The feedback communication system communicates using the patient's body as an electrical signal line. In particular, the communication path between the receiver and the external energizer can be established using a capacitive coupling, i.e. the feedback information can be capacitively transferred over a capacitor having parts outside and inside the patient's body. An energy balance between the amount of energy received in the receiver and the energy used by the medical implant can be followed over time, and then the feedback information is related to the energy balance.

Abstract: Devices for use in providing stimulation to cardiac tissue are provided. One device is configured for implantation in or near the heart and includes a flexible, elongate body. The body is configured to be positioned across two different sections of the vasculature such that (a) the first end can be positioned in a first section of the vasculature through which the device can stimulate a first chamber of the heart and (b) the second end can be positioned in a second section of the vasculature through which the device can stimulate a second chamber of the heart. The device further includes a receiver circuit configured to receive signals wirelessly from a transmitter device and to convert the signals into electrical power. The device also includes at least a first set of one or more electrodes configured to stimulate the heart using the electrical power.

Abstract: A portable housing supports a processor coupled to memory for storing medical firmware and wireless radio firmware, first and second radios, a processor, and a power source. Communications are effected between an implantable medical device and the first radio in accordance with program instructions of the medical firmware, and between the second radio and the wireless network in accordance with program instructions of the wireless radio firmware. The first and second radios are configured to operate cooperatively in a first testing configuration, by which the first radio operates as a transmitter and the second radio operates as a receiver, and cooperatively in a second testing configuration, by which the second radio operates as a transmitter and the first radio operates as a receiver. Functional testing of the first and second radios is implemented using one or both of the first and second testing configurations.

Abstract: Systems and methods involve an intrathoracic cardiac stimulation device operable to provide autonomous cardiac sensing and energy delivery. The cardiac stimulation device includes a housing configured for intrathoracic placement relative to a patient's heart. A fixation arrangement of the housing is configured to affix the housing at an implant location within cardiac tissue or cardiac vasculature. An electrode arrangement supported by the housing is configured to sense cardiac activity and deliver stimulation energy to the cardiac tissue or cardiac vasculature. Energy delivery circuitry in the housing is coupled to the electrode arrangement. Detection circuitry is provided in the housing and coupled to the electrode arrangement. Communications circuitry may optionally be supported by the housing. A controller in the housing coordinates delivery of energy to the cardiac tissue or cardiac vasculature in accordance with an energy delivery protocol appropriate for the implant location.