Abstract: The invention relates to a method for operating an implanted, ventricular assist system (2), comprising the following steps: a) determine a first impedance parameter at a first point in time by means of the assist system (2), b) determine a second impedance parameter at a second point in time by means of the assist system (2), c) at least determine a change of the impedance parameter using the first impedance parameter and the second impedance parameter, or compare at least the first or second impedance parameter to a threshold value.

Abstract: An energy supplying component (100) includes a plurality of power sources (161, 171, 181, 191) and at least one switch (163, 165, 167, 173, 175, 177, 183, 185, 187, 193, 195, 197). Each power source of the plurality of power sources is configured to output a defined energy level. The at least one switch is configured to reversibly combine two or more power sources of the plurality of power sources for enabling the energy supplying component to supply requested energy at one or both of a needed voltage or a needed current.

Abstract: A ventricular pacemaker is configured to determine a ventricular rate interval by determining at least one ventricular event interval between two consecutive ventricular events and determine a rate smoothing ventricular pacing interval based on the ventricular rate interval. The pacemaker is further configured to detect an atrial event from a sensor signal and deliver a ventricular pacing pulse in response to detecting the atrial event from the sensor signal. The pacemaker may start the rate smoothing ventricular pacing interval to schedule a next pacing pulse to be delivered upon expiration of the rate smoothing ventricular pacing interval.

Abstract: A system comprises processing circuitry and memory comprising program instructions that, when executed by the processing circuitry, cause the processing circuitry to: apply a first set of rules to first patient parameter data for a first determination of whether sudden cardiac arrest of a patient is detected; determine that a one or more context criteria of the first determination are satisfied; and in response to satisfaction of the context criteria, apply a second set of rules to second patient parameter data for a second determination of whether sudden cardiac arrest of the patient is detected. At least the second set of rules comprises a machine learning model, and the second patient parameter data comprises at least one patient parameter that is not included in the first patient parameter data.

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

Abstract: The present disclosure provides systems and methods for optimizing pacing parameters of a cardiac pacing device implanted in a patient. The systems and methods measure a plurality of hemodynamic responses of the patient. Each hemodynamic response is associated with the cardiac pacing device configured with one candidate pacing parameter set of a plurality of candidate pacing parameter sets. Each candidate pacing parameter set is classified as electrically equivalent to a reference pacing parameter set according to a classification criterion. The systems and methods further identify an optimal hemodynamic response from the plurality of hemodynamic responses, and select a final candidate pacing parameter set corresponding to the optimal hemodynamic response.

Abstract: A patient monitoring system includes at least one sensor configured to measure patient data including physiologic waveform data, a defibrillator configured to couple to the at least one sensor and including a touchscreen user interface, at least one processor communicatively coupled to the touchscreen user interface and configured to cause the touchscreen user interface to display the patient data including at least one physiologic waveform based on the physiologic waveform data, detect user input including a first user touchscreen input and a second user touchscreen input, define endpoints of a caliper based on the first user touchscreen input and the second user touchscreen input, wherein the endpoints of the caliper identify a particular portion of the at least one physiologic waveform, and cause the touchscreen to display a measurement of the particular portion of the at least one physiologic waveform based on the endpoints of the caliper.

Abstract: A medical system is configured to deliver an implantable medical device to a targeted implant site. The system may include a processor configured to receive a cardiac electrical signal and determine a feature of the cardiac electrical signal. The processor may be configured to determine a position of the delivery tool based on at least one feature of the cardiac electrical signal. The processor may detect a deployment position of the delivery tool in response to the cardiac electrical signal feature meeting criteria for detecting the deployment position.

Abstract: A relatively compact implantable medical device includes a fixation member formed by a plurality of fingers mounted around a perimeter of a distal end of a housing of the device; each finger is elastically deformable from a relaxed condition to an extended condition, to accommodate delivery of the device to a target implant site, and from the relaxed condition to a compressed condition, to accommodate wedging of the fingers between opposing tissue surfaces at the target implant site, wherein the compressed fingers hold a cardiac pacing electrode of the device in intimate tissue contact for the delivery of pacing stimulation to the site. Each fixation finger is preferably configured to prevent penetration thereof within the tissue when the fingers are compressed and wedged between the opposing tissue surfaces. The pacing electrode may be mounted on a pacing extension, which extends distally from the distal end of the device housing.

Abstract: Disclosed herein are methods of treating arrhythmogenic right ventricular cardiomyopathy in a subject, comprising administering a gene therapy construct comprising a connexin 43 sequence, wherein as a result of the administration, connexin 43 levels in at least a portion of the heart are increased. Further disclosed are other cardiovascular diseases can be treated with the method.

Abstract: System and methods for delivering defibrillator incident information to a PSAP in real-time during emergency use of an AED are described. Such information is utilized by a telecommunicator at a PSAP to provide better guidance to volunteer caregivers during potential cardiac arrest incidents. In another aspect the AED's current instruction state and optionally the time in that state is provided to the PSAP.

Abstract: Systems, apparatus, and methods for treating medication refractory epilepsy are disclosed. In one embodiment, a method of treating epilepsy is disclosed comprising detecting, using a first electrode array coupled to a first endovascular carrier, an electrophysiological signal of a subject. The method further comprises analyzing the electrophysiological signal using a neuromodulation unit electrically coupled to the first electrode array and stimulating an intracorporeal target of the subject using a second electrode array coupled to a second endovascular carrier implanted within a part of a bodily vessel superior to a base of the skull of the subject.

Abstract: The invention relates to a patient monitoring apparatus (6) comprising a first measuring unit (7) for performing an electrical measurement of a physiological property like an electrocardiogram measurement providing a heart rate, while an electrical treatment procedure is not performed, and a second measuring unit (8) for performing a non-electrical measurement of the physiological property like an optical photoplethysmogram measurement providing the heartrate. A data communication unit (10) is adapted to receive a treatment indication, which indicates that the electrical treatment procedure will be performed, from an electrical treatment apparatus (12), and a controller (9) is adapted to control the patient monitoring apparatus such that the measurement of the physiological property is switched from the electrical measurement to the non-electrical measurement, after the treatment indication has been received.

Abstract: An implantable device comprises a housing having an oblong shape extending along a longitudinal axis, and a coil arrangement for communicating with an external device, the coil arrangement comprising a coil winding and a bobbin on which the coil winding is arranged. The coil arrangement is received in the housing such that the coil winding and the bobbin extend along a transverse direction with respect to the longitudinal axis, wherein the coil winding is wound on the bobbin about the transverse direction and has an elongated shape along the transverse direction.

Abstract: Systems and method for powering an implanted blood pump are disclosed herein. The system can be a mechanical circulatory support system. The mechanical circulatory support system can include an implantable blood pump. The implantable blood pump includes a DC powered pump control unit that can control the blood pump according to one or several stored instructions. The implantable blood pump includes a rectifier electrically connected to the pump control unit. The implantable rectifier can convert the AC to DC for powering the pump control unit. The system can include an external controller electrically connected to the rectifier. The external controller can provide AC electrical power to the implantable blood pump.

Abstract: An image processing apparatus for evaluating cardiac images and a ventricular status identification method are provided. In the method, a region of interest (ROI) is determined from multiple target images, a variation in grayscale values of multiple pixels in the ROIs of each target image is determined, and one or more representative images are obtained according to the variation in the grayscale values. The target image is related to the pixels within an endocardial contour of a left ventricle. A boundary of the ROI is approximately located at two sides of a bottom of the endocardial contour. The ROI corresponds to a mitral valve. The variation in the grayscale values is related to a motion of the mitral valve. The representative image is for evaluating a status of the left ventricle.

Abstract: A method for storing measurement data detected by a sensor and indicative of an analyte in a body fluid sample using a system having a processor and a memory. First and second measurement data indicative of first and second measurement values measured by a sensor, respectively, are provided. A relative measurement value is determined by the processor and is indicative of a value difference between the first and second measurement values. The first measurement value is stored in a first storage area having a first storage size in the memory. The relative measurement value is stored in a second storage area having a second storage size in the memory that is smaller than the first storage size. An indicator is also stored in the memory and is assigned to the relative measurement storage data in the memory and is indicative of a characteristic of the relative measurement storage data.

Abstract: Medical devices for closing anatomical apertures, such as atrial or ventricular septal defects, are disclosed. The medical devices can include a plug body having a proximal end, a distal end, and a longitudinal axis. The plug body can include an exterior surface, an interior surface defining an interior lumen, and a seal which can be located within the interior lumen. The medical devices can also include at least one arm member extending through the plug body between the exterior surface and the interior surface of the plug body. In certain embodiments, the medical device can include a distal loop and a proximal loop extending through the plug body. In certain embodiments, the proximal loop can be smaller than the distal loop, such that a top end and a bottom end of the proximal loop can fit within a top end and a bottom end of the distal loop.

Abstract: Recovery circuitry for passively recovering charge from capacitances at electrodes in an Implantable Pulse Generator (IPG) is disclosed. The passive recovery circuitry includes passive recovery switches intervening between each electrode node and a common reference voltage, and each switch is in series with a variable resistance that may be selected based on differing use models of the IPG. The passive recovery switches may also be controlled in different modes. For example, in a first mode, the only recovery switches closed after a stimulation pulse are those associated with electrodes used to provide stimulation. In a second mode, all recovery switches are closed after a stimulation pulse, regardless of the electrodes used to provide stimulation. In a third mode, all recovery switches are closed continuously, which can provide protection when the IPG is in certain environments (e.g., MRI), and which can also be used during stimulation therapy itself.

Abstract: A system for computational localization of fibrillation sources is provided. In some implementations, the system performs operations comprising generating a representation of electrical activation of a patient's heart and comparing, based on correlation, the generated representation against one or more stored representations of hearts to identify at least one matched representation of a heart. The operations can further comprise generating, based on the at least one matched representation, a computational model for the patient's heart, wherein the computational model includes an illustration of one or more fibrillation sources in the patient's heart. Additionally, the operations can comprise displaying, via a user interface, at least a portion of the computational model. Related systems, methods, and articles of manufacture are also described.

Abstract: This disclosure is directed to devices, systems, and techniques for monitoring a patient condition. In some examples, a medical device system includes processing circuitry configured to determine a plurality of pulse transit time (PTT) intervals, determine, based on an accelerometer signal, a posture of a patient from a plurality of postures corresponding to each PTT interval of the plurality of PTT intervals, classify each PTT interval of the plurality of PTT intervals based on the respective posture of the patient corresponding to the respective PTT interval, and monitor, based on the classified plurality of PTT intervals, a patient condition.

Abstract: A method for stimulating nerve fibers to treat a condition in a patient first involves identifying carotid sinus nerve afferent fibers in a first side of the patient's neck and identifying cardiac-specific vagal nerve afferent fibers in the first side of the patient's neck. The method further involves placing a first multipolar electrode device around the carotid sinus nerve afferent fibers and the cardiac-specific vagal nerve afferent fibers. Finally, the method involves stimulating the carotid sinus nerve afferent fibers and the cardiac-specific vagal nerve afferent fibers, using the first multipolar electrode device. This method may be performed on a second side of the neck as well.

Abstract: A variety of dispatcher user interfaces, communications architectures, methods, apparatus, APIs and protocols are described that can help facilitate the integration of volunteer responder networks into the workflows of PSAP dispatchers. In one aspect, a dispatcher user interface facilitates activation of the volunteer responder network, as well as tracking and/or communicating notes to medical devices such as AEDs in the responder network that have accepted an incident.

Abstract: An electrocardiograph according to an aspect of the present invention includes an electrocardiographic measurement unit configured to measure electrocardiographic information of a user, a physiological indicator measurement unit configured to measure a physiological indicator of the user, the physiological indicator being different from the electrocardiographic information, a first determination unit configured to determine whether or not the user is in a relaxed state, on the basis of a measurement result of the physiological indicator, and a measurement control unit configured to control the electrocardiographic measurement unit on the basis of a determination result by the first determination unit.

Abstract: A method for heart failure management includes monitoring one or more sensor-based parameters for a patient to determine a pacing therapy. If the one or more parameters indicate atrial tachycardia or atrial fibrillation, a first pacing therapy is delivered. If the one or more parameters do not indicate atrial tachycardia or atrial fibrillation, it is determined whether the patient is asleep. If the patient is asleep, a second pacing therapy is delivered. If the one or more parameters do not indicate atrial tachycardia, atrial fibrillation, or that the patient is asleep, the patient's P-wave duration is evaluated with respect to a P-wave duration threshold value. When the patient's P-wave duration is determined to exceed the P-wave duration threshold value, a third pacing therapy is delivered, and when the patient's P-wave duration is determined to not exceed the P-wave duration threshold value, a fourth pacing therapy is delivered.

Abstract: One aspect includes a manufacturing method for a multielectrode system including providing several conductors, which are electrically conductive in their longitudinal direction; bundling the conductors at a proximal portion of the multielectrode system by means of a sheath surrounding the conductors to form a conductor bundle configured to be used as a lead of the multielectrode system; and providing several ring electrodes each surrounding one of the conductors at a distal portion of the multielectrode system and electrically connecting the ring electrodes and the conductors to form a multielectrode array of the multielectrode system. The multielectrode array is configured to be in a longitudinally extended or in a transversally expanded configuration.

Abstract: Systems are provided for generating data representing electromagnetic states of a heart for medical, scientific, research, and/or engineering purposes. The systems generate the data based on source configurations such as dimensions of, and scar or fibrosis or pro-arrhythmic substrate location within, a heart and a computational model of the electromagnetic output of the heart. The systems may dynamically generate the source configurations to provide representative source configurations that may be found in a population. For each source configuration of the electromagnetic source, the systems run a simulation of the functioning of the heart to generate modeled electromagnetic output (e.g., an electromagnetic mesh for each simulation step with a voltage at each point of the electromagnetic mesh) for that source configuration.

Abstract: A method and external device for providing sub-perception stimulation to a patient via an implantable stimulator device is disclosed. Stimulation parameters for the patient are determined that provide sub-perception stimulation to address a symptom of the patient. A schedule is determined to provide scheduled boluses of stimulation, where each bolus comprises a duration during which stimulation is applied to the patient in accordance with the stimulation parameters, and where the scheduled boluses are separated by off times when no stimulation is provided to the patient. Preferably, the duration of each of the scheduled boluses is 3 minutes or longer, and the duration of each of the off times is 30 minutes or greater. Additional boluses can be provided on demand in addition to the scheduled boluses by selecting an option on the external device, although the provision of such additional boluses may be constrained by a lockout period.

Abstract: According to some aspects, a cardiac pacemaker for implantation within a subject is provided, the pacemaker including a housing, at least one sensor configured to detect an activity level of the subject, and at least one processor coupled to the sensor configured to detect inactivity of the subject based on output from the at least one sensor, produce a first signal configured to increase the heart rate of the subject to a first heart rate during a first time period, wherein the first heart rate is above a resting heart rate and below 100 beats per minute, and in response to determining that the first time period has elapsed, producing a second signal configured to increase the heart rate of the subject to a second heart rate during a second time period, wherein the second heart rate is between 100 and 140 beats per minute.

Abstract: A method for quantifying a metric indicative of a condition of cardiac tissue in an electrogram is disclosed. The method comprises detecting extrema in the electrogram, analyzing the detected extrema, selecting certain extrema based on a threshold and generating a fractionation metric comprising a count of the selected extrema.

Abstract: An electrode apparatus includes a portable amplifier and a plurality of external electrodes to be disposed proximate a patient's skin. A portable computing apparatus is operably coupled to the electrode apparatus. The portable computing apparatus is configured to monitor electrical activity from tissue of a patient using the plurality of external electrodes to generate a plurality of electrical signals over time. The portable computing apparatus is configured to perform at least one of optimizing at least one parameter of the of the implantable pacing device based on the plurality of electrical signals and determining cardiac synchrony based on the plurality of electrical signals.

Abstract: Implantable medical devices include an enclosure that is constructed by machining of a material rather than by forming or stamping. The machining produces one or more internal features within the enclosure. These internal features may include shelves that may act as a stiffener and create separate compartments within the enclosure. These internal features may include contoured edges along the shelves to accommodate conductors and other structures that extend from one compartment to another. These features may include slots that are present in one or more locations, such as on a surface of one of the shelves. These internal features may also include standoffs that establish a gap between an internal component and the external wall of the enclosure. These internal features may also include different thicknesses in different areas of the enclosure, such as one wall thickness in one compartment and a different wall thickness in another compartment.

Abstract: An apparatus for providing arrhythmia information uses an esophageal probe having a longitudinal axis oriented in the direction of the esophagus where it is intended to be lodged, the probe comprising at least three electrode portions spaced in the longitudinal esophageal direction of the probe. The apparatus comprises a control unit, wherein the electrode portions are connected to the control unit, wherein the control unit is configured to detect potential differences between different pairs of the electrode portions. The control unit is configured to determine a repeating heart beat pattern as basis for a time resolved determination of the potential in the direction of the longitudinal axis and possibly also a perpendicular axis of the esophageal probe using compressive sensing. The apparatus is configured to provide a plot with the representation of the activation map as observed on the posterior wall or any other wall of the heart.

Abstract: Methods and systems for seamless adjustment of treatment are disclosed. A determination can be made as to whether to intervene with a patient's treatment based on data obtained from implantable electrodes and/or non-implantable electrodes. The data from non-implantable electrodes have a correction factor applied to adjust for less accuracy compared to data acquired from implantable electrodes.

Abstract: The disclosed physiological feedback systems and methods assist with assessing, monitoring and/or treating a patient experiencing a cardiac arrest event. The systems and methods receive multiple inputs and are continuous and/or iterative during a treatment session to provide physiological state trends of the patient. An index of the physiological state of the patient can be derived and confounders, and/or their effects, can be identified, and/or removed, from the index. Additionally, the systems and methods can assist with determining ischemic injury in a patient based on cerebral tissue oxygenation and/or other physiological data.

Abstract: An implantable medical device which performs the following steps during operation: a) performing a detection of whether the implantable medical device is in an implanted state; b) if it is detected that the implantable medical device is in an implanted state, activating a first diagnostic or therapeutic function of the implantable medical device, and subsequently activating a second diagnostic or therapeutic function of the implantable medical device, wherein the second diagnostic or therapeutic function is activated only after the fulfillment of at least one activation criterion selected from the group consisting of an elapse of a first time period from the activation of the first diagnostic or therapeutic function, an elapse of a second time period from the detection that the implantable medical device is in an implanted state, and a passing of a function test.

Abstract: Systems are provided for generating data representing electromagnetic states of a heart for medical, scientific, research, and/or engineering purposes. The systems generate the data based on source configurations such as dimensions of, and scar or fibrosis or pro-arrhythmic substrate location within, a heart and a computational model of the electromagnetic output of the heart. The systems may dynamically generate the source configurations to provide representative source configurations that may be found in a population. For each source configuration of the electromagnetic source, the systems run a simulation of the functioning of the heart to generate modeled electromagnetic output (e.g., an electromagnetic mesh for each simulation step with a voltage at each point of the electromagnetic mesh) for that source configuration.

Abstract: Systems and methods for controlling blood pressure via electrical stimulation of the heart are disclosed. Embodiments may include at least two different stimulation patterns, each configured to reduce blood pressure to a different degree, and may alternate between stimulation patterns based on the need of a patient, for example, alternating between day and night or between periods of strenuous and light activity. Some embodiments may take advantage of a slow baroreflex response that occurs after treatment is stopped, suspending treatment for extended periods, and then resuming treatment before blood pressure levels reach pretreatment values. Embodiments may control blood pressure by controlling atrial pressure and atrial stretch.

Abstract: Transcardiac diaphragmatic stimulation includes detecting a cardiac event based on signals sensed through a cardiac event sensor located in or on a region of a heart in proximity to a diaphragm, and delivering an ADS therapy through an ADS therapy mechanism that is located in proximity with the region of the heart, to induce a contraction of the diaphragm without inducing a contraction of the heart. The cardiac event sensor may be located a) on an interior surface of a cardiac wall that abuts the diaphragm, or 2) on an exterior surface of the heart, between a cardiac wall and the diaphragm. The ADS therapy mechanism may be located: a) on an interior surface of a cardiac wall that abuts the diaphragm, 2) on a superior surface of the diaphragm that abuts a cardiac wall, or 3) on an inferior surface of the diaphragm at a region of the diaphragm that abuts the heart.

Abstract: Medical apparatus includes a probe with a basket assembly at its distal end, including a plurality of resilient spines with multiple electrodes arrayed along a length of each of the spines. Processing circuitry is configured to acquire a first bipolar electrical signal from the tissue between first and second electrodes at first and second locations along a first spine of the basket assembly, and to acquire a second bipolar electrical signal from the tissue between the first electrode and a third electrode in a third location on a second spine of the basket assembly, and to interpolate, based on the first and second bipolar electrical signals, a vectorial electrical property of the tissue along an axis that passes through the first location and between the second and third locations.

Abstract: Pacemaker-initiated atrial fibrillation during competitive atrial pacing is a common arrhythmia with potentially serious consequences The novel pacing method proposes a novel way to automatically detect and diagnose competitive atrial pacing, and to deliver an intervention via a pacing stimulus in the atrium simultaneously with delivering a pacing stimulus in the ventricle, and doing this after a longer waiting period. By doing this, potentially hazardous scenarios causing atrial fibrillation in competitive atrial pacing are avoided, while the rhythm regularity and the synchrony between the upper and lower chambers of the heart are maintained. At the same time, the vicious cycle of retrograde conduction from the ventricle to the atrium—the culprit of the problem—is terminated and not allowed to reoccur for several subsequent cardiac cycles, thereby preventing the extended propagation of repetitive non-reentrant ventriculo-atrial synchrony.

Abstract: The present technology generally includes devices, systems, and methods for providing electrical stimulation to the left ventricle of a human heart in a patient suffering from Left Bundle Branch Block (LBBB). In particular, the present technology includes an implantable receiver-stimulator and an implantable controller-transmitter for leadless electrical stimulation of the heart. The receiver-stimulator can include one or more sensors capable of detecting the electrical conduction of the heart and the receiver-stimulator can be configured to pace the stimulation of the left ventricle based off the sensed electrical conduction to achieve synchronization of the left and right ventricles.

Abstract: Systems and methods for pacing cardiac conductive tissue are described. An embodiment of a medical system includes an electrostimulation circuit to generate His-bundle pacing (HBP) pulses to stimulate a His bundle, and a cardiac event detector to detect a His-bundle activity within a time window following an atrial activity. The cardiac event detector may use a cross-chamber blanking, or an adjustable His-bundle sensing threshold, to avoid or reduce over-sensing of far-field atrial activity and inappropriate inhibition of HBP therapy. The electrostimulation circuit may deliver HBP in the presence of the His-bundle activity. The system may further recognize the detected His-bundle activity as either a FFPW or a valid inhibitory event, and deliver or withhold HBP therapy based on the recognition of the His-bundle activity.

Abstract: Systems and methods are described herein for determining whether cardiac conduction system pacing therapy may be beneficial and/or determining how proximal or distal a cardiac conduction system block may be using external cardiac signals. To do so, one or more left-sided metrics of electrical heterogeneity information may be generated based on left-sided surrogate cardiac electrical measured using a plurality of left external electrodes.

Abstract: In some examples, an assembly for a medical device. The assembly includes a first electrode comprising a first conductive tab, and a first current collector; a second electrode including a second conductive tab, a second current collector, a third current collector, and at least one connector connecting the second current collector to the third current collector, wherein the second current collector and the third current collector are folded over each other about the at least one connector, wherein the second conductive tab is coupled to the second current collector, and wherein the third current collector is electrically coupled to second conductive tab via the at least one connector and the second current collector; and a foil package being sealed over the first conductive tab and the second conductive tab to partially enclose the first electrode and second electrode.

Abstract: System and methods for delivering defibrillator incident information to a PSAP in real-time during emergency use of an AED are described. Such information is utilized by a telecommunicator at a PSAP to provide better guidance to volunteer caregivers during potential cardiac arrest incidents. In another aspect the AED's current instruction state and optionally the time in that state is provided to the PSAP.

Abstract: Various aspects of the present subject matter relate to an implantable device. Various device embodiments comprise at least one port to connect to at least one lead with at least electrode, stimulation circuitry connected to the at least one port and adapted to provide at least one neural stimulation therapy to at least one neural stimulation target using the at least one electrode, sensing circuitry connected to the at least one port and adapted to provide a sensed signal, and a controller connected to the stimulation circuitry to provide the at least one neural stimulation therapy and to the sensing circuitry to receive the sensed signal. In response to a triggering event, the controller is adapted to switch between at least two modes. Other aspects and embodiments are provided herein.

Abstract: Systems and methods for determining a contact angle of a catheter relative to tissue are provided. In one embodiment, a system includes a catheter with three or more electrodes, and a processor circuit in communication with the catheter. The processor circuit controls the three or more electrodes to emit a plurality of electrical voltages and to measure the plurality of electrical voltages. Based on the measured electrical voltages, the processor circuit calculates a first interelectrode impedance and a second interelectrode impedance. The processor circuit calculates, for each of a plurality of hypothetical i.e. model angles, a first hypothetical i.e. model contact force and a second hypothetical i.e. model contact force based on the first and second interelectrode impedances. The processor circuit determines and outputs the contact angle of the catheter based on a comparison of the first and second model contact forces calculated for each of the plurality of model angles.

Abstract: In some examples, an implantable medical device includes a battery, an electronics module electrically connected to the battery, and an elongated housing comprising a side wall positioned between the battery and an end cap, wherein the electronics module is positioned within the elongated housing between the battery and the end cap. The implantable medical device also includes an electrical contact assembly comprising a first spring contact and a second spring contact. The electrical contact assembly of the implantable medical device is positioned within the elongated housing between the electronics module and the battery or the end cap.

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.