Abstract: The present disclosure relates generally to systems, methods, and devices for interpreting neural signals to determine a desired movement of a target, transmitting electrical signals to the target, and dynamically monitoring subsequent neural signals or movement of the target to change the signal being delivered if necessary, so that the desired movement is achieved. In particular, the neural signals are decoded using a feature extractor, decoder(s) and a body state observer to determine the electrical signals that should be sent.

Abstract: A medical device is utilized to monitor physiological parameters of a patient and capture segments of the monitored physiological parameters. The medical device includes circuitry configured to monitor one or more physiological parameters associated with the patient and an analysis module that includes a buffer and a processor. The buffer stores monitored physiological parameters and the processor analyzes the monitored physiological parameters and triggers capture of segments from the buffer in response to a triggering criteria being satisfied. The analysis module selects a pre-trigger duration based at least in part on the triggering criteria.

Abstract: A method of treating a patient having a blood pressure comprises delivering neuromodulation therapy to sustain or increase the blood pressure. The neuromodulation therapy includes placing a sympathetic therapy electrode in a posterior portion of a blood vessel and stimulating at least one extravascular cardiac sympathetic nerve fiber using said electrode.

Abstract: An assembly for placement of a cardiac, aortic or arterial implant. The assembly includes an insertion sheath of an introducer or of a delivery catheter, which is of a size smaller than that of an introducer, intended to be introduced into an artery of a human body. The metal support of an electrode of the external cardiac stimulator being integrated into the insertion sheath of a peripheral venous or arterial accessory catheter, or a sleeve around the accessory catheter, which is introduced into the peripheral vein or artery of a patient. The sheath of the accessory catheter or the sleeve is therefore directly in contact with a peripheral vein or artery of the patient.

Abstract: Provided is a method for displaying electrocardiogram (ECG) data for the detection of myocardial ischemia, wherein a map is configured in the form of concentric circles using ST segments obtained through ECG measurement such that the inner circle consists of a “depression” origin and the outer circle consists of an “elevation” origin so as to display by connecting graphs or dots according to the measured ECG values of limb leads (frontal plane leads; I to aVF) and chest leads (precordial plane leads; V1 to V6), and the intuitive confirmation of the presence of subendocardial ischemia or transmural injury is enabled through the map, thereby making it possible to quickly and accurately recognize the patient's conditions and inducing prompt treatment.

Abstract: Implantable devices and systems include one or more leads adapted to be emplaced in the internal thoracic vein (ITV) of a patient. The lead may include features to adapt the lead for such placement. An associated device for use with the lead may include operational circuitry adapted for use with a lead having an electrode for sensing and/or therapy purposes coupled thereto. Methods for implantation and use of such devices and systems are disclosed as well.

Abstract: A method is provided for treating a patient with an arrhythmia. In some embodiments, the method collects a first patient arrhythmia cardiogram from the patient. The method identifies a first target location and a first ablation pattern associated with a first library arrhythmia cardiogram that is similar to the first patient arrhythmia cardiogram. The method then performs a first ablation near the first target location, factoring in the first ablation pattern, and after the ablation, collects a second patient arrhythmia cardiogram of the patient. The method continues to identify a second target location and a second ablation pattern associated with a second library arrhythmia cardiogram that is similar to the second patient arrhythmia cardiogram. The second library arrhythmia cardiogram is identified, in part, based on ablation characteristics of the first ablation. The method then performs a second ablation near the second target location, factoring in the second ablation pattern.

Abstract: A stretch-measurement probe includes an elongate outer sleeve, expansion feature associated with a distal portion of the outer sleeve, and an elongate inner rod disposed at least partially within the outer sleeve. The expansion feature is configured to allow a longitudinal distance between a proximal end of the outer sleeve and the distal end of the outer sleeve to be varied.

Abstract: A method and apparatus for treatment of hypertension and heart failure by increasing vagal tone and secretion of endogenous atrial hormones by excitory pacing of the heart atria. Atrial pacing is done during the ventricular refractory period resulting in atrial contraction against closed AV valves, and atrial contraction rate that is higher than the ventricular contraction rate. Pacing results in the increased atrial wall stress. An implantable device is used to monitor ECG and pace the atria in a nonphysiologic manner.

Abstract: Devices, systems and methods are disclosed for treating a variety of diseases and disorders that are primarily or at least partially driven by an imbalance in neurotransmitters in the brain, such as asthma, COPD, depression, anxiety, epilepsy, fibromyalgia, and the like. The invention involves the use of an energy source comprising magnetic and/or electrical energy that is transmitted non-invasively to, or in close proximity to, a selected nerve to temporarily stimulate, block and/or modulate the signals in the selected nerve such that neural pathways are activated to release inhibitory neurotransmitters in the patient's brain.

Abstract: The present invention is directed to transcutaneous electrical nerve stimulation (TENS) devices which utilize novel stimulation waveforms and novel arrangements of TENS electrodes to improve the efficiency of power consumption while enhancing therapeutic effects.

Abstract: One aspect is a system for reception or emission of an electrical signal from or into the human or animal body, comprising at least one insulated electrical conductor; a sleeve-shaped electrode that is electrically connected to the electrical conductor and includes an internal side, an external side, and a channel, wherein the channel defines a longitudinal axis along which the conductor is arranged. According to one embodiment, the conductor extends without interruption along the entire area of the electrode, and the electrode further includes a slit that extends from the internal side to the external side of the electrode and in which the conductor is appropriately arranged in the slit such that the electrode forms a direct durable mechanical and electrical connection to the conductor.

Abstract: The invention relates to an active implantable medical device comprising a processing unit able to be alternately operated during a predetermined period of activity and on standby during a standby period in a cyclical manner, and means for acquiring data relating to physiological and/or physical activity. The device also comprises means for calculating a frequency analysis of the data acquired, said calculating means being capable of successively perform part of the frequency analysis during periods of activity of the processing unit.

Abstract: In some implementations, a system enables an administrator to customize a set of rules to dynamically adjust the configuration and output of an application provided to users. A configuration interface for setting rules that dynamically adjust output of an application is provided. Data indicating one or more rules are received through the configuration interface. Activity data indicating user interaction with the application or sensor data for at least some of a plurality of users of the application are then received from multiple client devices. A determination relating to the activity data satisfying at least one condition or trigger is then made. Instructions to adjust output of the application according to one or more system actions of the one or more rules are then communicated to client devices associated with the users in the first subset of the plurality of users.

Abstract: Systems, devices, and methods for monitoring and assessing immunotherapy toxicity are discussed. An exemplary system receives physiologic information from a patient using an ambulatory medical device. In response to an immunotherapy such as CAR T-cell therapy, the system determines a toxicity indication using the received physiologic information. A therapy can be initiated or adjusted using the toxicity indication.

Abstract: Method for recovering and stabilizing normal heart rate of patients suffering in or being inclined to having atrial fibrillation, comprising the step of sensing primary electrical pulses generated in the right atrium (1), of generating artificial electrical stimulation pulses coordinated with the sensed pulses and stimulating therewith the portion of the left atrium (9) which is remote from the right atrium (1), whereby increasing the areas of the heart muscles that can be reached during a simulation pulse within a predetermined period of time.

Abstract: A device and method for monitoring the heart rate of a patient for a bradyarrhythmia event and thereafter administering medications is disclosed. The method comprises the steps of monitoring heart rate via at least one sensor secured to the neck or head of a patient; and if a bradyarrhythmia event is determined; applying an anticholinergic medication to the conjunctiva of at least one eye and releasing ammonia vapor in close proximity to the nostrils of a patient.

Abstract: Systems, devices, and methods for monitoring for atrial capture are disclosed. Such a method, for use within an implantable system including an atrial leadless pacemaker (aLP) and a ventricular leadless pacemaker (vLP), includes storing within a memory of the vLP a paced atrial activation morphology template corresponding to far-field atrial signal components expected to be present in a vEGM sensed by the vLP when an atrial pacing pulse delivered by the aLP captures atrial tissue. The vLP senses a vEGM and compares a morphology of a portion of the sensed vEGM to the paced atrial activation morphology template to determine whether a match therebetween is detected. Additionally, the vLP determines whether atrial capture occurred or failed to occur (responsive to an atrial pacing pulse), based on whether the vLP detects a match between the morphology of a portion of the sensed vEGM and the paced atrial activation morphology template.

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: Apparatus and methods for determining positioning of a energy delivery element include deploying a energy delivery element at a treatment site proximal to a vessel wall; using a multi-region pressure sensing apparatus to sense pressures applied in a plurality of directions about the energy delivery element; and determining an orientation of the energy delivery element based on the pressures measured in the plurality of directions about the energy delivery element.

Abstract: In an embodiment, an electrogram (EGM) processing system provides, for display by a head-mounted display (HMD) worn by a user, a holographic rendering of intracardiac geometry. The HMD also displays an electrogram waveform. The EGM processing system determines a gaze direction of the user by processing sensor data from the HMD. The HMD displays a marker overlaid on the electrogram waveform at a location based on an intersection point between the gaze direction and the electrogram waveform. The EGM processing system determines a measurement of the electrogram waveform using the location of the marker. The HMD displays the measurement of the electrogram waveform.

Abstract: A medical device includes: a case at least a portion of which functions as a first electrode; a second electrode disposed in a header coupled to the case; a core assembly, the core assembly including operational circuitry enclosed within a core assembly housing, wherein the case includes the core assembly housing; and a battery assembly, the battery assembly including a battery enclosed within a battery housing, where the case further comprises the battery housing; where the operational circuitry is configured to drive a regulated voltage onto the case.

Abstract: A probe generates location signals, and has an electrode at a distal end which acquires from heart chamber surface positions electrical signals due to a conduction wave traversing the surface. A processor derives LATs from the electrical signals, calculates a first time difference between LATs at a first pair of positions and a second time difference between LATs at a second pair of positions. The processor calculates first and second LAT-derived distances as products of the first and second time differences with a conduction wave velocity, identifies an arrhythmia origin at a surface location where a first difference in distances from the location to the first pair of the positions is equal to the first LAT-derived distance, and a second difference in distances from the location to the second pair of the positions is equal to the second LAT-derived distance, and marks the origin on a surface representation.

Abstract: Apparatus and methods are described, including a stent configured to be placed in a lumen. The stent includes a generally cylindrical stent body including a plurality of struts, at least one electrode post protruding from the stent body, and a plurality of antenna posts protruding longitudinally from an end of the stent body. The antenna posts are longitudinally separated from the electrode post. An antenna is disposed annularly on the antenna posts, such that the antenna posts separate the antenna from the end of the stent body, and at least one electrode is coupled to the stent by being placed on the electrode post. Additional embodiments are also described.

Abstract: An implantable medical device implements a special mode of operation, such as a mode of electrical stimulation therapy, during conditions where there may be an increased likelihood that a device reset will occur. The implantable medical device recovers from the device reset by copying values that specify the special mode and that are stored in a non-volatile memory to an operating memory. The special mode is implemented after the device reset has occurred by using the values copied to the operating memory. One version of the special mode is an MRI mode that allows the implantable medical device to safely operate during an MRI scan. The fields of the MRI scan may trigger a device reset, but the MRI mode values are copied from the non-volatile memory to the operating memory, and the MRI mode is implemented after the reset by using the values copied to the operating memory.

Abstract: A method that electrically stimulates a heart muscle to alter the ejection profile of the heart, to control the mechanical function of the heart and reduce the observed blood pressure of the patient. The therapy may be invoked by an implantable blood pressure sensor associated with a pacemaker like device. In some cases, where a measured pretreatment blood pressure exceeds a treatment threshold, a patient's heart may be stimulated with an electrical stimulus timed relative to the patient's cardiac ejection cycle. This is done to cause dyssynchrony between at least two cardiac chambers or within a cardiac chamber, which alters the patient's cardiac ejection profile from a pretreatment cardiac ejection profile. This has the effect of reducing the patient's blood pressure from the measured pretreatment blood pressure.

Abstract: VfA cardiac therapy uses an implantable medical device or system. The implantable medical device includes a tissue-piercing electrode implanted in the basal and/or septal region of the left ventricular myocardium of the patient's heart from the triangle of Koch region of the right atrium through the right atrial endocardium and central fibrous body. The device may include a right atrial electrode, a right atrial motion detector, or both. The device may be implanted completely within the patient's heart or may use one or more leads to implant electrodes in the patient's heart. The device may be used to provide cardiac therapy, including single or multiple chamber pacing, atrioventricular synchronous pacing, asynchronous pacing, triggered pacing, cardiac resynchronization pacing, or tachycardia-related therapy. A separate medical device may be used to provide some functionality for cardiac therapy, such as sensing, pacing, or shock therapy.

Abstract: An active implantable medical device for neurostimulation therapy is disclosed. The device produces stimulation pulse sequences generated continuously in succession during activity periods separated by intermediate inactivity periods during which no stimulation is issued. An input signal, provided by a physiological sensor, representative of cardiac activity and/or of the patient's hemodynamic status is received by circuitry. The circuitry further provides for dynamic control of the neurostimulation therapy, wherein the length of activity periods is modulated based on the current value level of the control parameter compared to a threshold. The duration of the next period of inactivity is calculated by the circuitry at the end of each activity period to maintain a constant duty cycle ratio between periods of activity and periods of inactivity.

Abstract: A polymerizable unit that yields an electrochemically responsive polymer (advantageously pyrrole) is anchored by polymerization within a polycaprolactone matrix to form an electroactive scaffold upon which cells can be cultured and in which the micro- and nano-topological features of the polycaprolactone matrix are preserved. A scaffold manufactured in accordance with the preferred embodiment can support Schwann cells, which produce nerve growth factor when electrically stimulated. Nerve growth factor has been demonstrated to promote the regeneration of nerve tissue. By implanting the scaffold on which Schwann cells have been cultured into damaged nerve tissue and applying a voltage across the scaffold, nerve growth factor is produced, thereby promoting repair of the damaged nerve tissue.

Abstract: Methods and systems for treating cardiac malfunction are disclosed, which according to an embodiment, may involve delivering a stimulation pattern of stimulation pulses to at least one cardiac chamber of a heart, with at least one of the stimulation pulses having a first stimulation setting configured to reduce at least one of end systolic volume (ESV) and end diastolic volume (EDV) in the heart and at least one of the stimulation pulses having a second stimulation setting different from the first stimulation setting, and with the stimulation pattern being configured to reduce the at least one of end systolic volume (ESV) and end diastolic volume (EDV) by at least 5% and maintain the at least one of end systolic volume (ESV) and end diastolic volume (EDV) on average at such reduced volume for a time period of at least one hour.

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: Systems, methods, and devices, including computer-readable media, for managing operation of devices in complex systems and changing environments. In some implementations, a server system stores data indicating management plans for each of a plurality of different devices, each management plan indicating a device-specific set of program states for programs in a predetermined set of programs. The server system alters the management plans and enforces interdependence of the programs, and the server system generates a customized instruction that alters operation of the device according to the device-specific set of program states assigned in the altered management plan for the device. The server system causes each device to perform one or more operations of the device determined according to the device-specific set of program states assigned in the altered management plan for the device.

Abstract: Methods and systems for alleviating disorders and complications associated with autonomic nervous system dysfunction. The approach generally includes measuring heart rate signals from a subject to measure heart rate variability and determine a heart rate variability threshold, determining that the subject is experiencing autonomic nervous system dysfunction, and alerting the subject to stimulate the auricular branch of the vagus nerve with an ear device.

Abstract: A stimulation control unit that outputs a stimulation signal for reducing a myocardial workload to an electrode for stimulation inserted in a blood vessel running in the vicinity of the vagus nerve of a patient in order to stimulate the vagus nerve; a detecting unit that detects first biological information and second biological information of the patient; a setting unit that sets threshold information for determining a normal range of the first biological information and second biological information; and a determining unit that determines whether or not values of the detected first biological information and second biological information are within the normal range determined in the threshold information; where the stimulation control unit adjusts the intensity of the stimulation signal such that the values of the first biological information and second biological information are within the normal range, and the value of the second biological information is reduced by a predetermined ratio or more as compar

Abstract: Electrical stimulation, including high frequency stimulation, for altering autonomic functions, and associated systems and methods are disclosed. A representative method includes directing an electrical signal to a target tissue at (a) a ventral region of the patient's spinal canal, (b) a sympathetic chain structure, or (c) both (a) and (b), at a frequency in a range from 1 kHz to 100 kHz, and an amplitude that does not generate an objectionable, patient-detectable sensation.

Abstract: Methods and systems are provided for a rate adaptive bi-ventricular fusion pacing. The methods and systems deliver a first pulse at a left ventricular (LV) lead and a second pulse at a right ventricular (RV) lead based on a paced atrio-ventricular (AV) delay. The first pulse timed to be delivered concurrently with an intrinsic ventricular conduction. The methods and systems further repeat the delivery of the first pulse and the second pulse for a predetermined number of cycles. Additionally, the methods and systems measure an intrinsic AV conduction interval, and adjust the paced AV delay based on the intrinsic AV conduction interval and a negative hysteresis delta.

Abstract: A method for implanting a replacement heart valve within a diseased valve includes accessing a patient's heart by piercing a myocardium, advancing a guidewire into the patient's heart, and installing an access device in a wall of the heart. The access device preferably has at least one valve mechanism. A valve delivery device is advanced over the guidewire and through the access device. The valve delivery device has a replacement heart valve disposed along a distal end portion thereof. The replacement heart valve preferably includes an outer support structure and a leaflet valve disposed within the outer support structure. The replacement heart valve is radially expanded within the diseased valve. During implantation, the outer support structure conforms to a diameter of the diseased valve and the leaflet valve expands to a fixed size having a diameter smaller than the diameter of the diseased valve.

Abstract: A medical device is configured to generate fluid status signal data of a patient by determining impedance metrics from an impedance signal, determining cardiac electrical signal amplitudes from a cardiac electrical signal and determining a calibration relationship between the impedance metrics and cardiac electrical signal amplitudes. The medical device generates a fluid status signal data by adjusting cardiac electrical signal amplitudes according to the determined calibration relationship. The fluid status signal data may be displayed or monitored for detecting a change in the patient's fluid status.

Abstract: A subcutaneous implantable medical device and method (SIMD) provided. A pulse generator (PG) is configured to be positioned subcutaneously within a lateral region of a chest of a patient. The PG has a housing that includes a PG electrode. The PG has an electronics module. An elongated lead is electrically coupled to the pulse generator. The elongated lead includes a first electrode that is configured to be positioned along a first parasternal region proximate a sternum of the patient and a second electrode that is configured to be positioned at an anterior region of the patient. The first and second electrodes are coupled to be electrically common with one another. The electronics module is configured to provide electrical shocks for antiarrhythmic therapy along at least one shocking vector between the PG electrode and the first and second electrodes.

Abstract: An external wearable medical device includes an electrode to detect patient cardiac activity; a therapy electrode to provide a therapy in response to detecting an arrhythmia event; a GUI display comprising a caregiver interface and a patient interface; and a processor configured to provide, to the caregiver interface, a first set of information that includes information for operating the device in conjunction with the patient and an alert history of the device including an indication of one or more detected arrhythmia events, provide, to the patient interface, a second set of information that includes information for allowing the patient to cause the device to suspend providing the therapy and a direction to the patient to contact a caregiver responsive to detecting an event affecting at least one of the device and the patient, and responsive to detecting the event, automatically transmitting a notification of the event to an external entity.

Abstract: A method for delivering energy as a function of degree coupling may utilize an external unit configured for location external to a body of a subject and at least one processor associated with the implant unit and configured for electrical communication with a power source. The method may determine a degree of coupling between the primary antenna and a secondary antenna associated with the implant unit, and regulate delivery of power to the implant unit based on the degree of coupling between the primary antenna and the secondary antenna.

Abstract: A method and system of providing therapy to a patient implanted with an array of electrodes is provided. A train of electrical stimulation pulses is conveyed within a stimulation timing channel between a group of the electrodes to stimulate neural tissue, thereby providing continuous therapy to the patient. Electrical parameter is sensed within a sensing timing channel using at least one of the electrodes, wherein the first stimulation timing channel and sensing timing channel are coordinated, such that the electrical parameter is sensed during the conveyance of the pulse train within time slots that do not temporally overlap any active phase of the stimulation pulses.

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: An electrode lead for the coronary sinus, with a lead body that has a distal section for insertion into the coronary sinus, and at least one electrode to make contact with body tissue, the at least one electrode being arranged on the distal section of the lead body. The electrode lead has a fixation device that can be extended out of the lead body to fix the electrode lead in a blood vessel.

Abstract: In some examples, medical device systems that deliver anti-tachyarrhythmia shock(s) (e.g., defibrillation shock(s)) to a heart of a patient in coordination with the respiration of the patient. In one example, a medical device system including therapy generation circuitry configured to generate a defibrillation shock. The medical device system also includes processing circuitry configured to identify a time at which a respiratory volume of a lung of a patient is at approximately end tidal volume or less; and control the therapy generation circuitry to deliver the defibrillation shock to a heart of the patient at the time that the respiratory volume of the lung of a patient is at the approximately end tidal volume or less.

Abstract: VfA cardiac therapy uses an implantable medical device or system. The implantable medical device includes a tissue-piercing electrode implanted in the basal and/or septal region of the left ventricular myocardium of the patient's heart from the triangle of Koch region of the right atrium through the right atrial endocardium and central fibrous body. The device may include a right atrial electrode, a right atrial motion detector, or both. The device may be implanted completely within the patient's heart or may use one or more leads to implant electrodes in the patient's heart. The device may be used to provide cardiac therapy, including single or multiple chamber pacing, atrioventricular synchronous pacing, asynchronous pacing, triggered pacing, cardiac resynchronization pacing, or tachycardia-related therapy. A separate medical device may be used to provide some functionality for cardiac therapy, such as sensing, pacing, or shock therapy.

Abstract: Systems and methods are provided for detecting arrhythmias in cardiac activity is provided. The systems and methods include measuring conduction delays between an atria (A) and multiple left ventricular (LV) electrodes to obtain multiple intrinsic A/LV intervals, measuring conduction delays between a right ventricular (RV) and the multiple LV electrodes to obtain multiple intrinsic VV intervals. The systems and methods include calculating a first atrial ventricular (AV) delay based on at least one of the intrinsic A/LV intervals, and calculating a second AV delay based on at least one of the intrinsic VV intervals. The systems and methods include selecting a biventricular (BiV) pacing mode or an LV only pacing mode based on a relation between the first and second AV delays, and delivering a pacing therapy based on the selecting operation.

Abstract: Cardiac resynchronization therapy (CRT) delivered to a heart of a patient may be adjusted based on detection of a surrogate indication of the intrinsic atrioventricular conduction of the heart. In some examples, the surrogate indication is determined to be a sense event of the first depolarizing ventricle of the heart within a predetermined period of time following the delivery of a fusion pacing stimulus to the later depolarizing ventricle. In some examples, the CRT is switched from a fusion pacing configuration to a biventricular pacing configuration if the surrogate indication is not detected, and the CRT is maintained in a fusion pacing configuration if the surrogate indication is detected.

Abstract: Systems and methods for pacing cardiac conductive tissue are described. In an embodiment, a medical system includes an electrostimulation circuit to generate His-bundle pacing (HBP) pulses. A sensing circuit senses an atrial activation. A control circuit detects a retrograde atrial conduction timing, such as a His-to-atrial interval between the HBP pulse and the sensed atrial activation in response to the HBP pulse, and verifies capture status using the determined retrograded atrial conduction timing. Based on the capture status, the control circuit determines a HBP threshold, and the electrostimulation circuit delivers HBP pulses in accordance with the determined HBP threshold.

Abstract: A computer implemented method and device for providing dual chamber sensing with a single chamber leadless implantable medical device (LIMD) are provided. The method is under control of one or more processors in the LIMD configured with specific executable instructions. The method obtains a far field (FF) cardiac activity (CA) signals for activity in a remote chamber of a heart and compares the far field CA signals to a P-wave template to identify an event of interest associated with the remote chamber. The method sets an atrial-ventricular (AV) delay based on the P-wave identified and delivers pacing pulses at a pacing site of interest to a local chamber based on the AV delay.