Systems, methods and implantable devices configured to provide cardiac resynchronization therapy and/or bradycardia pacing therapy. A first device located in the heart of the patient is configured to receive a communication from a second device and deliver a pacing therapy in response to or in accordance with the received communication. A second device located elsewhere is configured to determine an atrial event has occurred and communicate to the first device to trigger the pacing therapy. The second device may be configured for sensing the atrial event by the use of vector selection and atrial event windowing, among other enhancements. Exception cases are discussed and handled as well.

Various embodiments of a die carrier package and a method of forming such package are disclosed. The package includes one or more dies disposed within a cavity of a carrier substrate, where a first die contact of one or more of the dies is electrically connected to a first die pad disposed on a recessed surface of the cavity, and a second die contact of one or more of the dies is electrically connected to a second die pad also disposed on the recessed surface. The first and second die pads are electrically connected to first and second package contacts respectively. The first and second package contacts are disposed on a first major surface of the carrier substrate adjacent the cavity.

A pacemaker system includes a drive-sense circuit (DSC) operably coupled to a pacemaker lead. The DSC generates a pace signal including electrical impulses based on a reference signal. The DSC provides the pace signal via the pacemaker lead to an electrically responsive portion of a cardiac conductive system of a subject to facilitate cardiac operation of a cardiovascular system of the subject. The DSC senses, via the pacemaker lead, cardiac electrical activity of the cardiovascular system of the subject that is generated in response to the pace signal and electrically coupled into the pacemaker lead and generates a digital signal that is representative of the cardiac electrical activity of the cardiovascular system of the subject that is sensed via the pacemaker lead. The DSC provides digital information to one or more processing modules that includes and/or is coupled to memory and that provide the reference signal to the DSC.

Systems and methods are disclosed to determine a measure of patient weight using existing medical device sensors, comprising receiving acceleration information of a patient and, if a value of the acceleration information exceeds an activity threshold over a measurement window, detecting patient steps in the measurement window using the acceleration information, determining a patient step rate over the measurement window using the detected patient steps, determining a measure of patient step force for the measurement window, and determining a measure of patient weight using the determined patient step rate and measure of patient step force.

Embodiments described herein can reduce a burden associated with analyzing EGM segments obtained from an IMD that monitors for arrhythmic episodes. Respective EGM data and respective classification data is obtained for each arrhythmic episode detected by the IMD during a period of time. A representative R-R interval or HR for each of the arrhythmic episodes is also obtained, wherein a manner for determining the representative R-R interval or HR depends on the type of the arrhythmic episode, such that for at least two different types of arrhythmic episodes the manners differ. One or more arrhythmic episodes is/are selected for which corresponding EGM segments are to be displayed for each type of arrhythmic episode, wherein the selecting is performed based on the representative R-R intervals or HRs that are determined for the plurality of arrhythmic episodes. Additional and alternative embodiments are also described herein.

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

Disclosed herein are medical products, including an implantable device coated with a crosslinked extracellular matrix comprising at least one of Type IV collagen and laminin, wherein the crosslinked extracellular matrix contains no more than 0.024 mg/ml total concentration of glucose, amino acids and salts having a molecular weight of 2000 daltons or less. Corresponding systems and method also are disclosed.

Techniques and devices for implementing the techniques for adjusting atrial arrhythmia detection based on analysis of one or more P-wave sensing windows associated with one or more R-waves. An implantable medical device may determine signal characteristics of the cardiac signal within the P-wave sensing window, determine whether the cardiac signal within the sensing window corresponds to a P-wave based on the determined signal characteristics, determine a signal to noise ratio of the cardiac signal within the sensing window, update the arrhythmia score when the P-wave is identified in the sensing window and the determined signal to noise ratio satisfies a signal to noise threshold.

Systems and methods for detecting worsening cardiac conditions such as worsening heart failure events are described. A system may include sensor circuits to sense physiological signals and signal processors to generate from the physiological signals first and second signal metrics. The system may include a risk stratifier circuit to produce a cardiac risk indication. The system may use at least the first signal metric to generate a primary detection indication, and use at least the second signal metric and the risk indication to generate a secondary detection indication. The risk indication may be used to modulate the second signal metric. A detector circuit may detect the worsening cardiac event using the primary and secondary detection indications.

A method of detecting an improvement in a seizure condition of a patient includes identifying a first EEG synchronization of the seizure condition of the patient; applying a therapy configured to improve the seizure condition of the patient; and identifying a second EEG synchronization of the seizure condition of the patient subsequent to application of the therapy, wherein an improvement of the seizure condition of the patient is demonstrated by a reduced EEG synchronization of the patient such that the second EEG synchronization is less than the first EEG synchronization.