A method comprising detecting an epileptic event in a patient; applying an electrical therapy to a first target area in at least one of a brain region or a cranial nerve of said patient in response to said detecting; receiving a body signal responsive to the electrical therapy, wherein said body signal is selected from an autonomic signal, a neurologic signal, a metabolic signal, an endocrine signal, or a tissue stress marker signal; determining whether said body signal indicates that said electrical therapy has an efficacious effect; and terminating the application of said electrical therapy if the response indicates that the electrical therapy has an efficacious effect. An apparatus capable of performing the method. A non-transitive, computer-readable storage device for storing data that when executed by a processor, perform the method.

An implantable medical device system is configured to sense cardiac events in response to a cardiac electrical signal crossing a cardiac event sensing threshold. A control circuit is configured to determine a drop time interval based on a heart rate and control a sensing circuit to hold the cardiac event sensing threshold at a threshold value during the drop time interval.

A subcutaneously implantable device is implantable into a body of a patient, and includes a prong and an electrode. The prong has a contact portion at or adjacent to a distal end thereof that is configured to contact an organ. The prong is constructed to apply pressure to the organ with spring action so as to maintain contact between the contact portion and the organ without fixing the contact portion to the organ. The electrode is provided at the contact portion of the prong, is configured to contact the organ, and is electrically coupled or couplable with circuitry that is configured to provide monitoring, therapeutic, and/or diagnostic capabilities with respect to the organ.

A patient-worn ambulatory cardiac monitoring device for monitoring a patient during a patient activity includes at least one physiological sensor configured to detect signals indicative of cardiac activity, an activity sensor and associated circuitry configured to monitor patient movements, and a vibrational sensor configured to monitor a cardio-vibrational signal of the patient. The at least one physiological sensor can include one of an ECG sensor and a heart rate sensor. At least one processor in communication with the at least one physiological sensor, the activity sensor, and the vibrational sensor, is configured to measure, during the patient activity, at least one time interval between an ECG fiducial point in an ECG signal and a cardio-vibrational fiducial point in the cardio-vibrational signal during a cardiac cycle of the patient's heart.

A medical device system determines first values associated with a first plurality of patient parameters associated with arrhythmic substrate and/or physiological triggers for acute cardiac events based on a first one or more of the physiological signals generated during the period and determines, based on the first values associated with the first plurality of patient parameters, whether to assess alterations in cardiac cellular electrophysiology and/or mechanical alterations of the patient. The system may, in response to determining to assess the alterations in cardiac cellular electrophysiology, determine second values associated with a second plurality of patient parameters relating to cardiac electrophysiology based on a second one or more of the physiological signals generated during the period and determine whether to generate an alert indicating that an acute cardiac event of the patient is predicted based at least in part on the second values associated with the second plurality of patient parameters.

A subcutaneously implantable device is implantable into a body of a patient, and includes a prong and an electrode. The prong has a contact portion at or adjacent to a distal end thereof that is configured to contact an organ, a nerve, and/or a tissue of the patient. The prong is constructed to apply pressure to the organ, the nerve, and/or the tissue so as to maintain contact between the contact portion and the organ, the nerve, and/or the tissue without fixing the contact portion to the organ, the nerve, and/or the tissue. The electrode is provided at the contact portion of the prong, is configured to contact the organ, the nerve, and/or the tissue, and is electrically coupled or couplable with circuitry that is configured to provide monitoring, therapeutic, and/or diagnostic capabilities with respect to the organ, the nerve, and/or the tissue.

An implantable medical device (IMD) is provided and includes electrodes configured to be located in or about a heart. The electrodes include a bipolar electrode combination that define a bipolar sensing vector. The electrodes include a unipolar electrode combination that define a unipolar sensing vector. The IMD includes sensing circuitry configured to define a first sensing channel coupled to the bipolar electrode combination and a second sensing channel coupled to the unipolar electrode combination. The IMD includes memory to store program instructions and one or more processors configured to implement the program instructions to collect cardiac activity (CA) signals over the first and second sensing channels for a series of beats, identify a sensed interval delta (SID) from the CA signals for at least a portion of the series of beats, the SID representing a timing interval between i) a COI in the CA signals collected over the first sensing channel and ii) the same COI in the CA signals collected over the second sensing channel; and designate the series of beats to correspond to be a polymorphic ventricular tachycardia (PVT) or a monomorphic ventricular tachycardia (MVT) based on the SID.

A medical device is configured to deliver anti-tachycardia pacing (ATP) in the presence of T-wave alternans. The device is configured to detect a ventricular tachyarrhythmia from a cardiac electrical signal received by the medical device. In response to the detected ventricular tachyarrhythmia, the device delivers a plurality of ATP pulses at alternating time intervals. The alternating time intervals comprise at least a first ATP time interval separating a first pair of the ATP pulses and a second ATP time interval different than the first ATP time interval. The second ATP time interval consecutively follows the first ATP time interval and separates a second pair of the ATP pulses.

Techniques are disclosed for detecting arrhythmia episodes for a patient. A medical device may receive one or more sensor values indicative of motion of a patient. The medical device may determine, based at least in part on the one or more sensor values, an activity level of the patient. The medical device may determine a heart rate threshold for triggering detection of an arrhythmia episode based at least in part on the activity level of the patient. The medical device may determine whether to trigger detection of the arrhythmia episode for the patient based at least in part on comparing a heart rate of the patient with the heart rate threshold. The medical device may, in response to triggering detection of the arrhythmia episode, collect information associated with the arrhythmia episode.

A system and methods of maintaining communication with a medical device for exchange of information, instructions, and programs, in a highly reliable manner. Apparatus and methods for accomplishing this task include: 1) The inclusion of a locating device in the system, in close proximity to an implanted device, but which does not drain the implanted device battery. 2) The use of motion detection and global positioning system devices to locate elements within a communicating system for the medical device; 3) The assessment of received signal quality by elements of the system; 4) The use of a notification system for a device user who is moving out of range of communications; and 5) Documenting the absolute and functional integrity of instructions received by the medical device. A method of assuring the identification of communication participants is presented.