Systems and methods for dynamically controlling His-bundle pacing (HBP) according to an indication of a rate-related or intermittent atrioventricular (AV) block in a subject are disclosed. An exemplary medical system includes an AV conduction monitor to detect an indication of either a presence or an absence of intermittent or rate-related AV conduction disturbance using physiologic information of the subject. In the event that an intermittent or rate-related AV conduction disturbance is present, a control circuit provides a control signal to an electrostimulation circuit to deliver HBP pulses. If there is no indication of intermittent or rate-related AV conduction disturbance, or a previously detected intermittent or rate-related AV conduction disturbance has been terminated, the control circuit withholds or discontinues delivery of the HBP pulses to promote intrinsic ventricular conduction and activation.

The embodiments described herein relate to a self-positioning, quick-deployment low profile transvenous electrode system for sequentially pacing both the atrium and ventricle of the heart in the “dual chamber” mode, and methods for deploying the same.

A system and method for improving heart contractions during a heart function cycle (heartbeat) of a patient requires detecting a local electrical event (depolarization) during the cycle. This local electrical event is then used to trigger a stimulation interval Δt at a time t.sub.0. Importantly, the stimulation interval Δt is set to end at a time t.sub.1 during the absolute refractory period of the heart function cycle. At the time t.sub.1, a stimulator is triggered to stimulate a local sympathetic nerve on the epicardial surface of the heart. With this stimulation the sympathetic nerve secretes norepinephrine to improve a subsequent contraction of the heart.

A medical device is configured to deliver His-Purkinje pacing pulses according to multiple settings of a pacing control parameter and determine an electromechanical time delay from a ventricular electrical event to a fiducial point of the pressure signal for each of the pacing control parameter settings. The medical device may be configured to select an operating pacing control parameter from the pacing control parameter settings based on a determined electromechanical time delay being less than a threshold interval. The medical device may deliver pacing pulses to the His-Purkinje conduction system according to the selected operating pacing control parameter.

The disclosure relates to a method for improving pacing settings of a pace maker, comprising: receiving a set of pacing settings for the pace maker; receiving measurements or fluid mechanics data relating to the heart of a subject for all or part of the pacing settings of the set; estimating hemodynamic forces parameters by elaborating such measurements or inputting hemodynamic forces parameters as received; estimating hemodynamic forces parameters in the heart of the subject by elaborating such hemodynamic forces; selecting an optimal pacing setting of the set, or calculating further pace settings, based on the hemodynamic forces parameters as estimated A corresponding device and computer program are also disclosed.

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.

A computer-implemented method includes accessing electrophysiological data and generating an electroanatomic map for a surface of interest based on the electrophysiological data acquired during or after application of a first intervention to temporarily perturb electrical properties of a region of interest on or within the patient’s heart. The method also includes determining changes in the map or information derived from the map responsive to application of a first intervention. The first intervention can include including applying a non-lethal energy and/or a bioactive agent to induce or inhibit conduction of electrical activity for the region of interest. The method also includes controlling a second intervention to permanently alter the electrical properties of the region of interest based on the determination indicating a desired change in cardiac electrical activity responsive to the first intervention.

Medical device systems include processing circuitry configured to acquire sensed cardiac signals associated with cardiac activity of a heart of a patient, and to analyze the sensed cardiac signals to determine if a noise signal is present within the cardiac signals.

Medical device systems include processing circuitry configured to acquire sensed cardiac signals associated with cardiac activity of a heart of a patient, and to analyze the sensed cardiac signals to determine if a noise signal is present within the cardiac signals.

Wirelessly networked systems of implantable and non-implantable medical devices with networking protocols, software, and hardware that allow for communications and energy transfer between different the medical devices (free standing, implants and wearables) using ultrasonic waves. The networks and methods of use are used to construct cardiac pacing, deep brain stimulation, and neurostimulation networks based on ultrasonic wide band technology.