A medical device is configured to detect an atrial tachyarrhythmia episode. The device senses a cardiac signal, identifies R-waves in the cardiac signal attendant ventricular depolarizations and determines classification factors from the R-waves identified over a predetermined time period. The device classifies the predetermined time period as one of unclassified, atrial tachyarrhythmia and non-atrial tachyarrhythmia by comparing the determined classification factors to classification criteria. A classification criterion is adjusted from a first classification criterion to a second classification criterion after at least one time period being classified as atrial tachyarrhythmia. An atrial tachyarrhythmia episode is detected by the device in response to at least one subsequent time period being classified as atrial tachyarrhythmia based on the adjusted classification criterion.

Rechargeable implantable cardioverter defibrillator including a hermetically sealed can and at least one lead, coupled with the hermetically sealed can, the hermetically sealed can including at least one high voltage capacitor, an electronic circuit, coupled with the high voltage capacitor and a rechargeable battery, coupled with the electronic circuit and the high voltage capacitor, an outer surface of the hermetically sealed can including an active section and a non-active section, the non-active section being electrically insulated from the active section, wherein a surface area of the active section acts as at least one of an electrode with the lead for forming an electric shock vector for applying a high voltage shock and a sensor for sensing electrical activity and wherein a surface area of the non-active section acts as at least one antenna for transmitting and receiving information wirelessly while also receiving electromagnetic energy to inductively charge the rechargeable battery.

Embodiments of the invention provide methods for detection and treatment of atrial fibrillation (AF) and related conditions. One embodiment provides a method comprising measuring electrical activity of the heart using electrodes arranged on the heart surface to define an area for detecting aberrant electrical activity (AEA) and then using the measured electrical activity (MEA) to detect foci of AEA causing AF. A pacing signal may then be sent to the foci to prevent AF onset. Atrial wall motion characteristics (WMC) may be sensed using an accelerometer placed on the heart and used with MEA to detect AF. The WMC may be used to monitor effectiveness of the pacing signal in preventing AF and/or returning the heart to normal sinus rhythm (NSR). Also, upon AF detection, a cardioversion signal may be sent to the atria using the electrodes to depolarize an atrial area causing AF and return the heart to NSR.

Methods and apparatus for a three-stage ventricular cardioversion and defibrillation therapy that treats ventricular tachycardia and fibrillation at low energy levels. An implantable therapy generator adapted to generate and selectively deliver a three-stage ventricular therapy and at least two leads operably each having at least one electrode adapted to be positioned proximate the ventricle of the patient. The device is programmed to deliver a three-stage therapy via both a far-field configuration and a near-field configuration of the electrodes upon detection of a ventricular arrhythmia. The three-stage therapy includes a first stage for unpinning of one or more singularities associated with the ventricular arrhythmia, a second stage for anti-repinning of the one or more singularities, both of which are delivered via the far-field configuration of the electrodes, and a third stage for extinguishing of the one or more singularities associated delivered via the near-field configuration of the electrodes.

A wearable medical treatment system for medical treatment of a patient is described. An example of the system includes sensors configured to be externally positioned on the patient, the sensors including cardiac sensing electrodes configured to provide a signal indicative of the patient's cardiac information, defibrillation electrodes configured to be externally positioned on the patient and to deliver a defibrillation shock, a cuff configured to contract about a patient's limb, and a controller communicatively coupled to the sensors, the defibrillation electrodes, and the cuff. The controller is configured to receive the signal indicative of the patient's cardiac information, determine the patient's cardiac information, control delivery of the defibrillation shock by the defibrillation electrodes based at least in part on the patient's cardiac information, and control contraction of the cuff based according to a remote ischemic conditioning (RIC) protocol and based at least in part on the patient's cardiac information.

The disclosed systems and methods provide a mobile defibrillator system that can include a mobile defibrillator (AED) unit configured to operatively connect to a device capable of running an application. The mobile AED unit can include circuitry for administering an electric shock to a subject; and one or more pads. Each pad can include one or more needles electrically connected to the circuitry and can be configured to pierce skin of the subject; reside within the subject; and deliver current from the electrical shock to the subject.

An apparatus comprises an arrhythmia detection circuit configured to: detect atrial arrhythmia in a first portion of a sensed cardiac signal using a first arrhythmia detection criteria, wherein the sensed cardiac signal is representative of cardiac activity of a subject; and upon detection of the atrial arrhythmia, analyze a second portion of the cardiac signal that is prior in time to the first portion using a second different arrhythmia detection criteria to detect the presence or absence of the atrial arrhythmia in the second portion of the cardiac signal.

A method to provide electrical stimulation therapy to stabilize ventricular rate of a heart during episodes of atrial fibrillation. The stimulation therapy may be a plurality of stimulation pulses delivered to the AV node during the AV node refractory period following the sensing of an atrial event.

Methods and apparatus for a three-stage atrial cardioversion therapy that treats atrial arrhythmias within pain tolerance thresholds of a patient. An implantable therapy generator adapted to generate and selectively deliver a three-stage atrial cardioversion therapy and at least two leads, each having at least one electrode adapted to be positioned proximate the atrium of the patient. The device is programmed for delivering a three-stage atrial cardioversion therapy via both a far-field configuration and a near-field configuration of the electrodes upon detection of an atrial arrhythmia. The three-stage atrial cardioversion therapy includes a first stage for unpinning of one or more singularities associated with an atrial arrhythmia, a second stage for anti-repinning of the one or more singularities, both of which are delivered via the far-field configuration of the electrodes, and a third stage for extinguishing of the one or more singularities delivered via the near-field configuration of the electrodes.

Rechargeable implantable cardioverter defibrillator including a hermetically sealed can and at least one lead, coupled with the hermetically sealed can, the hermetically sealed can including at least one high voltage capacitor, an electronic circuit, coupled with the high voltage capacitor and a rechargeable battery, coupled with the electronic circuit and the high voltage capacitor, an outer surface of the hermetically sealed can including an active section and a non-active section, the non-active section being electrically insulated from the active section, wherein a surface area of the active section acts as at least one of an electrode with the lead for forming an electric shock vector for applying a high voltage shock and a sensor for sensing electrical activity and wherein a surface area of the non-active section acts as at least one antenna for transmitting and receiving information wirelessly while also receiving electromagnetic energy to inductively charge the rechargeable battery.