Systems and methods for managing cardiac arrhythmias are discussed. A data management system receives a first detection algorithm including a detection criterion for detecting a cardiac arrhythmia. An arrhythmia detector detects arrhythmia episodes from a physiologic signal using a second detection algorithm that is different from and has a higher sensitivity for detecting the cardiac arrhythmia than the first detection algorithm. The arrhythmia detector assigns a detection indicator to each of the detected arrhythmia episodes. The detection indicator indicates a likelihood that the detected arrhythmia episode satisfies the detection criterion of the first detection algorithm. The system prioritizes the detected arrhythmia episodes according to the assigned detection indicators, and outputs the arrhythmia episodes to a user or a process according to the episode prioritization.

Apparatus, systems, and methods are provided for monitoring AF episodes, delivering ATP pulses, and/or achieving electrical isolation of the left atrial appendage (LAA) of a patient's heart and/or preventing thrombus formation after electrical isolation. For example, devices are provided that may implanted from within the left atrium, e.g., to isolate the LAA, prevent thrombus formation within the LAA, facilitate endothelialization, and/or deliver pacing.

A personal wearable emergency medical treatment device, including: a first housing unit including an control unit for an automatic defibrillator device; at least two, and preferably three, electrodes in electrical communication with the housing unit; wherein the electrodes are adapted to be positioned in proximity to a human body at preselected positions selected for monitoring for heartbeat abnormalities and providing electric pulses to the human body.

In one example, a cardiac monitoring system comprises a processor to receive a segment of an electrocardiogram (ECG) signal of a patient, and a memory to store the segment of the ECG. The processor is configured to identify QRS complexes in the segment of the ECG signal, generate a supraventricular (SV) template for SV complexes in the QRS complexes, identify SV complexes in the QRS complexes using the template, identify normal sinus rhythm (NSR) complexes in the segment of the ECG signal, obtain an atrial template for atrial waveforms in the NSR complexes, measure a range of a P-wave of the atrial waveforms from the NSR complexes, save the measured P-waves, and classify the identified SV complexes as either atrial fibrillation (AF) or supraventricular tachycardia (SVT) using the atrial template. Other examples and related methods are also disclosed herein.

Methods and systems for detecting stability of the arrhythmia or fibrillation, determining whether defibrillation or pacing is needed to disrupt the fibrillation, and, if so, optimizing the timing of low energy therapies to improve efficacy of low energy therapy for defibrillation. By transforming electrogram signals into a discrete series of electrogram conformations, recurrence variables of the electrogram signal can be determined that are highly indicative of sources of the arrhythmia, that predict the likelihood of spontaneous termination of the arrhythmia, and that detect the optimal timing of low energy treatment to terminate the arrhythmia.

The present invention provides both methods and devices for termination of arrhythmias, such as ventricular or atrial tachyarrhythmias. The device and method involves application of alternating current (AC) for clinically significant durations at selected therapeutic frequencies through the cardiac tissue to a subject experiencing arrhythmia. Methods are also provided to minimize or eliminate pain during defibrillation.

An implantable system for stimulating a heart contains a processor, a memory, a stimulator, and a first detection unit for detecting a cardiac rhythm disturbance of a cardiac region. The memory includes a computer-readable program, which prompts the processor to carry out the following steps: a) detecting via the first detection unit whether a cardiac rhythm disturbance is present in a cardiac region of a heart of a patient; b) when a cardiac rhythm disturbance is present, selecting a stimulation strategy based on a selection criterion; c) stimulating the cardiac region in which the cardiac rhythm disturbance was detected by way of the stimulator, using the selected stimulation strategy; d) detecting a success and/or an efficiency of the conducted stimulation; e) comparing the success and/or the efficiency to a predefinable success and/or efficiency criterion; and f) if the predefinable success and/or efficiency criterion was not achieved, optimizing the stimulation strategy.

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.

Systems and methods for assessing hemodynamic status of a patient experiencing atrial tachyarrhythmia such as an atrial fibrillation (AF) episode are disclosed. A system can comprise an atrial tachyarrhythmia detection circuit configured to detect an AF episode, a hemodynamic sensor circuit configured to sense at least one hemodynamic signal, and a hemodynamic status analyzer circuit that can calculate one or more signal metrics using the sensed hemodynamic signal during the AF episode. The hemodynamic status analyzer circuit can categorize the hemodynamic status of the patient into one of two or more categorical hemodynamic status levels which indicate elevated hemodynamic impact of the detected AF episode. A user interface can provide to an end-user a presentation of the categorized hemodynamic status level during AF.

An implantable electrical stimulating device and system provides for a remote determination of the identity of the person in whom the stimulating device is implanted. The stimulating device may be a pacemaker, a defibrillator, another medical device or a non-medical device. The bases for the remote identification are (1) the comingling of (A) biologic identification information of the person linked to the stimulating device, and (B) information pertaining to a physiologic parameter (e.g. heart rate information) of that person, and (2) the modulation of the physiologic parameter by external information. Embodiments of the invention in which the stimulating device is external to the person are possible. By utilizing the apparatus providing for the remote identification of a person plus stimulating device, one aspect of secure communication—that based on reliable mutual identification of each participant in a communication—is achieved.