Systems and methods for monitoring chronic over-pacing (COP) to the heart are discussed herein. In an embodiment, a system includes a receiver circuit to receive information about pacing rates of a plurality of paced heart beats, and a pacing analyzer circuit to generate a pacing rate distribution using pacing rates of the plurality of the paced heart beats. The pacing rate distribution includes a pacing rate histogram. The pacing analyzer circuit may recognize a morphological pattern from the pacing rate distribution, and detect a COP indication using the extracted feature. A programmer circuit adjusts one or more therapy parameters in response to the detected. COP indication.

An implantable system for treating a heart contains a processor, a memory unit, a treatment unit including a treatment electrode, and a detection unit for detecting a cardiac event requiring treatment. The memory unit includes a computer-readable program, which prompts the processor to perform the following steps: a) detecting by way of the detection unit whether a cardiac event to be treated has occurred in the heart; b) if a cardiac event to be treated has occurred, determining a position of the treatment electrode or determining a variable correlating with this position; and c) comparing the position of the treatment electrode or the variable correlating with the position to a reference variable, and carrying out, or not carrying out a cardiac treatment by way of the treatment unit and the treatment electrode as a function of the position of the treatment electrode or the variable correlating with the position.

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.

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.

Provided herein are systems for providing therapy to the heart of a patient. The systems include an implantable device for implantation proximate the heart of the patient. The implantable device includes: an anchoring element for maintaining the position of the implantable device after implantation in the patient, at least one sensing electrode for sensing the electrical activity of the heart, at least three pacing electrodes for delivering electrical energy to the tissue of the heart, and a controller including an algorithm for determining when the patient requires therapy. The systems further include an external device having a transceiver for transmitting energy to the implantable device.

A system for treating cardiac arrhythmias comprising a generator including: a sensing circuitry configured to evaluate one or more identified signals representative of electrical activity of the heart and detect an arrhythmia, a control circuitry that is configured to control delivery of a therapy in response to the detected arrhythmia, the therapy including a first stage of electrical pulses delivered via at least a first electrode, wherein the first set of electrical pulses is configured to destabilize and/or terminate a reentry associated with the arrhythmia, and a first lead coupled to the generator, wherein the first lead includes the first electrode.

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.

Method for recovering and stabilizing normal heart rate of patients suffering in or being inclined to having atrial fibrillation, comprising the step of sensing primary electrical pulses generated in the right atrium (1), of generating artificial electrical stimulation pulses coordinated with the sensed pulses and stimulating therewith the portion of the left atrium (9) which is remote from the right atrium (1), whereby increasing the areas of the heart muscles that can be reached during a simulation pulse within a predetermined period of time.

An implantable system for stimulating a human heart or an animal heart contains a processor, a memory unit, an atrial stimulation unit, and a detection unit for detecting atrial tachycardia. The system is characterized in that the memory unit stores a computer-readable program, which prompts the processor to carry out the following steps when the program is being executed on the processor: a) detecting by way of the detection unit whether atrial tachycardia to be treated is present in a human heart or an animal heart; b) when atrial tachycardia to be treated is present, applying atrial antitachycardia pacing by way of the atrial stimulation unit; and c) after the atrial antitachycardia pacing has been applied, carrying out an atrial post-treatment stimulation, the post-treatment stimulation being configured to be within a range of 1 minute up to 7 days.

A method and apparatus for treatment of hypertension and heart failure by increasing vagal tone and secretion of endogenous atrial hormones by excitory pacing of the heart atria. Atrial pacing is done during the ventricular refractory period resulting in atrial contraction against closed AV valves, and atrial contraction rate that is higher than the ventricular contraction rate. Pacing results in the increased atrial wall stress. An implantable device is used to monitor ECG and pace the atria in a nonphysiologic manner.