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.

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.

An implantable medical device (IMD) includes therapy delivery circuitry, sensing circuitry, and processing circuitry. The processing circuitry is configured to determine one or more sleep apnea therapy parameters, control the therapy delivery circuitry to deliver sleep apnea therapy via a first set of electrodes implantable within the patient in accordance with the one or more sleep apnea therapy parameters, and at least one of: (1) monitor a cardiac signal sensed with the sensing circuitry, or (2) determine one or more cardiac therapy parameters, and control the therapy delivery circuitry to deliver cardiac therapy via a second set of electrodes implantable within the patient in accordance with the one or more cardiac therapy parameters.

A medical device and method conserve electrical power used in monitoring cardiac arrhythmias. The device includes a sensing circuit configured to sense a cardiac signal, a power source and a control circuit having a processor powered by the power source. The control circuit is configured to operate in a normal state by waking up the processor to analyze the cardiac electrical signal for determining a state of an arrhythmia. The control circuit switches from the normal state to a power saving state that includes waking up the processor at a lower rate than during the normal state.

A method for automatically discriminating between a supraventricular tachycardia event and a ventricular tachycardia event is provided. The method includes sensing a first cardiac signal using a first electrode pair and a second cardiac signal using a second electrode pair during a heartbeat, applying a first algorithm to the first cardiac signal to determine whether the first cardiac signal is indicative for a supraventricular tachycardia or indicative for the ventricular tachycardia; applying a second algorithm to the second cardiac signal to determine whether the second cardiac signal is indicative for the supraventricular tachycardia or indicative for the ventricular tachycardia, the second comparison algorithm being different from the first comparison algorithm; and assigning to a heartbeat-specific indicator a first value indicative for the ventricular tachycardia when at least one of the first cardiac signal and the second cardiac signal have been determined to be indicative tor the ventricular tachycardia.

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.

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.

An apparatus for terminating or unpinning rotating electric activity in a cardiac tissue analyzes an electric parameter for rotating electric activity in the cardiac tissue, and generates electric pulses in response to the rotating electric activity. The electric pulses are applied as electric field pulses and include a plurality of rotating electric activity synchronization pulses arranged at first intervals and a rotating electric activity termination or unpinning pulse following to the last synchronization pulse at a second interval which is similar to one of the first intervals. A maximum electric field strength caused the synchronization pulses is not more than 82% of a maximum electric field strength caused by the termination or unpinning pulse, and an electric pulse energy delivered to the cardiac tissue by each of the synchronization pulses is not more than 67% of an electric pulse energy delivered by the termination or unpinning pulse.

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 he 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 tire one or more singularities delivered via the near-field configuration of the electrodes.