Systems and methods for detecting worsening cardiac conditions such as worsening heart failure events are described. A system may include sensor circuits to sense physiological signals and signal processors to generate from the physiological signals first and second signal metrics. The system may include a risk stratifier circuit to produce a cardiac risk indication. The system may use at least the first signal metric to generate a primary detection indication, and use at least the second signal metric and the risk indication to generate a secondary detection indication. The risk indication may be used to modulate the second signal metric. A detector circuit may detect the worsening cardiac event using the primary and secondary detection indications.

A method for determining and responding in real-time to an increased risk of death relating to a patient with epilepsy is provided. The method includes receiving cardiac data and determining a cardiac index based upon the cardiac data. The method includes determining an increased risk of death associated with epilepsy if the indices are extreme, issuing a warning of the increased risk of death and logging information related to the increased risk of death. Also presented is a second method for determining and responding in real-time to an increased risk of death relating to a patient with epilepsy comprising receiving at least one of arousal data, responsiveness data or awareness data and determining an arousal index, a responsiveness index or an awareness index, where the indices are based on arousal data, responsiveness data or awareness data respectively. The second method includes determining an increased risk of death related to epilepsy if indices are extreme values, issuing a warning of the increased risk of death and logging information related to the increased risk of death. A computer readable program storage device is also provided. Also provided is a method for receiving body data, determining a cardiac, an arousal, a responsiveness, or a kinetic index, determining an increased or increasing risk of death over a first time window relating to a patient with epilepsy and issuing a warning and logging relevant information.

According to some aspects, a cardiac pacemaker for implantation within a subject is provided, the pacemaker including a housing, at least one sensor configured to detect an activity level of the subject, and at least one processor coupled to the sensor configured to detect inactivity of the subject based on output from the at least one sensor, produce a first signal configured to increase the heart rate of the subject to a first heart rate during a first time period, wherein the first heart rate is above a resting heart rate and below 100 beats per minute, and in response to determining that the first time period has elapsed, producing a second signal configured to increase the heart rate of the subject to a second heart rate during a second time period, wherein the second heart rate is between 100 and 140 beats per minute.

A ventricularly implantable medical device that includes a sensing module that is configured to detect an artifact during ventricular filling and to identify an atrial event based at least on part on the detected artifact. Control circuitry of the implantable medical device is configured to deliver a ventricular pacing therapy to a patient's heart, wherein the ventricular pacing therapy is time dependent, at least in part, on the identified atrial event.

A controller detects a cyclic cardiac event of the patient based on a signal obtained from one or more electrodes configured for placement on or near a diaphragm, and delivers an electrical stimulation therapy to a diaphragm of the patient through the one or more electrodes. The delivery of electrical stimulation therapy is timed to the detection of the cyclic cardiac event, and the electrical stimulation therapy is defined by stimulation parameters. The controller monitors a pressure associated with the intrathoracic cavity of the patient based on a signal provided by a pressure measurement source configured to provide a signal indicative of a pressure within an intrathoracic cavity, to determine whether an adjustment of one or more of the stimulation parameters is warranted.

An ICD multimode system comprises a microcontroller or FPGA having a memory, a differentially driven phased array amplifier, one or more sensors, and a wireless transmitter/receiver. Based upon sensor data and demand criteria programmed into the memory, the system provides late systolic impulse (LSI) therapy to treat congestive heart failure (CHF) and ventricle level-shifting (VLS) therapy to block unwanted PVCs to prevent VT or VF dynamically and use a phased array amplifier therapy to accurately manage CRT. An external echocardiogram and ultrasound system adjusts the therapies administered based upon sensor and demand data in real time to allow a patient's heart to function at a level of improved performance and increase ejection fraction EF.

Systems and methods for controlling blood pressure via electrical stimulation of the heart are disclosed. Embodiments may include at least two different stimulation patterns, each configured to reduce blood pressure to a different degree, and may alternate between stimulation patterns based on the need of a patient, for example, alternating between day and night or between periods of strenuous and light activity. Some embodiments may take advantage of a slow baroreflex response that occurs after treatment is stopped, suspending treatment for extended periods, and then resuming treatment before blood pressure levels reach pretreatment values. Embodiments may control blood pressure by controlling atrial pressure and atrial stretch.

A cardiac pacing system that includes a pulse generator to generate therapeutic electrical pulses and at least one lead inserted through an intercostal space in the region of a cardiac notch of the left lung of a patient, the lead having a distal end configured to transmit the therapeutic electrical pulses generated by the pulse generator to pace the heart of the patient.

An example of a system for pacing through multiple electrodes in a ventricle includes a sensing circuit to sense cardiac signal(s), a pacing output circuit to deliver pacing pulses, a heart sound sensor to sense a heart sound signal, and a control circuit to control the delivery of the pacing pulses. The control circuit includes a heart sound detector to detect heart sounds using the heart sound signal, an electrical event detector to detect cardiac electrical events using the cardiac signal(s), a measurement module to measure an optimization parameter using the detected heart sounds, an optimization module to perform an optimization procedure using the optimization parameter in response to an optimization command, and an optimization initiator to generate the optimization command. The optimization procedure includes selection of a single electrode or a plurality of electrodes from the multiple electrodes in the ventricle for pacing that ventricle.

An example of a system for pacing through multiple electrodes in a ventricle includes a sensing circuit to sense cardiac signal(s), a pacing output circuit to deliver pacing pulses, a heart sound sensor to sense a heart sound signal, and a control circuit to control the delivery of the pacing pulses. The control circuit includes a heart sound detector to detect heart sounds using the heart sound signal, an electrical event detector to detect cardiac electrical events using the cardiac signal(s), a measurement module to measure an optimization parameter using the detected heart sounds, and an optimization module to approximately optimize one or more pacing parameters using the measured optimization parameter. The one or more pacing parameters include an electrode configuration parameter specifying one or more electrodes selected from the multiple electrodes in the ventricle for delivering ventricular pacing pulses to that ventricle.