The present invention generally relates to heart treatment systems. In some aspects, methods and systems are provided for facilitating communication between implanted devices. For example, an implantable cardiac rhythm management device may be configured to communicate with an implantable blood pump. The implantable cardiac rhythm management device may deliver heart stimulation rate information in addition to information associated with any detected abnormalities in heart function. In response, the pump may be configured to adjust pumping by the pump to better accommodate a patient's particular needs.

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.

An implantable medical device (IMD) is provided and includes electrodes configured to be located in or about a heart. The electrodes include a bipolar electrode combination that define a bipolar sensing vector. The electrodes include a unipolar electrode combination that define a unipolar sensing vector. The IMD includes sensing circuitry configured to define a first sensing channel coupled to the bipolar electrode combination and a second sensing channel coupled to the unipolar electrode combination. The IMD includes memory to store program instructions and one or more processors configured to implement the program instructions to collect cardiac activity (CA) signals over the first and second sensing channels for a series of beats, identify a sensed interval delta (SID) from the CA signals for at least a portion of the series of beats, the SID representing a timing interval between i) a COI in the CA signals collected over the first sensing channel and ii) the same COI in the CA signals collected over the second sensing channel; and designate the series of beats to correspond to be a polymorphic ventricular tachycardia (PVT) or a monomorphic ventricular tachycardia (MVT) based on the SID.

Techniques for switching an implantable medical device (IMD) from a first mode to a second mode in relation to signals obtained from internal sensors are described. The internal sensors may include a temperature sensor and a biosensor. In some examples, processing circuitry of the IMD may make a first preliminary determination that the IMD is implanted based on a first signal from the temperature sensor. In response to the first preliminary determination being that the IMD is implanted, the processing circuitry may make a second preliminary determination that the IMD is implanted based on a second signal from the biosensor. The processing circuitry may switch the IMD from a first mode to a second mode based on both the first preliminary determination and the second preliminary determination being that the IMD is implanted.

A ventricular pacemaker is configured to determine a ventricular rate interval by determining at least one ventricular event interval between two consecutive ventricular events and determine a rate smoothing ventricular pacing interval based on the ventricular rate interval. The pacemaker is further configured to detect an atrial event from a sensor signal and deliver a ventricular pacing pulse in response to detecting the atrial event from the sensor signal. The pacemaker may start the rate smoothing ventricular pacing interval to schedule a next pacing pulse to be delivered upon expiration of the rate smoothing ventricular pacing interval.

A system includes an implantable medical device (IMD) and processing circuitry. The IMD includes sensing circuitry configured to sense cardiac electrical signals of a patient, and therapy delivery circuitry configured to deliver demand cardiac pacing to a heart of the patient based on the cardiac electrical signals. The processing circuitry is configured to: determine, for each of a plurality of time units, based on the cardiac electrical signals and the delivery of demand cardiac pacing during the time units, a plurality of metrics indicative of a need for continued delivery of demand cardiac pacing to the heart of the patient. The plurality of metrics includes a metric associated with a duration of one or more pacing episodes during the time unit. The processing circuitry is further configured to generate a graphical representation of the plurality of metrics of the plurality of time units for presentation to a user.

Systems and methods are described herein for evaluation and adjustment cardiac therapy. The systems and methods may initially evaluate a first pacing parameter while other pacing parameters are fixed to, for example, nominal values, and determine an effective setting for the first pacing parameter. Then, a second pacing parameter may be evaluated while the first pacing parameter is fixed to the previously-determined effective setting. Each evaluation may not test every possible setting for the pacing parameters, and instead, may utilize various processes to limit the settings to a subset of settings to test.

A medical device senses cardiac electrical signals including T-waves attendant to ventricular myocardial repolarizations and detects a T-wave template condition associated with non-pathological changes in T-wave morphology. The device generates a T-wave template from T-waves sensed by the sensing circuit during the T-wave template condition. After generating the T-wave template, the device acquires a T-wave signal from the cardiac electrical signal and compares the acquired T-wave signal to the T-wave template. The device detects a pathological event in response to the acquired T-wave signal not matching the T-wave template.

In some examples, controlling delivery of CRT includes delivering ventricular pacing according to a sequence of different values of at least one of A-V delay or V-V delay, and acquiring one or more electrograms from respective vectors. For each of the different values of the at least one of A-V delay or V-V delay, at least one of a QRS amplitude or a QRS area may be determined based on the one or more electrograms, and a target change in QRS amplitude or QRS area between adjacent ones of the values of the at least one of A-V delay or V-V delay of the sequence may be identified. In response to the identification of the target change, the implantable medical device may deliver the ventricular pacing at a value of the at least one of A-V delay or V-V delay determined based on the identification to provide CRT.

A medical device includes a motion sensor for producing a motion signal including cardiac event signals. The medical device generates a ventricular pacing pulse upon expiration of a pacing interval. The medical device determines a synchrony metric from the motion signal after a delivered ventricular pacing pulse and adjusts the pacing interval based on the synchrony metric.