Systems and methods for managing heart failure are described. The system receives physiological information including a first HS signal corresponding to paced ventricular contractions and a second HS signal corresponding to intrinsic ventricular contractions. The system detects worsening heart failure (WHF) using the received physiological information. A signal analyzer circuit can generate a paced HS metric from the first HS signal and a sensed HS metric from the second HS signal, and determine a concordance indicator between the paced and the sensed HS metrics. In response to the detected WHF, the system can use the concordance indicator to generate a therapy adjustment indicator for adjusting electrostimulation therapy, or a worsening cardiac contractility indicator indicating the detected WHF is attributed to degrading myocardial contractility.

Computer implemented methods and systems are provided that comprise, under control of one or more processors of a medical device, where the one or more processors are configured with specific executable instructions. The methods and systems obtain motion data indicative of at least one of a posture or a respiration cycle; obtain cardiac activity (CA) signals for a series of beats; identify whether a characteristic of interest (COI) from at least a first segment of the CA signals exceeds a COI limit; analyze the motion data to determine whether at least one of the posture or respiration cycle at least in part caused the COI to exceed the COI limit. Based on the analyzing operation, the methods and systems automatically adjust a CA sensing parameter utilized by the medical device to detect R-waves in subsequent CA signals; and detect an arrhythmia based on a presence or absence of one or more of the R-waves in at least a second segment of the CA signals.

In some examples, a computing apparatus may determine information corresponding to a data structure and indicating delays associated with an atrium lead, a left ventricle (LV) lead, and a right ventricle (RV) lead based on one or more input variables. The computing apparatus may determine a plurality of individualized characteristics based on the information corresponding to the data structure. The computing apparatus may receive, from the plurality of measurement electrodes, a plurality of second sets of electrical measurements indicating second electrical signals applied to the patient's heart based on the plurality of individualized characteristics. The computing apparatus may determine cardiac resynchronization index (CRI) values using a first set of electrical measurements (e.g., native measurements) and the plurality of second sets of electrical measurements. The computing apparatus may generate a graphical representation based on a populated data structure and cause display of the graphical representation.

Methods and systems for diagnosis of lead system anomalies for an implantable medical device. More particularly, the present disclosure relates to prediction and/or detection of a lead system condition by utilizing electrogram (EGM) analysis to identify which non-physiological short interval signals (NPSIs) are more indicative of lead system conditions, including lead failure, than of other causes.

An apparatus includes an interface and a processor. The interface is configured to receive one or more magnetic-positioning signals from one or more position sensors coupled to one or more body-surface patches attached to a body of a patient, the magnetic-positioning signals indicative of respective positions of the position sensors. The processor is configured to (i) detect an inadvertent stimulation of a phrenic nerve of the patient, which occurs due to cardiac pacing applied by an intra-cardiac electrode in a heart of the patient, (ii) estimate, based on the magnetic-positioning signals, a motion of one or more of the body-surface patches occurring during the detected stimulation of the phrenic nerve, (iii) estimate, based on the estimated motion of the body-surface patches, a distance between the pacing electrode and the phrenic nerve, and (iv) send an output derived from the estimated distance to the output device.

A leadless cardiac pacemaker device is configured to provide HIS bundle pacing and contains a housing having a tip, a first electrode arranged on the housing in the vicinity of the tip, the first electrode being configured to engage with intra-cardiac tissue, and a second electrode arranged on the housing at a distance from the tip of the housing. A processor is enclosed in the housing and operatively connected to the first electrode and the second electrode. The processor is configured to process a reception signal received by at least one of the first electrode and the second electrode and to generate a pacing signal to be emitted using at least one of the first electrode and the second electrode.

The present invention provides monitoring of brain blood circulation in a patient with cardiac pacemaker for the prevention of symptoms associated with pacemaker syndrome and stroke. The monitoring of brain blood flow velocity is performed using a transcranial Doppler ultrasound device synchronized with an implanted cardiac pacemaker, to select the pacing mode that enhances cerebral perfusion in the patient. The system further detects microembolic signals in the cerebral circulation and triggers sonothrombolysis as well as release of thromolytic and neuroprotective agents for clot dissolution.

Methods, systems and devices for providing cardiac resynchronization therapy (CRT) to a patient using a leadless cardiac pacemaker (LCP) and an extracardiac device (ED). The LCP is configured to deliver pacing therapy at a pacing interval. Illustratively, the ED may be configured to analyze the cardiac cycle including a portion preceding the pacing therapy delivery for one or several cardiac cycles, and determine whether an interval from the P-wave to the pace therapy in the cardiac cycle(s) is in a desired range. In an example, if the P-wave to pace interval is outside the desired range, the ED communicates to the LCP to adjust the pacing interval.

A medical device is configured to deliver anti-tachycardia pacing (ATP) in the presence of T-wave alternans. The device is configured to detect a ventricular tachyarrhythmia from a cardiac electrical signal received by the medical device. In response to the detected ventricular tachyarrhythmia, the device delivers a plurality of ATP pulses at alternating time intervals. The alternating time intervals comprise at least a first ATP time interval separating a first pair of the ATP pulses and a second ATP time interval different than the first ATP time interval. The second ATP time interval consecutively follows the first ATP time interval and separates a second pair of the ATP pulses.

The present technology relates to intracardiac sensors and associated systems and methods. In some embodiments, the present technology includes a device for monitoring pressure within a patient's heart. The device can include an implantable capacitor having a capacitance value that is variable based on the pressure within the patients heart and a sensing circuit configured to measure the capacitance value. The device can also include an implantable inductor and a power circuit configured to wirelessly receive power from an external source via the inductor. When the device is in a first configuration, the capacitor can be electrically coupled to the sensing circuit and the inductor can be electrically coupled to the power circuit. When the device is in a second configuration, the capacitor can be electrically coupled to the inductor to form a resonant circuit.