A computer implemented method and system for confirming a device documented arrhythmia in cardiac activity are provided. The method is under control of one or more processors configured with executable instructions. The method obtains a cardiac activity (CA) data set that includes CA signals for a series of cardiac events and includes device documented (DD) markers within the series of cardiac events. The device documented markers are indicative of atrial fibrillation (AF) detected by the ICM utilizing an on-board R-R interval irregularity (ORI) process to analyze the CA signals. The method applies a feature enhancement function to the CA signals to form modified CA signals with enhanced sinus features and analyzes the enhanced sinus features in the modified CA signals. The method utilized a confirmatory feature detection process to identify false AF detection by the ORI process. The method records a result of the analysis identifying false AF detection by the ORI process.

A leadless pacemaker device for providing an intra-cardiac pacing includes processing circuitry configured to generate ventricular pacing signals for stimulating ventricular activity at a ventricular pacing rate, a first sensor configuration receiving a first sense signal, and a second sensor configuration receiving a second sense signal. The processing circuitry derives, in a first sensing state, atrial events from the first sense signal for controlling the ventricular pacing rate based on the atrial events. The processing circuitry switches, based on at least one switching criterion, from the first sensing state to a second sensing state in which the processing circuitry derives atrial events from the second sense signal. The second sense signal is received by the second sensor configuration for detection of atrial events and the second sensor configuration is a motion sensor or a sound sensor. A method for operating the pacemaker device is also provided.

The current technology is relevant to a system having a programming device capable of communication with an implantable medical device, where the programming device is configured to identify a patient condition comprising the patient's inability to exercise to a desired capacity, configured to notify a clinical user of the identified condition and configured to identify a therapy appropriate for the identified condition.

A method for heart failure management includes monitoring one or more sensor-based parameters for a patient to determine a pacing therapy. If the one or more parameters indicate atrial tachycardia or atrial fibrillation, a first pacing therapy is delivered. If the one or more parameters do not indicate atrial tachycardia or atrial fibrillation, it is determined whether the patient is asleep. If the patient is asleep, a second pacing therapy is delivered. If the one or more parameters do not indicate atrial tachycardia, atrial fibrillation, or that the patient is asleep, the patient's P-wave duration is evaluated with respect to a P-wave duration threshold value. When the patient's P-wave duration is determined to exceed the P-wave duration threshold value, a third pacing therapy is delivered, and when the patient's P-wave duration is determined to not exceed the P-wave duration threshold value, a fourth pacing therapy is delivered.

Systems, interfaces, and methods are described herein related to the evaluation of a patient's cardiac conduction system and evaluation of cardiac conduction system pacing therapy being delivered to the patient's cardiac conduction system. Evaluation of the patient's cardiac conduction system may utilize a plurality of breakthrough maps to determine where a cardiac conduction system block may be located. Evaluation of cardiac conduction system pacing therapy may utilize various electrical heterogeneity information monitored before and during delivery of cardiac conduction system pacing therapy.

Apparatus and methods for placement of electrodes into selected tissue, such as the septal wall separating the left and right ventricles, with, in some cases, access to the septal wall from the right ventricle. Torque sleeves may be used to provide for rotation as needed.

Systems, methods, and interfaces are described herein for assisting a user in noninvasive evaluation of patients for cardiac therapy and noninvasive evaluation of cardiac therapy being delivered. The systems, methods, and interfaces may provide graphical representations of cardiac electrical activation times about one or more portions of human anatomy and one or more cardiac health metrics.

A connector block that permits simultaneous and continuous interconnection of the three leads of the epicardial pacing wires, the pacemaker, and the ECG monitor on clear separately labeled connectors is provided. Circuitry is provided that allows the display of epicardial signals on the telemetry unit, while still preserving the ability to pace the heart from the pacemaker. When pacing the connector block prevents excessive loading of the pacer signals by the ECG monitor and/or damage to the monitor by the high-voltage pacer signals. The connector block may be used universally on all monitors without the need for sophisticated understanding of the electrical characteristics of the ECG monitor or concern for damage or improper signal loading.

The device includes a cardiac therapy circuit with a first terminal, and a peripheral therapy circuit with a second terminal. These terminals can either receive a cardiac detection/stimulation lead or a peripheral detection/stimulation lead of an organ. The device is configured to recognize the leads and automatically configure the connection terminals according to the type of lead received by the terminal. This includes discrimination methods for identifying the terminal on which a cardiac signal is detected, and selectively activating the cardiac therapy circuit and the peripheral therapy circuit based on the detection of the cardiac signal on a lead.

Embodiments of the invention provide methods for the detection and treatment of atrial fibrillation (AF) and related conditions. One embodiment provides a method comprising measuring electrical activity of the heart using electrodes arranged on the heart surface to define an area for detecting aberrant electrical activity (AEA) and then using the measured electrical activity (MEA) to detect foci of AEA causing AF. A pacing signal may then be sent to the foci to prevent AF onset. Atrial wall motion characteristics (WMC) may be sensed using an accelerometer placed on the heart and used with MEA to detect AF. The WMC may be used to monitor effectiveness of the pacing signal in preventing AF and/or returning the heart to normal sinus rhythm (NSR). Also, upon AF detection, a cardioversion signal may be sent to the atria using the electrodes to depolorize an atrial area causing AF and return the heart to NSR.