A medical device is configured to sense a cardiac electrical signal and determine from the cardiac electrical signal at least one of a maximum peak amplitude of a positive slope of the cardiac electrical signal and a maximum peak time interval from a pacing pulse to the maximum peak amplitude. The device is configured to determine a capture type of the pacing pulse based on at least one or both of the maximum peak amplitude and the maximum peak time interval.

Systems and methods for cardiac pacing during a procedure are disclosed and may include an external pulse generator (EPG) for connecting to a lead. A remote-control module (RCM) wirelessly connected to the EPG may include user inputs to control the EPG. A central processing unit (CPU) with a memory unit for storing code and a processor for executing the code may be included where the CPU is connected to the EPG and RCM. The code may control the EPG in response to user input from the RCM. The CPU may be disposed in the EPG or the RCM, or an interface module (IM) configured to communicate between an otherwise conventional EPG and the RCM. The executable code may perform a continuity test (CT) routine, a capture check (CC) routine, rapid pacing (RP) routine, and/or a back-up pacing (BP) routine, in response to user input from the RCM.

An implantable medical device system receives a cardiac electrical signal produced by a patient's heart and comprising atrial P-waves and delivers a His bundle pacing pulse to the patient's heart via a His pacing electrode vector. The system determines a timing of a sensed atrial P-wave relative to the His bundle pacing pulse and determines a type of capture of the His bundle pacing pulse in response to the determined timing of the atrial P-wave.

Systems and methods for implanting a lead. The system includes an active guidewire having proximal and distal ends. The distal end includes a guidewire anchor that is configured to be attached to a target SOL. The active guidewire is configured to be utilized to electrically map the target SOI by at least one of delivering stimulation energy through the active guide wire to the target SOI or sensing an evoked response at the target SOI from the guidewire. The system also includes a lead having a lead body with proximal and distal ends and with a lumen extending between the proximal and distal ends. The distal end of the lead body is configured to receive the proximal end of the active guidewire. The lumen is configured to permit the lead body to be advanced over the active guidewire.

An implantable medical device system delivers a pacing pulse to a patient's heart and starts a first pacing interval corresponding to a pacing rate in response to the delivered pacing pulse. The system charges a holding capacitor to a pacing voltage amplitude during the first pacing interval. The system detects an increased intrinsic heart rate that is at least a threshold rate faster than the current pacing rate from a cardiac electrical signal received by a sensing circuit of the implantable medical device. The system starts a second pacing interval in response to an intrinsic cardiac event sensed from the cardiac electrical signal and withholds charging of the holding capacitor for at least a portion of the second pacing interval in response to detecting the increased intrinsic heart rate.

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 system and method for designating between types of activation by a pulse generator configured to deliver a left ventricular (LV) pacing pulse at an LV pacing site as part of a cardiac resynchronization therapy (CRT) are provided. The system includes a sensing channel configured to collect cardiac activity (CA) signals along at least one sensing vector extending through a septal wall between the LV and right ventricle (RV). The CA signals are indicative of one or more beats and include a pre-LV pacing segment indicative of cardiac activity preceding the LV pacing pulse and a post-LV pacing segment indicative of cardiac activity following the LV pacing pulse. The system includes memory to store program instructions. One or more processors are configured to implement the program instructions to analyze the pre-LV pacing segment to identify a first myocardium activation (MA) characteristic of interest (COI). The system analyzes the post-LV pacing segment to a second MA COI, compares the first and second MA COI to first and second MA criteria, respectively, designates the CA signals to be indicative of one of a fusion beat, a capture beat or a pseudofusion beat based on the comparison of the first and second MA COI to first and second MA criteria and store a result of the designation.

Systems, methods, and interfaces are described herein for identification of effective electrodes to be used in sensing and/or therapy. Two or more portions of a signal monitored using an electrode may be compared to determine whether the electrode is effective. The two or more portions may correspond to the same portion or window of a cardiac cycle. Further, signals from a first electrode and from a second electrode located proximate the first electrode may be compared to determine whether one or both of the electrodes are effective.

The embodiments described herein relate to a self-positioning, quick-deployment low profile transvenous electrode system for sequentially pacing both the atrium and ventricle of the heart in the “dual chamber” mode, and methods for deploying the same.

Passive tissue biasing circuitry in an Implantable Pulse Generator (IPG) is disclosed to facilitate the sensing of neural responses by holding the voltage of the tissue to a common mode voltage (Vcm). The IPG's conductive case electrode, or any other electrode, is passively biased to Vcm using a capacitor, as opposed to actively driving the (case) electrode to a prescribed voltage using a voltage source. Once Vcm is established, voltages accompanying the production of stimulation pulses will be referenced to Vcm, which eases neural response sensing. An amplifier can be used to set a virtual reference voltage and to limit the amount of current that flows to the case during the production of Vcm. In other examples, circuitry can be used to monitor the virtual reference voltage as useful to enabling the sensing the neural responses, and as useful to setting a compliance voltage for the current generation circuitry.