A medical device is configured to deliver therapeutic electrical stimulation pulses by generating frequency modulated electrical stimulation pulse signals. The medical device includes a pulse signal source and a modulator. The pulse signal source generates an electrical stimulation pulse signal having a pulse width. The modulator may include a high frequency modulator configured to modulate a frequency of the pulse signal from a starting frequency down to a minimum frequency during the pulse width. The modulator may include a low frequency bias generator to modulate the offset of the pulse signal between a minimum offset and a maximum offset in other examples.

A method includes detecting, by an implantable medical device (IMD), attachment to the IMD of at least one implantable medical lead with at least one electrode; and triggering by the IMD, based on the detecting of the attachment to the IMD of the at least one medical lead, a device test sequence in which the IMD performs the following qualification tests over an evaluation period: detecting an impedance for at least one electrical path that includes the at least one electrode to determine a connection status of the IMD to the at least one electrode; and comparing EGM (electrogram) amplitudes of the patient over an EGM test period against a predetermined threshold.

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.

Systems and methods may monitor electrical activity of a patient's heart using electrodes during delivery of cardiac therapy and determine a degree of posterior left bundle branch engagement based on the monitored electrical activity. The systems and methods may adjust the cardiac therapy based on the degree of posterior left bundle branch engagement.

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 SOI. 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 has a therapy module configured to generate a composite pacing pulse including a series of at least two individual pulses. The therapy module is configured to generate the composite pacing pulse by generating a first pulse of the at least two individual pulses by selectively coupling a first portion of a plurality of capacitors to an output signal line and generate a second pulse of the at least two individual pulses by selectively coupling a second portion of the plurality of capacitors to the output signal line.

A system for stimulating phrenic nerves to provide smooth breathing patterns is provided. More specifically, by identifying contraction threshold voltages for muscles associated with each of the left and right portions of a patient's diaphragm, a phrenic nerve pacing signal customized for each phrenic nerve may be provided to a patient. More specifically, a voltage of a pacing voltage provided to a first phrenic nerve may be less than the contraction threshold while a voltage of a pacing voltage provided to a second phrenic nerve may be greater than the contraction threshold.

The invention relates to a stimulation device for electrotherapy, in particular a defibrillator device and/or external pacemaker device, comprising at least two contact electrodes, which can be applied to the body of a patient at suitable stimulation positions and by means of which current pulses can be applied to the body of the patient, the first of the at least two contact electrodes acting as a charging electrode having positive polarity, and the second of the at least two contact electrodes acting as a discharging electrode having negative polarity with respect to an emitted current pulse, and with a current pulse generator, which is or can be connected to the contact electrodes by means of line connections. The invention further relates to a method for determining the polarity of contact electrodes applied to the body of a patient.

An implantable medical device is configured to control a therapy module to couple a capacitor array comprising a plurality of capacitors to a plurality of extra-cardiovascular electrodes and control the therapy module to deliver a composite pacing pulse to a patient's heart via the plurality of extra-cardiovascular electrodes by sequentially discharging at least a portion of the plurality capacitors to produce a series of at least two individual pulses that define the composite pacing pulse.

VfA cardiac therapy uses an implantable medical device or system. The implantable medical device includes a tissue-piercing electrode implanted in the basal and/or septal region of the left ventricular myocardium of the patient's heart from the triangle of Koch region of the right atrium through the right atrial endocardium and central fibrous body. The device may include a right atrial electrode, a right atrial motion detector, or both. The device may be implanted completely within the patient's heart or may use one or more leads to implant electrodes in the patient's heart. The device may be used to provide cardiac therapy, including single or multiple chamber pacing, atrioventricular synchronous pacing, asynchronous pacing, triggered pacing, cardiac resynchronization pacing, or tachycardia-related therapy. A separate medical device may be used to provide some functionality for cardiac therapy, such as sensing, pacing, or shock therapy.