This disclosure describes an implantable medical electrical lead and an ICD system utilizing the lead. The lead includes a lead body defining a proximal end and a distal portion, wherein at least a part of the distal portion of the lead body defines an undulating configuration. The lead includes a defibrillation electrode that includes a plurality of defibrillation electrode segments disposed along the undulating configuration spaced apart from one another by a distance. The lead also includes at least one electrode disposed between adjacent sections of the plurality of defibrillation sections. The at least one electrode is configured to deliver a pacing pulse to the heart and/or sense cardiac electrical activity of the heart.

System and methods are provided herein and include a HIS electrode configured to be located proximate to a HIS bundle and to at least partially define a HIS sensing vector. They system includes memory to store program instructions and cardiac activity (CA) signals for a series of beats utilizing a candidate sensing configuration. The candidate sensing configuration is defined by i) the HIS sensing vector and ii) a sensing channel that utilizes sensing circuitry configured to operate based on one or more sensing settings to detect near field and far field activity. The system includes one or more processors that, when executing the program instructions, are configured to analyze the CA signals to obtain an atrial (A) feature of interest (FOI) and a ventricular (V) FOI for the corresponding beats within the series of beats and identify a V-A FOI relation between the A FOIs and the V FOIs across the series of beats. The system adjusts the candidate sensing configuration and repeat the obtain, analyze and identify operations to obtain a collection of V-A FOI relations for a corresponding collection of candidate sensing configurations and selects a resultant sensing configuration from the collection of candidate sensing configurations based on one or more criteria, the resultant sensing configuration to be utilized to manage HIS bundle pacing during an atrial arrhythmia.

A lead impedance stimulation architecture and a dual current source and sink methodology to output a biphasic current pulse and measure a resulting induced voltage across the stimulation electrodes to determine lead impedance. A common mode capacitance on the electrode interface may have little impact on the stimulation architecture of this disclosure allowing for fast voltage rise time and consistent and accurate impedance measurement. In addition, the dual source and sink includes a monitor circuit on each of the source and the sink circuitry. In the event of an open circuit indicating a lead breakage, loose connection, lead migration, insulation leak, and so on, the monitor circuit may provide an output to indicate specifically which electrode is unable to reach the correct current stimulation amplitude. In this manner the techniques of this disclosure, may also detect a lead break in a single lead impedance measurement.

A device and a method thereof for determining a hemodynamic state of an individual from a magnitude of a perfusion signal or a signal which is a measure of a volume of blood in the thoracic cavity of the individual, wherein the control device is configured to receive a first signal and a heart rate signal, divide the first signal into frames, wherein a frame length is determined from an oscillation period of the heart rate signal, and determine a magnitude of the first signal from at least two frames, so as to obtain a more reliable magnitude of the first signal.

Apparatus and methods are described, including a stent configured to be placed in a lumen. The stent includes a generally cylindrical stent body including a plurality of struts, at least one electrode post protruding from the stent body, and a plurality of antenna posts protruding longitudinally from an end of the stent body. The antenna posts are longitudinally separated from the electrode post. An antenna is disposed annularly on the antenna posts, such that the antenna posts separate the antenna from the end of the stent body, and at least one electrode is coupled to the stent by being placed on the electrode post. Additional embodiments are also described.

In some examples, processing circuitry of a medical device system determines, for each of a plurality of patient parameters, a difference metric for a current period based on a value of a patient parameter determined for the current period and a value of the patient parameter determined for an immediately preceding period, and determines a score for the current period based on a sum of the difference metrics for at least some of the plurality of patient parameters. The processing circuitry determines a threshold for the current period based on scores determined for N periods that precede the current period, compares the score for the current period to the threshold, and determines whether to generate an alert indicating that an acute cardiac event of the patient, e.g., ventricular tachyarrhythmia, is predicted, and/or deliver a therapy configured to prevent the acute cardiac event, based on the comparison.

Aspects of the present disclosure are directed to an electronic switchbox for automatically switching between receive and transmit functionalities. In one embodiment, an electronic switchbox automatically switches between receiving electrocardiograph signals and transmitting cardioversion impulses.

The present disclosure relates to an implantable device for improving the pump function of the heart of a human patient by applying an external force on the heart muscle. The device is provided with a first part having a first surface comprising a ceramic material, and a second part having a second surface comprising a ceramic material.

A medical device system, such as an extra-cardiovascular implantable cardioverter defibrillator ICD, senses R-waves from a first cardiac electrical signal by a first sensing channel and stores a time segment of a second cardiac electrical signal in response to each sensed R-wave. The medical device system determines a morphology parameter correlated to signal noise from time segments of the second cardiac electrical signal, detects a noisy signal segment based on the signal morphology parameter; and withholds detection of a tachyarrhythmia episode in response to detecting a threshold number of noisy signal segments.

A medical device system includes a cardiac electrical stimulation device and a ventricular assist device (VAD). The cardiac stimulation device and the VAD are capable of communication with each other to confirm detection of cardiac events.