Apparatus, systems, and methods are provided for optimizing intracardiac filling pressures and cardiac output in patients with heart failure, conduction disease, and atrial fibrillation. The system is able to adjust and optimize intracardiac filling pressures and cardiac output by adjusting heart rate and the effective amount of total body blood volume. The device includes an adjustable member that may create a mean pressure differential in order to manifest an effective “mechanical diuresis” by sequestering extraneous blood volume to the high-capacitance of the venous vasculature. The system is therefore designed to reduce intracardiac filling pressures while maintaining or even increasing cardiac output.

Controllers and methods for heart treatments are disclosed herein. The controller can include a communication module that can send and receive data from heart therapy devices. The controller can include memory including stored instruction. The controller can include a processor. The processor can receive a signal of an impending electrical treatment at a processor. The processor can determine a current operating parameter of a blood pump communicatingly coupled with the processor. The processor can determine an adjustment to the operating parameter of the blood pump to affect an impedance of heart tissue to be affected by the impending electrical treatment. The processor can control the blood pump according to the adjustment to the operating parameter of the blood pump.

An implantable medical device stimulates a human or animal heart. The medical device contains a processor, a memory unit, a His electrode having a first electrode pole configured to detect an electrical signal at a His bundle of a heart, and a further electrode having a further electrode pole configured to detect an electrical signal at a cardiac region of the same heart different from the His bundle. During operation of the device, performing the steps of: measuring electric signals at a His bundle of a heart with the first electrode pole; measuring electric signals at a cardiac region of the same heart different from the His bundle with the further electrode pole; and evaluating intracardiac electrogram signals and/or impedance signals measured between the first electrode pole and the further electrode pole, with the provision that this evaluating does not only contain a determination of an atrial-His bundle transition time.

An example method includes establishing a communications link between an electrophysiology (EP) monitoring system and an implantable medical device (IMD). IMD electrical data is received at the monitoring system via the communications link. The IMD electrical data may be synchronized with EP measurement data to provide synchronized electrical data based on timing of a synchronization signal sensed by an IMD electrode and/or EP electrodes. The method also includes computing reconstructed electrical signals for locations on a surface of interest within the patient's body based on the synchronized electrical data and geometry data. The geometry data represents locations of the EP electrodes, a location of the IMD electrode within the patient's body and the surface of interest.

Systems and methods for pacing cardiac conductive tissue are described. In an embodiment, a medical system includes an electrostimulation circuit to generate pacing pulses to stimulate a His bundle or a bunch branch. A sensing circuit senses a far-field ventricular activation, determines a cardiac synchrony indicator using the far-field ventricular activation in response to His bundle or bundle branch pacing, and verifies His-bundle capture status using the determined cardiac synchrony indicator. The system can determine a pacing threshold using the capture status under different stimulation strength values. The electrostimulation circuit can deliver stimulation pulses in accordance with the determined pacing threshold.

An extra-cardiovascular medical device is configured to select a capacitor configuration from a capacitor array and deliver a low voltage, pacing pulse by discharging the selected capacitor configuration across an extra-cardiovascular pacing electrode vector. In some examples, the medical device is configured to determine the capacitor configuration based on a measured impedance of the extra-cardiovascular pacing electrode vector.

A health care system acquires data determines whether a patient is at risk of hypervolemia or hypovolemia. The method comprises (a) acquiring from a device memory a patient's absolute intrathoracic impedance data over a pre-specified time period, (b) determining a running average of the intrathoracic impedance data over the pre-specified time period, and (c) determining by the system whether the running average of the intrathoracic impedance data over the pre-specified time period exceeds one of a first and second range, the first range being a higher value boundary of intrathoracic electrical impedance and the second range being a lower value boundary of intrathoracic electrical impedance.

Implantable medical devices including a transseptal lead are described herein. The transseptal lead may be positioned or placed through the interatrial septum from the right atrium to the left atrium of a patient's heart and further through the mitral valve. The transseptal lead may include at least one left atrial electrode and at least one left ventricular electrode for sensing, among other things, left atrial and left ventricular electrograms, left atrial and left ventricular impedances, and cross mitral valve impedance.

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.

A method for programming an implantable medical device for stimulating a human or animal heart with the help of a programming device. The method comprises the following steps: a) providing a first input parameter to the programming device, the first input parameter being indicative whether a first stimulation unit is to be used to stimulate the His bundle of a heart; b) if the first input parameter indicates that the first stimulation unit is to be used to stimulate the His bundle of the heart, supporting a user of the programming device to configure the implantable medical device for His bundle pacing by automatically proposing at least one stimulation parameter and an assigned stimulation parameter value specifically adapted for His bundle pacing; c) allowing programming of the implantable medical device by allowing setting the at least one stimulation parameter value.