This document discusses, among other things, systems and methods to generate a first pacing waveform during a first pacing period and a second pacing waveform during a second pacing period, to alternate first and second pacing periods to provide pacing-based hypertension therapy to a heart of a patient to reduce patient blood pressure, and to determine an increased pacing rate for the first pacing waveform during the first pacing period using the first AV delay, wherein the first pacing waveform has a first atrioventricular (AV) delay and the second pacing waveform has a second AV delay longer than the first AV delay.

Systems and methods are provided for optimizing hemodynamics within a patient's heart, e.g., to improve the patient's exercise capacity. In one embodiment, a system is configured to be implanted in a patient's body to monitor and/or treat the patient that includes at least one sensor configured to provide sensor data that corresponds to a blood pressure within or near the patient's heart; at least one adjustable component designed to cause blood to flow in a direction opposite to the normal direction (regurgitation) within the patient's heart; and a controller configured for adjusting the function of the at least one adjustable component based at least in part on sensor data from the at least one sensor.

A treatment method for stimulating a nerve includes sensing pressure relating to an organ.

Systems and methods for pacing cardiac conductive tissue are described. A medical system includes an electrostimulation circuit that may generate His-bundle pacing (HBP) pulses for delivery at or near the His bundle. In response to the delivery of the HBP pulse, the system senses a near-field cardiac activity representative of excitation of a para-Hisian myocardial tissue, and a far-field cardiac activity representative of excitation of the His bundle and a ventricle. The system classifies a tissue response to HBP into one of a plurality of capture types based on the sensed near-field and far-field cardiac activities. The system includes a control circuit to adjust one or more stimulation parameters based on the classified capture type. The electrostimulation circuit generates and delivers the HBP pulses according to the adjusted stimulation parameters to excite the His bundle.

A device determines values for one or more metrics that indicate the quality of a patient's sleep based on sensed physiological parameter values. Sleep efficiency, sleep latency, and time spent in deeper sleep states are example sleep quality metrics for which values may be determined. The sleep quality metric values may be used, for example, to evaluate the effectiveness of a therapy delivered to the patient by a medical device. In some embodiments, determined sleep quality metric values are automatically associated with the therapy parameter sets according to which the medical device delivered the therapy when the physiological parameter values were sensed, and used to evaluate the effectiveness of the various therapy parameter sets. The medical device may deliver the therapy to treat a non-respiratory neurological disorder, such as epilepsy, a movement disorder, or a psychological disorder. The therapy may be, for example, deep brain stimulation (DBS) therapy.

The disclosed physiological feedback systems and methods assist with assessing, monitoring and/or treating a patient experiencing a cardiac arrest event. The systems and methods receive multiple inputs and are continuous and/or iterative during a treatment session to provide physiological state trends of the patient. An index of the physiological state of the patient can be derived and confounders, and/or their effects, can be identified, and/or removed, from the index. Additionally, the systems and methods can assist with determining ischemic injury in a patient based on cerebral tissue oxygenation and/or other physiological data.

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.

Systems and methods for pacing cardiac conductive tissue are described. A medical system includes electrostimulation circuit that may generate His-bundle pacing (HBP) pulses for delivery at or near the His bundle. A capture verification circuit may detect, from a far-field signal representing ventricular response to the HBP pulses, a His-bundle response representative of excitation of the His bundle directly resulting from the HBP pulses, and a myocardial response representative of excitation of the myocardium directly resulting from the HBP pulses. A control circuit may adjust one or more stimulation parameters based on the His-bundle response and myocardial response. The electrostimulation circuit may generate and deliver the HBP pulses according to the adjusted stimulation parameters to excite the His bundle.

An implantable cardiac rhythm management medical device is configured to switch from a first operating mode to a second, ventricular assist device operating mode for detecting cardiac arrhythmias and controlling delivery of anti-arrhythmia therapy during the ventricular assist device operating mode. The implantable medical device may receive a command from another medical device indicating co-implantation of a ventricular assist device with the implantable medical device in a patient and switch from the first mode of operating to the second mode of operating in response to receiving the command. Switching from the first mode to the second mode may include adjusting at least one control parameter used for controlling an electrical stimulation therapy deliverable by the implantable cardiac rhythm management medical device.

A computing device includes a memory configured to store instructions. The computing device also includes a processor to execute the instructions to perform operations that include providing an alternating electrical signal to a patient through at least a pair of electrodes, and determining transthoracic impedance of the patient from a measurement associated with the applied alternating electrical signal. Operations also include identifying, from the transthoracic impedance, a sequence of resistance values for controlling the discharge of a charge storage device located external to the patient, and controlling the discharge of the charge storage device using the identified sequence of resistance values.