A patient-worn arrhythmia monitoring and treatment device includes a pair of therapy electrodes and at least one pair of sensing electrodes disposed proximate to the skin and configured to continually sense at least one ECG signal of the patient over an extended period of time. The device includes a therapy delivery circuit coupled to the pair of therapy electrodes and configured to deliver one or more therapeutic pulses. A controller coupled to therapy delivery circuit is configured to analyze the at least one ECG signal and detect one or more treatable arrhythmias and cause the therapy delivery circuit to deliver the one or more therapeutic pulses to the patient. At least one of the one or more therapeutic pulses is formed as a biphasic waveform delivering within 15 percent of 360 J of energy to a patient body having a transthoracic impedance from about 20 to about 200 ohms.

An implantable medical device for stimulating a human/animal heart, comprising a housing, a processor, a memory unit, a stimulation unit configured to stimulate the His bundle, and a detection unit configured to detect an electrical signal at the His bundle. The device performs: a) stimulating the His bundle with a stimulation pulse delivered by the stimulation unit; b) measuring an electric signal at the His bundle with the detection unit upon termination of a first period of time starting upon delivering of the stimulation pulse, wherein the first period of time is from 35 ms to 500 ms; c) measuring an impedance of the same heart with the detection unit upon termination of a second period of time starting upon delivering of the stimulation pulse, wherein the second period of time is equal to or longer than the first period of time and is from 50 ms to 500 ms.

Systems and methods for monitoring and treating patients with heart failure (HF) are discussed. The system may sense cardiac signals, and receives information about patient physiological or functional conditions. A stimulation parameter table that includes recommended values of atrioventricular delay (AVD) or other timing parameters may be created at a multitude of patient physiological or functional conditions. The system may periodically reassess patient physiological or functional conditions. A therapy programmer circuit may dynamically switch between left ventricular-only pacing and biventricular pacing, or switch between single site pacing and multisite pacing based on the patient condition. The therapy programmer circuit may adjust AVD and other timing parameters using the cardiac signal input and the stored stimulation parameter table. A HF therapy may be delivered according to the determined stimulation site, stimulation mode, and the stimulation timing.

Systems and methods for controlling blood pressure via electrical stimulation of the heart are disclosed. Embodiments may include at least two different stimulation patterns, each configured to reduce blood pressure to a different degree, and may alternate between stimulation patterns based on the need of a patient, for example, alternating between day and night or between periods of strenuous and light activity. Some embodiments may take advantage of a slow baroreflex response that occurs after treatment is stopped, suspending treatment for extended periods, and then resuming treatment before blood pressure levels reach pretreatment values. Embodiments may control blood pressure by controlling atrial pressure and atrial stretch.

An implantable medical device is configured determine a numerical value of a variable that is monitored by the implantable medical device and convert the numerical value to a data sequence of modulated electrical stimulation rate intervals. The implantable medical device delivers electrical stimulation pulses according to the data sequence of modulated stimulation rate intervals to cause a modulated rate of activation of excitable tissue of a patient corresponding to the modulated stimulation rate intervals. The modulated rate of activation is detectable by a rate monitor for demodulation to the numerical value of the monitored variable data value. In some examples, the implantable medical device is a pacemaker delivering cardiac pacing pulses according to modulated pacing rate intervals to cause a modulated heart rate of the patient detectable by a heart rate monitor for demodulation to the numerical value of the monitored variable.

An implantable medical device is configured determine a numerical value of a variable that is monitored by the implantable medical device and convert the numerical value to a data sequence of modulated electrical stimulation rate intervals. The implantable medical device delivers electrical stimulation pulses according to the data sequence of modulated stimulation rate intervals to cause a modulated rate of activation of excitable tissue of a patient corresponding to the modulated stimulation rate intervals. The modulated rate of activation is detectable by a rate monitor for demodulation to the numerical value of the monitored variable data value. In some examples, the implantable medical device is a pacemaker delivering cardiac pacing pulses according to modulated pacing rate intervals to cause a modulated heart rate of the patient detectable by a heart rate monitor for demodulation to the numerical value of the monitored variable.

A method for treatment of cardiac problems includes performing modulation of a cardiac rhythm of a patient by increasing a number of heart beats the patient during time interval with high pleural pressure relative to the number during low (negative) pleural pressure, wherein an amplitude of the modulation of the cardiac rhythm between these segments is determined by severity of a respiratory effort and lung congestion of the patient.

A system is provided that includes electrodes configured to be implanted in a body, and a pulse generator (PG) circuitry to deliver a stimulus to one or more of the electrodes. The system also includes sensing circuitry configured to define a sensing channel between one or more of the electrodes to sense signals indicative of a physiologic activity of interest, and the sensing circuitry further configured to collect a calibration signal over the sensing channel. The sensing circuitry and PG circuitry are housed within an implantable medical device (IMD). The system also includes one or more processors configured to determine a signal characteristic of interest (COI) of the calibration signal. The one or more processors are also configured to compare a signal COI of the stimulus to the signal COI of the calibration signal, and adjust a parameter of the sensing circuitry or PG circuitry based on the comparison.

A system for removing fluid from a urinary tract includes: at least one sensor configured to detect signal(s) representative of bioelectrical impedance and communicate signal(s) representative of the impedance; and a controller. The controller is configured to: receive and process the signal(s) from the at least one sensor to determine if the impedance is above, below, or at a predetermined value; and provide a control signal, determined at least in part from the signal(s) representative of the impedance received from the at least one sensor, to a negative pressure source to apply negative pressure to a urinary catheter when the impedance is below the predetermined value and to cease applying negative pressure when the impedance is at or above the predetermined value.

A medical device is configured to determine a rate smoothing pacing interval based on at a ventricular cycle length ending with a ventricular pacing pulse and determine a post-sense ventricular pacing interval based on a ventricular cycle length ending with a sensed ventricular event signal. The medical device may be configured to start a ventricular pacing interval set to the post-sense ventricular pacing interval in response to the sensed ventricular event signal and generate a ventricular pacing pulse in response to the expiration of the post-sense ventricular pacing interval.