Devices and methods for improving device therapy such as cardiac resynchronization therapy by determining a value for a device parameter are described. An ambulatory medical device (AMD) can include a sensor circuit to sense a physiological signal and generate two or more signal metrics, and detect an event of worsening cardiac condition using the two or more signal metrics. In response to the detection of worsening cardiac condition, the AMD can determine, for a stimulator, a value of at least one stimulation parameter based on temporal responses of two or more signal metrics. The temporal responses include near-term and long-term responses to the stimulation. The AMD can program the stimulator with the determined parameter value, and generate stimulation according to the determined parameter value to stimulate target tissue.

A wearable defibrillator includes garment configured to be worn by a patient, treatment electrodes configured to apply electric current to the patient, and an alarm module configured to provide audio, visual, and haptic notifications. The notifications are configured to indicate that an electric current will be administered imminently, and prompt the patient to provide a response input. The wearable defibrillator includes a motion sensor configured to detect motion and a lack of motion of the patient, and a controller in electrical communication with the alarm module and the motion sensor. The controller is configured to monitor for the response input, cause administration of the electric current to be delayed or cancelled if the response input is received and motion of the patient is detected, and cause administration of the electric current to be delivered if no response input from the patient is received and a lack of motion is detected.

A cardiac pacing system that includes a pulse generator to generate therapeutic electrical pulses and at least one lead inserted through an intercostal space in the region of a cardiac notch of the left lung of a patient, the lead having a distal end configured to transmit the therapeutic electrical pulses generated by the pulse generator to pace the heart of the patient.

The disclosure describes techniques for associating therapy adjustments with posture states using a timer. The techniques may include detecting a patient adjustment to electrical stimulation therapy delivered to the patient, sensing a posture state of the patient, and associating the detected adjustment with the sensed posture state if the sensed posture state is sensed within a first period following the detection of the adjustment and if the sensed posture state does not change during a second period following the sensing of the sensed posture state.

Aspects of the present disclosure are directed toward a medical device having a a core assembly. The core assembly includes a core circuit assembly and a core assembly housing configured to enclose the core circuit assembly. The core assembly housing includes a first portion, and a second portion configured to be coupled to the first portion along a weld seam. The second portion includes at least one weld joint feature, which includes a thinned section of the second portion.

A cardiac pacing system having a pulse generator for generating therapeutic electric pulses, a lead electrically coupled with the pulse generator having an electrode, a first sensor configured to monitor a physiological characteristic of a patient, a second sensor configured to monitor a second physiological characteristic of a patient and a controller. The controller can determine a pacing vector based on variables including a signal received from the second sensor, and cause the pulse generator to deliver the therapeutic electrical pulses according to the determined pacing vector. The controller can also modify pacing characteristics based on variables including a signal received from the second sensor.

A ventricularly implantable medical device that includes a sensing module that is configured to detect an artifact during ventricular filling and to identify an atrial event based at least on part on the detected artifact. Control circuitry of the implantable medical device is configured to deliver a ventricular pacing therapy to a patient's heart, wherein the ventricular pacing therapy is time dependent, at least in part, on the identified atrial event.

A ventricularly implantable medical device that includes a sensing module that is configured to detect an atrial fiducial and identify an atrial contraction based at least on part on the detected atrial fiducial. Control circuitry in the implantable medical device is configured to deliver a ventricular pacing therapy to a patient's heart based at least in part on the identified atrial contraction, and can automatically switch or revert the ventricular pacing therapies on the fly.

An implantable cardiac pacemaker, wherein the pacemaker is configured to apply pacing pulses to the heart of a person during operation of the pacemaker, and wherein the pacemaker comprises a motion detection system that comprises a first module and a second module. The first module is configured to continuously run during operation of the pacemaker. The second module is configured to receive a trigger signal to change from an idle state to an active state or to receive a further trigger signal to change from an active state to an idle state. An energy consumption per time unit of the second module in the active state is larger than in the idle state. When the second module is in its active state, the second module is configured to execute a rate adaptation algorithm that adapts a rate of the pacing pulses to meet a metabolic demand of the person.

An active implantable medical device includes a VNS pulse bursts generator for stimulation of the vagus nerve according to several selectable configurations. The device may further include a sensor of the current activity level of the patient. The generator is controlled on the activity signal via a classifier determining the of class the current level of activity among a plurality of classes of activity. A controller selects a configuration of VNS therapy depending on the class of activity thus determined. Limits of the activity classes are dynamically changeable by a calibration module that conducts a historical analysis of the successive current activity levels over a predetermined analysis period. The calibration module can prepare a histogram of the historical analysis, and can define the limits of the activity classes depending on the outcome of the historical analysis and the histogram.