One system includes a stimulation device such as a vagus nerve stimulation lead, and a controller for controlling the stimulation device according to a set of stimulation parameters. A memory of the stimulation device contains a state transition model, and for each state defines a set of stimulation parameters and at least one expected response during the application of stimulation with the parameters. A matrix determines the transition rules between states based on physiological levels measured versus target levels. A state transition control unit determines, in an organized timely method, possible transitions between states according to the rules on physiological levels obtained in response to the implementation of the stimulation parameters of the current state, and a transition from a current state to a new state causes a corresponding change in the parameter set used for stimulation.

According to an embodiment of a method for providing neural stimulation, activity is sensed, and neural stimulation is automatically controlled based on the sensed activity. An embodiment determines periods of rest and periods of exercise using the sensed activity, and applies neural stimulation during rest and withdrawing neural stimulation during exercise. Other embodiments are provided herein.

A Medical Device Application (MDA) is disclosed for an external device (e.g., a cell phone) that can communicate with an Implantable Medical Device (IMD). The MDA receives data logged in the IMD, processes that data in manners reviewable by an IMD patient, and that can control the IMD based on such processed data. The MDA can use the logged data to adjust IMD therapy based on patient activity or posture, and allows a patient to learn optimal therapy settings for particular activities. The MDA can also use the logged data to allow a patient to review details about IMD battery performance, whether such battery is primary or rechargeable, and to control stimulation parameters based on that performance. The MDA also allows a patient to enter medicine dose information, to review the relationship between medicinal therapy and IMD therapy, and to adjust IMD therapy based on the dosing information.

A medical device senses cardiac electrical signals including T-waves attendant to ventricular myocardial repolarizations and detects a T-wave template condition associated with non-pathological changes in T-wave morphology. The device generates a T-wave template from T-waves sensed by the sensing circuit during the T-wave template condition. After generating the T-wave template, the device acquires a T-wave signal from the cardiac electrical signal and compares the acquired T-wave signal to the T-wave template. The device detects a pathological event in response to the acquired T-wave signal not matching the T-wave template.

A vestibular stimulation system and method that includes a housing, a power supply disposed in the housing, an electrode assembly adapted to be coupled to the housing, and a controller disposed in the housing and operatively coupled to the power supply. The controller controls the delivery of energy from the power supply to the electrode assembly. An input element is also disposed on an exterior surface of the housing. The input element is manually manipulated to control the operation of the vestibular stimulation system. A display disposed on an exterior surface of the housing provides visual information regarding the operation of the vestibular stimulation system. A mounting assembly is coupled to the housing to mount the housing on such a user.

Regulating cardiac activity may include pacing the patient's heart at a starting pacing rate and instigating an intrinsic heart beat search algorithm that includes pacing at a reduced rate for a period of time and capturing electrical signals representative of cardiac electrical activity while pacing at the reduced rate in order to determine a presence or absence of intrinsic heart beats. If intrinsic heart beats are not detected, the heart may be paced at a further reduced rate for a period of time. If intrinsic beats are detected, the heart may be paced again at the starting pacing rate. This may continue until intrinsic heart beats are detected or until a lower search rate limit is reached. Diagnostic data may be collected at each stage and transmitted to a display device for analysis by a physician or the like.

Systems, devices, or methods can be used to detect an event, or series of events, that can indicate worsening of congestive heart failure (CHF), or can be used to identify a subject at an elevated risk for developing CHF. A CHF event predictor can be provided using a characteristic minimum of subject cardiac intervals. In an example, the subject cardiac intervals can be obtained during a night-time period or during periods of reduced subject physical activity. A CHF event predictor can be determined using information about physiologic signals received from a subject, such as from a physiologic sensor associated with an ambulatory or implantable medical device.

For use by an implantable system including a first and second leadless pacemakers (LPs) implanted, respectively, in first and second cardiac chambers, a method comprises storing, within memory of the first LP, a paced activation morphology template corresponding to far-field signal components expected to be present in an EGM sensed by the first LP when a pacing pulse delivered to the second cardiac chamber by the second LP captures the second cardiac chamber. The method also includes the first LP comparing a morphology of a portion of an EGM sensed by the first LP to the paced activation morphology template to determine whether a match therebetween is detected, and determining whether capture of the second cardiac chamber occurred or failed to occur, based on whether the first LP detects a match between the morphology of the portion of the EGM and the paced activation morphology template.

Techniques and systems disclosed herein are directed to determining pacing attributes for a patient and include determining use of a beta blocker with intrinsic sympathomimetic activity (ISA) by the patient, receiving a current physiological input, and determining pacing attributes based on the determining use of the beta blocker with ISA and the current physiological input. They further include receiving a current physiological input, determining pacing attributes based on the current physiological input, causing a pacing device to output pacing outputs based on the pacing attributes, receiving an updated physiological input after causing the pacing device to output the pacing outputs, determining that a difference between the current physiological input and the updated physiological input does not meet a threshold difference, and generating an indication of a presence or use of a non-ISA beta blocker based on the difference not meeting the threshold difference.

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.