Implantable medical devices such as leadless cardiac pacemakers may be configured to communicate using more than one mode of communication. For example, in some cases, an implantable medical device may be configured to communicate via conducted communication in some circumstances and to communicate via inductive communication in other circumstances. In some cases, the implantable medical device may be configured to switch between communication modes in order to improve communication.

The disclosure is directed towards posture-responsive therapy. To avoid interruptions in effective therapy, an implantable medical device may include a posture state module that detects the posture state of the patient and automatically adjusts therapy parameter values according to the detected posture state. A system may include a memory that stores posture state definitions, a posture state module that records a plurality of postures of a patient over a period of time, and a processor that identifies a set of the plurality of postures that fall within a posture state, and redefines a boundary of the posture state based on where the postures fall within the posture state.

Systems, devices, and methods for pacing a heart of a patient are disclosed. An illustrative method may include determining a motion level of the patient using a motion sensor of an implantable medical device secured relative to a patient's heart, and setting a pacing rate based at least in part on the patient's motion level. The patient's motion level may be determined by, for example, comparing the motion level sensed by the motion sensor during a current heart beat to a motion level associated with one or more previous heart beats. Noise may occur in the motion level measurements during those heart beats that transition between an intrinsically initiated heart beat and pace initiated heart beat. Various techniques may be applied to the motion level measurements to help reduce the effect of such noise.

Systems, devices, and methods for pacing a heart of a patient are disclosed. An illustrative method may include determining a motion level of the patient using a motion sensor of an implantable medical device secured relative to a patient's heart, and setting a pacing rate based at least in part on the patient's motion level. The patient's motion level may be determined by, for example, comparing the motion level sensed by the motion sensor during a current heart beat to a motion level associated with one or more previous heart beats. Noise may occur in the motion level measurements during those heart beats that transition between an intrinsically initiated heart beat and pace initiated heart beat. Various techniques may be applied to the motion level measurements to help reduce the effect of such noise.

The disclosure is directed towards posture-responsive therapy. To avoid interruptions in effective therapy, an implantable medical device may include a posture state module that detects the posture state of the patient and automatically adjusts therapy parameter values according to the detected posture state. A system may include a user interface that receives user input linking a plurality of posture states of a patient, and selecting a set of therapy parameter values for delivery of therapy to the patient for each of a linked posture states, a processor that defines the therapy to be delivered to the patient for each of the linked posture states based on the selection, and an implantable medical device that delivers the therapy to the patient for each of the linked posture states based on the selection.

The disclosure provides a system that displays graphical representations of posture zones associated with posture states of a patient, on a display device communicatively coupled to a medical device. The medical device is configured to deliver therapy to the patient based on detected posture states of the patient, where the detected posture state is based on the posture zones. The display device may allow a user to manipulate the graphical representations of the posture zones, including changing the size of the posture zones. Additionally, the display device may allow a user to change transition times associated with transitions between posture states, and displaying an indication of the changed transition time by highlighting the two graphical representations of the posture zones corresponding to the posture states associated with the changed transition time.

A system embodiment comprises an implantable device including controller circuitry, memory, a transceiver, and a generator configured to generate electrical stimulation to modulate the neural activity. The controller circuitry and the transceiver configured to cooperate to receive, from another device, data corresponding to a user-programmable stimulation pattern and store the data in the memory. The user-programmable pattern includes a programmable pattern of bursts with multiple burst durations and multiple burst interval sequences, and the bursts include pulses with a user-programmable wave morphology. The controller circuitry is operably connected to the memory and the generator to use the data stored in the memory to control generation of the electrical stimulation to provide the user-programmable stimulation pattern that includes the pulses with the user-programmable wave morphology and that includes the multiple burst durations and the multiple burst interval sequences.

An implantable rate responsive pacemaker includes a sensor module configured to produce an activity signal correlated to a metabolic demand of a patient and a posture signal correlated to patient posture. The pacemaker further includes a pulse generator configured to generate and deliver pacing pulses to a patient's heart via a pair of electrodes coupled to the pacemaker. A control module is coupled to the pulse generator and the sensor module and is configured to determine a sensor indicated pacing rate from the activity signal, compare the posture signal to verification criteria for confirming an exercising posture of the patient, and withhold an adjustment of a pacing rate to the sensor indicated pacing rate responsive to the verification criteria not being met.

An implantable medical device system includes an implantable cardioverter defibrillator (ICD) for detecting and treating ventricular tachycardia (VT). The ICD includes a sensing module for sensing a cardiac signal from available cardiac signal sensing vectors. A control module generates morphology templates of the cardiac signals for multiple patient postures for each of the available sensing vectors and determines a set of posture-independent template features. An unknown cardiac rhythm is classified in response to comparing features of a cardiac signal received during the unknown rhythm to the set of posture-independent features.

Techniques related to classifying a posture state of a living body are disclosed. One aspect relates to sensing at least one signal indicative of a posture state of a living body. Posture state detection logic classifies the living body as being in a posture state based on the at least one signal, wherein this classification may take into account at least one of posture and activity state of the living body. The posture state detection logic further determines whether the living body is classified in the posture state for at least a predetermined period of time. Response logic is described that initiates a response as a result of the body being classified in the posture state only after the living body has maintained the classified posture state for at least the predetermined period of time. This response may involve a change in therapy, such as neurostimulation therapy, that is delivered to the living body.