This document discusses, among other things, systems and methods to receive physiologic information from a patient during different first and second pacing periods having respective, different first and second atrioventricular (AV) delays, determine first and second physiologic parameters using respective received physiologic information from the first and second pacing periods, and adjust the first AV delay using the determined first and second physiologic parameters, wherein the second AV delay is longer than the first AV delay.

A wearable defibrillator for use in monitoring patient movement and cardiac activity and treating a patient includes a garment configured to be worn by the patient, treatment electrodes configured to apply an 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 body position of a 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 after the prompt, determine, based on the detected motion and body position, whether the patient is sleeping, and cause a change in one or more characteristics of the prompt on determining that the patient is sleeping.

A medical device is configured to generate an acceleration signal and a temperature signal. The device is configured to determine an activity metric from the acceleration signal that is representative of patient physical activity. In response to determining that the activity metric is equal to or greater than a previously determined activity metric, the device is configured to adjust a target cardiac pacing rate based at least on a temperature change determined from the temperature signal. The device may include a pulse generator for generating cardiac pacing pulses based on the target cardiac pacing rate.

A system for application of neurostimulation includes an outer sheath, an elongate inner member in the outer sheath and movable relative to the outer sheath. The inner lumen has a distal end. An expandable member is coupled to the distal end of the inner member and is in the outer sheath. The expandable member is self-expanding upon from a compressed state in the outer sheath to an expanded state out of the outer sheath. The expandable member includes a distal portion including a plurality of wires woven together and a proximal portion including the plurality of wires extending parallel to a longitudinal axis. The system includes a plurality of electrode assemblies outward of the expandable member and circumferentially spaced around the expandable member. Each electrode assembly is coupled to two of the wires extending parallel to the longitudinal axis. Each electrode assembly includes a plurality of longitudinally-spaced electrodes.

A pacemaker control system includes a pacemaker; a plurality of sensors which are internal to the pacemaker, a plurality of sensors which are external to the pacemaker, a circuit for entering patient reports; and a circuit for using artificial intelligence to process outputs from the plurality sensors internal and external to the pacemaker and from the circuit for entering patient reports, which are collectively identified as a labeled dataset, to reiteratsvely learn a function which determines the labeled dataset most likely to provide optimal pacemaker function for the patient. The means for using artificial intelligence comprises a database of archive outputs from the plurality sensors internal and external to the pacemaker and from the means for entering patient reports for the patient used for optimization of rate modulation to intelligently, continuously and physiologically control the pacemaker.

An implantable medical device includes an activity sensor, a pulse generator, and a control module. The control module is configured to determine activity metrics from the activity signal and determine an activity metric value at a predetermined percentile of the activity metrics. The control module sets a lower pacing rate set point based on the activity metric value at the predetermined percentile.

Embodiments described herein relate to implantable medical devices (IMDs) and methods for use therewith. Such a method includes using an accelerometer of an IMD (e.g., a leadless pacemaker) to produce one or more accelerometer outputs indicative of the orientation of the IMD. The method can also include controlling communication pulse parameter(s) of one or more communication pulses (produced by pulse generator(s)) based on accelerator output(s) indicative of the orientation of the IMD. The communication pulse parameter(s) that is/are controlled can be, e.g., communication pulse amplitude, communication pulse width, communication pulse timing, and/or communication pulse morphology. Such embodiments can be used to improve conductive communications between IMDs whose orientation relative to one another may change over time, e.g., due to changes in posture and/or due to cardiac motion over a cardiac cycle.

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 leadless cardiac pacemaker (LCP) is configured to sense cardiac activity and to pace a patient's heart and is disposable within a ventricle of the patient's heart. The LCP may include a housing, a first electrode and a second electrode that are secured relative to the housing and are spaced apart. A controller is disposed within the housing and is operably coupled to the first electrode and the second electrode such that the controller is capable of receiving, via the first electrode and the second electrode, electrical cardiac signals of the heart. The LCP may include a pressure sensor and/or an accelerometer. The controller may determine a pace time for a cardiac cycle based at least in part upon a signal from the pressure sensor.

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.