A device determines values for one or more metrics that indicate the quality of a patient's sleep based on sensed physiological parameter values. Sleep efficiency, sleep latency, and time spent in deeper sleep states are example sleep quality metrics for which values may be determined. The sleep quality metric values may be used, for example, to evaluate the effectiveness of a therapy delivered to the patient by a medical device. In some embodiments, determined sleep quality metric values are automatically associated with the therapy parameter sets according to which the medical device delivered the therapy when the physiological parameter values were sensed, and used to evaluate the effectiveness of the various therapy parameter sets. The medical device may deliver the therapy to treat a non-respiratory neurological disorder, such as epilepsy, a movement disorder, or a psychological disorder. The therapy may be, for example, deep brain stimulation (DBS) therapy.

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 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.

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 accelerometer 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.

Embodiments of the present technology described herein are directed to implantable systems for performing cardiac resynchronization therapy (CRT), methods for use therewith, and leadless pacemakers for use therewith. Such a system can include a first leadless pacemaker configured to be implanted in or on the right atrial (RA) chamber and selectively pace the RA chamber, a second leadless pacemaker configured to be implanted in or on the right ventricular (RV) chamber and selectively pace the RV chamber, and a third leadless pacemaker configured to be implanted in or on the left ventricular (LV) chamber and selectively pace the LV chamber, wherein one of the leadless pacemaker is designated a master leadless pacemaker. In certain embodiments, the master leadless pacemaker determines a VV delay and an AV delay and coordinates CRT using such delays.

A medical device and method conserve electrical power used in monitoring cardiac arrhythmias. The device includes a sensing circuit configured to sense a cardiac signal, a power source and a control circuit having a processor powered by the power source. The control circuit is configured to operate in a normal state by waking up the processor to analyze the cardiac electrical signal for determining a state of an arrhythmia. The control circuit switches from the normal state to a power saving state that includes waking up the processor at a lower rate than during the normal state.

Techniques are disclosed for adjusting event detection parameters used for sensing mechanical motion data of a heart of a patient for use in cardiac pacing therapy. For example, processing circuitry receives, from a user, an input specifying one or more event detection parameters defining mechanical motion sensing of a heart of a patient by one or more motion sensors of an implantable medical device (IMD). The processing circuitry controls the IMD to perform mechanical motion sensing of the heart of the patient in accordance with the one or more event detection parameters. The processing circuitry obtains mechanical motion data of the heart of the patient sensed in accordance with the one or more event detection parameters. The processing circuitry controls the IMD to deliver cardiac pacing therapy based on the mechanical motion data of the heart of the patient sensed in accordance with the one or more event detection parameters.

A medical device includes a motion sensor configured to produce a motion signal and a control circuit configured to set sensing control parameters and sense atrial events from the motion signal during ventricular cycles according to the sensing control parameters. In some examples, the control circuit is configured to determine a feature of the motion signal for at least some ventricular cycles, determine a metric of the motion signal based on the determined features, and adjust at least one of the sensing control parameters based on the metric.

A medical device includes a motion sensor configured to produce a motion signal and a control circuit configured to sense atrial events from the motion signal. In some examples, the control circuit is configured to set a ventricular diastolic event window and set a threshold amplitude during the ventricular diastolic event window for sensing an atrial event in response to the motion signal crossing the threshold amplitude during the ventricular diastolic window. The control circuit may determine a maximum amplitude of the motion signal during the ventricular diastolic event window for multiple ventricular cycles and determine an amplitude metric based on at least a portion of the determined maximum amplitudes. The control circuit may determine a target value of the threshold amplitude based on at least the amplitude metric and adjust the threshold amplitude toward the target value.

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 maybe 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.