A receiver module of an autonomous implanted capsule receives a human body communication, HBC, signal sensed by an electrode in contact with body tissues or fluids of a patient. The signal is a pulse-modulated, baseband PPM pulse signal. The receiver module comprises a non-linear LNA amplifier stage comprising a pair of complementary transistors arranged as a voltage inverter circuit with an input coupled to the modulated-input-signal collecting electrode. The amplifier stage input is polarized to an intermediate operating point voltage between a supply voltage of the complementary transistor pair and a ground voltage. The amplifier stage has a gain of at least 40 dB, a gain-bandwidth product of at least 20 MHz, and a consumption lower than or equal to 100 nW. It is followed by a downstream demodulator stage made up of a fast comparator circuit of the Threshold Inverter Quantization, TIQ, type, comprising two inverters with cascade-coupled complementary transistors, one of the inverters operating as a voltage reference and the other inverter operating as a gain booster.

An implantable medical device system delivers a pacing pulse to a patient's heart and starts a first pacing interval corresponding to a pacing rate in response to the delivered pacing pulse. The system charges a holding capacitor to a pacing voltage amplitude during the first pacing interval. The system detects an increased intrinsic heart rate that is at least a threshold rate faster than the current pacing rate from a cardiac electrical signal received by a sensing circuit of the implantable medical device. The system starts a second pacing interval in response to an intrinsic cardiac event sensed from the cardiac electrical signal and withholds charging of the holding capacitor for at least a portion of the second pacing interval in response to detecting the increased intrinsic heart rate.

Systems and methods for dynamically controlling His-bundle pacing (HBP) according to an indication of a rate-related or intermittent atrioventricular (AV) block in a subject are disclosed. An exemplary medical system includes an AV conduction monitor to detect an indication of either a presence or an absence of intermittent or rate-related AV conduction disturbance using physiologic information of the subject. In the event that an intermittent or rate-related AV conduction disturbance is present, a control circuit provides a control signal to an electrostimulation circuit to deliver HBP pulses. If there is no indication of intermittent or rate-related AV conduction disturbance, or a previously detected intermittent or rate-related AV conduction disturbance has been terminated, the control circuit withholds or discontinues delivery of the HBP pulses to promote intrinsic ventricular conduction and activation.

Some aspects relate to systems, devices, and methods of delivering rate responsive pacing therapy. The method includes monitoring activity information related to an activity level of a patient and delivering rate responsive pacing (RRP) to the patient at a pacing rate corresponding to a RRP profile. The RRP profile may be used to generate the pacing rate based on the activity information and may be adjusted based on the monitored activity information.

A computer implemented method and device for providing dual chamber sensing with a single chamber leadless implantable medical device (LIMD) are provided. The method is under control of one or more processors in the LIMD configured with specific executable instructions. The method obtains a far field (FF) cardiac activity (CA) signals for activity in a remote chamber of a heart and compares the far field CA signals to a P-wave template to identify an event of interest associated with the remote chamber. The method sets an atrial-ventricular (AV) delay based on the P-wave identified and delivers pacing pulses at a pacing site of interest to a local chamber based on the AV delay,

A computer implemented method for determining heart arrhythmias based on cardiac activity that includes under control of one or more processors of an implantable medical device (IMD) configured with specific executable instructions to obtain far field cardiac activity (CA) signals at electrodes located remote from the heart, and obtain acceleration signatures, at an accelerometer of the IMD, indicative of heart sounds generated during the cardiac beats. The IMD is also configured with specific executable instructions to declare a candidate arrhythmia based on a characteristic of at least one R-R interval from the cardiac beats, and evaluate the acceleration signatures for ventricular events (VEs) to re-assess a presence or absence of at least one R-wave from the cardiac beats and based thereon confirming or denying the candidate arrhythmia.

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 electrical lead and methods of implanting medical electrical leads in lumens. Leads in accordance with the invention employ preformed biases to stabilize the lead within a lumen or lumen and to provide feedback to lead implanters.

Implantable medical devices (IMD) such as a cardiac pacemakers may include a sensor and electrodes. In some cases, the IMD may include electronics to use the sensor to determine the heart rate of a patient's heart. The electronics may use the electrodes to deliver pacing pulses to the heart at a first energy level if the heart rate is below a threshold and pace the heart at an enhanced energy level if the heart rate is above the threshold.

An implantable pacemaker is configured to provide electrical pacing pulses to the heart of a patient. The pacemaker has a pulse generator configured to generate the electrical pacing pulses, at least one pacing electrode to apply the electrical pacing pulses to the heart, a sensing unit configured to sense events of electrical activity of a ventricle of the heart, a sensor configured to measure a signal relating to the patient, and a memory configured to store values of a parameter. The pacemaker is configured to be operated in a first mode to generate a reference curve and to select a target range of values of the parameter corresponding to a desired range of atrioventricular delays. The pacemaker is further configured to be operated in a second mode for approaching the target range.