Devices and methods for detecting physiological target event such as events indicative of heart failure (HF) decompensation status are described. An ambulatory medical device (AMD) can detect device site maturation such as in a device encapsulation pocket, and classify the maturation status into one of two or more device site maturation states. The AMD can include an electrical impedance analyzer circuit that can measure a first maturation-insensitive impedance vector and a second maturation-sensitive impedance vector. At least one impedance vector can be selected or a composite impedance vector can be generated in accordance with the classified device site maturation state. The AMD can generate an impedance indicator using the selected or composite impedance vector, and detect a target physiologic event indicative of worsening of HF using the impedance indicator.

Disclosed are methods, systems, and computer-readable medium for implementing a closed-loop system for determining an adjusted physiological pacing rate based on receiving one or more biomarker levels, comparing the one or more biomarker levels to a target biomarker level, and determining an adjusted physiological pacing rate based on comparing the one or more biomarker levels to the target biomarker level.

Embodiments herein relate to integrated thermo-photonic chemical sensors as part of an implantable sensing device. In a first aspect, an implantable sensing device is included having a sensing element, an optical excitation assembly configured to illuminate the sensing element, an optical detection assembly configured to receive optical signals from the sensing element, and a control circuit, wherein the control circuit is configured to receive signals from the optical detection assembly, receive signals reflecting temperature, and process signals from the optical detection assembly while adjusting for the signals reflecting temperature. Other embodiments are also included herein.

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.