Systems and methods for reducing ventricle filling volume are disclosed. In some embodiments, a stimulation circuit may be used to stimulate a patient's heart to reduce ventricle filling volume or even blood pressure. When the heart is stimulated at a consistent rate to reduce blood pressure, the cardiovascular system may over time adapt to the stimulation and revert back to the higher blood pressure. In some embodiments, the stimulation pattern may be configured to be inconsistent such that the adaptation response of the heart is reduced or even prevented. In some embodiments, a stimulation circuit may be used to stimulate a patient's heart to cause at least a portion of an atrial contraction to occur while the atrioventricular valve is closed. Such an atrial contraction may deposit less blood into the corresponding ventricle than when the atrioventricular valve is opened throughout an atrial contraction.

An implantable medical device (IMD) is configured with a pressure sensor. The IMD includes a housing and a diaphragm that is exposed to the environment outside of the housing. The diaphragm is configured to transmit a pressure from the environment outside of the housing to a piezoelectric membrane. In response, the piezoelectric membrane generates a voltage and/or a current, which is representative of a pressure change applied to the housing diaphragm. In some cases, only changes in pressure over time are used, not absolute or gauge pressures.

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.

Systems and methods for controlling blood pressure by controlling atrial pressure and atrial stretch are disclosed. In some embodiments, a stimulation circuit may be configured to deliver a stimulation pulse to at least one cardiac chamber of a heart of a patient, and at least one controller may be configured to execute delivery of one or more stimulation patterns of stimulation pulses to the at least one cardiac chamber, wherein at least one of the stimulation pulses stimulates the heart such that an atrial pressure resulting from atrial contraction of an atrium overlaps in time a passive pressure build-up of the atrium, such that an atrial pressure of the atrium resulting from the stimulation is a combination of the atrial pressure resulting from atrial contraction and the passive pressure build-up and is higher than an atrial pressure of the atrium would be without the stimulation, and such that the blood pressure of the patient is reduced.

Systems and methods are provided for optimizing hemodynamics within a patient. Specifically, the system incorporates invasive sensor data (e.g., pressure measurements) combined with mechanisms to dynamically change the loading conditions of the heart and/or heart rate, in order to understand hemodynamic parameters. Computational analyses on dynamic sensor data are used to understand and guide heart rate, filling pressures, and/or volume resuscitation in critically ill patients. By pacing the heart or inducing tricuspid regurgitation, the system may cause dynamic changes in sensor data to understand optimal loading conditions and heart rates. While determining optimal hemodynamic parameters, the system may then automatically optimize the heart rate and/or filling pressures in critically ill patients.

A biventricular (BiV) implantable cardiac stimulator contains a stimulation control unit, one or more stimulation units, an impedance measurement unit and an impedance evaluation unit. The stimulation control unit is operatively connected to one or more stimulation units to control delivery of stimulation pulses by the one or more stimulation units. The stimulation control unit is configured to assess ventricular contractility based on an impedance signal generated by the impedance evaluation unit and to switch between at least a univentricular left ventricular stimulation mode and a biventricular stimulation mode and to evaluate the ventricular contractility in relation to the respective ventricular stimulation mode.

Various systems, devices, and methods are disclosed herein for treating acute myocardial infarction (AMI) patients using a heart pump controlled in a manner that maximizes mechanical unloading of the left ventricle in the presence of cardiovascular instability and minimizes myocardial oxygen consumption (MVO2) and consequentially infarct size to prevent the development of subsequent heart failure. In a closed feedback system, the system can include a sensor configured to generate an output used to measure or calculate a left ventricular systolic pressure (LSVP) within the left ventricle of a heart and a controller coupled to a heart pump. The controller can be configured to measure or calculate the LVSP based on the output of the sensor and to control an operation of the heart pump to maximize mechanical unloading of the left ventricle based on the measured or calculated LVSP.

Systems and methods for controlling blood pressure by controlling atrial pressure and atrial stretch are disclosed. In some embodiments, a stimulation circuit may be configured to deliver a stimulation pulse to at least one cardiac chamber of a heart of a patient, and at least one controller may be configured to execute delivery of one or more stimulation patterns of stimulation pulses to the at least one cardiac chamber, wherein at least one of the stimulation pulses stimulates the heart such that an atrial pressure resulting from atrial contraction of an atrium overlaps in time a passive pressure build-up of the atrium, such that an atrial pressure of the atrium resulting from the stimulation is a combination of the atrial pressure resulting from atrial contraction and the passive pressure build-up and is higher than an atrial pressure of the atrium would be without the stimulation, and such that the blood pressure of the patient is reduced.

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.

Systems and methods for reducing ventricle filling volume are disclosed. In some embodiments, a stimulation circuit may be used to stimulate a patient's heart to reduce ventricle filling volume or even blood pressure. When the heart is stimulated at a consistent rate to reduce blood pressure, the cardiovascular system may over time adapt to the stimulation and revert back to the higher blood pressure. In some embodiments, the stimulation pattern may be configured to be inconsistent such that the adaptation response of the heart is reduced or even prevented. In some embodiments, a stimulation circuit may be used to stimulate a patient's heart to cause at least a portion of an atrial contraction to occur while the atrioventricular valve is closed. Such an atrial contraction may deposit less blood into the corresponding ventricle than when the atrioventricular valve is opened throughout an atrial contraction.