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.

Systems, methods, and devices for detecting or confirming fibrillation are discussed. In one example, a method for detecting a cardiac arrhythmia of a patients' heart comprises receiving, by a leadless cardiac pacemaker fixed in the patients' heart, an indication from a remote device that a cardiac arrhythmia is detected, monitoring by the leadless cardiac pacemaker a signal generated by a sensor that is located within the patients' heart, and based at least in part on the monitored signal, confirming whether a cardiac arrhythmia is occurring or not. In some embodiments, the method may further comprise, if a cardiac arrhythmia is confirmed, delivering a therapy to treat the cardiac arrhythmia.

Methods and devices for reducing ventricle filling volume are disclosed. In some embodiments, an electrical stimulator may be used to stimulate a patient's heart to reduce ventricle filling volume or even blood pressure. When the heart is stimulated in a consistent way 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, an electrical stimulator 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 intracardiac ventricular pacemaker is configured to detect an atrial mechanical event from a motion sensor signal received by an atrial event detector circuit of the pacemaker. The motion sensor signal is responsive the motion of blood flowing in the ventricle. A pacing pulse is scheduled at an expiration of a pacing interval set by a pace timing circuit in response to detecting the atrial mechanical event. An atrial-synchronized ventricular pacing pulse is delivered upon expiration of the pacing interval.

An apparatus for treating a heart of a patient includes a first lead and at least a second lead for pacing the heart adapted to be in electrical communication with the heart. The apparatus includes a microcontroller in communication with the first and second leads which triggers the first lead at either different times or the same time from when the microcontroller triggers the second lead. Alternatively, the apparatus includes a microcontroller in communication with the first and second leads that determines heart volume, including stroke volume, end-systolic volume, and calculated values including ejection fraction, from admittance from signals from the first and second leads and uses the admittance as feedback to control heart volume ejected, as measured by stroke volume, calculated values such as ejection fraction, and control end-systolic volume, with respect to the first and second leads. A method for treating the heart of a patient.

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.

Methods and devices for reducing ventricle filling volume are disclosed. In some embodiments, an electrical stimulator may be used to stimulate a patient's heart to reduce ventricle filling volume or even blood pressure. When the heart is stimulated in a consistent way 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, an electrical stimulator 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.

A system for evaluating an efficacy of vagus nerve stimulation is provided, wherein the system has a neurostimulator that is configured to perform vagus nerve stimulation, and a measuring component for evaluating the efficacy based on at least one parameter that is indicative of a myocardial contractile state of the heart. A corresponding method is also provided.

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 analyzes 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.

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.