The device includes a cardiac therapy circuit with a first terminal, and a peripheral therapy circuit with a second terminal. These terminals can either receive a cardiac detection/stimulation lead or a peripheral detection/stimulation lead of an organ. The device is configured to recognize the leads and automatically configure the connection terminals according to the type of lead received by the terminal. This includes discrimination methods for identifying the terminal on which a cardiac signal is detected, and selectively activating the cardiac therapy circuit and the peripheral therapy circuit based on the detection of the cardiac signal on a lead.

An apparatus for coupling to a plurality of electrodes implantable at a plurality of tissue sites of a heart chamber of a subject. The apparatus including a stimulus circuit configured to provide an electrical cardiac pacing stimulation to the plurality of electrodes, a switching circuit configured to select electrodes of the plurality of electrodes for electrical coupling to the stimulus circuit, and a control circuit including a heart rate sub-circuit configured to determine heart rate; and a pacing site activation sub-circuit configured to selectively change which electrodes of the plurality of electrodes are used to provide the electrical cardiac pacing stimulation therapy according to the determined heart rate.

A method for determining the degree of parallel activation of a heart undergoing pacing includes calculating vectorcardiogram (VCG), or electrocardiogram (ECG), or electrogram (EGM) waveforms from right ventricular pacing (RVp) and left ventricular pacing (LVp). A synthetic biventricular pacing (BIVP) waveform is generated by summing the VCG of the RVp and LVp, or by summing the ECG of the RVp and the LVp, or by summing the EGM of the RVp and the LVp. A corresponding EGM or ECG or VCG waveform from real BIVP is calculated. The method includes comparing the synthetic BIVP waveform and the real BIVP waveform and calculating time to fusion by determining the point in time in which the activation from RVp and LVp meets and the synthetic and the real BIVP curves start to deviate. A delay in time to fusion indicates a higher degree of parallel activation.

The present disclosure relates generally to pacing of cardiac tissue, and more particularly to adjusting delivery of His bundle or bundle branch pacing in a cardiac pacing system to achieve synchronized ventricular activation. Bundle pacing may be delivered in response to determining whether the QRS parameter or activation interval is greater than a threshold. A set of AV delays may be generated, and an optimal AV delay may be selected from the stored set of AV delays. His-bundle or bundle-branch pacing may be selectively delivered based on RV or LV activation time. Pacing may also be adjusted based on dyssynchrony detected or the type of bundle branch block pattern detected.

An electric stimulator for heart (as in heart pacemakers), brain (as in DBS), organs and general cells, with electrodes in the space surrounding the main stimulating electrodes. These surrounding electrodes are more effective at creating the best electric field to guide the stimulating electric charges necessary for the purpose of the device. The surrounding electrodes are supported on a second supporting device, while the main electrodes are in a first supporting device we call picafina.

A system is provided for controlling a left univentricular (LUV) pacing therapy using an implantable medical device (IMD). The system also includes one or more processors configured to determine an atrial-ventricular (AV) conduction interval (AR.sub.RV) between the A site and a first RV sensed event at the RV site, determine an inter-ventricular (VV) conduction interval (R.sub.LV-R.sub.RV) between a paced event at the LV site and a second RV sensed event at the RV site, and set a ventricular refractory period (VRP) based on at least one of the AV conduction interval or the VV conduction interval and a predetermined offset. The one or more processors are also configured to blank signals over the RV sensing channel during the VRP.

An implantable device comprises a plurality of electrode pairs, a sensing unit, and a pacing unit. The electrode pairs comprise a first electrode pair. The first electrode pair is configured to implant at or near a first location of a heart. The sensing unit is configured to sense electrical activity in the heart, determine that the electrical activity indicates an abnormal rhythm, determine a feature of the electrical activity, and select the first electrode pair from the electrode pairs based on the feature. The pacing unit is configured to cause, in response to the abnormal rhythm and the feature, the first electrode pair to provide a first electrical pulse at a first time.

A method and implantable medical device system for delivering a left ventricular (LV) cardiac pacing therapy via a single-pass coronary sinus lead and sensing far-field cardiac signals via one or more far-field sensing vectors formed between the plurality of electrodes. Beat morphologies corresponding to the far-field cardiac signals are determined, and a beat morphology match between each of the far-field beat morphologies and an intrinsic beat morphology template is determined so that one of loss of LV capture, pseudo fusion and loss of synchrony is determined in response to the determined beat morphology match. One of a loss of capture adjustment, a pseudo fusion adjustment, and a resynchronization adjustment is performed in response to the determined one of loss of LV capture, pseudo fusion and loss of synchrony in response to the determined beat morphology match to generate an adjusted LV cardiac pacing therapy.

A device for providing cardiac pacing of triangle of Koch and bundle of His zones by multiple electrodes inserted using in a single conduit is disclosed. The single conduit includes a plurality of individual electrodes capable of expanding from the distal end and forming a scattered pattern once deployed in the heart. Individual or group testing against a predetermined acceptance criterion is used to select a subset of individual electrodes for use in cardiac pacing.

A system is provided for controlling a left univentricular (LUV) pacing therapy using an implantable medical device (IMD). The system also includes one or more processors configured to determine an atrial-ventricular (AV) conduction interval (AR.sub.RV) between the A site and a first RV sensed event at the RV site, determine an inter-ventricular (VV) conduction interval (R.sub.LV-R.sub.RV) between a paced event at the LV site and a second RV sensed event at the RV site, and set a ventricular refractory period (VRP) based on at least one of the AV conduction interval or the VV conduction interval and a predetermined offset. The one or more processors are also configured to blank signals over the RV sensing channel during the VRP.