An interface unit for epicardial pacemaking and telemetry monitoring connects a pacemaker and bedside monitor for simultaneous pacing during electrogram visualization using epicardial pacing leads. The interface unit provides an electrically insulating housing having single handed manual attachment of the epicardial leads and a retractable protective shroud extending over the epicardial leads. The interface unit further provides electrical connectors for selective attachment to the pacemaker and bedside monitor.

A medical device includes a motion sensor configured to produce a motion signal and a control circuit configured to set sensing control parameters and sense atrial events from the motion signal during ventricular cycles according to the sensing control parameters. In some examples, the control circuit is configured to determine a feature of the motion signal for at least some ventricular cycles, determine a metric of the motion signal based on the determined features, and adjust at least one of the sensing control parameters based on the metric.

A medical device includes a motion sensor configured to produce a motion signal and a control circuit configured to sense atrial events from the motion signal. In some examples, the control circuit is configured to set a ventricular diastolic event window and set a threshold amplitude during the ventricular diastolic event window for sensing an atrial event in response to the motion signal crossing the threshold amplitude during the ventricular diastolic window. The control circuit may determine a maximum amplitude of the motion signal during the ventricular diastolic event window for multiple ventricular cycles and determine an amplitude metric based on at least a portion of the determined maximum amplitudes. The control circuit may determine a target value of the threshold amplitude based on at least the amplitude metric and adjust the threshold amplitude toward the target value.

An energy harvester converts into electrical energy the external stresses applied to the implant at the rhythm of the heartbeats. This harvester comprises an inertial unit. A transducer provides an oscillating electrical signal that is rectified and regulated, for powering the implant and/or charging a battery. The instantaneous variations of this electrical signal between two heartbeats are analyzed inside successive time windows, to derive therefrom a physiological parameter and/or a physical activity parameter of the patient with the implant, in particular as a function of a peak of amplitude of the first oscillation of the electrical signal, and of the level of this signal after the bounce phase of the signal oscillation.

A leadless pacemaker, and method for storing event data therein, comprising a central processing unit, a first logic circuit configured to generate event data based on a first event occurring during operation of the leadless pacemaker, a first hardware event counter configured to be incremented if specific event data are generated by said first logic circuit, a first memory unit comprising a first bit configured to be set if said first hardware event counter is incremented to a first maximum number of counts, a second memory unit communicating with said first memory unit, wherein said central processing unit is configured to transfer said first bit to said second memory unit, a first RAM event counter in a random access memory of said leadless pacemaker, wherein said central processing unit is configured to increment said first RAM event counter if said first bit is transferred to the second memory unit.

A system and method for measuring and monitoring charge states of one or more electrodes of an implanted stimulation lead system associated with an IPG. A Kelvin connection scheme operative with a switching circuit is provided for coupling select electrode terminals disposed in a Kelvin connection measurement loop in a switchable manner to sense and reference inputs of an analog-to-digital converter (ADC) configured as at least part of diagnostic circuitry for the IPG.

A medical device is configured to detect an alternating pattern of signal features determined from consecutive segments of a cardiac electrical signal and determine a gross morphology metric from at least one segment of the cardiac electrical signal. The device is configured to detect cardiac event oversensing in response to detecting the alternating pattern and the gross morphology metric not meeting tachyarrhythmia morphology criteria. The medical device may withhold detecting an arrhythmia in response to detecting the cardiac event oversensing.

A pericardial implantable cardioverter defibrillator (ICD) may be delivered to the heart through the chest wall using an ultrasound image guided catheter. The ICD may comprise a patch and wire leads which may be secured by a clam shell-like pad at a distal end and comprise a pig-tail shaped securing tail at the other end so that the ICD is firmly attached to the pericardium of a human heart. The ICD may be attached where most needed and serve as either a pacemaker or a defibrillator. In one embodiment, the ICD may emit radio frequency warning signals of heart failure sensed when pacemaker or defibrillator usage is rendered necessary.

Computer implemented methods and systems for detecting arrhythmias in cardiac activity are provided. The method is under control of one or more processors configured with specific executable instructions. The method obtains a far field cardiac activity (CA) data set that includes far field CA signals for beats. The method applies a feature enhancement function to the CA signals to form an enhanced feature in the CA data set. The method calculates an adaptive sensitivity level and sensitivity limit based on the enhanced feature from one or more beats within the CA data set and automatically iteratively analyzes a beat segment of interest by comparing the beat segment of interest to the current sensitivity level to determine whether one or more R-waves are present within the beat segment of interest. The method repeats the iterative analyzing operation while progressively adjusting the current sensitivity level until i) the one or more R-waves are detected in the beat segment of interest and/or ii) the current sensitivity level reaches the sensitivity limit. The method detects an arrhythmia within the beat segment of interest based on a presence or absence of the one or more R-waves and records results of the detecting of the arrhythmia.

Methods, systems, and devices for signal analysis in an implanted cardiac monitoring and treatment device such as an implantable cardioverter defibrillator. In illustrative examples, captured data including detected events is analyzed to identify likely overdetection of cardiac events. In some illustrative examples, when overdetection is identified, data may be modified to correct for overdetection, to reduce the impact of overdetection, or to ignore overdetected data. New methods for organizing the use of morphology and rate analysis in an overall architecture for rhythm classification and cardiac signal analysis are also discussed.