Disclosed herein are implantable medical devices (IMDs) including a receiver and a battery, and methods for use therewith. The receiver includes first and second differential amplifiers, each of which monitors for a predetermined signal within a frequency range and drains power from the battery while enabled, and while not enabled drains substantially no power from the battery. To remove undesirable input offset voltages, each of the differential amplifiers, while enabled, is selectively put into an offset correction phase during which time the predetermined signal is not detectable by the differential amplifier. At any given time at least one of the first and second differential amplifiers is enabled without being in the offset correction phase so that at least one of the differential amplifiers is always monitoring for the predetermined signal. In this manner, the receiver is never blind to signals, including the predetermined signals, sent by another IMD.

Methods and systems are provided for detecting arrhythmias in cardiac activity is provided. The method and systems are under control of one or more processors configured with specific executable instructions. The method and systems obtain a far field cardiac activity (CA) signal that includes a series of beats, the CA signal including paced events. The method and systems identify the paced events in the CA signals. The method and systems determine a score based on an amount of paced events and adjust at least one parameter of an atrial fibrillation (AF) detection process based on the score.

Computer implemented methods, devices and systems for monitoring a trend in heart failure (HF) progression are provided. The method comprises sensing left ventricular (LV) activation events at multiple LV sensing sites along a multi-electrode LV lead. The activation events are generated in response to an intrinsic or paced ventricular event. The method implements program instructions on one or more processors for automatically determining a conduction pattern (CP) across the LV sensing sites based on the LV activation events, identifying morphologies (MP) for cardiac signals associated with the LV activation events and repeating the sensing, determining and identifying operations, at select intervals, to build a CP collection and an MP collection. The method calculates an HF trend based on the CP collection and MP collection and classifies a patient condition based on the HF trend to form an HF assessment.

Methods and devices for sensing vector analysis in an implantable cardiac stimulus system. In an illustrative example, a first sensing vector is analyzed to determine whether it is suitable, within given threshold conditions, for use in cardiac event detection and analysis. If so, the first vector may be selected for detection and analysis. Otherwise, one or more additional vectors are analyzed. A detailed example illustrates methods for analyzing sensing vectors by the use of a scoring system. Devices adapted to perform these methods are also discussed, including implantable medical devices adapted to perform these methods, and systems comprising implantable medical devices and programmers adapted to communicate with implantable medical devices, the systems also being adapted to perform these methods. Another example includes a programmer configured to perform these methods including certain steps of directing operation of an associated implanted or implantable medical device.

A method includes acquiring a bipolar signal from a first electrode and a second electrode contacting a first location and a second location, respectively, in a heart of a living subject. The method further includes acquiring a unipolar signal from the first electrode while in contact with the first location, and deriving from the bipolar signal and the unipolar signal a point in time at which the first location is generating the unipolar signal. The method also includes computing a metric for a conduction velocity of the unipolar signal at the first location based on a shape of the unipolar signal at the point in time.

An implantable medical device performs a method that includes detecting a cardiac event interval that is greater than a P-wave oversensing threshold interval. In response to detecting the cardiac event interval greater than the P-wave oversensing threshold interval, the device determines the amplitude of the sensed cardiac signal and withholds restarting a pacing interval in response to the amplitude satisfying P-wave oversensing criteria. A pacing pulse may be generated in response to the pacing interval expiring without sensing an intrinsic cardiac electrical event that is not detected as a P-wave oversensing event.

An implantable medical device (IMD) may include a sensor for providing a sensor output signal and a sense channel configured to receive the sensor output signal from the sensor. The sense channel may be configured to process the sensor output signal and output a sense channel output signal. The sense channel may have an adjustable performance level, wherein for a higher performance level the sense channel consumes more power than for a lower performance level. A controller may be configured to adjust the performance level of the sense channel to achieve more performance and more power consumption when a higher degree of sense channel performance is desired and to achieve less performance and less power consumption when a higher degree of performance is not desired.

A medical device system, such as an extra-cardiovascular implantable cardioverter defibrillator ICD, senses R-waves from a first cardiac electrical signal by a first sensing channel and stores a time segment of a second cardiac electrical signal in response to each sensed R-wave. The medical device system determines a morphology parameter correlated to signal noise from time segments of the second cardiac electrical signal, detects a noisy signal segment based on the signal morphology parameter; and withholds detection of a tachyarrhythmia episode in response to detecting a threshold number of noisy signal segments.

An implantable cardioverter defibrillator (ICD) performs a method that includes determining whether first criteria for detecting a ventricular tachyarrhythmia are met by a cardiac electrical signal. The ICD determines features from cardiac signal segment of a group of cardiac signal segments and determines whether a first portion of the features satisfy monomorphic waveform criteria and determines whether a second portion of the features satisfy supraventricular beat criteria. The ICD determines whether second criteria for detecting the ventricular tachyarrhythmia are met and withholds detecting of the ventricular tachyarrhythmia in response to the monomorphic waveform criteria and the supraventricular beat criteria being met.

Various embodiments of a hermetically-sealed package and a method of forming such package are disclosed. The package can include a housing having an inner surface and an outer surface, and a non-conductive substrate hermetically sealed to the housing. The package can also include a light source disposed on a first major surface of the substrate and adapted to emit light through the first and second major surfaces of the substrate, and a detector disposed on the first major surface of the substrate and adapted to detect the light emitted by the light source.