Methods and systems in which a first medical device provides patient status details to a second medical device. Patient status details may include one or more of patient posture and/or patient activity level, or other indications of patient status. The second medical device, in response to information about patient status and changes in patient status, uses a sensing configuration management function to respond to and accommodate the change in patient status. In an example, a first medical device monitors patient posture and communicates information related to patient posture to a second medical device, which then tailors sensing configurations to the patient posture.

The invention relates to an implantable sensor for detecting an electrical excitation of muscle cells, in particular cardiac muscle cells, wherein it is provided that the sensor comprises a dielectric component and a contact point for contacting muscle cells, which is connected to the dielectric component, so that an electric field in the dielectric component, and correspondingly a capacitance of the dielectric component, change with an electrical excitation of the muscle cells. The invention furthermore relates to a system comprising a sensor and an implant.

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.

A method and medical device for adjusting a blanking period that includes sensing cardiac signals from a plurality of electrodes, the plurality of electrodes forming a plurality of sensing vectors, determining whether to adjust a blanking period during a first operating state, advancing from the first operating state to a second operating state in response to the sensed cardiac signals, determining, while in the second operating state, whether the blanking period was adjusted while in the first operating state, and adjusting the blanking period while in the second operating state in response to the blanking period being adjusted while in the first operating state.

Techniques are described for discriminating SVT and, in particular, rapidly conducting AF. The techniques include detecting an onset of a fast rate of ventricular events sensed from a cardiac electrical signal and detecting a pause in the fast rate of ventricular sensed events. A threshold number of ventricular event intervals required to detect a ventricular tachyarrhythmia is detected with each of the threshold number of ventricular event intervals being less than a tachyarrhythmia detection interval. Detection of the ventricular tachyarrhythmia and an electrical stimulation therapy for treating the ventricular tachyarrhythmia are withheld in response to at least the pause being detected.

A pacemaker system includes a drive-sense circuit (DSC) operably coupled to a pacemaker lead. The DSC generates a pace signal including electrical impulses based on a reference signal. The DSC provides the pace signal via the pacemaker lead to an electrically responsive portion of a cardiac conductive system of a subject to facilitate cardiac operation of a cardiovascular system of the subject. The DSC senses, via the pacemaker lead, cardiac electrical activity of the cardiovascular system of the subject that is generated in response to the pace signal and electrically coupled into the pacemaker lead and generates a digital signal that is representative of the cardiac electrical activity of the cardiovascular system of the subject that is sensed via the pacemaker lead. The DSC provides digital information to one or more processing modules that includes and/or is coupled to memory and that provide the reference signal to the DSC.

Embodiments of a wearable cardioverter defibrillator (WCD) system are configured to monitor a patient's ECG for shockable arrhythmias and deliver a shock to the patient in response to such a detection. To monitor the patient's ECG with reduced signal noise to improve the system's performance, the system includes a cable assembly having: a signal line; an inner shield and an outer shield; an ECG electrode electrically connected to the signal line of the cable assembly; and an amplifier having first and second input nodes respectively connected to the signal line and the outer shield of the cable assembly. The amplifier's output node is electrically connected to the inner shield of the cable assembly to reduce the reactive load seen by the patient's heart in driving the ECG sensing circuitry, which reduces the noise on the ECG signal outputted by the amplifier.

Described herein are methods, devices, and systems for identifying false R-R intervals, and false arrhythmia detections, resulting from R-wave undersensing or intermittent AV conduction block. Each of one or more of the R-R intervals is classified as being a false R-R interval in response to a duration the R-R interval being greater than a first specific threshold, and the duration the R-R interval being within a second specified threshold of being an integer multiple of at least X other R-R intervals for which information is obtained, wherein the integer multiple is at least 2, and wherein X is a specified integer that is 1 or greater. When performed for R-R intervals in a window leading up to a detection of a potential arrhythmic episode, results of the classifying can be used to determine whether the potential arrhythmic episode was a false positive detection.

Described herein are methods for use with an implantable system including at least an atrial leadless pacemaker (aLP). Also described herein are specific implementations of an aLP, as well as implantable systems including an aLP. In certain embodiments, the aLP senses a signal from which cardiac activity associated with a ventricular chamber can be detected by the aLP itself based on feature(s) of the sensed signal. The aLP monitors the sensed signal for an intrinsic or paced ventricular activation within a ventricular event monitor window. In response to the aLP detecting an intrinsic or paced ventricular activation itself from the sensed signal within the ventricular event monitor window, the aLP resets an atrial escape interval timer that is used by the aLP to time delivery of an atrial pacing pulse if an intrinsic atrial activation is not detected within an atrial escape interval.

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.