A system including a medical device is provided. The medical device includes at least one sensor configured to acquire first data descriptive of a patient, first memory storing a plurality of templates, and at least one processor coupled to the at least one sensor and the first memory. The at least one processor is configured to identify a first template of the plurality of templates that is similar to the first data, to determine first difference data based on the first template and the first data, and to store the first difference data in association with the first template. The system may further include the programmable device.

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.

Systems and methods for managing cardiac arrhythmias are discussed. A data management system receives a first detection algorithm including a detection criterion for detecting a cardiac arrhythmia. An arrhythmia detector detects arrhythmia episodes from a physiologic signal using a second detection algorithm that is different from and has a higher sensitivity for detecting the cardiac arrhythmia than the first detection algorithm. The arrhythmia detector assigns a detection indicator to each of the detected arrhythmia episodes. The detection indicator indicates a likelihood that the detected arrhythmia episode satisfies the detection criterion of the first detection algorithm. The system prioritizes the detected arrhythmia episodes according to the assigned detection indicators, and outputs the arrhythmia episodes to a user or a process according to the episode prioritization.

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 electrophysiology system including signal channels each of which processes an electrophysiological signal along a signal path extending from an input port that receives the analog electrophysiological signal, via an adjustable gain element that amplifies the electrophysiological signal, and via an ADC element that converts the analog signal into a corresponding digital signal, to an output port. The system further includes a monitoring element that generates a monitoring signal representative of a DC component of the electrophysiological signal and a gain control element that generates a control signal responsive to the monitoring signal. The control signal controls the gain setting of the gain element to cause a decrease in gain, if an increase in the magnitude of the DC component is determined; and/or an increase in gain, if a decrease in the magnitude of the DC component is determined.

Described herein are methods, systems, and devices for estimating remaining longevity of an IMD powered by a battery that at any given time has a battery voltage (BV) and a remaining battery capacity (RBC). Such a method can include estimating the RBC using a first technique when the battery is operating within a t least one of one or more plateau regions, estimating the RBC using a second technique, that differs from the first technique when the battery is operating within a decline region, and estimating the remaining longevity of the IMD based on at least one of the estimates of the RBC. Additionally, historical battery data can be stored and used to estimate the RBC, e.g., when the battery is operating within a heavy usage and recovery period. RBC estimation can also depend on whether the IMD is close to its recommended replacement time (RRT).

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.

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. A leadless pacing device (LPD) may include a plurality of electrodes comprising a bundle pacing electrode leadlessly connected to the housing, which may be implanted proximate to or in the His bundle or bundle branch of the patient's heart. An electrical pulse generator may generate and deliver electrical His-bundle or bundle-branch stimulation pulses using the bundle pacing electrode based on sensing one or both of an atrial event and a ventricular event. The LPD may receive communication from another implantable device, such as a subcutaneously implanted device, and deliver His-bundle or bundle-branch pacing in response to the communication.

An intracardiac ventricular pacemaker having a motion sensor, a pulse generator and a control circuit coupled to the pulse generator and the motion sensor is configured to identify a ventricular systolic event, detect a ventricular passive filling event signal from the motion signal, and determine a time interval from the ventricular systolic event to the ventricular passive filling event. The pacemaker establishes a minimum pacing interval based on the time interval.

A medical device processor is configured to receive at least one cardiac electrical signal that is sensed during bilateral bundle branch pacing delivered from a bipolar electrode pair comprising an anode positioned along a first bundle branch and a cathode positioned along a second bundle branch opposite the first bundle branch, determine at least one feature from the first cardiac electrical signal, determine that the at least one feature meets first bundle branch capture criteria; and determine anodal bundle branch capture in response to the first bundle branch capture criteria being met.