An electrical stimulation system includes a sheath that includes conductive points that are operative to facilitate electrical stimulation to a bodily portion of a user. Drive-sense circuits (DSCs) generate electrical stimulation signals based on reference signals and provide those electrical stimulation signals via electrodes to the conductive points of the sheath. The electrical stimulation signal is coupled into respective locations of the bodily portion of the user that are in proximity to or in contact with the conductive points of the sheath. In addition, the DSCs sense, via the conductive points of the sheath and via the electrodes, changes of the electrical stimulation signals based on coupling of them into the respective locations of the bodily portion of the user. The DSCs provide digital signals that are representative of the changes of the electrical stimulation signals to one or more processing modules that includes and/or is coupled to memory.

A method is provided. The method is implemented by a determination engine executed stored on a memory as processor executable code that is executed by a processor. The method includes determining that a stimulating pacing signal is captured from at least a portion of an anatomical structure and determining a time duration between the stimulating pacing signal and a subsequent response from the portion of an anatomical structure. The method further includes outputting the time duration.

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.

Computer implemented methods and systems are provided for automatically determining capture thresholds for an implantable medical device equipped for cardiac stimulus pacing using a multi-pole left ventricular (LV) lead. The methods and systems measures a base capture threshold for a base pacing vector utilizing stimulation pulses varied over at least a portion of an outer test range. The base pacing vector is defined by a first LV electrode provided on the LV lead and a second electrode located remote from an LV chamber. The methods and systems designate a secondary pacing vector that includes the first LV electrode and a neighbor LV electrode provided on the LV lead. The methods and systems further define an inner test range having secondary limits based on the base capture threshold, wherein at least one of the limits for the inner test range differs from a corresponding limit for the outer test range. The methods and systems measure a secondary capture threshold associated with the secondary pacing vector utilizing stimulation pulses varied over at least a portion of the inner test range.

An analysis device for supporting the implantation of a system for stimulating the human heart or animal heart, comprising a processor and a memory unit. The memory unit includes a computer-readable program, which prompts the processor to carry out the following steps when the program is being executed on the processor: a) receiving an electrocardiogram of a human heart or an animal heart into which a system for stimulating this heart is being implanted; b) automatically identifying signals of the electrocardiogram caused by a His bundle stimulation, a signal being identified which appears between an atrial signal and a ventricular signal; c) marking the previously identified signals in the received electrocardiogram; and d) outputting the electrocardiogram thus marked on an output device. The analysis device comprises a detection unit having a sensitivity of at least 0.25 mV.

An implantable medical device stimulates a human or animal heart. The medical device contains a processor, a memory unit, a His electrode having a first electrode pole configured to detect an electrical signal at a His bundle of a heart, and a further electrode having a further electrode pole configured to detect an electrical signal at a cardiac region of the same heart different from the His bundle. During operation of the device, performing the steps of: measuring electric signals at a His bundle of a heart with the first electrode pole; measuring electric signals at a cardiac region of the same heart different from the His bundle with the further electrode pole; and evaluating intracardiac electrogram signals and/or impedance signals measured between the first electrode pole and the further electrode pole, with the provision that this evaluating does not only contain a determination of an atrial-His bundle transition time.

An electrical stimulation system includes a sheath that includes conductive points that are operative to facilitate electrical stimulation to a bodily portion of a user. Drive-sense circuits (DSCs) generate electrical stimulation signals based on reference signals and provide those electrical stimulation signals via electrodes to the conductive points of the sheath. The electrical stimulation signal is coupled into respective locations of the bodily portion of the user that are in proximity to or in contact with the conductive points of the sheath. In addition, the DSCs sense, via the conductive points of the sheath and via the electrodes, changes of the electrical stimulation signals based on coupling of them into the respective locations of the bodily portion of the user. The DSCs provide digital signals that are representative of the changes of the electrical stimulation signals to one or more processing modules that includes and/or is coupled to memory.

Systems and methods for pacing cardiac conductive tissue are described. In an embodiment, a medical system includes an electrostimulation circuit to generate His-bundle pacing (HBP) pulses. A sensing circuit senses an atrial activation. A control circuit detects a retrograde atrial conduction timing, such as a His-to-atrial interval between the HBP pulse and the sensed atrial activation in response to the HBP pulse, and verifies capture status using the determined retrograded atrial conduction timing. Based on the capture status, the control circuit determines a HBP threshold, and the electrostimulation circuit delivers HBP pulses in accordance with the determined HBP threshold.

Methods and systems of evaluating cardiac pacing in candidate patients for cardiac resynchronization therapy and cardiac resynchronization therapy patients are disclosed. The methods and systems disclosed allow treatments to be personalized to patients by measuring the extent of tissue capture from cardiac pacing under various therapy parameter conditions. Systems and methods of optimizing right ventricle only cardiac pacing are also disclosed.

Systems and methods are provided for managing patient activated capture of transient data by an implantable medical device (IMD). The systems and methods collect transient data using the IMD. The collected transient data is stored in a temporary memory section of the IMD. The IMD receives a patient activated storage request including activation information related to a patient designated trigger point from an external device. The IMD transfers a segment of the transient data from the temporary memory section to a long-term memory, wherein the segment of transferred transient data is based on the trigger point. The activation information includes an elapsed time corresponding to a duration of time between entry of the trigger point and issuance of the patient activated storage request by an external activation device.