Systems, devices, and methods for monitoring for atrial capture are disclosed. Such a method, for use within an implantable system including an atrial leadless pacemaker (aLP) and a ventricular leadless pacemaker (vLP), includes storing within a memory of the vLP a paced atrial activation morphology template corresponding to far-field atrial signal components expected to be present in a vEGM sensed by the vLP when an atrial pacing pulse delivered by the aLP captures atrial tissue. The vLP senses a vEGM and compares a morphology of a portion of the sensed vEGM to the paced atrial activation morphology template to determine whether a match therebetween is detected. Additionally, the vLP determines whether atrial capture occurred or failed to occur (responsive to an atrial pacing pulse), based on whether the vLP detects a match between the morphology of a portion of the sensed vEGM and the paced atrial activation morphology template.

A system and methods of maintaining communication with a medical device for exchange of information, instructions, and programs, in a highly reliable manner. Apparatus and methods for accomplishing this task include: 1) The inclusion of a locating device in the system, in close proximity to an implanted device, but which does not drain the implanted device battery. 2) The use of motion detection and global positioning system devices to locate elements within a communicating system for the medical device; 3) The assessment of received signal quality by elements of the system; 4) The use of a notification system for a device user who is moving out of range of communications; and 5) Documenting the absolute and functional integrity of instructions received by the medical device. A method of assuring the identification of communication participants is presented.

A balance prosthesis device for an individual including a sensor module configured to obtain a sensor signal indicative of a balance or equilibrium state of the individual, a processing module configured to determine at least one neurostimulation signal based at least in part on the obtained sensor signal, and a transmitter module configured to transmit the determined neurostimulation signal to a neurostimulation device of the individual. The neurostimulation signal is configured to elicit an artificial sensation in a specific sensory cortex area of the individual via directly stimulating afferent sensory axons of the central or peripheral nervous system of the individual targeting sensory neurons of the sensory cortex area not directly associated with vestibulocortical pathways of the individual. The elicited artificial sensation provides a balance indication to the individual in order to support, mimic, substitute or enhance the natural sense of balance of the individual.

An implantable system including an atrial leadless pacemaker (aLP) and a ventricular leadless pacemaker (vLP), and methods for use therewith, are configured or used to terminate a pacemaker mediated tachycardia (PMT). In an embodiment, in response to the aLP detecting a PMT, the aLP initiates a PMT PA interval, and the aLP does not inform the vLP, via an i2i communication, of an atrial sensed event that caused the PMT to be detected, thereby preventing the vLP from initiating a PV interval during the PMT PA interval. The aLP selectively terminates the PMT PA interval. Additionally, the aLP informs the vLP, via an i2i communication, of an intrinsic atrial event being detected during the PMT PA interval, or of an atrial paced event being performed in response to the PMT PA interval expiring without an intrinsic atrial event being detected during the PMT PA interval.

Systems and methods for stimulating the sensory cortex of an individual by obtaining a neuronal stimulation signal adapted to provide a movement cue for the individual and transmitting the neuronal stimulation signal to an electric contact of a neuronal stimulation electrode that is already implanted into the brain of the individual for a purpose different from providing the movement cue. Proprioceptive information is communicated to the individual by obtaining information about the body posture of the individual and applying a neuronal stimulation signal to an afferent axon targeting a sensory neuron in the cortex of the individual. The neuronal stimulation signal is determined based on the obtained body posture information and corresponds to the proprioceptive information. A first neuronal stimulation signal providing the movement cue and a second neuronal stimulation signal providing the proprioceptive information may be applied together to the cortex of the individual.

Embodiments described herein relate to implantable medical devices (IMDs) and methods for use therewith. Such a method includes using an accelerometer of an IMD (e.g., a leadless pacemaker) to produce one or more accelerometer outputs indicative of the orientation of the IMD. The method can also include controlling communication pulse parameter(s) of one or more communication pulses (produced by pulse generator(s)) based on accelerator output(s) indicative of the orientation of the IMD. The communication pulse parameter(s) that is/are controlled can be, e.g., communication pulse amplitude, communication pulse width, communication pulse timing, and/or communication pulse morphology. Such embodiments can be used to improve conductive communications between IMDs whose orientation relative to one another may change over time, e.g., due to changes in posture and/or due to cardiac motion over a cardiac cycle.

A neurostimulator implant includes an insulating member and an elongate circuitry unit. The circuitry unit includes (a) a first electrode, disposed on an outer surface of a first end portion of the circuitry unit; (b) a second electrode, disposed on an outer surface of a second end portion of the circuitry unit; and (c) circuitry, disposed inside the circuitry unit, and configured to be wirelessly powered to drive an electrical current between the first and second electrodes. The circuitry unit is disposed alongside a medial part of the insulating member, bulging away from the insulating member to define a generally arced portion of the implant. Lateral parts of the insulating member extend laterally outward from the medial part to define lateral zones laterally beyond the circuitry unit. The second side of the insulating member defines a generally flat side of the implant. Other embodiments are also described.

A method of communication in a system comprising plurality of implantable medical devices, where a first device comprises a means for detection of a signal representative of atrial activity, a transmitter, and a controller, and a second device independent of the first device, the second device comprising a receiver and a controller. The method comprises synchronizing the first device with the second device, determining the duration of a cardiac cycle, determining a synchronization interval, the duration of the synchronization interval determined as a function of the duration of the cardiac cycle, the synchronization interval being shorter than the duration of the cardiac cycle, and the start of the synchronization interval is determined as a function of the synchronization signal, and activating the receiver of the second device during the synchronization interval, wherein the receiver of the second device is deactivated outside of the synchronization interval.

Systems, methods and implantable devices configured to provide cardiac resynchronization therapy and/or bradycardia pacing therapy. A first device located in the heart of the patient is configured to receive a communication from a second device and deliver a pacing therapy in response to or in accordance with the received communication. A second device located elsewhere is configured to determine an atrial event has occurred and communicate to the first device to trigger the pacing therapy. The second device may be configured for sensing the atrial event by the use of vector selection and atrial event windowing, among other enhancements. Exception cases are discussed and handled as well.

In some examples, processing circuitry of a medical device system determines, for each of a plurality of patient parameters, a difference metric for a current period based on a value of a patient parameter determined for the current period and a value of the patient parameter determined for an immediately preceding period, and determines a score for the current period based on a sum of the difference metrics for at least some of the plurality of patient parameters. The processing circuitry determines a threshold for the current period based on scores determined for N periods that precede the current period, compares the score for the current period to the threshold, and determines whether to generate an alert indicating that an acute cardiac event of the patient, e.g., ventricular tachyarrhythmia, is predicted, and/or deliver a therapy configured to prevent the acute cardiac event, based on the comparison.