Method and system for determining an atrial contraction timing fiducial in a leadless cardiac pacemaker system is disclosed. An electrical cardiac signal associated with an atrial contraction of the patient's heart and a mechanical response to the atrial contraction of a patient's heart are used to determine an atrial contraction timing fiducial. A ventricle pacing pulse may then be generated an A-V delay after the atrial contraction timing fiducial.

An apparatus comprises a respiration sensing circuit configured for coupling electrically to a plurality of electrodes and for sensing a respiration signal representative of respiration of a subject; a signal processing circuit electrically coupled to the respiration sensing circuit and configured to extract a respiration parameter from a sensed respiration signal and determine a signal performance metric for the sensed respiration signal using the respiration parameter; and a control circuit. The control circuit is configured to: initiate sensing of a plurality of respiration signals using different electrode combinations of the plurality of electrodes and determining of the signal performance metric for the sensed respiration signals; and enable an electrode combination from the plurality of electrodes and for use in monitoring respiration of the subject according to the signal performance metric.

A cardiac pacing system having a pulse generator for generating therapeutic electric pulses, a lead electrically coupled with the pulse generator having an electrode, a first sensor configured to monitor a physiological characteristic of a patient, a second sensor configured to monitor a second physiological characteristic of a patient and a controller. The controller can determine a pacing vector based on variables including a signal received from the second sensor, and cause the pulse generator to deliver the therapeutic electrical pulses according to the determined pacing vector. The controller can also modify pacing characteristics based on variables including a signal received from the second sensor.

Computer implemented methods and systems are provided that comprise, under control of one or more processors of a medical device, where the one or more processors are configured with specific executable instructions. The methods and systems obtain motion data indicative of at least one of a posture or a respiration cycle; obtain cardiac activity (CA) signals for a series of beats; identify whether a characteristic of interest (COI) from at least a first segment of the CA signals exceeds a COI limit; analyze the motion data to determine whether at least one of the posture or respiration cycle at least in part caused the COI to exceed the COI limit. Based on the analyzing operation, the methods and systems automatically adjust a CA sensing parameter utilized by the medical device to detect R-waves in subsequent CA signals; and detect an arrhythmia based on a presence or absence of one or more of the R-waves in at least a second segment of the CA signals.

A cardiac defibrillation system that includes a pulse generator to generate therapeutic electrical pulses and at least one lead inserted through an intercostal space in the region of a cardiac notch of the left lung of a patient, the lead having a distal end configured to transmit the therapeutic electrical pulses generated by the pulse generator to defibrillate the heart of the patient.

The present invention relates to non-excitatory electrical heart failure therapy as a therapy for Heart failure with preserved ejection fraction.

A computer implemented method is provided that includes, under control of one or more processors of an implantable medical device (IMD), obtaining motion data indicative of a first posture, and determining a first sense setting of the IMD based on the first posture. The method also includes obtaining cardiac activity (CA) signals for a series of beats while applying the first sense setting, obtaining a characteristic of interest (COI) from the CA signals for the series of beats, and calculating a statistical indicator from the COI over the series of beats based on the COI from the CA signals. The method also includes deriving a second sense setting based on the first sense setting and the statistical indicator of the COI.

A system comprises an implantable medical device configured to generate temperature data and impedance data associated with temperature and impedance of a patient proximate to the implantable medical device. The system further comprises processing circuitry configured to determine whether a first one or more infection criteria are satisfied by temperature data and impedance data generated by the implantable medical device during a first time interval, wherein the first one or more infection criteria include at least one criterion indicative of decreased impedance, determine whether a second one or more infection criteria are satisfied by the temperature data and impedance data generated by the implantable medical device during a second time interval subsequent to the first time interval, wherein the second one or more infection criteria include at least one criterion indicative of increased impedance, and output, based on satisfaction of the first and second infection criteria, an indication of infection.

Systems and methods for monitoring and treating patients with heart failure (HF) are discussed. The system may sense cardiac signals, and receives information about patient physiological or functional conditions. A stimulation parameter table that includes recommended values of atrioventricular delay (AVD) or other timing parameters maybe created at a multitude of patient physiological or functional conditions. The system may periodically reassess patient physiological or functional conditions. A therapy programmer circuit may dynamically switch between left ventricular-only pacing and biventricular pacing, or switch between single site pacing and multisite pacing based on the patient condition. The therapy programmer circuit may adjust AVD and other timing parameters using the cardiac signal input and the stored stimulation parameter table. A HF therapy may be delivered according to the determined stimulation site, stimulation mode, and the stimulation timing.

Systems and methods for monitoring and treating patients with heart failure (HF) are discussed. The system may sense cardiac signals, and receives information about patient physiological or functional conditions. A stimulation parameter table that includes recommended values of atrioventricular delay (AVD) or other timing parameters may be created at a multitude of patient physiological or functional conditions. The system may periodically reassess patient physiological or functional conditions. A therapy programmer circuit may dynamically switch between left ventricular-only pacing and biventricular pacing, or switch between single site pacing and multisite pacing based on the patient condition. The therapy programmer circuit may adjust AVD and other timing parameters using the cardiac signal input and the stored stimulation parameter table. A HF therapy may be delivered according to the determined stimulation site, stimulation mode, and the stimulation timing.