An implantable medical device for stimulating a human/animal heart having a stimulation unit which stimulates the His bundle and a detection unit which detects an electrical signal at the His bundle. The device performs: a) determining a first value of a parameter of a first measuring pulse measured between a first electrode pole and a housing; b) determining a second value of the same parameter of a second measuring pulse measured between the first electrode pole and a second electrode pole; c) comparing the first and second values; d) determining, based on the comparing step, whether the first or second measuring pulses enables a higher available level control range of the analog-to-digital converter; e) measuring an impedance in a unipolar manner between the first electrode pole and the housing or in a bipolar manner between the first electrode pole and the second electrode pole depending on the determining step.

Some aspects relate to systems, devices, and methods of delivering rate responsive pacing therapy. The method includes monitoring activity information related to an activity level of a patient and delivering rate responsive pacing (RRP) to the patient at a pacing rate corresponding to a RRP profile. The RRP profile may be used to generate the pacing rate based on the activity information and may be adjusted based on the monitored activity information.

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.

Systems and methods for pacing cardiac conductive tissue are described. In an embodiment, a medical system includes an electrostimulation circuit to generate pacing pulses to stimulate a His bundle or a bunch branch. A sensing circuit senses a far-field ventricular activation, determines a cardiac synchrony indicator using the far-field ventricular activation in response to His bundle or bundle branch pacing, and verifies His-bundle capture status using the determined cardiac synchrony indicator. The system can determine a pacing threshold using the capture status under different stimulation strength values. The electrostimulation circuit can deliver stimulation pulses in accordance with the determined pacing threshold.

Systems and methods are provided for optimizing hemodynamics within a patient's heart, e.g., to improve the patient's exercise capacity. In one embodiment, a system is configured to be implanted in a patient's body to monitor and/or treat the patient that includes at least one sensor configured to provide sensor data that corresponds to a blood pressure within or near the patient's heart; at least one component designed to cause dyssynchrony of the right ventricle, and a controller configured for adjusting the function of the at least one component based at least in part on sensor data from the at least one sensor.

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.

Systems and methods for dynamically controlling His-bundle pacing (HBP) according to an indication of a rate-related or intermittent atrioventricular (AV) block in a subject are disclosed. An exemplary medical system includes an AV conduction monitor to detect an indication of either a presence or an absence of intermittent or rate-related AV conduction disturbance using physiologic information of the subject. In the event that an intermittent or rate-related AV conduction disturbance is present, a control circuit provides a control signal to an electrostimulation circuit to deliver HBP pulses. If there is no indication of intermittent or rate-related AV conduction disturbance, or a previously detected intermittent or rate-related AV conduction disturbance has been terminated, the control circuit withholds or discontinues delivery of the HBP pulses to promote intrinsic ventricular conduction and activation.

A medical device is configured to deliver His-Purkinje pacing pulses according to multiple settings of a pacing control parameter and determine an electromechanical time delay from a ventricular electrical event to a fiducial point of the pressure signal for each of the pacing control parameter settings. The medical device may be configured to select an operating pacing control parameter from the pacing control parameter settings based on a determined electromechanical time delay being less than a threshold interval. The medical device may deliver pacing pulses to the His-Purkinje conduction system according to the selected operating pacing control parameter.

A state assessment system, a diagnosis and treatment system and a method for operating the diagnosis and treatment system are disclosed. An oscillator model converts a physiological signal of a subject into a defined feature image. A classification model analyzes state information of the subject based on the feature image. An analysis model outputs a treatment suggestion for the subject based on the state information of the subject. An AR projection device projects acupoint positions of a human body onto the subject, for the subject to be treated based on the treatment suggestion.

The disclosure relates to a method for improving pacing settings of a pace maker, comprising: receiving a set of pacing settings for the pace maker; receiving measurements or fluid mechanics data relating to the heart of a subject for all or part of the pacing settings of the set; estimating hemodynamic forces parameters by elaborating such measurements or inputting hemodynamic forces parameters as received; estimating hemodynamic forces parameters in the heart of the subject by elaborating such hemodynamic forces; selecting an optimal pacing setting of the set, or calculating further pace settings, based on the hemodynamic forces parameters as estimated A corresponding device and computer program are also disclosed.