A method and apparatus for treatment of heart failure by increasing secretion of endogenous naturetic hormones ANP and BNP such as by stimulation of the heart atria. Heart pacing is done at an atrial contraction rate that is increased and can be higher than the ventricular contraction rate. Pacing may include mechanical distension of the right atrial appendage. An implantable device is used to periodically cyclically stretch the walls of the appendage with an implanted balloon.

A method and apparatus for treatment of heart failure by increasing secretion of endogenous naturetic hormones ANP and BNP such as by stimulation of the heart atria. Heart pacing is done at an atrial contraction rate that is increased and can be higher than the ventricular contraction rate. Pacing may include mechanical distension of the right atrial appendage. An implantable device is used to periodically cyclically stretch the walls of the appendage with an implanted balloon.

Systems and methods can be used to provide an indication of heart function, such as an indication of mechanical function or hemodynamics of the heart, based on electrical data. For example, a method for assessing a function of the heart can include determining a time-based electrical characteristic for a plurality of points distributed across a spatial region of the heart. The plurality of points can be grouped into at least two subsets of points based on at least one of a spatial location for the plurality of points or the time-based electrical characteristics for the plurality of points. An indication of synchrony for the heart can be quantified based on relative analysis of the determined time-based electrical characteristic for each of the at least two subsets of points.

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.

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.

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.

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 method and apparatus for treatment of heart failure by increasing secretion of endogenous naturetic hormones ANP and BNP such as by stimulation of the heart atria. Heart pacing is done at an atrial contraction rate that is increased and can be higher than the ventricular contraction rate. Pacing may include mechanical distension of the right atrial appendage. An implantable device is used to periodically cyclically stretch the walls of the appendage with an implanted balloon.

A method and apparatus for treatment of heart failure by increasing secretion of endogenous naturetic hormones ANP and BNP such as by stimulation of the heart atria. Heart pacing is done at an atrial contraction rate that is increased and can be higher than the ventricular contraction rate. Pacing may include mechanical distension of the right atrial appendage. An implantable device is used to periodically cyclically stretch the walls of the appendage with an implanted balloon.

A pacemaker has a housing and a therapy delivery circuit enclosed by the housing for generating pacing pulses for delivery to a patient's heart. An electrically insulative distal member is coupled directly to the housing and at least one non-tissue piercing cathode electrode is coupled directly to the insulative distal member. A tissue piercing electrode extends away from the housing.