A stimulation system includes an energy source, an electronics unit with a controller, and an actuator that is coupled with the electronics unit and/or the energy source. The actuator emits electromagnetic waves for stimulation of genetically manipulated tissue. The electronics unit is disposed in a housing. The stimulation system is configured for at least temporary implantation in a human or animal body. The controller controls the stimulation of tissue in the body by way of the electromagnetic waves emitted by the actuator. A selector of the stimulation system selects the area of the said tissue for stimulation. The selector includes a masking device for masking certain areas of the tissue, so that an intensity of the stimulation for the masked areas is reduced or equal to zero.

The present invention relates to a system and method for replacing an implanted medical device with an implantable medical replacement device, wherein a programming device sends a command signal to the medical device to change an address of the medical device to a new address being different from an address of the replacement device to allow independent communication of the programming device with both the medical device and the replacement device.

A medical device is configured to sense at least one cardiac electrical signal and generate pacing pulses according to a first pacing therapy by generating pacing pulses for delivery to a first combination of ventricular pacing sites including at least one ventricular conduction system pacing site. The medical device may be configured to determine a ventricular conduction condition based on a QRS signal feature of the sensed cardiac signal during the first pacing therapy. The medical device may change to a second pacing therapy different than the first pacing therapy based on the determined ventricular conduction condition.

A system may include a stimulator, sensing circuitry and a controller. The stimulator may be operably connected to at least one stimulation electrode, and configured to deliver an electrical waveform for an electrical therapy using the at least one stimulation electrode. The sensing circuitry may be operably connected to at least one sensing electrode, and configured to sense electrical potentials that are evoked by the electrical waveform to provide sensed evoked signals. The controller may be operably connected to the stimulator and the sensing circuitry. The controller may be configured to automatically define a sampling window, sample the sensed evoked potentials during the sampling window to provide sampled values, detect at least one feature from the sampled values, and automatically provide feedback for closed-loop control of the electrical therapy based on the at least one feature.

In one embodiment, a medical procedure system includes a probe for insertion into a chamber of a heart of a living subject, and including a first electrode to apply a sequence of pacing pulses at a position in the chamber, a second electrode to sense an electrical activation signal responsively to electrical activations induced by capture of the pacing pulses in a myocardium of the chamber, a display, and processing circuitry to evaluate a successful acquisition by the second electrode of the induced electrical activations responsively to the electrical activation signal, the successful acquisition being indicative of a successful capture of the pacing pulses by the myocardium, compute a capture grade responsively to the evaluation of the successful acquisition of the induced electrical activations, the capture grade being indicative of a count of the induced electrical activations evaluated as being successfully acquired, and render the capture grade to the display.

An extra-cardiovascular implantable cardioverter defibrillator (ICD) having a low voltage therapy module and a high voltage therapy module is configured to select, by a control module of the ICD, a pacing output configuration from at least a low-voltage pacing output configuration of the low voltage therapy module and a high-voltage pacing output configuration of the high voltage therapy module. The high voltage therapy module includes a high voltage capacitor having a first capacitance and the low voltage therapy module includes a plurality of low voltage capacitors each having up to a second capacitance that is less than the first capacitance. The ICD control module controls a respective one of the low voltage therapy module or the high voltage therapy module to deliver extra-cardiovascular pacing pulses in the selected pacing output configuration via extra-cardiovascular electrodes coupled to the ICD.

An implantable medical device is configured determine a numerical value of a variable that is monitored by the implantable medical device and convert the numerical value to a data sequence of modulated electrical stimulation rate intervals. The implantable medical device delivers electrical stimulation pulses according to the data sequence of modulated stimulation rate intervals to cause a modulated rate of activation of excitable tissue of a patient corresponding to the modulated stimulation rate intervals. The modulated rate of activation is detectable by a rate monitor for demodulation to the numerical value of the monitored variable data value. In some examples, the implantable medical device is a pacemaker delivering cardiac pacing pulses according to modulated pacing rate intervals to cause a modulated heart rate of the patient detectable by a heart rate monitor for demodulation to the numerical value of the monitored variable.

Described herein is a method and system for gap detection in ablation lines. Microelectrodes are implemented at a distal tip of a catheter to provide localized gap detection along an ablation line. A pacing protocol is used to sequence through each of the microelectrode pairs for a tissue location. If living tissue is present, the pacing signal travels through the living tissue to pulse the heart. An operator will see a capture signal and know that there is a gap in the ablation line. The ablation electrode is then used to ablate the tissue in the gap. Pacing and ablation are therefore performed at the same place without the need to switch between instruments and/or catheters. In an implementation, a force sensor can automate the pacing protocol by determining which microelectrode pair is contacting the tissue. Moreover, signaling between microelectrode pairs can determine contact between the catheter and the tissue.

An implantable medical device is configured determine a numerical value of a variable that is monitored by the implantable medical device and convert the numerical value to a data sequence of modulated electrical stimulation rate intervals. The implantable medical device delivers electrical stimulation pulses according to the data sequence of modulated stimulation rate intervals to cause a modulated rate of activation of excitable tissue of a patient corresponding to the modulated stimulation rate intervals. The modulated rate of activation is detectable by a rate monitor for demodulation to the numerical value of the monitored variable data value. In some examples, the implantable medical device is a pacemaker delivering cardiac pacing pulses according to modulated pacing rate intervals to cause a modulated heart rate of the patient detectable by a heart rate monitor for demodulation to the numerical value of the monitored variable.

Passive tissue biasing circuitry in an Implantable Pulse Generator (IPG) is disclosed to facilitate the sensing of neural responses by holding the voltage of the tissue to a common mode voltage (Vcm). The IPG's conductive case electrode, or any other electrode, is passively biased to Vcm using a capacitor, as opposed to actively driving such electrode to a prescribed voltage using a voltage source. Once Vcm is established, voltages accompanying the production of stimulation pulses will be referenced to Vcm, which eases neural response sensing. An amplifier can be used to set a virtual reference voltage and to limit the amount of current that flows to the case during the production of Vcm. Circuitry can be used to monitor the virtual reference voltage to enable sensing neural responses, and to set a compliance voltage for the current generation circuitry.