An implanted stimulator can deliver a patient-detectable electrical stimulation to remind or prompt a patient to interact with an implanted therapeutic device (e.g., neurostimulator) when a prompting event occurs. For example, the apparatuses and methods described herein may be configured to apply a prompting patient-detectable electrical vagus nerve stimulation to remind a patient that it is time to administer a therapeutic dose. When the therapeutic device is operated in an automatic fashion, the apparatus can also deliver a patient-detectable warning stimulation prior to the therapeutic stimulation to let the patient know that a therapeutic stimulation will be delivered soon thereafter.

A system for generating an alert for a systemic infection of a patient comprises an implantable medical device configured to measure at least one physiological parameter, a remote monitoring system configured to receive information from the implantable medical device, and an information system configured to communicate with said remote monitoring system. At least one of the implantable medical device, the remote monitoring system and the information system is configured to analyze information relating to said at least one physiological parameter to generate an alert signal for a systemic infection of the patient based on a state of the at least one physiological parameter, wherein at least one of the implantable medical device, the remote monitoring system and the information system is further configured to generate an alert message to be provided to a specified destination based on said alert signal.

A method comprises acquiring a set of measurements of impedance of an implantable medical lead, determining a metric of variability of the set of impedance measurements, determining that the metric of variability satisfies a criterion, and generating a lead integrity alert in response to the metric of variability satisfying the criterion.

A system for minimizing misalignment notifications for a TETS having an implantable blood pump, an external controller having a power source and a processing circuitry, a transmission coil in communication with the external controller, a receiving coil configured for transcutaneous inductive communication with the transmission coil, and an implantable controller in communication with the receiving coil and the implantable blood pump. The implantable controller having a power source configured to receive power from the receiving coil. The processing circuitry may be configured to: operate in a first mode where an alert is generated when a power efficiency transfer between the transmission coil and the receiving coil is below a first predetermined threshold; and operate in a second mode where the alert is only generated when the power remaining in the power source for the implantable controller is below a first predetermined power source threshold.

Semi-autonomous vehicle apparatus which is controlled by a plurality of control sources includes a vehicle which may function autonomously and apparatus for control of the vehicle by either an onboard driver or a driver not situated onboard. The vehicle may also be controlled by an off-vehicle computational device. Hierarchy setting apparatus determines which one or combination of the possible control entities take priority. Persons using the apparatus are identified by either a password or, preferably by providing identification based on a biologic feature. Management of impaired vehicle operators is provided for.

Systems, devices, and methods for remote monitoring and managing of patients with chronic pain are discussed. A remote monitoring system comprises a cloud-computing device and a remote device. The cloud-computing device receives patient data including physiological or functional information sensed by sensors, and provides on-demand cloud-based services including establishing a correspondence between one or more physiological or functional states and one or more pain levels, detecting patient physiological or functional state, predicting a pain level, detecting a patient behavior, generating a recommendation for adjusting sensor operations based on the patient behavior, and storing patient data and other information in a cloud storage. The remote device can access the cloud storage and the cloud-based services, provide the stored information to an authorized user or the patient, control an implantable device to initiate or adjust a neuromodulation therapy, or adjust sensor operations.

Methods and systems for use of the Q-wave to R-wave interval to guide placement of a leadless cardiac pacemaker are disclosed. An implant delivery device is equipped with sensing electrodes to sense R-wave onset in a ventricle of a patient's heart to allow placement at a location of last or latest onset of the R-wave. Guidance tools are provided to assist in determination of the Q-wave to R-wave interval during implantation. For a chronic system, a cooperative approach is disclosed in which an implantable medical device and a leadless cardiac pacemaker exchange data to determine Q-wave to R-wave intervals and enhance cardiac resynchronization therapy delivery by the leadless cardiac pacemaker.

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. The locating device may be implanted or external to the body. 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, implantable medical system and an external system for communicating an alert signal via a transcutaneous energy transfer system (TETS), with or without the presence of transmission of the alert signal by an alternative wireless communication system, are disclosed. According to one aspect, a method in an implanted medical system includes obtaining the alert signal based on an occurrence of an event, and transmitting the alert signal from the implanted medical device to the external system via a TETS used to transfer power requests to the external system.

Techniques are disclosed for detecting arrhythmia episodes for a patient. A medical device may receive one or more sensor values indicative of motion of a patient. The medical device may determine, based at least in part on the one or more sensor values, an activity level of the patient. The medical device may determine a heart rate threshold for triggering detection of an arrhythmia episode based at least in part on the activity level of the patient. The medical device may determine whether to trigger detection of the arrhythmia episode for the patient based at least in part on comparing a heart rate of the patient with the heart rate threshold. The medical device may, in response to triggering detection of the arrhythmia episode, collect information associated with the arrhythmia episode.