Implantable medical device with multiple modes of operation

1. An implantable medical device (IMD) comprising:

a controller;

a receiver having a higher power mode and a lower power mode, wherein:

in the higher power mode, the receiver can receive a communication from an external device and pass the received communication to the controller;

in the lower power mode, the receiver cannot receive the communication from the external device and the IMD is configured to operate independently of the external device;

a physiological sensor providing an output to the controller; and

wherein the controller is configured to:

identify a physiological parameter value based on the output of the physiological sensor, the physiological parameter value including a heart rate value;

based on one or more rules conditioned at least in part on the identified physiological parameter value, control whether the receiver is in the higher power mode or the lower power mode; and

wherein when the one or more rules specify that the receiver is to be placed in the higher power mode, the receiver is intermittently switched between a higher power level and a lower power level and spends relatively more time at the higher power level, and when the receiver is to be placed in the lower power mode, the receiver is intermittently switched between the higher power level and the lower power level and spends relatively more time at the lower power level.

2. The IMD according to claim 1 , wherein the communication from the external device comprises a signal and the controller is further configured to control whether the receiver is in the higher power mode or the lower power mode based at least in part on the signal.

3. The IMD according to claim 1 , wherein the implantable medical device is configured to receive a command from the external device when the receiver is in the higher power mode and the implantable medical device is configured to use a hysteresis function when switching from the higher power mode to the lower power mode.

4. The IMD according to claim 1 , wherein the one or more rules specify that the receiver is to be placed in the higher power mode when the heart rate value is above a heart rate threshold and the receiver is to be placed in the lower power mode when the heart rate value is below the heart rate threshold.

5. The IMD according to claim 1 , wherein when the one or more rules specify that the receiver is to be placed in the higher power mode, the receiver is intermittently switched between the higher power level and the lower power level at a first rate,

and when the receiver is to be placed in the lower power mode, the receiver is intermittently switched between the higher power level and the lower power level at a second rate, wherein the first rate is higher than the second rate.

6. The IMD according to claim 1 , wherein the identified physiological parameter value further includes one of a PH value, a potassium level, a glucose level, an ammonium level, a temperature value, a respiration rate, a ECG morphology value, an accelerometer value, a posture of a patient, a time of day.

7. The IMD according to claim 1 , wherein the implantable medical device is a leadless cardiac pacemaker (LCP).

8. A leadless cardiac pacemaker (LCP) comprising:

a housing;

one or more physiological sensors for sensing one or more physiological parameters of a patient;

two or more electrodes at least two of which for delivering pacing pulses to a heart of the patient;

a receiver disposed within the housing and configured to operate in a lower power mode and a higher power mode, wherein:

in the higher power mode, the receiver can receive an ATP command from an external device;

in the lower power mode, the receiver cannot receive the ATP command from the external device;

operational circuitry operatively coupled to the one or more physiological sensors, the two or more electrodes, and the receiver, the operational circuitry configured to:

switch the receiver between the lower power mode and the higher power mode based at least in part on a heart rate of the patient determined at least in part on one or more physiological parameters sensed by one or more of the physiological sensors; and

deliver anti-tachyarrhythmia pacing (ATP) therapy via two or more of the electrodes in response to the receiver receiving an ATP command from the external device when the receiver is in the higher power mode; and

not receiving an ATP command from the external device when the receiver is in the lower power mode, and thus not delivering ATP therapy via the two or more electrodes.

9. The LCP of claim 8 , wherein the operational circuitry is configured to:

place the receiver in the higher power mode when the heart rate exceeds an ATP heart rate threshold; and

place the receiver in the lower power mode when the heart rate does not exceed the ATP heart rate threshold.

10. The LCP of claim 8 , wherein the operational circuitry is configured to:

switch the receiver to the higher power mode when the heart rate exceeds a heart rate threshold, and in the higher power mode, the receiver is switched back and forth between a higher power level and a lower power level and spends relatively more time at the higher power level; and

switch the receiver to the lower power mode when the heart rate does not exceed the heart rate threshold, and in the lower mode power, the receiver is switched back and forth between the higher power level and the lower power level and spends relatively more time at the lower power level.

11. The LCP of claim 8 , wherein the one or more physiological sensors comprise two or more of the electrodes.

12. The LCP of claim 11 , wherein the one or more physiological sensors comprises one or more cardiac electrical sensors, and the one or more physiological parameters comprise one or more electrical signals produced by the one or more cardiac electrical sensors.

13. The LCP of claim 8 , wherein the one or more physiological sensors comprise a mechanical sensor, and the one or more physiological parameters comprise one or more mechanical signals produced by the mechanical sensor.

14. A leadless cardiac pacemaker (LCP) comprising:

a housing;

one or more physiological sensors for sensing one or more physiological parameters of a patient;

two or more electrodes for delivering pacing pulses to a heart of the patient;

a receiver with an adjustable power level;

electronics operatively coupled to the one or more physiological sensors, the two or more electrodes, and the receiver, the electronics is configured to:

adjust the receiver between a lower power level and a higher power level based at least in part on the one or more of the physiological parameters sensed by one or more of the physiological sensors, wherein:

in the higher power level, the receiver can receive a command from an external device;

in the lower power level, the receiver cannot receive the command from the external device; and

operate the LCP independently of the external device when the receiver is at the lower power level.

15. The LCP according to claim 14 , wherein the LCP is configured to operate in cooperation with the external device, at least at times when the receiver is at the higher power level.

16. The LCP according to claim 15 , wherein the LCP is configured to operate in accordance with a command received from the external device when the receiver is at the higher power level.

17. The LCP according to claim 16 , wherein the command is an ATP trigger command.