Enhanced implant-to-implant communications

A leadless pacemaker (LP) configured to be implanted in a patient and to perform conductive communication with another implantable medical device (IMD) that is also configured to be implanted in the patient, the LP comprising:

• a plurality of electrodes;
• memory that stores information that specifies when, within a cardiac cycle of the patient, the LP and the other IMD are likely oriented relative to one another such that conductive communication between the LP and the other IMD should be successful;
• one or more pulse generators coupled to at least two of the electrodes and configured to produce stimulation pulses and communication pulses, the stimulation pulses for use in pacing a cardiac chamber within which the LP is implanted, and the communication pulses for use in performing conductive communication with the other IMD;
• a sensing circuit coupled to at least two of the electrodes and configured to sense a signal indicative of cardiac activity of the patient over a plurality of cardiac cycles;
• and
• a controller communicatively coupled to the sensing circuit and the one or more pulse generators, the controller configured to:
• identify, based on the stored information and the sensed signal, a portion of at least one of the cardiac cycles during which the LP and the other IMD are likely oriented relative to one another such that the conductive communication between the LP and the other IMD should be successful;
• and
• control outputting of one or more conductive communication pulses, by at least one of the one or more pulse generators, so that the outputting of the one or more conductive communication pulses occurs during the portion of at least one of the cardiac cycles identified based on the stored information and the sensed signal.

A system, comprising:

• a leadless pacemaker (LP) and another implantable medical device (IMD) that are configured to be implanted in a patient and to perform conductive communication with one another;
• the LP including:
• a plurality of electrodes;
• memory that stores information that specifies when, within a cardiac cycle of the patient, the LP and the other IMD are likely oriented relative to one another such that conductive communication between the LP and the other IMD should be successful;
• one or more pulse generators coupled to at least two of the electrodes and configured to produce stimulation pulses and communication pulses, the stimulation pulses for use in pacing a cardiac chamber within which the LP is implanted, and the communication pulses for use in performing conductive communication with the other IMD;
• a sensing circuit coupled to at least two of the electrodes and configured to sense a signal indicative of cardiac activity of the patient over a plurality of cardiac cycles;
• and
• a controller communicatively coupled to the sensing circuit and the one or more pulse generators, the controller configured to:
• identify, based on the stored information and the sensed signal, a portion of at least one of the cardiac cycles during which the LP and the other IMD are likely oriented relative to one another such that the conductive communication between the LP and the other IMD should be successful;
• and
• control outputting of one or more conductive communication pulses, by at least one of the one or more pulse generators, so that the outputting of the one or more conductive communication pulses occurs during the portion of at least one of the cardiac cycles identified based on the stored information and the sensed signal.