Abstract: Systems and methods for monitoring a subject for sleep apnea risk based on a bradycardia burden are disclosed. A sleep apnea monitoring system comprises a risk stratification circuit configured to detect bradycardia using cardiac information of the subject during a monitoring period, determine a bradycardia burden representing accumulated time or relative time of the subject being in the detected bradycardia over the monitoring period, and determine an apnea risk based on the bradycardia burden. An output unit can provide the apnea risk to a user, or to a process executed by an apnea detector to perform a confirmatory apnea detection.

Abstract: Systems and methods for detecting cardiac arrhythmia are discussed. A medical-device system includes an ambulatory monitor device and an arrhythmia analysis device communicatively coupled to each other. The ambulatory monitor device can sense a cardiac signal from the patient, and intermittently collect data segments of the cardiac signal in accordance with a data segment collection rate or schedule over a monitoring period. The data segments each has a specific segment duration. The monitor device can transmit the intermittently collected data segments to the arrhythmia analysis device in accordance with a transmission schedule or in response to a trigger event. The arrhythmia analysis device can detect a cardiac arrhythmia from the intermittently collected data segments. The segment duration or the data segment collection rate or schedule may be adjusted based on a performance measure of the arrhythmia detection.

Abstract: Systems and methods for pacing cardiac conductive tissue are described. An embodiment of a medical system includes an electrostimulation circuit to generate His-bundle pacing (HBP) pulses to stimulate a His bundle, and a cardiac event detector to detect a His-bundle activity within a time window following an atrial activity. The cardiac event detector may use a cross-chamber blanking, or an adjustable His-bundle sensing threshold, to avoid or reduce over-sensing of far-field atrial activity and inappropriate inhibition of HBP therapy. The electrostimulation circuit may deliver HBP in the presence of the His-bundle activity. The system may further recognize the detected His-bundle activity as either a FFPW or a valid inhibitory event, and deliver or withhold HBP therapy based on the recognition of the His-bundle activity.

Abstract: Systems and methods for calibrating an orientation of an implantable device in a patient is described. An exemplary system includes a calibration circuit that can receive acceleration information sensed from an implantable medical device (IMD) implanted in a patient, and receive reference acceleration information sensed from a reference device associated with the patient. The acceleration information and the reference acceleration information are acquired when the patient assumes a first posture or in a first position. The calibration circuit determines a spatial relationship between an orientation of the IMD and a reference orientation of the reference device using the received acceleration information and the received reference acceleration information, and calibrate subsequent acceleration information sensed from the IMD using the determined spatial relationship to correct for the orientation of the IMD.

Abstract: Systems and methods for managing pain in patient are described. A system may include sensors configured to sense physiological or functional signals, and a pain analyzer to generate signal metrics from the physiological or functional signals. The pain analyzer also generates weight factors corresponding to the signal metrics. The weight factors may indicate the signal metrics reliability in representing an intensity of the pain. The pain analyzer generates a pain score using a plurality of signal metrics and a plurality of weight factors. The pain score may be output to a user or a process. The system may additionally include an electrostimulator to generate and deliver closed-loop pain therapy according to the pain score.

Abstract: Systems and methods for detecting cardiac events in a patient are described herein. An embodiment of a medical system includes a detection circuit configured to detect cardiac events of the patient at different detection settings using physiologic information of the patient and a control circuit to determine a priority for each detected cardiac event based on the detection setting used to detect the respective cardiac event and to prioritize system resources for the detected cardiac event according to the determined priorities, wherein to prioritize system resources comprises to allocate memory space for the detected cardiac events or to prioritize data transmission of the detected cardiac events to an external system based on the determined priority for each respective cardiac event.

Abstract: Systems and methods for managing physiological events generated by a medical device in a patient are discussed. An exemplary system includes a controller circuit to receive information about a plurality of physiological events detected by a medical device in a patient, generate for each of the physiological events a respective feature set using the received information, and cluster the physiological events into different event groups using values of temporal or morphological features of the generated feature sets. The event groups each include a respective set of physiological events. The controller circuit can identify from at least one event group a representative event representing the physiological events of that event group, and output to a user or a process the representative event and an indication that the representative event has been determined and represents the set of physiological events in the even group.

Abstract: Systems and methods for detecting an arrhythmic event and storing physiological information associated with the detected arrhythmic event are described. A system may include a first detector to detect an arrhythmic event from a physiological signal sensed from a subject, and generate a confidence indicator indicating a confidence level of the detection of the arrhythmic event. If the confidence indicator indicates a relatively high confidence of arrhythmia detection, the system may provide the detected arrhythmic event to a first process for storing the detected arrhythmic event or generating an alert. If the confidence indicator indicates a relatively low confidence of arrhythmia detection, the system may provide the detected arrhythmic event to at least a second process including confirming or rejecting the detected arrhythmic event.

Abstract: Systems and methods for detecting physiologic events in a patient are described herein. An embodiment of a medical system includes a memory circuit to store physiologic event episodes detected and recorded by a medical device. The system includes a control circuit to analyze the stored physiologic event episodes, and determine a presence of a target cardiac event under a plurality of detection settings. Using the determined presence of the target cardiac event from the stored physiologic event episodes, and user adjudication of the stored event episodes, the control circuit may select, from the plurality of detection settings, a detection setting to detect a subsequent target cardiac event. The control circuit may also prioritize the physiologic event episodes for storage in the memory circuit.

Abstract: Systems and methods for pacing cardiac conductive tissue are described. In an embodiment, a medical system includes an electrostimulation circuit to generate pacing pulses to stimulate a His bundle or a bunch branch. A sensing circuit senses a far-field ventricular activation, determines a cardiac synchrony indicator using the far-field ventricular activation in response to His bundle or bundle branch pacing, and verifies His-bundle capture status using the determined cardiac synchrony indicator. The system can determine a pacing threshold using the capture status under different stimulation strength values. The electrostimulation circuit can deliver stimulation pulses in accordance with the determined pacing threshold.

Abstract: An example of a system for managing pain may include a pain monitoring circuit, a pain relief device, and a control circuit. The pain monitoring circuit may include a parameter analyzer and a pain score generator. The parameter analyzer may be configured to receive and analyze at least two parameters selected from a physiological parameter indicative of a physiological function or state of a patient, a functional parameter indicative of a physical activity or state of the patient, or a patient parameter including subjective information provided by the patient. The pain score generator may be configured to compute a composite pain score using an outcome of the analysis. The composite pain score may indicate a degree of the pain. The pain relief device may be configured to deliver a pain-relief therapy. The control circuit may be configured to control the delivery of the pain-relief therapy using the composite pain score.

Abstract: This document discusses, among other things, systems and methods to detect an initial arrhythmia event indication and, after a threshold amount of detection window intervals detecting the initial arrhythmia event indication, adjust a set of arrhythmia parameters or at least one of a respective set of parameter thresholds to increase sensitivity of an extended arrhythmia event indication detection.

Abstract: Systems and methods for pacing cardiac conductive tissue are described. In an embodiment, a medical system includes an electrostimulation circuit to generate pacing pulses to stimulate a His bundle or a bunch branch. A sensing circuit senses a far-field ventricular activation, determines a cardiac synchrony indicator using the far-field ventricular activation in response to His bundle or bundle branch pacing, and verifies His-bundle capture status using the determined cardiac synchrony indicator. The system can determine a pacing threshold using the capture status under different stimulation strength values. The electrostimulation circuit can deliver stimulation pulses in accordance with the determined pacing threshold.

Abstract: Systems and methods for detecting cardiac arrhythmias such as atrial tachyarrhythmia (AT) are discussed. An exemplary system includes an arrhythmia detector circuit that can receive physiologic information sensed from a patient over time, detect an arrhythmia onset when the physiologic information during a first time period satisfies an onset condition, and in response to the detected arrhythmia onset, detect an arrhythmia termination when the physiologic information during a second time period, subsequent to and longer than the first time period, satisfies an exit condition. An arrhythmia episode can be detected based on an arrhythmia duration between the detected onset and termination. The detected sustained arrhythmia episode can be provided to a user or a processor for further processing.

Abstract: This document discusses, among other things, systems and methods to receive cardiac electrical information of a subject, detect a premature ventricular contraction (PVC) event in a first detection window using the received cardiac electrical information, determine a count of detected PVC events in the first detection window, remove cardiac electrical information associated with the detected PVC event from the first detection window based on the determined count of detected PVC events, and detect an indication of atrial fibrillation of the subject for the first detection window using remaining cardiac electrical information in the first detection window.

Abstract: This document discusses, among other things, systems and methods for managing pain in a subject. A system may include one or more sensors configured to sense from the subject information corresponding to emotional reaction to pain, such as emotional expression. The emotional expression includes facial or vocal expression. A pain analyzer circuit may generate a pain score using signal metrics of facial or vocal expression extracted from the sensed information. The pain score may be output to a user or a process. The system may additionally include a neurostimulator that can adaptively control the delivery of pain therapy by automatically adjusting stimulation parameters based on the pain score.

Abstract: Systems and methods for managing medical information storage and transmission are discussed. A data management system may include a receiver circuit to receive information about a physiological event sensed from a patient, and an event prioritizer circuit to assign a priority to the received information. A control circuit may perform data reduction of the received information according to the assigned priority. Data reduction at a higher reduction rate is performed on the received information if a lower priority is assigned than if a higher priority is assigned. The system may include an output circuit to output the received information to a user or a process, or to transmit the received information to an external device, according to the assigned priority.

Abstract: Systems and methods for ambulatory detection of Q wave-to-T wave (QT) interval prolongation are discussed. A medical-device system comprises a controller circuit and a user interface device. The controller circuit includes a long QT syndrome (LQTS) detector that measures a QT interval from a subcutaneous cardiac signal sensed from a patient using implantable electrodes, and detects an indication of QT prolongation using the measured QT time interval and a programmable threshold received as a user input from the user interface. The control circuit can adjust device operation based on the detected indication of QT prolongation. An output unit can generate a programmable alert of the QT prolongation corresponding to the user input of the programmable threshold.

Abstract: Systems and methods for monitoring and treating patients with heart failure (HF) are discussed. The system may sense cardiac signals, and receives information about patient physiological or functional conditions. A stimulation parameter table that includes recommended values of atrioventricular delay (AVD) or other timing parameters may be created at a multitude of patient physiological or functional conditions. The system may periodically reassess patient physiological or functional conditions. A therapy programmer circuit may dynamically switch between left ventricular-only pacing and biventricular pacing, or switch between single site pacing and multisite pacing based on the patient condition. The therapy programmer circuit may adjust AVD and other timing parameters using the cardiac signal input and the stored stimulation parameter table. A HF therapy may be delivered according to the determined stimulation site, stimulation mode, and the stimulation timing.

Abstract: Systems and methods for managing machine-generated alert notifications of medical events detected from one or more patients are described herein. An embodiment of a data management system may receive an adjudication of a medical event episode including an episode characterization. A storage unit stores an association between one or more episode characterizations and corresponding detection algorithms for detecting a medical event having respective episode characterizations. An episode management circuit may detect from a subsequent episode, using the stored association, a medical event having an episode characterization of at least one medical event episode presented for adjudication, and schedule presenting at least a portion of the subsequent episode based on the detection.