Abstract: A portable electronic device for instant messaging is disclosed. One aspect of the invention involves a graphical user interface (GUI) on a portable electronic device with a touch screen display. The GUI has a set of messages exchanged between a user of the device and another person. The set of messages are displayed in a chronological order. In response to detecting a scrolling gesture comprising a substantially vertical movement of a user contact with the touch screen display, the display of messages are scrolled in accordance with a direction of the scrolling gesture. The detecting of the scrolling gesture is substantially independent of a horizontal position of the user contact with the touch screen display.

Abstract: There is provided a computer-readable medium storing a program causing a processor to execute a procedure. The processor is provided in a portable electronic apparatus. The procedure includes detecting acceleration in the gravitational acceleration direction of the portable electronic apparatus, determining whether or not the acceleration in the gravitational acceleration direction is a threshold value or less, the threshold value being stored in a determination threshold value table, and raising an alarm for prediction of stumbling of a user when the acceleration in the gravitational acceleration direction is the threshold value or less.

Abstract: Techniques for determining whether a patient will respond to cardiac resynchronization therapy (CRT) include identifying a plurality of consecutive cardiac beats within a cardiac electrogram of the patient and, for each of the consecutive cardiac beats, measuring a repolarization interval. The techniques also include determining a variability of the measured repolarization intervals. The variability of the measured repolarization intervals indicates whether the patient will respond to CRT. For example, a variability lower than a predetermined threshold may indicate that the patient is a CRT responder, while a variability greater than the predetermined threshold may indicate that the patient is a CRT non-responder.

Abstract: Dual chamber pacemaker systems can lead to two forms of pacemaker-facilitated tachycardia—pacemaker-mediated tachycardia (PMT) and tracking of sinus or atrial tachycardia. Current pacemaker algorithms can not always differentiate between these two tachycardias. Various embodiments for differentiating these particular mechanisms of pacemaker-facilitated tachycardia, which is based on the specific termination response to PVARP extension are provided. The response to PVARP extension (V-A-A-V vs V-A-V) is a specific method for differentiation and can be used in conjunction with observations of atrial rate and electrogram morphology (or surface P wave morphology) for distinguishing between the two mechanisms of pacemaker-facilitated tachycardia.

Abstract: Various method embodiments detect a concurrent therapy, where the concurrent therapy includes a plurality of therapy pulses. Detecting the concurrent therapy includes detecting at least one electrical pulse, extracting at least one characteristic from the at least one electrical pulse, comparing the at least one characteristic of the detected pulse to at least one characteristic of therapy pulses, and detecting that the concurrent therapy is being applied if the at least one characteristic of the detected pulse favorably compares to the at least one characteristic of the therapy pulses.

Abstract: Systems and methods are provided to generate an waveform for micro current therapy. The waveform includes overshoot signals overlaid on constant currents and is capable of stimulating cells or nerves to achieve healing. The system can include an oscillator configured to generate a reference signal, a pulse wave generator to generate a pulse waveform signal based on the reference signal, an overshoot generator to generate an overshoot signal based on the reference signal, and an output module to generate a composite output waveform signal based on the overshoot signal and the pulse waveform signal, wherein the composite output waveform includes one or more pulses having one or more overshoots that extend a width of each of the pulses. The system can be adjusted by a user depending on the disease, condition, or preference of the user.

Abstract: Systems, methods and circuits for providing GUI controls with touch-gesture inputs with movable alternate interaction objects. The GUI controls include (i) a set of base interactions associated with touch gestures available over substantially an entire viewing area and (ii) a plurality of alternate interaction icons that are individually movable over the display via touch gestures by a user touch to allow one or more users to interact with the visualization presented on the display. The alternate interaction icons each have a set of alternate interaction choices that are different from the set of base interactions and appear on the display only when a selected respective alternate interaction icon is touched.

Abstract: A therapy tracking system and method may include a processor that obtains physiological information regarding a patient and a time period during which a deep brain stimulation (DBS) therapy is conducted. The information may be organized into a plurality of sessions. The processor may arrange in a display device a separate representation of the information for each of at least a subset of the sessions, such that the sessions are presented in order of time.

Abstract: Data is received characterizing an electrocardiogram (ECG) measured from a patient having a pacemaker. The pacemaker can intermittently provide a pace to a heart of the patient. By comparing at least a portion of the received data to a template a pace pulse can be detected from at least a portion of the received data. The template comprises one or more pace pulses measured from the patient. The template is modified, at least in part, by the detected pace pulse to update the template. Data characterizing the detected pace pulse is provided. Related apparatus, systems, techniques and articles are also described.

Abstract: A biometric monitoring device measuring various biometric information is provided that allows the person to take and/or display a heart rate reading by a simple user interaction with the device, e.g., by simply touching a heart rate sensor surface area or moving the device in a defined motion pattern. Some embodiments of this disclosure provide biometric monitoring devices that allow a person to get a quick heart rate reading without removing the device or interrupting their other activities. Some embodiments provide heart rate monitoring with other desirable features such as feedback on data acquisition status.

Abstract: A system for serial comparison of physiological data, including: a controller; a user interface; and a memory including instructions that, when executed by the controller, perform the steps of: receiving from a first data source a current clinical report including first set of physiological data of a patient and computer-generated first interpretive statements; accessing, from the patient file in a patient database, a previous clinical report including a second set of physiological data of the patient and physician-edited interpretive statements; mapping the physician-edited interpretive statements into one or more codes of a structured data format, wherein each code uniquely identifies a medical state; performing a serial comparison between the current clinical report and the previous clinical report to generate serial comparison interpretive statements; providing to a user, via the user interface, the serial comparison interpretive statements; and receiving, via the user interface, current physician-edited

Abstract: Methods, devices, and processor-readable storage media are provided for the diagnosis of heart failure. One method includes collecting, using an implantable device, reference episodes; generating an in-suspicion model-cycle and an off-suspicion model-cycle based on the reference episodes; and determining whether to generate a heart failure alert, based on a difference between the in-suspicion model-cycle and the off-suspicion model-cycle.

Abstract: A method and medical device for monitoring cardiac function in a patient that includes a plurality of electrodes to deliver cardiac pacing therapy, and a processor configured to determine a pacing threshold in response to initial delivery of the pacing therapy, determine whether there is a change in the pacing threshold during initial delivery of the pacing therapy, adjust a delivery parameter of the pacing therapy in response to determining the change in the pacing threshold during initial delivery of the pacing therapy, determine whether there is an increase in the pacing threshold during delivery of the adjusted pacing therapy, and determine hypokalemia in response to the increase in the pacing threshold during delivery of the adjusted pacing therapy being present.

Abstract: A method and medical device for monitoring cardiac function in a patient that includes a plurality of electrodes to deliver cardiac pacing therapy, and a processor configured to determine a pacing threshold in response to initial delivery of the pacing therapy, determine whether there is a change in the pacing threshold during initial delivery of the pacing therapy, adjust a delivery parameter of the pacing therapy in response to determining whether there is a change in the pacing threshold during initial delivery of the pacing therapy, determine whether there is a decrease in the pacing threshold during delivery of the adjusted pacing therapy, and determine hyperkalemia in response to the decrease in the pacing threshold during delivery of the adjusted pacing therapy being present.

Abstract: The present invention is directed toward a detection architecture for use in implantable cardiac rhythm devices. The detection architecture of the present invention provides methods and devices for discriminating between arrhythmias. Moreover, by exploiting the enhanced specificity in the origin of the identified arrhythmia, the detection architecture can better discriminate between rhythms appropriate for device therapy and those that are not.

Abstract: A system includes a first computing device comprising a processor coupled to a memory. The processor and the memory are configured to receive at least one of (i) information indicative of treatment of a victim by a first caregiver using the first computing device and (ii) information indicative of a health status of the victim; determine that treatment of the victim by the first caregiver using the first computing device is completed; and transmit the received information to a second computing device.

Abstract: A defibrillating system includes a processor coupled to a memory. The processor and the memory are configured to identify a treatment event associated with treatment of a victim with the defibrillating system, and transmit a representation of a portion of an ECG signal associated with the identified treatment event. In some cases, the processor and the memory are configured to identify the portion of the ECG signal associated with the identified treatment event. In some cases, the portion of the ECG signal is of a predetermined length of time having a start time and an end time based on a time associated with the identified treatment event.

Abstract: An implantable device and method for monitoring changes in the risk of arrhythmia induced by medications. The implantable device monitors risk of arrhythmia by analyzing an aspect of T-wave morphology to generate a metric of transmural dispersion of repolarization (“TDR”) as a proxy for the risk of arrhythmia. The implantable device generates an index of change in the risk of arrhythmia by comparing values of the metric of TDR obtained for different time periods. The implantable device generates a warning if the change in risk of arrhythmia is outside acceptable limits. The implantable device can also communicate with other devices to correlate changes in risk of arrhythmia with medications taken by the patient.

Abstract: A system includes a processor coupled to a memory, the processor and memory configured to determine a proficiency level of a user of a rescue application based on stored data indicative of the user's proficiency level, and based on the user's proficiency level, select a level of operation for the rescue application. The rescue application is executed on a mobile device and configured to control operation of an AED. Each of multiple levels of operation for the rescue application allows the user a different degree of control over the operation of the AED. The processor and memory are configured to present, to the user, a set of instructions associated with the selected level of operation; and to enable control of the AED according to the selected levels of operation. A different set of instructions is associated with each of the multiple levels.

Abstract: A method of analysis of medical signals is presented which provides useful clinical information concerning the state of the myocardium during cardiopulmonary resuscitation (CPR). The analysis during CPR can be used to (i) identify the underlying rhythm, (ii) provide a measure of the efficacy of CPR, and (iii) to predict the outcome from a defibrillation shock.

Abstract: A cardiac resynchronization pacemaker and a method of adjusting the pacemaker. The method includes deriving a vectorcardiogram from implanted electrodes (D-VCG), analyzing the D-VCG, deriving optimal CRT pacing parameters from the analysis of the D-VCG, and adjusting the CRT pacemaker according to the derived parameters. The pacemaker may include a processor configured to perform the method.

Abstract: A leadless implantable medical device comprises a first electrode configured to deliver electrical pacing energy, a second electrode configured to sense intrinsic electrical cardiac activity, and a third electrode configurable to both deliver electrical pacing energy and sense intrinsic electrical cardiac activity. The first and third electrodes are used for delivering electrical pacing energy and the second and third electrodes are used to sense intrinsic electrical cardiac activity. None of the first, second and third electrodes are incorporated into a lead.

Abstract: In an example of a method, the method includes testing for phrenic nerve stimulation (PS) threshold. If PS beats are detected at the pacing output level, analyzing the detected PS beats using criteria to determine if the pacing output level can be declared to be the PS threshold. If the pacing output level cannot be declared to be the PS threshold based on the analysis of the PS beat at the pacing output level, performing a PS beat confirmation procedure. The PS beat confirmation procedure may include delivering additional cardiac paces at the pacing output level to generate additional PS beats, and analyzing the detected PS beats using other criteria to determine if the pacing output level can be confirmed as the PS threshold.

Abstract: Methods and kits for treating a cardiac arrhythmia using a platelet rich plasma (PRP) composition are provided. Any type of arrhythmia may be treated using the PRP composition. The PRP composition may comprise PRP developed using blood collected from a patient suffering the cardiac arrhythmia. The PRP composition may be buffered to a physiological pH and may include one or more anti-arrhythmic agents, anti-coagulants, or other drugs. The PRP composition may be delivered using a nebulizer, minimally invasively, or surgically.

Abstract: An exemplary computer-implemented method is disclosed for detection of onset of depolarization on far-field electrograms (EGMs) or electrocardiogram (ECG)- or ECG-like signals. The method includes determining a baseline rhythm using a plurality of body-surface electrodes. The baseline rhythm includes an atrial marker and a ventricular marker. A pre-specified window is defined as being between the atrial marker and the ventricular marker. A low pass filter is applied to a signal within the window. A rectified slope of the signal within the window is determined. A determination is made as to whether a time point (t1) is present such that the rectified slope exceeds 10% of a maximum value of the rectified slope. A point of onset of a depolarization complex in the signal is determined. The point of onset occurs at a largest curvature in the signal within the window.

Abstract: A method and system for discriminating ventricular arrhythmia is disclosed. In an embodiment, the method can include implementing an arrhythmia discrimination algorithm that can discriminate between supraventricular tachycardia (SVT) and ventricular tachycardia (VT) using at least one programmable parameter programmed to a first value. The method can include analyzing an SVT event, where analyzing the SVT event can include sensing a physiological signal during the SVT event and identifying characteristics of the sensed physiological signal. The method can further include analyzing a cardiac signal to classify the cardiac signal as either an SVT or a VT using the arrhythmia discrimination algorithm with the programmable parameter (programmed to a second value. The second value can be determined from the identified characteristics of the sensed physiological signal.

Abstract: A system and method for performing independent, off-line evaluation of event sensing for collected electrograms, comprising: sensing an electrogram using an implantable medical device (IMD); determining locations of heart beats on at least one channel of the electrogram using a multi-pass process, resulting in a group of multi-pass beat locations; storing the electrogram and device-identified beat locations in a memory location; and retrieving the electrogram and device-identified beat locations from the memory location. The multi-pass process determines locations of heart beats on at least a first channel of the electrogram. The device-identified group of beat locations are then compared to the multi-pass group of beat locations identified using the multi-pass method. Based on the comparing step, oversensing of beats, undersensing of beats, or noise from the device can be detected.

Abstract: A cardiac rhythm management (CRM) device can extract ventilation information from thoracic impedance or other information, and adjust a delivery rate of the CRM therapy. A tidal volume of a patient is measured and used to adjust a ventilation rate response factor. The measured tidal volume can optionally be adjusted using a ventilation rate dependent adjustment factor. The ventilation rate response factor can also be adjusted using a maximum voluntary ventilation (MVV), an age predicted maximum heart rate, a resting heart rate, and a resting ventilation determined for the patient. In various examples, a global ventilation sensor rate response factor (for a population) can be programmed into the CRM device, and automatically tailored to be appropriate for a particular patient.

Abstract: A chronically implanted medical device, connected to a medical electrical lead that includes a sensor, is used to detect diastolic dysfunction. A LV accelerometer signal is sensed through the sensor. Based on the LV accelerometer signal, a determination is made as to whether diastolic dysfunction data exists.

Abstract: Implantable cardiac devices and methods of their use. A method of operation in an implantable cardiac device may include steps for characterizing detected events as noise or not noise, identifying a set of consecutive noise events or a threshold quantity of noise events in a set period of time and declaring a noisy series to have occurred. In response to the declaration of a noisy series, the method initiates a baseline correction algorithm. Devices for performing such methods are also disclosed.

Abstract: Systems, methods, and graphical user interfaces are described herein for identification of optimal electrical vectors for use in assisting a user in implantation of implantable electrodes to be used in cardiac therapy. Cardiac improvement information may be generated for each pacing configuration, and one or more pacing configuration may be selected based on the cardiac improvement information. Optimal electrical vectors using the selected pacing configurations may be identified using longevity information generated for each electrical vector. Electrodes may then be implanted for use in cardiac therapy to form the optimal electrical vector.

Abstract: Systems, methods, and interfaces are described herein for identification of effective electrodes to be used in sensing and/or therapy. Two or more portions of a signal monitored using an electrode may be compared to determine whether the electrode is effective. The two or more portions may correspond to the same portion or window of a cardiac cycle. Further, signals from a first electrode and from a second electrode located proximate the first electrode may be compared to determine whether one or both of the electrodes are effective.

Abstract: Systems, methods, and interfaces are described herein for identification of effective electrodes to be used in sensing and/or therapy. Two or more portions of a signal monitored using an electrode may be compared to determine whether the electrode is effective. The two or more portions may correspond to the same portion or window of a cardiac cycle. Further, signals from a first electrode and from a second electrode located proximate the first electrode may be compared to determine whether one or both of the electrodes are effective.

Abstract: Described herein are implantable systems and devices, and methods for use therewith, that can be used to perform arrhythmia discrimination based on activation times. A plurality of different sensing vectors are used to obtain a plurality of IEGMs that collectively enable electrical activations to be detected in the left atrial (LA) chamber, the right atrial (RA) chamber, and at least one ventricular chamber of a patient's heart. For each of a plurality of cardiac cycles, there is a determination, based on the plurality of obtained IEGMs, of an LA activation time, an RA activation time, and a ventricular activation time. Arrhythmia discrimination is then performed based on the determined activation times.

Abstract: A method of locating a tip of a central venous catheter (“CVC”) having a distal and proximal pair of electrodes disposed within the superior vena cava, right atrium, and/or right ventricle. The method includes obtaining a distal and proximal electrical signal from the distal and proximal pair of electrodes and using those signals to generate a distal and proximal P wave, respectively. A deflection value is determined for each of the P waves. A ratio of the deflection values is then used to determine a location of the tip of the CVC. Optionally, the CVC may include a reference pair of electrodes disposed within the superior vena cava from which a reference deflection value may be obtained. A ratio of one of the other deflection values to the reference deflection value may be used to determine the location of the tip of the CVC.

Abstract: An implantable cardiac rhythm management (CRM) device includes a sensing and detection circuit that senses at least one cardiac signal and detects cardiac electrical events from the sensed cardiac signal using a detection threshold that is adjusted based on a dynamic noise estimation. The sensed cardiac signal is filtered to produce a filtered cardiac signal having a signal frequency band and a noise signal having a noise frequency band. The noise frequency band is substantially different from the signal frequency band. A dynamic noise floor is produced based on the noise signal and used as the minimum value for the detection threshold. A cardiac electrical is detected when the amplitude of the filtered cardiac signal exceeds the detection threshold.

Abstract: A method and system are provided for characterizing cardiac function. The method and system comprise collecting cardiac signals associated with electrical or mechanical behavior of a heart over at least one cardiac cycle; identifying a timing feature of interest (FOI) from the cardiac signals; collecting dynamic impedance (DI) data over at least one cardiac cycle (CC), designated by the timing FOI, along at least one of i) a venous return (VR) vector or ii) a right ventricular function (RVF) vector; and analyzing at least one morphologic characteristic from the DI data based on at least one of i) a VR-DI correlation metric to obtain a VR indicator associated with the CC or ii) a RVF-DI correlation metric to obtain a RVF indicator associated with CC.

Abstract: A system and method for correlating health related data for display. The system includes a medical device recording data and a display producing device which correlates the data and simultaneously displays different types of data or displays two sets of the same type of data along with the circumstances at which the two sets of data were recorded. Such displays aid a physician in prescribing and ascertaining the efficacy of cardiac therapies.

Abstract: Methods, systems, and devices for signal analysis in an implanted cardiac monitoring and treatment device such as an implantable cardioverter defibrillator. In some examples, captured data including detected events is analyzed to identify likely overdetection of cardiac events. In some illustrative examples, when overdetection is identified, data may be modified to correct for overdetection, to reduce the impact of overdetection, or to ignore overdetected data. Several examples emphasize the use of morphology analysis using correlation to static templates and/or inter-event correlation analysis.

Abstract: A method and system of post-processing of sensing data generated by a medical device that includes transmitting a plurality of stored sensing data generated by the medical device to an access device, the stored sensing data including sensed atrial events and sensed ventricular events. The access device determines, in response to the transmitted data, instances where the medical device identified a cardiac event being detected in response to the sensing data, and determines a ratio of sensed atrial events to sensed ventricular events in response to the transmitted data.

Abstract: A cardiac implant includes a classifier configured analyze the data for comparison to thresholds prioritized according to a Boolean decision tree. The implant can generate an indicator of alert status (i.e., alert or no alert). A supervisory device operated, for example, by a doctor can associate each indicator a marker (AE/no AE) indicating the presence or absence of an observed adverse event. In the presence of a false positive, a command for update of the thresholds of the decision tree is transmitted to the implant. A database of reference patients can be used to recreate or further update the decision tree to avoid the occurrence of false negatives.

Abstract: A device for detecting cardiac ischemia is disclosed. The device includes a processor that is configured to distinguish between two different heart beats types such as ventricularly paced beats and supraventricular beats. The processor collects separate reference data for each beat type indicative of the normal values of a cardiac feature associated with these beat types. The processor performs an ischemia test by separately comparing present values of the cardiac feature for each beat type with the reference values for the corresponding beat type.

Abstract: Methods and implantable devices for cardiac signal analysis. The methods and devices make use of waveform appraisal techniques to distinguish event detections into categories for suspect events and waveform appraisal passing events. When adjustments are made to the data entering analysis for waveform appraisal, the waveform appraisal thresholds applied are modified as well. For example, when the data analysis window for waveform appraisal changes in length, a waveform appraisal threshold is modified. Other changes, including changes in sensing characteristics with which waveform appraisal operates may also result in changes to the waveform appraisal threshold including changes in gain, sensing vector, activation of other devices, implantee posture and other examples which are explained.

Abstract: Methods of locating a tip of a central venous catheter (“CVC”) relative to the superior vena cava, sino-atrial node, right atrium, and/or right ventricle using electrocardiogram data. The CVC includes at least one electrode. In particular embodiments, the CVC includes two or three pairs of electrodes. Further, depending upon the embodiment implemented, one or more electrodes may be attached to the patient's skin. The voltage across the electrodes is used to generate a P wave. A reference deflection value is determined for the P wave detected when the tip is within the proximal superior vena cava. Then, the tip is advanced and a new deflection value determined. A ratio of the new and reference deflection values is used to determine a tip location. The ratio may be used to instruct a user to advance or withdraw the tip.

Abstract: A computer-implemented method of recording the times of events related to the medical care delivered to patient, and for integrating those times to provide a patient history, including recording a first time of occurrence of a first event, recording first clock information characterizing a first time source from which the first time of occurrence was obtained, recording a second time of occurrence of a second event, recording second clock information characterizing a second time source from which the second time of occurrence was obtained, wherein the first time source and the second time source are independent of one another and not synchronized with one another, transferring recorded data so that the first time of occurrence, first clock information, second time of occurrence, and second clock information are accessible at a computer; and producing a patient history using at least the first and second times of occurrence.

Abstract: One embodiment enables detection of MI/I and emerging infarction in an implantable system. A plurality of devices may be used to gather and interpret data from within the heart, from the heart surface, and/or from the thoracic cavity. The apparatus may further alert the patient and/or communicate the condition to an external device or medical caregiver. Additionally, the implanted apparatus may initiate therapy of MI/I and emerging infarction.

Abstract: An implantable heart stimulating device for indicating congestive heart failure (CHF) has a processor and a sensor combination that senses at least two heart events during one heart cycle at different locations of the heart. The processor is supplied with signals from the sensor combination relating to the sensed events, and determines therefrom at least one heart time interval between the sensed events in the same heart cycle. The processor determines a CHF indicator value representing a degree of CHF based on a variability measure calculated from at least two heart time intervals from at least two different heart cycles. The processor determines the CHF indicator value in relation to previous CHF indicator values.

Abstract: Methods, apparatus, and systems are provided to control contraction of the heart. At least one sensing element receives signals indicating electrical activity of sinus rhythm of the heart. The electrical activity is monitored and analyzed to detect an event. In addition, the electrical activity is monitored to detect, for example, premature stimulation and contraction of a portion of the heart, such as the left ventricle. Contraction in the pre-excited portion of the heart is then suppressed using electrical pulses. The heart may then be allowed to contract naturally, or a stimulating pulse may be applied to assist the heart in contracting.

Abstract: A method and system for discriminating ventricular arrhythmia is disclosed. In an embodiment, the method can include implementing an arrhythmia discrimination algorithm that can discriminate between supraventricular tachycardia (SVT) and ventricular tachycardia (VT) using at least one programmable parameter programmed to a first value. The method can include analyzing an SVT event, where analyzing the SVT event can include sensing a physiological signal during the SVT event and identifying characteristics of the sensed physiological signal. The method can further include analyzing a cardiac signal to classify the cardiac signal as either an SVT or a VT using the arrhythmia discrimination algorithm with the programmable parameter (programmed to a second value. The second value can be determined from the identified characteristics of the sensed physiological signal.

Abstract: A system and method for monitoring at least one chamber of a heart (e.g., a left ventricular chamber) during delivery of extrasystolic stimulation to determine if the desired extra-systole (i.e., ventricular mechanical capture following refractory period expiration) occurs. The system includes an implantable or external cardiac stimulation device in association with a set of leads such as epicardial, endocardial, and/or coronary sinus leads equipped with motion sensor(s). The device receives and processes acceleration sensor signals to determine a signal characteristic indicative of chamber capture resulting from one or more pacing stimulus delivered closely following expiration of the refractory period.