Abstract: An example system and method of reconstructing cardiac activation information are disclosed. An analysis signal and a reference signal are processed to determine whether there is a first point of change in a first selected-order derivative of the analysis signal with respect to a first selected-order derivative of the reference signal above a first threshold. The analysis signal and the reference signal are processed to determine whether there is a second point of change in a second selected-order derivative of the analysis cardiac signal with respect to a second selected-order derivative of the reference cardiac signal above a second threshold. An activation onset time is assigned in the analysis cardiac signal at a point based on a mathematical association of the first point of change and the second point of change to define cardiac activation indicating a beat in the analysis cardiac signal.

Abstract: Methods and devices for cardiac signal analysis in implantable cardiac therapy systems. Several signal processing and/or conditioning methods are shown including R-wave detection embodiments including the use of thresholds related to previous peak amplitudes. Also, some embodiments include sample thresholding to remove extraneous data from sampled signals. Some embodiments include weighting certain samples more heavily than other samples within a sampled cardiac signal for analysis.

Abstract: A method, system, and device for detection of an arrhythmia, and discrimination between different types of arrhythmia, for example to determine whether to administer an electric shock to the heart, the device comprising a wearable monitor with electrodes that detect the electrical activity of a beating heart, attached to an embedded monitoring system having an amplifier, a microprocessor, a data storage device, and a power supply, all disposed on a substrate having large distal end portions that attach to the electrodes and a narrow intermediate portion that attaches to the monitoring system.

Abstract: An atrial fibrillation classification system collects celectrocardiogram signals and converts them to a frequency, time, or phase domain representation for analysis. An evaluation stage extracts energy density profile over a range of frequencies, time intervals, or phases, which is then summed and normalized to form dispersion metrics. The system then analyzes the dispersion metrics, in their respective domains, to determine whether a patient is experiencing an arrhythmia and then to classify the type of arrhythmia being experienced.

Abstract: Methods and systems for assessing cardiac fibrillogenicity in a patient includes generating a map of a duration of one or more measurements indicative of a number of electrical circuit cores and distribution of the electrical circuit cores across a cardiac tissue substrate in the patient's heart in response to electrical activity in the cardiac tissue substrate, the map being registered onto a representation of the patient's heart, applying a set of executable instructions to the map to define an optimal placement of at least one ablation lesion in the cardiac tissue substrate, and calculating total length of the at least one ablation lesion, wherein the total length measure is indicative of the patient's cardiac fibrillogenicity to inform treatment using catheter ablation.

Abstract: A method of determining health and mortality includes obtaining a ventricular activation (RR) time series from a subject for multiple temporal intervals. The method also includes calculating a cardiac entropy in the RR time series over the temporal intervals using coefficient of sample entropy (COSEn). Additionally, the method includes comparing the cardiac entropy between the intervals to determine health and mortality. The absolute and relative changes in entropy over a patient's follow up period provide dynamic information regarding health and mortality risk. The determination of health and mortality can then be used to create a treatment plan for the subject.

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: A method and system for determining activation times for electric potentials from complex electrograms to identify the location of arrhythmic sources or drivers. The method includes counting a number deflections in a recorded cardiac electrogram signal from at least one electrode for a predetermined amount of time. A deflection time is identified for each of the counted number of deflections. A most negative slope is identified between each of the identified deflections times. Each of the identified most negative slopes is correlated to a possible activation time. Each possible activation time is associated with a corresponding electrode from the at least one electrode. A spatial voltage gradient at each corresponding electrode is calculated for each possible activation time. The greatest spatial voltage gradient is identified. The greatest spatial voltage gradient is correlated to an activation time.

Abstract: A system improves analysis, diagnosis and characterization of cardiac function signals (including surface ECG signals and intra-cardiac electrograms) based on cardiac electrophysiological activity momentum computation, characterization and mapping. The system calculates an electrophysiological signal momentum of different portions of cardiac signals including a timing, location and severity of cardiac pathology and improves reliability of diagnosis, detection, mapping to an identified medical condition, and characterization. The system improves identification of cardiac disorders, differentiation of cardiac arrhythmias, characterization of pathological severity, prediction of life-threatening events and supports evaluation of drug administration effects.

Abstract: An arrangement may include a first system provided by a mobile device for processing ECG data representative of a beating heart. The mobile device may be adapted to execute a process for using at least one pattern to detect a notable finding in the ECG data and for sending the notable finding to a second system. The second system may be adapted to execute a process for analyzing the notable finding, for determining at least one new pattern to send to the mobile device, and for sending the at least one new pattern to the mobile device. The at least one new pattern may also include a rule that includes a set of conditions and an action to perform if the set of conditions is met.

Abstract: Methods, systems, and apparatus for detecting and/or validating a detection of a state change by matching the shape of one or more of an cardiac data series, a heart rate variability data series, or at least a portion of a heart beat complex, derived from cardiac data, to an appropriate template.

Abstract: Disclosed herein is a framework for facilitating patient signal analysis. In accordance with one aspect, at least one region of interest within a cycle of a waveform of patient signal data is identified. The identified region of interest may be segmented into portions using amplitude percentage categories. A sequential morphological data series may be generated by compiling time intervals of the segmented portions. One or more sequential signal parameters may be calculated based on the sequential morphological data series. A report may then be generated based at least in part on the one or more sequential signal parameters.

Abstract: A cardiac-based metric is computed based upon characteristics of a subject's cardiac function. In accordance with one or more embodiments, the end of a mechanical systole is identified for each of a plurality of cardiac cycles of a subject, based upon an acoustical vibration associated with closure of an aortic valve during the cardiac cycle. The end of an electrical systole of an electrocardiogram (ECG) signal for each cardiac cycle is also identified. A cardiac-based metric is computed, based upon a time difference between the end of the electrical systole and the end of the mechanical systole, for the respective cardiac cycles.

Abstract: Apparatus and methods are described, including a method for treating a clinical episode. The method comprises sensing at least one parameter of a subject without contacting or viewing the subject or clothes the subject is wearing, analyzing the parameter, detecting the clinical episode at least in part responsively to the analysis, and responsively to detecting the clinical episode, treating the clinical episode using a device implanted in the subject. Other applications are also described.

Abstract: Embodiments of the present invention relate to implantable systems, and methods for use therewith, for assessing a patients' myocardial electrical stability. Implanted electrodes are used to obtain an electrogram (EGM) signal, which is used to identify periods when the patient experiences T-wave alternans. Additionally, the EGM signal is used to determine whether premature ventricular contractions (PVCs) cause phase reversals of the T-wave alternans. The patient's myocardial electrical stability is assessed based on whether, and in a specific embodiment the extent to which, PVCs cause phase reversals of the T-wave alternans. This abstract is not intended to be a complete description of, or limit the scope of, the invention.

Abstract: The system presented allows secure control of and secure data extraction from implantable medical devices (IMD) using smartphones or other mobile devices. In particular, a patient's or a healthcare provider's mobile device can be utilized to securely interface with an IMD that has been implanted in or on a patient's body. Embodiments include, but are not limited to devices, systems, and methods for securing implanted medical devices.

Abstract: In an implantable medical device, such as a bi-ventricular pacemaker and a method for detecting and monitoring mechanical dyssynchronicity of the heart, a dyssynchronicity measure indicating a degree of mechanical dyssynchronicity of a heart of a patient is calculated. A first intracardiac impedance set is measured using electrodes placed such that the first intracardiac impedance set substantially reflects a mechanical activity of the left side of the heart and a second intracardiac impedance set is measure using electrodes placed such that the second intracardiac impedance set substantially reflects a mechanical activity of the right side of the heart.

Abstract: A medical device and associated method for classifying an unknown cardiac signal that includes sensing a cardiac signal over a plurality of cardiac cycles, determining a template of a known cardiac signal in response to the cardiac signal sensed over the plurality of cardiac cycles, sensing an unknown cardiac signal over an unknown cardiac cycle, determining a fourth order difference signal, determining a template alignment point and an unknown cardiac signal alignment point in response to the fourth order difference signal; determining an R-wave onset and an R-wave offset in response to the fourth order difference signal of the unknown cardiac cycle signal, determining an R-wave width as the difference between the R-wave onset and the R-wave offset, determining a morphology analysis window in response to the R-wave width, and determining a first morphology match metric across the morphology analysis window.

Abstract: Devices and methods for analyzing cardiac signal data. An illustrative method includes identifying a plurality of detected events and measuring intervals between the detected events for use in rate estimation. In the illustrative embodiment, a set of intervals is used to make the rate estimation by first discarding selected intervals from the set. The remaining intervals are then used to calculate an estimated interval, for example by averaging the remaining intervals.

Abstract: Embodiments of the invention pertain to kiosks and home kits capable of providing authenticated health information for purposes of privacy, rewards, or incentives. In an embodiment of the invention, biometric measurement devices coupled with a communications infrastructure implement a system of secure information exchange and enhanced data security. In an embodiment of the invention, a user's communications device such as a cell phone is wirelessly connected through or by the machine to a call center or other responder to allow for consultation when appropriate. In an embodiment of the invention, a security/verification system is built into the kiosk, so as to be able to verify a user's identity.

Abstract: A system include circuitry to receive information from a mobile device including ECG data representative of a beating heart, circuitry to analyze the ECG data using at least one pattern to detect a notable finding in the ECG data and circuitry to determine at least one pattern to send to the mobile device, based on the analysis of the ECG data. The system sends the at least one determined pattern to the mobile device.

Abstract: An implantable cardiac device is configured to classify cardiac arrhythmias using a plurality of arrhythmia discrimination algorithms. Data is provided that is associated with a plurality of cardiac arrhythmic episodes for which a cardiac electrical therapy was delivered or withheld by the implantable medical device based on the plurality of arrhythmia discrimination algorithms. A metric for each of the arrhythmic episodes is computed. The metric defines a measure by which the implantable cardiac device properly classified the arrhythmia. Potentially misclassified arrhythmic episodes of the plurality of cardiac arrhythmic episodes for which cardiac electrical therapy was inappropriately delivered or withheld are algorithmically identified using the metric.

Abstract: A system including a sensor interface coupled to a processor. The sensor interface is configured to receive and process an analog electrocardiogram signal of a subject and provide a digitized electrocardiogram signal sampled over a first time period and a second time period that is subsequent to the first time period. The processor is configured to receive the digitized electrocardiogram signal, to analyze a frequency domain transform of the digitized electrocardiogram signal sampled over the first and second time periods and determine first and second metrics indicative of metabolic state of a myocardium of the subject during the first and second time periods, respectively, to compare the first and second metrics to determine whether the metabolic state of the myocardium of the subject is improving, and to indicate administration of an intervention to the subject in response to a determination that the metabolic state is not improving.

Abstract: Easy to use, cost-effective methods and devices for evaluating and treating stress and thereby disorders caused or exacerbated by stress are provided. More particularly methods and devices for identifying RSA waves during respiration which provide a subject with near real-time RSA wave information are provided. This information can be used in biofeedback settings to assist subjects in reducing levels of stress by achieving rhythmic breathing patterns.

Abstract: Disclosed is a system for the detection of cardiac events that includes an implanted device called a cardiosaver, a physician's programmer and an external alarm system. The system is designed to provide early detection of cardiac events such as acute myocardial infarction or exercise induced myocardial ischemia caused by an increased heart rate or exertion. The system can also alert the patient with a less urgent alarm if a heart arrhythmia is detected. Using different algorithms, the cardiosaver can detect a change in the patient's electrogram that is indicative of a cardiac event within five minutes after it occurs and then automatically warn the patient that the event is occurring. To provide this warning, the system includes an internal alarm sub-system (internal alarm means) within the cardiosaver and/or an external alarm system (external alarm means) which are activated after the ST segment of the electrogram exceeds a preset threshold.

Abstract: A system and method providing outpatient ECG monitoring and safe home based cardiac tele-rehabilitation. The system includes a recordation module for recording ECG signals using at least one lead, a tele-rehabilitation module for home based exercise management for a patient's recovery from a heart disease, the tele-rehabilitation module including a processing module for recognizing erroneous data from the ECG signals and an analysis module for calculating beat-to-beat annotations and determining if an ECG event and/or if a QT interval duration change has occurred.

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: The present disclosure relates to devices, implementations and techniques for health monitoring. Embodiments of the present disclosure relate to cardiac arrest monitoring devices.

Abstract: A biological information displaying apparatus includes an analyzing unit and a display unit. The analyzing unit analyzes measured continuous biological information waveforms to detect abnormal biological information waveforms.

Abstract: An example system and method of reconstructing cardiac activation information are disclosed. In accordance therewith, there are accessed pairs of cardiac signals out of a plurality of cardiac signals obtained from a patient. The pairs have a first cardiac signal that is common among the pairs and second cardiac signals that are different among the pairs. The first cardiac signal and the second cardiac signals of the pairs are processed to determine whether there are points of change in the first cardiac signal at which a derivative of the first cardiac signal diverges with respect to derivatives of the second cardiac signals above a threshold. An activation onset time is assigned at a point in the first cardiac signal based on correspondence of the points of change to define a cardiac activation indicating a beat if the points of change are in the first signal.

Abstract: System, assembly and method are provided to facilitate reconstruction of cardiac information representing a complex rhythm disorder associated with a patient's heart to indicate a source of the heart rhythm disorder. The complex rhythm disorder can be treated by application of energy to modify the source of the rhythm disorder.

Abstract: An example method of representing cardiac information associated with a heart rhythm disorder is disclosed. The method includes accessing a plurality of neighboring cardiac signals obtained from a patient. The method also includes eliminating far-field activations from the plurality of neighboring cardiac signals using one or more divergence criteria that define local activations in the plurality of neighboring cardiac signals, the divergence criteria being associated with divergence among the plurality of neighboring cardiac signals. The method further includes constructing a clinical representation of local activations in the plurality of neighboring cardiac signals.

Abstract: A method of analyzing a complex rhythm disorder in a human heart includes accessing signals from a plurality of sensors disposed spatially in relation to the heart, where the signals are associated with activations of the heart, and identifying a region of the heart having an activation trail that is rotational or radially emanating, where the activation trail is indicative of the complex rhythm disorder and is based on activation times associated with the activations of the heart.

Abstract: A method and system for determining the mechanism of cardiac arrhythmia in a patient is disclosed. The method basically entails measuring the impedance of cardiac tissue in a portion of the patient's heart using a catheter during an episode of supraventricular tachycardia to produce an iso-impedance map of that cardiac tissue on a video display and analyzing the pattern of the iso-impedance map to differentiate focal arrhythmia caused by a circumscribed region of focal firing and reentrant arrhythmia caused by a macroreentrant circuit. The method can also be used to identify regions of coherent rapidly conducting tissue e.g., Bachman's bundle or the inferoposterior pathway insertion points, to identify focal “mother rotors” throughout the left atrium that may participate in the generation and maintenance of atrial fibrillation and to identify areas of CAFE (complex atrial/fractionated electrograms) that truly reflect these mother rotors.

Abstract: A method estimates morphological features of heart beats from an ECG signal. Peaks of the R wave of the ECG are detected and classified using a parallel filtering structure. The first branch implements a bandpass filtering with cut off frequencies of about 10 Hz and 35 Hz, enhancing the signal-to-noise ratio (SNR) of the QRS complex. The second branch estimates morphological features of the heart beat from an alternating current (AC) replica of the ECG signal, that may be used to classify the beat and potentially detect arrhythmias.

Abstract: Systems and methods to assist in locating the focus of an atrial fibrillation include the association of atrial fibrillation cycle length values and statistics relating thereto with temporal locations on an electrogram of a given electrode, and/or the coordination of electrode locations with respective the spectral analyses of electrogram signals and further parameters and statistics relating thereto. Ablation therapy can proceed under guidance of such information.

Abstract: A method for identifying a target arrhythmia, for example, atrial fibrillation, with very high specificity includes obtaining heart rhythm data such as EKG data, selecting and analyzing a segment of the data for arrhythmia, if an arrhythmia is found then reanalyzing the segment of data for a hidden regularity that would indicate the data is not the target arrhythmia. If no hidden regularity is found, then identifying the segment as the target arrhythmia.

Abstract: The present invention is a visual cuing device which allows users to rapidly and easily identify ECG/EKG cardiac arrhythmias and twelve lead ECG/EKG arrhythmias. A visual cuing device contains a plurality of panels with a plurality of graphically displayed ECG/EKG abnormalities alternated with visually high-contrast, solid colored text sections. A visual cuing device may also contain additional tools, such as a heart rate reference line, time reference line or baseline window to aid in analysis and interpreting ECG/EKG strips. A visual cuing device may also be adapted to display using a touch screen or other user interface.

Abstract: A system to measure intracardiac impedance includes implantable electrodes and a medical device. The electrodes sense electrical signals of a heart of a subject. The medical device includes a cardiac signal sensing circuit coupled to the implantable electrodes, an impedance measurement circuit coupled to the same or different implantable electrodes, and a controller circuit coupled to the cardiac signal sensing circuit and the impedance measurement circuit. The cardiac signal sensing circuit provides a sensed cardiac signal. The impedance measurement circuit senses intracardiac impedance between the electrodes to obtain an intracardiac impedance signal. The controller circuit determines cardiac cycles of the subject using the sensed cardiac signal, and detects tachyarrhythmia using cardiac-cycle to cardiac-cycle changes in a plurality of intracardiac impedance parameters obtained from the intracardiac impedance signal.

Abstract: An ambulatory medical device including a plurality of electrodes configured to be disposed at spaced apart positions about a patient's body, an electrode signal acquisition circuit, and a monitoring circuit. The acquisition circuit has a plurality of inputs each electrically coupled to a respective electrode of the plurality of electrodes and is configured to sense a respective signal provided by a plurality of different pairings of the plurality of electrodes. The monitoring circuit is electrically coupled to an output of the acquisition circuit and is configured to analyze the respective signal provided by each of the plurality of different pairings and to instruct the acquisition circuit to select at least one of the plurality of different pairings to monitor based on at least one of the quality of the respective signal, a phase difference between the respective signal and that of other pairings, a position of electrodes relative to the patient's body, and other criteria.

Abstract: A method is disclosed for displaying patient ECG data. The method includes receiving ECG data including an ECG waveform; receiving analyzed ECG data including arrhythmic events; generating an indicia of the detected arrhythmic event; and displaying the indicia of the detected arrhythmic event in relation to the ECG waveform at a position associated with a time of the detected arrhythmic event. A system for displaying patient ECG data is also disclosed.

Abstract: Methods and systems are disclosed for analyzing three dimensional orthogonal ECG measurements to assess patient risk of a subsequent cardiac event based on evaluation of cardiac vector values in view of risk factors defined by the invention.

Abstract: A system and method for non-invasively generating a report of cardiac electrical activities of a subject includes determining, using cardiac electrical activation information, equivalent current densities (ECDs). The ECDs are assembled into time-course ECD information and a spectrum of the time-course ECD information is analyzed to determine peaks for spectral characteristics of atrial fibrillation (AF). The spectral characteristics of AF are correlated with potential electrical sources of the AF and a report is generated indicating the potential electrical sources of the AF spatially registered with the medical imaging data.

Abstract: Embodiments of the present invention relate to implantable systems, and methods for use therein, that can detect T-wave alternans and analyze the detected alternans to provide information regarding cardiac instabilities and predict impending arrhythmias.

Abstract: Risk determination for a near fatal ventricular arrhythmia of a patient. An electrocardiogram of a heart of the patient is obtained. A parameter is measured, using an electrocardiogram of a heart of the patient, indicative of an autonomic nervous system of the patient. A numeric score is assigned for the parameter indicative of the conduction system of the heart. A numeric score is assigned for the parameter indicative of the autonomic nervous system. A ratio of the numeric score of the parameter indicative of the conduction system of the heart of the patient and the numeric score of the parameter indicative of the autonomic nervous system of the patient is calculated. The risk of the potentially near fatal ventricular arrhythmia of the patient is determined to be significant if the ratio is greater than a predetermined threshold. An action responsive to the determining step is taken.

Abstract: In specific embodiments, one or more cardiogenic impedance signal template is stored, where each template has a corresponding morphology. Additionally, one or more cardiogenic impedance signal is obtained using electrodes implanted within a patient, where each signal has a corresponding morphology. The morphology of one or more obtained cardiogenic impedance signal is compared to the morphology of one or more stored template, to determine one or more metric indicative of similarity between the compared morphologies. The one or more metric indicative of similarity is used to analyze the patient's cardiac condition, to discriminate among arrhythmias and/or to adjust a cardiac pacing parameter.

Abstract: A method for managing care of a person receiving emergency cardiac is disclosed and involves monitoring, with an external defibrillator, multiple parameters of the person receiving emergency cardiac assistance; determining from at least one of the parameters, an indication of trans-thoracic impedance of the person receiving emergency cardiac care; determining, from at least one of the parameters corresponding to an electrocardiogram of the person receiving emergency cardiac assistance, an initial indication of likely shock effectiveness; determining, as a function of at least the indication of trans-thoracic impedance and the initial indication of likely shock effectiveness, an indication of whether a shock provided to the person receiving emergency medical assistance will be effective; and affecting control of the defibrillator by a caregiver as a result of determining the indication of whether a shock will be effective.

Abstract: Implantable electromedical device or loop recorders or ILRs that solve the problem of very low arrhythmia detection specificities in, i.e., high number of false positives, based on detection and analysis of external noise, specifically muscle noise surrounding the electromedical device. Embodiments generally employ active detection of lead or device movement that induces signal artifacts indicative of external noise. One or more embodiments may detect lead or device movement through use of a piezoelectric transducer, for example located proximally to the device or in the lead of the electromedical.

Abstract: A set of cardiogenic impedance signals are detected along different sensing vectors passing through the heart of the patient, particularly vectors passing through the ventricular myocardium. A measure of mechanical dyssynchrony is detected based on differences, if any, among the cardiogenic impedance signals detected along the different vectors. In particular, differences in peak magnitude delay times, peak velocity delay times, peak magnitudes, and waveform integrals of the cardiogenic impedance signals are quantified and compared to detect abnormally contracting segments, if any, within the heart of the patient. Warnings are generated upon detection of any significant increase in mechanical dyssynchrony. Diagnostic information is recorded for clinical review. Pacing therapies such as cardiac resynchronization therapy (CRT) can be activated or controlled in response to mechanical dyssynchrony to improve the hemodynamic output of the heart.

Abstract: System, assembly and method are provided to facilitate reconstruction of cardiac information representing a complex rhythm disorder associated with a patient's heart to indicate a source of the heart rhythm disorder. The complex rhythm disorder can be treated by application of energy to modify the source of the rhythm disorder.