Abstract: Body sensor networks (BSNs) and methods for monitoring an electrocardiogram using such BSNs include a base station that generates an ECG model and an output ECG signal for displaying on a display device, and a sensor platform in electrical communication with the base station. The sensor platform may be configured to receive a sensed ECG signal from one or more sensors, receive an instance of the ECG model, and produce a model ECG signal from the instance. The sensor platform compares the sensed ECG signal to the model ECG signal and, if a deviation of the sensed ECG signal from the model ECG signal exceeds a threshold, transmits deviation data describing the deviation to the base station module. The sensor platform module does not transmit any data to the base station if there is no such deviation.

Abstract: A method includes retrieving electrogram (EGM) data for N cardiac cycles from a memory of an implantable medical device. N is an integer greater than 1. The method further include categorizing each of the N cardiac cycles into one of a plurality of categories based on a morphology of the N cardiac cycles and performing comparisons between pairs of the N cardiac cycles. Each of the comparisons between two cardiac cycles includes detecting a mismatch between the two cardiac cycles when the two cardiac cycles are in different categories, and detecting a match between the two cardiac cycles when the two cardiac cycles are in the same category. Additionally, the method includes classifying the rhythm of the N cardiac cycles based on a number of detected matches and detected mismatches.

Abstract: An example system and method of reconstructing biological activation information are disclosed. A first biological signal and a second biological signal associated with an organ are processed via a computing device to determine whether there is a point of change in a derivative of the first biological signal with respect to a derivative of the second biological signal above a threshold. An activation onset time is assigned in the first biological signal at the point of change to define biological activation associated with the organ in the first biological signal if it is determined that the point of change is above the threshold.

Abstract: Techniques include determining a first vector of temporal changes in electrical data measured at multiple electrical sensors positioned at corresponding locations on a surface of a living body due to a natural electrical pulse. A different vector of temporal changes in electrical data measured at the same electrical sensors is determined due to each stimulated signal of multiple stimulated signals within the living body. Stimulated position data is received, which indicates a different corresponding position within the living body where each of the stimulated signals originates. The site of origin of the natural electrical pulse is determined based on the first vector and the multiple different vectors and the stimulated position data. Among other applications, these techniques allow the rapid, automatic determination of the site of origin of ventricular tachycardia arrhythmia (VT).

Abstract: A method for treating atrial fibrillation in an atrium of a heart includes (a) acquiring an image or map of the atrium; (b) displaying the image or map of the atrium; (c) marking at least one feature on the image or map; (d) calculating dimensions of the at least one feature; (e) identifying one or more points on or within the atrium for treatment as part of a treatment plan; (f) determining paths to the one or more points on or within the atrium for treatment; (g) simulating insertion of a sheath into the atrium; (h) simulating insertion of a medical device through the sheath and into the atrium; (i) verifying that the one or more points on or within the atrium can be accessed for treatment; (j) computing an overall surface area of the atrium; (k) calculating an estimated area not treated in the atrium based on the treatment plan; (l) assessing whether macro-reentrant circuits can exist in the estimated area not treated in the atrium; (m) repeating steps (e)-(l) in the event step (l) indicates that macro-ree

Abstract: A catheter and method for the treatment of a patient having atrial flutter or other arrhythmia comprises an elongated catheter body having an outer wall, proximal and distal ends, and at least one lumen extending therethrough. Further it has a distal tip section comprising a flexible tubing having a proximal end and a distal end and a plurality of lumens extending therethrough. The proximal end of the tip section is fixedly attached to the distal end of the catheter body. The tip section further comprises a nitinol tube having slots formed therein which causes the distal tip section to deflect using the same puller-wire action used to cause the deflectable catheter to deflect at a point proximal to the distal tip section.

Abstract: The present disclosure relates generally to patient monitoring systems and, more particularly, to signal analysis for patient monitoring systems. In one embodiment, a method of analyzing a detector signal of a physiological patient sensor includes obtaining the detector signal from the physiological patient sensor, and determining a ratio of the signal between two or more channels. A distribution of the angles between the points of the ratio over time may be used to determine a true ratio or a ratio of ratios for use in the determination of a physiological parameter.

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: A system for monitoring a cardiac characteristic. The system including: a sensor patch adhered to a surface of the skin which includes: a patch body having a surface and an adhesive, the patch body further having a cavity; a sensor disposed in the cavity and configured for detecting the cardiac characteristic; a transmitter connected to the sensor for transmitting a signal representative of the cardiac characteristic; and a power source disposed in the cavity for powering the sensor and transmitter; and a receiver for receiving or monitoring the signal from the transmitter and outputting information associated with the cardiac characteristic. The receiver can be a cellular phone having an application used to receive the signal from the transmitter and generate the information associated with the cardiac characteristic. The cardiac characteristic can be a cardiac abnormality or useful in monitoring or providing feedback to the user while exercising.

Abstract: Methods, systems, and computer-readable and executable instructions are provided for classifying an electrocardiogram (ECG) signal. Classifying an ECG signal can include analyzing the ECG signal using a stream of pulses generated by a sampler, extracting cardiac pulse features from a timing of the stream of pulses, and classifying the ECG signal based on the extracted cardiac pulse feature.

Abstract: A system and method for evaluating cardiovascular performance in real time and characterized by conversion of a surface potential into multi-channels are introduced. The system includes an electrocardiographic signal measuring unit, a reconstruction unit, and a parameter computation and assessment unit. The reconstruction unit reconstructs electrocardiographic signals (ECG signals) recorded by the electrocardiographic signal measuring unit, such that the ECG signals are reconstructed as ones located at different spatial positions but actually not having a channel. The method includes calculating a variation manifested spatially during an interval between a Q wave and a T wave of an ECG signal against time with a parameter computation and assessment algorithm, to evaluate its discreteness degree and thereby diagnose cardiovascular diseases (CVD) and locate lesions thereof.

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: Methods for determination of timing for electrical shocks to the heart to determine shock strength necessary to defibrillate a fibrillating heart. The timing corresponds the window of most vulnerability in the heart, which occurs during the T-wave of a heartbeat. Using a derivatized T-wave representation, the timing of most vulnerability is determined by a center of the area method, peak amplitude method, width method, or other similar methods. Devices are similarly disclosed embodying the methods of the present disclosure.

Abstract: An arrhythmia classification system receives cardiac data from an implantable medical device, performs automatic adjudication of each cardiac arrhythmia episode indicated by the cardiac data, and generates episode data representative of information associated with the episode. The episode data include at least an episode classification resulting from the automatic adjudication of the episode and a confidence level in the episode classification. In one embodiment, the episode data further include key features rationalizing the automatic adjudication of the episode.

Abstract: The invention concerns the therapy with a cardiac resynchronization device (CRT) and/or therapy with an automated internal cardiac defibrillator (ICD) for treating patients with any cancer or patients with cachexia due to acute or chronic illness other than cardiac illness, including malignant tumor disease, COPD, chronic renal failure, liver cirrhosis, chronic infections, and/or AIDS. Areas of application are the life sciences, in particular medicine and medical technology.

Abstract: A device and method of detecting the severity of myocardial ischemia and heart attack risk is provided. The method includes obtaining an electrogram signal, determining T-wave measurements based on the electrogram signal, and determining ST segment measurements based on the electrogram signal. The method also includes identifying T-wave alternans based on the T-wave measurements and identifying ST segment changes based on the ST segment measurements. The method further includes correlating the T-wave alternans with the ST segment changes in order to detect a severity of ischemia.

Abstract: Apparatus using one or more modes of statistical analysis with one or more monitored parameters of a patient's heart to identify and/or assess arrhythmias. Through use of the one or more modes of statistical analysis, a medical professional can be aided during evaluation of patient data for diagnosis of the patient. At least one of the monitored parameters may include one or more values used representatively for storage intervals of a selected length. As such, for each storage interval, a value may be determined for the one monitored parameter occurring at an upper percentile and a lower percentile. In addition, a median value may be determined for the one monitored parameter for each storage interval. Over a plurality of the storage intervals, these determined values can be used in one or more modes of statistical analysis to better identify and assess the arrhythmias.

Abstract: An in-vehicle electrocardiograph device includes: a direct electrode that is used to detect an electric potential of a body of a vehicle occupant in a state in which the direct electrode contacts a skin of the occupant; a capacitive-coupled electrode that is used to detect the electric potential of the body of the occupant in a state in which the capacitive-coupled electrode does not contact the skin of the occupant; and an electrocardiographic waveform determination unit that determines an electrocardiographic waveform of the occupant based on an electric potential at the direct electrode and an electric potential at the capacitive-coupled electrode.

Abstract: A data collection system collects and stores physiological data from an ambulatory patient at a high resolution and/or a high data rate (“more detailed data”) and sends a low-resolution and/or downsampled version of the data (“less detailed data”) to a remote server via a wireless network. The server automatically analyzes the less detailed data to detect an anomaly, such as an arrhythmia. A two-tiered analysis scheme is used, where the first tier is more sensitive and less specific than the second tier. If the more sensitive analysis detects or suspects the anomaly, the server signals the data collector to send more detailed data that corresponds to a time period associated with the anomaly. The more specific second tier analyses the more detailed data to verify the anomaly. The server may also store the received data and make it available to a user, such as via a graphical or tabular display.

Abstract: In a subcutaneous implantable cardioverter/defibrillator, cardiac arrhythmias are detected to determine necessary therapeutic action. Cardiac signal information is sensed from far field electrodes implanted in a patient. The sensed cardiac signal information is then amplified and filtered. Parameters such as rate, QRS pulse width, cardiac QRS slew rate, amplitude and stability measures of these parameters from the filtered cardiac signal information are measured, processed and integrated to determine if the cardioverter/defibrillator needs to initiate therapeutic action.

Abstract: A data collection system collects and stores physiological data from an ambulatory patient at a high resolution and/or a high data rate (“more detailed data”) and sends a low-resolution and/or downsampled version of the data (“less detailed data”) to a remote server via a wireless network. The server automatically analyzes the less detailed data to detect an anomaly, such as an arrhythmia. A two-tiered analysis scheme is used, where the first tier is more sensitive and less specific than the second tier. If the more sensitive analysis detects or suspects the anomaly, the server signals the data collector to send more detailed data that corresponds to a time period associated with the anomaly. The more specific second tier analyses the more detailed data to verify the anomaly. The server may also store the received data and make it available to a user, such as via a graphical or tabular display.

Abstract: The present invention relates to a method for assessing the electrical function of a heart, comprising the steps of:—(1) for each of a plurality of leads of an ECG, determining a value derived from the output of that lead and which corresponds to an action potential duration; (2) for each of the plurality of leads of the ECG, determining a value derived from the output of that lead and which corresponds to a diastolic interval; (3) for each of the plurality of leads of the ECG, determining a relationship between the determined values for action potential duration and for diastolic interval; (3) assessing the differences between the determined relationships for each of the plurality of leads. The invention further relates to apparatus and a computer program that may be used in the method.

Abstract: The invention discloses a method, a system, a computer program and a device for determining the surface charge and/or dipole densities on heart walls. Using the foregoing, a table of dipole densities ?(P?, t) and/or a table of surface charge densities ?(P?, t) of a given heart chamber can be generated.

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: Embodiments of the invention provide methods of obtaining continuous cardiac information from a mammal. First, attach a self-contained, wearable, portable continuous cardiac monitor to he mammal to create a chamber containing electrodes used to detect cardiac signals from the mammal. Next, continuously detect without analyzing the cardiac signals from the mammal for at least 24 hours. Next, store information related to substantially all detected cardiac signals in the cardiac monitor.

Abstract: Method, system and apparatus to detect, diagnose and treat biological rhythm disorders. In preferred particularly desirable embodiment relating to the real-time detection of heart rhythm disorders, this invention identifies localized sources for complex rhythms including atrial fibrillation to guide the localized application of energy to modify the source and treat the rhythm disorder.

Abstract: Systems and methods for determining whether there is a correlation between arrhythmias and myocardial ischemic episodes are provided. An implantable system (e.g., a monitor, pacemaker or ICD) is used to monitor for arrhythmias and to monitor for myocardial ischemic episodes. When such events are detected by the implantable system, the implantable system stores (e.g., in its memory) data indicative of the detected arrhythmias and data indicative of the detected myocardial ischemic episodes. Then, for each detected arrhythmia, a determination is made based on the data, whether there was a myocardial ischemic episode detected within a specified temporal proximity of (e.g., within a specified amount of time of) the arrhythmia. Where a myocardial ischemic episode occurred within the specified temporal proximity of an arrhythmia, data for the two events can be linked.

Abstract: A system comprises a physiologic sensing circuit configured to generate physiologic data for a subject and a processing circuit. The processing circuit includes a data parsing circuit configured to parse the physiologic data to identify one or more physiologic events and a report generation circuit. The report generation circuit is configured to associate narrative text with the identified physiologic events according to a text generating rule and generate a narrative report for the identified physiologic events using the narrative text.

Abstract: A tachyarrhythmia detection and classification system classifies tachyarrhythmias based on an analysis of morphological features of a cardiac signal enhanced by using one or more physiological parameters indicative of hemodynamic stability and/or activity level. The tachyarrhythmia detection and classification system computes a measure of similarity between an arrhythmic waveform of the cardiac signal, a template waveform for that cardiac signal, such as a correlation coefficient representative of the correlation between morphological features of the arrhythmic waveform and morphological features of the template waveform. A detected tachyarrhythmia episode is classified by comparing the measure of similarity to a threshold that is dynamically adjusted using the one or more physiological parameters.

Abstract: Techniques are provided for estimating left atrial pressure (LAP) or other cardiac performance parameters based on measured conduction delays. In particular, LAP is estimated based interventricular conduction delays. Predetermined conversion factors stored within the device are used to convert the various the conduction delays into LAP values or other appropriate cardiac performance parameters. The conversion factors may be, for example, slope and baseline values derived during an initial calibration procedure performed by an external system, such as an external programmer. In some examples, the slope and baseline values may be periodically re-calibrated by the implantable device itself. Techniques are also described for adaptively adjusting pacing parameters based on estimated LAP or other cardiac performance parameters. Still further, techniques are described for estimating conduction delays based on impedance or admittance values and for tracking heart failure therefrom.

Abstract: Techniques are provided for estimating left atrial pressure (LAP) or other cardiac performance parameters based on measured conduction delays. In particular, LAP is estimated based interventricular conduction delays. Predetermined conversion factors stored within the device are used to convert the various the conduction delays into LAP values or other appropriate cardiac performance parameters. The conversion factors may be, for example, slope and baseline values derived during an initial calibration procedure performed by an external system, such as an external programmer. In some examples, the slope and baseline values may be periodically re-calibrated by the implantable device itself. Techniques are also described for adaptively adjusting pacing parameters based on estimated LAP or other cardiac performance parameters. Still further, techniques are described for estimating conduction delays based on impedance or admittance values and for tracking heart failure therefrom.

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: 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: A method is provided that includes providing a monitoring apparatus including one or more modules within a target cavity or lumen of a body. The one or more modules are provided within the target cavity or lumen in a first state in which the monitoring apparatus is configured to remain within the target cavity or lumen. The method further includes monitoring physiological conditions of the body using one or more sensors within the one or more modules, and providing the one or more modules in a second state in which the monitoring apparatus is configured to exit the target cavity or lumen.

Abstract: Methods of cardiac rhythm analysis in an implantable cardiac stimulus device, and devices configured for such methods. In an illustrative embodiment, certain data relating to cardiac event rate or amplitude is modified following delivery of a cardiac stimulus. In another embodiment, cardiac rhythm analysis is performed using one of plural states, with the plural states using different criteria, such as a detection threshold, to detect cardiac events in a sensed signal. Following delivery of a cardiac stimulus, data is manipulated to force the analysis into one of the states, where stimulus is delivered, in the illustrative embodiment, only after a different state is invoked. Implantable devices incorporating operational circuitry for performing such methods are also included in other illustrative embodiments.

Abstract: A medical device and associated method sense a cardiac signal and initiate an arrhythmia episode detection process in response to the cardiac signal by enabling an arrhythmia detection counter to be adjusted during the detection process. Data is accumulated relating to cardiac events during the detection process. An arrhythmia episode profile is established using the accumulated data. The accumulated data includes a pattern of the adjustment of the detection counter during the detection process.

Abstract: Disclosed are methods for detecting an acute myocardial infarction (i.e., a heart attack) at the earliest possible time and promptly warning the patient that he should immediately seek medical care. The present invention includes an implantable electronic system that can sense a change in the patient's electrogram that is indicative of a heart attack. If a heart attack is sensed, the device would then cause an implantable and/or externally located alarm to be actuated to warn the patient of his condition and a medical practitioner at a remote diagnostic center would receive the patient's electrogram for analysis. The patient or a caretaker would then be informed to self-inject medication through a subcutaneous, pass-through drug port that can be a separate device or integrated into the implanted device that is designed for the early detection of a heart attack.

Abstract: A system and method for automatically analyzing a cardiac signal, including the step of providing an episode database on a computer storage medium including a plurality of episode data records of one or more patients. Each episode data record includes a cardiac signal from at least one data-generating device. The method also includes the step of selecting one or more of the N beats to be one or more beat templates, for at least a first cardiac signal having N beats. Another step is determining a value K for the cardiac signal using a computer system where K beat templates can represent all the N beats in the cardiac signal.

Abstract: Systems and methods for rhythm discrimination using the motion of an implantable lead are described. In an example, an implantable medical device can include a receiver circuit configured to be electrically coupled to an implantable lead and be configured to obtain information indicative of a movement of the implantable lead due at least in part to a motion of a heart. The device can include an arrhythmia detection circuit configured to determine an arrhythmia status using the information indicative of the movement of the implantable lead and an arrhythmia classification circuit configured to determine one or more of a location or a type of an arrhythmia, using the information indicative of the movement of the implantable lead, when the arrhythmia status indicates that an arrhythmia is occurring or has occurred.

Abstract: Portable systems and methods for continuous and discontinuous monitoring of a user's heart activity, for obtaining a complete, up to twelve-lead electrocardiogram reading are disclosed. A plurality of wearable wired or wireless sensors obtain raw electrocardiogram data from the user. The raw electrocardiogram data is transmitted to data storage media, which include computer instructions for converting the raw data to a complete, up to twelve-lead electrocardiogram reading. The computer instructions can compare the electrocardiogram to one or more predetermined threshold parameters and/or medical standards. The results of the comparison, the electrocardiogram, the parameters, the raw data, the user's location, or combinations thereof, can be transmitted to one or more destinations, which can include medical facilities, insurance providers, emergency responders, and/or family physicians or specialists.

Abstract: Systems, devices, structures, and methods are provided to present a visual display based on data from an implantable medical device. The display includes a chart showing the frequency of a detected type of arrhythmia over a predetermined period of time.

Abstract: A method and apparatus for controlling an atrial overdrive pacing therapy include detecting an atrial arrhythmia episode and determining if the atrial arrhythmia episode is an early recurring episode. Delivery of the atrial overdrive pacing therapy is enabled in response to the early recurring episode and commences upon detection of an atrial arrhythmia episode or a long pause.

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 a 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: Detected changes in atrial activation can be used to discriminate between hemodynamically stable and hemodynamically unstable tachyarrhythmias.

Abstract: Systems and methods are provided in the disclosure for estimating a risk of arrhythmia in a patient using electrocardiographic analysis. In certain aspects, a method of estimating a risk of arrhythmia in a patient is provided. The method comprises receiving electrocardiographic signals of the patient from a plurality of leads over a plurality of heart beats, averaging the electrocardiographic signals to produce an averaged electrocardiographic signal, and determining deflections in the averaged electrocardiographic signal, wherein each deflection has an amplitude and a duration. The method further comprises determining a significance of each deflection based on whether the amplitude of that deflection exceeds a threshold, and estimating a risk of arrhythmia in the patient based on at least one of a number, the amplitudes, and the durations of the significant deflections within a portion of the averaged electrocardiographic signal.

Abstract: A method and apparatus for controlling an atrial overdrive pacing therapy include detecting an atrial arrhythmia episode and determining if the atrial arrhythmia episode is an early recurring episode. Delivery of the atrial overdrive pacing therapy is enabled in response to the early recurring episode and commences upon detection of an atrial arrhythmia episode or a long pause.

Abstract: The present disclosure is directed to the classification of cardiac episodes using an algorithm. In various examples, an episode classification algorithm evaluates electrogram signal data collected by an implantable medical device. The episode classification algorithm may classify may include a sinus template and a comparison of the electrogram signal to the sinus template. Possible classifications of the cardiac episode may include, for example, unknown, inappropriate, appropriate, supraventricular tachycardia, ventricular tachycardia, ventricular fibrillation or ventricular over-sensing.

Abstract: The disclosure describes techniques for diagnosing premature contractions of a patient's heart. This system may differentiate premature atrial contractions (PACs) and premature ventricular contractions (PVCs) from atrial fibrillation by identifying changes in R-wave intervals, i.e., R-R intervals, on a Lorenz plot, measuring a coupling interval between R-waves, and analyzing a morphology of the premature contractions, e.g., the QRS complex. These techniques may also identify when severe premature contractions, or bigeminy, are present. In response to the type of premature contractions detected, the system may alert a user of the premature contractions and/or deliver cardiac pacing at an increased pacing rate to eliminate the abnormal intrinsic contractions. The system may also adjust the pacing rate and pacing rate duration for persistent premature contractions.

Abstract: A method of displaying electrocardiograms comprises displaying a reference electrocardiogram; and displaying a measured electrocardiogram so that the reference electrocardiogram and the measured electrocardiogram are displayed in an overlapping state.

Abstract: Systems and methods for determining whether there is a correlation between arrhythmias and myocardial ischemic episodes are provided. An implantable system (e.g., a monitor, pacemaker or ICD) is used to monitor for arrhythmias and to monitor for myocardial ischemic episodes. When such events are detected by the implantable system, the implantable system stores (e.g., in its memory) data indicative of the detected arrhythmias and data indicative of the detected myocardial, ischemic episodes. Then, for each detected arrhythmia, a determination is made based on the data, whether there was a myocardial ischemic episode detected within a specified temporal proximity of (e.g., within a specified amount of time of) the arrhythmia. Where a myocardial ischemic episode occurred within the specified temporal proximity of an arrhythmia, data for the two events can be linked.