Abstract: Disclosed is a system having an implanted component and external component which are configured to provide a test of wireless communication in order to assess the success or failure of such communication and to store attributes related to such test in a memory log. To provide the communication test the implantable and external components can attempt wireless communication according to communication test parameters which relate to number of times to retry communication, duration of sending communication test signals, durations of waiting for communication test signals and the schedule of the communication tests. The schedule of tests may be periodic or may change over time in order to become more or less frequent according to a programmable schedule that may also decrease if the communication tests are successful and indicate patient compliance in keeping the external components close by.

Abstract: A heart monitor computes ST segment deviation as the difference in the value of an electrocardiogram signal at the ST and PQ points of a heartbeat. The ST point is found based on slope criteria and temporal criteria. The maximum (positive) slope of the QRS (maxQRS) is located. Within a preset window after the maxQRS point, the processor searches for a sample at which the second finite difference is less than a threshold that is a function of average QRS amplitude. If such a qualifying sample is found, the processor examines its location relative to the location of an adaptive window that is centered on a sample that is an adaptively determined distance from the peak of the R wave. If the qualifying point is within the adaptive window, it is chosen as the ST point. If the qualifying point is after the adaptive window, the ST point is set at the end of the adaptive window. Finally, if the qualifying point is before the adaptive window, the ST point is selected at the beginning of the adaptive window.

Abstract: A system for the detection of cardiac events occurring in a human patient. At least two electrodes are included in the system for obtaining an electrical signal from a patient's heart. An electrical signal processor is electrically coupled to the electrodes for processing the electrical signal. The system receives data regarding the patient's state (e.g. asleep, exercising). Patient state information is stored in a patient state array, thereby enabling the system to track the patient's state over time, and to select an appropriate test for detecting a cardiac event based on both past and present data regarding the patient's state.

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: A system for the detection of cardiac events occurring in a human patient is disclosed to include at least two electrodes for obtaining an electrical signal from a patient's heart. At least two electrodes are included in the system for obtaining an electrical signal from a patient's heart. An electrical signal processor is electrically coupled to the electrodes for processing the electrical signal. The system determines the presence of a cardiovascular condition by applying a sliding scale rule to heart signal feature values. When the cardiovascular condition is ischemia, the ST segment may be analyzed. A sliding scale is applied to ST segment shifts such that when the magnitudes of ST segment shifts are relatively small, a larger number of beats is required to detect ischemia compared to the case when the magnitudes of ST shifts are large.

Abstract: A heart monitor is disclosed. The monitor computes ST segment deviations and stores the results in heart rate based histograms. Periodically, the monitor analyzes the histogram data to determine a normal range of ST deviation for a particular heart rate range. The monitor computes heart rate dependent ischemia detection thresholds based on the upper and lower boundaries of the normal range.

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 physician's programmer for an implantable device is disclosed. The programmer includes a receiver for receiving wireless transmission data from the implantable heart monitor. A processor is configured to extract from the wireless transmission data ST-deviation histogram data as a function of heart rate. The histogram data for a particular heart rate range is shown on a display in the form of a bar chart. The histogram data for a plurality of heart rate ranges is shown in the form of a chart with multiple line plots.

Abstract: A heart monitor is disclosed. The monitor computes ST segment deviations and stores the results in heart rate based histograms. Periodically, the monitor analyzes the histogram data to determine a normal range of ST deviation for a particular heart rate range. The monitor computes heart rate dependent ischemia detection thresholds based on the upper and lower boundaries of the normal range.

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 left bundle branch block beats and normal sinus beats. The processor applies different ischemia tests to the two different beat types, and generates alert when it detects ischemia.

Abstract: A physician's programmer for an implantable device is disclosed. The programmer includes a receiver for receiving wireless transmission data from the implantable heart monitor. A processor is configured to extract from the wireless transmission data ST-deviation histogram data as a function of heart rate. The histogram data for a particular heart rate range is shown on a display in the form of a bar chart. The histogram data for a plurality of heart rate ranges is shown in the form of a chart with multiple line plots.

Abstract: A system for the detection of cardiac events occurring in a human patient is provided. At least two electrodes are included in the system for obtaining an electrical signal from a patient's heart. An electrical signal processor is electrically coupled to the electrodes for processing the electrical signal and a patient alarm means is further provided and electrically coupled to the electrical signal processor. The electrical signal is acquired in the form of electrogram segments, which are categorized according to heart rate, ST segment shift and type heart rhythm (normal or abnormal). Baseline electrogram segments are tracked over time.

Abstract: A heart rate monitor generates an ST deviation time series by employing a recursive filter that is preferably an exponential average filter whose output is a weighted sum of the then existing ST time series value and current ST deviation values of analyzable beats. Beats are detected in segments of data. ST deviation is measured for analyzable beats. The ST deviation time series is updated only if certain criteria are met. A first criterion for updating the time series is that at least half of the beats within a segment must be normal sinus rhythm beats. A second criterion for updating the time series is that (i) the average RR interval of the segment is between ¾ and 1.5 times the average RR interval of the previous segment; or (ii) both (a) the number of abnormal beats in the current segment is less than 2, and (b) the number of premature ventricular contractions within the current segment is less than 2.

Abstract: The invention describes fluid-based lead systems. The fluid-based leads may be used for sensing from, and stimulating of, human tissue. The fluid-based leads can be used to transfer signals between two locations. The fluid-based leads offer advantages when communicating signals along their length since the leads may be safely used in magnetic environments and offer increased elastic characteristics which are less prone to breakage. The leads can be used externally or with implantable devices, such as those used to monitor, and deliver therapy during the treatment of medical disorders such as cardiac and neurological disorders.

Abstract: A medical alarm communications system comprises a pager like device to be kept near a patient. The pager like device communicates medical alerts regarding the patient to a remote central station, which can provide therapeutic and/or diagnostic assistance by communicating to the pager like device. When the pager like device determines that an alert should be sent to the central station, it attempts to establish communication with the central station according to a primary communication protocol. If this attempt is unsuccessful according to some predetermined criteria (e.g. too much time has elapsed before communication is established), then the pager like device generates a message to the patient indicative of the failure, and The attempts to establish communication with the central station according to a secondary communication protocol.

Abstract: Disclosed is a system for the detection of cardiac events (a guardian system) 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 one or more detection 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 guardian system includes an internal alarm sub-system (internal alarm means) within the cardiosaver and/or an external alarm system (external alarm means).

Abstract: A heart monitor is disclosed. The monitor computes ST segment deviations and stores the results in heart rate based histograms. Periodically, the monitor analyzes the histogram data to determine a normal range of ST deviation for a particular heart rate range. The monitor computes heart rate dependent ischemia detection thresholds based on the upper and lower boundaries of the normal range.

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 heart monitor is disclosed. The monitor computes ST segment deviations and stores the results in heart rate based histograms. Periodically, the monitor analyzes the histogram data to determine heart rate dependent acute ischemia detection thresholds. If the statistical distribution associated with a heart rate range is insufficient, the threshold for that heart rate range is set as a function of the threshold for a neighboring heart rate range. Thresholds are also increased for heart rate ranges associated with statistical distributions that are sufficient but that have a relatively small number of entries.

Abstract: An implanted device which includes a vibrator having a drive motor and a drive circuit. An accelerometer is connected to the vibrator and senses alarm test data related to the displacement of the vibrator. A power source provides electricity to the implanted device and a processor is configured for bi-directional wireless communication. The processor is configured for receiving a command from an external device for performance of an alarm test and the processor analyzes the alarm test data for generating test results.