Abstract: Systems and techniques for monitoring cardiac activity. In one aspect, a method includes collecting information describing the variability in heart rate over a series of beats, designating variability at a lower end of physiological values as being largely irrelevant to atrial fibrillation, designating variability in a midrange of physiological values as being indicative of atrial fibrillation, designating variability in an upper range of physiological values as being negatively indicative of atrial fibrillation, and determining a relevance of the variability described in the collection to atrial fibrillation.

Abstract: A medical monitoring system has a sensor system including a sensor associated with a patient and a remote monitoring unit. The remote monitoring unit includes a microprocessor in communication with the sensor system, and a portable-monitoring unit transceiver system in communication with the microprocessor. The portable-monitoring unit transceiver system has a land-line telephone transceiver and/or a cellular telephone transceiver, and a third-network transceiver such as a paging-network transceiver. A full data set is transmitted over the land-line telephone transceiver or the cellular telephone transceiver when communications links over these transceivers are available, and a reduced data set is transmitted over the third-network transceiver when communications links over the land-line telephone transceiver and the cellular telephone transceiver are not available.

Abstract: System and techniques for distributed monitoring of cardiac activity include selective T wave filtering. In general, in one implementation, a distributed cardiac activity monitoring system includes a monitoring apparatus, with a selectively activated T wave filter, and a monitoring station. The monitoring apparatus can include a communications interface, a real-time QRS detector, a T wave filter, and a selector that activates the T wave filter to preprocess a cardiac signal provided to the real-time QRS detector in response to a message. The monitoring station can communicatively couple with the monitoring apparatus, over a communications channel, via the communications interface and can transmit the message to the monitoring apparatus to activate the T wave filter based at least in part upon a predetermined criteria (e.g., abnormal T waves for an individual, as identified by a system operator).

Abstract: Access to a medical monitoring system, which includes a patient-portable monitoring device and an associated monitoring service at a central unit, is controlled by inputting a set of identification data elements into a medical monitoring device, which then establishes a communication link with a central unit and communicates the set of identification data elements to the central unit. The medical monitoring device and the central unit cooperatively determine whether the medical monitoring device may be activated for rendering medical monitoring device service, by evaluating the set of identification data elements as to whether they meet a set of basic structural requirements, and obtaining financial or other authorization from a third-party source. In the event that the identification data elements meet the set of basic structural requirements and the authorization is obtained, the central unit issues an activation signal to the medical monitoring device over the communication link.

Abstract: A method and apparatus for communicating with and monitoring the operation of a device implanted within a patient. A transceiver capable of being implanted within a patient provides a communication interface between an implanted medical device and a monitor external to the patient's body. The external monitor can communicate with a remote monitoring center over a communication network. The external monitor also provides control signals to the implanted device via the transceiver unit. The transceiver apparatus is capable of two-way communication between the implanted device and the external monitor. The transceiver apparatus is also capable of detecting actions performed by the implanted device and physiological signals directly from the patient's body. Thus, the transceiver apparatus provides circuitry for determining whether an implanted medical device is operating properly. The transceiver apparatus provides a way to remotely reprogram one or more implanted medical devices.

Abstract: An automated, real-time, reprogrammable monitoring and control system for portable, remote sensors and subjects includes one or more portable monitoring units, each of the portable monitoring units having a sensor, a location-determining device, and a sensor interface unit. Each sensor interface unit is separately configured to monitor its sensor and to transmit that sensor's data, via a digital wireless communications network, to a central monitoring device. The portable unit is carried or worn by a person or animal, or affixed to an inanimate subject.

Abstract: A patient is monitored using a monitoring apparatus including a remote monitoring unit associated with the patient and having a sensor that measures a physiological characteristic of the patient, a central unit, and a communications device which selectively establishes a communications link between the remote monitoring unit and the central unit. The remote monitoring unit obtains a monitored data set for the patient, analyzes the monitored data set to obtain a derived data set from the monitored data set, and determines from the derived data set that communication with the central unit is required. A communications link is established with the central unit, and the remote monitoring unit transmits to the central unit an initially transmitted data set related to the monitored data set.

Abstract: A monitoring system includes a remote monitoring unit with a sensor unit in bidirectional wireless communication with a monitor unit. Information is transmitted bidirectionally between the sensor unit and the monitor unit. The monitor unit may inform the sensor unit that transmitted data has been corrupted, that the distance between the units is becoming too large, that transmission signal strength may be altered, that interference requires a change in transmitting frequency, or that attention is needed by the patient to the monitor unit.

Abstract: A medical monitoring system has a sensor system including a sensor associated with a patient and a remote monitoring unit. The remote monitoring unit includes a microprocessor in communication with the sensor system, and a portable-monitoring unit transceiver system in communication with the microprocessor. The portable-monitoring unit transceiver system has a land-line telephone transceiver and/or a cellular telephone transceiver, and a third-network transceiver such as a paging-network transceiver. A full data set is transmitted over the land-line telephone transceiver or the cellular telephone transceiver when communications links over these transceivers are available, and a reduced data set is transmitted over the third-network transceiver when communications links over the land-line telephone transceiver and the cellular telephone transceiver are not available.

Abstract: Access to a medical monitoring system, which includes a patient-portable monitoring device and an associated monitoring service at a central unit, is controlled by inputting a set of identification data elements into a medical monitoring device, which then establishes a communication link with a central unit and communicates the set of identification data elements to the central unit. The medical monitoring device and the central unit cooperatively determine whether the medical monitoring device may be activated for rendering medical monitoring device service, by evaluating the set of identification data elements as to whether they meet a set of basic structural requirements, and obtaining financial or other authorization from a third-party source. In the event that the identification data elements meet the set of basic structural requirements and the authorization is obtained, the central unit issues an activation signal to the medical monitoring device over the communication link.

Abstract: A patient is monitored using a monitoring apparatus including a remote monitoring unit associated with the patient and having a sensor that measures a physiological characteristic of the patient, a central unit, and a communications device which selectively establishes a communications link between the remote monitoring unit and the central unit. The remote monitoring unit obtains a monitored data set for the patient, analyzes the monitored data set to obtain a derived data set from the monitored data set, and determines from the derived data set that communication with the central unit is required. A communications link is established with the central unit, and the remote monitoring unit transmits to the central unit an initially transmitted data set related to the monitored data set.

Abstract: A medical monitoring system has a sensor system including a sensor associated with a patient and a remote monitoring unit. The remote monitoring unit includes a microprocessor in communication with the sensor system, and a portable-monitoring-unit transceiver system in communication with the microprocessor. The portable-monitoring-unit transceiver system has a land-line telephone transceiver and/or a cellular telephone transceiver, and a third-network transceiver such as a paging-network transceiver. A full data set is transmitted over the land-line telephone transceiver or the cellular telephone transceiver when communications links over these transceivers are available, and a reduced data set is transmitted over the third-network transceiver when communications links over the land-line telephone transceiver and the cellular telephone transceiver are not available.

Abstract: Access to medical monitoring device service is controlled by inputting a set of identification data elements into a medical monitoring device system, which then establishes a communication link with a central unit and communicating the set of identification data elements to the central unit. The medical monitoring device system and the central unit cooperatively determining whether the medical monitoring device may be activated for rendering medical monitoring device service, by evaluating the set of identification data elements as to whether they meet a set of basic structural requirements, and obtaining financial or other authorization from a third-party source. In the event that the identification data elements meet the set of basic structural requirements and the authorization is obtained, the central, unit issues an activation signal to the medical monitoring device system over the communication link.

Abstract: A method and apparatus for communicating with and monitoring the operation of a device implanted within a patient. A transceiver capable of being implanted within a patient provides a communication interface between an implanted medical device and a monitor external to the patient's body. The external monitor can communicate with a remote monitoring center over a communication network. The external monitor also provides control signals to the implanted device via the transceiver unit. The transceiver apparatus is capable of two-way communication between the implanted device and the external monitor. The transceiver apparatus is also capable of detecting actions performed by the implanted device and physiological signals directly from the patient's body. Thus, the transceiver apparatus provides a means for determining whether an implanted medical device is operating properly. The transceiver apparatus provides a way to remotely reprogram one or more implanted medical devices.

Abstract: An automated, real-time, reprogrammable monitoring and control system for portable, remote sensors and subjects includes one or more portable monitoring units, each of the portable monitoring units having a sensor, a location-determining device, and a sensor interface unit. Each sensor interface unit is separately configured to monitor its sensor and to transmit that sensor's data, via a digital wireless communications network, to a central monitoring device. The portable unit is carried or worn by a person or animal, or affixed to an inanimate subject.

Abstract: A patient is monitored by establishing a current warning limit for a physiological characteristic of the patient, providing a sensor for the physiological characteristic, and measuring a measured value of the physiological characteristic of the patient using the sensor. A revised warning limit is selected responsive to at least one of the steps of providing and measuring. The revised warning limit is then typically substituted for the current warning limit. The current warning limit serves to trigger some action in the event that the measured value of the physiological characteristic is not within an acceptable range defined by the current warning limit.

Abstract: An automated, real-time, reprogrammable monitoring and control system for portable, remote sensors and subjects includes one or more portable monitoring units, each of the portable monitoring units having a sensor, a location-determining device, and a sensor interface unit. Each sensor interface unit is separately configured to monitor its sensor and to transmit that sensor's data, via a digital wireless communications network, to a central monitoring device. The portable unit is carried or worn by a person or animal, or affixed to an inanimate subject.