Abstract: An adherent device may be placed on a patient's chest for monitoring heart rate variability for chiropractic care. The device may comprise an adherent patch configured to adhere to the patient continuously for an extended period, for example an extended period of one week, and the HRV can be determined for the extended period. Two or more electrodes may be used to measure a cardiac signal and determine the HRV. The device may comprise accelerometers to measure at least one of posture, flexion/extension or lateral movement of the patient. The device may be placed on the patient and used in the clinic, and the patient may be sent home from the clinic with the adherent device. The device may wirelessly transmit heart rate data to an external device, such as a handheld monitor, that the chiropractor may consult during treatment.

Abstract: A device to measure tissue impedance comprises drive circuitry coupled to calibration circuitry, such that a calibration signal from the calibration circuitry corresponds to the current delivered through the tissue. Measurement circuitry can be coupled to measurement electrodes and the calibration circuitry, such that the tissue impedance can be determined in response to the measured calibration signal from the calibration circuitry and the measured tissue impedance signal from the measurement electrodes. Processor circuitry comprising a tangible medium can be configured to determine a complex tissue impedance in response to the calibration signal and the tissue impedance signal. The processor can be configured to select a frequency for the drive current, and the amount of drive current at increased frequencies may exceed a safety threshold for the drive current at lower frequencies.

Abstract: Systems and methods of detecting an impending cardiac decompensation of a patient measure an electrocardiogram signal of the patient. An incidence of cardiac arrhythmias is determined from the electrocardiogram signal. A risk of impending decompensation is determined in response to the incidence of cardiac arrhythmias. In many embodiments, the impending decompensation can be detected early enough to avoid, or at least delay, the impending decompensation, such that patient trauma and/or expensive ICU care can be avoided. Although embodiments make specific reference to monitoring electrocardiogram and other physiological signals with an adherent patch, the system methods and devices are applicable to many applications in which physiological monitoring is used, for example wireless physiological monitoring with implanted sensors for extended periods.

Abstract: An adherent device is configured to adhere to the skin of the patient with an adherent patch, for example breathable tape, coupled to at least four electrodes. The device comprises impedance circuitry coupled to the at least four electrodes and configured to measure respiration of the patient to detect sleep apnea and/or hypopnea. The impedance circuitry may be used to measure hydration of the patient. An accelerometer can be mechanically coupled to the adherent patch such that the accelerometer can be coupled to and move with the skin of the patient. Electrocardiogram circuitry to generate an electrocardiogram signal may be coupled to at least two of the at least four electrodes to detect the sleep apnea and/or hypopnea.

Abstract: Systems, devices and methods transmit data from a patient device to a location, for example a remote location, where the patient is monitored. The system may comprise a server system, for example a backend server system, a gateway and the patient worn device. The gateway can be configured to communicate with the patient worn device in response to a list transmitted from the server, for example an approved patient device list transmitted from the server to the gateway. The gateway may exclude communication with patient worn devices that are not on the list. This use of the list can control data throughput from the patient device to the gateway and also from the gateway to the server, such that the communication from the device on the list to the server is maintained and appropriate information can be reliably sent from the patient device to the server.

Abstract: An adherent device to monitor a tissue hydration of a patient comprises an adhesive patch to adhere to a skin of the patient. At least four electrodes are connected to the patch and capable of electrically coupling to the patient. Impedance circuitry is coupled to the at least four electrodes to measure a tissue resistance of the patient, where the circuitry is configured to determine the tissue hydration in response to tissue resistance. The circuitry may comprise a processor system and the tissue resistance may correspond to a change in patient body fluid. The impedance circuitry is configured to measure the hydration signal using at least one low measurement frequency, which may be in the range of 0 to 10 kHz. Multiple measurement frequencies may be used and the hydration signal may include a tissue reactance measurement.

Abstract: An injectable detecting device is provided for use in physiological monitoring. The device includes a plurality of sensors axially spaced along a body that provide an indication of at least one physiological event of a patient, a monitoring unit within the body coupled to the plurality of sensors configured to receive data from the plurality of sensors and create processed patient data, a power source within the body coupled to the monitoring unit, and a communication antenna external to the body coupled to the monitoring unit configured to transfer data to/from other devices.

Abstract: An adherent device to monitor a patient comprises an adhesive patch to adhere to a skin of the patient. At least four electrodes are connected to the patch and capable of electrically coupling to the patient. Impedance circuitry is coupled to the at least four electrodes to measure a hydration signal of the patient. Electrocardiogram circuitry is coupled to at least two of the at least four electrodes to measure an electrocardiogram signal of the patient. An accelerometer can be mechanically coupled to the adhesive patch to generate a signal in response to at least one of an activity or a position of the patient.

Abstract: An adherent device comprises an adhesive patch with at least two electrodes and an accelerometer. The accelerometer can be used to determine an orientation of the at least two measurement electrodes on a patient. By determining the orientation of the electrodes of the patch on the patient, physiologic measurements with the at least two electrodes can be adjusted and/or corrected in response to the orientation of the patch on the patient. The adherent patch and/or electrodes can be replaced with a second adherent patch and/or electrodes, and the orientation of the second adherent patch and/or electrodes can be determined with the accelerometer or a second accelerometer. The determined orientation of the second patch and/or electrodes on the patient can be used to correct measurements made with the second adherent patch and/or electrodes.

Abstract: A system for physiological monitoring and prediction. The system includes a detecting system, one or more medical devices and a remote monitoring system. The detecting system includes an adherent device configured to be coupled to a patient, the adherent device including a plurality of sensors that provide an indication of at least one physiological event of a patient and a wireless communication device coupled to the plurality of sensors and configured to transfer patient data from the plurality of sensors and one or more medical treatment devices to the remote monitoring system. The one or more medical treatment devices are coupled to the wireless communication device to communicate wirelessly with the plurality of sensors, with at least one medical treatment device being an implanted device.

Abstract: A system is provided for tracking an individual, engaged in extreme physical activity, physiological status and detecting and predicting negative physiological events. A monitoring system is provided that includes a plurality of sensors. Each sensor has a sensor output, and a combination of the sensor outputs is used to determine distress of the monitored individual engaged in extreme physical activity. A wireless communication device is coupled to the plurality of sensors and transfers data directly or indirectly from the plurality of sensors to a remote monitoring system. A remote monitoring system is coupled to the wireless communication device and configured to receive the processed data.

Abstract: Methods and devices for monitoring and/or treating patients comprise a switch to automatically start-up the device when the device contacts tissue. By automatically starting up the device, the device may be installed without the clinician and/or user turning on the device, such that the device can be easy to use. In many embodiments, the device comprises startup circuitry with very low current and/or power consumption, for example less than 100 pA. The startup circuitry can detect tissue contact and turn on circuitry that is used to monitor or treat the patient.

Abstract: An adherent device comprises an adhesive patch to adhere to a skin of the patient. At least two electrodes are connected to the patch and capable of electrically coupling to the patient. Electrocardiogram circuitry can be coupled to at the least two electrodes to measure an electrocardiogram signal of the patient. An accelerometer can be mechanically coupled to the adhesive patch to generate an accelerometer signal in response to at least one of an activity or a position of the patient. A processor comprising a tangible medium can be configured to communicate with the electrocardiogram circuitry and the accelerometer to generate an alarm signal in response to the electrocardiogram signal and the accelerometer signal.

Abstract: A heart failure patient management system includes a detecting system. The detecting system includes an adherent device configured to be coupled to a patient. The adherent device includes a plurality of sensors to monitor physiological parameters of the patient to determine heart failure status. At least one ID may be coupled to the adherent device that is addressable and unique to each adherent device. A wireless communication device is coupled to the plurality of sensors and configured to transfer patient data directly or indirectly from the plurality of sensors to a remote monitoring system. The remote monitoring system is coupled to the wireless communication device.

Abstract: An adherent device to monitor a patient for an extended period comprises a breathable tape. The breathable tape comprises a porous material with an adhesive coating to adhere the breathable tape to a skin of the patient. At least one electrode is affixed to the breathable tape and capable of electrically coupling to a skin of the patient. A printed circuit board is connected to the breathable tape to support the printed circuit board with the breathable tape when the tape is adhered to the patient. Electronic components electrically are connected to the printed circuit board and coupled to the at least one electrode to measure physiologic signals of the patient. A breathable cover and/or an electronics housing is disposed over the circuit board and electronic components and connected to at least one of the electronics components, the printed circuit board or the breathable tape.

Abstract: A respiratory monitoring system is provided. A measuring system is provided that includes, (i) an adherent device configured to be coupled to a patient, the adherent device including a plurality of sensors that monitor respiratory status, at least one of the sensors configured to monitor the patient's respiration, and (ii) a wireless communication device coupled to the plurality of sensors and configured to transfer patient data directly or indirectly from the plurality of sensors to a remote monitoring system. A remote monitoring system is coupled to the wireless communication device.

Abstract: A heart failure patient management system includes a detecting system. The detecting system includes an adherent device configured to be coupled to a patient. The adherent device includes a plurality of sensors to monitor physiological parameters of the patient to determine heart failure status. At least one ID may be coupled to the adherent device that is addressable and unique to each adherent device. A wireless communication device is coupled to the plurality of sensors and configured to transfer patient data directly or indirectly from the plurality of sensors to a remote monitoring system. The remote monitoring system is coupled to the wireless communication device.

Abstract: Systems and methods of detecting an impending cardiac decompensation of a patient measure at least two of an electrocardiogram signal of the patient, a hydration signal of the patient, a respiration signal of the patient or an activity signal of the patient. The at least two of the electrocardiogram signal, the hydration signal, the respiration signal or the activity signal are combined with an algorithm to detect the impending cardiac decompensation.

Abstract: A system and methods are provided for physiological monitoring and prediction. The system includes a detecting system and a remote monitoring system. The detecting system includes, (i) an adherent device with a plurality of sensors that provide an indication of at least one physiological event of a patient, the adherent device being coupled to the patient's thorax and (ii) a wireless communication device coupled to the plurality of sensors and configured to transfer patient data directly or indirectly from the plurality of sensors to a remote monitoring system. The remote monitoring system is coupled to the wireless communication device. Logic resources may be provided at the remote monitoring system to determine the physiological event of the patient.

Abstract: An adherent device to monitor and treat a patient comprises an adhesive patch to adhere to a skin of the patient. At least two electrodes are connected to the patch and capable of electrically coupling to the patient. Sensor circuitry is coupled to the at least two electrodes and configured to measure at least two of an electrocardiogram signal of the patient, a respiration signal of the patient or an activity signal of the patient. Therapy circuitry is coupled to the at least two electrodes and configured to deliver a high-energy shock therapy for cardioversion and/or defibrillation. A processor system comprising a tangible medium and coupled to the sensor circuitry and therapy circuitry, the processor is configured to generate a treatment signal to deliver the high-energy shock therapy in response to the at least two of the electrocardiogram signal, the respiration signal or the activity signal.