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: A system and method of monitoring and reporting premature ventricular contractions (PVCs) detected in a patient is described. The method includes monitoring an electro-cardiogram (ECG) signal of the patient with an adherent device that includes a plurality of electrodes. Premature ventricular contraction (PVC) beats are detected based on the monitored ECG signal, and ECG episodes associated with detected PVC beats are stored for subsequent analysis. A morphology signal is calculated by quantifying the stored ECG episodes associated with detected PVC beats, wherein the morphology signal numerically represents the shape of the detected PVC beat. The PVC beats are then numerically clustered based on the calculated morphology signals to group PVC beats having a similar morphology or shape, and a report is generated based on the clustering of the PVC beats.

Abstract: A system and method of detecting and classifying atrial fibrillations (AFs) monitors an electro-cardiogram (ECG) signal of the patient. Based on the monitored ECG signals, AF episodes are detected. Monitored physiological parameters are utilized to determine an activity level of the patient at the time of the detected AF episode, wherein the activity level is associated with the detected AF episode. The etiology of the detected AF episodes is classified as adrenergic if the AF episodes occur while the patient is active, and classified as vagal if the AF episodes occur while the patient is at rest.

Abstract: Embodiments relate to a method of monitoring physiological parameters of a patient with renal dysfunction. The method includes electrically connecting one or more medical device electrodes with a measurement site of a patient, generating one or more first stimulation signals sufficient to provide input physiological parameters specific to the patient, measuring one or more first bioimpedance values from the generated signals, analyzing at least one of the input physiological parameters within the one or more first bioimpedance values and generating a personalized dialysis program. The systems and methods can further provide essentially real-time data of patient undergoing treatment and control of treatment to a patient.

Abstract: Methods and apparatus to determine the presence of and track functional chronotropic incompetence (hereinafter “CI”) in an in-home setting under conditions of daily living. The functional CI of the patient may be determined with one or more of a profile of measured patient heart rates, a measured maximum patient heart rate, or a peak of the heart rate profile. The functional CI of the patient may be determined with the measured heart rate profile, in which the measured heart rate profile may correspond to heart rates substantially less than the maximum heart rate of the patient, such that the heart rate can be safely measured when the patient is remote from a health care provider. The functional CI of the patient may be determined based a peak of the remotely measured heart rate profile, for example a peak corresponding to the mode of the heart rate distribution profile.

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: Embodiments relate to a method of monitoring physiological parameters of a patient with renal dysfunction. The method includes electrically connecting one or more medical device electrodes with a measurement site of a patient, generating one or more first stimulation signals sufficient to provide input physiological parameters specific to the patient, measuring one or more first bioimpedance values from the generated signals, analyzing at least one of the input physiological parameters within the one or more first bioimpedance values and generating a personalized dialysis program. The systems and methods can further provide essentially real-time data of patient undergoing treatment and control of treatment to a patient.

Abstract: An injectable device for use in a subcutaneous physiological monitoring of a patient includes a body, a plurality of sensors, and a monitoring unit. The plurality of sensors provide an indication of at least one physiological event of a patient, wherein the plurality of sensors includes two or more electrodes in contact with tissue of the patient. The monitoring unit is located within the body and is coupled to the plurality of sensors and configured to monitor a physiologic signal of the patient using the electrodes, wherein the physiologic signal includes an impedance signal related to hydration of tissue of the patient and wherein the monitoring unit is further configured to, based at least in part on the impedance signal measured from the patient, detect an impending cardiac decompensation of the patient.

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: In one configuration, an adherent device to adhere to a skin of a subject includes a stretchable base layer having an upper side and a lower side and an adhesive coating on the lower side to adhere the base layer to the skin of the subject. The base layer has at least two openings extending therethrough, each of the at least two openings having a size. The adherent device also includes a stretchable covering layer positioned above and adhered to the base layer with an adhesive to define at least two pockets. The adherent device also includes at least two gels, each gel having a size larger than the size of openings to retain the gel substantially within the pocket, and a circuit carrier supported with the stretchable base layer to measure at least one physiologic signal of the subject. Other configurations and methods are also claimed.

Abstract: An adherent patient device is configured to adhere to the skin of the patient and measure electrocardiogram data, impedance data, accelerometer data, blood oxygen data and temperature data. The adherent device can communicate wirelessly with gateways and a local processor system, such that the patient can wander about the hospital and update the monitoring station with the patient data when the patient is ambulatory. The local processor system can be configured to customize alerts for the patient, for example to notify automatically a specialist in response to a special condition of the patient. The adherent device may comprise a unique adherent device identifier such that the customized alert can be sent based on the unique device identifier. Each of the gateways can be carried and may comprise a unique gateway identifier, such that the unique device identifier and the unique gateway identifier can be used to locate the ambulatory patient.

Abstract: Systems and methods for management of physiological data, for example data obtained from monitoring an electrocardiogram signal of a patient. In one example use, digital data is obtained and episodes of arrhythmias are detected. Snapshots of the digitized ECG signal may be stored for later physician review. One or more techniques may be used to avoid recording of redundant data, while ensuring that at least a minimum number of episodes of each detected arrhythmia can be stored. The system may automatically tailor its data collection to the cardiac characteristics of a particular patient. In one technique, memory is allocated to include for each detectable arrhythmia a memory segment designated to receive ECG snapshots representing only the respective arrhythmia. A shared memory pool may receive additional snapshots of as the designated memory segments fill.

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. A plurality of electrodes are connected to the patch and capable of electrically coupling to the patient. Circuitry is coupled to the plurality of electrodes to measure a tissue resistance of the patient at a first frequency and to detect a low frequency droop in the measured tissue resistance. In response to detected low frequency droop, the circuitry is configured to measure a tissue resistance of the patient at a second frequency that is lower than the first frequency to verify the detection of low frequency droop, and to temporarily suspend data collection based on the detection and verification of low frequency droop.

Abstract: A system for detecting impending acute cardiac decompensation of a patient includes impedance circuitry, an activity sensor, and a processor system. The impedance circuitry measures a hydration signal of the patient, wherein the hydration signal corresponds to a tissue hydration of the patient. The activity sensor to measure an activity level of the patient, and the processor system includes a computer readable memory in communication with the impedance circuitry and the activity sensor, wherein the computer readable memory of the processor system embodies instructions to combine the hydration signal and the activity level of the patient to detect the impending acute cardiac decompensation.

Abstract: An injectable device for use in a subcutaneous physiological monitoring of a patient includes a body, a plurality of sensors, and a monitoring unit. The plurality of sensors provide an indication of at least one physiological event of a patient, wherein the plurality of sensors includes two or more electrodes in contact with tissue of the patient. The monitoring unit is located within the body and is coupled to the plurality of sensors and configured to monitor a physiologic signal of the patient using the electrodes, wherein the physiologic signal includes an impedance signal related to hydration of tissue of the patient and wherein the monitoring unit is further configured to, based at least in part on the impedance signal measured from the patient, detect an impending cardiac decompensation of the patient.

Abstract: A system and method for decompensation prediction of a heart failure patient with one or more injectable detecting systems communicating wirelessly with a remote monitoring system. The system includes one or more injectable detecting systems having a plurality of sensors that provide an indication of at least one physiological event of a patient, a wireless communication device coupled to the one or more injectable detecting systems and configured to transfer patient data directly or indirectly from the one or more injectable detecting systems to a remote monitoring system, and a remote monitoring system coupled to the wireless communication device, the remote monitoring system using processed data to determine heart failure status and predict impending decompensation of the patient.

Abstract: Methods and apparatus combine patient measurement data with demographic or physiological data of the patient to determine an output that can be used to diagnose and treat the patient. A customized output can be determined based the demographics of the patient, physiological data of the patient, and data of a population of patients. In another aspect, patient measurement data is used to predict an impending cardiac event, such as acute decompensated heart failure. At least one personalized value is determined for the patient, and a patient event prediction output is generated based at least in part on the personalized value and the measurement data. For example, bioimpedance data may be used to establish a baseline impedance specific to the patient, and the patient event prediction output generated based in part on the relationship of ongoing impedance measurements to the baseline impedance. Multivariate prediction models may enhance prediction accuracy.

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: 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.