Abstract: Systems and methods are described for subject rehospitalization management. In an example, multiple physiologic signals can be obtained from a subject using multiple sensors. In response to a hospitalization event, pre-hospitalization characteristics of the multiple physiologic signals can be identified. Post-hospitalization characteristics of the multiple physiologic signals can be identified, including characteristics that differ from their corresponding pre-hospitalization characteristics. Later subsequent physiologic signals can be further monitored after the hospitalization event, such as using the same multiple sensors, and subsequent physiologic signal characteristics can be identified. In an example, a heart failure diagnostic indication can be determined using information about the pre-hospitalization characteristics, the post-hospitalization characteristics, and the subsequent characteristics.

Abstract: Systems and methods are described for subject rehospitalization management. In an example, multiple physiologic signals can be obtained from a subject using multiple sensors. In response to a hospitalization event, pre-hospitalization characteristics of the multiple physiologic signals can be identified. Post-hospitalization characteristics of the multiple physiologic signals can be identified, including characteristics that differ from their corresponding pre-hospitalization characteristics. Later subsequent physiologic signals can be further monitored after the hospitalization event, such as using the same multiple sensors, and subsequent physiologic signal characteristics can be identified. In an example, a heart failure diagnostic indication can be determined using information about the pre-hospitalization characteristics, the post-hospitalization characteristics, and the subsequent characteristics.

Abstract: Systems and methods are described for subject rehospitalization management. In an example, multiple physiologic signals can be obtained from a subject using multiple sensors. In response to a hospitalization event, pre-hospitalization characteristics of the multiple physiologic signals can be identified. Post-hospitalization characteristics of the multiple physiologic signals can be identified, including characteristics that differ from their corresponding pre-hospitalization characteristics. Later subsequent physiologic signals can be further monitored after the hospitalization event, such as using the same multiple sensors, and subsequent physiologic signal characteristics can be identified. In an example, a heart failure diagnostic indication can be determined using information about the pre-hospitalization characteristics, the post-hospitalization characteristics, and the subsequent characteristics.

Abstract: Systems and methods are described for subject rehospitalization management. In an example, multiple physiologic signals can be obtained from a subject using multiple sensors. In response to a hospitalization event, pre-hospitalization characteristics of the multiple physiologic signals can be identified. Post-hospitalization characteristics of the multiple physiologic signals can be identified, including characteristics that differ from their corresponding pre-hospitalization characteristics. Later subsequent physiologic signals can be further monitored after the hospitalization event, such as using the same multiple sensors, and subsequent physiologic signal characteristics can be identified. In an example, a heart failure diagnostic indication can be determined using information about the pre-hospitalization characteristics, the post-hospitalization characteristics, and the subsequent characteristics.

Abstract: Systems and methods for assessing hemodynamic status of a patient experiencing atrial tachyarrhythmia such as an atrial fibrillation (AF) episode are disclosed. A system can comprise an atrial tachyarrhythmia detection circuit configured to detect an AF episode, a hemodynamic sensor circuit configured to sense at least one hemodynamic signal, and a hemodynamic status analyzer circuit that can calculate one or more signal metrics using the sensed hemodynamic signal during the AF episode. The hemodynamic status analyzer circuit can categorize the hemodynamic status of the patient into one of two or more categorical hemodynamic status levels which indicate elevated hemodynamic impact of the detected AF episode. A user interface can provide to an end-user a presentation of the categorized hemodynamic status level during AF.

Abstract: This document discusses, among other things, systems and methods to receive physiologic information of a patient, to receive pulse pressure information from the patient different than the received physiologic information, and to determine an indication of atrial fibrillation (AF) using the received physiologic information and the received pulse pressure information.

Abstract: An apparatus, such as a cardiac function management system can detect heart sounds following a sensed transition in physical activity level, such as from an elevated physical activity level to rest. A technique can include systems, methods, machine-readable media, or other techniques that can include identifying a physical activity level transition, receiving a heart sound signal, determining characteristics of the heart sound and subject physiologic activity to provide an indication, such as a heart failure status indication.

Abstract: An anatomical mapping system including a plurality of mapping electrodes disposed in or near an anatomical structure and configured to detect activation signals of physiological activity, each of the plurality of mapping electrodes having an electrode location, and a processing system associated with the plurality of mapping electrodes, and configured to record the detected activation signals and associate one of the plurality of mapping electrodes with each recorded activation signal. The processing system further configured to determine a dominant frequency at each electrode location, and determine a wavefront vector at each electrode location based on a difference between the dominant frequency at a first electrode location and the dominant frequency at neighboring electrode locations.

Abstract: A method and system for mapping an anatomical structure includes sensing activation signals of intrinsic physiological activity with a plurality of mapping electrodes disposed in or near the anatomical structure, each of the plurality of mapping electrodes having an electrode location. A vector field map which represents a direction of propagation of the activation signals at each electrode location is generated to identify a signature pattern and a location in the vector field map according to at least one vector field template. A target location of the identified signature pattern is identified according to a corresponding electrode location.

Abstract: Systems and methods are described for subject rehospitalization management. In an example, multiple physiologic signals can be obtained from a subject using multiple sensors. In response to a hospitalization event, pre-hospitalization characteristics of the multiple physiologic signals can be identified. Post-hospitalization characteristics of the multiple physiologic signals can be identified, including characteristics that differ from their corresponding pre-hospitalization characteristics. Later subsequent physiologic signals can be further monitored after the hospitalization event, such as using the same multiple sensors, and subsequent physiologic signal characteristics can be identified. In an example, a heart failure diagnostic indication can be determined using information about the pre-hospitalization characteristics, the post-hospitalization characteristics, and the subsequent characteristics.

Abstract: An apparatus may include a sensing circuit and an arrhythmia detection circuit. The sensing circuit is configured to generate a sensed physiological signal representative of cardiac activity of a subject. The arrhythmia detection circuit is configured to monitor ventricular depolarization (V-V) intervals using the sensed physiological signal, detect when at least a portion of the V-V intervals satisfies an arrhythmia detection threshold interval, calculate a value of variability of the V-V intervals and calculate a value of variability of a systolic portion of the V-V intervals in response to the detection, and generate an indication of atrial fibrillation (AF) according to a comparison including the value of variability of the V-V intervals and the value of variability of the systolic portion of the V-V intervals and provide the indication to at least one of a user or process.

Abstract: A cardiac rhythm management system senses a cardiac signal indicative of heartbeats and an acoustic signal indicative of heart sounds and detects atrial tachyarrhythmia based on the sensed cardiac and acoustic signals. In various embodiments, the system senses the cardiac and acoustic signals without using an atrial lead, thus allowing for, for example, monitoring atrial fibrillation burden in a heart failure patient who does not wear an implantable device with an atrial lead. In various embodiments, the system detects heartbeats and heart sounds, measures parameters associated with the detected heartbeats and heart sounds, and detects one or more specified types of atrial tachyarrhythmia using the measured parameters. In various embodiments, the measured parameters are selected from heart rate, heart sound amplitude, cycle length variability, and systolic and diastolic intervals.

Abstract: Systems and methods are described for subject rehospitalization management. In an example, multiple physiologic signals can be obtained from a subject using multiple sensors. In response to a hospitalization event, pre-hospitalization characteristics of the multiple physiologic signals can be identified. Post-hospitalization characteristics of the multiple physiologic signals can be identified, including characteristics that differ from their corresponding pre-hospitalization characteristics. Later subsequent physiologic signals can be further monitored after the hospitalization event, such as using the same multiple sensors, and subsequent physiologic signal characteristics can be identified. In an example, a heart failure diagnostic indication can be determined using information about the pre-hospitalization characteristics, the post-hospitalization characteristics, and the subsequent characteristics.

Abstract: A catheter system includes a mapping catheter including a plurality of mapping electrodes, each mapping electrode configured to sense signals associated with an anatomical structure. The catheter system further includes a processor operatively coupled to the plurality of mapping electrodes and configured to receive the signals sensed by the plurality of mapping electrodes, characterize the signals sensed by the plurality of mapping electrodes based on a signal parameter of the sensed signals, and generate an output of a quality of contact of the plurality of mapping electrodes with the anatomical structure based on the signal characterization.

Abstract: This document discusses, among other things, systems and methods to receive physiologic information of a patient, to receive pulse pressure information from the patient different than the received physiologic information, and to determine an indication of atrial fibrillation (AF) using the received physiologic information and the received pulse pressure information.

Abstract: Medical devices and methods for using medical devices are disclosed. An example mapping medical device may include a catheter shaft with a plurality of electrodes. The plurality of electrodes may include a first pair of electrodes, a second pair of electrodes, a third pair of electrodes and a fourth pair of electrodes. The mapping medical device may further include a processor, wherein the processor may be configured to determine a first latency between the first pair of electrodes, determine a second latency between the second pair of electrodes, determine a third latency between the third pair of electrodes, determine a fourth latency between the fourth pair of electrodes, and determine a target signal by interpolating the first latency, the second latency, the third latency and the fourth latency.

Abstract: Electrical activity propagation along an electrode array within a cardiac chamber is reconstructed. Signals are sampled from the electrode array and the signals are plotted in multi-dimensional space with each axis corresponding to a channel in the electrode array. An excursion direction of global activation in the multi-dimensional space is estimated and a change in vectors of the sampled signals over time is determined. Signals with vectors that change over time in the excursion direction are suppressed.

Abstract: Systems and methods for detecting atrial tachyarrhythmias such as atrial fibrillation (AF) are disclosed. A medical system can sense a heart rate (HR) output and a hemodynamic status output. An AF detector circuit automatically determines a first detection criterion and a different second detection criterion. The first detection criterion can be more sensitive to the presence of the AF episode than the second detection criterion, and the second detection criterion can be more specific to the AF episode than the first detection criterion. The AF detector circuit detects an AF onset event using the first detection criterion and at least one of the heart rate output or the hemodynamic status output, and detects an AF termination event using the second detection criterion and at least one of the heart rate output or the hemodynamic status output.

Abstract: A method and system for mapping an anatomical structure includes sensing activation signals of intrinsic physiological activity with a plurality of mapping electrodes disposed in or near the anatomical structure, each of the plurality of mapping electrodes having an electrode location. A vector field map which represents a direction of propagation of the activation signals at each electrode location is generated to identify a signature pattern and a location in the vector field map according to at least one vector field template. A target location of the identified signature pattern is identified according to a corresponding electrode location.

Abstract: An apparatus comprises one or more physiological sensing circuits that generate a sensed physiological signal and at least one of the physiological sensing circuits is implantable, a measurement circuit configured to recurrently measure one or more physiological parameters that indicate a status of heart failure of the subject, a comparison circuit configured to compare the one or more physiological parameter measurements to one or more physiological parameter target values, a therapy circuit configured to control delivery of one or more drugs to treat heart failure, and a control circuit in electrical communication with the comparison circuit and the therapy circuit and configured to recurrently adjust delivery of drug therapy according to the comparison of the measured physiological parameters to the physiological parameter targets.