Abstract: A method includes storing, by one or more servers, separate packages of data received from separate medical devices. The separate packages of data are respectively associated with different patients. The method includes automatically determining which subset of the patients experiences the most health events among the different patients. Access to the packages of data is provided via a user interface, and an indicator is displayed on the user interface showing which of the patients is associated with the subset. A computing system such as a server can be programmed to carry out one or more steps of the method.

Abstract: Systems and methods are disclosed to determine and record one or more key metrics of atrial fibrillation for a patient, including determining indications of atrial fibrillation of the patient in respective detection windows of a day using received physiologic information, recording first physiologic information of the patient at a first sampling frequency for the determined indications of atrial fibrillation of the patient up to and not exceeding a first threshold of the medical device system for transmission to a remote device, and determining and recording one or more key metrics of atrial fibrillation for the determined indications of atrial fibrillation of the patient at a second sampling frequency lower than the first sampling frequency without regard to the first threshold.

Abstract: Systems and methods for managing cardiac arrhythmias are discussed. A data management system receives a first detection algorithm including a detection criterion for detecting a cardiac arrhythmia. An arrhythmia detector detects arrhythmia episodes from a physiologic signal using a second detection algorithm that is different from and has a higher sensitivity for detecting the cardiac arrhythmia than the first detection algorithm. The arrhythmia detector assigns a detection indicator to each of the detected arrhythmia episodes. The detection indicator indicates a likelihood that the detected arrhythmia episode satisfies the detection criterion of the first detection algorithm. The system prioritizes the detected arrhythmia episodes according to the assigned detection indicators, and outputs the arrhythmia episodes to a user or a process according to the episode prioritization.

Abstract: Systems and methods are disclosed to an ambulatory medical device comprising a cardiac signal sensing circuit configured to sense a cardiac signal representative of cardiac activity of a patient when connected to electrodes, and a control circuit. The control circuit is configured to monitor cardiac depolarizations in the sensed cardiac signal, detect a bimodal distribution of heart rate of the patient, identify cardiac depolarization intervals shorter than a predetermined interval threshold, identify premature atrial contractions (PACs) in the sensed cardiac signal that are conducted normally and conducted aberrantly, and count a number of conducted PACs and produce an alert related to PC burden of the patient based on the number.

Abstract: This document discusses, among other things, systems and methods for managing pain in a subject. A system may include one or more sensors configured to sense from the subject information corresponding to emotional reaction to pain, such as emotional expression. The emotional expression includes facial or vocal expression. A pain analyzer circuit may generate a pain score using signal metrics of facial or vocal expression extracted from the sensed information. The pain score may be output to a user or a process. The system may additionally include a neurostimulator that can adaptively control the delivery of pain therapy by automatically adjusting stimulation parameters based on the pain score.

Abstract: Systems and methods are disclosed to signal processing device of a patient management system. The signal processing device comprising a communication circuit configured to receive a cardiac signal from an AMD, wherein the received cardiac signal is a frequency filtered cardiac signal produced from a broader frequency band cardiac signal sensed using the AMD; signal processing circuitry configured to restore the received cardiac signal to the broader frequency band cardiac signal; detect an elevated ST segment in the restored broader frequency band cardiac signal; and generate an alert of myocardial infarction in response to detecting the elevated ST segment.

Abstract: A method of operating a cardiac rhythm management (CRM) system includes sending a list of electrodes to an ambulatory medical device (AMD) of the CRM system from a programming device for the AMD, the list of electrodes including types of electrodes available to the AMD and position of the electrodes; sending a selection of one or more capture confirming criteria to confirm pacing capture to the AMD; performing, by the AMD, an automatic pacing threshold test for all potential pacing vectors that include the electrodes in the list of electrodes; collecting data for each pace of the pacing threshold test confirmed to capture according to the selected one or more capture confirming criteria; communicating the collected data to the programming device; and presenting the collected data as a trend relative to at least one selected capture confirming criterion and the pacing stimulation energy that resulted in capture.

Abstract: A method of operating a cardiac rhythm management (CRM) system includes measuring a baseline PR interval of a cardiac depolarization; measuring one or both of a heart sound and a QRS width for the cardiac depolarization; delivering pacing stimulation according to an atrial sense to ventricular pace interval (AsVp interval) and measuring the one or both of the heart sound and the QRS width for the AsVp interval, wherein the pacing stimulation is delivered using a conduction system pacing (CSP) vector that includes an electrode positioned in an interventricular septum; delivering pacing stimulation according to an atrial pace to ventricular pace interval (ApVp interval) and measuring the one or both of the heart sound and the QRS width for the ApVp interval; and generating a recommended atrial to ventricular delay setting for CSP according to the measured one or both of the heart sounds and the QRS widths.

Abstract: A method of controlling operation of a medical device includes delivering electrical cardiac pacing energy to a left conduction bundle branch (LBB) area of the subject according to a primary pacing mode that uses a tip electrode of an implantable cardiac lead connected to the medical device for cathodal capture in the LBB area; monitoring for loss of cathodal capture of the LBB area when delivering the electrical cardiac pacing energy in the primary pacing mode; and changing to a backup pacing mode when the loss of cathodal capture is detected, wherein the backup pacing mode uses a ring electrode of the implantable cardiac lead for anodal capture in an interventricular septum of the subject.

Abstract: Systems and methods for pacing cardiac conductive tissue are described. An embodiment of a medical system includes an electrostimulation circuit to generate His-bundle pacing (HBP) pulses to stimulate a His bundle, and a cardiac event detector to detect a His-bundle activity within a time window following an atrial activity. The cardiac event detector may use a cross-chamber blanking, or an adjustable His-bundle sensing threshold, to avoid or reduce over-sensing of far-field atrial activity and inappropriate inhibition of HBP therapy. The electrostimulation circuit may deliver HBP in the presence of the His-bundle activity. The system may further recognize the detected His-bundle activity as either a FFPW or a valid inhibitory event, and deliver or withhold HBP therapy based on the recognition of the His-bundle activity.

Abstract: Systems and methods for monitoring a subject for sleep apnea risk based on a bradycardia burden are disclosed. A sleep apnea monitoring system comprises a risk stratification circuit configured to detect bradycardia using cardiac information of the subject during a monitoring period, determine a bradycardia burden representing accumulated time or relative time of the subject being in the detected bradycardia over the monitoring period, and determine an apnea risk based on the bradycardia burden. An output unit can provide the apnea risk to a user, or to a process executed by an apnea detector to perform a confirmatory apnea detection.

Abstract: Systems and methods for detecting cardiac arrhythmia are discussed. A medical-device system includes an ambulatory monitor device and an arrhythmia analysis device communicatively coupled to each other. The ambulatory monitor device can sense a cardiac signal from the patient, and intermittently collect data segments of the cardiac signal in accordance with a data segment collection rate or schedule over a monitoring period. The data segments each has a specific segment duration. The monitor device can transmit the intermittently collected data segments to the arrhythmia analysis device in accordance with a transmission schedule or in response to a trigger event. The arrhythmia analysis device can detect a cardiac arrhythmia from the intermittently collected data segments. The segment duration or the data segment collection rate or schedule may be adjusted based on a performance measure of the arrhythmia detection.

Abstract: Systems and methods for pacing cardiac conductive tissue are described. An embodiment of a medical system includes an electrostimulation circuit to generate His-bundle pacing (HBP) pulses to stimulate a His bundle, and a cardiac event detector to detect a His-bundle activity within a time window following an atrial activity. The cardiac event detector may use a cross-chamber blanking, or an adjustable His-bundle sensing threshold, to avoid or reduce over-sensing of far-field atrial activity and inappropriate inhibition of HBP therapy. The electrostimulation circuit may deliver HBP in the presence of the His-bundle activity. The system may further recognize the detected His-bundle activity as either a FFPW or a valid inhibitory event, and deliver or withhold HBP therapy based on the recognition of the His-bundle activity.

Abstract: Systems and methods for calibrating an orientation of an implantable device in a patient is described. An exemplary system includes a calibration circuit that can receive acceleration information sensed from an implantable medical device (IMD) implanted in a patient, and receive reference acceleration information sensed from a reference device associated with the patient. The acceleration information and the reference acceleration information are acquired when the patient assumes a first posture or in a first position. The calibration circuit determines a spatial relationship between an orientation of the IMD and a reference orientation of the reference device using the received acceleration information and the received reference acceleration information, and calibrate subsequent acceleration information sensed from the IMD using the determined spatial relationship to correct for the orientation of the IMD.

Abstract: Systems and methods for managing pain in patient are described. A system may include sensors configured to sense physiological or functional signals, and a pain analyzer to generate signal metrics from the physiological or functional signals. The pain analyzer also generates weight factors corresponding to the signal metrics. The weight factors may indicate the signal metrics reliability in representing an intensity of the pain. The pain analyzer generates a pain score using a plurality of signal metrics and a plurality of weight factors. The pain score may be output to a user or a process. The system may additionally include an electrostimulator to generate and deliver closed-loop pain therapy according to the pain score.

Abstract: Systems and methods for detecting cardiac events in a patient are described herein. An embodiment of a medical system includes a detection circuit configured to detect cardiac events of the patient at different detection settings using physiologic information of the patient and a control circuit to determine a priority for each detected cardiac event based on the detection setting used to detect the respective cardiac event and to prioritize system resources for the detected cardiac event according to the determined priorities, wherein to prioritize system resources comprises to allocate memory space for the detected cardiac events or to prioritize data transmission of the detected cardiac events to an external system based on the determined priority for each respective cardiac event.

Abstract: Systems and methods for managing physiological events generated by a medical device in a patient are discussed. An exemplary system includes a controller circuit to receive information about a plurality of physiological events detected by a medical device in a patient, generate for each of the physiological events a respective feature set using the received information, and cluster the physiological events into different event groups using values of temporal or morphological features of the generated feature sets. The event groups each include a respective set of physiological events. The controller circuit can identify from at least one event group a representative event representing the physiological events of that event group, and output to a user or a process the representative event and an indication that the representative event has been determined and represents the set of physiological events in the even group.

Abstract: Systems and methods for detecting an arrhythmic event and storing physiological information associated with the detected arrhythmic event are described. A system may include a first detector to detect an arrhythmic event from a physiological signal sensed from a subject, and generate a confidence indicator indicating a confidence level of the detection of the arrhythmic event. If the confidence indicator indicates a relatively high confidence of arrhythmia detection, the system may provide the detected arrhythmic event to a first process for storing the detected arrhythmic event or generating an alert. If the confidence indicator indicates a relatively low confidence of arrhythmia detection, the system may provide the detected arrhythmic event to at least a second process including confirming or rejecting the detected arrhythmic event.

Abstract: Systems and methods for detecting physiologic events in a patient are described herein. An embodiment of a medical system includes a memory circuit to store physiologic event episodes detected and recorded by a medical device. The system includes a control circuit to analyze the stored physiologic event episodes, and determine a presence of a target cardiac event under a plurality of detection settings. Using the determined presence of the target cardiac event from the stored physiologic event episodes, and user adjudication of the stored event episodes, the control circuit may select, from the plurality of detection settings, a detection setting to detect a subsequent target cardiac event. The control circuit may also prioritize the physiologic event episodes for storage in the memory circuit.

Abstract: Systems and methods for pacing cardiac conductive tissue are described. In an embodiment, a medical system includes an electrostimulation circuit to generate pacing pulses to stimulate a His bundle or a bunch branch. A sensing circuit senses a far-field ventricular activation, determines a cardiac synchrony indicator using the far-field ventricular activation in response to His bundle or bundle branch pacing, and verifies His-bundle capture status using the determined cardiac synchrony indicator. The system can determine a pacing threshold using the capture status under different stimulation strength values. The electrostimulation circuit can deliver stimulation pulses in accordance with the determined pacing threshold.