Abstract: Physiological monitoring can be provided through a lightweight wearable monitor that includes two components, a flexible extended wear electrode patch and a reusable monitor recorder that removably snaps into a receptacle on the electrode patch. The wearable monitor sits centrally (in the midline) on the patient's chest along the sternum oriented top-to-bottom. The placement of the wearable monitor in a location at the sternal midline, with its unique narrow “hourglass”-like shape, significantly improves the ability of the wearable monitor to cutaneously sense cardiac electrical potential signals, particularly the P-wave and, to a lesser extent, the QRS interval signals indicating ventricular activity in the ECG waveforms. Additionally, the monitor recorder includes an ECG sensing circuit that measures raw cutaneous electrical signals and performs signal processing prior to outputting the processed signals for sampling and storage.

Abstract: Long-term electrocardiographic and physiological monitoring over a period lasting up to several years in duration can be provided through a continuously-recording subcutaneous insertable cardiac monitor (ICM). The sensing circuitry and the physical layout of the electrodes are specifically optimized to capture electrical signals from the propagation of low amplitude, relatively low frequency content cardiac action potentials, particularly the P-waves that are generated during atrial activation. In general, the ICM is intended to be implanted centrally and positioned axially and slightly to either the left or right of the sternal midline in the parasternal region of the chest. Additionally, the ICM includes an ECG sensing circuit that measures raw cutaneous electrical signals and performs signal processing prior to outputting the processed signals for sampling and storage.

Abstract: A system and method for display of subcutaneous cardiac monitoring data are provided. Cutaneous action potentials of a patient and other sensed data associated with the patient are recorded as electrocardiogram (EGC) data over a set time period using a subcutaneous insertable cardiac monitor. A set of R-wave peaks is identified within the ECG data and an R-R interval plot is constructed. A difference between recording times of successive pairs of the R-wave peaks in the set is determined. A heart rate associated with each difference is also determined. The pairs of the R-wave peaks and associated heart rate are plotted as the R-R interval plot. A diagnosis of cardiac disorder is facilitated based on patterns of the plotted pairs of the R-wave peaks, the associated heart rates in the R-R interval plot, and background data based on the other sensed data.

Abstract: Physiological monitoring can be provided through a lightweight wearable monitor that includes two components, a flexible extended wear electrode patch and a reusable monitor recorder that removably snaps into a receptacle on the electrode patch. The wearable monitor sits centrally on the patient's chest along the sternum oriented top-to-bottom. The placement of the wearable monitor in a location at the sternal midline, with its unique narrow “hourglass”-like shape, significantly improves the ability of the wearable monitor to cutaneously sense cardiac electrical potential signals, particularly the P-wave and the QRS interval signals indicating ventricular activity in the ECG waveforms. In particular, the ECG electrodes on the electrode patch are tailored to be positioned axially along the midline of the sternum for capturing action potential propagation in an orientation that corresponds to the aVF lead used in a conventional 12-lead ECG that is used to sense positive or upright P-waves.

Abstract: An ambulatory electrocardiography monitor is provided. The monitor includes a housing adapted to couple to a monitoring patch that includes electrocardiographic electrodes; and electronic circuitry provided within the housing. The electronic circuitry includes an electrocardiographic front end circuit; the microcontroller configured to: execute a power up sequence upon the housing coupling to the patch; after the execution of the power-up sequence, retrieve from the monitoring patch an identifier associated with the patch and a password for accessing results of a physiological monitoring conducted using the patch; read samples of the electrocardiographic signals, buffer the samples of the electrocardiographic signals, compress the buffered samples of the electrocardiographic signals, buffer the compressed samples of the electrocardiographic signals, and write-the buffered samples into a memory in association with the password and the identifier; and the memory electrically interfaced with the microcontroller.

Abstract: An extended wear electrocardiography patch is provided. An integrated flexible circuit includes a single piece of material and has an upper end and a lower end opposite the upper end. A mirror image of the upper end extends from at least a portion of one side of the upper end and folds over the upper end. One circuit trace is positioned on the upper end and one circuit trace is positioned on the lower end. Electrical pads are located on a contact surface of the upper end and on an outward facing surface of the mirror image of the upper end. An electrocardiographic electrode is positioned on the contact surface of the upper end and another electrocardiographic electrode is positioned on a contact surface of the lower end. A battery is directly adhered to the outward facing surface of the mirror image of the upper end.

Abstract: In one embodiment, an ambulatory encoding monitor recorder optimized for rescalable encoding and a method of use are provided. The monitor recorder includes a memory configured to store a plurality of codes and a plurality of electrocardiographic values associated with each of the codes; and a micro-processor configured to obtain electrocardiographic values during a sequence of temporal windows and to process the electrocardiographic values within each of the windows, the processing including: perform a mathematical operation on two of the electrocardiographic values; analyze a result of each of the mathematical operations; based on the analysis, adjust the plurality of the electrocardiographic values associated with each of the codes; encode each of the electrocardiography values within that window with one of the codes based on the adjusted plurality of the electrocardiographic values associated with that code; and write each of the codes into a sequence in the memory.

Abstract: A system and method for facilitating a cardiac rhythm disorder diagnosis based on subcutaneous cardiac monitoring data with the aid of a digital computer are provided. Cutaneous action potentials of a patient are recorded as electrocardiogram (EGC) data over a set time period using a subcutaneous insertable cardiac monitor. A set of R-wave peaks is identified within the ECG data and an R-R interval plot is constructed. A difference between recording times of successive pairs of the R-wave peaks in the set is determined. A heart rate associated with each difference is also determined. The pairs of the R-wave peaks and associated heart rate are plotted as the R-R interval plot. A diagnosis of cardiac disorder is facilitated based on patterns of the plotted pairs of the R-wave peaks and the associated heart rates in the R-R interval plot.

Abstract: Physiological monitoring can be provided through a lightweight wearable monitor that includes two components, a flexible extended wear electrode patch and a reusable monitor recorder that removably snaps into a receptacle on the electrode patch. The wearable monitor sits centrally (in the midline) on the patient's chest along the sternum oriented top-to-bottom. The placement of the wearable monitor in a location at the sternal midline, with its unique narrow “hourglass”-like shape, significantly improves the ability of the wearable monitor to cutaneously sense cardiac electrical potential signals, particularly the P-wave and, to a lesser extent, the QRS interval signals indicating ventricular activity in the ECG waveforms. Additionally, the monitor recorder includes an ECG sensing circuit that measures raw cutaneous electrical signals and performs signal processing prior to outputting the processed signals for sampling and storage.

Abstract: A self-authenticating electrocardiography and physiological sensor monitor is provided. An electrode patch includes an elongated strip and electrodes exposed on each end. A receptacle is adhered to the elongated strip and includes electrical pads. Circuit traces are electrically coupled to the electrocardiographic electrodes and the electrical pads. A monitor recorder having a sealed housing is adapted to be secured into the receptacle. Circuitry within the housing includes a microcontroller with a private key. A copy of the private key is stored on the patch. Self-authentication is performed each time the monitor recorder is inserted into a new patch by challenging the patch using a code hashed with the private key and by receiving a response from the patch in reply to the challenge. A front end circuit senses electrocardiographic signals via electrodes on the patch when the response received by the microcontroller is positive, until the electrode patch expires.

Abstract: A subcutaneous electrocardiography monitor configured for self-optimizing ECG data compression is provided. ECG waveform characteristics are rarely identical in patients with cardiac disease making this innovation crucial for the long-term data storage and analysis of complex cardiac rhythm disorders. The monitor includes a memory and a micro-controller operable to execute under a micro-programmable control and configured to: obtain a series of electrode voltage values; select one or more of a plurality of compression algorithms for compressing the electrode voltage series; apply one or more of the selected compression algorithms to the electrode voltage series; evaluate a degree of compression of the electrode voltage series achieved using the application of the selected algorithms; apply one or more of the compression algorithms to the compressed electrode voltage series upon the degree of compression not meeting a predefined threshold; and store the compressed electrode voltage series within the memory.

Abstract: Long-term electrocardiographic and physiological monitoring over a period lasting up to several years in duration can be provided through a continuously-recording subcutaneous insertable cardiac monitor (ICM). The sensing circuitry and the physical layout of the electrodes are specifically optimized to capture electrical signals from the propagation of low amplitude, relatively low frequency content cardiac action potentials, particularly the P-waves that are generated during atrial activation. In general, the ICM is intended to be implanted centrally and positioned axially and slightly to either the left or right of the sternal midline in the parasternal region of the chest. Additionally, the ICM includes an ECG sensing circuit that measures raw cutaneous electrical signals and performs signal processing prior to outputting the processed signals for sampling and storage.

Abstract: A system and method for neural-network-based atrial fibrillation detection with the aid of a digital computer are provided. Electrocardiography (ECG) features and annotated patterns of the features are maintained in a database, at least some of the patterns associated with atrial fibrillation. A classifier is trained based on the annotated patterns, the classifier implemented by a convolutional neural network. A representation of an ECG signal recorded by one or more ambulatory monitors is received. ECG features in the representation falling within each of the temporal windows are detected. The trained classifier is used to identify patterns of the ECG features. At least one matrix with weights for the patterns are generated. A value indicative of whether portions of the representation are associated the patient experiencing atrial fibrillation is calculated. That one or more of the portions are associated with the patient experiencing atrial fibrillation is determined.

Abstract: An electrocardiography patch is provided. The patch includes a backing and at least two electrocardiographic electrodes each positioned on the backing, across from another of the electrocardiographic electrodes, to capture electrocardiographic signals. A flexible circuit includes a pair of circuit traces electrically coupled to the electrocardiographic electrodes. A wireless transceiver communicates at least a portion of the electrocardiographic signals.

Abstract: A monitoring apparatus is provided. A strip includes a first end section, a second end section opposite the first end section, and a midsection between the first end section and the second end section, and further includes a first surface and a second surface. An adhesive covers a portion of the first surface of the strip. Only two electrocardiographic electrodes are included. A flexible circuit is mounted to the second surface of the strip. An accelerometer, a respiratory sensor, and a wireless transceiver are provided on the second surface of the strip. A processor is positioned over a portion of the flexible circuit and coupled to the electrodes and the wireless transceiver.

Abstract: A method for data exchange and charging is provided. An implantable medical device is monitored and charging of the implantable medical device is initiated by providing charge parameters to a bedside monitor. Communication is initiated between a puck associated with the bedside monitor and implantable medical device. The implantable medical device is charged using the charge parameters. Simultaneously with the charging, transfer of data between the implantable medical device and the bedside monitor is initiated.

Abstract: A method for continuous data transfer is provided. Data blocks are generated from a continuous data stream captured via a physiological monitoring device by segmenting data from the continuous data stream into the data blocks. A time at which the data associated with each data block occurs is determined and a sample number is associated with each data block. The data blocks are transmitted from the physiological monitoring device to a server. The data blocks are ordered on the server based on the time and the sample number associated with each data block.

Abstract: An insertable cardiac monitor (ICM) with induction-based recharging capabilities and a transmitting coil for recharging the same are disclosed. The length of the monitoring performed by the ICM is extended and the functionality of the ICM enhanced, by including an internal energy harvesting module that allows for charging the ICM at a high speed without burning the patient or overheating components of the ICM. Internally, the energy harvesting module includes at least two overlapping receiving coils that are spaced to be orthogonal to each other and that have a tilt angle of substantially 45°. Such overlapping wire combination allows to minimize mutual inductance of the solenoid coils and increase the rate at which energy can be provided to the energy harvesting module. Further, the rate at which the energy is transmitted from the outside can be increased by defining in a transmitting coil a substantially triangular gap.

Abstract: An electrocardiography monitor is provided. A sealed housing includes one end wider than an opposite end of the sealed housing. Electronic circuitry is provided within the sealed housing. The electronic circuitry includes an electrographic front end circuit to sense electrocardiographic signals and a micro-controller interfaced to the electrocardiographic front end circuit to sample the electrocardiographic signals. A buzzer within the housing outputs feedback to a wearer of the sealed housing.

Abstract: A noise-separating cardiac monitor is provided. An implantable housing includes an external surface. A wireless antenna is shaped to wrap around an interior periphery of the implantable housing. Electrodes are provided on a ventral surface of the implantable housing to capture P-wave signals and R-wave signals. Electronic circuitry is provided within the wearable housing and includes a low power microcontroller. A front end circuit includes a signal lead operable to sense cardiac electrical potentials through one of the electrodes, a reference lead operable to sense the cardiac electrical potentials through another electrode, and a reference generator configured to inject a driven reference to the reference lead. The signal lead includes a coupling capacitor and a protection resistor associated with thermal noise. The thermal noise is not contained in the driven reference and not introduced to the reference lead. A non-volatile memory is electrically interfaced with the microcontroller.