Abstract: This disclosure provides cascaded reference circuits and low amplitude signal sensing circuits that are useful in wearable devices. Circuits for measuring electrovesselgram (EVG) and subdermal spectrogram (SSG) are provided, as well as methods for using these circuits to determine quantities and qualities of a person's moods, such as how much and what kinds of stress they experience. The provided devices are useful on limbs and appendages, such as in a smart watch that is worn on the wrist. Methods are provided for using the devices of this disclosure to privately alert wearers to an increase in bad stress in the moment when they can take actions to reduce their stress and physiological stress responses. These devices are useful for measuring and increasing the effectiveness of relaxation techniques. As a result of using methods and devices of this disclosure, people are healthier, they make more response-able decisions, and relationships improve.

Abstract: A wearable electrocardiography monitoring ensemble is provided. A first receptacle is defined in a wearable garment by two horizontal bands placed across the wearable garment. A second receptacle is defined by two further horizontal bands positioned across the wearable garment under the first receptacle. A first electrode assembly is positioned within the first receptacle and includes a backing with an electrical connection having an electrode on one end of the electrical connection and terminated at the other end of the electrical connection to connect with a monitor recorder. A second electrode assembly is positioned within the second receptacle and includes a backing with an electrical connection having an electrode on one end of the electrical connection and terminated at the other end of the electrical connection to connect with a further monitor recorder, wherein the first and second electrodes are aligned longitudinally in the wearable garment.

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 and storing samples of captured signals. In general, the ICM is intended to be implanted centrally and positioned axially and either over the sternum or slightly to either the left or right of the sternal midline in the parasternal region of the chest.

Abstract: A computer-implemented system and method for providing a personal mobile device-triggered medical intervention is provided. An activity monitor is associated with a patient and is configured to sense cardiac activity data, including heart rate and heart rhythm. A mobile device is paired with the activity monitor to execute an application for detecting a potentially medically significant cardiac event based on the cardiac activity data. An electrocardiography and physiological sensor monitor is fitted to a sternal region of the patient to sense electrocardiographic signals that the activity monitor is not capable of obtaining. The patient's access to the electrocardiography and physiological sensor monitor is triggered upon detection of the potentially medically significant cardiac event and the electrocardiographic signals are directly uploaded into an electronic medical record for the patient for review by a medical professional.

Abstract: A remotely-interfaceable electrocardiography patch is provided. The remotely-interfaceable electrocardiography patch includes a backing formed of a strip of material and an electrocardiographic electrode on each end of the backing 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 one of the electrocardiographic signals and other physiological measures with one or more of a physiology and activity sensor, communication device, server, and personal computer.

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: A system and method for secure physiological data acquisition and storage. An identifier of a physiological monitoring patch is obtained by a programming wand, the patch configured to store the identifier within a cryptographic circuit. A password for accessing physiological monitoring data collected using that patch is generated based on at least a portion of the identifier, the password is encrypted using a secret key, and the encrypted password is loaded into the cryptographic circuit. The key is loaded onto a monitor recorder that couples with the patch and obtains the physiological monitoring data using the patch, wherein the monitor recorder offloads the data together with the identifier and the decoded password. The identifier and the password are reported to a server that stores the offloaded physiological monitoring data using the identifier within a secure database and grants access to the data upon receipt of the decoded password.

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 method for constructing a stress-pliant physiological electrode assembly is provided. An electrode backing is formed from a stretchable woven textile material compatible to contact the skin on at least one surface. A pair of flexile wires is provided to serve as electrode circuit trace and electrode signal pickup. At least one of the flexile wires is sewn into the textile material which provides a stress-pliant malleability. Each of the flexile wires has an electrically-contacting area functioning for electric signal pickup. The electrically-contacting area may be sewn into the woven textile or affixed to the woven textile via conductive adhesives. The stress-pliant physiological electrode assembly is applicable for a wide array of physiological monitors, including ECG monitors, and especially is suitable for long-term wear. The method disclosed is both environmentally friendly and low-cost.

Abstract: An extended wear electrocardiography patch with wire interconnects is provided. The patch includes a flexible backing formed of an elongated strip of stretchable material with narrow longitudinal midsection evenly tapering inward from a distal end and a proximal end, the elongated strip adherable only at a contact surface defined on each of the ends; a pair of electrocardiographic electrodes interfaced to one or more of a set of electrode pads, each of the electrodes including an electrically conductive surface only exposed on the contact surface; a battery connected to one or more of the pads of the set via at least one flexile wire interconnect, the battery secured in place via a flexile wire; and the set of electrical contact pads included on the flexible backing and formed by a set of further flexile wires, the set configured to interface the electrodes and the battery with an electrocardiography monitor recorder.

Abstract: Physiological monitoring can be provided through a lightweight wearable monitor that includes two components, a flexible extended wear electrode patch with sewn electrodes and a reusable monitor recorder that removably snaps into a receptacle on the electrode patch. The 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: A monitor recorder optimized for electrocardiography and respiratory data acquisition and processing is provided.

Abstract: An extended wear electrocardiography patch is provided. A flexible backing includes an elongated strip of stretchable material. An electrocardiographic electrode is respectively affixed to and conductively exposed on each end of the elongated strip. A flexible circuit is affixed on each end to the elongated strip and includes a pair of circuit traces each originating within one of the ends of the elongated strip and coupled to one of the electrocardiographic electrodes. A non-conductive receptacle securely adhered on the one end of the elongated strip and includes electrode terminals aligned to interface the pair of circuit traces to an electrocardiography monitor to obtain electrocardiographic signals through the electrocardiographic electrodes.

Abstract: A wearable electrocardiography monitoring ensemble is provided, which includes a garment made of a compressible and elastomeric material. The garment is wearable about an upper region of the torso and further includes an internal structure forming a compressive bias circumferential to the torso. The ensemble also includes an electrode assembly provided on an inside surface of the garment on an underside of the internal structure. The electrode assembly has a pair of electrocardiography electrodes, a pair of terminated electrical connections that are each coupled to one of the electrocardiography electrodes, and a backing to which the electrocardiography electrodes are affixed.

Abstract: A self-expiring electrocardiography and physiological monitor recorder is provided. A sealed housing is adapted to be removably secured into a non-conductive receptacle on an electrode patch. Electronic circuity is provided within the sealed housing and includes an electrocardiographic front end circuit operable to sense electrocardiographic signals through electrocardiographic electrodes provided on the electrode patch and flash memory to record the electrocardiographic signals. The electronic circuitry also includes a micro-controller to draw power from a battery provided on the electrode patch, to receive from the electrode patch a recording duration, and to terminate recording of the electrocardiographic signals upon satisfaction of the recording duration.

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: 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: A remotely-interfaceable electrocardiography patch is provided. A flexible backing is formed from an elongated strip of material. A pair of electrocardiographic electrodes are exposed on a contact surface of the flexible backing for capturing electrocardiographic signals. A non-conductive receptacle is adhered to an outward-facing surface of the flexible backing and includes a plurality of electrical pads. A flexible circuit has a pair of circuit traces electrically coupled to the pair of electrocardiographic electrodes and a pair of the electrical pads. A wireless transceiver communicates samples of the electrocardiographic signals.

Abstract: Physiological monitoring can be provided through a wearable monitor that includes two components, a flexible extended wear electrode patch and a removable reusable monitor recorder. 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 (or immediately to either side of the sternum) benefits extended wear by removing the requirement that ECG electrodes be continually placed in the same spots on the skin throughout the monitoring period. The wearable monitor can interoperate wirelessly with other physiology and activity sensors and mobile devices. An application executed by the sensor or device can trigger the dispatch of a wearable monitor to the patient upon detecting potentially medically-significant events. The dispatched wearable monitor would then be capable of providing precise medically-actionable data, not merely an alert that some abnormality may be present.

Abstract: Physiological monitoring can be provided through a wearable monitor that includes a flexible extended wear electrode patch and a removable reusable monitor recorder. A pair of flexile wires is interlaced or sewn into a flexible backing, serving as electrode signal pickup and electrode circuit traces. The wearable monitor sits centrally on the patient's chest along the sternum, which significantly improves the ability to sense cutaneously cardiac electric signals, particularly those generated by the atrium. The electrode patch is shaped to fit comfortably and conformal to the contours of the chest approximately centered on the sternal midline. To counter the dislodgment due to compressional and torsional forces, non-irritating adhesive is provided on the underside, or contact, surface of the electrode patch, but only on the distal and proximal ends.