Abstract: Methods and systems are directed to acquiring and organizing information associated with at least one syncope event. A syncope event may be a suspected syncope event, a verified syncope event or a syncope event that is suspected and verified. Automated processes are used to collect information associated with at least one syncope event and organize the information as a syncope log entry. At least one of acquiring the information and organizing the information is performed at least in part implantably.

Abstract: Methods and systems for evaluating a pathological condition include acquiring movement information, such as electromyogram (EMG) information, and sleep disordered breathing (SDB) information, and detecting the presence of a pathological condition using both movement and SDB information. Methods may involve sensing physiological signals including at least muscle movement signals. Sleep-related disorders are detected using the sensed physiological signals, the sleep-related disorders including at least an involuntary muscle movement disorder and sleep-disordered breathing. Methods and systems also provide for detecting and treating a sleep-related disorder using movement and SDB information. Cardiac, respiratory, nerve stimulation, drug, or a combination of such therapies may be delivered to treat a detected or diagnosed pathological condition.

Abstract: Methods and systems involve adjusting cardiac pacing based on information acquired via a respiratory therapy device. A medical system includes a respiratory therapy device having one or more sensors and a therapy delivery unit. The one or more sensors are configured to sense respiration cycles. The therapy delivery unit is configured to deliver an external respiratory therapy to the patient. The medical system also includes a pulse generator configured to deliver cardiac pacing pulses to the patient. A controller is coupled to the one or more sensors and the pulse generator. The control unit configured to adjust a cardiac pacing rate based on the patient's respiration cycles.

Abstract: Methods and systems involve coordinating therapies used for treating disordered breathing. Disordered breathing therapies may include cardiac electrical stimulation therapy and external respiratory therapy as well as other therapies for treating disordered breathing in a patient. The therapies delivered to the patient may be coordinated to enhance effectiveness of the therapy, to reduce therapy interactions, to improve patient sleep, or to achieve other therapeutic goals.

Abstract: Cardiac monitoring and/or stimulation methods and systems employing dyspnea measurement. An implantable cardiac device may sense transthoracic impedance and determine a patient activity level. An index indicative of pulmonary function is implantably computed to detect an episode of dyspnea based on a change, trend, and/or value exceeding a threshold at a determined patient activity level. Trending one or more pulmonary function index values may be done to determine a patient's pulmonary function index profile, which may be used to adapt a cardiac therapy. A physician may be automatically alerted in response to a pulmonary function index value and/or a trend of the patient's pulmonary index being beyond a threshold. Computed pulmonary function index values and their associated patient's activity levels may be stored periodically in a memory and/or transmitted to a patient-external device.

Abstract: Various approaches to detecting arousals from sleep involve generating signals modulated by muscle tone, brainwave activity, and/or other nervous system activity associated with a patient's autonomic arousal response. Generating the signals and/or detecting autonomic arousals from sleep may be performed using an implantable device. Arousal information may be useful to identify sleep disorder events associated with arousals from sleep, for diagnostic purposes, and/or for therapy adjustment.

Abstract: This patent document discusses, among other things, systems, devices, and methods for enhancing detection of pulmonary edema using, in addition to thoracic impedance, one or a combination of: physiologic information about a subject, at least one statistical parameter, a user-programmable detection level, at least one parameter associated with a previous pulmonary edema event, and patient symptom information about the subject. In one example, a (base) thoracic impedance threshold is modified to an adjusted thoracic impedance threshold. The adjusted thoracic impedance threshold provides an increased sensitivity of pulmonary edema detection as compared to the base thoracic impedance threshold. In another example, an alert is provided to a subject, a caregiver, or other user based on a pulmonary edema indication determined by the present systems, devices, and methods. In a further example, a therapy (provided to the subject) is adjusted or initiated in response to the pulmonary edema indication.

Abstract: Vector selection is automatically achieved via a thoracic or intracardiac impedance signal collected in a cardiac function management device or other implantable medical device that includes a test mode and a diagnostic mode. During a test mode, the device cycles through various electrode configurations for collecting thoracic impedance data. At least one figure of merit is calculated from the impedance data for each such electrode configuration. In one example, only non-arrhythmic beats are used for computing the figure of merit. A particular electrode configuration is automatically selected using the figure of merit. During a diagnostic mode, the device collects impedance data using the selected electrode configuration. In one example, the figure of merit includes a ratio of a cardiac stroke amplitude and a respiration amplitude. Other examples of the figure of merit are also described.

Abstract: Methods and systems involve coordinating therapies used for treating disordered breathing. Disordered breathing therapies may include cardiac electrical stimulation therapy and external respiratory therapy as well as other therapies for treating disordered breathing in a patient. The therapies delivered to the patient may be coordinated to enhance effectiveness of the therapy, to reduce therapy interactions, to improve patient sleep, or to achieve other therapeutic goals.

Abstract: Cardiac monitoring and/or stimulation methods and systems employing dyspnea measurement. An implantable cardiac device may sense transthoracic impedance and determine a patient activity level. An index indicative of pulmonary function is implantably computed to detect an episode of dyspnea based on a change, trend, and/or value exceeding a threshold at a determined patient activity level. Trending one or more pulmonary function index values may be done to determine a patient's pulmonary function index profile, which may be used to adapt a cardiac therapy. A physician may be automatically alerted in response to a pulmonary function index value and/or a trend of the patient's pulmonary index being beyond a threshold. Computed pulmonary function index values and their associated patient's activity levels may be stored periodically in a memory and/or transmitted to a patient-external device.

Abstract: This patent document discusses, among other things, systems, devices, and methods for enhancing detection of pulmonary edema using, in addition to thoracic impedance, one or a combination of: physiologic information about a subject, at least one statistical parameter, a user-programmable detection level, at least one parameter associated with a previous pulmonary edema event, and patient symptom information about the subject. In one example, a (base) thoracic impedance threshold is modified to an adjusted thoracic impedance threshold. The adjusted thoracic impedance threshold provides an increased sensitivity of pulmonary edema detection as compared to the base thoracic impedance threshold. In another example, an alert is provided to a subject, a caregiver, or other user based on a pulmonary edema indication determined by the present systems, devices, and methods. In a further example, a therapy (provided to the subject) is adjusted or initiated in response to the pulmonary edema indication.

Abstract: Devices and methods for detecting disordered breathing involve determining that the patient is asleep and sensing one or more signals associated with disordered breathing indicative of sleep-disordered breathing while the patient is asleep. Sleep-disordered breathing is detected using the sensed signals associated with disordered breathing. The sensed signals associated with disordered breathing may also be used to acquire a respiration pattern of one or more respiration cycles. Characteristics of the respiration pattern are determined. The respiration pattern is classified as a disordered breathing episode based on the characteristics of the respiration pattern. One or more processes involved in the detection of disordered breathing are performed using an implantable device.

Abstract: Vector selection is automatically achieved via a thoracic or intracardiac impedance signal collected in a cardiac function management device or other implantable medical device that includes a test mode and a diagnostic mode. During a test mode, the device cycles through various electrode configurations for collecting thoracic impedance data. At least one figure of merit is calculated from the impedance data for each such electrode configuration. In one example, only non-arrhythmic beats are used for computing the figure of merit. A particular electrode configuration is automatically selected using the figure of merit. During a diagnostic mode, the device collects impedance data using the selected electrode configuration. In one example, the figure of merit includes a ratio of a cardiac stroke amplitude and a respiration amplitude. Other examples of the figure of merit are also described.

Abstract: Systems and methods involve automatic activation, de-activation or modification of therapies or other medical processes based on brain state. A medical system includes a sensor system having one or more sensors configured to sense signals related to the brain state of the patient. A brain state analyzer detects various brain states, including sleep stage and/or brain seizures. A controller uses the brain state detection information to control a medical system configured to perform at least one respiratory or cardiac process. Methods involve sensing signals related to brain state and determining the brain state of a patient based on the sensed signals. At least one respiratory or cardiac medical process is controlled based on the patient's brain state.

Abstract: An event-based approach to collecting and organizing information associated with events affecting respiration is presented. The detection or prediction of an event affecting the respiration of a patient initiates acquisition of information associated with the event. The respiratory logbook system acquires information associated with the event during the event and during intervals proximate in time to the event. The information is organized as a respiratory log entry. The user can access the information by operating a user interface. The information may be presented in textual or graphical form.

Abstract: A gas therapy system involves sensing the blood gas concentration of the patient and adapting a gas therapy based on the sensed gas concentration. Disordered breathing may be detected bases on blood gas concentration, and gas or cardiac electrical therapy may be adapted to treat the detected disordered breathing. One or more of sensing the blood gas concentration, detecting disordered breathing, or adapting the therapy may be performed at least in part implantably. The gas therapy is delivered to the patient through an external respiratory device, such as a positive airway pressure device.

Abstract: Methods and systems provide an approach to therapy control based on assessment of a patient's cardiopulmonary status. Conditions sensed via sensors of an external respiratory therapy device are used to assess a patient's cardiopulmonary status. The respiratory therapy device sensors may be utilized alone or in combination with other sensors to determine cardiopulmonary status of a patient. Therapy delivered to the patient is controlled based on the cardiopulmonary status assessment. For example, therapy delivered to the patient may be initiated, terminated, and/or modified based on the assessed cardiopulmonary status of the patient. Cardiopulmonary status assessment, therapy control, or both, are performed by an implantable device.

Abstract: A system includes an implantable medical device that includes a trans-thoracic impedance measurement circuit providing a trans-thoracic impedance signal of a subject. A controller is coupled to the trans-thoracic impedance circuit. The controller extracts a respiration signal from the trans-thoracic impedance signal, measures a breathing volume of the subject using the amplitude of the respiration signal and a breathing volume calibration factor, computes an adjusted breathing volume calibration factor using a reference baseline value of the trans-thoracic impedance and a measured baseline value of the trans-thoracic impedance, and computes a calibrated breathing volume using the adjusted breathing volume calibration factor.

Abstract: Methods and systems are directed to delivering cardiac pacing therapy to a patient. A pacing therapy associated with one or more pacing parameters is delivered. Alternate cardiac pacing therapies associated with one or more alternate pacing parameters are transitioned to, based on a sleep/wake cycle of the patient. Interactions between the pacing parameters of the pacing therapy and the alternate pacing parameters are resolved. Resolving pacing parameters may be based on analysis of lower rate limits and/or lower rate hysteresis, for example.

Abstract: Methods and systems involve coordinating therapies used for treating disordered breathing. Disordered breathing therapies may include cardiac electrical stimulation therapy and external respiratory therapy as well as other therapies for treating disordered breathing in a patient. The therapies delivered to the patient may be coordinated to enhance effectiveness of the therapy, to reduce therapy interactions, to improve patient sleep, or to achieve other therapeutic goals.