Abstract: Systems and methods are disclosed to optimize resources of a medical device system, including to analyze physiologic information of a patient occurring over specific time periods relative to a prior heart failure event, to adjust, in response to a detected or received trigger event, a baseline value for the patient from a long-term baseline value to one of a shorter-term baseline value or a static value indicative of a baseline value at a prior time relative to the detected or received trigger event, to determine a readmission score for the patient based on the analyzed physiologic information, and to provide a control signal to control a mode or operation of the medical device system based on the readmission score to optimize resources of the medical device system.

Abstract: A medical device includes a processor, an acceleration sensor, and memory. The acceleration sensor is configured to generate acceleration data that comprises a plurality of acceleration measurements. The memory comprises instructions that when executed by the processor, cause the processor to: obtain the acceleration data from the acceleration sensor; and determine, based on the acceleration data, that the medical device has flipped.

Abstract: An ambulatory medical device includes a multi-axis posture sensor and processing circuitry. The multi-axis posture sensor is configured to provide an electrical posture sensor output representative of alignment of respective first, second, and third non-parallel axes of the ambulatory medical device with the gravitational field of the earth. The processing circuitry is configured to determine that the subject avoids lying on their left side using the posture sensor output, and compute a metric predictive of one or both of orthopnea and trepopnea in response to determining that the subject avoids lying on their left side.

Abstract: Systems and methods for monitoring and managing aortic stenosis are disclosed. An exemplary medical-device system comprises a data receiver to receive heart sound information sensed by ambulatory heart sound sensors, and a stenosis detector to detect a change in aortic valve surface area from a baseline stenosis-free state using heart sound components such as S1 and S2 sounds. Based on the change in aortic valve surface area, the stenosis detector can generate an aortic stenosis indicator indicating a presence and severity of aortic stenosis. Such indicator can be provided to a user, trigger symptom monitoring and evaluation of functional deterioration in the patient, facilitate assessment of patient candidacy for aortic valve replacement, or triage heart failure management strategies.

Abstract: Embodiments herein relate to body vibration analysis systems and methods. In an embodiment, a body vibration analysis system is included having a first light source configured to illuminate a surface of the body from a first angle with a first set of lighted features and a second light source configured to illuminate a surface of the body from a second angle with a second set of lighted features, wherein the second set of lighted features are optically distinguishable from the first set of lighted features. The system further includes a camera configured to detect light reflected from the surface of the body and a control circuit configured to receive an input from the camera and assess spatial vibration as a function of location on the surface of the body. Other embodiments are also included herein.

Abstract: Embodiments herein relate to systems for tracking and maintaining the integrity of patient device data over extended periods of time. In a first aspect, a medical device system is included having an implantable device that can include a control circuit, a communication circuit, and one or more sensors. The system can also include an external device including a control circuit and a communication circuit. The external device can be configured to receive patient data from the implantable device and execute a hashing operation on units of received patient device data and one or more previous digest packets to create new digest packets. The external device can be configured to store the new digest packets and forward digest packets onto another device of the medical device system when requested to allow patient data to be authenticated. Other embodiments are also included herein.

Abstract: Systems and methods for monitoring heart failure status in a patient are discussed. A medical-device system receives physiological and clinical information of the patient, and classifies the patient into one of a plurality of phenotypes using the received information. The plurality of phenotypes each can be characterized by a cluster physiological, clinical, demographic, or comorbidity features in a multi-dimensional feature space. Based on the classified phenotype, a heart failure detector determines a heart failure detection setting for the patient, and detects a heart failure status in the patient using the heart failure detection setting. A therapy circuit can deliver or adjust a heart failure therapy in response to the detected heart failure status.

Abstract: Systems and methods for detecting and managing heart failure are discussed. A medical-device system receives heart sound information sensed from the patient, generates a heart sound metric using the received heart sound information, and generate a heart failure indicator indicating whether the patient has a heart failure with preserved ejection fraction (HFpEF) or a heart failure with reduced ejection fraction (HFrEF) based at least in part on the heart sound metric. The medical-device system can detect a transition from HFpEF to HFrEF. A therapy circuit can deliver or adjust a heart failure therapy in response to the detected transition from HFpEF to HFrEF.

Abstract: Systems and methods for monitoring heart failure status in a patient are discussed. A medical-device system includes a storage device to store a correspondence between one or more heart failure comorbidities and corresponding one or more heart failure detection settings, and a heart failure detector circuit to detect a heart failure status of the patient. The heart failure detector circuit receives physiological information and heart failure comorbidity information of the patient, determines a detection setting for the patient based on the received comorbidity information and the stored correspondence, and detect a heart failure status using the received physiological information and the identified detection setting. A therapy circuit can deliver or adjust a heart failure therapy in response to the detected heart failure status.

Abstract: Systems and methods for detecting a blockage in a patient's cardiac conduction system using heart sound information is disclosed. An exemplary medical-device system includes a data receiver circuit to receive heart sound information sensed from a patient, and a controller circuit to generate a heart sound metric or characteristic from the received heart sound information. The heart sound metric can include one indicative of a presence or absence of split S1 sound. The controller circuit can detect a bundle branch block (BBB), including to discriminate a left bundle branch block (LBBB) from a right bundle branch block (RBBB), based at least in part on the heart sound metric. The BBB indicator can be provided to a user or a process executable by the medical-device system to optimize cardiac pacing and restore cardiac synchrony.

Abstract: Systems and methods for recognizing and classifying breathing patterns based on spatial analysis of chest wall or abdominal movement or acceleration are described. A medical-device system comprises a receiver circuit to receive respiration information of a patient, and a breath analyzer circuit to determine from the respiration information two or more spatial respiration components, such as accelerations of chest wall or abdominal movement in respective directions along the anatomical axes. The breath analyzer circuit can classify a breathing pattern as one of either chest breathing or diaphragmatic breathing based on the determined spatial respiration components. The classified breathing pattern can be used for detecting a physiological event such as worsening heart failure or for assessing the patient's risk of having metabolic disorders.

Abstract: Systems and methods for recognizing and tracking heart sound components are disclosed. An exemplary medical-device system comprises a data receiver circuit to receive heart sound information, and a heart sound recognition circuit to generate a representative heart sound segment within a cardiac cycle, such as an ensemble average of a plurality of heart sound segments taken from multiple cardiac cycles. The heart sound recognition circuit can partition the representative heart sound segment into multiple heart sound data windows, calculate spectral entropy values respectively for each of the multiple heart sound data windows, and determine one or more heart sound components including an S2 component using the calculated spectral entropy values. A physiologic event detector can detect a cardiac event using the recognized one or more heart sound components.

Abstract: Systems and methods are disclosed to determine a syncope metric for a patient as a function of cardiac acceleration information and the blood pressure information received from a signal receiver circuit and to determine an indication of a worsening risk of syncope or a syncope event for a patient using the determined syncope metric, wherein the determined indication of worsening risk of syncope or the syncope event can be provided to a user or a process.

Abstract: Systems and methods are disclosed to determine a P wave window for a patient using cardiac acceleration information of the patient, including a determined time of an S4 heart sound. Correlations between an S4 template and cardiac acceleration information in an S4 window having a duration longer than the S4 template can be determined. An S4 centroid can be determined as a peak of the determined multiple correlations, and the P wave window can be determined using the determined S4 centroid and an electromechanics delay.

Abstract: Systems and methods are disclosed to determine an indication of one of an atrial fibrillation S4 heart sound or a non-atrial fibrillation S4 heart sound for an S4 signal portion of cardiac acceleration information of a patient based on determined first and second correlations of a morphology of the S4 signal portion to atrial-fibrillation and non-atrial fibrillation S4 templates, respectively, and to determine an atrial fibrillation event of the patient using cardiac electrical information of the patient and the determined indication for the S4 signal portion.

Abstract: Systems, devices, and methods for monitoring and assessing blood glucose level in a patient are discussed. An exemplary system receives physiologic information from a patient using an ambulatory medical device. The physiologic information is correlated to, and different from, a direct glucose level measurement. The system determines a glucose index indicative of an abnormal blood glucose level using the received physiologic information by the two or more physiologic sensors. The system may use the glucose index to initiate or adjust a therapy, or to trigger a glucose sensor, separate from the two or more physiologic sensors, to directly measure blood glucose concentration.

Abstract: A medical device includes a processor, an acceleration sensor, and memory. The acceleration sensor is configured to generate acceleration data that comprises a plurality of acceleration measurements. The memory comprises instructions that when executed by the processor, cause the processor to: obtain the acceleration data from the acceleration sensor; and determine, based on the acceleration data, that the medical device has flipped.

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 detecting heart sound information from a subject's head are described. A system embodiment includes a headgear to be worn on the subject's head, and first and second sensors to sense respectively first and second physiologic signals each representing vibration, motion, or displacement conducted through patient body tissue. The sensed physiologic signals contain heart sound information. At least one of the first or the second sensor is included in the headgear, and placed at a head location to sense a physiologic signal indicative of heart sounds. The system includes a processor to generate a composite signal using the sensed first and second physiologic signals. The system may generate a heart sound metric using the composite signal, and detect a cardiac event such as an arrhythmia or worsening heart failure.

Abstract: A system and method for communication between an IMD and an external reader includes bringing a portion of a patient's body into contact with a device-body contact surface of an external reader. The reader transmits a first transdermal carrier wave from the contact surface into the patient's body, where the first carrier wave includes a request for communication with the IMD. The transdermal carrier waves are electrical conductive waves, optical waves, or acoustic waves. Upon detection of the first carrier wave, the IMD transmits a second transdermal carrier wave including a request for an access key from the reader and the reader replies by transmitting a third transdermal carrier wave including the access key back to the IMD. If the access key is valid, the IMD transmits information by radio frequency (RF) in an RF communication mode or a fourth transdermal carrier wave including data from the IMD.