Abstract: A system receives signals indicative of cardiopulmonary conditions sensed by a plurality of sensors and provides for monitoring and automated differential diagnosis of the cardiopulmonary conditions based on the signals. Cardiogenic pulmonary edema is detected based on one or more signals sensed by implantable sensors. If the cardiogenic pulmonary edema is not detected, obstructive pulmonary disease and restrictive pulmonary disease are each detected based on a forced vital capacity (FVC) parameter and a forced expiratory volume (FEV) parameter measured from a respiratory signal sensed by an implantable or non-implantable sensor. In one embodiment, an implantable medical device senses signals indicative of the cardiopulmonary conditions, and an external system detects the cardiopulmonary conditions based on these signals by executing an automatic detection algorithm.

Abstract: A plurality of chronic sensors are used to facilitate diagnosis and medical decision making for an individual patient. An expert system evaluates the sensor data, combines the sensor data with stored probability data and provides an output signal for notification or medical intervention.

Abstract: A system for detecting stenosis in a patient. The system includes an implantable sensing unit having a turbulence sensor and a communication device for transmitting a signal from the turbulence sensor. The system also includes a cardiac sensor for generating a signal corresponding to cardiac activity and a processing device configured to receive signals from the sensing unit and from the cardiac sensor. The processing device is configured to determine a time window corresponding to cardiac activity, to determine a turbulence level from the turbulence signal within the time window, and to detect the presence of stenosis from the turbulence level.

Abstract: Cardiac systems and methods using ECG and blood information for arrhythmia detection and discrimination. Detection circuitry is configured to produce an ECG. An implantable blood sensor configured to produce a blood sensor signal is coupled to a processor. The processor is coupled to the detection and energy delivery circuitry, and used to evaluate and treat cardiac rhythms using both the cardiac electrophysiologic and blood sensor signals. The blood sensor is configured for subcutaneous non-intrathoracic placement and provided in or on the housing, on a lead coupled to the housing, and/or separate to the housing and coupled to the processor via hardwire or wireless link. The blood sensor may be configured for optical sensing, using a blood oxygen saturation sensor or pulse oximeter. A cardiac rhythm may be evaluated using the electrocardiogram signal and the blood sensor signal, and tachyarrhythmias may be treated after confirmation using the blood sense signal.

Abstract: An external data processing device to interface with an ambulatory repeater and method thereof is presented. An external data processing device is interfaced in far field telemetric communication with an ambulatory repeater. The external data processing device receives sensitive information preencrypted prior to implant under a cryptographic key uniquely assigned to an implantable medical device over a secure connection from the ambulatory repeater. Physiological measures retrieved from the implantable medical device by the ambulatory repeater are received by the external data processing device over a non-secure connection.

Abstract: Various embodiments provide an implantable medical device comprising a detector, a neural stimulator, and a controller. The detector is configured to detect a pathological condition indicated for an acute neural stimulation therapy. The neural stimulator is capable of delivering a chronic neural stimulation therapy and the acute neural stimulation therapy. The controller is configured to control the neural stimulator to provide the chronic neural stimulation therapy, receive an indicator from the detector that the pathological condition is detected, and control the neural stimulator to integrate the acute neural stimulation therapy with the chronic neural stimulation therapy in response to the indicator.

Abstract: An ambulatory repeater for use in automated patient care is presented. A local memory store includes a cryptographic key, sensitive information, and physiological measures. The cryptographic key is uniquely assigned to the implantable medical device prior to implant of the implantable medical device into a patient. The sensitive information is preencrypted under the cryptographic key and physiological measures are measured by the implantable medical device. An authentication module is in receipt of the cryptographic key. A permissions module confirms authorization of an external data processing device against the cryptographic key. A decryption module decrypts the sensitive information with the cryptographic key into decrypted information. A processor is operatively coupled to the local memory store. A communications module exchanges the decrypted information and the physiological measures with the external data processing device over a wireless interface contingent upon the authorization confirmation.

Abstract: Cardiac systems and methods using ECG and blood information for arrhythmia detection and discrimination. Detection circuitry is configured to produce an ECG. An implantable blood sensor configured to produce a blood sensor signal is coupled to a processor. The processor is coupled to the detection and energy delivery circuitry, and used to evaluate and treat cardiac rhythms using both the cardiac electrophysiologic and blood sensor signals. The blood sensor is configured for subcutaneous non-intrathoracic placement and provided in or on the housing, on a lead coupled to the housing, and/or separate to the housing and coupled to the processor via hardwire or wireless link. The blood sensor may be configured for optical sensing, using a blood oxygen saturation sensor or pulse oximeter. A cardiac rhythm may be evaluated using the electrocardiogram signal and the blood sensor signal, and tachyarrhythmias may be treated after confirmation using the blood sense signal.

Abstract: Various system embodiments comprise a stimulator adapted to deliver a stimulation signal for a heart failure therapy, a number of sensors adapted to provide at least a first measurement of a heart failure status and a second measurement of the heart failure status, and a controller. The controller is connected to the stimulator and to the number of sensors. The controller is adapted to use the first and second measurements to create a heart failure status index, and control the stimulator to modulate the signal using the index. Other aspects and embodiments are provided herein.

Abstract: An ambulatory repeater for use in automated patient care and method thereof is presented. At least one sensor is communicatively interfaced to measure and collect patient health information on an ad hoc basis. A cryptographic key is uniquely assigned to an implantable medical device. Authorization to access patient health information stored on the implantable medical device is authenticated using an ambulatory repeater. The ambulatory repeater is interfaced to the at least one sensor and implantable medical device through wireless telemetry and interfaced to an external data processing device through wireless communications. The patient health information is exchanged with the at least one sensor, implantable medical device and external data processing device via the ambulatory repeater.

Abstract: A cardiac rhythm management system provides for assessment of cardiac mechanical dyssynchrony based on heart sound morphology and optimization of pacing parameters based on the effect of pacing on the cardiac mechanical dyssynchrony assessment. A degree of cardiac mechanical dyssynchrony is measured by the time delay between tricuspid valve closure and mitral valve closure and/or the time delay between pulmonary valve closure and aortic valve closure. A cardiac resynchronization therapy is optimized by determining therapy parameters to provide an approximately minimum degree of cardiac mechanical dyssynchrony by cardiac pacing.

Abstract: A cardiac device is described with the capability of detecting cardiac ischemia using multiple sensing modalities. The device may be configured to modify its behavior in delivering therapies to treat bradycardia or tachyarrhythmias in response to detection of cardiac ischemia.

Abstract: A cardiac monitoring and/or stimulation method and systems provide monitoring, defibrillation and/or pacing therapies, including systems detecting and/or treating cardiac arrhythmia. A system includes a housing coupled to a plurality of electrodes configured for subcutaneous non-intrathoracic sensing. A signal processor receives a plurality of composite signals associated with a plurality of sources, separates a signal from the plurality of composite signals using blind source separation, and identifies a cardiac signal. The signal processor may iteratively separate signals from the plurality of composite signals until the cardiac signal is identified. A method of signal separation includes detecting a plurality of composite signals at a plurality of locations, separating a signal using blind source separation, and identifying a cardiac signal. The separation may include a principal component analysis and/or an independent component analysis.

Abstract: Implantable medical devices and techniques are implemented that use bio-impedance to measure aspects of patient physiology. A signal separation method is performed at least in part in an implantable device. The method involves detecting a plurality of impedance signals using a plurality of implantable electrodes coupled to the implantable device. The method further involves separating one or more signals from the plurality of impedance signals using a signal separation technique, such as an algorithm-based separation technique.

Abstract: Systems, devices and methods provide for evaluation of heart failure symptoms. Sensor data associated with one or more symptoms of heart failure are acquired and trended. Statistical features, such as slope, are extracted from the data trend in a moving window and are used to develop a cumulative sum. The cumulative sum is compared to a threshold value or V-mask to detect a shift in cumulative sum indicating changes in heart failure symptoms. A shift beyond the threshold value may trigger an alert or implementation of therapy.

Abstract: An evaluation of heart failure status is provided based on a disordered breathing index. Patient respiration is sensed and a respiration signal is generated. Disordered breathing episodes are detected based on the respiration signal. A disordered breathing index is determined based on the disordered breathing episodes. The disordered breathing index is trended and used to evaluate heart failure status. The disordered breathing index may be combined with additional information and/or may take into account patient activity, posture, sleep stage, or other patient information.

Abstract: A patient management system includes a device, an interactive display, a repeater unit, and a host. The device assesses at least one dietary condition of a patient. The interactive display receives patient input related to the patient's dietary conditions and communicates dietary feedback to the patient. The system may also include at least one sensor configured to assess at least one dietary condition of the patient. The repeater unit collects information from the device, the interactive display and the sensors. The host communicates with the repeater through a network. The patient's own input of dietary information into the system can be useful for verifying sources of measured data and enhancing feedback given to the patient. The system is configured to perform accurately even in the absence of patient input or the input of incorrect information by the patient.

Abstract: A cardiac rhythm management system provides for assessment of cardiac mechanical dyssynchrony based on heart sound morphology and optimization of pacing parameters based on the effect of pacing on the cardiac mechanical dyssynchrony assessment. A degree of cardiac mechanical dyssynchrony is measured by the time delay between tricuspid valve closure and mitral valve closure and/or the time delay between pulmonary valve closure and aortic valve closure. A cardiac resynchronization therapy is optimized by determining therapy parameters to provide an approximately minimum degree of cardiac mechanical dyssynchrony by cardiac pacing.

Abstract: Systems and methods involve use of a medical device comprising sensing circuitry. One or more respiratory parameters are detected using the device. Patient baseline weight is provided, and an output signal indicative of a patient's congestive heart failure status is generated based on a change in the one or more respiratory parameters and a change in the patient's measured weight or predicted weight relative to the patient baseline weight. The respiratory parameters may include one or more of respiration rate, relative tidal volume, an index indicative of rapid shallow breathing by the patient, an index derived by computing a respiration rate and a tidal volume for each patient breath, and an index indicative of dyspnea, for example.

Abstract: Systems and methods provide for assessing a patient's hemodynamic response to a drug therapy. A patient's hemodynamic response to a drug therapy is monitored using sensor data acquired using one or more sensors. The patient's hemodynamic response to the drug therapy is quantified, such as by quantifying a patient's sensitivity or refractoriness to the drug therapy. The quantified data may be used to optimize a patient's drug therapy, among other uses.