Abstract: Systems and methods for rhythm discrimination using the motion of an implantable lead are described. In an example, an implantable medical device can include a receiver circuit configured to be electrically coupled to an implantable lead and be configured to obtain information indicative of a movement of the implantable lead due at least in part to a motion of a heart. The device can include an arrhythmia detection circuit configured to determine an arrhythmia status using the information indicative of the movement of the implantable lead and an arrhythmia classification circuit configured to determine one or more of a location or a type of an arrhythmia, using the information indicative of the movement of the implantable lead, when the arrhythmia status indicates that an arrhythmia is occurring or has occurred.

Abstract: This document discusses, among other things, systems and methods for predicting heart failure decompensation using within-patient diagnostics. A method comprises detecting an alert status of each of one or more sensors; calculating an alert score by combining the detected alerts; and calculating a composite alert score, the composite alert score being indicative of a physiological condition and comprising a combination of two or more alert scores.

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: A system comprises a risk analysis module and a worsening heart failure (WHF) detection module. The risk analysis module measures at least one first physiological parameter of a subject using a physiological sensor of an ambulatory medical device, and determines a heart failure (HF) risk score for the subject according to the at least one measured first physiological parameter. The HF risk score indicates susceptibility of the subject to experiencing a HF event. The WHF detection module measures at least one second physiological parameter of the subject using the same or different physiological sensor, and generates an indication of prediction that the subject will experience a WHF event when the at least one second physiological parameter satisfies a WHF detection algorithm. The risk analysis module adjusts generation of the indication by the WHF detection algorithm according to the determined HF risk score.

Abstract: Estimating a frequency of a sampled cardiac rhythm signal and classifying the rhythm. The received signal is sampled and transformed into a curvature series. A lobe in the curvature series corresponds to a characteristic point in the sampled series. Characteristic points are selected based on a time of a lobe in the curvature series and, in one embodiment, an amplitude of the signal at the time of the lobe. A frequency of the sampled series is estimated by autocorrelating a function of the series of the characteristic points. In one embodiment, the function is a time difference function. The rhythm is classified by plotting the timewise proximity of characteristic points derived from an atrial signal with characteristic points derived from a ventricular signal. Regions of the plot are associated with a particular rhythm and the grouping of the data corresponds to the classification.

Abstract: A system and method for narrowcasting text messages to a plurality of cellular phones. The system and method allow a potential user to opt in to receive the text messages the user wants to receive. The potential user can opt in through a computer network based web page. Once the potential user sends a sign up request application to participate via the computer network, the user will receive a first text message containing an authorization code on their cell phone. The user enters the authorization code into the web page and sends the authorization code. Receipt of the authorization code back through the computer network will trigger the phone number of the potential user to be added to a list of authorized text message receivers. A narrowcaster then instructs the central computer to narrowcast text messages to the phone numbers on the list that have indicated they want to receive messages on a certain topic.

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: This document discusses, among other things, a system and method for remote monitoring of patient cognitive function using implanted cardiac rhythm management (CRM) devices and a patient management system. The method comprising: presenting a cognitive test to a patient via a user interface; receiving a result of the cognitive test using the user interface; and using the result of the cognitive test in determining a heart failure condition status.

Abstract: An apparatus and method for adjusting the performance of an implanted device based on data including contextual information. Contextual information, including operational and performance data concerning the implanted device as well as the patient with the implanted device, is stored by a portable electronic device. In one embodiment, the portable electronic device is adapted for battery operation and includes a personal digital assistant (PDA). The portable electronic device is adapted for use as an interface to conduct wireless communications with the implanted device. In one embodiment, the portable electronic device interfaces with a clinical programmer for use by a physician.

Abstract: A system comprises an implantable medical device (MID) including an implantableimplantabie heart sound sensor circuit configured to produce an electrical heart sound signal representative of a heart sound of a subject and a processor circuit. The processor circuit is coupled to the heart sound sensor circuit and includes a detection circuit, a heart sound feature circuit and a trending circuit. The detection circuit configured to detect a physiologic perturbation and the heart sound feature circuit is configured to identify a heart sound feature in the electrical signal. The processor circuit is configured to trigger the heart sound feature circuit in relation to a detected physiologic perturbation. The trending circuit is configured to trend the heart sound feature in relation to a recurrence of the physiologic perturbation. The processor circuit is configured to declare a change in a physiologic condition of the patient according to the trending.

Abstract: Advanced patient management systems include a unit for collecting data from a device associated with a patient, and a host in communication with the unit, the host identifying a time for the device to update data on the device. The system can identify a time for the device to update data associated with the device by developing a histogram of the availability of the device for interrogation. The system can also optimize processing loads for the system by developing a histogram of the time at which the caregiver is most likely to access the system to review the collected and processed data. Methods for optimizing device data update and processing times are also included.

Abstract: This document discusses, among other things, systems and methods for predicting heart failure decompensation using within-patient diagnostics. A method comprises detecting an alert status of each of one or more sensors; calculating an alert score by combining the detected alerts; and calculating a composite alert score, the composite alert score being indicative of a physiological condition and comprising a combination of two or more alert scores.

Abstract: For a sampled signal, storing characteristic points generated based on parameters corresponding to curvature of the signal. The characteristic points include a time of occurrence of a lobe in a curvature series based on the signal and a corresponding amplitude of the signal. The characteristic points provide a compressed version of the sampled signal. The signal is reconstructed by establishing a function between a chronological sequence of characteristic points. For a repetitive signal, the stored data includes a code to indicate a time of reoccurrence of a previous cycle or data corresponding to differences between a previous cycle and a current cycle.

Abstract: Systems and methods for sleep state classification involve detecting conditions related to sleep, including at least one condition associated with rapid eye movement (REM) sleep. Additionally, a condition modulated by the sleep-wake status of the patient may be detected. A medical system that is partially or fully implantable incorporates sensors and circuitry for detecting and processing the sleep-related signals. A sleep state processor classifies the patient's sleep state based on the sleep-related signals. Sleep state classification may be used in connection with the delivery of sleep state appropriate therapy, diagnostic testing, or patient monitoring.

Abstract: Described herein are methods and devices that utilize electrical neural stimulation to treat heart failure by modulating a patient's autonomic balance in a manner that inhibits sympathetic activity and/or augments parasympathetic activity. Because other therapies for treating heart failure may also affect a patient's autonomic balance, a device for delivering neural stimulation is configured to appropriately titrate such therapy in either an open-loop or closed-loop fashion.

Abstract: Systems and methods to indicate heart failure co-morbidity are described. In an example, one or more physiological signals can be analyzed for a specified time period to determine at least one of an indication of a heart failure event or a characteristic of heart failure co-morbidity, such as a characteristic of a non-heart failure physiological event. At least one of the different physiological signals can be compared to a specified criterion indicative of the heart failure event to provide a comparison value, where the comparison value is indicative of whether the at least one of the different physiological signals contributed towards the indication of the heart failure event. An indication of a non-heart failure physiological event can be determined using the heart failure event indication, the non-heart failure physiological event characteristic, and the comparison value indicative of whether the one or more physiological signals contributed towards the heart failure event.

Abstract: Systems and methods to monitor an improvement of a subject's physiological condition using a goal improvement profile are described. In an example, a physiological condition of a subject can be compared to a goal improvement profile, where the profile includes at least one target condition indicative of an improved physiological condition detectable using a physiological sensor signal, and a target time when the subject is expected to reach the target condition, where the comparison can be used to indicate whether the subject has met the target condition by the target time.

Abstract: A patient management system is described that includes an implantable device for collecting one or more physiological parameter values and associated timestamps indicating the time at which the value is collected. The system is then configured to determine the periodic variation, if any, of a particular physiological parameter and use that periodicity in assessing changes in the parameter values over time.

Abstract: This document discusses, among other things, systems and methods for predicting heart failure decompensation using within-patient diagnostics. A method comprises detecting an alert status of each of one or more sensors; calculating an alert score by combining the detected alerts; and calculating a composite alert score, the composite alert score being indicative of a physiological condition and comprising a combination of two or more alert scores.

Abstract: This document discusses, among other things, a system comprising an implantable medical device (IMD) including an implantable heart sound sensor circuit configured to produce an electrical heart sound signal representative of a heart sound of a subject and a processor circuit. The processor circuit is coupled to the heart sound sensor circuit and includes a detection circuit, a heart sound feature circuit and a trending circuit. The detection circuit configured to detect a physiologic perturbation and the heart sound feature circuit is configured to identify a heart sound feature in the electrical signal. The processor circuit is configured to trigger the heart sound feature circuit in relation to a detected physiologic perturbation. The trending circuit is configured to trend the heart sound feature in relation to a recurrence of the physiologic perturbation. The processor circuit is configured to declare a change in a physiologic condition of the patient according to the trending.