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: A tachyarrhythmia detection and classification system classifies tachyarrhythmias based on an analysis of morphological features of a cardiac signal enhanced by using one or more physiological parameters indicative of hemodynamic stability and/or activity level. The tachyarrhythmia detection and classification system computes a measure of similarity between an arrhythmic waveform of the cardiac signal a template waveform for that cardiac signal, such as a correlation coefficient representative of the correlation between morphological features of the arrhythmic waveform and morphological features of the template waveform. A detected tachyarrhythmia episode is classified by comparing the measure of similarity to a threshold that is dynamically adjusted using the one or more physiological parameters.

Abstract: A tachyarrhythmia detection and classification system classifies tachyarrhythmias based on an analysis of morphological features of a cardiac signal enhanced by using one or more physiological parameters indicative of hemodynamic stability and/or activity level. The tachyarrhythmia detection and classification system computes a measure of similarity between an arrhythmic waveform of the cardiac signal a template waveform for that cardiac signal, such as a correlation coefficient representative of the correlation between morphological features of the arrhythmic waveform and morphological features of the template waveform. A detected tachyarrhythmia episode is classified by comparing the measure of similarity to a threshold that is dynamically adjusted using the one or more physiological parameters.

Abstract: Cardioprotective pre-excitation pacing may be applied to stress or de-stress a particular myocardial region delivering of pacing pulses in a manner that causes a dyssynchronous contraction. Such dyssynchronous contractions are responsible for the desired cardioprotective effects of pre-excitation pacing but may also be hazardous. Described herein is a method and system that uses measures of ventricular dyssynchrony or a patient's physiological response to ventricular dyssynchrony to control the delivery of cardioprotective pre-excitation pacing in closed-loop fashion.

Abstract: This document discusses, among other things, systems and methods for measuring patient compliance. A method comprises detecting or receiving one or more first indications of a first action, the first action being consciously initiated by a patient in response to a request or instruction; and analyzing the first indications to calculate a first surrogate measurement of patient compliance that represents the patient's ability to follow the request or instruction.

Abstract: This document discusses, among other things, systems and methods for using one or more inter-relations between within-patient detection methods and between-patient stratifier methods. A method comprises obtaining results of a first physiological assessment, wherein the first physiological assessment includes a between-patient assessment; and using the results to adjust one or more parameters of a second physiological assessment, wherein the second physiological assessment includes a within-patient assessment.

Abstract: This document discusses, among other things, systems and methods for using between-patient comparisons for risk stratification of future heart failure decompensation. A method comprises receiving patient data of a current patient, the patient data collected by a patient monitoring device; determining a reference group related to the patient; determining a reference group dataset selected from the reference group, wherein the dataset includes patient data that is of a similar type received from the patient monitoring device; generating a model of the reference group dataset; and automatically comparing the received physiological data to a model to derive an index for the patient.

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, systems and methods to enable physician labels on a remote server and use labels to verify and improve algorithm results. A method comprises using patient data in an automated analysis to obtain a result; receiving a message from the user, wherein the message is related to the result; and using at least a portion of the message to automatically modify the analysis.

Abstract: An implantable cardiac function management device including a programmable controller can be used to include a user-specifiable therapy control parameter set. The therapy control parameter set may then be configured to include at least one therapy control parameter that is user-configurable to automatically switch from a first parameter value to a second parameter value at a time that occurs between separate user programming sessions of the device. Various attributes of physiological measures may allow for refinement of the parameter sets to adapt to changed conditions of the subject. Methods of use are also presented.

Abstract: Methods and systems for arranging and labeling cardiac episodes based on acquired cardiac episode data are described. Cardiac episodes are algorithmically arranged based on one or more discriminating features of the episode data. A user is presented with at least one episode selected from the arrangement of cardiac episodes. The user inputs a label that characterizes the selected episode. The label is algorithmically appended to the data of the selected episode and to other episodes of the arrangement of cardiac episodes based on the discriminating features.

Abstract: An implantable cardiac device is configured to classify cardiac arrhythmias using a plurality of arrhythmia discrimination algorithms. Data is provided that is associated with a plurality of cardiac arrhythmic episodes for which a cardiac electrical therapy was delivered or withheld by the implantable medical device based on the plurality of arrhythmia discrimination algorithms. A metric for each of the arrhythmic episodes is computed. The metric defines a measure by which the implantable cardiac device properly classified the arrhythmia. Potentially misclassified arrhythmic episodes of the plurality of cardiac arrhythmic episodes for which cardiac electrical therapy was inappropriately delivered or withheld are algorithmically identified using the metric.

Abstract: A cardiac rhythm management (CRM) system delivers anti-tachyarrhythmia therapies and uses patient-specific and/or tachyarrhythmia event-specific information to automatically set and adjust one or more arrhythmia detection durations. In one embodiment, the CRM system initializes and updates the one or more arrhythmia detection durations using patient-specific information such as medical history and recent medical trends. In another embodiment, the CRM dynamically adjusts the one or more arrhythmia detection durations using the patient's hemodynamic performance. One example of such an arrhythmia detection duration is a sustained rate duration (SRD) that starts when a tachyarrhythmia such as a supraventricular tachyarrhythmia is detected. An anti-tachyarrhythmia therapy is delivered only if the tachyarrhythmia sustains throughout the SRD.

Abstract: This document discusses, among other things, methods and systems for facilitating automated device programming at changeout. A method comprises receiving, from a first device, physiological data at a temporary storage device; and processing the received physiological data, wherein the processing includes determining if a first signal processing function was used by the first device and substantially offsetting the first signal processing function if the first signal processing function was used by the first device; and processing the resultant physiological data to be compatible with a second device. The method further comprising providing the processed resultant physiological data to the second device.

Abstract: Cardiac treatment methods and devices providing templates representative of past tachyarrhythmia events, each template associated with a therapy. A cardiac waveform is detected, and if it corresponds to a particular template associated with a previous therapy that was satisfactory in terminating a past event, the previous therapy is delivered again. If unsatisfactory, the previous therapy is eliminated as an option. If, for example, the previous therapy was an antitachycardia pacing therapy unsatisfactory in terminating the past tachyarrhythmia event, delivery of the antitachycardia pacing therapy is eliminated as an option. Instead of ATP therapy, one or more of a cardioversion, defibrillation, or alternate anti-tachycardia pacing therapy may be associated with the particular template.

Abstract: This document discusses, among other things, a method of identifying a non-fatal tachyarrhythmia episode by determining a degree of similarity between the episode and a template generated from a previous tachyarrhythmia episode.

Abstract: A tachyarrhythmia detection and classification system classifies tachyarrhythmias based on an analysis of morphological features of a cardiac signal enhanced by using one or more physiological parameters indicative of hemodynamic stability and/or activity level. The tachyarrhythmia detection and classification system computes a measure of similarity between an arrhythmic waveform of the cardiac signal a template waveform for that cardiac signal, such as a correlation coefficient representative of the correlation between morphological features of the arrhythmic waveform and morphological features of the template waveform. A detected tachyarrhythmia episode is classified by comparing the measure of similarity to a threshold that is dynamically adjusted using the one or more physiological parameters.

Abstract: Cardiac arrhythmias are classified based on the morphology of the arrhythmia episode beats. Templates are formed using morphological features of the cardiac beats of the episode. The arrhythmia episode is classified as a monomorphic tachyarrhythmia or polymorphic tachyarrhythmia based on the one or more templates. The arrhythmia episode may be classified based on a number templates formed from the arrhythmia episode. The templates are formed by determining a measure of similarity between morphological features of a cardiac beat to a template. The similarities can be determined based on a pairing rule that determines which beat morphologies are compared. Selection of therapy for treating the arrhythmia episode may depend on the historical success of a therapy at mitigating previous arrhythmias of the same type as the arrhythmia episode.

Abstract: Cardiac systems and methods provide for discriminating between supraventricular tachyarrhythmia and ventricular tachyarrhythmia based on a determination that the patient's supraventricular rhythm exhibits rate dependency. One approach involves determining if a patient's supraventricular rhythm exhibits rate dependent morphology. If the patient's supraventricular rhythm is determined to exhibit rate dependent morphology, an implantable device classifies a detected tachyarrhythmia episode based on one or more templates selected from a plurality of rate-indexed templates stored in the device. Determining if the supraventricular rhythm exhibits rate dependent morphology may also include determining one or more rates at which the rate dependent morphology occurs.

Abstract: This document discusses, among other things, a method of identifying a non-fatal tachyarrhythmia episode by determining a degree of similarity between the episode and a template generated from a previous tachyarrhythmia episode.