Abstract: This document discusses, among other things, systems and methods to generate a first pacing waveform during a first pacing period and a second pacing waveform during a second pacing period, and alternate the first and second pacing periods to provide pacing-based hypertension therapy to a heart of a patient to reduce patient blood pressure, wherein the first pacing waveform has a first atrioventricular (AV) delay and the second pacing waveform has a second AV delay longer than the first AV delay. Physiologic information can be received from the patient, and one of the first or second pacing period for delivery to the patient can be determined using the received physiologic information.

Abstract: This document discusses, among other things, systems and methods to generate a first pacing waveform during a first pacing period and a second pacing waveform during a second pacing period, to alternate first and second pacing periods to provide pacing-based hypertension therapy to a heart of a patient to reduce patient blood pressure, to receive information indicative of patient metabolic demand, and to determine an adjusted pacing-based hypertension therapy parameter using the received information indicative of patient metabolic demand, wherein the first pacing waveform has a first atrioventricular (AV) delay and the second pacing waveform has a second AV delay longer than the first AV delay.

Abstract: An implantable medical device (IMD) that includes a housing, a first electrode secured relative to the housing, a second electrode secured relative to the housing, and a gyroscope secured relative to the housing. The IMD may include circuitry in the housing in communication with the first electrode, the second electrode, and the gyroscope. The circuitry may be configured to determine and store a plurality of torsion data measurements, from which a representation of a twist profile may be determined.

Abstract: This document discusses, among other things, systems and methods to determine an indication of discharge readiness for a patient using received physiologic information of the patient corresponding to hospitalization of the patient and received physiologic information of the patient corresponding to a time after hospitalization.

Abstract: The technology herein relates to a troubleshooting system for remote patient monitoring. A plurality of triggering conditions defines a data transmission error between a sensor and a remote location. A data transmission log is configured to receive characterization data defining each successful data transmission between a communicator and the remote location. An input user interface is configured to receive input from a user and an output user interface is configured to provide notification to a user. Processing circuitry is in communication with the input interface and the output interface, where the processing circuitry is configured to compare each of the triggering conditions to the characterization data to identify a data transmission error. Upon identification of the data transmission error, the processing circuitry causes the output interface to present a query to the user.

Abstract: An example of a system for monitoring and treating respiratory distress in a patient may include one or more non-invasive monitoring devices to acquire patient condition signals and a respiratory distress monitoring circuit to monitor a state of the respiratory distress using the patient condition signals. The respiratory distress monitoring circuit may include a signal processing circuit to generate patient condition parameters using the patient condition signals and a respiratory distress analyzer, which may include a parameter analysis circuit and a notification circuit. The parameter analysis circuit may be configured to produce a patient condition metric being a function of the patient condition parameters and to perform prediction and/or detection of an exacerbation of the respiratory distress based on the patient condition metric. The notification circuit may be configured to produce an alert notifying a result of the performance of the prediction and/or detection.

Abstract: Systems and methods for monitoring patients for risk of worsening heart failure (WHF) are discussed. A patient management system includes a receiver to receive patient respiration measurement. A respiratory pattern analyzer circuit measures respiratory pattern indicative of rapid-shallow breathing pattern from the received respiration measurement, and determine a respiratory pattern variability indicator. A risk analyzer circuit determines patient WHF risk using the respiratory pattern variability indicator. The system may use the WHF risk to guide WHF event detection, or to deliver or adjust a heart failure therapy.

Abstract: An example of a system for monitoring and treating respiratory distress in a patient may include signal inputs, a signal processing circuit, and a respiratory distress analyzer. The signal inputs may be configured to receive patient condition signals indicative of autonomic balance of the patient. The signal processing circuit may be configured to process the patient condition signals and to generate patient condition parameters indicative of the autonomic balance using the processed patient condition signals. The respiratory distress analyzer may be configured to determine a state of the respiratory distress using the patient condition parameters, and may include a parameter analysis circuit configured to analyze the autonomic balance of the patient and to determine the state of the respiratory distress using an outcome of the analysis.

Abstract: Systems, devices, and methods for managing alerts associated with a target physiological event such as a worsening heart failure event are described. A system may detect one or more alert onsets using an onset threshold, and one or more corresponding alert terminations using a reset threshold. Alerts may be issued corresponding to the detected alert onsets and alert terminations. The system may compare the alerts to a specified alert characteristic, and iteratively adjust the onset or reset threshold until the alerts corresponding to the adjusted onset or reset threshold satisfy the specified alert characteristic. The adjusted onset and reset thresholds may be presented to a user or a process for detecting the target physiological event.

Abstract: Systems and methods for detecting a target cardiac condition such as events indicative of worsening heart failure are described. A system may include sensor circuits for sensing physiological signals and a signal processor for generating a predictor trend indicative of temporal change of the physiological signal. The predictor trend may be transformed into a sequence of transformed indices using a codebook that includes a plurality of threshold pairs each including onset and reset thresholds. The codebook may be constructed and updated using physiological data. The system may detect target cardiac condition using the transformed indices.

Abstract: A mobile device, having a processor, includes an accelerometer configured to generate acceleration data, the acceleration data including a plurality of acceleration measurements. The mobile device also includes a memory having embodied thereon computer-executable instructions that are configured to, when executed by the processor, cause the processor to: obtain the acceleration data from the accelerometer; and generate, based on the acceleration data, heart sound data, the heart sound data including data associated with one or more heart sounds.

Abstract: Systems and methods for treating a medical condition such as worsening heart failure (WHF) are described. A medical system may sense one or more physiological signals, and generate from the sensed physiological signals a signal metric trend indicating a progression of heart failure. A detector may detect a physiological event leading to WHF. A therapy control circuit may generate a therapy titration protocol using the generated signal metric trend. The therapy titration protocol includes a temporal profile of therapy dosage relative to a target dosage. The therapy control circuit may adjust the target dosage based on patient response. Therapies may be administered by a clinician or automatically delivered to the patient according to the therapy titration protocol.

Abstract: The technology disclosed herein relates to a system and method for analyzing medical device programming parameters. One aspect of the current technology is a method where an overall performance metric is detected for a cardiac medical device that is outside of a threshold at a first cardiac location in a patient. Processing circuitry identifies a first operating condition and sensing circuitry measures a first sensor response during the first operating condition. An adjustment is proposed to one or more programming parameters of the medical device based on the performance metric, the first operating condition, and the sensor response to the operating condition.

Abstract: Systems and methods for monitoring patients for risk of worsening heart failure (WHF) are discussed. A patient management system includes a sensor circuit to receive respiration measurements, and an input device to receive patient dyspnea descriptor indicating dyspnea symptom severity. The system includes a risk analyzer circuit to trend the respiration measurement over time, and to generate a WHF risk indicator using both the trended respiration measurement and the received dyspnea descriptor. A control circuit controls the receiver circuit to receive the dyspnea descriptor in response to the trended respiration measurement satisfying a specific condition. The system can present the WHF risk indicator to a user or a process, or deliver or adjust a HF therapy based on the WHF risk indicator.

Abstract: Systems and methods for managing machine-generated alerts of a medical event such as worsening heart failure (WHF) are described. A patient management system includes a patient database of information about a correspondence between a plurality of alert thresholds (ATHs) and corresponding clinical outcome indicators (COIs) for a plurality of patients. A control circuit can query the patient database for a matching patient that meets specific query criteria compared to a target patient, retrieve an ATH-COI correspondence associated with the matching patient, and determine the alert threshold using a user input of a COI and the retrieved ATH-COI correspondence. A medical event detector detects the medical event using physiological signals sensed from the target patient and the determined alert threshold.

Abstract: Systems and methods for managing machine-generated medical events detected from one or more patients are described herein. A medical event management system includes an event analyzer circuit to detect a medical event using physiological data from a patient-triggered episode acquired from a medical device. The event analyzer circuit determines a confidence score of the medical event detection, and generates an alignment indicator indicating a degree of concordance between the detected medical event and the information about the patient-triggered episode. The system assigns priority information to the patient-triggered episode using the generated alignment indicator and the confidence score of the detection. An output circuit can output the received physiological information to a user or a process according to the assigned priority information.

Abstract: IMD devices, systems, and treatment methods are discussed and disclosed. An IMD having electrodes for placement in an internal thoracic vein (ITV) of a patient may be employed to facilitate electrical impedance tomography (EIT) imaging. An alternating current (A/C) may be applied using the electrodes and impedances may be determined that are useful to produce a tomographic image.

Abstract: IMD devices, systems, and treatment methods are discussed and disclosed. An IMD having oscillatory sensors for placement in an internal thoracic vein (ITV) of a patient may be employed to detect activity of a body part, determining a status of the body part or patient more generally, and then monitor the status of the body part. Therapy decisions may rely on the status of the body part, and information related to such status may be communicated to an external device.

Abstract: Systems and methods for displaying medical or physiologic data are disclosed. The system can receive medical data such as a physiologic trend indicative of worsening of heart failure. The system can generate a graphical representation of the medical data in a two-dimensional or a higher-dimensional coordinate space. The graphical representation can include line segments indicating temporal variation of the medical data. The system can determine a desired range, including lower and upper bounds, for displaying the medical data using signal statistics and a correction factor, and specified number of tickmarks between the desired LB and UB. The desired lower and upper bounds can enhance visual perception of temporal variation of the medical data, and thus to facilitate data interpretation and clinical decision making. A display unit can display the graphical representation of the medical data within the desired lower and upper bounds.

Abstract: Systems, devices, or methods can be used to detect an event, or series of events, that can indicate worsening of congestive heart failure (CHF), or can be used to identify a subject at an elevated risk for developing CHF. A CHF event predictor can be provided using a characteristic minimum of subject cardiac intervals. In an example, the subject cardiac intervals can be obtained during a night-time period or during periods of reduced subject physical activity. A CHF event predictor can be determined using information about physiologic signals received from a subject, such as from a physiologic sensor associated with an ambulatory or implantable medical device.