Abstract: Methods, systems, and apparatuses are provided for detecting fall events of a person. Fall events are falls that are likely to occur, are occurring, or have occurred. Fall detectors and fall detector systems detect fall events of the person. Data relating to the person are received from sensors and analyzed to perform fall detection. Data relating to the person includes accelerations and forces experience by the person, changes in body position of the person, movements of the person, and body signals and sounds of the person. Neurological tests are administered to determine levels of responsiveness and awareness of the person in response to detections. Warnings are issued, and safety measures are deployed, in response to detections. Data relating to fall events are recorded and logged. Fall event histories based upon the logged data and fall detection algorithm performance are used to improve future fall detection and prediction.

Abstract: Automated pre-implant screening for candidate recipients of implantable medical devices. A set of cutaneous electrodes placed on a patient transcutaneously capture a cardiac signal using a screening device coupled to the electrodes. A first beat rate may be determined by identifying individual R-waves, QRS complexes or cardiac cycles from the captured cardiac signal using the cutaneous electrodes. A second beat rate may be calculated using one of several different methods, for example, by optical measurement, by monitoring heart sounds, by a second electric cardiac signal analysis, or by using an implanted device. The rates are compared to one another and, if a match is identified, the patient is deemed well suited to receive a particular device.

Abstract: Systems and methods for evaluating electrograms are described. An example method of evaluating an electrogram such as an atrial and/or ventricular electrogram containing a plurality of data samples each having a voltage includes selecting an activity interval for the electrogram, calculating an energy level for each window of a plurality of windows of the electrogram based on the voltages of the data samples in each window, assigning the calculated energy levels to a plurality of bins, and calculating an index based at least in part on a number of energy levels assigned to a particular bin of the plurality of bins.

Abstract: The present invention relates, generally, to scientific and medical system methods for diagnosis of implantable cardioverter defibrillator (ICD) lead conductor anomalies, in particular conductor migration and externalization within an ICD implantable cardiac lead. The method uses an “imaginary” component of the high frequency transmission line impedance having certain spectral changes that correspond to movements of the conductor or an “imaginary impedance”. This allows the detection of conductor migration and small insulation failures.

Abstract: An ECG monitoring system for ambulatory patients includes a disposable multi-electrode patch that adhesively attaches to the chest of a patient. A reusable battery-powered ECG monitor clips onto the patch and receives patient electrical signals from the electrodes of the patch. A processor continuously processes received ECG signals and stores the signals in memory in the monitor. The processor also analyzes the received ECG signals for predefined arrhythmia. If an arrhythmia is detected, a bi-directional wireless transceiver in the ECG monitor transmits the event information and an ECG strip to a cellphone handset. The cellphone handset automatically relays the event information and ECG strip to a monitoring center for further diagnosis and necessary intervention.

Abstract: Techniques develop models for classification for physical conditions of a subject based on monitored physiologic signal data. The models for classification are determined from data transformed and feature extracted using a Taut-string transformation and in some instances using a further Stockwell-transformation, applied in parallel or in series. Physical conditions, specifying the state of hemodynamic stability and reflective of the cardiovascular and nervous systems, are thus modeled using these techniques.

Abstract: Techniques for evaluating cardiac electrical dyssynchrony are described. In some examples, an activation time is determined for each of a plurality of torso-surface potential signals. The dispersion or sequence of these activation times may be analyzed or presented to provide variety of indications of the electrical dyssynchrony of the heart of the patient. In some examples, the locations of the electrodes of the set of electrodes, and thus the locations at which the torso-surface potential signals were sensed, may be projected on the surface of a model torso that includes a model heart. The inverse problem of electrocardiography may be solved to determine electrical activation times for regions of the model heart based on the torso-surface potential signals sensed from the patient.

Abstract: There is provided an information processing apparatus, including a display control section which determines which display layers out of a plurality of mutually overlapping display layers information is to be displayed on based on parameters associated with the information.

Abstract: A computer-implemented method for processing ECG data may include: receiving ECG data representing a plurality of heartbeats; analyzing the ECG data to determine whether each of the plurality of heartbeats is a normal heartbeat or an abnormal heartbeat; associating each of the abnormal heartbeats with an existing template or a new template; receiving input related to each new template, wherein the input includes either: a) a confirmation that the new template represents an abnormal heartbeat, or b) a reclassification of the new template as representing a normal heartbeat or a different abnormal heartbeat; and in response to the user input, updating a label of each of the heartbeats associated with each confirmed new template and each of the heartbeats associated with each reclassified new template.

Abstract: The present invention provides for a computer system including at least one server having software stored on a non-transient computer readable medium; where, upon execution of the software, the at least one server is at least configured to: i) receiving physiological data representative of a first physiological measurement of at least one physiological characteristic of an epileptic user; ii) receiving physiological data representative of a second physiological measurement of at least one physiological characteristic of the epileptic user; iii) comparing the first physiological measurement of the epileptic user to the second physiological measurement of the epileptic user; iv) based on the comparing, determining that a difference between the first physiological measurement of the epileptic user and the second physiological measurement is: a) higher than a predetermined threshold value, or b) smaller than the predetermined threshold value; and v) generating at least one alert; vi) transmitting the at least one

Abstract: Physiological monitoring can be provided through a lightweight wearable monitor that includes two components, a flexible extended wear electrode patch and a reusable monitor recorder that removably snaps into a receptacle on the electrode patch. The wearable monitor sits centrally (in the midline) on the patient's chest along the sternum oriented top-to-bottom. The placement of the wearable monitor in a location at the sternal midline, with its unique narrow “hourglass”-like shape, significantly improves the ability of the wearable monitor to cutaneously sense cardiac electrical potential signals, particularly the P-wave and, to a lesser extent, the QRS interval signals indicating ventricular activity in the ECG waveforms. Additionally, the monitor recorder includes an ECG sensing circuit that measures raw cutaneous electrical signals and performs signal processing prior to outputting the processed signals for sampling and storage.

Abstract: A method for displaying electroanatomical information is provided. The method comprises identifying at least one multiple-activation area of a surface of a heart, at which multiple-activation area were recorded at least two different local activations during a single cardiac cycle of the heart. The multiple-activation area is displayed, on an electroanatomical map of the surface of the heart, in a manner that indicates a time difference between respective times of the two local activations. Other embodiments are also described.

Abstract: A method includes obtaining an electrical signal that includes a set of at least two sensed physiologic measurements of a patient, comparing the at least two physiologic measurements with a predetermined physiologic measurement range, identifying data required to determine a probability and a severity of a condition of interest of the patient, in response to determining the at least two physiologic measurements do not satisfy the physiologic measurement range, receiving the identified data in electronic format, determining a first probability and a first severity of the condition of interest based on the received identified data, determining a recommended course of action for the patient based on the first probability and the first severity, resources of a healthcare facility, and an event guideline; and causing a display to visually present the first probability and first severity and the recommended course of action.

Abstract: A medical monitoring system includes one or more processors (23) configured to receive (84) monitored physiological measures (16) and corresponding one or more alarm occurrences for a patient (10) and an adjustable alarm setting (56). The one or more processors are further configured to configure (86) a display (28) of at least one monitored physiological measure (76) and a retrospective graphical illustration of the physiological measure (30) including illustrations of the one or more occurrences of alarms (32) corresponding to the adjustable alarm setting (56).

Abstract: Individuals who suffer from certain kinds of medical conditions, particularly conditions that only sporadically exhibit measurable symptoms, can feel helpless in their attempts to secure access to medical care because, at least in part, they are left to the mercy of their condition to present symptoms at the right time to allow diagnosis and treatment. Providing these individuals with ambulatory extended-wear health monitors that record ECG and physiology, preferably available over-the-counter and without health insurance preauthorization, is a first step towards addressing their needs. In addition, these individuals need a way to gain entry into the health care system once a medically-actionable medical condition has been identified. Here, the ECG and physiology is downloaded and evaluated post-monitoring against medical diagnostic criteria.

Abstract: An ambulatory medical device including a plurality of electrodes configured to be disposed at spaced apart positions about a patient's body, an electrode signal acquisition circuit, and a monitoring circuit. The acquisition circuit has a plurality of inputs each electrically coupled to a respective electrode of the plurality of electrodes and is configured to sense a respective signal provided by a plurality of different pairings of the plurality of electrodes. The monitoring circuit is electrically coupled to an output of the acquisition circuit and is configured to analyze the respective signal provided by each of the plurality of different pairings and to instruct the acquisition circuit to select at least one of the plurality of different pairings to monitor based on at least one of the quality of the respective signal, a phase difference between the respective signal and that of other pairings, a position of electrodes relative to the patient's body, and other criteria.

Abstract: Systems, methods, and interfaces are described herein for identification of effective electrodes to be used in sensing and/or therapy. Two or more portions of a signal monitored using an electrode may be compared to determine whether the electrode is effective. The two or more portions may correspond to the same portion or window of a cardiac cycle. Further, signals from a first electrode and from a second electrode located proximate the first electrode may be compared to determine whether one or both of the electrodes are effective.

Abstract: Systems, methods, and interfaces are described herein for identification of effective electrodes to be used in sensing and/or therapy. Two or more portions of a signal monitored using an electrode may be compared to determine whether the electrode is effective. The two or more portions may correspond to the same portion or window of a cardiac cycle. Further, signals from a first electrode and from a second electrode located proximate the first electrode may be compared to determine whether one or both of the electrodes are effective.

Abstract: The invention provides a neck-worn sensor that is a single, body-worn system that measures the following parameters from an ambulatory patient: heart rate, pulse rate, pulse oximetry, respiratory rate, temperature, thoracic fluid levels, stroke volume, cardiac output, and a parameter sensitive to blood pressure called pulse transit time. From stroke volume, a first algorithm employing a linear model can estimate the patient's pulse pressure. And from pulse pressure and pulse transit time, a second algorithm, also employing a linear algorithm, can estimate systolic blood pressure and diastolic blood pressure. Thus, the sensor can measure all five vital signs along with hemodynamic parameters. It also includes a motion-detecting accelerometer, from which it can determine motion-related parameters such as posture, degree of motion, activity level, respiratory-induced heaving of the chest, and falls.

Abstract: A method may include storing electrical measurement data and geometry. One or more boundary conditions can be determined based on supplemental information associated with at least one selected location associated an anatomic envelope within a patient's body. Reconstructed electrical activity can be computed for a plurality of locations residing on the anatomic envelope within the patient's body based on the electrical data and the geometry data, the least one boundary condition being imposed to improve the computing.

Abstract: The present invention relates to a method for assessing the electrical function of a heart, comprising the steps of: (1) for each of a plurality of leads of an ECG, determining a value derived from the output of that lead and which corresponds to an action potential duration; (2) for each of the plurality of leads of the ECG, determining a value derived from the output of that lead and which corresponds to a diastolic interval; (3) for each of the plurality of leads of the ECG, determining a relationship between the determined values for action potential duration and for diastolic interval; (3) assessing the differences between the determined relationships for each of the plurality of leads. The invention further relates to apparatus and a computer program that may be used in the method.

Abstract: The present disclosure includes a medical monitoring hub as the center of monitoring for a monitored patient. The hub includes configurable medical ports and serial ports for communicating with other medical devices in the patient's proximity. Moreover, the hub communicates with a portable patient monitor. The monitor, when docked with the hub provides display graphics different from when undocked, the display graphics including anatomical information. The hub assembles the often vast amount of electronic medical data, associates it with the monitored patient, and in some embodiments, communicates the data to the patient's medical records.

Abstract: Example electronic devices, including but not limited to implantable medical devices, and methods employing dynamic announcing for creation of wireless communication connections are disclosed herein. In an example, an electronic device includes a wireless communication interface to transmit announcement signals for creating a wireless communication connection with the external device. The electronic device also includes a sensor to detect a characteristic of an environment external to the electronic device, and a control circuit including an announcement timing control module to dynamically control timing of the announcement signals based on the detected characteristic.

Abstract: In embodiments, a wearable cardiac defibrillator system includes an energy storage module configured to store a charge. Two electrodes can be configured to be applied to respective locations of a patient. One or more reservoirs can store one or more conductive fluids. Respective fluid deploying mechanisms can be configured to cause the fluids to be released from one or more of the reservoirs, which decreases the impedance at the patient location, and decreases discomfort for the patient. In some embodiments an impedance is sensed between the two electrodes, and the stored charge is delivered when the sensed impedance meets a discharge condition. In some embodiments, different fluids are released for different patient treatments. In some embodiments, fluid release is controlled to be in at least two doses, with an intervening pause.

Abstract: This disclosure relates to bioelectric signal detecting circuits, lead wire detecting circuits and medical devices. The lead wire detecting circuit may include a reference voltage generator, at least one comparator, and a logic control module, wherein input ends of the comparator are connected to an output end of the reference voltage generator and an signal output end of a lead wire, respectively, for inputting a reference voltage and a lead signal, and the comparator compares the lead signal with the reference voltage and changes an output voltage at an output end of the comparator according to a comparison result; wherein an input end of the logic control module is connected to the output end of the comparator, and the logic control module determines whether the lead wire is in a connected state or disconnected state by the output voltage at the output end of the comparator.

Abstract: A method and system are provided for analyzing data for a region of interest in connection with cardiac mapping. The method and system acquire data recordings of at least one of electrical sensor measurements from an electrical sensor and motion data from a motion sensor in contact with the region of interest, determine cycle lengths associated with cardiac events in the data recordings; and identify a reference cycle length from the cycle lengths determined. The method and system analyze the cycle lengths such that differences in heart rate and cycle length have limited effect on an overall map.

Abstract: A visualization apparatus includes a storage unit and a computation unit. The storage unit stores a three-dimensional model of a heart, excitation propagation data indicating temporal variations of electrical signal strength in myocardium during propagation of excitation in the heart, and infarct area data indicating locations of infarct areas in the heart. The computation unit places a measurement point on an accessory pathway between the infarct areas. Then based on the excitation propagation data, the computation unit determines a variation range of electrical signal strength as a range between its minimum and maximum values at the measurement point. The computation unit outputs a picture that visualizes propagation of cardiac excitation in the three-dimensional model, based on the excitation propagation data, by varying a visual property in the picture to represent variations of the electric signal strength within the determined variation range.

Abstract: A method of directing positioning of ECG electrodes on a patient includes receiving at a processor an image of the patient with one or more electrodes and determining with the processor an actual location of each of the electrodes on the patient based on the image. The method further includes determining with the processor whether the actual location of each of the electrodes is correct and providing information via a user interface regarding the actual location of the electrodes.

Abstract: A device 1 is described for analyzing electrocardiogram data. The device comprises processing means for comparing at least one parameter, indicative of a morphological feature comprising a multi-dimensional ST segment feature, derived from a temporal sequence of electrocardiogram data to a previously determined distribution of the at least one parameter. Based on the comparison, a signal representative of a risk of a myocardial infarction occurring in the body of the user is provided. A corresponding method and device are also described. The electrocardiogram data comprises a bipolar measurement between a chest electrode point and the right upper extremity, a bipolar measurement between the left crista iliaca and the right upper extremity and a bipolar measurement between the left and the right upper extremity.

Abstract: Systems and methods provide automatic messaging to a client on behalf of a healthcare treatment professional by setting up one or more computer implemented agents, each specializing in a disease state, with rules to respond to a client condition; during run-time, receiving a communication from the client and in response selecting one or more computer implemented agents to respond to the communication; and automatically generating a response to be rendered on a client mobile device to encourage healthy behavior.

Abstract: A wearable device is provided having multiple sensors configured to detect and measure different parameters of interest. The wearable device includes at least one monolithic integrated multi-sensor (MIMS) device. The MIMS device comprises at least two sensors of different types formed on a common semiconductor substrate. For example, the MIMS device can comprise an indirect sensor and a direct sensor. The wearable device couples a first parameter to be measured directly to the direct sensor. Conversely, the wearable device can couple a second parameter to be measured to the indirect sensor indirectly. Other sensors can be added to the wearable device by stacking a sensor to the MIMS device or to another substrate coupled to the MIMS device.

Abstract: A new apparatus, algorithm, and method are introduced herein to support navigation and placement of an intravascular catheter using the electrical conduction system of the heart (ECSH) and control electrodes placed on the patient's skin.

Abstract: A system comprises a plurality of sensors, a sensor processor, and a sampling rate engine. The sensor processor is coupled to an output of each sensor of the plurality of sensors. The sensor processor estimates user dynamics in response to a first output signal of a first sensor of the plurality of sensors. The sampling rate engine is coupled to an output of the sensor processor./ The sampling rate engine determines a sampling rate value of a second sensor of the plurality of sensors in response to a user dynamics value from the sensor processor. The second sensor comprises a selectable sampling rate. The selectable sampling rate is configured in response to the sampling rate value determined by the sampling rate engine.

Abstract: Methods and devices providing multiple criteria for use in arrhythmia identification. Based on inputs including defined rules or parameters, one of a more conservative or more aggressive set of arrhythmia identification parameters can be selected. One or the other of the selectable sets of arrhythmia identification parameters may also be adaptive or modifiable during the use of the system, for example, in response to identified nonsustained episodes, the more conservative set of arrhythmia identification parameters can be modified to become still more conservative. Such modification of arrhythmia identification criteria allows reduced time to therapy when indicated, while allowing more deliberate decisions in other circumstances.

Abstract: A defibrillator system employs an external ECG monitor (40) and a defibrillator (20). In operation, external ECG monitor (40) generates a synchronized cardioversion input signal as one of an external ECG waveform (50) of a heart (11) of a patient (10) or an external synchronized pulse (51) indicative of a detection by the external ECG monitor (40) of at least one QRS complex of the external ECG waveform (50). Defibrillator (40) includes a synchronized cardioversion input channel (29) for receiving the synchronized cardioversion input signal from external ECG monitor (40), and controls a conditional delivery of a defibrillation shock synchronized with the synchronized cardioversion input signal to the patient (10) in response to the defibrillator (20) receiving the synchronized cardioversion input signal. One condition for shock delivery is a measured time delay between an internal ECG waveform (30) and the synchronized cardioversion input signal being less than a baseline time delay.

Abstract: A heart beat detection device comprises at least one optical reflection sensor to be positioned on the skin of a person. The sensor unit is provided with a light emitter and a corresponding light receiver which converts the light reflected by the skin into an electric signal and comprises electrically adjustable opt cal filters connected to the emitter, to the receiver or to both of them in order to select, upon operation, a desired light wavelength and perform processing of the signals thus obtained in order to reinforce the heart beat signal. A system with this device and a detection method are also described.

Abstract: A method for characterizing an electrocardiogram, including receiving a first unipolar signal from a first location of a heart and a second unipolar signal from a second location of the heart. The method further includes generating a bipolar signal from the first and second unipolar signals, and analyzing the bipolar signal to delineate a time period during which the first and second locations generate a bipolar complex. The method also includes analyzing the first unipolar signal within the time period to determine an activation time of the first location.

Abstract: Autonomic nervous system control via high frequency spinal cord modulation, and associated systems and methods. A method for treating a patient in accordance with a particular embodiment includes selecting a neural modulation site to include a neural population of the patient's spinal cord, and selecting parameters of a neural modulation signal to at least reduce an autonomic system deficit in the patient.

Abstract: A wearable defibrillator system includes a support structure with one or more electrodes in an unbiased state. A monitoring device monitors, for the long term, a parameter of the person that is not the person's ECG; rather, the monitored parameter can be the person's motion, a physiological parameter, or both. When a value of the monitored parameter reaches a threshold, such as when the person is having an actionable episode, the electrode becomes mechanically biased against the person's body, for making good electrical contact. Then, if necessary, the person can be given electrical therapy, such as defibrillation. As such, the electrodes of the wearable defibrillator system can be worn loosely for the long term, without making good electrical contact. This can reduce the person's aversion to wearing the defibrillation system.

Abstract: The invention relates to a method and apparatus for diagnosis of conductor anomalies, such as insulation failures, in an implantable medical device, such as an implantable cardioverter defibrillator (ICD), a pacemaker, or a neurostimulator. Insulation failures are detected and localized by identifying changes in electrical fields via surface (skin) potentials. Small variations in potential are detected along the course of the electrode near the site of insulation failure.

Abstract: A system may include a port, at least one sensing circuit, and at least one processor. The port is configured to receive an indication of dosing of medication to treat a pulmonary condition of a heart failure (HF) subject and the at least one sensing circuit configured to sense at least one physiological signal, wherein the physiological signal includes physiological information of the HF subject. The at least one processor includes a parameter module configured to extract values of at least one physiological parameter indicative of health status of the HF subject, and a trending module configured to trend extracted values of the at least one physiological parameter and detect an effect of the dosing of the medication on the HF subject using the trending of the extracted values of the at least one physiological parameter.

Abstract: A method and medical device for detecting a cardiac event that includes sensing cardiac signals from a plurality of electrodes forming a first sensing vector sensing a first interval of the cardiac signal during a predetermined time period and a second sensing vector simultaneously sensing a second interval of the cardiac signal during the predetermined time period, identifying each of the first interval and the second interval as being one of shockable and not shockable in response to first processing of the first interval and the second interval and in response to second processing of one or both of the first interval and the second interval, the second processing being different from the first processing, and determining whether to deliver therapy for the cardiac event in response to identifying each of the first interval and the second interval as being one of shockable and not shockable in response to both the first processing and the second processing of the first interval and the second interval.

Abstract: A system and method are provided for determining electrophysiological data. The system comprises an electronic control unit that is configured to receive electrical signals from a set of electrodes, receive position and orientation data for the set of electrodes from a mapping system, compensate for position and orientation artifacts of the set of electrodes, compose cliques of a subset of neighboring electrodes in the set of electrodes, determine catheter orientation independent information of a target tissue, and output the orientation independent information to a display.

Abstract: The disclosure herein provides cardiac monitoring and diagnostic system, methods, and devices. A cardiac diagnostic system for detecting potential indicators of cardiac disease comprises: a cardiac monitoring device comprising at least one electrode configured to detect an analog electrical cardiac signal of a user; a cardiac signal filter configured to convert the analog electrical cardiac signal to digital electrocardiogram data; an atypical cardiac sequence detector configured to detect atypical cardiac patterns in the electrocardiogram data that are potentially indicative of cardiac disease; and a notification transmitter configured to generate an alert when a detected atypical cardiac pattern is determined to be indicative of cardiac disease.

Abstract: Individuals who suffer from certain kinds of medical conditions, particularly conditions that only sporadically exhibit measurable symptoms, can feel helpless in their attempts to secure access to medical care because, at least in part, they are left to the mercy of their condition to present symptoms at the right time to allow diagnosis and treatment. Providing these individuals with ambulatory extended-wear health monitors that record ECG and physiology, preferably available over-the-counter and without health insurance preauthorization, is a first step towards addressing their needs. In addition, these individuals need a way to gain entry into the health care system once a medically-actionable medical condition has been identified. Here, the ECG and physiology is downloaded and evaluated post-monitoring against medical diagnostic criteria.

Abstract: An example of a system for pacing through multiple electrodes in a ventricle includes a sensing circuit to sense cardiac signal(s), a pacing output circuit to deliver pacing pulses, a heart sound sensor to sense a heart sound signal, and a control circuit to control the delivery of the pacing pulses. The control circuit includes a heart sound detector to detect heart sounds using the heart sound signal, an electrical event detector to detect cardiac electrical events using the cardiac signal(s), a measurement module to measure an optimization parameter using the detected heart sounds, and an optimization module to approximately optimize one or more pacing parameters using the measured optimization parameter. The one or more pacing parameters include an electrode configuration parameter specifying one or more electrodes selected from the multiple electrodes in the ventricle for delivering ventricular pacing pulses to that ventricle.

Abstract: A cluster database includes existing ECG datasets organized into clusters, wherein each existing ECG dataset includes an existing ECG waveform with at least one corresponding existing feature and existing interpretation. Each cluster is comprised of existing ECG datasets having a common existing feature. The cluster training module is executable by the processor to receive a new ECG waveform and a feature extracted from the new ECG waveform. The cluster training module then selects a cluster interpretation module based on the feature, wherein the cluster interpretation module is trained on one of the clusters from the cluster database. The cluster training module processes the new ECG waveform and/or the feature to provide a cluster interpretation output. The cluster interpretation output is then displayed on the user interface, and the cluster training module receives clinician input via the user interface accepting or rejecting the cluster interpretation output.

Abstract: A resuscitation system for use by a rescuer for resuscitating a patient, comprising at least two high-voltage defibrillation electrodes, a first electrical unit comprising circuitry for providing resuscitation prompts to the rescuer, a second electrical unit separate from the first unit and comprising circuitry for providing defibrillation pulses to the electrodes, and circuitry for providing at least one electrical connection between the first and second units.

Abstract: A system, method and device are described for detecting a heart rate. A sensing unit can have a skin-facing surface that is removably securable to a user's skin surface and include at least one sensor positioned to acquire a bio-signal from the skin surface. A controller can be configured to capture a bio-signal stream using the at least one sensor and generate a preprocessed bio-signal stream by band-pass filtering the captured bio-signal stream with a predetermined passband. The controller can also be configured to determine, in a moving window, heartbeat signal portions when the preprocessed bio-signal stream has heartbeat impulse characteristics and determine the time between adjacent heartbeat signal portions to compute the heart rate.

Abstract: A medical device includes a VNS pulse burst generator for stimulation of the vagus nerve, and a controller for analyzing the cardiac rhythm. It further includes a sequencer that uses an estimator to calculate during a given cycle an estimate of the temporal position of the R wave of the next cycle. The controller is configured to define the moment of application of the VNS pulse burst as an instant corresponding to the estimate minus a predetermined advance delay. VNS therapy is thus delivered in a non-vulnerable period, near the end of the period of natural ventricular escape.