Abstract: Methods for automatically determining whether a patient monitor alarm will sound from a true or false signal, in particular from ventricular tachycardia (VT) and suppressing false alarms without eliminating any true alarms are presented. A multiresolution wavelet is extracted from a raw ECG waveform. Features are then extracted from the wavelets that account for summary statistics, noise, areas under the curve and summary statistics of the KL-divergence of the power spectra density between every two ECG leads. A classifier can be then be trained and its performance measured.

Abstract: An extra-cardiovascular implantable cardioverter defibrillator (ICD) is configured to induce a tachyarrhythmia by charging a high voltage capacitor to a voltage amplitude and delivering a series of pulses to a patient's heart by discharging the capacitor via an extra-cardiovascular electrode vector. Delivering the series of pulses includes recharging the high-voltage capacitor during an inter-pulse interval between consecutive pulses of the series of pulses.

Abstract: An automated external defibrillator includes a first pad at least partially colored in a first color, a second pad at least partially colored in a second color, and a main unit to which the first pad and the second pad are connected. The main unit has a first guidance surface that indicates how to attach of the first pad and the second pad. The first guidance surface has a first marker in the first color at a position corresponding to an attachment position of the first pad and a second marker in the second color at a position corresponding to an attachment position of the second pad.

Abstract: A method and medical device for generating a template that includes sensing a cardiac signal from a plurality of electrodes, determining a plurality of beats in response to the sensed cardiac signal, determining whether to store a beat of the plurality of beats in a subgroup of a plurality of subgroups for storing beats, determining whether a number of beats stored in one of the plurality of subgroups exceeds a subgroup threshold, and generating a template in response to beats stored in the one of the plurality of subgroups that exceeds the subgroup threshold.

Abstract: The present disclosure provides systems and methods for classifying signals of interest in a cardiac rhythm management (CRM) device. A CRM device includes an intrinsic activation sensing circuit configured to pass signals falling within a first passband, a crosstalk sensing circuit configured to pass signals falling within a second passband, wherein the second passband contains higher frequencies than the first passband, and a computing device communicatively coupled to the intrinsic activation sensing circuit and the crosstalk sensing circuit, the computing device configured to classify a signal of interest as one of an intrinsic activation signal and a crosstalk signal based on whether the signal of interest is passed by the intrinsic activation sensing circuit and the crosstalk sensing circuit.

Abstract: An extra-cardiovascular implantable cardioverter defibrillator (ICD) is configured to induce a tachyarrhythmia by charging a high voltage capacitor to a voltage amplitude and delivering a series of pulses to a patient's heart by discharging the capacitor via an extra-cardiovascular electrode vector. Delivering the series of pulses includes recharging the high-voltage capacitor during an inter-pulse interval between consecutive pulses of the series of pulses.

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: According to various method embodiments, a person is indicated for a therapy to treat a cardiovascular disease, and the therapy is delivered to the person to treat the cardiovascular disease. Delivering the therapy includes delivering a vagal stimulation therapy (VST) to a vagus nerve of the person at a therapeutically-effective intensity for the cardiovascular disease that is below an upper boundary at which upper boundary the VST would lower an intrinsic heart rate during the VST.

Abstract: The device includes a cardiac therapy circuit with a first terminal, and a peripheral therapy circuit with a second terminal. These terminals can either receive a cardiac detection/stimulation lead or a peripheral detection/stimulation lead of an organ. The device is configured to recognize the leads and automatically configure the connection terminals according to the type of lead received by the terminal. This includes discrimination methods for identifying the terminal on which a cardiac signal is detected, and selectively activating the cardiac therapy circuit and the peripheral therapy circuit based on the detection of the cardiac signal on a lead.

Abstract: An implantable medical device includes a low-power circuit, a high-power circuit, and a dual-cell power source. The power source is coupled to a dual-transformer such that each cell is connected to only one of the transformers. Each transformer includes multiple windings and each of the windings is coupled to a capacitor, and the capacitors are all connected in a series configuration. The low power circuit is coupled to the power source and issues a control signal to control the delivery of charge from the power source to the plurality of capacitors through the first and second transformers.

Abstract: A diagnostic ECG system analyzes lead traces for evidence of ST elevation in the lead signals. The pattern of ST elevation in leads having predetermined vantage points to the electrical activity of the heart and, in some instances, the presence of ST depression in certain other leads, identifies a specific coronary artery or branch as the culprit coronary artery for an acute ischemic event. ECG measurements which are associated with the identity of specific arterial occlusion locations are calculated and used to form a classifier of the probability of occlusion at different locations. The location identified as having the highest probability is indicated to a user as the most likely occlusion location.

Abstract: A method and system of driving an LED load. A driver is configured to deliver a level of current indicated by a control signal to the LED load when a PWM signal is ON and stop delivering the level of current when the PWM signal is OFF. An output capacitance element is coupled across a differential output of the LED driver. A feedback path, having a store circuit, is configured to store an information indicative of a first voltage level across the output capacitance element as a stored feedback reference signal just after the PWM signal is turned OFF. The feedback path causes the voltage across the output capacitance element to be at the first voltage level just before the PWM signal is turned ON.

Abstract: In a subcutaneous implantable cardioverter/defibrillator, cardiac arrhythmias are detected to determine necessary therapeutic action. Cardiac signal information is sensed from far field electrodes implanted in a patient. The sensed cardiac signal information is then amplified and filtered. Parameters such as rate, QRS pulse width, cardiac QRS slew rate, amplitude and stability measures of these parameters from the filtered cardiac signal information are measured, processed and integrated to determine if the cardioverter/defibrillator needs to initiate therapeutic action.

Abstract: A out-of-hospital cardiac treatment apparatus, comprising: a cardiac waveform monitor capable of sensing a physiological signal from a heart of a patient and wirelessly transmitting the sensed physiological signal to a remote medical provider, an electrical stimulator adapted to deliver a therapeutic dose of electrical energy to the heart of the patient, a medical provider transceiver adapted to receive the sensed physiological signal from the cardiac waveform monitor and also wirelessly transmit a command signal to control the electrical stimulator.

Abstract: An electrical living body stimulation signal waveform generation device includes a waveform generation unit that generates a low-frequency pulse signal wave and a high-frequency signal wave individually, and a waveform synthesis circuit that superimposes the high-frequency signal wave on the low-frequency pulse signal wave during an ON period of the low-frequency pulse signal wave to form a synthesized wave having a waveform in which a level gradually rises from a point of time when the superimposition is started and the ON period and an OFF period are continuously repeated, wherein the synthesized wave is given as an electrical stimulus to a living body.

Abstract: A technology to grasp a state of a human being more accurately is provided. The technology is provided with means for acquiring a time-series waveform of a frequency from a time-series waveform of a biological signal sampled from the upper body of a human being and for further acquiring a time-series waveform of frequency slope and a time-series waveform of frequency fluctuation and for applying frequency analysis to them. In the frequency analysis, a power spectrum of each frequency corresponding to a functional adjustment signal, a fatigue reception signal, and an activity adjustment signal, respectively, determined in advance is acquired. Then, a state of a human being is determined from a time-series change of each power spectrum.

Abstract: A transthoracic defibrillator for external defibrillation comprises at least three electrodes configured to be attached to the thorax of a patient to establish at least two electrical paths across the thoracic cavity and through the heart of the patient. In addition, a defibrillator circuit contained in a defibrillator housing has the capability to deliver a different defibrillation waveform across each of the at least two electrical paths.

Abstract: At least two energy storage devices are used to realize biphasic defibrillation therapy. One of the energy storage devices is the primary energy storage device and the other (e.g. second) energy storage device is the auxiliary energy storage device. The first energy storage device is used to implement both the first and second phase pulses of biphasic pulse therapy to the patient, and the second energy storage device can be used to assist in the first and/or second phase pulse. In other words, the second energy storage device may be combined with the first energy storage device to discharge electricity to the patient to realize the first and/or second phase pulse.

Abstract: Methods and systems are disclosed for producing a plurality of archetype signals in wavelet space at a plurality of wavelet scales. A signal is transformed using a continuous wavelet transform based at least in part on a wavelet function. A scale dependent archetype transformed signal is computed based at least in part on the transformed signal and based at least in part on a natural periodicity of the wavelet function used to transform the signal. Information may be derived about the signal from the archetype transform signal, and stored in memory.

Abstract: A wearable device and method of monitoring the condition of a patient. The wearable device includes at least one sensor and at least one processor operatively connected to the at least one sensor. The wearable device also includes an operator interface device operatively connected to the at least one processor. The at least one processor causes the device to allow for customization of at least one output message to be delivered via the operator interface device.

Abstract: An electrode assembly includes a first surface to be placed adjacent a person's skin and a second surface including a plurality of reservoirs of conductive gel. The plurality of reservoirs of conductive gel are disposed on sections of the electrode assembly that are at least partially physically separated and may move at least partially independently of one another to conform to contours of a body of a patient. The electrode assembly is configured to dispense an amount of the electrically conductive gel onto the first surface in response to an activation signal and to provide for a defibrillating shock to be applied to the patient through the amount of the electrically conductive gel.

Abstract: A non-invasive bodily-attached ambulatory medical monitoring and treatment device with pacing is provided. The noninvasive ambulatory pacing device includes a battery, at least one therapy electrode coupled to the battery, a memory storing information indicative of a patient's cardiac activity, and at least one processor coupled to the memory and the at least one therapy electrode. The at least one processor is configured to identify a cardiac arrhythmia within the information and execute at least one pacing routine to treat the identified cardiac arrhythmia.

Abstract: This document relates to cardiac resuscitation, and in particular to systems and techniques for protecting rescuers from electrical shock during defibrillation of a patient.

Abstract: A disclosed telemetry system comprises an Nth number of telemetry devices and an equal number of standard disposable circular electrode patches. A body of each telemetry device in the system includes a female snap receptor configured to attach to a single male snap post of an electrode patch. A wireless transmitter module is disposed immediately around and in direct connection with each female snap receptor. Each wireless transmitter module transmits a signal from the respective female snap receptor to a receiver. A wireless receiver module is configured to receive and to process an Nth number of transmitted signals from the Nth number of telemetry devices into an Nth?1 number of signals where the number of signals is greater than zero. There are Nth?1 number of signals because at least one of the Nth telemetry devices is configured as a ground reference for the rest of the Nth telemetry devices.

Abstract: Recent advancements in power electronics technology have provided opportunities for enhancements to circuits of implantable medical devices. The enhancements have contributed to increasing circuit miniaturization and an increased efficiency in the operation of the implantable medical devices. The therapy delivery circuits and techniques of the disclosure facilitate generation of a therapy stimulation waveform that may be shaped based on the patient's physiological response to the stimulation waveform. The generated therapy stimulation waveforms include a stepped leading-edge that may be shaped having a varying slope and varying amplitudes associated with each of the segments of the slope. Unlike the truncated exponential waveform delivered by the conventional therapy delivery circuit which is based on the behavior of the output capacitors (i.e., i=C(dV/dt)), the stimulation waveform of the present disclosure may be dynamically shaped as a function of an individual patient's response.

Abstract: Wireless systems and methods include a plurality of peripheral electronic devices each having a wireless communication system. A processor is configured to establish an association confidence level indicative of a likelihood that a peripheral electronic device is associated to a monitored subject for each peripheral electronic device based on association criteria. Indicators are configured to communicate the association the association confidence level.

Abstract: A portable defibrillator according to embodiments of the present invention includes a defibrillator engine configured to receive defibrillator information from defibrillator sensors coupled to a patient and display the defibrillator information; an external device engine configured to receive information from medical device sensors coupled to the patient; a medical device virtual machine configured to display the patient parameter information from the external device engine; and a display screen operating a user interface through which the defibrillator engine displays the defibrillator information and the medical device virtual machine displays the patient parameter information from the external device engine.

Abstract: Systems and techniques that enable a user to selectively extend the time prior to providing an indication of power source depletion, e.g., allow an extended the recommended replacement time (RRT) prior to providing an elective replacement indication (ERI), are described. The user provides input, which may indicate an acceptable level of implantable medical device performance, e.g., that lesser performance for a period between a default RRT and an extended RRT is acceptable. In response to the input, the time until providing an RRT/ERI notification, or some other indication of depletion of the implantable medical device power source, may be extended.

Abstract: A system includes a processor coupled to a memory, the processor and memory configured to determine a proficiency level of a user of a rescue application based on stored data indicative of the user's proficiency level, and based on the user's proficiency level, select a level of operation for the rescue application. The rescue application is executed on a mobile device and configured to control operation of an AED. Each of multiple levels of operation for the rescue application allows the user a different degree of control over the operation of the AED. The processor and memory are configured to present, to the user, a set of instructions associated with the selected level of operation; and to enable control of the AED according to the selected levels of operation. A different set of instructions is associated with each of the multiple levels.

Abstract: A method includes receiving cardiac data and determining a cardiac index based upon the cardiac data; determining an increased risk of death associated with epilepsy if the indices are extreme, issuing a warning of the increased risk of death and logging information related to the increased risk of death. A second method comprises receiving at least one of arousal data, responsiveness data or awareness data and determining an arousal index, a responsiveness index or an awareness index, where the indices are based on arousal data, responsiveness data or awareness data respectively; determining an increased risk of death related to epilepsy if indices are extreme values, issuing a warning of the increased risk of death and logging information related to the increased risk of death. A non-transitory computer readable program storage device encoded with instructions that, when executed by a computer, perform a method is also provided.

Abstract: According to an embodiment of a method, a predetermined cardiac activity indicated for an antitachycardia shock is detected. Neural stimulation is applied to lower a defibrillation threshold in preparation for the shock, and the shock is subcutaneously delivered. According to one embodiment, neural stimulation is applied as part of a prophylactic therapy. A predetermined cardiac activity indicated for an antitachycardia shock is detected, and the shock is subcutaneously delivered. Other aspects and embodiments are provided herein.

Abstract: Techniques are provided for controlling spinal cord stimulation (SCS) or other forms of neurostimulation. Far-field cardiac electrical signals are sensed using a lead of the SCS device and neurostimulation is selectively delivering using a set of adjustable SCS control parameters. Parameters representative of cardiac rhythm are derived from the far-field cardiac electrical signals. The parameters representative of cardiac rhythm are correlated with SCS control parameters to thereby map neurostimulation control settings to cardiac rhythm parameters. The delivery of further neurostimulation is then controlled based on the mapping of neurostimulation control settings to cardiac rhythm parameters to, for example, address any cardiovascular disorders detected based on the far-field cardiac signals. In this manner, a closed loop control system is provided to automatically adjust SCS control parameters to respond to changes in cardiac rhythm such as changes associated with ischemia, arrhythmia or heart failure.

Abstract: A method and system are provided to analyze valve related timing and monitor heart failure. The method and system comprise collecting cardiac signals associated with an atrial chamber of interest; collecting dynamic impedance (DI) data along an atria-function focused (AFF) vector to form a DI data set, the DI data set including information corresponding to a mechanical function (MF) of a valve associated with the atrial chamber of interest; identifying, from the cardiac signals, an intra-atrial conduction timing (IACT) associated with the atrial chamber of interest; estimating an MF landmark at which the mechanical function of the valve occurs based on the DI data set; analyzing a timing delay between the MF landmark and the IACT; and adjusting a therapy, based on the timing delay, to encourage atrial contribution to ventricular filling.

Abstract: An implantable electronic therapy device, having a therapy unit, a heart rate capturing unit, a contractility determination unit, and an evaluation and control unit. The therapy unit delivers an antitachycardiac therapy. The heart rate capturing unit determines a ventricular heart rate from an input signal, and the contractility determination unit generates from an input signal, a contraction signal reflecting a contractility of a ventricle. The evaluation and control unit is connected to the therapy unit, the heart rate capturing unit, and the contractility determination unit actuates the therapy unit to administer an antitachycardiac therapy when the heart rate capturing unit detects an increase in the heart rate above a specified threshold value and the contractility determination unit supplies a contraction signal which is not physiologically adequate for the increase in the heart rate.

Abstract: A medical device such as an external defibrillator delivers electrical therapy using a special ascending, biphasic waveform. The special waveform is characterized by a set of at least two peaks. The amplitude of the second peak is greater than the amplitude of the first peak. The waveform is generated by switching capacitance configuration in the defibrillator from a parallel configuration to a series configuration while the defibrillator is delivering the defibrillation shock to the patient. Because of the switching capacitances and/or the waveform, the external defibrillator can be made physically smaller and weigh less, without sacrificing the therapeutic effect of a larger external defibrillator that would deliver a defibrillation shock of higher energy. As such, the defibrillator is easier to configure for transporting, handling, and even wearing.

Abstract: Implantable medical devices switch from a constant current mode of operation to a constant voltage mode of operation. The switching may be based on the device determining that tissue impedance stability has occurred. The determination may be a measurement of output voltage stability of the constant current source or based on other factors such as an amount of time that has elapsed. The switching may be as the result of an externally generated request such as by a clinician via an external device. The implantable medical device may begin constant voltage mode by utilizing stimulation parameters based on those initially programmed for constant current mode and based upon a measurement of voltage amplitude being output by the constant current source prior to the switch.

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: A medical therapy device comprises: a housing; a controller positioned within the housing for monitoring a condition of a patient based on a signal received from at least one sensor associated with the patient and initiating a treatment based on the condition of the patient; and at least one indication mechanism provided on the housing and configured to provide an indication to the patient of at least one condition of at least one of the medical therapy device, the at least one sensor, and the patient. The at least one indication mechanism is visible without manipulation of the housing of the medical therapy device.

Abstract: A method of analyzing a physiological (e.g., an ECG) signal during application of chest compressions. The method includes acquiring a physiological signal during application of chest compressions; acquiring the output of a sensor from which information on the velocity of chest compressions can be determined; and using the information on the velocity to reduce at least one signal artifact in the physiological signal resulting from the chest compressions.

Abstract: A device for assisting a caregiver in delivering therapy to a patient, the device comprising a user interface configured to deliver prompts to a caregiver to assist the caregiver in delivering therapy to a patient; at least one sensor configured to detect the caregiver's progress in delivering the therapy, wherein the sensor is other than an electrode in an electrical contact with the body; a memory in which a plurality of different prompts are stored; a processor configured to determine which of the different prompts should be selected for delivery based on the progress detected by the sensor.

Abstract: An improvement in a light therapy device including multiple light-emitting diodes (LEDs) positioned in a handheld portable device is disclosed. Where the housing and the LEDs are configured to have direct contact with the skin or tissue of the user without any intermediary materials, and light the surface and underlying layers of tissue for photodynamic stimulation of the cells. Two iterations of the device utilize light known to have a bactericidal effect in the case or acne or Rosacea. The devices are fabricated from an injection molded plastic housing. The housing contains an arrangement of 36-72 LEDs on a circuit board in an arrangement to provide even lighting over the skin or tissue surface.

Abstract: A modular external defibrillator system in embodiments of the teachings may include one or more of the following features: a base containing a defibrillator to deliver a defibrillation shock to a patient, (b) one or more pods each connectable to a patient via patient lead cables to collect at least one patient vital sign, the pods operable at a distance from the base, (c) a wireless communications link between the base and a selected one of the two or more pods to carry the at least one vital sign from the selected pod to the base, the selection being based on which pod is associated with the base.

Abstract: A method for managing care of a person receiving emergency cardiac is disclosed and involves monitoring, with an external defibrillator, multiple parameters of the person receiving emergency cardiac assistance; determining from at least one of the parameters, an indication of trans-thoracic impedance of the person receiving emergency cardiac care; determining, from at least one of the parameters corresponding to an electrocardiogram of the person receiving emergency cardiac assistance, an initial indication of likely shock effectiveness; determining, as a function of at least the indication of trans-thoracic impedance and the initial indication of likely shock effectiveness, an indication of whether a shock provided to the person receiving emergency medical assistance will be effective; and affecting control of the defibrillator by a caregiver as a result of determining the indication of whether a shock will be effective.

Abstract: A single-chamber implantable device for detecting a patient's atrial activity using a monobody lead is disclosed. The monobody lead (10) includes a ventricular coil (16), a supraventricular coil (18), a distal electrode (14) forming three electrodes for detecting depolarization signals. A generator (12) of the implantable device collects a first unipolar signal (20) between the ventricular coil and the generator housing and a second unipolar signal (22) between the supraventricular coil and the generator housing. An independent component analysis is performed to the detected depolarization signals to determine an estimated atrial activity signal from the first and second unipolar signals.

Abstract: A method for extinguishing a cardiac arrhythmia utilizes destructive interference of the passing of the reentry wave tip of an anatomical reentry through a depolarized region created by a relatively low voltage electric field in such a way as to effectively unpin the anatomical reentry. Preferably, the relatively low voltage electric field is defined by at least one unpinning shock(s) that are lower than an expected lower limit of vulnerability as established, for example, by a defibrillation threshold test. By understanding the physics of the electric field distribution between cardiac cells, the method permits the delivery of an electric field sufficient to unpin the core of the anatomical reentry, whether the precise or estimated location of the reentry is known or unknown and without the risk of inducting ventricular fibrillation. A number of embodiments for performing the method are disclosed.

Abstract: A method of treating a patient for ventricular tachycardia using a wearable defibrillator includes monitoring the patient for a predetermined condition via one or more electrodes on the defibrillator, sending a message to the patient in response to the predetermined condition, activating the defibrillator so that the defibrillator delivers defibrillation energy to the patient, and storing at least one of the results of the monitoring, sending and activating steps in a memory on the defibrillator. The method also includes downloading information stored in the memory of the defibrillator to a base station having an external interface, and transmitting the information downloaded from the memory of the base station to an external location via the external interface of the base station.

Abstract: An external defibrillator includes patient electrodes (20) for obtaining the patient's electrocardiogram (ECG) and for applying a shock to the patient. A microprocessor (24) analyses the patient's ECG using a diagnostic algorithm to detect if the patient's heart is in a shockable rhythm, and shock delivery circuitry (10) is enabled when a shockable rhythm is detected by the diagnostic algorithm. The patient electrodes also allow obtaining a signal (Z) which is a measure of the patient's transthoracic impedance and the microprocessor is responsive to Z to detect conditions likely to cause the diagnostic algorithm to generate a false detection of a shockable rhythm. If such detection is made, the microprocessor prevents detection of a shockable rhythm by the diagnostic algorithm, at least for a period of time.

Abstract: Various aspects of the present subject matter provide devices and methods to treat AV-conducted ventricular tachyarrhythmia (AVCVT). According to various embodiments of the method, an AVCVT is sensed, an IVC-LA fat pad is stimulated when the AVCVT is sensed to block AV conduction, and bradycardia support pacing is provided while the IVC-LA fat pad is stimulated. Other aspects and embodiments are provided herein.

Abstract: A system and method of enabling detection enhancements selected from a plurality of detection enhancements. In a system having a plurality of clinical rhythms, including a first clinical rhythm, where each of the detection enhancements is associated with the clinical rhythms, the first clinical rhythm is selected. The first clinical rhythm is associated with first and second detection enhancements. When the first clinical rhythm is selected, parameters of the first and second detection enhancements are set automatically. A determination is made as to whether changes are to be made to the parameters. If so, one or more of the parameters are modified under user control.

Abstract: An implantable medical device capable of sensing cardiac signals and delivering cardiac electrical stimulation therapies is enabled to detect a short circuit event. A signal is sensed by a sensing module coupled to electrodes. A controller detects a short circuit event in response to a slope of the sensed signal exceeding a short circuit threshold.