Methods and systems for providing neuromodulation therapy are disclosed. The methods and systems are configured to sense an evoked neural response and use the evoked neural response as feedback for providing neuromodulation therapy. Methods of reducing stimulation artifacts that obscure the sensed evoked neural response are disclosed. The methods of artifact reduction include recording a stimulation artifact in the absence of an evoked neural response, aligning and scaling the stimulation artifact with respect to the obscured signal, and subtracting the aligned and scaled artifact from the obscured signal.

The present disclosure provides computer-implemented methods, systems, and devices for improved skin temperature monitoring. Accurate estimates of skin and ambient temperature are generated based on determinations and comparisons of skin and internal device temperature sensor measurements contained on or within example devices. The estimates of skin and ambient temperature measurements facilitate monitoring skin and core temperature changes, detecting physiological events of a wearer of example devices, and determining when skin temperature changes are environmentally or physiologically induced.

A method for detecting a stimulus pulse by using two or more electrical signals derived from a living body, the method comprising the following steps: (a) for each electrical signal, digitizing the signal with an analog-to-digital converter to produce a sampled signal S.sub.k; (b) for each signal S.sub.k at a sample time t.sub.i, computing a primary difference Δ.sub.kp(t.sub.i)=abs[S.sub.k(t.sub.i)−S.sub.k(t.sub.i−p)]; (c) determining the minimum value of all of the computed differences, such minimum being a detector output D(t.sub.i); (d) comparing the detector output D(t.sub.i) with a detection threshold; and (e) indicating that a stimulus pulse has been detected when the detector output D(t.sub.i) is above the detection threshold.

Systems and methods for monitoring phrenic nerve function of a patient are disclosed, including, including establishing a diaphragmatic movement value threshold; positioning a diaphragmatic movement sensor on an external surface of an abdomen of the patient; applying a treatment regimen to a tissue region in proximity to the phrenic nerve; measuring a diaphragmatic movement value with the diaphragmatic movement sensor; comparing the measured diaphragmatic movement value to the established diaphragmatic movement value threshold; and generating an alert in response to the comparison.

A brain navigation device, comprising a lead with an elongated lead body, at least one macro-electrode contact positioned on an outer surface on the lead, wherein the at least one macro-electrode contact is located at the distal part of the lead, and wherein the at least one macro-electrode contact is configured to be used during lead navigation.

Devices and methods provide for the sensing of physiological signals during stimulation therapy by preventing stimulation waveform artifacts from being passed through to the amplification of the sensed physiological signal. Thus, the sensing amplifier is not adversely affected by the stimulation waveform and can provide for successful sensing of physiological signals. A common mode voltage is applied to the stimulation electrodes while sensing during a recharge period where the common mode voltage approximates the stimulation pulse being received at the sensing electrodes. This common mode voltage is determined based on measuring a common mode signal for at least one of the inputs of the amplifier or by deriving the proper common mode from monitoring the output signal of the amplifier to observe the elimination of artifacts during stimulation. Blanking switches may be used to blank the sensing of the peak of the recharge period should that peak be relatively large.

Previous research has shown that the risk of sudden death due to cardiac arrhythmias can be predicted by observing the shape of recorded endocardial electrograms in response to pacing, and in particularly detecting certain small deflections in the recorded electrogram following early stimulation of the heart. A long standing problem has been the reliable detection of these small individual potentials because of the presence of noise in the recorded electrical signals created by other electrical equipment within a typical catheter laboratory. The solution described involves deriving a model of noise from a first portion of the electrogram in which a physiological signal is presumed to be absent, and transforming a second portion of the electrogram, presumed to contain a physiological signal, into the model of noise. The physiological signal can then be identified by identifying portions of signal within the second portion of the electrogram that do not conform to the model of noise.

A catheter with an electrode assembly has a functional electrode located at a first position on the electrode assembly and a shunting electrode located proximal to the first position. Irrigation fluid carried by the catheter may be electrically coupled with a patient's blood through the shunting electrode. The shunting electrode may be used to reduce noise in an electrocardiogram signal that results from the pump used to supply the irrigation fluid.

The provided systems, methods and devices describe lightweight, wireless tissue monitoring devices that are capable of establishing conformal contact due to the flexibility or bendability of the device. The described systems and devices are useful, for example, for skin-mounted intraoperative monitoring of nerve-muscle activity. The present systems and methods are versatile and may be used for a variety of tissues (e.g. skin, organs, muscles, nerves, etc.) to measure a variety of different parameterps (e.g. electric signals, electric potentials, electromyography, movement, vibration, acoustic signals, response to various stimuli, etc.).

A portable medical device having improved ECG trace display and reporting. Embodiments implement features to ameliorate artifacts created by virtue of attempting to eliminate compression artifacts due to mechanical compression devices. Other embodiments additionally implement features to seek to detect the occurrence of ROSC while chest compressions are ongoing.