A method for evaluation of electrical propagation in the heart includes receiving a pacing signal applied to a heart of a patient, the pacing signal including a sequence of normal and shorter, abnormal, pacing stimuli. A responsive cardiac signal is received, that is sensed by electrodes at a location in the heart and on the body surface of the patient. A model response is found and annotated from evoked potentials caused by the normal pacing stimuli. A correlation is made between the model response along the different signal sections to find and calculate a normal and decremental time delays between the pacing stimuli and respectively resulting evoked potentials at a tissue location. A time difference is calculated, between the normal time delay and the decremental time delay. An EP map of at least a portion of the heart is presented to a user, with a graphical indication of the time difference presented at the tissue location.

A wearable medical device is provided. The device includes electrodes to receive electrical signals from a patient, monitor for a cardiac arrhythmia, and provide a therapeutic shock to the patient in response to detecting the arrhythmia. The device includes a user interface to receive patient input indicating initiation or termination of a high-noise activity. The device can include accelerometers to generate motion signals. The device includes a processor to monitor for initiation or termination of the high-noise activity based on a noise level in the electrical signals, the motion signals, and the patient input. The processor can cause, in response to the initiation of the high-noise activity, an arrhythmia detection process to execute in an activity-induced noise (AIN) robust mode, and cause, in response to the termination of the high-noise activity, the arrhythmia detection process to execute in an AIN sensitive mode.

Apparatus and methods for the management and safety monitoring of temporary cardiac pacing devices adapted to monitor a cardiac pacing device, the apparatus comprising; electrical connections with the heart and with the pacing device; a signal acquisition module adapted to acquire via the electrical connections cardiac signals indicative of cardiac operation, pacing impulses emitted by the pacing device, evoked signals emitted from the heart in response to the pacing impulses, and any unidentified noise signals; a processor adapted to receive from the signal acquisition module and to analyse the cardiac and evoked signals, the pacing impulses and any noise signals; a data store, and a display, wherein the processor is adapted to: i. establish a base level operation of the heart and pacing device and to store the associated quality, size and/or timing values of the cardiac and evoked signals and the pacing impulses in the date store; ii, receive instantaneous values of quality, size and/or timing values of the cardiac and evoked signals and the pacing impulses and to cause the display to show these values; iii. compare the instantaneous values against the values in the data store to establish differences therebetween; iv. analyse; a, any noise signal received, b. the instantaneous values received at step ii above, and c. any difference(s) at step iii above in terms of its/their quality, size and timing, and v, raise an alarm in the event a noise signal occurs and/or no evoked signal is received,

This document relates to systems and techniques for the treatment of a cardiac arrest victim via electromagnetic stimulation of physiologic tissue.

A novel therapeutic biphasic or multiphasic pulse waveform and method are provided. The novel therapeutic biphasic or multiphasic pulse waveform may be used in a defibrillator, or in another medical device that delivers therapeutic electrical stimulation pulses to a patient.

Instrument and systems for applying ablative energy to epicardial tissue via a subxiphoid access surgical approach. The instrument has a head assembly sized and shaped for a subxiphoid surgical approach to a patient's heart and defines a contact face. The head assembly includes a paddle body, a first ablation electrode, and a second ablation electrode. The ablation electrodes are coupled to the paddle body in a spaced apart, spatially-fixed fashion. The ablation electrodes are exteriorly exposed at the contact face. A tubular member extends from the head assembly and maintains wiring connected to the ablation electrodes. The instrument is manipulable to locate the contact face on epicardial tissue of a patient's heart via a subxiphoid surgical approach, such as between the left and right pulmonary vein junctions of the posterior left atrium.

An ambulatory medical device is provided. The ambulatory medical device includes at least one sensor configured to acquire physiological data of a patient, at least one network interface and at least one processor coupled to the at least one sensor and the at least one network interface. The at least one processor is configured to detect, via the at least one network interface, a medical device, to establish a secure communication session with the medical device via the at least one network interface, to detect a data capacity of the secure communication session, to identify a category of patient data associated with the data capacity, and to transmit patient data of the category to the medical device via the secure communication session.

In at least one example, a medical device is provided. The medical device includes at least one therapy electrode, at least one acoustic sensor, and at least one processor coupled with the at least one therapy electrode and the at least one acoustic sensor. The at least one processor is configured to deliver at least one pacing pulse via the at least one therapy electrode and to analyze processed acoustic data to determine whether the at least one pacing pulse resulted in capture.

An ambulatory medical device is provided. The ambulatory medical device includes at least one sensor configured to acquire physiological data of a patient, at least one network interface and at least one processor coupled to the at least one sensor and the at least one network interface. The at least one processor is configured to detect, via the at least one network interface, a medical device, to establish a secure communication session with the medical device via the at least one network interface, to detect a data capacity of the secure communication session, to identify a category of patient data associated with the data capacity, and to transmit patient data of the category to the medical device via the secure communication session.

There is described a technique using apparatus for recording and analyzing a surface electrocardiogram (ECG) for distinguishing a physiological signal from noise. The technique involves aligning and averaging multiple surface electrogram records taken for repeated pacing sequence with the same interval between pacing stimuli.