Dislodgement of a defibrillation lead from the right ventricle to the right atrium is a rare complication associated with implantable cardioverter-defibrillators. However, such dislodgement deserves attention out of proportion to its low incidence because of the possibility to cause fatal proarrhythmia. Various embodiments are directed to algorithms for detecting lead dislodgement, including a primary algorithm that operates during baseline rhythm and a secondary algorithm that operates during detection of ventricular tachycardia or ventricular fibrillation to identify lead dislodgement during atrial fibrillation.

The current technology relates to a shock deferral unit that is portable by an ambulatory patient. The shock deferral unit has a bi-directional communication device configured to receive a notification of an impending shock from a defibrillator and configured to send an instruction to defer the impending shock to the defibrillator. An authentication interface is configured to receive authentication data from a user. A user instruction interface is configured to receive the instruction to defer the impending shock from the user. An authentication device is configured to authenticate the user based on the authentication data and instruct the bi-directional communication device to send the instruction to defer a shock upon authentication and receipt of the instruction to defer the shock.

Medical system and method for operation of an active implantable medical device (IMD) and an extracorporeal device attached to a patient's skin, comprising: determining data regarding a bodily parameter of the patient by the IMD, processing the determined data and detecting a condition from a plurality of predefined conditions based on the determined data, periodically sending an intra-body communication signal representing the detected condition by the IMD to the extracorporeal device, receiving the intra-body communication signal by the extracorporeal device, providing a predefined notification signal by the extracorporeal device to the patient to motivate the patient to perform a predefined action based on the received intra-body communication signal, sending a termination signal by the extracorporeal device to the IMD, and receiving the termination signal by the IMD and subsequently terminating sending the intra-body communication signal which was initiated by the previously detected condition.

Systems and methods for ambulatory detection of medical events such as cardiac arrhythmia are described herein. An embodiment of an arrhythmia detection system may include a detection criterion circuit that determines a patient-specific detection criterion using a baseline cardiac characteristic when the patient is free of cardiac arrhythmias. The detection criterion circuit generates a patient-specific threshold of a signal metric by adjusting a population-based threshold of the signal metric, where the manner and the amount of adjustment is based on information about patient baseline cardiac characteristic. The arrhythmia detection system detects an arrhythmia episode using a physiologic signal sensed from the patient and the patient-specific arrhythmia detection threshold.

A system and methods of maintaining communication with a medical device for exchange of information, instructions, and programs, in a highly reliable manner. Apparatus and methods for accomplishing this task include: 1) The inclusion of a locating device in the system, in close proximity to an implanted device, but which does not drain the implanted device battery. The locating device may be implanted or external to the body. 2) The use of motion detection and global positioning system devices to locate elements within a communicating system for the medical device; 3) The assessment of received signal quality by elements of the system; 4) The use of a notification system for a device user who is moving out of range of communications; and 5) Documenting the absolute and functional integrity of instructions received by the medical device.

Techniques are disclosed for detecting arrhythmia episodes for a patient. A medical device may receive one or more sensor values indicative of motion of a patient. The medical device may determine, based at least in part on the one or more sensor values, an activity level of the patient. The medical device may determine a heart rate threshold for triggering detection of an arrhythmia episode based at least in part on the activity level of the patient. The medical device may determine whether to trigger detection of the arrhythmia episode for the patient based at least in part on comparing a heart rate of the patient with the heart rate threshold. The medical device may, in response to triggering detection of the arrhythmia episode, collect information associated with the arrhythmia episode.

In one embodiment, an implantable medical device (IMD) comprises: therapeutic circuitry for controlling delivery of a medical therapy to a patient; a processor for controlling the IMD according to executable code; wireless communication circuitry for conducting wireless communications; and memory for storing data and executable code, wherein the executable comprises code for causing the processor to (1) communicate with an external programming device to define therapeutic settings for operation of the IMD, (2) perform validation operations on one or more instances of therapeutic settings by determining whether a respective instance of therapeutic settings is accompanied by permanent validation data or temporary validation data, wherein the validation operations comprise analyzing temporary validation data against at least one key of a plurality of cryptographic keys stored by the IMD.

A system for generating an alert for a systemic infection of a patient comprises an implantable medical device configured to measure a measurement parameter indicative of the heart rate at rest of the patient, and a remote monitoring system configured to receive information from the implantable medical device. A module is configured to analyze information relating to said measurement parameter indicative of the heart rate at rest of the patient to generate an alert signal for a systemic infection of the patient based on a state of the heart rate at rest.

A system comprising a remotely programmable micromonitor with a wireless sensing system-on-module (SOM), one or more sensors to detect one or more conditions in a subject by monitoring one or more parameters associated with the conditions by comparing any monitored parameter to a baseline measurement of the monitored parameter from the subject, a plurality of sensors corresponding to a monitored parameter and connected to the micromonitor to convey measurements of all monitored parameters, the sensors including at least one of a non-optical pulse wave sensor or an electrocardiogram (ECG) sensor, a communications module capable of communicating with a wireless technology, wherein the module can send an alert signal to the subject or an attending physician or a remote service center or any other subject, and one or more algorithms for monitoring conditions and/or for predicting conditions, including at least one of a fall detection or fall prediction algorithm.

In one embodiment, a method of alerting a user of a WCD is described. The method includes receiving an alert from the WCD on a remote device associated with the user and in communication with the WCD and transcribing the alert into a message for the user. The method also includes personalizing the message for the user and delivering the message to the user via the remote device.