Systems, apparatus, and methods are disclosed for conveying signals between a patient and monitoring and treatment devices. An EP system provides large-signal input protection and RF ablation signal noise suppression while preserving the integrity of relevant components of small signals. The EP system has a low-noise amplifier topology with minimal hardware filtering. An input protection circuit shunts to ground signals with amplitude above an ablation voltage. An RF filter circuit linearly attenuates the signals between 300 kHz and 600 kHz. A low-frequency feedback circuit drives a common mode node of the RF filter circuit for additional attenuation. A signal amplification circuit amplifies the signals between 0.01 Hz and 1000 Hz. A fast recovery circuit feeds back a low-frequency voltage signal to the signal amplification circuit to gradually reduce offset voltage of the signals. A high-resolution A/D converter converts the signals from the signal amplification circuit to clean digital signals.

Some aspects of this disclosure generally are related to improving the robustness of a flexible circuit structure, for example, by providing fault-tolerant electrical pathways for flow of electric current through the flexible circuit structure. In some embodiments, such fault tolerance is enhanced by way of a conductive mesh provided between an adjacent pair of resistive elements. Some aspects are related to improved voltage, current, or voltage and current measurement associated with various pairs of adjacent resistive elements at least when the various pairs have differing distances between them.

A medical apparatus includes a shaft, an expandable frame, a membrane, a diagnostic electrode, a reference electrode, and a processor. The shaft is configured for insertion into an organ of a patient. The expandable frame is coupled to a distal end of the shaft. The diagnostic electrode, which is disposed on an external surface of the expandable frame, is configured to sense diagnostic signals when in contact with tissue. The reference electrode is disposed on a surface of the expandable frame directly opposite the diagnostic electrode, wherein the reference electrode is electrically insulated from the tissue and is configured to sense interfering signals.

A system for monitoring a subject for an arrhythmia includes an external monitoring device (EMD) configured to be disposed outside of a subject's body. The EMD includes a first communication component configured to receive, from a medical device, a first physiological parameter signal and an indication of a detected trigger event associated with a first portion of the first physiological parameter signal. The trigger event is indicative of a potential arrhythmia. The EMD also includes an analysis component configured to (1) identify a second portion of the first physiological parameter signal, where the second portion satisfies a discard criterion, (2) discard the second portion, and (3) perform an arrhythmia confirmation evaluation using a third portion of the first physiological parameter signal.

Cardiac mapping catheters and methods for using the catheters are described. The catheter can detect the presence, direction and/or source of a depolarization wave front associated with cardiac arrhythmia. A mapping catheter includes a plurality of bipolar electrode pairs in which the members of each pair are opposed to one another across a perimeter, for instance in a circular pattern. The spaced arrangement of the electrodes can be utilized to identify directional paths of moving electric fields or wave fronts in any direction passing across the endocardial surface. The catheters can be used to identify locations and types of triggers and/or drivers of cardiac arrhythmia including rotors, ectopic trigger foci and/or to delineate reentrant pathways.

Apparatus and methods remove a voltage offset from an electrical signal, specifically a biomedical signal. A signal is received at a first operational amplifier and is amplified by a gain. An amplitude of the signal is monitored, by a first pair of diode stages coupled to an output of the first operational amplifier, for the voltage offset. The amplitude of the signal is then attenuated by the first pair of diode stages and a plurality of timing banks. The attenuating includes limiting charging, by the first pair of diode stages, of the plurality of timing banks and setting a time constant based on the charging. The attenuating removes the voltage offset persisting at a threshold for a duration of at least the time constant. Saturation of the signal is limited to a saturation recovery time while the saturated signal is gradually pulled into monitoring range over the saturation recovery time.

A catheter may be adapted to map a chamber of the heart. The catheter may include a magnetic and/or ultrasound sensor for navigation. The body of the catheter may be pliable and configured to form a predetermined shape upon exiting a catheter sheath. Upon exiting the catheter sheath, the catheter body may be configured to form one or more loops, and the loops may be non-overlapping loops. In some examples, the non-overlapping loops may be concentric loops. Alternatively, the catheter body may be configured to form one or more splines. The catheter body may include an embedded electrode assembly. The electrodes of the electrode assembly may be may be arranged in one or more rows and configured to detect a wave front. The electrode assembly may also be configured to generate and activation sequence and determine a direction of an activation source. The electrode assembly may also be configured to determine the type of activation source, for example a rotational activation source, a focal activation source, and a single-wide activation source.

A myocardial excitation complementation/visualization apparatus includes an acquiring section that acquires intracardiac electrocardiograms of a subject, the intracardiac electrocardiograms being recorded by a recording unit having a plurality of electrodes, a processing section that performs a computation for completing and visualizing a state of excitation in a myocardium of the subject based on the intracardiac electrocardiograms, and a displaying section that displays the state of excitation in the myocardium of the subject based on an output of the processing section. The processing section includes a first generating section, a correcting section, a second generating section, and a third generating section. The displaying section displays a change of the state of excitation in the myocardium of the subject based on the visualized data.

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.

Disclosed is a method for diagnosing paroxysmal atrial fibrillation in a subject, involving: determining the amount of FABP-3 (Fatty acid binding protein 3) in a sample from a subject suspected to suffer from paroxysmal atrial fibrillation, and comparing the determined amount to a reference amount. The method may further involve the determination of a BNP-type peptide. Also disclosed is a device adapted to carry out the method.