An example of a system for providing patient care guidance to a caregiver based on ultrasound detection of blood flow includes a defibrillator including an electrode assembly and an output device, a portable computing device communicatively coupled to the defibrillator and including an output device, a Doppler shift waveform evaluation engine disposed at the defibrillator and/or the portable computing device, and a wearable ultrasound blood flow sensor configured to couple to a patient and the defibrillator and/or the portable computing device and to generate data signals representing a Doppler shift waveform. The engine is configured to receive the data signals representing the waveform, generate caregiver instructions according to a cardiac arrest protocol, analyze the waveform based on the received data signals, identify heart-induced blood flow based on the waveform analysis, and generate and provide caregiver instructions according to a non-cardiac arrest protocol based on the identified heart-induced blood flow.

A medical device is configured to detect an atrial tachyarrhythmia episode. The device senses a cardiac signal, identifies R-waves in the cardiac signal attendant ventricular depolarizations and determines classification factors from the R-waves identified over a predetermined time period. The device classifies the predetermined time period as one of unclassified, atrial tachyarrhythmia and non-atrial tachyarrhythmia by comparing the determined classification factors to classification criteria. A classification criterion is adjusted from a first classification criterion to a second classification criterion after at least one time period being classified as atrial tachyarrhythmia. An atrial tachyarrhythmia episode is detected by the device in response to at least one subsequent time period being classified as atrial tachyarrhythmia based on the adjusted classification criterion.

Methods, systems, and devices for signal analysis in an implanted cardiac monitoring and treatment device such as an implantable cardioverter defibrillator. In some examples, captured data including detected events is analyzed to identify likely overdetection of cardiac events. In some illustrative examples, when overdetection is identified, data may be modified to correct for overdetection, to reduce the impact of overdetection, or to ignore overdetected data. Several examples emphasize the use of morphology analysis using correlation to static templates and/or inter-event correlation analysis.

A semiconductor device comprises a first chip bonded on a second chip. The first chip comprises a first substrate and first interconnection components formed in first IMD layers. The second chip comprises a second substrate and second interconnection components formed in second IMD layers. The device further comprises a first conductive plug formed within the first substrate and the first IMD layers, wherein the first conductive plug is coupled to a first interconnection component and a second conductive plug formed through the first substrate and the first IMD layers and formed partially through the second IMD layers, wherein the second conductive plug is coupled to a second interconnection component.

A system employing an ECG monitor (40) and a defibrillation advisory controller (20). In operation, the ECG monitor (40) monitors a cardiac rhythm of a patient, and the defibrillation advisory controller (20) generates a defibrillation advisory based on a cardiac rhythm status and a metabolic cardiac status of the patient, and optionally further based on an electrical cardiac status of the patient. The controller (20) derives the cardiac rhythm status as monitored by ECG monitor (40), and the optional electrical cardiac status inclusive of the cardiac rhythm monitored by the ECG monitor (40), and derives the metabolic cardiac status exclusive of the cardiac rhythm monitored by the ECG monitor (40). The controller (20) may compute or receive metabolic cardiac data indicative of the metabolic cardiac status (e.g., incorporating or coupled to a user input device (50), a breath analyzer (60) and a blood analyzer (70)), and compares the metabolic cardiac data to a metabolic cardiac threshold (fixed or variable) and/or monitors a trend of the metabolic cardiac data to derive the metabolic cardiac status of the patient.

Systems and methods are provided for optimizing hemodynamics within a patient's heart, e.g., to improve the patient's exercise capacity. In one embodiment, a system is configured to be implanted in a patient's body to monitor and/or treat the patient that includes at least one sensor configured to provide sensor data that corresponds to a blood pressure within or near the patient's heart; at least one component designed to cause dyssynchrony of the right ventricle, and a controller configured for adjusting the function of the at least one component based at least in part on sensor data from the at least one sensor.

In embodiments a WCD system is worn and/or carried by an ambulatory patient. The WCD system analyzes an ECG signal of the patient, to determine whether or not the patient should be given an electric shock to restart their heart. If so, then the WCD system first gives a preliminary alarm to the patient, asking them to prove they are alive if they are. The WCD system further determines whether the ECG signal contains too much High Amplitude (H-A) noise, which can distort the analysis of the ECG signal. If too much H-A noise is detected for a long time, the WCD system may eventually alert the patient about their activity, so that the ECG noise may be abated. The WCD system may even pause the analysis of the ECG signal, so that there will be no preliminary alarms that could be false until the ECG noise is abated.

A patient-coupled resuscitation device for use with a plurality of medical devices is provided. The resuscitation device includes a portion configured to provide treatment, a connector configured to connect the resuscitation device to one of a first medical device and a second medical device, and a housing including a memory and associated circuitry. The memory and associated circuitry is configured to store a device identifier to identify the resuscitation device; receive medical treatment information from the first medical device, the medical treatment information including at least one of: patient physiological data, patient characteristic data, and rescuer performance data; receive timing information of the medical treatment information from the first medical device; record the medical treatment information and the timing information; and transfer, upon detecting a connection to the second medical device, the medical treatment information and the timing information to the second medical device.

Wearable devices are provided herein including wearable defibrillators, wearable devices for diagnosing symptoms associated with sleep apnea, and wearable devices for diagnosing symptoms associated with heart failure. The wearable external defibrillators can include a plurality of ECG sensing electrodes and a first defibrillator electrode pad and a second defibrillator electrode pad. The ECG sensing electrodes and the defibrillator electrode pads are configured for long term wear. Methods are also provided for using the wearable external defibrillators to analyze cardiac signals of the wearer and to provide an electrical shock if a treatable arrhythmia is detected. Methods are also disclosed for refurbishing wearable defibrillators. Methods of using wearable devices for diagnosing symptoms associated with sleep apnea and for diagnosing symptoms associated with heart failure are also provided.

An intracardiac defibrillation catheter system includes a defibrillation catheter, a power supply device, and an electrocardiograph, in which an arithmetic processing unit of the power supply device sequentially senses an event estimated to be an R wave from an electrocardiogram input from the electrocardiograph, calculates a heart rate each time sensing is performed, and, when, after an event (V.sub.n) is sensed and after an application execution switch is input, an event (V.sub.n+m) is sensed, performs arithmetic processing so that a DC voltage is applied in synchronization with the event (V.sub.n+m) only in a case where the event (V.sub.n+m) is sensed after a lapse of a refractory period whose length corresponds to 50% of a reciprocal of a heart rate (A.sub.n) at a sensing time point of the event (V.sub.n), to control a DC power supply unit. The defibrillation catheter system can reliably avoid performing defibrillation in synchronization with a T wave without being affected by the level of the heart rate of a patient.