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DESCRIPTION provided by applicant In band artifact and noise present a major obstacle to efficient extraction of accurate reliable and repeatable information from ambulatory recordings of subcutaneous and surface ECGs With more than million patients a year experiencing ambulatory evaluations for cardiac arrhythmia in band artifact and noise is an urgent wide reaching challenge In clinical care for example the high incidence of false positive arrhythmia detections resulting from noise and artifact can require expensive manual over read leading to poor operational efficiencies and higher cost of delivering care Some manufacturers have attempted to address this issue in ambulatory event recorders by tuning the arrhythmia detection algorithm to increase positive predictive value reduce false positive events at the expense of decreased sensitivity resulting in missed events and a reduction in diagnostic yield In addition to inducing significant numbers of false positive events noise can mask P waves rendering a definitive diagnosis of atrial fibrillation difficult Noise also impacts studies of drg safety and effectiveness because noise introduces variability in risk markers which in turn increases sample size and cost and compromises the quality of information To address this need a novel miniature cc fully functioning Holter event mobile cardiac telemetry device will be developed in Phase II This device employs the patented VivaQuant MDSP algorithm for real time processing of ECGs This algorithm provides for andgt dB reduction in in band noise without distorting ECG morphology and provides superior event detection sensitivity and PPV especially in noisy recordings This Phase II effort will build upon a successful Phase I effort an will optimize algorithm power consumption and performance based upon numerical optimization strategies researched in Phase I The remaining features including wireless communications data compression and symptomatic event recording will be implemented and tested in Phase II At the completion of the Phase II effort all testing to applicable standards and documentation will be completed and a k will be submitted to FDA The Holter event recorder developed in this multi phase effort will result in a significant improvement in the quality of diagnostic information available to physicians leading to better informed therapeutic decisions improved patient quality of life and higher quality care delivered at a lower cost The small size and othe patient friendly features of the device will render it more comfortable to wear leading to improved patient compliance and higher quality diagnostic information In addition once the embedded algorithm is optimized we will pursue partnerships to commercialize the MDSP algorithm in other applications where accurate ultra low power ECG processing is required such as for implantable loop recorders subcutaneous defibrillators and neural stimulation devices PUBLIC HEALTH RELEVANCE Successful completion of this proposed multiphase SBIR research program will result in a combination Holter event recorder mobile cardiac telemetry device for monitoring the million ambulatory patients that seek treatment for arrhythmias each year The proposed device will provide noise free ECG recordings and includes several features that we hypothesize will significantly increase diagnostic yield compared to current devices The improved diagnostic information will lead to more informed therapeutic decisions improved patient quality of life and higher quality care delivered at a lower cost