In general, the invention is directed to monitoring fluid retention that may accompany congestive heart failure and pulmonary edema. A medical device, such as an implanted pacemaker or an external defibrillator, senses electrical signals associated with the periodic depolarization and re-polarization of a heart. The device processes the electrical signals to obtain one or more "cardiac parameters," which reflect pulmonary edema. By monitoring the cardiac parameters, the device monitors pulmonary edema. Cardiac parameters comprise the amplitude of the QRS complex, the integral of the QRS complex, or the integral of the QRST segment and the like. When the device detects fluid buildup, the device may respond by taking remedial action and/or generating an alert.

A decaying, propagating reference signal allows for the efficient implementation of various image morphological operations, including grayscale dilations and erosions, with only two passes through the image. Pyramid and other morphological shape operators can be duplicated by varying the decay rate(s) of the reference signal, the offset directions and magnitudes of the comparison vector(s), and the paths and number of passes through the image. The methods may also be performed in parallel on the same input image to generate an adaptive threshold image defined as the biased average of an image separately transformed by a dilation and by an erosion. Applications of the technique in one and two dimensions are disclosed.

A portable differential stethoscope includes small microphone elements which are attached to the stethoscope heads to pick up acoustic signals from the body. The sounds picked up by the stethoscope heads include body noise signals as well as heartbeat signals. Each stethoscope head and microphone element provides an output which is amplified in an individual amplifier. The two amplified signals are inputted to separate terminals of a differential amplifier through a gain and balance control element. The differential amplifier outputs a difference signal which is amplified and inputted to an electrical headset or an electrical earphone element which is acoustically coupled to the conventional acoustic tube.

Method and apparatus for detecting cardiac repolarization abnormality using at least one electrocardiogram signal. The at least one electrocardiogram signal can be obtained from any number of continuous or non-continuous windows. The method can include deriving a total quantity of representative beats of the at least one electrocardiogram signal. At least one morphology shape descriptor can be used to determine a total quantity of values representing the total quantity of representative beats. Data corresponding to at least some of the total quantity of values can be used to assess cardiac repolarization abnormality.

Method and apparatus for determining alternans data of an ECG signal. The method can include determining at least one value representing at least one morphology feature of each beat of the ECG signal and generating a set of data points based on a total quantity of values and a total quantity of beats. The data points can each include a first value determined using a first mathematical function and a second value determined using a second mathematical function. The method can also include several preprocessing algorithms to improve the signal to noise ratio. The method can also include separating the data points into a first group of points and a second group of points and generating a feature map by plotting the first group of points and the second group of points in order to assess an alternans pattern of variation. The feature map can be analyzed by statistical tests to determine the significance difference between groups and clusters.