Cardiac Pacemakers, Inc.

Aaron Lewicke

John D Hatlestad

Yi Zhang

Keith R Maile

Kenneth C Beck

Imad Libbus

Abhilash Patangay

Yunlong Zhang

Jeffrey E Stahmann

Ramesh Wariar

Julie A Thompson

Yousufali H Dalal

Andres Belalcazar

Systems and methods for diagnosing one or more respiration distress manifestations by implantably recognizing their occurrence and evaluating information about the same to provide an indication of present or impending worsening heart failure are discussed. Using information produced by an implantable respiration sensor circuit and an implantable physiological sensor circuit, such as at least one of a physical activity sensor circuit or a posture sensor circuit, an implantable or external processor circuit may detect a respiration disturbance and an associated subsequent arousal from stable state occurrence and thereafter evaluate over time arousal from stable state occurrences to provide the indication of present or impending worsening heart failure. In one example, information about a fluid level within a subject is used in determining the indication of worsening heart failure. In various examples, a regimen is initiated or adjusted in response to the indication of present or impending worsening heart failure.

Using respiration distress manifestations for heart failure detection

A device and method can monitor or trend a patient's respiration rate measurements according to the time of day. The device, which may be implantable or external, collects and classifies respiration rate measurements over time. The trended information about particular classes of respiration rate measurements is then communicated to a remote external device, which in turn provides an indication of heart failure decompensation. Examples of classes of respiration rate measurements include a daily maximum respiration rate value, a daily minimum respiration rate value, a daily maximum respiration rate variability value, a daily minimum respiration rate variability value, and a daily central respiration rate value. These respiration rate measurements can be further classified into daytime or nighttime respiration rate measurements.

Daytime/nighttime respiration rate monitoring

A system and method automatically calibrate a posture sensor, such as by detecting a walking state or a posture change. For example, a three-axis accelerometer can be used to detect a patient's activity or posture. This information can be used to automatically calibrate subsequent posture or acceleration data.

Posture sensor automatic calibration

Various method embodiments of the present invention concern sensing patient-internal pressure measurements indicative of physiological exertion, identifying one or more steady state periods of physiological exertion based on the patient-internal pressure measurements, sensing extra-cardiac response data and cardiac response data corresponding to the one or more physiological exertion steady state periods, respectively comparing the extra-cardiac response data and the cardiac response data to extra-cardiac response information and cardiac response information associated with equivalent levels of physiological exertion intensity of the one or more steady state periods, and determining the likelihood that myocardial ischemia occurred during the one or more steady state periods based on the comparison of the extra-cardiac response data to the extra-cardiac response information and the cardiac response data to the cardiac response information.

Methods and apparatuses for detection of myocardial ischemia upon exertion

Systems and methods include obtaining a measure of cardiac contractility. A cardiac contractility variability is determined from the measure of cardiac contractility. Analyzing the cardiac contractility variability, an indication of cardio-vasculature health is provided.

Measures of cardiac contractility variability during ischemia

An example method includes monitoring a first posture including a first lateral decubitus posture (LDP), recording a first LDP record based on the first LDP, computing a first posture trend based on the first LDP record and determining and providing a wellness indication based on the first posture trend.

Method and apparatus for determining wellness based on decubitus posture

In an embodiment, an implantable medical device includes a controller circuit, a posture sensing circuit, and a physiological sensing circuit. The controller circuit senses a change in a physiological signal as a result of a change in posture, and generates a response as a function of that change. In another embodiment, the controller circuit identifies a heart failure condition as a function of the change in the physiological signal.

Physiological response to posture change

This document discusses, among other things, systems and methods for measuring the dynamics of pulmonary congestion in heart failure subjects over time to monitor the subjects susceptibility to pulmonary edema, including sensing and receiving information indicative of a bodily pressure and information indicative of pulmonary fluid, and using the transient responses of these measurements to compute parameters related to the dynamics of thoracic fluid accumulation, such as a critical pressure (P), a critical time (T), or a filtration index (K).

Systems and methods for monitoring pulmonary edema dynamics

This patent document describes, among other things, systems and methods for monitoring lung fluid status, such as monitoring the presence or absence of pulmonary edema, in a subject using information about the cardiac impedance-indicating component of a measured impedance-indicating signal. In various examples, an amplitude or contribution change over multiple cardiac cycles of the cardiac impedance-indicating component is used to compute and provide a lung status indication. In various examples, a decreasing amplitude or contribution trend of the cardiac impedance-indicating component signifies an increasing amount of fluid in the subject's lungs, as a greater portion of an injected thoracic impedance measurement current formerly traversing the heart is rerouted through the lung due to the less resistance path created by the fluid accumulation therein. In another example, measurements of the impedance-indicating signal, and thus the cardiac impedance-indicating component, are taken at one or a combination of end-inspiration or end-expiration.

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Forest Lake, MN, United States of America

Aaron Lewicke