Cardiac Pacemakers, Inc.

Other

Kenneth C Beck

Yi Zhang

John D Hatlestad

Ramesh Wariar

Jeffrey E Stahmann

Pramodsingh Hirasingh Thakur

Kent Lee

Krzysztof Z Siejko

Viktoria A Averina

Julie A Thompson

Abhilash Patangay

Jonathan T Kwok

Zheng Lin

Gerrard Merrill Carlson

Aaron Lewicke

Bryan Allen Clark

Shantha Arcot-Krishnamurthy

Marina V Brockway

Donald Lee Hopper

Lili Liu

Yunlong Zhang

Veerichetty A Kadhiresan

Yachuan Pu

Aiden Flanagan

Eric A Mokelke

Jon Peterson

Lemont Baker

Chie Kawahara

Kassity Yefei Liu

An implantable or other ambulatory medical apparatus comprises a posture sensing circuit, a physiologic sensing circuit that senses a time varying physiologic signal, and a processor circuit. The processor circuit includes a posture calculation circuit and a measurement circuit. The posture calculation circuit determines a posture of the subject using posture data obtained using the posture signal and determines when the posture of the subject is steady state. The measurement circuit derives a physiologic measurement using physiologic data extracted from the physiologic signal during at least one time period when posture is determined to be steady state and provides the physiologic measurement to at least one of a user and a process in association with the determined steady state posture.

Physiologic response to posture

An apparatus comprises plurality of sensors and a processor. Each sensor provides a sensor signal that includes physiological information and at least one sensor is implantable. The processor includes a physiological change event detection module that detects a physiological change event from a sensor signal and produces an indication of occurrence of one or more detected physiological change events, and a heart failure (HF) detection module. The HF detection module determines, using a first rule, whether the detected physiological change event indicative of a change in HF status of a subject, determines whether to override the first rule HF determination using a second rules, and declares whether the change in HF status occurred according to the first and second rules.

Multi-sensor strategy for heart failure patient management

Patient posture information can be received, such as to indicate a change in patient posture by at least a threshold amount. A transient response signal indicative of a change in a physiological parameter can be received at multiple instances near a change in patient posture. Waveform morphology features can be extracted from a transient response signal and used to provide an indication of a cardiac status, such as a heart failure status.

Transient sensor response to posture as a measure of patient status

A system may include a port, at least one sensing circuit, and at least one processor. The port is configured to receive an indication of dosing of medication to treat a pulmonary condition of a heart failure (HF) subject and the at least one sensing circuit configured to sense at least one physiological signal, wherein the physiological signal includes physiological information of the HF subject. The at least one processor includes a parameter module configured to extract values of at least one physiological parameter indicative of health status of the HF subject, and a trending module configured to trend extracted values of the at least one physiological parameter and detect an effect of the dosing of the medication on the HF subject using the trending of the extracted values of the at least one physiological parameter.

Chronic obstructive pulmonary disease drug titration and management

An apparatus may include a sensing circuit and a processor. The sensing circuit is configured to generate a sensed physiological signal, wherein the physiological signal includes respiration information of a subject. The processor includes an end expiratory volume (EEV) module configured to determine a value of EEV of the subject using the sensed physiological signal, and a lung hyperinflation detection module configured to generate an indication of lung hyperinflation of the subject according to the value of EEV and provide the indication to at least one of a user or process.

Detection of chronic obstructive pulmonary disease exacerbations from breathing patterns

Systems and methods for detecting a worsening of patient's heart failure condition based, at least in part, on an increasing trend in a representative rapid shallow breathing index (RSBI) value over multiple days. The RSBI value may be a minimum RSBI, and more particularly may be a minimum RSBI value determined for an afternoon portion of each of the multiple days. The minimum RSBI value measured during an afternoon portion of the day may be more sensitive to changes in a patient's respiration, particularly when a patient is expected to be more active, and thus, may more readily exhibit an increasing trend when patient's heart failure is in decline.

System and method for detecting worsening of heart failure based on rapid shallow breathing index

A physiological response to activity (PRA) during a subject's activities of daily living (ADL) can be used, such as to generate useful diagnostic information about the subject. This can involve using a template, such as an impulse response template. The technique can be used with an implantable or other ambulatory medical monitoring or therapy device, such as a cardiac function management device, or with a local or remote external interface device.

Kinetics of physiological response to activity during activities of daily living

An apparatus comprises plurality of sensors and a processor. Each sensor provides a sensor signal that includes physiological information and at least one sensor is implantable. The processor includes a physiological change event detection module that detects a physiological change event from a sensor signal and produces an indication of occurrence of one or more detected physiological change events, and a heart failure (HF) detection module. The HF detection module determines, using a first rule, whether the detected physiological change event is indicative of a change in HF status of a subject, determines whether to override the first rule HF determination using a second rules, and declares whether the change in HF status occurred according to the first and second rules.

An implantable activity detector can detect metabolic stress levels, which can be normalized, such as to identify times of activities such as walking and running or to identify trends such as a decrease in metabolic activity. The data can be derived from different sources such as an accelerometer and pedometer. This data can be compared to independently specifiable thresholds, such as to trigger an alert or responsive therapy, or to display one or more trends. The information can also be combined with other congestive heart failure (CHF) indications. The alert can notify the patient or a caregiver, such as via remote monitoring. Metabolic activity data from one or more of the activity detectors can be used to establish a model of metabolic stress, to which further activity data can be compared for identifying periods of increased or decreased metabolic stress.

Logging daily average metabolic activity using a motion sensor

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

An apparatus comprises a physiologic sensing circuit and a control circuit. The physiologic sensing circuit is configured to sense an electrical respiration signal representative of respiration of a subject. The control circuit includes a respiration monitor circuit and a therapy circuit. The respiration monitor circuit is configured to extract a respiration parameter from the respiration signal and detect that a value of the respiration parameter is outside of a target value range for the respiration parameter. The therapy circuit is configured to deliver neural stimulation to the carotid sinus of the subject to stimulate respiration and to adjust respiration to maintain the value of the respiration parameter within the target value range.

Neural control of central sleep apnea

An inspiratory muscle stimulation system uses an implantable medical device to deliver stimulation to control diaphragmatic contractions for slower and deeper breathing, thereby conditioning and strengthening inspiratory muscles. In various embodiments, respiratory and/or cardiac performance are monitored for controlling parameters of the stimulation.

Method and apparatus for inspiratory muscle stimulation using implantable device

Systems and methods permit remotely-monitored rehabilitation of a patient. A system can comprise a patient monitor configured to monitor a patient's physiological data. The patient monitor can monitor using a first monitoring mode. A patient communication device can be configured to present, to the patient, an option to perform an exercise regimen, and to receive a response indicating whether the patient will perform the exercise regimen. A configuration module coupled to the patient communication device can be configured to activate a second monitoring mode when the response indicates that the patient will perform the exercise regimen. When the exercise regimen is complete, the first monitoring mode can be re-established. When the response indicates that the patient will not perform the exercise regimen, the response can be recorded as a negative response, and the option to perform the exercise regimen can be presented again.

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Liberty, UT, United States of America

Kenneth C Beck