Cardiac Pacemakers, Inc.

Yousufali H Dalal

Yi Zhang

Marina V Brockway

John D Hatlestad

Krzysztof Z Siejko

Carlos Haro

Richard O Kuenzler

Gerrard Merrill Carlson

Kent Lee

Abhilash Patangay

Viktoria A Averina

Julie A Thompson

Richard Fogoros

Loell Boyce Moon

Jeffrey E Stahmann

Andrew P Kramer

James Gregory Bentsen

Yunlong Zhang

Yachuan Pu

Haresh G Sachanandani

Aaron Lewicke

Gerard M Carlson

Lizbeth M Mino

Systems and methods provide for assessing the heart failure status of a patient and, more particularly, to generating a trend parameter based on a distribution of the patient's respiration rate. Systems and methods provide for detecting, using an implantable device or a patient-external device, patient respiration and computing a respiration rate based on the detected patient respiration. A distribution of the respiration rate is calculated, and a trend parameter based on the respiration rate distribution is generated. The trend parameter is indicative of a patient's heart failure status. An output signal indicative of the patient's heart failure status may be generated based on the trend parameter.

System and method for generating a trend parameter based on respiration rate distribution

Assessing decongestive therapy delivered to a heart failure patient involves use of an implantable sensor configured to sense a physiologic parameter indicative of the patient's diuresis status and a processor coupled to the implantable sensor. The sensor may comprise a thoracic fluid sensor, a heart sounds sensor, a cardiac chamber or arterial pressure sensor, a respiration sensor, or a blood chemistry sensor, for example. The processor is configured to determine if a target level of patient diuresis has been achieved based on a relationship between the sensed physiologic parameter and a threshold developed for the patient, and to produce an output in response to determining that the target level of patient diuresis has been achieved. The processor may be disposed in an implantable housing, in a patient-external housing, or in a network server system.

Decongestive therapy titration for heart failure patients using implantable sensor

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

Implantable medical devices and techniques are implemented that use bio-impedance to measure aspects of patient physiology. A signal separation method is performed at least in part in an implantable device. The method involves detecting a plurality of impedance signals using a plurality of implantable electrodes coupled to the implantable device. The method further involves separating one or more signals from the plurality of impedance signals using a signal separation technique, such as an algorithm-based separation technique.

Bio-impedance sensor and sensing method

The health state of a subject is automatically evaluated or predicted using at least one implantable device. In varying examples, the health state is determined by sensing or receiving information about at least one physiological process having a circadian rhythm whose presence, absence, or baseline change is associated with impending disease, and comparing such rhythm to baseline circadian rhythm prediction criteria. Other chronobiological rhythms beside circadian may also be used. The baseline prediction criteria may be derived using one or more past physiological process observation of the subject or population of subjects in a non-disease health state. The prediction processing may be performed by the at least one implantable device or by an external device in communication with the implantable device. Systems and methods for invoking a therapy in response to the health state, such as to prevent or minimize the consequences of predicted impending heart failure, are also discussed.

Monitoring of chronobiological rhythms for disease and drug management using one or more implantable device

A system comprising an implantable medical device (IMD) includes an implantable heart sound sensor to produce an electrical signal representative of at least one heart sound. The heart sound is associated with mechanical activity of a patient's heart. Additionally, the IMD includes a heart sound sensor interface circuit coupled to the heart sound sensor to produce a heart sound signal, and a signal analyzer circuit coupled to the heart sound sensor interface circuit. The signal analyzer circuit measures a baseline heart sound signal, and deems that an ischemic event has occurred using, among other things, a measured subsequent change in the heart sound signal from the established baseline heart sound signal.

Ischemia detection using a heart sound sensor

Various system embodiments include a glucose control input, a low physical activity input, and a diabetic therapy delivery system adapted to respond to the glucose control input and the low physical activity input to deliver diabetic therapy. According to various embodiments, the diabetic therapy includes an anti-arrhythmia therapy, a hypertension therapy, a neural stimulation therapy adapted to reduce a risk of myocardial infarction, a neural stimulation therapy adapted to be applied after a myocardial infarction to reduce an infarct area, a neural stimulation therapy adapted to reduce a risk of sudden cardiac death, a therapy adapted to secrete insulin, or a therapy to reduce a workload of a diabetic heart. Other aspects and embodiments are provided herein.

System for providing diabetic therapy

A system delivers stimulation to volume receptors in the cardiovascular system to induce diuresis in a patient suffering volume overload. The system senses a volume signal indicative of a level of fluid retention in the patient's body and controls the delivery of the stimulation using the volume signal. In various embodiments, the stimulation includes one or more of electrical stimulation, which delivers electrical pulses to the volume receptors, and mechanical stimulation, which physically stretches the volume receptors.

Method and apparatus for regulating blood volume using volume receptor stimulation

This document discusses, among other things, systems and methods for determining sleep state, such as awake, sleeping, non-REM sleep, or REM sleep. Respiration and heart contractions are monitored. A cardio-respiratory ratio such as beats per breath is computed and used in the sleep state determination. Other information, such as heart rate variability (HRV), posture, and activity level can also be used in the sleep state determination. The sleep state information can be used to qualify or trigger storage of other physiological sensor data, or to permit remote sleep study monitoring of a subject, or to control or adjust one or more monitoring, diagnostic, or therapy algorithms, such as, for example a continuous positive airflow pressure (CPAP) device.

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Northbridge, CA, United States of America

Yousufali H Dalal