Cardiac rhythm management system for edema
First Claim
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1. A method comprising:
- detecting a thoracic impedance of a subject;
lowpass filtering the thoracic impedance using a cutoff frequency that is approximately between 0.1 Hz and 0.5 Hz to obtain a resulting baseline thoracic impedance;
obtaining the baseline thoracic impedance at first and second times, the second time delayed from the first time;
comparing the baseline thoracic impedance at the first time with the baseline thoracic impedance at the second time; and
if the baseline thoracic impedance at the first time is less than the baseline thoracic impedance at the second time by a magnitude that exceeds a predetermined threshold value, then declaring a first condition to exist.
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Abstract
A cardiac rhythm management system detects edema. In response to an episode of detected edema, it initiates or adjusts a cardiac resynchronization therapy and/or a cardiac contractility modulation (CCM) therapy.
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Citations
120 Claims
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1. A method comprising:
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detecting a thoracic impedance of a subject;
lowpass filtering the thoracic impedance using a cutoff frequency that is approximately between 0.1 Hz and 0.5 Hz to obtain a resulting baseline thoracic impedance;
obtaining the baseline thoracic impedance at first and second times, the second time delayed from the first time;
comparing the baseline thoracic impedance at the first time with the baseline thoracic impedance at the second time; and
if the baseline thoracic impedance at the first time is less than the baseline thoracic impedance at the second time by a magnitude that exceeds a predetermined threshold value, then declaring a first condition to exist. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8)
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9. A cardiac rhythm management system comprising:
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an edema detection circuit to sense a condition correlative to edema in a subject, the edema detection circuit comprising a thoracic impedance detection circuit that comprises;
an averager/lowpass filter, comprising an input to receive a thoracic impedance signal and an output to provide a baseline portion of the thoracic impedance signal;
a delay circuit, comprising an input coupled to the output of the averager/lowpass filter, and comprising an output to provide a delayed baseline portion of the thoracic impedance signal; and
a comparator, comprising a first input coupled to the output of the delay circuit, and comprising a second input coupled to the output of the averager/lowpass filter, and comprising an output providing an edema indicator using a comparison of signals at the first and second inputs of the comparator;
an electrical energy delivery circuit to deliver electrical energy to the subject; and
a controller circuit, coupled to the edema detection circuit to receive the edema indicator, and coupled to the energy delivery circuit to provide a control signal for timing delivery of the electrical energy to the subject, the controller, and in which the controller is configured to initiate or adjust, in response to the edema indicator, a cardiac rhythm management therapy. - View Dependent Claims (10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20)
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21. A method comprising:
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detecting a thoracic impedance of a subject;
lowpass filtering the thoracic impedance to obtain a resulting lowpass filtered thoracic impedance;
comparing the lowpass filtered thoracic impedance to the thoracic impedance before such lowpass filtering;
if the thoracic impedance before such lowpass filtering is less than the lowpass filtered thoracic impedance by a magnitude that exceeds a predetermined threshold value, then declaring a thoracic fluid accumulation condition to exist. - View Dependent Claims (22, 23, 24, 25, 26, 27, 28)
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29. A cardiac rhythm management system comprising:
an edema detection circuit to sense a condition correlative to edema in a subject, the edema detection circuit comprising a thoracic impedance detection circuit that comprises;
an averager/lowpass filter, comprising an input to receive a thoracic impedance signal and an output to provide a baseline portion of the thoracic impedance signal; and
a comparator, comprising a first input coupled to the output of the averager/lowpass filter circuit, and comprising a second input coupled to the input of the averager/lowpass filter, and comprising an output providing an edema indicator using a comparison of signals at the first and second inputs of the comparator;
an electrical energy delivery circuit to deliver electrical energy to the subject; and
a controller circuit, coupled to the edema detection circuit to receive the edema indicator, and coupled to the energy delivery circuit to provide a control signal for timing delivery of the electrical energy to the subject, the controller, and in which the controller is configured to initiate or adjust, in response to the edema indicator, a cardiac rhythm management therapy. - View Dependent Claims (30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40)
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41. A method comprising:
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sensing, in a subject, a condition correlative to edema; and
initiating or adjusting, in response to the sensing, a cardiac resynchronization therapy that coordinates a spatial nature of a depolarization associated with a heart contraction in at least one heart chamber. - View Dependent Claims (42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54)
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55. A method comprising:
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sensing, in a subject, a condition correlative to edema; and
initiating or adjusting, in response to the sensing, a cardiac contractility modulation therapy that comprises delivering electrical energy to a portion of a heart during a refractory time period of the portion of the heart. - View Dependent Claims (56, 57, 58, 59, 60, 61, 62, 63)
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64. A method comprising:
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sensing, in a subject, a condition correlative to edema; and
selecting, in response to the sensing, a cardiac rhythm management therapy from a prioritized list of therapies. - View Dependent Claims (65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98)
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99. A cardiac rhythm management system comprising:
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an edema detection circuit to sense a condition correlative to edema in a subject;
an electrical energy delivery circuit to deliver electrical energy to the subject; and
a controller circuit, coupled to the edema detection circuit to receive a detected edema indicator, and coupled to the energy delivery circuit to provide a control signal for timing delivery of the electrical energy to the subject, the controller comprising a cardiac resynchronization therapy parameter, and in which the controller is configured to initiate or adjust, in response to the detected edema indicator, a cardiac resynchronization therapy that coordinates a spatial nature of a depolarization associated with a heart contraction in at least one heart chamber. - View Dependent Claims (100, 101, 102, 103, 104, 105, 106, 107, 108, 109, 110, 111, 112)
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113. A cardiac rhythm management system comprising:
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an edema detection circuit to sense a condition correlative to edema in a subject;
an electrical energy delivery circuit to deliver electrical energy to the subject; and
a controller circuit, coupled to the edema detection circuit to receive a detected edema indicator, and coupled to the energy delivery circuit to provide a control signal for timing delivery of the electrical energy to the subject, the controller comprising a cardiac contractility therapy mode, and in which the controller is configured to initiate or adjust, in response to the detected edema indicator, a cardiac contractility modulation therapy that comprises delivering electrical energy to a portion of a heart during a refractory time period of the portion of the heart - View Dependent Claims (114, 115, 116, 117, 118, 119, 120)
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Specification