DEVICES AND METHODS FOR DISEASE DETECTION, MONITORING AND/OR MANAGEMENT

• US 20080294060A1
• Filed: 05/21/2007
• Published: 11/27/2008
• Est. Priority Date: 05/21/2007
• Status: Abandoned Application

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Stahmann, Jeffrey E., Zhang, Yi, Lee, Kent, Beck, Kenneth C., Haro, Carlos F.
• Application Number:
  US11/751,111
• Publication Number:
  US 20080294060A1
• Time in Patent Office: Days
• US Class Current: 600/538
• CPC Class Codes: A61B 5/03 Detecting, measuring or recording fluid pressure within the body other than blood pressure, e.g. cerebral pressure; Measuring pressure in body tissues or organs A61B5/205 takes precedence
• CPC Class Codes: A61B 5/0535 Impedance plethysmography for measuring blood flow A61B5/0295
• CPC Class Codes: A61B 5/0809 by impedance pneumography
• CPC Class Codes: A61B 5/087 Measuring breath flow
• CPC Class Codes: A61B 5/6846 specially adapted to be brought in contact with an internal body part, i.e. invasive

Abstract

Embodiments of the invention are related to methods and devices for respiratory or cardiac disease detection, monitoring, and/or management. In an embodiment, the invention includes a method of calculating a pulmonary function parameter of a subject. The method can include obtaining a first signal indicative of lung volume change during breathing from a first sensor, obtaining a second signal indicative of distending pressure from a second sensor, and calculating the pulmonary function parameter based on the first signal and the second signal. In an embodiment, the invention includes a method of monitoring pulmonary or cardiac disease status. In an embodiment, the invention includes an implantable medical device. The implantable medical device can include a first sensor configured to produce a first signal indicative of lung volume change during breathing, a second sensor configured to produce a second signal indicative of intrapleural pressure, and a processor configured to calculate lung compliance or pulmonary resistance based on the first signal and the second signal. Other aspects and embodiments are provided herein.

Claims

1. A method of determining a pulmonary function parameter of a subject, the method comprising

obtaining a first signal indicative of lung volume change during breathing from a first sensor;

obtaining a second signal indicative of lung distending pressure from a second sensor, wherein at least one of the first and second sensors are chronically implanted; and

calculating the pulmonary function parameter based on the first signal and the second signal.

2. The method of claim 1, the pulmonary function parameter selected from the group consisting of lung compliance, pulmonary resistance, pressure-volume loop area, and pressure-volume loop centroid.

3. The method of claim 1, further comprising prompting the subject to perform a respiratory maneuver.

4. The method of claim 1, further comprising electrically stimulating contraction of the diaphragm.

5. The method of claim 1, further comprising electrically stimulating the phrenic nerve.

6. The method of claim 1, wherein both the first sensor and the second sensor are chronically implanted.

7. The method of claim 1, wherein obtaining a first signal indicative of lung volume change during breathing from a first sensor comprises obtaining an impedance signal from an impedance sensor.

8. The method of claim 1, wherein obtaining a second signal indicative of distending pressure from a second sensor comprises obtaining a pulmonary artery pressure signal from a pressure sensor.

9. The method of claim 1, wherein obtaining a second signal indicative of distending pressure from a second sensor comprises obtaining a pleural pressure signal.

10. The method of claim 1, further comprising transmitting the first signal and second signal to a processing unit.

11. The method of claim 1, wherein obtaining the first signal and obtaining the second signal are performed during normal tidal breathing of the patient.

12. The method of claim 1, wherein obtaining the first signal and obtaining the second signal are only performed in response to a triggering signal.

13. The method of claim 12, the triggering signal related to posture of the subject, wherein the triggering signal indicates that the subject is in a supine position.

14. The method of claim 12, the triggering signal related to the time of day.

15. The method of claim 12, the triggering signal related to the activity level of the subject, wherein the triggering signal indicates that the subject is at a particular level of activity.

16. A method of monitoring pulmonary or cardiac disease status, the method comprising:

obtaining a first signal indicative of lung volume change during breathing with a first sensor;

obtaining a second signal indicative of distending pressure with a second sensor, wherein at least one of the first and second sensors is chronically implanted;

calculating lung compliance and/or pulmonary resistance based on the first signal and the second signal; and

monitoring lung compliance and/or pulmonary resistance values over a period of time to obtain a lung compliance or pulmonary resistance trend.

17. The method of claim 16, further comprising evaluating whether or not the lung compliance or pulmonary resistance trend is adverse.

18. The method of claim 16, further comprising initiating administration of appropriate therapy based on the lung compliance or pulmonary resistance trend.

19. The method of claim 16, further comprising reporting the lung compliance or pulmonary resistance trend to a care provider.

20. An implantable medical device comprising:

a first sensor configured to produce a first signal indicative of lung volume change during breathing;

a second sensor configured to produce a second signal indicative of intrapleural pressure; and

a processor configured to calculate a pulmonary function parameter based on the first signal and the second signal.

21. The implantable medical device of claim 20, the first sensor comprising an impedance sensor.

22. The implantable medical device of claim 20, the second sensor comprising a pressure sensor.

23. The implantable medical device of claim 20, wherein at least one of the first sensor and the second sensor are in wireless communication with the processing unit.

24. The implantable medical device of claim 20, further comprising an electrode configured to stimulate contraction of the diaphragm.

25. A method of titrating drug therapy comprising:

obtaining a first signal indicative of lung volume change during breathing from a first sensor;

obtaining a second signal indicative of distending pressure from a second sensor, wherein at least one of the first and second sensors is chronically implanted;

calculating a value of a pulmonary function parameter based on the first signal and the second signal;

comparing the value of the pulmonary function parameter with a baseline value of the pulmonary function parameter; and

adjusting drug therapy if indicated based on comparison between the value of the pulmonary function parameter and the baseline value of the pulmonary function parameter.