METHOD AND APPARATUS FOR DETERMINING WELLNESS BASED ON DECUBITUS POSTURE

• US 20090024005A1
• Filed: 07/19/2007
• Published: 01/22/2009
• Est. Priority Date: 07/19/2007
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Patangay, Abhilash, Hatlestad, John D., Lewicke, Aaron
• Granted Patent: US 8,801,636 B2
• Time in Patent Office: Days
• US Class Current: 600/301
• CPC Class Codes: A61B 5/1112 Global tracking of patients, e.g. by using GPS
• CPC Class Codes: A61B 5/1116 Determining posture transitions
• CPC Class Codes: A61B 5/686 Permanently implanted devices, e.g. pacemakers, other stimulators, biochips A61B5/6861 takes precedence

Abstract

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.

Claims

1. A method, comprising:

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.

2. The method of claim 1, comprising:

detecting a physiological indication other than posture; and

computing the wellness indication also based on the physiological indication.

3. The method of claim 1, where the wellness indication includes an actual or potential heart failure indication.

4. The method of claim 1, where the first posture trend is recorded over one circadian rhythm period.

5. The method of claim 1, comprising:

recording a second posture differing from the first LDP;

computing a second posture trend based on the second posture; and

determining and providing the wellness indication based on the first posture trend and the second posture trend.

6. The method of claim 5, comprising comparing the first posture trend to the second posture trend and determining and providing the wellness indication based on the comparison of the first posture trend and the second posture trend.

7. The method of claim 5, where the first posture includes a right lateral decubitus posture (RLDP), and the second posture includes a left lateral decubitus posture (LLDP).

8. The method of claim 5, where the second posture includes at least one of a supine posture or a prone posture.

9. The method of claim 5, comprising providing an alert when the wellness indication includes a decreased wellness indication.

10. The method of claim 1, comprising:

recording a second posture differing from the first LDP;

computing the wellness indication based on the first posture and the second posture, the wellness indication including a first wellness level based on the first posture and a second wellness level based on the second posture;

comparing the first wellness level and the second wellness level to determine a third posture associated with increased wellness over the first and second postures; and

providing an indication of the third posture.

11. The method of claim 10, where the third posture includes a supine tilt posture.

12. An apparatus, comprising:

a posture sensor configured to produce a first posture indication including a first lateral decubitus posture (LDP);

a posture memory circuit coupled to the posture sensor, the posture memory circuit configured to store a first LDP record based on the first posture indication;

a posture trend circuit coupled to the posture memory circuit, the posture trend circuit configured to produce a posture trend based on the first LDP record; and

a wellness indicator circuit coupled to the posture trend circuit, the wellness indicator circuit configured to compute and provide a wellness indication based on the posture trend.

13. The apparatus of claim 12, where the first LDP is a left lateral decubitus posture (LLDP), the posture sensor is configured to produce a second posture indication include a right lateral decubitus posture (RLDP), the posture memory circuit is configured to store an RLDP record based on the second posture indication, and the posture trend circuit is configured to produce the posture trend based on a comparison of the first LDP record and the RLDP record.

14. The apparatus of claim 12, where the posture sensor is implantable.

15. The apparatus of claim 12, where the posture sensor is configured to produce a second posture indication including at least one of a supine posture or a prone posture, the posture memory circuit is configured to store a supine record and a prone record, the prone record and the supine record based on the second posture indication, and the posture trend circuit is configured to produce the posture trend based on a comparison of the first LDP record, the supine record and the prone record.

16. The apparatus of claim 12, where the wellness indicator circuit is configured to compare the posture trend to a specified posture trend.

17. The apparatus of claim 16, comprising an alert circuit communicatively coupled to the wellness indicator circuit, the alert circuit configured to trigger an alert when the wellness indication includes a decreased wellness indication.

18. The apparatus of claim 17, where the alert includes at least one of an email message, a phone call, a flashing light, a mattress tilt adjustment signal, a mattress temperature adjustment signal, a mattress firmness adjustment signal, or an audible tone.

19. The apparatus of claim 17, comprising an electrical pulse circuit coupled to the alert circuit, the electrical pulse circuit configured to provide an electrical pulse based on the alert.

20. The apparatus of claim 19, where the electrical pulse circuit is configured to produce at least one of a premature ventricular complex (PVC), an intermittent diaphragm stimulation, or an uncomfortable electric shock.

21. The apparatus of claim 12, comprising:

a physiologic sensor configured to produce a physiologic indication other than posture;

a physiologic indication memory, coupled to the physiologic sensor, the physiologic indication memory configured to store a physiologic indication record based on the physiology indication; and

a physiologic indication trend circuit coupled to the physiologic indication memory circuit, the physiologic indication trend circuit configured to produce a physiologic indication trend based on the physiologic indication record,

wherein the wellness circuit is configured to compute the wellness indication based on the physiologic record.

22. The apparatus of claim 21, where the physiologic sensor includes, and uses for forming the physiologic indication, at least one of an autonomic balance sensor, a breath sensor, an pulmonary fluid sensor, a cardiac output sensor, a preload circuit, a weight change sensor, a pressure sensor, a heart rate sensor, a heart rate variability sensor, or a heart sounds sensor.

23. The apparatus of claim 22, where the autonomic balance sensor includes a heart rate variability power spectrum comparator configured to produce a ratio of low frequency autonomic activity to high frequency autonomic activity.

24. The apparatus of claim 22, where the physiologic indication includes at least one of a paroxysmal nocturnal dyspnea indication or an orthopnea indication.

25. A system for monitoring a patient, comprising:

means for monitoring patient posture;

means for recording a lateral decubitus posture (LDP);

means for computing a posture trend based on the LDP; and

means for determining and providing a wellness indication based on the posture trend.

26. The system of claim 25, where the means for monitoring patient posture include a posture sensor configured to produce a first posture indication including a lateral decubitus posture (LDP).

27. The system of claim 26, where the means for recording a lateral decubitus posture (LDP) include a posture memory circuit coupled to the posture sensor, the posture memory circuit configured to store an LDP record based on the first posture indication.

28. The system of claim 27, where the means for computing a posture trend based on the LDP include a posture trend circuit coupled to the posture memory circuit, the posture trend circuit configured to produce a posture trend based on the LDP record.

29. The system of claim 28, where the means for determining a wellness indication based on the posture trend include a wellness indicator circuit coupled to the posture trend circuit, the wellness indicator circuit configured to compute and provide a wellness indication based on the posture trend.