WEARABLE CARDIOVERTER DEFIBRILLATOR (WCD) APPARATUS AND METHOD FOR IMPROVED COMFORT AND LONGER WEAR

• US 20170367591A1
• Filed: 12/18/2015
• Published: 12/28/2017
• Est. Priority Date: 12/18/2014
• Status: Abandoned Application

• Current Assignee: Koninklijke Philips N.V.
• Original Assignee: Koninklijke Philips N.V.
• Inventors: JORGENSON, DAWN BLILIE
• Application Number:
  US15/535,581
• Publication Number:
  US 20170367591A1
• Time in Patent Office: Days
• CPC Class Codes: A61B 5/0002 Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network A61B5/07 takes precedence; transmission systems for measured values G08C; transmission H04B; transmission of digital information H04L; wireless communication networks H04W
• CPC Class Codes: A61B 5/0205 Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
• CPC Class Codes: A61B 5/02416 using photoplethysmograph signals, e.g. generated by infrared radiation A61B5/14552 takes precedence
• CPC Class Codes: A61B 5/02438 with portable devices, e.g. worn by the patient
• CPC Class Codes: A61B 5/0816 Measuring devices for examining respiratory frequency measuring frequency of electric signals G01R23/00
• CPC Class Codes: A61B 5/1107 Measuring contraction of parts of the body, e.g. organ, muscle apparatus for measuring work or force in general G01L
• CPC Class Codes: A61B 5/14551 for measuring blood gases
• CPC Class Codes: A61B 5/282 Holders for multiple electrodes for introduction into the body A61B5/287
• CPC Class Codes: A61B 5/361 Detecting fibrillation
• CPC Class Codes: A61B 5/363 Detecting tachycardia or bradycardia
• CPC Class Codes: A61B 5/6805 Vests
• CPC Class Codes: A61B 5/6822 Neck
• CPC Class Codes: A61B 5/6823 Trunk, e.g., chest, back, abdomen, hip
• CPC Class Codes: A61B 5/6824 Arm or wrist
• CPC Class Codes: A61B 5/7405 using sound
• CPC Class Codes: A61N 1/046 Specially adapted for shock therapy, e.g. defibrillation
• CPC Class Codes: A61N 1/0484 Garment electrodes worn by the patient
• CPC Class Codes: A61N 1/37258 Alerting the patient
• CPC Class Codes: A61N 1/3904 External heart defibrillators [EHD]
• CPC Class Codes: A61N 1/3993 User interfaces for automatic external defibrillators

Abstract

A wearable cardioverter defibrillator (WCD) (10) and method (60) comprise a set of electrodes (12) for placement on a subject (14), a mechanism for electrically engaging (16) the set of electrodes to the subject'"'"'s skin, and at least one non-invasive physiologic sensor (18, 20) configured for placement on the subject. A controller (24) monitors an output of the non-invasive physiologic sensor (18, 20) for detecting a change in a health parameter of the subject being indicative of one or more of a change in subject condition that may be a precursor to potential cardiac arrhythmia or a simultaneously occurring cardiac arrhythmia. Responsive to detecting the change, the controller (24) activates an alarm (26) for requesting a response from the subject (14) within a predetermined time. Responsive to receiving the subject'"'"'s response within the predetermined time, the controller (24) inhibits the mechanism (16) from electrically engaging the set of electrodes (12) to the subject'"'"'s skin. Responsive to not receiving the subject'"'"'s response, the controller (24) initiates the mechanism (16) for electrically engaging the set of electrodes (12) to the subject'"'"'s skin.

Claims

1. A wearable cardioverter defibrillator (WCD) comprising:

a set of electrodes configured for placement on a subject, the set of electrodes at least operable to sense an ECG signal from the subject;

means for electrically engaging the set of electrodes to the subject'"'"'s skin;

at least one non-invasive physiologic sensor configured for placement on the subject, wherein the at least one non-invasive physiologic sensor comprises one or more of a photoplethysmographic (PPG) sensor and accelerometer sensor; and

a controller configured to monitor an output of said at least one non-invasive physiologic sensor for detecting a change in a health parameter of the subject being indicative of one or more of a change in subject condition that may be a precursor to potential cardiac arrhythmia or a simultaneously occurring cardiac arrhythmia, wherein responsive to detecting the change, said controller activates an alarm for requesting a response from the subject within a predetermined period of time, wherein (i) responsive to receiving the response from the subject within the predetermined period of time, said controller inhibits the means for electrically engaging the set of electrodes to the subject'"'"'s skin, and (ii) responsive to not receiving the response from the subject within the predetermined period of time, said controller initiates the means for electrically engaging the set of electrodes to the subject'"'"'s skin,

wherein the set of electrodes comprises a first set of electrodes operable to sense the ECG signal from the subject and a second set of electrodes operable to deliver a therapeutic shock to the subject,

wherein the engaging means electrically engages the first set of electrodes and the second set of electrodes to the subject'"'"'s skin, and

wherein the controller is operable to initiate the means for electrically engaging (i) the first set of electrodes and (ii) the second set of electrodes, the controller further operable to obtain an ECG signal after the first set of electrodes is electrically engaged and deliver the therapeutic shock, in response to an analysis of the ECG signal obtained after the first set of electrodes is electrically engaged, after the second set of electrodes is electrically engaged.

2. The WCD of claim 1, wherein the set of electrodes comprises a single set of electrodes that is further at least operable to deliver a therapeutic shock to the subject, and wherein the controller is further operable to deliver the therapeutic shock in response to an analysis of an ECG signal obtained after the set of electrodes is electrically engaged.

4. The WCD of claim 1, wherein the means for electrically engaging the set of electrodes includes a mechanism for disposing at least one conductive portion of each electrode of the set of electrodes between a non-conductive contact position and a conductive contact position, wherein responsive to being in the non-conductive contact position, the at least one electrically conductive portion of each electrode of the set of electrodes does not physically engage the set of electrodes for electrical contact to the subject'"'"'s skin, and wherein responsive to being in the conductive contact position, the at least one electrically conductive portion of each electrode of the set of electrodes physically engages the set of electrodes for electrical contact to the subject'"'"'s skin.

5. The WCD of claim 2, further wherein the set of electrodes comprises dry therapeutic electrodes with self-deploying gel that automatically deploys the gel prior to shock delivery, the therapeutic electrodes being configured for both obtaining of the ECG signal for assessment and shock determination and delivery of the therapeutic shock. operable to sense an ECG signal from the subject (Step 64);

configuring at least one non-invasive physiologic sensor for placement on the subject, wherein the at least one non-invasive physiologic sensor comprises one or more of a photoplethysmographic (PPG) sensor and accelerometer sensor (Step 66); and

monitoring, via a controller, an output of said at least one non-invasive physiologic sensor for detecting a change in a health parameter (Step 68) of the subject being indicative of one or more of a change in subject condition that may be a precursor to potential cardiac arrhythmia or a simultaneously occurring cardiac arrhythmia, wherein responsive to detecting the change, activating, via the controller, an alarm (Step 72) for requesting a response from the subject within a predetermined period of time, wherein (i) responsive to receiving the response from the subject within the predetermined period of time, inhibiting (Step 76), via the controller, an electrical engagement of the set of electrodes to the subject'"'"'s skin, and (ii) responsive to not receiving the response from the subject within the predetermined period of time, initiating (Step 78), via the controller, a control signal for electrically engaging the set of electrodes, via an electrical engagement mechanism, to the subject'"'"'s skin,

wherein configuring the set of electrodes (Step 64) comprises configuring a first set of electrodes operable to sense the ECG signal from the subject and a second set of electrodes operable to deliver a therapeutic shock to the subject,

wherein electrically engaging (Step 78) comprises electrically engaging the first set of electrodes and the second set of electrodes to the subject'"'"'s skin, and

wherein initiating the control signal further comprises for electrically engaging (i) the first set of electrodes and (ii) the second set of electrodes, for obtaining an ECG signal after the first set of electrodes is electrically engaged, in response to an analysis of the ECG signal obtained after the first set of electrodes is electrically engaged, after the second set of electrodes is electrically engaged.

3. (canceled)

12. The method of claim 11, wherein configuring the set of electrodes (Step 64) further includes configuring a single set of electrodes for being at least operable to deliver a therapeutic shock to the subject, further comprising delivering the therapeutic shock in response to an analysis of an ECG signal obtained after the set of electrodes is electrically engaged.

15. The method of claim 12, further wherein the set of electrodes comprises dry therapeutic electrodes with self-deploying gel that automatically deploys the gel prior to shock delivery, the therapeutic electrodes being configured for both obtaining of the ECG signal for assessment and shock determination and delivery of the therapeutic shock.

13. (canceled)

14. The method of claim 11, wherein electrically engaging (Step 78) the set of electrodes includes disposing at least one conductive portion of each electrode of the set of electrodes between a non-conductive contact position and a conductive contact position, wherein responsive to being in the non-conductive contact position, the at least one electrically conductive portion of each electrode of the set of electrodes does not physically engage the set of electrodes for electrical contact to the subject'"'"'s skin, and wherein responsive to being in the conductive contact position, the at least one electrically conductive portion of each electrode of the set of electrodes physically engages the set of electrodes for electrical contact to the subject'"'"'s skin.

16. The method of claim 11, further wherein the first set of electrodes comprises dry non-adhesive sensing electrodes and the second set of electrodes comprises dry therapeutic electrodes with self-deploying gel that automatically deploys the gel prior to shock delivery.

17. The method of claim 11, further comprising:

providing an alarm module for providing the alarm as activated, wherein the alarm includes at least one or more of an audible, tactile, or visible alarm; and

providing a user interface for receiving the response from the subject.

18. The method of claim 11, further comprising:

disposing the set of electrodes on at least one surface of a wearable garment adjacent the subject'"'"'s skin in response to being worn by the subject.

19. The method of claim 11, further comprising:

communicating to a remote device, via at least one or more of wireless and wired communication, an occurrence of a therapeutic shock delivery with the set of electrodes.

20. The method of claim 11, wherein the photoplethysmographic (PPG) sensor is configured to monitor the change in health parameter as a function of arterial oxygen saturation, and wherein the accelerometer sensor is configured to monitor the change in health parameter as a function of respiration and a lack of breathing.