Enhancements to the detection of pulmonary edema when using transthoracic impedance
First Claim
1. A system comprising:
- an implantable thoracic impedance measurement circuit, adapted to sense a thoracic impedance signal from a subject;
a parameter collection device, adapted to sense or receive physiologic information about the subject, the physiologic information including at least one heart sound and a neurohormone level;
a posture sensor adapted to sense a posture signal;
a pulmonary edema indicator, coupled with the thoracic impedance measurement circuit to accept the thoracic impedance signal, coupled with the parameter collection device to accept the physiologic information, and coupled with the posture sensor to accept the posture signal, wherein the pulmonary edema indicator is adapted to provide a pulmonary edema indication using the thoracic impedance signal, the physiologic information, and the posture signal.
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Abstract
This patent document discusses, among other things, systems, devices, and methods for enhancing detection of pulmonary edema using, in addition to thoracic impedance, one or a combination of: physiologic information about a subject, at least one statistical parameter, a user-programmable detection level, at least one parameter associated with a previous pulmonary edema event, and patient symptom information about the subject. In one example, a (base) thoracic impedance threshold is modified to an adjusted thoracic impedance threshold. The adjusted thoracic impedance threshold provides an increased sensitivity of pulmonary edema detection as compared to the base thoracic impedance threshold. In another example, an alert is provided to a subject, a caregiver, or other user based on a pulmonary edema indication determined by the present systems, devices, and methods. In a further example, a therapy (provided to the subject) is adjusted or initiated in response to the pulmonary edema indication.
151 Citations
39 Claims
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1. A system comprising:
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an implantable thoracic impedance measurement circuit, adapted to sense a thoracic impedance signal from a subject; a parameter collection device, adapted to sense or receive physiologic information about the subject, the physiologic information including at least one heart sound and a neurohormone level; a posture sensor adapted to sense a posture signal; a pulmonary edema indicator, coupled with the thoracic impedance measurement circuit to accept the thoracic impedance signal, coupled with the parameter collection device to accept the physiologic information, and coupled with the posture sensor to accept the posture signal, wherein the pulmonary edema indicator is adapted to provide a pulmonary edema indication using the thoracic impedance signal, the physiologic information, and the posture signal. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 29, 30)
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9. A method comprising:
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implantably sensing a thoracic impedance signal from the thorax of a subject; sensing or receiving physiologic information about the subject, the physiologic information including at least one heart sound and a neurohormone level; sensing a posture signal corresponding to the posture of the subject; determining, using a processor circuit, a pulmonary edema indication using the thoracic impedance signal, the physiologic information, and the posture signal, wherein determining the pulmonary edema indication includes comparing the thoracic impedance signal to a thoracic impedance threshold. - View Dependent Claims (10, 11, 12, 13, 36)
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14. A system comprising:
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an implantable thoracic impedance measurement circuit, adapted to sense a thoracic impedance signal from a subject; a posture sensor coupled to the pulmonary edema indicator, the posture sensor adapted to sense a posture signal; a parameter collection device, adapted to sense or receive patient symptom information about the subject, the patient symptom information including a user-entered feeling of anxiety; a pulmonary edema indicator, coupled with the thoracic impedance measurement circuit to accept the thoracic impedance signal, coupled with the parameter collection device to accept the patient symptom information, and coupled with the posture sensor to accept the posture signal, wherein the pulmonary edema indicator is adapted to determine a pulmonary edema indication using the thoracic impedance signal, the patient symptom information, and the posture signal. - View Dependent Claims (15, 16, 17, 18, 19, 20, 21, 31, 32, 33, 34, 35)
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22. A method comprising:
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implantably sensing a thoracic impedance signal from the thorax of a subject; sensing or receiving at least one patient symptom about the subject, the patient symptom including a user-entered feeling of anxiety; sensing a posture signal corresponding to the posture of the subject; and determining, using a processor circuit, a pulmonary edema indication using the at least one patient symptom and the posture signal, wherein determining the pulmonary edema indication includes comparing the thoracic impedance signal to a thoracic impedance threshold. - View Dependent Claims (23, 24, 25, 26, 37)
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27. An apparatus comprising:
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means for implantably sensing a thoracic impedance signal from the thorax of a subject; means for sensing a posture signal corresponding to the posture of the subject; means for sensing or receiving physiologic information about the subject, the physiologic information selected including at least one heart sound and a neurohormone level; and means for determining a pulmonary edema indication using the thoracic impedance signal, the posture signal, and the physiologic information, wherein determining the pulmonary edema indication includes comparing the thoracic impedance signal to a thoracic impedance threshold. - View Dependent Claims (38)
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28. An apparatus comprising:
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means for implantably sensing a thoracic impedance signal from the thorax of a subject; means for sensing a posture signal corresponding to the posture of the subject; means for sensing or receiving at least one patient symptom about the subject, the patient symptom including a user-entered feeling of anxiety; and means for determining a pulmonary edema indication using the at least one patient symptom and the posture signal, wherein determining the pulmonary edema indication includes comparing the thoracic impedance signal to a thoracic impedance threshold. - View Dependent Claims (39)
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Specification