Methods and devices for detection of context when addressing a medical condition of a patient

• US 7,986,998 B2
• Filed: 07/10/2008
• Issued: 07/26/2011
• Est. Priority Date: 10/11/2002
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Hatlestad, John D.
• Primary Examiner(s): Bertram; Eric D.
• Application Number:
  US12/171,210
• Publication Number:
  US 20080269622A1
• Time in Patent Office: 1,111 Days
• Field of Search: 607/60, 600/301
• US Class Current: 607/60
• CPC Class Codes: A61B 2560/0242 adapted to measure environmental factors, e.g. temperature, pollution
• CPC Class Codes: A61B 5/024 Detecting, measuring or recording pulse rate or heart rate A61B5/0205, A61B5/021 take precedence
• 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
• CPC Class Codes: A61N 1/3987 characterised by the timing or triggering of the shock

Abstract

Methods and devices detect context related to a patient when monitoring a physiological condition of the patient and/or when applying one or more modes of therapy. The context may be a patient context such as posture or an environmental context such as ambient conditions. The context may be used in various ways in relation to the physiological measurement, such as to control when the physiological measurements are made, to appropriately flag physiological measurements, to be recorded in association with the physiological measurements, and/or to correct the physiological measurements based on a reference context. A device such as a beacon transmitter is used in detecting the context and a measurement device such as an implantable cardiovascular device is used to capture the physiological measurements.

Claims

1. A method of monitoring physiological conditions of an ambulatory patient who is capable of moving to a plurality of non-clinical locations, comprising:

measuring at least one physiological condition of the patient with an implanted medical device;

associating a non-clinical location with a contextual condition for the patient that is relevant when measuring the at least one physiological condition of the patient, wherein the non-clinical location is one of the plurality of non-clinical locations to which the ambulatory patient is capable of moving; and

while measuring the at least one physiological condition, utilizing the implantable medical device for sensing an external device in the non-clinical location and determining that the contextual condition associated with the non-clinical location exists when the patient is within a range of the external device and the implantable medical device senses the external device; and

flagging with a first indicator one or more measurements resulting from the measuring done while the contextual condition continues to exist.

2. The method of claim 1, wherein the contextual condition is determinative of a patient context.

3. The method of claim 2, wherein detecting whether the at least one contextual condition exists comprises interacting from the external device to the implanted medical device for detecting the patient context.

4. The method of claim 1, wherein sensing that the external device is within the range comprises:

emitting a signal from the external device;

receiving the signal at the implanted medical device when the implanted medical device is within the range of the external device; and

flagging with the first indicator one or more measurements of the at least one physiological condition upon the implanted medical device receiving the signal.

5. The method of claim 1, wherein the at least one contextual condition defines an environmental context.

6. The method of claim 5, wherein the environmental context is temperature present proximal to the patient.

7. The method of claim 1, wherein measuring the at least one physiological condition comprises measuring a cardiovascular value.

8. The method of claim 1, wherein measuring the at least one physiological condition comprises measuring a respiratory value.

9. The method of claim 1, comprising changing a therapy mode of the implantable medical device in association with sensing the external device.

10. A system for monitoring physiological conditions of a patient, comprising:

a transmitter external to the patient and in a predetermined location associated with at least one contextual condition;

a detector adapted to detect whether the detector is within a range of the transmitter to detect the at least one contextual condition;

an implanted physiological sensor adapted to sense a physiological condition of the patient inside and outside of the range; and

a processing device configured to communicate with the implanted physiological sensor to measure at least one physiological condition of the patient, to determine if measurements from the implanted physiological sensor were taken when the detector detects the at least one contextual condition, and to flag the measurements taken when the detector detects the at least one contextual condition.

11. The system of claim 10, wherein the detector is an electromagnetic wave receiver.

12. The system of claim 10, wherein the physiological sensor is a cardiovascular sensor.

13. The system of claim 10, further comprising:

a second transmitter that outputs a signal encoded with the measurements made by the processing device from the physiological sensor; and

a receiver external to the patient adapted to receive the signal of the second transmitter.

14. A method of monitoring physiological conditions of an ambulatory patient who is capable of moving to a plurality of non-clinical locations, comprising:

measuring at least one physiological condition of the patient with a measurement device while the patient is in non-clinical locations;

while measuring the at least one physiological condition, utilizing the measurement device for sensing that an external device is within a range and for detecting whether at least one contextual condition associated with the patient exists, the external device in a predetermined location associated with the contextual condition, the external device for emitting a signal from the predetermined location, wherein utilizing the external device includes using the measurement device for detecting the signal emitted by the external device and for determining that the measurement device is proximal to the predetermined location and that the at least one contextual condition exists when the signal from the external device is detected; and

flagging with a first indicator one or more measurements resulting from the measuring done while the signal is received by the measurement device.

15. The method of claim 14, wherein the external device transmits the signal from the predetermined location before the patient is within range for the measurement device to sense the signal transmitted from the predetermined location.

16. The method of claim 15, wherein the predetermined location is relevant to measuring the at least one physiological condition of the patient.

17. The method of claim 16, wherein flagging includes automatically flagging in response to detecting the signal.

18. The method of claim 14, wherein the at least one contextual condition is a patient context, and measuring the at least one physiological condition includes measuring a cardiovascular value or a respiratory value.

19. The method of claim 14, comprising changing a therapy mode of the implantable medical device in association with sensing the external device.

20. The method of claim 14, wherein detecting whether at least one contextual condition associated with the patient exists includes detecting whether a patient posture exists.