Methods and systems for implantably monitoring external breathing therapy

• US 7,993,279 B2
• Filed: 07/15/2008
• Issued: 08/09/2011
• Est. Priority Date: 09/18/2003
• Status: Expired due to Fees

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Lee, Kent, Stahmann, Jeffrey E., Hartley, Jesse W., Ni, Quan
• Primary Examiner(s): Layno; Carl H.
• Assistant Examiner(s): MORALES, JON ERIC C
• Application Number:
  US12/218,409
• Publication Number:
  US 20080312548A1
• Time in Patent Office: 1,120 Days
• Field of Search: None
• US Class Current: 600/529
• CPC Class Codes: A61B 5/0031 Implanted circuitry
• CPC Class Codes: A61B 5/0538 invasively, e.g. using a catheter
• CPC Class Codes: A61B 5/0809 by impedance pneumography
• CPC Class Codes: A61B 5/4812 Detecting sleep stages or cycles
• CPC Class Codes: A61B 5/4815 Sleep quality
• CPC Class Codes: A61B 5/4818 Sleep apnoea
• CPC Class Codes: A61M 16/00 Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes stimulating the respiratory movement by mechanical, pneumatic or electrical means, iron lungs combined with gas breathing means A61H31/00
• CPC Class Codes: A61M 16/0051 with alarm devices
• CPC Class Codes: A61M 16/026 specially adapted for predicting, e.g. for determining an information representative of a flow limitation during a ventilation cycle by using a root square technique or a regression analysis
• CPC Class Codes: A61M 2205/3523 using telemetric means
• CPC Class Codes: A61M 2205/52 with memories providing a history of measured variating parameters of apparatus or patient
• CPC Class Codes: A61M 2230/00 Measuring parameters of the user
• CPC Class Codes: A61M 2230/04 Heartbeat characteristics, e.g. ECG, blood pressure modulation
• CPC Class Codes: A61M 2230/18 Rapid eye-movements [REM]
• CPC Class Codes: A61M 2230/30 Blood pressure A61M2230/04 takes precedence
• CPC Class Codes: A61M 2230/40 Respiratory characteristics
• CPC Class Codes: A61M 2230/50 Temperature
• CPC Class Codes: A61M 2230/60 Muscle strain, i.e. measured on the user
• CPC Class Codes: A61M 2230/63 Motion, e.g. physical activity
• CPC Class Codes: A61M 2230/65 Impedance, e.g. conductivity, capacity
• CPC Class Codes: A61N 1/368 : comprising more than one electrode co-operating with different heart regions A61N1/3622, A61N1/3627 take precedence
• CPC Class Codes: A61N 1/3684 : for stimulating the heart at multiple sites of the ventricle or the atrium
• CPC Class Codes: A61N 1/36842 : Multi-site stimulation in the same chamber

Abstract

An implantable device is used to monitor one or more conditions associated with an external breathing therapy delivered to the patient. The device may monitor therapy parameters including therapy effectiveness, impact of the therapy on the patient, therapy usage, compliance with a prescribed usage, therapy interactions, and/or other parameters.

Claims

1. A method of monitoring respiration therapy delivered to a patient, comprising:

sensing one or more conditions associated with patient-external breathing therapy;

analyzing a sensed respiratory signal; and

implantably monitoring the patient-external breathing therapy based on the one or more sensed conditions, wherein implantably monitoring comprises monitoring the patient'"'"'s use of the patient-external breathing therapy based on the respiratory signal analysis, wherein monitoring the patient'"'"'s use comprises comparing a respiratory signal sensed during patient use of the patient-external breathing therapy with a sensed respiratory signal during non-use of the patient-external breathing therapy to detect signal features that indicate usage of the patient-external breathing therapy.

2. The method of claim 1, wherein sensing the one or more conditions comprises sensing one or more conditions associated with positive airway pressure breathing therapy.

3. The method of claim 1, wherein sensing the one or more conditions comprises sensing transthoracic impedance of the patient.

4. The method of claim 1, wherein analyzing the sensed respiratory signal comprises analyzing a sensed waveform morphology of the sensed respiratory signal.

5. The method of claim 1, wherein analyzing the sensed respiratory signal comprises detecting a pressure notch indicative of flow controlled breathing therapy usage in a waveform of the respiratory signal.

6. The method of claim 1, wherein implantably monitoring the patient-external breathing therapy comprises implantably monitoring an effectiveness of the patient-external breathing therapy.

7. The method of claim 6, wherein implantably monitoring the effectiveness of the patient-external breathing therapy comprises:

detecting disordered breathing episodes; and

monitoring the effectiveness of the patient-external breathing therapy based on the detected disordered breathing episodes and the patient'"'"'s use of the patient-external breathing therapy.

8. The method of claim 1, wherein implantably monitoring the patient'"'"'s use of the patient-external breathing therapy comprises comparing the sensed respiratory signal with a respiratory signal indicating usage of the patient-external breathing therapy.

9. The method of claim 1, wherein implantably monitoring the patient use of the patient-external breathing therapy comprises comparing the patient use of patient-external breathing therapy with a prescribed use of the patient-external breathing therapy.

10. The method of claim 1, further comprising providing one or more alert signals associated with the patient use of the patient-external breathing therapy.

11. The method of claim 1, wherein implantably monitoring the patient-external breathing therapy comprises implantably monitoring an impact of the patient-external breathing therapy on the patient.

12. The method of claim 1, wherein implantably monitoring the patient-external breathing therapy comprises implantably monitoring one or more interactions between the patient-external breathing therapy and another therapy delivered to the patient.

13. The method of claim 1, further comprising adapting the patient-external breathing therapy based on the patient'"'"'s monitored use of the patient-external breathing therapy.

14. A medical system, comprising:

a sensing system configured to sense one or more conditions associated with a patient-external breathing therapy, the one or more conditions comprising patient proximity to a device delivering the patient-external breathing therapy; and

an implantable monitoring device, coupled to the sensing system, the implantable monitoring device configured to monitor patient use of the patient-external breathing therapy based on the one or more sensed conditions, wherein the monitoring device is configured to monitor the patient use by comparing a respiratory signal sensed during patient use of the patient-external breathing therapy with a sensed respiratory signal during non-use of the patient-external breathing therapy to detect signal features that indicate usage of the patient-external breathing therapy.

15. The system of claim 14, wherein the patient-external breathing therapy comprises positive airway pressure therapy.

16. The system of claim 14, wherein the implantable monitoring device is disposed within a housing of a cardiac therapy device.

17. The system of claim 14, wherein the implantable monitoring device is configured to monitor an effectiveness of the patient-external breathing therapy based on the sensed conditions.

18. The system of claim 14, wherein the implantable monitoring device comprises a disordered breathing detector configured to detect disordered breathing using the sensed conditions and to monitor the patient-external breathing therapy based on the detection of disordered breathing.

19. The system of claim 14, wherein the implantable monitoring device comprises a communication interface for communicatively coupling with a remote device and the implantable monitoring device is configured to transmit information associated with the one or more sensed conditions to the remote device.

20. The system of claim 14, further comprising a transmitter and receiver distributed between the implantable monitoring device and the device delivering the patient-external breathing therapy, the receiver configured to receive a signal broadcast by the transmitter, reception of the signal indicating proximity between the implantable monitoring device and the device delivering the patient-external breathing therapy.

21. A medical system, comprising:

means for sensing one or more conditions associated with patient-external breathing therapy;

means for analyzing a sensed respiratory signal;

means for implantably monitoring the patient-external breathing therapy based on the one or more sensed conditions, wherein implantably monitoring comprises monitoring the patient'"'"'s use of the patient-external breathing therapy based on the respiratory signal analysis, the respiratory signal analysis including comparing a respiratory signal sensed during patient use of the patient-external breathing therapy with a sensed respiratory signal during non-use of the patient-external breathing therapy to detect signal features that indicate usage of the patient-external breathing therapy.

22. The system of claim 21, wherein analyzing the sensed respiratory signal comprises analyzing a sensed respiratory waveform morphology of the sensed respiratory signal.

23. The system of claim 21, wherein analyzing the sensed respiratory signal comprises detecting a pressure notch in the sensed respiratory signal indicative of flow controlled breathing therapy usage in the respiratory waveform.

24. The system of claim 21, further comprising means for comparing patient usage of the patient-external breathing therapy to a prescribed usage.