Enhancements to the detection of pulmonary edema when using transthoracic impedance
First Claim
1. A system comprising:
- an implantable thoracic impedance measurement circuit configured to sense a thoracic impedance signal from a subject;
a parameter collection device configured to sense or receive physiologic information about the subject, the physiologic information including heart wall motion, the parameter collection device including a heart wall dyssynchrony measurement device, wherein the heart wall dyssynchrony measurement device is configured to sense a first heart wall motion signal from a first cardiac site and a second heart wall motion signal from a second cardiac site, and wherein the parameter collection device is configured to provide a heart wall dyssynchrony signal indicative of the heart wall motion from a phase difference between the first heart wall motion signal and the second heart wall motion signal; and
a pulmonary edema indicator coupled with the thoracic impedance measurement circuit to accept the thoracic impedance signal and coupled with the parameter collection device to accept the heart wall dyssynchrony signal, wherein the pulmonary edema indicator is configured to provide a pulmonary edema indication using the thoracic impedance signal and the heart wall dyssynchrony 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.
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Citations
14 Claims
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1. A system comprising:
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an implantable thoracic impedance measurement circuit configured to sense a thoracic impedance signal from a subject; a parameter collection device configured to sense or receive physiologic information about the subject, the physiologic information including heart wall motion, the parameter collection device including a heart wall dyssynchrony measurement device, wherein the heart wall dyssynchrony measurement device is configured to sense a first heart wall motion signal from a first cardiac site and a second heart wall motion signal from a second cardiac site, and wherein the parameter collection device is configured to provide a heart wall dyssynchrony signal indicative of the heart wall motion from a phase difference between the first heart wall motion signal and the second heart wall motion signal; and a pulmonary edema indicator coupled with the thoracic impedance measurement circuit to accept the thoracic impedance signal and coupled with the parameter collection device to accept the heart wall dyssynchrony signal, wherein the pulmonary edema indicator is configured to provide a pulmonary edema indication using the thoracic impedance signal and the heart wall dyssynchrony signal. - View Dependent Claims (2, 3, 4, 5, 6, 7)
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8. 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 heart wall motion, wherein sensing or receiving the physiologic information includes; sensing a first heart wall motion signal from a first cardiac site and a second heart wall motion signal from a second cardiac site; and providing a heart wall dyssynchrony signal indicative of the heart wall motion from a phase difference between the first heart wall motion signal and the second heart wall motion signal; and determining, using a processor circuit, a pulmonary edema indication using the thoracic impedance signal and the heart wall dyssynchrony signal, wherein determining the pulmonary edema indication includes comparing the thoracic impedance signal to a thoracic impedance threshold. - View Dependent Claims (9, 10, 11, 12, 13)
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14. A system comprising:
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means for implantably sensing a thoracic impedance signal from the thorax of a subject; means for sensing or receiving physiologic information about the subject, the physiologic information including heart wall motion, wherein the means for sensing or receiving the physiologic information includes; means for sensing a first heart wall motion signal from a first cardiac site and a second heart wall motion signal from a second cardiac site to provide a heart wall dyssynchrony signal indicative of the heart wall motion from a phase difference between the first heart wall motion signal and the second heart wall motion signal; and means for determining a pulmonary edema indication using the thoracic impedance signal and the heart wall dyssynchrony signal, wherein the means for determining the pulmonary edema indication includes means for comparing the thoracic impedance signal to a thoracic impedance threshold.
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Specification