Cardiac rhythm management device and sensor-suite for the optimal control of ultrafiltration and renal replacement therapies

• US 20070175827A1
• Filed: 02/02/2006
• Published: 08/02/2007
• Est. Priority Date: 02/02/2006
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Wariar, Ramesh
• Granted Patent: US 8,246,563 B2
• Time in Patent Office: Days
• US Class Current: 210/645
• CPC Class Codes: A61B 5/02055 Simultaneously evaluating both cardiovascular condition and temperature
• CPC Class Codes: A61B 5/0215 by means inserted into the body catheters A61M25/00
• CPC Class Codes: A61B 5/02405 Determining heart rate variability
• CPC Class Codes: A61B 5/02438 with portable devices, e.g. worn by the patient
• CPC Class Codes: A61B 5/053 Measuring electrical impedance or conductance of a portion of the body
• CPC Class Codes: A61B 5/076 Permanent implantations telemetry using implanted circuitry A61B5/0031; implanted stimulators for therapy A61N1/3605, A61N1/362, A61N1/372
• CPC Class Codes: A61B 5/11 Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb for measuring pulse A61B5/02 ;A61B5/1038 takes precedence; motion detection to correct for motion artifacts in physiological signals A61B5/721
• CPC Class Codes: A61B 5/1112 Global tracking of patients, e.g. by using GPS
• CPC Class Codes: A61B 5/145 Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissuemeasuring of blood pressure or blood flow A61B5/02; non-radiation detecting or locating of foreign bodies in blood A61B5/06
• CPC Class Codes: A61B 5/14532 for measuring glucose, e.g. by tissue impedance measurement
• CPC Class Codes: A61B 5/4806 Sleep evaluation A61B5/4821 takes precedence; devices for inducing sleep A61M21/02
• CPC Class Codes: A61B 5/6866 Extracorporeal blood circuits, e.g. dialysis circuits
• CPC Class Codes: A61M 1/16 with membranes
• CPC Class Codes: A61M 1/1611 Weight of the patient
• CPC Class Codes: A61M 1/1613 Profiling or modelling of patient or predicted treatment evolution or outcome
• CPC Class Codes: A61M 2205/3523 using telemetric means
• CPC Class Codes: A61M 2205/3561 local, e.g. within room or hospital
• CPC Class Codes: A61M 2230/04 Heartbeat characteristics, e.g. ECG, blood pressure modulation
• CPC Class Codes: A61M 2230/10 Electroencephalographic signals
• CPC Class Codes: A61M 2230/208 pH-value
• CPC Class Codes: A61M 2230/30 : Blood pressure A61M2230/04 takes precedence
• CPC Class Codes: A61M 2230/65 : Impedance, e.g. conductivity, capacity
• CPC Class Codes: A61N 1/37282 : characterised by communication with experts in remote locations using a network
• CPC Class Codes: G16H 20/40 : relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
• CPC Class Codes: G16H 40/63 : for local operation
• CPC Class Codes: G16H 50/20 : for computer-aided diagnosis, e.g. based on medical expert systems

Abstract

A cardiorenal patient monitoring system comprising, either implanted or non-implanted device(s), remote peripheral device(s), computer network(s), host, and communication means between the device(s), computer network(s), and host. The preferred embodiment shows an advanced patient monitoring system for using an implanted cardiac device and a dialysis machine in renal therapy. In addition, the method of advanced patient monitoring is in conjunction with the advanced patient monitoring system is disclosed.

Claims

1. An integrated cardiorenal disease management system, comprising:

a. a renal therapy device;

b. an implanted cardiac rhythm management device including sensors for measuring data representative of patient physiological parameters; and

c. a control system coupled to the renal therapy device and configured to receive data representative of patient physiological parameters.

2. The cardiorenal disease therapy management system of claim 1, wherein said renal therapy device comprises a dialysis machine.

3. The cardiorenal disease therapy management system of claim 1, wherein said renal therapy device comprises an ultrafiltration machine.

4. The cardiorenal disease therapy management system of claim 1 wherein the control system directs therapy provided by the renal therapy device in response to the patient physiological parameters received.

5. The cardiorenal disease therapy management system of claim 4 wherein the control system directs therapy by modifying at least one of the following, flow of blood through the renal therapy device, flow of dialysate or ultrafiltrate through renal therapy device, flow of medications or saline into the renal therapy device, ionic composition of dialysate fluid flowing into the device, and temperature of blood or dialysate in the device.

6. The cardiorenal disease therapy management system of claim 1 wherein the renal therapy device is a dialysis therapy device.

7. The cardiorenal disease therapy management system of claim 1 wherein the renal therapy device is an ultrafiltration therapy device.

8. The cardiorenal disease therapy management system of claim 1 wherein the patient physiological parameters is comprised of data representative of at least one of the following, heart rate, heart rate variability, electrograms, autonomic balance, heart vibrations, thoracic impedance, thoracic fluid status, intracardiac pressure, cardiac oxygenation,, patient activity level, patient temperature, blood pressure, breathing patterns, blood chemistry, pH, blood conductivity, blood flow, blood oxygenation, cardiac volumes, cardiac output, ejection fraction, and stroke volume.

9. A method of optimally controlling renal therapy a patient receives from a renal therapy device comprising the steps of:

a. transmitting data representative of patient physiological parameters from at least one sensor implanted within the body of a patient;

b. processing the data representative of patient physiological parameters; and

c. modifying the renal therapy the patient receives in response to the data representative of patient physiological parameters.

10. The method of claim 9 wherein the renal therapy comprises ultrafiltration and the renal therapy device comprises an ultrafiltration device.

11. The method of claim 10 including the step of trending said patient physiological parameters to determine cardiovascular performance changes in relation to an ultrafiltration rate, wherein the data representative of patient physiological parameters includes at least said thoracic fluid, patient cardiac volume, blood conductivity, and heart rate variability.

12. The method of claim 9 wherein the processing step further comprises processing data representative of the blood pressure of the patient, wherein the step of modifying further comprises modifying the rate at which blood may be removed from the patient'"'"'s body in response to the data representative of the blood pressure of the patient.

13. The method of claim 9 wherein the processing step further comprises processing data representative of the transthoracic impedance of the patient, wherein the step of modifying further comprises modifying fluid removal from the patient'"'"'s body in response to the data representative of the transthoracic impedance of the patient.

14. The method of claim 9 further including the step of measuring fluid volume within a patient and immediately transmitting said data representative of said fluid volume in order to control renal therapy a patient receives in real-time.

15. The method of claim 9, wherein said renal therapy comprises at least one of the following therapies dialysis therapy and ultrafiltration therapies.

16. A renal disease therapy management system, comprising:

a. a renal therapy device;

b. an implanted cardiac rhythm management device including sensors for capturing data representative of patient physiological parameters; and

c. a health management host system coupled to the renal therapy and the implanted cardiac rhythm management device in a manner that allows data transmission;

d. said renal therapy device including a communications and control system that records and transmits data relating to renal therapy, said renal therapy control system configured to transmit and receive data representative of patient physiological parameters; and

e. said health management host system configured to receive data related to renal therapy and receive data representative of patient physiological parameters.

17. The renal disease therapy management system of claim 16, wherein the health management host system is configured to analyze and display renal therapy data and data representative of patient physiological parameters on a health management display.

18. The renal disease therapy management system of claim 17, wherein the patient physiological data comprises weight, includes at least fluid retention data.

19. The renal disease therapy management system of claim 17, wherein the renal therapy device is configured with a display device to illustrate a renal therapy strategy.

20. The renal disease therapy management system of claim 16, wherein said renal therapy device comprises a dialysis machine.

21. The renal disease therapy management system of claim 16, wherein said renal therapy device comprises an ultrafiltration machine.