Detection of congestion from monitoring patient response to a recumbent position

• US 7,819,804 B2
• Filed: 09/04/2008
• Issued: 10/26/2010
• Est. Priority Date: 10/09/2002
• Status: Expired due to Fees

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Stahmann, Jeffrey E., Hatlestad, John D., Zhu, Qingsheng
• Primary Examiner(s): Nasser; Robert L
• Application Number:
  US12/204,152
• Publication Number:
  US 20090005697A1
• Time in Patent Office: 782 Days
• Field of Search: None
• US Class Current: 600/300
• CPC Class Codes: A61B 5/0809 by impedance pneumography
• CPC Class Codes: A61B 5/0816 Measuring devices for examining respiratory frequency measuring frequency of electric signals G01R23/00
• CPC Class Codes: A61B 5/1071 measuring angles, e.g. using goniometers A61B5/1123 takes precedence
• CPC Class Codes: A61B 5/1116 Determining posture transitions
• CPC Class Codes: A61B 5/1135 by monitoring thoracic expansion
• CPC Class Codes: A61B 5/4806 Sleep evaluation A61B5/4821 takes precedence; devices for inducing sleep A61M21/02
• CPC Class Codes: A61B 5/6831 Straps, bands or harnesses
• CPC Class Codes: A61B 5/6846 specially adapted to be brought in contact with an internal body part, i.e. invasive
• CPC Class Codes: A61B 5/686 Permanently implanted devices, e.g. pacemakers, other stimulators, biochips A61B5/6861 takes precedence
• CPC Class Codes: A61N 1/36542 controlled by body motion, e.g. acceleration
• 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

Systems and methods obtain information that allows detection of whether a patient suffers from congestion by monitoring a response of the patient to a recumbent position of the patient'"'"'s body. The patient may be monitored to determine a respiration pattern for a non-recumbent position such as standing and a respiration pattern for a recumbent position such as lying down. The two patterns may be compared, either by a processing device or a physician, to determine a difference in the two respiration patterns. Furthermore, the congestion may be inferred from detecting an amount of time that the patient spends in a recumbent position or from detecting the recumbent angle that the patient obtains, either of which is presumed to indicate whether a recumbent position presents discomfort to the patient due to the presence of congestion.

Claims

1. A system, comprising:

a reclination sensor that produces a reclination signal indicative of a reclination of a patient;

reclination circuitry that produces reclination data from the reclination signal;

a respiration sensor that produces a respiration signal indicative of respiration patterns of the patient;

respiration circuitry that produces respiration pattern data from the respiration signal; and

a processing device that is configured to communicate with the reclination circuitry and the respiration circuitry to determine, from the reclination data and the respiration pattern data, recumbent respiration pattern data and non-recumbent respiration pattern data, to compare the recumbent and non-recumbent respiration pattern data, and to determine, using a result of the comparison, whether the patient is suffering from congestion.

2. The system of claim 1, wherein the processing device is configured to determine whether the patient is in a recumbent position by comparing the reclination data to data representative of a reclination threshold.

3. The system of claim 1, wherein the reclination sensor includes a tilt switch.

4. The system of claim 1, wherein the reclination sensor includes an accelerometer.

5. The system of claim 1, wherein the respiration sensor is configured to produce a respiration signal in response to a change in trans-thoracic impedance.

6. The system of claim 1, wherein the processing device is configured to compare the recumbent respiration pattern data and the non-recumbent respiration pattern data to detect whether a difference in respiration rate exists.

7. The system of claim 1, wherein the processing device is configured to compare the recumbent respiration pattern data and the non-recumbent respiration pattern data to detect whether a difference in tidal volume of respiration exists.

8. The system of claim 1, wherein the processing device is configured to compare the recumbent respiration pattern data and the non-recumbent respiration pattern data to detect whether a difference in a ratio of respiration rate to tidal volume of respiration exists.

9. The system of claim 1, comprising a communication device configured to communicate at least one of the reclination data or the respiration pattern data to a remote device.

10. The system of claim 1, wherein the system includes an implantable device.

11. The system of claim 1, wherein the system includes an external device.

12. A system, comprising:

a reclination sensor that produces a reclination signal indicative of a reclination of a patient;

reclination circuitry that produces reclination data from the reclination signal;

a respiration sensor that produces a respiration signal indicative of respiration patterns of the patient;

respiration circuitry that produces respiration pattern data from the respiration signal; and

a processing device, including;

a monitoring module configured to monitor the respiration pattern data and the reclination data;

a reclination module configured to determine whether the patient is in a recumbent position by comparing the reclination data to data representative of a reclination threshold;

an association module configured to associate the respiration pattern data obtained at a specified time with the reclination data obtained at the specified time;

a comparison module configured to compare the respiration pattern data obtained with the patient in a recumbent position to the respiration pattern data obtained with the patient in a non-recumbent position to determine whether a difference is present between the respiration patterns associated with recumbent and non-recumbent positions; and

an analysis module configured to analyze the difference between the respiration patterns associated with recumbent and non-recumbent positions to determine whether the patient is suffering from congestion.

13. The system of claim 12, comprising a communication device configured to transmit at least one of the reclination data or the respiration pattern data.

14. The system of claim 12, wherein the system includes an implantable device.

15. The system of claim 12, wherein the system includes an external device.

16. The system of claim 15, wherein the external device includes a respiratory effort band.

17. The system of claim 12, wherein the reclination sensor includes a multi-axis responsive reclination sensor that produces a reclination signal indicative of reclinations of a patient at more than one orientation.

18. The system of claim 12, wherein the processing device is configured to determine whether the patient is in a recumbent position by comparing the reclination data to data representative of a reclination threshold.

19. The system of claim 12, wherein the processing device includes a trending module configured to trend analyses of the respiration patterns associated with recumbent and non-recumbent positions.

20. A system, comprising:

means for sensing reclination of a patient;

means for sensing respiration of the patient;

means for processing sensed reclination and sensed respiration to produce recumbent respiration pattern data and non-recumbent respiration pattern data; and

means for comparing the recumbent and non-recumbent respiration pattern data to determine, using a result of the comparison, whether the patient is suffering from congestion.

21. The system of claim 20, comprising means for communicating at least one of the recumbent respiration pattern data or the non-recumbent respiration pattern data to a remote device.

22. The system of claim 20, wherein the means for sensing reclination includes a tilt switch.

23. The system of claim 20, wherein the means for sensing reclination includes an accelerometer.

24. The system of claim 20, wherein the means for sensing respiration includes a respiration sensor configured to produce a respiration signal in response to a change in trans-thoracic impedance.