WO2009036256A1 - Injectable physiological monitoring system - Google Patents
Injectable physiological monitoring system Download PDFInfo
- Publication number
- WO2009036256A1 WO2009036256A1 PCT/US2008/076146 US2008076146W WO2009036256A1 WO 2009036256 A1 WO2009036256 A1 WO 2009036256A1 US 2008076146 W US2008076146 W US 2008076146W WO 2009036256 A1 WO2009036256 A1 WO 2009036256A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- injectable
- patient
- sensors
- data
- sensor
- Prior art date
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
- A61B5/7271—Specific aspects of physiological measurement analysis
- A61B5/7282—Event detection, e.g. detecting unique waveforms indicative of a medical condition
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/0002—Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network
- A61B5/0031—Implanted circuitry
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/0205—Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/0205—Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
- A61B5/02055—Simultaneously evaluating both cardiovascular condition and temperature
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/05—Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves
- A61B5/053—Measuring electrical impedance or conductance of a portion of the body
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/07—Endoradiosondes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/07—Endoradiosondes
- A61B5/076—Permanent implantations
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/145—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue
- A61B5/14503—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue invasive, e.g. introduced into the body by a catheter or needle or using implanted sensors
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
- A61B5/25—Bioelectric electrodes therefor
- A61B5/279—Bioelectric electrodes therefor specially adapted for particular uses
- A61B5/28—Bioelectric electrodes therefor specially adapted for particular uses for electrocardiography [ECG]
- A61B5/283—Invasive
- A61B5/287—Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/48—Other medical applications
- A61B5/4869—Determining body composition
- A61B5/4875—Hydration status, fluid retention of the body
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
- A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
- A61B5/6847—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive mounted on an invasive device
- A61B5/686—Permanently implanted devices, e.g. pacemakers, other stimulators, biochips
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2560/00—Constructional details of operational features of apparatus; Accessories for medical measuring apparatus
- A61B2560/02—Operational features
- A61B2560/0204—Operational features of power management
- A61B2560/0214—Operational features of power management of power generation or supply
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2560/00—Constructional details of operational features of apparatus; Accessories for medical measuring apparatus
- A61B2560/04—Constructional details of apparatus
- A61B2560/0462—Apparatus with built-in sensors
- A61B2560/0468—Built-in electrodes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2562/00—Details of sensors; Constructional details of sensor housings or probes; Accessories for sensors
- A61B2562/02—Details of sensors specially adapted for in-vivo measurements
- A61B2562/0219—Inertial sensors, e.g. accelerometers, gyroscopes, tilt switches
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2562/00—Details of sensors; Constructional details of sensor housings or probes; Accessories for sensors
- A61B2562/04—Arrangements of multiple sensors of the same type
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2562/00—Details of sensors; Constructional details of sensor housings or probes; Accessories for sensors
- A61B2562/06—Arrangements of multiple sensors of different types
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2562/00—Details of sensors; Constructional details of sensor housings or probes; Accessories for sensors
- A61B2562/16—Details of sensor housings or probes; Details of structural supports for sensors
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/103—Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
- A61B5/11—Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb
- A61B5/1118—Determining activity level
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
- A61B5/7232—Signal processing specially adapted for physiological signals or for diagnostic purposes involving compression of the physiological signal, e.g. to extend the signal recording period
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/372—Arrangements in connection with the implantation of stimulators
- A61N1/37205—Microstimulators, e.g. implantable through a cannula
Definitions
- the subject matter of the present application is related to the following applications: 60/972,512; 60/972,616; 60/972,363; 60/972,343; 60/972,581; 60/972,629; 60/972,316; 60/972,333; 60/972,359; 60/972,336; 60/972,340 all of which were filed on September 14, 2007; 61/046,196 filed April 18, 2008; 61/047,875 filed April 25, 2008; 61/055,645, 61/055,656, 61/055,662, all filed May 23, 2008; and 61/079,746 filed July 10, 2008.
- This invention relates generally to systems and methods for remote patient monitoring, and more particularly to an injectable physiological monitoring system for decompensation prediction of a heart failure patient.
- HF heart failure
- congestive heart failure a syndrome in which the heart is unable to efficiently pump blood to the vital organs. Most instances of HF occur because of a decreased myocardial capacity to contract (systolic dysfunction). However, HF can also result when an increased pressure-stroke- volume load is imposed on the heart, such as when the heart is unable to expand sufficiently during diastole to accommodate the ventricular volume, causing an increased pressure load (diasystolic dysfunction).
- HF is characterized by diminished cardiac output and/or damming back of blood in the venous system.
- cardiac function curve In HF, there is a shift in the cardiac function curve and an increase in blood volume caused in part by fluid retention by the kidneys. Indeed, many of the significant morphologic changes encountered in HF are distant from the heart and are produced by the hypoxic and congestive effects of the failing circulation upon other organs and tissues.
- edema One of the major symptoms of HF is edema, which has been defined as the excessive accumulation of interstitial fluid, either localized or generalized.
- HF is the most common indication for hospitalization among adults over 65 years of age, and the rate of admission for this condition has increased progressively over the past two decades. It has been estimated that HF affects more than 3 million patients in the U.S. (O'Connell, J.B. et al., J. Heart Lung Transpl, 13(4):S107-112 (1993)).
- Another area in which home-monitoring is of particular interest is in the remote monitoring of a patient parameter that provides information on the titration of a drug, particularly with drugs that have a consequential effect following administration, such as insulin, anticoagulants, ACE inhibitors, beta-blockers, diuretics and the like.
- Subcutaneous implantation of sensors has been achieved with an insertion and tunneling tool.
- the tunneling tool includes a stylet and a peel-away sheath.
- the tunneling tool is inserted into an incision and the stylet is withdrawn once the tunneling tool reaches a desired position.
- An electrode segment is inserted into the subcutaneous tunnel and the peel-away sheath is removed.
- a pointed tip is inserted through the skin and a plunger is actuated to drive the sensor to its desired location.
- an implant trocar in other delivery systems, includes a cannula for puncturing the skin and an obturator for delivering the implant.
- a spring element received within the cannula prevents the sensor from falling out during the implant process.
- Another sensor delivery device includes an injector that has a tubular body divided into two adjacent segments with a hollow interior bore. A pair of laterally adjacent tines extend longitudinally from the first segment to the distal end of the tubular body.
- a plunger rod has an exterior diameter just slightly larger than the interior diameter of the tubular body.
- embodiments of the present invention provide a system for decompensation prediction of a heart failure patient.
- the system comprises one or more injectable detecting systems having a plurality of sensors that provide an indication of at least one physiological event of a patient, a wireless communication device coupled to the one or more injectable detecting systems and configured to transfer patient data directly or indirectly from the one or more injectable detecting systems to a remote monitoring system, and a remote monitoring system coupled to the wireless communication device, the remote monitoring system using processed data to determine heart failure status and predict impending decompensation of the patient.
- embodiments of the present invention provide a system for decompensation prediction of a heart failure patient.
- the system comprises one or more injectable detecting systems having a plurality of sensors that provide an indication of at least one physiological event of a patient, the one or more injectable detecting systems being inserted below the skin of the patient, the one or more injectable detecting systems being injected below the skin of the patient by gun or syringe injection, a wireless communication device coupled to the one or more injectable detecting systems and configured to transfer patient data directly or indirectly from the one or more injectable detecting systems to a remote monitoring system, and a remote monitoring system coupled to the wireless communication device, the remote monitoring system using processed data to determine heart failure status and predict impending decompensation of the patient.
- embodiments of the present invention provide a method for decompensation prediction of a heart failure patient.
- the method comprising injecting subcutaneously one or more injectable detecting systems having a plurality of sensors that provide an indication of at least one physiological event of a patient, wirelessly transferring patient data directly or indirectly from the one or more injectable detecting systems to a remote monitoring system via a wireless communication device coupled to the one or more injectable detecting systems, and processing the data using the remote monitoring system to determine heart failure status and predict impending decompensation of the patient.
- the one or more injectable detecting systems are inserted below the skin of the patient by at least one of, catheter delivery, blunt tunneling and needle insertion.
- the systems and methods further comprise an imaging system to assist in guiding the injectable detecting system to a desired location.
- each of a sensor is selected from at least one of, bioimpedance, heart rate, heart rhythm, HRV, HRT, heart sounds, respiratory sounds, respiratory rate and respiratory rate variability, blood pressure, activity, posture, wake/sleep, orthopnea, temperature, heat flux and an accelerometer.
- each of a sensor is an activity sensors selected from at least one of, ball switch, accelerometer, minute ventilation, HR, bioimpedance noise, skin temperature/heat flux, BP, muscle noise and posture.
- the injectable detecting systems include a power source, a memory, logic resources and an antenna.
- the power source is a rechargeable battery transcutaneously with an external unit.
- At least a portion of the injectable detecting systems have a drug eluting coating.
- the one or more injectable detecting systems are anchored in the patient by at least one of, barbs, anchors, tissue adhesion pads, suture loops, shape of device, self-expanding metal structure, wherein self-expanding metal structure is made of Nitinol.
- embodiments of the present invention provide and injection system for injecting one or more injectable physiological monitoring systems for use in physiological monitoring of a patient.
- the system includes a body capable of holding one or more injectable physiological monitoring systems, the body having a proximal end and distal end, wherein the distal end is shaped to penetrate tissue, a pusher configured to engage the one or more injectable physiological monitoring systems within the body and a movable handle coupled to a pusher configured to distally advance the one or more injectable physiological monitoring systems through the body.
- inventions of the present invention provide an injectable detecting device for use in physiological monitoring.
- the device comprises a plurality of sensors axially spaced along a body that provide an indication of at least one physiological event of a patient, a monitoring unit within the body coupled to the plurality of sensors configured to receive data from the plurality of sensors and create processed patient data, a power source within the body coupled to the monitoring unit, and a communication antenna external to the body coupled to the monitoring unit configured to transfer data to/from other devices.
- the monitoring unit includes a processor.
- the processor includes program instructions for evaluating values received from the sensors with respect to acceptable physiological ranges for each value received by the processor and determine variances.
- the monitoring unit includes logic resources that determine heart failure status and predict impending decompensation.
- the monitoring unit is configured to perform one or more of, data compression, prioritizing of sensing by a sensor, cycling sensors, monitoring all or some of sensor data by all or a portion of the sensors, sensing by the sensors in real time, noise blanking to provide that sensor data is not stored if a selected noise level is determined, low-power of battery caching and decimation of old sensor data.
- the monitoring unit includes a notification device configured to provide notification when values received from the plurality of sensors are not within acceptable physiological ranges.
- the monitoring unit is configured to serve as a communication hub for multiple medical devices, coordinating sensor data and therapy delivery while transmitting and receiving data from a remote monitoring system.
- the monitoring unit is configured to deactivate selected sensors to reduce redundancy.
- each of a sensor is selected from at least one of, bioimpedance, heart rate, heart rhythm, HRV, HRT, heart sounds, respiratory sounds, respiratory rate and respiratory rate variability, blood pressure, activity, posture, wake/sleep, orthopnea, temperature, heat flux and an accelerometer.
- each of a sensor is an activity sensor selected from at least one of, ball switch, accelerometer, minute ventilation, HR, bioimpedance noise, skin temperature/heat flux, BP, muscle noise and posture.
- the sensors are made of at least a material selected from, silicone, polyurethane, Nitinol, titanium, a biocompatible material, ceramics and a bioabsorbable material.
- At least a portion of sensors of the plurality of sensors have an insulative material selected from, PEEK, ETFE, PTFE, and polyimide, silicon, polyurethane. [0038] In many embodiments, at least a portion of sensors of the plurality of sensors have openings or an absorbent material configured to sample a hydration level or electrolyte level in a surrounding tissue site of the plurality of sensors.
- the plurality of sensors includes current delivery electrodes and sensing electrodes.
- the outputs of the plurality of sensors is used to calculate and monitor blended indices.
- the blended indices include at least one of, heart rate (HR) or respiratory rate (RR) response to activity, HR/RR response to posture change, HR + RR, HR/RR + bioimpedance, and/or minute ventilation/accelerometer.
- the body and antenna are injectable in the patient by at least one of, catheter delivery, blunt tunneling, insertion with a needle, by injection, with a gun or syringe device with a stiffening wire stylet, guidewire, or combination of stylet or guidewire with a catheter.
- the body is flexible. [0043] In many embodiments, at least a portion of the body has a drug eluting coating.
- the power source comprises a rechargeable battery transcutaneously chargeable with an external unit.
- FIG. 1 is a block diagram illustrating one embodiment of a patient monitoring system of the present invention.
- FIG. 2(a) illustrates one embodiment of an injectable detecting system of the present invention that is injectable and includes multiple sensors, power and communication and a communication antenna.
- FIG. 2(b) illustrates the insertion of the device of FIG. 2(a) into an injector.
- FIG. 2(c) illustrates the device of FIG. 2(a) in the injector and ready to be introduced into the patient.
- FIG. 2(d) illustrates the implanted sensor device of FIG. 2(a).
- FIG. 2(e) illustrates the implanted sensor device of FIG. 2(a) as it flexes from a rigid state in the body.
- FIG. 2(f) illustrates a patient laying on top of a matt that has coils, where downloading of patient data and recharging can occur via the matt or also through an adherent patch or wearable device by the patient.
- FIG. 2(g) illustrates the patient laying on top of the matt from FIG. 2(f) and the downloading of data from the sensors to the matt.
- FIG. 2(h) is a close up view of FIG. 2(g) showing the downloading of data from the sensors to the matt, and then transfer of the data from the matt to a modem.
- FIG. 2(i) illustrates a patient with an implanted device, such as a pacing device, and the implanted device of FIG. 2(a) in communication with the implanted device.
- FIG. 3 illustrates one embodiment of an energy management device that is coupled to the plurality of sensors of FIG. 1.
- FIG. 4 illustrates one embodiment of present invention illustrating logic resources configured to receive data from the sensors and/or the processed patient for monitoring purposes, analysis and/or prediction purposes.
- FIG. 5 illustrates an embodiment of the patient monitoring system of the present invention with a memory management device.
- FIG. 6 illustrates an embodiment of the patient monitoring system of the present invention with an external device coupled to the sensors.
- FIG. 7 illustrates an embodiment of the patient monitoring system of the present invention with a notification device.
- FIG. 8 is a block diagram illustrating an embodiment of the present invention with sensor leads that convey signals from the sensors to a monitoring unit at the detecting system, or through a wireless communication device to a remote monitoring system.
- FIG. 9 is a block diagram illustrating an embodiment of the present invention with a control unit at the detecting system and/or the remote monitoring system.
- FIG. 10 is a block diagram illustrating an embodiment of the present invention where a control unit encodes patient data and transmits it to a wireless network storage unit at the remote monitoring system.
- FIG. 11 is a block diagram illustrating one embodiment of an internal structure of a main data collection station at the remote monitoring system of the present invention.
- FIG. 12 is a flow chart illustrating an embodiment of the present invention with operation steps performed by the system of the present invention in transmitting information to the main data collection station.
- FIG. 13 shows one embodiment of an injection system for use with multiple injectable detecting systems.
- FIG. 14 shows one embodiment of an injection system that includes a bevel needle shaped to receive the injectable detecting system.
- the present invention is directed to a heart failure patient management system consisting of one or more subcutaneously injectable physiological monitoring systems inserted below the patient's skin.
- the system continuously monitors physiological parameters, communicates wirelessly with a remote center, and provides alerts when necessary.
- a variety of delivery devices and methods are also disclosed.
- the system monitors physiological parameters and uses a proprietary algorithm to determine heart failure status and predict impending decompensation.
- the injectable system communicates with a remote center, preferably via an intermediate device in the patient's home. In some embodiments, the remote center receives the data and applies the prediction algorithm. When a flag is raised, the center may communicate with the patient, hospital, nurse, and/or physician to allow for therapeutic intervention to prevent decompensation.
- the injectable system may be inserted with one of the following techniques: catheter delivery, blunt tunneling (with either a separate tunneling tool or a wire-stiffened lead), and insertion with a needle.
- the injectable system may be injected with a gun or syringe-like device.
- the injectable system may be flexible, and may be implanted with a stiffening wire or stylet.
- the injectable system may be implanted in a non-sterile, non-surgical setting. Implantation may occur with or without local anesthesia, and with or without imaging assistance.
- the system may consist of an implantable component and an external component.
- the injected component with or without physiological sensing electrodes, would be used to anchor an external electronics unit.
- the anchoring mechanism may be magnetic or mechanical.
- the injectable system may contain one of the following features to facilitate subsequent extraction: an isodiametric profile, a breakaway anchor, a bioabsorbable material, coatings to limit tissue in-growth, and an electrically activated or fusable anchor.
- the injectable system may be modular, containing multiple connected components, a subset of which is easily extractable.
- the present invention is intended for heart failure patient monitoring, the system may be applicable to any human application in which wireless physiological monitoring and prediction is required.
- the present invention is a system that delivers a percutaneous sensing device for remote patient monitoring.
- the remote monitoring tracks the patient's physiological status, detects and predicts negative physiological events.
- the implanted sensing device includes a plurality of sensors that are used in combination to enhance detection and prediction capabilities as more fully explained below.
- the system 10 includes an injectable detecting system 12 that includes a plurality of sensors 14 and/or electrodes, that provide an indication of at least one physiological event of a patient.
- the injectable detecting system 12 is inserted subcutaneously. In one embodiment the injectable detecting system 12 is inserted in the patient's thorax.
- the system 10 also includes a wireless communication device 16, coupled to the plurality of sensors 14.
- the wireless communication device transfers patient data directly or indirectly from the plurality of sensors 14 to a remote monitoring system 18.
- the remote monitoring system 18 uses data from the sensors to determine the patient's status.
- the system 10 can continuously, or non-continuously, monitor the patient, alerts are provided as necessary and medical intervention is provided when required.
- the wireless communication device 16 is a wireless local area network for receiving data from the plurality of sensors.
- the sensors 14 are subcutaneously inserted with the injectable detecting system 12 that is catheter based, blunt tunneling (with either a separate tunneling tool or a wire- stiffened lead), needle insertion gun or syringe-like injection.
- the injectable detecting system 12 can be flexible, and be used with a stiffening wire, stylet, catheter or guidewire.
- the injectable detecting system 12 can include any of the following to assist in subsequent extraction: (i) an isodiametric profile, (ii) a breakaway anchor, (iii) a bioabsorbable material, (iv) coatings to limit tissue in-growth, (v) an electrically activated or fusable anchor, and the like.
- the injectable detecting system 12 can be modular, containing multiple connected components, a subset of which is easily extractable.
- the injectable detecting system 12 can be inserted in the patient in a non-sterile or sterile setting, non-surgical setting or surgical setting, implanted with our without anesthesia and implanted with or without imaging assistance from an imaging system.
- the injectable detecting system 12 can be anchored in the patient by a variety of means including but not limited to, barbs, anchors, tissue adhesion pads, suture loops, with sensor shapes that conform to adjacent tissue anatomy or provide pressure against the adjacent tissue, with the use of self-expanding materials such as a nitinol anchor and the like.
- FIG. 2(a) shows one embodiment of the injectable detecting system 12 with sensors 14 that is introduced below the skin surface.
- the device includes power and communication elements 32, and a communication antenna 34.
- the antenna may be a self expanding antenna expandable from a first compressed shape to a second expanded shape, such as disclosed in U.S. Provisional Application No. 61/084,567, filed July 29, 2008 entitled "Communication-Anchor Loop For Injectable Device", the full disclosure of which is incorporated herein by reference.
- FIG. 2(b) illustrates the injectable detecting system 12 being loaded into an injector 36 having a needle end 38.
- FIG. 2(c) shows the injectable detecting system 12 being introduced subcutaneously into a patient 40.
- FIG. 2(d) shows the injectable detecting system 12 being implanted subcutaneously from the injector 36. In FIG. 2(e), the injector 36 is removed and the injectable detecting system 12 flexes from a rigid configuration.
- recharging coils 42 are placed in a mat 44 on the patient's bed, such as under a mattress pad. Recharging of the sensors/battery and data transfer can occur during sleep of the patient.
- the rechargeable batteries can be transcutaneously charged with an external unit other than the mat.
- FIG. 2(g) shows downloading from the sensors and data transfer during sleep of the patient.
- the injectable detecting system 12 downloads data to the mat and a modem is used from data transfer.
- an implantable device 50 such as a pacing device communicates with the injectable detecting system 12 of FIG. 2(a).
- the wireless communication device 16 is configured to receive instructional data from the remote monitoring system and communicate instructions to the injectable detecting system.
- an energy management device 19 is coupled to the plurality of sensors. In one embodiment, the energy management device 19 is part of the detecting system.
- the energy management device 19 performs one or more of, modulate drive levels per sensed signal of a sensor 14, modulate a clock speed to optimize energy, watch cell voltage drop - unload cell, coulomb-meter or other battery monitor, sensor dropoff at an end of life of a battery coupled to a sensor, battery end of life dropoff to transfer data, elective replacement indicator, call center notification, sensing windows by the sensors 14 based on a monitored physiological parameter and sensing rate control.
- the energy management device 19 is configured to manage energy by at least one of, a thermo-electric unit, kinetics, fuel cell, nuclear power, a micro- battery and with a rechargeable device.
- the system 10 is configured to automatically detect events.
- the system 10 automatically detects events by at least one of, high noise states, physiological quietness, sensor continuity and compliance.
- patient states are identified when data collection is inappropriate.
- patient states are identified when data collection is desirable.
- Patient states include, physiological quietness, rest, relaxation, agitation, movement, lack of movement and a patient's higher level of patient activity.
- the system uses an intelligent combination of sensors to enhance detection and prediction capabilities, as more fully discloses in U.S. patent application, Serial Nos. 60/972,537 filed September 14, 2008 and 61/055,666 filed May 23, 2008, both titled “Adherent Device with Multiple Physiological Sensors", incorporated herein by reference, and as more fully explained below.
- the injectable detecting system 12 communicates with the remote monitoring system 18 periodically or in response to a trigger event.
- the trigger event can include but is not limited to at least one of, time of day, if a memory is full, if an action is patient initiated, if an action is initiated from the remote monitoring system, a diagnostic event of the monitoring system, an alarm trigger, a mechanical trigger, and the like.
- the injectable detecting system 12 can continuously, or non-continuously, monitor the patient, alerts are provided as necessary and medical intervention is provided when required.
- the wireless communication device 16 is a wireless local area network for receiving data from the plurality of sensors in the injectable detecting system.
- a processor 20 is coupled to the plurality of sensors 14 in the injectable detecting system 12.
- the processor 20 receives data from the plurality of sensors 14 and creates processed patient data.
- the processor 20 is at the remote monitoring system 18.
- the processor 20 is at the detecting system 12.
- the processor 20 can be integral with a monitoring unit 22 that is part of the injectable detecting system 12 or part of the remote monitoring system 18.
- the processor 20 has program instructions for evaluating values received from the sensors 14 with respect to acceptable physiological ranges for each value received by the processor 20 and determine variances.
- the processor 20 can receive and store a sensed measured parameter from the sensors 14, compare the sensed measured value with a predetermined target value, determine a variance, accept and store a new predetermined target value and also store a series of questions from the remote monitoring system 18.
- logic resources 24 are provided that take the data from the sensors 14, and/or the processed patient data from the processor 20, to predict an impending decompensation.
- the logic resources 24 can be at the remote monitoring system 18 or at the detecting system 12, such as in the monitoring unit 22.
- a memory management device 25 is provided as illustrated in FIG. 5.
- the memory management device 25 performs one or more of data compression, prioritizing of sensing by a sensor 14, monitoring all or some of sensor .. .
- the injectable detecting system 12 can provide a variety of different functions, including but not limited to, initiation, programming, measuring, storing, analyzing, communicating, predicting, and displaying of a physiological event of the patient.
- the injectable detecting system 12 can be sealed, such as housed in a hermetically sealed package.
- at least a portion of the sealed packages include a power source, a memory, logic resources and a wireless communication device.
- an antenna is included that is exterior to the sealed package of the injectable detecting system 12.
- the sensors 14 include, flex circuits, thin film resistors, organic transistors and the like.
- the sensors 14 can include ceramics, titanium PEEK, along with a silicon, PU or other insulative adherent sealant, to enclose the electronics. Additionally, the injectable detecting system 12 can include drug eluting coatings, including but not limited to, an antibiotic, anti-inflammatory agent and the like.
- a wide variety of different sensors 14 can be utilized, including but not limited to, bioimpedance, heart rate, heart rhythm, HRV, HRT, heart sounds, respiration rate, respiration rate variability, respiratory sounds, SpO 2 , blood pressure, activity, posture, wake/sleep, orthopnea, temperature, heat flux, an accelerometer. glucose sensor, other chemical sensors associated with cardiac conditions, and the like.
- a variety activity sensors can be utilized, including but not limited to a, ball switch, accelerometer, minute ventilation, HR, bioimpedance noise, skin temperature/heat flux, BP, muscle noise, posture and the like.
- the output of the sensors 14 can have multiple features to enhance physiological sensing performance. These multiple features have multiple sensing vectors that can include redundant vectors.
- the sensors 14 can include current delivery electrodes and sensing electrodes. Size and shape of current delivery electrodes, and the sensing electrodes, can be optimized to maximize sensing performance.
- the system 10 can be configured to determine an optimal sensing configuration and electronically reposition at least a portion of a sensing vector of a sensing electrode.
- the multiple features enhance the system's 10 ability to determine an optimal sensing configuration and electronically reposition sensing vectors.
- the sensors 14 can be partially masked to minimize contamination of parameters sensed by the sensors 14.
- the size and shape of current delivery electrodes, for bioimpedance, and sensing electrodes can be optimized to maximize sensing performance. Additionally, the outputs of the sensors 14 can be used to calculate and monitor blended indices. Examples of the blended indices include but are not limited to, heart rate (HR) or respiratory rate (RR) response to activity, HR/RR response to posture change, HR + RR, HR/RR + bioimpedance, and/or minute ventilation/accelerometer and the like.
- the sensors 14 can be cycled in order to manage energy, and different sensors 14 can sample at different times.
- each sensor 14 instead of each sensor 14 being sampled at a physiologically relevant interval, e.g. every 30 seconds, one sensor 14 can be sampled at each interval, and sampling cycles between available sensors.
- the sensors 14 can sample 5 seconds for every minute for ECG, once a second for an accelerometer sensor, and 10 seconds for every 5 minutes for impedance.
- a first sensor 14 is a core sensor 14 that continuously monitors and detects, and a second sensor 14 verifies a physiological status in response to the core sensor 14 raising a flag. Additionally, some sensors 14 can be used for short term tracking, and other sensors 14 used for long term tracking.
- the injectable detecting system 12 is inserted into the patient by a variety of means, including but not limited to, catheter delivery, blunt tunneling, insertion with a needle, by injection, with a gun or syringe device with a stiffening wire and stylet and the like.
- the sensors 14 can be inserted in the patient in a non-sterile or sterile setting, nonsurgical setting or surgical setting, injected with our without anesthesia and injected with or without imaging assistance.
- the injectable detecting system 12 can be anchored in the patient by a variety of means including but not limited to, barbs, anchors, tissue adhesion pads, suture loops.
- the injectable detecting system 12 can come in a variety of different form factors including but not limited to, cylinder, dog-bone, half dog-bone, trapezoidal cross-section, semicircular cross-section, star-shaped cross-section, v-shaped cross-section, L-shaped, canted, W shaped, or in other shapes that assist in their percutaneous delivery, S-shaped, sine-wave shaped, J-shaped, any polygonal shape, helical/spiral, fin electrodes, and linear device with a radius of curvature to match a radius of the injection site and the like. Further, the injectable detecting system 12 can have flexible body configurations. Additionally, the injectable detecting system 12 can be configured to deactivate selected sensors 14 to reduce redundancy.
- the sensors 14 can be made of a variety of materials, including but not limited to, silicone, polyurethane, Nitinol, a biocompatible material, a bioabsorbable material and the like. Electrode sensors 14 can have a variety of different conductors, including but not limited to, platinum, MP35N which is a nickel-cobalt-chromium-molybdenum alloy, MP35N/Ag core, platinum/tantalum core, stainless steel, titanium and the like.
- the sensors 14 can have insulative materials, including but not limited to, polyetheretherketone (PEEK), ethylene-tetrafluoroethylene (ETFE), polytetrafluoroethlene (PTFE), polyimide, silicon, polyurethane, and the like. Further, the sensors 14 can have openings, or an absorbent material, configured to sample a hydration level or electrolyte level in a surrounding tissue site at the location of the sensor 14.
- the sensor 14 electrodes can be made of a variety of materials, including but not limited to platinum, iridium, titanium, and the like. Electrode coatings can be included, such as iridium oxide, platinum black, TiN, and the like.
- the injectable detecting system 12 can include one or more a rechargeable batteries 36 that can be transcutaneously chargeable with an external unit.
- an external device 38 including a medical treatment device, is coupled to the injectable detecting system 12.
- the external device 38 can be coupled to a monitoring unit 22 that is part of the injectable detecting system 12, or in direct communication with the sensors 14.
- a variety of different external devices 38 can be used, including but not limited to, a weight scale, blood pressure cuff, cardiac rhythm management device, a medical treatment device, medicament dispenser, glucose monitor, insulin pump, drug delivery pumps, drug delivery patches, and the like.
- Suitable cardiac rhythm management devices include but are not limited to, Boston Scientific's Latitude system, Medtronic's CareLink system, St. Jude Medical's HouseCall system and the like. Such communication may occur directly or via an external translator unit.
- the external device 38 can be coupled to an auxiliary input of the monitoring unit 22 at the injectable detecting system 12 or to the monitoring system 22 at the remote monitoring system 18. Additionally, an automated reader can be coupled to an auxiliary input in order to allow a single monitoring unit 22 to be used by multiple patients.
- the monitoring unit 22 can be at the remote monitoring system 18 and each patient can have a patient identifier (ID) including a distinct patient identifier.
- the ID identifier can also contain patient specific configuration parameters.
- the automated reader can scan the patient identifier ID and transmit the patient ID number with a patient data packet such that the main data collection station can identify the patient.
- the injectable detecting system 12 can communicate wirelessly with the external devices 38 in a variety of ways including but not limited to, a public or proprietary communication standard and the like.
- the injectable detecting system 12 can be configured to serve as a communication hub for multiple medical devices, coordinating sensor data and therapy delivery while transmitting and receiving data from the remote monitoring system 18.
- the injectable detecting system 12 coordinate data sharing between the external systems 38 allowing for sensor integration across devices. The coordination of the injectable detecting system 12 provides for new pacing, sensing, defibrillation vectors, and the like.
- the processor 20 is included in the monitoring unit 22 and the external device 38 is in direct communication with the monitoring unit 22.
- a notification device 42 is coupled to the injectable detecting system 12 and the remote monitoring system 18.
- the notification device 42 is configured to provide notification when values received from the sensors 14 are not within acceptable physiological ranges.
- the notification device 42 can be at the remote monitoring system 18 or at the monitoring unit 22 that is part of the injectable detecting system 12.
- a variety of notification devices 42 can be utilized, including but not limited to, a visible patient indicator, an audible alarm, an emergency medical service notification, a call center alert, direct medical provider notification and the like.
- the notification device 42 provides notification to a variety of different entities, including but not limited to, the patient, a caregiver, the remote monitoring system, a spouse, a family member, a medical provider, from one device to another device such as the external device 38, and the like.
- Notification can be according to a preset hierarchy.
- the preset hierarchy can be, patient notification first and medical provider second, patient notification second and medical provider first, and the like.
- a medical provider, the remote monitoring system 18, or a medical treatment device can trigger a high-rate sampling of physiological parameters for alert verification.
- the system 10 can also include an alarm 46, that can be coupled to the notification device 42, for generating a human perceptible signal when values received from the sensors 14 are not within acceptable physiological ranges.
- the alarm 46 can trigger an event to render medical assistance to the patient, provide notification as set forth above, continue to monitor, wait and see, and the like.
- the notification is with the at least one of, the patient, a spouse, a family member, a caregiver, a medical provider and from one device to another device, to allow for therapeutic intervention to prevent decompensation.
- the injectable detecting system 12 can switch between different modes, wherein the modes are selected from at least one of, a stand alone mode with communication directly with the remote monitoring system 18, communication with an implanted device, communication with a single implanted device, coordination between different devices (external systems) coupled to the plurality of sensors and different device communication protocols.
- the patient can be a congestive heart failure patient.
- Heart failure status is determined by a weighted combination change in sensor outputs and be determined by a number of different means, including but not limited to, (i) when a rate of change of at least two sensor outputs is an abrupt change in the sensor outputs as compared to a change in the sensor outputs over a longer period of time, (ii) by a tiered combination of at least a first and a second sensor output, with the first sensor output indicating a problem that is then verified by at least a second sensor output, (iii) by a variance from a baseline value of sensor outputs, and the like.
- the baseline values can be defined in a look up table.
- heart failure status is determined using three or more sensors by at least one of, (i) when the first sensor output is at a value that is sufficiently different from a baseline value, and at least one of the second and third sensor outputs is at a value also sufficiently different from a baseline value to indicate heart failure status, (ii) by time weighting the outputs of the first, second and third sensors, and the time weighting indicates a recent event that is indicative of the heart failure status and the like.
- the wireless communication device 16 can include a, modem, a controller to control data supplied by the injectable detecting system 12, serial interface, LAN or equivalent network connection and a wireless transmitter.
- the wireless communication device 16 can include a receiver and a transmitter for receiving data indicating the values of the physiological event detected by the plurality of sensors, and for communicating the data to the remote monitoring system 18. Further, the wireless communication device 16 can have data storage for recording the data received from the injectable detecting system 12 and an access device for enabling access to information recording in the data storage from the remote monitoring system 18. [0115] In various embodiments, the remote monitoring system 18 can include a, receiver, a transmitter and a display for displaying data representative of values of the one physiological event detected by the injectable detecting system 12.
- the remote monitoring system can also include a, data storage mechanism that has acceptable ranges for physiological values stored therein, a comparator for comparing the data received from the injectable detecting system 12 with the acceptable ranges stored in the data storage device and a portable computer.
- the remote monitoring system 18 can be a portable unit with a display screen and a data entry device for communicating with the wireless communication device 16.
- a sensor lead 112 and 114 conveys signals from the sensor 14 to the monitoring unit 22 at the injectable detecting system 12, or through the wireless communication device 16 to the remote monitoring system 18.
- each signal from a sensor 14 is first passed through a low-pass filter 116, at the injectable detecting system 12 or at the remote monitoring system 18, to smooth the signal and reduce noise.
- the signal is then transmitted to an analog-to-digital converter 118A, which transforms the signals into a stream of digital data values that can be stored in a digital memory 118B.
- data values are transmitted to a data bus 120, along which they are transmitted to other components of the circuitry to be processed and archived. From the data bus 120, the digital data can be stored in a non-volatile data archive memory.
- the digital data can be transferred via the data bus 120 to the processor 20, which processes the data based in part on algorithms and other data stored in a non-volatile program memory.
- the injectable detecting system 12 can also include a power management module 122 configured to power down certain components of the system, including but not limited to, the analog-to-digital converters 118A and 124, digital memories 118B and the nonvolatile data archive memory and the like, between times when these components are in use. This helps to conserve battery power and thereby extend the useful life. Other circuitry and signaling modes may be devised by one skilled in the art.
- a control unit 126 is included at the detecting system 12, the remote monitoring system 18, or at both locations.
- control unit 126 can be a microprocessor, for example, a Pentium or 486 processor.
- the control unit 126 can be coupled to the sensors 14 directly at the injectable detecting system 12, indirectly at the injectable detecting system 12 or indirectly at the remote monitoring system 18. Additionally the control unit 126 can be coupled to one or more devices, for example, a blood pressure monitor, cardiac rhythm management device, scale, a device that dispenses medication, a device that can indicate the medication has been dispensed, and the like.
- the control unit 126 can be powered by AC inputs which are coupled to internal AC/DC converters 134 that generate multiple DC voltage levels. After the control unit 126 has collected the patient data from the sensors 14, the control unit 126 encodes the recorded patient data and transmits the patient data through the wireless communication device 16 to transmit the encoded patient data to a wireless network storage unit 128 at the remote monitoring system 18, as shown in FIG. 10. In another embodiment, wireless communication device 16 transmits the patient data from the injectable detecting system 12 to the control unit 126 when it is at the remote monitoring system 18.
- the communication link can be wireless, wired, or a combination of wireless and wired for redundancy, e.g., the wired link checks to see if a wireless communication can be established. If the wireless communication link 16 is available, the control unit 126 transmits the encoded patient data through the wireless communication device 16. However, if the wireless communication device 16 is not available for any reason, the control unit 126 waits and tries again until a link is established. [0123] Referring now to FIG. 11, one embodiment of an internal structure of a main data collection station 130, at the remote monitoring system 18, is illustrated.
- the patient data can be transmitted by the remote monitoring system 18 by either the wireless communication device 16 or conventional modem to the wireless network storage unit 128.
- the wireless network storage unit 128 can be accessed by the main data collection station 130.
- the main data collection station 130 allows the remote monitoring system 18 to monitor the patient data of numerous patients from a centralized location without requiring the patient or a medical provider to physically interact with each other.
- the main data collection station 130 can include a communications server 136 that communicates with the wireless network storage unit 128.
- the wireless network storage unit 128 can be a centralized computer server that includes a unique, password protected mailbox assigned to and accessible by the main data collection station 130.
- the main data collection station 130 contacts the wireless network storage unit 128 and downloads the patient data stored in a mailbox assigned to the main data collection station 130.
- the patient data can be transferred to a database server 138.
- the database server 138 includes a patient database 140 that records and stores the patient data of the patients based upon identification included in the data packets sent by each of the monitoring units 22. For example, each data packet can include an identifier.
- Each data packet transferred from the remote monitoring system 18 to the main data collection station 130 does not have to include any patient identifiable information. Instead, the data packet can include the serial number assigned to the specific injectable detecting system 12. The serial number associated with the detecting system 12 can then be correlated to a specific patient by using information stored on the patient database 138. In this manner, the data packets transferred through the wireless network storage unit 128 do not include any patient-specific identification. Therefore, if the data packets are intercepted or improperly routed, patient confidentiality can not be breached. [0127]
- the database server 138 can be accessible by an application server 142.
- the application server 142 can include a data adapter 144 that formats the patient data information into a form that can be viewed over a conventional web-based connection.
- the transformed data from the data adapter 144 can be accessible by propriety application software through a web server 146 such that the data can be viewed by a workstation 148.
- the workstation 148 can be a conventional personal computer that can access the patient data using proprietary software applications through, for example, HTTP protocol, and the like.
- the main data collection station further can include an escalation server 150 that communicates with the database server 138.
- the escalation server 150 monitors the patient data packets that are received by the database server 138 from the monitoring unit 22. Specifically, the escalation server 150 can periodically poll the database server 138 for unacknowledged patient data packets. The patient data packets are sent to the remote monitoring system 18 where the processing of patient data occurs. The remote monitoring system 18 communicates with a medical provider in the event that an alert is required. If data packets are not acknowledged by the remote monitoring system 18.
- the escalation server 150 can be programmed to automatically deliver alerts to a specific medical provider if an alarm message has not been acknowledged within a selected time period after receipt of the data packet.
- the escalation server 150 can be configured to generate the notification message to different people by different modes of communication after different delay periods and during different time periods.
- the main data collection station 130 can include a batch server 152 connected to the database server 138.
- the batch server 152 allows an administration server 154 to have access to the patient data stored in the patient database 140.
- the administration server 154 allows for centralized management of patient information and patient classifications.
- the administration server 154 can include a batch server 156 that communicates with the batch server 152 and provides the downloaded data to a data warehouse server 158.
- the data warehouse server 158 can include a large database 160 that records and stores the patient data.
- the administration server 154 can further include an application server 162 and a maintenance workstation 164 that allow personnel from an administrator to access and monitor the data stored in the database 160.
- the data packet utilized in the transmission of the patient data can be a variable length ASCII character packet, or any generic data formats, in which the various patient data measurements are placed in a specific sequence with the specific readings separated by commas.
- the control unit 126 can convert the readings from each sensor 14 into a standardized sequence that forms part of the patient data packet. In this manner, the control unit 126 can be programmed to convert the patient data readings from the sensors 14 into a standardized data packet that can be interpreted and displayed by the main data collection station 130 at the remote monitoring system 18.
- the control unit 126 fills the portion of the patient data packet associated with the external device 38 with a null indicator.
- the null indicator can be the lack of any characters between commas in the patient data packet.
- the lack of characters in the patient data packet can indicate that the patient was not available for the patient data recording.
- the null indicator in the patient data packet can be interpreted by the main data collection station 130 at the remote monitoring system 18 as a failed attempt to record the patient data due to the unavailability of the patient, a malfunction in one or more of the sensors 14, or a malfunction in one of the external devices 38.
- the null indicator received by the main data collection station 130 can indicate that the transmission from the injectable detecting system 12 to the remote monitoring system 18 was successful.
- the integrity of the data packet received by the main data collection station 130 can be determined using a cyclic redundancy code, CRC- 16, check sum algorithm.
- the check sum algorithm can be applied to the data when the message can be sent and then again to the received message.
- control unit 126 displays the sensor data, including but not limited to blood pressure cuff data and the like, as illustrated by step B.
- the patient data can be placed in the patient data packet, as illustrated in step C.
- the system 10 can take additional measurements utilizing one or more auxiliary or external devices 38 such as those mentioned previously. Since the patient data packet has a variable length, the auxiliary device patient information can be added to the patient data packet being compiled by the remote monitoring unit 22 during patient data acquisition period being described. Data from the external devices 38 is transmitted by the wireless communication device 16 to the remote monitoring system 18 and can be included in the patient data packet.
- the remote monitoring unit 22 can first determine if there can be an internal communication error, as illustrated in step D.
- a no communication error can be noted as illustrated in step E. If a communication error is noted the control unit 126 can proceed to wireless communication device 16 or to a conventional modem transmission sequence, as will be described below. However, if the communication device is working, the control unit 126 can transmit the patient data information over the wireless network 16, as illustrated in step F. After the communication device has transmitted the data packet, the control unit 126 determines whether the transmission was successful, as illustrated in step G. If the transmission has been unsuccessful only once, the control unit 126 retries the transmission. However, if the communication device has failed twice, as illustrated in step H, the control unit 126 proceeds to the conventional modem process if the remote monitoring unit 22 was configured in an auto mode.
- control unit 126 When the control unit 126 is at the injectable detecting system 12, and the control unit 126 transmits the patient data over the wireless communication device 16, as illustrated in step I, if the transmission has been successful, the display of the remote monitoring unit 22 can display a successful message, as illustrated in step J. However, if the control unit 126 determines in step K that the communication of patient data has failed, the control unit 126 repeats the transmission until the control unit 126 either successfully completes the transmission or determines that the transmission has failed a selected number of times, as illustrated in step L. The control unit 126 can time out the and a failure message can be displayed, as illustrated in steps M and N. Once the transmission sequence has either failed or successfully transmitted the data to the main data collection station, the control unit 126 returns to a start program step O.
- the patient data packets are first sent and stored in the wireless network storage unit 128. From there, the patient data packets are downloaded into the main data collection station 130.
- the main data collection station 130 decodes the encoded patient data packets and records the patient data in the patient database 140.
- the patient database 140 can be divided into individual storage locations for each patient such that the main data collection station 130 can store and compile patient data information from a plurality of individual patients.
- a report on the patient's status can be accessed by a medical provider through a medical provider workstation that is coupled to the remote monitoring system 18. Unauthorized access to the patient database can be prevented by individual medical provider usernames and passwords to provide additional security for the patient's recorded patient data.
- the main data collection station 130 and the series of work stations 148 allow the remote monitoring system 18 to monitor the daily patient data measurements taken by a plurality of patients reporting patient data to the single main data collection station 130.
- the main data collection station 130 can be configured to display multiple patients on the display of the workstations 148.
- the internal programming for the main data collection station 130 can operate such that the patients are placed in a sequential top-to-bottom order based upon whether or not the patient can be generating an alarm signal for one of the patient data being monitored.
- this patient can be moved toward the top of the list of patients and the patient's name and/or patient data can be highlighted such that the medical personnel can quickly identify those patients who may be in need of medical assistance.
- the following paragraphs is a representative order ranking method for determining the order which the monitored patients are displayed:
- Alarm Display Order Patient Status Patients are then sorted 1 Medical Alarm Most alarms violated to least alarms violated, then oldest to newest 2 Missing Data Alarm Oldest to newest 3 Late Oldest to newest 4 Reviewed Medical Alarms Oldest to newest 5 Reviewed Missing Data Oldest to newest Alarms 6 Reviewed Null Oldest to newest 7 NDR Oldest to newest 8 Reviewed NDR Oldest to newest
- the order of patients listed on the display can be ranked based upon the seriousness and number of alarms that are registered based upon the latest patient data information. For example, if the blood pressure of a single patient exceeds the tolerance level and the patient's heart rate also exceeds the maximum level, this patient will be placed above a patient who only has one alarm condition. In this manner, the medical provider can quickly determine which patient most urgently needs medical attention by simply identifying the patient's name at the top of the patient list.
- the order which the patients are displayed can be configurable by the remote monitoring system 18 depending on various preferences.
- the escalation server 150 automatically generates a notification message to a specified medical provider for unacknowledged data packets based on user specified parameters.
- the software of the main data collection station 130 allows the medical provider to trend the patient data over a number of prior measurements in order to monitor the progress of a particular patient, hi addition, the software allows the medical provider to determine whether or not a patient has been successful in recording their patient data as well as monitor the questions being asked by the remote monitoring unit 22.
- Electrocardiogram circuitry can be coupled to the sensors 14, or electrodes, to measure an electrocardiogram signal of the patient.
- An accelerometer can be mechanically coupled, for example adhered or affixed, to the sensors 14, adherent patch and the like, to generate an accelerometer signal in response to at least one of an activity or a position of the patient.
- the accelerometer signals improve patient diagnosis, and can be especially useful when used with other signals, such as electrocardiogram signals and impedance signals, including but not limited to, hydration respiration, and the like.
- Mechanically coupling the accelerometer to the sensors 14, electrodes, for measuring impedance, hydration and the like can improve the quality and/or usefulness of the impedance and/or electrocardiogram signals.
- mechanical coupling of the accelerometer to the sensors 14, electrodes, and to the skin of the patient can improve the reliability, quality and/or accuracy of the accelerometer measurements, as the sensor 14, electrode, signals can indicate the quality of mechanical coupling of the patch to the patient so as to indicate that the device is connected to the patient and that the accelerometer signals are valid.
- sensor interaction examples include but are not limited to, (i) orthopnea measurement where the breathing rate is correlated with posture during sleep, and detection of orthopnea, (ii) a blended activity sensor using the respiratory rate to exclude high activity levels caused by vibration (e.g. driving on a bumpy road) rather than exercise or extreme physical activity, (iii) sharing common power, logic and memory for sensors, electrodes, and the like.
- FIG. 13 shows one embodiment of an injection system 200 for use with multiple injectable detecting systems 12 that includes a magazine 205 with several injectable detecting systems 12 loaded therein.
- the injection system 200 can be placed against the tissue 210, as shown.
- a handle 215 can be pulled proximally 220 to inject one of the injectable detecting systems 12 into the patient 40, and injectable detecting systems 12 in the magazine 205 are advanced such that the next injectable detecting system 12 is ready for injection at a subsequent location.
- FIG. 14 shows one embodiment of an injection system 250 that includes a needle 255 configured to hold one or more injectable detecting systems 12.
- the needled 255 includes a bevel needle shaped tip 265, that is inserted into the tissue with the injectable detecting system 12 loaded into the needle 255.
- a pusher 265 is advanced distally to advance the injectable detecting system 12 into the tissue after the needle has penetrated the tissue
Abstract
A system and method are provided for decompensation prediction of a heart failure patient with one or more injectable detecting systems communicating wirelessly with a remote monitoring system. The system includes one or more injectable detecting systems having a plurality of sensors that provide an indication of at least one physiological event of a patient, a wireless communication device coupled to the one or more injectable detecting systems and configured to transfer patient data directly or indirectly from the one or more injectable detecting systems to a remote monitoring system, and a remote monitoring system coupled to the wireless communication device, the remote monitoring system using processed data to determine heart failure status and predict impending decompensation of the patient.
Description
INJECTABLE PHYSIOLOGICAL MONITORING SYSTEM
CROSS-REFERENCES TO RELATED APPLICATIONS
[0001] The present application claims the benefit under 35 USC 119(e) of US Provisional Application Nos. 60/972,329, 60/972,336, 60/972,354 and 60/972,537, all filed September 14, 2007, and 61/055,666 filed May 23, 2008; the full disclosures of which are incorporated herein by reference in their entirety.
[0002] The subject matter of the present application is related to the following applications: 60/972,512; 60/972,616; 60/972,363; 60/972,343; 60/972,581; 60/972,629; 60/972,316; 60/972,333; 60/972,359; 60/972,336; 60/972,340 all of which were filed on September 14, 2007; 61/046,196 filed April 18, 2008; 61/047,875 filed April 25, 2008; 61/055,645, 61/055,656, 61/055,662, all filed May 23, 2008; and 61/079,746 filed July 10, 2008.
[0003] The following applications are being filed concurrently with the present application, on September 12, 2008: Attorney Docket Nos. 026843-00011 OUS entitled "Multi-Sensor Patient Monitor to Detect Impending Cardiac Decompensation Prediction"; 026843-000220US entitled "Adherent Device with Multiple Physiological Sensors"; 026843-00041 OUS entitled "Injectable Device for Physiological Monitoring"; 026843- 00051 OUS entitled "Injectable Physiological Monitoring System"; 026843-000620US entitled "Adherent Device for Cardiac Rhythm Management"; 026843-000710US entitled "Adherent Device for Respiratory Monitoring"; 026843 -00081 OUS entitled "Adherent Athletic Monitor"; 026843-00091 OUS entitled "Adherent Emergency Monitor"; 026843- 001320US entitled "Adherent Device with Physiological Sensors"; 026843-001410US entitled "Medical Device Automatic Start-up upon Contact to Patient Tissue"; 026843- 001900US entitled "System and Methods for Wireless Body Fluid Monitoring"; 026843- 00201 OUS entitled "Adherent Cardiac Monitor with Advanced Sensing Capabilities"; 026843-00241 OUS entitled "Adherent Device for Sleep Disordered Breathing"; 026843- 00271 OUS entitled "Dynamic Pairing of Patients to Data Collection Gateways"; 026843- 00301 OUS entitled "Adherent Multi-Sensor Device with Implantable Device Communications Capabilities"; 026843-00311 OUS entitled "Data Collection in a Multi- Sensor Patient Monitor"; 026843-003210US entitled "Adherent Multi-Sensor Device with Empathic Monitoring"; 026843-00331 OUS entitled "Energy Management for Adherent
Patient Monitor"; and 026843-00341 OUS entitled "Tracking and Security for Adherent Patient Monitor."
BACKGROUND OF THE INVENTION
[0004] Field of the Invention. This invention relates generally to systems and methods for remote patient monitoring, and more particularly to an injectable physiological monitoring system for decompensation prediction of a heart failure patient.
[0005] Frequent monitoring of patients permits the patients' physician to detect worsening symptoms as they begin to occur, rather than waiting until a critical condition has been reached. As such, home monitoring of patients with chronic conditions is becoming increasingly popular in the health care industry for the array of benefits it has the potential to provide. Potential benefits of home monitoring are numerous and include: better tracking and management of chronic disease conditions, earlier detection of changes in the patient condition, and reduction of overall health care expenses associated with long term disease management. The home monitoring of a number of diverse "chronic diseases" is of interest, where such diseases include diabetes, dietary disorders such as anorexia and obesity, anxiety, depression, epilepsy respiratory diseases, AIDS and other chronic viral conditions, conditions associated with the long term use of immunosuppressant's, e.g. in transplant patients, asthma, chronic hypertension, chronic use of anticoagulants, and the like. [0006] Of particular interest in the home monitoring sector of the health care industry is the remote monitoring of patients with heart failure (HF), also known as congestive heart failure. HF is a syndrome in which the heart is unable to efficiently pump blood to the vital organs. Most instances of HF occur because of a decreased myocardial capacity to contract (systolic dysfunction). However, HF can also result when an increased pressure-stroke- volume load is imposed on the heart, such as when the heart is unable to expand sufficiently during diastole to accommodate the ventricular volume, causing an increased pressure load (diasystolic dysfunction).
[0007] In either case, HF is characterized by diminished cardiac output and/or damming back of blood in the venous system. In HF, there is a shift in the cardiac function curve and an increase in blood volume caused in part by fluid retention by the kidneys. Indeed, many of the significant morphologic changes encountered in HF are distant from the heart and are produced by the hypoxic and congestive effects of the failing circulation upon other organs
and tissues. One of the major symptoms of HF is edema, which has been defined as the excessive accumulation of interstitial fluid, either localized or generalized.
[0008] HF is the most common indication for hospitalization among adults over 65 years of age, and the rate of admission for this condition has increased progressively over the past two decades. It has been estimated that HF affects more than 3 million patients in the U.S. (O'Connell, J.B. et al., J. Heart Lung Transpl, 13(4):S107-112 (1993)).
[0009] In the conventional management of HF patents, where help is sought only in crisis, a cycle occurs where patients fail to recognize early symptoms and do not seek timely help from their care-givers, leading to emergency department admissions (Miller, P.Z., Home monitoring for congestive heart failure patients, Caring Magazine, 53-54 (Aug. 1995)).
Recently, a prospective, randomized trial of 282 patients was conducted to assess the effect of the intervention on the rate of admission, quality of life, and cost of medical care. In this study, a nurse-directed, multi-disciplinary intervention (which consisted of comprehensive education of the patient and family, diet, social-service consultation and planning, review of medications, and intensive assessment of patient condition and follow-up) resulted in fewer readmissions than the conventional treatment group and a concomitant overall decrease in the cost of care (Rich, M. W. et al., New Engl. J. Med, 333:1190-95 (1995)).
[0010] Similarly, comprehensive discharge planning and a home follow-up program was shown to decrease the number of readmissions and total hospital charges in an elderly population (Naylor, M. et al., Amer. College Physicians, 120:999-1006 (1994)). Therefore, home monitoring is of particular interest in the HF management segment of the health care industry.
[0011] Another area in which home-monitoring is of particular interest is in the remote monitoring of a patient parameter that provides information on the titration of a drug, particularly with drugs that have a consequential effect following administration, such as insulin, anticoagulants, ACE inhibitors, beta-blockers, diuretics and the like.
[0012] Although a number of different home monitoring systems have been developed, there is continued interest in the development of new monitoring systems. Of particular interest would be the development of a system that provides for improved patient compliance, ease of use, etc. Of more particular interest would be the development of such a system that is particularly suited for use in the remote monitoring of patients suffering
[0013] Subcutaneous implantation of sensors has been achieved with an insertion and tunneling tool. The tunneling tool includes a stylet and a peel-away sheath. The tunneling tool is inserted into an incision and the stylet is withdrawn once the tunneling tool reaches a desired position. An electrode segment is inserted into the subcutaneous tunnel and the peel-away sheath is removed. In another delivery device, a pointed tip is inserted through the skin and a plunger is actuated to drive the sensor to its desired location.
[0014] In other delivery systems, an implant trocar includes a cannula for puncturing the skin and an obturator for delivering the implant. A spring element received within the cannula prevents the sensor from falling out during the implant process. Another sensor delivery device includes an injector that has a tubular body divided into two adjacent segments with a hollow interior bore. A pair of laterally adjacent tines extend longitudinally from the first segment to the distal end of the tubular body. A plunger rod has an exterior diameter just slightly larger than the interior diameter of the tubular body. With the second segment inserted beneath the skin, the push rod is advanced longitudinally through the tubular body, thereby pushing the sensor through the bore. As the implant and rod pass through the second segment, the tines are forced radially away from each other, thereby dilating or expanding the incision, and facilitating implant. The instrument is removed from the incision following implantation.
[0015] For the above and other reasons, it would be desirable to provide a non-surgical instrument and method for subcutaneous implantation of sensors and solid materials that preferably does not require an incision preparatory to instrument insertion. It would also be desirable to provide an improved home monitoring of patients with chronic conditions and improved percutaneous sensor delivery devices.
BRIEF SUMMARY OF THE INVENTION [0016] In a first aspect, embodiments of the present invention provide a system for decompensation prediction of a heart failure patient. The system comprises one or more injectable detecting systems having a plurality of sensors that provide an indication of at least one physiological event of a patient, a wireless communication device coupled to the one or more injectable detecting systems and configured to transfer patient data directly or indirectly from the one or more injectable detecting systems to a remote monitoring system, and a remote monitoring system coupled to the wireless communication device, the remote
monitoring system using processed data to determine heart failure status and predict impending decompensation of the patient.
[0017] In another aspect, embodiments of the present invention provide a system for decompensation prediction of a heart failure patient. The system comprises one or more injectable detecting systems having a plurality of sensors that provide an indication of at least one physiological event of a patient, the one or more injectable detecting systems being inserted below the skin of the patient, the one or more injectable detecting systems being injected below the skin of the patient by gun or syringe injection, a wireless communication device coupled to the one or more injectable detecting systems and configured to transfer patient data directly or indirectly from the one or more injectable detecting systems to a remote monitoring system, and a remote monitoring system coupled to the wireless communication device, the remote monitoring system using processed data to determine heart failure status and predict impending decompensation of the patient.
[0018] In another aspect, embodiments of the present invention provide a method for decompensation prediction of a heart failure patient. The method comprising injecting subcutaneously one or more injectable detecting systems having a plurality of sensors that provide an indication of at least one physiological event of a patient, wirelessly transferring patient data directly or indirectly from the one or more injectable detecting systems to a remote monitoring system via a wireless communication device coupled to the one or more injectable detecting systems, and processing the data using the remote monitoring system to determine heart failure status and predict impending decompensation of the patient.
[0019] In many embodiments, the one or more injectable detecting systems are inserted below the skin of the patient by at least one of, catheter delivery, blunt tunneling and needle insertion. [0020] In many embodiments, the systems and methods further comprise an imaging system to assist in guiding the injectable detecting system to a desired location.
[0021] In many embodiments, each of a sensor is selected from at least one of, bioimpedance, heart rate, heart rhythm, HRV, HRT, heart sounds, respiratory sounds, respiratory rate and respiratory rate variability, blood pressure, activity, posture, wake/sleep, orthopnea, temperature, heat flux and an accelerometer.
[0022] In many embodiments, each of a sensor is an activity sensors selected from at least one of, ball switch, accelerometer, minute ventilation, HR, bioimpedance noise, skin temperature/heat flux, BP, muscle noise and posture.
[0023] In many embodiments, the injectable detecting systems include a power source, a memory, logic resources and an antenna. In many embodiments the power source is a rechargeable battery transcutaneously with an external unit.
[0024] In many embodiments, at least a portion of the injectable detecting systems have a drug eluting coating.
[0025] In many embodiments, the one or more injectable detecting systems are anchored in the patient by at least one of, barbs, anchors, tissue adhesion pads, suture loops, shape of device, self-expanding metal structure, wherein self-expanding metal structure is made of Nitinol.
[0026] In another aspect, embodiments of the present invention provide and injection system for injecting one or more injectable physiological monitoring systems for use in physiological monitoring of a patient. The system includes a body capable of holding one or more injectable physiological monitoring systems, the body having a proximal end and distal end, wherein the distal end is shaped to penetrate tissue, a pusher configured to engage the one or more injectable physiological monitoring systems within the body and a movable handle coupled to a pusher configured to distally advance the one or more injectable physiological monitoring systems through the body.
[0027] In another aspect, embodiments of the present invention provide an injectable detecting device for use in physiological monitoring is provided. The device comprises a plurality of sensors axially spaced along a body that provide an indication of at least one physiological event of a patient, a monitoring unit within the body coupled to the plurality of sensors configured to receive data from the plurality of sensors and create processed patient data, a power source within the body coupled to the monitoring unit, and a communication antenna external to the body coupled to the monitoring unit configured to transfer data to/from other devices.
[0028] In many embodiments, the monitoring unit includes a processor. In many embodiments, the processor includes program instructions for evaluating values received
from the sensors with respect to acceptable physiological ranges for each value received by the processor and determine variances.
[0029] In many embodiments, the monitoring unit includes logic resources that determine heart failure status and predict impending decompensation. [0030] In many embodiments, the monitoring unit is configured to perform one or more of, data compression, prioritizing of sensing by a sensor, cycling sensors, monitoring all or some of sensor data by all or a portion of the sensors, sensing by the sensors in real time, noise blanking to provide that sensor data is not stored if a selected noise level is determined, low-power of battery caching and decimation of old sensor data. [0031] In many embodiments, the monitoring unit includes a notification device configured to provide notification when values received from the plurality of sensors are not within acceptable physiological ranges.
[0032] In many embodiments, the monitoring unit is configured to serve as a communication hub for multiple medical devices, coordinating sensor data and therapy delivery while transmitting and receiving data from a remote monitoring system.
[0033] In many embodiments, the monitoring unit is configured to deactivate selected sensors to reduce redundancy.
[0034] In many embodiments, each of a sensor is selected from at least one of, bioimpedance, heart rate, heart rhythm, HRV, HRT, heart sounds, respiratory sounds, respiratory rate and respiratory rate variability, blood pressure, activity, posture, wake/sleep, orthopnea, temperature, heat flux and an accelerometer.
[0035] In many embodiments, each of a sensor is an activity sensor selected from at least one of, ball switch, accelerometer, minute ventilation, HR, bioimpedance noise, skin temperature/heat flux, BP, muscle noise and posture. [0036] In many embodiments, the sensors are made of at least a material selected from, silicone, polyurethane, Nitinol, titanium, a biocompatible material, ceramics and a bioabsorbable material.
[0037] In many embodiments, at least a portion of sensors of the plurality of sensors have an insulative material selected from, PEEK, ETFE, PTFE, and polyimide, silicon, polyurethane.
[0038] In many embodiments, at least a portion of sensors of the plurality of sensors have openings or an absorbent material configured to sample a hydration level or electrolyte level in a surrounding tissue site of the plurality of sensors.
[0039] In many embodiments, the plurality of sensors includes current delivery electrodes and sensing electrodes.
[0040] In many embodiments, the outputs of the plurality of sensors is used to calculate and monitor blended indices. The blended indices include at least one of, heart rate (HR) or respiratory rate (RR) response to activity, HR/RR response to posture change, HR + RR, HR/RR + bioimpedance, and/or minute ventilation/accelerometer. [0041] In many embodiments, the body and antenna are injectable in the patient by at least one of, catheter delivery, blunt tunneling, insertion with a needle, by injection, with a gun or syringe device with a stiffening wire stylet, guidewire, or combination of stylet or guidewire with a catheter.
[0042] In many embodiments, the body is flexible. [0043] In many embodiments, at least a portion of the body has a drug eluting coating.
[0044] In many embodiments, the power source comprises a rechargeable battery transcutaneously chargeable with an external unit.
BRIEF DESCRIPTION OF THE DRAWINGS [0045] FIG. 1 is a block diagram illustrating one embodiment of a patient monitoring system of the present invention.
[0046] FIG. 2(a) illustrates one embodiment of an injectable detecting system of the present invention that is injectable and includes multiple sensors, power and communication and a communication antenna. [0047] FIG. 2(b) illustrates the insertion of the device of FIG. 2(a) into an injector.
[0048] FIG. 2(c) illustrates the device of FIG. 2(a) in the injector and ready to be introduced into the patient.
[0049] FIG. 2(d) illustrates the implanted sensor device of FIG. 2(a).
[0050] FIG. 2(e) illustrates the implanted sensor device of FIG. 2(a) as it flexes from a rigid state in the body.
[0051] FIG. 2(f) illustrates a patient laying on top of a matt that has coils, where downloading of patient data and recharging can occur via the matt or also through an adherent patch or wearable device by the patient.
[0052] FIG. 2(g) illustrates the patient laying on top of the matt from FIG. 2(f) and the downloading of data from the sensors to the matt.
[0053] FIG. 2(h) is a close up view of FIG. 2(g) showing the downloading of data from the sensors to the matt, and then transfer of the data from the matt to a modem. [0054] FIG. 2(i) illustrates a patient with an implanted device, such as a pacing device, and the implanted device of FIG. 2(a) in communication with the implanted device.
[0055] FIG. 3 illustrates one embodiment of an energy management device that is coupled to the plurality of sensors of FIG. 1.
[0056] FIG. 4 illustrates one embodiment of present invention illustrating logic resources configured to receive data from the sensors and/or the processed patient for monitoring purposes, analysis and/or prediction purposes.
[0057] FIG. 5 illustrates an embodiment of the patient monitoring system of the present invention with a memory management device.
[0058] FIG. 6 illustrates an embodiment of the patient monitoring system of the present invention with an external device coupled to the sensors.
[0059] FIG. 7 illustrates an embodiment of the patient monitoring system of the present invention with a notification device.
[0060] FIG. 8 is a block diagram illustrating an embodiment of the present invention with sensor leads that convey signals from the sensors to a monitoring unit at the detecting system, or through a wireless communication device to a remote monitoring system.
[0061] FIG. 9 is a block diagram illustrating an embodiment of the present invention with a control unit at the detecting system and/or the remote monitoring system.
[0062] FIG. 10 is a block diagram illustrating an embodiment of the present invention where a control unit encodes patient data and transmits it to a wireless network storage unit at the remote monitoring system.
[0063] FIG. 11 is a block diagram illustrating one embodiment of an internal structure of a main data collection station at the remote monitoring system of the present invention.
[0064] FIG. 12 is a flow chart illustrating an embodiment of the present invention with operation steps performed by the system of the present invention in transmitting information to the main data collection station.
[0065] FIG. 13 shows one embodiment of an injection system for use with multiple injectable detecting systems.
[0066] FIG. 14 shows one embodiment of an injection system that includes a bevel needle shaped to receive the injectable detecting system.
DETAILED DESCRIPTION OF THE INVENTION [0067] The present invention is directed to a heart failure patient management system consisting of one or more subcutaneously injectable physiological monitoring systems inserted below the patient's skin. The system continuously monitors physiological parameters, communicates wirelessly with a remote center, and provides alerts when necessary. A variety of delivery devices and methods are also disclosed. [0068] The system monitors physiological parameters and uses a proprietary algorithm to determine heart failure status and predict impending decompensation. The injectable system communicates with a remote center, preferably via an intermediate device in the patient's home. In some embodiments, the remote center receives the data and applies the prediction algorithm. When a flag is raised, the center may communicate with the patient, hospital, nurse, and/or physician to allow for therapeutic intervention to prevent decompensation.
[0069] The injectable system may be inserted with one of the following techniques: catheter delivery, blunt tunneling (with either a separate tunneling tool or a wire-stiffened lead), and insertion with a needle. The injectable system may be injected with a gun or syringe-like device. The injectable system may be flexible, and may be implanted with a stiffening wire or stylet.
[0070] The injectable system may be implanted in a non-sterile, non-surgical setting. Implantation may occur with or without local anesthesia, and with or without imaging assistance.
[0071] The system may consist of an implantable component and an external component. In such an embodiment, the injected component, with or without physiological sensing electrodes, would be used to anchor an external electronics unit. The anchoring mechanism may be magnetic or mechanical.
[0072] The injectable system may contain one of the following features to facilitate subsequent extraction: an isodiametric profile, a breakaway anchor, a bioabsorbable material, coatings to limit tissue in-growth, and an electrically activated or fusable anchor. The injectable system may be modular, containing multiple connected components, a subset of which is easily extractable.
[0073] While the present invention is intended for heart failure patient monitoring, the system may be applicable to any human application in which wireless physiological monitoring and prediction is required.
[0074] In one embodiment, illustrated in FIG. 1, the present invention is a system that delivers a percutaneous sensing device for remote patient monitoring. The remote monitoring tracks the patient's physiological status, detects and predicts negative physiological events. In one embodiment, the implanted sensing device includes a plurality of sensors that are used in combination to enhance detection and prediction capabilities as more fully explained below.
[0075] Referring again to FIG. 1, in one embodiment, the system 10 includes an injectable detecting system 12 that includes a plurality of sensors 14 and/or electrodes, that provide an indication of at least one physiological event of a patient. The injectable detecting system 12 is inserted subcutaneously. In one embodiment the injectable detecting system 12 is inserted in the patient's thorax. The system 10 also includes a wireless communication device 16, coupled to the plurality of sensors 14. The wireless communication device transfers patient data directly or indirectly from the plurality of sensors 14 to a remote monitoring system 18. The remote monitoring system 18 uses data from the sensors to determine the patient's status. The system 10 can continuously, or non-continuously, monitor the patient, alerts are provided as necessary and medical intervention is provided
when required. In one embodiment, the wireless communication device 16 is a wireless local area network for receiving data from the plurality of sensors.
[0076] The sensors 14 are subcutaneously inserted with the injectable detecting system 12 that is catheter based, blunt tunneling (with either a separate tunneling tool or a wire- stiffened lead), needle insertion gun or syringe-like injection. The injectable detecting system 12 can be flexible, and be used with a stiffening wire, stylet, catheter or guidewire. The injectable detecting system 12 can include any of the following to assist in subsequent extraction: (i) an isodiametric profile, (ii) a breakaway anchor, (iii) a bioabsorbable material, (iv) coatings to limit tissue in-growth, (v) an electrically activated or fusable anchor, and the like. The injectable detecting system 12 can be modular, containing multiple connected components, a subset of which is easily extractable.
[0077] The injectable detecting system 12 can be inserted in the patient in a non-sterile or sterile setting, non-surgical setting or surgical setting, implanted with our without anesthesia and implanted with or without imaging assistance from an imaging system. The injectable detecting system 12 can be anchored in the patient by a variety of means including but not limited to, barbs, anchors, tissue adhesion pads, suture loops, with sensor shapes that conform to adjacent tissue anatomy or provide pressure against the adjacent tissue, with the use of self-expanding materials such as a nitinol anchor and the like.
[0078] FIG. 2(a) shows one embodiment of the injectable detecting system 12 with sensors 14 that is introduced below the skin surface. The device includes power and communication elements 32, and a communication antenna 34. The antenna may be a self expanding antenna expandable from a first compressed shape to a second expanded shape, such as disclosed in U.S. Provisional Application No. 61/084,567, filed July 29, 2008 entitled "Communication-Anchor Loop For Injectable Device", the full disclosure of which is incorporated herein by reference. FIG. 2(b) illustrates the injectable detecting system 12 being loaded into an injector 36 having a needle end 38. FIG. 2(c) shows the injectable detecting system 12 being introduced subcutaneously into a patient 40. FIG. 2(d) shows the injectable detecting system 12 being implanted subcutaneously from the injector 36. In FIG. 2(e), the injector 36 is removed and the injectable detecting system 12 flexes from a rigid configuration.
[0079] In one embodiment, illustrated in FIGs. 2(f) and 2(g), recharging coils 42 are placed in a mat 44 on the patient's bed, such as under a mattress pad. Recharging of the
sensors/battery and data transfer can occur during sleep of the patient. The rechargeable batteries can be transcutaneously charged with an external unit other than the mat. FIG. 2(g) shows downloading from the sensors and data transfer during sleep of the patient. In FIG. 2(h), the injectable detecting system 12 downloads data to the mat and a modem is used from data transfer. In FIG. 2(i), an implantable device 50, such as a pacing device communicates with the injectable detecting system 12 of FIG. 2(a).
[0080] In one embodiment, the wireless communication device 16 is configured to receive instructional data from the remote monitoring system and communicate instructions to the injectable detecting system. [0081] As illustrated in FIG. 3, an energy management device 19 is coupled to the plurality of sensors. In one embodiment, the energy management device 19 is part of the detecting system. In various embodiments, the energy management device 19 performs one or more of, modulate drive levels per sensed signal of a sensor 14, modulate a clock speed to optimize energy, watch cell voltage drop - unload cell, coulomb-meter or other battery monitor, sensor dropoff at an end of life of a battery coupled to a sensor, battery end of life dropoff to transfer data, elective replacement indicator, call center notification, sensing windows by the sensors 14 based on a monitored physiological parameter and sensing rate control.
[0082] In one embodiment, the energy management device 19 is configured to manage energy by at least one of, a thermo-electric unit, kinetics, fuel cell, nuclear power, a micro- battery and with a rechargeable device.
[0083] The system 10 is configured to automatically detect events. The system 10 automatically detects events by at least one of, high noise states, physiological quietness, sensor continuity and compliance. In response to a detected physiological event, patient states are identified when data collection is inappropriate. In response to a detected physiological event, patient states are identified when data collection is desirable. Patient states include, physiological quietness, rest, relaxation, agitation, movement, lack of movement and a patient's higher level of patient activity.
[0084] The system uses an intelligent combination of sensors to enhance detection and prediction capabilities, as more fully discloses in U.S. patent application, Serial Nos. 60/972,537 filed September 14, 2008 and 61/055,666 filed May 23, 2008, both titled
"Adherent Device with Multiple Physiological Sensors", incorporated herein by reference, and as more fully explained below.
[0085] In one embodiment, the injectable detecting system 12 communicates with the remote monitoring system 18 periodically or in response to a trigger event. The trigger event can include but is not limited to at least one of, time of day, if a memory is full, if an action is patient initiated, if an action is initiated from the remote monitoring system, a diagnostic event of the monitoring system, an alarm trigger, a mechanical trigger, and the like.
[0086] The injectable detecting system 12 can continuously, or non-continuously, monitor the patient, alerts are provided as necessary and medical intervention is provided when required. In one embodiment, the wireless communication device 16 is a wireless local area network for receiving data from the plurality of sensors in the injectable detecting system.
[0087] A processor 20 is coupled to the plurality of sensors 14 in the injectable detecting system 12. The processor 20 receives data from the plurality of sensors 14 and creates processed patient data. In one embodiment, the processor 20 is at the remote monitoring system 18. In another embodiment, the processor 20 is at the detecting system 12. The processor 20 can be integral with a monitoring unit 22 that is part of the injectable detecting system 12 or part of the remote monitoring system 18.
[0088] The processor 20 has program instructions for evaluating values received from the sensors 14 with respect to acceptable physiological ranges for each value received by the processor 20 and determine variances. The processor 20 can receive and store a sensed measured parameter from the sensors 14, compare the sensed measured value with a predetermined target value, determine a variance, accept and store a new predetermined target value and also store a series of questions from the remote monitoring system 18. [0089] As illustrated in FIG. 4, logic resources 24 are provided that take the data from the sensors 14, and/or the processed patient data from the processor 20, to predict an impending decompensation. The logic resources 24 can be at the remote monitoring system 18 or at the detecting system 12, such as in the monitoring unit 22.
[0090] In one embodiment, a memory management device 25 is provided as illustrated in FIG. 5. In various embodiments, the memory management device 25 performs one or more of data compression, prioritizing of sensing by a sensor 14, monitoring all or some of sensor
.. .
data by all or a portion of the sensors 14, sensing by the sensors 14 in real time, noise blanking to provide that sensor data is not stored if a selected noise level is determined, low- power of battery caching and decimation of old sensor data.
[0091] The injectable detecting system 12 can provide a variety of different functions, including but not limited to, initiation, programming, measuring, storing, analyzing, communicating, predicting, and displaying of a physiological event of the patient. The injectable detecting system 12 can be sealed, such as housed in a hermetically sealed package. In one embodiment, at least a portion of the sealed packages include a power source, a memory, logic resources and a wireless communication device. In one embodiment, an antenna is included that is exterior to the sealed package of the injectable detecting system 12. In one embodiment, the sensors 14 include, flex circuits, thin film resistors, organic transistors and the like. The sensors 14 can include ceramics, titanium PEEK, along with a silicon, PU or other insulative adherent sealant, to enclose the electronics. Additionally, the injectable detecting system 12 can include drug eluting coatings, including but not limited to, an antibiotic, anti-inflammatory agent and the like.
[0092] A wide variety of different sensors 14 can be utilized, including but not limited to, bioimpedance, heart rate, heart rhythm, HRV, HRT, heart sounds, respiration rate, respiration rate variability, respiratory sounds, SpO2, blood pressure, activity, posture, wake/sleep, orthopnea, temperature, heat flux, an accelerometer. glucose sensor, other chemical sensors associated with cardiac conditions, and the like. A variety activity sensors can be utilized, including but not limited to a, ball switch, accelerometer, minute ventilation, HR, bioimpedance noise, skin temperature/heat flux, BP, muscle noise, posture and the like.
[0093] The output of the sensors 14 can have multiple features to enhance physiological sensing performance. These multiple features have multiple sensing vectors that can include redundant vectors. The sensors 14 can include current delivery electrodes and sensing electrodes. Size and shape of current delivery electrodes, and the sensing electrodes, can be optimized to maximize sensing performance. The system 10 can be configured to determine an optimal sensing configuration and electronically reposition at least a portion of a sensing vector of a sensing electrode. The multiple features enhance the system's 10 ability to determine an optimal sensing configuration and electronically reposition sensing vectors. In one embodiment, the sensors 14 can be partially masked to minimize contamination of parameters sensed by the sensors 14.
[0094] The size and shape of current delivery electrodes, for bioimpedance, and sensing electrodes can be optimized to maximize sensing performance. Additionally, the outputs of the sensors 14 can be used to calculate and monitor blended indices. Examples of the blended indices include but are not limited to, heart rate (HR) or respiratory rate (RR) response to activity, HR/RR response to posture change, HR + RR, HR/RR + bioimpedance, and/or minute ventilation/accelerometer and the like.
[0095] The sensors 14 can be cycled in order to manage energy, and different sensors 14 can sample at different times. By way of illustration, and without limitation, instead of each sensor 14 being sampled at a physiologically relevant interval, e.g. every 30 seconds, one sensor 14 can be sampled at each interval, and sampling cycles between available sensors.
[0096] By way of illustration, and without limitation, the sensors 14 can sample 5 seconds for every minute for ECG, once a second for an accelerometer sensor, and 10 seconds for every 5 minutes for impedance.
[0097] In one embodiment, a first sensor 14 is a core sensor 14 that continuously monitors and detects, and a second sensor 14 verifies a physiological status in response to the core sensor 14 raising a flag. Additionally, some sensors 14 can be used for short term tracking, and other sensors 14 used for long term tracking.
[0098] The injectable detecting system 12 is inserted into the patient by a variety of means, including but not limited to, catheter delivery, blunt tunneling, insertion with a needle, by injection, with a gun or syringe device with a stiffening wire and stylet and the like. The sensors 14 can be inserted in the patient in a non-sterile or sterile setting, nonsurgical setting or surgical setting, injected with our without anesthesia and injected with or without imaging assistance. The injectable detecting system 12 can be anchored in the patient by a variety of means including but not limited to, barbs, anchors, tissue adhesion pads, suture loops.
[0099] The injectable detecting system 12 can come in a variety of different form factors including but not limited to, cylinder, dog-bone, half dog-bone, trapezoidal cross-section, semicircular cross-section, star-shaped cross-section, v-shaped cross-section, L-shaped, canted, W shaped, or in other shapes that assist in their percutaneous delivery, S-shaped, sine-wave shaped, J-shaped, any polygonal shape, helical/spiral, fin electrodes, and linear device with a radius of curvature to match a radius of the injection site and the like. Further, the injectable detecting system 12 can have flexible body configurations.
Additionally, the injectable detecting system 12 can be configured to deactivate selected sensors 14 to reduce redundancy.
[0100] The sensors 14 can be made of a variety of materials, including but not limited to, silicone, polyurethane, Nitinol, a biocompatible material, a bioabsorbable material and the like. Electrode sensors 14 can have a variety of different conductors, including but not limited to, platinum, MP35N which is a nickel-cobalt-chromium-molybdenum alloy, MP35N/Ag core, platinum/tantalum core, stainless steel, titanium and the like. The sensors 14 can have insulative materials, including but not limited to, polyetheretherketone (PEEK), ethylene-tetrafluoroethylene (ETFE), polytetrafluoroethlene (PTFE), polyimide, silicon, polyurethane, and the like. Further, the sensors 14 can have openings, or an absorbent material, configured to sample a hydration level or electrolyte level in a surrounding tissue site at the location of the sensor 14. The sensor 14 electrodes can be made of a variety of materials, including but not limited to platinum, iridium, titanium, and the like. Electrode coatings can be included, such as iridium oxide, platinum black, TiN, and the like. [0101] The injectable detecting system 12 can include one or more a rechargeable batteries 36 that can be transcutaneously chargeable with an external unit.
[0102] Referring to FIG. 6, in one embodiment, an external device 38, including a medical treatment device, is coupled to the injectable detecting system 12. The external device 38 can be coupled to a monitoring unit 22 that is part of the injectable detecting system 12, or in direct communication with the sensors 14. A variety of different external devices 38 can be used, including but not limited to, a weight scale, blood pressure cuff, cardiac rhythm management device, a medical treatment device, medicament dispenser, glucose monitor, insulin pump, drug delivery pumps, drug delivery patches, and the like. Suitable cardiac rhythm management devices include but are not limited to, Boston Scientific's Latitude system, Medtronic's CareLink system, St. Jude Medical's HouseCall system and the like. Such communication may occur directly or via an external translator unit.
[0103] The external device 38 can be coupled to an auxiliary input of the monitoring unit 22 at the injectable detecting system 12 or to the monitoring system 22 at the remote monitoring system 18. Additionally, an automated reader can be coupled to an auxiliary input in order to allow a single monitoring unit 22 to be used by multiple patients. As previously mentioned above, the monitoring unit 22 can be at the remote monitoring system
18 and each patient can have a patient identifier (ID) including a distinct patient identifier. In addition, the ID identifier can also contain patient specific configuration parameters. The automated reader can scan the patient identifier ID and transmit the patient ID number with a patient data packet such that the main data collection station can identify the patient. [0104] It will be appreciated that other medical treatment devices can also be used. The injectable detecting system 12 can communicate wirelessly with the external devices 38 in a variety of ways including but not limited to, a public or proprietary communication standard and the like. The injectable detecting system 12 can be configured to serve as a communication hub for multiple medical devices, coordinating sensor data and therapy delivery while transmitting and receiving data from the remote monitoring system 18.
[0105] In one embodiment, the injectable detecting system 12 coordinate data sharing between the external systems 38 allowing for sensor integration across devices. The coordination of the injectable detecting system 12 provides for new pacing, sensing, defibrillation vectors, and the like. [0106] In one embodiment, the processor 20 is included in the monitoring unit 22 and the external device 38 is in direct communication with the monitoring unit 22.
[0107] In another embodiment, illustrated in FIG. 7, a notification device 42 is coupled to the injectable detecting system 12 and the remote monitoring system 18. The notification device 42 is configured to provide notification when values received from the sensors 14 are not within acceptable physiological ranges. The notification device 42 can be at the remote monitoring system 18 or at the monitoring unit 22 that is part of the injectable detecting system 12. A variety of notification devices 42 can be utilized, including but not limited to, a visible patient indicator, an audible alarm, an emergency medical service notification, a call center alert, direct medical provider notification and the like. The notification device 42 provides notification to a variety of different entities, including but not limited to, the patient, a caregiver, the remote monitoring system, a spouse, a family member, a medical provider, from one device to another device such as the external device 38, and the like.
[0108] Notification can be according to a preset hierarchy. By way of illustration, and without limitation, the preset hierarchy can be, patient notification first and medical provider second, patient notification second and medical provider first, and the like. Upon receipt of a notification, a medical provider, the remote monitoring system 18, or a medical
treatment device can trigger a high-rate sampling of physiological parameters for alert verification.
[0109] The system 10 can also include an alarm 46, that can be coupled to the notification device 42, for generating a human perceptible signal when values received from the sensors 14 are not within acceptable physiological ranges. The alarm 46 can trigger an event to render medical assistance to the patient, provide notification as set forth above, continue to monitor, wait and see, and the like.
[0110] When the values received from the sensors 14 are not within acceptable physiological ranges the notification is with the at least one of, the patient, a spouse, a family member, a caregiver, a medical provider and from one device to another device, to allow for therapeutic intervention to prevent decompensation.
[0111] In another embodiment, the injectable detecting system 12 can switch between different modes, wherein the modes are selected from at least one of, a stand alone mode with communication directly with the remote monitoring system 18, communication with an implanted device, communication with a single implanted device, coordination between different devices (external systems) coupled to the plurality of sensors and different device communication protocols.
[0112] By way of illustration, and without limitation, the patient can be a congestive heart failure patient. Heart failure status is determined by a weighted combination change in sensor outputs and be determined by a number of different means, including but not limited to, (i) when a rate of change of at least two sensor outputs is an abrupt change in the sensor outputs as compared to a change in the sensor outputs over a longer period of time, (ii) by a tiered combination of at least a first and a second sensor output, with the first sensor output indicating a problem that is then verified by at least a second sensor output, (iii) by a variance from a baseline value of sensor outputs, and the like. The baseline values can be defined in a look up table.
[0113] In another embodiment, heart failure status is determined using three or more sensors by at least one of, (i) when the first sensor output is at a value that is sufficiently different from a baseline value, and at least one of the second and third sensor outputs is at a value also sufficiently different from a baseline value to indicate heart failure status, (ii) by time weighting the outputs of the first, second and third sensors, and the time weighting indicates a recent event that is indicative of the heart failure status and the like.
[0114] In one embodiment, the wireless communication device 16 can include a, modem, a controller to control data supplied by the injectable detecting system 12, serial interface, LAN or equivalent network connection and a wireless transmitter. Additionally, the wireless communication device 16 can include a receiver and a transmitter for receiving data indicating the values of the physiological event detected by the plurality of sensors, and for communicating the data to the remote monitoring system 18. Further, the wireless communication device 16 can have data storage for recording the data received from the injectable detecting system 12 and an access device for enabling access to information recording in the data storage from the remote monitoring system 18. [0115] In various embodiments, the remote monitoring system 18 can include a, receiver, a transmitter and a display for displaying data representative of values of the one physiological event detected by the injectable detecting system 12. The remote monitoring system can also include a, data storage mechanism that has acceptable ranges for physiological values stored therein, a comparator for comparing the data received from the injectable detecting system 12 with the acceptable ranges stored in the data storage device and a portable computer. The remote monitoring system 18 can be a portable unit with a display screen and a data entry device for communicating with the wireless communication device 16.
[0116] Referring now to FIG. 8, for each sensor 14, a sensor lead 112 and 114 conveys signals from the sensor 14 to the monitoring unit 22 at the injectable detecting system 12, or through the wireless communication device 16 to the remote monitoring system 18.
[0117] In one embodiment, each signal from a sensor 14 is first passed through a low-pass filter 116, at the injectable detecting system 12 or at the remote monitoring system 18, to smooth the signal and reduce noise. The signal is then transmitted to an analog-to-digital converter 118A, which transforms the signals into a stream of digital data values that can be stored in a digital memory 118B. From the digital memory 118B, data values are transmitted to a data bus 120, along which they are transmitted to other components of the circuitry to be processed and archived. From the data bus 120, the digital data can be stored in a non-volatile data archive memory. The digital data can be transferred via the data bus 120 to the processor 20, which processes the data based in part on algorithms and other data stored in a non-volatile program memory.
[0118] The injectable detecting system 12 can also include a power management module 122 configured to power down certain components of the system, including but not limited to, the analog-to-digital converters 118A and 124, digital memories 118B and the nonvolatile data archive memory and the like, between times when these components are in use. This helps to conserve battery power and thereby extend the useful life. Other circuitry and signaling modes may be devised by one skilled in the art.
[0119] As can be seen in FIG. 9, a control unit 126 is included at the detecting system 12, the remote monitoring system 18, or at both locations.
[0120] In one embodiment, the control unit 126 can be a microprocessor, for example, a Pentium or 486 processor. The control unit 126 can be coupled to the sensors 14 directly at the injectable detecting system 12, indirectly at the injectable detecting system 12 or indirectly at the remote monitoring system 18. Additionally the control unit 126 can be coupled to one or more devices, for example, a blood pressure monitor, cardiac rhythm management device, scale, a device that dispenses medication, a device that can indicate the medication has been dispensed, and the like.
[0121] The control unit 126 can be powered by AC inputs which are coupled to internal AC/DC converters 134 that generate multiple DC voltage levels. After the control unit 126 has collected the patient data from the sensors 14, the control unit 126 encodes the recorded patient data and transmits the patient data through the wireless communication device 16 to transmit the encoded patient data to a wireless network storage unit 128 at the remote monitoring system 18, as shown in FIG. 10. In another embodiment, wireless communication device 16 transmits the patient data from the injectable detecting system 12 to the control unit 126 when it is at the remote monitoring system 18.
[0122] Every time the control unit 126 plans to transmit patient data to a main data collection station 130, located at the remote monitoring system 18, the control unit 126 attempts to establish a communication link. The communication link can be wireless, wired, or a combination of wireless and wired for redundancy, e.g., the wired link checks to see if a wireless communication can be established. If the wireless communication link 16 is available, the control unit 126 transmits the encoded patient data through the wireless communication device 16. However, if the wireless communication device 16 is not available for any reason, the control unit 126 waits and tries again until a link is established.
[0123] Referring now to FIG. 11, one embodiment of an internal structure of a main data collection station 130, at the remote monitoring system 18, is illustrated. The patient data can be transmitted by the remote monitoring system 18 by either the wireless communication device 16 or conventional modem to the wireless network storage unit 128. After receiving the patient data, the wireless network storage unit 128 can be accessed by the main data collection station 130. The main data collection station 130 allows the remote monitoring system 18 to monitor the patient data of numerous patients from a centralized location without requiring the patient or a medical provider to physically interact with each other. [0124] The main data collection station 130 can include a communications server 136 that communicates with the wireless network storage unit 128. The wireless network storage unit 128 can be a centralized computer server that includes a unique, password protected mailbox assigned to and accessible by the main data collection station 130. The main data collection station 130 contacts the wireless network storage unit 128 and downloads the patient data stored in a mailbox assigned to the main data collection station 130.
[0125] Once the communications server 136 has formed a link with the wireless network storage unit 128, and has downloaded the patient data, the patient data can be transferred to a database server 138. The database server 138 includes a patient database 140 that records and stores the patient data of the patients based upon identification included in the data packets sent by each of the monitoring units 22. For example, each data packet can include an identifier.
[0126] Each data packet transferred from the remote monitoring system 18 to the main data collection station 130 does not have to include any patient identifiable information. Instead, the data packet can include the serial number assigned to the specific injectable detecting system 12. The serial number associated with the detecting system 12 can then be correlated to a specific patient by using information stored on the patient database 138. In this manner, the data packets transferred through the wireless network storage unit 128 do not include any patient-specific identification. Therefore, if the data packets are intercepted or improperly routed, patient confidentiality can not be breached. [0127] The database server 138 can be accessible by an application server 142. The application server 142 can include a data adapter 144 that formats the patient data information into a form that can be viewed over a conventional web-based connection. The
transformed data from the data adapter 144 can be accessible by propriety application software through a web server 146 such that the data can be viewed by a workstation 148. The workstation 148 can be a conventional personal computer that can access the patient data using proprietary software applications through, for example, HTTP protocol, and the like.
[0128] The main data collection station further can include an escalation server 150 that communicates with the database server 138. The escalation server 150 monitors the patient data packets that are received by the database server 138 from the monitoring unit 22. Specifically, the escalation server 150 can periodically poll the database server 138 for unacknowledged patient data packets. The patient data packets are sent to the remote monitoring system 18 where the processing of patient data occurs. The remote monitoring system 18 communicates with a medical provider in the event that an alert is required. If data packets are not acknowledged by the remote monitoring system 18. The escalation server 150 can be programmed to automatically deliver alerts to a specific medical provider if an alarm message has not been acknowledged within a selected time period after receipt of the data packet.
[0129] The escalation server 150 can be configured to generate the notification message to different people by different modes of communication after different delay periods and during different time periods. [0130] The main data collection station 130 can include a batch server 152 connected to the database server 138. The batch server 152 allows an administration server 154 to have access to the patient data stored in the patient database 140. The administration server 154 allows for centralized management of patient information and patient classifications.
[0131] The administration server 154 can include a batch server 156 that communicates with the batch server 152 and provides the downloaded data to a data warehouse server 158. The data warehouse server 158 can include a large database 160 that records and stores the patient data.
[0132] The administration server 154 can further include an application server 162 and a maintenance workstation 164 that allow personnel from an administrator to access and monitor the data stored in the database 160.
[0133] The data packet utilized in the transmission of the patient data can be a variable length ASCII character packet, or any generic data formats, in which the various patient data measurements are placed in a specific sequence with the specific readings separated by commas. The control unit 126 can convert the readings from each sensor 14 into a standardized sequence that forms part of the patient data packet. In this manner, the control unit 126 can be programmed to convert the patient data readings from the sensors 14 into a standardized data packet that can be interpreted and displayed by the main data collection station 130 at the remote monitoring system 18.
[0134] Referring now to the flow chart of FIG. 12, if an external device 38 fails to generate a valid reading, as illustrated in step A, the control unit 126 fills the portion of the patient data packet associated with the external device 38 with a null indicator. The null indicator can be the lack of any characters between commas in the patient data packet. The lack of characters in the patient data packet can indicate that the patient was not available for the patient data recording. The null indicator in the patient data packet can be interpreted by the main data collection station 130 at the remote monitoring system 18 as a failed attempt to record the patient data due to the unavailability of the patient, a malfunction in one or more of the sensors 14, or a malfunction in one of the external devices 38. The null indicator received by the main data collection station 130 can indicate that the transmission from the injectable detecting system 12 to the remote monitoring system 18 was successful. In one embodiment, the integrity of the data packet received by the main data collection station 130 can be determined using a cyclic redundancy code, CRC- 16, check sum algorithm. The check sum algorithm can be applied to the data when the message can be sent and then again to the received message.
[0135] After the patient data measurements are complete, the control unit 126 displays the sensor data, including but not limited to blood pressure cuff data and the like, as illustrated by step B. In addition to displaying this data, the patient data can be placed in the patient data packet, as illustrated in step C.
[0136] As previously described, the system 10 can take additional measurements utilizing one or more auxiliary or external devices 38 such as those mentioned previously. Since the patient data packet has a variable length, the auxiliary device patient information can be added to the patient data packet being compiled by the remote monitoring unit 22 during patient data acquisition period being described. Data from the external devices 38 is
transmitted by the wireless communication device 16 to the remote monitoring system 18 and can be included in the patient data packet.
[0137] If the remote monitoring system 18 can be set in either the auto mode or the wireless only mode, the remote monitoring unit 22 can first determine if there can be an internal communication error, as illustrated in step D.
[0138] A no communication error can be noted as illustrated in step E. If a communication error is noted the control unit 126 can proceed to wireless communication device 16 or to a conventional modem transmission sequence, as will be described below. However, if the communication device is working, the control unit 126 can transmit the patient data information over the wireless network 16, as illustrated in step F. After the communication device has transmitted the data packet, the control unit 126 determines whether the transmission was successful, as illustrated in step G. If the transmission has been unsuccessful only once, the control unit 126 retries the transmission. However, if the communication device has failed twice, as illustrated in step H, the control unit 126 proceeds to the conventional modem process if the remote monitoring unit 22 was configured in an auto mode.
[0139] When the control unit 126 is at the injectable detecting system 12, and the control unit 126 transmits the patient data over the wireless communication device 16, as illustrated in step I, if the transmission has been successful, the display of the remote monitoring unit 22 can display a successful message, as illustrated in step J. However, if the control unit 126 determines in step K that the communication of patient data has failed, the control unit 126 repeats the transmission until the control unit 126 either successfully completes the transmission or determines that the transmission has failed a selected number of times, as illustrated in step L. The control unit 126 can time out the and a failure message can be displayed, as illustrated in steps M and N. Once the transmission sequence has either failed or successfully transmitted the data to the main data collection station, the control unit 126 returns to a start program step O.
[0140] As discussed previously, the patient data packets are first sent and stored in the wireless network storage unit 128. From there, the patient data packets are downloaded into the main data collection station 130. The main data collection station 130 decodes the encoded patient data packets and records the patient data in the patient database 140. The patient database 140 can be divided into individual storage locations for each patient such
that the main data collection station 130 can store and compile patient data information from a plurality of individual patients.
[0141] A report on the patient's status can be accessed by a medical provider through a medical provider workstation that is coupled to the remote monitoring system 18. Unauthorized access to the patient database can be prevented by individual medical provider usernames and passwords to provide additional security for the patient's recorded patient data.
[0142] The main data collection station 130 and the series of work stations 148 allow the remote monitoring system 18 to monitor the daily patient data measurements taken by a plurality of patients reporting patient data to the single main data collection station 130. The main data collection station 130 can be configured to display multiple patients on the display of the workstations 148. The internal programming for the main data collection station 130 can operate such that the patients are placed in a sequential top-to-bottom order based upon whether or not the patient can be generating an alarm signal for one of the patient data being monitored. For example, if one of the patients monitored by monitoring system 130 has a blood pressure exceeding a predetermined maximum amount, this patient can be moved toward the top of the list of patients and the patient's name and/or patient data can be highlighted such that the medical personnel can quickly identify those patients who may be in need of medical assistance. By way of illustration, and without limitation, the following paragraphs is a representative order ranking method for determining the order which the monitored patients are displayed:
[0143] Alarm Display Order Patient Status Patients are then sorted 1 Medical Alarm Most alarms violated to least alarms violated, then oldest to newest 2 Missing Data Alarm Oldest to newest 3 Late Oldest to newest 4 Reviewed Medical Alarms Oldest to newest 5 Reviewed Missing Data Oldest to newest Alarms 6 Reviewed Null Oldest to newest 7 NDR Oldest to newest 8 Reviewed NDR Oldest to newest
[0144] As listed in the above, the order of patients listed on the display can be ranked based upon the seriousness and number of alarms that are registered based upon the latest patient data information. For example, if the blood pressure of a single patient exceeds the tolerance level and the patient's heart rate also exceeds the maximum level, this patient will be placed above a patient who only has one alarm condition. In this manner, the medical provider can quickly determine which patient most urgently needs medical attention by
simply identifying the patient's name at the top of the patient list. The order which the patients are displayed can be configurable by the remote monitoring system 18 depending on various preferences.
[0145] As discussed previously, the escalation server 150 automatically generates a notification message to a specified medical provider for unacknowledged data packets based on user specified parameters.
[0146] In addition to displaying the current patient data for the numerous patients being monitored, the software of the main data collection station 130 allows the medical provider to trend the patient data over a number of prior measurements in order to monitor the progress of a particular patient, hi addition, the software allows the medical provider to determine whether or not a patient has been successful in recording their patient data as well as monitor the questions being asked by the remote monitoring unit 22.
[0147] As previously mentioned, the system 10 uses an intelligent combination of sensors to enhance detection and prediction capabilities. Electrocardiogram circuitry can be coupled to the sensors 14, or electrodes, to measure an electrocardiogram signal of the patient. An accelerometer can be mechanically coupled, for example adhered or affixed, to the sensors 14, adherent patch and the like, to generate an accelerometer signal in response to at least one of an activity or a position of the patient. The accelerometer signals improve patient diagnosis, and can be especially useful when used with other signals, such as electrocardiogram signals and impedance signals, including but not limited to, hydration respiration, and the like. Mechanically coupling the accelerometer to the sensors 14, electrodes, for measuring impedance, hydration and the like can improve the quality and/or usefulness of the impedance and/or electrocardiogram signals. By way of illustration, and without limitation, mechanical coupling of the accelerometer to the sensors 14, electrodes, and to the skin of the patient can improve the reliability, quality and/or accuracy of the accelerometer measurements, as the sensor 14, electrode, signals can indicate the quality of mechanical coupling of the patch to the patient so as to indicate that the device is connected to the patient and that the accelerometer signals are valid. Other examples of sensor interaction include but are not limited to, (i) orthopnea measurement where the breathing rate is correlated with posture during sleep, and detection of orthopnea, (ii) a blended activity sensor using the respiratory rate to exclude high activity levels caused by vibration
(e.g. driving on a bumpy road) rather than exercise or extreme physical activity, (iii) sharing common power, logic and memory for sensors, electrodes, and the like.
[0148] FIG. 13 shows one embodiment of an injection system 200 for use with multiple injectable detecting systems 12 that includes a magazine 205 with several injectable detecting systems 12 loaded therein. The injection system 200 can be placed against the tissue 210, as shown. A handle 215 can be pulled proximally 220 to inject one of the injectable detecting systems 12 into the patient 40, and injectable detecting systems 12 in the magazine 205 are advanced such that the next injectable detecting system 12 is ready for injection at a subsequent location. [0149] FIG. 14 shows one embodiment of an injection system 250 that includes a needle 255 configured to hold one or more injectable detecting systems 12. The needled 255 includes a bevel needle shaped tip 265, that is inserted into the tissue with the injectable detecting system 12 loaded into the needle 255. A pusher 265 is advanced distally to advance the injectable detecting system 12 into the tissue after the needle has penetrated the tissue
[0150] While the invention is susceptible to various modifications and alternative constructions, certain illustrated embodiments thereof are shown in the drawings and have been described above in detail. It should be understood, however, that there is no intention to limit the invention to the specific form or forms disclosed, but on the contrary, the intention is to cover all modifications, alternative constructions, and equivalents falling within the spirit and scope of the invention.
Claims
1. A system for decompensation prediction of a heart failure patient, comprising: one or more injectable detecting systems having a plurality of sensors that provide an indication of at least one physiological event of a patient; a wireless communication device coupled to the one or more injectable detecting systems and configured to transfer patient data directly or indirectly from the one or more injectable detecting systems to a remote monitoring system; and a remote monitoring system coupled to the wireless communication device, the remote monitoring system using processed data to determine heart failure status and predict impending decompensation of the patient.
2. The system of claim 1, wherein the one or more injectable detecting systems are inserted below the skin of the patient by at least one of, catheter delivery, blunt tunneling and needle insertion.
3. The system of claim 1, further comprising an imaging system to assist in guiding the injectable detecting system to a desired location.
4. The system of claim 1, wherein each of a sensor is selected from at least one of, bioimpedance, heart rate, heart rhythm, HRV, HRT, heart sounds, respiratory sounds, respiratory rate and respiratory rate variability, blood pressure, activity, posture, wake/sleep, orthopnea, temperature, heat flux and an accelerometer.
5. The system of claim 1, wherein each of a sensor is an activity sensor selected from at least one of, ball switch, accelerometer, minute ventilation, HR, bioimpedance noise, skin temperature/heat flux, BP, muscle noise and posture.
6. The system of claim 1, wherein the one or more injectable detecting systems include a power source, a memory, logic resources and an antenna.
7. The system of claim 6, wherein the power source is a rechargeable battery transcutaneously with an external unit.
8. The system of claim 1, wherein at least a portion of the one or more injectable detecting systems have a drug eluting coating.
9. The system of claim 1, wherein the one or more injectable detecting systems are anchored in the patient by at least one of, barbs, anchors, tissue adhesion pads, suture loops, shape of device, self-expanding metal structure, wherein self-expanding metal structure is made of Nitinol.
10. A system for decompensation prediction of a heart failure patient, comprising: one or more injectable detecting systems having a plurality of sensors that provide an indication of at least one physiological event of a patient, the one or more injectable detecting systems being inserted below the skin of the patient, the one or more injectable detecting systems being injected below the skin of the patient by gun or syringe injection; a wireless communication device coupled to the one or more injectable detecting systems and configured to transfer patient data directly or indirectly from the one or more injectable detecting systems to a remote monitoring system; and a remote monitoring system coupled to the wireless communication device, the remote monitoring system using processed data to determine heart failure status and predict impending decompensation of the patient.
11. The system of claim 10, further comprising an imaging system to assist in guiding the one or more injectable detecting systems to a desired location.
12. The system of claim 10, wherein each of a sensor is selected from at least one of, bioimpedance, heart rate, heart rhythm, HRV, HRT, heart sounds, respiratory sounds, blood pressure, activity, posture, wake/sleep, orthopnea, temperature, heat flux and an accelerometer.
13. The system of claim 10, wherein each of a sensor is an activity sensors selected from at least one of, ball switch, accelerometer, minute ventilation, HR, bioimpedance noise, skin temperature/heat flux, BP, muscle noise and posture.
14. The system of claim 10, wherein the one or more injectable detecting systems include a power source, a memory, logic resources and an antenna.
15. The system of claim 10, wherein at least a portion of the one or more injectable detecting systems have a drug eluting coating.
16. The system of claim 10, wherein the one or more injectable detecting systems are anchored in the patient by at least one of, barbs, anchors, tissue adhesion pads, suture loops, shape of device, self-expanding metal structure, wherein self-expanding metal structure is made of Nitinol.
17. A method for decompensation prediction of a heart failure patient comprising: injecting subcutaneously one or more injectable detecting systems having a plurality of sensors that provide an indication of at least one physiological event of a patient; wirelessly transferring patient data directly or indirectly from the one or more injectable detecting systems to a remote monitoring system via a wireless communication device coupled to the one or more injectable detecting systems; and processing the data using the remote monitoring system to determine heart failure status and predict impending decompensation of the patient.
18. The method of claim 17, wherein each of a sensor is selected from at least one of, bioimpedance, heart rate, heart rhythm, HRV, HRT, heart sounds, respiratory sounds, respiratory rate and respiratory rate variability, blood pressure, activity, posture, wake/sleep, orthopnea, temperature, heat flux, an accelerometer, hydration level or electrolyte level in a surrounding tissue site.
19. The method of claim 17, further comprising guiding the one or more injectable detecting system to a desired location with an imaging system.
20. An injection system for injecting one or more injectable physiological monitoring systems for use in physiological monitoring of a patient, the injection system comprising: a body capable of holding one or more injectable physiological monitoring systems, the body having a proximal end and distal end, wherein the distal end is shaped to penetrate tissue; a pusher configured to engage the one or more injectable physiological monitoring systems within the body; and a movable handle coupled to a pusher configured to distally advance the one or more injectable physiological monitoring systems through the body.
21. An injectable device for use in physiological monitoring, comprising: a plurality of sensors axially spaced along a body that provide an indication of at least one physiological event of a patient; a monitoring unit within the body coupled to the plurality of sensors configured to receive data from the plurality of sensors and create processed patient data; a power source within the body coupled to the monitoring unit; and a communication antenna external to the body coupled to the monitoring unit configured to transfer data to/from other devices.
22. The device of claim 21 , wherein the monitoring unit includes a processor.
23. The device of claim 22, wherein the processor includes program instructions for evaluating values received from the sensors with respect to acceptable physiological ranges for each value received by the processor and determine variances.
24. The device of claim 21, wherein the monitoring unit includes logic resources that determine heart failure status and predict impending decompensation.
25. The device of claim 21 , wherein the monitoring unit is configured to perform one or more of, data compression, prioritizing of sensing by a sensor, cycling sensors, monitoring all or some of sensor data by all or a portion of the sensors, sensing by the sensors in real time, noise blanking to provide that sensor data is not stored if a selected noise level is determined, low-power of battery caching and decimation of old sensor data.
26. The device of claim 21, wherein the monitoring unit includes a notification device configured to provide notification when values received from the plurality of sensors are not within acceptable physiological ranges.
27. The device of claim 21 , wherein the monitoring unit is configured to serve as a communication hub for multiple medical devices, coordinating sensor data and therapy delivery while transmitting and receiving data from a remote monitoring system.
28. The device of claim 21, wherein the monitoring unit is configured to deactivate selected sensors to reduce redundancy.
29. The device of claim 21, wherein each of a sensor is selected from at least one of, bioimpedance, heart rate, heart rhythm, HRV, HRT, heart sounds, respiratory sounds, respiratory rate and respiratory rate variability, blood pressure, activity, posture, wake/sleep, orthopnea, temperature, heat flux and an accelerometer.
30. The device of claim 21, wherein each of a sensor is an activity sensor selected from at least one of, ball switch, accelerometer, minute ventilation, HR, bioimpedance noise, skin temperature/heat flux, BP, muscle noise and posture.
31. The device of claim 21 , wherein the sensors are made of at least a material selected from, silicone, polyurethane, Nitinol, titanium, a biocompatible material, ceramics and a bioabsorbable material.
32. The system of claim 21, wherein at least a portion of sensors of the plurality of sensors have an insulative material selected from, PEEK, ETFE, PTFE, and polyimide, silicon, polyurethane.
33. The device of claim 21, wherein at least a portion of sensors of the plurality of sensors have openings or an absorbent material configured to sample a hydration level or electrolyte level in a surrounding tissue site of the plurality of sensors.
34. The device of claim 21, wherein the plurality of sensors includes current delivery electrodes and sensing electrodes.
35. The device of claim 21, wherein the outputs of the plurality of sensors is used to calculate and monitor blended indices.
36. The device of claim 35, wherein the blended indices include at least one of, heart rate (HR) or respiratory rate (RR) response to activity, HR/RR response to posture change, HR + RR, HR/RR + bioimpedance, and/or minute ventilation/accelerometer.
37. The device of claim 21, wherein the body and antenna are injectable in the patient by at least one of, catheter delivery, blunt tunneling, insertion with a needle, by injection, with a gun or syringe device with a stiffening wire stylet, guidewire, or combination of stylet or guidewire with a catheter.
38. The device of claim 21, wherein the body is flexible.
39. The device of claim 21 , wherein at least a portion of the body has a drug eluting coating.
40. The device of claim 21 , wherein the power source comprises a rechargeable battery transcutaneously chargeable with an external unit.
Applications Claiming Priority (10)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US97253707P | 2007-09-14 | 2007-09-14 | |
US97233607P | 2007-09-14 | 2007-09-14 | |
US97235407P | 2007-09-14 | 2007-09-14 | |
US97232907P | 2007-09-14 | 2007-09-14 | |
US60/972,537 | 2007-09-14 | ||
US60/972,329 | 2007-09-14 | ||
US60/972,336 | 2007-09-14 | ||
US60/972,354 | 2007-09-14 | ||
US5566608P | 2008-05-23 | 2008-05-23 | |
US61/055,666 | 2008-05-23 |
Publications (1)
Publication Number | Publication Date |
---|---|
WO2009036256A1 true WO2009036256A1 (en) | 2009-03-19 |
Family
ID=40452497
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/US2008/076146 WO2009036256A1 (en) | 2007-09-14 | 2008-09-12 | Injectable physiological monitoring system |
Country Status (2)
Country | Link |
---|---|
US (4) | US9186089B2 (en) |
WO (1) | WO2009036256A1 (en) |
Cited By (6)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US8463361B2 (en) | 2007-05-24 | 2013-06-11 | Lifewave, Inc. | System and method for non-invasive instantaneous and continuous measurement of cardiac chamber volume |
US8996110B2 (en) | 2012-06-29 | 2015-03-31 | Pacesetter, Inc. | System and method for determining cause of irregularity within physiologic data |
US9002427B2 (en) | 2009-03-30 | 2015-04-07 | Lifewave Biomedical, Inc. | Apparatus and method for continuous noninvasive measurement of respiratory function and events |
US9078582B2 (en) | 2009-04-22 | 2015-07-14 | Lifewave Biomedical, Inc. | Fetal monitoring device and methods |
US9241638B2 (en) | 2012-05-04 | 2016-01-26 | Pacesetter, Inc. | System and method for implanting a physiologic sensor assembly |
CN113692249A (en) * | 2019-03-07 | 2021-11-23 | 普罗赛普特生物机器人公司 | Implant for continuous patient monitoring and smart therapy |
Families Citing this family (138)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US8326423B2 (en) | 2004-12-20 | 2012-12-04 | Cardiac Pacemakers, Inc. | Devices and methods for steering electrical stimulation in cardiac rhythm management |
AR047851A1 (en) | 2004-12-20 | 2006-03-01 | Giniger Alberto German | A NEW MARCAPASOS THAT RESTORES OR PRESERVES THE PHYSIOLOGICAL ELECTRIC DRIVING OF THE HEART AND A METHOD OF APPLICATION |
US8369944B2 (en) * | 2007-06-06 | 2013-02-05 | Zoll Medical Corporation | Wearable defibrillator with audio input/output |
US8271082B2 (en) | 2007-06-07 | 2012-09-18 | Zoll Medical Corporation | Medical device configured to test for user responsiveness |
US7974689B2 (en) | 2007-06-13 | 2011-07-05 | Zoll Medical Corporation | Wearable medical treatment device with motion/position detection |
US8140154B2 (en) | 2007-06-13 | 2012-03-20 | Zoll Medical Corporation | Wearable medical treatment device |
WO2009036348A1 (en) | 2007-09-14 | 2009-03-19 | Corventis, Inc. | Medical device automatic start-up upon contact to patient tissue |
US8790257B2 (en) | 2007-09-14 | 2014-07-29 | Corventis, Inc. | Multi-sensor patient monitor to detect impending cardiac decompensation |
US9186089B2 (en) | 2007-09-14 | 2015-11-17 | Medtronic Monitoring, Inc. | Injectable physiological monitoring system |
US20090076343A1 (en) | 2007-09-14 | 2009-03-19 | Corventis, Inc. | Energy Management for Adherent Patient Monitor |
US8591430B2 (en) | 2007-09-14 | 2013-11-26 | Corventis, Inc. | Adherent device for respiratory monitoring |
US20090076345A1 (en) | 2007-09-14 | 2009-03-19 | Corventis, Inc. | Adherent Device with Multiple Physiological Sensors |
US8460189B2 (en) | 2007-09-14 | 2013-06-11 | Corventis, Inc. | Adherent cardiac monitor with advanced sensing capabilities |
EP2257216B1 (en) | 2008-03-12 | 2021-04-28 | Medtronic Monitoring, Inc. | Heart failure decompensation prediction based on cardiac rhythm |
US8412317B2 (en) | 2008-04-18 | 2013-04-02 | Corventis, Inc. | Method and apparatus to measure bioelectric impedance of patient tissue |
US20100234755A1 (en) * | 2009-03-11 | 2010-09-16 | Latman Neal S | Electrode holder for use on hairy animals such as horses, camels, and the like |
US8849682B2 (en) * | 2009-10-05 | 2014-09-30 | Cardiac Pacemakers, Inc. | Adaptive data storage and download in a medical device |
WO2011050283A2 (en) | 2009-10-22 | 2011-04-28 | Corventis, Inc. | Remote detection and monitoring of functional chronotropic incompetence |
US9451897B2 (en) | 2009-12-14 | 2016-09-27 | Medtronic Monitoring, Inc. | Body adherent patch with electronics for physiologic monitoring |
US9000914B2 (en) * | 2010-03-15 | 2015-04-07 | Welch Allyn, Inc. | Personal area network pairing |
US8965498B2 (en) | 2010-04-05 | 2015-02-24 | Corventis, Inc. | Method and apparatus for personalized physiologic parameters |
US9228785B2 (en) | 2010-05-04 | 2016-01-05 | Alexander Poltorak | Fractal heat transfer device |
WO2011143490A2 (en) | 2010-05-12 | 2011-11-17 | Irhythm Technologies, Inc. | Device features and design elements for long-term adhesion |
WO2011146448A1 (en) | 2010-05-18 | 2011-11-24 | Zoll Medical Corporation | Wearable therapeutic device |
CN105054924A (en) | 2010-05-18 | 2015-11-18 | 佐尔医药公司 | Wearable ambulatory medical device with multiple sensing electrodes |
US8907782B2 (en) | 2010-06-30 | 2014-12-09 | Welch Allyn, Inc. | Medical devices with proximity detection |
US8957777B2 (en) * | 2010-06-30 | 2015-02-17 | Welch Allyn, Inc. | Body area network pairing improvements for clinical workflows |
US20120094600A1 (en) | 2010-10-19 | 2012-04-19 | Welch Allyn, Inc. | Platform for patient monitoring |
US8585604B2 (en) | 2010-10-29 | 2013-11-19 | Medtronic, Inc. | Integrated patient care |
US9937355B2 (en) | 2010-11-08 | 2018-04-10 | Zoll Medical Corporation | Remote medical device alarm |
WO2012078857A2 (en) | 2010-12-09 | 2012-06-14 | Zoll Medical Corporation | Electrode with redundant impedance reduction |
BR112013014219A2 (en) | 2010-12-10 | 2016-09-13 | Zoll Medical Corp | therapeutic device |
US9427564B2 (en) | 2010-12-16 | 2016-08-30 | Zoll Medical Corporation | Water resistant wearable medical device |
WO2012125273A2 (en) | 2011-03-14 | 2012-09-20 | Cardiac Pacemakers, Inc. | His capture verification using electro-mechanical delay |
US8600486B2 (en) | 2011-03-25 | 2013-12-03 | Zoll Medical Corporation | Method of detecting signal clipping in a wearable ambulatory medical device |
US9684767B2 (en) | 2011-03-25 | 2017-06-20 | Zoll Medical Corporation | System and method for adapting alarms in a wearable medical device |
US9135398B2 (en) | 2011-03-25 | 2015-09-15 | Zoll Medical Corporation | System and method for adapting alarms in a wearable medical device |
US8897860B2 (en) | 2011-03-25 | 2014-11-25 | Zoll Medical Corporation | Selection of optimal channel for rate determination |
US9782578B2 (en) | 2011-05-02 | 2017-10-10 | Zoll Medical Corporation | Patient-worn energy delivery apparatus and techniques for sizing same |
WO2013033238A1 (en) | 2011-09-01 | 2013-03-07 | Zoll Medical Corporation | Wearable monitoring and treatment device |
US9949677B2 (en) * | 2011-10-21 | 2018-04-24 | Incube Labs, Llc | Implantable oximetric measurement apparatus and method of use |
US9339691B2 (en) | 2012-01-05 | 2016-05-17 | Icon Health & Fitness, Inc. | System and method for controlling an exercise device |
US9878171B2 (en) | 2012-03-02 | 2018-01-30 | Zoll Medical Corporation | Systems and methods for configuring a wearable medical monitoring and/or treatment device |
US9427165B2 (en) | 2012-03-02 | 2016-08-30 | Medtronic Monitoring, Inc. | Heuristic management of physiological data |
EP2854940B1 (en) | 2012-05-31 | 2022-07-06 | Zoll Medical Corporation | Medical monitoring and treatment device with external pacing |
US10328266B2 (en) | 2012-05-31 | 2019-06-25 | Zoll Medical Corporation | External pacing device with discomfort management |
US11097107B2 (en) | 2012-05-31 | 2021-08-24 | Zoll Medical Corporation | External pacing device with discomfort management |
WO2013181607A1 (en) | 2012-05-31 | 2013-12-05 | Zoll Medical Corporation | Systems and methods for detecting health disorders |
US9560996B2 (en) * | 2012-10-30 | 2017-02-07 | Masimo Corporation | Universal medical system |
EP2934662B1 (en) * | 2012-11-21 | 2017-07-05 | Newpace Ltd. | Injectable subcutaneous string heart device |
AU2014209376B2 (en) | 2013-01-24 | 2017-03-16 | Irhythm Technologies, Inc. | Physiological monitoring device |
US9999393B2 (en) | 2013-01-29 | 2018-06-19 | Zoll Medical Corporation | Delivery of electrode gel using CPR puck |
US8880196B2 (en) | 2013-03-04 | 2014-11-04 | Zoll Medical Corporation | Flexible therapy electrode |
US9254409B2 (en) | 2013-03-14 | 2016-02-09 | Icon Health & Fitness, Inc. | Strength training apparatus with flywheel and related methods |
EP2983593B1 (en) | 2013-04-08 | 2021-11-10 | Irhythm Technologies, Inc. | Skin abrader |
CN105492070A (en) | 2013-06-28 | 2016-04-13 | 卓尔医疗公司 | Systems and methods of delivering therapy using an ambulatory medical device |
EP3047607B1 (en) * | 2013-09-20 | 2017-09-06 | Telefonaktiebolaget LM Ericsson (publ) | In band control channels of a communication network |
US9700227B2 (en) | 2013-09-25 | 2017-07-11 | Bardy Diagnostics, Inc. | Ambulatory electrocardiography monitoring patch optimized for capturing low amplitude cardiac action potential propagation |
US10888239B2 (en) | 2013-09-25 | 2021-01-12 | Bardy Diagnostics, Inc. | Remote interfacing electrocardiography patch |
US9504423B1 (en) | 2015-10-05 | 2016-11-29 | Bardy Diagnostics, Inc. | Method for addressing medical conditions through a wearable health monitor with the aid of a digital computer |
US9737224B2 (en) | 2013-09-25 | 2017-08-22 | Bardy Diagnostics, Inc. | Event alerting through actigraphy embedded within electrocardiographic data |
US10820801B2 (en) | 2013-09-25 | 2020-11-03 | Bardy Diagnostics, Inc. | Electrocardiography monitor configured for self-optimizing ECG data compression |
US9408545B2 (en) | 2013-09-25 | 2016-08-09 | Bardy Diagnostics, Inc. | Method for efficiently encoding and compressing ECG data optimized for use in an ambulatory ECG monitor |
US9717433B2 (en) | 2013-09-25 | 2017-08-01 | Bardy Diagnostics, Inc. | Ambulatory electrocardiography monitoring patch optimized for capturing low amplitude cardiac action potential propagation |
US10433751B2 (en) | 2013-09-25 | 2019-10-08 | Bardy Diagnostics, Inc. | System and method for facilitating a cardiac rhythm disorder diagnosis based on subcutaneous cardiac monitoring data |
US11213237B2 (en) | 2013-09-25 | 2022-01-04 | Bardy Diagnostics, Inc. | System and method for secure cloud-based physiological data processing and delivery |
US9619660B1 (en) | 2013-09-25 | 2017-04-11 | Bardy Diagnostics, Inc. | Computer-implemented system for secure physiological data collection and processing |
US10463269B2 (en) | 2013-09-25 | 2019-11-05 | Bardy Diagnostics, Inc. | System and method for machine-learning-based atrial fibrillation detection |
US10736529B2 (en) | 2013-09-25 | 2020-08-11 | Bardy Diagnostics, Inc. | Subcutaneous insertable electrocardiography monitor |
US10165946B2 (en) | 2013-09-25 | 2019-01-01 | Bardy Diagnostics, Inc. | Computer-implemented system and method for providing a personal mobile device-triggered medical intervention |
US10624551B2 (en) | 2013-09-25 | 2020-04-21 | Bardy Diagnostics, Inc. | Insertable cardiac monitor for use in performing long term electrocardiographic monitoring |
US9345414B1 (en) | 2013-09-25 | 2016-05-24 | Bardy Diagnostics, Inc. | Method for providing dynamic gain over electrocardiographic data with the aid of a digital computer |
US9433367B2 (en) | 2013-09-25 | 2016-09-06 | Bardy Diagnostics, Inc. | Remote interfacing of extended wear electrocardiography and physiological sensor monitor |
US10806360B2 (en) | 2013-09-25 | 2020-10-20 | Bardy Diagnostics, Inc. | Extended wear ambulatory electrocardiography and physiological sensor monitor |
US9364155B2 (en) | 2013-09-25 | 2016-06-14 | Bardy Diagnostics, Inc. | Self-contained personal air flow sensing monitor |
US9775536B2 (en) | 2013-09-25 | 2017-10-03 | Bardy Diagnostics, Inc. | Method for constructing a stress-pliant physiological electrode assembly |
US10433748B2 (en) | 2013-09-25 | 2019-10-08 | Bardy Diagnostics, Inc. | Extended wear electrocardiography and physiological sensor monitor |
US10667711B1 (en) | 2013-09-25 | 2020-06-02 | Bardy Diagnostics, Inc. | Contact-activated extended wear electrocardiography and physiological sensor monitor recorder |
US20190167139A1 (en) | 2017-12-05 | 2019-06-06 | Gust H. Bardy | Subcutaneous P-Wave Centric Insertable Cardiac Monitor For Long Term Electrocardiographic Monitoring |
US10799137B2 (en) | 2013-09-25 | 2020-10-13 | Bardy Diagnostics, Inc. | System and method for facilitating a cardiac rhythm disorder diagnosis with the aid of a digital computer |
US10251576B2 (en) | 2013-09-25 | 2019-04-09 | Bardy Diagnostics, Inc. | System and method for ECG data classification for use in facilitating diagnosis of cardiac rhythm disorders with the aid of a digital computer |
US9615763B2 (en) | 2013-09-25 | 2017-04-11 | Bardy Diagnostics, Inc. | Ambulatory electrocardiography monitor recorder optimized for capturing low amplitude cardiac action potential propagation |
US9730593B2 (en) | 2013-09-25 | 2017-08-15 | Bardy Diagnostics, Inc. | Extended wear ambulatory electrocardiography and physiological sensor monitor |
US9408551B2 (en) | 2013-11-14 | 2016-08-09 | Bardy Diagnostics, Inc. | System and method for facilitating diagnosis of cardiac rhythm disorders with the aid of a digital computer |
US9433380B1 (en) | 2013-09-25 | 2016-09-06 | Bardy Diagnostics, Inc. | Extended wear electrocardiography patch |
US11723575B2 (en) | 2013-09-25 | 2023-08-15 | Bardy Diagnostics, Inc. | Electrocardiography patch |
US9655538B2 (en) | 2013-09-25 | 2017-05-23 | Bardy Diagnostics, Inc. | Self-authenticating electrocardiography monitoring circuit |
US10736531B2 (en) | 2013-09-25 | 2020-08-11 | Bardy Diagnostics, Inc. | Subcutaneous insertable cardiac monitor optimized for long term, low amplitude electrocardiographic data collection |
US9717432B2 (en) | 2013-09-25 | 2017-08-01 | Bardy Diagnostics, Inc. | Extended wear electrocardiography patch using interlaced wire electrodes |
WO2015048194A1 (en) | 2013-09-25 | 2015-04-02 | Bardy Diagnostics, Inc. | Self-contained personal air flow sensing monitor |
US9655537B2 (en) | 2013-09-25 | 2017-05-23 | Bardy Diagnostics, Inc. | Wearable electrocardiography and physiology monitoring ensemble |
USD892340S1 (en) | 2013-11-07 | 2020-08-04 | Bardy Diagnostics, Inc. | Extended wear electrode patch |
USD831833S1 (en) | 2013-11-07 | 2018-10-23 | Bardy Diagnostics, Inc. | Extended wear electrode patch |
USD717955S1 (en) | 2013-11-07 | 2014-11-18 | Bardy Diagnostics, Inc. | Electrocardiography monitor |
USD801528S1 (en) | 2013-11-07 | 2017-10-31 | Bardy Diagnostics, Inc. | Electrocardiography monitor |
USD744659S1 (en) | 2013-11-07 | 2015-12-01 | Bardy Diagnostics, Inc. | Extended wear electrode patch |
USD793566S1 (en) | 2015-09-10 | 2017-08-01 | Bardy Diagnostics, Inc. | Extended wear electrode patch |
WO2015100429A1 (en) | 2013-12-26 | 2015-07-02 | Icon Health & Fitness, Inc. | Magnetic resistance mechanism in a cable machine |
WO2015123198A1 (en) | 2014-02-12 | 2015-08-20 | Zoll Medical Corporation | System and method for adapting alarms in a wearable medical device |
WO2015138339A1 (en) | 2014-03-10 | 2015-09-17 | Icon Health & Fitness, Inc. | Pressure sensor to quantify work |
US10426989B2 (en) | 2014-06-09 | 2019-10-01 | Icon Health & Fitness, Inc. | Cable system incorporated into a treadmill |
WO2015195965A1 (en) | 2014-06-20 | 2015-12-23 | Icon Health & Fitness, Inc. | Post workout massage device |
CA2960367C (en) | 2014-09-08 | 2022-12-06 | Newpace Ltd. | Flexible rechargeable implantable subcutaneous medical device structure and method of assembly |
EP4218580A1 (en) | 2014-10-31 | 2023-08-02 | Irhythm Technologies, Inc. | Wireless physiological monitoring device and systems |
WO2016100906A1 (en) | 2014-12-18 | 2016-06-23 | Zoll Medical Corporation | Pacing device with acoustic sensor |
US10391361B2 (en) | 2015-02-27 | 2019-08-27 | Icon Health & Fitness, Inc. | Simulating real-world terrain on an exercise device |
US10321877B2 (en) | 2015-03-18 | 2019-06-18 | Zoll Medical Corporation | Medical device with acoustic sensor |
US10542961B2 (en) | 2015-06-15 | 2020-01-28 | The Research Foundation For The State University Of New York | System and method for infrasonic cardiac monitoring |
USD766447S1 (en) | 2015-09-10 | 2016-09-13 | Bardy Diagnostics, Inc. | Extended wear electrode patch |
WO2017059202A1 (en) | 2015-10-02 | 2017-04-06 | Cardiac Pacemakers, Inc. | Predictions of worsening heart failure |
US10638980B2 (en) | 2015-10-13 | 2020-05-05 | Koninklijke Philips N.V. | System and method for predicting heart failure decompensation |
US11602281B2 (en) | 2015-11-02 | 2023-03-14 | North Carolina State University | Injectable sensors and methods of use |
PL3693057T3 (en) | 2015-11-23 | 2023-02-20 | Zoll Medical Corporation | Garments for wearable medical devices |
US11617538B2 (en) | 2016-03-14 | 2023-04-04 | Zoll Medical Corporation | Proximity based processing systems and methods |
US10272317B2 (en) | 2016-03-18 | 2019-04-30 | Icon Health & Fitness, Inc. | Lighted pace feature in a treadmill |
US10493349B2 (en) | 2016-03-18 | 2019-12-03 | Icon Health & Fitness, Inc. | Display on exercise device |
US10625137B2 (en) | 2016-03-18 | 2020-04-21 | Icon Health & Fitness, Inc. | Coordinated displays in an exercise device |
WO2018013668A1 (en) | 2016-07-12 | 2018-01-18 | Alexander Poltorak | System and method for maintaining efficiency of a heat sink |
US10671705B2 (en) | 2016-09-28 | 2020-06-02 | Icon Health & Fitness, Inc. | Customizing recipe recommendations |
US10165125B2 (en) | 2017-03-02 | 2018-12-25 | Biosense Webster (Israel) Ltd. | Remote control and interaction with implanted devices |
US11009870B2 (en) | 2017-06-06 | 2021-05-18 | Zoll Medical Corporation | Vehicle compatible ambulatory defibrillator |
US11730403B2 (en) | 2018-02-06 | 2023-08-22 | Arnold Chase | Diversified glucose sensor system |
WO2019209412A1 (en) * | 2018-04-27 | 2019-10-31 | Dorsey Tammy | Apparatus and method for determining physiological parameters of an infant in-utero |
US10736509B2 (en) | 2018-07-30 | 2020-08-11 | Biosense Webster (Israel) Ltd. | Dual frequency control for a physiologic monitor |
US11568984B2 (en) | 2018-09-28 | 2023-01-31 | Zoll Medical Corporation | Systems and methods for device inventory management and tracking |
US11890461B2 (en) | 2018-09-28 | 2024-02-06 | Zoll Medical Corporation | Adhesively coupled wearable medical device |
WO2020139880A1 (en) | 2018-12-28 | 2020-07-02 | Zoll Medical Corporation | Wearable medical device response mechanisms and methods of use |
US11096579B2 (en) | 2019-07-03 | 2021-08-24 | Bardy Diagnostics, Inc. | System and method for remote ECG data streaming in real-time |
US11116451B2 (en) | 2019-07-03 | 2021-09-14 | Bardy Diagnostics, Inc. | Subcutaneous P-wave centric insertable cardiac monitor with energy harvesting capabilities |
US11696681B2 (en) | 2019-07-03 | 2023-07-11 | Bardy Diagnostics Inc. | Configurable hardware platform for physiological monitoring of a living body |
CN213609416U (en) | 2019-10-09 | 2021-07-06 | Zoll医疗公司 | Treatment electrode part and wearable treatment device |
KR20230119036A (en) | 2020-02-12 | 2023-08-14 | 아이리듬 테크놀로지스, 아이엔씨 | Non-invasive cardiac monitor and methods of using recorded cardiac data to infer a physiological characteristic of a patient |
US11620464B2 (en) * | 2020-03-31 | 2023-04-04 | Covidien Lp | In-vivo introducible antenna for detection of RF tags |
US11350865B2 (en) | 2020-08-06 | 2022-06-07 | Irhythm Technologies, Inc. | Wearable device with bridge portion |
CA3188343A1 (en) | 2020-08-06 | 2022-02-10 | Jeff ABERCROMBIE | Electrical components for physiological monitoring device |
WO2022094248A1 (en) * | 2020-10-29 | 2022-05-05 | The Regents Of The University Of Michigan | Injector device for arrhythmia classification using measurement of cardiac activity and power analysis |
CN116669626A (en) | 2020-11-04 | 2023-08-29 | 因维克塔医药公司 | Implantable electrode with remote power delivery for treating sleep apnea and related systems and methods |
WO2023028052A1 (en) * | 2021-08-23 | 2023-03-02 | Elless, Llc | Devices, systems, and methods for leak detection |
Citations (6)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4451254A (en) * | 1982-03-15 | 1984-05-29 | Eli Lilly And Company | Implant system |
US5564434A (en) * | 1995-02-27 | 1996-10-15 | Medtronic, Inc. | Implantable capacitive absolute pressure and temperature sensor |
US20050070768A1 (en) * | 2003-09-30 | 2005-03-31 | Qingsheng Zhu | Sensors having protective eluting coating and method therefor |
US20060241701A1 (en) * | 2005-04-26 | 2006-10-26 | Markowitz H T | Remotely enabled pacemaker and implantable subcutaneous cardioverter/defibrillator system |
US20060271116A1 (en) * | 2005-05-24 | 2006-11-30 | Cardiac Pacemakers, Inc. | Prediction of thoracic fluid accumulation |
US20070142732A1 (en) * | 2005-12-20 | 2007-06-21 | Marina Brockway | Detection of heart failure decompensation based on cumulative changes in sensor signals |
Family Cites Families (659)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US834261A (en) | 1906-04-04 | 1906-10-30 | Clarence S Chambers | Vaccine-injector. |
US2087124A (en) | 1936-10-08 | 1937-07-13 | Clarence O Smith | Wire cable cutter |
US2184511A (en) | 1937-10-28 | 1939-12-26 | Samuel M Bagno | Method and apparatus for measuring impedance |
US3170459A (en) | 1962-03-20 | 1965-02-23 | Clifford G Phipps | Bio-medical instrumentation electrode |
US3232291A (en) | 1962-11-23 | 1966-02-01 | San Francisco Res Corp | Surgical adhesive tape and bandage |
CH441014A (en) | 1964-04-16 | 1967-07-31 | Cescati Arturo | Pneumatically operated, automatic device for the electrical display of the pressure present in motor vehicle tires |
USRE30101E (en) | 1964-08-19 | 1979-09-25 | Regents Of The University Of Minnesota | Impedance plethysmograph |
US3517999A (en) | 1966-01-07 | 1970-06-30 | Itt | Optical strain gauge |
US3620216A (en) | 1969-06-25 | 1971-11-16 | Abbott Lab | Implant trocar |
US3677260A (en) | 1970-09-04 | 1972-07-18 | Statham Instrument Inc | Arrhythmia detector |
US3805769A (en) | 1971-08-27 | 1974-04-23 | R Sessions | Disposable electrode |
US3845757A (en) | 1972-07-12 | 1974-11-05 | Minnesota Mining & Mfg | Biomedical monitoring electrode |
US3882853A (en) | 1973-02-15 | 1975-05-13 | Cardiodynamics | Biomedical electrode |
US3874368A (en) | 1973-04-19 | 1975-04-01 | Manfred Asrican | Impedance plethysmograph having blocking system |
US4121573A (en) | 1973-10-04 | 1978-10-24 | Goebel Fixture Co. | Wireless cardiac monitoring system and electrode-transmitter therefor |
US3942517A (en) | 1973-12-03 | 1976-03-09 | Dracard Limited | Electrodes |
US3972329A (en) | 1974-11-25 | 1976-08-03 | Kaufman John George | Body electrode for electro-medical use |
US4008712A (en) * | 1975-11-14 | 1977-02-22 | J. M. Richards Laboratories | Method for monitoring body characteristics |
US4024312A (en) | 1976-06-23 | 1977-05-17 | Johnson & Johnson | Pressure-sensitive adhesive tape having extensible and elastic backing composed of a block copolymer |
US4077406A (en) | 1976-06-24 | 1978-03-07 | American Cyanamid Company | Pellet implanter for animal treatment |
GB1596298A (en) | 1977-04-07 | 1981-08-26 | Morgan Ltd P K | Method of and apparatus for detecting or measuring changes in the cross-sectional area of a non-magnetic object |
US4185621A (en) * | 1977-10-28 | 1980-01-29 | Triad, Inc. | Body parameter display incorporating a battery charger |
US4141366A (en) * | 1977-11-18 | 1979-02-27 | Medtronic, Inc. | Lead connector for tape electrode |
US4216462A (en) | 1978-03-06 | 1980-08-05 | General Electric Company | Patient monitoring and data processing system |
US4838273A (en) | 1979-04-30 | 1989-06-13 | Baxter International Inc. | Medical electrode |
US4300575A (en) | 1979-06-25 | 1981-11-17 | Staodynamics, Inc. | Air-permeable disposable electrode |
US4522211A (en) | 1979-12-06 | 1985-06-11 | C. R. Bard, Inc. | Medical electrode construction |
US4358678A (en) | 1980-11-19 | 1982-11-09 | Hersey Products, Inc. | Fiber optic transducer and method |
US5862802A (en) * | 1981-04-03 | 1999-01-26 | Forrest M. Bird | Ventilator having an oscillatory inspiratory phase and method |
FI62422C (en) | 1981-06-24 | 1982-12-10 | Kone Oy | TESTING PROCEDURES FOR FASTS ADJUSTMENT AV EN ECG ELECTRODES |
US4409983A (en) | 1981-08-20 | 1983-10-18 | Albert David E | Pulse measuring device |
US4699146A (en) | 1982-02-25 | 1987-10-13 | Valleylab, Inc. | Hydrophilic, elastomeric, pressure-sensitive adhesive |
SE455043B (en) | 1982-04-22 | 1988-06-20 | Karolinska Inst | DEVICE FOR MONITORING THE LIQUID BALANCE OF THE HUMAN BODY BY MEASURING THE IMPEDANCE OF THE BODY |
US4450527A (en) | 1982-06-29 | 1984-05-22 | Bomed Medical Mfg. Ltd. | Noninvasive continuous cardiac output monitor |
US4478223A (en) | 1982-12-06 | 1984-10-23 | Allor Douglas R | Three dimensional electrocardiograph |
US4981139A (en) * | 1983-08-11 | 1991-01-01 | Pfohl Robert L | Vital signs monitoring and communication system |
US4692685A (en) | 1984-03-14 | 1987-09-08 | Blaze Kevin L | Electrical measuring apparatus, and methods for determining the condition or identity of biological material |
JPS60261431A (en) | 1984-06-11 | 1985-12-24 | 浅井 利夫 | Water-proof electrode with transmitter for recording cardiograph |
DE3428975A1 (en) | 1984-08-06 | 1986-02-13 | Michael S. 8113 Kochel Lampadius | BREATH-CONTROLLED HEART PACEMAKER |
DE3513400A1 (en) | 1985-04-15 | 1986-10-16 | Philips Patentverwaltung Gmbh, 2000 Hamburg | OPTICAL MOTION SENSOR |
NZ216003A (en) | 1985-05-06 | 1987-10-30 | Phillips Pty Ltd N J | Pellet-implanting injector with indexing mechanism |
US4781200A (en) | 1985-10-04 | 1988-11-01 | Baker Donald A | Ambulatory non-invasive automatic fetal monitoring system |
US4669480A (en) | 1985-10-16 | 1987-06-02 | Murray Electronics Associates Limited Partnership | Temperature indicating electrotherapy electrode/coil and method of use |
US4661103A (en) | 1986-03-03 | 1987-04-28 | Engineering Development Associates, Ltd. | Multiple implant injector |
US4733107A (en) | 1986-07-10 | 1988-03-22 | Western Digital Corporation | Low current high precision CMOS schmitt trigger circuit |
US4730611A (en) | 1986-09-02 | 1988-03-15 | Absorbent Cotton Company | Medical dressing device |
FR2604890A1 (en) | 1986-10-14 | 1988-04-15 | Thomson Csf | OPTICAL DEVICE FOR THE SIMULTANEOUS DETECTION OF HEART MOVEMENT AND BREATHING AND ITS USE IN THE SYNCHRONIZATION OF NUCLEAR MAGNETIC RESONANCE ACQUISITION IMAGING DEVICES |
US4838279A (en) | 1987-05-12 | 1989-06-13 | Fore Don C | Respiration monitor |
US4850370A (en) | 1987-07-22 | 1989-07-25 | Dower Gordon E | Method and apparatus for sensing and analyzing electrical activity of the human heart |
US4911175A (en) | 1987-09-17 | 1990-03-27 | Diana Twyman | Method for measuring total body cell mass and total extracellular mass by bioelectrical resistance and reactance |
JPH01126535A (en) | 1987-11-12 | 1989-05-18 | Kao Corp | Method and apparatus for measuring content of skin moisture |
US4895163A (en) | 1988-05-24 | 1990-01-23 | Bio Analogics, Inc. | System for body impedance data acquisition |
US4880004A (en) | 1988-06-07 | 1989-11-14 | Intermedics, Inc. | Implantable cardiac stimulator with automatic gain control and bandpass filtering in feedback loop |
US4988335A (en) * | 1988-08-16 | 1991-01-29 | Ideal Instruments, Inc. | Pellet implanter apparatus |
US5080099A (en) | 1988-08-26 | 1992-01-14 | Cardiotronics, Inc. | Multi-pad, multi-function electrode |
US4955381A (en) | 1988-08-26 | 1990-09-11 | Cardiotronics, Inc. | Multi-pad, multi-function electrode |
US5012810A (en) | 1988-09-22 | 1991-05-07 | Minnesota Mining And Manufacturing Company | Biomedical electrode construction |
US5133355A (en) | 1988-09-22 | 1992-07-28 | Minnesota Mining And Manufacturing Company | Biomedical electrode construction |
US5001632A (en) | 1989-12-22 | 1991-03-19 | Hall Tipping Justin | Video game difficulty level adjuster dependent upon player's aerobic activity level during exercise |
US5511553A (en) | 1989-02-15 | 1996-04-30 | Segalowitz; Jacob | Device-system and method for monitoring multiple physiological parameters (MMPP) continuously and simultaneously |
US5168874A (en) | 1989-02-15 | 1992-12-08 | Jacob Segalowitz | Wireless electrode structure for use in patient monitoring system |
AU629609B2 (en) | 1989-02-22 | 1992-10-08 | Longyear Tm Inc | Wire line core drilling apparatus |
JPH0315502U (en) | 1989-06-28 | 1991-02-15 | ||
US5769793A (en) | 1989-09-08 | 1998-06-23 | Steven M. Pincus | System to determine a relative amount of patternness |
US5050612A (en) | 1989-09-12 | 1991-09-24 | Matsumura Kenneth N | Device for computer-assisted monitoring of the body |
US5086781A (en) | 1989-11-14 | 1992-02-11 | Bookspan Mark A | Bioelectric apparatus for monitoring body fluid compartments |
US5027824A (en) | 1989-12-01 | 1991-07-02 | Edmond Dougherty | Method and apparatus for detecting, analyzing and recording cardiac rhythm disturbances |
US5140985A (en) | 1989-12-11 | 1992-08-25 | Schroeder Jon M | Noninvasive blood glucose measuring device |
US5083563A (en) * | 1990-02-16 | 1992-01-28 | Telectronics Pacing Systems, Inc. | Implantable automatic and haemodynamically responsive cardioverting/defibrillating pacemaker |
US5125412A (en) | 1990-07-23 | 1992-06-30 | Thornton William E | Musculoskeletal activity monitor |
US5113869A (en) | 1990-08-21 | 1992-05-19 | Telectronics Pacing Systems, Inc. | Implantable ambulatory electrocardiogram monitor |
WO1992004806A1 (en) | 1990-08-31 | 1992-03-19 | The General Hospital Corporation | A network for portable patient monitoring devices |
US5063937A (en) | 1990-09-12 | 1991-11-12 | Wright State University | Multiple frequency bio-impedance measurement system |
US5271411A (en) | 1990-09-21 | 1993-12-21 | Colin Electronics Co., Ltd. | Method and apparatus for ECG signal analysis and cardiac arrhythmia detection |
US5642734A (en) | 1990-10-04 | 1997-07-01 | Microcor, Inc. | Method and apparatus for noninvasively determining hematocrit |
US5150708A (en) | 1990-12-03 | 1992-09-29 | Spacelabs, Inc. | Tabbed defibrillator electrode pad |
NL9100160A (en) * | 1991-01-30 | 1992-08-17 | Texas Instruments Holland | INJECTOR. |
US5437285A (en) | 1991-02-20 | 1995-08-01 | Georgetown University | Method and apparatus for prediction of sudden cardiac death by simultaneous assessment of autonomic function and cardiac electrical stability |
MX9702434A (en) | 1991-03-07 | 1998-05-31 | Masimo Corp | Signal processing apparatus. |
US5632272A (en) | 1991-03-07 | 1997-05-27 | Masimo Corporation | Signal processing apparatus |
WO1992015955A1 (en) | 1991-03-07 | 1992-09-17 | Vital Signals, Inc. | Signal processing apparatus and method |
US5226417A (en) | 1991-03-11 | 1993-07-13 | Nellcor, Inc. | Apparatus for the detection of motion transients |
JP2655204B2 (en) | 1991-04-05 | 1997-09-17 | メドトロニック インコーポレーテッド | Implantable medical device |
EP0588982B1 (en) | 1991-06-12 | 2001-03-21 | Florida Atlantic University Research Corp. | Detecting atherosclerosis in humans |
NL9101489A (en) | 1991-09-03 | 1993-04-01 | Texas Instruments Holland | INJECTOR FOR IMMEDIATELY IMPLANTING AN OBJECT IN A LIVING BEING. |
US5309917A (en) | 1991-09-12 | 1994-05-10 | Drexel University | System and method of impedance cardiography and heartbeat determination |
US5335664A (en) | 1991-09-17 | 1994-08-09 | Casio Computer Co., Ltd. | Monitor system and biological signal transmitter therefor |
US5257627A (en) | 1991-11-14 | 1993-11-02 | Telmed, Inc. | Portable non-invasive testing apparatus |
US5353793A (en) | 1991-11-25 | 1994-10-11 | Oishi-Kogyo Company | Sensor apparatus |
US5291013A (en) | 1991-12-06 | 1994-03-01 | Alamed Corporation | Fiber optical monitor for detecting normal breathing and heartbeat motion based on changes in speckle patterns |
EP0553372B1 (en) | 1992-01-29 | 1996-11-13 | Hewlett-Packard GmbH | Method and system for monitoring vital signs |
US5301677A (en) | 1992-02-06 | 1994-04-12 | Cardiac Pacemakers, Inc. | Arrhythmia detector using delta modulated turning point morphology of the ECG wave |
US5282840A (en) | 1992-03-26 | 1994-02-01 | Medtronic, Inc. | Multiple frequency impedance measurement system |
EP0636009B1 (en) | 1992-04-03 | 2000-11-29 | Micromedical Industries Limited | system for physiological monitoring |
US5241300B1 (en) | 1992-04-24 | 1995-10-31 | Johannes Buschmann | Sids detection apparatus and methods |
IL102300A (en) | 1992-06-24 | 1996-07-23 | N I Medical Ltd | Non-invasive system for determining of the main cardiorespiratory parameters of the human body |
US5984102A (en) | 1992-09-24 | 1999-11-16 | Survivalink Corporation | Medical electrode packaging technology |
US5411530A (en) | 1992-11-13 | 1995-05-02 | Akhtar; Masood | Sensing algorithm for anti-tachycardia devices using dual chamber sensing |
US5362069A (en) | 1992-12-03 | 1994-11-08 | Heartbeat Corporation | Combination exercise device/video game |
US5375604A (en) | 1992-12-11 | 1994-12-27 | Siemens Medical Electronics, Inc. | Transportable modular patient monitor |
US5450845A (en) | 1993-01-11 | 1995-09-19 | Axelgaard; Jens | Medical electrode system |
US5797960A (en) * | 1993-02-22 | 1998-08-25 | Stevens; John H. | Method and apparatus for thoracoscopic intracardiac procedures |
US5558638A (en) | 1993-04-30 | 1996-09-24 | Healthdyne, Inc. | Patient monitor and support system |
US5406945A (en) | 1993-05-24 | 1995-04-18 | Ndm Acquisition Corp. | Biomedical electrode having a secured one-piece conductive terminal |
US5607454A (en) | 1993-08-06 | 1997-03-04 | Heartstream, Inc. | Electrotherapy method and apparatus |
DE4329898A1 (en) * | 1993-09-04 | 1995-04-06 | Marcus Dr Besson | Wireless medical diagnostic and monitoring device |
US5464012A (en) | 1993-09-13 | 1995-11-07 | Hewlett-Packard Company | Patient alarm detection using target mode |
US5454377A (en) | 1993-10-08 | 1995-10-03 | The Ohio State University | Method for measuring the myocardial electrical impedance spectrum |
US5724025A (en) | 1993-10-21 | 1998-03-03 | Tavori; Itzchak | Portable vital signs monitor |
US5523742A (en) | 1993-11-18 | 1996-06-04 | The United States Of America As Represented By The Secretary Of The Army | Motion sensor |
US5544661A (en) | 1994-01-13 | 1996-08-13 | Charles L. Davis | Real time ambulatory patient monitor |
US5964703A (en) | 1994-01-14 | 1999-10-12 | E-Z-Em, Inc. | Extravasation detection electrode patch |
US5447529A (en) | 1994-01-28 | 1995-09-05 | Philadelphia Heart Institute | Method of using endocardial impedance for determining electrode-tissue contact, appropriate sites for arrhythmia ablation and tissue heating during ablation |
US6067467A (en) | 1994-02-07 | 2000-05-23 | New York University | EEG operative and post-operative patient monitoring method |
US5598848A (en) | 1994-03-31 | 1997-02-04 | Ep Technologies, Inc. | Systems and methods for positioning multiple electrode structures in electrical contact with the myocardium |
US5575284A (en) | 1994-04-01 | 1996-11-19 | University Of South Florida | Portable pulse oximeter |
US5566671A (en) | 1994-05-23 | 1996-10-22 | Lyons; Chad | Medical acoustic sensor receptacle |
WO1995033372A1 (en) | 1994-06-07 | 1995-12-14 | Agrizap, Inc. | A portable pest electrocution device with resistive switch sensor |
US5518001A (en) | 1994-06-17 | 1996-05-21 | Pacesetter, Inc. | Cardiac device with patient-triggered storage of physiological sensor data |
NO180024C (en) | 1994-10-11 | 1997-01-29 | Oerjan G Martinsen | Measurement of moisture in the skin |
US5560368A (en) | 1994-11-15 | 1996-10-01 | Berger; Ronald D. | Methodology for automated QT variability measurement |
AUPM964094A0 (en) | 1994-11-24 | 1994-12-15 | Sullivan, C.E. | Biophysical foetal monitor |
US5778882A (en) | 1995-02-24 | 1998-07-14 | Brigham And Women's Hospital | Health monitoring system |
US5503157A (en) | 1995-03-17 | 1996-04-02 | Sramek; Bohumir | System for detection of electrical bioimpedance signals |
US6327487B1 (en) | 1995-05-04 | 2001-12-04 | Robert A. Stratbucker | Bioelectric interface |
NL1001282C2 (en) * | 1995-09-26 | 1997-03-28 | A J Van Liebergen Holding B V | Stroke volume determination device for a human heart. |
US5772508A (en) | 1995-09-28 | 1998-06-30 | Amtex Co., Ltd. | Game or play facilities controlled by physiological information |
US5807272A (en) | 1995-10-31 | 1998-09-15 | Worcester Polytechnic Institute | Impedance spectroscopy system for ischemia monitoring and detection |
US5678562A (en) | 1995-11-09 | 1997-10-21 | Burdick, Inc. | Ambulatory physiological monitor with removable disk cartridge and wireless modem |
US5944659A (en) | 1995-11-13 | 1999-08-31 | Vitalcom Inc. | Architecture for TDMA medical telemetry system |
US5748103A (en) | 1995-11-13 | 1998-05-05 | Vitalcom, Inc. | Two-way TDMA telemetry system with power conservation features |
US5803915A (en) | 1995-12-07 | 1998-09-08 | Ohmeda Inc. | System for detection of probe dislodgement |
US6035233A (en) | 1995-12-11 | 2000-03-07 | Intermedics Inc. | Implantable medical device responsive to heart rate variability analysis |
US5860860A (en) | 1996-01-31 | 1999-01-19 | Federal Patent Corporation | Integral video game and cardio-waveform display |
US6463328B1 (en) | 1996-02-02 | 2002-10-08 | Michael Sasha John | Adaptive brain stimulation method and system |
FI960636A (en) | 1996-02-12 | 1997-08-13 | Nokia Mobile Phones Ltd | A procedure for monitoring the health of a patient |
US6051017A (en) * | 1996-02-20 | 2000-04-18 | Advanced Bionics Corporation | Implantable microstimulator and systems employing the same |
US5833603A (en) | 1996-03-13 | 1998-11-10 | Lipomatrix, Inc. | Implantable biosensing transponder |
US6496715B1 (en) | 1996-07-11 | 2002-12-17 | Medtronic, Inc. | System and method for non-invasive determination of optimal orientation of an implantable sensing device |
JP2000514682A (en) | 1996-07-11 | 2000-11-07 | メドトロニック・インコーポレーテッド | Minimal invasive implantable device for monitoring physiological events |
US5687717A (en) | 1996-08-06 | 1997-11-18 | Tremont Medical, Inc. | Patient monitoring system with chassis mounted or remotely operable modules and portable computer |
US6141575A (en) | 1996-08-16 | 2000-10-31 | Price; Michael A. | Electrode assemblies |
US6112224A (en) | 1996-09-20 | 2000-08-29 | Georgia Tech Research Corporation | Patient monitoring station using a single interrupt resource to support multiple measurement devices |
DE19638585A1 (en) | 1996-09-20 | 1998-03-26 | Biotronik Mess & Therapieg | Device for rejection diagnosis after organ transplantation |
US5718234A (en) * | 1996-09-30 | 1998-02-17 | Northrop Grumman Corporation | Physiological data communication system |
US5814079A (en) | 1996-10-04 | 1998-09-29 | Medtronic, Inc. | Cardiac arrhythmia management by application of adnodal stimulation for hyperpolarization of myocardial cells |
US6198394B1 (en) | 1996-12-05 | 2001-03-06 | Stephen C. Jacobsen | System for remote monitoring of personnel |
US5876353A (en) | 1997-01-31 | 1999-03-02 | Medtronic, Inc. | Impedance monitor for discerning edema through evaluation of respiratory rate |
US5957861A (en) | 1997-01-31 | 1999-09-28 | Medtronic, Inc. | Impedance monitor for discerning edema through evaluation of respiratory rate |
US6102856A (en) | 1997-02-12 | 2000-08-15 | Groff; Clarence P | Wearable vital sign monitoring system |
US6164284A (en) | 1997-02-26 | 2000-12-26 | Schulman; Joseph H. | System of implantable devices for monitoring and/or affecting body parameters |
US6208894B1 (en) | 1997-02-26 | 2001-03-27 | Alfred E. Mann Foundation For Scientific Research And Advanced Bionics | System of implantable devices for monitoring and/or affecting body parameters |
AU6667698A (en) * | 1997-02-26 | 1998-09-18 | Alfred E. Mann Foundation For Scientific Research | Battery-powered patient implantable device |
US5865733A (en) | 1997-02-28 | 1999-02-02 | Spacelabs Medical, Inc. | Wireless optical patient monitoring apparatus |
US5959529A (en) | 1997-03-07 | 1999-09-28 | Kail, Iv; Karl A. | Reprogrammable remote sensor monitoring system |
US6148233A (en) | 1997-03-07 | 2000-11-14 | Cardiac Science, Inc. | Defibrillation system having segmented electrodes |
DE69841846D1 (en) | 1997-03-17 | 2010-09-30 | Adidas Ag | INFORMATION RECONDITIONING SYSTEM FOR PHYSIOLOGICAL SIGNALS |
AUPO616697A0 (en) | 1997-04-11 | 1997-05-08 | Heartlink Pty Ltd | Method for diagnosing psychiatric disorders |
US7941534B2 (en) | 1997-04-14 | 2011-05-10 | Carlos De La Huerga | System and method to authenticate users to computer systems |
US5788643A (en) | 1997-04-22 | 1998-08-04 | Zymed Medical Instrumentation, Inc. | Process for monitoring patients with chronic congestive heart failure |
US6050267A (en) | 1997-04-28 | 2000-04-18 | American Cardiac Ablation Co. Inc. | Catheter positioning system |
FR2766376B1 (en) | 1997-07-25 | 1999-10-22 | Lhd Lab Hygiene Dietetique | WOUND THERAPEUTIC TREATMENT DEVICE |
US6190313B1 (en) | 1998-04-20 | 2001-02-20 | Allen J. Hinkle | Interactive health care system and method |
EP1014859A4 (en) | 1997-08-19 | 2007-05-02 | Philipp Lang | Measurement of capillary related interstitial fluid using ultrasound methods and devices |
US6259939B1 (en) | 1997-08-20 | 2001-07-10 | R. Z. Comparative Diagnostics Ltd. | Electrocardiography electrodes holder including electrocardiograph electronics |
US6090056A (en) | 1997-08-27 | 2000-07-18 | Emergency Medical Systems, Inc. | Resuscitation and alert system |
US6007532A (en) | 1997-08-29 | 1999-12-28 | 3M Innovative Properties Company | Method and apparatus for detecting loss of contact of biomedical electrodes with patient skin |
US5836990A (en) | 1997-09-19 | 1998-11-17 | Medtronic, Inc. | Method and apparatus for determining electrode/tissue contact |
US6027523A (en) * | 1997-10-06 | 2000-02-22 | Arthrex, Inc. | Suture anchor with attached disk |
US6409674B1 (en) | 1998-09-24 | 2002-06-25 | Data Sciences International, Inc. | Implantable sensor with wireless communication |
US6080106A (en) | 1997-10-28 | 2000-06-27 | Alere Incorporated | Patient interface system with a scale |
US6050951A (en) | 1997-11-10 | 2000-04-18 | Critikon Company, L.L.C. | NIBP trigger in response to detected heart rate variability |
US20050096513A1 (en) | 1997-11-11 | 2005-05-05 | Irvine Sensors Corporation | Wearable biomonitor with flexible thinned integrated circuit |
US6129744A (en) | 1997-12-04 | 2000-10-10 | Vitatron Medical, B.V. | Cardiac treatment system and method for sensing and responding to heart failure |
US6047259A (en) | 1997-12-30 | 2000-04-04 | Medical Management International, Inc. | Interactive method and system for managing physical exams, diagnosis and treatment protocols in a health care practice |
US6125297A (en) | 1998-02-06 | 2000-09-26 | The United States Of America As Represented By The United States National Aeronautics And Space Administration | Body fluids monitor |
US6038464A (en) | 1998-02-09 | 2000-03-14 | Axelgaard Manufacturing Co., Ltd. | Medical electrode |
US5904708A (en) | 1998-03-19 | 1999-05-18 | Medtronic, Inc. | System and method for deriving relative physiologic signals |
US6579231B1 (en) | 1998-03-27 | 2003-06-17 | Mci Communications Corporation | Personal medical monitoring unit and system |
US5941831A (en) | 1998-04-03 | 1999-08-24 | Pacesetter, Inc. | Method for diagnosing cardiac arrhythmias using interval irregularity |
US5967995A (en) | 1998-04-28 | 1999-10-19 | University Of Pittsburgh Of The Commonwealth System Of Higher Education | System for prediction of life-threatening cardiac arrhythmias |
US6045513A (en) | 1998-05-13 | 2000-04-04 | Medtronic, Inc. | Implantable medical device for tracking patient functional status |
IL124964A (en) | 1998-06-17 | 2002-02-10 | Nimeda Ltd | Method for disclosing a physiological indication and a non-invasive diagnostic physiological monitoring system for use therewith |
US6095991A (en) | 1998-07-23 | 2000-08-01 | Individual Monitoring Systems, Inc. | Ambulatory body position monitor |
EP1102560A4 (en) | 1998-08-07 | 2003-03-12 | Infinite Biomedical Technologi | Implantable myocardial ischemia detection, indication and action technology |
US6052615A (en) | 1998-08-17 | 2000-04-18 | Zymed Medical Instrumentation, Inc. | Method and apparatus for sensing and analyzing electrical activity of the human heart using a four electrode arrangement |
ES2306525T3 (en) | 1998-08-26 | 2008-11-01 | Sensors For Medicine And Science, Inc. | OPTICAL-BASED DETECTION DEVICES. |
US6104949A (en) | 1998-09-09 | 2000-08-15 | Vitatron Medical, B.V. | Medical device |
US6343140B1 (en) * | 1998-09-11 | 2002-01-29 | Quid Technologies Llc | Method and apparatus for shooting using biometric recognition |
WO2000017615A2 (en) | 1998-09-23 | 2000-03-30 | Keith Bridger | Physiological sensing device |
US6402689B1 (en) | 1998-09-30 | 2002-06-11 | Sicel Technologies, Inc. | Methods, systems, and associated implantable devices for dynamic monitoring of physiological and biological properties of tumors |
US6306088B1 (en) | 1998-10-03 | 2001-10-23 | Individual Monitoring Systems, Inc. | Ambulatory distributed recorders system for diagnosing medical disorders |
US6519487B1 (en) | 1998-10-15 | 2003-02-11 | Sensidyne, Inc. | Reusable pulse oximeter probe and disposable bandage apparatus |
EP1135188B1 (en) * | 1998-11-02 | 2007-11-28 | ALZA Corporation | Electrotransport device including a compatible antimicrobial agent |
US6358208B1 (en) | 1998-11-21 | 2002-03-19 | Philipp Lang | Assessment of cardiovascular performance using ultrasound methods and devices that interrogate interstitial fluid |
US6398727B1 (en) | 1998-12-23 | 2002-06-04 | Baxter International Inc. | Method and apparatus for providing patient care |
US6049730A (en) | 1998-12-28 | 2000-04-11 | Flaga Hf | Method and apparatus for improving the accuracy of interpretation of ECG-signals |
WO2000040146A1 (en) | 1999-01-06 | 2000-07-13 | Ball Semiconductor, Inc. | Wireless ekg |
US6206831B1 (en) | 1999-01-06 | 2001-03-27 | Scimed Life Systems, Inc. | Ultrasound-guided ablation catheter and methods of use |
US6117077A (en) | 1999-01-22 | 2000-09-12 | Del Mar Medical Systems, Llc | Long-term, ambulatory physiological recorder |
US6473640B1 (en) | 1999-01-25 | 2002-10-29 | Jay Erlebacher | Implantable device and method for long-term detection and monitoring of congestive heart failure |
WO2000044580A1 (en) | 1999-01-27 | 2000-08-03 | Compumedics Sleep Pty. Ltd. | Vigilance monitoring system |
US6305943B1 (en) | 1999-01-29 | 2001-10-23 | Biomed Usa, Inc. | Respiratory sinus arrhythmia training system |
US6212427B1 (en) | 1999-02-02 | 2001-04-03 | J&J Engineering | Heart rate variability feedback monitor system |
US6266554B1 (en) | 1999-02-12 | 2001-07-24 | Cardiac Pacemakers, Inc. | System and method for classifying cardiac complexes |
US6821249B2 (en) | 1999-03-08 | 2004-11-23 | Board Of Regents, The University Of Texas | Temperature monitoring of congestive heart failure patients as an indicator of worsening condition |
US6454707B1 (en) | 1999-03-08 | 2002-09-24 | Samuel W. Casscells, III | Method and apparatus for predicting mortality in congestive heart failure patients |
US6223078B1 (en) | 1999-03-12 | 2001-04-24 | Cardiac Pacemakers, Inc. | Discrimination of supraventricular tachycardia and ventricular tachycardia events |
US6751498B1 (en) | 1999-03-15 | 2004-06-15 | The Johns Hopkins University | Apparatus and method for non-invasive, passive fetal heart monitoring |
GB2348707B (en) | 1999-04-07 | 2003-07-09 | Healthcare Technology Ltd | Heart activity detection apparatus |
US6494829B1 (en) | 1999-04-15 | 2002-12-17 | Nexan Limited | Physiological sensor array |
US6416471B1 (en) | 1999-04-15 | 2002-07-09 | Nexan Limited | Portable remote patient telemonitoring system |
US6385473B1 (en) | 1999-04-15 | 2002-05-07 | Nexan Limited | Physiological sensor device |
US6450953B1 (en) | 1999-04-15 | 2002-09-17 | Nexan Limited | Portable signal transfer unit |
US6454708B1 (en) | 1999-04-15 | 2002-09-24 | Nexan Limited | Portable remote patient telemonitoring system using a memory card or smart card |
US7577475B2 (en) | 1999-04-16 | 2009-08-18 | Cardiocom | System, method, and apparatus for combining information from an implanted device with information from a patient monitoring apparatus |
US6290646B1 (en) | 1999-04-16 | 2001-09-18 | Cardiocom | Apparatus and method for monitoring and communicating wellness parameters of ambulatory patients |
US6190324B1 (en) | 1999-04-28 | 2001-02-20 | Medtronic, Inc. | Implantable medical device for tracking patient cardiac status |
AUPQ047899A0 (en) | 1999-05-21 | 1999-06-10 | Cooke, Michael | A device for use with computer games |
US6312378B1 (en) | 1999-06-03 | 2001-11-06 | Cardiac Intelligence Corporation | System and method for automated collection and analysis of patient information retrieved from an implantable medical device for remote patient care |
AUPQ113799A0 (en) | 1999-06-22 | 1999-07-15 | University Of Queensland, The | A method and device for measuring lymphoedema |
US7454359B2 (en) | 1999-06-23 | 2008-11-18 | Visicu, Inc. | System and method for displaying a health status of hospitalized patients |
US6287252B1 (en) | 1999-06-30 | 2001-09-11 | Monitrak | Patient monitor |
US7149773B2 (en) | 1999-07-07 | 2006-12-12 | Medtronic, Inc. | System and method of automated invoicing for communications between an implantable medical device and a remote computer system or health care provider |
AU5911900A (en) | 1999-07-09 | 2001-01-30 | Eastern Virginia Medical School | Method and apparatus for encouraging physiological self-regulation through modulation of an operators control input to a video game or training simulator |
US6512949B1 (en) * | 1999-07-12 | 2003-01-28 | Medtronic, Inc. | Implantable medical device for measuring time varying physiologic conditions especially edema and for responding thereto |
US6347245B1 (en) | 1999-07-14 | 2002-02-12 | Medtronic, Inc. | Medical device ECG marker for use in compressed data system |
CA2314517A1 (en) | 1999-07-26 | 2001-01-26 | Gust H. Bardy | System and method for determining a reference baseline of individual patient status for use in an automated collection and analysis patient care system |
US6221011B1 (en) | 1999-07-26 | 2001-04-24 | Cardiac Intelligence Corporation | System and method for determining a reference baseline of individual patient status for use in an automated collection and analysis patient care system |
JP2001052930A (en) | 1999-08-06 | 2001-02-23 | Tdk Corp | Laminated inductor and manufacture thereof |
US6442422B1 (en) | 1999-08-11 | 2002-08-27 | Ge Medical Systems Information Technologies, Inc. | Compliance monitoring apparatus and method |
US6718198B2 (en) | 1999-08-24 | 2004-04-06 | Cardiac Pacemakers, Inc. | Arrhythmia display |
WO2001028416A1 (en) | 1999-09-24 | 2001-04-26 | Healthetech, Inc. | Physiological monitor and associated computation, display and communication unit |
US6272377B1 (en) | 1999-10-01 | 2001-08-07 | Cardiac Pacemakers, Inc. | Cardiac rhythm management system with arrhythmia prediction and prevention |
US6527711B1 (en) | 1999-10-18 | 2003-03-04 | Bodymedia, Inc. | Wearable human physiological data sensors and reporting system therefor |
US6520967B1 (en) * | 1999-10-20 | 2003-02-18 | Cauthen Research Group, Inc. | Spinal implant insertion instrument for spinal interbody prostheses |
US6350237B1 (en) | 1999-11-05 | 2002-02-26 | General Electric Company | Method and apparatus for monitoring fetal status data |
US6480733B1 (en) | 1999-11-10 | 2002-11-12 | Pacesetter, Inc. | Method for monitoring heart failure |
US6942622B1 (en) | 1999-11-10 | 2005-09-13 | Pacesetter, Inc. | Method for monitoring autonomic tone |
US6600949B1 (en) | 1999-11-10 | 2003-07-29 | Pacesetter, Inc. | Method for monitoring heart failure via respiratory patterns |
US6527729B1 (en) | 1999-11-10 | 2003-03-04 | Pacesetter, Inc. | Method for monitoring patient using acoustic sensor |
US6368284B1 (en) | 1999-11-16 | 2002-04-09 | Cardiac Intelligence Corporation | Automated collection and analysis patient care system and method for diagnosing and monitoring myocardial ischemia and outcomes thereof |
US6336903B1 (en) * | 1999-11-16 | 2002-01-08 | Cardiac Intelligence Corp. | Automated collection and analysis patient care system and method for diagnosing and monitoring congestive heart failure and outcomes thereof |
US6277078B1 (en) | 1999-11-19 | 2001-08-21 | Remon Medical Technologies, Ltd. | System and method for monitoring a parameter associated with the performance of a heart |
US6602191B2 (en) * | 1999-12-17 | 2003-08-05 | Q-Tec Systems Llp | Method and apparatus for health and disease management combining patient data monitoring with wireless internet connectivity |
US7127370B2 (en) | 2000-01-07 | 2006-10-24 | Nocwatch International Inc. | Attitude indicator and activity monitoring device |
US7483743B2 (en) | 2000-01-11 | 2009-01-27 | Cedars-Sinai Medical Center | System for detecting, diagnosing, and treating cardiovascular disease |
JP2001198098A (en) | 2000-01-21 | 2001-07-24 | Tanita Corp | Dropsy measurement method and dropsy measurement device |
US6551251B2 (en) | 2000-02-14 | 2003-04-22 | The United States Of America As Represented By The Administrator Of The National Aeronautics And Space Administration | Passive fetal heart monitoring system |
US6582441B1 (en) * | 2000-02-24 | 2003-06-24 | Advanced Bionics Corporation | Surgical insertion tool |
US6893396B2 (en) | 2000-03-01 | 2005-05-17 | I-Medik, Inc. | Wireless internet bio-telemetry monitoring system and interface |
US6699200B2 (en) | 2000-03-01 | 2004-03-02 | Medtronic, Inc. | Implantable medical device with multi-vector sensing electrodes |
GB0005247D0 (en) | 2000-03-03 | 2000-04-26 | Btg Int Ltd | Electrical impedance method for differentiating tissue types |
JP3846844B2 (en) | 2000-03-14 | 2006-11-15 | 株式会社東芝 | Body-mounted life support device |
US6584343B1 (en) | 2000-03-15 | 2003-06-24 | Resolution Medical, Inc. | Multi-electrode panel system for sensing electrical activity of the heart |
US6871211B2 (en) | 2000-03-28 | 2005-03-22 | Ge Medical Systems Information Technologies, Inc. | Intranet-based medical data distribution system |
US6650943B1 (en) * | 2000-04-07 | 2003-11-18 | Advanced Bionics Corporation | Fully implantable neurostimulator for cavernous nerve stimulation as a therapy for erectile dysfunction and other sexual dysfunction |
EP1296591B1 (en) | 2000-04-17 | 2018-11-14 | Adidas AG | Systems for ambulatory monitoring of physiological signs |
US6496705B1 (en) * | 2000-04-18 | 2002-12-17 | Motorola Inc. | Programmable wireless electrode system for medical monitoring |
FR2808609B1 (en) | 2000-05-05 | 2006-02-10 | Univ Rennes | DEVICE AND METHOD FOR DETECTING ABNORMAL SITUATIONS |
BR0110594A (en) | 2000-05-05 | 2004-12-14 | Hill Rom Services Inc | Hospital monitoring system to monitor hospital staff, and method of controlling devices at a patient location |
US6478800B1 (en) | 2000-05-08 | 2002-11-12 | Depuy Acromed, Inc. | Medical installation tool |
US6572557B2 (en) | 2000-05-09 | 2003-06-03 | Pacesetter, Inc. | System and method for monitoring progression of cardiac disease state using physiologic sensors |
US6544174B2 (en) | 2000-05-19 | 2003-04-08 | Welch Allyn Protocol, Inc. | Patient monitoring system |
US20040049132A1 (en) | 2000-06-15 | 2004-03-11 | The Procter & Gamble Company | Device for body activity detection and processing |
US6605038B1 (en) | 2000-06-16 | 2003-08-12 | Bodymedia, Inc. | System for monitoring health, wellness and fitness |
US7689437B1 (en) | 2000-06-16 | 2010-03-30 | Bodymedia, Inc. | System for monitoring health, wellness and fitness |
US20060122474A1 (en) | 2000-06-16 | 2006-06-08 | Bodymedia, Inc. | Apparatus for monitoring health, wellness and fitness |
US7261690B2 (en) | 2000-06-16 | 2007-08-28 | Bodymedia, Inc. | Apparatus for monitoring health, wellness and fitness |
AU2001269702A1 (en) * | 2000-06-23 | 2002-01-08 | Physiometrix, Inc. | Frontal electrode array for patient eeg signal acquisition |
IL153516A (en) | 2000-06-23 | 2007-07-24 | Bodymedia Inc | System for monitoring health, wellness and fitness |
US6480734B1 (en) | 2000-06-30 | 2002-11-12 | Cardiac Science Inc. | Cardiac arrhythmia detector using ECG waveform-factor and its irregularity |
US6569160B1 (en) | 2000-07-07 | 2003-05-27 | Biosense, Inc. | System and method for detecting electrode-tissue contact |
US6636754B1 (en) | 2000-07-10 | 2003-10-21 | Cardiodynamics International Corporation | Apparatus and method for determining cardiac output in a living subject |
US7149576B1 (en) | 2000-07-10 | 2006-12-12 | Cardiodynamics International Corporation | Apparatus and method for defibrillation of a living subject |
US6602201B1 (en) | 2000-07-10 | 2003-08-05 | Cardiodynamics International Corporation | Apparatus and method for determining cardiac output in a living subject |
US6659947B1 (en) * | 2000-07-13 | 2003-12-09 | Ge Medical Systems Information Technologies, Inc. | Wireless LAN architecture for integrated time-critical and non-time-critical services within medical facilities |
WO2002006826A1 (en) | 2000-07-17 | 2002-01-24 | Opt-E-Scrip, Inc. | Single-patient drug trials used with accumulated database |
CA2414309C (en) | 2000-07-18 | 2006-10-31 | Motorola, Inc. | Wireless electrocardiograph system and method |
JP3977983B2 (en) * | 2000-07-31 | 2007-09-19 | 株式会社タニタ | Dehydration state determination device by bioimpedance measurement |
AU2001288989A1 (en) | 2000-09-08 | 2002-03-22 | Wireless Medical, Inc. | Cardiopulmonary monitoring |
US20020099277A1 (en) | 2000-09-12 | 2002-07-25 | Nexan Limited | Disposable vital signs monitoring sensor band with removable alignment sheet |
DE10046075A1 (en) | 2000-09-15 | 2002-04-04 | Friendly Sensors Ag | Device and method for generating measurement data |
US7120495B2 (en) * | 2000-09-18 | 2006-10-10 | Cameron Health, Inc. | Flexible subcutaneous implantable cardioverter-defibrillator |
US6572636B1 (en) | 2000-09-19 | 2003-06-03 | Robert Sean Hagen | Pulse sensing patch and associated methods |
US6490478B1 (en) | 2000-09-25 | 2002-12-03 | Cardiac Science Inc. | System and method for complexity analysis-based cardiac tachyarrhythmia detection |
US6752151B2 (en) | 2000-09-25 | 2004-06-22 | Respironics, Inc. | Method and apparatus for providing variable positive airway pressure |
US7499742B2 (en) * | 2001-09-26 | 2009-03-03 | Cvrx, Inc. | Electrode structures and methods for their use in cardiovascular reflex control |
US6665559B2 (en) | 2000-10-06 | 2003-12-16 | Ge Medical Systems Information Technologies, Inc. | Method and apparatus for perioperative assessment of cardiovascular risk |
EP1324692A1 (en) | 2000-10-10 | 2003-07-09 | MAGILL, Alan Remy | Health monitoring |
US20020045836A1 (en) | 2000-10-16 | 2002-04-18 | Dima Alkawwas | Operation of wireless biopotential monitoring system |
FI119716B (en) | 2000-10-18 | 2009-02-27 | Polar Electro Oy | Electrode structure and heart rate measurement arrangement |
US6738671B2 (en) | 2000-10-26 | 2004-05-18 | Medtronic, Inc. | Externally worn transceiver for use with an implantable medical device |
US6978177B1 (en) | 2000-11-14 | 2005-12-20 | Cardiac Pacemakers, Inc. | Method and apparatus for using atrial discrimination algorithms to determine optimal pacing therapy and therapy timing |
US6658300B2 (en) | 2000-12-18 | 2003-12-02 | Biosense, Inc. | Telemetric reader/charger device for medical sensor |
WO2002052480A1 (en) | 2000-12-22 | 2002-07-04 | Trac Medical Solutions, Inc. | Dynamic electronic chain-of-trust document with audit trail |
WO2002065901A2 (en) | 2000-12-29 | 2002-08-29 | Ares Medical, Inc. | Sleep apnea risk evaluation |
EP1379161B1 (en) | 2001-02-08 | 2006-11-08 | Mini-Mitter Company, Inc | Skin patch including a temperature sensor |
DE60232224D1 (en) | 2001-02-14 | 2009-06-18 | Draeger Medical Systems Inc | PATIENT MONITORING AREA NETWORK |
ITBO20010110A1 (en) | 2001-03-01 | 2002-09-01 | Tre Esse Progettazione Biomedi | PROCEDURE AND IMPLANTABLE DEVICE FOR THE INTRA-PULMONARY MEASUREMENT OF PHYSICAL PROPERTIES OF THE PULMONARY FABRIC DEPENDENT ON ITS DENSIT |
US6595929B2 (en) | 2001-03-30 | 2003-07-22 | Bodymedia, Inc. | System for monitoring health, wellness and fitness having a method and apparatus for improved measurement of heat flow |
WO2002080762A1 (en) | 2001-04-06 | 2002-10-17 | Medic4All Inc. | A physiological monitoring system for a computational device of a human subject |
US20050283197A1 (en) | 2001-04-10 | 2005-12-22 | Daum Douglas R | Systems and methods for hypotension |
EP1249691A1 (en) | 2001-04-11 | 2002-10-16 | Omron Corporation | Electronic clinical thermometer |
US6665385B2 (en) | 2001-04-23 | 2003-12-16 | Cardionet, Inc. | Medical monitoring system having multipath communications capability |
US6885895B1 (en) * | 2001-04-26 | 2005-04-26 | Advanced Bionics Corporation | Methods and systems for electrical and/or drug stimulation as a therapy for erectile dysfunction |
US6641542B2 (en) | 2001-04-30 | 2003-11-04 | Medtronic, Inc. | Method and apparatus to detect and treat sleep respiratory events |
US7702394B2 (en) | 2001-05-01 | 2010-04-20 | Intrapace, Inc. | Responsive gastric stimulator |
US6894204B2 (en) | 2001-05-02 | 2005-05-17 | 3M Innovative Properties Company | Tapered stretch removable adhesive articles and methods |
US6587715B2 (en) | 2001-05-03 | 2003-07-01 | The Nutrition Solutions Corporation | Assessment of organs for transplant, xenotransplant, and predicting time of death |
CA2445385A1 (en) | 2001-05-03 | 2002-11-14 | Telzuit Technologies, Inc. | Wireless medical monitoring apparatus and system |
US20070104840A1 (en) | 2001-05-03 | 2007-05-10 | Singer Michael G | Method and system for the determination of palatability |
US20060161073A1 (en) | 2001-05-03 | 2006-07-20 | Singer Michael G | In vitro and in vivo assessment of organs and tissue and use, transplant, freshness and tissue conditions |
US7003346B2 (en) | 2001-05-03 | 2006-02-21 | Singer Michaeal G | Method for illness and disease determination and management |
US7242306B2 (en) | 2001-05-08 | 2007-07-10 | Hill-Rom Services, Inc. | Article locating and tracking apparatus and method |
US6622042B1 (en) | 2001-05-09 | 2003-09-16 | Pacesetter, Inc. | Implantable cardiac stimulation device and method utilizing electrogram spectral analysis for therapy administration |
US6952695B1 (en) | 2001-05-15 | 2005-10-04 | Global Safety Surveillance, Inc. | Spontaneous adverse events reporting |
CA2451992C (en) | 2001-05-15 | 2013-08-27 | Psychogenics Inc. | Systems and methods for monitoring behavior informatics |
US6701271B2 (en) | 2001-05-17 | 2004-03-02 | International Business Machines Corporation | Method and apparatus for using physical characteristic data collected from two or more subjects |
DE60209717T2 (en) | 2001-05-21 | 2006-09-21 | Colder Products Co., St. Paul | CONNECTING DEVICE FOR REGULATING A LIQUID DISPENSER |
US20050065445A1 (en) | 2001-05-22 | 2005-03-24 | Arzbaecher Robert C. | Cardiac arrest monitor and alarm system |
CN1287729C (en) | 2001-05-29 | 2006-12-06 | 生殖健康技术公司 | System for detection and analysis of material uterine, material and fetal cardiac and fetal brain activity |
US6795722B2 (en) | 2001-06-18 | 2004-09-21 | Neotech Products, Inc. | Electrode sensor package and application to the skin of a newborn or infant |
WO2003000015A2 (en) | 2001-06-25 | 2003-01-03 | Science Applications International Corporation | Identification by analysis of physiometric variation |
US7160258B2 (en) | 2001-06-26 | 2007-01-09 | Entrack, Inc. | Capsule and method for treating or diagnosing the intestinal tract |
US7044911B2 (en) | 2001-06-29 | 2006-05-16 | Philometron, Inc. | Gateway platform for biological monitoring and delivery of therapeutic compounds |
US6553312B2 (en) | 2001-06-29 | 2003-04-22 | The Regents Of The University Of California | Method and apparatus for ultra precise GPS-based mapping of seeds or vegetation during planting |
US6697658B2 (en) | 2001-07-02 | 2004-02-24 | Masimo Corporation | Low power pulse oximeter |
IL144110A0 (en) | 2001-07-02 | 2002-05-23 | Sharony Reuven | Methods and apparatus for objective fetal diagnosis |
WO2003009221A2 (en) | 2001-07-20 | 2003-01-30 | Hill-Rom Services, Inc. | Badge for a locating and tracking system |
US6595927B2 (en) * | 2001-07-23 | 2003-07-22 | Medtronic, Inc. | Method and system for diagnosing and administering therapy of pulmonary congestion |
US7257438B2 (en) | 2002-07-23 | 2007-08-14 | Datascope Investment Corp. | Patient-worn medical monitoring device |
US7191000B2 (en) * | 2001-07-31 | 2007-03-13 | Cardiac Pacemakers, Inc. | Cardiac rhythm management system for edema |
EP1297784B8 (en) | 2001-09-28 | 2011-01-12 | CSEM Centre Suisse d'Electronique et de Microtechnique SA - Recherche et Développement | Method and device for pulse rate detection |
DE10148440A1 (en) | 2001-10-01 | 2003-04-17 | Inflow Dynamics Inc | Implantable medical device for monitoring congestive heart failure comprises electrodes for measuring lung and heart tissue impedance, with an increase in impedance above a threshold value triggering an alarm |
US6890285B2 (en) | 2001-10-01 | 2005-05-10 | Tariq Rahman | Brace compliance monitor |
US20090182204A1 (en) | 2001-10-04 | 2009-07-16 | Semler Herbert J | Body composition, circulation, and vital signs monitor and method |
US20030087244A1 (en) | 2001-10-09 | 2003-05-08 | Vitivity, Inc | Diagnosis and treatment of vascular disease |
US20030093298A1 (en) | 2001-10-12 | 2003-05-15 | Javier Hernandez | System and method for providing secure remote access to patient files by authenticating personnel with biometric data |
US6748269B2 (en) | 2001-10-17 | 2004-06-08 | Cardiac Pacemakers, Inc. | Algorithm for discrimination of 1:1 tachycardias |
US6810282B2 (en) | 2001-10-25 | 2004-10-26 | GE Medical Systems Information Technolgies, Inc. | Method and apparatus for dynamically selecting an electrocardiogram compression process based on computerized analysis of cardiac rhythm and contour |
FR2831450B1 (en) | 2001-10-30 | 2004-07-30 | Ela Medical Sa | ACTIVE IMPLANTABLE MEDICAL DEVICE FOR THE TREATMENT OF HEART RATE DISORDERS, INCLUDING IMPROVED MEANS FOR DETECTING ATRIAL ARRHYTHMIAS |
US7054679B2 (en) | 2001-10-31 | 2006-05-30 | Robert Hirsh | Non-invasive method and device to monitor cardiac parameters |
US6577139B2 (en) | 2001-11-06 | 2003-06-10 | Keystone Thermometrics | Impedance converter circuit |
US6894456B2 (en) | 2001-11-07 | 2005-05-17 | Quallion Llc | Implantable medical power module |
US6980851B2 (en) | 2001-11-15 | 2005-12-27 | Cardiac Pacemakers, Inc. | Method and apparatus for determining changes in heart failure status |
DE10156833A1 (en) | 2001-11-20 | 2003-05-28 | Boehm Stephan | Electrode for biomedical measurements has contact plate connected to line driver high impedance input and current source current output, line driver, current source close to contact plate |
ATE363859T1 (en) | 2001-12-12 | 2007-06-15 | Fresenius Medical Care De Gmbh | DETERMINING A PATIENT'S HYDRATION STATE |
GB0130010D0 (en) | 2001-12-14 | 2002-02-06 | Isis Innovation | Combining measurements from breathing rate sensors |
US20030149349A1 (en) | 2001-12-18 | 2003-08-07 | Jensen Thomas P. | Integral patch type electronic physiological sensor |
US20030143544A1 (en) | 2002-01-09 | 2003-07-31 | Vitivity, Inc. | Diagnosis and treatment of vascular disease |
US6980852B2 (en) | 2002-01-25 | 2005-12-27 | Subqiview Inc. | Film barrier dressing for intravascular tissue monitoring system |
US6912414B2 (en) | 2002-01-29 | 2005-06-28 | Southwest Research Institute | Electrode systems and methods for reducing motion artifact |
US6645153B2 (en) | 2002-02-07 | 2003-11-11 | Pacesetter, Inc. | System and method for evaluating risk of mortality due to congestive heart failure using physiologic sensors |
US7468032B2 (en) | 2002-12-18 | 2008-12-23 | Cardiac Pacemakers, Inc. | Advanced patient management for identifying, displaying and assisting with correlating health-related data |
US6936006B2 (en) | 2002-03-22 | 2005-08-30 | Novo Nordisk, A/S | Atraumatic insertion of a subcutaneous device |
CA2379268A1 (en) | 2002-03-26 | 2003-09-26 | Hans Kolpin | Skin impedance matched biopotential electrode |
AU2003220574A1 (en) | 2002-03-27 | 2003-10-13 | Cvrx, Inc. | Electrode structures and methods for their use in cardiovascular reflex control |
US20030187370A1 (en) | 2002-03-27 | 2003-10-02 | Kodama Roy K. | Uterine contraction sensing system and method |
US7654901B2 (en) | 2002-04-10 | 2010-02-02 | Breving Joel S | Video game system using bio-feedback devices |
US7448996B2 (en) | 2002-04-16 | 2008-11-11 | Carematix, Inc. | Method and apparatus for remotely monitoring the condition of a patient |
US7136703B1 (en) | 2002-04-16 | 2006-11-14 | Pacesetter, Inc. | Programmer and surface ECG system with wireless communication |
AU2003229165A1 (en) | 2002-05-07 | 2003-11-11 | Izmail Batkin | Remote monitoring of cardiac electrical activity using a cell phone device |
US20030221687A1 (en) | 2002-05-09 | 2003-12-04 | William Kaigler | Medication and compliance management system and method |
NO321659B1 (en) | 2002-05-14 | 2006-06-19 | Idex Asa | Volume specific characterization of human skin by electrical immitance |
TW528593B (en) | 2002-05-17 | 2003-04-21 | Jang-Min Yang | Device for monitoring physiological status and method for using the device |
US6922586B2 (en) | 2002-05-20 | 2005-07-26 | Richard J. Davies | Method and system for detecting electrophysiological changes in pre-cancerous and cancerous tissue |
US7151961B1 (en) * | 2002-05-24 | 2006-12-19 | Advanced Bionics Corporation | Treatment of movement disorders by brain stimulation |
US6906530B2 (en) | 2002-05-30 | 2005-06-14 | D.J. Geisel Technology, Inc. | Apparatus and method to detect moisture |
US7047067B2 (en) | 2002-05-31 | 2006-05-16 | Uab Research Foundation | Apparatus, methods, and computer program products for evaluating a risk of cardiac arrhythmias from restitution properties |
GB2391625A (en) | 2002-08-09 | 2004-02-11 | Diagnostic Ultrasound Europ B | Instantaneous ultrasonic echo measurement of bladder urine volume with a limited number of ultrasound beams |
CA2487255C (en) | 2002-06-11 | 2014-05-06 | Jeffrey A. Matos | System for cardiac resuscitation |
US20070265582A1 (en) * | 2002-06-12 | 2007-11-15 | University Of Southern California | Injection Devices for Unimpeded Target Location Testing |
US7096061B2 (en) | 2002-07-03 | 2006-08-22 | Tel-Aviv University Future Technology Development L.P. | Apparatus for monitoring CHF patients using bio-impedance technique |
US6997879B1 (en) | 2002-07-09 | 2006-02-14 | Pacesetter, Inc. | Methods and devices for reduction of motion-induced noise in optical vascular plethysmography |
US7027862B2 (en) | 2002-07-25 | 2006-04-11 | Medtronic, Inc. | Apparatus and method for transmitting an electrical signal in an implantable medical device |
US20040019292A1 (en) | 2002-07-29 | 2004-01-29 | Drinan Darrel Dean | Method and apparatus for bioelectric impedance based identification of subjects |
IL151029A0 (en) | 2002-08-01 | 2003-04-10 | Art Medical Instr Ltd | Bio-filter pad for facilitating the detection of an occurrence of a physiological action, and method therefor, and fetal activity monitoring apparatus |
US6879850B2 (en) | 2002-08-16 | 2005-04-12 | Optical Sensors Incorporated | Pulse oximeter with motion detection |
WO2004016168A1 (en) | 2002-08-19 | 2004-02-26 | Czarnek & Orkin Laboratories, Inc. | Capacitive uterine contraction sensor |
US7020508B2 (en) | 2002-08-22 | 2006-03-28 | Bodymedia, Inc. | Apparatus for detecting human physiological and contextual information |
US7294105B1 (en) | 2002-09-03 | 2007-11-13 | Cheetah Omni, Llc | System and method for a wireless medical communication system |
US7118531B2 (en) | 2002-09-24 | 2006-10-10 | The Johns Hopkins University | Ingestible medical payload carrying capsule with wireless communication |
US7736309B2 (en) | 2002-09-27 | 2010-06-15 | Medtronic Minimed, Inc. | Implantable sensor method and system |
KR20050055072A (en) | 2002-10-09 | 2005-06-10 | 보디미디어 인코퍼레이티드 | Apparatus for detecting, receiving, deriving and displaying human physiological and contextual information |
US20040073094A1 (en) | 2002-10-15 | 2004-04-15 | Baker Donald A. | Fetal monitoring systems with ambulatory patient units and telemetric links for improved uses |
GB2394294A (en) | 2002-10-18 | 2004-04-21 | Cambridge Neurotechnology Ltd | Cardiac sensor with accelerometer |
AU2003282961A1 (en) | 2002-10-18 | 2004-05-04 | Trustees Of Boston University | Patient activity monitor |
GB0224425D0 (en) | 2002-10-21 | 2002-11-27 | Univ Leicester | Method for prediction of cardiac disease |
US6878121B2 (en) | 2002-11-01 | 2005-04-12 | David T. Krausman | Sleep scoring apparatus and method |
AR039364A1 (en) | 2002-11-07 | 2005-02-16 | Carlos Daniel Silva | RESPIRATORY MOVEMENT MONITOR |
FI114199B (en) | 2002-11-08 | 2004-09-15 | Polar Electro Oy | Method and device to measure stress |
US20040106954A1 (en) * | 2002-11-15 | 2004-06-03 | Whitehurst Todd K. | Treatment of congestive heart failure |
US7130679B2 (en) | 2002-11-20 | 2006-10-31 | Medtronic, Inc. | Organ rejection monitoring |
EP1565105A4 (en) * | 2002-11-22 | 2009-04-01 | Impedimed Ltd | Multifrequency bioimpedance determination |
US20040106951A1 (en) | 2002-11-22 | 2004-06-03 | Edman Carl Frederick | Use of electric fields to minimize rejection of implanted devices and materials |
US20040100376A1 (en) | 2002-11-26 | 2004-05-27 | Kimberly-Clark Worldwide, Inc. | Healthcare monitoring system |
CA2450971A1 (en) | 2002-11-27 | 2004-05-27 | Z-Tech (Canada) Inc. | Apparatus and method for determining adequacy of electrode-to-skin contact and electrode quality for bioelectrical measurements |
US8814793B2 (en) | 2002-12-03 | 2014-08-26 | Neorad As | Respiration monitor |
US7072718B2 (en) | 2002-12-03 | 2006-07-04 | Cardiac Pacemakers, Inc. | Antenna systems for implantable medical device telemetry |
US7986994B2 (en) | 2002-12-04 | 2011-07-26 | Medtronic, Inc. | Method and apparatus for detecting change in intrathoracic electrical impedance |
US7452334B2 (en) | 2002-12-16 | 2008-11-18 | The Regents Of The University Of Michigan | Antenna stent device for wireless, intraluminal monitoring |
US20060155174A1 (en) * | 2002-12-16 | 2006-07-13 | Arkady Glukhovsky | Device, system and method for selective activation of in vivo sensors |
US20040143170A1 (en) | 2002-12-20 | 2004-07-22 | Durousseau Donald R. | Intelligent deception verification system |
US7127541B2 (en) | 2002-12-23 | 2006-10-24 | Microtune (Texas), L.P. | Automatically establishing a wireless connection between adapters |
US7395117B2 (en) | 2002-12-23 | 2008-07-01 | Cardiac Pacemakers, Inc. | Implantable medical device having long-term wireless capabilities |
GB0230361D0 (en) | 2002-12-27 | 2003-02-05 | Koninkl Philips Electronics Nv | Electrode arrangement |
US20040133079A1 (en) | 2003-01-02 | 2004-07-08 | Mazar Scott Thomas | System and method for predicting patient health within a patient management system |
US7160252B2 (en) * | 2003-01-10 | 2007-01-09 | Medtronic, Inc. | Method and apparatus for detecting respiratory disturbances |
DE10300735A1 (en) | 2003-01-11 | 2004-07-22 | Corscience Gmbh & Co.Kg | Method for detecting a fibrillation state and device for defibrillation |
US7423526B2 (en) | 2003-01-29 | 2008-09-09 | Despotis George J | Integrated patient diagnostic and identification system |
US7445605B2 (en) | 2003-01-31 | 2008-11-04 | The Board Of Trustees Of The Leland Stanford Junior University | Detection of apex motion for monitoring cardiac dysfunction |
US6956572B2 (en) | 2003-02-10 | 2005-10-18 | Siemens Medical Solutions Health Services Corporation | Patient medical parameter user interface system |
JP4607859B2 (en) | 2003-02-19 | 2011-01-05 | サイセル・テクノロジーズ,インコーポレイテッド | In vivo fluorescent sensor, system and related methods operating in conjunction with a fluorescent analyte |
WO2004084720A2 (en) | 2003-03-21 | 2004-10-07 | Welch Allyn, Inc. | Personal status physiologic monitor system and architecture and related monitoring methods |
US20040199056A1 (en) | 2003-04-03 | 2004-10-07 | International Business Machines Corporation | Body monitoring using local area wireless interfaces |
US7134999B2 (en) | 2003-04-04 | 2006-11-14 | Dexcom, Inc. | Optimized sensor geometry for an implantable glucose sensor |
US20070010702A1 (en) * | 2003-04-08 | 2007-01-11 | Xingwu Wang | Medical device with low magnetic susceptibility |
US20050079132A1 (en) * | 2003-04-08 | 2005-04-14 | Xingwu Wang | Medical device with low magnetic susceptibility |
US20050107870A1 (en) | 2003-04-08 | 2005-05-19 | Xingwu Wang | Medical device with multiple coating layers |
US20040215240A1 (en) | 2003-04-11 | 2004-10-28 | Lovett Eric G. | Reconfigurable subcutaneous cardiac device |
US7130684B2 (en) | 2003-04-30 | 2006-10-31 | Medtronic, Inc. | Method and apparatus for improving ventricular status using the force interval relationship |
US20040225203A1 (en) | 2003-05-06 | 2004-11-11 | Jemison Mae C. | Real-time and simultaneous monitoring of multiple parameters from multiple living beings |
AU2003902187A0 (en) | 2003-05-08 | 2003-05-22 | Aimedics Pty Ltd | Patient monitor |
US20040225199A1 (en) | 2003-05-08 | 2004-11-11 | Evanyk Shane Walter | Advanced physiological monitoring systems and methods |
US7149574B2 (en) | 2003-06-09 | 2006-12-12 | Palo Alto Investors | Treatment of conditions through electrical modulation of the autonomic nervous system |
US7289761B2 (en) | 2003-06-23 | 2007-10-30 | Cardiac Pacemakers, Inc. | Systems, devices, and methods for selectively preventing data transfer from a medical device |
US7171258B2 (en) | 2003-06-25 | 2007-01-30 | Cardiac Pacemakers, Inc. | Method and apparatus for trending a physiological cardiac parameter |
US20050158539A1 (en) | 2003-06-25 | 2005-07-21 | Andover Coated Products, Inc. | Pressure-sensitive adhesive tapes |
US20050027204A1 (en) | 2003-06-26 | 2005-02-03 | Kligfield Paul D. | ECG diagnostic system and method |
US7142907B2 (en) | 2003-07-01 | 2006-11-28 | Ge Medical Systems Information Technologies, Inc. | Method and apparatus for algorithm fusion of high-resolution electrocardiograms |
BR0314067B1 (en) | 2003-07-08 | 2013-12-03 | PROCESS FOR PREPARING CHLOROTRIS (TRIPHENYPHOSPHAN) RODIUM (I) | |
US7320689B2 (en) | 2003-07-15 | 2008-01-22 | Cervitech, Inc. | Multi-part cervical endoprosthesis with insertion instrument |
US20050015095A1 (en) * | 2003-07-15 | 2005-01-20 | Cervitech, Inc. | Insertion instrument for cervical prostheses |
US20050027175A1 (en) | 2003-07-31 | 2005-02-03 | Zhongping Yang | Implantable biosensor |
US7295877B2 (en) * | 2003-07-31 | 2007-11-13 | Biosense Webster, Inc. | Encapsulated sensor with external antenna |
US20060195020A1 (en) | 2003-08-01 | 2006-08-31 | Martin James S | Methods, systems, and apparatus for measuring a pulse rate |
US20050131288A1 (en) | 2003-08-15 | 2005-06-16 | Turner Christopher T. | Flexible, patient-worn, integrated, self-contained sensor systems for the acquisition and monitoring of physiologic data |
US7616988B2 (en) | 2003-09-18 | 2009-11-10 | Cardiac Pacemakers, Inc. | System and method for detecting an involuntary muscle movement disorder |
EP2382920A1 (en) | 2003-08-20 | 2011-11-02 | Philometron, Inc. | Hydration monitoring |
US7320675B2 (en) * | 2003-08-21 | 2008-01-22 | Cardiac Pacemakers, Inc. | Method and apparatus for modulating cellular metabolism during post-ischemia or heart failure |
US7194306B1 (en) | 2003-09-05 | 2007-03-20 | Pacesetter, Inc. | Cardiac optimization through low-frequency analysis of hemodynamic variables |
JP2005080720A (en) | 2003-09-05 | 2005-03-31 | Tanita Corp | Bioelectric impedance measuring apparatus |
WO2005025405A2 (en) | 2003-09-10 | 2005-03-24 | Maternus Partners, Ltd. | Periumbilical infant ecg sensor and monitoring system |
JP5174348B2 (en) | 2003-09-12 | 2013-04-03 | ボディーメディア インコーポレイテッド | Method and apparatus for monitoring heart related condition parameters |
US20050059867A1 (en) | 2003-09-13 | 2005-03-17 | Cheng Chung Yuan | Method for monitoring temperature of patient |
US7088242B2 (en) | 2003-09-16 | 2006-08-08 | International Business Machines Corporation | Collective personal articles tracking |
EP1677852A4 (en) | 2003-09-16 | 2009-06-24 | Cardiomems Inc | Implantable wireless sensor |
US7129836B2 (en) | 2003-09-23 | 2006-10-31 | Ge Medical Systems Information Technologies, Inc. | Wireless subject monitoring system |
JP2005110801A (en) | 2003-10-03 | 2005-04-28 | Aprica Kassai Inc | Biomedical measurement sensor and biomedical measurement method |
US8428717B2 (en) | 2003-10-14 | 2013-04-23 | Medtronic, Inc. | Method and apparatus for monitoring tissue fluid content for use in an implantable cardiac device |
US8467876B2 (en) | 2003-10-15 | 2013-06-18 | Rmx, Llc | Breathing disorder detection and therapy delivery device and method |
WO2005046446A2 (en) | 2003-11-10 | 2005-05-26 | Philometron, Inc. | Structures and devices for parenteral drug delivery and diagnostic sampling |
CA2842420C (en) | 2003-11-18 | 2016-10-11 | Adidas Ag | Method and system for processing data from ambulatory physiological monitoring |
AU2004305423B2 (en) | 2003-11-26 | 2009-03-26 | Cardionet, Inc. | System and method for processing and presenting arrhythmia information to facilitate heart arrhythmia identification and treatment |
US7184821B2 (en) | 2003-12-03 | 2007-02-27 | Regents Of The University Of Minnesota | Monitoring thoracic fluid changes |
US20050124901A1 (en) | 2003-12-05 | 2005-06-09 | Misczynski Dale J. | Method and apparatus for electrophysiological and hemodynamic real-time assessment of cardiovascular fitness of a user |
CA2552976A1 (en) | 2003-12-12 | 2005-06-30 | Philometron, Inc. | Multiple section parenteral drug delivery apparatus |
US20050137626A1 (en) | 2003-12-19 | 2005-06-23 | Pastore Joseph M. | Drug delivery system and method employing external drug delivery device in conjunction with computer network |
US20050137464A1 (en) | 2003-12-23 | 2005-06-23 | Bomba Frank C. | Wireless sensor and sensor initialization device and method |
US20050148895A1 (en) | 2004-01-06 | 2005-07-07 | Misczynski Dale J. | Method and apparatus for ECG derived sleep monitoring of a user |
JP5094125B2 (en) | 2004-01-15 | 2012-12-12 | コーニンクレッカ フィリップス エレクトロニクス エヌ ヴィ | Adaptive physiological monitoring system and method of using the system |
CA2555807A1 (en) | 2004-02-12 | 2005-08-25 | Biopeak Corporation | Non-invasive method and apparatus for determining a physiological parameter |
US8068905B2 (en) | 2004-02-26 | 2011-11-29 | Compumedics Limited | Method and apparatus for continuous electrode impedance monitoring |
US7277741B2 (en) | 2004-03-09 | 2007-10-02 | Nellcor Puritan Bennett Incorporated | Pulse oximetry motion artifact rejection using near infrared absorption by water |
JP2005253840A (en) | 2004-03-15 | 2005-09-22 | Tanita Corp | Skin condition estimating device |
US7805196B2 (en) | 2004-03-16 | 2010-09-28 | Medtronic, Inc. | Collecting activity information to evaluate therapy |
US7395113B2 (en) | 2004-03-16 | 2008-07-01 | Medtronic, Inc. | Collecting activity information to evaluate therapy |
EP1729845B1 (en) | 2004-03-18 | 2017-02-22 | Respironics, Inc. | Methods and devices for relieving stress |
US7474918B2 (en) | 2004-03-24 | 2009-01-06 | Noninvasive Medical Technologies, Inc. | Thoracic impedance monitor and electrode array and method of use |
US20070150008A1 (en) | 2004-03-25 | 2007-06-28 | Koninklijke Philips Electronics, N.V. | Defibrillation electrode having drug delivery capablity |
US20050215844A1 (en) | 2004-03-25 | 2005-09-29 | Ten Eyck Lawrence G | Patient carestation |
US7505814B2 (en) | 2004-03-26 | 2009-03-17 | Pacesetter, Inc. | System and method for evaluating heart failure based on ventricular end-diastolic volume using an implantable medical device |
US20050228244A1 (en) | 2004-04-07 | 2005-10-13 | Triage Wireless, Inc. | Small-scale, vital-signs monitoring device, system and method |
US20050261598A1 (en) | 2004-04-07 | 2005-11-24 | Triage Wireless, Inc. | Patch sensor system for measuring vital signs |
US7238159B2 (en) | 2004-04-07 | 2007-07-03 | Triage Wireless, Inc. | Device, system and method for monitoring vital signs |
US20060009697A1 (en) | 2004-04-07 | 2006-01-12 | Triage Wireless, Inc. | Wireless, internet-based system for measuring vital signs from a plurality of patients in a hospital or medical clinic |
US20050228238A1 (en) | 2004-04-09 | 2005-10-13 | Arnold Monitzer | Patient parameter automatic acquisition system |
WO2005104930A1 (en) | 2004-04-30 | 2005-11-10 | Biowatch Pty Ltd | Animal health monitoring system |
US7470232B2 (en) | 2004-05-04 | 2008-12-30 | General Electric Company | Method and apparatus for non-invasive ultrasonic fetal heart rate monitoring |
EP1761165A4 (en) | 2004-05-10 | 2011-07-13 | Univ Minnesota | Portable device for monitoring electrocardiographic signals and indices of blood flow |
WO2005110529A1 (en) * | 2004-05-10 | 2005-11-24 | Advanced Bionics Corporation | Implantable electrode, insertion tool for use therewith, and insertion method |
US7324845B2 (en) | 2004-05-17 | 2008-01-29 | Beth Israel Deaconess Medical Center | Assessment of sleep quality and sleep disordered breathing based on cardiopulmonary coupling |
US20050261743A1 (en) | 2004-05-19 | 2005-11-24 | Kroll Mark W | System and method for automated fluid monitoring |
KR100592934B1 (en) | 2004-05-21 | 2006-06-23 | 한국전자통신연구원 | Wearable physiological signal detection module and measurement apparatus with the same |
US20050267555A1 (en) * | 2004-05-28 | 2005-12-01 | Marnfeldt Goran N | Engagement tool for implantable medical devices |
US7333850B2 (en) | 2004-05-28 | 2008-02-19 | University Of Florida Research Foundation, Inc. | Maternal-fetal monitoring system |
US7548785B2 (en) | 2004-06-10 | 2009-06-16 | Pacesetter, Inc. | Collecting and analyzing sensed information as a trend of heart failure progression or regression |
US20050277841A1 (en) | 2004-06-10 | 2005-12-15 | Adnan Shennib | Disposable fetal monitor patch |
US20050280531A1 (en) | 2004-06-18 | 2005-12-22 | Fadem Kalford C | Device and method for transmitting physiologic data |
US7477934B2 (en) | 2004-06-29 | 2009-01-13 | Polar Electro Oy | Method of monitoring human relaxation level, and user-operated heart rate monitor |
US7206630B1 (en) | 2004-06-29 | 2007-04-17 | Cleveland Medical Devices, Inc | Electrode patch and wireless physiological measurement system and method |
US7433853B2 (en) | 2004-07-12 | 2008-10-07 | Cardiac Pacemakers, Inc. | Expert system for patient medical information analysis |
EP1804649A4 (en) | 2004-07-23 | 2009-01-28 | Intercure Ltd | Apparatus and method for breathing pattern determination using a non-contact microphone |
US7356366B2 (en) | 2004-08-02 | 2008-04-08 | Cardiac Pacemakers, Inc. | Device for monitoring fluid status |
US7319386B2 (en) | 2004-08-02 | 2008-01-15 | Hill-Rom Services, Inc. | Configurable system for alerting caregivers |
US20060030782A1 (en) | 2004-08-05 | 2006-02-09 | Adnan Shennib | Heart disease detection patch |
US20060030781A1 (en) | 2004-08-05 | 2006-02-09 | Adnan Shennib | Emergency heart sensor patch |
US7387610B2 (en) | 2004-08-19 | 2008-06-17 | Cardiac Pacemakers, Inc. | Thoracic impedance detection with blood resistivity compensation |
US20070299325A1 (en) | 2004-08-20 | 2007-12-27 | Brian Farrell | Physiological status monitoring system |
US20060047215A1 (en) | 2004-09-01 | 2006-03-02 | Welch Allyn, Inc. | Combined sensor assembly |
WO2006029035A1 (en) | 2004-09-02 | 2006-03-16 | Philometron, Inc. | Monitoring platform for wound and ulcer monitoring and detection |
US20060066449A1 (en) | 2004-09-08 | 2006-03-30 | Industrial Widget Works Company | RFMON: devices and methods for wireless monitoring of patient vital signs through medical sensor readings from passive RFID tags |
US9820658B2 (en) * | 2006-06-30 | 2017-11-21 | Bao Q. Tran | Systems and methods for providing interoperability among healthcare devices |
US20060135858A1 (en) | 2004-09-13 | 2006-06-22 | International Business Machines Corporation | Displaying information related to a physical parameter of an individual |
US20060064133A1 (en) | 2004-09-17 | 2006-03-23 | Cardiac Pacemakers, Inc. | System and method for deriving relative physiologic measurements using an external computing device |
US20070106132A1 (en) | 2004-09-28 | 2007-05-10 | Elhag Sammy I | Monitoring device, method and system |
US7917196B2 (en) | 2005-05-09 | 2011-03-29 | Cardiac Pacemakers, Inc. | Arrhythmia discrimination using electrocardiograms sensed from multiple implanted electrodes |
US7840275B2 (en) | 2004-10-01 | 2010-11-23 | Medtronic, Inc. | In-home remote monitor with smart repeater, memory and emergency event management |
US7341560B2 (en) | 2004-10-05 | 2008-03-11 | Rader, Fishman & Grauer Pllc | Apparatuses and methods for non-invasively monitoring blood parameters |
US7609145B2 (en) | 2004-10-06 | 2009-10-27 | Martis Ip Holdings, Llc | Test authorization system |
US20080058656A1 (en) * | 2004-10-08 | 2008-03-06 | Costello Benedict J | Electric tomography |
US7865236B2 (en) | 2004-10-20 | 2011-01-04 | Nervonix, Inc. | Active electrode, bio-impedance based, tissue discrimination system and methods of use |
US7996075B2 (en) | 2004-10-20 | 2011-08-09 | Cardionet, Inc. | Monitoring physiological activity using partial state space reconstruction |
US7212849B2 (en) | 2004-10-28 | 2007-05-01 | Cardiac Pacemakers, Inc. | Methods and apparatuses for arrhythmia detection and classification using wireless ECG |
US8489189B2 (en) * | 2004-10-29 | 2013-07-16 | Medtronic, Inc. | Expandable fixation mechanism |
US7917199B2 (en) | 2004-11-02 | 2011-03-29 | Medtronic, Inc. | Patient event marking in combination with physiological signals |
US8768446B2 (en) | 2004-11-02 | 2014-07-01 | Medtronic, Inc. | Clustering with combined physiological signals |
CA2584863A1 (en) | 2004-11-09 | 2006-05-18 | Cybiocare Inc. | Method and apparatus for the reduction of spurious effects on physiological measurements |
US7751868B2 (en) | 2004-11-12 | 2010-07-06 | Philips Electronics Ltd | Integrated skin-mounted multifunction device for use in image-guided surgery |
JP2006343306A (en) | 2004-11-15 | 2006-12-21 | Denso Corp | Gas concentration detector |
WO2006056896A1 (en) | 2004-11-24 | 2006-06-01 | Koninklijke Philips Electronics, N.V. | An internet-protocol based telemetry patient monitoring system |
US20060116592A1 (en) | 2004-12-01 | 2006-06-01 | Medtronic, Inc. | Method and apparatus for detection and monitoring of T-wave alternans |
US8108046B2 (en) | 2004-12-17 | 2012-01-31 | Medtronic, Inc. | System and method for using cardiac events to trigger therapy for treating nervous system disorders |
US8041419B2 (en) | 2004-12-17 | 2011-10-18 | Medtronic, Inc. | System and method for monitoring or treating nervous system disorders |
US8734341B2 (en) | 2004-12-20 | 2014-05-27 | Ipventure, Inc. | Method and apparatus to sense hydration level of a person |
FI20045503A (en) | 2004-12-28 | 2006-06-29 | Polar Electro Oy | Sensor systems, accessories and heart rate monitors |
US7701227B2 (en) | 2005-01-05 | 2010-04-20 | Rensselaer Polytechnic Institute | High precision voltage source for electrical impedance tomography |
WO2006077528A2 (en) | 2005-01-18 | 2006-07-27 | Koninklijke Philips Electronics, N.V. | Electronically controlled capsule |
US8577455B2 (en) | 2005-01-18 | 2013-11-05 | Medtronic, Inc. | Method and apparatus for arrhythmia detection in a medical device |
JP2006198334A (en) | 2005-01-24 | 2006-08-03 | Tanita Corp | Bioelectrical impedance measuring device and body composition measuring apparatus |
JP2006204742A (en) | 2005-01-31 | 2006-08-10 | Konica Minolta Sensing Inc | Method and system for evaluating sleep, its operation program, pulse oxymeter, and system for supporting sleep |
US20080021336A1 (en) * | 2006-04-24 | 2008-01-24 | Dobak John D Iii | Devices and methods for accelerometer-based characterization of cardiac synchrony and dyssynchrony |
JP4731936B2 (en) | 2005-02-09 | 2011-07-27 | 本田技研工業株式会社 | Rotary variable resistor |
CN101198277B (en) | 2005-02-22 | 2011-06-15 | 海尔思-斯玛特有限公司 | Systems for physiological and psycho-physiological monitoring |
US20060212097A1 (en) | 2005-02-24 | 2006-09-21 | Vijay Varadan | Method and device for treatment of medical conditions and monitoring physical movements |
US7722622B2 (en) | 2005-02-25 | 2010-05-25 | Synthes Usa, Llc | Implant insertion apparatus and method of use |
US7616110B2 (en) | 2005-03-11 | 2009-11-10 | Aframe Digital, Inc. | Mobile wireless customizable health and condition monitor |
JP5273721B2 (en) | 2005-03-21 | 2013-08-28 | ビカス セラピューティクス,エルエルシー | Compositions and methods for mitigating cachexia |
US20060252999A1 (en) | 2005-05-03 | 2006-11-09 | Devaul Richard W | Method and system for wearable vital signs and physiology, activity, and environmental monitoring |
US20060224079A1 (en) | 2005-03-31 | 2006-10-05 | Washchuk Bohdan O | Edema monitoring system and method utilizing an implantable medical device |
US20060224072A1 (en) | 2005-03-31 | 2006-10-05 | Cardiovu, Inc. | Disposable extended wear heart monitor patch |
US8480577B2 (en) | 2005-04-15 | 2013-07-09 | Ivy Biomedical Systems, Inc. | Wireless patient monitoring system |
WO2006111878A1 (en) | 2005-04-20 | 2006-10-26 | Philips Intellectual Property & Standards Gmbh | Patient monitoring system |
US20060241641A1 (en) | 2005-04-22 | 2006-10-26 | Sdgi Holdings, Inc. | Methods and instrumentation for distraction and insertion of implants in a spinal disc space |
US7657317B2 (en) | 2005-04-26 | 2010-02-02 | Boston Scientific Neuromodulation Corporation | Evaluating stimulation therapies and patient satisfaction |
US7822627B2 (en) | 2005-05-02 | 2010-10-26 | St Martin Edward | Method and system for generating an echocardiogram report |
US9089275B2 (en) | 2005-05-11 | 2015-07-28 | Cardiac Pacemakers, Inc. | Sensitivity and specificity of pulmonary edema detection when using transthoracic impedance |
US7907997B2 (en) | 2005-05-11 | 2011-03-15 | Cardiac Pacemakers, Inc. | Enhancements to the detection of pulmonary edema when using transthoracic impedance |
US8688189B2 (en) | 2005-05-17 | 2014-04-01 | Adnan Shennib | Programmable ECG sensor patch |
WO2006124623A2 (en) | 2005-05-18 | 2006-11-23 | Rachelle Van Wyk | System, method, and kit for positioning a monitor transducer on a patient |
US7340296B2 (en) | 2005-05-18 | 2008-03-04 | Cardiac Pacemakers, Inc. | Detection of pleural effusion using transthoracic impedance |
US8021299B2 (en) | 2005-06-01 | 2011-09-20 | Medtronic, Inc. | Correlating a non-polysomnographic physiological parameter set with sleep states |
US9398853B2 (en) | 2005-06-03 | 2016-07-26 | LifeWatch Technologies, Ltd. | Communication terminal, medical telemetry system and method for monitoring physiological data |
KR100634544B1 (en) | 2005-06-04 | 2006-10-13 | 삼성전자주식회사 | Apparatus and method for measuring moisture content in skin using portable terminal |
US7387607B2 (en) | 2005-06-06 | 2008-06-17 | Intel Corporation | Wireless medical sensor system |
FR2886532B1 (en) | 2005-06-07 | 2008-03-28 | Commissariat Energie Atomique | METHOD AND SYSTEM FOR DETECTING THE FALL OF A PERSON |
TW200642660A (en) | 2005-06-14 | 2006-12-16 | We Gene Technologies Inc | Auto diagnosing method and device thereof for high mountain disease |
US20060293571A1 (en) | 2005-06-23 | 2006-12-28 | Skanda Systems | Distributed architecture for remote patient monitoring and caring |
US7295879B2 (en) | 2005-06-24 | 2007-11-13 | Kenergy, Inc. | Double helical antenna assembly for a wireless intravascular medical device |
US20070010721A1 (en) * | 2005-06-28 | 2007-01-11 | Chen Thomas C H | Apparatus and system of Internet-enabled wireless medical sensor scale |
US7848787B2 (en) | 2005-07-08 | 2010-12-07 | Biosense Webster, Inc. | Relative impedance measurement |
US20070016089A1 (en) | 2005-07-15 | 2007-01-18 | Fischell David R | Implantable device for vital signs monitoring |
US20070021678A1 (en) * | 2005-07-19 | 2007-01-25 | Cardiac Pacemakers, Inc. | Methods and apparatus for monitoring physiological responses to steady state activity |
US20070027497A1 (en) | 2005-07-27 | 2007-02-01 | Cyberonics, Inc. | Nerve stimulation for treatment of syncope |
US7813778B2 (en) * | 2005-07-29 | 2010-10-12 | Spectros Corporation | Implantable tissue ischemia sensor |
CN100471445C (en) | 2005-08-01 | 2009-03-25 | 周常安 | Paster style physiological monitoring device, system and network |
ATE383106T1 (en) | 2005-08-17 | 2008-01-15 | Osypka Medical Gmbh | DIGITAL DEMODULATION DEVICE AND METHOD FOR MEASURING ELECTRICAL BIOIMPEDANCE OR BIOADMITTANCE |
US8992436B2 (en) | 2005-09-16 | 2015-03-31 | Cardiac Pacemakers, Inc. | Respiration monitoring using respiration rate variability |
US7775983B2 (en) | 2005-09-16 | 2010-08-17 | Cardiac Pacemakers, Inc. | Rapid shallow breathing detection for use in congestive heart failure status determination |
US20080058614A1 (en) | 2005-09-20 | 2008-03-06 | Triage Wireless, Inc. | Wireless, internet-based system for measuring vital signs from a plurality of patients in a hospital or medical clinic |
US20070073361A1 (en) | 2005-09-23 | 2007-03-29 | Bioq, Inc. | Medical device for restoration of autonomic and immune functions impaired by neuropathy |
WO2007038607A2 (en) | 2005-09-27 | 2007-04-05 | Telzuit Technologies, Llc | Apparatus and method for monitoring patients |
US20070083092A1 (en) | 2005-10-07 | 2007-04-12 | Rippo Anthony J | External exercise monitor |
US20070082189A1 (en) | 2005-10-11 | 2007-04-12 | Gillette William J | Waterproof, breathable composite material |
CA2625631C (en) | 2005-10-11 | 2016-11-29 | Impedance Cardiology Systems, Inc. | Hydration status monitoring |
JP2007105316A (en) | 2005-10-14 | 2007-04-26 | Konica Minolta Sensing Inc | Bioinformation measuring instrument |
US7420472B2 (en) | 2005-10-16 | 2008-09-02 | Bao Tran | Patient monitoring apparatus |
US8118750B2 (en) | 2005-10-21 | 2012-02-21 | Medtronic, Inc. | Flow sensors for penile tumescence |
US20070123904A1 (en) | 2005-10-31 | 2007-05-31 | Depuy Spine, Inc. | Distraction instrument and method for distracting an intervertebral site |
US20070123903A1 (en) | 2005-10-31 | 2007-05-31 | Depuy Spine, Inc. | Medical Device installation tool and methods of use |
US7942824B1 (en) | 2005-11-04 | 2011-05-17 | Cleveland Medical Devices Inc. | Integrated sleep diagnostic and therapeutic system and method |
US7682313B2 (en) | 2005-11-23 | 2010-03-23 | Vital Sensors Holding Company, Inc. | Implantable pressure monitor |
US7766840B2 (en) | 2005-12-01 | 2010-08-03 | Cardiac Pacemakers, Inc. | Method and system for heart failure status evaluation based on a disordered breathing index |
US7957809B2 (en) | 2005-12-02 | 2011-06-07 | Medtronic, Inc. | Closed-loop therapy adjustment |
US8016776B2 (en) | 2005-12-02 | 2011-09-13 | Medtronic, Inc. | Wearable ambulatory data recorder |
WO2007065015A2 (en) | 2005-12-03 | 2007-06-07 | Masimo Corporation | Physiological alarm notification system |
AU2006321918B2 (en) | 2005-12-06 | 2011-08-25 | St. Jude Medical, Atrial Fibrillation Division Inc. | Assessment of electrode coupling for tissue ablation |
US20070180047A1 (en) | 2005-12-12 | 2007-08-02 | Yanting Dong | System and method for providing authentication of remotely collected external sensor measures |
RU2008129670A (en) | 2005-12-19 | 2010-01-27 | Конинклейке Филипс Электроникс Н.В. (Nl) | DEVICE FOR MONITORING FREQUENCY OF HEART CONTRACTIONS AND / OR CHANGE OF FREQUENCY OF HEART CONTRACTIONS OF A HUMAN WATCHES CONTAINING SUCH DEVICE |
US20070142715A1 (en) | 2005-12-20 | 2007-06-21 | Triage Wireless, Inc. | Chest strap for measuring vital signs |
US8050774B2 (en) | 2005-12-22 | 2011-11-01 | Boston Scientific Scimed, Inc. | Electrode apparatus, systems and methods |
TWI311067B (en) | 2005-12-27 | 2009-06-21 | Ind Tech Res Inst | Method and apparatus of interactive gaming with emotion perception ability |
US20070162089A1 (en) | 2006-01-09 | 2007-07-12 | Transoma Medical, Inc. | Cross-band communications in an implantable device |
US20070172424A1 (en) | 2006-01-26 | 2007-07-26 | Mark Costin Roser | Enabling drug adherence through closed loop monitoring & communication |
WO2007092543A2 (en) | 2006-02-06 | 2007-08-16 | The Board Of Trustees Of The Leland Stanford Junior University | Non-invasive cardiac monitor and methods of using continuously recorded cardiac data |
US20070255184A1 (en) | 2006-02-10 | 2007-11-01 | Adnan Shennib | Disposable labor detection patch |
US20090177145A1 (en) * | 2006-02-28 | 2009-07-09 | Malin Ohlander | Medical device and method for monitoring hematocrit and svo2 |
JP4921491B2 (en) * | 2006-03-02 | 2012-04-25 | コーニンクレッカ フィリップス エレクトロニクス エヌ ヴィ | Body parameter detection |
US7668588B2 (en) | 2006-03-03 | 2010-02-23 | PhysioWave, Inc. | Dual-mode physiologic monitoring systems and methods |
US8200320B2 (en) | 2006-03-03 | 2012-06-12 | PhysioWave, Inc. | Integrated physiologic monitoring systems and methods |
US20090030292A1 (en) | 2006-03-10 | 2009-01-29 | Daniel Bartnik | Cardiography system and method using automated recognition of hemodynamic parameters and waveform attributes |
DE102006015291B4 (en) | 2006-04-01 | 2015-10-29 | Drägerwerk AG & Co. KGaA | Procedure for setting a patient monitor |
US8936629B2 (en) | 2006-04-12 | 2015-01-20 | Invention Science Fund I Llc | Autofluorescent imaging and target ablation |
US7359837B2 (en) | 2006-04-27 | 2008-04-15 | Medtronic, Inc. | Peak data retention of signal data in an implantable medical device |
US7818050B2 (en) | 2006-05-02 | 2010-10-19 | Lono Medical Systems, Llc | Passive phonography heart monitor |
US7616980B2 (en) | 2006-05-08 | 2009-11-10 | Tyco Healthcare Group Lp | Radial electrode array |
US8005543B2 (en) * | 2006-05-08 | 2011-08-23 | Cardiac Pacemakers, Inc. | Heart failure management system |
US7539533B2 (en) | 2006-05-16 | 2009-05-26 | Bao Tran | Mesh network monitoring appliance |
US20070282173A1 (en) | 2006-05-31 | 2007-12-06 | Bily Wang | Vital sign sending method and a sending apparatus thereof |
US7346380B2 (en) | 2006-06-16 | 2008-03-18 | Axelgaard Manufacturing Co., Ltd. | Medical electrode |
US7749164B2 (en) | 2006-06-28 | 2010-07-06 | The General Electric Company | System and method for the processing of alarm and communication information in centralized patient monitoring |
US8700143B2 (en) | 2006-07-28 | 2014-04-15 | Medtronic, Inc. | Adaptations to optivol alert algorithm |
WO2008017042A1 (en) * | 2006-08-03 | 2008-02-07 | Microchips, Inc. | Cardiac biosensor devices and methods |
US9773060B2 (en) | 2006-09-05 | 2017-09-26 | Cardiac Pacemaker, Inc. | System and method for providing automatic setup of a remote patient care environment |
US20080091089A1 (en) | 2006-10-12 | 2008-04-17 | Kenneth Shane Guillory | Single use, self-contained surface physiological monitor |
US9619621B2 (en) | 2006-10-24 | 2017-04-11 | Kent Dicks | Systems and methods for medical data interchange via remote command execution |
US8449469B2 (en) | 2006-11-10 | 2013-05-28 | Sotera Wireless, Inc. | Two-part patch sensor for monitoring vital signs |
US20080120784A1 (en) | 2006-11-28 | 2008-05-29 | General Electric Company | Smart bed system and apparatus |
US8157730B2 (en) | 2006-12-19 | 2012-04-17 | Valencell, Inc. | Physiological and environmental monitoring systems and methods |
US20080171929A1 (en) | 2007-01-11 | 2008-07-17 | Katims Jefferson J | Method for standardizing spacing between electrodes, and medical tape electrodes |
US20080294020A1 (en) | 2007-01-25 | 2008-11-27 | Demetrios Sapounas | System and method for physlological data readings, transmission and presentation |
US20090017910A1 (en) | 2007-06-22 | 2009-01-15 | Broadcom Corporation | Position and motion tracking of an object |
US9044136B2 (en) | 2007-02-16 | 2015-06-02 | Cim Technology Inc. | Wearable mini-size intelligent healthcare system |
US20080221399A1 (en) | 2007-03-05 | 2008-09-11 | Triage Wireless, Inc. | Monitor for measuring vital signs and rendering video images |
US20080220865A1 (en) | 2007-03-06 | 2008-09-11 | Wei Hsu | Interactive playstation controller |
EP2063771A1 (en) * | 2007-03-09 | 2009-06-03 | Proteus Biomedical, Inc. | In-body device having a deployable antenna |
US20080287752A1 (en) | 2007-05-10 | 2008-11-20 | Mayo Foundation For Medical Education And Research | Ear canal physiological parameter monitoring system |
US7884727B2 (en) | 2007-05-24 | 2011-02-08 | Bao Tran | Wireless occupancy and day-light sensing |
TW200846061A (en) | 2007-05-25 | 2008-12-01 | Asustek Comp Inc | Game controller |
US9754078B2 (en) | 2007-06-21 | 2017-09-05 | Immersion Corporation | Haptic health feedback monitoring |
US9380966B2 (en) | 2007-06-22 | 2016-07-05 | Vioptix, Inc. | Tissue retractor oximeter |
US20090005016A1 (en) | 2007-06-29 | 2009-01-01 | Betty Eng | Apparatus and method to maintain a continuous connection of a cellular device and a sensor network |
US20090018456A1 (en) | 2007-07-11 | 2009-01-15 | Chin-Yeh Hung | Display storage apparatus capable of detecting a pulse |
US8926509B2 (en) | 2007-08-24 | 2015-01-06 | Hmicro, Inc. | Wireless physiological sensor patches and systems |
US20090062670A1 (en) | 2007-08-30 | 2009-03-05 | Gary James Sterling | Heart monitoring body patch and system |
US20090076349A1 (en) | 2007-09-14 | 2009-03-19 | Corventis, Inc. | Adherent Multi-Sensor Device with Implantable Device Communication Capabilities |
US8460189B2 (en) | 2007-09-14 | 2013-06-11 | Corventis, Inc. | Adherent cardiac monitor with advanced sensing capabilities |
WO2009036319A1 (en) | 2007-09-14 | 2009-03-19 | Corventis, Inc. | Adherent emergency patient monitor |
US20090076343A1 (en) | 2007-09-14 | 2009-03-19 | Corventis, Inc. | Energy Management for Adherent Patient Monitor |
US8591430B2 (en) | 2007-09-14 | 2013-11-26 | Corventis, Inc. | Adherent device for respiratory monitoring |
US20090076341A1 (en) | 2007-09-14 | 2009-03-19 | Corventis, Inc. | Adherent Athletic Monitor |
WO2009036348A1 (en) | 2007-09-14 | 2009-03-19 | Corventis, Inc. | Medical device automatic start-up upon contact to patient tissue |
US8790257B2 (en) | 2007-09-14 | 2014-07-29 | Corventis, Inc. | Multi-sensor patient monitor to detect impending cardiac decompensation |
US20090076345A1 (en) | 2007-09-14 | 2009-03-19 | Corventis, Inc. | Adherent Device with Multiple Physiological Sensors |
US20090076342A1 (en) | 2007-09-14 | 2009-03-19 | Corventis, Inc. | Adherent Multi-Sensor Device with Empathic Monitoring |
US9186089B2 (en) | 2007-09-14 | 2015-11-17 | Medtronic Monitoring, Inc. | Injectable physiological monitoring system |
WO2009036321A1 (en) | 2007-09-14 | 2009-03-19 | Corventis, Inc. | Adherent device for cardiac rhythm management |
US8057486B2 (en) * | 2007-09-18 | 2011-11-15 | Bioness Inc. | Apparatus and method for inserting implants into the body |
US20090204180A1 (en) * | 2008-02-13 | 2009-08-13 | Daniel Gelbart | System for implanting a microstimulator |
EP2257216B1 (en) | 2008-03-12 | 2021-04-28 | Medtronic Monitoring, Inc. | Heart failure decompensation prediction based on cardiac rhythm |
CN101977543B (en) | 2008-03-19 | 2013-05-22 | 艾利森电话股份有限公司 | NFC communications for implanted medical data acquisition devices |
US20090292194A1 (en) | 2008-05-23 | 2009-11-26 | Corventis, Inc. | Chiropractic Care Management Systems and Methods |
US20100191310A1 (en) | 2008-07-29 | 2010-07-29 | Corventis, Inc. | Communication-Anchor Loop For Injectable Device |
WO2010025144A1 (en) | 2008-08-29 | 2010-03-04 | Corventis, Inc. | Method and apparatus for acute cardiac monitoring |
WO2011050283A2 (en) | 2009-10-22 | 2011-04-28 | Corventis, Inc. | Remote detection and monitoring of functional chronotropic incompetence |
US9451897B2 (en) | 2009-12-14 | 2016-09-27 | Medtronic Monitoring, Inc. | Body adherent patch with electronics for physiologic monitoring |
US8965498B2 (en) | 2010-04-05 | 2015-02-24 | Corventis, Inc. | Method and apparatus for personalized physiologic parameters |
US8774944B2 (en) * | 2010-06-25 | 2014-07-08 | Advanced Bionics Ag | Tools, systems, and methods for inserting an electrode array portion of a lead into a bodily orifice |
-
2008
- 2008-09-12 US US12/209,479 patent/US9186089B2/en not_active Expired - Fee Related
- 2008-09-12 WO PCT/US2008/076146 patent/WO2009036256A1/en active Application Filing
- 2008-09-12 US US12/209,430 patent/US8684925B2/en active Active
-
2014
- 2014-03-18 US US14/218,594 patent/US10405809B2/en active Active
-
2015
- 2015-10-23 US US14/921,827 patent/US9538960B2/en active Active
Patent Citations (6)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4451254A (en) * | 1982-03-15 | 1984-05-29 | Eli Lilly And Company | Implant system |
US5564434A (en) * | 1995-02-27 | 1996-10-15 | Medtronic, Inc. | Implantable capacitive absolute pressure and temperature sensor |
US20050070768A1 (en) * | 2003-09-30 | 2005-03-31 | Qingsheng Zhu | Sensors having protective eluting coating and method therefor |
US20060241701A1 (en) * | 2005-04-26 | 2006-10-26 | Markowitz H T | Remotely enabled pacemaker and implantable subcutaneous cardioverter/defibrillator system |
US20060271116A1 (en) * | 2005-05-24 | 2006-11-30 | Cardiac Pacemakers, Inc. | Prediction of thoracic fluid accumulation |
US20070142732A1 (en) * | 2005-12-20 | 2007-06-21 | Marina Brockway | Detection of heart failure decompensation based on cumulative changes in sensor signals |
Cited By (7)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US8463361B2 (en) | 2007-05-24 | 2013-06-11 | Lifewave, Inc. | System and method for non-invasive instantaneous and continuous measurement of cardiac chamber volume |
US9002427B2 (en) | 2009-03-30 | 2015-04-07 | Lifewave Biomedical, Inc. | Apparatus and method for continuous noninvasive measurement of respiratory function and events |
US9078582B2 (en) | 2009-04-22 | 2015-07-14 | Lifewave Biomedical, Inc. | Fetal monitoring device and methods |
US9241638B2 (en) | 2012-05-04 | 2016-01-26 | Pacesetter, Inc. | System and method for implanting a physiologic sensor assembly |
US8996110B2 (en) | 2012-06-29 | 2015-03-31 | Pacesetter, Inc. | System and method for determining cause of irregularity within physiologic data |
CN113692249A (en) * | 2019-03-07 | 2021-11-23 | 普罗赛普特生物机器人公司 | Implant for continuous patient monitoring and smart therapy |
EP3934535A4 (en) * | 2019-03-07 | 2022-11-02 | PROCEPT BioRobotics Corporation | Implant for continuous patient monitoring and intelligent treatment |
Also Published As
Publication number | Publication date |
---|---|
US9538960B2 (en) | 2017-01-10 |
US9186089B2 (en) | 2015-11-17 |
US10405809B2 (en) | 2019-09-10 |
US20160045169A1 (en) | 2016-02-18 |
US20090076348A1 (en) | 2009-03-19 |
US8684925B2 (en) | 2014-04-01 |
US20140323821A1 (en) | 2014-10-30 |
US20090076401A1 (en) | 2009-03-19 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
US9538960B2 (en) | Injectable physiological monitoring system | |
US8112149B2 (en) | System and method for heart and activity monitoring | |
US20090076349A1 (en) | Adherent Multi-Sensor Device with Implantable Device Communication Capabilities | |
US20090076342A1 (en) | Adherent Multi-Sensor Device with Empathic Monitoring | |
US20090076346A1 (en) | Tracking and Security for Adherent Patient Monitor | |
US7483743B2 (en) | System for detecting, diagnosing, and treating cardiovascular disease | |
US8160702B2 (en) | Method for digital cardiac rhythm management | |
US20060149324A1 (en) | Cardiac rhythm management with interchangeable components | |
US20070129769A1 (en) | Wearable ambulatory data recorder | |
US20060149330A1 (en) | Digitally controlled cardiac rhythm management | |
US20120046528A1 (en) | System and method for detecting and treating cardiovascular disease | |
US20210093220A1 (en) | Determining health condition statuses using subcutaneous impedance measurements | |
US20210093253A1 (en) | Determining heart condition statuses using subcutaneous impedance measurements | |
US11911177B2 (en) | Determining an efficacy of a treatment program | |
US20090137890A1 (en) | Devices to monitor glucose levels and ischemia | |
EP4059425B1 (en) | Detection and/or prediction of a medical condition using atrial fibrillation and glucose measurements |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
121 | Ep: the epo has been informed by wipo that ep was designated in this application |
Ref document number: 08829991 Country of ref document: EP Kind code of ref document: A1 |
|
NENP | Non-entry into the national phase |
Ref country code: DE |
|
122 | Ep: pct application non-entry in european phase |
Ref document number: 08829991 Country of ref document: EP Kind code of ref document: A1 |