US20050137480A1 - Remote control of implantable device through medical implant communication service band - Google Patents
Remote control of implantable device through medical implant communication service band Download PDFInfo
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- US20050137480A1 US20050137480A1 US11/007,046 US704604A US2005137480A1 US 20050137480 A1 US20050137480 A1 US 20050137480A1 US 704604 A US704604 A US 704604A US 2005137480 A1 US2005137480 A1 US 2005137480A1
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- 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
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- 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
- A61B5/05—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
- A61B5/0537—Measuring body composition by impedance, e.g. tissue hydration or fat content
-
- 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
- A61B5/316—Modalities, i.e. specific diagnostic methods
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- 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
- A61N1/362—Heart stimulators
- A61N1/3627—Heart stimulators for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy
-
- 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
- A61B2560/0266—Operational features for monitoring or limiting apparatus function
- A61B2560/0271—Operational features for monitoring or limiting apparatus function using a remote monitoring unit
-
- 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
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/08—Detecting, measuring or recording devices for evaluating the respiratory organs
- A61B5/0809—Detecting, measuring or recording devices for evaluating the respiratory organs by impedance pneumography
-
- 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
- A61N1/362—Heart stimulators
- A61N1/365—Heart stimulators controlled by a physiological parameter, e.g. heart potential
- A61N1/36514—Heart stimulators controlled by a physiological parameter, e.g. heart potential controlled by a physiological quantity other than heart potential, e.g. blood pressure
- A61N1/36521—Heart stimulators controlled by a physiological parameter, e.g. heart potential controlled by a physiological quantity other than heart potential, e.g. blood pressure the parameter being derived from measurement of an electrical impedance
Definitions
- This invention relates to electronic medical devices that are implanted in the body of a patient. More particularly, it relates to a congestive heart failure monitor for detecting and monitoring the progression of congestive heart failure and the method of remote control and communication with the device.
- CHF congestive heart failure
- the left heart fails while the pumping function of the right heart remains adequate, because the latter has only about 20% of the workload of the former.
- CHF congestive heart failure
- Increased fluid in the stomach and intestines reduce their ability to absorb drugs prescribed for treatment of CHF, particularly diuretics.
- the congestion is often accompanied by a worsening of myocardial function, with consequent drop in blood pressure and reduced renal perfusion, which only further aggravates the congestive situation.
- late recognition of congestion leads to increased dosages of oral diuretics that are unsuccessful to treat the condition, ultimately requiring that the patient be hospitalized.
- the ApexPro FH enhances patient safety by using a bi-directional, frequency-hopping infrastructure to help ensure that patient data is transmitted clearly and completely to a central patient monitoring station. While this system is based on external data and provided by GE Healthcare using a Unity Network, the use of the medical implant communication service band is not part of the system nor is an implantable device considered to be part of the communication system. This system relies rather on data external to the patient.
- this invention senses a trans-thoracic impedance as well as patient posture and correlates changes in posture with trans-thoracic impedance in order to assess the degree of congestive heart failure.
- the Device for Detecting Pericardial Effusion, Godie et al., U.S. Pat. No. 6,351,667 describes an apparatus for detecting pericardial effusion that includes a measurement apparatus connected to a wire probe to be anchored to the right heart ventricle and two other wire probes to measure the impedance between different probes in order to assess the degree of pericardial effusion.
- the implantable medical device of the present invention may be of size smaller than a typical pacemaker device—about the size of a thumb. It may be implanted in a subcutaneous pocket formed by a surgeon in the patient's chest, under local anesthesia and minimally invasive requirements.
- the device includes a hermetically sealed can with appropriate electronic circuitry inside.
- a set of device-mounted electrodes may be used to measure the impedance of the adjacent tissue and most especially the lung tissue. The progressive retention of fluid in the lungs and congestion of the ventricle together result in a reduced resistance measurement that is monitored either continuously or periodically by the device.
- the device alerts the patient and/or the attending physician when a diagnostic threshold is reached which is indicative of the progression of CHF.
- a diagnostic threshold is reached which is indicative of the progression of CHF.
- the overall architecture of the device follows implantable practice, however, it should be appreciated that the partitioning of the device is flexible and the division of sensing and analysis structures can be shared between implanted and external (remote, i.e., non-implanted) devices.
- a low-power radio transceiver operating in the Medical Implant Communications Service (MICS) band can be use for linking the device to a proximate base station.
- the base station can communicate with one or more remote locations via telecommunications or wideband networks to permit monitoring patient data and programming the device remotely.
- the Medical Implant Communications Service is an ultra-low power, unlicensed, mobile radio service for transmitting data in support of diagnostic or therapeutic functions associated with implanted medical devices.
- the MICS permits individuals and medical practitioners to utilize ultra-low power medical implant devices, such as CHF monitors, cardiac pacemakers and defibrillators, without causing interference to other users of the electromagnetic radio spectrum. No licensing is required, but MICS equipment is intended for operation only by healthcare professionals.
- Signal processing may be performed entirely internally within the device, or the device may operate as a data logger and communicate with an external base station which participates in data reduction and analysis.
- the electrode set used to determine the impedance of the lungs could be used for additional purposes.
- a congestive heart failure monitoring device a cardiac pacemaker, defibrillator, neurostimulator, muscle stimulator, gastric stimulator, or diagnostic implantable device for monitoring a variety of physiologic body functions such as CO 2 , blood pressure, oxygen, glucose, ventilation, heart rate, activity, posture, hormones, cytokines, or neurofunctions.
- FIG. 1 is an exterior view of an embodiment of the device
- FIG. 2 is a schematic representation of an implantation of the device in the body of a patient
- FIG. 3 is a block diagram of the internal circuitry of the device
- FIG. 4 is a flow chart illustrating the operation of the device
- FIG. 5 is a graph of the device operation in terms of the reciprocal of impedance versus time
- FIG. 6 is a schematic drawing of a system comprising an implanted device in a patient's body and a proximate base station having links to various telecommunication facilities;
- FIG. 7A is a block diagram of one embodiment of a base station according to the present invention.
- FIG. 7B is a block diagram of an alternative embodiment having a dedicated microcontroller integrating the functions of 210 , 211 , 212 , and 213 in FIG. 8 ;
- FIG. 8 is a block diagram of system operation through a base/repeater station, a data handling and coordinating center and a local patient care physician center;
- FIG. 9 is a block diagram of another exemplary embodiment of the invention.
- FIG. 10 illustrates the advanced processing and analysis of information derived from patients' history, physical examination, current medication, patient related parameters and the actual and/or previous data received from a patient implant device such as a heart failure monitor, ECG monitor, activity sensor, pacemaker, defibrillator or other diagnostic or therapeutic electronic implant in the patient's body.
- a patient implant device such as a heart failure monitor, ECG monitor, activity sensor, pacemaker, defibrillator or other diagnostic or therapeutic electronic implant in the patient's body.
- the data from the implant device may be analyzed, evaluated and/or commented in light of evidence-based medicine by using input from the library with medical publications, drug action and adverse effects, medical guidelines in order to provide a specific patient tailored recommendation.
- the device of the preferred embodiment of the invention is disclosed in the preferred implementation as being a stand-alone diagnostic device to simplify the description of its operation.
- identical reference numerals indicate identical structure. Views of the device either alone or as implanted are not intended to represent actual or relative sizes.
- FIG. 1 illustrates the exterior of the device 18 in its presently preferred embodiment.
- Device 18 includes a circuit module (to be discussed below in conjunction with the description of FIG. 3 ) within a hermetically sealed “can” or case 24 composed, for example, of titanium.
- the size of the case 24 is clearly dictated by the size of the internal circuit components and wiring included printed circuit board(s) and other forms, but preferably is very small, currently about 5.0 cm long by 2.0 cm wide by less than 1.0 cm thick.
- Case 24 is a standard rectangular case with rounded edges and a header of epoxy resin on top (not shown in FIG. 1 ).
- Case 24 has a curvilinear shape which presents a concave shape or surface 26 on one side (in contrast to an edge of the case) and a convex shape on the opposite side of the case.
- Four surface mounted electrodes 10 , 12 , 14 and 16 are positioned in spaced-apart relationship on the slightly concave surface 26 , with each electrode being electrically insulated from the case 24 itself.
- the electrodes should be of low polarization, preferably composed of or coated with iridium oxide.
- “inner” electrodes 10 and 12 are spaced apart on the concave side inward of opposite edges and centrally along the length of the case, while “outer” electrodes 14 and 16 are spaced farther apart—preferably, by at least about 4 cm—on that same side inward of opposite edges and centrally along the width of the case.
- the shape of the case is designed (and preferred) to conform to the shape of the anatomy of the human chest. With the concave side of the case placed toward the interior of the body within the implant site of device 18 , the device is prevented from turning within its subcutaneous pocket which would otherwise position the surface electrodes at the wrong side—namely, toward the exterior of the patient's body. The reason for this positioning will become apparent as the description proceeds.
- FIG. 2 illustrates in schematic form a side view of a patient (in phantom) with the device 18 implanted in a pectoral of the chest over the basal region of lungs 28 and heart 30 , outside the rib cage 32 .
- An implantation at the preferred site places the device on the left anterior thorax side between the 5th and 6th intercostals space.
- an impedance signal is developed which represents the impedance of the lungs and heart tissue by virtue of current injected into the circuit path that establishes a field through that portion of the body from device 18 .
- FIG. 3 illustrates the exemplary circuit module within device 18 .
- An impedance signal generator 40 injects signal current into the body, preferably through “inner” electrodes 10 and 12 . The current traverses the circuit path through the body portion of interest and has a return path through “outer” electrodes 14 and 16 .
- Field lines 38 FIG. 2 ) attributable to current flowing from the electrodes emanate from the concave side 26 of device 18 , and, together with the electrode spacing, define the “viewing volume” of the device for the impedance sensing circuitry. Electrode spacing of at least four cm between the outer electrodes 14 , 16 will allow a measurement to a depth of up to 10 cm of lung tissue in the anterior lateral lower left thorax.
- the field lines produced by current through the circuit path intersect the lung tissue 28 and are somewhat less influenced by the volume of the heart 30 .
- the circuit module within device 18 is powered by a preferably lithium-ion battery 50 .
- Impedance generator 40 is controlled by microprocessor 48 , as is logic 42 for analysis and memory 44 for data. Measured values of impedance are stored in memory 44 , and used by microprocessor 48 to calculate various functions of the measured impedance values.
- a threshold detector 46 may be incorporated in device 18 as a patient alert function or alarm (e.g., by emitting an acoustic signal, vibrations, or low level pulses for local muscle contractions, recognizable by the patient) indicative of a need for immediate intervention when impedance associated with fluid level 64 , for example, is detected.
- Such an alarm condition may also be signaled by telemetry from an antenna or coil 58 within the circuit module at the microprocessor, normally used to transmit the other impedance data, to a remote programmer 56 to monitor and log the progress of the disease and the therapeutic effect of treatment for review by the patient's physician.
- the device is adapted to monitor impedance at a digital rate of 128 Hz, for partitioned analysis of contractile cardiac function, pulmonary ventilation function and long term pulmonary impedance, over an average of 72 hours or more.
- Signal processing allows deviation from basic impedance of the body region of interest, especially the lungs, to be detected as an early monitoring of a decrease in lung impedance, indicative of increasing congestion by fluid content in the lungs.
- the decrease in lung impedance associated with CHF occurs as the lungs fill with fluid, which is a considerably better electrical conductor than the normal lung tissue.
- Exemplary values of impedance for lung tissue are 400-1,000 ohms per centimeter ( ⁇ /cm), compared with 50 ⁇ /cm for fluid.
- Level 60 represents the relative additional amount of fluid associated with normal lung function.
- Level 62 represents the relative amount of fluid present for a compromised lung function associated with CHF.
- level 64 is the relative still additional amount of fluid associated with severely reduced lung function requiring immediate attention, indicative of advanced CHF.
- the device 18 may be designed to provide a threshold or trigger level at an accumulation of fluid corresponding approximately to level 64 . Algorithms are used to convert real time measurements into a diagnostic indication of congestion. The device may be operated continuously and the impedance data are then analyzed in kind. ECG data may be used additionally, detected at the outer electrodes 14 and 16 to improve the capability of the device to discern impedance changes in the heart.
- FIG. 4 is a flow chart of an exemplary detection algorithm used by the device 18 .
- impedance generator 40 is turned on to inject signal current into the body via the inner pair of electrodes 10 , 12 (start, 70).
- the impedance signal current is preferably a rectangular biphasic pulse wave at a rate of 128 Hz and a peak-to-peak amplitude of 1 milliampere (ma), or, alternatively, an alternating current in a range from 5 microamperes ( ⁇ a) to 10 ⁇ a.
- the pulses may be injected with considerably higher energy content than the AC wave because of their very short duration (e.g., 15 ⁇ sec or less), with no risk of myocardial depolarization, and are capable of detecting cardiac changes as well as pulmonary changes.
- Impedance is then calculated ( 72 ) from a measurement of the resulting voltage at the outer pair of electrodes 14 , 16 .
- a fixed voltage may be applied across the excitation (inner) electrodes and the resulting current measured at the measurement (outer) electrodes reflects the impedance.
- a long-term average of the impedance value is computed ( 74 ), covering a period ranging from days to weeks as a running average.
- a short-term average of the impedance value is also computed ( 76 ), covering a period from hours to days.
- the difference between the long-term (LT) and short-term (ST) averages is calculated ( 78 ) as a slope measurement (V) indicative of deterioration of the lung condition, to detect accelerating lung congestion.
- V exceeds a predetermined threshold (slope) value ( 80 )
- an alarm condition is indicated and the patient alert function ( 46 , FIG. 3 ) is initiated. In either case (an alarm condition or not), another impedance measurement is performed ( 72 ) and the processing cycle is repeated.
- FIG. 5 is a graph of the device operation using the exemplary detection algorithm represented by the flow chart of FIG. 4 .
- the vertical axis 90 is conductance, the reciprocal of impedance (1/Z). Therefore, the greater the lung congestion (i.e., the larger the fluid volume in the patient's lungs), the lower the value of the term 1/Z.
- the horizontal axis 92 represents time.
- the long-term average of the impedance measurement has a characteristic value that filters out the short-term variations of the measurement.
- impedance measurements at the frequency of 128 Hz can detect impedance changes with every pumping cycle, to provide indirect information on stroke volume, heart rate, and cardiac output calculated therefrom. Additionally, by adequate low pass filtering, the indirect tidal volume of ventilation can be separated out, as well as respiratory rate. Typically, ventilation is in a range from 0.2 Hz to 0.8 Hz, while cardiac events are in a range from 1 Hz to 3 Hz. Both subsignals, cardiac and ventilation, are used in addition to determine congestive heart failure indicated by increase in stroke volume, decrease in tidal volume, increase in heart rate, and increase in ventilation rate.
- a power saving can be achieved in the device by limiting the impedance measurement to fixed periods separated by intervals of no measurement, or even sporadic measurements, rather than performing continuous impedance measurements.
- the impedance measurement electrodes may be used to monitor the patient's ECG, as well as to obtain the raw data necessary for calculating absolute impedance and long-and short-term averages of impedance. Also, the cardiac- and ventilation-derived impedance phenomena may be correlated to the ECG for better evaluation. In addition, a miniaturized accelerometer within the case might give valuable information with regard to the daily and comparative physical activity of the patient.
- the spacing between the measurement electrodes 14 , 16 determines the volume and area of measurement. By spacing these electrodes at least 4 cm apart, the depth of measurement is increased beyond only the tissue in the immediate vicinity of the electrode, to the tissue for which specific impedance and impedance changes are sought to be measured, typically to a depth of up to 10 cm of lung tissue. Also, performing the measurements on the patient's left side rather than the right side, and particularly on the anterior lateral lower left thorax, enables early detection of changes in left ventricular parameters and congestion in the lung circulatory system, rather than limiting the measurement to tissue and liver impedance which is primarily a function of congestion of the right heart. Additionally, at this preferred location for conducting the measurements, the cardiac phenomena and stroke volume dependent impedance changes are more easily detected than on the right side or the upper left thorax where impedance changes primarily follow blood circulation.
- implanted devices such as the CHF monitor described above, pacemakers, defibrillators and medicine delivery pumps may communicate in real time or near real time with health professionals at a remote location.
- This communication can be facilitated by means of a repeater—a device for receiving electronic communication signals and delivering corresponding amplified ones.
- a repeater a device for receiving electronic communication signals and delivering corresponding amplified ones.
- a base station which may additionally process data received via such electronic communication signals prior to forwarding the data to a remote location.
- the 402-405 MHz frequency band is available for MICS operations on a shared, secondary basis.
- the FCC determined that, compared to other available frequencies, the 402-405 MHz frequency band best meets the technical requirements of the MICS for a number of reasons.
- the 402-405 MHz frequencies have propagation characteristics conducive to the transmission of radio signals within the human body.
- equipment designed to operate in the 402-405 MHz band can fully satisfy the requirements of the MICS with respect to size, power, antenna performance, and receiver design.
- the use of the 402-405 MHz band for the MICS is compatible with international frequency allocations.
- the U.S. Federal Communications Commission has determined that the use of the 402-405 MHz frequency band for the MICS does not pose a significant risk of interference to other radio operations in that band.
- the 402- to 405-MHz band is well suited for in-body communications networks, due to signal propagation characteristics in the human body, compatibility with the incumbent users of the band (meteorological aids, such as weather balloons), and its international availability.
- the MICS standard allows 10 channels of 300 kHz each and limits the output power to 25 microwatts.
- MICS multi-speed, longer-range wireless link between an implanted device and a base station.
- a base station can establish a high-speed, longer-range (typically 2 to 20 meters) wireless link between an implanted device and a base station.
- an ultra low-power RF transceiver in a CHF monitor can wirelessly send patient health and device operating data to a bedside RF transceiver and vice versa. Data can then be forwarded from the base station via telephone land line, wireless cell phone communication, or the Internet to a doctor.
- Advanced ultra low-power RF technology will dramatically improve the quality of life for patients with implanted medical devices.
- doctors can remotely monitor the health of patients and wirelessly adjust the performance of the implanted device. This means fewer unnecessary hospital visits for the patient. Instead, with remote monitoring the doctor can call the patient in to the hospital when a problem is detected.
- An implantable device such as a CHF monitor may be paired with a base station or repeater and linked by MICS transceivers.
- data from the monitor may be downloaded to the base station for data processing and analysis using higher performance data processing equipment (which typically has higher power consumption than lower performance processors).
- the base station may provide a communication interface to telecommunications networks such as the Public Switched Telephone Network (PSTN), computer networks including the Internet, and radio-based systems including cellular telephone networks, satellite phone systems and paging systems.
- PSTN Public Switched Telephone Network
- computer networks including the Internet
- radio-based systems including cellular telephone networks, satellite phone systems and paging systems.
- Such telecommunications can be used to send data to medical professionals who may use it to make treatment decisions including hospitalization, pharmaceutical dosage and/or measurement parameters of the implanted device. For example, if an increase in congestion is noted, more frequent measurements of impedance by the implanted device may be ordered by a physician via a return communications link.
- a representative system is shown schematically in FIG. 6 .
- a device 18 is implanted in patient P.
- Device 18 includes a short-range radio transceiver which utilizes the Medical Implant Communication Service.
- a corresponding transceiver in base station 100 receives data from device 18 , processes and/or stores the data and sends it to a remote location using one or more of the Public Switched Telephone Network T, computer network I, and radio communications system R.
- Computer network I may be a local area network (LAN), wide area network (WAN), an intranet or the Internet.
- Radio communications system R may, in certain embodiments, be a cellular telephone system, the PCS system, a satellite phone system, a pager system or a two-way radio link.
- the link between the implanted device 18 and base station 100 may be a one-way link.
- implanted device 18 may have a MICS transmitter (cf. transceiver) and base station 100 may have only a MICS receiver (cf. transceiver).
- FIG. 7A is a block diagram of an exemplary base station or repeater 100 .
- a power supply 102 may rectify and covert ac line voltage to dc at the voltage level(s) required by the various subsystems within the base station.
- power supply 102 may include an uninterruptible power supply (UPS) or battery 102 for operation during utility power interruptions or to permit brief operation of the base station at locations without external power.
- Power supply 102 may use an external wall transformer to deliver 9 or 12 volts DC to the system.
- An internal DC-DC converter may be used to step the voltage down to 3.3V (digital supply) and 5V (analog supply & radio(s) supply).
- An internal DC-DC converter may help to reduce noise (60 Hz line noise, etc). This would help the SNR (Signal to Noise Ratio) of both the wireless data radio modem, and the medical band radio—improving the range and efficiency of both.
- Optional battery 103 can allow device operation for an extended period of time in the event of power interruption.
- a 6 Ah @ 6V battery could provide several days, if not a week of uninterrupted operation in the event of power failure.
- a lightweight battery can be used in a portable embodiment (for example, a 1000-1800 mAh lithium-ion battery could provide several days of portable operation).
- Processor 104 may be a microprocessor or similar programmed system for implementing the methods of the system and controlling the various subsystems comprising base station 100 .
- base station 100 one particularly significant advantage of base station 100 is its ability to use a powerful processor 104 whose electrical power consumption would be prohibitive for use within a battery-operated, energy sensitive implanted device such as CHF monitor 18 .
- Microcontroller 104 may be a simple ⁇ fraction (8/16) ⁇ bit microcontroller.
- Attached EEPROM 106 may be used for code/firmware storage, or additionally used as a temporary storage location for cardiac data in the even that a network connection is not immediately available.
- Attached RAM 108 may be used for code execution/scratchpad, or additionally used as a data buffer for cardiac data during transmit or receive.
- base station 100 may include display or alarms (not shown) for displaying operational data and/or alerting the patient or caregiver of parameters which exceed defined limits.
- base station or repeater 100 may include MICS transceiver 118 and antenna 120 .
- Electrically small antennas are generally considered to be those with major dimensions less than 0.05 lambda, or in the MICS band, 37 mm.
- the corresponding antenna with which the base station or repeater 100 communicates may be folded within the case of device 18 .
- the antenna may be outside of the device 18 and encased in epoxy resin or other bio-compatible dielectric material. In this way, the usually metal case 24 will not significantly impede RF transmission to and from the antenna of device 18 .
- measuring electrodes for impedance and for EKG might be situated within the epoxy header. By way of doing so, the critical feed-through in the otherwise hermetically sealed case might be better protected.
- the MICS transceiver 118 enables communication with the implantable medical device 18 . It may operate on a different frequency than the GSM bands to avoid interference with radio modem 114 . Interface 118 provides high-speed wireless data communication with the implantable device 18 , within approximately 6 feet.
- a stationary base station 100 could be placed near a bed or other location where the patient could be close enough for data transmission. Similarly, a portable device could be worn by the patient.
- base station 100 may include network interface 116 .
- network interface 116 is an Ethernet Network Interface Card (NIC).
- NIC Ethernet can be used as an alternative connection to the Internet for uploading patient data, in the event that wireless data service is not available or is prohibitively expensive.
- Ethernet interface 116 can also be used for remote management and uploading/upgrading system firmware.
- An optional modem 117 for data transmission using the public switched telephone network may also be incorporated.
- radio modem 114 An alternative data communication interface for base station 100 is radio modem 114 .
- radio modem 114 may be a cellular telephone with a modem, or may operated similarly thereto.
- Radio modem 114 may couple to an antenna 121 which, in some embodiments, may be external to or remote from the main housing of base station 100 .
- the specific design of the antenna depends on the particular band used, but in any event could conform with GSM 900, 850, 1900, or 1880 standard.
- Use of a dedicated GSM/GPRS radio modem 114 can reduce system complexity, as this would require only a power supply and a data connection to the system. This reduces overall system complexity.
- Data may be transmitted to the Internet using GPRS (General Packet Radio Service) over the GSM band.
- GPRS General Packet Radio Service
- a quad-band (or tri-band) GSM/GPRS RF (Radio Frequency) transceiver can be used instead of a self-contained radio modem.
- GPRS RF Radio Frequency
- a different cellular data service such as X.25 or Cellular Digital Packet Data (CDPD) can be used.
- CDPD Cellular Digital Packet Data
- One preferred embodiment uses a RIM 902M Radio Modem operating in the GSM 900 band.
- RIM's proprietary Radio Access Protocol could be used to communicate with the modem 114 in this example.
- a different protocol such as RS-232, may be used.
- a custom interface could be defined, for example using memory-mapped I/O, or simply the GPIO (General Purpose I/O) pins on the controller to communicate with and control the radio.
- GPIO General Purpose I/O
- SIM Card 110 is a Subscriber Identity Module that identifies a particular user of a GSM network. SIM card 110 could be keyed to a Patient ID, for example, for billing purposes. Patient ID could be encrypted and sent separately along with patient data.
- base station 100 may be in data communication with a plurality of implanted devices.
- base station or repeater 100 could receive pacemaker data from an implanted device of a patient such as the disclosed CHF monitor, a pacemaker, a defibrillator, etc. and store such data and transmit it periodically to a doctor's office.
- Such a system would permit, for example, daily monitoring of a patient's condition as opposed to occasional visits to a doctor's office.
- device 18 may generate approximately 16 to 18 megabytes of data per day.
- data could be collected by the base station, parsed, analyzed and/or summarized, and periodically sent to a remote facility (such as a doctor's office) on, for example, a quarterly basis.
- a remote facility such as a doctor's office
- triggering events such as tachycardia or increasing congestion could be used to determine when the base station 100 would open a communications link and send data or alarm signals.
- Base station 100 could be used with other implanted sensors which could monitor, for example, blood glucose level, oxygen saturation, temperature or other metabolic parameters. Such monitoring could be useful in tracking the cardiovascular fitness not only of patients, but also soldiers, athletes and others subjected to physical stress or harsh environments such as special mission pilots or astronauts.
- FIG. 7B shows an alternative embodiment of the base station having an integrated microcontroller which performs several of the function of the separate function disclosed in FIG. 7A .
- FIG. 7A shows an alternative embodiment of the base station having an integrated microcontroller which performs several of the function of the separate function disclosed in FIG. 7A .
- the other system components shown in FIG. 7A have been omitted.
- Implantable device 18 could monitor and record the patient's ECG and other physiological parameters.
- the implantable device has a limited power supply in its on-board battery, and it is desirable to use as little power as possible to maximize the life of the device.
- the implantable device may have internal memory storage capable of buffering or temporarily holding the patient data so it does not need to continuously transmit the patient data.
- Flash memory or low-power SRAM can be used for memory storage. Flash memory does not consume any power once the data has been stored, however the amount of power consumed during program and erase can be significant. An SRAM requires constant power, but the amount of power is small.
- the amount of patient data that is collected per 24-hour period is less than 20 MB.
- a simple, power-efficient loss-less data compression algorithm may reduce that amount even further, perhaps even in half.
- a balance between power used to compress the data and power used to transmit the data is desirable.
- the MICS radio need not continuously transmit patient data.
- the patient data may be collected and stored in the memory storage, and subsequently transferred to the device at predetermined intervals.
- a portable, wearable device could use an hourly schedule.
- a stationary device under normal conditions could upload the data on a daily to weekly schedule.
- FIG. 8 depicts an alternative embodiment of the invention, and specifically shows a device 200 for monitoring CHF implanted in a patient 205 .
- the device 200 has an epoxy header 201 which is on top of medical electronics 202 (e.g., FIG. 3 ) contained in the hermetically sealed case 200 of the device.
- the header contains a pair of outer electrodes 203 and a pair of inner electrodes 204 . Those electrodes are connected through wires 206 which communicate with medical electronic 202 through the feedthrough 207 .
- an antenna 208 is incorporated in the epoxy header for communicating signals in the medical implant communications service bands. An antenna 208 having a length of 1 ⁇ 4 lambda may be used to transmit signals effectively.
- the device communicates with the base station or repeater 210 (similar to base station 100 of FIG. 7A for example) in the proximity of the implant patient 205 .
- the base station 210 which receives the signals from the implant device 200 , can transfer and/or amplify the signals, which in turn can be easily communicated through a wireless local network or a personal area network 211 to the interface of a computer 212 , preferably also in the proximity of the patient. Further connections through Internet lines 213 occur with a data handing and coordinating center 215 for further storage and analysis of this data.
- a repeater 210 communication pathway 211 and communication computer 212 , a single unit 214 as shown in FIGS. 7A and 7B is feasible.
- the data handling and coordination center 215 primarily receives the data either in a continuous manner, in a temporary intermittent manner, or in a predetermined activated manner as dictated by the implant device 200 .
- Signals can be received either as live or stored data, or as preprocessed data, or as data that fulfill certain selection criteria (such as an alarm condition).
- the data transfer occurs intermittently or continuously.
- the transfer of the stored data for one day, for example, can occur at certain fixed time periods (e.g., at night) or when the patient is in the proximity of the local repeater. This proximity is defined dependent on the power output of the device through the medical implant service bandwidth and preferably is kept at a low level to conserve battery life, battery power, and to extend the life of the implant device.
- data is preferably only sent if they fulfill certain criteria.
- the criteria can be incorporated in the logic or programming of the circuitry 202 of the implant device 200 or within similar logic or program of the base station 210 .
- data indicative of an emergency condition can be made to transfer on a priority basis, such as immediately, if sensor data from the device 200 indicates a life threatening condition such as tachycardia or an abnormal slow rate, which in turn could prompt immediate intervention by a physician and/or transfer of the patient to an emergency room.
- the emergency condition can be accompanied by an alert 217 , which can be communicated to both the patient (via links 213 , 212 , 211 , 210 , and 209 ), and to a local patient care physician center 216 .
- the alert may be manifested to the patient from a audible sound, vibration, or some other physical indicator emanating from the device 200 .
- a physician at the center 216 and/or the patient can then establish communication with each other through traditional means (Internet, phone, e-mail, direct physical presence, etc.).
- the doctor may also request additional data from the device, and/or can program the device 200 to perhaps better assist the health of the patient.
- the feedthrough 207 which is the most sensitive point in the hostile environment of the human body, can be protected. Moreover, as well as providing mechanical shielding for the feedthrough 207 , the header 201 provides electrical shielding. Moreover, the header 201 preferably contains the MICS-band antenna 208 , which will suffer less attenuation than were the antenna disposed within the hermetically sealed metallic case 200 of the device. As shown, the same electronic feedthrough 207 is used for both the antenna 208 and the electrodes 203 , 204 , but different feedthroughs may also be used.
- the device electronics 202 can digitize the data accordingly to its signal characteristics. For example, the EKG can be digitized with a sampling frequency of 100 Hz. If this is done, the resulting quantity for one day would roughly constitute 8 to 9 megabytes.
- An activity signal of a miniaturized accelerometer which is also incorporated in the hermetically sealed device and preferably situated on hybrid electronic circuitry 202 can be digitized at a much slower rate in a range of 10 Hz, perhaps amounting to less than 1 megabytes of data per day. For the impedance measurements, as described in the referenced and related applications, another 8 megabytes could be required bringing the daily data amount to roughly 16 to 20 megabytes.
- Modem storage memories incorporatable into the device 200 can easily handle such data, and a memory of 256 mega bits could handle the data for nearly 2 weeks.
- data for a whole host of patient parameters can be stored and periodically transferred, say every other day or week, unless built-in data handling and analysis triggers an earlier transmission of the data (such as during an emergency condition).
- FIG. 9 illustrates another embodiment of the present invention.
- the implant device 200 is comparable to the device described in FIG. 8 .
- communication occurs with a cell phone 221 which acts as a repeater/base station programmed with appropriate logic 220 to perform the function of the base station as discussed above.
- logic 220 can appear within the phone 221 itself, or in a traditional phone socket or cradle.
- Cell phone 221 communicates via an RF interface with the implant device 200 , and further communicates via an RF telephone link 222 to, for example, the Internet 223 , which can comprise one network intervening between the phone 221 and the coordination center 215 , where data is stored and/or analyzed.
- Alerts indicative of emergency conditions can be sent to the patient via the Internet 223 either to the cell phone, or through wireless cell phone communication from the patient care center 216 to cell phone 221 . Further communication of the alert to the patient can then be communicated through radio frequency link 209 to the device 200 .
- the local patent care physician center 216 can alert the patient through communication link 217 , which may be direct access, email, phone calls or physical presence of a person to assist the patient and resolve the current medical situation.
- FIG. 10 illustrates an advanced method of information technology and handling.
- the implant device 200 communicates through the mobile implant communication service band through links as described previously either through wireless, telephone, Internet, or land line telephone with the data handling and coordinating center 215 .
- evaluation of the data from the device 200 may be accomplished as before, but, in addition, other patient specific data like patient history, current medication, age, and other patient relevant information is assessed, as pulled from database 230 .
- analysis can be further assisted via data pulled from a library database 231 of current articles, from a medicine guidelines database containing recommendations for certain patient conditions, and from a drugs and adverse effect database 234 .
- This culmination of data can be used at center 215 to provide, in automated or semi-automated fashion, the best course of action or recommendation for a particular patient.
- This recommendation can be transmitted to the local patient care physician center 216 to allow a better evaluation of what might be done with the patient and what kind of measures could be given. It is up to the physician to communicate this kind of decision and recommendation to the patient including any action such as taking diuretics, new medications, beta blockers, antiarrhythmias, or the recommendation for implant of a brady- or tachyarrhythmia device.
- Implanted devices 200 may be programmed via the base station 210 and its associated data link(s). Such programming could replace the magnetic wand programming of the prior art which typically must be performed in a healthcare facility or doctor's office.
- implanted devices may be reduced in physical size.
- Implanted devices used in conjunction with the base station provide the benefit for allowing store and intermittent transfer of data. Sending data in short bursts not only conserves power (permitting smaller batteries to be used in the devices 200 ), but also reduces the potential time window for interference and provides more forgiving power supply requirements. This is important for implant systems, which frequently use batteries with high impedance.
- This approach also makes the use of a very high data transmission rate attractive for intermittent telemetry applications, such as in pacemakers, as a large capacitor can have its charge mortgaged for the period of the radio transmission, and then recharged at a lower rate. Another fact that points in favor of a high data rate is that the transmission will occur during a shorter time period, making it possible for more users to share the same radio channel.
Abstract
Description
- This application is a continuation-in-part of U.S. patent application Ser. No. 10/622,184, filed Jul. 16, 2003, which is a continuation-in-part of U.S. patent application Ser. No. 10/155,771, filed May 25, 2002, claiming priority of the German Patent Serial No. 101 48 440.2, filed Oct. 1, 2001. These applications are hereby incorporated by reference in their entireties, and priority is claimed to them.
- 1. Field of the Invention
- This invention relates to electronic medical devices that are implanted in the body of a patient. More particularly, it relates to a congestive heart failure monitor for detecting and monitoring the progression of congestive heart failure and the method of remote control and communication with the device.
- 2. Description of the Related Art
- Many patients who have suffered one or more myocardial infarctions subsequently require treatment for congestive heart failure (CHF). The left heart fails while the pumping function of the right heart remains adequate, because the latter has only about 20% of the workload of the former. This leads to an increase in blood volume congested to the lungs, resulting in pulmonary congestion, build up of increased levels of fluid, and congestion of internal organs including the stomach and intestines. Increased fluid in the stomach and intestines reduce their ability to absorb drugs prescribed for treatment of CHF, particularly diuretics. The congestion is often accompanied by a worsening of myocardial function, with consequent drop in blood pressure and reduced renal perfusion, which only further aggravates the congestive situation. Thus, late recognition of congestion leads to increased dosages of oral diuretics that are unsuccessful to treat the condition, ultimately requiring that the patient be hospitalized.
- Avoidance of hospitalization and the pitfalls of late treatment require detection of CHF at an early stage, so that the prescribed drugs can be fully absorbed and effective. If detected early, a combination of diuretics and other drugs can slow the progress of the disease and allow the patient to enjoy an improved lifestyle.
- An extensive review of telemonitoring for the management of heart failure by Louis et al. has been published in the past in the European Journal of Heart Failure. The conclusion of this article is that telemonitoring might have an important role as a strategy for delivery of effective health care for patients with heart failure. However, the current state of the art still lacks an adequate means to monitor the data and to communicate data.
- The ApexPro FH enhances patient safety by using a bi-directional, frequency-hopping infrastructure to help ensure that patient data is transmitted clearly and completely to a central patient monitoring station. While this system is based on external data and provided by GE Healthcare using a Unity Network, the use of the medical implant communication service band is not part of the system nor is an implantable device considered to be part of the communication system. This system relies rather on data external to the patient.
- Several patents have looked into impedance monitoring and data processing and monitoring and diagnosing hypertension or congestive heart failure in patients. Among those is Riff, U.S. Pat. No. 5,876,353 which describes an Impedance Monitor for Discerning Edema through Evaluation of Respiratory Rate. U.S. Pat. No. 5,957,861, Combs et al. and its continuation, U.S. Pat. No. 6,512,949 describes an Implantable Medical Device for Measuring Time Varying Physiologic Conditions Especially Edema and for Responding Thereto. The U.S. Pat. No. 6,104,949, Pitts Crick et al. relates to a device and method used for the diagnosis and treatment of congestive heart failure. Specifically, this invention senses a trans-thoracic impedance as well as patient posture and correlates changes in posture with trans-thoracic impedance in order to assess the degree of congestive heart failure. The Device for Detecting Pericardial Effusion, Godie et al., U.S. Pat. No. 6,351,667 describes an apparatus for detecting pericardial effusion that includes a measurement apparatus connected to a wire probe to be anchored to the right heart ventricle and two other wire probes to measure the impedance between different probes in order to assess the degree of pericardial effusion. U.S. Pat. No. 4,899,758, Finkelstein et al., describes a Method and Apparatus for Monitoring and Diagnosing Hypertension and Congestive Heart Failure, by using C2 and brachial artery pulses to discriminate a threshold of certain Windkessel function. U.S. Pat. No. 6,336,903, Bardy et al. relates to an automatic system and method for diagnosing and monitoring congestive heart failure and outcomes thereof. A plurality of monitoring sets are retrieved from a database and each patient's status change is tested against an indicator threshold corresponding to the same type of patient information as the recorded measures to which it was compared. The indicated threshold corresponds to a quantifiable physiological measure of a pathophysiology indicative of congestive heart failure. U.S. Pat. No. 6,416,471, Kumar et al., describes a Portable Remote Patient Telemonitoring System. This invention has useful application to the connection of patient data during drug trials and medical testing for regulatory approvals as well as the management of patients with chronic disease. U.S. Patent Publication No. 2002/0115939, Mulligan et al. describes an Implantable Medical Device for Monitoring Congestive Heart Failure in which incremental changes in a parameter data over time provide insight into the heart failure state of the patient's heart.
- None of those previous disclosures however describes adequate means to communicate those signals in a safe way between an implant device and an external data handling and coordinating center.
- It is a principal aim of the present invention to provide an implantable heart failure monitor which is capable of achieving very early detection of CHF. It is a further aim of the present invention to describe the method of remote controlling an implanted diagnostic or therapeutic electronic device in uni- or bi-directional ways.
- The implantable medical device of the present invention may be of size smaller than a typical pacemaker device—about the size of a thumb. It may be implanted in a subcutaneous pocket formed by a surgeon in the patient's chest, under local anesthesia and minimally invasive requirements. The device includes a hermetically sealed can with appropriate electronic circuitry inside. A set of device-mounted electrodes may be used to measure the impedance of the adjacent tissue and most especially the lung tissue. The progressive retention of fluid in the lungs and congestion of the ventricle together result in a reduced resistance measurement that is monitored either continuously or periodically by the device.
- In a preferred mode of operation, the device alerts the patient and/or the attending physician when a diagnostic threshold is reached which is indicative of the progression of CHF. The overall architecture of the device follows implantable practice, however, it should be appreciated that the partitioning of the device is flexible and the division of sensing and analysis structures can be shared between implanted and external (remote, i.e., non-implanted) devices. A low-power radio transceiver operating in the Medical Implant Communications Service (MICS) band can be use for linking the device to a proximate base station. The base station can communicate with one or more remote locations via telecommunications or wideband networks to permit monitoring patient data and programming the device remotely.
- The Medical Implant Communications Service is an ultra-low power, unlicensed, mobile radio service for transmitting data in support of diagnostic or therapeutic functions associated with implanted medical devices. The MICS permits individuals and medical practitioners to utilize ultra-low power medical implant devices, such as CHF monitors, cardiac pacemakers and defibrillators, without causing interference to other users of the electromagnetic radio spectrum. No licensing is required, but MICS equipment is intended for operation only by healthcare professionals.
- Signal processing may be performed entirely internally within the device, or the device may operate as a data logger and communicate with an external base station which participates in data reduction and analysis.
- Although specific structures are shown as being dedicated to specific tasks, it should be apparent that certain functions may be shared if the device is integrated with other diagnostic or therapeutic devices. For example, the electrode set used to determine the impedance of the lungs could be used for additional purposes.
- It is an object of the present invention to provide a device-implemented method of detecting and monitoring congestive heart failure in a patient wherein the body portion encompasses the patient's heart, including performing impedance measurements by means of a signal injected into the body portion from the device and retrieved as a signal subdivided into a cardiac portion, a pulmonary portion, and a total impedance portion.
- It is a further object of the present invention to provide a method of remote control of an implantable device through the Medical Implant Communication Service band by changing the settings, function, characteristics or parameters of the implantable device via bi-directional communication through the MICS band of 402 to 405 MHz.
- It is a further object of the present invention to provide a method of remote control using a local repeater base station that communicates bi-directionally and transmits signal to the implant device on one end and communicates and transmits the signal through a telephone land line, wireless telephone, or through a network such as the Internet to a control station on the other end.
- It is a further object of the present invention to provide a patient monitoring system with an implantable device wherein the implantable device is one of a congestive heart failure monitoring device, a cardiac pacemaker, defibrillator, neurostimulator, muscle stimulator, gastric stimulator, or diagnostic implantable device for monitoring a variety of physiologic body functions such as CO2, blood pressure, oxygen, glucose, ventilation, heart rate, activity, posture, hormones, cytokines, or neurofunctions.
- It is a further object of the present invention to provide a system for remote control of an implantable device through the Medical Implant Communication Service band capable of changing the settings, functions, characteristics or parameters of an implantable device via bi-directional communication through the MICS band of 402 to 405 MHz.
- It is a further object of the present invention to provide a method of communicating data with an implantable device through Medical Implant Communication Service band using a repeater in proximity to the patient.
- It is a further object of the present invention to provide a method of communicating data using a local repeater in proximity to a patient capable of communicating bi-directionally that communicates with the implantable device on one end and translates or amplifies the signals with a data handling and coordinating center on the other hand through an Internet or wireless Internet connection.
- It is a further object of the present invention to provide a method of communicating patient-derived data originating from an implantable device between a data handling and coordinating center and a local patient care physician center.
- The above and other aims, objectives, aspects, features and attendant advantages of the invention will be further understood from a reading of the following detailed description of the best mode presently contemplated for practicing the invention, taken with reference to certain presently preferred implementations and methods, and in conjunction with the accompanying drawings, in which:
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FIG. 1 is an exterior view of an embodiment of the device; -
FIG. 2 is a schematic representation of an implantation of the device in the body of a patient; -
FIG. 3 is a block diagram of the internal circuitry of the device; -
FIG. 4 is a flow chart illustrating the operation of the device; -
FIG. 5 is a graph of the device operation in terms of the reciprocal of impedance versus time; -
FIG. 6 is a schematic drawing of a system comprising an implanted device in a patient's body and a proximate base station having links to various telecommunication facilities; -
FIG. 7A is a block diagram of one embodiment of a base station according to the present invention; -
FIG. 7B is a block diagram of an alternative embodiment having a dedicated microcontroller integrating the functions of 210, 211, 212, and 213 inFIG. 8 ; -
FIG. 8 is a block diagram of system operation through a base/repeater station, a data handling and coordinating center and a local patient care physician center; -
FIG. 9 is a block diagram of another exemplary embodiment of the invention; -
FIG. 10 illustrates the advanced processing and analysis of information derived from patients' history, physical examination, current medication, patient related parameters and the actual and/or previous data received from a patient implant device such as a heart failure monitor, ECG monitor, activity sensor, pacemaker, defibrillator or other diagnostic or therapeutic electronic implant in the patient's body. The data from the implant device may be analyzed, evaluated and/or commented in light of evidence-based medicine by using input from the library with medical publications, drug action and adverse effects, medical guidelines in order to provide a specific patient tailored recommendation. - The device of the preferred embodiment of the invention is disclosed in the preferred implementation as being a stand-alone diagnostic device to simplify the description of its operation. Throughout the several views of the drawings identical reference numerals indicate identical structure. Views of the device either alone or as implanted are not intended to represent actual or relative sizes.
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FIG. 1 illustrates the exterior of thedevice 18 in its presently preferred embodiment.Device 18 includes a circuit module (to be discussed below in conjunction with the description ofFIG. 3 ) within a hermetically sealed “can” orcase 24 composed, for example, of titanium. The size of thecase 24 is clearly dictated by the size of the internal circuit components and wiring included printed circuit board(s) and other forms, but preferably is very small, currently about 5.0 cm long by 2.0 cm wide by less than 1.0 cm thick. -
Case 24 is a standard rectangular case with rounded edges and a header of epoxy resin on top (not shown inFIG. 1 ). In one preferred embodiment,Case 24 has a curvilinear shape which presents a concave shape orsurface 26 on one side (in contrast to an edge of the case) and a convex shape on the opposite side of the case. Four surface mountedelectrodes concave surface 26, with each electrode being electrically insulated from thecase 24 itself. The electrodes should be of low polarization, preferably composed of or coated with iridium oxide. By way of example, “inner”electrodes electrodes device 18, the device is prevented from turning within its subcutaneous pocket which would otherwise position the surface electrodes at the wrong side—namely, toward the exterior of the patient's body. The reason for this positioning will become apparent as the description proceeds. - The most preferred implant site of the device is the left lower anterior lateral hemithorax of the patient's body as shown in
FIG. 2 . In part, this is because optimal sensing occurs with the device placed slightly to the left of the patient's midline.FIG. 2 illustrates in schematic form a side view of a patient (in phantom) with thedevice 18 implanted in a pectoral of the chest over the basal region oflungs 28 andheart 30, outside therib cage 32. An implantation at the preferred site places the device on the left anterior thorax side between the 5th and 6th intercostals space. In this position of the device, an impedance signal is developed which represents the impedance of the lungs and heart tissue by virtue of current injected into the circuit path that establishes a field through that portion of the body fromdevice 18. -
FIG. 3 illustrates the exemplary circuit module withindevice 18. Animpedance signal generator 40 injects signal current into the body, preferably through “inner”electrodes electrodes FIG. 2 ) attributable to current flowing from the electrodes emanate from theconcave side 26 ofdevice 18, and, together with the electrode spacing, define the “viewing volume” of the device for the impedance sensing circuitry. Electrode spacing of at least four cm between theouter electrodes lung tissue 28 and are somewhat less influenced by the volume of theheart 30. - The circuit module within
device 18 is powered by a preferably lithium-ion battery 50.Impedance generator 40 is controlled bymicroprocessor 48, as islogic 42 for analysis and memory 44 for data. Measured values of impedance are stored in memory 44, and used bymicroprocessor 48 to calculate various functions of the measured impedance values. Athreshold detector 46 may be incorporated indevice 18 as a patient alert function or alarm (e.g., by emitting an acoustic signal, vibrations, or low level pulses for local muscle contractions, recognizable by the patient) indicative of a need for immediate intervention when impedance associated withfluid level 64, for example, is detected. Such an alarm condition may also be signaled by telemetry from an antenna or coil 58 within the circuit module at the microprocessor, normally used to transmit the other impedance data, to aremote programmer 56 to monitor and log the progress of the disease and the therapeutic effect of treatment for review by the patient's physician. - In a preferred embodiment, the device is adapted to monitor impedance at a digital rate of 128 Hz, for partitioned analysis of contractile cardiac function, pulmonary ventilation function and long term pulmonary impedance, over an average of 72 hours or more. Signal processing allows deviation from basic impedance of the body region of interest, especially the lungs, to be detected as an early monitoring of a decrease in lung impedance, indicative of increasing congestion by fluid content in the lungs. The decrease in lung impedance associated with CHF occurs as the lungs fill with fluid, which is a considerably better electrical conductor than the normal lung tissue. Exemplary values of impedance for lung tissue are 400-1,000 ohms per centimeter (Ω/cm), compared with 50 Ω/cm for fluid.
- Representative fluid levels accumulated in the lungs are illustrated in
FIG. 2 at 60, 62 and 64.Level 60 represents the relative additional amount of fluid associated with normal lung function.Level 62 represents the relative amount of fluid present for a compromised lung function associated with CHF. Andlevel 64 is the relative still additional amount of fluid associated with severely reduced lung function requiring immediate attention, indicative of advanced CHF. - The
device 18 may be designed to provide a threshold or trigger level at an accumulation of fluid corresponding approximately tolevel 64. Algorithms are used to convert real time measurements into a diagnostic indication of congestion. The device may be operated continuously and the impedance data are then analyzed in kind. ECG data may be used additionally, detected at theouter electrodes -
FIG. 4 is a flow chart of an exemplary detection algorithm used by thedevice 18. On commencement, counters are initialized andimpedance generator 40 is turned on to inject signal current into the body via the inner pair ofelectrodes 10, 12 (start, 70). The impedance signal current is preferably a rectangular biphasic pulse wave at a rate of 128 Hz and a peak-to-peak amplitude of 1 milliampere (ma), or, alternatively, an alternating current in a range from 5 microamperes (μa) to 10 μa. The pulses may be injected with considerably higher energy content than the AC wave because of their very short duration (e.g., 15 μsec or less), with no risk of myocardial depolarization, and are capable of detecting cardiac changes as well as pulmonary changes. - Impedance is then calculated (72) from a measurement of the resulting voltage at the outer pair of
electrodes FIG. 3 ) is initiated. In either case (an alarm condition or not), another impedance measurement is performed (72) and the processing cycle is repeated. - In the description of
FIG. 2 , the detection of lung congestion requiring immediate attention was the result of a simple volume measurement. In practice, however, a slope measurement is preferred to determine when an alarm condition is occurring or has occurred, because the variability of impedance signals makes it more difficult to achieve accurate threshold detection by volume measurement. -
FIG. 5 is a graph of the device operation using the exemplary detection algorithm represented by the flow chart ofFIG. 4 . Thevertical axis 90 is conductance, the reciprocal of impedance (1/Z). Therefore, the greater the lung congestion (i.e., the larger the fluid volume in the patient's lungs), the lower the value of theterm 1/Z. Thehorizontal axis 92 represents time. The long-term average of the impedance measurement has a characteristic value that filters out the short-term variations of the measurement. In the Figure, theLT value 96 of curve or slope 94 exhibits a more gradual slope than the ST value 98. The difference between the two is used to determine whether an alarm condition is occurring (LT−ST=V≧threshold). - In addition to the baseline impedance, impedance measurements at the frequency of 128 Hz can detect impedance changes with every pumping cycle, to provide indirect information on stroke volume, heart rate, and cardiac output calculated therefrom. Additionally, by adequate low pass filtering, the indirect tidal volume of ventilation can be separated out, as well as respiratory rate. Typically, ventilation is in a range from 0.2 Hz to 0.8 Hz, while cardiac events are in a range from 1 Hz to 3 Hz. Both subsignals, cardiac and ventilation, are used in addition to determine congestive heart failure indicated by increase in stroke volume, decrease in tidal volume, increase in heart rate, and increase in ventilation rate.
- A power saving can be achieved in the device by limiting the impedance measurement to fixed periods separated by intervals of no measurement, or even sporadic measurements, rather than performing continuous impedance measurements.
- The impedance measurement electrodes may be used to monitor the patient's ECG, as well as to obtain the raw data necessary for calculating absolute impedance and long-and short-term averages of impedance. Also, the cardiac- and ventilation-derived impedance phenomena may be correlated to the ECG for better evaluation. In addition, a miniaturized accelerometer within the case might give valuable information with regard to the daily and comparative physical activity of the patient.
- It is important to consider the factor of where the measurements are taken as well as the manner of obtaining the measurements. For example, the spacing between the
measurement electrodes - Due at least in part to the availability of advanced ultra low-power RF (radio frequency) capabilities, implanted devices such as the CHF monitor described above, pacemakers, defibrillators and medicine delivery pumps may communicate in real time or near real time with health professionals at a remote location. This communication can be facilitated by means of a repeater—a device for receiving electronic communication signals and delivering corresponding amplified ones. Even more desirable is a base station which may additionally process data received via such electronic communication signals prior to forwarding the data to a remote location.
- Until recently, no globally accepted frequency band has been dedicated to medical implant device communications. Where communication between an implant and a monitoring system was required, most device manufacturers used short-range systems based on magnetic coupling between coils. These systems required extremely close coupling (less than 10 cm) between the medical device and programmer and offered limited data transfer rates.
- This situation changed with the ITU-T Recommendation SA 1346, which outlined the shared use of the 402-405 MHz frequency band for a Medical Implant Communications Service (MICS). This recommendation has been implemented in the United States under the Federal Communications Commission (FCC) rules, and in Europe under the European Telecommunications Standards Institute (ETSI) Standard EN301 839. It is expected that MICS will become a true global standard within several years. Operations rules and technical regulations applicable to MICS transmitters may be found in 47 CFR 95.601-95.673 Subpart E.
- The 402-405 MHz frequency band is available for MICS operations on a shared, secondary basis. The FCC determined that, compared to other available frequencies, the 402-405 MHz frequency band best meets the technical requirements of the MICS for a number of reasons. The 402-405 MHz frequencies have propagation characteristics conducive to the transmission of radio signals within the human body. In addition, equipment designed to operate in the 402-405 MHz band can fully satisfy the requirements of the MICS with respect to size, power, antenna performance, and receiver design. Further, the use of the 402-405 MHz band for the MICS is compatible with international frequency allocations. Finally, the U.S. Federal Communications Commission has determined that the use of the 402-405 MHz frequency band for the MICS does not pose a significant risk of interference to other radio operations in that band.
- The 402- to 405-MHz band is well suited for in-body communications networks, due to signal propagation characteristics in the human body, compatibility with the incumbent users of the band (meteorological aids, such as weather balloons), and its international availability. The MICS standard allows 10 channels of 300 kHz each and limits the output power to 25 microwatts.
- With rising healthcare costs, an aging population, and a growing acceptance of home-based medical monitoring, the MICS band is spurring advances in telemedicine. Using MICS, a healthcare provider can establish a high-speed, longer-range (typically 2 to 20 meters) wireless link between an implanted device and a base station. For example, an ultra low-power RF transceiver in a CHF monitor can wirelessly send patient health and device operating data to a bedside RF transceiver and vice versa. Data can then be forwarded from the base station via telephone land line, wireless cell phone communication, or the Internet to a doctor.
- Advanced ultra low-power RF technology will dramatically improve the quality of life for patients with implanted medical devices. With a two-way RF link, doctors can remotely monitor the health of patients and wirelessly adjust the performance of the implanted device. This means fewer unnecessary hospital visits for the patient. Instead, with remote monitoring the doctor can call the patient in to the hospital when a problem is detected.
- An implantable device such as a CHF monitor may be paired with a base station or repeater and linked by MICS transceivers. In such a system, data from the monitor may be downloaded to the base station for data processing and analysis using higher performance data processing equipment (which typically has higher power consumption than lower performance processors). Moreover, the base station may provide a communication interface to telecommunications networks such as the Public Switched Telephone Network (PSTN), computer networks including the Internet, and radio-based systems including cellular telephone networks, satellite phone systems and paging systems.
- Such telecommunications can be used to send data to medical professionals who may use it to make treatment decisions including hospitalization, pharmaceutical dosage and/or measurement parameters of the implanted device. For example, if an increase in congestion is noted, more frequent measurements of impedance by the implanted device may be ordered by a physician via a return communications link.
- A representative system is shown schematically in
FIG. 6 . Adevice 18 is implanted inpatient P. Device 18 includes a short-range radio transceiver which utilizes the Medical Implant Communication Service. A corresponding transceiver inbase station 100 receives data fromdevice 18, processes and/or stores the data and sends it to a remote location using one or more of the Public Switched Telephone Network T, computer network I, and radio communications system R. Computer network I may be a local area network (LAN), wide area network (WAN), an intranet or the Internet. Radio communications system R may, in certain embodiments, be a cellular telephone system, the PCS system, a satellite phone system, a pager system or a two-way radio link. - In some embodiments, the link between the implanted
device 18 andbase station 100 may be a one-way link. For example, implanteddevice 18 may have a MICS transmitter (cf. transceiver) andbase station 100 may have only a MICS receiver (cf. transceiver). -
FIG. 7A is a block diagram of an exemplary base station orrepeater 100. Apower supply 102 may rectify and covert ac line voltage to dc at the voltage level(s) required by the various subsystems within the base station. In some embodiments,power supply 102 may include an uninterruptible power supply (UPS) orbattery 102 for operation during utility power interruptions or to permit brief operation of the base station at locations without external power.Power supply 102 may use an external wall transformer to deliver 9 or 12 volts DC to the system. An internal DC-DC converter may be used to step the voltage down to 3.3V (digital supply) and 5V (analog supply & radio(s) supply). An internal DC-DC converter may help to reduce noise (60 Hz line noise, etc). This would help the SNR (Signal to Noise Ratio) of both the wireless data radio modem, and the medical band radio—improving the range and efficiency of both. -
Optional battery 103 can allow device operation for an extended period of time in the event of power interruption. A 6 Ah @ 6V battery could provide several days, if not a week of uninterrupted operation in the event of power failure. A lightweight battery can be used in a portable embodiment (for example, a 1000-1800 mAh lithium-ion battery could provide several days of portable operation). -
Processor 104 may be a microprocessor or similar programmed system for implementing the methods of the system and controlling the various subsystems comprisingbase station 100. As noted above, one particularly significant advantage ofbase station 100 is its ability to use apowerful processor 104 whose electrical power consumption would be prohibitive for use within a battery-operated, energy sensitive implanted device such as CHF monitor 18.Microcontroller 104 may be a simple {fraction (8/16)} bit microcontroller. - Attached
EEPROM 106 may be used for code/firmware storage, or additionally used as a temporary storage location for cardiac data in the even that a network connection is not immediately available. - Attached
RAM 108 may be used for code execution/scratchpad, or additionally used as a data buffer for cardiac data during transmit or receive. - Certain embodiments of
base station 100 may include display or alarms (not shown) for displaying operational data and/or alerting the patient or caregiver of parameters which exceed defined limits. - For short-range communication with implanted
device 18, base station orrepeater 100 may includeMICS transceiver 118 andantenna 120. Electrically small antennas are generally considered to be those with major dimensions less than 0.05 lambda, or in the MICS band, 37 mm. In some embodiments the corresponding antenna with which the base station orrepeater 100 communicates may be folded within the case ofdevice 18. In other embodiments, the antenna may be outside of thedevice 18 and encased in epoxy resin or other bio-compatible dielectric material. In this way, the usuallymetal case 24 will not significantly impede RF transmission to and from the antenna ofdevice 18. In addition, also measuring electrodes for impedance and for EKG might be situated within the epoxy header. By way of doing so, the critical feed-through in the otherwise hermetically sealed case might be better protected. - The
MICS transceiver 118 enables communication with the implantablemedical device 18. It may operate on a different frequency than the GSM bands to avoid interference withradio modem 114.Interface 118 provides high-speed wireless data communication with theimplantable device 18, within approximately 6 feet. Astationary base station 100 could be placed near a bed or other location where the patient could be close enough for data transmission. Similarly, a portable device could be worn by the patient. - For data communication with remote locations, such as doctor's offices,
base station 100 may includenetwork interface 116. One examples ofnetwork interface 116 is an Ethernet Network Interface Card (NIC). Ethernet can be used as an alternative connection to the Internet for uploading patient data, in the event that wireless data service is not available or is prohibitively expensive.Ethernet interface 116 can also be used for remote management and uploading/upgrading system firmware. Anoptional modem 117 for data transmission using the public switched telephone network may also be incorporated. - An alternative data communication interface for
base station 100 isradio modem 114. In certain embodiments,radio modem 114 may be a cellular telephone with a modem, or may operated similarly thereto.Radio modem 114 may couple to anantenna 121 which, in some embodiments, may be external to or remote from the main housing ofbase station 100. The specific design of the antenna depends on the particular band used, but in any event could conform with GSM 900, 850, 1900, or 1880 standard. Use of a dedicated GSM/GPRS radio modem 114 can reduce system complexity, as this would require only a power supply and a data connection to the system. This reduces overall system complexity. - Data may be transmitted to the Internet using GPRS (General Packet Radio Service) over the GSM band. Alternatively, instead of a self-contained radio modem, a quad-band (or tri-band) GSM/GPRS RF (Radio Frequency) transceiver can be used. However only the radio and associated components are included, so further additional hardware might be required for baseband processing, etc. This can connect to and switch between a greater number of GSM networks, allowing for greater coverage area (and coverage in more countries).
- Alternatively, instead of GPRS/GSM, a different cellular data service, such as X.25 or Cellular Digital Packet Data (CDPD) can be used. One preferred embodiment uses a
RIM 902M Radio Modem operating in the GSM 900 band. For example, RIM's proprietary Radio Access Protocol could be used to communicate with themodem 114 in this example. Alternatively, if a self-contained radio modem from another manufacturer is used, a different protocol, such as RS-232, may be used. - In yet other embodiments, if a custom GSM/GPRS RF solution is used instead of a self-contained radio modem, a custom interface could be defined, for example using memory-mapped I/O, or simply the GPIO (General Purpose I/O) pins on the controller to communicate with and control the radio.
-
SIM Card 110 is a Subscriber Identity Module that identifies a particular user of a GSM network.SIM card 110 could be keyed to a Patient ID, for example, for billing purposes. Patient ID could be encrypted and sent separately along with patient data. - It will be appreciated by those skilled in the art that
base station 100 may be in data communication with a plurality of implanted devices. For example, base station orrepeater 100 could receive pacemaker data from an implanted device of a patient such as the disclosed CHF monitor, a pacemaker, a defibrillator, etc. and store such data and transmit it periodically to a doctor's office. Such a system would permit, for example, daily monitoring of a patient's condition as opposed to occasional visits to a doctor's office. - Depending on the digitization rate,
device 18 may generate approximately 16 to 18 megabytes of data per day. Using the system of the present invention, data could be collected by the base station, parsed, analyzed and/or summarized, and periodically sent to a remote facility (such as a doctor's office) on, for example, a quarterly basis. Alternatively, triggering events such as tachycardia or increasing congestion could be used to determine when thebase station 100 would open a communications link and send data or alarm signals. -
Base station 100 could be used with other implanted sensors which could monitor, for example, blood glucose level, oxygen saturation, temperature or other metabolic parameters. Such monitoring could be useful in tracking the cardiovascular fitness not only of patients, but also soldiers, athletes and others subjected to physical stress or harsh environments such as special mission pilots or astronauts. -
FIG. 7B shows an alternative embodiment of the base station having an integrated microcontroller which performs several of the function of the separate function disclosed inFIG. 7A . For clarity, the other system components shown inFIG. 7A have been omitted. -
Implantable device 18 could monitor and record the patient's ECG and other physiological parameters. The implantable device has a limited power supply in its on-board battery, and it is desirable to use as little power as possible to maximize the life of the device. For this reason, the implantable device may have internal memory storage capable of buffering or temporarily holding the patient data so it does not need to continuously transmit the patient data. For example, Flash memory or low-power SRAM can be used for memory storage. Flash memory does not consume any power once the data has been stored, however the amount of power consumed during program and erase can be significant. An SRAM requires constant power, but the amount of power is small. - The amount of patient data that is collected per 24-hour period is less than 20 MB. A simple, power-efficient loss-less data compression algorithm may reduce that amount even further, perhaps even in half. A balance between power used to compress the data and power used to transmit the data is desirable.
- As mentioned before, for power conservation reasons, the MICS radio need not continuously transmit patient data. The patient data may be collected and stored in the memory storage, and subsequently transferred to the device at predetermined intervals. A portable, wearable device could use an hourly schedule. A stationary device under normal conditions could upload the data on a daily to weekly schedule.
-
FIG. 8 depicts an alternative embodiment of the invention, and specifically shows adevice 200 for monitoring CHF implanted in apatient 205. Thedevice 200 has anepoxy header 201 which is on top of medical electronics 202 (e.g.,FIG. 3 ) contained in the hermetically sealedcase 200 of the device. The header contains a pair ofouter electrodes 203 and a pair ofinner electrodes 204. Those electrodes are connected throughwires 206 which communicate with medical electronic 202 through thefeedthrough 207. In addition, anantenna 208 is incorporated in the epoxy header for communicating signals in the medical implant communications service bands. Anantenna 208 having a length of ¼ lambda may be used to transmit signals effectively. Throughradio frequency radiation 209, the device communicates with the base station or repeater 210 (similar tobase station 100 ofFIG. 7A for example) in the proximity of theimplant patient 205. Thebase station 210, which receives the signals from theimplant device 200, can transfer and/or amplify the signals, which in turn can be easily communicated through a wireless local network or apersonal area network 211 to the interface of acomputer 212, preferably also in the proximity of the patient. Further connections throughInternet lines 213 occur with a data handing and coordinatingcenter 215 for further storage and analysis of this data. Instead of arepeater 210,communication pathway 211 andcommunication computer 212, asingle unit 214 as shown inFIGS. 7A and 7B is feasible. - The data handling and
coordination center 215 primarily receives the data either in a continuous manner, in a temporary intermittent manner, or in a predetermined activated manner as dictated by theimplant device 200. Signals can be received either as live or stored data, or as preprocessed data, or as data that fulfill certain selection criteria (such as an alarm condition). The data transfer occurs intermittently or continuously. The transfer of the stored data for one day, for example, can occur at certain fixed time periods (e.g., at night) or when the patient is in the proximity of the local repeater. This proximity is defined dependent on the power output of the device through the medical implant service bandwidth and preferably is kept at a low level to conserve battery life, battery power, and to extend the life of the implant device. - Also, to preserve energy and optimize the capacity of all links involved in the data processing, data is preferably only sent if they fulfill certain criteria. The criteria can be incorporated in the logic or programming of the
circuitry 202 of theimplant device 200 or within similar logic or program of thebase station 210. Despite such criteria, data indicative of an emergency condition can be made to transfer on a priority basis, such as immediately, if sensor data from thedevice 200 indicates a life threatening condition such as tachycardia or an abnormal slow rate, which in turn could prompt immediate intervention by a physician and/or transfer of the patient to an emergency room. The emergency condition can be accompanied by an alert 217, which can be communicated to both the patient (vialinks care physician center 216. The alert may be manifested to the patient from a audible sound, vibration, or some other physical indicator emanating from thedevice 200. Either way, a physician at thecenter 216 and/or the patient can then establish communication with each other through traditional means (Internet, phone, e-mail, direct physical presence, etc.). As communication with the device is two-way, the doctor may also request additional data from the device, and/or can program thedevice 200 to perhaps better assist the health of the patient. - Because
electrodes nonmetallic header 201, preferably a polymer of epoxy resin, thefeedthrough 207, which is the most sensitive point in the hostile environment of the human body, can be protected. Moreover, as well as providing mechanical shielding for thefeedthrough 207, theheader 201 provides electrical shielding. Moreover, theheader 201 preferably contains the MICS-band antenna 208, which will suffer less attenuation than were the antenna disposed within the hermetically sealedmetallic case 200 of the device. As shown, the sameelectronic feedthrough 207 is used for both theantenna 208 and theelectrodes - For data storage, the
device electronics 202 can digitize the data accordingly to its signal characteristics. For example, the EKG can be digitized with a sampling frequency of 100 Hz. If this is done, the resulting quantity for one day would roughly constitute 8 to 9 megabytes. An activity signal of a miniaturized accelerometer which is also incorporated in the hermetically sealed device and preferably situated on hybridelectronic circuitry 202 can be digitized at a much slower rate in a range of 10 Hz, perhaps amounting to less than 1 megabytes of data per day. For the impedance measurements, as described in the referenced and related applications, another 8 megabytes could be required bringing the daily data amount to roughly 16 to 20 megabytes. Modem storage memories incorporatable into thedevice 200 can easily handle such data, and a memory of 256 mega bits could handle the data for nearly 2 weeks. In short, data for a whole host of patient parameters can be stored and periodically transferred, say every other day or week, unless built-in data handling and analysis triggers an earlier transmission of the data (such as during an emergency condition). -
FIG. 9 illustrates another embodiment of the present invention. In this case, theimplant device 200 is comparable to the device described inFIG. 8 . However, in this embodiment, communication occurs with acell phone 221 which acts as a repeater/base station programmed withappropriate logic 220 to perform the function of the base station as discussed above.Such logic 220 can appear within thephone 221 itself, or in a traditional phone socket or cradle.Cell phone 221 communicates via an RF interface with theimplant device 200, and further communicates via anRF telephone link 222 to, for example, theInternet 223, which can comprise one network intervening between thephone 221 and thecoordination center 215, where data is stored and/or analyzed. (one skilled in the art will realize that other communication networks in addition to the Internet would logically be used, but are not shown). Alerts indicative of emergency conditions can be sent to the patient via theInternet 223 either to the cell phone, or through wireless cell phone communication from thepatient care center 216 tocell phone 221. Further communication of the alert to the patient can then be communicated throughradio frequency link 209 to thedevice 200. On the other hand, the local patentcare physician center 216 can alert the patient through communication link 217, which may be direct access, email, phone calls or physical presence of a person to assist the patient and resolve the current medical situation. -
FIG. 10 illustrates an advanced method of information technology and handling. Theimplant device 200 communicates through the mobile implant communication service band through links as described previously either through wireless, telephone, Internet, or land line telephone with the data handling and coordinatingcenter 215. In thiscenter 215, evaluation of the data from thedevice 200 may be accomplished as before, but, in addition, other patient specific data like patient history, current medication, age, and other patient relevant information is assessed, as pulled fromdatabase 230. Furthermore, analysis can be further assisted via data pulled from alibrary database 231 of current articles, from a medicine guidelines database containing recommendations for certain patient conditions, and from a drugs andadverse effect database 234. This culmination of data (current patient data fromdevice 200, historical patient data, etc.), can be used atcenter 215 to provide, in automated or semi-automated fashion, the best course of action or recommendation for a particular patient. This recommendation can be transmitted to the local patientcare physician center 216 to allow a better evaluation of what might be done with the patient and what kind of measures could be given. It is up to the physician to communicate this kind of decision and recommendation to the patient including any action such as taking diuretics, new medications, beta blockers, antiarrhythmias, or the recommendation for implant of a brady- or tachyarrhythmia device. - Implanted
devices 200 may be programmed via thebase station 210 and its associated data link(s). Such programming could replace the magnetic wand programming of the prior art which typically must be performed in a healthcare facility or doctor's office. - By using the system of the present invention, implanted devices may be reduced in physical size. Implanted devices used in conjunction with the base station provide the benefit for allowing store and intermittent transfer of data. Sending data in short bursts not only conserves power (permitting smaller batteries to be used in the devices 200), but also reduces the potential time window for interference and provides more forgiving power supply requirements. This is important for implant systems, which frequently use batteries with high impedance. This approach also makes the use of a very high data transmission rate attractive for intermittent telemetry applications, such as in pacemakers, as a large capacitor can have its charge mortgaged for the period of the radio transmission, and then recharged at a lower rate. Another fact that points in favor of a high data rate is that the transmission will occur during a shorter time period, making it possible for more users to share the same radio channel.
- Although a presently contemplated best mode, preferred embodiment and method of practicing the invention have been described in this specification, it will be apparent to those skilled in the art from a consideration of the foregoing description that variations and modifications of the disclosed embodiments and methods may be made without departing from the spirit and scope of the invention. It is therefore intended that the invention shall be limited only to the extent required by the appended claims and the rules and principles of applicable law.
Claims (55)
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US11/852,746 US9775532B2 (en) | 2001-10-01 | 2007-09-10 | Remote control of implantable device through medical implant communication service band |
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DE10148440A DE10148440A1 (en) | 2001-10-01 | 2001-10-01 | 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 |
US10/155,771 US6829503B2 (en) | 2001-10-01 | 2002-05-25 | Congestive heart failure monitor |
US10/622,184 US8777851B2 (en) | 2001-10-01 | 2003-07-16 | Congestive heart failure monitor and ventilation measuring implant |
US11/007,046 US20050137480A1 (en) | 2001-10-01 | 2004-12-07 | Remote control of implantable device through medical implant communication service band |
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Cited By (141)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20030028221A1 (en) * | 2001-07-31 | 2003-02-06 | Qingsheng Zhu | Cardiac rhythm management system for edema |
US20060041280A1 (en) * | 2004-08-19 | 2006-02-23 | Cardiac Pacemakers, Inc. | Thoracic impedance detection with blood resistivity compensation |
US20060258952A1 (en) * | 2005-05-11 | 2006-11-16 | Cardiac Pacemakers, Inc. | Enhancements to the detection of pulmonary edema when using transthoracic impedance |
US20060271088A1 (en) * | 2005-05-02 | 2006-11-30 | Almuhannad Alfrhan | Percutaneous intragastric balloon device and method |
US20060293609A1 (en) * | 2005-05-11 | 2006-12-28 | Cardiac Pacemakers, Inc. | Sensitivity and specificity of pulmonary edema detection when using transthoracic impedance |
US20070149887A1 (en) * | 2005-12-22 | 2007-06-28 | Samsung Electronics Co., Ltd. | Portable electrocardiogram measurement device |
US20070180047A1 (en) * | 2005-12-12 | 2007-08-02 | Yanting Dong | System and method for providing authentication of remotely collected external sensor measures |
US20080024293A1 (en) * | 2006-07-28 | 2008-01-31 | Lee Stylos | Adaptations to optivol alert algorithm |
US20080027349A1 (en) * | 2006-07-28 | 2008-01-31 | Lee Stylos | Adaptations to intra-thoracic fluid monitoring algorithm |
EP1898782A1 (en) * | 2005-07-01 | 2008-03-19 | Impedimed Limited | Monitoring system |
US20080103551A1 (en) * | 2006-10-30 | 2008-05-01 | Javaid Masoud | Implantable Medical Device with Variable Data Retransmission Characteristics Based Upon Data Type |
US20080103530A1 (en) * | 2006-10-31 | 2008-05-01 | Vitense Holly S | Methods and Apparatus for Manually Suspending Intrathoracic Impedance Fluid Status Measurements |
US20080270051A1 (en) * | 2005-08-02 | 2008-10-30 | Impedimed Limited | Impedance Parameter Values |
US20080264431A1 (en) * | 2007-04-24 | 2008-10-30 | Javaid Masoud | Channel Selection and Mapping for Medical Device Communication |
US20080319336A1 (en) * | 2004-06-18 | 2008-12-25 | Leigh Ward | Oedema Detection |
US20090287102A1 (en) * | 2008-02-15 | 2009-11-19 | Impedimed Limited | Blood flow assessment of venous insufficiency |
US20090292340A1 (en) * | 2008-05-22 | 2009-11-26 | William Mass | Regulatory Compliant Transmission of Medical Data Employing a Patient Implantable Medical Device and a Generic Network Access Device |
US20100100003A1 (en) * | 2007-01-15 | 2010-04-22 | Impedimed Limited | Monitoring system |
US20100100151A1 (en) * | 2008-10-20 | 2010-04-22 | Terry Jr Reese S | Neurostimulation with signal duration determined by a cardiac cycle |
US20100109739A1 (en) * | 2007-03-30 | 2010-05-06 | Impedimed Limited | Active guarding for reduction of resistive and capacitive signal loading with adjustable control of compensation level |
US20100324436A1 (en) * | 2008-02-04 | 2010-12-23 | University Of Virginia Patent Foundation | System, Method and Computer Program Product for Detection of Changes in Health Status and Risk of Imminent Illness |
US7869867B2 (en) | 2006-10-27 | 2011-01-11 | Cyberonics, Inc. | Implantable neurostimulator with refractory stimulation |
US7869885B2 (en) | 2006-04-28 | 2011-01-11 | Cyberonics, Inc | Threshold optimization for tissue stimulation therapy |
US20110054343A1 (en) * | 2005-07-01 | 2011-03-03 | Impedimed Limited | Monitoring system |
US7917226B2 (en) | 2008-04-23 | 2011-03-29 | Enteromedics Inc. | Antenna arrangements for implantable therapy device |
US7974701B2 (en) | 2007-04-27 | 2011-07-05 | Cyberonics, Inc. | Dosing limitation for an implantable medical device |
US7979115B2 (en) | 2005-05-18 | 2011-07-12 | Cardiac Pacemakers, Inc. | Detection of pleural effusion using transthoracic impedance |
US20110270052A1 (en) * | 2009-01-06 | 2011-11-03 | Marc Jensen | Ingestion-Related Biofeedback and Personalized Medical Therapy Method and System |
US8103337B2 (en) | 2004-11-26 | 2012-01-24 | Impedimed Limited | Weighted gradient method and system for diagnosing disease |
US8150508B2 (en) | 2006-03-29 | 2012-04-03 | Catholic Healthcare West | Vagus nerve stimulation method |
US8200326B2 (en) | 2005-04-26 | 2012-06-12 | Cardiac Pacemakers, Inc. | Calibration of impedance monitoring of respiratory volumes using thoracic D.C. impedance |
US8204603B2 (en) | 2008-04-25 | 2012-06-19 | Cyberonics, Inc. | Blocking exogenous action potentials by an implantable medical device |
US8233974B2 (en) | 1999-06-22 | 2012-07-31 | Impedimed Limited | Method and device for measuring tissue oedema |
US20120239597A1 (en) * | 2011-03-16 | 2012-09-20 | Mckesson Financial Holdings | Method, apparatus and computer program product for providing evidence-based clinical decision support that is workflow environment independent |
WO2012165667A1 (en) * | 2011-05-30 | 2012-12-06 | 주식회사 엠아이텍 | Insertion-type medical device having window for communicating with external device |
US8335992B2 (en) | 2009-12-04 | 2012-12-18 | Nellcor Puritan Bennett Llc | Visual indication of settings changes on a ventilator graphical user interface |
US20130018243A1 (en) * | 2011-07-13 | 2013-01-17 | Lockheed Martin Corporation | Three dimensional microfluidic multiplexed diagnostic system |
US20130085550A1 (en) * | 2011-09-30 | 2013-04-04 | Greatbatch, Ltd. | Medical implant range extension bridge apparatus and method |
US20130090534A1 (en) * | 2011-09-13 | 2013-04-11 | Thomas W. Burns | Intraocular physiological sensor |
US8443294B2 (en) | 2009-12-18 | 2013-05-14 | Covidien Lp | Visual indication of alarms on a ventilator graphical user interface |
US8453645B2 (en) | 2006-09-26 | 2013-06-04 | Covidien Lp | Three-dimensional waveform display for a breathing assistance system |
US8540632B2 (en) | 2007-05-24 | 2013-09-24 | Proteus Digital Health, Inc. | Low profile antenna for in body device |
US8542123B2 (en) | 2008-03-05 | 2013-09-24 | Proteus Digital Health, Inc. | Multi-mode communication ingestible event markers and systems, and methods of using the same |
US8547248B2 (en) | 2005-09-01 | 2013-10-01 | Proteus Digital Health, Inc. | Implantable zero-wire communications system |
US8545436B2 (en) | 2008-12-15 | 2013-10-01 | Proteus Digital Health, Inc. | Body-associated receiver and method |
US8555881B2 (en) | 1997-03-14 | 2013-10-15 | Covidien Lp | Ventilator breath display and graphic interface |
US8565867B2 (en) | 2005-01-28 | 2013-10-22 | Cyberonics, Inc. | Changeable electrode polarity stimulation by an implantable medical device |
US8583227B2 (en) | 2008-12-11 | 2013-11-12 | Proteus Digital Health, Inc. | Evaluation of gastrointestinal function using portable electroviscerography systems and methods of using the same |
US8597198B2 (en) | 2006-04-21 | 2013-12-03 | Covidien Lp | Work of breathing display for a ventilation system |
US8674825B2 (en) | 2005-04-28 | 2014-03-18 | Proteus Digital Health, Inc. | Pharma-informatics system |
US8718193B2 (en) | 2006-11-20 | 2014-05-06 | Proteus Digital Health, Inc. | Active signal processing personal health signal receivers |
US8730031B2 (en) | 2005-04-28 | 2014-05-20 | Proteus Digital Health, Inc. | Communication system using an implantable device |
US8761870B2 (en) | 2006-05-30 | 2014-06-24 | Impedimed Limited | Impedance measurements |
US20140249852A1 (en) * | 2013-03-04 | 2014-09-04 | Hello Inc. | Methods using patient monitoring devices with unique patient IDs and a telemetry system |
US20140250181A1 (en) * | 2013-03-04 | 2014-09-04 | Hello Inc. | Method using wearable device with unique user ID and telemetry system in communication with one or more social networks |
US8831716B2 (en) | 2007-09-11 | 2014-09-09 | Cardiac Pacemakers, Inc. | Histogram-based thoracic impedance monitoring |
US8836345B2 (en) | 2007-11-05 | 2014-09-16 | Impedimed Limited | Impedance determination |
US8858432B2 (en) | 2007-02-01 | 2014-10-14 | Proteus Digital Health, Inc. | Ingestible event marker systems |
US8868453B2 (en) | 2009-11-04 | 2014-10-21 | Proteus Digital Health, Inc. | System for supply chain management |
US8900154B2 (en) | 2005-05-24 | 2014-12-02 | Cardiac Pacemakers, Inc. | Prediction of thoracic fluid accumulation |
US8924878B2 (en) | 2009-12-04 | 2014-12-30 | Covidien Lp | Display and access to settings on a ventilator graphical user interface |
US8945005B2 (en) | 2006-10-25 | 2015-02-03 | Proteus Digital Health, Inc. | Controlled activation ingestible identifier |
US8956288B2 (en) | 2007-02-14 | 2015-02-17 | Proteus Digital Health, Inc. | In-body power source having high surface area electrode |
US8956287B2 (en) | 2006-05-02 | 2015-02-17 | Proteus Digital Health, Inc. | Patient customized therapeutic regimens |
US8961412B2 (en) | 2007-09-25 | 2015-02-24 | Proteus Digital Health, Inc. | In-body device with virtual dipole signal amplification |
US9014779B2 (en) | 2010-02-01 | 2015-04-21 | Proteus Digital Health, Inc. | Data gathering system |
WO2015107042A1 (en) * | 2014-01-16 | 2015-07-23 | Dermal Devices Inc. | Health monitoring system |
US20150209588A1 (en) * | 2014-01-24 | 2015-07-30 | Medtronic, Inc. | Pre-implant detection |
US9119925B2 (en) | 2009-12-04 | 2015-09-01 | Covidien Lp | Quick initiation of respiratory support via a ventilator user interface |
US9159223B2 (en) | 2013-03-04 | 2015-10-13 | Hello, Inc. | User monitoring device configured to be in communication with an emergency response system or team |
US9198608B2 (en) | 2005-04-28 | 2015-12-01 | Proteus Digital Health, Inc. | Communication system incorporated in a container |
US9235683B2 (en) | 2011-11-09 | 2016-01-12 | Proteus Digital Health, Inc. | Apparatus, system, and method for managing adherence to a regimen |
US9262588B2 (en) | 2009-12-18 | 2016-02-16 | Covidien Lp | Display of respiratory data graphs on a ventilator graphical user interface |
US9270503B2 (en) | 2013-09-20 | 2016-02-23 | Proteus Digital Health, Inc. | Methods, devices and systems for receiving and decoding a signal in the presence of noise using slices and warping |
US9314633B2 (en) | 2008-01-25 | 2016-04-19 | Cyberonics, Inc. | Contingent cardio-protection for epilepsy patients |
US9320435B2 (en) | 2013-03-04 | 2016-04-26 | Hello Inc. | Patient monitoring systems and messages that send alerts to patients |
US9330561B2 (en) | 2013-03-04 | 2016-05-03 | Hello Inc. | Remote communication systems and methods for communicating with a building gateway control to control building systems and elements |
US9339188B2 (en) | 2013-03-04 | 2016-05-17 | James Proud | Methods from monitoring health, wellness and fitness with feedback |
US9345879B2 (en) | 2006-10-09 | 2016-05-24 | Endostim, Inc. | Device and implantation system for electrical stimulation of biological systems |
US9345403B2 (en) | 2013-03-04 | 2016-05-24 | Hello Inc. | Wireless monitoring system with activity manager for monitoring user activity |
US9345404B2 (en) | 2013-03-04 | 2016-05-24 | Hello Inc. | Mobile device that monitors an individuals activities, behaviors, habits or health parameters |
US9357922B2 (en) | 2013-03-04 | 2016-06-07 | Hello Inc. | User or patient monitoring systems with one or more analysis tools |
US9381344B2 (en) | 2010-03-05 | 2016-07-05 | Endostim, Inc. | Systems and methods for treating gastroesophageal reflux disease |
US9392939B2 (en) | 2013-03-04 | 2016-07-19 | Hello Inc. | Methods using a monitoring device to monitor individual activities, behaviors or habit information and communicate with a database with corresponding individual base information for comparison |
US9398854B2 (en) | 2013-03-04 | 2016-07-26 | Hello Inc. | System with a monitoring device that monitors individual activities, behaviors or habit information and communicates with a database with corresponding individual base information for comparison |
US9406220B2 (en) | 2013-03-04 | 2016-08-02 | Hello Inc. | Telemetry system with tracking receiver devices |
US9432091B2 (en) | 2013-03-04 | 2016-08-30 | Hello Inc. | Telemetry system with wireless power receiver and monitoring devices |
US9430938B2 (en) | 2013-03-04 | 2016-08-30 | Hello Inc. | Monitoring device with selectable wireless communication |
US9439599B2 (en) | 2011-03-11 | 2016-09-13 | Proteus Digital Health, Inc. | Wearable personal body associated device with various physical configurations |
US9439566B2 (en) | 2008-12-15 | 2016-09-13 | Proteus Digital Health, Inc. | Re-wearable wireless device |
US9498619B2 (en) | 2013-02-26 | 2016-11-22 | Endostim, Inc. | Implantable electrical stimulation leads |
US9504406B2 (en) | 2006-11-30 | 2016-11-29 | Impedimed Limited | Measurement apparatus |
US9526422B2 (en) | 2013-03-04 | 2016-12-27 | Hello Inc. | System for monitoring individuals with a monitoring device, telemetry system, activity manager and a feedback system |
US9532716B2 (en) | 2013-03-04 | 2017-01-03 | Hello Inc. | Systems using lifestyle database analysis to provide feedback |
US9577864B2 (en) | 2013-09-24 | 2017-02-21 | Proteus Digital Health, Inc. | Method and apparatus for use with received electromagnetic signal at a frequency not known exactly in advance |
US9585593B2 (en) | 2009-11-18 | 2017-03-07 | Chung Shing Fan | Signal distribution for patient-electrode measurements |
US9603550B2 (en) | 2008-07-08 | 2017-03-28 | Proteus Digital Health, Inc. | State characterization based on multi-variate data fusion techniques |
US9615767B2 (en) | 2009-10-26 | 2017-04-11 | Impedimed Limited | Fluid level indicator determination |
US9616225B2 (en) | 2006-05-18 | 2017-04-11 | Endostim, Inc. | Device and implantation system for electrical stimulation of biological systems |
US9615766B2 (en) | 2008-11-28 | 2017-04-11 | Impedimed Limited | Impedance measurement process |
US9623238B2 (en) | 2012-08-23 | 2017-04-18 | Endostim, Inc. | Device and implantation system for electrical stimulation of biological systems |
US9634921B2 (en) | 2013-03-04 | 2017-04-25 | Hello Inc. | Wearable device coupled by magnets positioned in a frame in an interior of the wearable device with at least one electronic circuit |
US9659423B2 (en) | 2008-12-15 | 2017-05-23 | Proteus Digital Health, Inc. | Personal authentication apparatus system and method |
US9682234B2 (en) | 2014-11-17 | 2017-06-20 | Endostim, Inc. | Implantable electro-medical device programmable for improved operational life |
US9724510B2 (en) | 2006-10-09 | 2017-08-08 | Endostim, Inc. | System and methods for electrical stimulation of biological systems |
US9724012B2 (en) | 2005-10-11 | 2017-08-08 | Impedimed Limited | Hydration status monitoring |
US9730638B2 (en) | 2013-03-13 | 2017-08-15 | Glaukos Corporation | Intraocular physiological sensor |
US9737214B2 (en) | 2013-03-04 | 2017-08-22 | Hello Inc. | Wireless monitoring of patient exercise and lifestyle |
US9756874B2 (en) | 2011-07-11 | 2017-09-12 | Proteus Digital Health, Inc. | Masticable ingestible product and communication system therefor |
US9789309B2 (en) | 2010-03-05 | 2017-10-17 | Endostim, Inc. | Device and implantation system for electrical stimulation of biological systems |
US9827425B2 (en) | 2013-09-03 | 2017-11-28 | Endostim, Inc. | Methods and systems of electrode polarity switching in electrical stimulation therapy |
US9848776B2 (en) | 2013-03-04 | 2017-12-26 | Hello Inc. | Methods using activity manager for monitoring user activity |
US9878165B2 (en) | 2011-06-28 | 2018-01-30 | Nuvectra Corporation | Patient programmer having a key-fob-sized form factor |
US9925367B2 (en) | 2011-09-02 | 2018-03-27 | Endostim, Inc. | Laparoscopic lead implantation method |
US9950129B2 (en) | 2014-10-27 | 2018-04-24 | Covidien Lp | Ventilation triggering using change-point detection |
US10084880B2 (en) | 2013-11-04 | 2018-09-25 | Proteus Digital Health, Inc. | Social media networking based on physiologic information |
US10187121B2 (en) | 2016-07-22 | 2019-01-22 | Proteus Digital Health, Inc. | Electromagnetic sensing and detection of ingestible event markers |
US20190060655A1 (en) * | 2015-08-20 | 2019-02-28 | Cardiac Pacemakers, Inc. | Header core fixation design for an imd |
US10223905B2 (en) | 2011-07-21 | 2019-03-05 | Proteus Digital Health, Inc. | Mobile device and system for detection and communication of information received from an ingestible device |
US10307074B2 (en) | 2007-04-20 | 2019-06-04 | Impedimed Limited | Monitoring system and probe |
US10362967B2 (en) | 2012-07-09 | 2019-07-30 | Covidien Lp | Systems and methods for missed breath detection and indication |
US10398161B2 (en) | 2014-01-21 | 2019-09-03 | Proteus Digital Heal Th, Inc. | Masticable ingestible product and communication system therefor |
US10426955B2 (en) | 2006-10-09 | 2019-10-01 | Endostim, Inc. | Methods for implanting electrodes and treating a patient with gastreosophageal reflux disease |
US20190313970A1 (en) * | 2016-12-06 | 2019-10-17 | ART MEDICAL Ltd. | Systems and methods for sensing lung fluid and functionality |
US10529044B2 (en) | 2010-05-19 | 2020-01-07 | Proteus Digital Health, Inc. | Tracking and delivery confirmation of pharmaceutical products |
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 |
US10617349B2 (en) * | 2013-11-27 | 2020-04-14 | Medtronic, Inc. | Precision dialysis monitoring and synchronization system |
US10653883B2 (en) | 2009-01-23 | 2020-05-19 | Livanova Usa, Inc. | Implantable medical device for providing chronic condition therapy and acute condition therapy using vagus nerve stimulation |
EP3562393A4 (en) * | 2016-12-27 | 2020-09-02 | Sensible Medical Innovations Ltd. | Method and system for radiofrequency (rf) tissue(s) monitoring |
US11065056B2 (en) | 2016-03-24 | 2021-07-20 | Sofradim Production | System and method of generating a model and simulating an effect on a surgical repair site |
US11102306B2 (en) * | 2008-02-21 | 2021-08-24 | Dexcom, Inc. | Systems and methods for processing, transmitting and displaying sensor data |
US11158149B2 (en) | 2013-03-15 | 2021-10-26 | Otsuka Pharmaceutical Co., Ltd. | Personal authentication apparatus system and method |
US11191964B2 (en) | 2011-06-28 | 2021-12-07 | Cirtec Medical Corporation | Dual patient controllers |
US20220133999A1 (en) * | 2020-10-30 | 2022-05-05 | Medtronic, Inc. | Monitoring of physiological parameters with impedance measurement |
US11523746B2 (en) | 2018-10-28 | 2022-12-13 | Cardiac Pacemakers, Inc. | Implantable medical device having two electrodes in the header |
US11577077B2 (en) | 2006-10-09 | 2023-02-14 | Endostim, Inc. | Systems and methods for electrical stimulation of biological systems |
US11612321B2 (en) | 2007-11-27 | 2023-03-28 | Otsuka Pharmaceutical Co., Ltd. | Transbody communication systems employing communication channels |
US11672934B2 (en) | 2020-05-12 | 2023-06-13 | Covidien Lp | Remote ventilator adjustment |
US11717681B2 (en) | 2010-03-05 | 2023-08-08 | Endostim, Inc. | Systems and methods for treating gastroesophageal reflux disease |
US11744481B2 (en) | 2013-03-15 | 2023-09-05 | Otsuka Pharmaceutical Co., Ltd. | System, apparatus and methods for data collection and assessing outcomes |
US11819683B2 (en) | 2016-11-17 | 2023-11-21 | Endostim, Inc. | Modular stimulation system for the treatment of gastrointestinal disorders |
Families Citing this family (148)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP1578262A4 (en) | 2002-12-31 | 2007-12-05 | Therasense Inc | Continuous glucose monitoring system and methods of use |
US7587287B2 (en) * | 2003-04-04 | 2009-09-08 | Abbott Diabetes Care Inc. | Method and system for transferring analyte test data |
US8066639B2 (en) | 2003-06-10 | 2011-11-29 | Abbott Diabetes Care Inc. | Glucose measuring device for use in personal area network |
KR100777765B1 (en) * | 2003-06-30 | 2007-11-20 | 니뽄 덴신 덴와 가부시키가이샤 | Tranceiver |
CA2556331A1 (en) | 2004-02-17 | 2005-09-29 | Therasense, Inc. | Method and system for providing data communication in continuous glucose monitoring and management system |
US7697967B2 (en) | 2005-12-28 | 2010-04-13 | Abbott Diabetes Care Inc. | Method and apparatus for providing analyte sensor insertion |
US9636450B2 (en) | 2007-02-19 | 2017-05-02 | Udo Hoss | Pump system modular components for delivering medication and analyte sensing at seperate insertion sites |
US8260426B2 (en) | 2008-01-25 | 2012-09-04 | Cyberonics, Inc. | Method, apparatus and system for bipolar charge utilization during stimulation by an implantable medical device |
US8836513B2 (en) | 2006-04-28 | 2014-09-16 | Proteus Digital Health, Inc. | Communication system incorporated in an ingestible product |
US8912908B2 (en) | 2005-04-28 | 2014-12-16 | Proteus Digital Health, Inc. | Communication system with remote activation |
US8802183B2 (en) | 2005-04-28 | 2014-08-12 | Proteus Digital Health, Inc. | Communication system with enhanced partial power source and method of manufacturing same |
US8880138B2 (en) | 2005-09-30 | 2014-11-04 | Abbott Diabetes Care Inc. | Device for channeling fluid and methods of use |
US7766829B2 (en) | 2005-11-04 | 2010-08-03 | Abbott Diabetes Care Inc. | Method and system for providing basal profile modification in analyte monitoring and management systems |
US11298058B2 (en) | 2005-12-28 | 2022-04-12 | Abbott Diabetes Care Inc. | Method and apparatus for providing analyte sensor insertion |
US7996079B2 (en) | 2006-01-24 | 2011-08-09 | Cyberonics, Inc. | Input response override for an implantable medical device |
US7736310B2 (en) | 2006-01-30 | 2010-06-15 | Abbott Diabetes Care Inc. | On-body medical device securement |
US7981034B2 (en) | 2006-02-28 | 2011-07-19 | Abbott Diabetes Care Inc. | Smart messages and alerts for an infusion delivery and management system |
US7826879B2 (en) | 2006-02-28 | 2010-11-02 | Abbott Diabetes Care Inc. | Analyte sensors and methods of use |
US8374668B1 (en) | 2007-10-23 | 2013-02-12 | Abbott Diabetes Care Inc. | Analyte sensor with lag compensation |
US7618369B2 (en) | 2006-10-02 | 2009-11-17 | Abbott Diabetes Care Inc. | Method and system for dynamically updating calibration parameters for an analyte sensor |
US7653425B2 (en) | 2006-08-09 | 2010-01-26 | Abbott Diabetes Care Inc. | Method and system for providing calibration of an analyte sensor in an analyte monitoring system |
US8473022B2 (en) | 2008-01-31 | 2013-06-25 | Abbott Diabetes Care Inc. | Analyte sensor with time lag compensation |
US9392969B2 (en) | 2008-08-31 | 2016-07-19 | Abbott Diabetes Care Inc. | Closed loop control and signal attenuation detection |
US7620438B2 (en) | 2006-03-31 | 2009-11-17 | Abbott Diabetes Care Inc. | Method and system for powering an electronic device |
US8140312B2 (en) | 2007-05-14 | 2012-03-20 | Abbott Diabetes Care Inc. | Method and system for determining analyte levels |
US8346335B2 (en) | 2008-03-28 | 2013-01-01 | Abbott Diabetes Care Inc. | Analyte sensor calibration management |
US8226891B2 (en) | 2006-03-31 | 2012-07-24 | Abbott Diabetes Care Inc. | Analyte monitoring devices and methods therefor |
US7962220B2 (en) | 2006-04-28 | 2011-06-14 | Cyberonics, Inc. | Compensation reduction in tissue stimulation therapy |
US8932216B2 (en) | 2006-08-07 | 2015-01-13 | Abbott Diabetes Care Inc. | Method and system for providing data management in integrated analyte monitoring and infusion system |
US8206296B2 (en) | 2006-08-07 | 2012-06-26 | Abbott Diabetes Care Inc. | Method and system for providing integrated analyte monitoring and infusion system therapy management |
EP2087589B1 (en) | 2006-10-17 | 2011-11-23 | Proteus Biomedical, Inc. | Low voltage oscillator for medical devices |
US8126733B2 (en) * | 2006-10-24 | 2012-02-28 | Medapps, Inc. | Systems and methods for medical data interchange using mobile computing devices |
US8126729B2 (en) * | 2006-10-24 | 2012-02-28 | Medapps, Inc. | Systems and methods for processing and transmittal of data from a plurality of medical devices |
US8966235B2 (en) * | 2006-10-24 | 2015-02-24 | Kent E. Dicks | System for remote provisioning of electronic devices by overlaying an initial image with an updated image |
US9543920B2 (en) * | 2006-10-24 | 2017-01-10 | Kent E. Dicks | Methods for voice communication through personal emergency response system |
US8126732B2 (en) | 2006-10-24 | 2012-02-28 | Medapps, Inc. | Systems and methods for processing and transmittal of medical data through multiple interfaces |
US20080097912A1 (en) * | 2006-10-24 | 2008-04-24 | Kent Dicks | Systems and methods for wireless processing and transmittal of medical data through an intermediary device |
US8126734B2 (en) * | 2006-10-24 | 2012-02-28 | Medapps, Inc. | Systems and methods for adapter-based communication with a medical device |
WO2008051939A2 (en) * | 2006-10-24 | 2008-05-02 | Medapps, Inc. | Systems and methods for medical data transmission |
US8126735B2 (en) * | 2006-10-24 | 2012-02-28 | Medapps, Inc. | Systems and methods for remote patient monitoring and user interface |
US20080097550A1 (en) * | 2006-10-24 | 2008-04-24 | Kent Dicks | Systems and methods for remote patient monitoring and command execution |
US8954719B2 (en) * | 2006-10-24 | 2015-02-10 | Kent E. Dicks | Method for remote provisioning of electronic devices by overlaying an initial image with an updated image |
US8126728B2 (en) * | 2006-10-24 | 2012-02-28 | Medapps, Inc. | Systems and methods for processing and transmittal of medical data through an intermediary device |
US20080097917A1 (en) * | 2006-10-24 | 2008-04-24 | Kent Dicks | Systems and methods for wireless processing and medical device monitoring via remote command execution |
US8126730B2 (en) * | 2006-10-24 | 2012-02-28 | Medapps, Inc. | Systems and methods for storage and forwarding of medical data |
US20080097914A1 (en) * | 2006-10-24 | 2008-04-24 | Kent Dicks | Systems and methods for wireless processing and transmittal of medical data through multiple interfaces |
US8131566B2 (en) | 2006-10-24 | 2012-03-06 | Medapps, Inc. | System for facility management of medical data and patient interface |
WO2008066424A1 (en) * | 2006-11-30 | 2008-06-05 | St. Jude Medical Ab | Device and method for initiating communication with a selected implantable medical device by means of a directional antenna |
US20080199894A1 (en) | 2007-02-15 | 2008-08-21 | Abbott Diabetes Care, Inc. | Device and method for automatic data acquisition and/or detection |
US10860943B2 (en) | 2007-02-22 | 2020-12-08 | WellDoc, Inc. | Systems and methods for disease control and management |
WO2008103827A1 (en) | 2007-02-22 | 2008-08-28 | Welldoc Communications, Inc. | System and method for providing treatment recommendations based on models |
US10872686B2 (en) | 2007-02-22 | 2020-12-22 | WellDoc, Inc. | Systems and methods for disease control and management |
US8123686B2 (en) | 2007-03-01 | 2012-02-28 | Abbott Diabetes Care Inc. | Method and apparatus for providing rolling data in communication systems |
US9270025B2 (en) | 2007-03-09 | 2016-02-23 | Proteus Digital Health, Inc. | In-body device having deployable antenna |
EP2124725A1 (en) | 2007-03-09 | 2009-12-02 | Proteus Biomedical, Inc. | In-body device having a multi-directional transmitter |
CA2683953C (en) | 2007-04-14 | 2016-08-02 | Abbott Diabetes Care Inc. | Method and apparatus for providing data processing and control in medical communication system |
ES2817503T3 (en) | 2007-04-14 | 2021-04-07 | Abbott Diabetes Care Inc | Procedure and apparatus for providing data processing and control in a medical communication system |
US9615780B2 (en) | 2007-04-14 | 2017-04-11 | Abbott Diabetes Care Inc. | Method and apparatus for providing data processing and control in medical communication system |
WO2008130898A1 (en) | 2007-04-14 | 2008-10-30 | Abbott Diabetes Care, Inc. | Method and apparatus for providing data processing and control in medical communication system |
WO2008130895A2 (en) | 2007-04-14 | 2008-10-30 | Abbott Diabetes Care, Inc. | Method and apparatus for providing dynamic multi-stage signal amplification in a medical device |
US8665091B2 (en) | 2007-05-08 | 2014-03-04 | Abbott Diabetes Care Inc. | Method and device for determining elapsed sensor life |
US7928850B2 (en) | 2007-05-08 | 2011-04-19 | Abbott Diabetes Care Inc. | Analyte monitoring system and methods |
US8461985B2 (en) | 2007-05-08 | 2013-06-11 | Abbott Diabetes Care Inc. | Analyte monitoring system and methods |
US8456301B2 (en) | 2007-05-08 | 2013-06-04 | Abbott Diabetes Care Inc. | Analyte monitoring system and methods |
US8260558B2 (en) | 2007-05-14 | 2012-09-04 | Abbott Diabetes Care Inc. | Method and apparatus for providing data processing and control in a medical communication system |
US9125548B2 (en) | 2007-05-14 | 2015-09-08 | Abbott Diabetes Care Inc. | Method and apparatus for providing data processing and control in a medical communication system |
US8600681B2 (en) | 2007-05-14 | 2013-12-03 | Abbott Diabetes Care Inc. | Method and apparatus for providing data processing and control in a medical communication system |
US8239166B2 (en) | 2007-05-14 | 2012-08-07 | Abbott Diabetes Care Inc. | Method and apparatus for providing data processing and control in a medical communication system |
US8444560B2 (en) | 2007-05-14 | 2013-05-21 | Abbott Diabetes Care Inc. | Method and apparatus for providing data processing and control in a medical communication system |
US8103471B2 (en) | 2007-05-14 | 2012-01-24 | Abbott Diabetes Care Inc. | Method and apparatus for providing data processing and control in a medical communication system |
US8560038B2 (en) | 2007-05-14 | 2013-10-15 | Abbott Diabetes Care Inc. | Method and apparatus for providing data processing and control in a medical communication system |
US10002233B2 (en) | 2007-05-14 | 2018-06-19 | Abbott Diabetes Care Inc. | Method and apparatus for providing data processing and control in a medical communication system |
JP2010531169A (en) | 2007-06-21 | 2010-09-24 | アボット ダイアベティス ケア インコーポレイテッド | Health monitoring device |
AU2008265541B2 (en) | 2007-06-21 | 2014-07-17 | Abbott Diabetes Care, Inc. | Health management devices and methods |
US8160900B2 (en) | 2007-06-29 | 2012-04-17 | Abbott Diabetes Care Inc. | Analyte monitoring and management device and method to analyze the frequency of user interaction with the device |
US8834366B2 (en) | 2007-07-31 | 2014-09-16 | Abbott Diabetes Care Inc. | Method and apparatus for providing analyte sensor calibration |
US8409093B2 (en) | 2007-10-23 | 2013-04-02 | Abbott Diabetes Care Inc. | Assessing measures of glycemic variability |
US8377031B2 (en) | 2007-10-23 | 2013-02-19 | Abbott Diabetes Care Inc. | Closed loop control system with safety parameters and methods |
US20090164239A1 (en) | 2007-12-19 | 2009-06-25 | Abbott Diabetes Care, Inc. | Dynamic Display Of Glucose Information |
US8591410B2 (en) | 2008-05-30 | 2013-11-26 | Abbott Diabetes Care Inc. | Method and apparatus for providing glycemic control |
US8924159B2 (en) | 2008-05-30 | 2014-12-30 | Abbott Diabetes Care Inc. | Method and apparatus for providing glycemic control |
US7826382B2 (en) * | 2008-05-30 | 2010-11-02 | Abbott Diabetes Care Inc. | Close proximity communication device and methods |
US8876755B2 (en) | 2008-07-14 | 2014-11-04 | Abbott Diabetes Care Inc. | Closed loop control system interface and methods |
AU2009281876B2 (en) | 2008-08-13 | 2014-05-22 | Proteus Digital Health, Inc. | Ingestible circuitry |
US8734422B2 (en) | 2008-08-31 | 2014-05-27 | Abbott Diabetes Care Inc. | Closed loop control with improved alarm functions |
US9943644B2 (en) | 2008-08-31 | 2018-04-17 | Abbott Diabetes Care Inc. | Closed loop control with reference measurement and methods thereof |
US8622988B2 (en) | 2008-08-31 | 2014-01-07 | Abbott Diabetes Care Inc. | Variable rate closed loop control and methods |
US20100057040A1 (en) | 2008-08-31 | 2010-03-04 | Abbott Diabetes Care, Inc. | Robust Closed Loop Control And Methods |
US8986208B2 (en) | 2008-09-30 | 2015-03-24 | Abbott Diabetes Care Inc. | Analyte sensor sensitivity attenuation mitigation |
KR101192690B1 (en) | 2008-11-13 | 2012-10-19 | 프로테우스 디지털 헬스, 인코포레이티드 | Ingestible therapy activator system, therapeutic device and method |
EP3395333A1 (en) | 2009-01-06 | 2018-10-31 | Proteus Digital Health, Inc. | Pharmaceutical dosages delivery system |
US9402544B2 (en) | 2009-02-03 | 2016-08-02 | Abbott Diabetes Care Inc. | Analyte sensor and apparatus for insertion of the sensor |
WO2010111403A2 (en) | 2009-03-25 | 2010-09-30 | Proteus Biomedical, Inc. | Probablistic pharmacokinetic and pharmacodynamic modeling |
US8497777B2 (en) | 2009-04-15 | 2013-07-30 | Abbott Diabetes Care Inc. | Analyte monitoring system having an alert |
CN102458236B (en) | 2009-04-28 | 2016-01-27 | 普罗秋斯数字健康公司 | The Ingestible event marker of high reliability and using method thereof |
US9226701B2 (en) | 2009-04-28 | 2016-01-05 | Abbott Diabetes Care Inc. | Error detection in critical repeating data in a wireless sensor system |
US8483967B2 (en) | 2009-04-29 | 2013-07-09 | Abbott Diabetes Care Inc. | Method and system for providing real time analyte sensor calibration with retrospective backfill |
US8368556B2 (en) | 2009-04-29 | 2013-02-05 | Abbott Diabetes Care Inc. | Method and system for providing data communication in continuous glucose monitoring and management system |
US9149423B2 (en) | 2009-05-12 | 2015-10-06 | Proteus Digital Health, Inc. | Ingestible event markers comprising an ingestible component |
US20100298663A1 (en) * | 2009-05-20 | 2010-11-25 | Pacesetter, Inc. | System and method for detection and treatment of irregular metabolic function |
WO2010138856A1 (en) | 2009-05-29 | 2010-12-02 | Abbott Diabetes Care Inc. | Medical device antenna systems having external antenna configurations |
DK3173014T3 (en) | 2009-07-23 | 2021-09-13 | Abbott Diabetes Care Inc | Real-time control of data on physiological control of glucose levels |
EP4289355A3 (en) | 2009-07-23 | 2024-02-28 | Abbott Diabetes Care Inc. | Continuous analyte measurement system |
WO2011014851A1 (en) | 2009-07-31 | 2011-02-03 | Abbott Diabetes Care Inc. | Method and apparatus for providing analyte monitoring system calibration accuracy |
US8558563B2 (en) | 2009-08-21 | 2013-10-15 | Proteus Digital Health, Inc. | Apparatus and method for measuring biochemical parameters |
AU2010286917B2 (en) | 2009-08-31 | 2016-03-10 | Abbott Diabetes Care Inc. | Medical devices and methods |
EP2473099A4 (en) | 2009-08-31 | 2015-01-14 | Abbott Diabetes Care Inc | Analyte monitoring system and methods for managing power and noise |
US9314195B2 (en) | 2009-08-31 | 2016-04-19 | Abbott Diabetes Care Inc. | Analyte signal processing device and methods |
EP4070728A1 (en) | 2009-08-31 | 2022-10-12 | Abbott Diabetes Care, Inc. | Displays for a medical device |
US8237555B2 (en) * | 2009-10-09 | 2012-08-07 | Mccarthy Tom | Hazardous vehicle alert system and method based on reaction time, distance and speed |
UA109424C2 (en) | 2009-12-02 | 2015-08-25 | PHARMACEUTICAL PRODUCT, PHARMACEUTICAL TABLE WITH ELECTRONIC MARKER AND METHOD OF MANUFACTURING PHARMACEUTICAL TABLETS | |
US8468239B2 (en) | 2009-12-30 | 2013-06-18 | Cisco Technology, Inc. | Health presence local management interface |
BR112012025650A2 (en) | 2010-04-07 | 2020-08-18 | Proteus Digital Health, Inc. | miniature ingestible device |
US10238362B2 (en) | 2010-04-26 | 2019-03-26 | Gary And Mary West Health Institute | Integrated wearable device for detection of fetal heart rate and material uterine contractions with wireless communication capability |
US20110306859A1 (en) * | 2010-05-06 | 2011-12-15 | Enrique Saldivar | Multipurpose, modular platform for mobile medical instrumentation |
EP2624745A4 (en) | 2010-10-07 | 2018-05-23 | Abbott Diabetes Care, Inc. | Analyte monitoring devices and methods |
US9717412B2 (en) | 2010-11-05 | 2017-08-01 | Gary And Mary West Health Institute | Wireless fetal monitoring system |
JP2014504902A (en) | 2010-11-22 | 2014-02-27 | プロテウス デジタル ヘルス, インコーポレイテッド | Ingestible device with medicinal product |
US10136845B2 (en) | 2011-02-28 | 2018-11-27 | Abbott Diabetes Care Inc. | Devices, systems, and methods associated with analyte monitoring devices and devices incorporating the same |
CA3177983A1 (en) | 2011-02-28 | 2012-11-15 | Abbott Diabetes Care Inc. | Devices, systems, and methods associated with analyte monitoring devices and devices incorporating the same |
US8542646B1 (en) | 2011-06-03 | 2013-09-24 | Olympus Corporation | Interference mitigation for network communications |
US8954148B2 (en) | 2011-06-28 | 2015-02-10 | Greatbatch, Ltd. | Key fob controller for an implantable neurostimulator |
WO2013066873A1 (en) | 2011-10-31 | 2013-05-10 | Abbott Diabetes Care Inc. | Electronic devices having integrated reset systems and methods thereof |
US9317656B2 (en) | 2011-11-23 | 2016-04-19 | Abbott Diabetes Care Inc. | Compatibility mechanisms for devices in a continuous analyte monitoring system and methods thereof |
US8710993B2 (en) | 2011-11-23 | 2014-04-29 | Abbott Diabetes Care Inc. | Mitigating single point failure of devices in an analyte monitoring system and methods thereof |
WO2013078426A2 (en) | 2011-11-25 | 2013-05-30 | Abbott Diabetes Care Inc. | Analyte monitoring system and methods of use |
US9271897B2 (en) | 2012-07-23 | 2016-03-01 | Proteus Digital Health, Inc. | Techniques for manufacturing ingestible event markers comprising an ingestible component |
EP3395252A1 (en) | 2012-08-30 | 2018-10-31 | Abbott Diabetes Care, Inc. | Dropout detection in continuous analyte monitoring data during data excursions |
US9968306B2 (en) | 2012-09-17 | 2018-05-15 | Abbott Diabetes Care Inc. | Methods and apparatuses for providing adverse condition notification with enhanced wireless communication range in analyte monitoring systems |
EP2901153A4 (en) | 2012-09-26 | 2016-04-27 | Abbott Diabetes Care Inc | Method and apparatus for improving lag correction during in vivo measurement of analyte concentration with analyte concentration variability and range data |
SG11201503027SA (en) | 2012-10-18 | 2015-05-28 | Proteus Digital Health Inc | Apparatus, system, and method to adaptively optimize power dissipation and broadcast power in a power source for a communication device |
JP2016508529A (en) | 2013-01-29 | 2016-03-22 | プロテウス デジタル ヘルス, インコーポレイテッド | Highly expandable polymer film and composition containing the same |
JP5941240B2 (en) | 2013-03-15 | 2016-06-29 | プロテウス デジタル ヘルス, インコーポレイテッド | Metal detector device, system and method |
US9796576B2 (en) | 2013-08-30 | 2017-10-24 | Proteus Digital Health, Inc. | Container with electronically controlled interlock |
US11587688B2 (en) | 2014-03-27 | 2023-02-21 | Raymond Anthony Joao | Apparatus and method for providing healthcare services remotely or virtually with or using an electronic healthcare record and/or a communication network |
US10185513B1 (en) | 2015-06-05 | 2019-01-22 | Life365, Inc. | Device configured for dynamic software change |
US11329683B1 (en) | 2015-06-05 | 2022-05-10 | Life365, Inc. | Device configured for functional diagnosis and updates |
US9974492B1 (en) | 2015-06-05 | 2018-05-22 | Life365, Inc. | Health monitoring and communications device |
US10560135B1 (en) | 2015-06-05 | 2020-02-11 | Life365, Inc. | Health, wellness and activity monitor |
AU2016291569B2 (en) | 2015-07-10 | 2021-07-08 | Abbott Diabetes Care Inc. | System, device and method of dynamic glucose profile response to physiological parameters |
US11051543B2 (en) | 2015-07-21 | 2021-07-06 | Otsuka Pharmaceutical Co. Ltd. | Alginate on adhesive bilayer laminate film |
US10388411B1 (en) | 2015-09-02 | 2019-08-20 | Life365, Inc. | Device configured for functional diagnosis and updates |
WO2017075154A1 (en) | 2015-10-29 | 2017-05-04 | Cardiac Pacemakers, Inc. | Prediction of worsening of heart failure |
EP3531901A4 (en) | 2016-10-26 | 2021-01-27 | Proteus Digital Health, Inc. | Methods for manufacturing capsules with ingestible event markers |
WO2018175489A1 (en) | 2017-03-21 | 2018-09-27 | Abbott Diabetes Care Inc. | Methods, devices and system for providing diabetic condition diagnosis and therapy |
US11696683B2 (en) | 2021-02-10 | 2023-07-11 | International Business Machines Corporation | Medical device system |
AU2022328745A1 (en) * | 2021-08-18 | 2024-01-18 | Advanced Neuromodulation Systems, Inc. | Systems and methods for providing digital health services |
EP4151270A1 (en) | 2021-09-20 | 2023-03-22 | BIOTRONIK SE & Co. KG | System for data communication and respective method |
Citations (17)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3876353A (en) * | 1972-04-11 | 1975-04-08 | Andrew R Nedoh | Mold assembly for applying a decorative facing to an article |
US4899758A (en) * | 1986-01-31 | 1990-02-13 | Regents Of The University Of Minnesota | Method and apparatus for monitoring and diagnosing hypertension and congestive heart failure |
US5331966A (en) * | 1991-04-05 | 1994-07-26 | Medtronic, Inc. | Subcutaneous multi-electrode sensing system, method and pacer |
US5899928A (en) * | 1996-05-14 | 1999-05-04 | Pacesetter, Inc. | Descriptive transtelephonic pacing intervals for use by an emplantable pacemaker |
US5920310A (en) * | 1996-11-15 | 1999-07-06 | Synaptics, Incorporated | Electronic device employing a touch sensitive transducer |
US5957861A (en) * | 1997-01-31 | 1999-09-28 | Medtronic, Inc. | Impedance monitor for discerning edema through evaluation of respiratory rate |
US5987352A (en) * | 1996-07-11 | 1999-11-16 | Medtronic, Inc. | Minimally invasive implantable device for monitoring physiologic events |
US6104949A (en) * | 1998-09-09 | 2000-08-15 | Vitatron Medical, B.V. | Medical device |
US6190324B1 (en) * | 1999-04-28 | 2001-02-20 | Medtronic, Inc. | Implantable medical device for tracking patient cardiac status |
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 |
US6351667B1 (en) * | 1997-10-24 | 2002-02-26 | Pulsion Medical Systems Ag | Device for detecting pericardial effusion |
US6416471B1 (en) * | 1999-04-15 | 2002-07-09 | Nexan Limited | Portable remote patient telemonitoring system |
US20020115939A1 (en) * | 2000-12-28 | 2002-08-22 | Mulligan Lawrence J. | Implantable medical device for monitoring congestive heart failure |
US6497655B1 (en) * | 1999-12-17 | 2002-12-24 | Medtronic, Inc. | Virtual remote monitor, alert, diagnostics and programming for implantable medical device systems |
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 |
US20030114898A1 (en) * | 2001-12-19 | 2003-06-19 | Von Arx Jeffrey A. | Telemetry duty cycle management system for an implantable medical device |
US20030139783A1 (en) * | 2001-10-16 | 2003-07-24 | Kilgore Kevin L. | Neural prosthesis |
Family Cites Families (14)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
DE3732640C1 (en) | 1987-09-28 | 1989-05-18 | Alt Eckhard | Medical device for determining physiological functional parameters |
US5342408A (en) * | 1993-01-07 | 1994-08-30 | Incontrol, Inc. | Telemetry system for an implantable cardiac device |
US5643328A (en) * | 1996-07-19 | 1997-07-01 | Sulzer Intermedics Inc. | Implantable cardiac stimulation device with warning system having elongated stimulation electrode |
US5792205A (en) * | 1996-10-21 | 1998-08-11 | Intermedics, Inc. | Cardiac pacemaker with bidirectional communication |
US5876353A (en) | 1997-01-31 | 1999-03-02 | Medtronic, Inc. | Impedance monitor for discerning edema through evaluation of respiratory rate |
US6941171B2 (en) * | 1998-07-06 | 2005-09-06 | Advanced Bionics Corporation | Implantable stimulator methods for treatment of incontinence and pain |
US6141588A (en) * | 1998-07-24 | 2000-10-31 | Intermedics Inc. | Cardiac simulation system having multiple stimulators for anti-arrhythmia therapy |
US7181505B2 (en) * | 1999-07-07 | 2007-02-20 | Medtronic, Inc. | System and method for remote programming of an implantable medical device |
US6445956B1 (en) * | 1999-10-18 | 2002-09-03 | Abiomed, Inc. | Implantable medical device |
US6600949B1 (en) | 1999-11-10 | 2003-07-29 | Pacesetter, Inc. | Method for monitoring heart failure via respiratory patterns |
US6752765B1 (en) * | 1999-12-01 | 2004-06-22 | Medtronic, Inc. | Method and apparatus for monitoring heart rate and abnormal respiration |
US6738667B2 (en) * | 2000-12-28 | 2004-05-18 | Medtronic, Inc. | Implantable medical device for treating cardiac mechanical dysfunction by electrical stimulation |
US6456256B1 (en) * | 2001-08-03 | 2002-09-24 | Cardiac Pacemakers, Inc. | Circumferential antenna for an implantable medical device |
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 |
-
2004
- 2004-12-07 US US11/007,046 patent/US20050137480A1/en not_active Abandoned
-
2006
- 2006-06-30 US US11/428,262 patent/US8073541B2/en not_active Expired - Fee Related
-
2007
- 2007-09-10 US US11/852,746 patent/US9775532B2/en active Active
Patent Citations (17)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3876353A (en) * | 1972-04-11 | 1975-04-08 | Andrew R Nedoh | Mold assembly for applying a decorative facing to an article |
US4899758A (en) * | 1986-01-31 | 1990-02-13 | Regents Of The University Of Minnesota | Method and apparatus for monitoring and diagnosing hypertension and congestive heart failure |
US5331966A (en) * | 1991-04-05 | 1994-07-26 | Medtronic, Inc. | Subcutaneous multi-electrode sensing system, method and pacer |
US5899928A (en) * | 1996-05-14 | 1999-05-04 | Pacesetter, Inc. | Descriptive transtelephonic pacing intervals for use by an emplantable pacemaker |
US5987352A (en) * | 1996-07-11 | 1999-11-16 | Medtronic, Inc. | Minimally invasive implantable device for monitoring physiologic events |
US5920310A (en) * | 1996-11-15 | 1999-07-06 | Synaptics, Incorporated | Electronic device employing a touch sensitive transducer |
US5957861A (en) * | 1997-01-31 | 1999-09-28 | Medtronic, Inc. | Impedance monitor for discerning edema through evaluation of respiratory rate |
US6351667B1 (en) * | 1997-10-24 | 2002-02-26 | Pulsion Medical Systems Ag | Device for detecting pericardial effusion |
US6104949A (en) * | 1998-09-09 | 2000-08-15 | Vitatron Medical, B.V. | Medical device |
US6416471B1 (en) * | 1999-04-15 | 2002-07-09 | Nexan Limited | Portable remote patient telemonitoring system |
US6190324B1 (en) * | 1999-04-28 | 2001-02-20 | Medtronic, Inc. | Implantable medical device for tracking patient cardiac status |
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 |
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 |
US6497655B1 (en) * | 1999-12-17 | 2002-12-24 | Medtronic, Inc. | Virtual remote monitor, alert, diagnostics and programming for implantable medical device systems |
US20020115939A1 (en) * | 2000-12-28 | 2002-08-22 | Mulligan Lawrence J. | Implantable medical device for monitoring congestive heart failure |
US20030139783A1 (en) * | 2001-10-16 | 2003-07-24 | Kilgore Kevin L. | Neural prosthesis |
US20030114898A1 (en) * | 2001-12-19 | 2003-06-19 | Von Arx Jeffrey A. | Telemetry duty cycle management system for an implantable medical device |
Cited By (255)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US8555882B2 (en) | 1997-03-14 | 2013-10-15 | Covidien Lp | Ventilator breath display and graphic user interface |
US8555881B2 (en) | 1997-03-14 | 2013-10-15 | Covidien Lp | Ventilator breath display and graphic interface |
US8233974B2 (en) | 1999-06-22 | 2012-07-31 | Impedimed Limited | Method and device for measuring tissue oedema |
US20030191503A1 (en) * | 2001-07-31 | 2003-10-09 | Cardiac Pacemakers, Inc. | Cardiac rhythm management system for edema |
US20080215108A1 (en) * | 2001-07-31 | 2008-09-04 | Cardiac Pacemakers, Inc. | Cardiac rhythm management system for edema |
US20030028221A1 (en) * | 2001-07-31 | 2003-02-06 | Qingsheng Zhu | Cardiac rhythm management system for edema |
US9265950B2 (en) | 2001-07-31 | 2016-02-23 | Cardiac Pacemakers, Inc. | Contractility modulation based on impedance signal |
US9149235B2 (en) | 2004-06-18 | 2015-10-06 | Impedimed Limited | Oedema detection |
US20080319336A1 (en) * | 2004-06-18 | 2008-12-25 | Leigh Ward | Oedema Detection |
US8744564B2 (en) | 2004-06-18 | 2014-06-03 | Impedimed Limited | Oedema detection |
US7672718B2 (en) | 2004-08-19 | 2010-03-02 | Cardiac Pacemakers, Inc. | Thoracic impedance detection with blood resistivity compensation |
US7881781B2 (en) | 2004-08-19 | 2011-02-01 | Cardiac Pacemakers, Inc. | Thoracic impedance detection with blood resistivity compensation |
US20060041280A1 (en) * | 2004-08-19 | 2006-02-23 | Cardiac Pacemakers, Inc. | Thoracic impedance detection with blood resistivity compensation |
US8103337B2 (en) | 2004-11-26 | 2012-01-24 | Impedimed Limited | Weighted gradient method and system for diagnosing disease |
US9586047B2 (en) | 2005-01-28 | 2017-03-07 | Cyberonics, Inc. | Contingent cardio-protection for epilepsy patients |
US8565867B2 (en) | 2005-01-28 | 2013-10-22 | Cyberonics, Inc. | Changeable electrode polarity stimulation by an implantable medical device |
US8200326B2 (en) | 2005-04-26 | 2012-06-12 | Cardiac Pacemakers, Inc. | Calibration of impedance monitoring of respiratory volumes using thoracic D.C. impedance |
US8730031B2 (en) | 2005-04-28 | 2014-05-20 | Proteus Digital Health, Inc. | Communication system using an implantable device |
US9198608B2 (en) | 2005-04-28 | 2015-12-01 | Proteus Digital Health, Inc. | Communication system incorporated in a container |
US8847766B2 (en) | 2005-04-28 | 2014-09-30 | Proteus Digital Health, Inc. | Pharma-informatics system |
US8674825B2 (en) | 2005-04-28 | 2014-03-18 | Proteus Digital Health, Inc. | Pharma-informatics system |
US9597010B2 (en) | 2005-04-28 | 2017-03-21 | Proteus Digital Health, Inc. | Communication system using an implantable device |
US20060271088A1 (en) * | 2005-05-02 | 2006-11-30 | Almuhannad Alfrhan | Percutaneous intragastric balloon device and method |
US9345604B2 (en) | 2005-05-02 | 2016-05-24 | Almuhannad Alfrhan | Percutaneous intragastric balloon device and method |
US7907997B2 (en) | 2005-05-11 | 2011-03-15 | Cardiac Pacemakers, Inc. | Enhancements to the detection of pulmonary edema when using transthoracic impedance |
US9089275B2 (en) | 2005-05-11 | 2015-07-28 | Cardiac Pacemakers, Inc. | Sensitivity and specificity of pulmonary edema detection when using transthoracic impedance |
US20060258952A1 (en) * | 2005-05-11 | 2006-11-16 | Cardiac Pacemakers, Inc. | Enhancements to the detection of pulmonary edema when using transthoracic impedance |
US20060293609A1 (en) * | 2005-05-11 | 2006-12-28 | Cardiac Pacemakers, Inc. | Sensitivity and specificity of pulmonary edema detection when using transthoracic impedance |
US8483818B2 (en) | 2005-05-11 | 2013-07-09 | Cardiac Pacemakers, Inc. | Enhancements to the detection of pulmonary edema when using transthoracic impedance |
US7979115B2 (en) | 2005-05-18 | 2011-07-12 | Cardiac Pacemakers, Inc. | Detection of pleural effusion using transthoracic impedance |
US8900154B2 (en) | 2005-05-24 | 2014-12-02 | Cardiac Pacemakers, Inc. | Prediction of thoracic fluid accumulation |
US11660013B2 (en) | 2005-07-01 | 2023-05-30 | Impedimed Limited | Monitoring system |
EP1898782A4 (en) * | 2005-07-01 | 2009-10-28 | Impedimed Ltd | Monitoring system |
US8548580B2 (en) | 2005-07-01 | 2013-10-01 | Impedimed Limited | Monitoring system |
US20110087129A1 (en) * | 2005-07-01 | 2011-04-14 | Impedimed Limited | Monitoring system |
US20110054343A1 (en) * | 2005-07-01 | 2011-03-03 | Impedimed Limited | Monitoring system |
US11737678B2 (en) | 2005-07-01 | 2023-08-29 | Impedimed Limited | Monitoring system |
US10327665B2 (en) | 2005-07-01 | 2019-06-25 | Impedimed Limited | Monitoring system |
AU2006265761B2 (en) * | 2005-07-01 | 2011-08-11 | Impedimed Limited | Monitoring system |
EP1898782A1 (en) * | 2005-07-01 | 2008-03-19 | Impedimed Limited | Monitoring system |
US8099250B2 (en) | 2005-08-02 | 2012-01-17 | Impedimed Limited | Impedance parameter values |
US20080270051A1 (en) * | 2005-08-02 | 2008-10-30 | Impedimed Limited | Impedance Parameter Values |
US8547248B2 (en) | 2005-09-01 | 2013-10-01 | Proteus Digital Health, Inc. | Implantable zero-wire communications system |
US11612332B2 (en) | 2005-10-11 | 2023-03-28 | Impedimed Limited | Hydration status monitoring |
US9724012B2 (en) | 2005-10-11 | 2017-08-08 | Impedimed Limited | Hydration status monitoring |
US20070180047A1 (en) * | 2005-12-12 | 2007-08-02 | Yanting Dong | System and method for providing authentication of remotely collected external sensor measures |
US20070149887A1 (en) * | 2005-12-22 | 2007-06-28 | Samsung Electronics Co., Ltd. | Portable electrocardiogram measurement device |
US8150508B2 (en) | 2006-03-29 | 2012-04-03 | Catholic Healthcare West | Vagus nerve stimulation method |
US9533151B2 (en) | 2006-03-29 | 2017-01-03 | Dignity Health | Microburst electrical stimulation of cranial nerves for the treatment of medical conditions |
US8219188B2 (en) | 2006-03-29 | 2012-07-10 | Catholic Healthcare West | Synchronization of vagus nerve stimulation with the cardiac cycle of a patient |
US9289599B2 (en) | 2006-03-29 | 2016-03-22 | Dignity Health | Vagus nerve stimulation method |
US8660666B2 (en) | 2006-03-29 | 2014-02-25 | Catholic Healthcare West | Microburst electrical stimulation of cranial nerves for the treatment of medical conditions |
US8280505B2 (en) | 2006-03-29 | 2012-10-02 | Catholic Healthcare West | Vagus nerve stimulation method |
US8615309B2 (en) | 2006-03-29 | 2013-12-24 | Catholic Healthcare West | Microburst electrical stimulation of cranial nerves for the treatment of medical conditions |
US9108041B2 (en) | 2006-03-29 | 2015-08-18 | Dignity Health | Microburst electrical stimulation of cranial nerves for the treatment of medical conditions |
US8738126B2 (en) | 2006-03-29 | 2014-05-27 | Catholic Healthcare West | Synchronization of vagus nerve stimulation with the cardiac cycle of a patient |
US8597198B2 (en) | 2006-04-21 | 2013-12-03 | Covidien Lp | Work of breathing display for a ventilation system |
US10582880B2 (en) | 2006-04-21 | 2020-03-10 | Covidien Lp | Work of breathing display for a ventilation system |
US7869885B2 (en) | 2006-04-28 | 2011-01-11 | Cyberonics, Inc | Threshold optimization for tissue stimulation therapy |
US8956287B2 (en) | 2006-05-02 | 2015-02-17 | Proteus Digital Health, Inc. | Patient customized therapeutic regimens |
US11928614B2 (en) | 2006-05-02 | 2024-03-12 | Otsuka Pharmaceutical Co., Ltd. | Patient customized therapeutic regimens |
US11517750B2 (en) | 2006-05-18 | 2022-12-06 | Endostim, Inc. | Device and implantation system for electrical stimulation of biological systems |
US10272242B2 (en) | 2006-05-18 | 2019-04-30 | Endostim, Inc. | Device and implantation system for electrical stimulation of biological systems |
US9616225B2 (en) | 2006-05-18 | 2017-04-11 | Endostim, Inc. | Device and implantation system for electrical stimulation of biological systems |
US8761870B2 (en) | 2006-05-30 | 2014-06-24 | Impedimed Limited | Impedance measurements |
US8700143B2 (en) | 2006-07-28 | 2014-04-15 | Medtronic, Inc. | Adaptations to optivol alert algorithm |
US8055335B2 (en) | 2006-07-28 | 2011-11-08 | Medtronic, Inc. | Adaptations to intra-thoracic fluid monitoring algorithm |
US20080024293A1 (en) * | 2006-07-28 | 2008-01-31 | Lee Stylos | Adaptations to optivol alert algorithm |
US20080027349A1 (en) * | 2006-07-28 | 2008-01-31 | Lee Stylos | Adaptations to intra-thoracic fluid monitoring algorithm |
US8453645B2 (en) | 2006-09-26 | 2013-06-04 | Covidien Lp | Three-dimensional waveform display for a breathing assistance system |
US9724510B2 (en) | 2006-10-09 | 2017-08-08 | Endostim, Inc. | System and methods for electrical stimulation of biological systems |
US10406356B2 (en) | 2006-10-09 | 2019-09-10 | Endostim, Inc. | Systems and methods for electrical stimulation of biological systems |
US9561367B2 (en) | 2006-10-09 | 2017-02-07 | Endostim, Inc. | Device and implantation system for electrical stimulation of biological systems |
US9345879B2 (en) | 2006-10-09 | 2016-05-24 | Endostim, Inc. | Device and implantation system for electrical stimulation of biological systems |
US11786726B2 (en) | 2006-10-09 | 2023-10-17 | Endostim, Inc. | Device and implantation system for electrical stimulation of biological systems |
US10426955B2 (en) | 2006-10-09 | 2019-10-01 | Endostim, Inc. | Methods for implanting electrodes and treating a patient with gastreosophageal reflux disease |
US11577077B2 (en) | 2006-10-09 | 2023-02-14 | Endostim, Inc. | Systems and methods for electrical stimulation of biological systems |
US10238604B2 (en) | 2006-10-25 | 2019-03-26 | Proteus Digital Health, Inc. | Controlled activation ingestible identifier |
US11357730B2 (en) | 2006-10-25 | 2022-06-14 | Otsuka Pharmaceutical Co., Ltd. | Controlled activation ingestible identifier |
US8945005B2 (en) | 2006-10-25 | 2015-02-03 | Proteus Digital Health, Inc. | Controlled activation ingestible identifier |
US7869867B2 (en) | 2006-10-27 | 2011-01-11 | Cyberonics, Inc. | Implantable neurostimulator with refractory stimulation |
US20080103551A1 (en) * | 2006-10-30 | 2008-05-01 | Javaid Masoud | Implantable Medical Device with Variable Data Retransmission Characteristics Based Upon Data Type |
US10420948B2 (en) * | 2006-10-30 | 2019-09-24 | Medtronic, Inc. | Implantable medical device with variable data retransmission characteristics based upon data type |
US20080103530A1 (en) * | 2006-10-31 | 2008-05-01 | Vitense Holly S | Methods and Apparatus for Manually Suspending Intrathoracic Impedance Fluid Status Measurements |
US8948868B2 (en) * | 2006-10-31 | 2015-02-03 | Medtronic, Inc. | Methods and apparatus for manually suspending intrathoracic impedance fluid status measurements |
US8718193B2 (en) | 2006-11-20 | 2014-05-06 | Proteus Digital Health, Inc. | Active signal processing personal health signal receivers |
US9083589B2 (en) | 2006-11-20 | 2015-07-14 | Proteus Digital Health, Inc. | Active signal processing personal health signal receivers |
US9444503B2 (en) | 2006-11-20 | 2016-09-13 | Proteus Digital Health, Inc. | Active signal processing personal health signal receivers |
US9504406B2 (en) | 2006-11-30 | 2016-11-29 | Impedimed Limited | Measurement apparatus |
WO2008070818A2 (en) * | 2006-12-07 | 2008-06-12 | Medtronic, Inc. | Adaptations to optival alert algorithm |
WO2008070818A3 (en) * | 2006-12-07 | 2008-10-09 | Medtronic Inc | Adaptations to optival alert algorithm |
US8594781B2 (en) | 2007-01-15 | 2013-11-26 | Impedimed Limited | Monitoring system |
US20100100003A1 (en) * | 2007-01-15 | 2010-04-22 | Impedimed Limited | Monitoring system |
US8858432B2 (en) | 2007-02-01 | 2014-10-14 | Proteus Digital Health, Inc. | Ingestible event marker systems |
US10441194B2 (en) | 2007-02-01 | 2019-10-15 | Proteus Digital Heal Th, Inc. | Ingestible event marker systems |
US8956288B2 (en) | 2007-02-14 | 2015-02-17 | Proteus Digital Health, Inc. | In-body power source having high surface area electrode |
US11464423B2 (en) | 2007-02-14 | 2022-10-11 | Otsuka Pharmaceutical Co., Ltd. | In-body power source having high surface area electrode |
US20100109739A1 (en) * | 2007-03-30 | 2010-05-06 | Impedimed Limited | Active guarding for reduction of resistive and capacitive signal loading with adjustable control of compensation level |
US8487686B2 (en) | 2007-03-30 | 2013-07-16 | Impedimed Limited | Active guarding for reduction of resistive and capacitive signal loading with adjustable control of compensation level |
US10307074B2 (en) | 2007-04-20 | 2019-06-04 | Impedimed Limited | Monitoring system and probe |
US20080264431A1 (en) * | 2007-04-24 | 2008-10-30 | Javaid Masoud | Channel Selection and Mapping for Medical Device Communication |
US7742822B2 (en) | 2007-04-24 | 2010-06-22 | Medtronic, Inc. | Channel selection and mapping for medical device communication |
US7974701B2 (en) | 2007-04-27 | 2011-07-05 | Cyberonics, Inc. | Dosing limitation for an implantable medical device |
US8306627B2 (en) | 2007-04-27 | 2012-11-06 | Cyberonics, Inc. | Dosing limitation for an implantable medical device |
US10517506B2 (en) | 2007-05-24 | 2019-12-31 | Proteus Digital Health, Inc. | Low profile antenna for in body device |
US8540632B2 (en) | 2007-05-24 | 2013-09-24 | Proteus Digital Health, Inc. | Low profile antenna for in body device |
US9439580B2 (en) | 2007-09-11 | 2016-09-13 | Cardiac Pacemakers, Inc. | Histogram-based thoracic impedance monitoring |
US8831716B2 (en) | 2007-09-11 | 2014-09-09 | Cardiac Pacemakers, Inc. | Histogram-based thoracic impedance monitoring |
US8961412B2 (en) | 2007-09-25 | 2015-02-24 | Proteus Digital Health, Inc. | In-body device with virtual dipole signal amplification |
US9433371B2 (en) | 2007-09-25 | 2016-09-06 | Proteus Digital Health, Inc. | In-body device with virtual dipole signal amplification |
US8836345B2 (en) | 2007-11-05 | 2014-09-16 | Impedimed Limited | Impedance determination |
US11612321B2 (en) | 2007-11-27 | 2023-03-28 | Otsuka Pharmaceutical Co., Ltd. | Transbody communication systems employing communication channels |
US9314633B2 (en) | 2008-01-25 | 2016-04-19 | Cyberonics, Inc. | Contingent cardio-protection for epilepsy patients |
US8588908B2 (en) | 2008-02-04 | 2013-11-19 | University Of Virginia Patent Foundation | System, method and computer program product for detection of changes in health status and risk of imminent illness |
US20100324436A1 (en) * | 2008-02-04 | 2010-12-23 | University Of Virginia Patent Foundation | System, Method and Computer Program Product for Detection of Changes in Health Status and Risk of Imminent Illness |
US20090287102A1 (en) * | 2008-02-15 | 2009-11-19 | Impedimed Limited | Blood flow assessment of venous insufficiency |
US9392947B2 (en) | 2008-02-15 | 2016-07-19 | Impedimed Limited | Blood flow assessment of venous insufficiency |
US11102306B2 (en) * | 2008-02-21 | 2021-08-24 | Dexcom, Inc. | Systems and methods for processing, transmitting and displaying sensor data |
US8810409B2 (en) | 2008-03-05 | 2014-08-19 | Proteus Digital Health, Inc. | Multi-mode communication ingestible event markers and systems, and methods of using the same |
US9258035B2 (en) | 2008-03-05 | 2016-02-09 | Proteus Digital Health, Inc. | Multi-mode communication ingestible event markers and systems, and methods of using the same |
US8542123B2 (en) | 2008-03-05 | 2013-09-24 | Proteus Digital Health, Inc. | Multi-mode communication ingestible event markers and systems, and methods of using the same |
US9060708B2 (en) | 2008-03-05 | 2015-06-23 | Proteus Digital Health, Inc. | Multi-mode communication ingestible event markers and systems, and methods of using the same |
US7917226B2 (en) | 2008-04-23 | 2011-03-29 | Enteromedics Inc. | Antenna arrangements for implantable therapy device |
US20110152971A1 (en) * | 2008-04-23 | 2011-06-23 | Enteromedics Inc. | Antenna arrangements for implantable therapy device |
US8483838B2 (en) | 2008-04-23 | 2013-07-09 | Enteromedics Inc. | Antenna arrangements for implantable therapy device |
US8204603B2 (en) | 2008-04-25 | 2012-06-19 | Cyberonics, Inc. | Blocking exogenous action potentials by an implantable medical device |
US8700158B2 (en) | 2008-05-22 | 2014-04-15 | Cardiac Pacemakers, Inc. | Regulatory compliant transmission of medical data employing a patient implantable medical device and a generic network access |
US8437854B2 (en) | 2008-05-22 | 2013-05-07 | Cardiac Pacemakers, Inc. | Regulatory compliant transmission of medical data employing a patient implantable medical device and a generic network access device |
US8103346B2 (en) | 2008-05-22 | 2012-01-24 | Cardiac Pacemakers, Inc. | Regulatory compliant transmission of medical data employing a patient implantable medical device and a generic network access device |
US8265757B2 (en) | 2008-05-22 | 2012-09-11 | Cardiac Pacemakers, Inc. | Regulatory compliant transmission of medical data employing a patient implantable medical device and a generic network access device |
US20090292340A1 (en) * | 2008-05-22 | 2009-11-26 | William Mass | Regulatory Compliant Transmission of Medical Data Employing a Patient Implantable Medical Device and a Generic Network Access Device |
US9603550B2 (en) | 2008-07-08 | 2017-03-28 | Proteus Digital Health, Inc. | State characterization based on multi-variate data fusion techniques |
US10682071B2 (en) | 2008-07-08 | 2020-06-16 | Proteus Digital Health, Inc. | State characterization based on multi-variate data fusion techniques |
US11217342B2 (en) | 2008-07-08 | 2022-01-04 | Otsuka Pharmaceutical Co., Ltd. | Ingestible event marker data framework |
US8874218B2 (en) | 2008-10-20 | 2014-10-28 | Cyberonics, Inc. | Neurostimulation with signal duration determined by a cardiac cycle |
US8457747B2 (en) | 2008-10-20 | 2013-06-04 | Cyberonics, Inc. | Neurostimulation with signal duration determined by a cardiac cycle |
US20100100151A1 (en) * | 2008-10-20 | 2010-04-22 | Terry Jr Reese S | Neurostimulation with signal duration determined by a cardiac cycle |
US9615766B2 (en) | 2008-11-28 | 2017-04-11 | Impedimed Limited | Impedance measurement process |
US8583227B2 (en) | 2008-12-11 | 2013-11-12 | Proteus Digital Health, Inc. | Evaluation of gastrointestinal function using portable electroviscerography systems and methods of using the same |
US9439566B2 (en) | 2008-12-15 | 2016-09-13 | Proteus Digital Health, Inc. | Re-wearable wireless device |
US8545436B2 (en) | 2008-12-15 | 2013-10-01 | Proteus Digital Health, Inc. | Body-associated receiver and method |
US9659423B2 (en) | 2008-12-15 | 2017-05-23 | Proteus Digital Health, Inc. | Personal authentication apparatus system and method |
US9149577B2 (en) | 2008-12-15 | 2015-10-06 | Proteus Digital Health, Inc. | Body-associated receiver and method |
US20110270052A1 (en) * | 2009-01-06 | 2011-11-03 | Marc Jensen | Ingestion-Related Biofeedback and Personalized Medical Therapy Method and System |
EP2385781A2 (en) * | 2009-01-06 | 2011-11-16 | Proteus Biomedical, Inc. | Ingestion-related biofeedback and personalized medical therapy method and system |
EP2385781A4 (en) * | 2009-01-06 | 2014-11-05 | Proteus Digital Health Inc | Ingestion-related biofeedback and personalized medical therapy method and system |
US9883819B2 (en) * | 2009-01-06 | 2018-02-06 | Proteus Digital Health, Inc. | Ingestion-related biofeedback and personalized medical therapy method and system |
US10653883B2 (en) | 2009-01-23 | 2020-05-19 | Livanova Usa, Inc. | Implantable medical device for providing chronic condition therapy and acute condition therapy using vagus nerve stimulation |
US9615767B2 (en) | 2009-10-26 | 2017-04-11 | Impedimed Limited | Fluid level indicator determination |
US9941931B2 (en) | 2009-11-04 | 2018-04-10 | Proteus Digital Health, Inc. | System for supply chain management |
US8868453B2 (en) | 2009-11-04 | 2014-10-21 | Proteus Digital Health, Inc. | System for supply chain management |
US10305544B2 (en) | 2009-11-04 | 2019-05-28 | Proteus Digital Health, Inc. | System for supply chain management |
US9585593B2 (en) | 2009-11-18 | 2017-03-07 | Chung Shing Fan | Signal distribution for patient-electrode measurements |
US8924878B2 (en) | 2009-12-04 | 2014-12-30 | Covidien Lp | Display and access to settings on a ventilator graphical user interface |
US9119925B2 (en) | 2009-12-04 | 2015-09-01 | Covidien Lp | Quick initiation of respiratory support via a ventilator user interface |
US8335992B2 (en) | 2009-12-04 | 2012-12-18 | Nellcor Puritan Bennett Llc | Visual indication of settings changes on a ventilator graphical user interface |
US8443294B2 (en) | 2009-12-18 | 2013-05-14 | Covidien Lp | Visual indication of alarms on a ventilator graphical user interface |
US8499252B2 (en) | 2009-12-18 | 2013-07-30 | Covidien Lp | Display of respiratory data graphs on a ventilator graphical user interface |
US9262588B2 (en) | 2009-12-18 | 2016-02-16 | Covidien Lp | Display of respiratory data graphs on a ventilator graphical user interface |
US9014779B2 (en) | 2010-02-01 | 2015-04-21 | Proteus Digital Health, Inc. | Data gathering system |
US10376218B2 (en) | 2010-02-01 | 2019-08-13 | Proteus Digital Health, Inc. | Data gathering system |
US9789309B2 (en) | 2010-03-05 | 2017-10-17 | Endostim, Inc. | Device and implantation system for electrical stimulation of biological systems |
US10058703B2 (en) | 2010-03-05 | 2018-08-28 | Endostim, Inc. | Methods of treating gastroesophageal reflux disease using an implanted device |
US10420934B2 (en) | 2010-03-05 | 2019-09-24 | Endostim, Inc. | Systems and methods for treating gastroesophageal reflux disease |
US11717681B2 (en) | 2010-03-05 | 2023-08-08 | Endostim, Inc. | Systems and methods for treating gastroesophageal reflux disease |
US11058876B2 (en) | 2010-03-05 | 2021-07-13 | Endostim (Abc), Llc | Device and implantation system for electrical stimulation of biological systems |
US9381344B2 (en) | 2010-03-05 | 2016-07-05 | Endostim, Inc. | Systems and methods for treating gastroesophageal reflux disease |
US10529044B2 (en) | 2010-05-19 | 2020-01-07 | Proteus Digital Health, Inc. | Tracking and delivery confirmation of pharmaceutical products |
US9439599B2 (en) | 2011-03-11 | 2016-09-13 | Proteus Digital Health, Inc. | Wearable personal body associated device with various physical configurations |
US20120239597A1 (en) * | 2011-03-16 | 2012-09-20 | Mckesson Financial Holdings | Method, apparatus and computer program product for providing evidence-based clinical decision support that is workflow environment independent |
WO2012165667A1 (en) * | 2011-05-30 | 2012-12-06 | 주식회사 엠아이텍 | Insertion-type medical device having window for communicating with external device |
US11191964B2 (en) | 2011-06-28 | 2021-12-07 | Cirtec Medical Corporation | Dual patient controllers |
US9878165B2 (en) | 2011-06-28 | 2018-01-30 | Nuvectra Corporation | Patient programmer having a key-fob-sized form factor |
US9756874B2 (en) | 2011-07-11 | 2017-09-12 | Proteus Digital Health, Inc. | Masticable ingestible product and communication system therefor |
US10080526B2 (en) * | 2011-07-13 | 2018-09-25 | Leidos Innovations Technology, Inc. | Three dimensional microfluidic multiplexed diagnostic system |
US20130018243A1 (en) * | 2011-07-13 | 2013-01-17 | Lockheed Martin Corporation | Three dimensional microfluidic multiplexed diagnostic system |
US10223905B2 (en) | 2011-07-21 | 2019-03-05 | Proteus Digital Health, Inc. | Mobile device and system for detection and communication of information received from an ingestible device |
US11052243B2 (en) | 2011-09-02 | 2021-07-06 | Endostim (Abc), Llc | Laparoscopic lead for esophageal sphincter implantation |
US9925367B2 (en) | 2011-09-02 | 2018-03-27 | Endostim, Inc. | Laparoscopic lead implantation method |
US11363951B2 (en) * | 2011-09-13 | 2022-06-21 | Glaukos Corporation | Intraocular physiological sensor |
US20130090534A1 (en) * | 2011-09-13 | 2013-04-11 | Thomas W. Burns | Intraocular physiological sensor |
US20130085550A1 (en) * | 2011-09-30 | 2013-04-04 | Greatbatch, Ltd. | Medical implant range extension bridge apparatus and method |
US9235683B2 (en) | 2011-11-09 | 2016-01-12 | Proteus Digital Health, Inc. | Apparatus, system, and method for managing adherence to a regimen |
US11642042B2 (en) | 2012-07-09 | 2023-05-09 | Covidien Lp | Systems and methods for missed breath detection and indication |
US10362967B2 (en) | 2012-07-09 | 2019-07-30 | Covidien Lp | Systems and methods for missed breath detection and indication |
US11052248B2 (en) | 2012-08-23 | 2021-07-06 | Endostim (Abc), Llc | Device and implantation system for electrical stimulation of biological systems |
US9623238B2 (en) | 2012-08-23 | 2017-04-18 | Endostim, Inc. | Device and implantation system for electrical stimulation of biological systems |
US9498619B2 (en) | 2013-02-26 | 2016-11-22 | Endostim, Inc. | Implantable electrical stimulation leads |
US9320435B2 (en) | 2013-03-04 | 2016-04-26 | Hello Inc. | Patient monitoring systems and messages that send alerts to patients |
US9330561B2 (en) | 2013-03-04 | 2016-05-03 | Hello Inc. | Remote communication systems and methods for communicating with a building gateway control to control building systems and elements |
US20140249852A1 (en) * | 2013-03-04 | 2014-09-04 | Hello Inc. | Methods using patient monitoring devices with unique patient IDs and a telemetry system |
US20140250181A1 (en) * | 2013-03-04 | 2014-09-04 | Hello Inc. | Method using wearable device with unique user ID and telemetry system in communication with one or more social networks |
US9159223B2 (en) | 2013-03-04 | 2015-10-13 | Hello, Inc. | User monitoring device configured to be in communication with an emergency response system or team |
US9298882B2 (en) * | 2013-03-04 | 2016-03-29 | Hello Inc. | Methods using patient monitoring devices with unique patient IDs and a telemetry system |
US9848776B2 (en) | 2013-03-04 | 2017-12-26 | Hello Inc. | Methods using activity manager for monitoring user activity |
US9320434B2 (en) | 2013-03-04 | 2016-04-26 | Hello Inc. | Patient monitoring systems and messages that send alerts to patients only when the patient is awake |
US9339188B2 (en) | 2013-03-04 | 2016-05-17 | James Proud | Methods from monitoring health, wellness and fitness with feedback |
US9345403B2 (en) | 2013-03-04 | 2016-05-24 | Hello Inc. | Wireless monitoring system with activity manager for monitoring user activity |
US9345404B2 (en) | 2013-03-04 | 2016-05-24 | Hello Inc. | Mobile device that monitors an individuals activities, behaviors, habits or health parameters |
US9357922B2 (en) | 2013-03-04 | 2016-06-07 | Hello Inc. | User or patient monitoring systems with one or more analysis tools |
US9737214B2 (en) | 2013-03-04 | 2017-08-22 | Hello Inc. | Wireless monitoring of patient exercise and lifestyle |
US9380941B2 (en) | 2013-03-04 | 2016-07-05 | Hello Inc. | Patient monitoring systems and messages that send alerts to patients |
US9392939B2 (en) | 2013-03-04 | 2016-07-19 | Hello Inc. | Methods using a monitoring device to monitor individual activities, behaviors or habit information and communicate with a database with corresponding individual base information for comparison |
US9634921B2 (en) | 2013-03-04 | 2017-04-25 | Hello Inc. | Wearable device coupled by magnets positioned in a frame in an interior of the wearable device with at least one electronic circuit |
US9398854B2 (en) | 2013-03-04 | 2016-07-26 | Hello Inc. | System with a monitoring device that monitors individual activities, behaviors or habit information and communicates with a database with corresponding individual base information for comparison |
US9406220B2 (en) | 2013-03-04 | 2016-08-02 | Hello Inc. | Telemetry system with tracking receiver devices |
US9425627B2 (en) | 2013-03-04 | 2016-08-23 | Hello Inc. | Telemetry system with remote firmware updates |
US9532716B2 (en) | 2013-03-04 | 2017-01-03 | Hello Inc. | Systems using lifestyle database analysis to provide feedback |
US9526422B2 (en) | 2013-03-04 | 2016-12-27 | Hello Inc. | System for monitoring individuals with a monitoring device, telemetry system, activity manager and a feedback system |
US9432091B2 (en) | 2013-03-04 | 2016-08-30 | Hello Inc. | Telemetry system with wireless power receiver and monitoring devices |
US9430938B2 (en) | 2013-03-04 | 2016-08-30 | Hello Inc. | Monitoring device with selectable wireless communication |
US9438044B2 (en) * | 2013-03-04 | 2016-09-06 | Hello Inc. | Method using wearable device with unique user ID and telemetry system in communication with one or more social networks |
US10849558B2 (en) | 2013-03-13 | 2020-12-01 | Glaukos Corporation | Intraocular physiological sensor |
US9730638B2 (en) | 2013-03-13 | 2017-08-15 | Glaukos Corporation | Intraocular physiological sensor |
US11158149B2 (en) | 2013-03-15 | 2021-10-26 | Otsuka Pharmaceutical Co., Ltd. | Personal authentication apparatus system and method |
US11744481B2 (en) | 2013-03-15 | 2023-09-05 | Otsuka Pharmaceutical Co., Ltd. | System, apparatus and methods for data collection and assessing outcomes |
US11741771B2 (en) | 2013-03-15 | 2023-08-29 | Otsuka Pharmaceutical Co., Ltd. | Personal authentication apparatus system and method |
US11052254B2 (en) | 2013-09-03 | 2021-07-06 | Endostim (Abc), Llc | Methods and systems of electrode polarity switching in electrical stimulation therapy |
US9827425B2 (en) | 2013-09-03 | 2017-11-28 | Endostim, Inc. | Methods and systems of electrode polarity switching in electrical stimulation therapy |
US9270503B2 (en) | 2013-09-20 | 2016-02-23 | Proteus Digital Health, Inc. | Methods, devices and systems for receiving and decoding a signal in the presence of noise using slices and warping |
US10498572B2 (en) | 2013-09-20 | 2019-12-03 | Proteus Digital Health, Inc. | Methods, devices and systems for receiving and decoding a signal in the presence of noise using slices and warping |
US11102038B2 (en) | 2013-09-20 | 2021-08-24 | Otsuka Pharmaceutical Co., Ltd. | Methods, devices and systems for receiving and decoding a signal in the presence of noise using slices and warping |
US9787511B2 (en) | 2013-09-20 | 2017-10-10 | Proteus Digital Health, Inc. | Methods, devices and systems for receiving and decoding a signal in the presence of noise using slices and warping |
US10097388B2 (en) | 2013-09-20 | 2018-10-09 | Proteus Digital Health, Inc. | Methods, devices and systems for receiving and decoding a signal in the presence of noise using slices and warping |
US9577864B2 (en) | 2013-09-24 | 2017-02-21 | Proteus Digital Health, Inc. | Method and apparatus for use with received electromagnetic signal at a frequency not known exactly in advance |
US10084880B2 (en) | 2013-11-04 | 2018-09-25 | Proteus Digital Health, Inc. | Social media networking based on physiologic information |
US10617349B2 (en) * | 2013-11-27 | 2020-04-14 | Medtronic, Inc. | Precision dialysis monitoring and synchronization system |
WO2015107042A1 (en) * | 2014-01-16 | 2015-07-23 | Dermal Devices Inc. | Health monitoring system |
US10357180B2 (en) | 2014-01-16 | 2019-07-23 | D.T.R. Dermal Therapy Research Inc. | Health monitoring system |
US10398161B2 (en) | 2014-01-21 | 2019-09-03 | Proteus Digital Heal Th, Inc. | Masticable ingestible product and communication system therefor |
US11950615B2 (en) | 2014-01-21 | 2024-04-09 | Otsuka Pharmaceutical Co., Ltd. | Masticable ingestible product and communication system therefor |
US9764139B2 (en) * | 2014-01-24 | 2017-09-19 | Medtronic, Inc. | Pre-implant detection |
CN106102828A (en) * | 2014-01-24 | 2016-11-09 | 美敦力公司 | Detection before implanting |
US20150209588A1 (en) * | 2014-01-24 | 2015-07-30 | Medtronic, Inc. | Pre-implant detection |
US10940281B2 (en) | 2014-10-27 | 2021-03-09 | Covidien Lp | Ventilation triggering |
US11712174B2 (en) | 2014-10-27 | 2023-08-01 | Covidien Lp | Ventilation triggering |
US9950129B2 (en) | 2014-10-27 | 2018-04-24 | Covidien Lp | Ventilation triggering using change-point detection |
US9682234B2 (en) | 2014-11-17 | 2017-06-20 | Endostim, Inc. | Implantable electro-medical device programmable for improved operational life |
US11478215B2 (en) | 2015-06-15 | 2022-10-25 | The Research Foundation for the State University o | System and method for infrasonic cardiac monitoring |
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 |
US11266843B2 (en) * | 2015-08-20 | 2022-03-08 | Cardiac Pacemakers, Inc. | Header core fixation design for an IMD |
US20190060655A1 (en) * | 2015-08-20 | 2019-02-28 | Cardiac Pacemakers, Inc. | Header core fixation design for an imd |
US11065056B2 (en) | 2016-03-24 | 2021-07-20 | Sofradim Production | System and method of generating a model and simulating an effect on a surgical repair site |
US11903653B2 (en) | 2016-03-24 | 2024-02-20 | Sofradim Production | System and method of generating a model and simulating an effect on a surgical repair site |
US10797758B2 (en) | 2016-07-22 | 2020-10-06 | Proteus Digital Health, Inc. | Electromagnetic sensing and detection of ingestible event markers |
US10187121B2 (en) | 2016-07-22 | 2019-01-22 | Proteus Digital Health, Inc. | Electromagnetic sensing and detection of ingestible event markers |
US11819683B2 (en) | 2016-11-17 | 2023-11-21 | Endostim, Inc. | Modular stimulation system for the treatment of gastrointestinal disorders |
US11678843B2 (en) | 2016-12-06 | 2023-06-20 | ART MEDICAL Ltd. | Systems and methods for sensing lung fluid and functionality |
US20190313970A1 (en) * | 2016-12-06 | 2019-10-17 | ART MEDICAL Ltd. | Systems and methods for sensing lung fluid and functionality |
US10835178B2 (en) * | 2016-12-06 | 2020-11-17 | ART MEDICAL Ltd. | Systems and methods for sensing lung fluid and functionality |
EP3562393A4 (en) * | 2016-12-27 | 2020-09-02 | Sensible Medical Innovations Ltd. | Method and system for radiofrequency (rf) tissue(s) monitoring |
US11122987B2 (en) | 2016-12-27 | 2021-09-21 | Sensible Medical Innovations Ltd. | Method and system for radiofrequency (RF) tissue(s) monitoring |
US11523746B2 (en) | 2018-10-28 | 2022-12-13 | Cardiac Pacemakers, Inc. | Implantable medical device having two electrodes in the header |
US11672934B2 (en) | 2020-05-12 | 2023-06-13 | Covidien Lp | Remote ventilator adjustment |
US20220133999A1 (en) * | 2020-10-30 | 2022-05-05 | Medtronic, Inc. | Monitoring of physiological parameters with impedance measurement |
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US20070299349A1 (en) | 2007-12-27 |
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