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US5904708A
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System and method for deriving relative physiologic signals
Assignee: Medtronic Inc
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Filing: 1998-03-19
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Granted: 1999-05-18
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Expires: 2018-03-19
Abstract
Abstract A patient monitoring and/or therapy delivery system and method employing an implantable medical device for sensing absolute physiologic signal values within the body of a patient, e.g., absolute blood pressure, temperature, etc., and an external monitoring device for monitoring and conveying ambient signal values to the implantable medical device, wherein the absolute physiologic signal values and the ambient signal values are combined to derive relative physiologic signal values for storage and/or control of a therapy provided by the implantable medical device. In the context of an implantable physiologic monitor, the relative and optionally, the absolute and/or ambient physiologic signal values are stored in memory for telemetry out to an external programmer in an uplink RF telemetry transmission initiated by medical personnel operating the external programmer. In the context of an implantable therapy delivery device, the relative physiologic signal values are also employed in therapy delivery algorithms.
Inventors
- 👤 Steven D. Goedeke
Bibliographic Details
Application Number
—
Jurisdiction
US
Data Source
google_patents
Last Synchronized
2026-10-28 15:44
CPC Classifications
A; A61; A61N; A61N1/00; A61N1/18; A61N1/32; A61N1/36; A61N1/372; A61N1/37211; A61N1/37252; A61B; A61B5/00; A61B5/0002; A61B5/0015; A61B5/002; A61B5/02; A61B5/021; A61B5/0215; A61B5/02156; A61N1/362; A61N1/37; A61N1/371; A61N1/38; A61N1/39; A61N1/3956; A61N1/3962; A61N1/39622; A61B2560/00; A61B2560/02; A61B2560/0204; A61B2560/0209; A61B5/0031; A61B5/0205; A61B5/02055; A61B5/145; A61B5/1455; A61N1/36042; A61N1/3621; A61N1/365; A61N1/36514; A61N1/3655; A61N1/36585
Claims Analysis
Total Claims: 48
Claim 1
Independent Claim
162 words
An implantable medical device method for deriving relative physiologic signal value data for use by and/or storage within an implantable medical device implanted within a patient's body comprising the steps of: providing an external monitoring device associated with the patient, and in the external monitoring device, sensing an ambient state or condition outside the body affecting a sensed physiologic state or condition within the body; deriving an ambient signal value from the sensed ambient state or condition; and conveying the ambient signal value from the external monitoring device to the implantable medical device; and in the implantable medical device implanted in the patient's body, sensing a physiologic state or condition within the body of the patient; deriving an absolute physiologic signal value from the sensed physiologic state or condition; receiving the ambient signal value conveyed from the external monitoring device; and combining the derived absolute physiologic signal value and the conveyed ambient signal value to derive a relative physiologic signal value therefrom.
Claim 2
Dependent Claim
162 words
An implantable medical device method for deriving relative physiologic signal value data for use by and/or storage within an implantable medical device implanted within a patient's body comprising the steps of: providing an external monitoring device associated with the patient, and in the external monitoring device, sensing an ambient state or condition outside the body affecting a sensed physiologic state or condition within the body; deriving an ambient signal value from the sensed ambient state or condition; and conveying the ambient signal value from the external monitoring device to the implantable medical device; and in the implantable medical device implanted in the patient's body, sensing a physiologic state or condition within the body of the patient; deriving an absolute physiologic signal value from the sensed physiologic state or condition; receiving the ambient signal value conveyed from the external monitoring device; and combining the derived absolute physiologic signal value and the conveyed ambient signal value to derive a relative physiologic signal value therefrom.
Claim 3
Dependent Claim
40 words
The method of claim 1, wherein the implantable medical device comprises implantable device memory and further comprising the step of: storing a plurality of relative physiologic signal values as relative physiologic signal value data in the implantable medical device memory.
Claim 4
Dependent Claim
44 words
The method of claim 1, wherein the implantable medical device comprises an implantable monitor having implantable device memory and further comprising the step of: storing a plurality of relative physiologic signal values as relative physiologic signal value data in the implantable medical device memory.
Claim 5
Dependent Claim
84 words
The method of claim 1, wherein the implantable medical device comprises an implantable monitor having implantable device memory and data conveying means for conveying data stored in the implantable memory to an external memory device further comprising the steps of: storing a plurality of relative physiologic signal values as relative physiologic signal value data in the implantable medical device memory; and activating said data conveying means to convey the relative physiological signal value data stored in the implantable memory to an external medical device.
Claim 6
Dependent Claim
72 words
The method of claim 1, wherein the implantable medical device comprises implantable device memory and a therapy delivery system for delivering a therapy to the patient and further comprising the steps of: storing a predetermined number of relative physiologic signal values as relative physiologic signal value data in the implantable medical device memory; and employing the relative physiologic signal values to control the delivery of the therapy by the implantable medical device.
Claim 7
Dependent Claim
48 words
The method of claim 1, wherein the implantable medical device comprises a therapy delivery system for delivering a therapy to the patient and further comprising the step of: controlling the delivery of the therapy by the implantable medical device as a function of the relative physiologic signal value.
Claim 8
Dependent Claim
93 words
The method of claim 6, wherein the implantable medical device comprises a bradycardia pacing therapy delivery system for delivering a pacing therapy to the patient to provide sufficient cardiac output for the patient's body, the physiologic state or condition reflects the cardiac output requirement of the patient's body, and the delivery controlling step further comprises the steps of: employing the relative physiologic signal values to control the bradycardia pacing rate of the implantable medical device to satisfy the cardiac output requirement; and delivering pacing pulses to the heart at the controlled pacing rate.
Claim 9
Dependent Claim
93 words
The method of claim 6, wherein the implantable medical device comprises an anti-tachyarrythmia therapy delivery system for delivering an anti-tachyarrythmia therapy to the patient to convert a tachyarrythmia to a normal heart rhythm, the physiologic state or condition reflects normal heart rhythm or a tachyarrythmia of the heart, and the delivery controlling step further comprises the steps of: employing the relative physiologic signal values to differentiate between normal heart rhythm and a tachyarrythmia of the heart; and delivering an anti-tachyarrythmia therapy to the heart to convert the tachyarrythmia to a normal heart rhythm.
Claim 10
Dependent Claim
62 words
The method of claim 6, wherein the implantable medical device comprises a drug delivery system for delivering a drug to the patient to treat an abnormal medical state or condition, and the delivery controlling step further comprises the steps of: employing the relative physiologic signal values to determine dosage of the drug to the patient; and delivering the drug to the patient.
Claim 11
Dependent Claim
67 words
The method of claim 6, wherein the implantable medical device comprises a heart pump for providing sufficient cardiac output for the patient's body, the physiologic state or condition reflects the cardiac output requirement of the patient's body, and the delivery controlling step fuirther comprises the step of: employing the relative physiologic signal values to control the operation of the heart pump to satisfy the cardiac output requirement.
Claim 12
Dependent Claim
95 words
The method of claim 6, wherein the implantable medical device comprises a cardiomyostimulation pacing therapy delivery system for pacing a skeletal muscle wrapped about the patient's heart to augment contraction of the heart muscle to provide sufficient cardiac output for the patient's body, the physiologic state or condition reflects the cardiac output requirement of the patient's body, and the delivery controlling step fuirther comprises the steps of: employing the relative physiologic signal values to control the pacing of the skeletal muscle to satisfy the cardiac output requirement; and delivering pacing pulses to the skeletal muscle.
Claim 13
Independent Claim
85 words
The method of any of the preceding claims 1-11, wherein the physiologic state or condition comprises the blood pressure of the patient, the sensed absolute physiologic signal value is absolute blood pressure value, the ambient state or condition comprises barometric pressure affecting the patient and the absolute pressure value, the relative physiologic signal value is relative blood pressure; and the step of combining the derived absolute physiologic signal value and the conveyed ambient signal value comprises subtracting the barometric pressure from the absolute blood pressure.
Claim 14
Independent Claim
83 words
The method of any of the preceding claims 1-11, wherein the physiologic state or condition comprises the blood temperature of the patient, the sensed absolute physiologic signal value is absolute blood temperature, the ambient state or condition comprises systemic patient temperature affected by fever or ambient conditions, the relative physiologic signal value is relative blood temperature; and the step of combining the derived absolute physiologic signal value and the conveyed ambient signal value comprises subtracting the ambient temperature from the absolute blood temperature.
Claim 15
Independent Claim
69 words
The method of any of the claims 1-11, wherein the steps performed by the external monitoring device are performed periodically to periodically derive and convey the ambient signal value to the implantable medical device, and the conveyed ambient signal value is used in the derivation of a plurality of relative physiologic signal values in the period between successive conveyances of the ambient signal value to the implantable medical device.
Claim 16
Independent Claim
185 words
A system for deriving relative physiologic signal values from absolute physiologic signal values for use by and/or storage within an implantable medical device comprising: an external monitoring device associated with the patient comprising, external sensing means for sensing an ambient state or condition outside the body affecting a sensed physiologic state or condition within the body; signal processing means coupled with said external sensing means for deriving an ambient signal value from the sensed ambient state or condition; and signal conveying means for conveying the ambient signal value from the external monitoring device to the implantable medical device; and the implantable medical device implanted within a patient's body comprising, implantable sensing means for sensing a physiologic state or condition within the body of the patient; signal processing means coupled with said implantable sensing means for deriving an absolute physiologic signal value from the sensed physiologic state or condition; receiving means for receiving ambient signal values conveyed from said signal conveying means; and means for combining each derived absolute physiologic signal value and the sensed ambient signal value to derive a relative physiologic signal value therefrom.
Claim 17
Independent Claim
185 words
A system for deriving relative physiologic signal values from absolute physiologic signal values for use by and/or storage within an implantable medical device comprising: an external monitoring device associated with the patient comprising, external sensing means for sensing an ambient state or condition outside the body affecting a sensed physiologic state or condition within the body; signal processing means coupled with said external sensing means for deriving an ambient signal value from the sensed ambient state or condition; and signal conveying means for conveying the ambient signal value from the external monitoring device to the implantable medical device; and the implantable medical device implanted within a patient's body comprising, implantable sensing means for sensing a physiologic state or condition within the body of the patient; signal processing means coupled with said implantable sensing means for deriving an absolute physiologic signal value from the sensed physiologic state or condition; receiving means for receiving ambient signal values conveyed from said signal conveying means; and means for combining each derived absolute physiologic signal value and the sensed ambient signal value to derive a relative physiologic signal value therefrom.
Claim 18
Dependent Claim
38 words
The system of claim 15, wherein the implantable medical device further comprises: implantable device memory; and means for storing a plurality of relative physiologic signal values as relative physiologic signal value data in the implantable medical device memory.
Claim 19
Dependent Claim
42 words
The system of claim 15, wherein the implantable medical device comprises an implantable monitor further comprising: implantable device memory; and means for storing a plurality of relative physiologic signal values as relative physiologic signal value data in the implantable medical device memory.
Claim 20
Dependent Claim
83 words
The system of claim 15, wherein the implantable medical device comprises an implantable monitor further comprising: implantable device memory; means for storing a plurality of relative physiologic signal values as relative physiologic signal value data in the implantable medical device memory; data conveying means for conveying data stored in the implantable memory to an external memory device; and means for activating said data conveying means to convey the relative physiological signal value data stored in the implantable memory to said external medical device.
Claim 21
Dependent Claim
72 words
The system of claim 15, wherein the implantable medical device further comprises a therapy delivery system for delivering a therapy to the patient further comprising: implantable device memory; means for storing a predetermined number of relative physiologic signal values as relative physiologic signal value data in the implantable medical device memory; and means for employing the relative physiologic signal values to control the delivery of the therapy by the implantable medical device.
Claim 22
Dependent Claim
46 words
The system of claim 15, wherein the implantable medical device comprises a therapy delivery system for delivering a therapy to the patient further comprising: means for controlling the delivery of the therapy by the implantable medical device as a function of the relative physiologic signal value.
Claim 23
Dependent Claim
94 words
The system of claim 20, wherein the implantable medical device comprises a bradycardia pacing therapy delivery system for delivering a pacing therapy to the patient to provide sufficient cardiac output for the patient's body, the physiologic state or condition reflects the cardiac output requirement of the patient's body, and the delivery controlling means further comprises: means for employing the relative physiologic signal values to control the bradycardia pacing rate of the implantable medical device to satisfy the cardiac output requirement; and means for delivering pacing pulses to the heart at the controlled pacing rate.
Claim 24
Dependent Claim
94 words
The system of claim 20, wherein the implantable medical device comprises an anti-tachyarrythmia therapy delivery system for delivering an anti-tachyarytimia therapy to the patient to convert a tachyarrythmia to a normal heart rhythm, the physiologic state or condition reflects normal heart rhythm or a tachyarrythmia of the heart, and the delivery controlling means further comprises: means for employing the relative physiologic signal values to differentiate between normal heart rhythm and a tachyarrythmia of the heart; and means for delivering an anti-tachyarrythmia therapy to the heart to convert the tachyarrytlmia to a normal heart rhythm.
Claim 25
Dependent Claim
63 words
The system of claim 20, wherein the implantable medical device comprises a drug delivery system for delivering a drug to the patient to treat an abnormal medical state or condition, and the delivery controlling means further comprises: means for employing the relative physiologic signal values to determine dosage of the drug to the patient; and means for delivering the drug to the patient.
Claim 26
Dependent Claim
65 words
The system of claim 20, wherein the implantable medical device comprises a heart pump for providing sufficient cardiac output for the patient's body, the physiologic state or condition reflects the cardiac output requirement of the patient's body, and the delivery controlling means comprises: means for employing the relative physiologic signal values to control the operation of the heart pump to satisfy the cardiac output requirement.
Claim 27
Dependent Claim
96 words
The system of claim 20, wherein the implantable medical device comprises a cardiomyostimulation pacing therapy delivery system for pacing a skeletal muscle wrapped about the patient's heart to augment contraction of the heart muscle to provide sufficient cardiac output for the patient's body, the physiologic state or condition reflects the cardiac output requirement of the patient's body, and the delivery controlling means fiuther comprises: means for employing the relative physiologic signal values to control the pacing of the skeletal muscle to satisfy the cardiac output requirement; and means for delivering pacing pulses to the skeletal muscle.
Claim 28
Independent Claim
93 words
The system of any of the preceding claims 15-25, wherein the physiologic state or condition comprises the blood pressure of the patient, the sensed absolute physiologic signal value is absolute blood pressure value, the ambient state or condition comprises barometric pressure affecting the patient and the absolute pressure value, the relative physiologic signal value is relative blood pressure; and the means for combining the derived absolute physiologic signal value and the conveyed ambient signal value comprises means for subtracting the barometric pressure from the absolute blood pressure to derive the relative blood pressure.
Claim 29
Independent Claim
91 words
The system of any of the preceding claims 15-25, wherein the physiologic state or condition comprises the blood temperature of the patient, the sensed absolute physiologic signal value is absolute blood temperature, the ambient state or condition comprises systemic patient temperature affected by fever or ambient conditions, the relative physiologic signal value is relative blood temperature; and the means for combining the derived absolute physiologic signal value and the conveyed ambient signal value comprises means for subtracting the ambient temperature from the absolute blood temperature to derive the relative blood temperature.
Claim 30
Independent Claim
66 words
The system of any of the preceding claims 15-25, wherein the external monitoring device further comprises: means for periodically deriving and conveying the ambient signal value to the implantable medical device, and the conveyed ambient signal value is used in the derivation of a plurality of relative physiologic signal values in the period between successive conveyances of the ambient signal value to the implantable medical device.
Claim 31
Dependent Claim
193 words
An implantable medical device method for deriving relative physiologic signal value data for use by and/or storage within an implantable medical device implanted within a patient's body comprising the steps of: providing an external monitoring device associated with the patient, and in the external monitoring device, periodically sensing an ambient state or condition outside the body affecting a sensed physiologic state or condition within the body and deriving an ambient signal value from each sensed ambient state or condition; storing a plurality of the ambient signal values; and conveying the plurality of ambient signal values from the external monitoring device to the implantable medical device; and in the implantable medical device implanted in the patient's body, periodically sensing a physiologic state or condition within the body of the patient and deriving an absolute physiologic signal value from each sensed physiologic state or condition; storing a plurality of the absolute physiologic signal values; receiving the plurality of ambient signal values conveyed from the external monitoring device; and combining the plurality of derived absolute physiologic signal values and the plurality of conveyed ambient signal values to derive a plurality of relative physiologic signal values therefrom.
Claim 32
Dependent Claim
193 words
An implantable medical device method for deriving relative physiologic signal value data for use by and/or storage within an implantable medical device implanted within a patient's body comprising the steps of: providing an external monitoring device associated with the patient, and in the external monitoring device, periodically sensing an ambient state or condition outside the body affecting a sensed physiologic state or condition within the body and deriving an ambient signal value from each sensed ambient state or condition; storing a plurality of the ambient signal values; and conveying the plurality of ambient signal values from the external monitoring device to the implantable medical device; and in the implantable medical device implanted in the patient's body, periodically sensing a physiologic state or condition within the body of the patient and deriving an absolute physiologic signal value from each sensed physiologic state or condition; storing a plurality of the absolute physiologic signal values; receiving the plurality of ambient signal values conveyed from the external monitoring device; and combining the plurality of derived absolute physiologic signal values and the plurality of conveyed ambient signal values to derive a plurality of relative physiologic signal values therefrom.
Claim 33
Dependent Claim
40 words
The method of claim 29, wherein the implantable medical device comprises implantable device memory and further comprising the step of: storing said plurality of relative physiologic signal values as relative physiologic signal value data in the implantable medical device memory.
Claim 34
Dependent Claim
44 words
The method of claim 29, wherein the implantable medical device comprises an implantable monitor having implantable device memory and further comprising the step of: storing said plurality of relative physiologic signal values as relative physiologic signal value data in the implantable medical device memory.
Claim 35
Dependent Claim
84 words
The method of claim 29, wherein the implantable medical device comprises an implantable monitor having implantable device memory and data conveying means for conveying data stored in the implantable memory to an external memory device further comprising the steps of: storing said plurality of relative physiologic signal values as relative physiologic signal value data in the implantable medical device memory; and activating said data conveying means to convey the relative physiological signal value data stored in the implantable memory to an external medical device.
Claim 36
Dependent Claim
72 words
The method of claim 29, wherein the implantable medical device comprises implantable device memory and a therapy delivery system for delivering a therapy to the patient and further comprising the steps of: storing said predetermined number of relative physiologic signal values as relative physiologic signal value data in the implantable medical device memory; and employing the relative physiologic signal values to control the delivery of the therapy by the implantable medical device.
Claim 37
Dependent Claim
49 words
The method of claim 29, wherein the implantable medical device comprises a therapy delivery system for delivering a therapy to the patient and further comprising the step of: controlling the delivery of the therapy by the implantable medical device as a function of the relative physiologic signal value data.
Claim 38
Independent Claim
85 words
The method of any of the preceding claims 29-34, wherein the physiologic state or condition comprises the blood pressure of the patient, the sensed absolute physiologic signal value is absolute blood pressure value, the ambient state or condition comprises barometric pressure affecting the patient and the absolute pressure value, the relative physiologic signal value is relative blood pressure; and the step of combining the derived absolute physiologic signal value and the conveyed ambient signal value comprises subtracting the barometric pressure from the absolute blood pressure.
Claim 39
Independent Claim
83 words
The method of any of the preceding claims 29-34, wherein the physiologic state or condition comprises the blood temperature of the patient, the sensed absolute physiologic signal value is absolute blood temperature, the ambient state or condition comprises systemic patient temperature affected by fever or ambient conditions, the relative physiologic signal value is relative blood temperature; and the step of combining the derived absolute physiologic signal value and the conveyed ambient signal value comprises subtracting the ambient temperature from the absolute blood temperature.
Claim 40
Independent Claim
209 words
A system for deriving relative physiologic signal values from absolute physiologic signal values for use by and/or storage within an implantable medical device comprising: an external monitoring device associated with the patient comprising, external sensing means for periodically sensing an ambient state or condition outside the body affecting a sensed physiologic state or condition within the body; signal processing means coupled with said external sensing means for deriving an ambient signal value from the sensed ambient state or condition; memory means for storing a plurality of the ambient signal values; and signal conveying means for conveying the plurality of ambient signal values from the external monitoring device to the implantable medical device; and the implantable medical device implanted within a patient's body comprising, implantable sensing means for periodically sensing a physiologic state or condition within the body of the patient; signal processing means coupled with said implantable sensing means for deriving an absolute physiologic signal value from the sensed physiologic state or condition; receiving means for receiving the plurality of ambient signal values conveyed from said signal conveying means; and means for combining the plurality of derived absolute physiologic signal values with the plurality of sensed ambient signal values to derive a plurality of relative physiologic signal values therefrom.
Claim 41
Independent Claim
209 words
A system for deriving relative physiologic signal values from absolute physiologic signal values for use by and/or storage within an implantable medical device comprising: an external monitoring device associated with the patient comprising, external sensing means for periodically sensing an ambient state or condition outside the body affecting a sensed physiologic state or condition within the body; signal processing means coupled with said external sensing means for deriving an ambient signal value from the sensed ambient state or condition; memory means for storing a plurality of the ambient signal values; and signal conveying means for conveying the plurality of ambient signal values from the external monitoring device to the implantable medical device; and the implantable medical device implanted within a patient's body comprising, implantable sensing means for periodically sensing a physiologic state or condition within the body of the patient; signal processing means coupled with said implantable sensing means for deriving an absolute physiologic signal value from the sensed physiologic state or condition; receiving means for receiving the plurality of ambient signal values conveyed from said signal conveying means; and means for combining the plurality of derived absolute physiologic signal values with the plurality of sensed ambient signal values to derive a plurality of relative physiologic signal values therefrom.
Claim 42
Dependent Claim
38 words
The system of claim 37, wherein the implantable medical device further comprises: implantable device memory; and means for storing said plurality of relative physiologic signal values as relative physiologic signal value data in the implantable medical device memory.
Claim 43
Dependent Claim
42 words
The system of claim 37, wherein the implantable medical device comprises an implantable monitor further comprising: implantable device memory; and means for storing a plurality of relative physiologic signal values as relative physiologic signal value data in the implantable medical device memory.
Claim 44
Dependent Claim
83 words
The system of claim 37, wherein the implantable medical device comprises an implantable monitor fuirther comprising: implantable device memory; means for storing a plurality of relative physiologic signal values as relative physiologic signal value data in the implantable medical device memory; data conveying means for conveying data stored in the implantable memory to an external memory device; and means for activating said data conveying means to convey the relative physiological signal value data stored in the implantable memory to said external medical device.
Claim 45
Dependent Claim
72 words
The system of claim 37, wherein the implantable medical device further comprises a therapy delivery system for delivering a therapy to the patient further comprising: implantable device memory; means for storing a predetermined number of relative physiologic signal values as relative physiologic signal value data in the implantable medical device memory; and means for employing the relative physiologic signal values to control the delivery of the therapy by the implantable medical device.
Claim 46
Dependent Claim
48 words
The system of claim 37, wherein the implantable medical device comprises a therapy delivery system for delivering a therapy to the patient further comprising: means for controlling the delivery of the therapy by the implantable medical device as a function of the plurality of relative physiologic signal values.
Claim 47
Independent Claim
110 words
The system of any of the preceding claims 37-42, wherein the physiologic state or condition comprises the blood pressure of the patient, the sensed absolute physiologic signal value is absolute blood pressure value, the ambient state or condition comprises barometric pressure affecting the patient and the absolute pressure value, the relative physiologic signal value is relative blood pressure; and the means for combining the plurality of derived absolute physiologic signal values with the plurality of sensed ambient signal values to derive a plurality of relative physiologic signal values therefrom comprises means for subtracting the barometric pressure value from the absolute blood pressure value to derive a relative blood pressure value.
Claim 48
Independent Claim
105 words
The system of any of the preceding claims 37-42, wherein the physiologic state or condition comprises the blood temperature of the patient, the sensed absolute physiologic signal value is absolute blood temperature, the ambient state or condition comprises systemic patient temperature affected by fever or ambient conditions, the relative physiologic signal value is relative blood temperature; and the means for combining the plurality of derived absolute physiologic signal values with the plurality of sensed ambient signal values to derive a plurality of relative physiologic signal values therefrom comprises means for subtracting the ambient temperature from the absolute blood temperature to derive a relative blood temperature.
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