Patent Grant
8852099
The present invention relates generally to measuring physiologic parameters of a patient, and more particularly, to systems, methods and devices for measuring and deriving physiologic parameters relative to various environmental parameters.
Medical devices are known that can be implanted within a patient's body for monitoring one or more physiological parameters and/or to provide therapeutic functions. For example, sensors or transducers can be placed in the body for monitoring a variety of properties, such as temperature, blood pressure, strain, fluid flow, chemical properties, electrical properties, magnetic properties, and the like. In addition, medical devices can be implanted that perform one or more therapeutic functions, such as drug delivery, cardiac pacing, defibrillation, electrical stimulation, and the like.
In many cases, the implanted medical devices (“IMDs”) are configured or adapted to communicate with external controllers or programmers, for example, to communicate data between the IMD and the external programmers, and/or to activate or otherwise control the IMDs. Typically, the IMDs can communicate with the external programmers via a wireless communication link, such as an RF communication link, or the like.
As mentioned above, IMDs can be configured to measure or sense a number of different parameters in the body. One parameter of particular interest is blood pressure. The implantable biosensors that measure pressure deep within anatomical structures, however, typically can only communicate the absolute pressure associated with the immediate anatomical environment. These devices are not capable of communicating gauge pressure because they are confined and sealed away from the ambient pressure external the body. In most cases, it is gauge pressure and not absolute pressure that is sought to be known, since the body regulates its activities based on the ambient pressure. Gauge pressure may be determined by correlating the absolute pressure with the ambient pressure. Similar situations exist for other parameters, as well, such as temperature.
Thus, a need exists for systems, methods, and/or devices for adjusting measured physiologic parameters, such as pressure, temperature and others, based on ambient or other environmental conditions.
One embodiment of the present invention relates to a system for deriving physiologic measurement values that are relative to ambient conditions. In one embodiment, the system comprises an implantable medical device (“IMD”), an external computing device, and a backend computing system. The IMD determines a physiologic parameter value within a patient's body, and communicates the physiologic parameter value outside the patient's body, for example, to the external computing device. Further, the external computing device receives the physiologic parameter from the IMD and communicates it to the backend computing system. The backend computing system receives the physiologic parameter value and obtains an ambient condition value outside the body. The backend computing system then calculates a relative physiologic parameter value from the ambient condition value and the physiologic parameter value, and in some embodiments, stores the relative physiologic parameter value in a storage location, such as a memory or database.
In one embodiment, the physiologic parameter value and/or the ambient condition value can be marked with a time stamp. Thus, because time stamps are used, the backend computing system can select an ambient condition value that is obtained or measured at a time reasonably close to the time when the physiologic parameter value is measured to calculate the relative physiologic parameter value.
Further, in another embodiment, the backend computing system can communicate the relative physiologic parameter value to the external computing device, which also can communicate the relative physiologic parameter value to the IMD. The IMD then can receive the relative physiologic parameter value and store it in a memory.
In some embodiments, the backend computing system can be a database accessible by one or more health care providers. Thus, the one or more health care providers can obtain the relative physiologic parameter value from the database and use the relative physiologic parameter value to provide a service to the patient, such as diagnosing the patient, prescribing medication to the patient, providing a therapy to the patient, modifying one or more settings of the IMD, or the like.
In addition, in other embodiment, the external computing device can include a sensor for measuring the ambient condition value. In this embodiment, the external computing device communicates the ambient condition value to the backend computing system. Further, in other embodiments, the backend computing system can receive the ambient condition value from an ambient condition source, such as an external monitor or other source. If an external monitor is used to obtain the ambient condition value, it can communicate the ambient condition value to the external computing device, which communicates the ambient condition value to the backend computing system. In some embodiments, the external monitor can be a wireless communication device carried on or near the patient's body. For example, the external monitor can be a device adapted to be worn around a patient's body part, a device that can be connected to a belt, a device that can be worn as a patch, a personal digital assistant (PDA), a device that can be carried in a pocket or a personal carry bag, a customized cell phone or pager, or any other suitable device that can perform the functions of the external monitor.
In some embodiments, the external computing device can be an IMD programmer, or a repeater device in communication with the backend computing system. In addition, in some embodiments, the IMD and the external computing device can communicate via a wireless communication connection, such as, for example, a radio frequency communication connection, an acoustic communication connection, a magnetic field communication connection, an optical communication connection, or any other suitable wireless communication connection.
The IMD can be any suitable implantable medical device. For example, in some embodiments, the IMD can be a physiologic parameter sensor, a pacemaker, a defibrillator, a bi-ventricular pacer, a ventricular assist blood pump, a drug delivery pump, a drug infusion device, a neurostimulating device, an intra-ocular shunt, an intra-cranial shunt, or any other suitable IMD. Also, the IMD can be adapted to provide therapy to a patient. In accordance with this embodiment, the IMD can be configured to use the relative physiologic parameter value to determine the proper therapy to provide to the patient. For example, in some embodiments, the IMD can use the relative physiologic parameter value to determine and provide therapies, such as, cardiac pacing therapy, anti-tachycardia therapy, drug delivery therapy, neurostimulation therapy, blood pump therapy, or any other suitable therapy provided by IMDs.
In still other embodiments, the IMD can include a processor that can be adapted to generate patient therapy information based at least in part on the relative physiologic parameter value. In accordance with this embodiment, the implantable medical device can be configured to communicate the patient therapy information to the external computing device, and the external computing device can include a patient communication interface adapted to provide the patient therapy information to the patient. In other embodiments, the external computing device can communicate the patient therapy information to the backend computing system for access by one or more health care providers.
In yet another embodiment, the backend computing system can determine a proper therapy to provide to a patient. In the embodiment, the backend computing system can use the relative physiologic parameter value to determine the therapy, and it can store the therapy information for access by one or more health care providers.
In yet other embodiments, the present invention can include methods performed by the IMD, the external computing device, and/or the backend computing system, and the present invention can include the IMDs and/or the external computing devices individually.
While multiple embodiments are disclosed, still other embodiments of the present invention will become apparent to those skilled in the art from the following detailed description, which shows and describes illustrative embodiments of the invention. Accordingly, the drawings and detailed description are to be regarded as illustrative in nature and not restrictive.
In the Figures, similar components and/or features may have the same reference label. Further, various components of the same type may be distinguished by following the reference label with a second label that distinguishes among the similar components. If only the first reference label is used in the specification, the description is applicable to any one of the similar components having the same first reference label irrespective of the second reference label.
While the invention is amenable to various modifications and alternative forms, specific embodiments have been shown by way of example in the drawings and are described in detail below. The intention, however, is not to limit the invention to the particular embodiments described. On the contrary, the invention is intended to cover all modifications, equivalents, and alternatives falling within the scope of the invention as defined by the appended claims.
The present invention relates generally to measuring physiological parameters of a patient, and more particularly, to systems, methods and devices for measuring and deriving physiological parameters relative to various environmental parameters. In contrast to prior art systems and methods, the present invention utilizes a backend computing system to obtain ambient measurement values, and then the backend computing system use the ambient values along with the measured physiologic parameters to calculate relative physiologic parameter values.
As discussed herein, the present invention relates to systems and methods for obtaining relative physiologic parameter values. The physiologic parameter values obtained can be any physiologic measurement, such as, blood pressure, temperature, blood or fluid flow, strain, electrical, chemical or magnetic properties within the body, or the like. As one skilled in the art will appreciate, the type of measurement being taken may determine whether the measurement will need to be adjusted for ambient or other environmental conditions that may affect the measurements within the body. For example, it is known that ambient pressure will affect intravascular blood pressure. Further, outside temperature may affect the internal body temperature of a person or other animal, depending, in part, on the severity of the outside temperature. Also, other environmental conditions, such as, altitude, humidity, electric or magnetic fields, or chemical compositions may affect other physiologic measurements of interest. Accordingly, the present invention can be used to adjust any internal physiologic measurements relative to environmental conditions, and thus, is not limited in scope to any particular measurement. Of course, as one skilled in the art will appreciate, adjusting measured internal blood pressure relative to ambient pressure (which also can be derived from or affected by temperature, humidity, altitude, etc.) is of particular interest for many clinical and therapeutic applications, and the present invention is well suited to obtain relative pressure values.
Referring now to
IMD 102 can be any type of implantable medical device that is configured to obtain physiologic measurements of a patient and/or provide therapy to the patient. For example, IMD 102 can be a pacemaker, an implantable cardioverter defibrillator (“ICD”), a cardiac resynchronization device, a bi-ventricular pacer, a ventricular assist blood pump, a drug delivery pump, a drug infusion device, a neurostimulating device, an intra-ocular shunt, an intra-cranial shunt, or any other suitable implantable device, which can obtain or measure physiologic parameter values. In the embodiment illustrated in
In addition, in alternative embodiments, sensors and/or therapy delivery systems 112 can be located separate from leads 110, and the sensor data can be transmitted to IMD 102 via other communication medium, such as a coupled communication connection, or a wireless communication connection. If a wireless communication connection is used, the wireless connection can be a radio frequency (RF) connection, an acoustic connection (e.g., ultrasound), an optical connection, an electric field connection, or any other suitable communication connection. For example, in one embodiment, sensors and/or therapy delivery systems 112 can be configured in one or more satellite devices (e.g., chronically implanted stent devices) as is disclosed in Published U.S. Patent Application No. 2003/0158584 A1, published on Aug. 21, 2003, and entitled “Chronically-Implanted Device For Sensing and Therapy,” the entirely of which is incorporated by reference herein for all purposes.
In addition, in some embodiments, IMD 102 is operable to communicate with external monitoring device 104 and external computing device 106 via wireless connections 114 and 116, respectively. Similarly, in some embodiments, external monitoring device 104 is operable to communicate with external computing device 106 via wireless connection 118. Further, in other embodiments, external monitor 104 and external computing device 106 can be in wireless communication with sensor circuitry 112 via wireless connections 120 and 122, respectively. Each of these different embodiments will be discussed in more detail below. Wireless connections 114, 116, 118, 120 and 122 all can be uni-directional or bi-directional communication links, depending on the IMD and the data being transferred. As such, IMD 102 and/or sensor circuitry 112 can send information to and receive information from external monitoring device 104 and external computing device 106 via the communication connections. Similarly, external monitoring device 104 can communicate bi-directionally with external computing device 106.
Referring now to
As one skilled in the art will appreciate, processors and memory devices are well known in the art, and the specific type and/or style of processor or memory device that can be used in IMD 102 is not limited. Accordingly, processor 202 can be any suitable processing device currently known or hereinafter developed, and memory device 204 can be any suitable memory device currently known or hereinafter developed.
Communication circuitry 206 is circuitry that allows IMD 102 to communicate with other devices, such as external computing device 106, external monitoring device 104, other IMDs, or other external devices. As discussed above, IMD 102 communicates with other devices via a wireless connection. The wireless connection can be, for example, a near field radio frequency (RF) communication connection, a far field RF communication connection, an acoustic communication connection (e.g., an ultrasound connection), an optical communication connection, or any other suitable wireless communication connection.
In one embodiment, communication circuitry 206 can include circuitry for both near field RF telemetry and far field RF telemetry. For example, one embodiment of communication circuitry that can be used in IMD 102 is disclosed in Published U.S. Patent App. No. US 2003/0114897 A1, published on Jun. 19, 2003, and entitled “Implantable Medical Device with Two or More Telemetry Systems,” and Published U.S. Patent App. No. U.S. 2003/0114898 A1, published on Jun. 19, 2003, and entitled “Telemetry Duty Cycle Management System for an Implantable Medical Device,” both of which are incorporated by reference herein for all purposes.
In addition, in other embodiments, power saving wireless communication circuitry and methods can be used. For example, the IMD communication circuitry 206 can be configured to reside in a power-saving, sleep mode for a majority of the time. In accordance with this embodiment, communication circuitry 206 can be configured to “wake-up” on a periodic basis to communicate with an external device. Upon “wake-up” the external device will monitor for RF activity, and if the external device locates it, communication between the IMD and the external device can be initiated. There are a number of different ways IMD power-saving modes can be implemented, and the present invention is not limited to any particular one. Indeed, the aforementioned Published U.S. Patent App. Nos. US 2003/0114897 A1 and US 2003/0114898 A1 disclose different ways of implementing IMD power-saving modes, which, as discussed above, are incorporated herein by reference for all purposes. In addition, additional power management systems and methods are disclosed in Published U.S. Patent App. No. US 2003/0149459 A1, published on Aug. 7, 2003, and entitled “Methods and Apparatuses for Implantable Medical Device Telemetry Power Management,” the entirety of which is incorporated by reference herein for all purposes.
Further, in accordance with other embodiments, communication circuitry 206 can be configured to communicate with an intermediary telemetry device, which, in turn, can facilitate communication with the external monitoring device 104 and/or external computing device 106. One example of this type of configuration is disclosed in Published U.S. Patent App. No. US 2003/0130708, published on Jul. 10, 2003, and entitled “Two-Hop Telemetry Interface for Medical Device,” the entirety of which is incorporated by reference herein for all purposes. In addition, other configurations for RF telemetry are known, and communication circuitry 206 can embody those configurations, as well. Thus, as one skilled in the art will appreciate, communication circuitry 206 is not limited by any particular configuration or communication means.
Therapy circuitry 208 comprises circuitry for providing one or more therapeutic functions to a patient. For example, therapy circuitry 208 can include circuitry for providing heart pacing therapy, cardiac defibrillation therapy, cardiac resynchronization therapy, drug delivery therapy, or any other therapy associated with a suitable IMD. In the case of cardiac therapy (e.g., pacing, defibrillation, etc.), therapy circuitry 208 can include cardiac leads for delivering the therapy to particular locations in the heart. In other embodiments, the therapy circuitry and/or therapy delivery mechanisms can reside in a satellite device wirelessly coupled to the IMD body 102, as discussed below.
Finally, sensor circuitry 210 comprises the sensors and circuitry needed to obtain or measure the physiologic parameters. For example, to obtain a blood pressure (e.g., intravascular or intracardiac blood pressure), sensor circuitry 210 comprises one or more pressure sensors and associated circuitry for recording the pressure accurately. Pressure sensors and the associated circuitry are well known in the art, and therefore, will not be disclosed in detail herein. In addition, in other embodiments, sensor circuitry 210 can be configured to obtain other physiologic parameters, such as temperature, electrical impedance, position, strain, pH, fluid flow, blood oxygen levels, and the like. In these cases, sensor circuitry 210 will include suitable bio-sensors for obtaining the corresponding physiologic parameters.
Also, as one skilled in the art will appreciate, the sensors and/or sensor circuitry can be, and many times are, electrically coupled to IMD 102, but placed remotely from the IMD; e.g., at the end of a lead or in a satellite device in wireless communication with IMD 102.
In an alternative embodiment, IMD 102 can comprise a planet/satellite configuration, in which the satellite portion of the IMD includes sensor and/or therapy delivery circuits and mechanisms. Such a configuration is disclosed in Published U.S. Patent Application No. US 2003/0158584 A1, published on Aug. 21, 2003, and entitled “Chronically-Implanted Device for Sensing and Therapy,” the entirety of which is incorporated herein by reference for all purposes. In this system, the planet or main body of the IMD communicates with one or more satellite sensor/therapy devices either by an electrical wire connection or wirelessly. In some embodiments, the planet or main body can command each satellite to provide sensing functions and therapy functions, such as delivering cardiac electrical pulses, drug delivery, or other functions, as discussed above. In other embodiments, the satellite devices can function autonomously, and then communicate with the planet device at their own direction, at the planet's direction, or at timed intervals. The relationships between the planet device and the satellite device(s) are discussed in more detail in the incorporated reference.
In accordance with one embodiment of the invention, the satellite sensor/therapy devices can be configured as stent-like, intravenous, chronically-implanted devices. The configuration of embodiments of stent-like devices is disclosed in more detail in the incorporated Published U.S. Patent Application No. US 2003/0158584.
The operation of circuitry 300 is described in greater detail in the incorporated Published U.S. Patent Application No. US 2003/0158584. However, in accordance with one embodiment, antenna 314 and transceiver 312 can be configured to communicate with the planet or main body of the IMD 102, with external monitor 104, or with external computing device 106. Such communication connections can be RF connections, acoustic connections (e.g., ultrasound), optical connections, or other suitable communication connections. In addition, antenna 314 and transceiver 312 can be configured to communicate with the multiple devices using one or more different connection types.
As discussed in more detail below, in some embodiments, sensor/therapy circuitry 300 is operable to receive ambient condition values, for example, from the main body of the IMD 102, external monitor 104 or external computing device 106 and calculate a relative physiologic parameter value using the ambient condition value. In accordance with these embodiments of the invention, data processor 310 can be configured to calculate the relative physiologic parameter values using measured values and the received ambient condition values. In addition, data processor 310 is operable to format data received by circuitry 300, as well as format data being transmitted by the satellite device. Again, a more complete description of the operation and configuration of the satellite device and associated circuitry is set forth in the incorporated reference.
Referring again to
External monitoring device 104 can comprise any type of processor-based device that can be carried on or near a patient's body. For example, external monitoring device 104 can be a device that is adapted to worn around a part of a patient's body, such as a wrist watch, a device connected to a belt, or some other device adapted to be worn around an ankle, leg, arm, neck, chest, stomach, etc. In addition, in other embodiments, external monitoring device can be a computing device worn as a patch, or a computing device that can be carried in a pocket, on a belt clip, or in a personal carry bag, such as a PDA, or a customized cellular phone or pager. One skilled in the art will appreciate that other device can be used as well.
Referring now to
As one skilled in the art will appreciate, and as discussed above with reference to IMD 102, processors and memory devices are well known in the art, and the specific type and/or style of processor or memory device that can be used in external monitoring device 104 is not limited. Accordingly, processor 402 can be any suitable processing device currently known or hereinafter developed, and memory device 404 can be any suitable memory device currently known or hereinafter developed. In addition, communication circuitry 406 is circuitry that allows external monitoring device 104 to communicate with IMD 102 and other devices, such as external computing device 106, and/or sensor/therapy circuitry 112. Thus, if IMD 102 and the other devices are communicating via an RF connection, communication circuitry 406 comprises RF communication circuitry, as well. Similarly, if optical or acoustic communication connections are used, communication circuitry 406 is adapted to facilitate such connections. Further, in some embodiments, IMD 102 might be communicating with external monitor 104 via one type of communication connection, while other devices, such as external computing device 106 or sensor/therapy circuitry 112 might be communicating with external monitor 104 via other types of connections. Thus, communication circuitry 406 can be any circuitry adapted to facilitate the communications with IMD 102, external computing device 106, and sensor/therapy circuitry 112, and communication circuitry 406 can facilitate multiple types of communications at the same time. As one skilled in the art will appreciate, such circuitry is known in the art, and therefore, will not be discussed in detail herein.
In one embodiment, external monitoring device 104 also can include a patient interface 408 adapted to communicate information, such as therapy or diagnostic information, to the patient. In accordance with this embodiment, patient interface 408 may comprise a visually readable screen that allows the patient to read information, an audible or sound interface that can broadcast or transmit audible or sound information to the patient, or some other communication means.
Finally, referring again to
Backend computing system 108 can be any type of computing system. In one embodiment, backend computing system is a networked system with a database operable to receive information regarding patients and their IMDs. The information then can be accessed by third parties, such as physicians, specialists, IMD manufacturers, insurance companies, pharmaceutical companies, or any other health care provider. As discussed in more detail below, backend computing system 108 can be configured to receive relative physiologic parameter values for patients and IMDs, other IMD information, and/or patient therapy information. In addition, backend computing system 108 can be configured to receive physiologic measurements and calculate relative measurements using ambient condition values. Further, backend computing system can determine patient therapy information based on data received from IMD 102, external monitor 104, and/or external computing device 106. Examples of embodiments of a one or more backend computing systems that can be used with the present invention are disclosed in U.S. Pat. No. 6,607,485 discussed above, and U.S. patent application Ser. No. 10/789,964, filed on Feb. 27, 2004, and entitled “Systems and Methods for Automatically Collecting, Formatting and Storing Medical Device Data in a Database,” both of which are incorporated by reference herein for all purposes.
Referring now to
PABP=PMBP−PRe f(TBlood) where:
As one skilled in the art will appreciate, most pressure sensors are configured to perform these adjustments automatically, and thus, special processing within the IMD typically is not needed to obtain the absolute blood pressure value.
After the IMD obtains the absolute physiologic parameter (e.g., absolute blood pressure), the IMD communicates the absolute physiologic parameter value to an external monitor (e.g., external monitor 104 in
The external monitor receives the absolute physiologic parameter value and obtains an ambient condition value (block 506). In some embodiments, the external monitor can obtain the ambient condition value either prior to or after receiving the absolute physiologic parameter value. In one embodiment, the external monitor includes a sensor for measuring the ambient condition value. Alternatively, in another embodiment, the external monitor could receive the ambient condition value from another source, such as another computing device in communication with the external monitor, the Internet, or some other source. The means by which the external monitor obtains the ambient condition value is not critical, and thus, the present invention is not limited to any particular method or system for obtaining the ambient condition value.
In some embodiments, the step of determining the absolute physiologic parameter value and the step of obtaining the ambient condition value may not occur at the same time or even close to the same time. For example, the external monitor may only measure or obtain the ambient condition value a few times a day, or there may be a delay between when the external monitor receives the ambient condition value and the absolute physiologic parameter value. As one skilled in the art will appreciate, ambient condition values can change relatively quickly, and thus, if an ambient condition value is not obtained at a time relatively close to when the absolute physiologic parameter value is obtained, the calculated relative value may be inaccurate. Therefore, the absolute physiologic parameter value and/or the ambient condition value can include a time stamp, so that values measured or obtained at about the same time can be used to calculate the relative physiologic parameter value. In some embodiments, if there is a gap between when ambient condition values are measured or obtained, averaged or prorated ambient values can be used.
As discussed above, in one embodiment, the systems and methods of the present invention can be used to obtain blood pressure. In accordance with this embodiment, the ambient condition value is atmospheric or barometric pressure (and/or other parameters, such as temperature, humidity, altitude, etc. that can affect barometric pressure), which can be measured by one or more sensors in the external monitor, or which can be passed to the external monitor from an outside source. As with the pressure sensor associated with the IMD, a pressure sensor in the external monitor also typically is adjusted for temperature and a built-in backing pressure. Thus, in one embodiment, the atmospheric pressure obtained by the external monitor can be calculated according to the following formula:
PATM=PMATM−PATM Re f(TATM) where:
As discussed above, most pressure sensors are configured to perform these adjustments automatically, and thus, special processing within the external monitor typically is not needed to obtain the adjusted atmospheric pressure.
After the external monitor obtains the ambient condition value and the absolute physiologic parameter value, the external monitor calculates a relative physiologic parameter value (block 508). For example, for intravascular blood pressure, a gauge blood pressure can be calculated by subtracting the atmospheric pressure from the absolute pressure value. When pressure sensor adjustments are taken into account, the following formula will apply:
PGauge=(PMBP−PRe f(TBlood))−(PMATM−PATM Re f(TATM)).
In other embodiments, the relative physiologic parameter values can be calculated using other mathematical operations or models. For example, in one embodiment, some vascular abnormalities, which can be precursors to some cardiac problems, can be diagnosed by measuring physiologic parameters in two or more locations within the body, using two or more separate sensors. The data from the multiple sensors then might undergo mathematical manipulation, which then can be reconciled with the external ambient condition measurements. Thus, the present invention is not limited to a pure subtraction operation. Further, as one skilled in the art will appreciate, the calculations needed to obtain relative physiologic parameter values from other types of physiologic measurements (e.g., temperature, pH, etc.) may be different depending on the measurements being taken. Also, as discussed briefly above, if the physiologic parameter value and/or the ambient condition value include time stamps, the external monitor will values that are similar in time (or averaged or prorated values), so that the relative value is accurate.
In one embodiment, after the external monitor calculates the relative physiologic parameter value, it communicates the relative value to the IMD (block 510), which, in turn, stores the relative physiologic parameter value in a memory (block 512). Again, the IMD and the external monitor can implement a data transmission check, such as a CRC check, to ensure the data is transmitted properly. After the relative physiologic parameter value is stored in the IMD memory, the IMD and/or the external monitor can perform a number of different operations with the relative value. This is illustrated by continuation block 514 in
Referring now to
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Referring now to
In an alternative embodiment, instead of the external monitor communicating the relative physiologic parameter value to the IMD, it can be configured to communicate the relative physiologic parameter value to the external computing device without first communicating it to the IMD. The external computing device then can communicate it to a backend computing system, or it can display it to the patient or another health care provider. In addition, instead of the IMD determining the therapy information, the external monitor or the external computing device can be configured to determine the therapy information based on, in part, the calculated relative physiologic parameter value. In this embodiment, the processor within the external monitor or the external computing device will include the therapy logic, not the processor within the IMD. In addition, as one skilled in the art will appreciate, the therapy and/or diagnosis information that the IMD, the external monitor, and/or the external computing device provide to the patient will depend upon the type of IMD and the type of physiologic parameters being measured. As discussed above, the present invention is not limited to any particular IMD or physiologic parameter value measurement.
Referring now to
After the IMD obtains the absolute physiologic parameter (e.g., absolute blood pressure), the IMD communicates the absolute physiologic parameter value to an external computing device (e.g., external computing device 106 in
The external computing device receives the absolute physiologic parameter value and obtains an ambient condition value (block 706). In one embodiment, the external computing device includes one or more sensors for measuring the ambient condition value. Alternatively, in another embodiment, the external computing device can receive the ambient condition value from another source, such as another computing device in communication with the external computing device, the Internet, or some other source. For example, as discussed above, an external monitor (e.g., external monitor 104 in
In one embodiment, the systems and methods of the present invention can be used to obtain blood pressure. In accordance with this embodiment, the ambient condition value is atmospheric or barometric pressure, which can be measured by one or more sensors in the external computing device, or which can be passed to the external computing device from an outside source (e.g., from an external monitor). As with the pressure sensor associated with the IMD, a pressure sensor in the external computing device or the external monitor also typically is adjusted for temperature and a built-in backing pressure. As mentioned above, most pressure sensors are configured to perform these adjustments automatically, and thus, special processing within the external computing device or the external monitor typically is not needed to obtain the adjusted atmospheric pressure.
After the external computing device obtains the ambient condition value, the external computing device calculates a relative physiologic parameter value (block 708). In one embodiment, for blood pressure, a gauge blood pressure can be calculated by subtracting the atmospheric pressure from the absolute pressure value, or as discussed above, other mathematical calculations can be used. In addition, the calculations needed to obtain relative physiologic parameter values from other types of physiologic measurements (e.g., temperature, pH, etc.) may be different depending on the measurements being taken. Further, as discussed above, the physiologic parameter value and/or the ambient condition value can include time stamps, so that the relative physiologic parameter value is calculated using values that are similar in time.
In one embodiment, after the external computing device calculates the relative physiologic parameter value, it communicates the relative value to a backend computing system (e.g., backend computing system 108 in
After the relative physiologic parameter value is communicated to the backend computing system, additional processing can occur in a number of different devices in the system. This is illustrated by continuation block 712 in
Referring now to
As illustrated by flow chart 810 in
Referring now to
Referring now to
In an alternative embodiment, after the external computing device (or external monitor) receives the therapy information from the IMD, a physician or other health care provider then can analyze the therapy information and provide it to the patient if the physician determines that it is appropriate, or the physician could provide different or additional therapy to the patient if the physician determines that an alternative therapy would be better. In addition, the therapy information can be uploaded to a backend computing system (e.g., backend computing system 108) (block 840) for later processing, access and/or analysis. Also, instead of the IMD determining the therapy information, the external computing device, the external monitor, and/or the backend computing system can be configured to determine the therapy information based on the relative physiologic parameter value. The present invention is not limited to the IMD determining the therapy.
Referring now to
After the IMD obtains the absolute physiologic parameter (e.g., absolute blood pressure), the IMD communicates the absolute physiologic parameter value to an external computing device (e.g., external computing device 106 in
The external computing device receives the absolute physiologic parameter value and communicates it to a backend computing system (e.g., backend computing system 108 in
After the backend computing system obtains the ambient condition value and the absolute physiologic parameter value, the backend computing system calculates a relative physiologic parameter value (block 910), and then the backend computing system stores the relative physiologic parameter value, for example, in a database or other similar storage area (block 912). The data then can be made available for later processing, access, and/or analysis by one or more health care providers, such as physicians, specialists, IMD manufacturers, insurance companies, pharmaceutical companies, or any other suitable health care provider.
After the relative physiologic parameter value is calculated at the backend computing system, additional processing can occur in a number of different devices in the system. This is illustrated by continuation block 914 in
Referring now to
In addition, as illustrated by flow chart 1000 in
Referring now to
In an alternative embodiment illustrated in
Further, as discussed above, after the external computing device (and/or the external monitor) receives the therapy information from the IMD, a physician or other health care provider then can analyze the therapy information and provide it to the patient if the physician determines that it is appropriate, or the physician could provide different or additional therapy to the patient if the physician determines that an alternative therapy would be better. The therapy information also can be uploaded to a backend computing system (e.g., backend computing system 108) (block 1029) for later processing, access and/or analysis. In addition, in an alternative embodiment, instead of the IMD determining the therapy information, the external computing device and/or the external monitor can be configured to calculate or determine the therapy information.
Referring now to
Referring now to
After the remote sensor system of the IMD obtains the absolute physiologic parameter (e.g., absolute blood pressure), an external device obtains an ambient condition value (block 1104). In one embodiment, the external device is an external monitor (e.g., external monitor 104 in
After the external device obtains the ambient condition value, it communicates the ambient condition value to the remote sensor system (block 1106), which then calculates a relative physiologic parameter value from the absolute physiologic parameter value and the ambient condition value (block 1108). As with other communication connections, the external device and the remote sensor system can implement a data transmission check (e.g., a cyclic redundancy code (“CRC”) check) to ensure the data is transmitted properly. Further, as discussed above, the physiologic parameter value and/or the ambient condition value can include time stamps, so that the relative physiologic parameter value is calculated using values that are similar in time. After the remote sensor system calculates the relative physiologic parameter value, additional processing can occur in a number of different devices in the system. This is illustrated by continuation block 1110 in
Referring now to
In addition, after the IMD receives the relative physiologic parameter value, it can communicate it to the external device (block 1214 in
In another embodiment, instead of the main body of the IMD communicating the relative physiologic parameter value to the external device, the remote sensor system can be configured to communicate the relative physiologic parameter value to the external device directly (block 1224 in
Upon receiving the relative physiologic parameter value, the backend computing system then can store the value in a database for access by health care providers. In addition, as discussed above, the backend computing system can use the relative physiologic parameter value to determine a therapy for the patient (block 1254 in
Referring now to
Various modifications and additions can be made to the exemplary embodiments discussed without departing from the scope of the present invention. For example, while the embodiments described above refer to particular features, the scope of this invention also includes embodiments having different combinations of features and embodiments that do not include all of the described features. Accordingly, the scope of the present invention is intended to embrace all such alternatives, modifications, and variations as fall within the scope of the claims, together with all equivalents thereof
This application is a continuation of U.S. application Ser. No. 10/943,627, filed on Sep. 17, 2004, entitled “SYSTEMS AND METHODS FOR DERIVING RELATIVE PHYSIOLOGIC MEASUREMENTS USING A BACKEND COMPUTING SYSTEM,” the entirety of which is incorporated herein by reference.
| Number | Name | Date | Kind |
|---|---|---|---|
| 2786899 | Carlisle | Mar 1957 | A |
| 3310885 | Alderson | Mar 1967 | A |
| 3320946 | Dethloff et al. | May 1967 | A |
| 3536836 | Pfeiffer | Oct 1970 | A |
| 3568661 | Franklin | Mar 1971 | A |
| 3672352 | Summers | Jun 1972 | A |
| 3692027 | Ellinwood | Sep 1972 | A |
| 3757770 | Brayshaw et al. | Sep 1973 | A |
| 3794840 | Scott | Feb 1974 | A |
| 3943915 | Severson | Mar 1976 | A |
| 4003379 | Ellinwood | Jan 1977 | A |
| 4041954 | Ohara | Aug 1977 | A |
| 4099530 | Chen et al. | Jul 1978 | A |
| 4127110 | Bullara | Nov 1978 | A |
| 4146029 | Ellinwood | Mar 1979 | A |
| 4223801 | Carlson | Sep 1980 | A |
| 4227407 | Drost | Oct 1980 | A |
| 4237900 | Schulman et al. | Dec 1980 | A |
| 4281664 | Duggen | Aug 1981 | A |
| 4360019 | Portner et al. | Nov 1982 | A |
| 4407296 | Anderson | Oct 1983 | A |
| 4450527 | Sramek | May 1984 | A |
| 4480483 | McShane | Nov 1984 | A |
| 4519401 | Ko et al. | May 1985 | A |
| 4541431 | Ibrahim et al. | Sep 1985 | A |
| 4543955 | Schroeppel | Oct 1985 | A |
| 4550370 | Baker | Oct 1985 | A |
| 4585004 | Brownlee | Apr 1986 | A |
| 4593703 | Cosman | Jun 1986 | A |
| 4600855 | Strachan | Jul 1986 | A |
| 4616640 | Kaali et al. | Oct 1986 | A |
| 4651740 | Schroeppel | Mar 1987 | A |
| 4653508 | Cosman | Mar 1987 | A |
| 4660568 | Cosman | Apr 1987 | A |
| 4676255 | Cosman | Jun 1987 | A |
| 4677985 | Bro et al. | Jul 1987 | A |
| 4680957 | Dodd | Jul 1987 | A |
| 4686987 | Salo et al. | Aug 1987 | A |
| 4697595 | Breyer et al. | Oct 1987 | A |
| 4768176 | Kehr et al. | Aug 1988 | A |
| 4768177 | Kehr et al. | Aug 1988 | A |
| 4781715 | Wurzel | Nov 1988 | A |
| 4791936 | Snell et al. | Dec 1988 | A |
| 4793825 | Benjamin et al. | Dec 1988 | A |
| 4809697 | Causey, III et al. | Mar 1989 | A |
| 4845503 | Adam et al. | Jul 1989 | A |
| 4846191 | Brockway et al. | Jul 1989 | A |
| 4854327 | Kunig | Aug 1989 | A |
| 4886064 | Strandberg | Dec 1989 | A |
| 4899752 | Cohen | Feb 1990 | A |
| 4909259 | Tehrani | Mar 1990 | A |
| 4918736 | Bordewijk | Apr 1990 | A |
| 4945914 | Allen | Aug 1990 | A |
| 4967749 | Cohen | Nov 1990 | A |
| 4986270 | Cohen | Jan 1991 | A |
| 4991579 | Allen | Feb 1991 | A |
| 4995068 | Chou et al. | Feb 1991 | A |
| 4995398 | Turnidge | Feb 1991 | A |
| 5003976 | Alt | Apr 1991 | A |
| 5024224 | Engebretson | Jun 1991 | A |
| 5025795 | Kunig | Jun 1991 | A |
| 5029582 | Lekholm | Jul 1991 | A |
| 5040536 | Riff | Aug 1991 | A |
| 5040538 | Mortazavi | Aug 1991 | A |
| 5113859 | Funke | May 1992 | A |
| 5154171 | Chirife | Oct 1992 | A |
| 5161536 | Vilkomerson et al. | Nov 1992 | A |
| 5163429 | Cohen | Nov 1992 | A |
| 5178151 | Sackner | Jan 1993 | A |
| 5178153 | Einzig | Jan 1993 | A |
| 5190035 | Salo et al. | Mar 1993 | A |
| 5199428 | Obel et al. | Apr 1993 | A |
| 5200891 | Kehr et al. | Apr 1993 | A |
| 5213098 | Bennett et al. | May 1993 | A |
| 5246008 | Mueller | Sep 1993 | A |
| 5267174 | Kaufman et al. | Nov 1993 | A |
| 5277191 | Hughes | Jan 1994 | A |
| 5279309 | Taylor et al. | Jan 1994 | A |
| 5279607 | Schentag et al. | Jan 1994 | A |
| 5289821 | Swartz | Mar 1994 | A |
| 5300092 | Schaldach | Apr 1994 | A |
| 5314457 | Jeutter et al. | May 1994 | A |
| 5329459 | Kaufman et al. | Jul 1994 | A |
| 5330505 | Cohen | Jul 1994 | A |
| 5339051 | Koehler et al. | Aug 1994 | A |
| 5368040 | Carney | Nov 1994 | A |
| 5375603 | Feiler | Dec 1994 | A |
| 5394457 | Leibinger et al. | Feb 1995 | A |
| 5397329 | Allen | Mar 1995 | A |
| 5411535 | Fujii et al. | May 1995 | A |
| 5411551 | Winston et al. | May 1995 | A |
| 5417717 | Salo et al. | May 1995 | A |
| 5423334 | Jordan | Jun 1995 | A |
| 5438990 | Wahlstrand et al. | Aug 1995 | A |
| 5445608 | Chen et al. | Aug 1995 | A |
| 5454838 | Vallana et al. | Oct 1995 | A |
| 5469859 | Tsoglin et al. | Nov 1995 | A |
| 5476488 | Morgan et al. | Dec 1995 | A |
| 5488954 | Sleva et al. | Feb 1996 | A |
| 5490962 | Cima et al. | Feb 1996 | A |
| 5509424 | Al-Ali | Apr 1996 | A |
| 5528067 | Farb | Jun 1996 | A |
| 5535752 | Halperin et al. | Jul 1996 | A |
| 5558091 | Acker et al. | Sep 1996 | A |
| 5562714 | Grevious | Oct 1996 | A |
| 5564434 | Halperin et al. | Oct 1996 | A |
| 5571152 | Chen et al. | Nov 1996 | A |
| 5604531 | Iddan et al. | Feb 1997 | A |
| 5619997 | Kaplan | Apr 1997 | A |
| 5626630 | Markowitz et al. | May 1997 | A |
| 5628782 | Myers | May 1997 | A |
| 5642731 | Kehr | Jul 1997 | A |
| 5643327 | Dawson et al. | Jul 1997 | A |
| 5650770 | Schlager et al. | Jul 1997 | A |
| 5656428 | McAllister et al. | Aug 1997 | A |
| 5704352 | Tremblay et al. | Jan 1998 | A |
| 5705753 | Hastings et al. | Jan 1998 | A |
| 5728281 | Holmstrom et al. | Mar 1998 | A |
| 5729129 | Acker | Mar 1998 | A |
| 5733313 | Barreras, Sr. et al. | Mar 1998 | A |
| 5735887 | Barreras, Sr. et al. | Apr 1998 | A |
| 5741316 | Chen et al. | Apr 1998 | A |
| 5749909 | Schroeppel et al. | May 1998 | A |
| 5752235 | Kehr et al. | May 1998 | A |
| 5752976 | Duffin et al. | May 1998 | A |
| 5755766 | Chastain et al. | May 1998 | A |
| 5769877 | Barreras, Sr. | Jun 1998 | A |
| 5776324 | Usala | Jul 1998 | A |
| 5792195 | Carlson et al. | Aug 1998 | A |
| 5796827 | Coppersmith et al. | Aug 1998 | A |
| 5800478 | Chen et al. | Sep 1998 | A |
| 5807258 | Cimochowski et al. | Sep 1998 | A |
| 5807395 | Mulier et al. | Sep 1998 | A |
| 5807397 | Barreras | Sep 1998 | A |
| 5810009 | Mine et al. | Sep 1998 | A |
| 5810735 | Halperin et al. | Sep 1998 | A |
| 5832924 | Archibald et al. | Nov 1998 | A |
| 5833603 | Kovacs et al. | Nov 1998 | A |
| 5835455 | Hanson et al. | Nov 1998 | A |
| 5836300 | Mault | Nov 1998 | A |
| 5843135 | Weijand et al. | Dec 1998 | A |
| 5855609 | Knapp | Jan 1999 | A |
| 5856722 | Haronian et al. | Jan 1999 | A |
| 5868673 | Vesely | Feb 1999 | A |
| 5873835 | Hastings et al. | Feb 1999 | A |
| 5886267 | Ortiz | Mar 1999 | A |
| 5891180 | Greeninger et al. | Apr 1999 | A |
| 5904708 | Goedeke et al. | May 1999 | A |
| 5911685 | Siess et al. | Jun 1999 | A |
| 5919221 | Miesel | Jul 1999 | A |
| 5941249 | Maynard | Aug 1999 | A |
| 5954641 | Kehr et al. | Sep 1999 | A |
| 5957950 | Mockros et al. | Sep 1999 | A |
| 5967986 | Cimochowski et al. | Oct 1999 | A |
| 5979898 | Pan | Nov 1999 | A |
| 6002963 | Mouchawar et al. | Dec 1999 | A |
| 6023641 | Thompson | Feb 2000 | A |
| 6024704 | Meador et al. | Feb 2000 | A |
| 6053873 | Govari et al. | Apr 2000 | A |
| 6083248 | Thompson | Jul 2000 | A |
| 6112116 | Fischell et al. | Aug 2000 | A |
| 6123861 | Santini, Jr. et al. | Sep 2000 | A |
| 6140740 | Porat et al. | Oct 2000 | A |
| 6141588 | Cox et al. | Oct 2000 | A |
| 6152885 | Taepke | Nov 2000 | A |
| 6155267 | Nelson | Dec 2000 | A |
| 6161032 | Acker | Dec 2000 | A |
| 6162238 | Kaplan et al. | Dec 2000 | A |
| 6171252 | Roberts | Jan 2001 | B1 |
| 6179767 | Ziegler et al. | Jan 2001 | B1 |
| 6185452 | Schulman et al. | Feb 2001 | B1 |
| 6198965 | Penner et al. | Mar 2001 | B1 |
| 6200265 | Walsh et al. | Mar 2001 | B1 |
| 6234973 | Meador et al. | May 2001 | B1 |
| 6236889 | Soykan et al. | May 2001 | B1 |
| 6237398 | Porat et al. | May 2001 | B1 |
| 6239724 | Doron et al. | May 2001 | B1 |
| 6248080 | Miesel et al. | Jun 2001 | B1 |
| 6256538 | Ekwall | Jul 2001 | B1 |
| 6266567 | Ishikawa et al. | Jul 2001 | B1 |
| 6273904 | Chen et al. | Aug 2001 | B1 |
| 6277078 | Porat et al. | Aug 2001 | B1 |
| 6278894 | Salo et al. | Aug 2001 | B1 |
| 6305381 | Weijand et al. | Oct 2001 | B1 |
| 6308099 | Fox et al. | Oct 2001 | B1 |
| 6330957 | Bell-Greenstreet | Dec 2001 | B1 |
| 6331163 | Kaplan | Dec 2001 | B1 |
| 6368275 | Sliwa et al. | Apr 2002 | B1 |
| 6397661 | Grimes et al. | Jun 2002 | B1 |
| 6409674 | Brockway et al. | Jun 2002 | B1 |
| 6409675 | Turcott | Jun 2002 | B1 |
| 6411850 | Kay et al. | Jun 2002 | B1 |
| 6416474 | Penner et al. | Jul 2002 | B1 |
| 6431175 | Penner et al. | Aug 2002 | B1 |
| 6432050 | Porat et al. | Aug 2002 | B1 |
| 6438408 | Mulligan et al. | Aug 2002 | B1 |
| 6441747 | Khair et al. | Aug 2002 | B1 |
| 6442413 | Silver | Aug 2002 | B1 |
| 6445953 | Bulkes et al. | Sep 2002 | B1 |
| 6456883 | Torgerson et al. | Sep 2002 | B1 |
| 6471645 | Warkentin et al. | Oct 2002 | B1 |
| 6472991 | Schulman et al. | Oct 2002 | B1 |
| 6475170 | Doron et al. | Nov 2002 | B1 |
| 6486588 | Doron et al. | Nov 2002 | B2 |
| 6504286 | Porat et al. | Jan 2003 | B1 |
| 6522914 | Huvelle et al. | Feb 2003 | B1 |
| 6567700 | Turcott et al. | May 2003 | B1 |
| 6574510 | Von Arx et al. | Jun 2003 | B2 |
| 6580946 | Struble | Jun 2003 | B2 |
| 6604000 | Lu | Aug 2003 | B2 |
| 6607485 | Bardy | Aug 2003 | B2 |
| 6609023 | Fischell et al. | Aug 2003 | B1 |
| 6615083 | Kupper | Sep 2003 | B2 |
| 6622049 | Penner et al. | Sep 2003 | B2 |
| 6628989 | Penner et al. | Sep 2003 | B1 |
| 6638231 | Govari et al. | Oct 2003 | B2 |
| 6644322 | Webb | Nov 2003 | B2 |
| 6654638 | Sweeney | Nov 2003 | B1 |
| 6675049 | Thompson et al. | Jan 2004 | B2 |
| 6699186 | Wolinsky et al. | Mar 2004 | B1 |
| 6702847 | DiCarlo | Mar 2004 | B2 |
| 6708061 | Salo et al. | Mar 2004 | B2 |
| 6708065 | Von Arx et al. | Mar 2004 | B2 |
| 6712772 | Cohen et al. | Mar 2004 | B2 |
| 6720709 | Porat et al. | Apr 2004 | B2 |
| 6720887 | Zunti | Apr 2004 | B1 |
| 6733447 | Lai et al. | May 2004 | B2 |
| 6738671 | Christophersom et al. | May 2004 | B2 |
| 6743173 | Penner et al. | Jun 2004 | B2 |
| 6764446 | Wolinsky et al. | Jul 2004 | B2 |
| 6782810 | Vilo | Aug 2004 | B2 |
| 6783499 | Schwartz | Aug 2004 | B2 |
| 6792308 | Corbucci | Sep 2004 | B2 |
| 6792311 | Fox et al. | Sep 2004 | B2 |
| 6805667 | Christopherson et al. | Oct 2004 | B2 |
| 6809507 | Morgan et al. | Oct 2004 | B2 |
| 6824512 | Warkentin et al. | Nov 2004 | B2 |
| 6840956 | Wolinsky et al. | Jan 2005 | B1 |
| 6855115 | Fonseca et al. | Feb 2005 | B2 |
| 6859665 | Ding et al. | Feb 2005 | B2 |
| 6865419 | Mulligan et al. | Mar 2005 | B2 |
| 6868346 | Larson et al. | Mar 2005 | B2 |
| 6869404 | Schulhauser et al. | Mar 2005 | B2 |
| 6871088 | Chinchoy | Mar 2005 | B2 |
| 6885889 | Chinchoy | Apr 2005 | B2 |
| 6889086 | Mass et al. | May 2005 | B2 |
| 6895265 | Silver | May 2005 | B2 |
| 6907285 | Denker et al. | Jun 2005 | B2 |
| 6915162 | Noren et al. | Jul 2005 | B2 |
| 6926670 | Rich et al. | Aug 2005 | B2 |
| 6937900 | Pianca et al. | Aug 2005 | B1 |
| 6949075 | Hatlesad et al. | Sep 2005 | B2 |
| 6961448 | Nichols et al. | Nov 2005 | B2 |
| 6970742 | Mann et al. | Nov 2005 | B2 |
| 6978182 | Mazar et al. | Dec 2005 | B2 |
| 6985773 | Von Arx et al. | Jan 2006 | B2 |
| 6993393 | Von Arx et al. | Jan 2006 | B2 |
| 7003350 | Denker et al. | Feb 2006 | B2 |
| 7018336 | Enegren et al. | Mar 2006 | B2 |
| 7024248 | Penner et al. | Apr 2006 | B2 |
| 7033322 | Silver | Apr 2006 | B2 |
| 7035684 | Lee | Apr 2006 | B2 |
| 7047065 | Kalgren et al. | May 2006 | B2 |
| 7060030 | Von Arx et al. | Jun 2006 | B2 |
| 7061381 | Forcier et al. | Jun 2006 | B2 |
| 7088254 | Liebenow | Aug 2006 | B2 |
| 7127290 | Girouard et al. | Oct 2006 | B2 |
| 7134999 | Brauker et al. | Nov 2006 | B2 |
| 7136703 | Cappa et al. | Nov 2006 | B1 |
| 7160252 | Cho et al. | Jan 2007 | B2 |
| 7195594 | Eigler et al. | Mar 2007 | B2 |
| 7198603 | Penner et al. | Apr 2007 | B2 |
| 7200439 | Zdeblick et al. | Apr 2007 | B2 |
| 7203545 | Schmitt et al. | Apr 2007 | B2 |
| 7204798 | Zdeblick et al. | Apr 2007 | B2 |
| 7212861 | Park et al | May 2007 | B1 |
| 7214189 | Zdeblick | May 2007 | B2 |
| 7236821 | Cates et al. | Jun 2007 | B2 |
| 7248923 | Maile et al. | Jul 2007 | B2 |
| 7273457 | Penner | Sep 2007 | B2 |
| 7294105 | Islam | Nov 2007 | B1 |
| 7335161 | Von Arx et al. | Feb 2008 | B2 |
| 7399313 | Brown et al. | Jul 2008 | B2 |
| 7425200 | Brockway et al. | Sep 2008 | B2 |
| 7452334 | Gianchandani et al. | Nov 2008 | B2 |
| 7481771 | Fonseca et al. | Jan 2009 | B2 |
| 7641619 | Penner | Jan 2010 | B2 |
| 8271093 | Von Arx et al. | Sep 2012 | B2 |
| 20020023123 | Madison | Feb 2002 | A1 |
| 20020042561 | Schulman et al. | Apr 2002 | A1 |
| 20020045804 | Christopherson et al. | Apr 2002 | A1 |
| 20020045812 | Ben-Haim et al. | Apr 2002 | A1 |
| 20020045836 | Alkawwas | Apr 2002 | A1 |
| 20020147406 | von Segesser | Oct 2002 | A1 |
| 20020151770 | Noll, III et al. | Oct 2002 | A1 |
| 20020183628 | Reich et al. | Dec 2002 | A1 |
| 20020188323 | Penner et al. | Dec 2002 | A1 |
| 20030009204 | Amundson et al. | Jan 2003 | A1 |
| 20030114897 | Von Arx et al. | Jun 2003 | A1 |
| 20030136417 | Fonseca et al. | Jul 2003 | A1 |
| 20030181794 | Rini et al. | Sep 2003 | A1 |
| 20030191383 | Ben-Haim et al. | Oct 2003 | A1 |
| 20040032187 | Penner et al. | Feb 2004 | A1 |
| 20040044393 | Yarden et al. | Mar 2004 | A1 |
| 20040064133 | Miller et al. | Apr 2004 | A1 |
| 20040077937 | Yarden | Apr 2004 | A1 |
| 20040122484 | Hatlestad et al. | Jun 2004 | A1 |
| 20040122486 | Stahmann et al. | Jun 2004 | A1 |
| 20040152999 | Cohen et al. | Aug 2004 | A1 |
| 20040172081 | Wang | Sep 2004 | A1 |
| 20050056539 | Morgan et al. | Mar 2005 | A1 |
| 20050102002 | Salo et al. | May 2005 | A1 |
| 20050137490 | Scheiner et al. | Jun 2005 | A1 |
| 20050149143 | Libbus et al. | Jul 2005 | A1 |
| 20050154321 | Wolinsky et al. | Jul 2005 | A1 |
| 20050159789 | Brockway et al. | Jul 2005 | A1 |
| 20050182330 | Brockway et al. | Aug 2005 | A1 |
| 20050187482 | O'Brien et al. | Aug 2005 | A1 |
| 20050192637 | Girouard et al. | Sep 2005 | A1 |
| 20050192844 | Esler et al. | Sep 2005 | A1 |
| 20050197585 | Brockway et al. | Sep 2005 | A1 |
| 20050215887 | Ben-Haim et al. | Sep 2005 | A1 |
| 20050242479 | Petisce et al. | Nov 2005 | A1 |
| 20050288727 | Penner | Dec 2005 | A1 |
| 20060031378 | Vallapureddy et al. | Feb 2006 | A1 |
| 20060064133 | Von Arx et al. | Mar 2006 | A1 |
| 20060064134 | Mazar et al. | Mar 2006 | A1 |
| 20060064142 | Chavan et al. | Mar 2006 | A1 |
| 20060064143 | Von Arx et al. | Mar 2006 | A1 |
| 20060085039 | Hastings et al. | Apr 2006 | A1 |
| 20060085041 | Hastings et al. | Apr 2006 | A1 |
| 20060085042 | Hastings et al. | Apr 2006 | A1 |
| 20060089694 | Zhang et al. | Apr 2006 | A1 |
| 20060136004 | Cowan et al. | Jun 2006 | A1 |
| 20060142651 | Brister et al. | Jun 2006 | A1 |
| 20070043394 | Zhang et al. | Feb 2007 | A1 |
| 20070049977 | Von Arx et al. | Mar 2007 | A1 |
| 20070060959 | Salo et al. | Mar 2007 | A1 |
| 20070129765 | Gilkerson et al. | Jun 2007 | A1 |
| 20070142727 | Zhang et al. | Jun 2007 | A1 |
| 20080015421 | Penner | Jan 2008 | A1 |
| 20080021333 | Huelskamp | Jan 2008 | A1 |
| 20080021972 | Huelskamp et al. | Jan 2008 | A1 |
| 20080071178 | Greenland et al. | Mar 2008 | A1 |
| 20080077440 | Doron | Mar 2008 | A1 |
| 20080312553 | Timmons | Dec 2008 | A1 |
| Number | Date | Country |
|---|---|---|
| 0897690 | Feb 1999 | EP |
| 0928598 | Jul 1999 | EP |
| 1266606 | Dec 2002 | EP |
| 1169085 | Aug 2004 | EP |
| 2002224053 | Aug 2002 | JP |
| WO8303345 | Oct 1983 | WO |
| WO9701986 | Jan 1997 | WO |
| WO9732519 | Sep 1997 | WO |
| WO9733513 | Sep 1997 | WO |
| WO9747236 | Dec 1997 | WO |
| WO9826716 | Jun 1998 | WO |
| WO9829030 | Jul 1998 | WO |
| WO9917095 | Apr 1999 | WO |
| WO9926530 | Jun 1999 | WO |
| WO9934453 | Jul 1999 | WO |
| WO9947205 | Sep 1999 | WO |
| WO9955223 | Nov 1999 | WO |
| WO9955225 | Nov 1999 | WO |
| WO9959460 | Nov 1999 | WO |
| WO9966988 | Dec 1999 | WO |
| WO0016686 | Mar 2000 | WO |
| WO0047109 | Aug 2000 | WO |
| WO0058744 | Oct 2000 | WO |
| WO0128627 | Apr 2001 | WO |
| WO0156467 | Aug 2001 | WO |
| WO01074278 | Oct 2001 | WO |
| WO0203347 | Jan 2002 | WO |
| WO0232502 | Apr 2002 | WO |
| WO03002243 | Jan 2003 | WO |
| WO03096889 | Nov 2003 | WO |
| WO2004056301 | Jul 2004 | WO |
| WO2004060043 | Jul 2004 | WO |
| WO2004073513 | Sep 2004 | WO |
| WO2005118056 | Dec 2005 | WO |
| WO2006033812 | Mar 2006 | WO |
| WO2006034183 | Mar 2006 | WO |
| WO2006045073 | Apr 2006 | WO |
| WO2006045074 | Apr 2006 | WO |
| WO2006045075 | Apr 2006 | WO |
| WO2006069215 | Jun 2006 | WO |
| WO2007030474 | Mar 2007 | WO |
| WO2007047287 | Apr 2007 | WO |
| WO2007047288 | Apr 2007 | WO |
| WO2007070794 | Jun 2007 | WO |
| WO2008011592 | Jan 2008 | WO |
| WO2008011593 | Jan 2008 | WO |
| WO2008154145 | Dec 2008 | WO |
| Entry |
|---|
| B. C. Penney et al., “Simplified electrode array for impedance cardiography,” Medical & Biological Engineering & Computing, 1985, 23, p. 1-7. |
| Henderson et al., “Interaction of Photodynamic Therapy and Hyperthermia: Tumor Response and Cell Survival after Treatment of Mice in Vivo,” Cancer Research, vol. 45, 6071 (Dec. 1985). |
| Bennett et al., “Subcutaneous pressure measurement as a surrogate for an external pressure reference for chronic implantable pressure monitoring,” Journal of Cardial Failure, Churchill Livingstone, vol. 9, No. 5, p. S51, Oct. 1, 2003, abstract only. |
| Bonnefoy E, Ninet J, Robin J, Leroux F, Boissonat P, Brule P, Champsaur G., 1994, Bipolar intramyocardial electrogram from an implanted telemetric pacemaker for the diagnosis of cardiac allograft rejection, Pacing Clin Electrophysiol, 17(11 Pt 2):2052-6. |
| C. Hierold et al. (Germany, 1998) “Implantable Low Power Integrated Pressure Sensor System for Minimal Invasive Telemetric Patient Monitoring” IEEE, pp. 568-573. |
| Dipl.-Ing. Torsten Eggers et al. (Germany) “Implantable Telemetric Endosytem (ITES)” IMSAS Institut Fur Mikrosensoren-Aktuatoren Und-Systeme, 1998. 2 pp. |
| E R. Cosman et al. (Massachussetts, Apr. 1979) “A Telemetric Pressure Sensor for Ventricular Shunt Systems” Surgical Neurology vol. 11, No. 4, pp. 287-294. |
| G.W.H. Schurink et al. (1998) “Late Endoleak After Endovascular Therapy for Abdominal Aortic Aneurysm” Eur. J. Vasc. Endovasc. Surg. vol. 17, pp. 448-450. |
| Gerhausser A, Reichel T, Neukomm P A, Bolz A, Hugel J, Schaldach M, 1997, Diagnosis of rejection after kidney transplantation by impedance spectroscopy with an implantable measuring system, Biomed Tech (Berl), 42 Suppl. 160-1. |
| GH White et al. (1997) “Endoleak Following Endoluminal Repair of AAA: Management Options and Patient Outcomes”, J. Endovasc Surg, pp. 1-45. |
| Graichen et al., “Patient Monitoring System for Load Measurement with Spinal Fixation Devices,” Med. Eng. Phys. 18, (1996), pp. 167-174. |
| Haas et al., “Photodynamic Effects of Dyes on Bacteria,” Published in Mutation Research, 1979, vol. 60, pp. 1-11. |
| Hashima et al., “Nonhomogenous Analysis of Epicardial Strain Distributions During Acute Myocardial Ischemia in the Dog,” J Biomech 1993, Jan. 26: 19-35. |
| Hetzer R. et al., 1998, Daily non-invasive rejection monitoring improves long-term survival in pediatric heart transplantation, Ann. Thorac. Surg. (66):1343-1349. |
| J.A. Parrish, “Photobiologic Consideration on Photoradiation Therapy,” pp. 91-108, Porphyrin Photosensitization, Plenum Press, (1983). |
| K.E. Uhrich et al., “Synthesis and characterization of degradable poly(anhydride-co-imides)”, Macromolecules, 1995, 28, 2184-93. |
| Karl E. Richard et al. (Germany, Jan. 1999) “First clinical results with a telemetric shunt-integrated ICP-sensor” Neurological Research vol. 21, pp. 117-120. |
| Labrousse and Satre, “Photodynamic Killing of Dictyostelium Discoideum Amoebae Mediated by 4′,5′-Diiodoflurescin Isothiocyanate Dextran. A strategy for the isolation of Thermoconditional Endocytosis Mutants,” published in Photochemistry and Photobiology. |
| Mackay et al., “Bio-medical Telemetry: Sensing and Transmitting Biological Information from Animals and Man,” John Wiley & Sons, Inc. New York (1970) pp. 244-245. |
| Pfitzmann R, Muller J, Grauhan O. Cohnert T, Hetzer R, Z Kardiol, 1998, Measuring bioelectric myocardial impedance as a non invasive method for diagnosis of graft rejection after heart transplantation, 87(4):258-266. |
| Pirolo J S, Shuman T S, Brunt E M, Liptay M J, Cox J L, Ferguson T B Jr., J Thoracic Cardiovasc Surg, 1992, Noninvasive detection of cardiac allograft rejection by prospective telemetric monitoring, 103(5):969-79. |
| Prof. Dr. Johannes Zacheja et al. (Germany, Sep. 1996) “An Implantable Microsystem for Biomedical Applications” Micro System Technologies 96, pp. 717-722. |
| S.K. Gupta et al. (1999) “Use of a Piezoelectric Film Sensor for Monitoring Vascular Grafts”, The American Journal of Surgery, vol. 160, pp. 182-186. |
| T. Chuter et al. (Sweden, Jan. 1997) “Aneurysm Pressure Following Endovascular Exclusion” Eur. J. Vasc. Endovasc. Surg. vol. 13, pp. 85-87. |
| T.A. Cochran et al. (1990) “Aortic Aneurysm Abdominal”, Current Therapy in Adult Medicine, Fourth Edition. |
| Z. Tang et al. (May 1995) “Data Transmission from an Implantable Biotelemeter by Load-Shift Keying Using Circuit Configuration Modulator” IEEE Transactions on Biomedical Engineering. vol. 42, No. 5, pp. 524-528. |
| Extended European Search Report issued in EP 10184174, mailed Dec. 7, 2010. |
| Non-Final Office Action issued in U.S. Appl. No. 10/943,627, mailed Oct. 2, 2008, 10 pages. |
| Non-Final Office Action issued in U.S. Appl. No. 09/943,627, mailed Oct. 7, 2009, 9 pages. |
| Number | Date | Country | |
|---|---|---|---|
| 20120296177 A1 | Nov 2012 | US |
| Number | Date | Country | |
|---|---|---|---|
| Parent | 10943627 | Sep 2004 | US |
| Child | 13564332 | US |
