JP2008526453A - 心音と姿勢を測定する装置 - Google Patents
心音と姿勢を測定する装置 Download PDFInfo
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B7/00—Instruments for auscultation
- A61B7/02—Stethoscopes
- A61B7/04—Electric stethoscopes
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/103—Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
- A61B5/11—Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb
- A61B5/1107—Measuring contraction of parts of the body, e.g. organ, muscle
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B7/00—Instruments for auscultation
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/08—Detecting organic movements or changes, e.g. tumours, cysts, swellings
- A61B8/0883—Detecting organic movements or changes, e.g. tumours, cysts, swellings for diagnosis of the heart
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/103—Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
- A61B5/11—Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb
- A61B5/1116—Determining posture transitions
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/362—Heart stimulators
- A61N1/3627—Heart stimulators for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/362—Heart stimulators
- A61N1/365—Heart stimulators controlled by a physiological parameter, e.g. heart potential
- A61N1/36514—Heart stimulators controlled by a physiological parameter, e.g. heart potential controlled by a physiological quantity other than heart potential, e.g. blood pressure
- A61N1/36535—Heart stimulators controlled by a physiological parameter, e.g. heart potential controlled by a physiological quantity other than heart potential, e.g. blood pressure controlled by body position or posture
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/362—Heart stimulators
- A61N1/365—Heart stimulators controlled by a physiological parameter, e.g. heart potential
- A61N1/36514—Heart stimulators controlled by a physiological parameter, e.g. heart potential controlled by a physiological quantity other than heart potential, e.g. blood pressure
- A61N1/36578—Heart stimulators controlled by a physiological parameter, e.g. heart potential controlled by a physiological quantity other than heart potential, e.g. blood pressure controlled by mechanical motion of the heart wall, e.g. measured by an accelerometer or microphone
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/362—Heart stimulators
- A61N1/365—Heart stimulators controlled by a physiological parameter, e.g. heart potential
- A61N1/36585—Heart stimulators controlled by a physiological parameter, e.g. heart potential controlled by two or more physical parameters
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Physics & Mathematics (AREA)
- Molecular Biology (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Biomedical Technology (AREA)
- Surgery (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Engineering & Computer Science (AREA)
- Acoustics & Sound (AREA)
- Biophysics (AREA)
- Pathology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Radiology & Medical Imaging (AREA)
- Cardiology (AREA)
- Physiology (AREA)
- Dentistry (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Measuring And Recording Apparatus For Diagnosis (AREA)
- Measuring Pulse, Heart Rate, Blood Pressure Or Blood Flow (AREA)
- Measurement Of The Respiration, Hearing Ability, Form, And Blood Characteristics Of Living Organisms (AREA)
Abstract
Description
参照によって本明細書に組み込まれている2005年1月18日出願の米国特許出願番号11/037275に対する優先権の利益が、本明細書によって主張される。
本出願は、参照によって本明細書に組み込まれている以下の同時係属で共通に譲渡された2004年7月28日出願の米国特許出願番号10/900570、名称「DETERMINING A PATIENT’S POSTURE FROM MECHANICAL VIBRATIONS OF THE HEART」、2003年11月6日出願の米国特許出願番号10/703175、名称「A DUAL USE SENSOR FOR RATE RESPONSIVE PACING AND HEART SOUND MONITORING」、および2002年12月30日出願の米国特許出願番号10/334694、名称「METHOD AND APPARATUS FOR MONITORING OF DIASTOLIC HEMODYNAMICS」に関する。
Claims (29)
- 患者の心臓の機械的活動に関連する心音の少なくとも1つを表す電気信号を作成するように動作可能である埋込型心音センサと、
心音信号を作成するために、前記心音センサに結合された心音センサ・インタフェース回路と、
患者の姿勢を表す電気信号を作成するように動作可能な埋込型姿勢センサと、
前記心音センサ・インタフェース回路と前記姿勢回路に結合され、少なくとも1つの感知された患者の姿勢に対応する前記少なくとも1つの心音を測定するように動作可能なコントローラ回路と
を備える装置を備えるシステム。 - 前記コントローラが、直立姿勢において前記心音を測定するように動作可能である請求項1に記載のシステム。
- 前記コントローラが、複数の姿勢において前記心音を測定するように動作可能である請求項1に記載のシステム。
- 前記装置が、前記コントローラに結合された記憶回路をさらに含み、前記コントローラが、患者の姿勢に対応する少なくとも1つの心音の測定を記憶するように動作可能である請求項3に記載のシステム。
- 前記コントローラが、スケーリング・ファクタを少なくとも1つの心音の測定に適用するように動作可能であり、前記スケーリング・ファクタが患者の姿勢の関数である請求項3に記載のシステム。
- 前記装置が時計回路をさらに含み、前記コントローラ回路が、患者が横臥姿勢にあるとき、1日のある時間において心音を測定するように動作可能である請求項1に記載のシステム。
- 前記コントローラ回路が、心音の測定が実施される前に、干渉が閾値レベルより低いことを判定するために前記埋込型心音センサによって提供された前記電気信号を使用するように動作可能である請求項1に記載のシステム。
- 前記装置が、少なくとも1つの固有心臓信号を検出するように動作可能な少なくとも1つの埋込型心臓信号感知回路をさらに含み、前記コントローラが、患者の心拍数が規定の心拍数閾値より低いとき、少なくとも1つの感知された患者の姿勢に対応する前記少なくとも1つの心音を測定するように動作可能である請求項1に記載のシステム。
- 前記装置が、埋込型活動センサをさらに含み、前記コントローラが、患者の活動レベルが規定の活動閾値より低いとき、少なくとも1つの感知された患者の姿勢に対応する前記少なくとも1つの心音を測定するように動作可能である請求項1に記載のシステム。
- 前記装置が、被験者の経胸腔的インピーダンス信号を提供するために、埋込型経胸腔的インピーダンス測定回路をさらに含み、前記コントローラが、少なくとも1つの感知された患者の姿勢と前記測定された心音に対応する前記経胸腔的インピーダンス測定を実施するように動作可能である請求項1に記載のシステム。
- 前記経胸腔的インピーダンス測定回路が、近DCの経胸腔的インピーダンスの測定を実施し、前記コントローラが、少なくとも1つの感知された患者の姿勢と前記測定された心音に対応する前記近DCの経胸腔的インピーダンス測定を実施するように動作可能である請求項10に記載のシステム。
- 前記装置が、外部装置と通信するために通信回路を含む埋込型装置であり、システムが前記外部装置をさらに含み、前記外部装置が、感知された患者の姿勢に関する心音情報を表示するためにディスプレイを含む請求項1に記載のシステム。
- 前記心音情報が、患者の姿勢に関する心音情報の少なくとも1つの傾向を含む請求項12に記載のシステム。
- 前記装置が、外部装置と通信するために通信回路を含む埋込型装置であり、システムが前記外部装置をさらに含み、前記外部装置が、コンピュータ・ネットワークと通信する請求項1に記載のシステム。
- 前記外部装置が、前記心音信号と前記患者の姿勢を含む情報に基づいて警告を伝達するように動作可能である請求項14に記載のシステム。
- 前記コントローラ回路が、姿勢に従って前記心音を分類するために分類モジュールを含む請求項1に記載のシステム。
- 前記コントローラ回路が、特定の患者の姿勢を条件として心音の測定を開始する請求項1に記載のシステム。
- 前記特定の患者の姿勢が、直立の患者の姿勢を含む請求項17に記載のシステム。
- 埋込型医療装置を使用して少なくとも1つの心音を感知するステップと、
前記埋込型医療装置を使用して患者の姿勢情報を決定するステップと、
前記姿勢情報に対応する前記心音を測定するステップとを備える、方法。 - 前記姿勢情報に対応する少なくとも1つの心音を測定するステップが、それぞれの姿勢に対応する心音を測定することと、心音の測定を姿勢に関係付けることとを含む請求項19に記載の方法。
- それぞれの姿勢に対応する少なくとも1つの心音を測定するステップが、少なくとも1つのスケーリング・ファクタを少なくとも1つの心音の測定に適用することを含み、前記スケーリング・ファクタが姿勢の関数である請求項20に記載の方法。
- 対応する心拍数が規定の心拍数閾値より高いとき、少なくとも1つの心音の測定を排除することを備える請求項19に記載の方法。
- 前記患者の姿勢に対応する少なくとも1つの心音を測定することが、前記患者が特定の姿勢にあることを条件として前記心音を測定することを含む請求項19に記載の方法。
- 前記特定の姿勢が直立姿勢である請求項23に記載の方法。
- 患者の活動レベルが特定の活動閾値より高いとき、少なくとも1つの心音の測定を排除することを備える請求項19に記載の方法。
- 機械的干渉レベルが閾値を超えるとき、少なくとも1つの心音の測定を排除することを備える請求項19に記載の方法。
- 前記患者の姿勢に対応する少なくとも1つの心音を前記測定することが、姿勢に関する心音の傾向を測定することを含む請求項19に記載の方法。
- 前記患者の姿勢に対応する前記少なくとも1つの心音の測定の傾向情報を記憶することをさらに備える請求項19に記載の方法。
- 前記傾向情報を表示用外部装置に伝達することをさらに含む請求項28に記載の方法。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US11/037,275 US7662104B2 (en) | 2005-01-18 | 2005-01-18 | Method for correction of posture dependence on heart sounds |
US11/037,275 | 2005-01-18 | ||
PCT/US2006/001801 WO2006078757A1 (en) | 2005-01-18 | 2006-01-18 | Device measuring heart sounds and posture |
Publications (3)
Publication Number | Publication Date |
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JP2008526453A true JP2008526453A (ja) | 2008-07-24 |
JP2008526453A5 JP2008526453A5 (ja) | 2009-03-26 |
JP5330692B2 JP5330692B2 (ja) | 2013-10-30 |
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Application Number | Title | Priority Date | Filing Date |
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JP2007551478A Expired - Fee Related JP5330692B2 (ja) | 2005-01-18 | 2006-01-18 | 心音と姿勢を測定するシステムおよび方法 |
Country Status (4)
Country | Link |
---|---|
US (2) | US7662104B2 (ja) |
EP (1) | EP1838218B1 (ja) |
JP (1) | JP5330692B2 (ja) |
WO (1) | WO2006078757A1 (ja) |
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US20100099997A1 (en) | 2010-04-22 |
WO2006078757A1 (en) | 2006-07-27 |
US7662104B2 (en) | 2010-02-16 |
EP1838218B1 (en) | 2013-07-31 |
JP5330692B2 (ja) | 2013-10-30 |
US7951087B2 (en) | 2011-05-31 |
EP1838218A1 (en) | 2007-10-03 |
US20060161070A1 (en) | 2006-07-20 |
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