WO2010059291A1 - Évaluation d'une résistance vasculaire pulmonaire par l'intermédiaire d'une pression artérielle pulmonaire - Google Patents
Évaluation d'une résistance vasculaire pulmonaire par l'intermédiaire d'une pression artérielle pulmonaire Download PDFInfo
- Publication number
- WO2010059291A1 WO2010059291A1 PCT/US2009/058242 US2009058242W WO2010059291A1 WO 2010059291 A1 WO2010059291 A1 WO 2010059291A1 US 2009058242 W US2009058242 W US 2009058242W WO 2010059291 A1 WO2010059291 A1 WO 2010059291A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- pulmonary
- vascular resistance
- pulmonary vascular
- pressure
- retrograde
- Prior art date
Links
- 230000036593 pulmonary vascular resistance Effects 0.000 title claims abstract description 107
- 230000004872 arterial blood pressure Effects 0.000 title claims abstract description 53
- 210000001147 pulmonary artery Anatomy 0.000 title claims abstract description 41
- 238000000034 method Methods 0.000 claims abstract description 45
- 230000002685 pulmonary effect Effects 0.000 claims abstract description 30
- 230000036581 peripheral resistance Effects 0.000 claims abstract description 9
- 230000001939 inductive effect Effects 0.000 claims abstract description 7
- 230000000747 cardiac effect Effects 0.000 claims abstract description 4
- 210000005246 left atrium Anatomy 0.000 claims description 16
- 230000001746 atrial effect Effects 0.000 claims description 11
- 230000008602 contraction Effects 0.000 claims description 8
- 230000002792 vascular Effects 0.000 claims description 8
- 210000002837 heart atrium Anatomy 0.000 claims description 5
- 238000004891 communication Methods 0.000 claims description 4
- 238000012806 monitoring device Methods 0.000 claims description 2
- 238000009530 blood pressure measurement Methods 0.000 abstract description 13
- 206010037423 Pulmonary oedema Diseases 0.000 abstract description 7
- 208000005333 pulmonary edema Diseases 0.000 abstract description 7
- 230000001269 cardiogenic effect Effects 0.000 abstract description 6
- 230000002861 ventricular Effects 0.000 description 16
- 210000005241 right ventricle Anatomy 0.000 description 12
- 210000005245 right atrium Anatomy 0.000 description 10
- 210000005166 vasculature Anatomy 0.000 description 10
- 238000002560 therapeutic procedure Methods 0.000 description 9
- 230000000004 hemodynamic effect Effects 0.000 description 8
- 210000003492 pulmonary vein Anatomy 0.000 description 8
- 206010019280 Heart failures Diseases 0.000 description 7
- 230000017531 blood circulation Effects 0.000 description 7
- 230000009885 systemic effect Effects 0.000 description 7
- 210000005240 left ventricle Anatomy 0.000 description 5
- 230000002526 effect on cardiovascular system Effects 0.000 description 4
- 238000012986 modification Methods 0.000 description 4
- 230000004048 modification Effects 0.000 description 4
- 210000000709 aorta Anatomy 0.000 description 3
- 210000001367 artery Anatomy 0.000 description 3
- 238000001514 detection method Methods 0.000 description 3
- 238000003745 diagnosis Methods 0.000 description 3
- 230000000694 effects Effects 0.000 description 3
- 210000004115 mitral valve Anatomy 0.000 description 3
- 208000002815 pulmonary hypertension Diseases 0.000 description 3
- 230000035945 sensitivity Effects 0.000 description 3
- 208000006545 Chronic Obstructive Pulmonary Disease Diseases 0.000 description 2
- 208000010378 Pulmonary Embolism Diseases 0.000 description 2
- 239000008280 blood Substances 0.000 description 2
- 210000004369 blood Anatomy 0.000 description 2
- 239000003990 capacitor Substances 0.000 description 2
- 210000005242 cardiac chamber Anatomy 0.000 description 2
- 230000002596 correlated effect Effects 0.000 description 2
- 210000004072 lung Anatomy 0.000 description 2
- 238000005259 measurement Methods 0.000 description 2
- 238000012544 monitoring process Methods 0.000 description 2
- 230000002441 reversible effect Effects 0.000 description 2
- 230000035939 shock Effects 0.000 description 2
- 210000002620 vena cava superior Anatomy 0.000 description 2
- 206010020772 Hypertension Diseases 0.000 description 1
- 208000007123 Pulmonary Atelectasis Diseases 0.000 description 1
- 210000001015 abdomen Anatomy 0.000 description 1
- 230000001133 acceleration Effects 0.000 description 1
- 230000001154 acute effect Effects 0.000 description 1
- 238000007792 addition Methods 0.000 description 1
- 238000013459 approach Methods 0.000 description 1
- 230000002457 bidirectional effect Effects 0.000 description 1
- 230000036772 blood pressure Effects 0.000 description 1
- 208000006218 bradycardia Diseases 0.000 description 1
- 230000036471 bradycardia Effects 0.000 description 1
- 206010061592 cardiac fibrillation Diseases 0.000 description 1
- 238000009125 cardiac resynchronization therapy Methods 0.000 description 1
- 230000001276 controlling effect Effects 0.000 description 1
- 201000010099 disease Diseases 0.000 description 1
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 1
- 230000002600 fibrillogenic effect Effects 0.000 description 1
- 239000012530 fluid Substances 0.000 description 1
- 239000007943 implant Substances 0.000 description 1
- 238000002513 implantation Methods 0.000 description 1
- 238000003780 insertion Methods 0.000 description 1
- 230000037431 insertion Effects 0.000 description 1
- 230000007774 longterm Effects 0.000 description 1
- 230000003287 optical effect Effects 0.000 description 1
- 230000000737 periodic effect Effects 0.000 description 1
- 230000002093 peripheral effect Effects 0.000 description 1
- 238000004393 prognosis Methods 0.000 description 1
- 230000035485 pulse pressure Effects 0.000 description 1
- 238000000718 qrs complex Methods 0.000 description 1
- 238000005070 sampling Methods 0.000 description 1
- 239000000126 substance Substances 0.000 description 1
- 238000012360 testing method Methods 0.000 description 1
- 230000001225 therapeutic effect Effects 0.000 description 1
- 230000001052 transient effect Effects 0.000 description 1
- 230000001960 triggered effect Effects 0.000 description 1
- 210000003462 vein Anatomy 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/021—Measuring pressure in heart or blood vessels
- A61B5/0215—Measuring pressure in heart or blood vessels by means inserted into the body
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/02007—Evaluating blood vessel condition, e.g. elasticity, compliance
Definitions
- the present invention relates generally to methods and systems for measuring hemodynamic parameters within a patient's body. More specifically, the present invention pertains to methods and systems for assessing pulmonary or systemic vascular resistance in a patient.
- Pulmonary vascular resistance is an important hemodynamic variable that affects prognosis and therapy in a wide range of cardiovascular and pulmonary conditions.
- pulmonary vascular resistance can be used as an indicator for the distension of small pulmonary vessels, which typically occurs in early stages of heart decompensation in response to elevated left atrial pressures.
- pulmonary vascular resistance can also be utilized as an indicator for other conditions, including pulmonary hypertension, pulmonary embolisms, and atelectasis. Since changes in pulmonary vascular resistance often occur in the early stage of diseases such as pulmonary edema, the periodic measurement of this parameter over time may provide a useful indicator for the early detection of an acutely worsening heart failure.
- pulmonary vascular resistance e.g., the left ventricle or aorta
- pulmonary vascular resistance While providing a means for calculating pulmonary vascular resistance, such methods typically require the insertion of a catheter within the body, and are therefore not useful in measuring long term trends that occur over longer periods of time.
- the present invention pertains to methods and systems for measuring pulmonary or systemic vascular resistance within a patient.
- An illustrative method of measuring pulmonary vascular resistance within a patient includes electrically inducing a retrograde pressure pulse within the patient's heart using a pulse generator, sensing at least one arterial pressure parameter in response to the retrograde pressure pulse using a pressure sensor located within a pulmonary artery, and computing a value of the change in pulmonary vascular resistance using the at least one sensed arterial pressure parameter.
- data from multiple pulmonary vascular resistance assessments can be trended over a period of time to aid in detecting an underlying cardiovascular or pulmonary condition such as cardiogenic pulmonary edema.
- An illustrative system for measuring pulmonary vascular resistance within a patient includes a pulse generator including at least one lead adapted to induce a retrograde pressure pulse within the left atrium of the heart, a pressure sensor implanted within a pulmonary artery and adapted to sense an arterial pressure waveform in response to the retrograde pressure pulse, and a processor adapted to compute a value of pulmonary vascular resistance using the sensed arterial pressure waveform.
- the processor may comprise a component or module of the pulse generator, the pressure sensor, or an external monitoring device in communication with the pulse generator and/or pressure sensor.
- Figure 1 is a schematic view of an illustrative system for measuring pulmonary vascular resistance within a patient's heart
- Figure 2 is an equivalent electrical circuit modeling the pulmonary vasculature of a patient
- Figure 3 is a simplified equivalent electrical circuit modeling the pulmonary vasculature of a patient
- Figure 4 is a flow chart showing an illustrative method of measuring pulmonary vascular resistance within a patient using the system of Figure 1 ;
- Figures 5A-5B are several graphs showing an illustrative
- ECG waveform and pulmonary artery pressure waveform in response to pacing signals provided by the pulse generator during the assessment mode of operation;
- Figure 6 is a flow chart showing an illustrative method of trending data from multiple pulmonary vascular resistance assessments taken over an extended period of time for detecting a cardiovascular or pulmonary condition within a patient;
- Figure 7 is a flow chart showing an illustrative method of producing a trend of pulmonary vascular resistance.
- FIG. 1 is a schematic view of an illustrative system 10 for measuring pulmonary vascular resistance within a patient.
- the system 10 includes a pulse generator 12, a remote pressure sensor 14 implanted deeply within the patient's body such as in one of the pulmonary arteries leading from the patient's heart 16, and an external monitor 18 positioned at a location outside of the patient's body.
- the heart 16 includes a right atrium 20, a right ventricle 22, a left atrium 24, and a left ventricle 26.
- the left atrium 24 and left ventricle 26 are separated by the mitral valve 28.
- the right ventricle 22 includes an outflow tract 30 that delivers blood during ventricular systole to the main pulmonary artery 32, the right pulmonary artery 34 and the left pulmonary artery 36, which, in turn, flows into the pulmonary capillaries 38 of the lungs 40,42.
- the blood fed into the pulmonary capillaries 38 is oxygenated and returned back to the heart 16 via the pulmonary veins 44,46,48,50, as shown.
- the pulse generator 12 can be implanted subcutaneously within the body, typically at a location such as in the patient's chest or abdomen, although other implantation locations are possible.
- the pulse generator 12 is a dual- chamber pacemaker adapted to provide atrioventricular (AV) pacing therapy to the patient's heart 16.
- a number of leads 52,60 provide electrical stimulus to the right ventricle 24 and right atrium 22, which during normal pulse generator operation, can be used to synchronize the operation of the heart 16.
- a first lead 52 may be used for pacing ventricular contractions in the heart 16, and includes a proximal section 54 coupled to a header 56 of the pulse generator 12 and a distal section 58 implanted within the right ventricle 22 of the heart 16.
- a second lead 60 in turn, may be used for pacing atrial contractions in the heart 16, and includes a proximal section 62 coupled to the header F&B Ref. No.: 371126 CPI Ref. No.: 08-955-PCT
- the system 10 depicts a dual-chamber pacemaker for use in providing atrioventricular pacing to the right atrium 20 and right ventricle 22 of the heart 16, in other embodiments, the system 10 may comprise a dual-chamber pacemaker adapted to pace the left atrium 24 and left ventricle 26 of the heart 16, or can comprise an implantable cardiac defibrillator (ICD) capable of providing electrical shocks to the heart 16.
- ICD implantable cardiac defibrillator
- the pulse generator 12 includes both pacing and defibrillation capabilities.
- the pacing therapy provided by the pulse generator 12 can be used to deliver bradycardia therapy, cardiac resynchronization therapy, or antitachycardia pacing therapy.
- the pulse generator 12 is capable of pacing an atria to produce a retrograde pressure pulse within the heart 16, as discussed further herein, but does not provide pacing therapy.
- the leads 52,60 are configured to convey electrical signals between the pulse generator 12 and the heart 16.
- the leads 52,60 can be utilized to deliver electrical therapeutic stimulus energy for providing atrioventricular pacing to the heart 16.
- the leads 52,60 can be utilized to deliver electrical shocks to the heart 16 in response to an event such as ventricle fibrillation.
- the leads 52,60 can also be utilized to periodically provide reverse, ventricular-atrial (VA) stimulus energy to the heart 16.
- VA ventricular-atrial
- This reverse, ventricular-atrial pacing can be utilized to induce a retrograde pressure pulse (i.e., a cannon wave) within the pulmonary arteries 32,34,36 that can be sensed by the F&B Ref. No.: 371126 CPI Ref. No.: 08-955-PCT pressure sensor 14 and used to calculate various hemodynamic properties, including pulmonary vascular resistance (PVR).
- the pressure sensor 14 can be implanted at a location within the right side of the heart 16 such as in the main pulmonary artery 32 or a branch of the main pulmonary artery such as the right or left pulmonary artery 34,36.
- the pressure sensor 14 is implanted within the left pulmonary artery 36.
- An illustrative pressure sensor suitable for use in sensing arterial pressure within the body is described, for example, in United States Patent No. 6,764,446, entitled “Implantable Pressure Sensors and Methods for Making and Using Them,” the contents of which is incorporated herein by reference in its entirety.
- the pressure sensor 14 can be implanted at other locations within the pulmonary vasculature, and can be configured to perform one or more other designated functions, including the sensing of other physiological parameters within the body.
- Example physiological parameters that can also be sensed using the pressure sensor 14 can include, but are not limited to, blood flow, temperature, strain, acceleration, as well as various electrical, chemical and/or magnetic properties within the body.
- the embodiment of Figure 1 illustrates a remote pressure sensor 14 that is chronically implanted within the body
- the pressure sensor 14 may comprise an acute or semi-acute sensing device that can be temporarily inserted into the patient's body for sensing arterial pressure.
- the pressure sensor 14 can be coupled to or formed integrally with a catheter that can be temporarily inserted into the body for sensing blood pressure within a pulmonary artery or a systemic artery.
- Other devices that are temporarily or permanently insertable within the body can also be used for obtaining blood pressure measurements within a pulmonary artery or a systemic artery.
- the pressure sensor 14 can be used in conjunction with the pulse generator 12 and/or the external monitor 18 to optimize F&B Ref.
- the pressure sensor 14 can be utilized in conjunction with the pulse generator 12 to control atrioventricular (AV) pacing therapy to the patient based at least in part on a measure of pulmonary vascular resistance.
- AV atrioventricular
- Other devices such as a pulmonary sound sensor, satellite pacing device, or other sensing and/or therapy-delivering device may also be used in conjunction with the pulse generator 12 and pressure sensor 14.
- the pressure sensor 14 can be configured to communicate with the pulse generator 12 and/or the external monitor 18 via a wireless or wired telemetry link.
- an acoustic telemetry link may be used to establish bidirectional wireless communications between the pressure sensor 14 and the pulse generator 12, and/or between the pressure sensor 14 and the external monitor 18.
- An example wireless telemetry system employing acoustic transducers is described, for example, in United States Patent No. 7,024,248, entitled "Systems and Methods For Communicating With Implantable Devices," the contents of which are incorporated herein by reference in its entirety.
- telemetry modes such as RF, inductive, electromagnetic, and optical may also be utilized to establish a wireless telemetry link between the pressure sensor 14 and the pulse generator 12 and/or external monitor 18.
- the pressure sensor 14 can communicate with other devices implanted within the body via either a wireless or wired telemetry link.
- the external monitor 18 is configured to monitor an arterial pressure waveform signal transmitted by the pressure sensor 14. Based on this signal, a processor 70 within the external monitor 18 is configured to determine various hemodynamic parameters associated with the heart 16, including pulmonary vascular resistance. In some embodiments, other hemodynamic parameters can also be F&B Ref. No.: 371126 CPI Ref. No.: 08-955-PCT determined from the arterial pressure waveform sensed by the pressure sensor 14.
- the external monitor 18 can be tasked to determine hemodynamic parameters such as pulmonary vascular resistance, in other embodiments other internal or external devices can be configured to compute such parameters.
- the pulse generator 12 includes a processor adapted to compute hemodynamic parameters such as pulmonary vascular resistance based on the arterial pressure waveform signal from the pressure sensor 14.
- the pressure sensor 14 includes a processor adapted to compute pulmonary vascular resistance based on the sensed arterial pressure waveform signal.
- the vascular system can be modeled as an equivalent electrical circuit, which as discussed further herein, can be used by the processor 70 to compute a measure of pulmonary vascular resistance from a retrograde pressure pulse induced within the pulmonary arteries 32,34,36 when the pulse generator 12 operates in an assessment mode of operation.
- An illustrative equivalent electrical circuit 72 for modeling the pulmonary vascular system of a patient is shown in Figure 2.
- the equivalent electrical circuit 72 may represent, for example, several analogous electrical elements that can be used to model the mechanical properties of the heart 16 and the pulmonary vasculature.
- the pump pressure and the mechanical resistance to the blood flow within the right ventricle 22 of the heart 16 can be modeled in the circuit 70, respectively, as a voltage source 74 (V RV ) and a resistor 76 (R RV ).
- the mechanical resistance of the blood flow 76 (R RV ) may represent, for example, the flow resistance to the pump pressure (V RV ) within the right ventricle 22 and pulmonic valve during a cardiac cycle.
- the pump pressure and the mechanical resistance to the blood flow within the left atrium 24 of the heart 16 in turn, can be modeled in the circuit 70, respectively, as a voltage source F&B Ref. No.: 371126 CPI Ref. No.: 08-955-PCT
- the mechanical resistance of the blood flow (R LA ) may represent, for example, the flow resistance to the pump pressure (V LA ) entering the left atrium 24 from the pulmonary veins 44,46,48,50.
- the flow resistance within the pulmonary vasculature, and in particular the pulmonary arteries 32,34,36 and the pulmonary veins 44,46,48,50, can be modeled within the circuit 70, respectively, as resistors 82 (R A ) and 84 (R v ).
- the flow resistance within the capillaries 38 of the lungs 40,42 in turn, can be modeled within the circuit 70 as a resistor 86 (R c ).
- the compliance of the pulmonary arteries 32,34,36 and the pulmonary veins 44,46,48,50 can be modeled in the circuit 70, respectively, as capacitors 88 (C A ) and 90 (Cv).
- the capacitors 86,88 may comprise, for example, modeled compliance values for the pulmonary arteries 32,34,36 and pulmonary veins 44,46,48,50.
- V PA voltage
- IRR V IRR V
- I the electrical equivalent of blood flow within the pulmonary arteries 32,34,36.
- a measure of the blood flow I within the circuit 92 can be determined from the following equation:
- VPA VRR V /(RRV + Rc +RLA).
- the pressure sensor 14 can be configured to take at least two measurements when a retrograde pressure pulse is induced by the pulse generator 12 during the assessment mode of operation, as reflected in the following two equations:
- R C i can be determined from a first pressure measurement taken by the pressure sensor 14 during venthcular-atrial (VA) pacing of the heart 16
- Rc2 can be determined from a second pressure measurement taken by the pressure sensor 14 during the ventricular- atrial (VA) pacing.
- VA venthcular-atrial
- ⁇ R C the change in the capillary resistance ⁇ R C can then be determined from the following expression:
- V(R RV ) V(R RV )
- a change in pulmonary capillary resistance can thus be estimated based on the pulse pressure measurements (i.e., V PA i, V PA 2) sensed by the pressure sensor 14 during the assessment mode of operation when the pulse generator 12 provides ventricular-athal pacing to induce a retrograde pressure pulse within the pulmonary arteries 32,34,36.
- FIG. 4 is a flow chart showing an illustrative method 96 of measuring pulmonary vascular resistance within a patient using the system 10 of Figure 1.
- Method 96 may represent, for example, an algorithm or routine used by the external monitor processor 70 of Figure 1 to compute a measure of pulmonary vascular resistance based on a retrograde pressure pulse sensed by the pressure sensor 14.
- the method 96 may represent an algorithm or routine run by another device located inside or outside of the patient's body.
- the method 96 may be performed by the pulse generator 12, another implant located within the body, or by the pressure sensor 14.
- the method 96 may begin generally at block 98, when the pulse generator 12 switches from a normal mode F&B Ref. No.: 371126 CPI Ref. No.: 08-955-PCT of operation to an assessment mode of operation used to compute pulmonary vascular resistance.
- the pulse generator 12 may switch from the normal operation mode to the assessment operation mode in response to a command or signal received from the external monitor 18.
- the pulse generator 12 may switch to the assessment mode at a predetermined time period (e.g., once a day, once a week, one a month, etc.) programmed within the pulse generator 12.
- a predetermined time period e.g., once a day, once a week, one a month, etc.
- the pulse generator 12 may temporarily suspend normal pacing activity provided by the leads 52,60 (block 100). Once suspended, the pulse generator 12 is then configured to electrically induce a retrograde pressure pulse within the left atrium 24 of the patient's heart 16.
- the retrograde pressure pulse is induced by first pacing the right ventricle 22 using the ventricular lead 52 at a first time period immediately before an intrinsic atrial contraction (block 102).
- the ventricular lead 52 can be configured to deliver an electrical pacing stimulus at a time period of about 150ms before an intrinsic atrial contraction.
- the pulse generator 12 may next pace the right atrium 24 at a second time period using the atrial lead 60 (block 104).
- the atrial lead 60 can be configured to deliver an electrical pacing stimulus at a period of about 100 ms after the first, ventricular pace, which causes the right and left atria 22,24 to contract.
- a retrograde pressure wave (i.e., an a-wave) is produced within the left atrium 24 (block 106).
- This retrograde pressure pulse wave then propagates through the pulmonary veins 44,46,48,50 and pulmonary capillaries 38 and back into the pulmonary arteries 32,34,36 (block 108).
- the pressure sensor 14 can be prompted to take one or more arterial pressure measurements to determine the amplitude and F&B Ref. No.: 371126 CPI Ref. No.: 08-955-PCT morphology characteristics of the retrograde pressure pulse wave, which as discussed above with respect to Figures 2-3, can be correlated with changes in the pulmonary vascular resistance.
- the pressure sensor 14 may sample a first arterial pressure parameter within the pulmonary artery at a first time period (block 110) subsequent to the VA pacing provided by the pulse generator 12.
- the first arterial pressure parameter may represent, for example, V PA i in equation (9) discussed herein with respect to Figures 2-3.
- the pressure sensor 14 may then sample a second arterial pressure parameter at a second time period (block 112) after the first sampled arterial pressure parameter.
- the second arterial pressure parameter may represent, for example, V PA 2 in equation (9) discussed above.
- the pressure sensor 14 can be configured to communicate the sensed arterial pressure measurements to the pulse generator 12 and/or the external monitor 18 (block 114).
- the pulse generator 12 and/or external monitor 18 may then analyze the amplitude and/or morphology of the arterial pressure measurements taken to determine the time rate of change of the arterial pressure waveform in response to the retrograde pressure pulse wave (block 116). Based on this change, a value of the pulmonary vascular resistance is then estimated (block 118).
- the change in pulmonary vascular resistance may be estimated by correlating the pulmonary capillary resistance value ( ⁇ RC ) computed using equation (9) discussed above with a correlation factor.
- the pressure pulse (i.e., conduction) velocity alone can be provide a useful diagnostic parameter for assessing a cardiovascular or pulmonary condition.
- the detection of elevated pulmonary arterial pressures without a significant increase in pulmonary vascular resistance can also be used to exclude the diagnosis of certain conditions such as chronic obstructive pulmonary disease (COPD), worsening pulmonary hypertension, or other non- F&B Ref. No.: 371126 CPI Ref. No.: 08-955-PCT cardiogenic conditions that cause an increase in pulmonary arterial pressure.
- COPD chronic obstructive pulmonary disease
- an increase in pulmonary vascular resistance in conjunction with other sensed parameters can also be used to diagnose certain conditions.
- an increase in pulmonary vascular resistance in conjunction with pulmonary artery distension may be used to aid in diagnosing a condition such as chronic obstructive pulmonary disease (COPD) or an increase in pulmonary hypertension.
- COPD chronic obstructive pulmonary disease
- changes in the systemic pressure morphology can also be measured to determine the systemic vascular resistance (SVR) and/or systemic conduction velocities.
- SVR systemic vascular resistance
- the pacing provided to the right atrium 22 of the heart 16 at step 104 also causes the right atrium 22 to simultaneously contract along with the left atrium 24, producing a retrograde pressure pulse from the right atrium 22 that propagates into the systemic arteries and veins.
- a pressure sensor implanted within the aorta, the peripheral vasculature, or the superior vena cava can be used to take pressure measurements to determine the amplitude and morphology characteristics of the retrograde pressure pulse wave induced within the systemic vasculature.
- the pressure sensor may sample first and second pressure parameters at a location such as the aorta or the superior vena cava, and then determine a time rate of change in the pressure waveform in response to the retrograde pressure pulse wave. Based on this change, a value of the systemic vascular resistance and/or systemic conduction velocity can then be estimated.
- Figures 5A-5B are several graphs showing an illustrative electrocardiograph (ECG) waveform and pulmonary artery pressure waveform in response to pacing signals provided by the pulse generator 12 during the assessment mode of operation. The electrical activity of the heart 16 in response to several AV and VA pacing pulses provided by the pulse generator 12 is depicted in a first graph 120 in Figure 5A.
- ECG electrocardiograph
- Figure 5A may represent, for example, a sensed ECG waveform 122 of the heart 16 in response to several pacing pulses F&B Ref. No.: 371126 CPI Ref. No.: 08-955-PCT provided to the heart 16 using the dual-chamber pacing leads 52,60 of the system 10 of Figure 1.
- the pulse generator 12 may provide several atrioventricular (AV) pacing pulses A S i,V S i, and As2,Vs2 to the heart 16, which as shown on the ECG waveform 122, results in the characteristic P-wave and QRS complex electrical signature of the heart 16.
- AV atrioventricular
- the pressure sensor 14 senses an arterial pressure waveform 128 within a pulmonary artery 32,34,36.
- the pulmonary artery pressure increases at points 130 and 132 in response to the AV pacing pulses A S i,V S i, and A S 2,V S 2 provided by the pulse generator 12.
- the pulse generator 12 provides retrograde VA conduction by supplying a first, ventricular pacing pulse V P to the right ventricle 22 of the heart 16 at a point in time immediately prior to an intrinsic atrial contraction, causing the mitral valve 28 to close and the right ventricle 22 and left ventricle 26 to contract.
- a second pacing pulse A P following the first, ventricular pacing pulse V P may then be provided to the right atrium 20, causing the right atrium 20 and left atrium 24 to contract and produce a retrograde pressure pulse wave that propagates through the pulmonary veins 44,46,48,50, the pulmonary capillaries 38, and back into the pulmonary arteries 32,34,36.
- Vp provided by the ventricular lead 52 causes the arterial pressure waveform 128 to initially spike at point 134 (i.e., systolic peak pressure) as a result of the ventricular contraction in the right ventricle 22.
- point 134 i.e., systolic peak pressure
- the pressure pulse induced in the left atrium 24 during ventricular systole provides a transient change in the pressure in the pulmonary arteries 32,34,36.
- the retrograde pressure pulse wave changes as a result of the right ventricular systolic pulse caused by the ventricular pace V P .
- the morphology of the arterial pressure waveform 128 at this section 136 can be analyzed in order to determine a measure of pulmonary vascular resistance within the pulmonary vasculature.
- the method 96 of Figure 4 can be used to obtain an estimate of the change in pulmonary vascular resistance by sampling a first arterial pressure measurement and a second arterial pressure measurement, computing a value of the change in pulmonary capillary resistance induced by the retrograde pressure pulse based on the first and second arterial pressure measurements, and then determining a value of the change in pulmonary vascular resistance from the change in capillary resistance.
- the morphology of the pulmonary artery pressure waveform 128 may be used to identify changes in vascular resistance by analyzing the timing of the retrograde pressure wave.
- the timing of the retrograde pressure wave indicates the pressure pulse velocity, which, in turn, is correlated to the vascular resistance.
- the time period at which the reflected wave reaches the pressure sensor can be seen in Figure 5B as the difference in time ⁇ T between the systolic peak pressure 134 and the reflected peak pressure at 136.
- the shorter the time difference ⁇ T between the ventricular systolic peak pressure (134) and the reflected peak pressure (136) the higher the vascular resistance.
- the longer the time difference ⁇ T between the ventricular systolic peak pressure (134) and the reflected peak pressure (136) the lesser the vascular resistance.
- Figure 6 is a flow chart showing an illustrative method
- the method 138 can be used by the system 10 of Figure 1 to permit the early detection of an acutely worsening heart failure due to conditions such as cardiogenic pulmonary edema, pulmonary F&B Ref. No.: 371126 CPI Ref. No.: 08-955-PCT hypertension, pulmonary embolisms, and/or atelactasis.
- the method 138 can also be used to detect other conditions where changes in pulmonary vascular resistance can occur over time.
- the method 138 is described with respect to pulmonary vascular resistance assessments, in other embodiments the method 138 may also be used to detect and analyze trends in systemic vascular resistance using a similar approach.
- the method 138 may begin generally at block 140, in which a first PVR assessment is made by the system 10 to determine an initial pulmonary vascular resistance (PVR) value.
- PVR pulmonary vascular resistance
- the first PVR assessment value may comprise a measure of the change in pulmonary vascular resistance occurring in response to a retrograde pressure pulse induced by ventricular-atrial conduction.
- the first PVR assessment value may comprise a running average of the change in pulmonary vascular resistance.
- the system 10 may then determine one or more subsequent pulmonary vascular resistance assessment values (block 142), which is/are then compared against the first PVR assessment value (block 144) to determine whether a change has occurred indicating the onset of an underlying condition such as cardiogenic pulmonary edema.
- a second PVR assessment value may be taken at a much later period of time (e.g., one month) after the initial PVR assessment value and then compared against the initial PVR assessment value to determine whether a significant change has occurred in the PVR over that time period. If no change is detected at decision block 146), the system 10 continues to take additional PVR assessments 148, which can then be compared against one or more prior assessment values.
- the system 10 may next compare that value against a reference PVR value (block 150) and determine whether the change in PVR is sufficiently large to indicate the presence of an underlying condition (block 152). If not sufficiently F&B Ref. No.: 371126 CPI Ref. No.: 08-955-PCT large, the system 10 may take one or more additional PVR assessment values. Otherwise, if the system 10 determines that the change in PVR is sufficiently large (e.g., greater than 5%), then the system 10 may trigger a flag causing the pulse generator 12 and/or external monitor 18 to output a message or alert to the patient or caregiver indicating that an underlying condition is suspected (block 154).
- a flag causing the pulse generator 12 and/or external monitor 18 to output a message or alert to the patient or caregiver indicating that an underlying condition is suspected (block 154).
- FIG. 7 is a flow chart showing another illustrative method 156 of producing a trend of pulmonary vascular resistance.
- the method 156 may begin generally at block 158, in which a first PVR assessment is made by the system 10 to determine an initial pulmonary vascular resistance (PVR) value. Subsequent to the initial assessment, the system 10 may then determine one or more subsequent pulmonary vascular resistance values (block 160). The one or more subsequent pulmonary vascular resistance values are then compared against the first PVR assessment value to determine a trend in the PVR (block 162).
- An example trend in the PVR may be, for example, a significant increase or decrease in PVR over a predetermined period of time.
- the PVR trend is transmitted to an external monitor (block 162) located on or near the patient (e.g., a programming unit) or at a location remote from the patient (e.g., a remote monitoring unit). From the PVR trend, the external monitor may then determine whether a condition is suspected (block 164). If a condition is suspected, the external monitor may then output a message or alert to the patient or caregiver indicating that an underlying condition is suspected (block 166).
- an external monitor located on or near the patient (e.g., a programming unit) or at a location remote from the patient (e.g., a remote monitoring unit). From the PVR trend, the external monitor may then determine whether a condition is suspected (block 164). If a condition is suspected, the external monitor may then output a message or alert to the patient or caregiver indicating that an underlying condition is suspected (block 166).
- the PVR trend(s) can be used for controlling the sensitivity and/or specificity of the message or alert provided to the patient or caregiver. For example, if a PVR trend indicates a condition such as heart decompensation, the external monitor may increase the sensitivity at which the message or alert is triggered in order to alert the patient or caregiver of further possible heart decompensation. The external monitor may also adjust the level F&B Ref. No.: 371126 CPI Ref. No.: 08-955-PCT of specificity of the message or alert generated to inform the patient or clinician that the particular type of condition suspected is heart decompensation. The adjustment of the sensitivity and specificity of the alert or message generated may then be used as an aid by the clinician in performing additional testing or diagnostics on the patient to confirm the suspected condition.
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Cardiology (AREA)
- Engineering & Computer Science (AREA)
- Heart & Thoracic Surgery (AREA)
- Physiology (AREA)
- Biophysics (AREA)
- Pathology (AREA)
- Vascular Medicine (AREA)
- Biomedical Technology (AREA)
- Physics & Mathematics (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Surgery (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Measuring Pulse, Heart Rate, Blood Pressure Or Blood Flow (AREA)
Abstract
L'invention porte sur des procédés et des systèmes d'évaluation de la résistance vasculaire pulmonaire ou systémique chez un patient à l'aide de mesures de pression. A titre illustratif, un procédé consistant à mesurer la résistance vasculaire pulmonaire comprend l'induction électrique d'une impulsion rétrograde de pression dans le cœur, la détection d'au moins un paramètre de pression artérielle en réponse à l'impulsion rétrograde de pression à l'aide d'un détecteur de pression situé dans une artère pulmonaire, et le calcul de la valeur de la résistance vasculaire pulmonaire à l'aide du ou des paramètres de pression artérielle détectés. On peut prélever des données provenant de multiples évaluations de résistance vasculaire pulmonaire sur une période de temps étendue dans le patient pour aider à détecter un état cardiaque ou pulmonaire sous-jacent tel qu'un œdème pulmonaire cardiogénique.
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US11617408P | 2008-11-19 | 2008-11-19 | |
US61/116,174 | 2008-11-19 |
Publications (1)
Publication Number | Publication Date |
---|---|
WO2010059291A1 true WO2010059291A1 (fr) | 2010-05-27 |
Family
ID=41394554
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/US2009/058242 WO2010059291A1 (fr) | 2008-11-19 | 2009-09-24 | Évaluation d'une résistance vasculaire pulmonaire par l'intermédiaire d'une pression artérielle pulmonaire |
Country Status (2)
Country | Link |
---|---|
US (1) | US8632470B2 (fr) |
WO (1) | WO2010059291A1 (fr) |
Cited By (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US9301702B2 (en) | 2012-11-19 | 2016-04-05 | Pacesetter, Inc. | Systems and methods for exploiting pulmonary artery pressure obtained from an implantable sensor to detect cardiac rhythm irregularities |
US9566442B2 (en) | 2012-11-19 | 2017-02-14 | Pacesetter, Inc. | Systems and methods for using pulmonary artery pressure from an implantable sensor to detect mitral regurgitation and optimize pacing delays |
US20210280319A1 (en) * | 2020-01-29 | 2021-09-09 | Tata Consultancy Services Limited | Neuromodulation based adaptive controller for mitral stenosis |
Families Citing this family (13)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US7455666B2 (en) | 2001-07-13 | 2008-11-25 | Board Of Regents, The University Of Texas System | Methods and apparatuses for navigating the subarachnoid space |
US7742815B2 (en) | 2005-09-09 | 2010-06-22 | Cardiac Pacemakers, Inc. | Using implanted sensors for feedback control of implanted medical devices |
US7955268B2 (en) | 2006-07-21 | 2011-06-07 | Cardiac Pacemakers, Inc. | Multiple sensor deployment |
US7869874B2 (en) * | 2006-09-25 | 2011-01-11 | G&L Consulting, Llc | Methods and apparatus to stimulate heart atria |
EP2242538B1 (fr) | 2008-02-11 | 2016-04-06 | Cardiac Pacemakers, Inc. | Procédés de surveillance d'état hémodynamique pour une discrimination de rythme à l'intérieur du coeur |
US8369960B2 (en) | 2008-02-12 | 2013-02-05 | Cardiac Pacemakers, Inc. | Systems and methods for controlling wireless signal transfers between ultrasound-enabled medical devices |
US8591423B2 (en) | 2008-10-10 | 2013-11-26 | Cardiac Pacemakers, Inc. | Systems and methods for determining cardiac output using pulmonary artery pressure measurements |
EP2485638B1 (fr) | 2009-10-07 | 2016-11-30 | Endophys Holdings, LLC | Dispositif médical de détection de pression |
US20140142398A1 (en) * | 2010-06-13 | 2014-05-22 | Angiometrix Corporation | Multifunctional guidewire assemblies and system for analyzing anatomical and functional parameters |
US9554785B2 (en) | 2012-12-21 | 2017-01-31 | Essential Medical, Inc. | Vascular locating systems and methods of use |
US20150208950A1 (en) * | 2014-01-28 | 2015-07-30 | The Texas A&M University System | Arterial and Venous Oxygenation Method and Apparatus |
US11350919B2 (en) | 2019-02-19 | 2022-06-07 | Teleflex Life Sciences Limited | Puncture locating system with blood pulsation indicator |
CN110916624A (zh) * | 2019-11-22 | 2020-03-27 | 新绎健康科技有限公司 | 一种用于检测血管阻力的智能诊脉方法及系统 |
Citations (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5423323A (en) * | 1993-08-30 | 1995-06-13 | Rocky Mountain Research, Inc. | System for calculating compliance and cardiac hemodynamic parameters |
WO1997018856A1 (fr) * | 1995-11-17 | 1997-05-29 | Medtronic, Inc. | Modulation baroreflexe par stimulation du nerf du sinus carotidien pour le traitement de la defaillance cardiaque |
US6832112B1 (en) * | 2001-12-28 | 2004-12-14 | Pacesetter, Inc. | Method of adjusting an AV and/or PV delay to improve hemodynamics and corresponding implantable stimulation device |
Family Cites Families (381)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
BE634453A (fr) * | 1962-07-30 | |||
US3310885A (en) * | 1964-06-04 | 1967-03-28 | Samuel W Alderson | Radio-therapy phantom |
US3568661A (en) * | 1968-10-02 | 1971-03-09 | Us Health Education & Welfare | Frequency modulated ultrasound technique for measurement of fluid velocity |
US3536836A (en) | 1968-10-25 | 1970-10-27 | Erich A Pfeiffer | Acoustically actuated switch |
US3672352A (en) * | 1969-04-09 | 1972-06-27 | George D Summers | Implantable bio-data monitoring method and apparatus |
US3757770A (en) | 1971-02-22 | 1973-09-11 | Bio Tel Western | Physiological pressure sensing and telemetry means employing a diode connected transistor transducer |
US3692027A (en) | 1971-04-23 | 1972-09-19 | Everett H Ellinwood Jr | Implanted medication dispensing device and method |
US3794840A (en) * | 1972-03-27 | 1974-02-26 | Charlotte Memorial Hospital | Method and apparatus for directing a radiation beam toward a tumor or the like |
US4003379A (en) * | 1974-04-23 | 1977-01-18 | Ellinwood Jr Everett H | Apparatus and method for implanted self-powered medication dispensing |
US4146029A (en) * | 1974-04-23 | 1979-03-27 | Ellinwood Jr Everett H | Self-powered implanted programmable medication system and method |
GB1505130A (en) | 1974-05-07 | 1978-03-22 | Seiko Instr & Electronics | Systems for detecting information in an artificial cardiac pacemaker |
US3943915A (en) * | 1974-11-29 | 1976-03-16 | Motorola, Inc. | Intracranial pressure sensing device |
US4127110A (en) | 1976-05-24 | 1978-11-28 | Huntington Institute Of Applied Medical Research | Implantable pressure transducer |
US4660568A (en) * | 1976-06-21 | 1987-04-28 | Cosman Eric R | Telemetric differential pressure sensing system and method therefore |
US4653508A (en) * | 1976-06-21 | 1987-03-31 | Cosman Eric R | Pressure-balanced telemetric pressure sensing system and method therefore |
US4593703A (en) | 1976-06-21 | 1986-06-10 | Cosman Eric R | Telemetric differential pressure sensor with the improvement of a conductive shorted loop tuning element and a resonant circuit |
US4223801A (en) | 1978-01-26 | 1980-09-23 | Carlson Torsten S | Automatic periodic drug dispensing system |
US4227407A (en) | 1978-11-30 | 1980-10-14 | Cornell Research Foundation, Inc. | Volume flow measurement system |
US4237900A (en) | 1979-02-14 | 1980-12-09 | Pacesetter Systems, Inc. | Implantable calibration means and calibration method for an implantable body transducer |
US4360019A (en) | 1979-02-28 | 1982-11-23 | Andros Incorporated | Implantable infusion device |
US4281664A (en) | 1979-05-14 | 1981-08-04 | Medtronic, Inc. | Implantable telemetry transmission system for analog and digital data |
US4407296A (en) | 1980-09-12 | 1983-10-04 | Medtronic, Inc. | Integral hermetic impantable pressure transducer |
US4686987A (en) | 1981-06-18 | 1987-08-18 | Cardiac Pacemakers, Inc. | Biomedical method and apparatus for controlling the administration of therapy to a patient in response to changes in physiologic demand |
US5190035A (en) * | 1981-06-18 | 1993-03-02 | Cardiac Pacemakers, Inc. | Biomedical method and apparatus for controlling the administration of therapy to a patient in response to changes in physiological demand |
US4450527A (en) * | 1982-06-29 | 1984-05-22 | Bomed Medical Mfg. Ltd. | Noninvasive continuous cardiac output monitor |
US4550370A (en) | 1982-10-29 | 1985-10-29 | Medtronic, Inc. | Pacemaker programmer with telemetric functions |
US4585703A (en) * | 1982-11-15 | 1986-04-29 | Dainippon Ink & Chemicals, Inc. | Method of treating woody material and treated woody material |
US4480483A (en) | 1983-04-06 | 1984-11-06 | Westinghouse Electric Corp. | Acousto-optical ultrasonic flowmeter |
US4543955A (en) | 1983-08-01 | 1985-10-01 | Cordis Corporation | System for controlling body implantable action device |
US4519401A (en) * | 1983-09-20 | 1985-05-28 | Case Western Reserve University | Pressure telemetry implant |
GB8325861D0 (en) | 1983-09-28 | 1983-11-02 | Syrinx Presicion Instr Ltd | Force transducer |
US4616640A (en) | 1983-11-14 | 1986-10-14 | Steven Kaali | Birth control method and device employing electric forces |
US5178153A (en) * | 1984-03-08 | 1993-01-12 | Einzig Robert E | Fluid flow sensing apparatus for in vivo and industrial applications employing novel differential optical fiber pressure sensors |
US4585004A (en) * | 1984-06-01 | 1986-04-29 | Cardiac Control Systems, Inc. | Heart pacing and intracardiac electrogram monitoring system and associated method |
US4768176A (en) | 1984-07-06 | 1988-08-30 | Kehr Bruce A | Apparatus for alerting a patient to take medication |
US4768177A (en) | 1984-07-06 | 1988-08-30 | Kehr Bruce A | Method of and apparatus for alerting a patient to take medication |
US4697595A (en) | 1984-07-24 | 1987-10-06 | Telectronics N.V. | Ultrasonically marked cardiac catheters |
GB8422876D0 (en) | 1984-09-11 | 1984-10-17 | Secr Defence | Silicon implant devices |
US4541431A (en) | 1984-09-20 | 1985-09-17 | Telectronics Pty. Ltd. | Use of telemetry coil to replace magnetically activated reed switch in implantable devices |
US4719021A (en) * | 1984-11-28 | 1988-01-12 | Sun Drilling Products Corporation | Shale-stabilizing drilling fluids and method for producing same |
US4791936A (en) | 1985-02-15 | 1988-12-20 | Siemens-Pacesetter, Inc. | Apparatus for interpreting and displaying cardiac events of a heart connected to a cardiac pacing means |
US4651740A (en) * | 1985-02-19 | 1987-03-24 | Cordis Corporation | Implant and control apparatus and method employing at least one tuning fork |
US4680957A (en) | 1985-05-02 | 1987-07-21 | The Davey Company | Non-invasive, in-line consistency measurement of a non-newtonian fluid |
US4676255A (en) * | 1985-07-03 | 1987-06-30 | Cosman Eric R | Telemetric in-vivo calibration method and apparatus using a negative pressure applicator |
US4677985A (en) | 1985-08-12 | 1987-07-07 | Bro William J | Apparatus and method for determining intracranial pressure and local cerebral blood flow |
US4719921A (en) | 1985-08-28 | 1988-01-19 | Raul Chirife | Cardiac pacemaker adaptive to physiological requirements |
US4781715A (en) | 1986-04-30 | 1988-11-01 | Temple University Of The Commonwealth System Of Higher Education | Cardiac prosthesis having integral blood pressure sensor |
DE3732640C1 (de) * | 1987-09-28 | 1989-05-18 | Alt Eckhard | Medizinisches Geraet zum Ermitteln von physiologischen Funktionsparametern |
US5163429A (en) | 1987-10-06 | 1992-11-17 | Leonard Bloom | Hemodynamically responsive system for treating a malfunctioning heart |
US4986270A (en) * | 1987-10-06 | 1991-01-22 | Leonard Bloom | Hemodynamically responsive system for and method of treating a malfunctioning heart |
US4899752A (en) * | 1987-10-06 | 1990-02-13 | Leonard Bloom | System for and method of therapeutic stimulation of a patient's heart |
US4967749A (en) | 1987-10-06 | 1990-11-06 | Leonard Bloom | Hemodynamically responsive system for and method of treating a malfunctioning heart |
US4809697A (en) * | 1987-10-14 | 1989-03-07 | Siemens-Pacesetter, Inc. | Interactive programming and diagnostic system for use with implantable pacemaker |
US4991579A (en) | 1987-11-10 | 1991-02-12 | Allen George S | Method and apparatus for providing related images over time of a portion of the anatomy using fiducial implants |
US4845503A (en) | 1988-02-05 | 1989-07-04 | Western Atlas International, Inc. | Electromagnetic digitizer |
US4854327A (en) | 1988-03-07 | 1989-08-08 | Kunig Horst E | Non-invasive and continuous cardiac performance monitoring device |
US5178151A (en) * | 1988-04-20 | 1993-01-12 | Sackner Marvin A | System for non-invasive detection of changes of cardiac volumes and aortic pulses |
US4846191A (en) | 1988-05-27 | 1989-07-11 | Data Sciences, Inc. | Device for chronic measurement of internal body pressure |
US5024224A (en) * | 1988-09-01 | 1991-06-18 | Storz Instrument Company | Method of readout of implanted hearing aid device and apparatus therefor |
DE3831809A1 (de) * | 1988-09-19 | 1990-03-22 | Funke Hermann | Zur mindestens teilweisen implantation im lebenden koerper bestimmtes geraet |
EP0381798B1 (fr) | 1989-02-10 | 1994-07-27 | Pacesetter AB | Appareil médical de stimulation adapté à l'activité corporelle |
US4909259A (en) * | 1989-04-21 | 1990-03-20 | Tehrani Fleur T | Method and apparatus for determining metabolic rate ratio |
US5025795A (en) * | 1989-06-28 | 1991-06-25 | Kunig Horst E | Non-invasive cardiac performance monitoring device and method |
US5040538A (en) | 1989-09-05 | 1991-08-20 | Siemens-Pacesetter, Inc. | Pulsed light blood oxygen content sensor system and method of using same |
US5084828A (en) | 1989-09-29 | 1992-01-28 | Healthtech Services Corp. | Interactive medication delivery system |
US5267174A (en) | 1989-09-29 | 1993-11-30 | Healthtech Services Corp. | Interactive medication delivery system |
US4995068A (en) * | 1989-10-02 | 1991-02-19 | S&S Inficon, Inc. | Radiation therapy imaging apparatus |
DE3939899A1 (de) | 1989-11-29 | 1991-06-06 | Biotronik Mess & Therapieg | Herzschrittmacher |
EP0439018B1 (fr) | 1990-01-08 | 1995-11-08 | Ernest Feiler, M.D. | Méthode à usage diagnostique pour le contrôle du flux sanguin |
US5752235A (en) | 1990-01-17 | 1998-05-12 | Informedix, Inc. | Electronic medication monitoring and dispensing method |
US5642731A (en) | 1990-01-17 | 1997-07-01 | Informedix, Inc. | Method of and apparatus for monitoring the management of disease |
US5200891A (en) | 1990-01-17 | 1993-04-06 | Bruce A. Kehr | Electronic medication dispensing method |
US5040536A (en) | 1990-01-31 | 1991-08-20 | Medtronic, Inc. | Intravascular pressure posture detector |
US4995398A (en) * | 1990-04-30 | 1991-02-26 | Turnidge Patrick A | Coronary angiography imaging system |
DE4100568A1 (de) | 1991-01-11 | 1992-07-16 | Fehling Guido | Vorrichtung zur ueberwachung eines patienten auf abstossungsreaktionen eines implantierten organs |
US5183051A (en) * | 1991-01-14 | 1993-02-02 | Jonathan Kraidin | Means and apparatus for continuously determining cardiac output in a subject |
NL9100150A (nl) | 1991-01-29 | 1992-08-17 | Tno | Werkwijze voor het bepalen van het slagvolume en het hartminuutvolume van het menselijk hart. |
US5188106A (en) * | 1991-03-08 | 1993-02-23 | Telectronics Pacing Systems, Inc. | Method and apparatus for chronically monitoring the hemodynamic state of a patient using doppler ultrasound |
US5139020A (en) | 1991-03-08 | 1992-08-18 | Telectronics Pacing Systems, Inc. | Method and apparatus for controlling the hemodynamic state of a patient based on systolic time interval measurements detecting using doppler ultrasound techniques |
US5161536A (en) | 1991-03-22 | 1992-11-10 | Catheter Technology | Ultrasonic position indicating apparatus and methods |
US5199428A (en) * | 1991-03-22 | 1993-04-06 | Medtronic, Inc. | Implantable electrical nerve stimulator/pacemaker with ischemia for decreasing cardiac workload |
US5279607A (en) | 1991-05-30 | 1994-01-18 | The State University Of New York | Telemetry capsule and process |
US5279309A (en) | 1991-06-13 | 1994-01-18 | International Business Machines Corporation | Signaling device and method for monitoring positions in a surgical operation |
US5154171A (en) | 1991-06-15 | 1992-10-13 | Raul Chirife | Rate adaptive pacemaker controlled by ejection fraction |
US5277191A (en) | 1991-06-19 | 1994-01-11 | Abbott Laboratories | Heated catheter for monitoring cardiac output |
US5213098A (en) | 1991-07-26 | 1993-05-25 | Medtronic, Inc. | Post-extrasystolic potentiation stimulation with physiologic sensor feedback |
DE69213657T2 (de) | 1991-11-04 | 1997-01-23 | Cardiac Pacemakers | Implantierbares Gerät zur Überwachung und Stimulation des Herzens für Diagnose und Therapie |
US5339051A (en) | 1991-12-09 | 1994-08-16 | Sandia Corporation | Micro-machined resonator oscillator |
JPH05245215A (ja) | 1992-03-03 | 1993-09-24 | Terumo Corp | 心臓ペースメーカ |
US5330505A (en) | 1992-05-08 | 1994-07-19 | Leonard Bloom | System for and method of treating a malfunctioning heart |
IL102300A (en) | 1992-06-24 | 1996-07-23 | N I Medical Ltd | Non-invasive system for determining of the main cardiorespiratory parameters of the human body |
IT1256900B (it) | 1992-07-27 | 1995-12-27 | Franco Vallana | Procedimento e dispositivo per rilevare la funzionalita` cardiaca. |
US5306294A (en) | 1992-08-05 | 1994-04-26 | Ultrasonic Sensing And Monitoring Systems, Inc. | Stent construction of rolled configuration |
US5855609A (en) * | 1992-08-24 | 1999-01-05 | Lipomatrix, Incorporated (Bvi) | Medical information transponder implant and tracking system |
DE4233978C1 (de) | 1992-10-08 | 1994-04-21 | Leibinger Gmbh | Vorrichtung zum Markieren von Körperstellen für medizinische Untersuchungen |
AU5597194A (en) | 1992-11-24 | 1994-06-22 | Medtronic, Inc. | Implantable medical device with magnetically actuated switch |
US5628782A (en) | 1992-12-11 | 1997-05-13 | W. L. Gore & Associates, Inc. | Method of making a prosthetic vascular graft |
US5265615A (en) | 1992-12-18 | 1993-11-30 | Eyal Frank | Method and apparatus for continuous measurement of cardiac output and SVR |
US5423334A (en) | 1993-02-01 | 1995-06-13 | C. R. Bard, Inc. | Implantable medical device characterization system |
US5314457A (en) | 1993-04-08 | 1994-05-24 | Jeutter Dean C | Regenerative electrical |
US5873835A (en) * | 1993-04-29 | 1999-02-23 | Scimed Life Systems, Inc. | Intravascular pressure and flow sensor |
US5390679A (en) | 1993-06-03 | 1995-02-21 | Eli Lilly And Company | Continuous cardiac output derived from the arterial pressure waveform using pattern recognition |
US5289821A (en) | 1993-06-30 | 1994-03-01 | Swartz William M | Method of ultrasonic Doppler monitoring of blood flow in a blood vessel |
US5368040A (en) | 1993-08-02 | 1994-11-29 | Medtronic, Inc. | Apparatus and method for determining a plurality of hemodynamic variables from a single, chroniclaly implanted absolute pressure sensor |
US5445608A (en) | 1993-08-16 | 1995-08-29 | James C. Chen | Method and apparatus for providing light-activated therapy |
US5807395A (en) | 1993-08-27 | 1998-09-15 | Medtronic, Inc. | Method and apparatus for RF ablation and hyperthermia |
US5558091A (en) | 1993-10-06 | 1996-09-24 | Biosense, Inc. | Magnetic determination of position and orientation |
US5490962A (en) | 1993-10-18 | 1996-02-13 | Massachusetts Institute Of Technology | Preparation of medical devices by solid free-form fabrication methods |
US5835455A (en) | 1993-11-17 | 1998-11-10 | University Of North Carolina - Chapel Hill | Audio prescription instruction device |
US5476488A (en) | 1993-12-15 | 1995-12-19 | Pacesetter, Inc. | Telemetry system power control for implantable medical devices |
IL108352A (en) | 1994-01-17 | 2000-02-29 | Given Imaging Ltd | In vivo video camera system |
IL108470A (en) | 1994-01-28 | 1998-12-06 | Mizur Technology Ltd | Passive sensor system using ultrasonic energy |
US5509424A (en) | 1994-01-28 | 1996-04-23 | Aws Salim Nashef | Continuous cardiac output monitoring system |
US5656428A (en) | 1994-09-08 | 1997-08-12 | Biode, Inc. | Homogeneous bioassay using acoustic emission spectroscopy |
US5488954A (en) | 1994-09-09 | 1996-02-06 | Georgia Tech Research Corp. | Ultrasonic transducer and method for using same |
US5810009A (en) | 1994-09-27 | 1998-09-22 | Kabushiki Kaisha Toshiba | Ultrasonic probe, ultrasonic probe device having the ultrasonic probe, and method of manufacturing the ultrasonic probe |
US5535753A (en) | 1994-10-04 | 1996-07-16 | Rutgers University | Apparatus and methods for the noninvasive measurement of cardiovascular system parameters |
US5626630A (en) | 1994-10-13 | 1997-05-06 | Ael Industries, Inc. | Medical telemetry system using an implanted passive transponder |
US5591217A (en) | 1995-01-04 | 1997-01-07 | Plexus, Inc. | Implantable stimulator with replenishable, high value capacitive power source and method therefor |
US5641915A (en) * | 1995-02-03 | 1997-06-24 | Lockheed Idaho Technologies Company | Device and method for measuring multi-phase fluid flow in a conduit using an elbow flow meter |
US5562714A (en) | 1995-02-03 | 1996-10-08 | Medtronic, Inc. | Magnetic field strength regulator for implant |
US5832924A (en) | 1995-02-16 | 1998-11-10 | Medwave, Inc. | Method of positioning a sensor for determining blood pressure of an artery |
US6002963A (en) | 1995-02-17 | 1999-12-14 | Pacesetter, Inc. | Multi-axial accelerometer-based sensor for an implantable medical device and method of measuring motion measurements therefor |
EP0814699B1 (fr) | 1995-02-27 | 2001-09-05 | Medtronic, Inc. | Capteur externe de reference pour patient |
US5535752A (en) | 1995-02-27 | 1996-07-16 | Medtronic, Inc. | Implantable capacitive absolute pressure and temperature monitor system |
US5564434A (en) | 1995-02-27 | 1996-10-15 | Medtronic, Inc. | Implantable capacitive absolute pressure and temperature sensor |
US5868673A (en) * | 1995-03-28 | 1999-02-09 | Sonometrics Corporation | System for carrying out surgery, biopsy and ablation of a tumor or other physical anomaly |
US5705753A (en) | 1995-03-31 | 1998-01-06 | Caldon, Inc. | Apparatus for determining fluid flow |
US5528067A (en) | 1995-05-08 | 1996-06-18 | Hughes Aircraft Company | Magnetic field detection |
US5571152A (en) | 1995-05-26 | 1996-11-05 | Light Sciences Limited Partnership | Microminiature illuminator for administering photodynamic therapy |
US5605154A (en) | 1995-06-06 | 1997-02-25 | Duke University | Two-dimensional phase correction using a deformable ultrasonic transducer array |
US5729129A (en) | 1995-06-07 | 1998-03-17 | Biosense, Inc. | Magnetic location system with feedback adjustment of magnetic field generator |
US5643327A (en) | 1995-06-20 | 1997-07-01 | Pacesetter, Inc. | Pacemaker and method having optimized A-V delay by using the evoked depolarization potential as an indicia of cardiac output |
US6083248A (en) | 1995-06-23 | 2000-07-04 | Medtronic, Inc. | World wide patient location and data telemetry system for implantable medical devices |
US5752976A (en) | 1995-06-23 | 1998-05-19 | Medtronic, Inc. | World wide patient location and data telemetry system for implantable medical devices |
US5704352A (en) | 1995-11-22 | 1998-01-06 | Tremblay; Gerald F. | Implantable passive bio-sensor |
SE9504233D0 (sv) | 1995-11-27 | 1995-11-27 | Pacesetter Ab | Implantable medical device |
US5856722A (en) * | 1996-01-02 | 1999-01-05 | Cornell Research Foundation, Inc. | Microelectromechanics-based frequency signature sensor |
US20020045812A1 (en) | 1996-02-01 | 2002-04-18 | Shlomo Ben-Haim | Implantable sensor for determining position coordinates |
US5800478A (en) | 1996-03-07 | 1998-09-01 | Light Sciences Limited Partnership | Flexible microcircuits for internal light therapy |
US5836300A (en) | 1996-03-11 | 1998-11-17 | Mault; James R. | Metabolic gas exchange and noninvasive cardiac output monitor |
US5833603A (en) | 1996-03-13 | 1998-11-10 | Lipomatrix, Inc. | Implantable biosensing transponder |
US5911685A (en) * | 1996-04-03 | 1999-06-15 | Guidant Corporation | Method and apparatus for cardiac blood flow assistance |
US5776324A (en) | 1996-05-17 | 1998-07-07 | Encelle, Inc. | Electrochemical biosensors |
US5797898A (en) | 1996-07-02 | 1998-08-25 | Massachusetts Institute Of Technology | Microchip drug delivery devices |
US5733313A (en) | 1996-08-01 | 1998-03-31 | Exonix Corporation | RF coupled, implantable medical device with rechargeable back-up power source |
US5941249A (en) | 1996-09-05 | 1999-08-24 | Maynard; Ronald S. | Distributed activator for a two-dimensional shape memory alloy |
US5954641A (en) | 1997-09-08 | 1999-09-21 | Informedix, Inc. | Method, apparatus and operating system for managing the administration of medication and medical treatment regimens |
US5749909A (en) | 1996-11-07 | 1998-05-12 | Sulzer Intermedics Inc. | Transcutaneous energy coupling using piezoelectric device |
US5855550A (en) | 1996-11-13 | 1999-01-05 | Lai; Joseph | Method and system for remotely monitoring multiple medical parameters |
US5796827A (en) | 1996-11-14 | 1998-08-18 | International Business Machines Corporation | System and method for near-field human-body coupling for encrypted communication with identification cards |
US5741316A (en) | 1996-12-02 | 1998-04-21 | Light Sciences Limited Partnership | Electromagnetic coil configurations for power transmission through tissue |
US5735887A (en) | 1996-12-10 | 1998-04-07 | Exonix Corporation | Closed-loop, RF-coupled implanted medical device |
US5792195A (en) | 1996-12-16 | 1998-08-11 | Cardiac Pacemakers, Inc. | Acceleration sensed safe upper rate envelope for calculating the hemodynamic upper rate limit for a rate adaptive cardiac rhythm management device |
EP0904009B1 (fr) * | 1997-01-03 | 2003-09-10 | Biosense, Inc. | Extenseur de detection de pression |
US5957950A (en) | 1997-01-21 | 1999-09-28 | Northwestern University Medical School | Vascular acoustic emission analysis in a balloon angioplasty system |
SE9700182D0 (sv) | 1997-01-22 | 1997-01-22 | Pacesetter Ab | Implantable heart stimulator |
US5755766A (en) | 1997-01-24 | 1998-05-26 | Cardiac Pacemakers, Inc. | Open-ended intravenous cardiac lead |
EP1666087A3 (fr) * | 1997-02-26 | 2009-04-29 | The Alfred E Mann Foundation for Scientific Research | Dispositif implantable sur un patient et fonctionnant sur batterie |
US5919221A (en) | 1997-04-22 | 1999-07-06 | Medtronic, Inc | Method and apparatus for calibrating pacemaker pressure sensor lead prior to chronic implant |
SE9702876D0 (sv) | 1997-08-06 | 1997-08-06 | Pacesetter Ab | A cardiac monitoring device and rate responsive pacemaker system |
EP0897690B1 (fr) | 1997-08-15 | 2013-04-24 | Academisch Ziekenhuis Leiden h.o.d.n. LUMC | Capteur de pression utilisé dans un anéurisme |
US6248080B1 (en) * | 1997-09-03 | 2001-06-19 | Medtronic, Inc. | Intracranial monitoring and therapy delivery control device, system and method |
US5979898A (en) | 1997-09-03 | 1999-11-09 | Pan; Francis | Electrical scoring dart target |
US20020120200A1 (en) | 1997-10-14 | 2002-08-29 | Brian Brockway | Devices, systems and methods for endocardial pressure measurement |
US5967986A (en) | 1997-11-25 | 1999-10-19 | Vascusense, Inc. | Endoluminal implant with fluid flow sensing capability |
US5807258A (en) | 1997-10-14 | 1998-09-15 | Cimochowski; George E. | Ultrasonic sensors for monitoring the condition of a vascular graft |
US6409674B1 (en) | 1998-09-24 | 2002-06-25 | Data Sciences International, Inc. | Implantable sensor with wireless communication |
US6088608A (en) * | 1997-10-20 | 2000-07-11 | Alfred E. Mann Foundation | Electrochemical sensor and integrity tests therefor |
US5843135A (en) | 1997-10-20 | 1998-12-01 | Medtronic, Inc. | Pacing system with lead having a single conductor for connecting to pressure sensor and electrode |
US6050951A (en) * | 1997-11-10 | 2000-04-18 | Critikon Company, L.L.C. | NIBP trigger in response to detected heart rate variability |
US6140740A (en) * | 1997-12-30 | 2000-10-31 | Remon Medical Technologies, Ltd. | Piezoelectric transducer |
US6486588B2 (en) | 1997-12-30 | 2002-11-26 | Remon Medical Technologies Ltd | Acoustic biosensor for monitoring physiological conditions in a body implantation site |
US6239724B1 (en) * | 1997-12-30 | 2001-05-29 | Remon Medical Technologies, Ltd. | System and method for telemetrically providing intrabody spatial position |
US6198965B1 (en) * | 1997-12-30 | 2001-03-06 | Remon Medical Technologies, Ltd. | Acoustic telemetry system and method for monitoring a rejection reaction of a transplanted organ |
US6475170B1 (en) | 1997-12-30 | 2002-11-05 | Remon Medical Technologies Ltd | Acoustic biosensor for monitoring physiological conditions in a body implantation site |
US6431175B1 (en) | 1997-12-30 | 2002-08-13 | Remon Medical Technologies Ltd. | System and method for directing and monitoring radiation |
US6237398B1 (en) * | 1997-12-30 | 2001-05-29 | Remon Medical Technologies, Ltd. | System and method for monitoring pressure, flow and constriction parameters of plumbing and blood vessels |
US20030036746A1 (en) | 2001-08-16 | 2003-02-20 | Avi Penner | Devices for intrabody delivery of molecules and systems and methods utilizing same |
US6432050B1 (en) | 1997-12-30 | 2002-08-13 | Remon Medical Technologies Ltd. | Implantable acoustic bio-sensing system and method |
SG71881A1 (en) | 1998-01-08 | 2000-04-18 | Microsense Cardiovascular Sys | Method and device for fixation of a sensor in a bodily lumen |
US6331163B1 (en) | 1998-01-08 | 2001-12-18 | Microsense Cardiovascular Systems (1196) Ltd. | Protective coating for bodily sensor |
SE9800040D0 (sv) | 1998-01-09 | 1998-01-09 | Pacesetter Ab | A heart stimulator |
US6305381B1 (en) | 1998-02-02 | 2001-10-23 | Medtronic Inc. | System for locating implantable medical device |
US5904708A (en) * | 1998-03-19 | 1999-05-18 | Medtronic, Inc. | System and method for deriving relative physiologic signals |
US6017313A (en) | 1998-03-20 | 2000-01-25 | Hypertension Diagnostics, Inc. | Apparatus and method for blood pressure pulse waveform contour analysis |
ES2253882T3 (es) | 1998-03-30 | 2006-06-01 | Biosense Webster, Inc. | Sensor de bobina de tres ejes. |
US6023641A (en) * | 1998-04-29 | 2000-02-08 | Medtronic, Inc. | Power consumption reduction in medical devices employing multiple digital signal processors |
US5891180A (en) * | 1998-04-29 | 1999-04-06 | Medtronic Inc. | Interrogation of an implantable medical device using audible sound communication |
US6024704A (en) * | 1998-04-30 | 2000-02-15 | Medtronic, Inc | Implantable medical device for sensing absolute blood pressure and barometric pressure |
US6152885A (en) | 1998-04-30 | 2000-11-28 | Medtronic, Inc. | Barometric pressure sensor for use with implantable absolute pressure sensor |
US6144880A (en) * | 1998-05-08 | 2000-11-07 | Cardiac Pacemakers, Inc. | Cardiac pacing using adjustable atrio-ventricular delays |
US6141588A (en) | 1998-07-24 | 2000-10-31 | Intermedics Inc. | Cardiac simulation system having multiple stimulators for anti-arrhythmia therapy |
US6308099B1 (en) | 1998-11-13 | 2001-10-23 | Intermedics Inc. | Implantable device and programmer system which permits multiple programmers |
US6330957B1 (en) | 1998-12-15 | 2001-12-18 | Daryl L. Bell-Greenstreet | Automatic medication dispenser |
US6397661B1 (en) | 1998-12-30 | 2002-06-04 | University Of Kentucky Research Foundation | Remote magneto-elastic analyte, viscosity and temperature sensing apparatus and associated methods of sensing |
US6155267A (en) | 1998-12-31 | 2000-12-05 | Medtronic, Inc. | Implantable medical device monitoring method and system regarding same |
US6236889B1 (en) * | 1999-01-22 | 2001-05-22 | Medtronic, Inc. | Method and apparatus for accoustically coupling implantable medical device telemetry data to a telephonic connection |
AU2975500A (en) | 1999-01-27 | 2001-08-07 | Government of the United States of America as represented by the Administrator of the National Aeronautics and Space Administration (NASA), The | Ultrasonic apparatus and technique to measure changes in intracranial pressure |
US6179767B1 (en) * | 1999-02-01 | 2001-01-30 | International Business Machines Corporation | Focussing of therapeutic radiation on internal structures of living bodies |
US6112116A (en) | 1999-02-22 | 2000-08-29 | Cathco, Inc. | Implantable responsive system for sensing and treating acute myocardial infarction |
US6162238A (en) | 1999-02-24 | 2000-12-19 | Aaron V. Kaplan | Apparatus and methods for control of body lumens |
US8636648B2 (en) | 1999-03-01 | 2014-01-28 | West View Research, Llc | Endoscopic smart probe |
US6273904B1 (en) | 1999-03-02 | 2001-08-14 | Light Sciences Corporation | Polymer battery for internal light device |
SE9901195D0 (sv) | 1999-03-31 | 1999-03-31 | Pacesetter Ab | A rate adaptive pacemaker |
US6200265B1 (en) * | 1999-04-16 | 2001-03-13 | Medtronic, Inc. | Peripheral memory patch and access method for use with an implantable medical device |
IT1315206B1 (it) | 1999-04-27 | 2003-02-03 | Salvatore Romano | Metodo e apparato per la misura della portata cardiaca. |
US6171252B1 (en) * | 1999-04-29 | 2001-01-09 | Medtronic, Inc. | Pressure sensor with increased sensitivity for use with an implantable medical device |
US6298267B1 (en) | 1999-04-30 | 2001-10-02 | Intermedics Inc. | Method and apparatus for treatment of cardiac electromechanical dissociation |
US6266567B1 (en) | 1999-06-01 | 2001-07-24 | Ball Semiconductor, Inc. | Implantable epicardial electrode |
US6607485B2 (en) | 1999-06-03 | 2003-08-19 | Cardiac Intelligence Corporation | Computer readable storage medium containing code for automated collection and analysis of patient information retrieved from an implantable medical device for remote patient care |
US6278894B1 (en) | 1999-06-21 | 2001-08-21 | Cardiac Pacemakers, Inc. | Multi-site impedance sensor using coronary sinus/vein electrodes |
US7149773B2 (en) | 1999-07-07 | 2006-12-12 | Medtronic, Inc. | System and method of automated invoicing for communications between an implantable medical device and a remote computer system or health care provider |
US20020023123A1 (en) * | 1999-07-26 | 2002-02-21 | Justin P. Madison | Geographic data locator |
US6411850B1 (en) | 1999-09-30 | 2002-06-25 | Uab Research Foundation | Method of determining a ventilatory threshold breakpoint for an adaptive rate pacemaker |
US6440082B1 (en) | 1999-09-30 | 2002-08-27 | Medtronic Physio-Control Manufacturing Corp. | Method and apparatus for using heart sounds to determine the presence of a pulse |
US7127290B2 (en) | 1999-10-01 | 2006-10-24 | Cardiac Pacemakers, Inc. | Cardiac rhythm management systems and methods predicting congestive heart failure status |
US6368275B1 (en) * | 1999-10-07 | 2002-04-09 | Acuson Corporation | Method and apparatus for diagnostic medical information gathering, hyperthermia treatment, or directed gene therapy |
US6409675B1 (en) | 1999-11-10 | 2002-06-25 | Pacesetter, Inc. | Extravascular hemodynamic monitor |
US6277078B1 (en) | 1999-11-19 | 2001-08-21 | Remon Medical Technologies, Ltd. | System and method for monitoring a parameter associated with the performance of a heart |
US6466821B1 (en) | 1999-12-08 | 2002-10-15 | Pacesetter, Inc. | AC/DC multi-axis accelerometer for determining patient activity and body position |
US6471645B1 (en) | 1999-12-30 | 2002-10-29 | Medtronic, Inc. | Communications system for an implantable device and a drug dispenser |
EP1246667B1 (fr) | 1999-12-30 | 2005-03-23 | Medtronic, Inc. | Authentification d'utilisateur dans des systemes de dispositifs medicaux |
US7483743B2 (en) | 2000-01-11 | 2009-01-27 | Cedars-Sinai Medical Center | System for detecting, diagnosing, and treating cardiovascular disease |
US6805667B2 (en) | 2000-02-04 | 2004-10-19 | Medtronic, Inc. | Information remote monitor (IRM) medical device |
US6416474B1 (en) | 2000-03-10 | 2002-07-09 | Ramon Medical Technologies Ltd. | Systems and methods for deploying a biosensor in conjunction with a prosthesis |
US6840956B1 (en) * | 2000-03-10 | 2005-01-11 | Remon Medical Technologies Ltd | Systems and methods for deploying a biosensor with a stent graft |
US6699186B1 (en) | 2000-03-10 | 2004-03-02 | Remon Medical Technologies Ltd | Methods and apparatus for deploying and implantable biosensor |
US6554774B1 (en) * | 2000-03-23 | 2003-04-29 | Tensys Medical, Inc. | Method and apparatus for assessing hemodynamic properties within the circulatory system of a living subject |
US6654638B1 (en) | 2000-04-06 | 2003-11-25 | Cardiac Pacemakers, Inc. | Ultrasonically activated electrodes |
US6708061B2 (en) | 2000-04-07 | 2004-03-16 | Cardiac Pacemakers, Inc. | Cardiac rhythm management system with optimization of cardiac performance using heart rate |
US6441747B1 (en) | 2000-04-18 | 2002-08-27 | Motorola, Inc. | Wireless system protocol for telemetry monitoring |
US6456883B1 (en) | 2000-04-26 | 2002-09-24 | Medtronic, Inc. | Apparatus and method for allowing immediate retrieval for information and identification from an implantable medical device having a depleted power source |
US6442413B1 (en) * | 2000-05-15 | 2002-08-27 | James H. Silver | Implantable sensor |
US6669631B2 (en) | 2000-06-14 | 2003-12-30 | Medtronic, Inc. | Deep computing applications in medical device systems |
US6522914B1 (en) | 2000-07-14 | 2003-02-18 | Cardiac Pacemakers, Inc. | Method and apparatuses for monitoring hemodynamic activities using an intracardiac impedance-derived parameter |
US6720887B1 (en) | 2000-08-18 | 2004-04-13 | James Michael Zunti | Flexible, reconfigurable wireless sensor system |
US7090648B2 (en) | 2000-09-28 | 2006-08-15 | Non-Invasive Monitoring Systems, Inc. | External addition of pulses to fluid channels of body to release or suppress endothelial mediators and to determine effectiveness of such intervention |
US7024248B2 (en) | 2000-10-16 | 2006-04-04 | Remon Medical Technologies Ltd | Systems and methods for communicating with implantable devices |
US6622049B2 (en) | 2000-10-16 | 2003-09-16 | Remon Medical Technologies Ltd. | Miniature implantable illuminator for photodynamic therapy |
US7198603B2 (en) * | 2003-04-14 | 2007-04-03 | Remon Medical Technologies, Inc. | Apparatus and methods using acoustic telemetry for intrabody communications |
US6764446B2 (en) | 2000-10-16 | 2004-07-20 | Remon Medical Technologies Ltd | Implantable pressure sensors and methods for making and using them |
US6628989B1 (en) | 2000-10-16 | 2003-09-30 | Remon Medical Technologies, Ltd. | Acoustic switch and apparatus and methods for using acoustic switches within a body |
US20020045836A1 (en) * | 2000-10-16 | 2002-04-18 | Dima Alkawwas | Operation of wireless biopotential monitoring system |
US7273457B2 (en) | 2000-10-16 | 2007-09-25 | Remon Medical Technologies, Ltd. | Barometric pressure correction based on remote sources of information |
US6567700B1 (en) | 2000-10-19 | 2003-05-20 | Robert Turcott | Implantable cardiac stimulation device and method which optimizes pacing effectiveness |
US6738671B2 (en) | 2000-10-26 | 2004-05-18 | Medtronic, Inc. | Externally worn transceiver for use with an implantable medical device |
SE0004224D0 (sv) | 2000-11-16 | 2000-11-16 | St Jude Medical | Medical device |
US6792308B2 (en) | 2000-11-17 | 2004-09-14 | Medtronic, Inc. | Myocardial performance assessment |
US6574510B2 (en) | 2000-11-30 | 2003-06-03 | Cardiac Pacemakers, Inc. | Telemetry apparatus and method for an implantable medical device |
EP1341439B1 (fr) * | 2000-12-01 | 2004-10-20 | Medtronic, Inc. | Appareil de mesure de la pression moyenne de l'artere pulmonaire a partir d'un ventricule dans un moniteur ambulatoire |
US6604000B2 (en) | 2000-12-08 | 2003-08-05 | Pacesetter, Inc. | Method and device for responding to the detection of ischemia in cardiac tissue |
US6665558B2 (en) * | 2000-12-15 | 2003-12-16 | Cardiac Pacemakers, Inc. | System and method for correlation of patient health information and implant device data |
US6783499B2 (en) | 2000-12-18 | 2004-08-31 | Biosense, Inc. | Anchoring mechanism for implantable telemetric medical sensor |
US6746404B2 (en) | 2000-12-18 | 2004-06-08 | Biosense, Inc. | Method for anchoring a medical device between tissue |
US6638231B2 (en) | 2000-12-18 | 2003-10-28 | Biosense, Inc. | Implantable telemetric medical sensor and method |
JP2004532664A (ja) | 2000-12-21 | 2004-10-28 | インシュレット コーポレイション | 医療機器の遠隔制御装置及び方法 |
US6738667B2 (en) | 2000-12-28 | 2004-05-18 | Medtronic, Inc. | Implantable medical device for treating cardiac mechanical dysfunction by electrical stimulation |
US6438408B1 (en) | 2000-12-28 | 2002-08-20 | Medtronic, Inc. | Implantable medical device for monitoring congestive heart failure |
US6556871B2 (en) * | 2001-01-04 | 2003-04-29 | Cardiac Pacemakers, Inc. | System and method for receiving telemetry data from an implantable medical device |
WO2002062215A2 (fr) | 2001-01-04 | 2002-08-15 | Medtronic, Inc. | Dispositif medical implantable pourvu d'un capteur |
US6445953B1 (en) | 2001-01-16 | 2002-09-03 | Kenergy, Inc. | Wireless cardiac pacing system with vascular electrode-stents |
US6926670B2 (en) | 2001-01-22 | 2005-08-09 | Integrated Sensing Systems, Inc. | Wireless MEMS capacitive sensor for physiologic parameter measurement |
ATE266962T1 (de) | 2001-03-01 | 2004-06-15 | Pulsion Medical Sys Ag | Gerät, computerprogramm und zentralvenenkatheter zur hämodynamischen überwachung |
US6708065B2 (en) | 2001-03-02 | 2004-03-16 | Cardiac Pacemakers, Inc. | Antenna for an implantable medical device |
US20020188323A1 (en) | 2001-03-19 | 2002-12-12 | Remon Medical Technologies Ltd. | Methods, systems and devices for in vivo electrochemical production of therapeutic agents |
WO2003001998A1 (fr) | 2001-04-02 | 2003-01-09 | University Of Lausanne | Appareils de stabilisation cardiaque |
US6889086B2 (en) * | 2001-04-06 | 2005-05-03 | Cardiac Pacemakers, Inc. | Passive telemetry system for implantable medical device |
US7052466B2 (en) | 2001-04-11 | 2006-05-30 | Cardiac Pacemakers, Inc. | Apparatus and method for outputting heart sounds |
US6580946B2 (en) | 2001-04-26 | 2003-06-17 | Medtronic, Inc. | Pressure-modulated rate-responsive cardiac pacing |
US6615083B2 (en) | 2001-04-27 | 2003-09-02 | Medtronic, Inc. | Implantable medical device system with sensor for hemodynamic stability and method of use |
US20020183628A1 (en) | 2001-06-05 | 2002-12-05 | Sanford Reich | Pressure sensing endograft |
US6671547B2 (en) | 2001-06-13 | 2003-12-30 | Koninklijke Philips Electronics N.V. | Adaptive analysis method for an electrotherapy device and apparatus |
US6472991B1 (en) | 2001-06-15 | 2002-10-29 | Alfred E. Mann Foundation For Scientific Research | Multichannel communication protocol configured to extend the battery life of an implantable device |
US6702847B2 (en) | 2001-06-29 | 2004-03-09 | Scimed Life Systems, Inc. | Endoluminal device with indicator member for remote detection of endoleaks and/or changes in device morphology |
US20030009204A1 (en) * | 2001-07-06 | 2003-01-09 | Amundson Mark D. | Adapative telemetry system and method for an implantable medical device |
US6675049B2 (en) | 2001-07-17 | 2004-01-06 | Medtronic, Inc. | Method and apparatus for automatic implantable medical lead recognition and configuration |
US6937899B2 (en) * | 2001-08-30 | 2005-08-30 | Medtronic, Inc. | Ischemia detection |
US6809507B2 (en) | 2001-10-23 | 2004-10-26 | Medtronic Minimed, Inc. | Implantable sensor electrodes and electronic circuitry |
FI110763B (fi) | 2001-11-21 | 2003-03-31 | Raute Oyj | Jatkuvatoiminen puristin |
US6712772B2 (en) | 2001-11-29 | 2004-03-30 | Biocontrol Medical Ltd. | Low power consumption implantable pressure sensor |
US7181268B2 (en) * | 2001-12-03 | 2007-02-20 | Medtronic, Inc. | Ischemia detection |
US7729776B2 (en) | 2001-12-19 | 2010-06-01 | Cardiac Pacemakers, Inc. | Implantable medical device with two or more telemetry systems |
US6993393B2 (en) * | 2001-12-19 | 2006-01-31 | Cardiac Pacemakers, Inc. | Telemetry duty cycle management system for an implantable medical device |
US7018336B2 (en) * | 2001-12-27 | 2006-03-28 | Medtronic Minimed, Inc. | Implantable sensor flush sleeve |
US7060030B2 (en) | 2002-01-08 | 2006-06-13 | Cardiac Pacemakers, Inc. | Two-hop telemetry interface for medical device |
US7699059B2 (en) | 2002-01-22 | 2010-04-20 | Cardiomems, Inc. | Implantable wireless sensor |
US6855115B2 (en) * | 2002-01-22 | 2005-02-15 | Cardiomems, Inc. | Implantable wireless sensor for pressure measurement within the heart |
WO2003063700A1 (fr) | 2002-01-29 | 2003-08-07 | Sicel Technologies, Inc. | Boitier de capteur implantable et procedes de formation |
US6985773B2 (en) * | 2002-02-07 | 2006-01-10 | Cardiac Pacemakers, Inc. | Methods and apparatuses for implantable medical device telemetry power management |
US7236821B2 (en) | 2002-02-19 | 2007-06-26 | Cardiac Pacemakers, Inc. | Chronically-implanted device for sensing and therapy |
US20040122486A1 (en) | 2002-12-18 | 2004-06-24 | Stahmann Jeffrey E. | Advanced patient management for acquiring, trending and displaying health-related parameters |
US7088254B2 (en) | 2002-03-06 | 2006-08-08 | Gateway Inc. | System and method for providing a device with protection from a weather event |
US8391989B2 (en) | 2002-12-18 | 2013-03-05 | Cardiac Pacemakers, Inc. | Advanced patient management for defining, identifying and using predetermined health-related events |
US7061381B2 (en) | 2002-04-05 | 2006-06-13 | Beezerbug Incorporated | Ultrasonic transmitter and receiver systems and products using the same |
US7136703B1 (en) | 2002-04-16 | 2006-11-14 | Pacesetter, Inc. | Programmer and surface ECG system with wireless communication |
US7024244B2 (en) | 2002-04-22 | 2006-04-04 | Medtronic, Inc. | Estimation of stroke volume cardiac output using an intracardiac pressure sensor |
US7195594B2 (en) * | 2002-05-14 | 2007-03-27 | Pacesetter, Inc. | Method for minimally invasive calibration of implanted pressure transducers |
US20050159639A1 (en) | 2002-05-15 | 2005-07-21 | Mikhail Skliar | Physiologically based control system and method for using the same |
US7399313B2 (en) | 2002-06-07 | 2008-07-15 | Brown Peter S | Endovascular graft with separable sensors |
US20050234517A1 (en) | 2002-08-02 | 2005-10-20 | Frieder Braunschweig | Apparatus and method for hemodynamic-based optimization of cardiac pacing |
US20040044393A1 (en) | 2002-08-27 | 2004-03-04 | Remon Medical Technologies Ltd. | Implant system |
US7294105B1 (en) | 2002-09-03 | 2007-11-13 | Cheetah Omni, Llc | System and method for a wireless medical communication system |
US6609023B1 (en) | 2002-09-20 | 2003-08-19 | Angel Medical Systems, Inc. | System for the detection of cardiac events |
US7736309B2 (en) | 2002-09-27 | 2010-06-15 | Medtronic Minimed, Inc. | Implantable sensor method and system |
US7209790B2 (en) * | 2002-09-30 | 2007-04-24 | Medtronic, Inc. | Multi-mode programmer for medical device communication |
US20040077937A1 (en) | 2002-10-21 | 2004-04-22 | Remon Medical Technologies Ltd | Apparatus and method for coupling a medical device to a body surface |
US6868346B2 (en) * | 2002-11-27 | 2005-03-15 | Cardiac Pacemakers, Inc. | Minute ventilation sensor with automatic high pass filter adjustment |
US7452334B2 (en) | 2002-12-16 | 2008-11-18 | The Regents Of The University Of Michigan | Antenna stent device for wireless, intraluminal monitoring |
US6978182B2 (en) | 2002-12-27 | 2005-12-20 | Cardiac Pacemakers, Inc. | Advanced patient management system including interrogator/transceiver unit |
US6949075B2 (en) | 2002-12-27 | 2005-09-27 | Cardiac Pacemakers, Inc. | Apparatus and method for detecting lung sounds using an implanted device |
US7160252B2 (en) * | 2003-01-10 | 2007-01-09 | Medtronic, Inc. | Method and apparatus for detecting respiratory disturbances |
US7200439B2 (en) * | 2003-01-24 | 2007-04-03 | Proteus Biomedical, Inc. | Method and apparatus for enhancing cardiac pacing |
US7204798B2 (en) * | 2003-01-24 | 2007-04-17 | Proteus Biomedical, Inc. | Methods and systems for measuring cardiac parameters |
WO2004071292A1 (fr) | 2003-02-10 | 2004-08-26 | Massachusetts Institute Of Technology | Procedes et dispositifs pour determiner le debit cardiaque |
US6869404B2 (en) * | 2003-02-26 | 2005-03-22 | Medtronic, Inc. | Apparatus and method for chronically monitoring heart sounds for deriving estimated blood pressure |
US7035684B2 (en) * | 2003-02-26 | 2006-04-25 | Medtronic, Inc. | Method and apparatus for monitoring heart function in a subcutaneously implanted device |
US6885889B2 (en) * | 2003-02-28 | 2005-04-26 | Medtronic, Inc. | Method and apparatus for optimizing cardiac resynchronization therapy based on left ventricular acceleration |
US20040172081A1 (en) | 2003-02-28 | 2004-09-02 | Dai-Yuan Wang | Intracardiac pressure guided pacemaker |
US6871088B2 (en) | 2003-03-20 | 2005-03-22 | Medtronic, Inc. | Method and apparatus for optimizing cardiac resynchronization therapy |
US7134999B2 (en) | 2003-04-04 | 2006-11-14 | Dexcom, Inc. | Optimized sensor geometry for an implantable glucose sensor |
US7130681B2 (en) | 2003-05-09 | 2006-10-31 | Medtronic, Inc. | Use of accelerometer signal to augment ventricular arrhythmia detection |
US7967756B2 (en) | 2003-09-18 | 2011-06-28 | Cardiac Pacemakers, Inc. | Respiratory therapy control based on cardiac cycle |
EP1677852A4 (fr) | 2003-09-16 | 2009-06-24 | Cardiomems Inc | Detecteur implantable sans fil |
US7003350B2 (en) * | 2003-11-03 | 2006-02-21 | Kenergy, Inc. | Intravenous cardiac pacing system with wireless power supply |
US7248923B2 (en) | 2003-11-06 | 2007-07-24 | Cardiac Pacemakers, Inc. | Dual-use sensor for rate responsive pacing and heart sound monitoring |
US9002452B2 (en) | 2003-11-07 | 2015-04-07 | Cardiac Pacemakers, Inc. | Electrical therapy for diastolic dysfunction |
US7452333B2 (en) | 2003-12-05 | 2008-11-18 | Edwards Lifesciences Corporation | Arterial pressure-based, automatic determination of a cardiovascular parameter |
CA2551553A1 (fr) * | 2003-12-23 | 2005-07-14 | Board Of Regents, The University Of Texas System | Modulation de recepteurs 5-ht2 en tant que traitement pour des maladies cardio-vasculaires |
US7869881B2 (en) | 2003-12-24 | 2011-01-11 | Cardiac Pacemakers, Inc. | Baroreflex stimulator with integrated pressure sensor |
EP1706177B1 (fr) | 2003-12-24 | 2009-08-19 | Cardiac Pacemakers, Inc. | Cordon permettant de stimuler les barorecepteurs situe dans l'artere pulmonaire |
WO2005063332A1 (fr) | 2003-12-24 | 2005-07-14 | Cardiac Pacemakers, Inc. | Systeme de stimulation du baroreflexe |
US7572228B2 (en) | 2004-01-13 | 2009-08-11 | Remon Medical Technologies Ltd | Devices for fixing a sensor in a lumen |
US7840263B2 (en) | 2004-02-27 | 2010-11-23 | Cardiac Pacemakers, Inc. | Method and apparatus for device controlled gene expression |
US20050192844A1 (en) | 2004-02-27 | 2005-09-01 | Cardiac Pacemakers, Inc. | Systems and methods for automatically collecting, formatting, and storing medical device data in a database |
US20050197585A1 (en) | 2004-03-06 | 2005-09-08 | Transoma Medical, Inc. | Vascular blood pressure monitoring system with transdermal catheter and telemetry capability |
JP3961500B2 (ja) | 2004-03-11 | 2007-08-22 | 株式会社中日電子 | 大動脈血流データ処理方法 |
US8277713B2 (en) | 2004-05-03 | 2012-10-02 | Dexcom, Inc. | Implantable analyte sensor |
US7212861B1 (en) * | 2004-05-03 | 2007-05-01 | Pacesetter, Inc. | Monitoring ventricular contractions using an implantable stimulation device |
DE102004024334A1 (de) | 2004-05-17 | 2005-12-22 | Pulsion Medical Systems Ag | Vorrichtung zur Ermittlung eines hämodynamischen Parameters |
CA2568064A1 (fr) | 2004-06-01 | 2005-12-15 | Remon Medical Technologies Ltd | Systeme destine a evaluer les performances cardiaques |
US7489967B2 (en) | 2004-07-09 | 2009-02-10 | Cardiac Pacemakers, Inc. | Method and apparatus of acoustic communication for implantable medical device |
US7857760B2 (en) | 2004-07-13 | 2010-12-28 | Dexcom, Inc. | Analyte sensor |
US7743151B2 (en) | 2004-08-05 | 2010-06-22 | Cardiac Pacemakers, Inc. | System and method for providing digital data communications over a wireless intra-body network |
US7335161B2 (en) * | 2004-08-20 | 2008-02-26 | Cardiac Pacemakers, Inc. | Techniques for blood pressure measurement by implantable device |
EP1799101A4 (fr) * | 2004-09-02 | 2008-11-19 | Proteus Biomedical Inc | Methodes et appareil d'activation et de surveillance de tissus |
US20060064134A1 (en) | 2004-09-17 | 2006-03-23 | Cardiac Pacemakers, Inc. | Systems and methods for deriving relative physiologic measurements |
US20060064133A1 (en) | 2004-09-17 | 2006-03-23 | Cardiac Pacemakers, Inc. | System and method for deriving relative physiologic measurements using an external computing device |
US7647109B2 (en) | 2004-10-20 | 2010-01-12 | Boston Scientific Scimed, Inc. | Leadless cardiac stimulation systems |
US7532933B2 (en) | 2004-10-20 | 2009-05-12 | Boston Scientific Scimed, Inc. | Leadless cardiac stimulation systems |
US20060089694A1 (en) | 2004-10-21 | 2006-04-27 | Cardiac Pacemakers, Inc. | Delivery system and method for pulmonary artery leads |
US20060122522A1 (en) | 2004-12-03 | 2006-06-08 | Abhi Chavan | Devices and methods for positioning and anchoring implantable sensor devices |
WO2006069215A2 (fr) | 2004-12-21 | 2006-06-29 | Ebr Systems, Inc. | Systeme cardiaque sans fil pour la stimulation et le traitement de l'arythmie |
US20060167361A1 (en) | 2005-01-27 | 2006-07-27 | Bennett Tommy D | Method and apparatus for continuous pulse contour cardiac output |
US7367951B2 (en) | 2005-01-27 | 2008-05-06 | Medtronic, Inc. | System and method for detecting cardiovascular health conditions using hemodynamic pressure waveforms |
US7651466B2 (en) | 2005-04-13 | 2010-01-26 | Edwards Lifesciences Corporation | Pulse contour method and apparatus for continuous assessment of a cardiovascular parameter |
US8494618B2 (en) | 2005-08-22 | 2013-07-23 | Cardiac Pacemakers, Inc. | Intracardiac impedance and its applications |
US7615012B2 (en) | 2005-08-26 | 2009-11-10 | Cardiac Pacemakers, Inc. | Broadband acoustic sensor for an implantable medical device |
US7742815B2 (en) | 2005-09-09 | 2010-06-22 | Cardiac Pacemakers, Inc. | Using implanted sensors for feedback control of implanted medical devices |
US7566308B2 (en) | 2005-10-13 | 2009-07-28 | Cardiac Pacemakers, Inc. | Method and apparatus for pulmonary artery pressure signal isolation |
US7580746B2 (en) | 2005-12-07 | 2009-08-25 | Cardiac Pacemakers, Inc. | Implantable medical device for generating cardiac pressure-volume loop and optimizing therapy |
US20070142727A1 (en) | 2005-12-15 | 2007-06-21 | Cardiac Pacemakers, Inc. | System and method for analyzing cardiovascular pressure measurements made within a human body |
US7844331B2 (en) | 2005-12-20 | 2010-11-30 | Cardiac Pacemakers, Inc. | Method and apparatus for controlling anti-tachyarrhythmia pacing using hemodynamic sensor |
US7582061B2 (en) | 2005-12-22 | 2009-09-01 | Cardiac Pacemakers, Inc. | Method and apparatus for morphology-based arrhythmia classification using cardiac and other physiological signals |
US7666144B2 (en) | 2006-02-21 | 2010-02-23 | Board Of Trustees Operating Michigan State University | Methods and apparatus for determining cardiac output and left atrial pressure |
CA2651000A1 (fr) | 2006-05-04 | 2007-11-15 | Cardiomems, Inc. | Capteur sans fil implantable pour releves de pression in vivo et determination de debit continu |
US7801608B2 (en) | 2006-06-05 | 2010-09-21 | Cardiac Pacemakers, Inc. | Method and apparatus for closed-loop control of anti-tachyarrhythmia pacing using hemodynamic sensor |
US8170668B2 (en) * | 2006-07-14 | 2012-05-01 | Cardiac Pacemakers, Inc. | Baroreflex sensitivity monitoring and trending for tachyarrhythmia detection and therapy |
US7908334B2 (en) | 2006-07-21 | 2011-03-15 | Cardiac Pacemakers, Inc. | System and method for addressing implantable devices |
US7955268B2 (en) | 2006-07-21 | 2011-06-07 | Cardiac Pacemakers, Inc. | Multiple sensor deployment |
US20080046037A1 (en) | 2006-08-18 | 2008-02-21 | Haubrich Gregory J | Wireless Communication Network for an Implantable Medical Device System |
US8725258B2 (en) * | 2006-08-25 | 2014-05-13 | Cardiac Pacemakers, Inc. | Method and apparatus for automated adjustment of arrhythmia detection duration |
ES2369203T3 (es) | 2006-09-15 | 2011-11-28 | Cardiac Pacemakers, Inc. | Anclaje para un dispositivo médico implantable. |
US20080077440A1 (en) | 2006-09-26 | 2008-03-27 | Remon Medical Technologies, Ltd | Drug dispenser responsive to physiological parameters |
US20080243007A1 (en) * | 2007-03-28 | 2008-10-02 | Cardiac Pacemakers, Inc. | Pulmonary Artery Pressure Signals And Methods of Using |
EP2231265A2 (fr) | 2007-12-12 | 2010-09-29 | Cardiac Pacemakers, Inc. | Système d'administration d'une neurostimulation à partir d'une artère pulmonaire |
EP2242538B1 (fr) | 2008-02-11 | 2016-04-06 | Cardiac Pacemakers, Inc. | Procédés de surveillance d'état hémodynamique pour une discrimination de rythme à l'intérieur du coeur |
US8369960B2 (en) | 2008-02-12 | 2013-02-05 | Cardiac Pacemakers, Inc. | Systems and methods for controlling wireless signal transfers between ultrasound-enabled medical devices |
EP2346392A1 (fr) | 2008-08-26 | 2011-07-27 | Cardiac Pacemakers, Inc. | Estimation de débit cardiaque utilisant la pression artérielle pulmonaire |
US8591423B2 (en) | 2008-10-10 | 2013-11-26 | Cardiac Pacemakers, Inc. | Systems and methods for determining cardiac output using pulmonary artery pressure measurements |
US20100324378A1 (en) | 2009-06-17 | 2010-12-23 | Tran Binh C | Physiologic signal monitoring using ultrasound signals from implanted devices |
-
2009
- 2009-09-24 WO PCT/US2009/058242 patent/WO2010059291A1/fr active Application Filing
- 2009-09-24 US US12/566,432 patent/US8632470B2/en not_active Expired - Fee Related
Patent Citations (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5423323A (en) * | 1993-08-30 | 1995-06-13 | Rocky Mountain Research, Inc. | System for calculating compliance and cardiac hemodynamic parameters |
WO1997018856A1 (fr) * | 1995-11-17 | 1997-05-29 | Medtronic, Inc. | Modulation baroreflexe par stimulation du nerf du sinus carotidien pour le traitement de la defaillance cardiaque |
US6832112B1 (en) * | 2001-12-28 | 2004-12-14 | Pacesetter, Inc. | Method of adjusting an AV and/or PV delay to improve hemodynamics and corresponding implantable stimulation device |
Non-Patent Citations (1)
Title |
---|
COHEN T J ET AL: "A hemodynamically responsive antitachycardia system. Development and basis for design in humans", CIRCULATION 1990 US, vol. 82, no. 2, 1990, pages 394 - 406, XP002560584, ISSN: 0009-7322 * |
Cited By (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US9301702B2 (en) | 2012-11-19 | 2016-04-05 | Pacesetter, Inc. | Systems and methods for exploiting pulmonary artery pressure obtained from an implantable sensor to detect cardiac rhythm irregularities |
US9566442B2 (en) | 2012-11-19 | 2017-02-14 | Pacesetter, Inc. | Systems and methods for using pulmonary artery pressure from an implantable sensor to detect mitral regurgitation and optimize pacing delays |
US20210280319A1 (en) * | 2020-01-29 | 2021-09-09 | Tata Consultancy Services Limited | Neuromodulation based adaptive controller for mitral stenosis |
US11728040B2 (en) * | 2020-01-29 | 2023-08-15 | Tata Consultancy Services Limited | Neuromodulation based adaptive controller for mitral stenosis |
Also Published As
Publication number | Publication date |
---|---|
US8632470B2 (en) | 2014-01-21 |
US20100125211A1 (en) | 2010-05-20 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
US8632470B2 (en) | Assessment of pulmonary vascular resistance via pulmonary artery pressure | |
US6915162B2 (en) | Implantable medical device for measuring ventricular pressure | |
JP5211177B2 (ja) | 心臓内の調律識別のための血行動態の監視方法 | |
JP3959025B2 (ja) | 平均肺動脈圧を決定する方法および装置 | |
US7409244B2 (en) | Method and apparatus for adjusting interventricular delay based on ventricular pressure | |
US9247883B2 (en) | Detecting worsening heart failure based on fluid accumulation with respiratory confirmatoin | |
US7946995B1 (en) | Analyzing circadian variations of a hemodynamic parameter to determine an adverse cardiac condition | |
US8591423B2 (en) | Systems and methods for determining cardiac output using pulmonary artery pressure measurements | |
EP1980292A2 (fr) | Surveillance de la pression pulmonaire | |
EP2004047B1 (fr) | Dispositif medical implantable d'evaluation de l'oedeme pulmonaire d'un patient | |
US8812093B2 (en) | Systems and methods for exploiting near-field impedance and admittance for use with implantable medical devices | |
US8494631B2 (en) | System and method for profiling a patients hemodynamic response based on heart sounds | |
US8702604B2 (en) | Detection of waveform artifact | |
US8670820B2 (en) | Near field-based systems and methods for assessing impedance and admittance for use with an implantable medical device | |
US8135468B2 (en) | Systems and methods for estimating left atrial pressure (LAP) in patients with acute mitral valve regurgitation for use by an implantable medical device | |
US7569020B2 (en) | Method for extracting timing parameters using a cardio-mechanical sensor | |
EP1758643B1 (fr) | Detection et/ou surveillance d'une insuffisance cardiaque diastolique | |
EP1538979B1 (fr) | Moniteur d'insuffisance cardiaque congestive | |
EP2280761B1 (fr) | Dispositif médical détectant une insuffisance cardiaque | |
US20140257070A1 (en) | Processing of lap signals |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
121 | Ep: the epo has been informed by wipo that ep was designated in this application |
Ref document number: 09792959 Country of ref document: EP Kind code of ref document: A1 |
|
NENP | Non-entry into the national phase |
Ref country code: DE |
|
122 | Ep: pct application non-entry in european phase |
Ref document number: 09792959 Country of ref document: EP Kind code of ref document: A1 |