# US 11,998,752 B2 · Wearable cardioverter defibrillator with a non-invasive blood pressure monitor

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- Number: US 11,998,752 B2
- Document ID: US11998752B2
- Status: Granted
- Kind: B2
- Application number: 17/720,146
- Filed: 2022-04-13
- Published: 2022-08-04
- Granted: 2024-06-04
- Earliest claimed: 2018-04-25
- Assignees: West Affum Holdings DAC
- Applicants: West Affum Holdings DAC
- Inventors: Kenneth F. Cowan; Steven E. Sjoquist; Zoie R. Engman; Erick M. Roane; Laura M. Gustavson; Douglas K. Medema; Garrett M. Kotlarchik; Pamela Breske; Jonathan P. Niegowski; Joseph L. Sullivan; Robert R. Buchanan
- Web page: https://patentgrep.com/patent/US11998752B2

## CPC

- A61N 1/3987: {characterised by the timing or triggering of the shock}
- A61B 5/0004: {characterised by the type of physiological signal transmitted}
- A61B 5/01: Measuring temperature of body parts {; Diagnostic temperature sensing, e.g. for malignant or inflamed tissue} (clinical contact thermometers G01K13/20)
- A61B 5/0205: Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
- A61B 5/02055: {Simultaneously evaluating both cardiovascular condition and temperature}
- A61B 5/02108: {from analysis of pulse wave characteristics}
- A61B 5/14552: {Details of sensors specially adapted therefor}
- A61B 5/282: Holders for multiple electrodes (for introduction into the body A61B5/287)
- A61B 5/361: Detecting fibrillation
- A61B 5/363: Detecting tachycardia or bradycardia
- A61B 5/366: Detecting abnormal QRS complex, e.g. widening
- A61B 5/4836: {Diagnosis combined with treatment in closed-loop systems or methods (A61B5/0036 takes precedence)}
- A61B 5/6805: {Vests, e.g. shirts or gowns}
- A61N 1/3904: {External heart defibrillators [EHD]}
- A61N 1/3925: {Monitoring; Protecting}
- A61N 1/3968: {Constructional arrangements, e.g. casings (A61N1/375 takes precedence)}
- A61B 5/021: Measuring pressure in heart or blood vessels
- A61B 5/024: Measuring pulse rate or heart rate
- A61B 5/086: {by impedance pneumography}
- A61B 5/6824: {Arm or wrist}
- A61B 5/6828: {Leg}
- A61B 5/6829: {Foot or ankle}
- A61B 2562/0271: Thermal or temperature sensors
- A61N: ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY (measurement of bioelectric currents A61B; surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body A61B18/00; anaesthetic apparatus in general A61M; incandescent lamps H01K; infrared radiators for heating H05B)
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)

## Abstract

A wearable cardioverter defibrillator (WCD) system comprises a plurality of patient parameter electrodes and a plurality of defibrillator electrodes to contact a patient's skin when the WCD is delivering therapy to the patient, a processor to receive one or more patient parameters from the one or more patient parameter electrodes, an energy storage device to store a charge to provide electrical therapy to the patient via the plurality of defibrillator electrodes, and a non-invasive blood pressure (NIBP) monitor to obtain a blood pressure measurement of the patient and to provide the blood pressure measurement to the processor. The processor is to determine whether to provide electrical therapy to the patient based on the one or more patient parameters during an episode, and to obtain the blood pressure measurement from the NIBP monitor during the episode.

## Claims

### Claim 1

A wearable patient monitoring system, comprising:
a support structure configured to be worn by a patient;
a housing;
a plurality of patient sensors including a non-invasive blood pressure (NIBP) monitor to be coupled to the patient when the patient is wearing the support structure, wherein the NIBP monitor is configured obtain a blood pressure measurement based on a pulse transit time (PTT) measurement, and wherein the plurality of patient sensors includes an ECG sensor to obtain patient ECG data when the patient is wearing the support structure;
one or more processors in the housing and coupled to the plurality of patient sensors to collect one or more patient parameters, wherein the one or more processors are configured to receive the patient ECG data from the ECG sensor and the blood pressure measurement from the NIBP monitor to determine the PTT, wherein the patient ECG data is used to increase accuracy of the PTT measurement to generate an enhanced accuracy blood pressure measurement; and
a memory coupled to the one or more processors to store the one or more patient parameters including one or more blood pressure readings obtained with the NIBP monitor; and
wherein the one or more processors are configured to determine whether the patient is experiencing ventricular tachycardia (VT) based at least in part on the patient ECG data, and to determine whether the VT is perfusing VT or non-perfusing VT based at least in part on the enhanced accuracy blood pressure measurement.

### Claim 2 (depends on 1)

The wearable patient monitoring system of claim 1, wherein the plurality of patient sensors includes a temperature sensor to obtain a patient temperature reading when the patient is wearing the support structure.

### Claim 3 (depends on 1)

The wearable patient monitoring system of claim 1, wherein the plurality of patient sensors includes a patient impedance sensor to obtain a patient impedance reading when the patient is wearing the support structure, wherein the patient impedance reading is used to determine patient respiration information.

### Claim 4 (depends on 1)

The wearable patient monitoring system of claim 1, wherein at least one of the one or more processors is configured to generate an alert when the enhanced accuracy blood pressure measurement has a value that is below a minimum value or above a maximum value.

### Claim 5 (depends on 1)

The wearable patient monitoring system of claim 1, wherein at least one of the one or more processors is configured to generate a prompt for the patient to obtain a blood pressure measurement.

### Claim 6 (depends on 1)

The wearable patient monitoring system of claim 1, wherein:
the one or more processors are configured to use the enhanced accuracy blood pressure measurement during an episode in combination with the one or more patient parameters to determine whether the patient requires electrical therapy.

### Claim 7 (depends on 1)

The wearable patient monitoring system of claim 1, wherein:
the NIBP monitor is disposed in a button coupled to the wearable patient monitoring system.

### Claim 8 (depends on 1)

The wearable patient monitoring system of claim 1, wherein:
the NIBP monitor is coupled to the ECG sensor.

### Claim 9 (depends on 1)

The wearable patient monitoring system of claim 1, wherein the NIBP monitor is attachable to an arm, a leg, a wrist, or an ankle of the patient, or at another location on the patient's body.

### Claim 10 (depends on 1)

The wearable patient monitoring system of claim 1, wherein the NIBP monitor is disposed in a smartphone or a wearable device that is capable of transmitting the enhanced accuracy blood pressure measurement to processor via a wired or a wireless communication link.

### Claim 11 (depends on 1)

The wearable patient monitoring system of claim 1, wherein the NIBP monitor comprises an SpO2 sensor or a temperature sensor, or a combination thereof.

### Claim 12 (depends on 1)

The wearable patient monitoring system of claim 1, wherein:
the one or more processors are configured to determine when the patient has a heart rate above a heart rate threshold and a blood pressure below a blood pressure threshold.

### Claim 13 (depends on 1)

The wearable patient monitoring system of claim 1, wherein:
the one or more processors are configured to analyze the patient ECG data in segments of patient ECG data and to obtain a blood pressure measurement for one or more of the segments of patient ECG data; and
wherein the one or more processors are configured to determine when a string of a predetermined number of segments indicate a ventricular tachycardia (VT) criterion is met and the patient is in a non-perfusing state.

### Claim 14 (depends on 13)

The wearable patient monitoring system of claim 13, wherein:
the one or more processors are configured to determine when the VT criterion is met and the patient is perfusing, and when a super ventricular tachycardia (SVT) criterion is met and the patient is non-perfusing.

### Claim 15 (depends on 1)

The wearable patient monitoring system of claim 1, wherein:
the one or more processors are configured to determined when the patient has a disorganized ventricular rhythm and has a blood pressure reading below a predetermined threshold, and when the patient ECG data indicates the patient is in a ventricular fibrillation (VF) zone.

### Claim 16 (depends on 1)

The wearable patient monitoring system of claim 1, wherein:
the one or more processors are configured to determine when the patient's heart rate is above a minimum threshold and the patient is non-perfusing, when the patient's QRS complex width is above a minimum threshold and the patient is non-perfusing, and when a sudden drop in blood pressure occurs coincident with an increased heart rate, an increase in R-wave width, or a disorganized heart rhythm.

### Claim 17 (depends on 1)

The wearable patient monitoring system of claim 1, wherein the NIBP monitor is configured to obtain a heart rate value independent from the patient ECG data.

### Claim 18

A wearable patient monitoring system, comprising:
a support structure configured to be worn by a patient;
a plurality of patient sensors including a single non-invasive blood pressure (NIBP) monitor to be coupled to the patient when the patient is wearing the support structure, wherein the NIBP monitor is configured obtain a blood pressure measurement based on a pulse transit time (PTT) measurement, and wherein the plurality of patient sensors includes an ECG sensor to obtain patient ECG data when the patient is wearing the support structure;
one or more processors coupled to the plurality of patient sensors to collect one or more patient parameters, wherein the one or more processors are configured to receive the blood pressure measurement from the single NIBP monitor to determine the PTT, wherein the patient ECG data is used to increase accuracy of the PTT measurement to generate an enhanced accuracy blood pressure measurement; and
a memory coupled to the one or more processors to store the one or more patient parameters including one or more blood pressure readings obtained with the NIBP monitor; and
wherein the one or more processors are configured to determine whether the patient is experiencing ventricular tachycardia (VT) based at least in part on the patient ECG data, and to determine whether the VT is perfusing VT or non-perfusing VT based at least in part on the enhanced accuracy blood pressure measurement.

### Claim 19 (depends on 18)

The wearable patient monitoring system of claim 18, wherein:
the one or more processors are configured to use the enhanced accuracy blood pressure measurement during an episode in combination with the one or more patient parameters to determine whether the patient requires electrical therapy.