# US 8,784,323 B2 · Methods and systems that use implanted posture sensor to monitor pulmonary edema > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 8,784,323 B2 - Document ID: US8784323B2 - Status: Granted - Kind: B2 - Application number: 12/649,647 - Filed: 2009-12-30 - Published: 2011-05-26 - Granted: 2014-07-22 - Earliest claimed: 2009-11-20 - Assignees: Pacesetter, Inc. - Applicants: Yelena Nabutovsky; Fujian Qu; Steve Koh; Dan E. Gutfinger; Alex Soriano - Inventors: Yelena Nabutovsky; Fujian Qu; Steve Koh; Dan E. Gutfinger; Alex Soriano - Web page: https://patentgrep.com/patent/US8784323B2 ## CPC - A61B 5/053: Measuring electrical impedance or conductance of a portion of the body - A61B 5/021: Measuring pressure in heart or blood vessels - A61B 5/1116: {Determining posture transitions} - A61B 5/4878: {Evaluating oedema} - A61N 1/3627: {for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy} - A61N 1/36521: {the parameter being derived from measurement of an electrical impedance} - A61N 1/36564: {controlled by blood pressure} - A61N 1/36585: {controlled by two or more physical parameters} - A61N 1/37258: {Alerting the patient} - A61B 5/686: {Permanently implanted devices, e.g. pacemakers, other stimulators, biochips (A61B5/6861 takes precedence)} - A61B 5/7275: {Determining trends in physiological measurement data; Predicting development of a medical condition based on physiological measurements, e.g. determining a risk factor} - A61N 1/3684: {for stimulating the heart at multiple sites of the ventricle or the atrium} - A61N 1/36842: {Multi-site stimulation in the same chamber} - A61N 1/36843: {Bi-ventricular stimulation} - A61N 1/3702: {Physiological parameters (A61N1/365 takes precedence; evoked response A61N1/371)} - A61N 1/39622: {Pacing therapy} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) - 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) ## Abstract In specific embodiments, a method to monitor pulmonary edema of a patient, comprises (a) detecting, using an implanted posture sensor, when a posture of the patient changes from a first predetermined posture to a second predetermined posture, (b) determining an amount of time it takes an impedance signal to achieve a steady state after the posture of the patient changes from the first predetermined posture to the second predetermined posture, where the impedance signal is obtained using implanted electrodes and is indicative of left atrial pressure and/or intra-thoracic fluid volume of the patient, and (c) monitoring the pulmonary edema of the patient based on the determined amount of time it takes the impedance signal to achieve the steady state after the posture of the patient changes from the first predetermined posture to the second pre-determined posture. ## Claims ### Claim 1 A method to monitor pulmonary edema of a patient, comprising: (a) detecting, using an implanted posture sensor, when a posture of the patient changes from a first predetermined posture to a second predetermined posture; (b) determining, based on an impedance signal, an amount of time it takes the impedance signal to achieve a steady state after the posture of the patient changes from the first predetermined posture to the second predetermined posture, where the impedance signal is obtained using implanted electrodes and is indicative of at least one of left atrial pressure or intra-thoracic fluid volume of the patient, and where the amount of time it takes the impedance signal to achieve a steady state, after the posture of the patient changes from the first predetermined posture to the second predetermined posture, is indicative of a degree of pulmonary edema; and (c) monitoring the pulmonary edema of the patient based on the determined amount of time it takes the impedance signal to achieve the steady state after the posture of the patient changes from the first predetermined posture to the second predetermined posture. ### Claim 2 (depends on 1) The method of claim 1 wherein the first predetermined posture is an upright posture and the second predetermined posture is a supine posture. ### Claim 3 (depends on 1) The method of claim 1 wherein the first predetermined posture is a supine posture and the second predetermined posture is an upright posture. ### Claim 4 (depends on 1) The method of claim 1, wherein: steps (a) and (b) are repeated a period of time thereafter; and step (c) includes identifying when a degree of the pulmonary edema of the patient, or a change therein, exceeds a threshold; and one or both of triggering an alert and adjusting therapy administered to the patient in response to identifying that the degree of the pulmonary edema, or change therein, exceeds the threshold. ### Claim 5 (depends on 4) The method of claim 4, wherein steps (a), (b) and (c) are performed by an implanted system including the implanted posture sensor and implanted electrodes; and wherein when an alert is triggered, the method further comprises: (d) transmitting the alert from the implanted system to a non-implanted system; and (e) at least one of displaying a visual warning or issuing an audible warning by way of the non-implanted system in response to the alert. ### Claim 6 (depends on 4) The method of claim 4, wherein steps (a), (b) and (c) are performed by an implanted system including the implanted posture sensor and implanted electrodes; and wherein when therapy administered to the patient is adjusted, the method further comprises: (d) adjusting medication based on a physician pre-determined formula; and (e) displaying a visual indication of the medication adjustment to the patient. ### Claim 7 (depends on 4) The method of claim 4, wherein steps (a), (b) and (c) are performed by an implanted system including the implanted posture sensor and implanted electrodes; and wherein when therapy administered to the patient is adjusted, the method further comprises: (d) adjusting electrical therapy administered by an implantable cardioverter-defibrillator (ICD) or cardiac resynchronization therapy defibrillator (CRT-D). ### Claim 8 (depends on 1) The method of claim 1, further comprising, after step (a), transmitting the impedance signal, or data indicative thereof, to a non-implanted system; and wherein steps (b) and (c) are performed by the non-implanted system. ### Claim 9 A system to monitor pulmonary edema of a patient comprising: an implantable posture sensor adapted to determine a posture of the patient; an implantable impedance sensor adapted to obtain, using implanted electrodes, an impedance signal indicative of at least one of left atrial pressure or intra-thoracic fluid volume of the patient; and a pulmonary edema monitor adapted to determine, based on the impedance signal, an amount of time it takes the impedance signal to achieve a steady state after the posture of the patient changes from a first predetermined posture to a second predetermined posture, where the amount of time it takes the impedance signal to achieve a steady state, after the posture of the patient changes from the first predetermined posture to the second predetermined posture, is indicative of a degree of pulmonary edema; and monitor the pulmonary edema of the patient based on the determined amount of time it takes the impedance signal to achieve the steady state after the posture of the patient changes from the first predetermined posture to the second predetermined posture. ### Claim 10 (depends on 9) The system of claim 9, wherein the first predetermined posture is an upright posture and the second predetermined posture is a supine posture. ### Claim 11 (depends on 9) The system of claim 9, wherein the first predetermined posture is a supine posture and the second predetermined posture is an upright posture. ### Claim 12 (depends on 9) The system of claim 9, wherein: the pulmonary edema monitor is adapted to trigger an alert in response to a degree of the pulmonary edema of the patient, or a change therein, exceeding a threshold. ### Claim 13 (depends on 9) The system of claim 9, wherein: the pulmonary edema monitor is associated with a non-implanted system that is adapted to at least one of display a visual warning or issue an audible warning in response to the alert; and the implantable impedance sensor is associated with an implantable device adapted to communicate with the non-implanted system. ### Claim 14 (depends on 9) The system of claim 9, wherein the implantable pulmonary edema monitor is associated with an implantable device; and further comprising a non-implanted device adapted to communicate with the implantable device and at least one of display a visual warning or issue an audible warning in response to an alert received from the implantable device.