Prosecution Insights
Last updated: October 02, 2026
Application No. 18/074,605

AMBULATORY MONITORING OF PHYSIOLOGIC RESPONSE TO VALSALVA MANEUVER

Final Rejection §103
Filed
Dec 05, 2022
Priority
Aug 03, 2018 — provisional 62/714,413 +1 more
Examiner
ROANE, AARON F
Art Unit
3792
Tech Center
3700 — Mechanical Engineering & Manufacturing
Assignee
Cardinal Health Inc.
OA Round
4 (Final)
73%
Grant Probability
Favorable
5-6
OA Rounds
0m
Est. Remaining
83%
With Interview

Examiner Intelligence

Grants 73% — above average
73%
Career Allowance Rate
657 granted / 895 resolved
+3.4% vs TC avg
Moderate +10% lift
Without
With
+9.7%
Interview Lift
resolved cases with interview
Typical timeline
3y 9m
Avg Prosecution
46 currently pending
Career history
923
Total Applications
across all art units

Statute-Specific Performance

§101
1.6%
-38.4% vs TC avg
§103
46.1%
+6.1% vs TC avg
§102
24.7%
-15.3% vs TC avg
§112
18.1%
-21.9% vs TC avg
Black line = Tech Center average estimate • Based on career data from 895 resolved cases

Office Action

§103
Notice of Pre-AIA or AIA Status The present application, filed on or after March 16, 2013, is being examined under the first inventor to file provisions of the AIA . Response to Arguments Applicant's arguments filed 06/26/2026 have been fully considered but they are not persuasive. Firstly, Applicant requests scheduling an interview in the event a notice of allowance is not issued as a result of Applicant’s 06/26/2026 response. Applicant may call the examiner and request an interview or Applicant may fill an Automated Interview Request form in order to request an interview. Secondly, on page 8, 1st full paragraph Applicant asserts: 1) “Thakur does not disclose or suggest a VM detector circuit that detects a VM session by determining one or more VM phases using increase or decrease trends of SI, S2, S3, or S4 intensity of the heart sound signal,” and 2) “nor does Thakur disclose responsively generating a diastolic function indicator during at least one such determined VM phase.” The examiner disagrees since Thakur et al. disclose “determining one or more VM phases using increase or decrease trends of S1, S2, S3, or S4 intensity of the heart sound signal” (see abstract, [0008]-[0017], [0027]-[0032], and [0062] for example). Thakur et al. also disclose “generating a diastolic function indicator during at least one such determined VM phase” since disclose the detection, measurement, and reporting of S1, S2, S3, or S4 intensity of the heart sound signal. Next, beginning on page 8, last five lines through page 9, last line Applicant traverses the obviousness rejection using among other things the Limited Universe of Options case law and rationale. Here Applicant states “physiologic relationship is not interchangeable with other possible ratios. S3 is associated with early passive ventricular filling, while S4 is associated with active ventricular filling caused by atrial contraction.” The Limited Universe of Options is not an interchangeability rationale but where there is a limited universe of potential options, the selection of any particular option would have been obvious to one of ordinary skill in the art. In re Jones, 412 F.2d 241, 162 USPQ 224 (CCPA 1962). Therefore, since there are only six heart sound intensity ratios, it would have been obvious to one of ordinary skill in the art to modify Thakur et al. in view of Wariar et al. show to use the heart sound intensity ratio of S3/S4 (or S4/S3) to use as an indicator relating to heart failure. Next beginning on page 10, 3rd full paragraph through page 11, line 2 Applicant traverses the rejection of claim 21 for “at least reasons similar to those discussed above with respect to claims 1, 5, and 7, Thakur and Wariar fail to disclose or suggest the amended claim 21 architecture.” As shown above these traversing arguments are unpersuasive. Applicant is invited to request an interview to discuss suggestions to find an acceptable conclusion of the prosecution for all parties. Accordingly Applicant’s arguments are unpersuasive and this action is made FINAL. Claim Rejections - 35 USC § 103 In the event the determination of the status of the application as subject to AIA 35 U.S.C. 102 and 103 (or as subject to pre-AIA 35 U.S.C. 102 and 103) is incorrect, any correction of the statutory basis (i.e., changing from AIA to pre-AIA ) for the rejection will not be considered a new ground of rejection if the prior art relied upon, and the rationale supporting the rejection, would be the same under either status. The following is a quotation of 35 U.S.C. 103 which forms the basis for all obviousness rejections set forth in this Office action: A patent for a claimed invention may not be obtained, notwithstanding that the claimed invention is not identically disclosed as set forth in section 102, if the differences between the claimed invention and the prior art are such that the claimed invention as a whole would have been obvious before the effective filing date of the claimed invention to a person having ordinary skill in the art to which the claimed invention pertains. Patentability shall not be negated by the manner in which the invention was made. Claims 1-98989898 are rejected under 35 U.S.C. 103 as being unpatentable over Thakur et al. (U.S. Patent Application Publication 2017 /0100081) in view of Wariar et al. (U.S. Patent Application Publication 2011/0301473). Regarding claim 1, Thakur et al. disclose a system comprising: a first detector circuit ( comprising A) "heart sound (HS)-based HF event detection circuit" 113, or 200, see [0050], [0055] and figures 1-2, or B) "signal sensor circuit 210 can sense HS information," see [0056], and alternate/equivalent counterparts in other embodiments) configured to detect heart event(s) using a heart sound signal sensed from a patient, wherein the first detector circuit detects/ determine one or more VM phases using an increase trend or a decrease trend of one or more of a first heart sound (S1) intensity, a second heart sound (S2) intensity, a third heart sound (S3) intensity, or a fourth heart sound (S4) intensity of the heart sound signal (see abstract, [0007]-[0032] and figures 7 and 8 for example); and a physiologic event detector circuit ( comprising A) "trending circuit 223 ," see [0066] and figure 2, and B) "processor 220," see [0055] and figure 2, and alternate/equivalent counterparts in other embodiments) configured to, in response to detection of the heart event(s) by the first detector circuit, generate a diastolic function indicator (see [0064 ], and [0092]) using physiologic information sensed from the patient during the heart event(s), and to detect a worsening heart failure (WHF) (see abstract, [0009]-[001 0], [0044 ], [0050], [0068] for example) event based at least in part on the generated diastolic function indicator (see [0008], [0064 ], and [0092]). Thakur et al. fail to explicitly disclose the first detector circuit is Valsalva maneuver (VM) detector circuit configured to detect a VM session/event. Like Thakur et al., Wariar et al. disclose a system for detecting heart sounds and indicating heart failure and /or worsening heart failure using an accelerometer, impedance measurements and teach a Valsalva maneuver can be identified by using both correlated heart sounds and impedance measurements (see [0014 ], [0024 ], [0046]-[0047] for example) in order to better enhance heart failure measurement and diagnosis. It should be understood the prior art combination makes the first detector circuit (of Thakur et al.) used to detect (and/or identify) a Valsalva maneuver. Therefore, at the time of the of invention it would have been obvious to one of ordinary skill in the art to modify the invention of Thakur et al., as taught by Wariar et al., to use the first detector circuit comprising the heart sounds detection/measurement as a Valsalva detection circuit in in order to better enhance heart failure measurement and diagnosis. Regarding claim 2, Thakur et al. disclose the physiologic event detector circuit is configured to generate the diastolic function indicator using the physiologic information that includes a heart sound component of the heart sound signal (see for example [0066]- [0067]). Regarding claim 3, Thakur et al. disclose the heart sound component used for generating the diastolic function indicator includes a third heart sound (S3) intensity, wherein the physiologic event detector circuit is configured to generate the diastolic function indicator indicating an impaired diastolic function in response to the S3 intensity exceeding a reference S3 intensity by a specific margin during the detected VM session (see [0062], [0068], [0072] for example). Regarding claim 8, Thakur et al. disclose the claimed invention (see [0064]). Regarding claim 9, Thakur et al. disclose the claimed invention (see Wariar et al. [0006], [0014], and [0055] for example). Regarding claim 11, Thakur et al. a therapy circuit configured to initiate or adjust a therapy (see [0051]) to the patient in response to the detection of the WHF event. Claims 5, and 7 are rejected under 35 U.S.C. 103 as being unpatentable over Thakur et al. (U.S. Patent Application Publication 2017/0100081) in view of Wariar et al. (U.S. Patent Application Publication 2011/0301473) as applied to claim 2 above, and further in view of case law - Limited Options (Limited Universe). Regarding claims 5 and 7, Thakur et al. in view of Wariar et al. show the invention above, including: Thakur et al. disclosing using the ratio of heart sound intensities of S 1, S2, S3, and S4 (see [0066]-[0067] specifically, and [0062]-[0067] in general). Yet, Thakur et al. fail to explicitly recite: 1) the heart sound component used for generating the diastolic function indicator includes a ratio of a third heart sound (S3) intensity to a fourth heart sound (S4) intensity; wherein the physiologic event detector circuit is configured to generate the diastolic function indicator indicating an impaired diastolic function in response to the ratio of the S3 intensity to the S4 intensity falling below a first threshold value lower than a baseline value range { claim 5};or 2) the heart sound component used for generating the diastolic function indicator includes a ratio of a third heart sound (S3) intensity to a fourth heart sound (S4) intensity, wherein the physiologic event detector circuit is configured to generate the diastolic function indicator indicating a restrictive ventricular filling in response to the ratio of the S3 intensity to the S4 intensity exceeding a second threshold value greater than a baseline value range {claim 7}. However, where there is a limited universe of potential options, the selection of any particular option would have been obvious to one of ordinary skill in the art. In re Jones, 412 F.2d 241, 162 USPQ 224 (CCPA 1962). Therefore, since there are only six heart sound intensity ratios, it would have been obvious to one of ordinary skill in the art to modify Thakur et al. in view of Wariar et al. show to use the heart sound intensity ratio of S3/S4 (or S4/S3) to use as an indicator relating to heart failure. Therefore, at the time of the of invention it would have been obvious to one of ordinary skill in the art to modify the invention of Thakur et al. in view of Wariar et al., as taught by Limited Options, to explicitly use the ratio of the heart sound intensity ratio of S3 /S4 (or S4/S3) to use as an indicator relating to heart failure. Additionally and finally, regarding the recitation of the ratio being less than or greater than a threshold, see Thakur et al. [0062]. Claims 21, and 24-26 are rejected under 35 U.S.C. 103 as being unpatentable over Thakur et al. (U.S. Patent Application Publication 2017 /0100081) in view of Wariar et al. (U.S. Patent Application Publication 2011/0301473) and further in view of case law – Limited Options (Limited Universe). Regarding claims 21, and 25, Thakur et al. disclose a system comprising: a first detector circuit (comprising A) "heart sound (HS)-based HF event detection circuit" 113, or 200, see [0050], [0055] and figures 1-2, or B) "signal sensor circuit 210 can sense HS information," see [0056], and alternate/equivalent counterparts in other embodiments) configured to detect heart event(s) using a heart sound signal sensed from a patient; and a physiologic event detector circuit ( comprising A) "trending circuit 223 ," see [0066] and figure 2, and B) "processor 220," see [0055] and figure 2, and alternate/equivalent counterparts in other embodiments) configured to, in response to detection of the heart event(s) by the first detector circuit, generate a diastolic function indicator (see [0064], and [0092]) using physiologic information sensed from the patient during the heart event(s), and to detect a worsening heart failure (WHF) (see abstract, [0009]-[001 0], [0044 ], [0050], [0068] for example) event based at least in part on the generated diastolic function indicator (see [0008 ], [0064], and [0092]). Additionally, regarding the recitation of the ratio being less than or greater than a threshold, see Thakur et al. [0062]. Thakur et al. fail to explicitly disclose: 1) the first detector circuit is Valsalva maneuver (VM) detector circuit configured to detect a VM session/event; 2) detecting a third heart sound (S3) intensity and a fourth heart sound (S4) intensity from the heart sound signal sensed during the detected VM session; 3) generating a diastolic function indicator using a combination (in the form of a ratio) of the S3 intensity and the S4 intensity; and Like Thakur et al., Wariar et al. disclose a system for detecting heart sounds and indicating heart failure and /or worsening heart failure using an accelerometer, impedance measurements and teach a Valsalva maneuver can be identified by using both correlated heart sounds and impedance measurements (see [0014], [0024], [0046]-[0047] for example) in order to better enhance heart failure measurement and diagnosis. It should be understood the prior art combination makes the first detector circuit (of Thakur et al.) used to detect (and/or identify) a Valsalva maneuver. Therefore, at the time of the of invention it would have been obvious to one of ordinary skill in the art to modify the invention of Thakur et al., as taught by Wariar et al., to use the first detector circuit comprising the heart sounds detection/measurement as a Valsalva detection circuit in in order to better enhance heart failure measurement and diagnosis. Thakur et al. disclose using the ratio of heart sound intensities of S 1, S2, S3, and S4 (see [0066]-[0067] specifically, and [0062]-[0067] in general). Where there is a limited universe of potential options, the selection of any particular option would have been obvious to one of ordinary skill in the art. In re Jones, 412 F.2d 241, 162 USPQ 224 (CCPA 1962). Therefore, since there are only six heart sound intensity ratios, it would have been obvious to one of ordinary skill in the art to modify Thakur et al. in view of Wariar et al. show to use the heart sound intensity ratio of S3 /S4 (or S4/S3) to use as an indicator relating to heart failure. Therefore, at the time of the of invention it would have been obvious to one of ordinary skill in the art to modify the invention of Thakur et al. in view of Wariar et al., as taught by Limited Options, to explicitly use the ratio of the heart sound intensity ratio of S3 /S4 ( or S4/S3) to use as an indicator relating to heart failure. Additionally and finally, regarding the recitation of the ratio being less than or greater than a threshold, see Thakur et al. [0062]. Regarding claims 24, and 26, Thakur et al. a therapy circuit configured to initiate or adjust a therapy (see [0051]) to the patient in response to the detection of the WHF event. Conclusion THIS ACTION IS MADE FINAL. Applicant is reminded of the extension of time policy as set forth in 37 CFR 1.136(a). A shortened statutory period for reply to this final action is set to expire THREE MONTHS from the mailing date of this action. In the event a first reply is filed within TWO MONTHS of the mailing date of this final action and the advisory action is not mailed until after the end of the THREE-MONTH shortened statutory period, then the shortened statutory period will expire on the date the advisory action is mailed, and any nonprovisional extension fee (37 CFR 1.17(a)) pursuant to 37 CFR 1.136(a) will be calculated from the mailing date of the advisory action. In no event, however, will the statutory period for reply expire later than SIX MONTHS from the mailing date of this final action. Applicant's amendment necessitated the new ground(s) of rejection presented in this Office action. Accordingly, THIS ACTION IS MADE FINAL. See MPEP § 706.07(a). Applicant is reminded of the extension of time policy as set forth in 37 CFR 1.136(a). A shortened statutory period for reply to this final action is set to expire THREE MONTHS from the mailing date of this action. In the event a first reply is filed within TWO MONTHS of the mailing date of this final action and the advisory action is not mailed until after the end of the THREE-MONTH shortened statutory period, then the shortened statutory period will expire on the date the advisory action is mailed, and any nonprovisional extension fee (37 CFR 1.17(a)) pursuant to 37 CFR 1.136(a) will be calculated from the mailing date of the advisory action. In no event, however, will the statutory period for reply expire later than SIX MONTHS from the mailing date of this final action. Any inquiry concerning this communication or earlier communications from the examiner should be directed to AARON F ROANE whose telephone number is (571)272-4771. The examiner can normally be reached generally Mon-Fri 8am-9pm. Examiner interviews are available via telephone, in-person, and video conferencing using a USPTO supplied web-based collaboration tool. To schedule an interview, applicant is encouraged to use the USPTO Automated Interview Request (AIR) at http://www.uspto.gov/interviewpractice. If attempts to reach the examiner by telephone are unsuccessful, the examiner’s supervisor, Niketa Patel can be reached at (571) 272-4156. The fax phone number for the organization where this application or proceeding is assigned is 571-273-8300. Information regarding the status of published or unpublished applications may be obtained from Patent Center. Unpublished application information in Patent Center is available to registered users. To file and manage patent submissions in Patent Center, visit: https://patentcenter.uspto.gov. Visit https://www.uspto.gov/patents/apply/patent-center for more information about Patent Center and https://www.uspto.gov/patents/docx for information about filing in DOCX format. For additional questions, contact the Electronic Business Center (EBC) at 866-217-9197 (toll-free). If you would like assistance from a USPTO Customer Service Representative, call 800-786-9199 (IN USA OR CANADA) or 571-272-1000. /AARON F ROANE/Primary Examiner, Art Unit 3792
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Prosecution Timeline

Show 1 earlier event
Jun 17, 2025
Non-Final Rejection mailed — §103
Sep 08, 2025
Response Filed
Dec 09, 2025
Final Rejection mailed — §103
Mar 09, 2026
Request for Continued Examination
Mar 23, 2026
Response after Non-Final Action
Mar 27, 2026
Non-Final Rejection mailed — §103
Jun 26, 2026
Response Filed
Sep 02, 2026
Final Rejection mailed — §103 (current)

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Study what changed to get past this examiner. Based on 5 most recent grants.

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Prosecution Projections

5-6
Expected OA Rounds
73%
Grant Probability
83%
With Interview (+9.7%)
3y 9m (~0m remaining)
Median Time to Grant
High
PTA Risk
Based on 895 resolved cases by this examiner. Grant probability derived from career allowance rate.

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