Apparatus and method for detection of sleep disordered breathing

• US 10,130,306 B2
• Filed: 03/13/2014
• Issued: 11/20/2018
• Est. Priority Date: 03/14/2013
• Status: Active Grant

• Current Assignee: Greatbatch Limited (Greatbatch Incorporated)
• Original Assignee: Greatbatch Limited (Greatbatch Incorporated)
• Inventors: Katra, Rodolphe, Chakravarthy, Niranjan
• Primary Examiner(s): Layno, Carl H
• Assistant Examiner(s): Kong, Qingjun
• Application Number:
  US14/208,021
• Publication Number:
  US 20140275837A1
• Time in Patent Office: 1,713 Days
• Field of Search: 600301, 600300
• CPC Class Codes: A61B 5/0031 Implanted circuitry
• CPC Class Codes: A61B 5/0205 Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
• CPC Class Codes: A61B 5/0803 Recording apparatus specially adapted therefor
• CPC Class Codes: A61B 5/4818 Sleep apnoea
• CPC Class Codes: A61B 5/6847 mounted on an invasive device

Abstract

An apparatus, system, and method directed to detecting a physiological signal during discrete time separated detection windows, deriving one or more respiratory disturbance indices from the physiological signal, detecting a respiratory disturbance state in response to the one or more respiratory disturbance indices deviating from a threshold value, interpolating the one or more respiratory disturbance indices between adjacent time separated detection windows, and declaring a respiratory disturbance episode based on the detected respiratory disturbance state during the detection windows and the interpolation between detection windows.

Claims

1. A system comprising:

a waveform acquisition apparatus configured to detect an electrocardiogram (ECG) signal during discrete time separated detection windows and configured to not detect the ECG signal during a time between the discrete time separated detection windows, the discrete time separated detection windows having a duration corresponding to at least a plurality of heart beats;

an analyzer, comprising;

first processing circuitry configured to derive one or more respiratory disturbance indices from the ECG signal and detect a respiratory disturbance state in response to the one or more respiratory disturbance indices deviating from a threshold value;

second processing circuitry configured to interpolate the one or more respiratory disturbance indices between an ending state and a subsequent beginning state of adjacent time separated detection windows; and

third processing circuitry configured to determine a respiratory disturbance episode based on the detected respiratory disturbance states during the detection windows and the interpolation between detection windows, wherein the respiratory disturbance episode is determined if the respiratory disturbance state is present in both the ending state and the subsequent beginning state of adjacent time separated detection windows, and wherein the respiratory disturbance episode is not determined if the respiratory disturbance state is not present at both the ending state and the subsequent beginning state of adjacent time separated detection windows; and

a respiratory therapy apparatus, wherein the respiratory therapy apparatus is configured to deliver a respiratory therapy in response to the respiratory disturbance episode.

2. The system of claim 1, wherein the waveform acquisition apparatus acquires electrocardiogram (ECG) waveforms from implanted subcutaneous extrathoracic electrodes.

3. The system of claim 2, wherein the waveform acquisition apparatus comprises an implantable loop recorder.

4. The system of claim 1, wherein the second processing circuitry interpolates one or more of heart activity and muscle activity between the ending state and the subsequent beginning state of adjacent time separated detection windows.

5. The system of claim 1, wherein the second processing circuitry is configured to interpolate the one or more respiratory disturbance indices based upon a priori information regarding patient wellness.

6. The system of claim 1, wherein the second processing circuitry is configured to interpolate the one or more respiratory disturbance indices based upon learned information regarding patient wellness.

7. The system of claim 1, wherein the second processing circuitry is configured to interpolate the one or more respiratory disturbance indices based upon one or more of a standard deviation, a variance, a personalized change, a normalized index, a physician set index, a percentage change of a preceding value, an absolute change, a relative change, and an adaptive threshold.

8. The system of claim 1, wherein the threshold value comprises one or more of a standard deviation, a variance, a personalized change, a normalized index, a physician set index, a percentage change of a preceding value, an absolute change, a relative change, and an adaptive threshold.

9. The system of claim 1, wherein the respiratory disturbance indices comprise one or more of a tidal volume intensity, a periodicity, and a turbulence.

10. The system of claim 1, wherein the threshold value is triggered based upon one or more of a threshold proportion of discrete time separated detection windows, a trend in collected data, and an Apnea-Hypopnea Index (AHI) score.

11. The system of claim 1, wherein the waveform acquisition apparatus is configured to shorten a duration between the one or more time separated detection windows in response to detection of the respiratory disturbance state.

12. The system of claim 1, wherein the waveform acquisition apparatus is configured to lengthen a duration between the one or more time separated detection windows in response to detection of a normal breathing state.

13. The system of claim 1, further comprising a battery.

14. An apparatus, comprising:

electrodes adapted to acquire electrocardiogram (ECG) waveforms from an implanted subcutaneous extrathoracic location of a patient;

a data acquisition module configured to capture the ECG waveforms during discrete time separated detection windows and configured to not detect the ECG waveforms during a time between the discrete time separated detection windows, the discrete time separated detection windows having a duration corresponding to at least a plurality of heart beats; and

an analyzer, comprising;

first processing circuitry configured to derive one or more respiratory disturbance indices from the ECG waveforms and detect a respiratory disturbance state in response to the one or more respiratory disturbance indices deviating from a threshold value;

second processing circuitry configured to interpolate the one or more respiratory disturbance indices between an ending state and a subsequent beginning state of adjacent time separated detection windows;

third processing circuitry configured to determine a respiratory disturbance episode based on the detected respiratory disturbance states during the detection windows and the interpolation between detection windows, wherein the respiratory disturbance episode is determined if the respiratory disturbance state is present in both the ending state and the subsequent beginning state of adjacent time separated detection windows, and wherein the respiratory disturbance episode is not determined if the respiratory disturbance state is not present at both the ending state and the subsequent beginning state of adjacent time separated detection windows; and

a respiratory therapy apparatus, wherein the respiratory therapy apparatus is configured to deliver a respiratory therapy in response to the respiratory disturbance episode.

15. The apparatus of claim 14, wherein the apparatus comprises an implantable loop recorder.

16. The apparatus of claim 14, wherein the second processing circuitry is configured to interpolate one or more of heart activity and muscle activity between the ending state and the subsequent beginning state of adjacent time separated detection windows.

17. The apparatus of claim 14, wherein the second processing circuitry is configured to interpolate the one or more respiratory disturbance indices based upon one or more of a standard deviation, a variance, a personalized change, a normalized index, a physician set index, a percentage change of a preceding value, an absolute change, a relative change, and an adaptive threshold.

18. The apparatus of claim 14, wherein the threshold value comprises one or more of a standard deviation, a variance, a personalized change, a normalized index, a physician set index, a percentage change of a preceding value, an absolute change, a relative change, and an adaptive threshold.

19. The apparatus of claim 14, wherein the respiratory disturbance indices comprise one or more of a tidal volume intensity, a periodicity, and a turbulence.

20. The apparatus of claim 14, wherein the threshold value is triggered based upon one or more of a threshold proportion of discrete time separated detection windows, a trend in collected data, and an Apnea-Hypopnea Index (AHI) score.

21. The apparatus of claim 14, wherein the waveform acquisition apparatus is configured to shorten a duration between the one or more time separated detection windows in response to detection of the respiratory disturbance state.

22. The apparatus of claim 14, wherein the waveform acquisition apparatus is configured to lengthen a duration between the one or more time separated detection windows in response to detection of a normal breathing state.

23. The apparatus of claim 14, further comprising a battery.