Methods and apparatus for stratifying risk of heart failure decompensation
First Claim
1. A medical device, comprising:
- a signal analyzer circuit, including;
a patient status input unit configured to receive at least a first demographic characteristic indicator and a second demographic characteristic indicator of a patient, the second demographic characteristic indicator non-identical to the first demographic characteristic indicator;
a signal receiver circuit configured to receive one or more physiologic signals of the patient;
a signal metrics generator circuit configured to generate a plurality of signal metrics from the one or more physiologic signals, including to generate a first set of one or more signal metrics in response to the first demographic characteristic indicator meeting at least one first specified criterion, and to generate a second set of signal metrics in response to the second demographic characteristic indicator meeting at least one second specified criterion; and
a patient-specific signal metric selector circuit configured to select a subset of patient-specific signal metrics from the first and second sets of signal metrics using signal metric performance measures of at least one metric from the first and second sets of signal metrics; and
a risk stratification circuit configured to generate a composite risk index using the selected subset of patient-specific signal metrics, the composite risk index indicative of the probability of the patient later developing an event indicative of worsening of heart failure, the risk stratification circuit comprising a risk report generator configured to generate a report to inform a user of an elevated risk of the patient developing the event indicative of worsening of heart failure.
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Abstract
Devices and methods for identifying patient at elevated risk of developing future heart failure (HF) events, such as events indicative of HF decompensation status, are described. The devices and methods can stratify the risk using sensor signals or signal metrics selected in accordance with patient chronic conditions. A medical device can receive a patient status input including at least a first and a second chronic condition indicators, sense one or more physiologic signals from the patient, and generate a plurality of signal metrics from the physiologic signals when the first chronic condition indicator and the second chronic condition indicator meets respective criterion. One or more patient-specific signal metrics can be selected from a group including the signal metrics selected for both the first and the second chronic conditions. A risk stratification algorithm can use the selected one or more patient-specific signal metrics to compute a composite risk index indicative of the probability of the patient later developing an event indicative of worsening of HF.
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Citations
20 Claims
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1. A medical device, comprising:
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a signal analyzer circuit, including; a patient status input unit configured to receive at least a first demographic characteristic indicator and a second demographic characteristic indicator of a patient, the second demographic characteristic indicator non-identical to the first demographic characteristic indicator; a signal receiver circuit configured to receive one or more physiologic signals of the patient; a signal metrics generator circuit configured to generate a plurality of signal metrics from the one or more physiologic signals, including to generate a first set of one or more signal metrics in response to the first demographic characteristic indicator meeting at least one first specified criterion, and to generate a second set of signal metrics in response to the second demographic characteristic indicator meeting at least one second specified criterion; and a patient-specific signal metric selector circuit configured to select a subset of patient-specific signal metrics from the first and second sets of signal metrics using signal metric performance measures of at least one metric from the first and second sets of signal metrics; and a risk stratification circuit configured to generate a composite risk index using the selected subset of patient-specific signal metrics, the composite risk index indicative of the probability of the patient later developing an event indicative of worsening of heart failure, the risk stratification circuit comprising a risk report generator configured to generate a report to inform a user of an elevated risk of the patient developing the event indicative of worsening of heart failure. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 19, 20)
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10. A method of operating a medical device to determine a patient risk of worsening of heart failure, comprising:
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receiving at least a first demographic characteristic indicator and a second demographic characteristic indicator of a patient via a patient status input unit included in a signal analyzer circuit, the second demographic characteristic indicator non-identical to the first demographic characteristic indicator; receiving one or more physiologic signals of the patient via a signal receiver circuit; generating a plurality of signal metrics from the one or more physiologic signals via a signal metrics generator circuit, including generating a first set of one or more signal metrics in response to the first demographic characteristic indicator meeting at least one first specified criterion, and generating a second set of signal metrics in response to the second demographic characteristic indicator meeting at least one second specified criterion; selecting, via a patient-specific signal metric selector circuit, a subset of patient-specific signal metrics from the first and second sets of signal metrics based on signal metrics performance measures of at least one metric from the first and second sets of signal metrics; generating, via a risk stratification circuit, a composite risk index using the selected subset of patient-specific signal metrics, the composite risk index indicative of the probability of the patient later developing an event indicative of worsening of heart failure; and generating, via a risk report generator, a report to inform a user of an elevated risk of the patient developing the event indicative of worsening of heart failure. - View Dependent Claims (11, 12, 13, 14, 15, 16, 17, 18)
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Specification