Indication-based worsening HF alert

• US 10,292,665 B2
• Filed: 04/19/2016
• Issued: 05/21/2019
• Est. Priority Date: 09/19/2008
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Zhang, Yi, Stahmann, Jeffrey E.
• Primary Examiner(s): Hulbert, Amanda K
• Assistant Examiner(s): Dinga, Roland
• Application Number:
  US15/132,738
• Publication Number:
  US 20160228072A1
• Time in Patent Office: 1,127 Days
• Field of Search: 600508
• 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 5/021 Measuring pressure in heart or blood vessels A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/024 Detecting, measuring or recording pulse rate or heart rate A61B5/0205, A61B5/021 take precedence
• CPC Class Codes: A61B 5/053 Measuring electrical impedance or conductance of a portion of the body
• CPC Class Codes: A61B 5/0816 Measuring devices for examining respiratory frequency measuring frequency of electric signals G01R23/00
• CPC Class Codes: A61B 5/0826 Detecting or evaluating apnoea events A61B5/4818 takes precedence
• CPC Class Codes: A61B 5/085 Measuring impedance of respiratory organs or lung elasticity
• CPC Class Codes: A61B 5/091 Measuring volume of inspired or expired gases, e.g. to determine lung capacity
• CPC Class Codes: A61B 5/1036 Measuring load distribution, e.g. podologic studies
• CPC Class Codes: A61B 5/1118 Determining activity level
• CPC Class Codes: A61B 5/165 Evaluating the state of mind, e.g. depression, anxiety
• CPC Class Codes: A61B 5/4836 Diagnosis combined with treatment in closed-loop systems or methods A61B5/0036 takes precedence
• CPC Class Codes: A61B 5/4878 Evaluating oedema
• CPC Class Codes: A61B 5/686 Permanently implanted devices, e.g. pacemakers, other stimulators, biochips A61B5/6861 takes precedence
• CPC Class Codes: 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
• CPC Class Codes: A61B 5/7282 Event detection, e.g. detecting unique waveforms indicative of a medical condition A61B5/4094, A61B5/4818, A61B5/349, A61B5/0823 take precedence
• CPC Class Codes: A61B 5/742 using visual displays A61B5/339 takes precedence
• CPC Class Codes: A61B 5/7435 Displaying user selection data, e.g. icons in a graphical user interface
• CPC Class Codes: A61B 5/746 Alarms related to a physiological condition, e.g. details of setting alarm thresholds or avoiding false alarms alarms per se G08B
• CPC Class Codes: A61B 5/7475 : User input or interface means, e.g. keyboard, pointing device, joystick
• CPC Class Codes: A61B 7/02 : Stethoscopes acoustic details thereof G10K11/00
• CPC Class Codes: G16H 50/20 : for computer-aided diagnosis, e.g. based on medical expert systems
• CPC Class Codes: G16H 50/30 : for calculating health indices; for individual health risk assessment

Abstract

This document discusses, among other things, receiving a user selection of a heart failure symptom, receiving a user selection of an abnormal psychological condition, receiving information about a physiological patient status parameter, and determining a heart failure status using the received information.

Claims

1. A system for managing heart failure (HF) in a patient, comprising:

a user input configured to receive a user selection of a patient symptom or a user selection of a HF comorbidity in the patient;

a physiological status detector configured to detect a physiological status parameter from the patient; and

a heart failure alert generator, coupled to the user input and the physiological status detector, and configured to;

adjust an alert range or an alert threshold based on the user selection of the patient symptom or the user selection of the HF comorbidity; and

generate an alert in response to the physiological status parameter falling within the adjusted alert range or crossing the adjusted alert threshold.

2. The system of claim 1, further comprising a therapy circuit configured to deliver a heart failure therapy.

3. The system of claim 1, wherein the physiological status parameter includes measurement from a physiological sensor, and wherein the heart failure generator is configured to adjust the alert range or the alert threshold associated with the sensor measurement.

4. The system of claim 1, wherein the physiological status parameter includes a HF status parameter, and wherein the heart failure alert generator is configured to adjust the alert range or the alert threshold associated with the HF status parameter and generate the alert indicating a worsening HF condition.

5. The system of claim 4, wherein the HF status parameter includes a composite HF parameter using at least a first physiological parameter derived from a first sensor and a different second parameter derived from a second sensor.

6. The system of claim 5, wherein the composite HF parameter includes a combination of the first physiological parameter scaled by a first weight and the second physiological parameter scaled by a second weight, the first and second weights determined based on the user selections of the patient symptom or the HF comorbidity.

7. The system of claim 1, wherein the user selection of the patient symptom includes a HF symptom indicating whether a heart failure symptom is or has been present, the HF symptom including one or more of dyspnea, edema, or weight change.

8. The system of claim 7, wherein the heart failure alert generator is configured to reduce an alert threshold, or to narrow an alert range, associated with an intrathoracic impedance parameter in response to a user selection of edema.

9. The system of claim 7, wherein the heart failure alert generator is configured to reduce an alert threshold, or to narrow an alert range, associated with one or more respiration parameters or physical activity parameters in response to a user selection of dyspnea.

10. The system of claim 1, wherein the user selection of HF comorbidity includes a HF comorbidity indicating whether an HF comorbidity is or has been present, the HF comorbidity including one or more of asthma, chronic obstructive pulmonary disease, pulmonary hypertension, anemia, or apnea.

11. The system of claim 1, wherein:

the user input is configured to further receive a user selection of a psychological condition indicating whether a psychological condition is or has been present; and

the heart failure alert generator is configured to adjust the alert range or the alert threshold based at least on the user selection of a psychological condition, and

wherein the psychological condition includes one or more of depression, anxiety, or stresses condition.

12. The system of claim 11, wherein the heart failure alert generator is configured to reduce an alert threshold, or to narrow an alert range, associated with a respiration-related physiological status parameter in response to a user selection of depression condition.

13. A method for managing heart failure (HF) in a patient via a HF management system, the method comprising:

receiving a user selection of a patient symptom or a user selection of a HF comorbidity in the patient;

detecting, via a detector of the HF management system, a physiological status parameter from the patient; and

adjusting an alert range or an alert threshold based on the user selection of the patient symptom or the user selection of the HF comorbidity; and

generating an alert in response to the physiological status parameter falling within the adjusted alert range or crossing the adjusted alert threshold.

14. The method claim 13, further comprising delivering a heart failure therapy in response to the physiological status parameter falling within the alert range or crossing the alert threshold.

15. The method of claim 13, wherein the physiological status parameter includes a HF status parameter, and wherein:

the adjustment of the alert range or the alert threshold includes adjusting an alert range or alert threshold associated with the HF status parameter; and

the alert is generated to indicate a worsening HF condition.

16. The method of claim 15, wherein the HF status parameter includes one of a heart rate, a respiration rate, a respiration timing, a blood pressure, a lung tidal volume, a physical activity level, a weight, an intrathoracic impedance, a heart sound timing, or a heart sound magnitude.

17. The method of claim 13, wherein the user selection of the patient symptom includes a HF symptom indicating whether a heart failure symptom is or has been present, the HF symptom including one or more of dyspnea, edema, or weight change.

18. The method of claim 17, wherein the adjustment of the alert range or the alert threshold includes one or more of:

reducing an alert threshold, or narrowing an alert range, associated with an intrathoracic impedance parameter in response to a user selection of edema;

or

reducing an alert threshold, or narrowing an alert range, associated with a respiration parameter or a physical activity parameter in response to a user selection of dyspnea.

19. The method of claim 13, wherein the user selection of HF comorbidity includes a HF comorbidity indicating whether an HF comorbidity is or has been present, the HF comorbidity including one or more of asthma, chronic obstructive pulmonary disease, pulmonary hypertension, anemia, or apnea.

20. The method of claim 13, further comprising receiving a user selection of a psychological condition indicating whether a psychological condition is or has been present, the psychological condition including one or more of depression, anxiety, or stresses condition, and

wherein the adjustment of the alert range or the alert threshold is based at least on the user selection of a psychological condition.