System and method for providing diagnosis and monitoring of myocardial ischemia for use in automated patient care

• US 20020143262A1
• Filed: 04/04/2002
• Published: 10/03/2002
• Est. Priority Date: 11/16/1999
• Status: Active Grant

• Current Assignee: Gust H. Bardy
• Original Assignee: Gust H. Bardy
• Inventors: Bardy, Gust H.
• Granted Patent: US 6,827,690 B2
• Time in Patent Office: Days
• US Class Current: 600/508
• CPC Class Codes: A61B 5/0006 ECG or EEG signals
• CPC Class Codes: A61B 5/02 Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
• 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 5/0215 by means inserted into the body catheters A61M25/00
• CPC Class Codes: A61B 5/02438 with portable devices, e.g. worn by the patient
• CPC Class Codes: A61B 5/029 Measuring or recording blood output from the heart, e.g. minute volume A61B8/065 takes precedence
• CPC Class Codes: A61B 5/318 Heart-related electrical modalities, e.g. electrocardiography [ECG]
• CPC Class Codes: A61B 5/349 Detecting specific parameters of the electrocardiograph cycle
• CPC Class Codes: A61B 5/361 Detecting fibrillation
• CPC Class Codes: A61B 5/366 Detecting abnormal QRS complex, e.g. widening
• CPC Class Codes: A61B 5/486 Bio-feedback A61B5/375 takes precedence
• CPC Class Codes: A61N 1/36507 controlled by gradient or slope of the heart potential
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 15/00 ICT specially adapted for medical reports, e.g. generation or transmission thereof
• CPC Class Codes: G16H 20/40 relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
• CPC Class Codes: G16H 40/67 for remote operation
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems

Abstract

A system and method for providing diagnosis and monitoring of myocardial ischemia for use in automated patient care is described. At least one recorded physiological measure is compared to at least one other recorded physiological measure on a substantially regular basis to quantify a change in patient pathophysiological status for equivalent patient information. An absence, an onset, a progression, a regression, and a status quo of myocardial ischemia is evaluated dependent upon the change in patient pathophysiological status.

Claims

1. A system for providing diagnosis and monitoring of myocardial ischemia for use in automated patient care, comprising:

a comparison module comparing at least one recorded physiological measure to at least one other recorded physiological measure on a substantially regular basis to quantify a change in patient pathophysiological status for equivalent patient information; and

an analysis module evaluating an absence, an onset, a progression, a regression, and a status quo of myocardial ischemia dependent upon the change in patient pathophysiological status.

2. A system according to claim 1, further comprising:

a diagnostic module comparing the change in patient pathophysiological status to an indicator threshold corresponding to a quantifiable physiological measure indicative of myocardial ischemia.

3. A system according to claim 1, further comprising:

a database module retrieving the at least one recorded physiological measure and the at least one other recorded physiological measure from monitoring sets stored in a database.

4. A system according to claim 3, further comprising:

a server system collecting the at least one recorded physiological measure and the at least one other recorded physiological measure into each monitoring set recorded on a substantially continuous basis or derived therefrom.

5. A system according to claim 4, further comprising:

at least one of an implantable medical device and an external medical device recording the at least one recorded physiological measure and the at least one other recorded physiological measure.

6. A system according to claim 1, further comprising:

the analysis module evaluating an absence, an onset, a progression, a regression, and a status quo of diseases other than myocardial ischemia dependent upon the change in patient pathophysiological status.

7. A system according to claim 1, further comprising:

a diagnostic module comparing at least one recorded quality of life measure to at least one other recorded quality of life measure on a substantially regular basis to qualify a change in patient pathophysiological status.

8. A system according to claim 1, further comprising:

a stored stickiness indicator defined for at least one physiological measure corresponding to a temporal boundary on one of patient diagnosis and treatment;

a diagnostic module timing each change in patient pathophysiological status for the equivalent patient information and determining one of a revised patient diagnosis and treatment responsive to each change in patient pathophysiological status with a timing exceeding the stickiness indicator.

9. A system according to claim 1, further comprising:

a diagnostic module comparing the change in patient pathophysiological status to a reference baseline comprising recorded physiological measures recorded during an initial time period.

10. A system according to claim 1, further comprising:

a diagnostic module comparing the change in patient pathophysiological status to equivalent patient information from at least one of an individual patient, a peer group, and a overall patient population.

11. A system according to claim 1, further comprising:

a diagnostic module grading the change in patient pathophysiological status on a fixed scale based on a degree of deviation from a pre-defined indicator threshold and performing a summation over a plurality of the graded changes to determine an overall change in patient pathophysiological status.

12. A system according to claim 1, further comprising:

a diagnostic module determining probabilistic weightings of the change in patient pathophysiological status on a statistical deviation and trends via linear fits from a pre-defined indicator threshold and performing a summation over a plurality of the probabilistic weightings to determine an overall change in patient pathophysiological status.

14. A method according to claim 13, further comprising:

comparing the change in patient pathophysiological status to an indicator threshold corresponding to a quantifiable physiological measure indicative of myocardial ischemia.

15. A method according to claim 13, further comprising:

retrieving the at least one recorded physiological measure and the at least one other recorded physiological measure from monitoring sets stored in a database.

16. A method according to claim 15, further comprising:

collecting the at least one recorded physiological measure and the at least one other recorded physiological measure into each monitoring set recorded on a substantially continuous basis or derived therefrom.

17. A method according to claim 16, further comprising:

recording the at least one recorded physiological measure and the at least one other recorded physiological measure with at least one of an implantable medical device and an external medical device.

18. A method according to claim 13, further comprising:

evaluating an absence, an onset, a progression, a regression, and a status quo of diseases other than myocardial ischemia dependent upon the change in patient pathophysiological status.

19. A method according to claim 13, further comprising:

comparing at least one recorded quality of life measure to at least one other recorded quality of life measure on a substantially regular basis to qualify a change in patient pathophysiological status.

20. A method according to claim 13, further comprising:

defining a stickiness indicator for at least one physiological measure corresponding to a temporal boundary on one of patient diagnosis and treatment;

timing each change in patient pathophysiological status for the equivalent patient information; and

determining one of a revised patient diagnosis and treatment responsive to each change in patient pathophysiological status with a timing exceeding the stickiness indicator.

21. A method according to claim 13, further comprising:

comparing the change in patient pathophysiological status to a reference baseline comprising recorded physiological measures recorded during an initial time period.

22. A method according to claim 13, further comprising:

comparing the change in patient pathophysiological status to equivalent patient information from at least one of an individual patient, a peer group, and a overall patient population.

23. A method according to claim 13, further comprising:

grading the change in patient pathophysiological status on a fixed scale based on a degree of deviation from a pre-defined indicator threshold; and

performing a summation over a plurality of the graded changes to determine an overall change in patient pathophysiological status.

24. A method according to claim 13, further comprising:

determining probabilistic weightings of the change in patient pathophysiological status on a statistical deviation and trends via linear fits from a pre-defined indicator threshold; and

performing a summation over a plurality of the probabilistic weightings to determine an overall change in patient pathophysiological status.

25. A computer-readable storage medium for a device holding code for performing the method according to claim 13.

27. A system according to claim 26, further comprising:

the analyzer analyzing the physiological measures in the physiological measures set relative to the other physiological measures to determine a pathophysiology indicating an absence, an onset, a progression, a regression, and a status quo of diseases other than myocardial ischemia.

28. A system according to claim 26, further comprising:

the server system receiving a set of one or more quality of life measures relating to patient information recorded on a substantially continuous basis or derived therefrom;

the database module storing the quality of life measures set into the patient care record for the individual patient into the database; and

the analyzer analyzing the quality of life measures in the physiological measures set relative to the other quality of life measures to determine a pathophysiology indicating an absence, an onset, a progression, a regression, and a status quo of myocardial ischemia.

29. A system according to claim 26, further comprising:

the server system receiving a set of one or more baseline physiological measures relating to patient information recorded during an initial time period or derived therefrom;

the database module storing the baseline physiological measures set into the patient care record for the individual patient into the database; and

the analyzer analyzing the physiological measures in the physiological measures set relative to the baseline physiological measures to determine a pathophysiology indicating an absence, an onset, a progression, a regression, and a status quo of myocardial ischemia.

30. A system according to claim 26, further comprising:

a comparison module retrieving the other physiological measures from measures sets for at least one of an individual patient, a peer group, and a overall patient population.

13. A method for providing diagnosis and monitoring of myocardial ischemia for use in automated patient care, comprising:

comparing at least one recorded physiological measure to at least one other recorded physiological measure on a substantially regular basis to quantify a change in patient pathophysiological status for equivalent patient information; and

evaluating an absence, an onset, a progression, a regression, and a status quo of myocardial ischemia dependent upon the change in patient pathophysiological status.

26. A system for analyzing a patient status for myocardial ischemia for use in automated patient care, comprising:

a server system receiving a set of one or more physiological measures relating to patient information recorded on a substantially continuous basis or derived therefrom;

a database module storing the physiological measures set into a patient care record for an individual patient into a database; and

an analyzer analyzing one or more of the physiological measures in the physiological measures set relative to one or more other physiological measures to determine a pathophysiology indicating an absence, an onset, a progression, a regression, and a status quo of myocardial ischemia.

31. A method for analyzing a patient status for myocardial ischemia for use in automated patient care, comprising:

receiving a set of one or more physiological measures relating to patient information recorded on a substantially continuous basis or derived therefrom;

storing the physiological measures set into a patient care record for an individual patient into a database; and

analyzing one or more of the physiological measures in the physiological measures set relative to one or more other physiological measures to determine a pathophysiology indicating an absence, an onset, a progression, a regression, and a status quo of myocardial ischemia.

32. A method according to claim 31, further comprising:

analyzing the physiological measures in the physiological measures set relative to the other physiological measures to determine a pathophysiology indicating an absence, an onset, a progression, a regression, and a status quo of diseases other than myocardial ischemia.

33. A method according to claim 31, further comprising:

receiving a set of one or more quality of life measures relating to patient information recorded on a substantially continuous basis or derived therefrom;

storing the quality of life measures set into the patient care record for the individual patient into the database; and

analyzing the quality of life measures in the physiological measures set relative to the other quality of life measures to determine a pathophysiology indicating an absence, an onset, a progression, a regression, and a status quo of myocardial ischemia.

34. A method according to claim 31, further comprising:

receiving a set of one or more baseline physiological measures relating to patient information recorded during an initial time period or derived therefrom;

storing the baseline physiological measures set into the patient care record for the individual patient into the database; and

analyzing the physiological measures in the physiological measures set relative to the baseline physiological measures to determine a pathophysiology indicating an absence, an onset, a progression, a regression, and a status quo of myocardial ischemia.

35. A method according to claim 31, further comprising:

retrieving the other physiological measures from measures sets for at least one of an individual patient, a peer group, and a overall patient population.

36. A computer-readable storage medium for a device holding code for performing the method according to claim 31.