Therapy control based on cardiopulmonary status

• US 20050065567A1
• Filed: 08/31/2004
• Published: 03/24/2005
• Est. Priority Date: 09/18/2003
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Stahmann, Jeffrey E., Hartley, Jesse W., Lee, Kent, Ni, Quan
• Granted Patent: US 7,662,101 B2
• Time in Patent Office: Days
• US Class Current: 607/17
• 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 5/0809 by impedance pneumography
• CPC Class Codes: A61B 5/083 Measuring rate of metabolism by using breath test, e.g. measuring rate of oxygen consumption
• CPC Class Codes: A61B 5/087 Measuring breath flow
• CPC Class Codes: A61B 5/091 Measuring volume of inspired or expired gases, e.g. to determine lung capacity
• CPC Class Codes: A61B 5/4818 Sleep apnoea
• 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: A61M 11/00 Sprayers or atomisers specially adapted for therapeutic purposes in general B05B; aerosol containers B65D83/14
• CPC Class Codes: A61M 16/0051 with alarm devices
• CPC Class Codes: A61M 16/026 specially adapted for predicting, e.g. for determining an information representative of a flow limitation during a ventilation cycle by using a root square technique or a regression analysis
• CPC Class Codes: A61M 2016/0021 with a proportional output signal, e.g. from a thermistor
• CPC Class Codes: A61M 2016/0036 in the breathing tube and used in both inspiratory and expiratory phase
• CPC Class Codes: A61M 2205/3523 using telemetric means
• CPC Class Codes: A61M 2205/3569 sublocal, e.g. between console and disposable
• CPC Class Codes: A61N 1/3601 of respiratory organs
• CPC Class Codes: A61N 1/365 controlled by a physiological parameter, e.g. heart potential evoked response A61N1/371
• CPC Class Codes: A61N 1/36521 the parameter being derived from measurement of an electrical impedance
• CPC Class Codes: A61N 1/3684 for stimulating the heart at multiple sites of the ventricle or the atrium
• CPC Class Codes: A61N 1/36842 Multi-site stimulation in the same chamber
• CPC Class Codes: A61N 1/36843 Bi-ventricular stimulation

Abstract

Methods and systems provide an approach to therapy control based on assessment of a patient'"'"'s cardiopulmonary status. Conditions sensed via sensors of an external respiratory therapy device are used to assess a patient'"'"'s cardiopulmonary status. The respiratory therapy device sensors may be utilized alone or in combination with other sensors to determine cardiopulmonary status of a patient. Therapy delivered to the patient is controlled based on the cardiopulmonary status assessment. For example, therapy delivered to the patient may be initiated, terminated, and/or modified based on the assessed cardiopulmonary status of the patient. Cardiopulmonary status assessment, therapy control, or both, are performed by an implantable device.

Claims

1. A method for controlling a therapy delivered to a patient, comprising:

sensing one or more physiological conditions using an external respiratory therapy device;

assessing a cardiopulmonary status of a patient based on the sensed physiological conditions; and

controlling a therapy delivered to the patient based on the patient'"'"'s cardiopulmonary status, wherein at least one of assessing and controlling is performed at least in part implantably.

2. The method of claim 1, wherein sensing the physiological conditions comprises sensing the physiological conditions using a disordered breathing therapy device.

3. The method of claim 1, wherein sensing the physiological conditions comprises sensing respiratory pressure.

4. The method of claim 1, wherein sensing the physiological conditions comprises sensing respiratory gas concentration.

5. The method of claim 1, further comprising sensing one or more additional physiological conditions using a medical device other than the respiratory therapy device, wherein assessing the cardiopulmonary status comprises assessing the cardiopulmonary status based on the physiological conditions sensed using the external respiratory therapy device and the additional physiological conditions sensed using the medical device.

6. The method of claim 5, wherein sensing the one or more additional physiological conditions comprises sensing the one or more additional physiological conditions using a cardiac therapy device.

7. The method of claim 1, wherein controlling the therapy comprises implantably controlling the therapy.

8. The method of claim 1, wherein:

determining the cardiopulmonary status comprises detecting a presence of a cardiopulmonary disorder based on the sensed physiological conditions; and

controlling the therapy comprises controlling the therapy to treat the cardiopulmonary disorder.

9. The method of claim 1, wherein:

detecting the presence of the cardiopulmonary disorder comprises detecting a breathing rhythm disorder; and

controlling the therapy comprises controlling the therapy to treat the breathing rhythm disorder.

10. The method of claim 1, wherein controlling the therapy further comprises controlling the therapy to enhance patient comfort.

11. The method of claim 1, wherein controlling the therapy comprises controlling a cardiac therapy.

12. The method of claim 1, wherein controlling the therapy comprises controlling a respiratory therapy.

13. A medical therapy control system, comprising:

an external respiratory device comprising a sensor system configured to sense one or more physiological conditions;

a cardiopulmonary status processor coupled to the sensor system and configured to determine a cardiopulmonary status of a patient based on the sensed physiological conditions; and

a therapy controller coupled to the cardiopulmonary status processor and configured to control a therapy delivered to the patient based on the patient'"'"'s cardiopulmonary status, wherein at least one of the cardiopulmonary status processor and the therapy controller are at least in part implantable.

14. The therapy control system of claim 13, wherein the external respiratory device comprises a disordered breathing therapy device.

15. The therapy control system of claim 13, wherein the sensor system comprises a sensor configured to sense respiratory flow.

16. The therapy control system of claim 13, wherein the sensor system comprises a sensor configured to sense respiratory pressure.

17. The therapy control system of claim 13, further comprising an additional device, the additional device comprising an additional sensor system configured to sense one or more additional physiological conditions, wherein the cardiopulmonary status processor is coupled to the additional sensor system and is configured to determine the cardiopulmonary status based on the physiological conditions sensed using the respiratory therapy device and the additional physiological conditions sensed using the additional device.

18. The therapy control system of claim 17, wherein the additional device comprises a cardiac device and the additional sensor system is configured to sense cardiac electrical activity.

19. The therapy control system of claim 17, wherein the additional device comprises a cardiac device and the additional sensor system is configured to sense blood pH.

20. The therapy control system of claim 13, wherein:

the cardiopulmonary status processor is configured to detect a presence of a cardiopulmonary disorder based on the sensed physiological conditions; and

the therapy controller is configured to control the therapy to treat the cardiopulmonary disorder.

21. The therapy control system of claim 13, wherein:

the cardiopulmonary status processor is configured to detect a presence of a breathing rhythm disorder based on the sensed physiological conditions; and

the therapy controller is configured to control the therapy to treat the breathing rhythm disorder.

22. The therapy control system of claim 13, wherein the therapy controller is configured to control a cardiac electrical stimulation therapy.

23. The therapy control system of claim 13, wherein the therapy controller is configured to control an external respiratory therapy.

24. A system for controlling a therapy delivered to a patient, comprising:

means for sensing one or more physiological conditions using an external respiratory therapy device;

means for assessing a cardiopulmonary status of a patient based on the sensed physiological conditions; and

means for controlling a therapy delivered to the patient based on the patient'"'"'s cardiopulmonary status, wherein at least one of the means for assessing and the means for controlling is performed implantably.

25. The method of claim 24, further comprising:

means for sensing one or more additional physiological conditions using a device other than the respiratory therapy device; and

means for assessing the cardiopulmonary status based on the physiological conditions sensed using the respiratory device and the additional physiological conditions.

26. The system of claim 24, further comprising:

means for detecting a presence of a cardiopulmonary disorder based on the sensed physiological conditions; and

means for controlling the therapy to treat the cardiopulmonary disorder.