System and method for detecting cardiovascular health conditions using hemodynamic pressure waveforms

• US 20060167359A1
• Filed: 01/27/2005
• Published: 07/27/2006
• Est. Priority Date: 01/27/2005
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Whitman, Teresa A., Hettrick, Douglas A., Bennett, Tommy D., Hill, Michael R.S., Igel, David A., Choi, Mark
• Granted Patent: US 7,367,951 B2
• Time in Patent Office: Days
• US Class Current: 600/485
• CPC Class Codes: A61B 5/02028 Determining haemodynamic parameters not otherwise provided for, e.g. cardiac contractility or left ventricular ejection fraction
• CPC Class Codes: A61B 5/02108 from analysis of pulse wave characteristics
• CPC Class Codes: A61B 5/0215 by means inserted into the body catheters A61M25/00
• CPC Class Codes: A61B 5/283 Invasive
• CPC Class Codes: A61B 5/29 for permanent or long-term implantation
• CPC Class Codes: A61B 5/352 Detecting R peaks, e.g. for synchronising diagnostic apparatus; Estimating R-R interval
• CPC Class Codes: A61N 1/36564 controlled by blood pressure

Abstract

A cardiovascular analysis system and method includes an implantable medical device with a sensor positioned to sense a hemodynamic pressure over time. The implantable medical device generates hemodynamic pressure waveform data based upon the hemodynamic pressure sensed. A processor analyzes the hemodynamic waveform data to provide an indication of cardiovascular health based upon prominent peaks in the hemodynamic waveform data.

Claims

1. A cardiovascular analysis system comprising:

an implantable medical device having a sensor adapted to sense a hemodynamic pressure in a heart over time, wherein the implantable medical device generates hemodynamic pressure waveform data based upon the sensed hemodynamic pressure; and

a processor for analyzing the hemodynamic pressure waveform data to provide an indication of cardiovascular and cardiopulmonary health based upon prominent peaks in the hemodynamic pressure waveform data.

2. A system according to claim 1, wherein the processor provides a signal related to an adverse cardiovascular health condition based at least in part upon certain prominent peaks in the hemodynamic pressure waveform data that correspond to the adverse health condition.

3. A system according to claim 2, wherein the adverse cardiovascular health condition comprises pulmonary hypertension.

4. A system according to claim 2, wherein the adverse cardiovascular health condition comprises coronary artery disease.

5. A system according to claim 1, wherein the processor identifies a prominent primary peak of the hemodynamic pressure waveform data, and wherein the prominent primary peak corresponds to a systolic pressure of a cardiovascular pulse cycle.

6. A system according to claim 1, wherein the processor indicates an adverse health condition that correlates to identification of a prominent primary peak and a prominent secondary peak of the hemodynamic pressure waveform data, and wherein the prominent secondary peak corresponds to a systolic pressure of a cardiovascular pulse cycle.

7. A system according to claim 6, wherein the processor identifies a prominent secondary peak of the hemodynamic waveform data when a peak pressure value of the hemodynamic pressure waveform data occurs after about 210 milliseconds of hemodynamic pressure sensing and a first derivative of the hemodynamic pressure waveform data includes a value greater than about 128 mmHg/sec between a period of hemodynamic pressure sensing occurring between about 188 and about 312 milliseconds of sensing.

8. A system according to claim 1, wherein the processor identifies an Augmentation Index for the hemodynamic pressure waveform data, and wherein an adverse cardiovascular condition corresponds to a generally positive Augmentation Index.

9. A system according to claim 1, wherein the processor identifies a Shoulder Index for the hemodynamic pressure waveform data, and wherein an adverse cardiovascular condition corresponds to a Shoulder Index greater than about one.

10. A system according to claim 1 and further comprising means for providing a treatment based upon the indication of cardiovascular health.

11. A method of cardiovascular analysis, the method comprising:

sensing a hemodynamic pressure in a heart;

generating a hemodynamic pressure waveform representing the hemodynamic pressure sensed for a cardiovascular pulse cycle; and

providing an indication of whether an adverse cardiovascular condition is present based upon a shape of the hemodynamic waveform over a systolic time interval.

12. A method according to claim 11, wherein the indication of the adverse cardiovascular condition indicates pulmonary hypertension.

13. A method according to claim 11, wherein the indication of the adverse cardiovascular condition indicates coronary artery disease.

14. A method according to claim 11 and further comprising identifying a prominent primary peak of the hemodynamic pressure waveform.

15. A method according to claim 14 and further comprising identifying a prominent secondary peak of the hemodynamic pressure waveform, wherein the prominent secondary peak of the hemodynamic pressure waveform corresponds to the systolic pressure, and wherein identification of the prominent secondary peak correlates to indication of an adverse cardiovascular health condition.

16. A method according to claim 15, wherein a prominent secondary peak of the hemodynamic waveform is identified when a peak pressure value of the hemodynamic pressure waveform occurs after about 210 milliseconds of hemodynamic pressure sensing and a first derivative of the pressure waveform includes a value greater than about 128 mmHg/sec between a period of hemodynamic pressure sensing occurring between about 188 and about 312 milliseconds of sensing.

17. A method according to claim 11, wherein the cardiovascular condition corresponds to a generally positive Augmentation Index.

18. A method according to claim 11, wherein the processor identifies a Shoulder Index for the hemodynamic pressure wave form data, and wherein an adverse cardiovascular condition corresponds to a Shoulder Index that is greater than about 1.0.

19. A method according to claim 11 and further comprising transmitting the hemodynamic pressure waveform to a processing device for analysis.

20. A system for cardiovascular analysis, the system comprising:

means for sensing a hemodynamic pressure to produce hemodynamic pressure waveform data corresponding to the sensed hemodynamic pressure as a function of time for a pulse cycle;

means for analyzing parameters of the hemodynamic pressure waveform data; and

means for indicating the absence of presence of an adverse cardiovascular health condition, wherein the presence of the condition is declared in the event that the hemodynamic pressure waveform data includes two prominent rises in pressure between a first pressure sample of the pulse cycle and a systolic pressure of the pulse cycle.