Respiration monitoring using respiration rate variability

• US 20070073181A1
• Filed: 09/01/2006
• Published: 03/29/2007
• Est. Priority Date: 09/16/2005
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Zhang, Yi, Pu, Yachuan, Carlson, Gerrard
• Granted Patent: US 8,992,436 B2
• Time in Patent Office: Days
• US Class Current: 600/529
• CPC Class Codes: A61B 5/0816 Measuring devices for examining respiratory frequency measuring frequency of electric signals G01R23/00

Abstract

Systems and methods provide for detecting respiration disturbances and changes in respiration disturbances, preferably by detecting variability in one or more respiration parameters. Respiration rate variability is determined for a variety of diagnostic and therapeutic purposes, including disease/disorder detection, diagnosis, treatment, and therapy titration. Systems and methods provide for generating a footprint, such as a two- or three-dimensional histogram, representative of a patient'"'"'s respiration parameter variability, and generating one or more indices representative of quantitative measurements of the footprint.

Claims

1. A method, comprising:

obtaining a respiration-modulated signal representative of patient breaths;

generating a footprint representative of the patient'"'"'s respiration rate variability using the respiration-modulated signal; and

generating one or more indices representative of quantitative measurements of the footprint.

2. The method of claim 1, wherein the one or more indices comprises an area or a location of the footprint.

3. The method of claim 1, wherein the one or more indices comprises a feature, a pattern, a shape, or a contour of the footprint.

4. The method of claim 1, wherein the one or more indices comprises an ectopic island of the footprint.

5. The method of claim 1, wherein the one or more indices comprises a conditional distribution developed from the footprint.

6. The method of claim 1, wherein the one or more indices comprises a respiration rate histogram developed from the footprint or a respiration rate variability histogram developed from the footprint.

7. The method of claim 1, wherein the one or more indices comprises a mapping of the footprint to one or more patient states, the one or more patient states comprising patient activity, time of day, sleep, and wakefulness.

8. The method of claim 1, comprising one or more of detecting, tracking and predicting a disordered breathing condition of the patient using the footprint and the one or more indices, the disordered breathing condition comprising one or more of sleep disordered breathing, dyspnea, and Cheyne-Stokes respiration.

9. The method of claim 1, comprising one or more of detecting, tracking and predicting a heart failure condition of the patient using the footprint and the one or more indices.

10. The method of claim 1, comprising discriminating between stable and worsening heart failure status of the patient using the footprint and the one or more indices.

11. The method of claim 1, comprising one or more of detecting, tracking and predicting a heart failure decompensation episode of the patient using the footprint and the one or more indices.

12. The method of claim 1, comprising generating an output signal based on the footprint and the one or more indices.

13. The method of claim 1, comprising displaying or plotting one or both of the footprint and the one or more indices.

14. The method of claim 1, comprising performing one or more statistical analyses of the footprint, and generating the one or more indices based on the one or more statistical analyses.

15. The method of claim 1, comprising performing pattern recognition analyses of the footprint, and generating the one or more indices based on recognized patterns.

16. The method of claim 1, comprising adjusting or titrating a therapy delivered to the patient based on the footprint and the one or more indices, the therapy comprising one or more of a cardiac stimulation therapy, a respiration therapy, and a drug therapy.

17. The method of claim 1, comprising one or both of determining and monitoring effectiveness of a therapy delivered to the patient based on the footprint and the one or more indices.

18. The method of claim 1, comprising alerting a physician or the patient based on the footprint and the one or more indices.

19. The method of claim 1, wherein the footprint represents a two-dimensional construct, the method comprising adding a third dimension to the footprint.

20. The method of claim 19, wherein the third dimension added to the footprint is indicated using a color scheme superimposed on the two-dimensional construct or by graphical indicia extending from a two-dimensional plane of the construct into a plane orthogonal of the two-dimensional plane.

21. The method of claim 19, wherein the third dimension is representative of tidal volume, a time duration in a particular respiration pattern or a frequency of occurrence of a particular respiration pattern.

22. The method of claim 1, comprising:

obtaining cardiac signals representative of the patient'"'"'s cardiac electrical activity;

generating a cardiac activity footprint representative of the patient'"'"'s heart rate variability using the cardiac signals; and

generating one or more indices representative of quantitative measurements of the cardiac activity footprint.

23. The method of claim 22, comprising combining the respiration rate variability footprint and the cardiac activity footprint to assess the patient'"'"'s cardio-respiratory function.

24. The method of claim 22, comprising developing a cardio-respiratory function index using the respiration rate variability (RRV) footprint and the cardiac activity footprint.

25. A system, comprising:

a medical device comprising sensing circuitry;

detection circuitry disposed in the medical device and coupled to the sensing circuitry, the detection circuitry configured to detect patient respiration; and

a processor coupled to the detection circuitry, the processor configured to generate a footprint representative of the patient'"'"'s respiration rate variability using a respiration-modulated signal developed by the detection circuitry and generate one or more indices representative of quantitative measurements of the footprint.

26. The system of claim 25, wherein the processor is disposed in a patient-external system.

27. The system of claim 25, wherein the medical device is an implantable medical device.

28. The system of claim 25, wherein the processor is disposed in an implantable housing.

29. The system of claim 25, comprising a user interface configured to plot or display the footprint.

30. A system, comprising:

means for obtaining a respiration-modulated signal representative of patient breaths;

means for computing a respiration rate (RR) using the respiration-modulated signal;

means for computing a difference of respiration rate (Δ

RR) between adjacent breaths;

means for generating a footprint representative of the patient'"'"'s respiration rate variability using Δ

RR; and

means for generating one or more indices using the footprint.