Multi-Sensor Patient Monitor to Detect Impending Cardiac Decompensation

• US 20090076344A1
• Filed: 09/12/2008
• Published: 03/19/2009
• Est. Priority Date: 09/14/2007
• Status: Active Grant

• Current Assignee: Medtronic Monitoring, Inc. (Medtronic Plc)
• Original Assignee: Corventis
• Inventors: Bly, Mark J., Libbus, Imad, Mazar, Scott T., James, Kristofer J., Wang, Jerry S.
• Granted Patent: US 8,790,257 B2
• Time in Patent Office: Days
• US Class Current: 600/301
• CPC Class Codes: A61B 2560/0412 Low-profile patch shaped housings
• CPC Class Codes: A61B 2562/0215 Silver or silver chloride containing
• CPC Class Codes: A61B 2562/043 in a linear array
• CPC Class Codes: A61B 5/01 Measuring temperature of body parts ; Diagnostic temperature sensing, e.g. for malignant or inflamed tissue clinical contact thermometers G01K13/20
• CPC Class Codes: A61B 5/0245 by using sensing means generating electric signals, i.e. ECG signals
• CPC Class Codes: A61B 5/0537 Measuring body composition by impedance, e.g. tissue hydration or fat content
• CPC Class Codes: A61B 5/259 using conductive adhesive means, e.g. gels
• CPC Class Codes: A61B 5/28 for electrocardiography [ECG]
• CPC Class Codes: A61B 5/282 Holders for multiple electrodes for introduction into the body A61B5/287
• CPC Class Codes: A61B 5/443 Evaluating skin constituents, e.g. elastin, melanin, water
• CPC Class Codes: A61B 5/6833 Adhesive patches
• CPC Class Codes: A61B 5/6843 Monitoring or controlling sensor contact pressure
• CPC Class Codes: G16H 40/67 for remote operation
• CPC Class Codes: G16H 50/30 for calculating health indices; for individual health risk assessment

Abstract

Systems and methods of detecting an impending cardiac decompensation of a patient measure at least two of an electrocardiogram signal of the patient, a hydration signal of the patient, a respiration signal of the patient or an activity signal of the patient. The at least two of the electrocardiogram signal, the hydration signal, the respiration signal or the activity signal are combined with an algorithm to detect the impending cardiac decompensation.

Claims

1. A method of detecting an impending cardiac decompensation of a patient, the method comprising:

measuring at least two of an electrocardiogram signal of the patient, a hydration signal of the patient, a respiration signal of the patient or an activity signal of the patient; and

combining the at least two of the electrocardiogram signal, the hydration signal, the respiration signal or the activity signal to detect the impending cardiac decompensation.

2. The method of claim 1 wherein the at least two comprise at least three of the electrocardiogram signal, the hydration signal, the respiration signal or the activity signal and the at least three are measured and combined to detect the impending cardiac decompensation.

3. The method of claim 2 wherein the at least three comprise at least four of the electrocardiogram signal, the hydration signal, the respiration signal or the activity signal and the at least four are measured and combined to detect the impending cardiac decompensation.

4. The method of claim 1 wherein the at least two of the electrocardiogram signal, the hydration signal, the respiration signal or the activity signal are used simultaneously to determine impending cardiac decompensation.

5. The method of claim 1 wherein combining comprises using the at least two of the electrocardiogram signal, the hydration signal, the respiration signal or the activity signal to look up a value in a previously existing array.

6. The method of claim 1 wherein combining comprises at least one of adding, subtracting, multiplying, scaling or dividing the at least two of the electrocardiogram signal, the hydration signal, the respiration signal or the activity signal.

7. The method of claim 1 wherein the at least two of the electrocardiogram signal, the hydration signal, the respiration signal or the activity signal are combined with at least one of a weighted combination, a tiered combination or a logic gated combination, a time weighted combination or a rate of change.

8. The method of claim 1 wherein a flag status is determined in response to the at least two of the electrocardiogram signal, the hydration signal, the respiration signal or the activity signal.

9. The method of claim 8 wherein the flag status is determined in response to a change in the at least two of the electrocardiogram signal, the hydration signal, the respiration signal or the activity signal.

10. The method of claim 8 wherein additional signal measurements of the patient are made in response to the flag status.

11. The method of claim 1 wherein the at least two of the electrocardiogram signal, the hydration signal, the respiration signal or the activity signal are combined in response to a time of day.

12. The method of claim 1 wherein the at least two of the electrocardiogram signal, the hydration signal, the respiration signal or the activity signal comprise at least one of a derived signal, a time averaged signal, a filtered signal or a raw signal.

13. The method of claim 1 further comprising determining baseline values of the patient for the at least two of the electrocardiogram signal, the hydration signal, the respiration signal or the activity signal and wherein the at least two of the electrocardiogram signal, the hydration signal, the respiration signal or the activity signal signals comprise changes from the baseline values.

14. The method of claim 1 wherein the at least two of the electrocardiogram signal, the hydration signal, the respiration signal or the activity signal comprise differences from baseline values of a patient population and wherein the impending decompensation is detected in response to the differences from the baseline value of the patient population.

15. The method of claim 1 wherein the hydration signal comprises an impedance signal and the activity signal comprise an accelerometer signal.

16. The method of claim 1 wherein the activity signal comprise an accelerometer signal to determine a posture of the patient.

17. The method of claim 16 wherein the accelerometer signal comprises a three dimensional inclination signal to determine a three dimensional orientation of the patient.

18. The method of claim 1 wherein a temperature signal is combined with the at least two of the electrocardiogram signal, the hydration signal, the respiration signal or the activity signal to detect the impending cardiac decompensation.

19. The method of claim 1 further comprising transmitting the at least two of the electrocardiogram signal, the hydration signal, the respiration signal or the activity signal to a remote site where the at least two of the electrocardiogram signal, the hydration signal, the respiration signal or the activity signal are combined to detect the impending cardiac decompensation.

20. The method of claim 1 further comprising transmitting instructions from a remote site to a processor supported with the patient, and wherein the at least two of the electrocardiogram signal, the hydration signal, the respiration signal or the activity signal are combined with the processor in response to the instructions to detect the impending cardiac decompensation.

21. A system to detect impending cardiac decompensation of a patient, the system comprising:

circuitry to measure at least two of an electrocardiogram signal of the patient, a hydration signal of the patient, or an activity signal of the patient; and

a processor system comprising a tangible medium in communication with the circuitry, the processor system configured to combine the at least two of the electrocardiogram signal, the hydration signal, the respiration signal or the activity signal to detect the impending cardiac decompensation.

22. The system of claim 21 wherein the processor system comprises a least one processor a location remote from the patient configured to detect the decompensation.

23. The system of claim 21 wherein the processor system, supported with the patient, receives instructions transmitted from a remote site and combines the at least two in response to the instructions to detect the impending cardiac decompensation.

24. The system of claim 21 wherein the at least two comprise at least three of the electrocardiogram signal, the hydration signal, the respiration signal or the activity signal and the at least three are measured and combined to detect the impending cardiac decompensation.

25. The system of claim 24 wherein the at least three comprise at least four of the electrocardiogram signal, the hydration signal, the respiration signal or the activity signal and the at least four are measured and combined to detect the impending cardiac decompensation.

26. The system of claim 21 wherein the processor system simultaneously uses the at least two of the electrocardiogram signal, the hydration signal, the respiration signal or the activity signal to determine impending cardiac decompensation.

27. The system of claim 21 wherein combining comprises the processor system using the at least two of the electrocardiogram signal, the hydration signal, the respiration signal or the activity signal to look up a value in a previously existing array.

28. The system of claim 21 wherein combining comprises at least one of adding, subtracting, multiplying, scaling or dividing the at least two of the electrocardiogram signal, the hydration signal, the respiration signal or the activity signal.

29. The system of claim 21 wherein the processor system combines the at least two of the electrocardiogram signal, the hydration signal, the respiration signal or the activity signal with at least one of a weighted combination, a tiered combination or a logic gated combination, a time weighted combination or a rate of change.

30. The system of claim 21 wherein the processor system determines a flag status in response to the at least two of the electrocardiogram signal, the hydration signal, the respiration signal or the activity signal.

31. The system of claim 28 wherein the processor system determines the flag status in response to a change in the at least two of the electrocardiogram signal, the hydration signal, the respiration signal or the activity signal.

32. The system of claim 28 wherein the processor system affects the circuitry to make additional signal measurements of the patient in response to the flag status.

33. The system of claim 21 wherein the processor system combines the at least two of the electrocardiogram signal, the hydration signal, the respiration signal or the activity signal in response to a time of day.

34. The system of claim 21 wherein the at least two of the electrocardiogram signal, the hydration signal, the respiration signal or the activity signal comprise at least one of a derived signal, a time averaged signal, a filtered signal or a raw signal.

35. The system of claim 21 wherein the processor determines baseline values of the patient for the at least two of the electrocardiogram signal, the hydration signal, the respiration signal or the activity signal and wherein the at least two of the electrocardiogram signal, the hydration signal, the respiration signal or the activity signal signals comprise changes from the baseline values.

36. The system of claim 21 wherein the at least two of the electrocardiogram signal, the hydration signal, the respiration signal or the activity signal comprise differences from baseline values of a patient population and wherein the impending decompensation is detected in response to the differences from the baseline value of the patient population.

37. The system of claim 21 wherein the hydration signal comprises an impedance signal and the activity signal comprise an accelerometer signal.

38. The system of claim 21 wherein the activity signal comprise an accelerometer signal to determine a posture of the patient.

39. The system of claim 36 wherein the accelerometer signal comprises a three dimensional inclination signal to determine a three dimensional orientation of the patient.

40. The system of claim 21 wherein the processor system combines a temperature signal with the at least two of the electrocardiogram signal, the hydration signal, the respiration signal or the activity signal to detect the impending cardiac decompensation.

41. The system of claim 21 wherein the processor transmits the at least two of the electrocardiogram signal, the hydration signal, the respiration signal or the activity signal to a remote site where the at least two of the electrocardiogram signal, the hydration signal, the respiration signal or the activity signal are combined to detect the impending cardiac decompensation.

42. The system of claim 21 further comprising transmitting instructions from a remote site to a processor supported with the patient, and wherein the processor combines at least two of the electrocardiogram signal, the hydration signal, the respiration signal or the activity signal in response to the instructions to detect the impending cardiac decompensation.