Prediction and Prevention of Cardiovascular Insult

• US 20090326595A1
• Filed: 06/30/2008
• Published: 12/31/2009
• Est. Priority Date: 06/30/2008
• Status: Abandoned Application

• Current Assignee: Data Sciences U K Limited (International Business Machines Corporation)
• Original Assignee: Transoma Medical, Inc.
• Inventors: Brockway, Marina V., Brockway, Brian P.
• Application Number:
  US12/165,361
• Publication Number:
  US 20090326595A1
• Time in Patent Office: Days
• US Class Current: 607/3
• CPC Class Codes: A61B 5/0031 Implanted circuitry
• 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 5/021 Measuring pressure in heart or blood vessels A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/022 by applying pressure to close blood vessels, e.g. against the skin; Ophthalmodynamometers
• CPC Class Codes: A61B 5/02405 Determining heart rate variability
• CPC Class Codes: A61B 5/026 Measuring blood flow A61B3/1233, A61B3/1241 take precedence
• CPC Class Codes: A61B 5/349 Detecting specific parameters of the electrocardiograph cycle
• CPC Class Codes: A61B 5/36 Detecting PQ interval, PR interval or QT interval
• CPC Class Codes: A61B 5/4035 Evaluating the autonomic nervous system
• CPC Class Codes: A61B 5/411 Detecting or monitoring allergy or intolerance reactions to an allergenic agent or substance
• CPC Class Codes: A61B 5/416 the spleen
• 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: A61N 1/36031 using physiological parameters for adjustment
• CPC Class Codes: A61N 1/37288 Communication to several implantable medical devices within one patient
• 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 50/30 for calculating health indices; for individual health risk assessment

Abstract

In a method of providing therapy to a patient to prevent an occurrence of a dangerous cardiac event, a cardiac signal sensed over multiple cardiac cycles is received. A risk of impending cardiovascular insult is determined, using the received cardiac signal, by assessing an indicator of proarrhythmogenic substrate and a change in sympathovagal balance. A therapy comprising acupuncture to modulate sympathovagal balance is administered based on the determined risk.

Claims

1. A method of providing therapy to a patient to prevent an occurrence of a dangerous cardiac event, the method comprising:

receiving a cardiac signal sensed over multiple cardiac cycles;

determining, using the received cardiac signal, a risk of impending cardiovascular insult by assessing an indicator of proarrhythmogenic substrate and a change in sympathovagal balance; and

administering, based on the determined risk, a therapy comprising acupuncture to modulate sympathovagal balance.

2. The method of claim 1, further comprising detecting, using the received cardiac signal, a cardiac instability trigger for use in determining the risk of cardiovascular insult.

3. The method of claim 2, wherein the cardiac instability trigger is one or more ectopic beats.

4. The method of claim 1, wherein the indicator of proarrhythmogenic substrate is an alternans burden that exceeds a predetermined threshold.

5. The method of claim 4, wherein in the alternans burden is a repolarization alternans burden determined from the cardiac signal.

6. The method of claim 4, wherein in the alternans burden is a QRS alternans burden determined from the cardiac signal.

7. The method of claim 4, wherein in the alternans burden is a mechanical alternans burden determined from the cardiac signal.

8. The method of claim 1, wherein the indicator of proarrhythmogenic substrate is a hypertension burden determined from the cardiac signal.

9. The method of claim 1, wherein the indicator of proarrhythmogenic substrate is one or more delayed afterdepolarizations, determined from the cardiac signal, that exceed a predetermined threshold.

10. The method of claim 1, wherein the indicator of proarrhythmogenic substrate is a QT interval change that exceeds a predetermined threshold.

11. The method of claim 1, wherein the change in sympathovagal balance is estimated from a heart rate variability measurement determined from the cardiac signal.

12. The method of claim 1, wherein the change in sympathovagal balance is estimated from a heart rate increase measurement determined from the cardiac signal.

13. The method of claim 1, wherein the therapy modulates sympathovagal balance by activating parasympathetic drive.

14. The method of claim 1, wherein the acupuncture comprises electro-acupuncture applied to one or more cardiovascular acupoints.

15. The method of claim 1, wherein the acupuncture comprises magneto-acupuncture applied to one or more cardiovascular acupoints.

16. The method of claim 1, wherein the cardiac signal is an electrocardiogram signal.

17. The method of claim 1, wherein the cardiac signal is a blood pressure signal.

18. The method of claim 1, wherein the impending cardiovascular insult is arrhythmia.

19. The method of claim 1, wherein the impending cardiovascular insult is acute myocardial ischemia.

20. The method of claim 1, further comprising initiating an alarm to alert an emergency responder to the impending cardiovascular insult.

21. The method of claim 1, further comprising issuing an alert in a manner that allows a preventative action to be taken to prevent the dangerous cardiac event.

22. The method of claim 21, wherein the preventative action comprises donning a wearable external defibrillator, and wherein the patient performs the action in response to the alert.

23. A system for providing therapy to prevent an occurrence of a dangerous cardiac event, comprising:

a monitoring component that receives a cardiac signal sensed over multiple cardiac cycles;

a processing component that determines, using the received cardiac signal, a risk of impending cardiovascular insult by assessing an indicator of proarrhythmogenic substrate and a change in sympathovagal balance; and

a therapy component that administers, based on the determined risk a therapy comprising acupuncture to modulate sympathovagal balance.