DAYTIME/NIGHTTIME RESPIRATION RATE MONITORING

• US 20100191076A1
• Filed: 02/19/2010
• Published: 07/29/2010
• Est. Priority Date: 06/15/2007
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Zhang, Yi, Hatlestad, John D., Lewicke, Aaron
• Granted Patent: US 9,743,859 B2
• Time in Patent Office: Days
• US Class Current: 600/301
• 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 5/0816 Measuring devices for examining respiratory frequency measuring frequency of electric signals G01R23/00
• CPC Class Codes: A61B 5/1116 Determining posture transitions
• CPC Class Codes: A61B 5/7264 Classification of physiological signals or data, e.g. using neural networks, statistical classifiers, expert systems or fuzzy systems neural networks per se G06N3/00; expert systems per se G06N5/00
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems

Abstract

A device and method can monitor or trend a patient'"'"'s respiration rate measurements according to the time of day. The device, which may be implantable or external, collects and classifies respiration rate measurements over time. The trended information about particular classes of respiration rate measurements is then communicated to a remote external device, which in turn provides an indication of heart failure decompensation. Examples of classes of respiration rate measurements include a daily maximum respiration rate value, a daily minimum respiration rate value, a daily maximum respiration rate variability value, a daily minimum respiration rate variability value, and a daily central respiration rate value. These respiration rate measurements can be further classified into daytime or nighttime respiration rate measurements.

Claims

1. A device-readable medium including instructions that, when performed by the device, comprise:

detecting a respiration signal from a subject;

determining respiration rate or interval measurements from the respiration signal;

classifying the respiration rate or interval measurements into a first class of respiration rate or interval measurements using respiration rate or interval measurements obtained during a specified first subperiod of a day, wherein the first subperiod is less than or equal to 18 hours of the day; and

trending the classified respiration rate or interval measurements repeatedly, over a period of multiple days, wherein the first subperiod corresponds to the same specified time of day during each of the multiple days.

2. The device-readable medium of claim 1, wherein the first class of respiration rate or interval measurements is selected from a group consisting of a daytime subperiod, a nighttime subperiod, a daily maximum respiration rate value, a daily minimum respiration rate value, a daily maximum respiration rate variability value, a daily minimum respiration rate variability value, and a daily central tendency of respiration rate value.

3. The device-readable medium of claim 1, comprising comparing the respiration rate or interval measurements within a first class.

4. The device-readable medium of claim 1, wherein determining respiration rate or interval measurements from the respiration signal comprises excluding a period of apneic breathing.

5. The device-readable medium of claim 1, wherein classifying the respiration rate or interval measurements into a first class includes classifying using at least one of a first subportion of a respiratory cycle or a different second subportion of the respiratory cycle.

6. The device-readable medium of claim 5, wherein the first subportion of the respiratory cycle corresponds to inspiration;

and wherein the second subportion of the respiratory cycle corresponds to expiration.

7. The device-readable medium of claim 1, wherein classifying the respiration rate or interval measurements into a first class includes classifying into at least one of the following classes:

a daily maximum respiration rate value, a daily minimum respiration rate value, a daily maximum respiration rate variability value, a daily minimum respiration rate variability value, and a daily central tendency of respiration rate value.

8. The device-readable medium of claim 1, wherein classifying the respiration rate or interval measurements into a first class includes classifying into a specified one of a daytime subperiod or a nighttime subperiod.

9. The device-readable medium of claim 1, comprising providing a diagnostic indicator using the trended respiration rate or interval measurement information.

10. The device-readable medium of claim 9, wherein the diagnostic indicator includes a heart failure decompensation indicator.

11. The device-readable medium of claim 9, comprising providing the diagnostic indicator using a detected change over time in a measure of centrality of a first class of respiration rate or interval measurements.

12. The device-readable medium of claim 9, comprising providing the diagnostic indicator using a detected change over time in a measure of spread or variance of a first class of respiration rate or interval measurements.

13. The device-readable medium of claim 9, comprising:

integrating or otherwise lowpass filtering the respiration rate or interval measurements to obtain lowpass filtered respiration rate or interval measurements;

detecting a change in the lowpass filtered respiration rate or interval measurements over a period of time; and

providing the diagnostic indicator using the detected change in the lowpass filtered respiration rate or interval measurements.

14. The device-readable medium of claim 9, comprising:

forming a histogram of the respiration rate or interval measurements;

updating the histogram over time;

detecting a change in the histogram over time; and

providing the diagnostic indicator using the detected change in the histogram.

15. The device-readable medium of claim 1, comprising classifying the respiration rate or interval measurements into a second class, the second class selected from a group consisting of a specified sleep stage measure, an angle of reclination, a physical activity level, or a posture.

16. The device-readable medium of claim 15, comprising trending respiration rate or interval information according to its second class.

17. The device-readable medium of claim 16, wherein the trending includes at least one of:

trending a central tendency measure of a respiration rate or interval obtained when the subject is in a supine position;

trending a variability measure of a respiration rate or interval obtained when the subject is exhibiting non-rapid eye movement sleep; and

trending a maximum respiration rate or interval measurement obtained when the patient is exhibiting a physical activity level that is above a specified threshold value.

18. The device-readable medium of claim 15, comprising classifying the respiration rate or interval measurements into a first class of respiration rate or interval measurements using the second class of respiration rate or interval measurements, and wherein the second class of respiration rate or interval measurements is obtained during the specified first subperiod of a day.

19. The device-readable medium of claim 1, comprising recording, in correspondence with the respiration rate or interval measurements, at least one of a heart rate, heart sound, heart rate variability, blood pressure, and impedance.

20. The device-readable medium of claim 1, comprising comparing respiration rate or interval measurement information collected during one of a daytime subperiod or a nighttime subperiod to respiration rate or interval measurement information collected during the other of the daytime or nighttime subperiod.