GRADED RESPONSE TO MYOCARDIAL ISCHEMIA

• US 20100312130A1
• Filed: 08/20/2010
• Published: 12/09/2010
• Est. Priority Date: 06/27/2006
• Status: Abandoned Application

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: An, Qi, Wariar, Ramesh, Zhang, Yi, Lee, Kent, Shome, Shibaji
• Application Number:
  US12/860,152
• Publication Number:
  US 20100312130A1
• Time in Patent Office: Days
• US Class Current: 600/508
• CPC Class Codes: A61B 5/02 Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
• CPC Class Codes: A61B 5/0535 Impedance plethysmography for measuring blood flow A61B5/0295
• CPC Class Codes: A61B 5/318 Heart-related electrical modalities, e.g. electrocardiography [ECG]
• CPC Class Codes: A61N 1/36521 the parameter being derived from measurement of an electrical impedance
• CPC Class Codes: A61N 1/36542 controlled by body motion, e.g. acceleration
• CPC Class Codes: A61N 1/36564 controlled by blood pressure
• CPC Class Codes: A61N 1/36578 controlled by mechanical motion of the heart wall, e.g. measured by an accelerometer or microphone
• CPC Class Codes: A61N 1/3702 Physiological parameters A61N1/365 takes precedence; evoked response A61N1/371
• CPC Class Codes: A61N 1/37254 Pacemaker or defibrillator security, e.g. to prevent or inhibit programming alterations by hackers or unauthorised individuals

Abstract

Severity and confidence level of a myocardial ischemia event can be determined, such as including using an ambulatory medical device, and such information can be used to determine a graded response to the myocardial ischemia event.

Claims

1. An apparatus comprising:

an ambulatory medical device, including a ischemia detector circuit configured to detect an indication of a myocardial ischemia event; and

a processor circuit, configured to be communicatively coupled to the ischemia detector and to;

receive the indication of the myocardial ischemia event;

determine a confidence level of the myocardial ischemia event having occurred; and

respond using the confidence level, the responding including at least one of initiating, selecting, or adjusting a response.

2. The apparatus of claim 1, wherein the processor circuit is configured to determine a severity indicator value of the indication of the myocardial ischemia event.

3. The apparatus of claim 2, wherein the processor circuit is configured such that the responding comprises responding using both the severity indicator value and the confidence level.

4. The apparatus of claim 3, wherein the processor circuit is configured such that the severity indicator is multi-valued and the confidence level is multi-valued.

5. The apparatus of claim 1, wherein the processor circuit is configured such that the determining the confidence level comprises using a regression model.

6. The apparatus of claim 5, wherein the processor circuit is configured such that:

the detecting the indication of the myocardial ischemia event comprises using one or more sensor measurements from the ischemia detector circuit to detect the indication of the myocardial ischemia event; and

the determining the confidence level comprises computing a probability according to;

7. The apparatus of claim 1, wherein the ambulatory medical device comprises an implantable medical device;

and wherein the implantable medical device includes the processor circuit.

8. The apparatus of claim 1, wherein the processor circuit is configured such that the confidence level is determined using a time-wise sequence of multiple indications of the myocardial ischemia event.

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

detecting an indication of a myocardial ischemia event;

determining a confidence level of the myocardial ischemia event having occurred; and

responding using the confidence level, the responding including at least one of initiating, selecting, or adjusting a response.

10. The device-readable medium of claim 9, wherein the instructions that, when performed by the device, comprise determining a severity indicator value of the indication of the myocardial ischemia event.

11. The device-readable medium of claim 10, wherein the responding comprises responding using both the severity indicator value and the confidence level.

12. The device-readable medium of claim 11, wherein the severity indicator is multi-valued and the confidence level is multi-valued.

13. The device-readable medium of claim 9, wherein the determining the confidence level comprises using a regression model.

14. The device-readable medium of claim 13, wherein:

the detecting the indication of the myocardial ischemia event comprises using one or more sensor measurements to detect the indication of the myocardial ischemia event; and

the determining the confidence level comprises computing a probability according to;

15. The device-readable medium of claim 9, wherein the responding comprises providing a local alert.

16. The device-readable medium of claim 9, wherein the determining the confidence level comprises using a time-wise sequence of multiple indications of the myocardial ischemia event.

17. A method comprising:

detecting an indication of a myocardial ischemia event using an ambulatory medical device;

determining a confidence level of the myocardial ischemia event having occurred; and

responding using the confidence level, the responding including at least one of initiating, selecting, or adjusting a response.

18. The method of claim 17, comprising determining a severity indicator value of the indication of the myocardial ischemia event.

19. The method of claim 18, wherein the responding comprises responding using both the severity indicator value and the confidence level.

20. The method of claim 19, wherein the severity indicator is multi-valued and the confidence level is multi-valued.