HEART FAILURE STATUS MONITORING

• US 20110230771A1
• Filed: 03/19/2010
• Published: 09/22/2011
• Est. Priority Date: 03/19/2010
• Status: Abandoned Application

• Current Assignee: Pacesetter Incorporated (Abbott Laboratories Incorporated)
• Original Assignee: Pacesetter Incorporated (Abbott Laboratories Incorporated)
• Inventors: Koh, Steve, Park, Euljoon
• Application Number:
  US12/728,064
• Publication Number:
  US 20110230771A1
• Time in Patent Office: Days
• US Class Current: 600/485
• 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 5/0215 by means inserted into the body catheters A61M25/00
• CPC Class Codes: A61B 5/1118 Determining activity level
• CPC Class Codes: A61B 5/4806 Sleep evaluation A61B5/4821 takes precedence; devices for inducing sleep A61M21/02
• CPC Class Codes: A61B 5/6869 Heart
• CPC Class Codes: A61N 1/3937 Monitoring output parameters
• CPC Class Codes: A61N 1/3956 Implantable devices for applying electric shocks to the heart, e.g. for cardioversion

Abstract

Left atrial pressure and temperature of a patient are monitored to identify a normal wake state, a normal sleep state, and any deviation from those normal states (e.g., an alarm state). In the event an alarm state is identified, a determination is made as to whether to generate an indication of heart failure exacerbation based on a heart failure score. In addition, congestion and perfusion in a patient may be monitored over time to provide a two-dimensional indication of a trend relating to the heart failure status of the patient.

Claims

1. An implantable medical apparatus, comprising:

a heart failure information acquisition circuit configured to collect temperature information and left atrial pressure information to provide data sets for an alarm state, a normal sleep state, and a normal wake state; and

a heart failure indication generator configured to;

determine whether a set of temperature and left atrial pressure information collected by the heart failure information acquisition circuit corresponds to the alarm state,

update a heart failure score based on the determination, and

generate at least one indication of heart failure status if the heart failure score meets at least one threshold.

2. The apparatus of claim 1, wherein:

the at least one threshold comprises a first threshold and a second threshold;

the at least one indication of heart failure status comprises a first type of indication and a second type of indication; and

the generation of the at least one indication comprises generating the first type of indication if the heart failure score meets the first threshold and generating the second type of indication if the heart failure score meets the second threshold.

3. The apparatus of claim 2, wherein:

the first threshold corresponds to an acute heart failure condition associated with higher than normal left atrial pressure and normal temperature; and

the second threshold corresponds to a chronic heart failure condition associated with higher than normal left atrial pressure and lower than normal temperature.

4. The apparatus of claim 2, wherein:

the first type of indication comprises an indication of possible onset of heart failure; and

the second type of indication comprises an indication of a need for immediate medical attention.

5. The apparatus of claim 2, wherein:

the first threshold comprises a first defined quantity indicative of how many recent occurrences of temperature and left atrial pressure information correspond to the alarm state;

the second threshold comprises a second defined quantity indicative of how many recent occurrences of temperature and left atrial pressure information correspond to the alarm state; and

the second defined quantity corresponds to a larger number of recent occurrences than the first defined quantity.

6. The apparatus of claim 1, wherein the updating of the heart failure score comprises:

increasing the heart failure score if the determination determined that there has been a transition from the alarm state to the wake or sleep state; and

decreasing the heart failure score if the determination determined that there has been a transition from the wake or sleep state to the alarm state.

7. The apparatus of claim 1, wherein the updating of the heart failure score comprises incrementing the heart failure score by a defined amount if temperature information collected by the heart failure information acquisition circuit indicates that patient temperature is below a temperature threshold during an alarm state.

8. The apparatus of claim 1, wherein the determination comprises comparing the set of temperature and left atrial pressure information with at least one of the group consisting of:

the alarm state data set, the sleep state data set, and the wake state data set.

9. The apparatus of claim 1, further comprising a temperature sensor configured to provide the temperature information.

10. The apparatus of claim 1, further comprising a pressure sensor configured to provide the left atrial pressure information.

11. A cardiac monitoring method, comprising:

collecting temperature information and left atrial pressure information to provide data sets for an alarm state, a normal sleep state, and a normal wake state;

determining whether a set of the collected temperature and left atrial pressure information corresponds to the alarm state;

updating a heart failure score based on the determination; and

generating at least one indication of heart failure status if the heart failure score meets at least one threshold.

12. The method of claim 11, wherein:

the at least one threshold comprises a first threshold and a second threshold;

the at least one indication of heart failure status comprises a first type of indication and a second type of indication; and

the generation of the at least one indication comprises generating the first type of indication if the heart failure score meets the first threshold and generating the second type of indication if the heart failure score meets the second threshold.

13. The method of claim 12, wherein:

the first threshold corresponds to an acute heart failure condition associated with higher than normal left atrial pressure and normal temperature; and

the second threshold corresponds to a chronic heart failure condition associated with higher than normal left atrial pressure and lower than normal temperature.

14. The method of claim 12, wherein:

the first type of indication comprises an indication of possible onset of heart failure; and

the second type of indication comprises an indication of a need for immediate medical attention.

15. A cardiac monitoring method, comprising:

collecting congestion information;

collecting perfusion information; and

providing a two-dimensional indication of a heart failure trend based on the collected congestion and perfusion information.

16. The method of claim 15, wherein the two-dimensional indication comprises chronological heart failure status information.

17. The method of claim 16, wherein the providing of the two-dimensional indication comprises displaying a two-dimensional plot where the congestion information corresponds to a first axis of the two-dimensional plot and the perfusion information corresponds to a second axis of the two-dimensional plot.

18. The method of claim 15, wherein the collection of the congestion and perfusion information comprises acquiring multiple instances of congestion and perfusion information over a period of time.

19. The method of claim 15, wherein the collected congestion information is derived from evoked response information.

20. The method of claim 15, wherein the collected perfusion information is derived from arteriole stiffness information.