METHOD AND APPARATUS FOR REMOTE DETECTION AND MONITORING OF FUNCTIONAL CHRONOTROPIC INCOMPETENCE

• US 20140371604A1
• Filed: 06/20/2014
• Published: 12/18/2014
• Est. Priority Date: 10/22/2009
• Status: Active Grant

• Current Assignee: Medtronic Monitoring, Inc. (Medtronic Plc)
• Original Assignee: Corventis
• Inventors: Katra, Rodolphe, Chakravarthy, Niranjan, Libbus, Imad
• Granted Patent: US 9,615,757 B2
• Time in Patent Office: Days
• US Class Current: 600/484
• CPC Class Codes: A61B 2560/0412 Low-profile patch shaped housings
• CPC Class Codes: A61B 5/0002 Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network A61B5/07 takes precedence; transmission systems for measured values G08C; transmission H04B; transmission of digital information H04L; wireless communication networks H04W
• 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 5/024 Detecting, measuring or recording pulse rate or heart rate A61B5/0205, A61B5/021 take precedence
• 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 5/08 Detecting, measuring or recording devices for evaluating the respiratory organs A61B5/0205 takes precedence
• 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 5/1118 Determining activity level
• CPC Class Codes: A61B 5/7246 using correlation, e.g. template matching or determination of similarity
• 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: A61B 5/746 Alarms related to a physiological condition, e.g. details of setting alarm thresholds or avoiding false alarms alarms per se G08B

Abstract

Methods and apparatus to determine the presence of and track functional chronotropic incompetence (hereinafter “CI”) in an in-home setting under conditions of daily living. The functional CI of the patient may be determined with one or more of a profile of measured patient heart rates, a measured maximum patient heart rate, or a peak of the heart rate profile. The functional CI of the patient may be determined with the measured heart rate profile, in which the measured heart rate profile may correspond to heart rates substantially less than the maximum heart rate of the patient, such that the heart rate can be safely measured when the patient is remote from a health care provider. The functional CI of the patient may be determined based a peak of the remotely measured heart rate profile, for example a peak corresponding to the mode of the heart rate distribution profile.

Claims

1. (canceled)

2. An apparatus to monitor a patient, the apparatus comprising,

a processor system comprising at least one processor having a tangible medium with instructions of a computer program embodied thereon, the processor system configured to:

receive heart rate data of the patient, the heart rate data comprising a plurality of measurements of the patient'"'"'s heart rate taken over a period of time;

determine a resting heart rate of the patient based on the received heart rate data; and

identify chronotropic incompetence based on the determined resting heart rate.

3. The apparatus of claim 2, wherein the processor system is further configured to determine a resting heart rate based on detected peaks in the measured heart rate data.

4. The apparatus of claim 3, wherein the processor system is further configured to:

determine an age-corrected maximum heart rate based on the determined resting heart rate;

determine a heart rate reserve (HRR) based on the age-corrected maximum heart rate; and

compare the HRR to a threshold value and identify chronotropic incompetence if the HRR is below the threshold.

5. The apparatus of claim 2, wherein the patient is a remote patient.

6. A method of monitoring a patient to detect chronotropic incompetence, the method comprising:

receiving heart rate data of the patient, the heart rate data comprising a plurality of measurements of the patient'"'"'s heart rate taken over a period of time;

determining a resting heart rate of the patient based on the received heart rate data;

identifying chronotropic incompetence based on the determined resting heart rate.

7. The method of claim 6, wherein determining the resting heart rate is based on detected peaks in the measured heart rate data.

8. The method of claim 7, further including:

determining an age-corrected maximum heart rate based on the determined resting heart rate;

determining a heart rate reserve (HRR) based on the age-corrected maximum heart rate; and

comparing the HRR to a threshold value, wherein chronotropic incompetence is identified if the HRR is below the threshold.

9. An apparatus to monitor a remote patient, the apparatus comprising,

a processor system comprising at least one processor having a tangible medium with instructions of a computer program embodied thereon, the processor system configured to:

receive data of the remote patient comprising heart rate data of the patient and activity data of the patient;

compare patient activity data to an activity threshold to determine activity above the activity threshold;

determine heart rate data corresponding with patient activity data above the activity threshold; and

identify chronotropic incompetence based on a correlation between the heart rate data observed above the activity threshold and activity data of the patient.

10. The apparatus of claim 9, wherein the processor further comprises instructions to determine a maximum heart rate of the heart rate data corresponding with patient activity data above the activity threshold.

11. The apparatus of claim 10, wherein the processor further comprises instructions to determine a correlation of the maximum heart rate with one or more of the patient activity, patient body posture, patient breath rate or patient respiration rate and wherein the processor system is configured to identify chronotropic incompetence based on the correlation.

12. The apparatus of claim 11, wherein the processor system is further configured to receive drug data of the patient and wherein the processor system comprises instructions to identify chronotropic incompetence based on the drug data and the correlation.

13. The apparatus of claim 9, wherein the activity threshold is determined based on a patient data received from a plurality of other patients.

14. A method of monitoring a patient to detect chronotropic incompetence, the method comprising:

receiving data corresponding with a remote patient, the data comprising heart rate data of the patient and activity data of the patient;

comparing patient activity data to an activity threshold to determine activity above the activity threshold;

determining heart rate data corresponding with patient activity data above the activity threshold; and

identifying chronotropic incompetence based on a correlation between the heart rate data observed above the activity threshold and activity data of the patient.

15. The method of claim 14, further comprising determining a maximum heart rate of the heart rate data corresponding with patient activity data above the activity threshold.

16. The method of claim 15, further comprising determining a correlation of the maximum heart rate with one or more of the patient activity, patient body posture, patient breath rate or patient respiration rate.

17. The method of claim 16, wherein identifying chronotropic incompetence is further based on the correlation.

18. The method of claim 17, further including receiving drug data of the patient, wherein identifying chronotropic incompetence is further based on the drug data received.

19. The method of claim 14, wherein the activity threshold is determined based on a patient data received from a plurality of other patients.