System and method to measure the condition of a patients heart

• US 5,758,652 A
• Filed: 10/19/1995
• Issued: 06/02/1998
• Est. Priority Date: 10/19/1995
• Status: Expired due to Fees

• Current Assignee: Telecom Medical Incorporated
• Original Assignee: Serjan D. Nikolic
• Inventors: Nikolic, Serjan D.
• Primary Examiner(s): Bahr, Jennifer
• Assistant Examiner(s): Winakur, Eric F.
• Application Number:
  US08/545,306
• Time in Patent Office: 957 Days
• Field of Search: 128/670, 128/672-675, 128/687, 128/690
• US Class Current: 600/487
• CPC Class Codes: A61B 5/0028 Body tissue as transmission medium, i.e. transmission systems where the medium is the human body
• CPC Class Codes: A61B 5/0031 Implanted circuitry
• CPC Class Codes: A61B 5/0215 by means inserted into the body catheters A61M25/00
• CPC Class Codes: A61B 5/7239 using differentiation including higher order derivatives

Abstract

A system and method for measuring the heart condition of a patient is disclosed. The system includes a measuring device used to generate an absolute blood pressure signal indicative of the absolute blood pressure of the patient. A processing element receives and processes the absolute blood pressure signal, and generates (1) a filtered blood pressure signal by removing certain variations from the absolute blood pressure signal caused by respiratory activity of the patient; and (2) a set of parameters derived from the filtered blood pressure signal. The set of parameters measure certain aspects of the absolute blood pressure signal which are indicative of the performance and condition of the patient'"'"'s heart.

Claims

1. A system used to measure the heart condition of a patient, the system comprising:

a measuring device configured to measure absolute blood pressure of the patient and to generate an absolute blood pressure signal indicative of the absolute blood pressure of the patient during a plurality of respiratory cycles of the patient; and

a processing element to process the absolute blood pressure signal, the processing element for generating a filtered blood pressure signal from the absolute blood pressure signal by substantially removing variations from the absolute blood pressure signal caused by respiratory activity of the patient during the plurality of respiratory cycles, the processing element further including a sampling element to sample the absolute blood pressure signal during a plurality of selected heart cycles that occur during the plurality of respiratory cycles and to generate a plurality of sampled blood pressure signals, and an averaging element to generate the filtered blood pressure signal by averaging the plurality of sampled blood pressure signals.

2. The system of claim 1, wherein the selected heart cycles occur at a selected phase of each of the plurality of respiratory cycles.

3. The system of claim 2, wherein the selected phase is an end exhalation phase of each of the plurality of respiratory cycles.

4. The system of claim 2, wherein the selected phase is an end inhalation phase of each of the plurality of respiratory cycles.

5. The system of claim 1, wherein the processing element further generates a derivative signal of the filtered blood pressure signal by performing a mathematical derivative on the filtered blood pressure signal.

6. The system of claim 1, wherein the processing element is further configured to derive one parameter from the filtered blood pressure signal that is indicative of the condition of the heart of the patient.

7. The system of claim 6, wherein the one parameter is a peak systolic pressure measurement of the filtered blood pressure signal.

8. The system of claim 6, wherein the one parameter is a minimum diastolic pressure measurement of the filtered blood pressure signal.

9. The system of claim 6, wherein the one parameter is a mean diastolic pressure measurement of the filtered blood pressure signal.

10. The system of claim 6, wherein the one parameter is a time constant of isovolumic pressure decay indicative of the rate at which the heart of the patient relaxes.

11. The system of claim 6, wherein the one parameter is a contraction signal indicative of the ability of the heart of the patient to contract.

12. The system of claim 11, wherein the processing element is configured to generate the contraction signal by determining a change in blood pressure over time during an isovolumic contraction phase of the filtered blood pressure signal.

13. The system of claim 11, wherein the contraction signal includes one of the following group of measurements derived from the filtered blood pressure signal, the group including the measurements of (a) a maximum pressure time derivative;

(b) a normalized maximum pressure time derivative;

(c) a time to the maximum pressure time derivative; and

(e) a normalized time to the maximum pressure time derivative.

14. The system of claim 6, wherein the one parameter is a relaxation signal indicative of the ability of the heart of the patient to relax.

15. The system of claim 14, wherein the processing element generates the relaxation signal by calculating a change in pressure over time during an isovolumic relaxation phase of the filtered blood pressure signal.

16. The system of claim 14, wherein the relaxation signal includes one of the following group of measurements which are derived from the filtered blood pressure signal, the group including the measurements of (a) a minimum pressure time derivative;

(b) a time to the minimum pressure time derivative;

(c) the value of the filtered blood pressure signal at the time to the minimum pressure time derivative;

(d) a minimum value of the second derivative; and

(e) the blood pressure at a predetermined point in the down slope of the second derivative of the filtered blood signal.

17. The system of claim 6, wherein the one parameter includes at least one of the following measurements:

(a) end diastolic pressure; and

(b) a time to the end diastolic pressure.

18. The system of claim 6, wherein the one parameter is a time measurement of a diastolic period of the filtered blood pressure signal.

19. The system of claim 6, wherein the one parameter is a measure of an asymptote of isovolumic relaxation pressure exponential derived from the filtered blood pressure signal.

20. The system of claim 6, wherein the one parameter is a measure of the heart rate of the patient.

21. The system of claim 1, wherein the processing element is an implantable device designed to be implanted into the body of the patient and includes digital circuitry configured to process the absolute blood pressure signal and to generate the filtered blood pressure signal by removing certain variations from the absolute blood pressure signal due to respiratory activity of the patient during the plurality of respiratory cycles.

22. The system of claim 1, wherein the processing element is an implantable device designed to be surgically implanted into the body of the patient and includes analog circuitry configured to process the absolute blood pressure signal and to generate the filtered blood pressure signal by removing certain variations from the absolute blood pressure signal due to respiratory activity of the patient during the plurality of respiratory cycles.

23. The system of claim 1, wherein the measuring device is configured to be implanted in a chamber of the patient'"'"'s heart and is configured to measure the absolute blood pressure flowing through the chamber of the patient'"'"'s heart.

24. The system of claim 1, wherein the measuring device and the processing unit are integrated into a housing.

25. The system of claim 24, wherein the housing is intended to be implanted into the heart of the patient.

31. The method of claim 25, wherein the processing step further comprises the step of deriving one parameter from the filtered blood pressure signal that is indicative of the condition of the heart of the patient.

32. The method of claim 31, wherein the step of deriving the one parameter comprises the step of deriving a peak systolic pressure measurement of the filtered blood pressure signal.

33. The method of claim 31, wherein the step of deriving the one parameter comprises the step of deriving a minimum diastolic pressure measurement of the filtered blood pressure signal.

34. The method of claim 31, wherein the step of deriving the one parameter comprises the step of deriving a mean diastolic pressure measurement of the filtered blood pressure signal.

35. The method of claim 31, wherein the step of deriving the one parameter comprises the step of deriving a time constant of isovolumic pressure decay indicative of the rate at which the heart of the patient relaxes.

36. The method of claim 31, wherein the step of deriving the one parameter comprises the step of deriving a contraction signal indicative of the ability of the heart of the patient to contract.

37. The method of claim 36, wherein the step of generating the contraction signal further includes the step of measuring a change in blood pressure over time during an isovolumic contraction phase of the filtered blood pressure signal.

38. The method of claim 36, further comprising the step of generating at least one of the following measurements after the step of deriving the contraction signal, measurements including (a) a maximum pressure time derivative;

(b) a normalized maximum pressure time derivative;

(c) a time to the maximum pressure time derivative; and

(e) a normalized time to the maximum pressure time derivative.

39. The method of claim 31, wherein the step of deriving one parameter comprises the step of deriving a relaxation signal indicative of the ability of the heart of the patient to relax.

40. The method of claim 31, wherein the step of generating the relaxation signal further includes the step of calculating a change in pressure over time during an isovolumic relaxation phase of the filtered blood pressure signal.

41. The method of claim 40, wherein the step of generating the relaxation signal includes at least one of the following steps of generating (a) a minimum pressure time derivative;

(b) a time to the minimum pressure time derivative;

(c) the value of the filtered blood pressure signal at the time to the minimum pressure time derivative;

(d) a minimum value of the second derivative; and

(e) the blood pressure at a predetermined point in the down slope of the second derivative of the filtered blood signal.

42. The method of claim 31, wherein the step of generating the one parameter includes the step of generating at least one of the following measurements:

(a) end diastolic pressure; and

(b) a time to the end diastolic pressure.

43. The method of claim 31, wherein the step of generating the one parameter includes the step of generating a time measurement of a diastolic period of the filtered blood pressure signal.

44. The method of claim 31, wherein the step of generating the one parameter further includes the step of generating a measure of an asymptote of isovolumic relaxation pressure exponential derived from the filtered blood pressure signal.

45. The method of claim 31, wherein the step of generating the one parameter further includes the step of generating a signal indicative of a measure of the heart rate of the patient.

46. The method of claim 25, further comprising the step of subscribing a medical treatment for the patient, if needed, based on the step of measuring the condition of the patient.

47. The method of claim 46, wherein the step of measuring the patient'"'"'s heart further comprising the steps of:

generating a set of parameters from the filtered blood pressure signal, each one of the set of parameters providing a measure of a particular function of the heart cycle of the patient at a first point in time;

generating a second set of parameters from a second filtered blood pressure signal, each one of the second set of parameters providing a measure of a particular function of the heart cycle of the patient at a second point in time;

comparing the first set of parameters and the second set of parameters; and

determining the relative differences between the first set of parameters generated at the first point in time and the second set of parameters generated at the second point in time.

26. A method to analyze the heart condition of a patient, comprising the steps of:

measuring absolute blood pressure of the patient during a plurality of respiratory cycles of the patient;

generating an absolute blood pressure signal indicative of the absolute blood pressure of the patient during the plurality of respiratory cycles of the patient;

generating a filtered blood pressure signal from the absolute blood pressure signal by substantially removing variations from the absolute blood pressure signal caused by respiratory activity of the patient during the plurality of respiratory cycles;

the step of generating the filtered blood pressure signal further including the steps of;

sampling the absolute blood pressure signal during each of a plurality of selected heart cycles that occur over course of the plurality of respiratory cycles;

generating sampled blood pressure signals;

averaging the sampled blood pressure signals;

generating the filtered blood pressure signal from the averaged sampled blood pressure signals; and

analyzing the condition of the patient'"'"'s heart based on the filtered blood pressure signal.

27. The method of claim 26, wherein the sampling step occurs at the same phase of each of the plurality of respiratory cycles.

28. The method of claim 27, wherein the sampling step occurs at an end exhalation phase of each of the plurality of respiratory cycles.

29. The method of claim 27, wherein the sampling step occurs at an end inhalation phase of each of the plurality of respiratory cycles.

30. The method of claim 26, wherein the processing step further comprises the step of generating a derivative signal of the filtered blood pressure signal by performing a mathematical derivative on the filtered blood pressure signal.