Method for monitoring heart failure
First Claim
1. A method for monitoring the progression of the disease state of a heart failure patient comprising the steps of:
- (a) sensing a physiologic signal indicative of cardiac contraction of said patient'"'"'s heart;
(b) identifying the location of fiducial points within said sensed signal;
(c) calculating a time interval between each of a sequence of successive fiducial points;
(d) calculating a measure of heart rate variability (HRV) based on said calculated time intervals;
(e) repeating steps (a) through (d) to acquire a plurality of HRV measures;
(f) storing a prescribed duration of the sensed physiologic signal in a long term memory; and
(g) analyzing said plurality of HRV measures to provide an indication of the progression of the disease state of said heart failure patient.
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Abstract
A method for monitoring the progression of the hemodynamic status of a heart failure patient. An implantable or other ambulatory monitor senses the patient'"'"'s electrocardiogram (ECG) and calculates R-R intervals. The R-R intervals are used to calculate a measure of heart rate variability (HRV). Significant excursions from the average of the HRV measure are indicative of a heart failure exacerbation. Alternatively, vascular plethysmography provides a measure of pulse amplitude. Significant reduction in pulse amplitude and pulse amplitude variability are indicative of a heart failure exacerbation. This information may be used to warn the patient or healthcare providers of changes in the patient'"'"'s condition warranting attention.
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Citations
32 Claims
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1. A method for monitoring the progression of the disease state of a heart failure patient comprising the steps of:
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(a) sensing a physiologic signal indicative of cardiac contraction of said patient'"'"'s heart;
(b) identifying the location of fiducial points within said sensed signal;
(c) calculating a time interval between each of a sequence of successive fiducial points;
(d) calculating a measure of heart rate variability (HRV) based on said calculated time intervals;
(e) repeating steps (a) through (d) to acquire a plurality of HRV measures;
(f) storing a prescribed duration of the sensed physiologic signal in a long term memory; and
(g) analyzing said plurality of HRV measures to provide an indication of the progression of the disease state of said heart failure patient. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8)
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9. A method for monitoring the progression of the disease state of a heart failure patient comprising the steps of:
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(a) sensing a physiologic signal including fiducial points indicative of cardiac contractions of said patient'"'"'s heart;
(b) calculating a measure of heart rate variability (HRV) based on said sensed physiologic signal, said measure of heart rate variability being based on a number of said sensed fiducial points occurring in each of a plurality of predetermined counting intervals;
(c) repeating steps (a) and (b) to acquire a plurality of HRV measures;
(d) analyzing said plurality of HRV measures to provide an indication of the progression of the disease state of said heart failure patient.
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10. A method for monitoring the progression of the disease state of a heart failure patient comprising the steps of:
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(a) sensing a physiologic signal indicative of the pulse amplitude of said patient to acquire a plurality of pulse amplitude measures;
(b) analyzing said plurality of pulse amplitude measures to provide an indication of the progression of the disease state of said heart failure patient. - View Dependent Claims (11, 12, 13, 14, 15)
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16. A method for monitoring the progression of the disease state of a heart failure patient comprising the steps of:
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(a) sensing a physiologic signal indicative of the pulse amplitude of said patient to acquire a plurality of pulse amplitude measures;
(b) calculating a measure of variability of said pulse amplitude;
(c) analyzing said measure of variability to provide an indication of the progression of the disease state of said heart failure patient. - View Dependent Claims (17, 18, 19, 20, 21)
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22. A method for monitoring the progression of the disease state of a heart failure patient comprising the steps of:
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(e) sensing a physiologic signal indicative of cardiac contraction of said patient'"'"'s heart;
(f) identifying the location of fiducial points within said sensed signal;
(g) calculating a time interval between each of a sequence of successive fiducial points;
(h) calculating a measure of heart rate variability (HRV) based on said calculated time intervals;
(e) repeating steps (a) through (d) to acquire a plurality of HRV measures;
(f) analyzing said plurality of HRV measures to provide an indication of the progression of the disease state of said heart failure patient; and
(g) using said indication from step (f) to trigger a warning of the patient'"'"'s changing condition. - View Dependent Claims (23)
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24. A method for monitoring the progression of the disease state of a heart failure patient comprising the steps of:
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(a) sensing a physiologic signal indicative of cardiac contraction of said patient'"'"'s heart;
(b) identifying the location of fiducial points within said sensed signal;
(c) calculating a time interval between each of a sequence of successive fiducial points;
(d) calculating a measure of heart rate variability (HRV) based on said calculated time intervals;
(e) repeating steps (a) through (d) to acquire a plurality of HRV measures;
(f) analyzing said plurality of HRV measures to provide an indication of the progression of the disease state of said heart failure patient; and
(g) periodically automatically telemetering some or all of the data collected and calculated in steps (a) through (f) to a receiver external to said patient.
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25. A method for monitoring the progression of the disease state of a heart failure patient comprising the steps of:
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(a) sensing a physiologic signal indicative of cardiac contraction of said patient'"'"'s heart;
(b) identifying the location of fiducial points within said sensed signal;
(c) calculating a time interval between each of a sequence of successive fiducial points;
(d) calculating a measure of heart rate variability (HRV) based on said calculated time intervals including performing a Fast Fourier Transform (FFT) on said time intervals;
(e) repeating steps (a) through (d) to acquire a plurality of HRV measures; and
(f) analyzing said plurality of HRV measures to provide an indication of the progression of the disease state of said heart failure patient.
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26. A method for monitoring the progression of the disease state of a heart failure patient comprising the steps of:
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(a) sensing a measure of an arterial pulse, said measure including fiducial points indicative of cardiac contractions of said patient'"'"'s heart;
(b) calculating a measure of heart rate variability (HRV) based on said sensed physiologic signal;
(c) repeating steps (a) and (b) to acquire a plurality of HRV measures;
(d) analyzing said plurality of HRV measures to provide an indication of the progression of the disease state of said heart failure patient. - View Dependent Claims (27)
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28. A method for monitoring the progression of the disease state of a heart failure patient comprising the steps of:
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(a) sensing a physiologic signal of a heart sound or a pressure signal, said sensed physiologic signal including fiducial points indicative of cardiac contractions of said patient'"'"'s heart;
(b) calculating a measure of heart rate variability (HRV) based on said sensed physiologic signal;
(c) repeating steps (a) and (b) to acquire a plurality of HRV measures;
(d) analyzing said plurality of HRV measures to provide an indication of the progression of the disease state of said heart failure patient.
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29. A method for monitoring the progression of the disease state of a heart failure patient comprising the steps of:
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(a) sensing with an ultrasound transducer a physiologic signal including fiducial points indicative of cardiac contractions of said patient'"'"'s heart;
(b) calculating a measure of heart rate variability (HRV) based on said sensed physiologic signal;
(c) repeating steps (a) and (b) to acquire a plurality of HRV measures;
(d) analyzing said plurality of HRV measures to provide an indication of the progression of the disease state of said heart failure patient.
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30. A method for monitoring an acute exacerbation of the heart failure condition a heart failure patient comprising the steps of:
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(a) sensing a physiologic signal including fiducial points indicative of cardiac contractions of said patient'"'"'s heart;
(b) calculating a measure of heart rate variability (HRV) based on said sensed physiologic signal;
(c) repeating steps (a) and (b) to acquire a plurality of HRV measures;
(d) analyzing said plurality of HRV measures to provide an indication an acute exacerbation of the heart failure condition of said heart failure patient. - View Dependent Claims (31, 32)
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Specification