Method for monitoring patient using acoustic sensor

• US 6,527,729 B1
• Filed: 10/11/2000
• Issued: 03/04/2003
• Est. Priority Date: 11/10/1999
• Status: Expired due to Term

• Current Assignee: Pacesetter Incorporated (Abbott Laboratories Incorporated)
• Original Assignee: Pacesetter Incorporated (Abbott Laboratories Incorporated)
• Inventors: Turcott, Robert
• Primary Examiner(s): Layno, Carl
• Application Number:
  US09/689,270
• Time in Patent Office: 874 Days
• Field of Search: 600/508, 600/514, 600/528
• US Class Current: 600/528
• CPC Class Codes: A61B 2562/0204 Acoustic sensors
• 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 5/02 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 5/0205 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 5/02405 Determining heart rate variability
• CPC Class Codes: A61B 5/1455 using optical sensors, e.g. spectral photometrical oximeters
• CPC Class Codes: A61B 5/349 Detecting specific parameters of the electrocardiograph cycle
• CPC Class Codes: A61B 5/6816 Ear lobe
• CPC Class Codes: A61B 5/6817 Ear canal
• CPC Class Codes: A61B 7/00 Instruments for auscultation
• CPC Class Codes: A61B 7/003 Detecting lung or respiration noise

Abstract

A method for monitoring the progression of the disease of a heart failure patient is provided. An implantable or other ambulatory monitor senses acoustic signals including heart and lung sounds within the patient. Significant changes in the energy content of either the heart or lung sounds is 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.

Claims

1. A method for monitoring the progression of the disease state of a heart failure patient comprising the steps of:

(a) sensing a physiologic acoustic signal inside a patient'"'"'s body at a first time period;

(b) calculating a value corresponding to the energy content of a portion of the acoustic signal for the first time period;

(c) sensing the acoustic signal at a second later time period;

(d) calculating a value corresponding to the energy content of the portion of the acoustic signal for the second time period; and

(e) comparing the calculated value of the energy content of the acoustic signal for the second time period with the calculated value of the energy content of the acoustic signal for the first time period and providing an output as a function of the results of the comparison.

2. The method of claim 1 wherein said step of calculating a value corresponding to the energy content includes calculating an integrated magnitude of the signal.

3. The method of claim 1 wherein said step of calculating a value corresponding to the energy content includes measuring the duration that the acoustic signal has significant excursions from the baseline.

4. The method of claim 1 wherein said step of calculating a value corresponding to the energy content includes calculating the maximum excursion from baseline.

5. The method of claim 1 wherein the portion of the acoustic signal for each of the first and second time periods corresponds to heart sounds.

6. The method of claim 5 wherein said portion of the acoustic signal corresponds to the S1 heart sound.

7. The method of claim 5 wherein said portion of the acoustic signal corresponds to the S2 heart sound.

8. The method of claim 5 wherein said portion of the acoustic signal corresponds to the S3 heart sound.

9. The method of claim 5 wherein said portion of the acoustic signal corresponds to the S4 heart sound.

10. The method of claim 1 wherein the portion of the acoustic signal for each of the first and second time periods corresponds to breathing sounds.

11. The method of claim 1 wherein the portion of the acoustic signal for each of the first and second time periods is provided by band pass filtering the acoustic signal.

12. The method of claim 5 wherein the portion of the acoustic signal for each of the first and second time periods is provided by sampling the acoustic signal during heart beats.

13. The method of claim 10 wherein the portion of the acoustic signal for each of the first and second time periods is provided by sampling the acoustic signal during a time between heart beats.

14. A method for monitoring the progression of the disease state of a heart failure patient comprising the steps of:

(a) sensing a physiologic acoustic signal inside a patient'"'"'s body at a first time period;

(b) identifying portions of the acoustic signal corresponding to cardiac contractions;

(c) calculating a value corresponding to the energy content of each of the cardiac contraction portions of the acoustic signal to provide a baseline heart sounds acoustic energy measure;

(d) sensing the acoustic signal at a second later time period;

(e) calculating a value corresponding to the energy content of each of the cardiac contraction portions of the acoustic signal for the second time period; and

(f) comparing the calculated value of the energy content of the cardiac contractions for the second time period with the baseline heart sounds acoustic energy measure and providing an output as a function of the results of the comparison.

15. The method of claim 14 wherein said step of calculating a value corresponding to the energy content includes calculating an integrated magnitude of the signal.

16. The method of claim 14 wherein said step of calculating a value corresponding to the energy content includes measuring the duration that the acoustic signal has significant excursions from the baseline.

17. The method of claim 14 wherein said step of calculating a value corresponding to the energy content includes calculating the maximum excursion from baseline.

18. The method of claim 14 wherein the acoustic signal from the first time period is stored in long term memory.

19. The method of claim 14 wherein the step of identifying portions of the acoustic signal corresponding to cardiac contractions includes the step of monitoring an electrocardiogram signal from the patient'"'"'s heart and correlating portions of the acoustic signal with successive QRS complexes of the electrogram signal.

20. The method of claim 14 wherein step (c) further includes the step of averaging the energy over a plurality of successive heart beats.

21. The method of claim 20 and further including the step of calculating a measure of variability for the energy content of the cardiac contractions of the first time period.

22. The method of claim 14 and further including the step of incrementing an alert counter in response to deviations between the energy content of the baseline energy measure and the energy content of the cardiac contractions for the second time period being greater than a prescribed amount in the comparing step.

23. The method of claim 21 and further including the step of incrementing an alert counter in response to deviations between the energy content of the baseline energy measure and the energy content of the cardiac contractions for the second time period being greater than a prescribed amount in the comparing step.

24. The method of claim 23 wherein said prescribed amount is a programmed variable greater than 1 times the calculated measure of variability.

25. The method of claim 23 and further including the step of using the output from step (f) to trigger a warning of the patient'"'"'s changing condition.

26. The method of claim 25 wherein said step of triggering a warning includes inducing a physically perceptible stimulation of the patient.

27. The method of claim 14 and further including the step of periodically automatically telemetering some or all of the data collected and calculated in steps (a) through (f) to a receiver external to said patient.

28. A method for monitoring the progression of the disease state of a heart failure patient comprising the steps of:

(a) sensing a physiologic acoustic signal inside a patient'"'"'s body at a first time period;

(b) identifying portions of the acoustic signal corresponding to the patient'"'"'s breathing;

(c) calculating a value corresponding to the energy content the acoustic signal corresponding to the patient'"'"'s breathing to provide a baseline breathing acoustic energy measure;

(d) sensing the acoustic signal at a second later time period;

(e) calculating a value corresponding to the energy content of the acoustic signal for the patient'"'"'s breathing for the second time period; and

(f) comparing the calculated value of the energy content of the acoustic signal for the patient'"'"'s breathing for the second time period with the baseline breathing acoustic energy measure and providing an output as a function of the results of the comparison.

29. The method of claim 28 wherein said step of calculating a value corresponding to the energy content includes calculating an integrated magnitude of the signal.

30. The method of claim 28 wherein said step of calculating a value corresponding to the energy content includes measuring the duration that the acoustic signal has significant excursions from the baseline.

31. The method of claim 28 wherein said step of calculating a value corresponding to the energy content includes calculating the maximum excursion from baseline.

32. The method of claim 28 wherein the acoustic signal from the first time period is stored in long term memory.

33. The method of claim 28 wherein the step of identifying portions of the acoustic signal corresponding to the patient'"'"'s breathing includes the step of monitoring an electrocardiogram signal from the patient'"'"'s heart and correlating portions of the acoustic signal with successive QRS complexes of the electrogram signal and ignoring those portions of the signal corresponding to a heart beat as identified by the QRS complexes.

34. The method of claim 28 wherein the step of identifying portions of the acoustic signal corresponding to the patient'"'"'s breathing includes the step of band pass filtering the acoustic signal to eliminate heart sounds.

35. The method of claim 28 wherein step (c) further includes the step of averaging the energy over the first time period.

36. The method of claim 35 and further including the step of calculating a measure of variability for the energy content of the acoustic signal of the first time period.

37. The method of claim 28 and further including the step of incrementing an alert counter in response to deviations between the energy content of the baseline breathing acoustic energy measure and the energy content of the acoustic signal for the patient'"'"'s breathing for the second time period being greater than a prescribed amount in the comparing step.

38. The method of claim 36 and further including the step of incrementing an alert counter in response to deviations between the energy content of the baseline breathing acoustic energy measure and the energy content of the acoustic signal for the patient'"'"'s breathing for the second time period being greater than a prescribed amount in the comparing step.

39. The method of claim 38 wherein said prescribed amount is a programmed variable greater than 1 times the calculated measure of variability.

40. The method of claim 28 and further including the step of using the output from step (f) to trigger a warning of the patient'"'"'s changing condition.

41. The method of claim 40 wherein said step of triggering a warning includes inducing a physically perceptible stimulation of the patient.

42. The method of claim 28 and further including the step of periodically automatically telemetering some or all of the data collected and calculated in steps (a) through (f) to a receiver external to said patient.