System and method for providing diagnosis and monitoring of atrial fibrillation for use in automated patient care

• US 6,826,425 B2
• Filed: 05/20/2002
• Issued: 11/30/2004
• Est. Priority Date: 11/16/1999
• Status: Expired due to Term

• Current Assignee: Cardiac Intelligence Corp (Boston Scientific Corporation)
• Original Assignee: Cardiac Intelligence Corp (Boston Scientific Corporation)
• Inventors: Bardy, Gust H.
• Primary Examiner(s): Evanisko, George R.
• Application Number:
  US10/152,650
• Publication Number:
  US 20020173727A1
• Time in Patent Office: 925 Days
• Field of Search: 607/4, 607/5, 607/14, 600/515-518, 128/920, 128/923
• US Class Current: 600/518
• CPC Class Codes: A61B 5/0031 Implanted circuitry
• CPC Class Codes: A61B 5/361 Detecting fibrillation
• CPC Class Codes: A61N 1/3622 comprising two or more electrodes co-operating with different heart regions
• CPC Class Codes: A61N 1/37282 characterised by communication with experts in remote locations using a network
• CPC Class Codes: Y10S 128/923 by comparison of patient data to other data

Abstract

An automated system and method for diagnosing and monitoring the outcomes of atrial fibrillation is described. A plurality of monitoring sets is retrieved from a database. Each of the monitoring sets include recorded measures relating to patient information recorded on a substantially continuous basis. A patient status change is determined in response to an atrial fibrillation diagnosis by comparing at least one recorded measure from each of the monitoring sets to at least one other recorded measure. Both recorded measures relate to the same type of patient information. Each patient status change is tested against an indicator threshold corresponding to the same type of patient information as the recorded measures which were compared. The indicator threshold corresponds to a quantifiable physiological measure of a pathophysiology resulting from atrial fibrillation.

Claims

1. A system for providing diagnosis and monitoring of atrial fibrillation for use in automated patient care, comprising:

a comparison module receiving a diagnosis of atrial fibrillation and comparing at least one recorded physiological measure to at least one other recorded physiological measure on a substantially regular basis in response to the atrial fibrillation diagnosis to quantify a change in patient pathophysiological status for equivalent patient information; and

an analysis module evaluating an absence, an onset, a progression, a regression, and a status quo of atrial fibrillation dependent upon the change in patient pathophysiological status.

2. A system according to claim 1, further comprising:

a management module for managing the atrial fibrillation diagnosis by controlling at least one of ventricular rate response and normal sinus rhythm.

3. A system according to claim 1, further comprising:

a database module retrieving the at least one recorded physiological measure and the at least one other recorded physiological measure from monitoring sets stored in a database.

4. A system according to claim 3, further comprising:

a server system collecting the at least one recorded physiological measure and the at least one other recorded physiological measure into each monitoring set recorded on a substantially continuous basis or derived therefrom.

5. A system according to claim 4, further comprising:

at least one of an implantable medical device and an external medical device recording the at least one recorded physiological measure and the at least one other recorded physiological measure.

6. A system according to claim 1, further comprising:

the analysis module evaluating an absence, an onset, a progression, a regression, and a status quo of diseases other than atrial fibrillation dependent upon the change in patient pathophysiological status.

7. A system according to claim 1, further comprising:

a diagnostic module comparing at least one recorded quality of life measure to at least one other recorded quality of life measure on a substantially regular basis to qualify a change in patient pathophysiological status.

8. A system according to claim 1, further comprising:

a stored stickiness indicator defined for at least one physiological measure corresponding to a temporal boundary on one of patient diagnosis and treatment;

a diagnostic module timing each change in patient pathophysiological status for the equivalent patient information and determining one of a revised patient diagnosis and treatment responsive to each change in patient pathophysiological status with a timing exceeding the stickiness indicator.

9. A system according to claim 1, further comprising:

a diagnostic module comparing the change in patient pathophysiological status to a reference baseline comprising recorded physiological measures recorded during an initial time period.

10. A system according to claim 1, further comprising:

a diagnostic module comparing the change in patient pathophysiological status to equivalent patient information from at least one of an individual patient, a peer group, and a overall patient population.

11. A system according to claim 1, further comprising:

a diagnostic module grading the change in patient pathophysiological status on a fixed scale based on a degree of deviation from a pre-defined indicator threshold and performing a summation over a plurality of the graded changes to determine an overall change in patient pathophysiological status.

12. A system according to claim 1, further comprising:

a diagnostic module determining probabilistic weightings of the change in patient pathophysiological status on a statistical deviation and trends via linear fits from a pre-defined indicator threshold and performing a summation over a plurality of the probabilistic weightings to determine an overall change in patient pathophysiological status.

13. A method for providing diagnosis and monitoring of atrial fibrillation for use in automated patient care, comprising:

receiving a diagnosis of atrial fibrillation;

comparing at least one recorded physiological measure to at least one other recorded physiological measure on a substantially regular basis in response to the atrial fibrillation diagnosis to quantify a change in patient pathophysiological status for equivalent patient information; and

evaluating an absence, an onset, a progression, a regression, and a status quo of atrial fibrillation dependent upon the change in patient pathophysiological status.

14. A method according to claim 13, further comprising:

managing the atrial fibrillation diagnosis by controlling at least one of ventricular rate response and normal sinus rhythm.

15. A method according to claim 13, further comprising:

retrieving the at least one recorded physiological measure and the at least one other recorded physiological measure from monitoring sets stored in a database.

16. A method according to claim 15, further comprising:

collecting the at least one recorded physiological measure and the at least one other recorded physiological measure into each monitoring set recorded on a substantially continuous basis or derived therefrom.

17. A method according to claim 16, further comprising:

recording the at least one recorded physiological measure and the at least one other recorded physiological measure with at least one of an implantable medical device and an external medical device.

18. A method according to claim 13, further comprising:

evaluating an absence, an onset, a progression, a regression, and a status quo of diseases other than atrial fibrillation dependent upon the change in patient pathophysiological status.

19. A method according to claim 13, further comprising:

comparing at least one recorded quality of life measure to at least one other recorded quality of life measure on a substantially regular basis to qualify a change in patient pathophysiological status.

20. A method according to claim 13, further comprising:

defining a stickiness indicator for at least one physiological measure corresponding to a temporal boundary on one of patient diagnosis and treatment;

timing each change in patient pathophysiological status for the equivalent patient information; and

determining one of a revised patient diagnosis and treatment responsive to each change in patient pathophysiological status with a timing exceeding the stickiness indicator.

21. A method according to claim 13, further comprising:

comparing the change in patient pathophysiological status to a reference baseline comprising recorded physiological measures recorded during an initial time period.

22. A method according to claim 13, further comprising:

comparing the change in patient pathophysiological status to equivalent patient information from at least one of an individual patient, a peer group, and a overall patient population.

23. A method according to claim 13, further comprising:

grading the change in patient pathophysiological status on a fixed scale based on a degree of deviation from a pre-defined indicator threshold; and

performing a summation over a plurality of the graded changes to determine an overall change in patient pathophysiological status.

24. A method according to claim 13, further comprising:

determining probabilistic weightings of the change in patient pathophysiological status on a statistical deviation and trends via linear fits from a pre-defined indicator threshold; and

performing a summation over a plurality of the probabilistic weightings to determine an overall change in patient pathophysiological status.

25. A computer-readable storage medium for a device holding code for performing the method according to claim 13.