Diagnosing cardiac health utilizing parameter trend analysis

• US 7,308,309 B1
• Filed: 01/11/2005
• Issued: 12/11/2007
• Est. Priority Date: 01/11/2005
• Status: Active Grant

• Current Assignee: Pacesetter Incorporated (Abbott Laboratories)
• Original Assignee: Pacesetter Incorporated (Abbott Laboratories)
• Inventors: Koh, Steve
• Primary Examiner(s): Mullen, Kristen Droesch
• Application Number:
  US11/032,639
• Time in Patent Office: 1,064 Days
• Field of Search: None
• US Class Current: 607/17
• CPC Class Codes: A61B 5/0031 Implanted circuitry
• 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 5/349 Detecting specific parameters of the electrocardiograph cycle
• 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: A61N 1/365 controlled by a physiological parameter, e.g. heart potential evoked response A61N1/371
• CPC Class Codes: A61N 1/3702 Physiological parameters A61N1/365 takes precedence; evoked response A61N1/371
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems

Abstract

Diagnosing a patient'"'"'s cardiac health through the use of parameter change analysis involves a system that includes an implantable cardiac device to sense a parameter related to a patient'"'"'s heart. The system further includes a parameter change detection sub-system configured to derive a trend of the parameter over time and to detect changes to the trend. The trend and detected changes can then be used to diagnose changes in the patient'"'"'s cardiac health. Results of the diagnosis are stored and presented to a care physician.

Claims

1. A method comprising:

obtaining, from a patient, data associated with at least one cardiac-related parameter related to the patient'"'"'s cardiac health, the data corresponding to numerous data samples obtained over first and second periods of time;

deriving a first trend of the parameter for the first period of time;

deriving an extrapolated trend, based on the first trend, for the second period of time;

deriving a second trend of the parameter during the second period of time;

processing the extrapolated trend and the second trend to determine whether the first trend continues for the second period or the second trend replaces the first trend for the second period; and

diagnosing a change in the patient'"'"'s cardiac health when the second trend replaces the first trend.

2. A method as recited in claim 1, wherein the obtaining comprises measuring the parameter using an implantable device.

3. A method as recited in claim 1, wherein the cardiac-related parameters are selected from a group of parameters comprising arrhythmia, morphology-related data, impedance, activity, activity variance, posture, conduction delay, pressure, heart rate recovery, heart rate variability, minute ventilation, respiration, and intrinsic heart rate.

4. A method as recited in claim 1, wherein deriving the first trend comprises establishing a first line segment from a first sub-set of the data corresponding to the first period of time and relating to an individual parameter, the first line segment representing the first trend of the parameter.

5. The method of claim 4, wherein deriving an extrapolated trend comprises extending the first line segment through the second period of time.

6. The method of claim 5, wherein deriving a second trend comprises establishing a second line segment from a second sub-set of the data corresponding to the second period of time and relating to the individual parameter.

7. The method of claim 6, wherein processing comprises comparing the extended first line segment and the second line segment.

8. A system comprising:

an implantable cardiac device to sense a parameter related to a patient'"'"'s cardiac health; and

a parameter change detection sub-system configured to derive a first trend of the parameter for a first period of time, derive an extrapolated trend of the parameter for a subsequent period of time, wherein the extrapolated trend is based on the first trend, derive a second trend of the parameter for the subsequent period of time, process the extrapolated trend and the second trend to determine whether the first trend continues for the subsequent period or the second trend replaces the first trend for the subsequent period.

9. A system as recited in claim 8, wherein the parameter is selected from a group of heart-related parameters comprising arrhythmia, morphology-related data, impedance, activity, activity variance, conduction delay, pressure, heart rate recovery, heart rate variability, minute ventilation, respiration, and intrinsic heart rate.

10. A system as recited in claim 8, wherein the parameter change sub-system is configured as part of the implantable cardiac device.

11. A system as recited in claim 8, wherein the parameter change sub-system is configured in an external device which is separate from the implantable cardiac device.

12. A system as recited in claim 8, wherein the parameter change sub-system employs a line segmentation algorithm.

13. A system as recited in claim 8, wherein the parameter change sub-system is configured to generate a first line segment representative of the first trend and when the second trend replaces the first trend, to generate a second line segment representative of the second trend.

14. A system as recited in claim 8, wherein the parameter change sub-system is adjustable to distinguish artifacts from the trend.

15. An implantable cardiac device comprising:

a memory to store at least one heart-related parameter from a patient over a first period of time and a second period of time;

a processing unit to process the parameter using a parameter change algorithm to derive a first trend of the parameter for the first period of time, derive an extrapolated trend of the parameter for the second period of time, wherein the extrapolated trend is based on the first trend, derive a second trend of the parameter for the second period of time, process the extrapolated trend and the second trend to determine whether the first trend continues for the second period or the second trend replaces the first trend for the second period.

16. An implantable cardiac device as recited in claim 15 further comprising circuitry, responsive to the processing unit, to apply a pacing therapy to stimulate a patient'"'"'s heart, the circuitry modifying the pacing therapy based, at least in part, on whether the second trend replaces the first trend for the second period.

17. An implantable cardiac device as recited in claim 15, wherein the heart related parameters are selected from a group comprising arrhythmia, morphology-related data, impedance, activity, activity variance, posture, conduction delay, pressure, heart rate recovery, heart rate variability, minute ventilation, respiration, and intrinsic heart rate.

18. A system comprising:

storage means for storing a parameter related to a patient'"'"'s cardiac health over a first period of time and a second period of time; and

means for detecting a trend change in the parameter as an indication of a change in the patient'"'"'s cardiac health by deriving a first trend of the parameter for the first period of time, deriving an extrapolated trend of the parameter for the second period of time, wherein the extrapolated trend is based on the first trend, deriving a second trend of the parameter for the second period of time, processing the extrapolated trend and the second trend to determine whether the first trend continues for the second period or the second trend replaces the first trend for the second period.

19. A system as recited in claim 18, wherein the parameter is measured by an implantable cardiac device.

20. A system as recited in claim 18, wherein the storage means stores multiple parameters and the detecting means detects trend changes in the multiple parameters, and wherein at least one parameter is measured by an implantable cardiac device and another parameter is obtained independently of the implantable cardiac device.

21. A system as recited in claim 18, further comprising means for presenting the trend change and a possible interpretation of the change in the patient'"'"'s cardiac health.

22. A system as recited in claim 18, further comprising pacing means for generating electrical stimulation pulses in response to the detecting means.