System, method, and apparatus for combining information from an implanted device with information from a patient monitoring apparatus

• US 7,577,475 B2
• Filed: 09/19/2005
• Issued: 08/18/2009
• Est. Priority Date: 04/16/1999
• Status: Expired due to Fees

• Current Assignee: Cardiocom LLC (Medtronic Plc)
• Original Assignee: Cardiocom LLC (Medtronic Plc)
• Inventors: Cosentino, Louis C., Cosentino, Daniel L.
• Primary Examiner(s): Layno; Carl H
• Assistant Examiner(s): Gedeon; Brian T
• Application Number:
  US11/230,810
• Publication Number:
  US 20060064030A1
• Time in Patent Office: 1,429 Days
• Field of Search: 600/508, 600/509, 607/6, 607 17- 19, 705/2, 705/30
• US Class Current: 600/509
• CPC Class Codes: A61B 5/002 Monitoring the patient using a local or closed circuit, e.g. in a room or building A61B5/0017 takes precedence
• CPC Class Codes: A61B 5/0022 Monitoring a patient using a global network, e.g. telephone networks, internet
• CPC Class Codes: A61B 5/0031 Implanted circuitry
• CPC Class Codes: A61B 5/021 Measuring pressure in heart or blood vessels A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/053 Measuring electrical impedance or conductance of a portion of the body
• CPC Class Codes: A61B 5/0537 Measuring body composition by impedance, e.g. tissue hydration or fat content
• CPC Class Codes: A61B 5/0538 invasively, e.g. using a catheter
• CPC Class Codes: A61B 5/318 Heart-related electrical modalities, e.g. electrocardiography [ECG]
• CPC Class Codes: A61B 5/4869 Determining body composition
• CPC Class Codes: A61N 1/3627 for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy
• CPC Class Codes: A61N 1/36521 the parameter being derived from measurement of an electrical impedance
• CPC Class Codes: A61N 1/37282 characterised by communication with experts in remote locations using a network
• CPC Class Codes: G01G 19/4146 for controlling caloric intake, e.g. diet control
• CPC Class Codes: G01G 19/44 for weighing persons
• CPC Class Codes: G01G 23/3735 using a digital network
• CPC Class Codes: G01G 23/3742 using a mobile telephone network
• CPC Class Codes: G16H 10/20 for electronic clinical trials or questionnaires
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: G16H 40/67 for remote operation
• CPC Class Codes: G16H 50/30 for calculating health indices; for individual health risk assessment

Abstract

A data set is generated by an implanted medical device, during operation of the device. The data set includes data characterizing various physiological states of the patient. The data set is communicated from the device to a patient monitoring apparatus. The patient monitoring apparatus develops its own data set by posing questions to the patient, and optionally by measuring a physiological parameter of the patient, such as weight. The two data sets are combined and are analyzed to determine medical information concerning the patient, such as impending decompensation of heart failure.

Claims

1. A computer-implemented method of detecting an impending decompensation of heart failure in a patient, the method comprising:

receiving, at a computer, transthoracic impedance data measured by a cardiac rhythm management device implanted in the patient, wherein the cardiac rhythm management device measures the transthoracic impedance data while the patient is standing on a scale;

obtaining, at the computer, a weight measurement, the weight measurement indicating a weight of the patient, the computer obtaining the weight measurement from the scale, the scale measuring the weight of the patient while the patient is standing on the scale; and

receiving, at the computer, answers provided by the patient to one or more questions posed to the patient;

detecting, at the computer, impending decompensation of acute heart failure, based at least in part upon the weight measurement, the answers and the transthoracic impedance data received from the cardiac rhythm management device,

wherein the act of detecting impending decompensation of heart failure comprises generating a score based at least in part upon the answers provided by the patient or the weight measurement and comparing the score to a threshold.

2. The method of claim 1, further comprising generating an alert when impending decompensation of acute heart failure is detected.

3. The method of claim 2, further comprising communicating the alert to a health care provider.

4. The method of claim 1, wherein the cardiac rhythm management device is a pacemaker.

5. A computer-implemented method of detecting impending decompensation of heart failure in a patient, the method comprising:

receiving, at a computer, transthoracic impedance data measured by a cardiac rhythm management device implanted in the patient, the cardiac rhythm management device measuring the transthoracic impedance data in response to detecting a rhythm abnormality in the patient'"'"'s heart;

posing one or more questions to the patient with the computer;

receiving, at the computer, answers to the one or more questions;

obtaining, at the computer, a weight measurement of the patient; and

detecting, at the computer, impending decompensation of heart failure, based at least in part upon the answers, the weight measurement and the transthoracic impedance data received from the cardiac rhythm management device

wherein the act of detecting impending decompensation of heart failure comprises;

generating, at the computer, a score based at least in part upon the answers or the weight measurement; and

comparing the score to a threshold.

6. The method of claim 5, further comprising generating an alert when impending decompensation of heart failure is detected.

7. The method of claim 6, further comprising communicating the alert to a health care provider.

8. The method of claim 5, wherein the cardiac rhythm management device is a pacemaker.

9. A computer-implemented method of detecting impending decompensation of heart failure in a patient, the method comprising:

receiving, with a processor device external to the patient, transthoracic impedance data measured by a cardiac rhythm management device implanted in the patient, the cardiac rhythm management device measuring the transthoracic impedance data in response to detecting a rhythm abnormality in the patient'"'"'s heart;

measuring a physiological parameter of the patient;

communicating the physiological parameter to the processor device;

receiving, with the processor device, answers to one or more questions posed to the patient; and

detecting, with the processor device, impending decompensation of heart failure, based at least in part upon a comparison between a score and a threshold, the processing device generating the score based upon the transthoracic impedance data, the answers and the physiological parameter.

10. The method of claim 9, further comprising communicating the physiological parameter, the answers, and the transthoracic impedance data to a remote computer.

11. The method of claim 9, further comprising generating an alert when impending decompensation of heart failure is detected.

12. The method of claim 11, further comprising communicating the alert to a health care provider.

13. The method of claim 9, wherein the cardiac rhythm management device is a pacemaker.