Therapy control based on cardiopulmonary status

• US 7,662,101 B2
• Filed: 08/31/2004
• Issued: 02/16/2010
• Est. Priority Date: 09/18/2003
• Status: Expired due to Fees

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Stahmann, Jeffrey E., Hartley, Jesse W., Lee, Kent, Ni, Quan
• Primary Examiner(s): Mallari; Patricia C
• Assistant Examiner(s): Toth; Karen E
• Application Number:
  US10/930,346
• Publication Number:
  US 20050065567A1
• Time in Patent Office: 1,995 Days
• Field of Search: 600/481, 600/529
• US Class Current: 600/484
• 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 5/0809 by impedance pneumography
• CPC Class Codes: A61B 5/083 Measuring rate of metabolism by using breath test, e.g. measuring rate of oxygen consumption
• CPC Class Codes: A61B 5/087 Measuring breath flow
• CPC Class Codes: A61B 5/091 Measuring volume of inspired or expired gases, e.g. to determine lung capacity
• CPC Class Codes: A61B 5/4818 Sleep apnoea
• 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: A61M 11/00 Sprayers or atomisers specially adapted for therapeutic purposes in general B05B; aerosol containers B65D83/14
• CPC Class Codes: A61M 16/0051 with alarm devices
• CPC Class Codes: A61M 16/026 specially adapted for predicting, e.g. for determining an information representative of a flow limitation during a ventilation cycle by using a root square technique or a regression analysis
• CPC Class Codes: A61M 2016/0021 with a proportional output signal, e.g. from a thermistor
• CPC Class Codes: A61M 2016/0036 in the breathing tube and used in both inspiratory and expiratory phase
• CPC Class Codes: A61M 2205/3523 using telemetric means
• CPC Class Codes: A61M 2205/3569 sublocal, e.g. between console and disposable
• CPC Class Codes: A61N 1/3601 of respiratory organs
• CPC Class Codes: A61N 1/365 controlled by a physiological parameter, e.g. heart potential evoked response A61N1/371
• CPC Class Codes: A61N 1/36521 the parameter being derived from measurement of an electrical impedance
• CPC Class Codes: A61N 1/3684 for stimulating the heart at multiple sites of the ventricle or the atrium
• CPC Class Codes: A61N 1/36842 Multi-site stimulation in the same chamber
• CPC Class Codes: A61N 1/36843 Bi-ventricular stimulation

Abstract

Methods and systems provide an approach to therapy control based on assessment of a patient'"'"'s cardiopulmonary status. Conditions sensed via sensors of an external respiratory therapy device are used to assess a patient'"'"'s cardiopulmonary status. The respiratory therapy device sensors may be utilized alone or in combination with other sensors to determine cardiopulmonary status of a patient. Therapy delivered to the patient is controlled based on the cardiopulmonary status assessment. For example, therapy delivered to the patient may be initiated, terminated, and/or modified based on the assessed cardiopulmonary status of the patient. Cardiopulmonary status assessment, therapy control, or both, are performed by an implantable device.

Claims

1. A medical therapy control system, comprising:

an external respiratory therapy device comprising a first sensor system configured to sense a first set of one or more physiological conditions and a therapy unit configured to provide positive airway pressure to a patient;

an implantable cardiac therapy device comprising a second sensor system configured to sense a second set of one or more physiological conditions and a therapy unit configured to deliver electrical stimulation to the patient'"'"'s heart;

a cardiopulmonary disorder processor coupled to the first and the second sensor systems and configured to detect rhythm breathing disorders, including at least apnea, and non-rhythm breathing disorders, including one or more pulmonary vasculature disorders, based on changes in the first set and the second set of sensed physiological conditions, the cardiopulmonary disorder processor configured to identify a cardiopulmonary disorder affecting a patient as a breathing rhythm disorder or a non-rhythm breathing disorder; and

a therapy controller coupled to the cardiopulmonary disorder processor and configured to control a therapy delivered to the patient based on the identified cardiopulmonary disorder, wherein at least one of the cardiopulmonary disorder processor and the therapy controller are disposed within the implantable cardiac therapy device;

wherein the cardiopulmonary disorder processor is further configured to detect one or more infectious pulmonary disorders based on the first set and the second set of sensed physiological conditions and to identify the cardiopulmonary disorder as the breathing rhythm disorder, the non-rhythm breathing disorder, or an infectious pulmonary disorder;

wherein the one or more infectious pulmonary disorders comprise one or more of bronchitis, pneumonia, bronchiolitis, tuberculosis, and bronchiectasis; and

wherein the cardiopulmonary disorder processor is further configured to identify the infectious pulmonary disorder as bronchitis, pneumonia, bronchiolitis, tuberculosis, or bronchiectasis.

2. A medical therapy control system, comprising:

an external respiratory therapy device comprising a first sensor system configured to sense a first set of one or more physiological conditions and a therapy unit configured to provide positive airway pressure to a patient;

an implantable cardiac therapy device comprising a second sensor system configured to sense a second set of one or more physiological conditions and a therapy unit configured to deliver electrical stimulation to the patient'"'"'s heart;

a cardiopulmonary disorder processor coupled to the first and the second sensor systems and configured to detect rhythm breathing disorders, including at least apnea, and non-rhythm breathing disorders, including one or more pulmonary vasculature disorders, based on changes in the first set and the second set of sensed physiological conditions, the cardiopulmonary disorder processor configured to identify a cardiopulmonary disorder affecting a patient as a breathing rhythm disorder or a non-rhythm breathing disorder; and

a therapy controller coupled to the cardiopulmonary disorder processor and configured to control a therapy delivered to the patient based on the identified cardiopulmonary disorder, wherein at least one of the cardiopulmonary disorder processor and the therapy controller are disposed within the implantable cardiac therapy device;

wherein the one or more pulmonary vasculature disorders comprise pulmonary edema and at least one other type of pulmonary vasculature disorder; and

wherein the cardiopulmonary disorder processor is configured to identify the cardiopulmonary disorder as a pulmonary vasculature disorder including discriminating between the pulmonary edema and the at least one other pulmonary vasculature disorder.

3. A medical therapy control system, comprising:

an external respiratory therapy device comprising a first sensor system configured to sense a first set of one or more physiological conditions and a therapy unit configured to provide positive airway pressure to a patient;

an implantable cardiac therapy device comprising a second sensor system configured to sense a second set of one or more physiological conditions and a therapy unit configured to deliver electrical stimulation to the patient'"'"'s heart;

a cardiopulmonary disorder processor coupled to the first and the second sensor systems and configured to detect rhythm breathing disorders, including at least apnea, and non-rhythm breathing disorders, including one or more pulmonary vasculature disorders, based on changes in the first set and the second set of sensed physiological conditions, the cardiopulmonary disorder processor configured to identify a cardiopulmonary disorder affecting a patient as a breathing rhythm disorder or a non-rhythm breathing disorder; and

a therapy controller coupled to the cardiopulmonary disorder processor and configured to control a therapy delivered to the patient based on the identified cardiopulmonary disorder, wherein at least one of the cardiopulmonary disorder processor and the therapy controller are disposed within the implantable cardiac therapy device;

wherein the cardiopulmonary disorder processor is configured to identify the cardiopulmonary disorder by discriminating between chronic bronchitis, emphysema, and asthma.

4. A medical therapy control system, comprising:

an external respiratory therapy device comprising a first sensor system configured to sense a first set of one or more physiological conditions and a therapy unit configured to provide positive airway pressure to a patient;

an implantable cardiac therapy device comprising a second sensor system configured to sense a second set of one or more physiological conditions and a therapy unit configured to deliver electrical stimulation to the patient'"'"'s heart;

a cardiopulmonary disorder processor coupled to the first and the second sensor systems and configured to detect rhythm breathing disorders, including at least apnea, and non-rhythm breathing disorders, including one or more pulmonary vasculature disorders, based on changes in the first set and the second set of sensed physiological conditions, the cardiopulmonary disorder processor configured to identify a cardiopulmonary disorder affecting a patient as a breathing rhythm disorder or a non-rhythm breathing disorder; and

a therapy controller coupled to the cardiopulmonary disorder processor and configured to control a therapy delivered to the patient based on the identified cardiopulmonary disorder, wherein at least one of the cardiopulmonary disorder processor and the therapy controller are disposed within the implantable cardiac therapy device;

wherein the cardiopulmonary disorder processor is configured to identify the non-rhythm breathing disorder including discriminating between pulmonary hypertension, pulmonary edema, and another type of non-rhythm breathing disorder.

5. A medical therapy control system, comprising:

an external respiratory therapy device comprising a first sensor system configured to sense a first set of one or more physiological conditions and a therapy unit configured to provide positive airway pressure to a patient;

an implantable cardiac therapy device comprising a second sensor system configured to sense a second set of one or more physiological conditions and a therapy unit configured to deliver electrical stimulation to the patient'"'"'s heart;

a cardiopulmonary disorder processor coupled to the first and the second sensor systems and configured to detect rhythm breathing disorders, including at least apnea, and non-rhythm breathing disorders, including one or more pulmonary vasculature disorders, based on changes in the first set and the second set of sensed physiological conditions, the cardiopulmonary disorder processor configured to identify a cardiopulmonary disorder affecting a patient as a breathing rhythm disorder or a non-rhythm breathing disorder; and

a therapy controller coupled to the cardiopulmonary disorder processor and configured to control a therapy delivered to the patient based on the identified cardiopulmonary disorder, wherein at least one of the cardiopulmonary disorder processor and the therapy controller are disposed within the implantable cardiac therapy device;

wherein the cardiopulmonary disorder processor is configured to detect one or more pleural disorders based on the first set and the second set of sensed physiological conditions, the cardiopulmonary disorder processor being further configured to identify the cardiopulmonary disorder as the breathing rhythm disorder, the non-rhythm breathing disorder, or a pleural disorder;

wherein the cardiopulmonary disorder processor is configured to identify the cardiopulmonary disorder as the pleural disorder including discriminating between pleural effusion, pneumothorax, and hemothorax.