System and method for generating a trend parameter based on respiration rate distribution

• US 7,731,663 B2
• Filed: 05/23/2006
• Issued: 06/08/2010
• Est. Priority Date: 09/16/2005
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Zhang, Yi, Averina, Viktoria A., Dalal, Yousufali H.
• Primary Examiner(s): Nasser; Robert L
• Assistant Examiner(s): D'ANGELO, MICHAEL J
• Application Number:
  US11/438,977
• Publication Number:
  US 20070073169A1
• Time in Patent Office: 1,477 Days
• Field of Search: 600/484, 600/538, 600/529
• US Class Current: 600/483
• CPC Class Codes: A61B 2562/0219 Inertial sensors, e.g. accelerometers, gyroscopes, tilt switches
• 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 5/053 Measuring electrical impedance or conductance of a portion of the body
• CPC Class Codes: A61B 5/08 Detecting, measuring or recording devices for evaluating the respiratory organs A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/0803 Recording apparatus specially adapted therefor
• CPC Class Codes: A61B 5/0816 Measuring devices for examining respiratory frequency measuring frequency of electric signals G01R23/00
• CPC Class Codes: A61B 5/411 Detecting or monitoring allergy or intolerance reactions to an allergenic agent or substance
• 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: C07C 17/361 by reactions involving a decrease in the number of carbon atoms
• CPC Class Codes: C07C 19/16 and iodine

Abstract

Systems and methods provide for assessing the heart failure status of a patient and, more particularly, to generating a trend parameter based on a distribution of the patient'"'"'s respiration rate. Systems and methods provide for detecting, using an implantable device or a patient-external device, patient respiration and computing a respiration rate based on the detected patient respiration. A distribution of the respiration rate is calculated, and a trend parameter based on the respiration rate distribution is generated. The trend parameter is indicative of a patient'"'"'s heart failure status. An output signal indicative of the patient'"'"'s heart failure status may be generated based on the trend parameter.

Claims

1. A method, comprising:

detecting respiration of a patient over a period of time;

computing a plurality of respiration rates for the period of time based on the detected patient respiration;

calculating a distribution of the respiration rates by generating a histogram based on the plurality of respiration rates;

generating a trend parameter based on the respiration rate distribution, the parameter based on a ratio between areas under a curve of the histogram, at least one of the areas defined relative to a respiration rate threshold of the histogram;

characterizing heart failure status of the patient based on the trend parameter; and

predicting patient decompensation episodes using the trend parameter, wherein at least one of detecting, computing, generating, and characterizing is performed at least in part using a processor.

2. The method of claim 1, wherein detecting patient respiration comprises detecting patient respiration using an implantable device.

3. The method of claim 1, wherein the at least one of the areas defined relative to a respiration rate threshold of the histogram is an area under the curve of the histogram that is either above or below the respiration rate threshold.

4. The method of claim 1, further comprising generating an output signal indicative of a patient'"'"'s heart failure status based on the trend parameter.

5. The method of claim 1, further comprising titrating a patient therapy using the trend parameter.

6. The method of claim 1, wherein the trend parameter characterizes a respiration rate and a burden of rapid shallow breathing of the patient.

7. The method of claim 1, further comprising discriminating between stable heart failure status and decompensated heart failure status of the patient using the trend parameter.

8. The method of claim 1, further comprising displaying one or both of data and graphs of one or more of the trend parameter, respiration rate, and respiration rate distribution.

9. The method of claim 1, wherein generating the histogram comprises categorizing the plurality of respiration rates along rate values, the respiration rate threshold is a respiration rate value within the histogram that divides the histogram into two portions each concerning different respiration rates, and the ratio is based on two areas under the curve of the histogram.

10. The method of claim 1, wherein the ratio is based on a first area under a portion of the curve of the histogram and a second area under the entire curve of the histogram, and the first portion of the curve is above the respiration rate threshold.

11. The method of claim 1, wherein the ratio is based on a first area under a portion of the curve of the histogram and a second area under the entire curve of the histogram, and the first portion of the curve is below the respiration rate threshold.

12. The method of claim 1, wherein the ratio is based on a first area under a first portion of the curve of the histogram and a second area under a second portion of the curve of the histogram, and the first portion of the curve is below the respiration rate threshold and the second portion of the curve is above the respiration rate threshold.

13. The method of claim 1, further comprising:

providing a measure of characteristic respiration rate for the histogram; and

determining a measure of respiration rate distribution spread;

wherein generating the trend parameter is based on a relationship between the measure of characteristic respiration rate and measure of respiration rate distribution spread.

14. The method of claim 13, further comprising generating a plot of the relationship between the measure of characteristic respiration rate and measure of respiration rate distribution spread.

15. A system, comprising:

a medical device comprising sensing circuitry;

detection circuitry disposed in the medical device and coupled to the sensing circuitry, the detection circuitry configured to detect one or more respiratory parameters; and

a processor coupled to the detection circuitry, the processor configured to calculate a distribution of a respiration rate comprising a histogram of the respiration rate developed from the one or more respiratory parameters, generate a trend parameter indicative of a ratio between areas under a curve of the histogram with at least one of the areas defined relative to a respiration rate threshold of the histogram, characterize heart failure status of the patient based on the trend parameter, and predict patient decompensation episodes using the trend parameter.

16. The system of claim 15, wherein the processor is configured to calculate the ratio between a first area under the curve of the histogram defined relative to the respiration rate threshold and a second area of the histogram.

17. The system of claim 15, wherein the medical device comprises an implantable housing, and the sensing circuitry and detection circuitry are disposed in the implantable housing.

18. The system of claim 15, wherein the medical device comprises a patient-external housing, and the sensing circuitry and detection circuitry are disposed in the patient-external housing.

19. The system of claim 15, wherein the processor comprises a processor of a networked patient management system.

20. The system of claim 15, wherein the processor comprises a processor of a programmer or a portable communicator.

21. The system of claim 15, wherein the sensing circuitry comprises at least one of a transthoracic impedance sensor and a minute ventilation sensor.

22. The system of claim 15, wherein the sensing circuitry comprises one or both of an accelerometer and a pressure sensor.

23. A system, comprising:

means for detecting respiration of a patient over a period of time;

means for computing a plurality of respiration rates for the period of time based on the detected patient respiration;

means for calculating a distribution of the respiration rates by generating a histogram based on the plurality of respiration rates;

means for generating a trend parameter based on the respiration rate distribution, the parameter based on a ratio between areas under a curve of the histogram, at least one of the areas defined relative to a respiration rate threshold of the histogram;

characterizing heart failure status of the patient based on the trend parameter; and

predicting patient decompensation episodes using the trend parameter.

24. The system of claim 23, wherein the respiration detecting means comprises means for detecting patient respiration from within a patient.