System and method for monitoring autonomic balance and physical activity

• US 7,833,164 B2
• Filed: 08/10/2009
• Issued: 11/16/2010
• Est. Priority Date: 10/28/2003
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Carlson, Gerrard M., Scheiner, Avram, Hopper, Donald L.
• Primary Examiner(s): Nasser; Robert L
• Application Number:
  US12/538,553
• Publication Number:
  US 20090299159A1
• Time in Patent Office: 463 Days
• Field of Search: None
• US Class Current: 600/485
• CPC Class Codes: A61B 5/029 Measuring or recording blood output from the heart, e.g. minute volume A61B8/065 takes precedence
• CPC Class Codes: A61B 5/366 Detecting abnormal QRS complex, e.g. widening
• CPC Class Codes: A61B 5/4035 Evaluating the autonomic nervous system
• CPC Class Codes: A61N 1/36585 controlled by two or more physical parameters

Abstract

An implantable device monitors the balance between sympathetic tone and parasympathetic tone as a function of an activity level. Cardio-neurological healthy users exhibit a generally sympathetic tone in conjunction with heavy activity level and a generally parasympathetic tone in conjunction with periods of low activity level. Deviations from expected results are associated with a health problem. Measured conditions are stored and available for subsequent reporting to a remote programmer. Therapy delivered by an implantable device is determined as a function of the relationship between autonomic balance and activity level.

Claims

1. An implantable device comprising:

an autonomic tone sensor to provide a tone signal as a function of a sympathetic nervous system and as a function of a parasympathetic nervous system for a predetermined period of time;

an activity sensor to provide an activity signal as a function of physical activity corresponding to the predetermined period; and

an information processing unit connected to the autonomic tone sensor and connected to the activity sensor and adapted to generate an output signal based upon a relationship between the tone signal and the activity signal, compare the output signal to a baseline that correlates different tone signals with different activity signals over a predetermined period of time, and classify a patient'"'"'s health status based upon the comparison.

2. The device of claim 1 wherein the information processing unit is adapted to use a baseline established with population norms.

3. The device of claim 1 wherein the information processing unit is adapted to establish multiple patient-specific baselines for different exertion levels that include a resting baseline.

4. The device of claim 1 wherein the information processing unit is adapted to establish multiple patient-specific baselines for different exertion levels that include a maximum exertion baseline.

5. The device of claim 1 wherein the autonomic tone sensor includes at least one sensor selected from any combination of a group including a heart rate sensor, a nerve electrode, a biochemical sensor, a ventilation sensor and a muscle activity sensor.

6. The device of claim 1 wherein the activity sensor includes at least one sensor selected from any combination of a group including a minute ventilation sensor, an accelerometer, a respiratory sensor, a QT interval sensor, an impedance sensor, a contractility sensor and a depolarization sensor.

7. The device of claim 1 further including a telemetry circuit connected to the information processing unit to communicate with a remote device.

8. The device of claim 1 further including a therapy circuit connected to the information processing unit.

9. The device of claim 1 further including a transducer for generating an audible or tactile warning message when a dangerous condition is detected.

10. The device of claim 1 wherein the autonomic tone sensor and information processing unit are adapted to determine heart rate variability.

11. A method comprising:

generating an autonomic tone signal as a function of autonomic tone detected during an epoch using an implantable sensor;

obtaining an activity signal as a function of physical activity during the epoch; and

generating an output signal based upon a relationship between the tone signal and the activity signal, compare the output signal to a baseline that correlates different tone signals with different activity signals over a predetermined period of time, and classify a patient'"'"'s health status based upon the comparison.

12. The method of claim 11 wherein the baseline is established with population norms.

13. The method of claim 11 further comprising establishing multiple patient-specific baselines for different exertion levels that include a resting baseline.

14. The method of claim 11 further comprising establishing multiple patient-specific baselines for different exertion levels that include a maximum exertion baseline.

15. The method of claim 11 wherein the autonomic tone signal includes at least one signal selected from any combination of a group including a heart rate, a nerve signal, a biochemical signal, a ventilation signal and a muscle activity signal.

16. The method of claim 11 wherein the activity signal includes at least one signal selected from any combination of a group including a minute ventilation signal, an acceleration signal, a QT interval sensor, an impedance signal, and a contractility signal.

17. The method of claim 11 further including communicating the output signal to a remote device via telemetry.

18. The method of claim 11 further including delivering therapy as a function of the output signal.

19. The method of claim 11 further including generating an audible or tactile warning message when a dangerous condition is detected.

20. The method of claim 11 wherein generating an autonomic tone signal includes determining heart rate variability.