Prediction of disordered breathing

• US 7,938,782 B2
• Filed: 05/12/2008
• Issued: 05/10/2011
• Est. Priority Date: 08/18/2003
• Status: Expired due to Fees

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Hartley, Jesse, Stahmann, Jeffrey E., Hatlestad, John D., Lee, Kent, Ni, Quan, Daum, Douglas R.
• Primary Examiner(s): Marmor, II; Charles A
• Assistant Examiner(s): Toth; Karen E
• Application Number:
  US12/152,029
• Publication Number:
  US 20080221468A1
• Time in Patent Office: 1,093 Days
• Field of Search: 324600-727, 600/506, 600529-543, 600/547
• US Class Current: 600/536
• CPC Class Codes: A61B 2560/0242 adapted to measure environmental factors, e.g. temperature, pollution
• CPC Class Codes: A61B 2562/0219 Inertial sensors, e.g. accelerometers, gyroscopes, tilt switches
• CPC Class Codes: A61B 5/0031 Implanted circuitry
• CPC Class Codes: A61B 5/02405 Determining heart rate variability
• CPC Class Codes: A61B 5/08 Detecting, measuring or recording devices for evaluating the respiratory organs A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/0816 Measuring devices for examining respiratory frequency measuring frequency of electric signals G01R23/00
• CPC Class Codes: A61B 5/1116 Determining posture transitions
• CPC Class Codes: A61B 5/1118 Determining activity level
• CPC Class Codes: A61B 5/4812 Detecting sleep stages or cycles
• CPC Class Codes: A61B 5/4815 Sleep quality
• CPC Class Codes: A61B 5/4818 Sleep apnoea
• CPC Class Codes: A61N 1/36514 controlled by a physiological quantity other than heart potential, e.g. blood pressure controlled by two or more physical parameters A61N1/36585

Abstract

An approach for predicting disordered breathing involves detecting one or more conditions associated with disordered breathing. The detected conditions are compared to disordered breathing prediction criteria. A prediction of disordered breathing is performed based on the comparison of the detected conditions to the prediction criteria. At least one of comparing the detected conditions to the prediction criteria and predicting disordered breathing is performed at least in part implantably.

Claims

1. A method of operating a medical device to predict disordered breathing in a patient, comprising:

measuring a transthoracic impedance of the patient;

detecting a pulmonary congestion condition of the patient based on the measured transthoracic impedance;

comparing the detected pulmonary congestion condition to a prediction criterion; and

predicting disordered breathing based on the comparison, wherein each of measuring, detecting, comparing and predicting is performed by the medical device.

2. The method of claim 1, wherein the detecting includes detecting a plurality of conditions associated with disordered breathing, of which the pulmonary congestion condition is one.

3. The method of claim 1, wherein the detecting includes detecting a plurality of conditions predisposing the patient to disordered breathing, of which the pulmonary congestion condition is one.

4. The method of claim 1, wherein the detected pulmonary congestion condition is one of a plurality of detected conditions, wherein the prediction criterion is included in one or more sets of prediction criteria, and wherein the comparing includes comparing the plurality of detected conditions to the one or more sets of prediction criteria.

5. The method of claim 1, wherein the predicting is performed at least in part implantably.

6. The method of claim 1, wherein each of measuring, detecting, comparing, and predicting is performed at least in part implantably.

7. The method of claim 1, wherein the detected pulmonary congestion condition is one of a plurality of detected conditions, and wherein the comparing includes (a) computing an estimated probability that disordered breathing will occur based on the detected conditions, and (b) comparing the estimated probability to a threshold probability associated with an onset of disordered breathing.

8. The method of claim 1, wherein the prediction criterion is included in one or more sets of prediction criteria, the method further comprising:

adjusting a particular set of prediction criteria based on the detected pulmonary congestion condition.

9. The method of claim 1, wherein the predicting includes predicting the disordered breathing will occur within a particular time interval.

10. A medical device operable to predict disordered breathing in a patient, comprising:

a sensor configured to sense a transthoracic impedance of the patient;

a detector system coupled to the sensor and configured to detect conditions associated with disordered breathing, the detected conditions including a pulmonary congestion condition of the patient; and

a prediction engine coupled to the detector system and configured to predict disordered breathing based on the detected conditions.

11. The device of claim 10, wherein the prediction engine includes an implantable component.

12. The device of claim 10, wherein the sensor, the detector system, and the prediction engine each include an implantable component.

13. The device of claim 10, wherein the prediction engine is further configured to (a) compare the detected pulmonary congestion condition to a prediction criterion, and (b) predict the disordered breathing based on the comparison.

14. The device of claim 10, wherein the prediction engine is further configured to (a) compare the detected conditions to one or more sets of prediction criteria, and (b) predict the disordered breathing based on the comparison.

15. The device of claim 14, wherein the prediction engine is further configured to (a) compute an estimated probability that disordered breathing will occur based on the detected conditions, and (b) compare the estimated probability to a threshold probability associated with an onset of disordered breathing.

16. The device of claim 14, wherein the prediction engine is further configured to adjust a particular set of prediction criteria based on the detected pulmonary congestion condition.

17. The device of claim 14, wherein the prediction engine is configured to predict that the disordered breathing will occur within a particular time interval.

18. The device of claim 10, further comprising a data storage unit configured to store data associated with disordered breathing predictions.

19. The device of claim 18, wherein the data storage unit is configured to count a number of disordered breathing predictions.