Use of external respiratory therapy device to detect cardiac electrical activity

• US 7,981,042 B2
• Filed: 02/14/2008
• Issued: 07/19/2011
• 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): Layno; Carl H
• Assistant Examiner(s): Stice; Paula J
• Application Number:
  US12/069,989
• Publication Number:
  US 20080139948A1
• Time in Patent Office: 1,251 Days
• Field of Search: 600/483, 600/484, 600/513, 600/529, 600/509
• US Class Current: 600/484
• 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 5/02055 Simultaneously evaluating both cardiovascular condition and temperature
• CPC Class Codes: A61B 5/0215 by means inserted into the body catheters A61M25/00
• CPC Class Codes: A61B 5/02405 Determining heart rate variability
• CPC Class Codes: A61B 5/053 Measuring electrical impedance or conductance of a portion of the body
• CPC Class Codes: A61B 5/0809 by impedance pneumography
• CPC Class Codes: A61B 5/0836 Measuring rate of CO2 production
• CPC Class Codes: A61B 5/087 Measuring breath flow
• CPC Class Codes: A61B 5/103 Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes A61B5/08 takes precedence; measuring aids for tailors A41H1/00; measuring instruments specially adapted for dentistry A61C19/04
• CPC Class Codes: A61B 5/1116 Determining posture transitions
• CPC Class Codes: A61B 5/113 occurring during breathing
• CPC Class Codes: A61B 5/285 Endotracheal, oesophageal or gastric probes
• CPC Class Codes: A61B 5/287 Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61B 5/363 Detecting tachycardia or bradycardia
• CPC Class Codes: A61B 5/369 Electroencephalography [EEG] devices for psychotechnics A61B5/16
• CPC Class Codes: A61B 5/389 Electromyography [EMG]
• CPC Class Codes: A61B 5/398 Electrooculography [EOG], e.g. detecting nystagmus; Electroretinography [ERG]
• CPC Class Codes: A61B 5/4818 Sleep apnoea
• CPC Class Codes: A61B 5/6803 Head-worn items, e.g. helmets, masks, headphones or goggles
• CPC Class Codes: A61B 5/6823 : Trunk, e.g., chest, back, abdomen, hip
• CPC Class Codes: A61B 5/686 : Permanently implanted devices, e.g. pacemakers, other stimulators, biochips A61B5/6861 takes precedence
• CPC Class Codes: A61M 16/0051 : with alarm devices
• CPC Class Codes: A61M 16/024 : including calculation means, e.g. using a processor
• CPC Class Codes: A61M 16/10 : Preparation of respiratory gases or vapours
• CPC Class Codes: A61M 2016/0021 : with a proportional output signal, e.g. from a thermistor
• CPC Class Codes: A61M 2016/0039 : in the inspiratory circuit
• CPC Class Codes: A61M 2016/0042 : in the expiratory circuit
• CPC Class Codes: A61M 2205/3561 : local, e.g. within room or hospital
• CPC Class Codes: A61M 2205/3592 : using telemetric means, e.g. radio or optical transmission
• CPC Class Codes: A61M 2230/04 : Heartbeat characteristics, e.g. ECG, blood pressure modulation
• CPC Class Codes: A61M 2230/10 : Electroencephalographic signals
• CPC Class Codes: A61M 2230/432 : partial CO2 pressure (P-CO2)
• CPC Class Codes: A61M 2230/435 : partial O2 pressure (P-O2)
• CPC Class Codes: A61M 2230/60 : Muscle strain, i.e. measured on the user
• CPC Class Codes: A61M 2230/63 : Motion, e.g. physical activity
• CPC Class Codes: A61M 2230/65 : Impedance, e.g. conductivity, capacity
• 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 1/36514 : controlled by a physiological quantity other than heart potential, e.g. blood pressure controlled by two or more physical parameters A61N1/36585
• CPC Class Codes: A61N 1/36592 : controlled by the heart rate variability
• CPC Class Codes: A61N 1/37 : Monitoring; Protecting

Abstract

Methods and systems provide an integrated approach to respiratory and cardiac monitoring, diagnosis and/or therapy. A medical system includes one or more cardiac electrodes coupled to an external respiratory therapy device. The cardiac electrodes sense cardiac electrical activity that is used to generate an electrocardiogram (ECG) signal. Cardiac events, such as arrhythmia, myocardial infarction and/or ischemia, may be detected based on the sensed cardiac electrical activity.

Claims

1. A medical system, comprising:

an external respiratory therapy device configured to deliver an external respiratory therapy to a patient, the external respiratory therapy device including;

a respiratory event detector configured to detect respiratory events;

control circuitry configured to adjust the respiratory therapy based on the detected respiratory events;

one or more cardiac electrodes configured to sense cardiac electrical activity, the one or more cardiac electrodes located external to the patient;

circuitry, disposed within a housing of the external respiratory therapy device, configured to generate an electrocardiogram (ECG) signal based on the sensed cardiac electrical activity;

a cardiac event detector configured to detect cardiac dysfunction events based on the ECG signal; and

circuitry, disposed within the external respiratory therapy device housing, the circuitry configured to collect information based at least in part on the ECG signal, the collected information stored during each of multiple uses of the respiratory therapy device, the multiple uses corresponding to multiple sleep periods during which the patient uses the external respiratory therapy device; and

a processor located external to the patient and configured to analyze cardiac conditions of the patient over the multiple uses based on the collected information.

2. The medical system of claim 1, wherein the cardiac event detector is configured to detect arrhythmia.

3. The medical system of claim 1, wherein the processor is configured to develop a trend of one or more cardiac conditions related to heart failure.

4. The medical system of claim 1, wherein the processor is configured to develop a trend of cardiac and respiratory conditions related to heart failure.

5. The medical system of claim 1, wherein the processor is configured to determine relationships between the cardiac dysfunction events and the respiratory events.

6. The medical system of claim 1, wherein the processor is configured to monitor progression of heart failure based on the collected information.

7. The medical system of claim 1, wherein the processor is configured to diagnose cardiac disorders and respiratory disorders based on the collected information.

8. The medical system of claim 1, wherein the ECG signals are not used to control the respiratory therapy.

9. The medical system of claim 1, wherein the ECG signals are used at least in part to adjust the respiratory therapy.

10. The medical system of claim 1, further comprising an implantable cardiac therapy device, wherein operation of the implantable cardiac therapy device is based at least in part on the ECG signal and the respiratory events.

11. The medical system of claim 10, wherein the implantable cardiac therapy device is configured to deliver an electrical cardiac therapy to treat heart failure and delivery of the electrical cardiac therapy is based at least in part on the ECG signal and the respiratory events.

12. The medical system of claim 1, further comprising an implantable cardiac therapy device, wherein operation of the implantable cardiac therapy device is based at least in part on the collected information.

13. The medical system of claim 12, wherein the implantable cardiac therapy device is configured to deliver an electrical cardiac therapy to treat heart failure and delivery of the electrical cardiac therapy is based at least in part on the ECG signal.

14. The medical system of claim 1, wherein the processor is further configured to determine heart rate variability based on the collected information.

15. The medical system of claim 1, wherein the external respiratory therapy device is configured to cause another device to initiate delivery of a cardiac therapy based on detection of arrhythmia by the processor.

16. The medical system of claim 1, wherein the control circuitry is configured to control delivery of the respiratory therapy based at least in part on the respiratory events and the cardiac conditions.

17. The medical system of claim 1, wherein the external respiratory therapy device comprises a mask assembly, the external respiratory therapy comprises positive airway pressure that is delivered through the mask assembly, the one or more cardiac electrodes are mechanically coupled to the mask assembly, and the mask assembly is configured to hold the one or more electrodes against the patient during delivery of the external respiratory therapy to facilitate sensing of the cardiac electrical activity.

18. A medical system, comprising:

an external respiratory therapy device configured to deliver an external respiratory therapy to a patient, the external respiratory therapy device including;

means for detecting respiratory events;

means for controlling the external respiratory therapy based on the detected respiratory events;

means for externally sensing cardiac electrical activity;

means for generating an electrocardiogram (ECG) signal based on the sensed cardiac electrical activity;

means for detecting cardiac dysfunction events based on the ECG signal;

means for collecting and storing information based at least in part on the ECG signal, the information collected during multiple deliveries of the external respiratory therapy, the multiple deliveries corresponding to multiple sleep periods during which the patient uses the external respiratory therapy device; and

means for externally analyzing cardiac conditions of the patient based on the information collected over the multiple deliveries of the external respiratory therapy.