Method and apparatus for determining respiratory effort in a medical device

• US 8,202,223 B2
• Filed: 10/31/2008
• Issued: 06/19/2012
• Est. Priority Date: 09/19/2008
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Cho, Yong K., Bennett, Tommy D., Erickson, Mark K., Shrivastav, Maneesh, Greenhut, Saul E., Kleckner, Karen J., Sperling, Charles P., Corey, Robert A.
• Primary Examiner(s): DUNSTON, JENNIFER ANN
• Application Number:
  US12/262,320
• Publication Number:
  US 20100076325A1
• Time in Patent Office: 1,327 Days
• Field of Search: None
• US Class Current: 600/484
• CPC Class Codes: A61B 5/0031 Implanted circuitry
• 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 5/0215 by means inserted into the body catheters A61M25/00
• CPC Class Codes: A61B 5/0816 Measuring devices for examining respiratory frequency measuring frequency of electric signals G01R23/00
• CPC Class Codes: A61B 5/4818 Sleep apnoea
• CPC Class Codes: A61B 5/6846 specially adapted to be brought in contact with an internal body part, i.e. invasive
• 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 1/3702 Physiological parameters A61N1/365 takes precedence; evoked response A61N1/371
• CPC Class Codes: A61N 1/37258 Alerting the patient

Abstract

A method of determining respiratory effort in a medical device in which pressure signals are sensed to generate corresponding sample points, an inspiration and an expiration are detected in response to the sensed pressure signals, a breath is detected in response to the detected inspiration and the detected expiration, and the respiratory effort is determined in response to the detected breath.

Claims

1. A method of determining respiratory effort in a medical device, comprising

sensing pressure signals to generate sample points;

detecting a first predetermined number of sample points less than a detection threshold;

detecting a second predetermined number of sample points greater than the detection threshold;

detecting an inspiration in response to the first predetermined number of sample points;

detecting an expiration in response to the second predetermined number of sample points;

detecting a breath in response to the detected inspiration and the detected expiration, wherein the second predetermined number of sample points occur subsequent to the first predetermined number of sample points within the breath;

detecting a peak inspiration of a first detected breath during a first interval, wherein the first interval is defined by a sample point of second predetermined sample points associated with a breath detected prior to the first detected breath and a sample point of the second predetermined number of sample points associated with the first detected breath;

detecting peak expiration of the first detected breath during a second interval, wherein the second interval is defined by a sample point of the first predetermined number of sample points associated with the first detected breath and a sample point of the first predetermined number of sample points associated with a breath detected subsequent to the first detected breath;

determining a difference between the peak inspiration and the peak expiration; and

determining the respiratory effort in response to the determined difference.

3. The method of claim 1 or claim 2, further comprising:

determining a heart rate;

filtering the sensed pressure signals in response to the determined heart rate to generate a heart-rate dependent frequency response; and

deriving a filtered signal in response to the heart rate dependent frequency response, wherein the sample points are generated in response to the derived filtered signal.

4. The method of claim 3, wherein filtering the sensed pressure signals comprises filtering the sensed pressure signals using a first filter having a first frequency response corresponding to the determined heart rate being greater than a heart rate threshold and a second filter having a second frequency response different from the first frequency response, the second frequency response corresponding to the determined heart rate being less than the heart rate threshold.

5. The method of claim 4, wherein the first filter and the second filter are selected one at a time in a sequential manner in response to the determined heart rate and the filtered signal is obtained as a continuous signal comprising sequential outputs of the first filter and the second filter.

6. The method of claim 4, wherein filtering the sensed pressure signals comprises selecting the first filter and the second filter simultaneously for parallel filtering of the pressure signals, and wherein the filtered signal comprises a first signal component corresponding to an output of the first filter and a second signal component corresponding to an output of the second filter.

7. The method of claim 4, wherein the first and second filters each comprise multiple filtering stages, the first filter is a subset of the multiple stages of the second filter, and further comprising decimating the pressure signal following at least one of the multiple stages.

2. A method of determining respiratory effort in a medical device, comprising

sensing pressure signals to generate sample points;

detecting a first predetermined number of sample points less than a detection threshold;

detecting a second predetermined number of sample points greater than the detection threshold;

detecting an inspiration in response to the first predetermined number of sample points;

detecting an expiration in response to the second predetermined number of sample points;

detecting a breath in response to the detected inspiration and the detected expiration, wherein the second predetermined number of sample points occur subsequent to the first predetermined number of sample points within the breath;

detecting a peak inspiration of a first detected breath during a first interval, wherein the first interval is defined by a sample point of second predetermined sample points associated with a breath detected prior to the first detected breath and a sample point of the second predetermined number of sample points associated with the first detected breath;

detecting peak expiration of the first detected breath during a second interval, wherein the second interval is defined by a sample point of the first predetermined number of sample points associated with the first detected breath and a sample point of the first predetermined number of sample points associated with a breath detected subsequent to the first detected breath;

determining a slope between the peak inspiration and the peak expiration; and

determining the respiratory effort in response to the determined slope.

8. A method of determining respiratory effort in a medical device, comprising

(a) sensing pressure signals to generate sample points;

(b) detecting an inspiration in response to a first predetermined number of sample points less than a detection threshold, comprising

(i) continuously adjusting a detection threshold in response to the generated sample points to generate a current adjusted detection threshold;

(ii) comparing a current generated sample point to the current adjusted detection threshold;

(iii) detecting a current generated sample point less than the current adjusted detection threshold;

(iv) suspending the continuous adjusting of the detection threshold and setting the detection threshold equal to the most current adjusted detection threshold generated prior to the suspending;

(v) comparing a next sample point, generated subsequent to the suspending, to the set detection threshold; and

(vi) detecting inspiration in response to a first predetermined number of sample points less than the set detection threshold;

(c) detecting an expiration in response to a second predetermined number of sample points greater than a detection threshold, wherein the second predetermined number of sample points occur subsequent to the first predetermined number of sample points within a breath, comprising;

(i) continuously adjusting a detection threshold in response to the generated sample points to generate a current adjusted detection threshold;

(ii) comparing a current generated sample point to the current adjusted detection threshold;

(iii) detecting a current generated sample point greater than the current adjusted detection threshold;

(iv) suspending the continuous adjusting of the detection threshold and setting the detection threshold equal to the most current adjusted detection threshold generated prior to the suspending;

(v) comparing a next sample point, generated subsequent to the suspending, to the set detection threshold; and

(vi) detecting expiration in response to a second predetermined number of sample points greater than the set detection threshold;

(d) detecting a breath in response to the detected inspiration and the detected expiration; and

(e) determining the respiratory effort in response to the detected breath.

9. A method of determining respiratory effort in a medical device, comprising:

(a) sensing cardiac pressure signals;

(b) sensing cardiac signals and determining a heart rate in response to the sensed cardiac signals;

(c) filtering the sensed cardiac pressure signals in response to the determined heart rate to generate a heart-rate dependent frequency response;

(d) deriving a filtered signal in response to the heart rate dependent frequency response;

(e) generating sample points in response to the derived filtered signal;

(f) detecting an inspiration in response to a first predetermined number of sample points less than a detection threshold, comprising

(i) continuously adjusting a detection threshold in response to the generated sample points to generate a current adjusted detection threshold;

(ii) comparing a current generated sample point to the current adjusted detection threshold;

(iii) detecting a current generated sample point less than the current adjusted detection threshold;

(iv) suspending the continuous adjusting of the detection threshold and setting the detection threshold equal to the most current adjusted detection threshold generated prior to the suspending;

(v) comparing a next sample point, generated subsequent to the suspending, to the set detection threshold; and

(vi) detecting inspiration in response to a first predetermined number of sample points less than the set detection threshold;

(g) detecting an expiration in response to a second predetermined number of sample points greater than a detection threshold, wherein the second predetermined number of sample points occur subsequent to the first predetermined number of sample points within a breath, comprising;

(i) continuously adjusting a detection threshold in response to the generated sample points to generate a current adjusted detection threshold;

(ii) comparing a current generated sample point to the current adjusted detection threshold;

(iii) detecting a current generated sample point greater than the current adjusted detection threshold;

(iv) suspending the continuous adjusting of the detection threshold and setting the detection threshold equal to the most current adjusted detection threshold generated prior to the suspending;

(v) comparing a next sample point, generated subsequent to the suspending, to the set detection threshold; and

(vi) detecting expiration in response to a second predetermined number of sample points greater than the set detection threshold;

(h) detecting a breath in response to the detected inspiration and the detected expiration; and

(i) determining the respiratory effort in response to the detected breath.

10. The method of claim 9, wherein determining the respiratory effort comprises:

detecting a peak inspiration and a peak expiration; and

determining a difference between the peak inspiration and the peak expiration.

11. The method of claim 9, wherein determining the respiratory effort comprises:

detecting a peak inspiration of a first detected breath during a first interval; and

detecting a peak expiration of the first detected breath during a second interval,

wherein the first interval is defined by a sample point of second predetermined sample points associated with a breath detected prior to the first detected breath and a sample point of the second predetermined number of sample points associated with the first detected breath, and wherein the second interval is defined by a sample point of the first predetermined number of sample points associated with the first detected breath and a sample point of the first predetermined number of sample points associated with a breath detected subsequent to the first detected breath.

12. The method of claim 9, wherein determining the respiratory effort comprises determining a slope between a sample point of the first predetermined number of sample points and a sample point of the second predetermined number of sample points.

13. The method of claim 9, wherein filtering the sensed pressure signals comprises filtering the sensed pressure signals using a first filter having a first frequency response corresponding to the determined heart rate being greater than a heart rate threshold and a second filter having a second frequency response different from the first frequency response, the second frequency response corresponding to the determined heart rate being less than the heart rate threshold.

14. The method of claim 13, wherein the first filter and the second filter are selected one at a time in a sequential manner in response to the determined heart rate and the filtered signal is obtained as a continuous signal comprising sequential outputs of the first filter and the second filter.

15. The method of claim 13, wherein filtering the sensed pressure signals comprises selecting the first filter and the second filter simultaneously for parallel filtering of the pressure signals, and wherein the filtered signal comprises a first signal component corresponding to an output of the first filter and a second signal component corresponding to an output of the second filter.

16. The method of claim 13, wherein the first and second filters each comprise multiple filtering stages, the first filter is a subset of the multiple stages of the second filter, and further comprising decimating the pressure signal following at least one of the multiple stages.