Physiological event detection systems and methods

• US 8,257,271 B2
• Filed: 05/10/2010
• Issued: 09/04/2012
• Est. Priority Date: 03/13/2006
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Siejko, Krzysztof Z., Hatlestad, John D.
• Primary Examiner(s): Bertram, Eric D.
• Application Number:
  US12/776,557
• Publication Number:
  US 20100222653A1
• Time in Patent Office: 848 Days
• Field of Search: 600/300, 600/508
• US Class Current: 600/508
• CPC Class Codes: A61B 5/00 Measuring for diagnostic purposes radiation diagnosis A61B6/00; diagnosis by ultrasonic, sonic or infrasonic waves A61B8/00; Identification of persons
• CPC Class Codes: A61B 5/053 Measuring electrical impedance or conductance of a portion of the body
• CPC Class Codes: A61B 5/746 Alarms related to a physiological condition, e.g. details of setting alarm thresholds or avoiding false alarms alarms per se G08B
• CPC Class Codes: A61B 7/023 for introduction into the body, e.g. into the oesophagus oesophageal ECG probes A61B5/285
• 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: G16H 40/40 for the management of medical equipment or devices, e.g. scheduling maintenance or upgrades
• CPC Class Codes: G16H 40/63 for local operation

Abstract

Systems and methods using constant false alarm rate techniques for event detection. One example of an event detection method includes collecting a first distribution of measurements for a first physiological parameter. In another example, the first distribution of measurements includes only non-event measurements. One or more values are determined corresponding to at least a first tail area of the first distribution from at least one measurement of the first physiological parameter toward an end point of the distribution. A threshold is established based on a specified false alarm rate. The one or more values are compared to the threshold. The method includes determining if the measurement is representative of a detected event using the comparison.

Claims

1. A non-transitory device readable medium, comprising instructions that when performed by the device, cause the device to perform acts comprising:

forming a distribution of values of a first physiological parameter using the first physiological parameter and a second physiological parameter measured with one or more physiological sensors of a medical device;

receiving a specified false alarm rate;

computing an event detection threshold with a processor of the medical device, the event detection threshold is based on the specified false alarm rate and the distribution of values of the first physiological parameter, the processor changing the event detection threshold according to a change in the distribution of values;

obtaining a measurement of the first physiological parameter with one or more of the physiological sensors of the medical device;

comparing the measurement of the first physiological parameter to the event detection threshold; and

generating an indication representative of a detected event using the comparison.

2. The device readable medium of claim 1, wherein forming the distribution of values of the first physiological parameter includes associating one or more values of the first physiological parameter with the second physiological parameter.

3. The device readable medium of claim 1, wherein forming the distribution of values of the first physiological parameter includes screening values of the first physiological parameter with the second physiological parameter.

4. The method of claim 1 comprising:

associating the measurement of the first physiological parameter with the second physiological parameter if the measurement is obtained during detection of the second physiological parameter; and

adding the measurement to the distribution of values if the measurement is declared a non-event.

5. The device readable medium of claim 1, wherein obtaining the second physiological parameter includes detecting the second physiological parameter selected from the group consisting essentially of posture and sleep state.

6. The device readable medium of claim 1 comprising:

setting a static threshold independent of the specified false alarm rate and the distribution of values of the first physiological parameter;

comparing the measurement of the first physiological parameter to the static threshold; and

declaring whether the measurement is representative of a detected event using the comparison with the static threshold.

7. The device readable medium of claim 1, wherein one or more of obtaining the first and second physiological parameters, forming the distribution of values and obtaining the measurement of the first physiological parameter are performed by an implantable medical device.

8. The device readable medium of claim 1 wherein forming the distribution of values of the first physiological parameter is performed on a recurring basis.

9. The device readable medium of claim 1, comprising:

obtaining the first physiological parameter;

obtaining the second physiological parameter.

10. A method comprising:

screening a first distribution of values for a first physiological parameter according to a second physiological parameter, the first and second physiological parameters are measured with one or more physiological sensors of a medical device;

establishing an event detection threshold with a processor of the medical device, the event detection threshold based on a specified false alarm rate and the screened first distribution of values, the processor changing the event detection threshold according to changes in the first distribution of values;

obtaining a measurement of the first physiological parameter with one or more of the physiological sensors of a medical device;

comparing the measurement to the event detection threshold; and

generating an indication representative of a detected event using the comparison.

11. The method of claim 10 comprising excluding one or more values from the first distribution of values where the one or more values are determined from a specified time period prior to obtaining of the measurement.

12. The method of claim 10 comprising:

setting a static threshold independent of the specified false alarm rate and the first distribution of values;

comparing the measurement of the first physiological parameter to the static threshold; and

determining the measurement is representative of a detected event using the comparison with the static threshold.

13. The method of claim 10, comprising excluding one or more values from the first distribution of values wherein the one or more values are associated with the second physiological parameter.

14. The method of claim 13, wherein excluding of the one or more values associated with the second physiological parameter includes exclusion of the one or more values determined while the second physiological parameter is detected.

15. The method of claim 13 comprising:

forming a second distribution of values with the excluded one or more values;

establishing a second event detection threshold based on a second specified false alarm rate and the second distribution of values, the second event detection threshold changing according to changes in the second distribution of values;

obtaining a second measurement of the first physiological parameter;

comparing the second measurement to the second event detection threshold; and

determining whether the second measurement is representative of a detected event using the comparison.

16. The method of claim 13, comprising excluding values obtained from a specified time period prior to obtaining of the measurement of the first physiological parameter.

17. An apparatus comprising:

a processor circuit comprising;

a distribution forming circuit configured to form a distribution of measurements of a first physiological parameter screened with a second physiological parameter,

a comparator configured to compare a measurement of the first physiological parameter with a threshold, the threshold based on a specified false alarm rate and the distribution of measurements, the threshold changing according to changes in the distribution of measurements, and

an event indicator configured to provide an event indication if the measurement is representative of a detected event using the comparison.

18. The apparatus of claim 17, wherein the distribution forming circuit is configured to associate the measurements of the first physiological parameter with the second physiological parameter where the measurements are collected while the second physiological parameter is detected.

19. The apparatus of claim 17, wherein the comparator is configured to compare the measurement with a static threshold, and

the event indicator is adapted to provide an event indication if the measurement is representative of a detected event using the comparison of the measurement with the static threshold.

20. The apparatus of claim 17 comprising:

a physiological status sensor to detect the second physiological parameter;

a physiological sensor to collect a plurality of measurements of the first physiological parameter.

21. The apparatus of claim 17, wherein one or more of the physiological status sensor, physiological sensor and the processor circuit are housed within an implantable medical device.

22. The apparatus of claim 17, wherein the physiological status sensor is adapted to detect second physiological parameter selected from the group consisting essentially of posture and sleep status.