Systems and methods for use by an implantable medical device for detecting heart failure based on the independent information content of immittance vectors

• US 8,280,511 B2
• Filed: 07/07/2008
• Issued: 10/02/2012
• Est. Priority Date: 07/07/2008
• Status: Active Grant

• Current Assignee: Pacesetter Incorporated (Abbott Laboratories Incorporated)
• Original Assignee: Pacesetter Incorporated (Abbott Laboratories Incorporated)
• Inventors: Zhao, Wenxia, Panescu, Dorin, Bjorling, Anders
• Primary Examiner(s): Layno, Carl H
• Assistant Examiner(s): MALAMUD, DEBORAH LESLIE
• Application Number:
  US12/168,750
• Publication Number:
  US 20100004712A1
• Time in Patent Office: 1,548 Days
• Field of Search: 607 1- 2, 607 5- 9, 607/11, 607 17- 18, 607/23, 607/28, 607/30, 607/32, 607115-116, 607/119, 607/122, 607/123, 600508-510, 600512-513, 600/526
• US Class Current: 607/17
• CPC Class Codes: A61B 5/053 Measuring electrical impedance or conductance of a portion of the body
• CPC Class Codes: A61B 5/0538 invasively, e.g. using a catheter
• 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 1/36521 the parameter being derived from measurement of an electrical impedance

Abstract

Techniques are provided for detecting heart failure or other medical conditions within a patient using an implantable medical device, such as pacemaker or implantable cardioverter/defibrillator, or external system. In one example, physiological signals, such as immittance-based signals, are sensed within the patient along a plurality of different vectors, and the amount of independent informational content among the physiological signals of the different vectors is determined. Heart failure is then detected by the implantable device based on a significant increase in the amount of independent informational content among the physiological signals. In response, therapy may be controlled, diagnostic information stored, and/or warning signals generated. In other examples, at least some of these functions are performed by an external system.

Claims

1. A method for use with an implantable medical device for implant within a patient, the method comprising:

sensing physiological signals within the patient along a plurality of different vectors;

determining an inter-vector cross-correlation coefficient from the plurality of different vectors;

determining an amount of independent informational content from the inter-vector cross-correlation coefficient; and

controlling at least one function based on the amount of independent informational content among the physiological signals of the different vectors.

2. The method of claim 1 wherein sensing physiological signals includes sensing immittance signals.

3. The method of claim 2 wherein sensing immittance signals includes sensing one or more of impedance or admittance signals along a plurality of different vectors within the thorax of the patient.

4. The method of claim 3 wherein at least one of the plurality of vectors passes through the heart of the patient.

5. The method of claim 4 wherein the plurality of vectors include one or more of:

LV ring to RA ring, LV ring to RV ring, and LV ring to Case vectors.

6. The method of claim 4 wherein

determining an inter-vector cross-correlation coefficient comprises determining an inter-vector cross-correlation coefficient from the immittance signals among the different vectors and wherein determining an amount of independent informational content comprises determining the amount of independent informational content from the inter-vector cross-correlation coefficient.

7. The method of claim 6 wherein the correlation coefficient is determined so that a decrease in the correlation coefficient is representative of an increase in the independent informational content among physiological signals of the different vectors.

8. The method of claim 7 wherein the different vectors are selected so that a decrease in the correlation coefficient is representative of a change in hemodynamic equilibrium within the patient.

9. The method of claim 7 wherein the different vectors are selected so that a decrease in the correlation coefficient is representative of deterioration of at least one physiological condition affecting hemodynamic equilibrium.

10. The method of claim 9 wherein the different vectors are selected so that a decrease in the correlation coefficient is representative of heart failure.

11. The method of claim 10 further including:

comparing the correlation coefficient against a predetermined threshold; and

detecting heart failure if the correlation coefficient falls below the threshold.

12. The method of claim 11 wherein a plurality of correlation coefficients are determined based on a plurality of groups of immittance signals and wherein heart failure is detected if a predetermined number of correlation coefficients falls below the threshold.

13. The method of claim 11 wherein a plurality of correlation coefficients are determined based on a plurality of groups of immittance signals and wherein the heart failure is detected if an index based on a predetermined numerical combination of the correlation coefficients falls below the threshold.

14. The method of claim 13 wherein the index is representative of an accumulated change in one or more correlation coefficients.

15. The method of claim 6 wherein determining the cross-correlation coefficient from the immittance signals among the different vectors includes calculating:

16. The method of claim 6 wherein determining the cross-correlation coefficient from the immittance signals among the different vectors is performed over a predetermined interval of time.

17. The method of claim 1 wherein controlling at least one function includes generating a signal indicative of detection of a medical condition based on a change in the amount of independent informational content among the physiological signals of the different vectors.

18. The method of claim 1 wherein controlling at least one function further includes generating a warning signal indicative of a significant increase in the amount of independent informational content among the physiological signals of the different vectors.

19. The method of claim 1 wherein controlling at least one function includes generating diagnostic information representative of the amount of independent informational content among the physiological signals of the different vectors.

20. The method of claim 19 wherein the amount of independent informational content among physiological signals of the different vectors is representative of deterioration of heart failure and wherein the diagnostic information include heart failure trend information.

21. The method of claim 1 wherein controlling at least one function includes controlling the delivery of therapy based on the amount of independent informational content among the physiological signals of the different vectors.

22. The method of claim 1 wherein the steps are performed by the implantable medical device.

23. The method of claim 1 wherein some of the steps are performed by the implantable medical device and others are performed by an external system.

24. The method of claim 23 wherein the step of sensing physiological signals within the patient along a plurality of different vectors is performed by the implantable medical device and wherein the steps of determining the amount of independent informational content and controlling at least one function based on the amount of independent informational content are performed by an external device based on physiological signals sensed within the patient and transmitted to the external device.

25. A system for use with an implantable medical device for implant within a patient, the system comprising:

a multiple vector physiological signal detection unit operative to sense physiological signals within the patient along a plurality of different vectors; and

an independent information content determination unit operative configured to determine an inter-vector cross-correlation coefficient from the plurality of different vectors; and

a controller operative to control at least one function based on the inter-vector cross-correlation coefficient.

26. The system of claim 25 wherein the multiple vector physiological signal detection unit, the independent information content determination unit, and the controller are components of the implantable medical device.

27. The system of claim 25 wherein some of the components of the system are components of the implantable medical device and others are components of an external system.

28. The system of claim 27 wherein the multiple vector physiological signal detection unit is a component of the implantable medical device and the independent information content determination unit and the controller are components of an external system.

29. The system of claim 27 wherein the external system comprises one or more of a device programmer, a bedside monitor, a computer server and a website.

30. The system of claim 25 wherein the amount of independent informational content among physiological signals of the different vectors is representative of heart failure and wherein the controller is operative to generate a warning signal indicative of heart failure.

31. A system for use with an implantable medical device for implant within a patient, the system comprising:

means for sensing physiological signals within the patient along a plurality of different vectors;

means for determining an inter-vector cross-correlation coefficient from the plurality of different vectors;

means for determining an amount of independent informational content from the inter-vector cross-correlation coefficient; and

means for controlling at least one function based on the amount of independent informational content among physiological signals of the different vectors.