Method and apparatus for management of heart failure hospitalization

• US 8,708,924 B2
• Filed: 11/05/2012
• Issued: 04/29/2014
• Est. Priority Date: 03/14/2007
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Wariar, Ramesh, Stahmann, Jeffrey E., Thompson, Julie A., Reeve-Stoffer, Helen L.
• Primary Examiner(s): PATTON, AMANDA K
• Application Number:
  US13/668,659
• Publication Number:
  US 20130060151A1
• Time in Patent Office: 540 Days
• Field of Search: 607/2, 607/18, 128/906, 128/920, 600/508
• US Class Current: 600/508
• 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 5/053 Measuring electrical impedance or conductance of a portion of the body
• CPC Class Codes: A61B 5/145 Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissuemeasuring of blood pressure or blood flow A61B5/02; non-radiation detecting or locating of foreign bodies in blood A61B5/06
• CPC Class Codes: A61B 5/14546 for measuring analytes not otherwise provided for, e.g. ions, cytochromes
• CPC Class Codes: A61B 5/283 Invasive
• CPC Class Codes: A61B 5/4836 Diagnosis combined with treatment in closed-loop systems or methods A61B5/0036 takes precedence
• CPC Class Codes: A61B 5/4839 combined with drug delivery
• CPC Class Codes: A61B 5/7239 using differentiation including higher order derivatives
• CPC Class Codes: A61B 5/7275 Determining trends in physiological measurement data; Predicting development of a medical condition based on physiological measurements, e.g. determining a risk factor
• 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 7/00 Instruments for auscultation
• CPC Class Codes: A61N 1/36139 with automatic adjustment
• CPC Class Codes: A61N 1/36585 controlled by two or more physical parameters
• CPC Class Codes: G16H 50/30 for calculating health indices; for individual health risk assessment
• CPC Class Codes: G16Z 99/00 Subject matter not provided for in other main groups of this subclass

Abstract

A hospitalization management system including a heart failure analyzer that receives diagnostic data including at least sensor data representative of one or more physiological signals sensed from a hospitalized patient using one or more sensors and assesses risk of rehospitalization for the patient using the diagnostic data. The outcome of the risk assessment is used during and following the patient'"'"'s hospitalization for reducing the risk of rehospitalization.

Claims

1. A system for managing a heart failure patient, the system comprising:

a sensor processing circuit configured to receive one or more physiological signals and produce sensor data representative of the one or more physiological signals; and

a heart failure analyzer circuit coupled to the sensor processing circuit, the heart failure analyzer configured to;

receive diagnostic data including the sensor data, the diagnostic data indicative of one or more conditions associated with heart failure decompensation; and

produce a risk class parameter classifying a level of risk for rehospitalization within a specified period using the diagnostic data.

2. The system of claim 1, wherein the heart failure analyzer is configured to produce the risk class parameter when the patient is hospitalized.

3. The system of claim 2, wherein the heart failure analyzer is further configured to produce an alarm signal indicative of a need for hospitalization or rehospitalization using the diagnostic data when the patient is not hospitalized.

4. The system of claim 1, wherein the heart failure analyzer circuit is configured to produce one or more parameters indicative of heart failure decompensation using the diagnostic data, and produce a trend indicative of progression of heart failure using at least one parameter of the one or more parameters.

5. The system of claim 4, further comprising a presentation device configured to present the trend.

6. The system of claim 5, comprising one or more implantable sensors configured to sense the one or more physiological signals.

7. The system of claim 6, wherein the one or more implantable sensors comprise a sensor configured to sense a heart sound signal of the one or more physiological signals, the heart sound signal indicative of third heart sounds (S3).

8. The system of claim 6, wherein the one or more implantable sensors comprise a sensor configured to sense a thoracic impedance signal of the one or more physiological signals.

9. The system of claim 6, wherein the heart failure analyzer circuit is configured to receive therapy parameters and produce the one or more parameters using the diagnostic data including the sensor data and the therapy parameters.

10. The system of claim 6, wherein the heart failure analyzer circuit is configured to receive diagnostic test results including laboratory test results and medical examination results and produce the one or more parameters indicative of heart failure decompensation using the diagnostic data including the sensor data and diagnostic test results.

11. The system of claim 6, wherein the heart failure analyzer circuit is configured to receive the patient'"'"'s medical history information including patient demographics and history of cardiac and produce the one or more parameters indicative of heart failure decompensation using the diagnostic data including the sensor data and the medical history information.

12. The system of claim 4, further comprising a therapy circuit configured to apply a therapy to the patient, and wherein the heart failure analyzer circuit is configured to analyze efficacy of the applied therapy using the one or more parameters and expected values of the one or more parameters associated with the applied therapy.

13. A method for managing a heart failure patient, the method comprising:

sensing one or more physiological signals;

producing sensor data representative of the one or more physiological signals;

receiving diagnostic data including the sensor data, the diagnostic data indicative of one or more conditions associated with heart failure decompensation; and

producing a risk class parameter classifying a level of risk for rehospitalization within a specified period using the diagnostic data.

14. The method of claim 13, further comprising:

producing one or more parameters indicative of heart failure decompensation using the diagnostic data; and

producing a trend indicative of progression of heart failure using at least one parameter of the one or more parameters.

15. The method of claim 14, further comprising presenting the trend using one or more of a display screen and a printer.

16. The method of claim 14, wherein producing the risk parameter comprises producing the risk class parameter using the one or more parameters when the patient is hospitalized.

17. The method of claim 15, further comprising producing an alarm signal indicative of a need for hospitalization or rehospitalization using the one or more parameters when the patient is not hospitalized.

18. The method of claim 14, wherein sensing the one or more physiological signals comprises sensing one or more physiological signals using one or more implantable sensors, and producing the one or more parameters associated with one or more of third heart sounds (S3), thoracic fluid volume, respiration, heart rate variability parameter, and the patient'"'"'s physical activities.

19. The method of claim 18, wherein producing the one or more parameters comprises producing the one or more parameters using the diagnostic data including the sensor data and data associated with one of more of therapies, diagnostic test results including laboratory test results and medical examination results, and medical history information including patient demographics and history of cardiac conditions.

20. The method of claim 14, further comprising:

applying a therapy to the patient, and

analyzing efficacy of the applied therapy using the one or more parameters and expected values of the one or more parameters associated with the applied therapy.