Prediction of thoracic fluid accumulation

• US 8,900,154 B2
• Filed: 05/24/2005
• Issued: 12/02/2014
• Est. Priority Date: 05/24/2005
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Stahmann, Jeffrey E., Ni, Quan, Hartley, Jesse W.
• Primary Examiner(s): D'Angelo, Michael
• Assistant Examiner(s): JANG, CHRISTIAN YONGKYUN
• Application Number:
  US11/136,195
• Publication Number:
  US 20060271116A1
• Time in Patent Office: 3,479 Days
• Field of Search: 600/484
• US Class Current: 600/484
• CPC Class Codes: A61B 5/0537 Measuring body composition by impedance, e.g. tissue hydration or fat content
• 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 1/365 controlled by a physiological parameter, e.g. heart potential evoked response A61N1/371
• CPC Class Codes: A61N 2001/0585 Coronary sinus electrodes

Abstract

This patent document discusses, among other things, systems, devices, and methods for predicting an occurrence of impending thoracic fluid accumulation and in one example, invoking a responsive therapy, such as to prevent or minimize the consequences of the impending thoracic fluid accumulation. One example of the present systems, devices, and methods senses or receives at least one parameter that is statistically associated with impending thoracic fluid accumulation from a subject. Using such parameter(s), a probability of impending thoracic fluid accumulation is estimated. A list of parameters determines which values are recurrently sensed or received at various desired time intervals. Another example of the present systems, devices, and methods weights the sensed or received parameter value(s) to compute the probability estimate of impending thoracic fluid accumulation. A responsive preventive thoracic fluid accumulation therapy or other therapy is selected and activated using the probability estimate of impending thoracic fluid accumulation.

Claims

1. A system comprising:

a prediction criteria module, adapted to store one or more thoracic fluid accumulation prediction criteria;

a parameter collection device, adapted to sense or receive at least one thoracic fluid accumulation parameter that is statistically associated with impending thoracic fluid accumulation; and

a thoracic fluid accumulation prediction module, coupled to the prediction criteria module to receive the one or more thoracic fluid accumulation prediction criteria, and coupled to the parameter collection device to receive the at least one thoracic fluid accumulation parameter,

wherein the thoracic fluid accumulation prediction module includes a probability processing module and a prediction processing module, the probability processing module for comparing the one or more thoracic fluid accumulation prediction criteria and the at least one thoracic fluid accumulation parameter and outputting to the prediction processing module a probability indication of the occurrence of impending thoracic fluid accumulation; and

wherein the prediction processing module generates, using the probability indication output from the probability processing module, a probability assertion that an occurrence of impending thoracic fluid accumulation will occur during a specified time after the prediction, wherein the probability assertion includes both a magnitude of the probability assertion and a defined time period during which the prediction is applicable, and wherein the probability assertion identifies which of the at least one thoracic fluid accumulation parameters contributed to the magnitude of the probability assertion.

2. The system of claim 1, wherein the at least one thoracic fluid accumulation parameter is a physiologic parameter that is selected from a physiologic group consisting essentially of a cardiac chamber pressure, a cardiac output, a cardiac dimension, at least one cardiac arrhythmia, a pulmonary vein pressure, a blood drug concentration, a respiratory rate, a tidal volume, a breathing sleep disorder, at least one night cough, at least one heart sound, at least one lung sound, a blood gas concentration, a blood electrolyte level, and a neurohormone level.

3. The system of claim 1, wherein the at least one thoracic fluid accumulation parameter is a therapeutic parameter that is selected from a therapeutic group consisting essentially of:

a cardiac resynchronization therapy parameter, a continuous positive air pressure parameter, a drug dose parameter, a drug compliance parameter, a diet compliance parameter, and a fluid intake compliance parameter.

4. The system of claim 1, wherein the at least one thoracic fluid accumulation parameter is an environmental parameter that is selected from an environmental group consisting essentially of:

a posture orientation, a subject activity level, and an altitude level.

5. The system of claim 1, wherein the predicted occurrence of impending thoracic fluid accumulation is computed, at least in part, using stored weighting factors, and

wherein each weighting factor corresponds to a different one of the at least one thoracic fluid accumulation parameter.

6. The system of claim 5, wherein a first weighting factor corresponding to a first thoracic fluid accumulation parameter depends on which at least one other thoracic fluid accumulation parameter is also being used to predict the occurrence of impending thoracic fluid accumulation.

7. The system of claim 5, wherein a first weighting factor corresponding to a first thoracic fluid accumulation parameter depends on how many other thoracic fluid accumulation parameters are also used to predict the occurrence of impending thoracic fluid accumulation.

8. The system of claim 1, wherein the one or more thoracic fluid accumulation prediction criteria is derived using one or more past observation of an occurrence of thoracic fluid accumulation in a subject from whom the at least one thoracic fluid accumulation parameter is sensed or received.

9. The system of claim 1, wherein the one or more thoracic fluid accumulation prediction criteria is derived using one or more past observation of an occurrence of thoracic fluid accumulation in at least one subject other than a subject from whom the at least one thoracic fluid accumulation parameter is sensed or received.

10. The system of claim 1, wherein the one or more thoracic fluid accumulation prediction criteria is entered into an external user interface.

11. The system of claim 1, further comprising a therapy control module, adapted to adjust or initiate a therapy using the predicted occurrence of impending thoracic fluid accumulation.

12. The system of claim 1, wherein the parameter collection device includes one or more of:

a sensing module, an internal sensor module, a communication module, an external sensor module, an external user interface, an external communication repeater, an Internet connection, and a computerized medical database,

wherein the sensing module, the internal sensor module, and the communication module are coupled to a controller, and

wherein the external sensor module, the external user interface, the external communication repeater, the Internet connection, and the computerized medical database are communicatively coupled to the communication module.

13. The system of claim 1, wherein the at least one thoracic fluid accumulation parameter is a physiologic parameter comprising a cardiac chamber pressure.

14. The system of claim 1, wherein the at least one thoracic fluid accumulation parameter is a physiologic parameter comprising a cardiac output.

15. The system of claim 1, wherein the at least one thoracic fluid accumulation parameter is a physiologic parameter comprising a cardiac dimension.

16. The system of claim 1, wherein the at least one thoracic fluid accumulation parameter is a physiologic parameter comprising at least one cardiac arrhythmia.

17. The system of claim 1, wherein the at least one thoracic fluid accumulation parameter is a physiologic parameter comprising a pulmonary vein pressure.

18. The system of claim 1, wherein the at least one thoracic fluid accumulation parameter is a physiologic parameter comprising a blood drug concentration.

19. The system of claim 1, wherein the at least one thoracic fluid accumulation parameter is a physiologic parameter comprising a respiratory rate.

20. The system of claim 1, wherein the at least one thoracic fluid accumulation parameter is a physiologic parameter comprising a tidal volume.

21. The system of claim 1, wherein the at least one thoracic fluid accumulation parameter is a physiologic parameter comprising a breathing sleep disorder.

22. The system of claim 1, wherein the at least one thoracic fluid accumulation parameter is a physiologic parameter comprising at least one night cough.

23. The system of claim 1, wherein the at least one thoracic fluid accumulation parameter is a physiologic parameter comprising at least one heart sound.

24. The system of claim 1, wherein the at least one thoracic fluid accumulation parameter is a physiologic parameter comprising at least one lung sound.

25. The system of claim 1, wherein the at least one thoracic fluid accumulation parameter is a physiologic parameter comprising a blood gas concentration.

26. The system of claim 1, wherein the at least one thoracic fluid accumulation parameter is a physiologic parameter comprising a blood electrolyte level.

27. The system of claim 1, wherein the at least one thoracic fluid accumulation parameter is a physiologic parameter comprising and a neurohormone level.

28. The system of claim 1, wherein the at least one thoracic fluid accumulation parameter is a therapeutic parameter.

29. The system of claim 1, further comprising an implantable medical device including one or more sensors and adapted to sense the at least one thoracic fluid accumulation parameter that is statistically associated with impending thoracic fluid accumulation.

30. The system of claim 1, wherein the probability assertion associated with the at least one thoracic fluid accumulation parameter is derived from past observations of instances in which the at least one thoracic fluid accumulation parameter occurs alone or together with a thoracic fluid accumulation within a specified time period.