Methods and apparatuses for detection of myocardial ischemia upon exertion
First Claim
1. A method of detecting ischemia during exertion, comprising:
- executing non-transitory machine-executable instructions stored in memory for;
obtaining static exertion measurements indicative of static physiological exertion;
identifying steady state periods of physiological exertion based on the static exertion measurements;
assessing the intensity of physiological exertion for each of the identified steady state periods;
sensing extra-cardiac response data during identified physiological exertion steady state periods;
sensing cardiac response data during identified physiological exertion steady state periods;
comparing the extra-cardiac response data corresponding to identified steady state periods of physiological exertion with extra-cardiac response information associated with equivalent physiological exertion intensity;
determining the normalcy of the extra-cardiac response data for each steady state period based on the comparison of the extra-cardiac response data and the extra-cardiac response information;
comparing the cardiac response data corresponding to identified steady state periods of physiological exertion with cardiac response information associated with equivalent physiological exertion intensity;
determining the normalcy of the cardiac response data for each steady state period based on the comparison of the cardiac response data and the cardiac response information; and
determining the likelihood that myocardial ischemia occurred during one or more of the identified steady state periods of physiological exertion, wherein;
the likelihood of ischemia for the one or more steady state periods is determined to be relatively high if both the extra-cardiac response data and the cardiac response data sensed during the one or more steady state periods are determined to be abnormal;
the likelihood of ischemia for the one or more steady state periods is determined to be relatively moderate if only one of the extra-cardiac response data and the cardiac response data sensed during the one or more steady state periods is determined to be abnormal; and
the likelihood of ischemia for the one or more steady state periods is determined to be relatively low if neither of the extra-cardiac response data and the cardiac response data sensed during the one or more steady state periods are determined to be abnormal.
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Abstract
Various method embodiments of the present invention concern sensing patient-internal pressure measurements indicative of physiological exertion, identifying one or more steady state periods of physiological exertion based on the patient-internal pressure measurements, sensing extra-cardiac response data and cardiac response data corresponding to the one or more physiological exertion steady state periods, respectively comparing the extra-cardiac response data and the cardiac response data to extra-cardiac response information and cardiac response information associated with equivalent levels of physiological exertion intensity of the one or more steady state periods, and determining the likelihood that myocardial ischemia occurred during the one or more steady state periods based on the comparison of the extra-cardiac response data to the extra-cardiac response information and the cardiac response data to the cardiac response information.
19 Citations
20 Claims
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1. A method of detecting ischemia during exertion, comprising:
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executing non-transitory machine-executable instructions stored in memory for; obtaining static exertion measurements indicative of static physiological exertion; identifying steady state periods of physiological exertion based on the static exertion measurements; assessing the intensity of physiological exertion for each of the identified steady state periods; sensing extra-cardiac response data during identified physiological exertion steady state periods; sensing cardiac response data during identified physiological exertion steady state periods; comparing the extra-cardiac response data corresponding to identified steady state periods of physiological exertion with extra-cardiac response information associated with equivalent physiological exertion intensity; determining the normalcy of the extra-cardiac response data for each steady state period based on the comparison of the extra-cardiac response data and the extra-cardiac response information; comparing the cardiac response data corresponding to identified steady state periods of physiological exertion with cardiac response information associated with equivalent physiological exertion intensity; determining the normalcy of the cardiac response data for each steady state period based on the comparison of the cardiac response data and the cardiac response information; and determining the likelihood that myocardial ischemia occurred during one or more of the identified steady state periods of physiological exertion, wherein; the likelihood of ischemia for the one or more steady state periods is determined to be relatively high if both the extra-cardiac response data and the cardiac response data sensed during the one or more steady state periods are determined to be abnormal; the likelihood of ischemia for the one or more steady state periods is determined to be relatively moderate if only one of the extra-cardiac response data and the cardiac response data sensed during the one or more steady state periods is determined to be abnormal; and the likelihood of ischemia for the one or more steady state periods is determined to be relatively low if neither of the extra-cardiac response data and the cardiac response data sensed during the one or more steady state periods are determined to be abnormal. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11)
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12. A method of detecting myocardial ischemia, comprising:
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executing non-transitory machine-executable instructions stored in memory for; obtaining exertion measurements indicative of physiological exertion; identifying one or more steady state periods of physiological exertion based on the exertion measurements; sensing extra-cardiac response data and cardiac response data corresponding to the one or more steady state periods of physiological exertion; respectively comparing the extra-cardiac response data and the cardiac response data to extra-cardiac response information and cardiac response information associated with equivalent levels of physiological exertion intensity of the one or more steady state periods; and determining the likelihood that myocardial ischemia occurred during the one or more steady state periods based on the comparison of the extra-cardiac response data to the extra-cardiac response information and the cardiac response data to the cardiac response information. - View Dependent Claims (13)
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14. A method of characterizing myocardial ischemia, comprising:
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executing non-transitory machine-executable instructions stored in memory for; identifying steady state periods of physiological exertion based on static exertion data; assigning one of a plurality of exertion intensity levels to each of the steady state periods; organizing physiological exertion-response data according to the assigned exertion intensity levels of the identified steady state periods of physiological exertion during which the physiological exertion-response data was respectively output; comparing the physiological exertion-response data with stored physiological response information associated with equivalent levels of physiological exertion intensity of the steady state periods to which the physiological exertion-response data is organized; and determining a likelihood that myocardial ischemia occurred during one or more of the periods based on the comparison of the physiological response information to the physiological exertion-response data; wherein; steady state periods of dynamic physiological exertion are further identified based on the dynamic exertion data; and a processor is configured to execute stored machine-executable instructions for classifying one or more of the steady state periods of physiological exertion as either a static exertion period or a dynamic exertion period, wherein the one or more steady state periods are classified as static exertion if an increase in patient internal pressure is sensed without a corresponding increase in physical movement indicated by the dynamic exertion data and the one or more steady state periods are classified as dynamic exertion if the increase in patient internal pressure corresponds with the increase in physical movement indicated by the dynamic exertion data. - View Dependent Claims (15, 16, 17, 18, 19, 20)
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Specification