Integrating device-based sensors and bedside biomarker assays to detect worsening heart failure
First Claim
1. A medical system, comprising:
- an ambulatory medical device (AMD), including a signal analyzer circuit coupled to at least first and second ambulatory physiologic sensors, the signal analyzer circuit configured to produce a first heart failure (HF) status indicator using the first ambulatory physiologic sensor and a second HF status indicator using the second ambulatory physiologic sensor;
an external biomarker device, including a biomarker sensor configured to provide information about an amount of a biomarker present in a biological substance, the amount of the biomarker present indicative of HF status; and
a patient monitor communicatively coupled to the AMD and the external device, the patient monitor including;
a receiver circuit configured to receive from the AMD information including the first and second HF status indicators, and to receive from the external biomarker device information including the amount of the biomarker present;
a processor circuit configured to select one of first and second HF status detection modes in response to the information from the biomarker device, and to generate an indicator of worsening of HF using the selected HF status detection mode, the first HF status detection mode detecting HF status using the first HF status indicator and the second HF status detection mode detecting HF status using the second HF status indicator, the second HF status detection mode different from and having a higher specificity than the first HF status detection mode; and
an output unit configured to output the indicator of worsening of HF.
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Abstract
Devices and methods for improving the sensitivity and specificity of heart failure (HF) detection are described. The devices and methods can detect a HF status such as using physiological sensor data and external biomarker assays. An apparatus can comprise ambulatory physiological sensors that can provide a first HF status indicator and a second HF status indicator to a user. An external biomarker sensor can provide an amount of a biomarker present, such as an assay for B-type natriuretic peptide (BNP), which provides information about HF status. A processor circuit can switch from a first HF detection mode to a second detection mode such as in response to the information from the biomarker sensor. The first detection mode can detect HF status using the first HF status indicator, and the second detection mode can detect HF status using the second HF status indicator. The second detection mode can have a higher specificity than the first detection mode.
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Citations
20 Claims
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1. A medical system, comprising:
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an ambulatory medical device (AMD), including a signal analyzer circuit coupled to at least first and second ambulatory physiologic sensors, the signal analyzer circuit configured to produce a first heart failure (HF) status indicator using the first ambulatory physiologic sensor and a second HF status indicator using the second ambulatory physiologic sensor; an external biomarker device, including a biomarker sensor configured to provide information about an amount of a biomarker present in a biological substance, the amount of the biomarker present indicative of HF status; and a patient monitor communicatively coupled to the AMD and the external device, the patient monitor including; a receiver circuit configured to receive from the AMD information including the first and second HF status indicators, and to receive from the external biomarker device information including the amount of the biomarker present; a processor circuit configured to select one of first and second HF status detection modes in response to the information from the biomarker device, and to generate an indicator of worsening of HF using the selected HF status detection mode, the first HF status detection mode detecting HF status using the first HF status indicator and the second HF status detection mode detecting HF status using the second HF status indicator, the second HF status detection mode different from and having a higher specificity than the first HF status detection mode; and an output unit configured to output the indicator of worsening of HF. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14)
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15. A method for operating a medical system for monitoring heart failure (HF) of a patient, the method comprising:
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sensing at least first and second physiologic signals from the patient using an ambulatory medical device (AMD); producing a first HF status indicator using the first physiologic signal and a second HF status indicator using the second physiologic signal; detecting information about an amount of a biomarker present in a biological substance using an external biomarker sensor, the amount of the biomarker present indicative of HF status; communicating the first and second HF status indicators and the information about the amount of the biomarker present to a patient monitor; using the patient monitor, selecting one of first and second HF status detection modes in response to the information about the amount of the biomarker present, the first HF status detection mode detecting HF status using the first HF status indicator and the second HF status detection mode detecting HF status using the second HF status indicator, the second HF status detection mode different from and having a higher specificity than the first HF status detection mode; and generating an indicator of worsening of HF using the selected HF status detection mode. - View Dependent Claims (16, 17, 18, 19, 20)
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Specification