Indication-based worsening HF alert

• US 9,351,647 B2
• Filed: 04/08/2013
• Issued: 05/31/2016
• Est. Priority Date: 09/19/2008
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Zhang, Yi, Stahmann, Jeffrey E.
• Primary Examiner(s): Voorhees, Catherine
• Assistant Examiner(s): Dinga, Roland
• Application Number:
  US13/858,631
• Publication Number:
  US 20130226011A1
• Time in Patent Office: 1,149 Days
• Field of Search: 600/484, 600/508, 600/485, 600/528, 600/483
• US Class Current: 1/1
• 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 5/021 Measuring pressure in heart or blood vessels A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/024 Detecting, measuring or recording pulse rate or heart rate A61B5/0205, A61B5/021 take precedence
• CPC Class Codes: A61B 5/053 Measuring electrical impedance or conductance of a portion of the body
• CPC Class Codes: A61B 5/0816 Measuring devices for examining respiratory frequency measuring frequency of electric signals G01R23/00
• CPC Class Codes: A61B 5/0826 Detecting or evaluating apnoea events A61B5/4818 takes precedence
• CPC Class Codes: A61B 5/085 Measuring impedance of respiratory organs or lung elasticity
• CPC Class Codes: A61B 5/091 Measuring volume of inspired or expired gases, e.g. to determine lung capacity
• CPC Class Codes: A61B 5/1036 Measuring load distribution, e.g. podologic studies
• CPC Class Codes: A61B 5/1118 Determining activity level
• CPC Class Codes: A61B 5/165 Evaluating the state of mind, e.g. depression, anxiety
• CPC Class Codes: A61B 5/4836 Diagnosis combined with treatment in closed-loop systems or methods A61B5/0036 takes precedence
• CPC Class Codes: A61B 5/4878 Evaluating oedema
• CPC Class Codes: A61B 5/686 Permanently implanted devices, e.g. pacemakers, other stimulators, biochips A61B5/6861 takes precedence
• 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 5/7282 Event detection, e.g. detecting unique waveforms indicative of a medical condition A61B5/4094, A61B5/4818, A61B5/349, A61B5/0823 take precedence
• CPC Class Codes: A61B 5/742 using visual displays A61B5/339 takes precedence
• CPC Class Codes: A61B 5/7435 Displaying user selection data, e.g. icons in a graphical user interface
• 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 5/7475 : User input or interface means, e.g. keyboard, pointing device, joystick
• CPC Class Codes: A61B 7/02 : Stethoscopes acoustic details thereof G10K11/00
• CPC Class Codes: G16H 50/20 : for computer-aided diagnosis, e.g. based on medical expert systems
• CPC Class Codes: G16H 50/30 : for calculating health indices; for individual health risk assessment

Abstract

This document discusses, among other things, receiving a user selection of a heart failure symptom, receiving a user selection of an abnormal psychological condition, receiving information about a physiological patient status parameter, and determining a heart failure status using the received information.

Claims

1. A system, comprising:

a user input configured to;

receive a user selection of a heart failure symptom to indicate whether a heart failure symptom is or has been present, wherein the heart failure symptom includes at least one of dyspnea, edema, or weight change; and

receive a user selection of a heart failure (HF) comorbidity to indicate whether an HF comorbidity is or has been present; and

a heart failure (HF) status processor, coupled to the user input, the HF status processor configured to determine a heart failure status using information about the user selection of the heart failure symptom and information received from a physiological patient status parameter detector, the information received from the physiological patient status parameter detector including information about a first physiological patient status parameter and a different second physiological patient status parameter;

wherein the HF status processor configured to determine the heart failure status is further configured to controllably adjust the heart failure status determination, wherein controllably adjusting the heart failure status determination comprises;

adjusting a first weight for the information about the first physiological patient status parameter relative to a second weight for the information about the different second physiological patient status parameter; and

using the information obtained from the first and second physiological patient status parameters in conjunction with the first and second weights.

2. The system of claim 1, comprising a heart failure (HF) status indicator configured to provide a heart failure status indication using information from the HF status processor.

3. The system of claim 2, wherein the HF status processor is configured to controllably adjust at least one of a sensitivity, a specificity, a positive predictive value, or a negative predictive value of the heart failure condition determination using information about the user selection of the heart failure symptom.

4. The system of claim 1, wherein the first physiological patient status parameter includes at least one of a heart rate, a respiration rate, a respiration timing, a blood pressure, a lung tidal volume, a physical activity level, a weight, an intrathoracic impedance, a heart sound timing, or a heart sound magnitude.

5. The system of claim 4, wherein the user input configured to receive the heart failure symptom indicator is further configured to receive an indication that edema is or has been present;

and

wherein the physiological patient status parameter includes the intrathoracic impedance.

6. The system of claim 4, wherein the user input configured to receive the heart failure symptom indicator is further configured to receive an indication that dyspnea is or has been present;

and

wherein the first physiological patient status parameter includes at least one of the respiration rate, the respiration timing, the lung tidal volume, or the physical activity level.

7. A method, comprising:

receiving a heart failure symptom indicator that indicates whether a heart failure symptom is or has been present, wherein the heart failure symptom includes at least one of dyspnea, edema, or weight change;

receiving a heart failure (HF) comorbidity indicator that indicates whether an HF comorbidity is or has been present;

receiving information about a first physiological patient status parameter; and

determining a heart failure status using information about;

the heart failure symptom;

the HF comorbidity; and

the first physiological patient status parameter,

wherein the determining the heart failure status includes controllably adjusting the heart failure status determination, the controllably adjusting comprising;

adjusting a first weight for the information about the first physiological patient status parameter relative to a second weight for the information about a different second physiological patient status parameter; and

using the information obtained from the first and second physiological patient status parameters in conjunction with the first and second weights.

8. The method of claim 7, comprising providing a heart failure status indication using information about the heart failure status.

9. The method of claim 7, comprising:

wherein the determining the heart failure status comprises;

adjusting at least one of a sensitivity, a specificity, a positive predictive value, or a negative predictive value of a worsening heart failure condition determination using information about the heart failure symptom indicator; and

determining a worsening heart failure condition using information about the first physiological patient status parameter; and

wherein the providing the heart failure status indication includes providing the worsening heart failure condition.

10. The method of claim 7, wherein the receiving the first physiological patient status parameter includes receiving at least one of a heart rate, a respiration rate, a respiration timing, a blood pressure, a lung tidal volume, a physical activity level, a weight, an intrathoracic impedance, a heart sound timing, or a heart sound magnitude.

11. The method of claim 10, wherein the receiving the heart failure symptom indicator includes receiving an indication that edema is or has been present;

and

wherein the receiving the first physiological patient status parameter includes receiving the intrathoracic impedance.

12. The method of claim 10, wherein the receiving the heart failure symptom indicator includes receiving an indication that dyspnea is or has been present;

and

wherein the receiving the first physiological patient status parameter includes receiving at least one of the respiration rate, the respiration timing, the lung tidal volume, or the physical activity level.

13. The method of claim 7, wherein the receiving the abnormal psychological condition includes receiving an indication that depression is or has been present;

and

wherein the determining the heart failure status includes controllably adjusting the heart failure status determination, the controllably adjusting comprising increasing an effect of respiration-related information on the heart failure status determination in response to receiving the indication that depression is or has been present.

14. The method of claim 7, wherein the receiving the heart failure symptom indicator includes receiving an indication that edema is or has been present;

and

wherein the determining the heart failure status includes controllably adjusting the heart failure status determination, the controllably adjusting comprising increasing an effect of intrathoracic impedance information on the heart failure status determination in response to receiving the indication that edema is or has been present.

15. The method of claim 7, wherein the receiving the heart failure symptom indicator includes receiving an indication that dyspnea is or has been present;

and

wherein the determining the heart failure status includes controllably adjusting the heart failure status determination, the controllably adjusting comprising increasing an effect of at least one of respiration rate information, respiration timing information, heart rate information, lung tidal volume information, or physical activity level information in response to receiving the indication that dyspnea is or has been present.

16. The method of claim 7, further comprising:

detecting at least one of the heart failure symptom and a heart failure comorbidity using information about the first physiological patient status parameter.

17. A system, comprising:

an assembly configured to;

receive a heart failure symptom indicator that indicates whether a heart failure symptom is or has been present, wherein the heart failure symptom includes at least one of dyspnea, edema, or weight change; and

receive a heart failure (HF) comorbidity indicator that indicates whether an HF comorbidity is or has been present; and

a heart failure (HF) status processor, coupled to the assembly, the HF status processor configured to determine a heart failure status using information about the heart failure symptom indicator and information received from a physiological patient status parameter detector, the information received from the physiological patient status parameter detector including information about a first physiological patient status parameter and a different second physiological patient status parameter;

wherein the HF status processor configured to determine the heart failure status is further configured to controllably adjust the heart failure status determination, wherein controllably adjusting the heart failure status determination comprises;

adjusting a first weight for the information about the first physiological patient status parameter relative to a second weight for the information about the different second physiological patient status parameter; and

using the information obtained from the first and second physiological patient status parameters in conjunction with the first and second weights.

18. The system of claim 17, further comprising a heart failure (HF) status indicator configured to provide a heart failure status indication using information from the HF status processor.

19. The system of claim 18, wherein the HF status processor is configured to controllably adjust at least one of a sensitivity, a specificity, a positive predictive value, or a negative predictive value of the heart failure condition determination using information about the heart failure symptom.

20. The system of claim 17, wherein the first physiological patient status parameter includes at least one of a heart rate, a respiration rate, a respiration timing, a blood pressure, a lung tidal volume, a physical activity level, a weight, an intrathoracic impedance, a heart sound timing, or a heart sound magnitude.