Systems and methods for monitoring and analyzing cardiovascular states

• US 9,808,160 B2
• Filed: 08/12/2014
• Issued: 11/07/2017
• Est. Priority Date: 08/12/2013
• Status: Active Grant

• Current Assignee: Intelomed, Inc.
• Original Assignee: Intelomed, Inc.
• Inventors: Berkow, Jan K., Brumfield, Anne M.
• Primary Examiner(s): Cattungal, Sanjay
• Application Number:
  US14/457,946
• Publication Number:
  US 20150045633A1
• Time in Patent Office: 1,183 Days
• Field of Search: 600473-480, 382128-132
• CPC Class Codes: A61B 3/16 for measuring intraocular pressure, e.g. tonometers
• CPC Class Codes: A61B 5/002 Monitoring the patient using a local or closed circuit, e.g. in a room or building A61B5/0017 takes precedence
• CPC Class Codes: A61B 5/0022 Monitoring a patient using a global network, e.g. telephone networks, internet
• 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 5/02108 from analysis of pulse wave characteristics
• CPC Class Codes: A61B 5/02416 using photoplethysmograph signals, e.g. generated by infrared radiation A61B5/14552 takes precedence
• CPC Class Codes: A61B 5/053 Measuring electrical impedance or conductance of a portion of the body
• CPC Class Codes: A61B 5/08 Detecting, measuring or recording devices for evaluating the respiratory organs A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/165 Evaluating the state of mind, e.g. depression, anxiety
• CPC Class Codes: A61B 5/349 Detecting specific parameters of the electrocardiograph cycle
• CPC Class Codes: A61B 5/4848 Monitoring or testing the effects of treatment, e.g. of medication
• CPC Class Codes: A61B 5/7257 using Fourier transforms
• 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 5/7278 Artificial waveform generation or derivation, e.g. synthesising signals from measured signals A61B5/327 takes precedence
• 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 5/7405 using sound
• 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: G16H 20/30 relating to physical therapies or activities, e.g. physiotherapy, acupressure or exercising
• CPC Class Codes: G16H 20/40 relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
• CPC Class Codes: G16H 40/63 : for local operation
• CPC Class Codes: G16H 40/67 : for remote operation
• CPC Class Codes: G16H 50/20 : for computer-aided diagnosis, e.g. based on medical expert systems

Abstract

A system and method for hemodynamic dysfunction detection may include at least one sensor configured to received one or more signals from a patient, a computing device in data communication with the at least one sensor, a computer-readable storage medium in communication with the computing device, an input device, and an output device. The system may include computer readable instructions to cause the system to receive at least one signal in the time domain from the sensor, determine at least one metric in the frequency domain from the at least one signal in the time domain, and determine the cardiovascular state of the patient from a combination of the at least one metric in the frequency domain and information contained in at least one database of cardiovascular states. The system may also notify a user of a immanent patient cardiovascular event and recommend one or more interventions to mitigate it.

Claims

1. A system for determining a cardiovascular state of a patient in a stress condition, the system comprising:

at least one sensor configured to received one or more signals from the patient;

a computing device in data communication with the at least one sensor;

a non-transitory, computer-readable storage medium in operable communication with the computing device;

an input device in operable communication with the computing device; and

an output device in operable communication with the computing device;

wherein the computer-readable storage medium contains one or more programming instructions that, when executed, cause the computing device to;

receive at least one signal in the time domain from the at least one sensor, wherein the at least one signal in the time domain is a pulse wave measurement of the patient;

determine at least one metric in the time domain from the at least one signal in the time domain;

determine at least one metric in the frequency domain from the at least one signal in the time domain;

derive one or more sets of parameters using the at least one metric in the time domain and the at least one metric in the frequency domain, a set of parameters being associated with a particular cardiovascular state;

evaluate temporal variations of the parameters within the one or more sets of parameters; and

determine the cardiovascular state of the patient from a combination of the temporal variations of parameters in a set of parameters and information from at least one database of cardiovascular states that are associated with the sets of parameters.

2. The system of claim 1, wherein the input device comprises one or more of a keyboard, a mouse, a touch screen, a joystick, a voice recognition system, a removable memory device, and a data communication link.

3. The system of claim 1, wherein the output device comprises one or more of a monitor, a flat-screen display, one or more LED devices, an audio device, and a data communication link.

4. The system of claim 1, wherein the computer-readable storage medium further contains the at least one database.

5. The system of claim 1, wherein the at least one database is contained in a memory storage device accessible to the computing device over a data communication link.

6. The system of claim 5, wherein the data communication link comprises one or more of an internet connection, a wireless connection, a telephonic connection, a LAN connection, a WAN connection, and a personal area network.

7. The system of claim 1, wherein the computer-readable storage medium contains one or more programming instructions that, when executed, further cause the computing device to:

transform the at least one signal in the time domain into at least one signal in the frequency domain;

select at least one frequency domain feature of the at least one signal in the frequency domain; and

normalize the at least one frequency domain feature to at least one frequency domain feature baseline.

8. The system of claim 1, wherein the computer-readable storage medium contains one or more programming instructions that, when executed, further cause the computing device to provide a notification to a health care provider of an emergent condition of the combination of the temporal variations of parameters in a set of parameters and the information from the at least one database of cardiovascular states.

9. The system of claim 8, wherein the notification to a health care provider comprises one or more of an audible signal, a visual signal on a display, and a text message to a mobile communication device.

10. The system of claim 1, wherein the computer-readable storage medium contains one or more programming instructions that, when executed, further cause the computing device to provide a list of one or more therapeutic actions for the patient to a health care provider from the combination of the temporal variations of parameters in a set of parameters and the information from the at least one database of cardiovascular states.

11. The system of claim 10, wherein the one or more therapeutic actions comprise one or more standard therapeutic protocols.

12. The system of claim 10, wherein the one or more therapeutic actions comprise one or more alterations to one or more standard therapeutic protocols.

13. The system of claim 1, wherein the computer-readable storage medium contains one or more programming instructions that, when executed, further cause the computing device to:

receive from an input device at least one indicator of a medical status of the patient and provide a list of one or more alterations to one or more standard therapeutic protocols for the patient to a health care provider from the at least one indicator of the medical status of the patient.

14. The system of claim 1 wherein the computer-readable storage medium contains one or more programming instructions that, when executed, further cause the computing device to:

evaluate temporal variations of the parameters within the one or more sets of parameters by evaluating changes in the parameter value and evaluating large changes in the parameter values; and

using the changes and large changes within a set of parameters for determining the cardiovascular state of a patient.

15. The system of claim 1 wherein the computer-readable storage medium contains one or more programming instructions that, when executed, further cause the computing device to:

derive one or more sets of parameters by comparing at least one metric in the frequency domain or at least one metric in the time domain to against a threshold value for a parameter.

16. The system of claim 15 wherein the threshold value includes at least one of an average value or a maximum value.

17. The system of claim 1 wherein the computer-readable storage medium contains one or more programming instructions that, when executed, further cause the computing device to:

derive one or more sets of parameters by comparing at least one metric in the frequency domain or at least one metric in the time domain against a range of values for the parameter.