Systems and methods to indicate heart failure co-morbidity

• US 9,986,918 B2
• Filed: 02/29/2012
• Issued: 06/05/2018
• Est. Priority Date: 03/14/2011
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Sweeney, Robert J.
• Primary Examiner(s): Mallari, Patricia
• Assistant Examiner(s): Ramachandran, Vasuda
• Application Number:
  US13/408,315
• Publication Number:
  US 20120238886A1
• Time in Patent Office: 2,288 Days
• CPC Class Codes: A61B 5/0031 Implanted circuitry
• CPC Class Codes: A61B 5/02055 Simultaneously evaluating both cardiovascular condition and temperature
• CPC Class Codes: A61B 5/021 Measuring pressure in heart or blood vessels A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/08 Detecting, measuring or recording devices for evaluating the respiratory organs A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/11 Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb for measuring pulse A61B5/02 ;A61B5/1038 takes precedence; motion detection to correct for motion artifacts in physiological signals A61B5/721
• CPC Class Codes: A61B 5/14551 for measuring blood gases
• CPC Class Codes: A61B 5/4836 Diagnosis combined with treatment in closed-loop systems or methods A61B5/0036 takes precedence
• CPC Class Codes: A61B 7/00 Instruments for auscultation
• CPC Class Codes: A61N 1/3627 for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy

Abstract

Systems and methods to indicate heart failure co-morbidity are described. In an example, one or more physiological signals can be analyzed for a specified time period to determine at least one of an indication of a heart failure event or a characteristic of heart failure co-morbidity, such as a characteristic of a non-heart failure physiological event. At least one of the different physiological signals can be compared to a specified criterion indicative of the heart failure event to provide a comparison value, where the comparison value is indicative of whether the at least one of the different physiological signals contributed towards the indication of the heart failure event. An indication of a non-heart failure physiological event can be determined using the heart failure event indication, the non-heart failure physiological event characteristic, and the comparison value indicative of whether the one or more physiological signals contributed towards the heart failure event.

Claims

1. A system comprising:

a heart failure event detection circuit, configured to analyze information from different physiological signals to determine a heart failure event indication corresponding to a time period;

a non-heart failure physiological event detection circuit, configured to determine a non-heart failure physiological event characteristic including detecting a heart failure co-morbidity different than an improvement or worsening of the heart failure event using at least one of the different physiological signals;

a comparison circuit, configured to compare the at least one of the different physiological signals to a specified criterion indicative of the heart failure event to provide a comparison value indicating whether the non-heart failure physiological event characteristic contributes to the heart failure event indication; and

a non-heart failure status indicator circuit, coupled to the heart failure event detection circuit and the non-heart failure physiological event detection circuit and the comparison circuit, and configured to compute a non-heart failure physiological status indication using a logical combination of the heart failure event indication, the non-heart failure physiological event characteristic, and the comparison value; and

wherein the non-heart failure physiological status indication indicates that the non-heart failure physiological event is absent, during the time period, when

the heart failure event indication indicates that the heart failure event is present during the time period,

the non-heart failure event characteristic indicates that the non-heart failure physiological event including the heart failure co-morbidity is present during the time period, and

the comparison value indicates that the at least one of the different physiological signals does meet the specified criterion indicative of the heart failure event.

2. The system of claim 1, wherein the non-heart failure physiological status indication indicates that the non-heart failure physiological event is present, during the time period, when

the heart failure event indication indicates that the heart failure event is present during the time period,

the non-heart failure event characteristic indicates that the non-heart failure physiological event is present during the time period, and

the comparison value indicates that at least one of the different physiological signals fails to meet the criterion indicative of the heart failure event.

3. The system of claim 1, wherein the non-heart failure physiological status indication indicates that the non-heart failure physiological event is present, during the time period, when

the heart failure event indication indicates that the heart failure event is absent during the time period,

the non-heart failure event characteristic indicates that the non-heart failure physiological event is present during the time period, and

the comparison value indicates that at least one of the different physiological signals fails to meet the criterion indicative of the heart failure event.

4. The system of claim 1, further comprising one or more physiological sensors configured to provide the at least one of the different physiological signals.

5. The system of claim 4, wherein the at least one of the different physiological signals is selected from a heart rate signal, a respiration signal, a blood pressure signal, a lung tidal volume signal, a physical activity level signal, a weight signal, a posture signal, an impedance signal, a heart sound signal, an airflow or respiration signal, a blood flow signal, a blood pressure signal, a minute ventilation signal, an electrocardiogram, a temperature signal, an autonomic tone signal, an autonomic balance signal, a hematocrit signal, a cardiac muscle contractility signal, an oxygen saturation level signal, a blood analyte signal, or a myocardial ischemia signal.

6. The system of claim 4, wherein the physiological sensor is configured to provide a respiration signal.

7. The system of claim 4, wherein the at least one of the different physiological signals comprises two or more physiological signals, wherein the criterion indicative of the heart failure event comprises a threshold, wherein the threshold corresponds to an interaction characteristic of said two or more physiological signals.

8. The system of claim 7, wherein a first of said two or more physiological signals is a respiration rate having a high respiration rate characteristic, and a second of said two or more physiological signals is a weight signal having a weight gain characteristic.

9. The system of claim 1, wherein the specified criterion indicative of the heart failure event is a threshold.

10. The system of claim 1, wherein the specified criterion indicative of the heart failure event is a weighting factor, wherein the weighting factor corresponds to an interaction characteristic of the two or more physiological signals.

11. The system of claim 1, comprising a remote monitoring system communicatively coupled to the heart failure event detection circuit and the non-heart failure status indicator circuit, wherein the remote monitoring system is configured to provide the heart failure event indication and the non-heart failure physiological status indication to a user.

12. The system of claim 11, wherein the remote monitoring system is configured to provide the heart failure event indication and the non-heart failure physiological status indication to a user through a graphical user interface.

13. The system of claim 1, wherein the heart failure event indication is a binary value.

14. The system of claim 1, wherein the heart failure event indication comprises a heart failure event status indication and physiological sensor signal information.

15. The system of claim 1, wherein the non-heart failure physiological status indication comprises a non-heart failure event status indication and physiological sensor signal information.

16. A method comprising:

analyzing information from different physiological signals by a heart failure event detection circuit to determine a heart failure event indication corresponding to a time period;

determining a non-heart failure physiological event characteristic including detecting a heart failure co-morbidity different than an improvement or worsening of the heart failure event by a non-heart failure physiological event detection circuit using at least one of the different physiological signals;

comparing, using a comparison circuit, the at least one of the different physiological signals to a specified criterion indicative of the heart failure event to provide a comparison value indicating whether the non-heart failure physiological event characteristic contributes to the heart failure event indication; and

computing, using a non-heart failure status indicator circuit, a non-heart failure physiological event indication using a logical combination of the heart failure event indication, the non-heart failure physiological event characteristic, and the comparison value; and

wherein the non-heart failure physiological status indication indicates that the non-heart failure physiological event is absent, during the time period, when

the heart failure event indication indicates that the heart failure event is present during the time period,

the non-heart failure event characteristic indicates that the non-heart failure physiological event including the heart failure co-morbidity is present during the time period, and

the comparison value indicates that the at least one of the different physiological signals does meet the specified criterion indicative of the heart failure event.

17. The method of claim 16, wherein the non-heart failure physiological status indication indicates that the non-heart failure physiological event is present, during the time period, when

the heart failure event indication indicates that the heart failure event is present during the time period,

the non-heart failure event characteristic indicates that the non-heart failure physiological event is present during the time period, and

the comparison value indicates that the at least one of the different physiological signals fails to meet the criterion indicative of the heart failure event.

18. The method of claim 16, wherein the non-heart failure physiological status indication indicates that the non-heart failure physiological event is present, during the time period, when

the heart failure event indication indicates that the heart failure event is absent during the time period,

the non-heart failure event characteristic indicates that the non-heart failure physiological event is present during the time period, and

the comparison value indicates that the at least one of the different physiological signals fails to meet the criterion indicative of the heart failure event.

19. The method of claim 16, further comprising receiving the at least one of the different physiological signals.

20. The method of claim 19, wherein the at least one of the different physiological signals is selected from one of a heart rate signal, a respiration signal, a blood pressure signal, a lung tidal volume signal, a physical activity level signal, a weight signal, a posture signal, an impedance signal, a heart sound signal, an airflow or respiration signal, a blood flow signal, a blood pressure signal, a minute ventilation signal, an electrocardiogram, a temperature signal, an autonomic tone signal, an autonomic balance signal, a hematocrit signal, a cardiac muscle contractility signal, an oxygen saturation level signal, a blood analyte signal, or a myocardial ischemia signal.