Prediction of thoracic fluid accumulation

• US 20060271116A1
• Filed: 05/24/2005
• Published: 11/30/2006
• Est. Priority Date: 05/24/2005
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Stahmann, Jeffrey E., Hartley, Jesse W., Ni, Quan
• Granted Patent: US 8,900,154 B2
• Time in Patent Office: Days
• US Class Current: 607/6
• CPC Class Codes: A61B 5/0537 Measuring body composition by impedance, e.g. tissue hydration or fat content
• CPC Class Codes: A61B 5/0538 invasively, e.g. using a catheter
• CPC Class Codes: A61N 1/3627 for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy
• CPC Class Codes: A61N 1/365 controlled by a physiological parameter, e.g. heart potential evoked response A61N1/371
• CPC Class Codes: A61N 2001/0585 Coronary sinus electrodes

Abstract

This patent document discusses, among other things, systems, devices, and methods for predicting an occurrence of impending thoracic fluid accumulation and in one example, invoking a responsive therapy, such as to prevent or minimize the consequences of the impending thoracic fluid accumulation. One example of the present systems, devices, and methods senses or receives at least one parameter that is statistically associated with impending thoracic fluid accumulation from a subject. Using such parameter(s), a probability of impending thoracic fluid accumulation is estimated. A list of parameters determines which values are recurrently sensed or received at various desired time intervals. Another example of the present systems, devices, and methods weights the sensed or received parameter value(s) to compute the probability estimate of impending thoracic fluid accumulation. A responsive preventive thoracic fluid accumulation therapy or other therapy is selected and activated using the probability estimate of impending thoracic fluid accumulation.

Claims

1. A system comprising:

a prediction criteria module, adapted to store one or more thoracic fluid accumulation prediction criteria;

a parameter collection device, adapted to sense or receive at least one thoracic fluid accumulation parameter that is statistically associated with impending thoracic fluid accumulation; and

a thoracic fluid accumulation prediction module, coupled to the prediction criteria module to receive the one or more thoracic fluid accumulation prediction criteria, and coupled to the parameter collection device to receive the at least one thoracic fluid accumulation parameter,

wherein the thoracic fluid accumulation prediction module is adapted to predict an occurrence of impending thoracic fluid accumulation using the one or more thoracic fluid accumulation prediction criteria and the at least one thoracic fluid accumulation parameter.

2. The system of claim 1, wherein the thoracic fluid accumulation prediction module is further adapted to predict an occurrence of impending thoracic fluid accumulation occurring during a specified prediction time period.

3. The system of claim 1, wherein the at least one thoracic fluid accumulation parameter is a physiologic parameter that is selected from a physiologic group consisting essentially of:

a cardiac chamber pressure, a cardiac output, a cardiac dimension, at least one cardiac arrhythmia, a pulmonary vein pressure, a blood drug concentration, a respiratory rate, a tidal volume, a breathing sleep disorder, at least one night cough, at least one heart sound, at least one lung sound, a blood gas concentration, a blood electrolyte level, and a neurohormone level.

4. The system of claim 1, wherein the at least one thoracic fluid accumulation parameter is a therapeutic parameter that is selected from a therapeutic group consisting essentially of:

a cardiac resynchronization therapy parameter, a continuous positive air pressure parameter, a drug dose parameter, a drug compliance parameter, a diet compliance parameter, and a fluid intake compliance parameter.

5. The system of claim 1, wherein the at least one thoracic fluid accumulation parameter is an environmental parameter that is selected from an environmental group consisting essentially of:

a posture orientation, a subject activity level, and an altitude level.

6. The system of claim 1, wherein the predicted occurrence of impending thoracic fluid accumulation is computed, at least in part, using stored weighting factors, and wherein each weighting factor corresponds to a different one of the at least one thoracic fluid accumulation parameter.

7. The system of claim 6, wherein a first weighting factor corresponding to a first thoracic fluid accumulation parameter depends on which at least one other thoracic fluid accumulation parameter is also being used to predict the occurrence of impending thoracic fluid accumulation.

8. The system of claim 6, wherein a first weighting factor corresponding to a first thoracic fluid accumulation parameter depends on how many other thoracic fluid accumulation parameters are also used to predict the occurrence of impending thoracic fluid accumulation.

9. The system of claim 1, wherein the one or more thoracic fluid accumulation prediction criteria is derived using one or more past observation of an occurrence of thoracic fluid accumulation in a subject from whom the at least one thoracic fluid accumulation parameter is sensed or received.

10. The system of claim 1, wherein the one or more thoracic fluid accumulation prediction criteria is derived using one or more past observation of an occurrence of thoracic fluid accumulation in at least one subject other than a subject from whom the at least one thoracic fluid accumulation parameter is sensed or received.

11. The system of claim 1, wherein the one or more thoracic fluid accumulation prediction criteria is entered into an external user interface.

12. The system of claim 1, further comprising a therapy control module, adapted to adjust or initiate a therapy using the predicted occurrence of impending thoracic fluid accumulation.

13. The system of claim 1, wherein the parameter collection device includes one or more of:

a sensing module, an internal sensor module, a communication module, an external sensor module, an external user interface, an external communication repeater, an Internet connection, and a computerized medical database,

wherein the sensing module, the internal sensor module, and the communication module are coupled to a controller, and

wherein the external sensor module, the external user interface, the external communication repeater, the Internet connection, and the computerized medical database are communicatively coupled to the communication module.

14. A method comprising:

sensing or receiving at an implantable device, at least one thoracic fluid accumulation parameter that is statistically associated with impending thoracic fluid accumulation;

comparing the at least one thoracic fluid accumulation parameter to one or more thoracic fluid accumulation prediction criteria; and

predicting an occurrence of impending thoracic fluid accumulation.

15. The method of claim 14, further comprising predicting an occurrence of impending thoracic fluid accumulation occurring during a specified prediction time period.

16. The method of claim 14, wherein sensing or receiving the at least one thoracic fluid accumulation parameter includes sensing or receiving at least one physiologic parameter selected from a physiologic group consisting essentially of:

a cardiac chamber pressure, a cardiac output, a cardiac dimension, at least one cardiac arrhythmia, a pulmonary vein pressure, a blood drug concentration, a respiratory rate, a tidal volume, a breathing sleep disorder, at least one night cough, at least one heart sound, at least one lung sound, a blood gas concentration, a blood electrolyte level, and a neurohormone level.

17. The method of claim 14, wherein sensing or receiving the at least one thoracic fluid accumulation parameter includes sensing or receiving at least one therapeutic parameter selected from a therapeutic group consisting essentially of:

a cardiac resynchronization therapy parameter, a continuous positive air pressure parameter, a drug dose parameter, a drug compliance parameter, a diet compliance parameter, and a fluid intake compliance parameter.

18. The method of claim 14, wherein sensing or receiving the at least one thoracic fluid accumulation parameter includes sensing or receiving at least one environmental parameter selected from an environmental group consisting essentially of:

a posture orientation, a subject activity level, and an altitude level.

19. The method of claim 14, wherein the one or more thoracic fluid accumulation prediction criteria is derived using one or more past observation of an occurrence of thoracic fluid accumulation in a subject from whom the at least one thoracic fluid accumulation parameter is sensed or received.

20. The method of claim 14, wherein the one or more thoracic fluid accumulation prediction criteria is derived using one or more past observation of an occurrence of thoracic fluid accumulation in at least one subject other than a subject from whom the at least one thoracic fluid accumulation parameter is sensed or received.

21. The method of claim 14, wherein the one or more thoracic fluid accumulation prediction criteria is entered into an external user interface.

22. The method of claim 14, further comprising weighting one or a combination of:

the at least one thoracic fluid accumulation parameter and the one or more thoracic fluid accumulation prediction criteria.

23. The method of claim 22, wherein the weighting depends, at least in part, on which at least one other thoracic fluid accumulation parameter is also used to predict the occurrence of impending thoracic fluid accumulation.

24. The method of claim 22, wherein the weighting depends, at least in part, on how many other thoracic fluid accumulation parameters are also used to predict the occurrence of impending thoracic fluid accumulation.

25. The method of claim 14, further comprising providing an alert in response to the predicted occurrence of impending thoracic fluid accumulation.

26. The method of claim 25, wherein the providing the alert includes transmitting information about the predicted occurrence of impending thoracic fluid accumulation to an external user interface.

27. The method of claim 14, further comprising adjusting or initiating a therapy using the predicted occurrence of impending thoracic fluid accumulation.