Method and apparatus for detecting respiratory disturbances

• US 7,524,292 B2
• Filed: 11/30/2006
• Issued: 04/28/2009
• Est. Priority Date: 04/21/2003
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Ning, Steven L., Sheldon, Todd J., Davie, Scott W., Erickson, Mark K., Cho, Yong K., Markowitz, H. Toby, Mongeon, Luc R.
• Primary Examiner(s): Marmor, II; Charles A
• Assistant Examiner(s): Natnithithadha; Navin
• Application Number:
  US11/565,092
• Publication Number:
  US 20070167843A1
• Time in Patent Office: 880 Days
• Field of Search: 600/484, 600483-486, 600/481, 600504-506, 600/529, 600/536, 600/547, 600323-325, 600/488, 600/509, 600/595, 607 17- 26
• US Class Current: 600/529
• 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 5/0215 by means inserted into the body catheters A61M25/00
• CPC Class Codes: A61B 5/0809 by impedance pneumography
• CPC Class Codes: A61B 5/1459 invasive, e.g. introduced into the body by a catheter A61B5/1464 takes precedence
• CPC Class Codes: A61B 5/318 Heart-related electrical modalities, e.g. electrocardiography [ECG]
• CPC Class Codes: A61B 5/4818 Sleep apnoea

Abstract

A system and method for monitoring respiration including sensing a signal that varies with respiration, deriving a respiration parameter, applying criteria for detecting a respiration disturbance and determining one or more respiratory disturbance metrics. The system preferably includes an implantable sensor with an associated implantable medical device such that chronic respiration monitoring is possible. The implantable medical device may execute methods for detecting and measuring respiratory disturbances or may store data to be transferred to an external device for detecting and measuring respiratory disturbances. Respiratory disturbance detection may trigger a responsive action such as physiological data storage, a change in therapy delivery, or a clinician warning. Assessment of cardiac function may be made based on metrics of respiratory disturbances or a measure of circulatory delay time following detection of a respiratory disturbance.

Claims

1. A device for detecting a respiratory disturbance, comprising:

means for sensing a physiological signal containing a frequency component or an amplitude component related to a common characteristic of at least two respiratory cycles;

means for deriving at least one respiratory parameter from the physiologic signal;

means for detecting a respiratory disturbance event when the at least one respiratory parameter meets or exceeds a predetermined criteria threshold for detecting the respiratory disturbance; and

means for determining a circulatory delay time comprising means for measuring an oxygen saturation and means for determining a time between the respiratory disturbance and one of a subsequent minimum and a subsequent maximum oxygen saturation.

2. A device according to claim claim 1, further comprising means for measuring the magnitude of a characteristic of the respiratory disturbance.

3. A device according to claim 2 wherein the means for measuring the magnitude of a characteristic of the respiratory disturbance comprises means for measuring the magnitude of a characteristic of at least one of:

an apnea duration;

a hypopnea duration;

a hyperpnea duration; and

a periodic breathing cycle length.

4. A device according to claim 1, wherein the means for sensing a physiological signal comprises means for sensing at least one of is at least a one of:

a thoracic impedance;

an ECG signal;

an EGM signal;

a blood pressure signal;

an activity level measurement; and

an oxygen saturation measurement.

5. A device according to claim 1, wherein the means for detecting a respiratory disturbance comprises means for detecting Kussmaul breathing.

6. A device according to claim 1, wherein the means for detecting a respiratory disturbance comprises means for detecting a Cheyne-Stokes respiration event.

7. A device according to claim 1, wherein the means for detecting a respiratory disturbance comprises comprises means for detecting a sleep apnea event.

8. A device according to claim 1, further comprising means for determining an estimate of cardiac output based on the circulatory delay time.

9. A device according to claim 1, further comprising means for determining an estimate of cardiac function based on a metric of the respiratory disturbance.

10. A device according to claim 9, further comprising means for determining a heart failure status of a patient in the event that the estimate of cardiac function is lower than a predetermined lower threshold.

11. A device according to claim 1, further comprising means for triggering the storage of a physiological data item upon the detection of the respiratory disturbance.

12. A device according to claim 1, further comprising means for triggering a therapy based at least in part upon detection of the respiratory disturbance.

13. A device according to claim 1, further comprising means for generating a warning to alert a clinician or a patient of the detection of the respiratory disturbance.

14. A computer readable medium for storing a set of computer instructions for performing the following method, comprising:

instructions for sensing a physiological signal containing a frequency component or an amplitude component related to a common characteristic of at least two respiratory cycles;

instructions for deriving at least one respiratory parameter from the physiologic signal;

instructions for detecting a respiratory disturbance event when the at least one respiratory parameter meets or exceeds a predetermined criteria threshold for detecting the respiratory disturbance; and

instructions for determining a circulatory delay time comprising measuring an oxygen saturation and determining a time between the respiratory disturbance and a subsequent minimum or a subsequent maximum oxygen saturation.

15. A medium according to claim 14, further including:

instructions for measuring the magnitude of a characteristic of the respiratory disturbance.

16. A medium according to claim 14, further comprising:

instructions for determining an estimate of cardiac output based on the circulatory delay time.

17. A medium according to claim 16, further comprising instructions for determining a heart failure status of a patient in the event that the estimate of cardiac function is lower than a predetermined lower threshold.

18. A medium according to claim 14, further including instructions determining an estimate of cardiac function based on a metric of the respiratory disturbance.

19. A medium according to claim 14, further comprising instructions for triggering the storage of a physiological data item upon the detection of the respiratory disturbance.

20. A medium according to claim 14, further comprising instructions for triggering a therapy based at least in part upon detection of the respiratory disturbance.

21. A medium according to claim 14, further comprising instructions for generating a warning to alert a clinician or a patient of the detection of the respiratory disturbance.