Synergistic use of medical devices for detecting medical disorders

• US 7,610,094 B2
• Filed: 09/13/2004
• Issued: 10/27/2009
• Est. Priority Date: 09/18/2003
• Status: Expired due to Fees

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Stahmann, Jeffrey E., Hartley, Jesse W., Lee, Kent, Ni, Quan
• Primary Examiner(s): Layno; Carl H.
• Assistant Examiner(s): Heller; Tammie K.
• Application Number:
  US10/939,586
• Publication Number:
  US 20050076909A1
• Time in Patent Office: 1,870 Days
• Field of Search: 128/920, 607/42
• US Class Current: 607/42
• CPC Class Codes: A61B 2560/0468 Built-in electrodes
• CPC Class Codes: A61B 2562/0219 Inertial sensors, e.g. accelerometers, gyroscopes, tilt switches
• 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 5/0215 by means inserted into the body catheters A61M25/00
• CPC Class Codes: A61B 5/02405 Determining heart rate variability
• CPC Class Codes: A61B 5/053 Measuring electrical impedance or conductance of a portion of the body
• CPC Class Codes: A61B 5/0809 by impedance pneumography
• CPC Class Codes: A61B 5/0836 Measuring rate of CO2 production
• CPC Class Codes: A61B 5/087 Measuring breath flow
• CPC Class Codes: A61B 5/103 Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes A61B5/08 takes precedence; measuring aids for tailors A41H1/00; measuring instruments specially adapted for dentistry A61C19/04
• CPC Class Codes: A61B 5/1116 Determining posture transitions
• CPC Class Codes: A61B 5/113 occurring during breathing
• CPC Class Codes: A61B 5/285 Endotracheal, oesophageal or gastric probes
• CPC Class Codes: A61B 5/287 Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61B 5/363 Detecting tachycardia or bradycardia
• CPC Class Codes: A61B 5/369 Electroencephalography [EEG] devices for psychotechnics A61B5/16
• CPC Class Codes: A61B 5/389 Electromyography [EMG]
• CPC Class Codes: A61B 5/398 Electrooculography [EOG], e.g. detecting nystagmus; Electroretinography [ERG]
• CPC Class Codes: A61B 5/4818 Sleep apnoea
• 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: A61M 16/0051 : with alarm devices
• CPC Class Codes: A61M 16/026 : specially adapted for predicting, e.g. for determining an information representative of a flow limitation during a ventilation cycle by using a root square technique or a regression analysis
• CPC Class Codes: A61M 16/10 : Preparation of respiratory gases or vapours
• CPC Class Codes: A61M 2016/0021 : with a proportional output signal, e.g. from a thermistor
• CPC Class Codes: A61M 2016/0039 : in the inspiratory circuit
• CPC Class Codes: A61M 2016/0042 : in the expiratory circuit
• CPC Class Codes: A61M 2205/3561 : local, e.g. within room or hospital
• CPC Class Codes: A61M 2205/3592 : using telemetric means, e.g. radio or optical transmission
• CPC Class Codes: A61M 2230/04 : Heartbeat characteristics, e.g. ECG, blood pressure modulation
• CPC Class Codes: A61M 2230/10 : Electroencephalographic signals
• CPC Class Codes: A61M 2230/432 : partial CO2 pressure (P-CO2)
• CPC Class Codes: A61M 2230/435 : partial O2 pressure (P-O2)
• CPC Class Codes: A61M 2230/60 : Muscle strain, i.e. measured on the user
• CPC Class Codes: A61M 2230/63 : Motion, e.g. physical activity
• CPC Class Codes: A61M 2230/65 : Impedance, e.g. conductivity, capacity
• 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 1/3629 : in combination with non-electric therapy
• CPC Class Codes: A61N 1/36514 : controlled by a physiological quantity other than heart potential, e.g. blood pressure controlled by two or more physical parameters A61N1/36585
• CPC Class Codes: A61N 1/36535 : controlled by body position or posture
• CPC Class Codes: A61N 1/36578 : controlled by mechanical motion of the heart wall, e.g. measured by an accelerometer or microphone
• CPC Class Codes: A61N 1/36592 : controlled by the heart rate variability
• CPC Class Codes: A61N 1/37 : Monitoring; Protecting
• CPC Class Codes: Y02A 90/10 : Information and communication technologies [ICT] supporting adaptation to climate change, e.g. for weather forecasting or climate simulation

Abstract

Methods and systems for detecting medical disorders through synergistic use of one or more medical devices are described. One or more medical devices are selected to sense one or more physiological parameters associated with a medical disorder. A presence of the medical disorder is assessed based on the sensed parameters. The medical devices used for sensing may be selected from a plurality of patient internal and/or patient-external medical devices.

Claims

1. An automated method for detecting a presence of a medical disorder, comprising:

detecting availability of one or more medical devices of a plurality of medical devices, each medical device configured for sensing one or more parameters indicative of a physiological condition, the plurality of medical devices comprising an implanted device and a patient external medical device;

assessing proficiency in sensing the one or more parameters indicative of the physiological condition of each of the one or more medical devices detected to be available;

selecting one of the plurality of medical devices to sense data indicative of the physiological condition associated with the medical disorder, the selection based on the proficiency assessment;

sensing data associated with the physiological condition using the selected medical device; and

assessing the presence of the medical disorder based on the sensed data associated with the physiological condition.

2. The method of claim 1, wherein each of the plurality of medical devices is configured to sense a common parameter indicative of the physiological condition and the proficiency assessment comprises comparing quality of data of the common parameter sensed by each of the plurality of medical devices.

3. The method of claim 1, wherein the medical disorder comprises disordered breathing and each device of the plurality of medical devices is configured to deliver a disordered breathing therapy.

4. The method of claim 1, wherein detecting availability of the one or more medical devices comprises detecting proximity of the patient external medical device to the implanted medical device.

5. The method of claim 1, wherein the implanted device is configured to sense a first parameter indicative of the physiological condition and the patient external medical device is configured to sense a second parameter indicative of the physiological condition, wherein the first parameter is different from the second parameter, and wherein the proficiency assessment comprises comparing proficiency of each of the plurality of medical devices in assessing the physiological condition using the first and second parameters.

6. The method of claim 1, wherein selecting the medical device comprises selecting the medical device of the plurality of medical devices that is least affected by noise in sensing the one or more parameters based on the proficiency assessment.

7. The method of claim 1, further comprising selecting the implanted device of the plurality of medical devices or another implanted device based on the proficiency assessment, the implanted device selected to sense a second parameter indicative of the physiological condition, wherein based on the proficiency assessment the patient external medical device is selected to sense a first parameter indicative of the physiological condition.

8. The method of claim 1, further comprising delivering therapy to treat the detected medical disorder using one or both of the implanted device and the patient external medical device.

9. The method of claim 1, wherein assessing proficiency further comprises assessing relative quality, reliability, repeatability, efficiency, accuracy, sensitivity, specificity, or resolution of each of the medical devices in sensing the one or more parameters indicative of the physiological condition.

10. A system for assessing a disease presence, comprising:

a plurality of medical devices including an implantable medical device and a patient external medical device, each medical device comprising a sensing system configured to sense one or more parameters indicative of a physiological condition;

a selection processor coupled to the plurality of medical devices, the selection processor configured to execute program instructions stored in memory to cause the system to detect availability of at least one of the plurality of medical devices, assess proficiency of each of the medical devices detected to be available in sensing the one or more parameters indicative of the physiological condition, and select one of the medical devices to sense the one or more parameters indicative of the physiological condition based on the proficiency assessment; and

a diagnosis processor coupled to the sensing system of each of the plurality of medical devices, the diagnosis processor configured to execute stored program instructions to assess a presence of a medical disorder based on the physiological condition.

11. The system of claim 10, wherein each of the plurality of medical devices is configured to sense a common parameter indicative of the physiological condition and the selection processor is configured to execute stored program instructions to compare proficiency of each of the plurality of medical devices in sensing the common parameter as part of the proficiency assessment.

12. The system of claim 10, wherein the selection processor is further configured to execute stored program instructions to alter the selection of the one or more medical devices based on a subsequent proficiency assessment of the one or more medical devices in sensing the one or more parameters indicative of the physiological condition.

13. The system of claim 10, wherein the selection processor is further configured to execute stored program instructions to assess relative quality, reliability, repeatability, efficiency, accuracy, sensitivity, specificity, or resolution of each of the medical devices in sensing the one or more parameters indicative of the physiological condition as part of the proficiency assessment.

14. The system of claim 10, wherein the implantable medical device is configured to deliver an electrical cardiac therapy, the external medical device is configured to deliver a respiratory therapy, and the physiological condition is associated with respiration.

15. The system of claim 10, further comprising a therapy unit configured to deliver patient therapy to treat the detected medical disorder based on the assessed presence of the medical disorder.

16. The system of claim 15, wherein the therapy unit comprises the implantable medical device and the implantable medical device is configured to deliver a cardiac electrical therapy based on the assessed presence of the medical disorder.

17. The system of claim 15, wherein the therapy unit comprises the patient external medical device and the patient external medical device is configured to deliver an external respiratory therapy based on the assessed presence of the medical disorder.

18. A system for detecting a presence of a medical disorder, comprising:

means for detecting availability of a plurality of medical devices, each medical device configured for sensing one or more parameters indicative of a physiological condition associated with a medical disorder and delivering a therapy to address the medical disorder, the plurality of medical devices comprising an implantable device and a patient external medical device;

means for assessing proficiency of each of the medical devices in sensing the one or more parameters indicative of the physiological condition;

means for selecting one of the medical devices to sense data associated with the physiological condition associated with the medical disorder based on the proficiency assessment;

means for sensing the one or more physiological conditions using the selected medical device; and

means for detecting the presence of the medical disorder based on the sensed physiological condition.

19. The system of claim 18, wherein the medical condition comprises disordered breathing, each device of the plurality of medical devices is configured to deliver disordered breathing therapy, and the proficiency assessment comprises comparing quality of data sensed by the implantable device and the patient external medical device.

20. The system of claim 18, further comprising:

means for collecting data based on the physiological condition using the selected medical device;

means for trending the collected data; and

means for assessing the medical disorder based on a data trend.