System and method for the detection of acute myocardial infarction

• US 8,298,153 B2
• Filed: 07/09/2008
• Issued: 10/30/2012
• Est. Priority Date: 07/09/2008
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Boute, Willem, van Hove, Jos, Hampton, David Robert, Wesselink, Wilbert
• Primary Examiner(s): Layno, Carl H
• Assistant Examiner(s): LEE, YUN H
• Application Number:
  US12/170,379
• Publication Number:
  US 20100010358A1
• Time in Patent Office: 1,574 Days
• Field of Search: 600/508
• US Class Current: 600/508
• CPC Class Codes: A61B 5/0031 Implanted circuitry
• 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 5/02055 Simultaneously evaluating both cardiovascular condition and temperature
• CPC Class Codes: A61B 5/0816 Measuring devices for examining respiratory frequency measuring frequency of electric signals G01R23/00
• CPC Class Codes: A61B 5/349 Detecting specific parameters of the electrocardiograph cycle
• 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 7/00 Instruments for auscultation
• CPC Class Codes: A61N 1/3702 Physiological parameters A61N1/365 takes precedence; evoked response A61N1/371
• CPC Class Codes: G16H 10/20 for electronic clinical trials or questionnaires
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems

Abstract

A system and method are provided for the detection of acute myocardial infarction (AMI) using a staged approach for accurate and rapid detection. Physiological signals in a patient'"'"'s body are sensed and corresponding physiological parameters are derived in a staged approach in order to determine the probability that AMI is occurring in a patient in a first detection stage. If the computed probability from physiological signals indicates the possibility of AMI, then the patient is prompted, such as through a patient-wearable device, to answer specific AMI-related questions to assist in diagnosis of AMI in a second stage. AMI is detected when the computed probability in the second stage exceeds a predefined detection threshold. A patient or physician alert may then be generated, which may further include the transfer of data via a communication link or network, in response to an AMI detection signal.

Claims

1. A method comprising:

sensing at least one physiological signal in a first stage;

deriving a corresponding physiological parameter from each sensed signal in the first stage;

computing a probability of acute myocardial infarction from the physiological parameters in the first stage;

determining that the computed probability of acute myocardial infarction has reached a sufficient threshold in the first stage;

in response to the determination that the computed probability of acute myocardial infarction reached the sufficient threshold in the first stage, collecting additional information related to acute myocardial infarction in a second stage;

computing a probability of acute myocardial infarction from the collected additional information in the second stage; and

classifying an event as acute myocardial infarction when the computed probability in the second stage exceeds a predefined detection threshold.

2. The method of claim 1, further comprising collecting additional information in the second stage by sensing at least one additional physiological signal and deriving a corresponding physiological parameter from each additional sensed signal.

3. The method of claim 1, further comprising collecting additional information in the second stage by collecting information from a patient relating to acute myocardial infarction-related symptoms being experienced by the patient.

4. The method of claim 3, further comprising querying the patient with acute myocardial infarction-related questions in response to the computed probability of acute myocardial infarction reaching the sufficient threshold in the first stage.

5. The method of claim 1, wherein the physiological signals comprise at least one of a cardiac electrical signal, a respiratory signal, a temperature signal and a heart sound signal.

6. The method of claim 1, further comprising generating an alert when the computed probability in the second stage exceeds a predefined detection threshold.

7. The method of claim 1, further comprising:

performing the sensing, deriving and computing actions of the first stage in an implantable medical device implanted in a patient; and

performing the collecting, computing and detecting actions of the second stage in a device external to the patient and in communication with the implantable medical device.

8. A system comprising:

at least one physiological sensor configured to sense a corresponding physiological signal;

a controller configured to derive a corresponding physiological parameter from each sensed signal, to compute a probability of acute myocardial infarction from the physiological parameters in a first stage, and to determine that the computed probability of acute myocardial infarction has reached a sufficient threshold in the first stage;

the controller further configured to, in response to determining that the computed probability of acute myocardial infarction has reached the sufficient threshold in the first stage, collect additional information related to acute myocardial infarction in a second stage;

the controller further configured to compute a probability of acute myocardial infarction from the collected additional information in the second stage and to classify an event as acute myocardial infarction when the computed probability in the second stage exceeds a predefined detection threshold.

9. The system of claim 8, further comprising at least one additional physiological sensor configured to sense a corresponding additional physiological signal, wherein the controller is further configured to collect information in the second stage by sensing the at least one additional physiological signal and to derive a corresponding physiological parameter from each additional sensed signal.

10. The system of claim 8, wherein the controller is further configured in the second stage to initiate the collection of information from a patient relating to acute myocardial infarction-related symptoms being experienced by the patient.

11. The system of claim 10, wherein the controller is further configured to generate a command to an external device to query the patient with acute myocardial infarction-related questions in response to the computed probability of acute myocardial infarction reaching the sufficient threshold in the first stage.

12. The system of claim 8, wherein the at least one physiological sensor is configured to sense at least one of a cardiac electrical signal, a respiratory signal, a temperature signal and a heart sound signal.

13. The system of claim 8, wherein the controller is further configured to generate an alert when the computed probability in the second stage exceeds a predefined detection threshold.

14. A system comprising:

means for sensing at least one physiological signal in a first stage;

means for deriving a corresponding physiological parameter from each sensed signal in the first stage;

means for computing a probability of acute myocardial infarction from the physiological parameters in the first stage;

means for determining that the computed probability of acute myocardial infarction has reached a sufficient threshold in the first stage;

means for collecting additional information related to acute myocardial infarction in a second stage in response to the determination that the computed probability of acute myocardial infarction from the physiological parameters in the first stage reached the sufficient threshold;

means for computing a probability of acute myocardial infarction from the collected additional information in the second stage; and

means for classifying an event as acute myocardial infarction when the computed probability in the second stage exceeds a predefined detection threshold.

15. The system of claim 14, wherein the means for collecting additional information in the second stage senses at least one additional physiological signal and derives a corresponding physiological parameter from each additional sensed signal.

16. The system of claim 14, wherein the means for collecting additional information in the second stage collects information from a patient relating to acute myocardial infarction-related symptoms being experienced by the patient.

17. The system of claim 16, further comprising means for querying the patient with acute myocardial infarction-related questions in response to the computed probability of acute myocardial infarction reaching the sufficient threshold in the first stage.

18. The system of claim 14, wherein the means for sensing at least one physiological signal sense at least one of a cardiac electrical signal, a respiratory signal, a temperature signal and a heart sound signal.

19. The system of claim 14, further comprising means for generating an alert when the computed probability in the second stage exceeds a predefined detection threshold.

20. The system of claim 19, further comprising means for generating a response to the classification of an event as acute myocardial infarction when an alert is generated.