Advanced patient management with composite parameter indices

• US 8,301,252 B2
• Filed: 06/16/2011
• Issued: 10/30/2012
• Est. Priority Date: 12/18/2002
• Status: Expired due to Term

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Hatlestad, John D., Stahmann, Jeffrey E., Zhu, Qingsheng
• Primary Examiner(s): Holmes, Rex R
• Application Number:
  US13/162,311
• Publication Number:
  US 20110251506A1
• Time in Patent Office: 502 Days
• Field of Search: 607 59- 62, 607 17- 23, 607/27, 600/420
• US Class Current: 607/27
• CPC Class Codes: A61B 2560/0271 using a remote monitoring unit
• CPC Class Codes: A61B 5/0031 Implanted circuitry
• CPC Class Codes: A61B 5/024 Detecting, measuring or recording pulse rate or heart rate A61B5/0205, A61B5/021 take precedence
• CPC Class Codes: A61B 5/02405 Determining heart rate variability
• CPC Class Codes: A61B 5/0816 Measuring devices for examining respiratory frequency measuring frequency of electric signals G01R23/00
• CPC Class Codes: A61B 5/091 Measuring volume of inspired or expired gases, e.g. to determine lung capacity
• CPC Class Codes: A61B 5/743 Displaying an image simultaneously with additional graphical information, e.g. symbols, charts, function plots
• CPC Class Codes: A61B 5/7475 User input or interface means, e.g. keyboard, pointing device, joystick
• CPC Class Codes: G16H 20/30 relating to physical therapies or activities, e.g. physiotherapy, acupressure or exercising
• CPC Class Codes: G16H 20/60 relating to nutrition control, e.g. diets
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: G16H 40/67 for remote operation
• CPC Class Codes: G16H 50/30 for calculating health indices; for individual health risk assessment

Abstract

Systems, devices and methods for defining, identifying and utilizing composite parameter indices from health-related parameters are disclosed. One aspect is a programmable device having machine executable instructions for performing a method to assist with managing a patient'"'"'s health. In various embodiments, a first set of at least two health-related parameters is acquired. A first composite parameter is generated using the first set of at least two health-related parameters. Other aspects and embodiments are provided herein.

Claims

1. A system for monitoring a heart failure status of a heart failure patient, comprising:

an implantable medical device; and

a programmable device having machine executable instructions for performing a method to assist with managing a patient'"'"'s health, the method performed by the programmable device including acquiring from the implantable medical device sensed physiological parameters, and using the sensed physiological parameters to generate a composite parameter indicative of a degree of dyspnea, wherein using the sensed physiological parameters to generate the composite parameter indicative of the degree of dyspnea includes using a ratio (P_RR/P_TV) of a respiration rate parameter (P_RR) to a tidal volume parameter (P_TV) to provide an index for the degree of dyspnea.

2. The system of claim 1, further comprising a trending module configured to trend the composite parameter and one or more of the sensed physiological parameters sensed by the implantable medical device.

3. The system of claim 2, wherein the system includes a display and the method performed by the programmable device includes displaying one or more trends of the composite parameter on the display.

4. The system of claim 2, wherein the method performed by the programmable device includes acquiring a patient context or environmental context, wherein the trending module is configured to trend the patient context or environmental context with the composite parameter.

5. The system of claim 4, wherein, in the method performed by the programmable device, acquiring the patient context or environmental context includes acquiring a patient context selected from the group of patient contexts consisting of posture, activity level, sleep/wake state, and mental/emotional state.

6. The system of claim 4, wherein, in the method performed by the programmable device, acquiring the patient context or environmental context includes acquiring an environmental context selected from the group of environmental contexts consisting of temperature, sound, altitude, air quality, pollen count, humidity, environmental pressure, and time of day.

7. The system of claim 1, wherein the device includes a wellness monitoring device within an advanced patient management system.

8. The system of claim 1, wherein the method performed by the programmable device further includes:

acquiring from the implantable medical device a cardiac output parameter, a mean pulmonary artery pressure parameter, and at least one of a mean pulmonary capillary wedge pressure parameter and a left atrial pressure parameter; and

generating a composite parameter indicative of pulmonary vascular resistance using the cardiac output parameter, the mean pulmonary artery pressure parameter, and at least one of the mean pulmonary capillary wedge pressure parameter and the left atrial pressure parameter.

9. The system of claim 8, wherein the device includes a wellness monitoring device within an advanced patient management system.

10. The system of claim 8, wherein the method performed by the programmable device includes acquiring a patient context selected from the group of patient contexts consisting of posture, activity level, sleep/wake state, and mental/emotional state, wherein the trending module is configured to trend the patient context or environmental context with the composite parameter.

11. The system of claim 8, wherein, in the method performed by the programmable device, acquiring the patient context or environmental context includes acquiring a patient context selected from the group of patient contexts consisting of posture, activity level, sleep/wake state, and mental/emotional state.

12. The system of claim 8, wherein the method performed by the programmable device includes acquiring an environmental context selected from the group of environmental contexts consisting of temperature, sound, altitude, air quality, pollen count, humidity, environmental pressure, and time of day.

13. The system of claim 8, wherein the system includes a display and the method performed by the programmable device includes displaying one or more trends of the composite parameter on the display.

14. The system of claim 1, wherein the method performed by the programmable device further includes:

acquiring from the implantable medical device a heart rate parameter and a parameter related to instantaneous lung volume; and

generating a composite parameter indicative of respiratory sinus arrhythmia using the heart rate parameter and the parameter related to instantaneous lung volume.

15. The system of claim 14, wherein the device includes a wellness monitoring device within an advanced patient management system.

16. The system of claim 14, wherein, in the method performed by the programmable device, acquiring the patient context or environmental context includes acquiring a patient context selected from the group of patient contexts consisting of posture, activity level, sleep/wake state, and mental/emotional state.

17. The system of claim 14, wherein the method performed by the programmable device includes acquiring an environmental context selected from the group of environmental contexts consisting of temperature, sound, altitude, air quality, pollen count, humidity, environmental pressure, and time of day.

18. The system of claim 14, wherein the system includes a display and the method performed by the programmable device includes displaying one or more trends of the composite parameter on the display.

24. The system of claim 1,

wherein the method performed by the programmable device further includes acquiring from the implantable medical device a cardiac output parameter, a mean arterial pressure parameter and a mean right atrial pressure parameter, and generating a composite parameter indicative of systemic vascular resistance (SVR) using the cardiac output parameter, the mean arterial pressure parameter and the mean right atrial pressure parameter.

25. The system of claim 24, wherein, in the method performed by the programmable device, acquiring the patient context or environmental context includes acquiring a patient context selected from the group of patient contexts consisting of posture, activity level, sleep/wake state, and mental/emotional state.

26. The system of claim 24, wherein the method performed by the programmable device includes acquiring an environmental context selected from the group of environmental contexts consisting of temperature, sound, altitude, air quality, pollen count, humidity, environmental pressure, and time of day.

27. The system of claim 24, wherein the system includes a display and the method performed by the programmable device includes displaying one or more trends of the composite parameter on the display.

19. A system for monitoring a heart failure status of a heart failure patient, comprising:

an implantable medical device; and

a programmable device having machine executable instructions for performing a method to assist with managing a patient'"'"'s health, the method comprising;

acquiring from the implantable medical device a respiration rate parameter (P_RR) and a tidal volume parameter (P_TV); and

generating a composite parameter indicative of a degree of dyspnea using the respiration rate parameter and the tidal volume parameter, wherein generating the composite parameter includes using a ratio (P_RR/P_TV) of the respiration rate parameter to the tidal volume parameter to provide an index for the degree of dyspnea.

20. The system of claim 19, wherein the device includes a wellness monitoring device within an advanced patient management system.

21. The system of claim 19, wherein the programmable device is configured to acquire a patient context selected from the group of patient contexts consisting of posture, activity level, sleep/wake state, and mental/emotional state, and to trend the patient context with the composite parameter indicative of the degree of dyspnea.

22. The system of claim 19, wherein the programmable device is configured to acquire an environmental context selected from the group of environmental contexts consisting of temperature, sound, altitude, air quality, pollen count, humidity, environmental pressure, and time of day, and to trend the environmental context with the composite parameter indicative of the degree of dyspnea.

23. The system of claim 19, wherein the system includes a display and the method performed by the programmable device includes displaying one or more trends of the composite parameter on the display.