System and method for predicting patient health within a patient management system

• US 8,628,471 B2
• Filed: 06/30/2010
• Issued: 01/14/2014
• Est. Priority Date: 01/02/2003
• Status: Expired due to Fees

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Mazar, Scott T., Fogoros, Richard, Manicka, Yatheendhar D., KenKnight, Bruce H., Pederson, Michael J.
• Primary Examiner(s): Thomson, Bill
• Assistant Examiner(s): JIAN, SHIRLEY XUEYING
• Application Number:
  US12/827,985
• Publication Number:
  US 20100268095A1
• Time in Patent Office: 1,294 Days
• Field of Search: 600/506, 600510-513, 600/547, 607/18, 607/20
• US Class Current: 600/301
• 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 5/0205 Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
• CPC Class Codes: A61B 5/0809 by impedance pneumography
• CPC Class Codes: A61B 5/11 Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb for measuring pulse A61B5/02 ;A61B5/1038 takes precedence; motion detection to correct for motion artifacts in physiological signals A61B5/721
• CPC Class Codes: A61B 5/14532 for measuring glucose, e.g. by tissue impedance measurement
• CPC Class Codes: A61B 5/14546 for measuring analytes not otherwise provided for, e.g. ions, cytochromes
• CPC Class Codes: A61B 5/352 Detecting R peaks, e.g. for synchronising diagnostic apparatus; Estimating R-R interval
• CPC Class Codes: A61B 5/363 Detecting tachycardia or bradycardia

Abstract

Systems and Methods for predicting patient health and patient relative well-being within a patient management system are disclosed. A preferred embodiment utilizes an implantable medical device comprising an analysis component and a sensing component further comprising a three-dimensional accelerometer, a transthoracic impedance sensor, a cardio-activity sensor, an oxygen saturation sensor and a blood glucose sensor. Some embodiments of a system disclosed herein also can be configured as an Advanced Patient Management System that helps better monitor, predict and manage chronic diseases.

Claims

1. An implantable device comprising:

an accelerometer to sense body motion data represented as an accelerometer data pattern and;

an impedance sensor to sense transthoracic impedance data;

a cardio-activity sensor to sense cardiac data;

an analysis component; and

a communications component communicatively coupled to the accelerometer, the impedance sensor, and the cardio-activity sensor, the communications component configured to communicate the body motion data, the transthoracic impedance data, and cardiac data to the analysis component,

the analysis component configured to;

obtain a transthoracic impedance variation pattern from the transthoracic impedance data;

identify a possible illness from the transthoracic impedance variation pattern, with the possible illnesses including an onset of asthma and a progression of heart failure;

obtain an inhalation/exhalation time ratio measured by the transthoracic impedance data; and

determine whether the possible illness is likely a progression of heart failure by removing the possibility of the possible illness being asthma based on the inhalation/exhalation time ratio and the accelerometer data pattern.

2. The implantable device of claim 1, wherein the impedance sensor is configured to sense an inhalation/exhalation ratio indicative of a progression of asthma indicated by the inhalation/exhalation time ratio.

3. The implantable device of claim 1, wherein the impedance sensor is configured to sense a variation pattern indicative of an onset of chronic obstructive pulmonary disease indicated by the variation pattern, and wherein the analysis module is configured to determine whether the possible illness is an onset of chronic obstructive pulmonary disease based on the variation pattern, the inhalation/exhalation time ratio, and the accelerometer data pattern.

4. The implantable device of claim 1, wherein the impedance sensor is configured to sense an indication of lung fluid accumulation indicative of a progression of heart failure indicated by the lung fluid accumulation, and wherein the analysis module is configured to determine whether the possible illness is a progression of heart failure based on the lung fluid accumulation, the inhalation/exhalation time ratio, and the accelerometer data pattern.

5. The implantable device of claim 1, wherein the cardio-activity sensor is configured to sense left and right intracardial R-wave amplitudes indicative of an onset of pulmonary edema indicated by the left and right intracardial R-wave amplitudes, and wherein the analysis module is configured to correlate changes in accelerometer and transthoracic impedance to determine whether the possible illness as an onset of pulmonary edema.

6. The implantable device of claim 1, wherein the accelerometer is a multi-axis accelerometer.

7. The implantable device of claim 1, comprising an oxygen saturation sensor to sense blood oxygen saturation and wherein the analysis component is configured to use the blood oxygen saturation to detect an onset or change in a cardiac or pulmonary disease state.

8. The implantable device of claim 1, wherein the analysis component is incorporated into the implantable device.

9. A computer-readable storage medium comprising instructions, which when executed by a machine, cause the machine to:

receive body motion data from an accelerometer;

receive transthoracic impedance data from an impedance sensor;

receive cardiac data from a cardio-activity sensor;

obtain a transthoracic impedance variation pattern from the transthoracic impedance data;

identify a possible illness from the transthoracic impedance variation pattern, with the possible illnesses including an onset of asthma, an occurrence of chronic obstructive pulmonary disease, and a progression of heart failure;

obtain an accelerometer data patter from the body motion data;

obtain an inhalation/exhalation time ratio measured by the transthoracic impedance data; and

determine whether the possible illness is likely a progression of heart failure by removing the possibility of the possible illness being asthma based on the inhalation/exhalation time ratio and the accelerometer data pattern.

10. The computer-readable storage medium of claim 9, wherein the transthoracic impedance data includes an inhalation/exhalation time ratio and wherein possible illnesses include a progression of asthma indicated by the inhalation/exhalation time ratio.

11. The computer-readable storage medium of claim 9, wherein the possible illnesses include an onset of chronic obstructive pulmonary disease indicated by the variation pattern, and wherein the instructions include instructions to determine whether the possible illness is an onset of chronic obstructive pulmonary disease based on the variation pattern, the inhalation/exhalation time ratio, and the accelerometer data pattern.

12. The computer-readable storage medium of claim 9, wherein the transthoracic impedance data includes an indication of lung fluid accumulation and wherein the possible illnesses include a progression of heart failure indicated by the lung fluid accumulation, and wherein the instructions include instructions to determine whether the possible illness is a progression of heart failure based on the lung fluid accumulation, the inhalation/exhalation time ratio, and the accelerometer data pattern.

13. The computer-readable storage medium of claim 9, wherein the cardiac data includes left and right intracardial R-wave amplitudes and wherein the possible illnesses include an onset of pulmonary edema indicated by the left and right intracardial R-wave amplitudes, and wherein the instructions include instructions to correlate changes in accelerometer and transthoracic impedance to determine whether the possible illness as an onset of pulmonary edema.

14. The computer-readable storage medium of claim 9, comprising instructions to:

receive blood oxygen saturation from an oxygen saturation sensor; and

use the blood oxygen saturation to detect an onset or change in a cardiac or pulmonary disease state.

15. A method comprising:

receiving body motion data from an accelerometer;

receiving transthoracic impedance data from an impedance sensor;

receiving cardiac data from a cardio-activity sensor;

obtaining a transthoracic impedance variation pattern from the transthoracic impedance data;

identifying a possible illness from the transthoracic impedance variation pattern, with the possible illnesses including an onset of asthma, an occurrence of chronic obstructive pulmonary disease, and a progression of heart failure;

obtaining an accelerometer data patter from the body motion data;

obtaining an inhalation/exhalation time ratio measured by the transthoracic impedance data; and

determining whether the possible illness is likely a progression of heart failure by removing the possibility of the possible illness being asthma based on the inhalation/exhalation time ratio and the accelerometer data pattern.

16. The method of claim 15, wherein the transthoracic impedance data includes an inhalation/exhalation time ratio and wherein the possible illnesses include a progression of asthma indicated by the inhalation/exhalation time ratio.

17. The method of claim 15, wherein the possible illnesses include an onset of chronic obstructive pulmonary disease indicated by the variation pattern, and wherein the method includes determining whether the possible illness is an onset of chronic obstructive pulmonary disease based on the variation pattern, the inhalation/exhalation time ratio, and the accelerometer data pattern.

18. The method of claim 15, wherein the transthoracic impedance data includes an indication of lung fluid accumulation and wherein the possible illnesses include a progression of heart failure indicated by the lung fluid accumulation, and wherein the method includes determining whether the possible illness is a progression of heart failure based on the lung fluid accumulation, the inhalation/exhalation time ratio, and the accelerometer data pattern.

19. The method of claim 15, wherein the cardiac data includes left and right intracardial R-wave amplitudes and wherein the possible illnesses include an onset of pulmonary edema indicated by the left and right intracardial R-wave amplitudes, and wherein the method includes correlating changes in accelerometer and transthoracic impedance to determine whether the possible illness as an onset of pulmonary edema.

20. The method of claim 15, comprising:

receiving blood oxygen saturation from an oxygen saturation sensor; and

using the blood oxygen saturation to detect an onset or change in a cardiac or pulmonary disease state.