System and method for automated diagnosis of atrial fibrillation through remote monitoring

• US 8,874,200 B2
• Filed: 10/31/2007
• Issued: 10/28/2014
• Est. Priority Date: 11/16/1999
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Bardy, Gust H.
• Primary Examiner(s): Koharski, Christopher D
• Assistant Examiner(s): D ABREU, MICHAEL JOSEPH
• Application Number:
  US11/933,278
• Publication Number:
  US 20080051668A1
• Time in Patent Office: 2,554 Days
• Field of Search: 600/483, 600/513
• US Class Current: 600/518
• CPC Class Codes: A61B 5/0031 Implanted circuitry
• CPC Class Codes: A61B 5/349 Detecting specific parameters of the electrocardiograph cycle
• CPC Class Codes: A61B 5/361 Detecting fibrillation
• CPC Class Codes: A61N 1/3622 comprising two or more electrodes co-operating with different heart regions
• CPC Class Codes: A61N 1/37282 characterised by communication with experts in remote locations using a network
• CPC Class Codes: Y10S 128/923 by comparison of patient data to other data

Abstract

A system and method for automated diagnosis of atrial fibrillation through remote monitoring is described. Physiological measures including data either recorded on a regular basis by a medical device or derived therefrom are stored. Physiological measures recorded during a baseline period are identified. Physiological measures including cardiac rhythm and changes to the cardiac rhythm originating subsequent to the baseline period are identified. Cardiac rhythm changes for palpitations are evaluated and a time course for the cardiac rhythm changes upon an indication of palpitations is determined. A patient status including an onset of atrial fibrillation conditioned on the time course comprising a short duration is formed.

Claims

1. A system for automated assessment of atrial fibrillation and related health disorders through remote monitoring, comprising:

an implantable medical device configured to collect physiological measures from a patient;

a server;

a database module maintained on the server and configured to store the physiological measures;

a comparison module configured to identify cardiac rhythm and cardiac rhythm changes from the physiological measures within a set time period;

an analysis module configured to evaluate the cardiac rhythm changes and determine a time span during which the cardiac rhythm changes occurred; and

a diagnostic module configured to generate an alert of an onset of atrial fibrillation occurring during the time span and to further detect the presence of one or more near-simultaneous disorders that share the same forms of symptomatology as atrial fibrillation.

2. A system according to claim 1 wherein the analysis module further specifies the time span is a 48-hour period.

3. A system according to claim 1, wherein the comparison module is further configured to identify the physiological measures recorded during a baseline period, and identify the cardiac rhythm changes originating subsequent to the baseline period;

and wherein the analysis module is further configured to evaluate the cardiac rhythm changes over the set time period relative to the baseline period.

4. A system according to claim 1, wherein the analysis module is further configured to categorize the cardiac rhythm changes by form of atrial fibrillation relative to type, sequence, and the non-identified physiological measures.

5. A system according to claim 1, wherein the diagnostic module is further configured to determine a therapy direction indicated by the form of atrial fibrillation comprising one of restoring normal sinus rhythm and terminating the atrial fibrillation.

6. A system according to claim 1, wherein the diagnostic module is further configured to form a patient status including an onset of atrial fibrillation occurring during the time span.

7. A system according to claim 1, wherein

the analysis module is further configured to evaluate changes to the non-identified physiological measures occurring over the same time span during which the cardiac rhythm changes occurred;

and

the diagnostic module is further configured to determine a therapy direction indicated by the evaluation of the cardiac rhythm and non-identified physiological measures.

8. A system according to claim 1, wherein the near-simultaneous disorder that shares the same forms of symptomatology as atrial fibrillation is stroke.

9. A method for automated assessment of atrial fibrillation and related health disorders through remote monitoring, comprising:

collecting physiological measures on a regular basis with an implantable medical device;

storing the physiological measures on a server;

a comparison module identifying cardiac rhythm and cardiac rhythm changes occurring within a set time period from the physiological measures stored on the server;

an analysis module evaluating the cardiac rhythm changes and determining a time course for the cardiac rhythm changes during the set time frame; and

a diagnostic module generating an alert of an onset of atrial fibrillation occurring during the time course; and

the diagnostic module further detecting the presence of one or more near-simultaneous disorders that share the same forms of symptomatology as atrial fibrillation.

10. A method according to claim 9, further comprising:

specifying the set time period as a 48-hour period within a one week time frame.

11. A method according to claim 9, further comprising:

identifying the physiological measures recorded during a baseline period;

identifying the cardiac rhythm changes originating subsequent to the baseline period; and

evaluating the cardiac rhythm changes over the set time period relative to the baseline period.

12. A method according to claim 9, further comprising categorizing the cardiac rhythm changes by form of atrial fibrillation relative to type, sequence, and the non-identified physiological measures.

13. A method according to claim 9, further comprising determining a therapy direction indicated by the form of atrial fibrillation comprising one of restoring normal sinus rhythm and terminating the atrial fibrillation.

14. A method according to claim 9, further comprising forming a patient status including an onset of atrial fibrillation occurring during the time span.

15. A method according to claim 9, further comprising

evaluating changes to the non-identified physiological measures occurring over the same time span during which the cardiac rhythm changes occurred;

and

determining a therapy direction indicated by the evaluation of the cardiac rhythm and non-identified physiological measures.

16. A method according to claim 9, wherein the near-simultaneous disorder that shares the same forms of symptomatology as atrial fibrillation is stroke.