System and method for discrimination of central and obstructive disordered breathing events

• US 9,814,429 B2
• Filed: 12/22/2008
• Issued: 11/14/2017
• 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: Lee, Kent, Hatlestad, John D., Zhu, Qingsheng, Stahmann, Jeffrey E., Hartley, Jesse W., Ni, Quan
• Primary Examiner(s): Mallari, Patricia
• Assistant Examiner(s): TOTH, KAREN E
• Application Number:
  US12/341,590
• Publication Number:
  US 20090112116A1
• Time in Patent Office: 3,249 Days
• Field of Search: 600529-543
• 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 5/08 Detecting, measuring or recording devices for evaluating the respiratory organs A61B5/0205 takes precedence
• 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 5/113 occurring during breathing
• CPC Class Codes: A61B 5/1135 by monitoring thoracic expansion
• CPC Class Codes: A61B 5/291 for electroencephalography [EEG]
• 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 5/7264 Classification of physiological signals or data, e.g. using neural networks, statistical classifiers, expert systems or fuzzy systems neural networks per se G06N3/00; expert systems per se G06N5/00
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems

Abstract

Disordered breathing events may be classified as central, obstructive or a combination of central an obstructive in origin based on patient motion associated with respiratory effort. Central disordered breathing is associated with disrupted respiration with reduced respiratory effort. Obstructive disordered breathing is associated with disrupted respiration accompanied by respiratory effort. A disordered breathing classification system includes a disordered breathing detector and a respiratory effort motion sensor. Components of the disordered breathing classification system may be fully or partially implantable.

Claims

1. A method of operating an implantable device to classify disordered breathing events of a patient, comprising:

sensing respiration with a respiration sensor and generating a respiration signal indicating patient respiration cycles;

sensing chest wall motion with a motion sensor and generating a motion signal indicating chest wall motion associated with inspiratory effort;

detecting disordered breathing based on the respiration signal using a disordered breathing detector;

time correlating the motion signal with the respiration signal using a processor of the implantable device;

classifying the disordered breathing event as a central disordered breathing event in response to the motion signal remaining below a motion threshold during a time period in which the respiration signal remains below an inspiration threshold;

or

classifying the disordered breathing event as an obstructive disordered breathing event in response to the motion signal rising above the motion threshold during a time period in which the respiration signal remains below the inspiration threshold; and

delivering a therapy to treat disordered breathing based on the classification of the disordered breathing event with a therapy delivery unit coupled to the processor.

2. The method of claim 1, wherein:

the sensing respiration and generating the respiration signal comprises sensing and generating using a transthoracic impedance sensor; and

the sensing chest wall motion and generating the motion signal comprises sensing and generating using an accelerometer.

3. The method of claim 1, wherein the sensing respiration, the sensing chest wall motion, and the detecting disordered breathing are each performed at least in part implantably by the implantable device.

4. The method of claim 3, wherein the classifying is also performed at least in part implantably by the implantable device.

5. The method of claim 1, wherein the sensing respiration is performed using a sensor selected from the group of a transthoracic impedance sensor, a microphone configured to detect snoring sounds, and airflow sensor, and a blood gas sensor.

6. The method of claim 1, wherein sensing chest wall motion includes distinguishing chest wall motion associated with respiratory effort from chest wall motion not associated with respiratory effort.

7. A system for classifying disordered breathing of a patient, comprising:

a respiration sensor configured to provide a respiration signal indicative of patient respiration cycles;

a motion sensor configured to provide a motion signal indicative of chest wall motion associated with inspiratory effort;

a disordered breathing detector coupled to the respiration sensor and configured to detect a disordered breathing event based on the respiration signal;

a disordered breathing classification processor of an implantable device coupled to the motion sensor and the disordered breathing detector, the disordered breathing classification processor configured to time correlate the motion signal with the respiration signal, classify the disordered breathing event as a central disordered breathing event in response to the motion signal remaining below a motion threshold during a time period in which the respiration signal remains below an inspiration threshold;

wherein at least one of the disordered breathing detector, the motion sensor, and the disordered breathing classification processor is at least in part implantable; and

a therapy delivery unit coupled to the disordered breathing classification processor and configured to deliver therapy to the patient to treat the disordered breathing event.

8. The system of claim 7, wherein each of the disordered breathing detector, the motion sensor, and the disordered breathing classification processor is at least in part implantable.

9. The system of claim 7, wherein the disordered breathing classification processor is configured to classify the disordered breathing event as an obstructive disordered breathing event in response to the motion signal rising above the motion threshold during the time period in which the respiration signal remains below the inspiration threshold.

10. The system of claim 7, wherein the respiration sensor includes a sensor selected from the group of sensor a transthoracic impedance sensor, a microphone configured to detect snoring sounds, and airflow sensor, and a blood gas sensor.

11. The system of claim 7, wherein the motion sensor is configured to distinguish chest wall motion associated with respiratory effort from chest wall motion not associated with respiratory effort.

12. The system of claim 7, wherein the motion sensor includes an accelerometer.

13. A system for implantably classifying disordered breathing of a patient, comprising:

means for sensing respiration and generating a respiration signal indicating patient respiration cycles;

means for sensing chest wall motion and generating a motion signal indicating chest wall motion associated with inspiratory effort;

means for detecting disordered breathing events based on the respiration signal;

means for time correlating the motion signal with the respiration signal, including a processor of an implantable device;

means for classifying the disordered breathing event as a central disordered breathing event in response to the motion signal remaining below a motion threshold during a time period in which the respiration signal remains below an inspiration threshold; and

means for delivering a therapy to treat disordered breathing based on the classification of the disordered breathing event.

14. The system of claim 13, wherein the means for classifying the disordered breathing event is configured to classify the disordered breathing event as an obstructive disordered breathing event in response to the motion signal rising above the motion threshold during the time period in which the respiration signal remains below the inspiration threshold.

15. The system of claim 13, wherein the means for sensing respiration includes a sensor selected from the group of sensor a transthoracic impedance sensor, a microphone configured to detect snoring sounds, and airflow sensor, and a blood gas sensor.

16. The system of claim 13, wherein the means for sensing chest wall motion is configured to distinguish chest wall motion associated with respiratory effort from chest wall motion not associated with respiratory effort.