US 2019/0336076 A1 · SENSING FOR HEART FAILURE MANAGEMENT

Abstract

In some examples, determining a heart failure status includes using an implantable medical device configured for subcutaneous implantation and comprising a plurality of electrodes and an optical sensor. Processing circuitry of a system comprising the device may determine, for a patient, a current tissue oxygen saturation value based on a signal received from the at least one optical sensor, a current tissue impedance value based on a subcutaneous tissue impedance signal received from the electrodes, and a current pulse transit time value based on a cardiac electrogram signal received from the electrodes and at least one of the signal received from the optical sensor and the subcutaneous tissue impedance signal. The processing circuitry may further compare the current tissue oxygen saturation value, current tissue impedance value, and current pulse transit time value to corresponding baseline values, and determine the heart failure status of the patient based on the comparison.

Claims28

Dependent claims

A method for determining a heart failure status of a patient using an implantable medical device configured for subcutaneous implantation outside of a thorax of the patient, the implantable medical device comprising a plurality of electrodes and at least one optical sensor, the method comprising, by processing circuitry of a medical device system comprising the implantable medical device:

determining a current tissue oxygen saturation value of the patient based on a signal received from the at least one optical sensor;
determining a current tissue impedance value of the patient based on a subcutaneous tissue impedance signal received from a first at least two of the plurality of electrodes;
determining a current pulse transit time value of the patient based on a cardiac electrogram signal received from a second at least two of the plurality of electrodes and at least one of the signal received from the at least one optical sensor and the subcutaneous tissue impedance signal;
comparing the current tissue oxygen saturation value, the current tissue impedance value, and the current pulse transit time value to corresponding ones of a baseline tissue oxygenation saturation value, a baseline tissue impedance value, and a baseline pulse transit time value;
and
determining the heart failure status of the patient based on the comparison.

3 more elements

A system for determining a heart failure status of a patient using an implantable medical device configured for subcutaneous implantation outside of a thorax of the patient, the system comprising:

the implantable medical device comprising:
at least one optical sensor;
and
a plurality of electrodes;
and
processing circuitry configured to:
determine a current tissue oxygen saturation value of the patient based on a signal received from the at least one optical sensor;
determine a current tissue impedance value of the patient based on a subcutaneous tissue impedance signal received from a first at least two of the plurality of electrodes;
determine a current pulse transit time value of the patient based on a cardiac electrogram signal received from a second at least two of the plurality of electrodes and at least one of the signal received from the at least one optical sensor and the subcutaneous tissue impedance signal;
compare the current tissue oxygen saturation value, the current tissue impedance value, and the current pulse transit time value to corresponding ones of a baseline tissue oxygenation saturation value, a baseline tissue impedance value, and a baseline pulse transit time value;
and
determine the heart failure status of the patient based on the comparison.

9 more elements

A system for determining a heart failure status of a patient using an implantable medical device configured for subcutaneous implantation outside of a thorax of the patient, the system comprising:

the implantable medical device, comprising:
at least one optical sensor;
a plurality of electrodes;
and
processing circuitry configured to:
determine a current tissue oxygen saturation value of the patient based on the signal received from the at least one optical sensor;
determine a current tissue impedance value of the patient based on a subcutaneous tissue impedance signal received from a first at least two of the plurality of electrodes;
determine a current pulse transit time value of the patient based on a cardiac electrogram signal received from a second at least two of the plurality of electrodes and at least one of the signal received from the at least one optical sensor and the subcutaneous tissue impedance signal;
determine whether a difference between the current tissue oxygen saturation value and the baseline tissue oxygen saturation value satisfies a tissue oxygen saturation threshold value that is associated with a change in a tissue-perfusion status of the patient;
determine whether a difference between the current tissue impedance value and the baseline tissue impedance value satisfies a tissue impedance threshold value that is associated with a change in a congestion status of the patient;
determine whether a difference between the current pulse transit time value and the baseline pulse transit time value satisfies a threshold pulse transit time value that is associated with a change in a blood-pressure status of the patient;
determine the heart failure status of the patient based on at least one of the difference between the current tissue oxygen saturation value and the baseline tissue oxygen saturation value, the difference between the current tissue impedance value and the baseline tissue impedance value, and the difference between the current pulse transit time and the baseline pulse transit time;
and
transmit the heart failure status of the patient to a remote computer;
and
the remote computer, wherein the remote computer comprises processing circuitry configured to:
receive the heart failure status of the patient transmitted by the processing circuitry of the implantable medical device;
and
transmit the instructions for the medical intervention to a user interface.

16 more elements

A system for determining a heart failure status of a patient, the system comprising:

means for determining a current tissue oxygen saturation value of the patient based on a signal received from at least one optical sensor;
means for determining a current tissue impedance value of the patient based on a subcutaneous tissue impedance signal received from a first at least two of a plurality of electrodes;
means for determining a current pulse transit time value of the patient based on a cardiac electrogram signal received from a second at least two of the plurality of electrodes and at least one of the signal received from the at least one optical sensor and the subcutaneous tissue impedance signal;
means for comparing the current tissue oxygen saturation value, the current tissue impedance value, and the current pulse transit time value to corresponding ones of a baseline tissue oxygenation saturation value, a baseline tissue impedance value, and a baseline pulse transit time value;
and
means for determining the heart failure status of the patient based on the comparison.

3 more elements

A non-transitory computer-readable medium storing instructions for causing processing circuitry to perform a method for determining a heart failure status of a patient using an implantable medical device configured for subcutaneous implantation outside of a thorax of the patient, the implantable medical device comprising a plurality of electrodes and at least one optical sensor, the method comprising:

determining a current tissue oxygen saturation value of the patient based on a signal received from the at least one optical sensor;
determining a current tissue impedance value of the patient based on a subcutaneous tissue impedance signal received from a first at least two of the plurality of electrodes;
determining a current pulse transit time value of the patient based on a cardiac electrogram signal received from a second at least two of the plurality of electrodes and at least one of the signal received from the at least one optical sensor and the subcutaneous tissue impedance signal;
comparing the current tissue oxygen saturation value, the current tissue impedance value, and the current pulse transit time value to corresponding ones of a baseline tissue oxygenation saturation value, a baseline tissue impedance value, and a baseline pulse transit time value;
and
determining the heart failure status of the patient based on the comparison.

3 more elements

Dependencies are inferred from the claim text.

Sensing for heart failure management

Life of this patent

Sensing for heart failure management

Life of this patent

Abstract

Claims28