HVAD adverse event detection from cardiac compass data
An example system includes an implantable medical device configured to obtain measurement values of one or more patient metrics; and processing circuitry configured to: determine a baseline value for each of the respective one or more patient metrics based on measurement values of the one or more patient metrics over a first period of time; determine a short-term value for each of the one or more patient metrics based on measurement values of the one or more patient metrics over a second period of time, determine a difference between each of the short-term values and the respective baseline value for each of the one or more patient metrics; determine that a risk of an adverse event occurring in the patient is high in response to the determined difference meeting a respective adverse event risk threshold; and generate for output an adverse event high risk alert.
1 . A system comprising:
an implantable blood pump of an implantable medical device, the implantable medical device configured to receive a plurality of sensed physiological signals indicative of a plurality of cardiovascular parameters of a patient, and to collect and store measurement values of one or more patient metrics of the patient corresponding to the cardiovascular parameters and based on the received plurality of physiological signals;
the implantable medical device comprising processing circuitry configured to:
determine a baseline value for each of the respective one or more patient metrics based on measurement values of the one or more patient metrics over a first period of time;
determine a short-term value for each of the one or more patient metrics based on measurement values of the one or more patient metrics over a second period of time, the second period of time being shorter in duration than the first period of time;
determine a difference between each of the short-term values and the respective baseline value for each of the one or more patient metrics;
determine that a risk of an adverse event occurring in the patient is high in response to the determined difference of at least one patient metric of the one or more patient metrics meeting a respective adverse event risk threshold or in response to an accumulated value of the determined differences for each of the one or more patient metrics meeting a respective accumulated adverse event risk threshold;
wherein the adverse event is a high risk of an occurrence of a stroke based on a determination using a first set of the one or more patient metrics or wherein the adverse event is a high risk of an occurrence of a thrombus based on a determination using a second set of the one or more patient metrics that is different from the first set of the one or more patient metrics; and
generate for output an adverse event high risk alert in response to determining the patient has the high risk of the adverse event occurring.
2 . The system of claim 1 , wherein the one or more patient metrics comprise at least one of (a) heart rate during a day time period; (b) heart rate during a night time period; (c) percent atrial pacing; (d) percent ventricular pacing; (e) heart rate variability; (f) a patient activity level; (g) daily intrathoracic impedance; or (h) ventricular tachycardia or ventricular fibrillation status.
3 . The system of claim 2 , wherein the processing circuitry is further configured to apply a long-term filter to the measurement values of each of the one or more patient metrics over the first period of time to determine the baseline value for each of the respective one or more patient metrics.
4 . The system of claim 3 , wherein the processing circuitry is further configured to apply a short-term filter to the measurement values of each of the one or more patient metrics over the second period of time to determine the short-term value for each of the respective one or more patient metrics.
5 . The system of claim 4 , wherein the first period of time is 6 months, and the second period of time is 30 days.
6 . The method of claim 4 , wherein the long-term filter is a moving average filter applied over the first period of time.
7 . The system of claim 4 , wherein the short-term filter is a moving average filter applied over the second period of time.
8 . The system of claim 2 , wherein the processing circuitry is further configured to determine that the risk of the thrombus occurring in the patient is high in response to the determined difference of at least one patient metric of patient metrics (a)-(g) meeting a respective thrombus risk threshold or in response to an accumulated value of the determined differences for each of the patient metrics (a)-(g) meeting a respective accumulated thrombus risk threshold.
9 . The system of claim 2 , wherein the processing circuitry is further configured to determine that the risk of the stroke occurring in the patient is high in response to the determined difference of at least one patient metric of patient metrics (a)-(e) meeting a respective stroke risk threshold or in response to an accumulated value of the determined differences for each of the patient metrics (a)-(e) meeting a respective accumulated stroke risk threshold.
10 . The system of claim 2 , wherein the adverse event is a heart ventricular assist device (HVAD) induced ventricular arrythmia and the processing circuitry is further configured to determine a risk of the HVAD induced ventricular arrythmia occurring in the patient is high in response to the determined difference of patient metric (h) meeting a respective HVAD induced ventricular arrythmia risk threshold.
11 . The system of claim 1 , wherein the adverse event is a heart ventricular assist device (HVAD) induced ventricular arrythmia.
12 . The system of claim 1 , wherein the generated adverse event high risk alert is to cause a medical intervention to be performed on the patient.
13 . A method comprising:
receiving, at a system comprising an implanted blood pump of an implantable medical device implanted in a patient, a plurality of sensed physiological signals, the sensed physiological signals indicative of measurement values of one or more patient metrics of the patient corresponding to a set of cardiovascular parameters of the patient;
performing, using processing circuitry included in the implantable medical device, the method further comprising:
determining a baseline value for each of the respect on or more patient metrics based on measurement values of the one or more patient metrics over a first period of time;
determining a short-term value for each of the one or more patient metrics based on measurement values of the one or more patient metrics over a second period of time, the second period of time being shorter than the first period of time;
determining a difference between each of the short-term values and the respective baseline value for each of the one or more patient metrics;
determining that a risk of an adverse event occurring in the patient is high in response to the determined difference of at least one patient metric of the one or more patient metrics meeting a respective adverse event risk threshold or in response to an accumulated value of the determined differences for each of the one or more metrics meeting a respective accumulated adverse event risk threshold;
wherein the adverse event is a high risk of an occurrence of a stroke based on a determination using a first set of the one or more patient metrics or wherein the adverse event is a high risk of an occurrence of a thrombus based on a determination using a second set of the one or more patient metrics that is different from the first set of the one or more patient metrics; and
generating for output an adverse event high risk alert in response to determining the patient has the high risk of the adverse event occurring.
14 . The method of claim 13 , wherein the one or more patient metrics comprise at least one of (a) heart rate during a day time period; (b) heart rate during a night time period; (c) percent atrial pacing; (d) percent ventricular pacing; (e) heart rate variability; (f) a patient activity level; (g) daily intrathoracic impedance; or (h) ventricular tachycardia or ventricular fibrillation status.
15 . The method of claim 14 , further comprising applying a long-term filter to the measurement values of each of the one or more patient metrics over the first period of time to determine the baseline value for each of the respective one or more patient metrics.
16 . The method of claim 15 , further comprising applying a short-term filter to the measurement values of each of the one or more patient metrics over the second period of time to determine the short-term value for each of the respective one or more patient metrics.
17 . The method of claim 16 , wherein the long-term filter is a moving average filter applied over the first period of time and the short-term filter is a moving average filter applied over the second period of time.
18 . The method of claim 14 , the method further comprising determining a risk of the thrombus occurring in the patient is high in response to the determined difference of at least one patient metric of patient metrics (a)-(g) meeting a respective thrombus risk threshold or in response to an accumulated value of the determined differences for each of the patient metrics (a)-(g) meeting a respective accumulated thrombus risk threshold.
19 . The method of claim 14 , the method further comprising determining a risk of the stroke occurring in the patient is high in response to the determined difference of at least one patient metric of patient metrics (a)-(e) meeting a respective a stroke risk threshold or in response to an accumulated value of the determined differences for each of the patient metrics (a)-(e) meeting a respective accumulated stroke risk threshold.
20 . The method of claim 14 , wherein the adverse event is a heart ventricular assist device (HVAD) induced ventricular arrythmia and the method further comprising determining a risk of the HVAD induced ventricular arrythmia occurring in the patient is high in response to the determined difference of patient metric (h) meeting a respective HVAD induced ventricular arrythmia risk threshold.