Heart failure patient treatment and management device
A device and method to detect and manage heart failure patient symptoms is provided. Respiration and/or cardiac parameters may be sensed or observed to determine the status of a patient's condition. These symptoms may be classified for appropriate patient disease management. A patient's activity level may be monitored in conjunction with respiration and/or cardiac parameters to provide additional patient status information. These symptoms may be classified for appropriate patient disease management. Pulmonary edema is one condition that may be determined to exist when a respiration parameter is out of range for a given sensed activity level. If edema is determined to be present, the device may be configured to respond to treat the edema.
1 . A patient management system comprising:
an implantable device comprising:
a physiological sensor configured to be coupled to a patient to monitor the patient, and configured to sense at least one cardiac parameter and at least one respiration parameter;
a patient condition status identifier configured to identify a patient condition status based on the at least one cardiac parameter and the at least one respiration parameter.
2 . The system of claim 1 wherein the condition status corresponds to a patient's heart failure status.
3 . The system of claim 1 wherein the patient status identifier further comprises a severity level sensor configured to determine a patient condition severity level.
4 . The system of claim 3 further comprising a responsive element configured to recommend a patient action based on the condition severity level.
5 . The system of claim 4 wherein the responsive element is configured to provide a medication intervention instruction based on the condition severity level.
6 . The system of claim 4 wherein the responsive element is configured to recommend a lifestyle modification.
7 . The system of claim 4 wherein the responsive element is configured to recommend a provider intervention.
8 . The system of claim 4 wherein the responsive element is configured to recommend an emergency intervention.
9 . The system of claim 1 further comprising a patient status communicator coupled to the patient status identifier and configured to communicate a patient status to a user.
10 . The system of claim 9 wherein the user is a patient.
11 . The system of claim 9 wherein the user is a health care provider.
12 . The system of claim 1 further comprising an activity monitor configured to detect patient activity.
13 . The system of claim 12 wherein the physiological sensor is further configured to correlate an activity level sensed by the activity monitor with one or more of the at least one cardiac parameter and the at least one respiration parameter.
14 . The system of claim 13 wherein the correlated activity with the at least one parameter further qualifies the patient status.
15 . The system of claim 1 wherein the patient status identifier comprises a baseline comparator configured to compare a baseline to the at least one parameter.
16 . The system of claim 15 wherein the patient status identifier is configured to identify a patient condition severity level at least in part based on the comparison of the baseline to the at least one parameter.
17 . The system of claim 1 wherein the device further comprises a patient compliance monitor.
18 . The system of claim 1 wherein the physiological parameter sensor is configured to sense a plurality of parameters and wherein the patient status identifier is configured to identify the patient condition status based the plurality of parameters
19 . The system of claim 1 , wherein the physiological parameter sensor is configured to sense the cardiac parameter from a location external to a patient's heart.
20 . The system of claim 1 wherein the physiological parameter sensor is configured to continuously monitor at least one parameter.
21 . The system of claim 1 wherein the patient condition status identifier is configured to identify a patient decompensating status.
22 . A method of managing a patient comprising the steps of:
continuously monitoring at least one cardiac parameter and at least one respiration parameter;
sensing the at least one cardiac parameter and at least one respiration parameter; and
identifying a patient status based on the at least one cardiac parameter and at least one respiration parameter.
23 . The method of claim 22 further comprising the step of determining a patient condition severity level based on the at least one cardiac parameter and at least one respiration parameter.
24 . The method of claim 23 further comprising the step of recommending a patient course of action based on the patient condition severity level.
25 . The method of claim 23 further comprising the step of communicating the patient condition severity level to the patient.
26 . The method of claim 23 further comprising the step of communicating the patient condition severity level to a healthcare provider.
27 . A device for detecting pulmonary edema comprising
a first sensor configured to sense activity of a subject and to generate a first signal corresponding to the activity of a subject;
a second sensor configured to sense at least one respiration parameter of the subject and generate a second signal corresponding to the at least on respiration parameter; and
an edema analyzer coupled to the first sensor and the second sensor, the edema analyzer configured to sense edema based on the first signal and the second signal.
28 . The device of claim 27 wherein the first sensor is configured to sense motion of a subject.
29 . The device of claim 27 wherein the at least one respiration parameter comprises a respiration rate.
30 . The device of claim 27 wherein the at least one respiration parameter comprises a morphology of a respiration waveform.
31 . The device of claim 27 wherein the edema detector is configured to detect edema when a sensed respiration rate exceeds a predetermined level of a sensed activity level.
32 . A method for detecting pulmonary edema comprising the steps of:
sensing activity of a subject;
sensing at least one respiration parameter of the subject; and
determining a pulmonary edema condition based on the activity and respiration parameter of the subject.
33 . The method of claim 32 wherein the step of determining pulmonary edema condition comprises determining a relative severity level of the pulmonary edema condition.
34 . A patient management system comprising:
an implantable device comprising:
a physiological sensor configured to be coupled to a patient to continuously monitor the patient, and configured to sense at least one physiological parameter selected from: at least one cardiac parameter sensed from a location external the heart and at least one respiration parameter;
a patient condition status identifier configured to identify a patient condition status based on the at least one physiological parameter.
35 . The system of claim 34 wherein the condition status corresponds to a patient's heart failure status.
36 . The system of claim 34 wherein the patient status identifier further comprises a severity level sensor configured to determine a patient condition severity level.
37 . The system of claim 36 further comprising a responsive element configured to recommend a patient action based on the condition severity level.
38 . The system of claim 37 wherein the responsive element is configured to provide a medication intervention instruction based on the condition severity level.
39 . The system of claim 37 wherein the responsive element is configured to recommend a lifestyle modification.
40 . The system of claim 37 wherein the responsive element is configured to recommend a provider intervention.
41 . The system of claim 37 wherein the responsive element is configured to recommend an emergency intervention.
42 . A device for sensing cardiac parameters comprising:
at least one electrode configured to be positioned adjacent a diaphragm of a subject and configured to sense an ECG signal.
43 . The device of claim 43 wherein the at least one electrode is configured to be positioned on the abdominal surface of a diaphragm.
44 . A method for sensing cardiac parameters comprising:
positioning an electrode adjacent a diaphragm of a subject; and
sensing an ECG with the diaphragm.
45 . The method of claim 44 wherein the step of positioning the electrode adjacent the diaphragm comprises positioning the electrode at the abdominal side of the diaphragm.
46 . The method of claim 44 wherein the step of positioning the electrode adjacent the diaphragm comprises positioning the electrode at the thoracic side of the diaphragm.