Detecting worsening heart failure

1. A method comprising:

monitoring a heart rate, a respiration rate and an activity level of a patient;

comparing the monitored heart rate, respiration rate and activity level to a predetermined threshold zone which is a function of heart rate, respiration rate and activity level;

determining the patient is experiencing worsening heart failure when the monitored heart rate, respiration rate and activity level are outside the predetermined threshold zone; and

after determining the patient is experiencing worsening heart failure when the monitored heart rate, respiration rate and activity level are outside the predetermined threshold zone, issuing an alert to indicate that the patient is experiencing worsening heart failure.

2. The method of claim 1 , further comprising:

measuring baseline heart rates and baseline respiration rates at a multitude of activity levels of the patient; and

calculating the predetermined threshold zone as a function of the measured baseline heart rates and baseline respiration rates for the multitude of activity levels.

3. The method of claim 2 , wherein calculating the predetermined threshold zone comprises:

recording a series of data points corresponding to short term average monitored heart rates, respiration rates and activity levels of the patient; and

defining the predetermined threshold zone according to the series of data points, wherein the predetermined threshold zone includes a majority of the data points in the series of data points.

4. The method of claim 3 , wherein the predetermined threshold zone includes a substantially all of the data points in the series of data points.

5. The method of claim 3 , wherein the measuring baseline heart rates and baseline respiration rates comprises recording the series of data points during a plurality of activity levels.

6. The method of claim 5 , wherein the plurality of activity levels includes a sleeping activity level and an activity level consistent with exercise.

7. The method of claim 2 , wherein the method of claim 2 is performed by an implantable medical device implanted within the patient, wherein the implantable medical device includes:

one or more accelerometers that outputs acceleration information indicative of the activity level of the patient;

one or more electrodes that outputs information indicative of the heart rate of the patient and the respiration rate of the patient; and

a diagnostic unit configured to:

compare the heart rate, respiration rate and activity level to the predetermined threshold zone, and

determine the patient is experiencing worsening heart failure when the monitored heart rate, respiration rate and activity level are outside the predetermined threshold zone.

8. The method of claim 1 , wherein the predetermined threshold zone is calculated specifically for the patient.

9. The method of claim 1 , wherein the method of claim 1 is performed by an implantable medical device implanted within the patient.

10. A medical system for monitoring a condition of a patient comprising:

one or more sensors configured to output one or more signals indicative of a heart rate, a respiration rate and an activity level of the patient;

a memory configured to store an indication of a predetermined threshold zone which is a function of heart rate, respiration rate and activity level;

a diagnostic unit configured to:

compare the monitored heart rate, respiration rate and activity level to the predetermined threshold zone, and

determine the patient is experiencing worsening heart failure when the monitored heart rate, respiration rate and activity level are outside the predetermined threshold zone; and

an alert module configured to issue an alert to indicate that the patient is experiencing worsening heart failure after the diagnostic unit determines the patient is experiencing worsening heart failure when the monitored heart rate, respiration rate and activity level are outside the predetermined threshold zone.

11. The medical system for monitoring a condition of a patient of claim 10 , further comprising an implantable medical device, wherein the implantable medical device includes the sensors.

12. The medical system for monitoring a condition of a patient of claim 11 , wherein the implantable medical device includes the memory and the diagnostic module.

13. The medical system for monitoring a condition of a patient of claim 12 , wherein the implantable medical device includes the alert module.

14. The medical system for monitoring a condition of a patient of claim 11 , further comprising a programmer, wherein the programmer includes:

the alert module; and

a telemetry module configured to communicate wirelessly with the implantable medical device configured to receive information from the implantable medical device that indicates the monitored heart rate, respiration rate and activity level are outside the predetermined threshold zone.

15. The medical system for monitoring a condition of a patient of claim 14 , wherein the programmer includes the memory and the diagnostic module.

16. The medical system for monitoring a condition of a patient of claim 11 , wherein the implantable medical device is one of a group consisting of:

a cardiac pacemaker;

a cardioverters; and

a defibrillator.

17. The medical system for monitoring a condition of a patient of claim 10 , wherein the sensors include:

one or more accelerometers that outputs acceleration information indicative of the activity level of the patient; and

one or more electrodes that outputs information indicative of the heart rate of the patient and the respiration rate of the patient.

18. The medical system for monitoring a condition of a patient of claim 10 , wherein the predetermined threshold zone was calculated specifically for the patient.

19. A system comprising:

means for monitoring a heart rate of a patient;

means for monitoring a respiration rate of the patient;

means for monitoring an activity level of the patient;

means for comparing the monitored heart rate, respiration rate and activity level to a predetermined threshold zone which is a function of heart rate, respiration rate and activity level;

means for determining the patient is experiencing worsening heart failure when the monitored heart rate, respiration rate and activity level are outside the predetermined threshold zone; and

means for, after determining the patient is experiencing worsening heart failure when the monitored heart rate, respiration rate and activity level are outside the predetermined threshold zone, issuing an alert to indicate that the patient is experiencing worsening heart failure.

20. A non-transitory computer readable storage medium comprising instructions that cause a processor to:

monitor a heart rate, a respiration rate and an activity level of a patient;

compare the monitored heart rate, respiration rate and activity level to a predetermined threshold zone which is a function of heart rate, respiration rate and activity level;

determine the patient is experiencing worsening heart failure when the monitored heart rate, respiration rate and activity level are outside the predetermined threshold zone; and

after determining the patient is experiencing worsening heart failure when the monitored heart rate, respiration rate and activity level are outside the predetermined threshold zone, issue an alert to indicate that the patient is experiencing worsening heart failure.