摘要:
A device can include at least a first physiologic sensor circuit configured to provide a first physiologic signal, a second physiologic sensor circuit configured to provide a second physiologic signal, and a processor circuit. The processor circuit includes a principal component analysis circuit configured to represent data determined from the at least first and second physiologic sensor circuits as at least first and second axes, respectively, in a multidimensional space, determine one or more principal components in the multidimensional space, determine a quantitative attribute of the first and the second physiologic signals using at least one of the determined principal components or a projection of the data along the at least one determined principal component, and provide an indication of heart failure status according to the quantitative attribute to at least one of a user or a process.
摘要:
The present subject matter includes apparatus, methods and device-readable media for using impedance and heart sounds to classify events and alerts. An apparatus can include a processor circuit configured to receive a physiological indication, classify the indication, and generate a multi-dimensional heart failure decompensation status indication. A method can include obtaining a physiological indication, classifying the indication and generating a multi-dimensional heart failure decompensation status indication. A device-readable medium can include instructions that, when performed by the device can obtain a physiological indication, classify the indication, and generate a multi-dimensional heart failure decompensation status alert.
摘要:
A device can include at least a first physiologic sensor circuit configured to provide a first physiologic signal, a second physiologic sensor circuit configured to provide a second physiologic signal, and a processor circuit. The processor circuit includes a principal component analysis circuit configured to represent data determined from the at least first and second physiologic sensor circuits as at least first and second axes, respectively, in a multidimensional space, determine one or more principal components in the multidimensional space, determine a quantitative attribute of the first and the second physiologic signals using at least one of the determined principal components or a projection of the data along the at least one determined principal component, and provide an indication of heart failure status according to the quantitative attribute to at least one of a user or a process.
摘要:
An implantable or other ambulatory medical apparatus comprises a posture sensing circuit, a physiologic sensing circuit that senses a time varying physiologic signal, and a processor circuit. The processor circuit includes a posture calculation circuit and a measurement circuit. The posture calculation circuit determines a posture of the subject using posture data obtained using the posture signal and determines when the posture of the subject is steady state. The measurement circuit derives a physiologic measurement using physiologic data extracted from the physiologic signal during at least one time period when posture is determined to be steady state and provides the physiologic measurement to at least one of a user and a process in association with the determined steady state posture.
摘要:
An implantable or other ambulatory medical apparatus comprises a posture sensing circuit, a physiologic sensing circuit that senses a time varying physiologic signal, and a processor circuit. The processor circuit includes a posture calculation circuit and a measurement circuit. The posture calculation circuit determines a posture of the subject using posture data obtained using the posture signal and determines when the posture of the subject is steady state. The measurement circuit derives a physiologic measurement using physiologic data extracted from the physiologic signal during at least one time period when posture is determined to be steady state and provides the physiologic measurement to at least one of a user and a process in association with the determined steady state posture.
摘要:
Physiological data, such as thoracic impedance data, can be obtained over a first time window to establish a baseline, or can be used to form one or more data clusters. Additional physiological data, such as thoracic impedance test data acquired over a later time window, can be obtained and compared to the baseline or data clusters to determine an indication of worsening heart failure. In an example, a quantitative attribute of one or more data clusters can be monitored and used to provide an indication of worsening heart failure. A posture discrimination metric can be obtained, such as using the physiological data obtained over the first time window. The additional physiological data, such as can be obtained over a second time window, can be compared to the posture discrimination metric to provide a patient posture status.
摘要:
A system comprises a cardiac signal sensing circuit and a processor circuit. To detect a QRS duration, the processor circuit determines an isoelectric amplitude value of the cardiac signal segment, identifies a time where the cardiac signal segment amplitude deviates from the first isoelectric amplitude value by a specified threshold deviation value as a Q time, determines an isoelectric value time after the determined maxima and minima times that the cardiac signal segment returns to the same or a different isoelectric amplitude value, identifies a time that follows both the determined maxima and minima times and precedes the isoelectric value time as an S time, wherein the cardiac signal segment amplitude at the identified S time satisfies a specified amplitude change criterion from an isoelectric amplitude value, and determines a time duration of the QRS complex in the cardiac signal segment using the identified Q and S times.
摘要:
Devices and methods for improving the sensitivity and specificity of heart failure (HF) detection are described. The devices and methods can detect a HF status such as using physiological sensor data and external biomarker assays. An apparatus can comprise ambulatory physiological sensors that can provide a first HF status indicator and a second HF status indicator to a user. An external biomarker sensor can provide an amount of a biomarker present, such as an assay for B-type natriuretic peptide (BNP), which provides information about HF status. A processor circuit can switch from a first HF detection mode to a second detection mode such as in response to the information from the biomarker sensor. The first detection mode can detect HF status using the first HF status indicator, and the second detection mode can detect HF status using the second HF status indicator. The second detection mode can have a higher specificity than the first detection mode.
摘要:
A differential or relative measurement between an orthogonal measurement vector and another measurement vector can be used to determine the location where fluid accumulation is occurring or the local change in such fluid accumulation. This can help diagnose or treat infection or hematoma or seroma at a pocket of an implanted cardiac rhythm management device, other implanted medical device, or prosthesis. It can also help diagnose or treat pulmonary edema, pneumonia, pulmonary congestion, pericardial effusion, pericarditis, pleural effusion, hemodilution, or another physiological condition.
摘要:
Physiological data, such as thoracic impedance data, can be obtained over a first time window to establish a baseline, or can be used to form one or more data clusters. Additional physiological data, such as thoracic impedance test data acquired over a later time window, can be obtained and compared to the baseline or data clusters to determine an indication of worsening heart failure. In an example, a quantitative attribute of one or more data clusters can be monitored and used to provide an indication of worsening heart failure. A posture discrimination metric can be obtained, such as using the physiological data obtained over the first time window. The additional physiological data, such as can be obtained over a second time window, can be compared to the posture discrimination metric to provide a patient posture status.