Combination therapy for sleep disordered breathing and heart failure

Patent metadata

Field	Value
Publication number	US-2016135734-A1
Application number	US-201514944626-A
Country	US
Kind code	A1
Filing date	Nov 18, 2015
Priority date	Nov 19, 2014
Publication date	May 19, 2016
Grant date	—

Abstract

Methods and apparatus provide evaluation of a cardiac condition of a patient with sleep disordered breathing. One or more processors, such as processors associated with any of ICDs, CRTs and/or respiratory pressure therapy devices, may be configured to receive data representing one or more respiratory parameters for the patient. The processor(s) may receive cardiac-related patient data for the patient. The processor(s) may determine a presence of a smooth hemodynamic baseline from the received data representing one or more respiratory parameters for the patient. The processors may evaluate the cardiac condition of the patient from the received cardiac-related patient data based on the determined presence of the smooth hemodynamic baseline.

First claim

1 . A method for evaluating a cardiac condition of a patient with sleep disordered breathing comprising:
receiving data representing one or more respiratory parameters for the patient; receiving cardiac-related patient data for the patient; determining in a processor a presence of a smooth hemodynamic baseline from the received data representing one or more respiratory parameters for the patient; and evaluating, with the processor, the cardiac condition of the patient from the received cardiac-related patient data based on the determined presence of the smooth hemodynamic baseline.

2 . The method of claim 1 wherein the determining comprises detecting absence of sleep disordered breathing events for a predetermined period of time.

3 . The method of claim 1 wherein the determining comprises:
detecting sleep disordered breathing events; and
controlling a respiratory therapy to alleviate the detected sleep disordered breathing events for a predetermined period of time.

4 . The method of claim 1 further comprising collecting, with one or more sensors, data representing one or more hemodynamic parameters for the patient while the patient is within the smooth hemodynamic baseline.

5 . The method of claim 4 , wherein the evaluating is based on the data representing one or more hemodynamic parameters.

6 . The method of claim 3 wherein the controlling comprises controlling a respiratory pressure therapy device to deliver respiratory pressure therapy for the patient.

7 . The method of claim 6 , wherein the respiratory pressure therapy comprises an adaptive servo-ventilation therapy.

8 . The method of claim 2 wherein the sleep disordered breathing events comprise one or more of apnea, hypopnea, Cheyne-Stokes respiration, snoring and flow limitation.

9 . The method of claim 3 , wherein the controlling comprises controlling an implanted device to provide at least one of genioglossal nerve stimulation and phrenic nerve stimulation.

10 . The method of claim 1 , further comprising determining, based on the evaluating, efficacy of a cardiac treatment that has been provided to the patient.

11 . The method of claim 10 , wherein the cardiac treatment comprises one or more of administering a pharmaceutical cardiac drug and application of a cardiac resynchronization therapy.

12 . The method of claim 10 , further comprising titrating the cardiac treatment according to the cardiac condition of the patient.

13 . The method of claim 12 wherein the titration of the cardiac treatment comprises determination of a diuretic dose.

14 . The method of claim 12 wherein the titration of the cardiac treatment comprises an adjustment to a target ventilation of a respiratory pressure therapy.

15 . The method of claim 14 wherein the respiratory pressure therapy is a pressure support ventilation therapy controlled in accordance with the target ventilation.

16 . The method of claim 5 wherein the evaluating comprises outputting one or more hemodynamic parameters according to a time period of the smooth hemodynamic baseline.

17 . The method of claim 5 wherein the evaluating comprises detecting a change in one or more hemodynamic parameters within a time period initiated with the smooth hemodynamic baseline.

18 . The method of claim 1 wherein the received cardiac-related patient data comprises measurements generated by a pulmonary artery sensor.

19 . The method of claim 1 wherein the received data representing one or more respiratory parameters comprises measurements generated by a Doppler radar motion sensor.

20 . A system for evaluating a cardiac condition of a patient with sleep disordered breathing comprising:
one or more memories; and one or more processors in communication with the one or more memories, the one or more processors configured to: receive data representing one or more respiratory parameters for the patient; receive cardiac-related patient data for the patient; determine a presence of a smooth hemodynamic baseline from the received data representing one or more respiratory parameters for the patient; and evaluate the cardiac condition of the patient from the received cardiac-related patient data for the patient based on the determined presence of the smooth hemodynamic baseline.

21 . The system of claim 20 wherein determination of the presence of the smooth hemodynamic baseline comprises detecting absence of sleep disordered breathing events for a predetermined period of time.

22 . The system of claim 20 wherein determination of the presence of the smooth hemodynamic baseline comprises detecting sleep disordered breathing events and controlling a respiratory therapy to alleviate the detected sleep disordered breathing events for a predetermined period of time.

23 . The system of claim 20 further comprising collecting, with one or more sensors, cardiac-related patient data while the patient is within the smooth hemodynamic baseline.

24 . The system of claim 23 wherein evaluation of the cardiac condition is based on the cardiac-related patient data.

25 . The system of claim 20 further comprising a respiratory pressure therapy apparatus, the apparatus configured to alleviate detected sleep disordered breathing events by controlling a respiratory pressure therapy for the patient.

26 . The system of claim 25 , wherein the respiratory pressure therapy comprises an adaptive servo-ventilation therapy.

27 . The system of claim 21 wherein the sleep disordered breathing events comprise one or more of apneas, hypopneas, Cheyne-Stokes respiration, snoring, and flow limitation.

28 . The system of claim 20 , further comprising an implanted device configured to alleviate sleep disordered breathing events by controlling providing at least one of genioglossal nerve stimulation and phrenic nerve stimulation.

29 . The system of claim 20 , wherein the one or more processors is further configured to determine, based on the evaluating, efficacy of a cardiac treatment that has been provided to the patient.

30 . The system of claim 29 , wherein the cardiac treatment comprises one or more of administering a pharmaceutical cardiac drug and providing a cardiac resynchronization therapy.

31 . The system of claim 29 , wherein the evaluation further comprises titration of the cardiac treatment according to the cardiac condition of the patient.

32 . The system of claim 31 wherein the cardiac treatment comprises a diuretic dose and the titration comprises determining the diuretic dose.

33 . The system of claim 31 wherein the titration of the cardiac treatment comprises an adjustment to a target ventilation of a respiratory pressure therapy.

34 . The system of claim 33 wherein the respiratory pressure therapy is a pressure support ventilation therapy controlled in accordance with the target ventilation and provided by an adaptive servo-ventilator of the system.

35 . The system of claim 20 wherein the evaluation comprises outputting, by the one or more processors, one or more hemodynamic parameters according to a time period of the smooth hemodynamic baseline.

36 . The system of claim 20 wherein the evaluation comprises detecting by the one or more processors a change in

Assignees

• Resmed Ltd

Inventors

• Schindhelm Klaus Henry

Classifications

• A61N1/36135

  using physiological parameters · CPC title

• A61M16/0069

  the speed thereof being controlled by respiratory parameters, e.g. by inhalation · CPC title

• A61N1/3611

  Respiration control (stimulating respiratory organs A61N1/3601) · CPC title

• A61B5/097

  Devices for facilitating collection of breath or for directing breath into or through measuring devices · CPC title

• A61B5/4818 Primary

  Sleep apnoea · CPC title