Systems and Methods for Indicating Aberrant Behavior Detected by an Implanted Medical Device

Abstract

Various systems and methods provide for intervening where aberrant heart and/or respiratory functionality is detected. For example, some embodiments of the present invention provide a monitor capable of detecting the occurrence of various aberrant events, and in some cases for intervening in the event. In some cases, a pacemaker or some other medical device detects an abnormality, and an information signal indicating the detected abnormality is transmitted from the pacemaker to a bedside monitor or some other monitor associated with the patient. Based on the received information signal, the bedside monitor can deliver an appropriate therapy. Such a therapy can be, but are not limited to, the sounding of an audible alarm to awake the patient, and/or the programming of a medical device implanted in the patient. Further, in some cases, the detected aberrant behavior and/or events surrounding the aberrant behavior can be transmitted from the bedside monitor to a remote monitor. Information can be retrieved from the remote monitor by a clinician and used in real time, or at a later time to diagnose and/or treat the patient.

1 . A system for mitigating sleep disordered breathing, the system comprising:
 an implantable sensor configured to determine if a patient is in a restive state;   an implantable medical device communicatively coupled to the sensor and configured to generate an information signal indicating an occurrence of apnea based at least in part on the restive state determination; and   a local external monitor comprising:
 communication circuitry configured to receive the information signal; 
 memory configured to store the information signal; and 
 a processor configured to associate a time stamp with the information signal; 
   the processor configured to autonomously select and initiate at least one appropriate therapy from among a plurality of available therapies for mitigating the occurrence of the apnea based at least in part on the information signal; and   the processor cooperating with the communication circuitry to communicate a message based at least in part on the information signal and the time stamp to a remote monitor disposed beyond a telemetry range of the implantable medical device.   
     
     
         2 . The system of  claim 1 , wherein the information signal generated by the implantable medical device is received by the communication circuitry of the local monitor via a wireless link. 
     
     
         3 . The system of  claim 1 , wherein:
 the local monitor is disposed within an external telemetry range of the implantable medical device deployed within the patient; and   the remote monitor is disposed beyond the external telemetry range.   
     
     
         4 . The system of  claim 1 , wherein the communication circuitry of the local monitor is configured to communicate the message to the remote monitor via a medium selected from a group consisting of a cellular telephone link, the Internet, a virtual private network, a public switched telephone network, a local area network, a pager network, and a direct wired connection. 
     
     
         5 . The system of  claim 1 , wherein the therapy includes sounding an audible alarm. 
     
     
         6 . The system of  claim 1 , wherein the processor is configured to initiate the therapy at least in part by programming the implantable medical device. 
     
     
         7 . The system of  claim 1 , wherein the processor is configured to associate the time stamp and a physical location of the processor with the information signal. 
     
     
         8 . A programmer comprising at least the local monitor according to  claim 1 . 
     
     
         9 . A system for mitigating sleep disordered breathing, the system comprising:
 an implantable sensor configured to determine if a patient is in a restive state;   an implantable medical device communicatively coupled to the sensor and configured to generate an information signal comprising sleep disordered breathing information based at least in part on the restive state determination;   a local external monitor comprising:
 communication circuitry configured to receive the information signal; 
 memory configured to store the information signal; 
 an alert system comprising an alert generator configured to generate a perceivable alarm; and 
 a processor configured to associate a time stamp with the information signal; and 
   a diagnostic system configured to indicate an occurrence of apnea based at least in part on the information signal;   the processor configured to autonomously select and initiate at least one appropriate therapy from among a plurality of available therapies for mitigating the occurrence of the apnea based at least in part on the information signal; and   the processor cooperating with the alert system to communicate a message based at least in part on the information signal and the time stamp to a remote monitor disposed beyond a telemetry range of the implantable medical device.   
     
     
         10 . The system of  claim 9 , wherein the implantable medical device comprises the diagnostic system. 
     
     
         11 . The system of  claim 9 , wherein the local monitor comprises the diagnostic system. 
     
     
         12 . The system of  claim 9 , wherein the information signal generated by the implantable medical device is received by the communication circuitry of the local monitor via a wireless link. 
     
     
         13 . The system of  claim 9 , wherein:
 the local monitor is disposed within an external telemetry range of the implantable medical device deployed within the patient; and   the remote monitor is disposed beyond the external telemetry range.   
     
     
         14 . The system of  claim 9 , wherein the communication circuitry of the local monitor is configured to communicate the message to the remote monitor via a medium selected from a group consisting of a cellular telephone link, the Internet, a virtual private network, a public switched telephone network, a local area network, a pager network, and a direct wired connection. 
     
     
         15 . The system of  claim 9 , wherein the therapy includes sounding an audible alarm generated by the alert system. 
     
     
         16 . The system of  claim 9 , wherein the processor is configured to initiate the therapy at least in part by programming the implantable medical device. 
     
     
         17 . The system of  claim 9 , wherein the processor is configured to associate the time stamp and a physical location of the processor with the information signal. 
     
     
         18 . The system of  claim 9 , wherein at least the communication circuitry, memory, alert system, and processor are disposed is a bedside monitor. 
     
     
         19 . The system of  claim 9 , wherein at least the communication circuitry, memory, and processor are disposed is a bedside monitor, and at least an output device of the alert system is disposed remotely of the beside monitor. 
     
     
         20 . A system for mitigating sleep disordered breathing, the system comprising:
 an implantable sensor arrangement configured to determine if a patient is in a restive state and to detect a breathing rate of the patient;   an implantable pulse generator coupled to the implantable sensor arrangement and configured to generate pacing pulses according to a pacing rate that is responsive to the detected breathing rate, the pulse generator configured to generate an information signal in response to concurrently determining that the patient is in the restive state and detecting a high breathing rate that exceeds a predetermined value; and   a local external monitor comprising:
 communication circuitry configured to effect communication between the local monitor and the pulse generator, and to receive the information signal; and 
 a processor configured to query the pulse generator in response to the information signal to determine if the pulse generator is modifying the pacing rate based on the breathing rate; and 
   the processor configured to communicate with the pulse generator to cause a change in pulse generator operation such that the pacing rate is not responsive to the detected breathing rate.   
     
     
         21 . The system of  claim 20 , wherein the implantable sensor arrangement comprises a transthoracic impedance sensor. 
     
     
         22 . The system of  claim 20 , wherein the pulse generator is configured to generate the information signal indicating an occurrence of sustained hyperventilation in response to concurrently determining that the patient is in the restive state and detecting the high breathing rate that exceeds the predetermined value. 
     
     
         23 . The system of  claim 20 , wherein the pulse generator is configured to associate a time stamp with the information signal. 
     
     
         24 . The system of  claim 23 , wherein the communication circuitry of the local monitor is configured to communicate a message based at least in part on the information signal and the time stamp to a remote monitor disposed beyond a telemetry range of the pulse generator. 
     
     
         25 . The system of  claim 20 , wherein the processor is configured to communicate with the pulse generator to cause a reduction in the pacing rate to a rate that is not influenced by the high rate breathing. 
     
     
         26 . The system of  claim 20 , wherein the processor is configured to program the pulse generator with updated parameters that cause the pulse generator to discontinue pacing modification with response to the patient's breathing rate.