Differentiating decompensation detection based on co-morbidities in heart failure

Abstract

This document discusses, among other things, a system comprising a sensor signal processor configured to receive a plurality of electrical sensor signals produced by a plurality of sensors and at least one sensor signal produced by an implantable sensor, a memory that includes information indicating a co-morbidity of a subject, a sensor signal selection circuit that selects a sensor signal to monitor from among the plurality of sensor signals, according to an indicated co-morbidity, a threshold adjustment circuit that adjusts a detection threshold of the selected sensor signal according to the indicated co-morbidity, and a decision circuit that applies the adjusted detection threshold to the selected sensor signal to determine whether an event associated with worsening heart failure (HF) occurred in the subject and outputs an indication of whether the event associated with worsening HF occurred to a user or process.

1 . (canceled) 
     
     
         2 . An apparatus comprising:
 a sensor signal processor configured to receive a plurality of physiologic sensor signals;   a memory, including physiological information of the subject, wherein the physiologic information includes severity data, wherein the physiological information includes severity information of a physiological condition of the subject;   a sensor signal selection circuit, in electrical communication with the sensor signal processor, configured to select one or more sensor signals to monitor from among the plurality of sensor signals according to the severity information; and   a decision circuit configured to determine heart failure (HF) status associated with worsening heart failure (HF) of the subject using the selected combination of sensor signals and generate an indication of the HF status.   
     
     
         3 . The apparatus of  claim 2 , wherein the severity information includes severity information associated with a comorbidity of the subject. 
     
     
         4 . The apparatus of  claim 2 , wherein the severity information is severity of comorbidity information received from a separate device. 
     
     
         5 . The apparatus of  claim 2 , including a therapy circuit configured to deliver cardiac resynchronization therapy (CRT) to the subject, and a threshold adjustment circuit configured to adjust detection thresholds of the one or more selected physiologic sensor signals when an indication of the CRT therapy is received. 
     
     
         6 . The apparatus of  claim 2 , wherein the sensor signal selection circuit is configured to:
 enable a default combination of the physiological sensor signals to monitor to detect an event associated with worsening HF when first severity information is indicated in the physiological information; and   add or remove one or more sensor signals to the default combination of sensor signals when second severity information is indicated in the physiological information.   
     
     
         7 . The apparatus of  claim 2 , including a threshold adjustment circuit configured to:
 set one or more default sensor signal detection thresholds for the selected combination of sensor signals to detect an event associated with worsening HF; and change the one or more detection thresholds according to the severity information.   
     
     
         8 . The apparatus of  claim 2 , wherein the sensor signal selection circuit is configured to select a first combination of sensor signals to monitor when the physiological information indicates diabetes of the subject and select a second different combination of sensor signals to monitor when the physiological information indicates a co-morbidity different than diabetes. 
     
     
         9 . The apparatus of  claim 2 , wherein the sensor signal selection circuit is configured to select a first combination of sensor signals to monitor when the physiological information indicates hypertension and select a second different combination of sensor signals to monitor when the physiological information indicates a co-morbidity different than hypertension. 
     
     
         10 . The apparatus of  claim 2 , wherein the sensor signal selection circuit is configured to select a first combination of sensor signals to monitor when myocardial infarction (MI) is indicated in the physiological information and select a second different combination of sensor signals to monitor when the physiological information indicates a co-morbidity different than MI. 
     
     
         11 . The apparatus of  claim 2 , wherein the sensor signal selection circuit is configured to select a first combination of sensor signals to monitor when the physiological information indicates a chronic-obstructive pulmonary disorder (COPD) and select a second different combination of sensor signals to monitor when the physiological information indicates a co-morbidity different than COPD. 
     
     
         12 . A method of controlling operation of a medical device, the method comprising:
 receiving a plurality of physiologic sensor signals at the medical device;   selecting one or more sensor signals to monitor from among the plurality of sensor signals available according to physiological information of a subject, wherein the physiological information includes severity information of a physiological condition of the subject; and   determining heart failure (HF) status associated with worsening heart failure (HF) of the subject using the selected combination of sensor signals and generate an indication of the HF status.   
     
     
         13 . The apparatus of  claim 12 , wherein the severity information is stored in the medical device and includes severity information associated with a comorbidity of the subject. 
     
     
         14 . The apparatus of  claim 12 , wherein the severity information is severity of comorbidity information received from a separate device. 
     
     
         15 . The apparatus of  claim 12 , including delivering cardiac resynchronization therapy (CRT) to the subject, and adjusting a detection threshold of the one or more selected physiologic sensor signals when an indication of the CRT therapy is received. 
     
     
         16 . The method of  claim 12 , including:
 enabling a default combination of the physiological sensor signals to monitor to detect an event associated with worsening HF when first severity information is indicated in the physiological information; and   adding or removing one or more sensor signals to the default combination of sensor signals when second severity information is indicated in the physiological information.   
     
     
         17 . The method of  claim 12 , including:
 setting one or more default sensor signal detection thresholds for the selected combination of sensor signals to detect the event associated with worsening HF; and   changing the one or more detection thresholds according to the severity information.   
     
     
         18 . The method of  claim 12 , including selecting a first combination of sensor signals to monitor when the physiological information indicates diabetes of the subject and selecting a second different combination of sensor signals to monitor when a co-morbidity different from diabetes is indicated. 
     
     
         19 . The method of  claim 12 , including selecting a first combination of sensor signals to monitor when the physiological information indicates hypertension and selecting a second different combination of sensor signals to monitor when the physiological information indicates a co-morbidity different than hypertension. 
     
     
         20 . The method of  claim 12 , including selecting a first combination of sensor signals to monitor when myocardial infarction (MI) is indicated and selecting a second different combination of sensor signals to monitor when the indicated co-morbidity is different than MI. 
     
     
         21 . The method of  claim 12 , including selecting a first combination of sensor signals to monitor when the physiological information indicates the subject has chronic-obstructive pulmonary disorder (COPD), and selecting a second different combination of sensor signals to monitor when the physiological information indicates a co-morbidity different than COPD.