Medical system for therapy adjustment

Abstract

Methods and systems for seamless adjustment of treatment are disclosed. A determination can be made as to whether to intervene with a patient's treatment based on data obtained from implantable electrodes and/or non-implantable electrodes. The data from non-implantable electrodes have a correction factor applied to adjust for less accuracy compared to data acquired from implantable electrodes.

1 . A system for managing patient therapy, the system comprising:
 (a) an implantable medical device comprising one or more electrodes configured to be implanted within a patient's body, to acquire first signals corresponding to signals sensed from within the patient's body and to generate first data transmissions in response to the acquired first signals;   (b) a wearable device comprising one or more electrodes configured to be positioned in contact with an external surface of the patient's body, to acquire second signals corresponding to signals sensed from the external surface of the patient's body, and to generate second data transmissions in response to the acquired second signals;   (c) an input/output device to receive the first data transmissions and the second data transmissions; and   (d) one or more processors configured to:
 (1) receive the first data transmissions and the second data transmissions, 
 (2) compare the received first data transmissions and the received second data transmissions to one or more thresholds, 
 (3) determine whether data of the received first data transmissions and the received second data transmissions is indicative of a heart failure (HF) worsening episode based on the comparing, and 
 (4) adjust a patient's therapy in response to the HF worsening episode being indicated. 
   
     
     
         2 . A system for managing patient therapy, the system comprising:
 (a) an implantable medical device comprising one or more electrodes configured to be implanted within a patient's body, to acquire first signals corresponding to signals sensed from within the patient's body and to generate first data transmissions in response to the acquired first signals;   (b) a wearable device comprising one or more electrodes configured to be positioned in contact with an external surface of the patient's body, to acquire second signals corresponding to signals sensed from the external surface of the patient's body, and to generate second data transmissions in response to the acquired second signals;   (c) an input/output device to receive the first data transmissions and the second data transmissions; and   (d) one or more processors configured to:
 (i) receive the first data transmissions and the second data transmissions, 
 (ii) calculate a heart failure risk score such that the first data transmissions are weighted differently than the second data transmissions, 
 (iii) determine whether data of the received first data transmissions and the received second data transmissions is indicative of a heart failure (HF) worsening episode based on the comparing, and 
 (iv) displaying one of the worsening HF episode or a risk score on a graphical user interface of a computing device in response to the HF worsening episode being indicated. 
   
     
     
         3 . The system of  claim 2  wherein the heart failure risk score is weighted such that the second data transmissions is accorded up to 85% weight compared to the first data transmissions being weighted 100%. 
     
     
         4 . The system of  claim 2  wherein the heart failure risk score is weighted such that the second data transmissions is accorded up to 90% weight compared to the first data transmissions. 
     
     
         5 . The system of  claim 2  wherein the heart failure risk score is weighted such that the second data transmissions is accorded up to 95% weight compared to the first data transmissions. 
     
     
         6 . The system of  claim 2  wherein the heart failure risk score is weighted such that the second data transmissions is accorded less weight compared to the first data transmissions. 
     
     
         7 . The system of  claim 2  wherein the heart failure risk score is weighted such that the second data transmissions is accorded less weight compared to the first data transmissions wherein fraction xi, is smaller for external electrodes compared to implanted electrodes, a weighted sum equation being X=Σ x=1   n (xi*wi)/(Σ x=1   n (wi). 
     
     
         8 . A method for managing patient therapy, the method comprising:
 a. sensing signals from one or more electrodes associated with an implantable medical device disposed within a patient's body;   b. acquiring first signals corresponding to the signals sensed from within the patient's body and generating first data transmissions in response to the acquired first signals;   c. sensing signals from electrodes capable of being positioned over an external surface of the patient's body, acquiring second signals from the external surface of the patient's body and generating second data transmissions in response to the acquired second signals;   d. receiving the first data transmissions and the second data transmissions by an input/output device;
 1. receiving the first data transmissions and the second data transmissions via one or more processors, 
 2. comparing, via the one or more processors, the received first data transmissions and the received second data transmissions to one or more thresholds, 
 3. determining, via the one or more processors, whether data of the received first data transmissions and the received second data transmissions is indicative of a heart failure (HF) worsening episode based on the comparing, and 
 4. adjusting, via the one or more processors, a patient's therapy in response to the HF worsening episode being indicated. 
   
     
     
         9 . The method of  claim 8  wherein the heart failure risk score is weighted such that the second data transmissions is accorded up to 85% weight compared to the first data transmissions. 
     
     
         10 . The method of  claim 8  wherein the heart failure risk score is weighted such that the second data transmissions is accorded up to 90% weight compared to the first data transmissions. 
     
     
         11 . The system of  claim 8  wherein the heart failure risk score is weighted such that the second data transmissions is accorded up to 95% weight compared to the first data transmissions. 
     
     
         12 . A system for managing patient therapy, the system comprising:
 (a) an implantable medical device comprising one or more electrodes configured to be implanted within a patient's body, the one or more electrodes configured to pace tissue;   (b) a wearable device comprising one or more electrodes configured to be positioned in contact with an external surface of the patient's body, to acquire second signals corresponding to signals sensed from the external surface of the patient's body, and to generate second data transmissions in response to the acquired second signals;   (c) an input/output device to receive the second data transmissions; and   (d) one or more processors configured to:
 (1) receive the second data transmissions, 
 (2) compare the received second data transmissions to one or more thresholds, 
 (3) determine whether data of the received second data transmissions is indicative of a heart failure (HF) worsening episode based on the comparing, and 
 (4) adjust a patient's pacing therapy in response to the HF worsening episode being indicated. 
   
     
     
         13 . The system of  claim 12  wherein the acquired signals are solely from one or more electrodes positioned in contact with the external surface of the patient's body. 
     
     
         14 . The system of  claim 12  wherein a battery of an implantable medical device is conserved by solely using the one or more external electrodes to acquire signals from the patient's body. 
     
     
         15 . The system of  claim 12  wherein a processor external to a patient's body causes a signal to be generated to adjust therapy delivered to the patient. 
     
     
         16 . The system of  claim 12  wherein a processor, external to a patient's body, determines a patient is experiencing arrhythmia from the signals from the one or more electrodes external to the surface of the patient's body. 
     
     
         17 . The system of  claim 12  wherein the adjusted therapy comprises changing dosage of a medication. 
     
     
         18 . The system of  claim 12  wherein the adjusted therapy comprises the implantable medical device automatically changing a pacing mode. 
     
     
         19 . The system of  claim 19  wherein changing the pacing mode comprises switching between monoventricular pacing to biventricular pacing. 
     
     
         20 . A system for managing patient therapy, the system comprising:
 (a) an implantable medical device comprising one or more electrodes configured to be implanted within a patient's body and to perform one of sensing and pacing of tissue;   (b) a wearable device comprising one or more electrodes configured to be positioned in contact with an external surface of the patient's body, to acquire second signals corresponding to signals sensed from the external surface of the patient's body, and to generate second data transmissions in response to the acquired second signals;   (c) an input/output device to receive the first data transmissions and the second data transmissions; and   (d) one or more processors configured to:
 (1) receive the second data transmissions, 
 (2) compare the received second data transmissions to one or more thresholds, 
 (3) determine whether data of the received second data transmissions is indicative of a heart failure (HF) worsening episode based on the comparing, and 
 (4) adjust a pacing therapy in response to the HF worsening episode being indicated.