WO2006081336A3 - System for detecting hypoglycemia, hyperglycemia and cardiac ischemia - Google Patents

System for detecting hypoglycemia, hyperglycemia and cardiac ischemia Download PDF

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Publication number
WO2006081336A3
WO2006081336A3 PCT/US2006/002722 US2006002722W WO2006081336A3 WO 2006081336 A3 WO2006081336 A3 WO 2006081336A3 US 2006002722 W US2006002722 W US 2006002722W WO 2006081336 A3 WO2006081336 A3 WO 2006081336A3
Authority
WO
WIPO (PCT)
Prior art keywords
hyperglycemia
hypoglycemia
distinguished
segment elevation
cardiac ischemia
Prior art date
Application number
PCT/US2006/002722
Other languages
French (fr)
Other versions
WO2006081336A2 (en
Inventor
Jong Gill
Peter Boileau
Rupinder Bharmi
Xiaoyi Min
Joseph J Florio
Michael Benser
Gene A Bornzin
Original Assignee
Pacesetter Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Pacesetter Inc filed Critical Pacesetter Inc
Priority to DE602006013419T priority Critical patent/DE602006013419D1/en
Priority to EP06719544A priority patent/EP1850909B1/en
Priority to AT06719544T priority patent/ATE463279T1/en
Publication of WO2006081336A2 publication Critical patent/WO2006081336A2/en
Publication of WO2006081336A3 publication Critical patent/WO2006081336A3/en

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/38—Applying electric currents by contact electrodes alternating or intermittent currents for producing shock effects
    • A61N1/39—Heart defibrillators
    • A61N1/3956—Implantable devices for applying electric shocks to the heart, e.g. for cardioversion
    • A61N1/3962—Implantable devices for applying electric shocks to the heart, e.g. for cardioversion in combination with another heart therapy
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/145—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue
    • A61B5/14532—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue for measuring glucose, e.g. by tissue impedance measurement
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
    • A61B5/346—Analysis of electrocardiograms
    • A61B5/349—Detecting specific parameters of the electrocardiograph cycle
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
    • A61B5/346—Analysis of electrocardiograms
    • A61B5/349—Detecting specific parameters of the electrocardiograph cycle
    • A61B5/358—Detecting ST segments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
    • A61B5/346—Analysis of electrocardiograms
    • A61B5/349—Detecting specific parameters of the electrocardiograph cycle
    • A61B5/364—Detecting abnormal ECG interval, e.g. extrasystoles, ectopic heartbeats
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/362—Heart stimulators
    • A61N1/3621—Heart stimulators for treating or preventing abnormally high heart rate
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/362—Heart stimulators
    • A61N1/3627—Heart stimulators for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/362—Heart stimulators
    • A61N1/365—Heart stimulators controlled by a physiological parameter, e.g. heart potential
    • A61N1/36514—Heart stimulators controlled by a physiological parameter, e.g. heart potential controlled by a physiological quantity other than heart potential, e.g. blood pressure
    • A61N1/36557—Heart stimulators controlled by a physiological parameter, e.g. heart potential controlled by a physiological quantity other than heart potential, e.g. blood pressure controlled by chemical substances in blood
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/38—Applying electric currents by contact electrodes alternating or intermittent currents for producing shock effects
    • A61N1/39—Heart defibrillators
    • A61N1/3925—Monitoring; Protecting
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/38—Applying electric currents by contact electrodes alternating or intermittent currents for producing shock effects
    • A61N1/39—Heart defibrillators
    • A61N1/3956—Implantable devices for applying electric shocks to the heart, e.g. for cardioversion
    • A61N1/3962—Implantable devices for applying electric shocks to the heart, e.g. for cardioversion in combination with another heart therapy
    • A61N1/39622—Pacing therapy

Abstract

Techniques are described for detecting and distinguishing among ischemia, hypoglycemia or hyperglycemia based on intracardiac electrogram (IEGM) signals. In one technique, these conditions are detected and distinguished based on an analysis of: the interval between the QRS complex and the peak of a T-wave (QTmax), the interval between the QRS complex and the end of a T-wave (QTend), alone or in combination with a change in ST segment elevation. By exploiting QTmax and QTend in combination with ST segment elevation, changes in ST segment elevation caused by hypo/hyperglycemia can be properly distinguished from changes caused by cardiac ischemia. In another technique, hyperglycemia and hypoglycemia are predicted, detected and/or distinguished from one another based on an analysis of the amplitudes of P-waves, QRS-complexes and T-waves within the IEGM. Appropriate warning signals are delivered and therapy is automatically adjusted.
PCT/US2006/002722 2005-01-25 2006-01-25 System for detecting hypoglycemia, hyperglycemia and cardiac ischemia WO2006081336A2 (en)

Priority Applications (3)

Application Number Priority Date Filing Date Title
DE602006013419T DE602006013419D1 (en) 2005-01-25 2006-01-25 SYSTEM FOR DETECTING HYPOGLYKEMIA, HYPERGLYCEMIA AND CARDIAC
EP06719544A EP1850909B1 (en) 2005-01-25 2006-01-25 System for detecting hypoglycemia, hyperglycemia and cardiac ischemia
AT06719544T ATE463279T1 (en) 2005-01-25 2006-01-25 SYSTEM FOR DETECTING HYPOGLYCEMIA, HYPERGLYCEMIA AND CARDIAC ISCHEMIA

Applications Claiming Priority (8)

Application Number Priority Date Filing Date Title
US11/043,804 US7297114B2 (en) 2005-01-25 2005-01-25 System and method for distinguishing among cardiac ischemia, hypoglycemia and hyperglycemia using an implantable medical device
US11/043,612 2005-01-25
US11/043,612 US7502644B2 (en) 2005-01-25 2005-01-25 System and method for distinguishing among cardiac ischemia, hypoglycemia and hyperglycemia using an implantable medical device
US11/043,804 2005-01-25
US11/043,780 US7272436B2 (en) 2005-01-25 2005-01-25 System and method for distinguishing among cardiac ischemia, hypoglycemia and hyperglycemia using an implantable medical device
US11/043,780 2005-01-25
US11/127,370 2005-05-11
US11/127,370 US7524287B2 (en) 2005-01-25 2005-05-11 System and method for distinguishing between hypoglycemia and hyperglycemia using an implantable medical device

Publications (2)

Publication Number Publication Date
WO2006081336A2 WO2006081336A2 (en) 2006-08-03
WO2006081336A3 true WO2006081336A3 (en) 2006-11-09

Family

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Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US2006/002722 WO2006081336A2 (en) 2005-01-25 2006-01-25 System for detecting hypoglycemia, hyperglycemia and cardiac ischemia

Country Status (5)

Country Link
US (8) US7272436B2 (en)
EP (3) EP2308556B1 (en)
AT (1) ATE463279T1 (en)
DE (1) DE602006013419D1 (en)
WO (1) WO2006081336A2 (en)

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