System and method for cardiac monitoring using rate-based sensitivity levels

• US 10,143,395 B2
• Filed: 09/28/2016
• Issued: 12/04/2018
• Est. Priority Date: 09/28/2016
• Status: Active Grant

• Current Assignee: Medtronic Monitoring, Inc. (Medtronic Plc)
• Original Assignee: Medtronic Monitoring, Inc. (Medtronic Plc)
• Inventors: Chakravarthy, Niranjan, Katra, Rodolphe
• Primary Examiner(s): Hulbert, Amanda
• Assistant Examiner(s): Dinga, Roland
• Application Number:
  US15/278,566
• Publication Number:
  US 20180085021A1
• Time in Patent Office: 797 Days
• Field of Search: 600518
• CPC Class Codes: A61B 2505/07 Home care
• CPC Class Codes: A61B 5/0006 ECG or EEG signals
• CPC Class Codes: A61B 5/0022 Monitoring a patient using a global network, e.g. telephone networks, internet
• CPC Class Codes: A61B 5/02405 Determining heart rate variability
• CPC Class Codes: A61B 5/0245 by using sensing means generating electric signals, i.e. ECG signals
• CPC Class Codes: A61B 5/02455 provided with high/low alarm devices
• CPC Class Codes: A61B 5/1118 Determining activity level
• CPC Class Codes: A61B 5/1123 Discriminating type of movement, e.g. walking or running A61B5/1116, A61B5/112 take precedence
• CPC Class Codes: A61B 5/259 using conductive adhesive means, e.g. gels
• CPC Class Codes: A61B 5/287 Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61B 5/316 Modalities, i.e. specific diagnostic methods
• CPC Class Codes: A61B 5/333 Recording apparatus specially adapted therefor
• CPC Class Codes: A61B 5/352 Detecting R peaks, e.g. for synchronising diagnostic apparatus; Estimating R-R interval
• CPC Class Codes: A61B 5/361 Detecting fibrillation
• CPC Class Codes: A61B 5/363 Detecting tachycardia or bradycardia
• CPC Class Codes: A61B 5/7264 Classification of physiological signals or data, e.g. using neural networks, statistical classifiers, expert systems or fuzzy systems neural networks per se G06N3/00; expert systems per se G06N5/00
• CPC Class Codes: G16H 40/67 for remote operation
• CPC Class Codes: G16Z 99/00 Subject matter not provided for in other main groups of this subclass

Abstract

A system and method for detecting arrhythmic electrocardiogram (ECG) signals includes defining a plurality of threshold heart rates and rate-dependent sensitivity levels for detecting arrhythmic ECG episodes, wherein more clinically relevant heart rates are assigned rate-dependent sensitivity levels with higher sensitivities. ECG signals are monitored by a medical device, and monitored ECG signals are processed using the plurality of threshold heart rates and rate-dependent sensitivity levels to detect and capture arrhythmic ECG segments.

Claims

1. A method of detecting arrhythmic electrocardiogram (ECG) signals, the method comprising:

monitoring one or more physiological parameters associated with a patient;

determining whether the patient is at rest based on one or more physiological parameters; and

measuring a basal/resting heart rate of the patient in response to a determination that the patient is at rest, wherein the plurality of threshold heart rates are defined based on the measured basal/resting heart rate;

defining a plurality of threshold heart rates and rate-dependent sensitivity levels for detecting arrhythmic ECG episodes, wherein the plurality of threshold heart rates are defined based on the measured basal/resting heart rate, wherein more clinically relevant heart rates are assigned rate-dependent sensitivity levels with higher sensitivities;

monitoring ECG signals associated with a patient using a monitoring device; and

processing the monitored ECG signals using the plurality of threshold heart rates and rate-dependent sensitivity levels to detect and capture arrhythmic ECG segments.

2. The method of claim 1, wherein the monitoring device processes the monitored ECG signals locally, and wherein captured arrhythmic ECG segments are communicated to a remote monitoring center for review.

3. The method of claim 1, wherein monitored ECG signals are communicated to a remote monitoring center for processing of the monitored ECG signals using the plurality of threshold heart rates and rate-dependent sensitivity levels.

4. The method of claim 1, wherein the plurality of threshold heart rates include a plurality of heart rate thresholds associated with tachycardia thresholds and a plurality of heart rate thresholds associated with bradycardia thresholds, and wherein higher rate tachycardia thresholds are assigned a higher sensitivity level than lower rate tachycardia thresholds, and lower rate bradycardia thresholds are assigned a higher sensitivity level than higher rate bradycardia thresholds.

5. The method of claim 1, wherein the plurality of heart rate thresholds are selected based on one or more patient characteristics.

6. The method of claim 5, wherein the one or more patient characteristics include one or more of patient age, weight, sex, and/or basal/resting heart rate.

7. The method of claim 1, wherein captured arrhythmic ECG segments are reviewable at a remote monitoring center, wherein the captured arrhythmic ECG segments includes one or more tags that can be utilized to filter and search the plurality of captured arrhythmic ECG segments.

8. The method of claim 7, wherein the tags include one or more of a heart-rate threshold that triggered capture of the ECG segment, a rate-based sensitivity level associated with the heart-rate threshold, ratio of beats exceeding the heart-rate threshold, trigger arrhythmic condition, and patient activity level.

9. A system for monitoring electrocardiogram (ECG) signals and detecting arrhythmic ECG episodes, the system comprising:

a monitoring device having one or more electrodes and sensing circuitry for monitoring ECG signals associated with a patient; and

a processing module configured to receive the monitored ECG, wherein the processing module utilizes a plurality of heart-rate thresholds and rate-dependent sensitivity levels to detect and capture arrhythmic ECG segments, wherein the processing module determines whether the patient is at rest based on one or more physiological parameters, and measures a basal/resting heart rate of the patient in response to a determination that the patient is at rest, wherein the plurality of threshold heart rates are defined based on the measured basal/resting heart rate.

10. The system of claim 9, wherein the processing module is included on the monitoring device and includes memory for storing the plurality of heart-rate thresholds and rate-dependent sensitivity levels and a processor for processing the monitored ECG signals using the heart-rate thresholds and rate-dependent sensitivity levels.

11. The system of claim 10, wherein the processing module includes wireless communications circuitry for communicating captured ECG segments to a remote monitoring center for review.

12. The system of claim 9, wherein the plurality of threshold heart rates include a plurality of heart rate thresholds associated with tachycardia thresholds and a plurality of heart rate thresholds associated with bradycardia thresholds, and wherein higher rate tachycardia thresholds are assigned a higher sensitivity level than lower rate tachycardia thresholds, and lower rate bradycardia thresholds are assigned a higher sensitivity level than higher rate bradycardia thresholds.

13. The system of claim 9, wherein the plurality of heart rate thresholds are selected based on one or more patient characteristics, comprising one or more of patient age, weight, sex, and/or basal/resting heart rate.

14. The system of claim 9, wherein the captured arrhythmic ECG segments communicated to a remote monitoring center include one or more tags that can be utilized to filter and search the plurality of captured arrhythmic ECG segments, wherein tags comprise one or more of a heart-rate threshold that triggered capture of the ECG segment, a rate-based sensitivity level associated with the heart-rate threshold, ratio of beats exceeding the heart-rate threshold, trigger arrhythmic condition, and patient activity level.

15. A medical device, comprising:

a sensing unit that monitors an electrocardiogram (ECG) signal;

a memory unit that stores a plurality of heart-rate thresholds and rate-dependent sensitivity levels; and

a processor that processes the monitored ECG signal to detect and capture arrhythmic ECG segments based on the plurality of heart-rate thresholds and rate-dependent sensitivity levels, wherein the processing module determines whether the patient is at rest based on one or more physiological parameters, and measures a basal/resting heart rate of the patient in response to a determination that the patient is at rest, wherein the plurality of threshold heart rates are defined based on the measured basal/resting heart rate.

16. The medical device of claim 15, wherein the plurality of threshold heart rates include a plurality of heart rate thresholds associated with tachycardia thresholds and a plurality of heart rate thresholds associated with bradycardia thresholds, and wherein higher rate tachycardia thresholds are assigned a higher sensitivity level than lower rate tachycardia thresholds, and lower rate bradycardia thresholds are assigned a higher sensitivity level than higher rate bradycardia thresholds.

17. The medical device of claim 15, wherein the medical device is one of an adherent device, an implantable device, an insertable device, an injectable device or a wearable device.