Electrogram summary

• US 10,251,573 B2
• Filed: 02/24/2014
• Issued: 04/09/2019
• Est. Priority Date: 05/03/2013
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Ousdigian, Kevin T, Lauer, Joel R, Richardson, Adam C
• Primary Examiner(s): Levicky, William J
• Application Number:
  US14/187,695
• Publication Number:
  US 20140330147A1
• Time in Patent Office: 1,870 Days
• CPC Class Codes: A61B 5/316 Modalities, i.e. specific diagnostic methods
• CPC Class Codes: A61B 5/339 Displays specially adapted therefor
• CPC Class Codes: A61B 5/349 Detecting specific parameters of the electrocardiograph cycle
• CPC Class Codes: A61B 5/361 Detecting fibrillation
• CPC Class Codes: A61B 5/363 Detecting tachycardia or bradycardia
• CPC Class Codes: A61B 5/7282 Event detection, e.g. detecting unique waveforms indicative of a medical condition A61B5/4094, A61B5/4818, A61B5/349, A61B5/0823 take precedence
• CPC Class Codes: A61B 5/742 using visual displays A61B5/339 takes precedence
• CPC Class Codes: A61N 1/3622 comprising two or more electrodes co-operating with different heart regions
• CPC Class Codes: A61N 1/37235 Aspects of the external programmer
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means

Abstract

Example techniques, systems, and devices select one or more portions of EGM signal data for presentation based on an identified cardiac episode type of the EGM signal data. For example, one or more processors are configured to receive cardiac electrogram (EGM) signal data collected from a medical device associated with a patient. The EGM signal data may include a detected cardiac episode identified as one of a plurality of episode types. The one or more processors may also be configured to select, based on the identified one of the plurality of episode types, one or more portions of the EGM signal data associated with the detected cardiac episode, and output the selected one or more portions of the EGM signal data.

Claims

1. A system comprising:

one or more processors configured to;

receive cardiac electrogram (EGM) signal data collected from a medical device associated with a patient, wherein the EGM signal data is representative of a detected single cardiac episode identified as one of a plurality of episode types;

select, based on the identified one of the plurality of episode types, a plurality of non-overlapping portions of the EGM signal data associated with the detected single cardiac episode, wherein the identified episode type of the plurality of episode types is associated with a respective selection of portions of the EGM signal data, and wherein at least two non-overlapping portions of the plurality of the non-overlapping portions of the EGM signal data are discontinuous non-overlapping portions; and

output, for display, the selected plurality of non-overlapping portions of the EGM signal data as an episode summary for the detected single cardiac episode, the episode summary comprising each non-overlapping portion of the EGM signal data of the plurality of non-overlapping portions of the EGM signal data arranged in chronological order.

2. The system of claim 1, wherein the plurality of episode types comprise at least two of a treated ventricular tachycardia/ventricular fibrillation (VT/VF) episode, a monitored VT episode, a non-sustained ventricular tachycardia (VTNS) episode, a high-rate non-sustained ventricular tachycardia (VTNS) episode, a VT/VF episode with treatment withheld, a supraventricular tachycardia (SVT) episode, a ventricular oversensing (VOS) episode, a fast atrial and ventricular rate episode, a treated atrial tachycardia/atrial fibrillation (AT/AF) episode, and a monitored AT/AF episode.

3. The system of claim 1, wherein each episode type of the plurality of episode types is associated with a respective one or more episode subtypes, and wherein the one or more processors are configured to:

classify the detected cardiac episode as one of the respective one or more episode subtypes; and

select, based on the classified one of the respective one or more episode subtypes, the plurality of non-overlapping portions of the EGM signal data, wherein the different episode subtypes are associated with different selections of portions of the EGM signal data.

4. The system of claim 3, wherein the one or more processors are configured to, for each of the plurality of non-overlapping portions of the EGM signal data, determine, based on the classified one of the respective one or more episode subtypes, a time length of the respective portion of the EGM signal data.

5. The system of claim 1, wherein the detected cardiac episode is previously identified by the medical device as the one identified episode type of the plurality of episode types.

6. The system of claim 1, wherein the one or more processors are configured to identify, based on one or more signal characteristics, the detected cardiac episode represented by the EGM signal data as one of the plurality of episode types.

7. The system of claim 1, wherein the one or more processors are configured to determine, based on the identified one of the plurality of episode types, a number of the plurality of non-overlapping portions of the EGM signal data to be selected.

8. The system of claim 1, wherein the plurality of non-overlapping portions of the EGM signal data are associated with one or more events associated with the detected cardiac episode, and wherein the one or more events comprise one or more of an onset of the cardiac episode, a medical device detection of the cardiac episode, a delivered therapy, or a termination of the cardiac episode.

9. The system of claim 1, wherein the one or more processors are configured to:

compare time windows for each portion of the respective selection of portions of EGM signal data, wherein the respective time windows indicate a time duration during which the EGM signal data was collected from the patient;

determine that a first time window for a first portion of the respective selection of portions of EGM signal data overlaps with a second time window for a second portion of the respective selection of portions of EGM signal data; and

truncate at least one of the first portion of the respective selection of portions of EGM signal data and the second portion of the respective selection of portions of EGM signal data to prevent the first portion from including EGM signal data from the same time as the second portion.

10. The system of claim 9, wherein the one or more processors are configured to combine the first portion of the respective selection of portions of EGM signal data with the second portion of the respective selection of portions of EGM signal data into a single timewise continuous portion of EGM signal data, the single timewise continuous portion of EGM signal data comprising two or more of the plurality of non-overlapping portions of the EGM signal data.

11. The system of claim 1, wherein the one or more processors are configured to:

generate a timeline of markers, each of the markers indicating the occurrence of one of a respective sensed ventricular contraction or a respective delivered pacing pulse;

generate, based on the EGM signal data, an interval summary indicating at least one of atrial contraction intervals and ventricle contraction intervals;

organize, into the episode summary, the plurality of non-overlapping portions of the EGM signal data and the interval summary above the timeline of markers, wherein the plurality of non-overlapping portions of the EGM signal data are matched to respective times of the timeline of markers, and wherein the interval summary is positioned above a portion of the time of markers corresponding to onset of the cardiac event; and

output, for display, the organized episode summary.

12. The system of claim 1, further comprising:

a network interface configured to transmit, via a network, the selected plurality of non-overlapping portions of the EGM signal data to a computing device for display at a display device controlled by the computing device; and

one or more networked servers that house the one or more processors and the network interface.

13. A non-transitory computer-readable storage medium comprising instructions that, when executed, cause one or more processors to:

receive cardiac electrogram (EGM) signal data collected from a medical device associated with a patient, wherein the EGM signal data is representative of a detected single cardiac episode identified as one of a plurality of episode types;

select, based on the identified one of the plurality of episode types, a plurality of non-overlapping portions of the EGM signal data associated with the detected single cardiac episode, wherein the identified episode type of the plurality of episode types is associated with a respective selection of portions of the EGM signal data, and wherein at least two non-overlapping portions of the plurality of the non-overlapping portions of the EGM signal data are discontinuous non-overlapping portions; and

output, for display, the selected plurality of non-overlapping portions of the EGM signal data as an episode summary for the detected single cardiac episode, the episode summary comprising each non-overlapping portion of the EGM signal data of the plurality of non-overlapping portions of the EGM signal data arranged in chronological order.

14. The non-transitory computer-readable storage medium of claim 13, wherein the plurality of episode types comprise at least two of a treated ventricular tachycardia/ventricular fibrillation (VT/VF) episode, a monitored VT episode, a non-sustained ventricular tachycardia (VTNS) episode, a high-rate non-sustained ventricular tachycardia (VTNS) episode, a VT/VF episode with treatment withheld, a supraventricular tachycardia (SVT) episode, a ventricular oversensing (VOS) episode, a fast atrial and ventricular rate episode, a treated atrial tachycardia/atrial fibrillation (AT/AF) episode, and a monitored AT/AF episode.

15. The non-transitory computer-readable storage medium of claim 13, wherein:

each episode type of the plurality of episode types is associated with a respective one or more episode subtypes;

the computer-readable storage medium further comprises instructions that, when executed, cause the one or more processors to classify the detected cardiac episode as one of the respective one or more episode subtypes; and

the instructions that, when executed, cause the one or more processors to select the plurality of non-overlapping portions of the EGM signal comprises instructions that, when executed, cause the one or more processors to select, based on the classified one of the respective one or more episode subtypes, the plurality of non-overlapping portions of the EGM signal data, wherein the different episode subtypes are associated with different selections of portions of the EGM signal data.

16. A method comprising:

receiving cardiac electrogram (EGM) signal data collected from a medical device associated with a patient, wherein the EGM signal data is representative of a detected single cardiac episode identified as one of a plurality of episode types;

selecting, by one or more processors and based on the identified one of the plurality of episode types, a plurality of non-overlapping portions of the EGM signal data associated with the detected single cardiac episode, wherein the identified episode type of the plurality of episode types is associated with a respective selection of portions of the EGM signal data, and wherein at least two non-overlapping portions of the plurality of the non-overlapping portions of the EGM signal data are discontinuous non-overlapping portions; and

outputting, by the one or more processors and for display, the selected plurality of non-overlapping portions of the EGM signal data as an episode summary for the detected single cardiac episode, the episode summary comprising each non-overlapping portion of the plurality of non-overlapping portions of the EGM signal data arranged in chronological order.

17. The method of claim 16, wherein the plurality of episode types comprise at least two of a treated ventricular tachycardia/ventricular fibrillation (VT/VF) episode, a monitored VT episode, a non-sustained ventricular tachycardia (VTNS) episode, a high-rate non-sustained ventricular tachycardia (VTNS) episode, a VT/VF episode with treatment withheld, a supraventricular tachycardia (SVT) episode, a ventricular oversensing (VOS) episode, a fast atrial and ventricular rate episode, a treated atrial tachycardia/atrial fibrillation (AT/AF) episode, and a monitored AT/AF episode.

18. The method of claim 16, wherein:

each episode type of the plurality of episode types is associated with a respective one or more episode subtypes;

the method further comprises classifying the detected cardiac episode as one of the respective one or more episode subtypes; and

selecting the plurality of non-overlapping portions of the EGM signal comprises selecting, based on the classified one of the respective one or more episode subtypes, the plurality of non-overlapping portions of the EGM signal data, wherein the different episode subtypes are associated with different selections of portions of the EGM signal data.

19. The method of claim 18, wherein selecting the plurality of non-overlapping portions of the EGM signal data comprises, for each of the plurality of non-overlapping portions of the EGM signal data, determining, based on the classified one of the respective one or more episode subtypes, a time length of the respective portion of the EGM signal data.

20. The method of claim 16, wherein the medical device previously identified the detected cardiac episode as the one of the plurality of episodes types.

21. The method of claim 16, further comprising identifying, based on one or more signal characteristics, the detected cardiac episode represented by the EGM signal data as one episode type of the plurality of episode types.

22. The method of claim 16, further comprising determining, based on the identified one of the plurality of episode types, a number of the plurality of non-overlapping portions of the EGM signal data to be selected.

23. The method of claim 16, wherein the plurality of non-overlapping portions of the EGM signal data are associated with one or more events associated with the detected cardiac episode, and wherein the one or more events comprise one or more of an onset of the cardiac episode, a medical device detection of the cardiac episode, a delivered therapy, or a termination of the cardiac episode.

24. The method of claim 16, wherein selecting the plurality of non-overlapping portions of the EGM data further comprises:

comparing time windows for each portion of the respective selection of portions of EGM signal data, wherein the respective time windows indicate a time duration during which the EGM signal data was collected from the patient;

determining that a first time window for a first portion of the respective selection of portions of EGM signal data overlaps with a second time window for a second portion of the respective selection of portions of EGM signal data; and

truncating at least one of the first portion of the respective selection of portions of EGM signal data and the second portion of the respective selection of portions of EGM signal data to prevent the first portion from including EGM signal data from the same time as the second portion.

25. The method of claim 24, further comprising combining the first portion of the respective selection of portions of EGM signal data with the second portion of the respective selection of portions of EGM signal data into a single timewise continuous portion of EGM signal data, the single timewise continuous portion of EGM signal data comprising two or more non-overlapping portions of the plurality of non-overlapping portions of the EGM signal data.

26. The method of claim 16, further comprising:

generating a timeline of markers, each of the markers indicating the occurrence of one of a respective sensed ventricular contraction or a respective delivered pacing pulse;

generating, based on the EGM signal data, an interval summary indicating at least one of atrial contraction intervals and ventricle contraction intervals;

organizing, into the episode summary, the plurality of non-overlapping portions of the EGM signal data and the interval summary above the timeline of markers, wherein the plurality of non-overlapping portions of the EGM signal data are matched to respective times of the timeline of markers, and wherein the interval summary is positioned above a portion of the time of markers corresponding to onset of the cardiac event; and

outputting, for display, the organized episode summary.

27. The method of claim 16, wherein outputting the selected plurality of non-overlapping portions of the EGM signal data comprises transmitting, from a networked server and via a network, the selected plurality of non-overlapping portions of the EGM signal data to a computing device for display at a display device controlled by the computing device.