Morphology-based diagnostic monitoring of electrograms by implantable cardiac device

• US 20040158165A1
• Filed: 11/26/2003
• Published: 08/12/2004
• Est. Priority Date: 09/19/2002
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Yonce, David J., Ternes, David
• Granted Patent: US 8,509,897 B2
• Time in Patent Office: Days
• US Class Current: 600/510
• CPC Class Codes: A61B 5/35 by template matching
• 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: A61N 1/3627 for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy
• CPC Class Codes: A61N 1/3684 for stimulating the heart at multiple sites of the ventricle or the atrium
• CPC Class Codes: A61N 1/36842 Multi-site stimulation in the same chamber
• CPC Class Codes: A61N 1/36843 Bi-ventricular stimulation
• CPC Class Codes: A61N 1/3702 Physiological parameters A61N1/365 takes precedence; evoked response A61N1/371
• CPC Class Codes: A61N 1/3712 Auto-capture, i.e. automatic adjustment of the stimulation threshold
• CPC Class Codes: A61N 1/37217 characterised by the communication link, e.g. acoustic or tactile
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems

Abstract

A system and method is presented in which an implantable cardiac device is configured to generate representative electrograms which can be transmitted to an external programmer for display. A representative electrogram represents a patient'"'"'s typical electrogram during a defined time period or when a particular condition exists. Such representative electrograms may be averages or other statistical measures of electrograms recorded continuously or periodically during the defined time period or during the time when the particular condition exists.

Claims

1. A system for recording and presenting electrophysiological data, comprising:

an implantable cardiac device having a first sensing channel for sensing cardiac electrical activity and generating electrogram signals;

wherein a controller of the implantable cardiac device is programmed to compute a plurality of representative electrograms with respect to time, with each such representative electrogram representing a defined time period and being derived from one or more electrograms recorded during the defined time period; and

,

an external programmer configured to download representative electrograms from the implantable device and generate an aggregate display of the representative electrograms.

2. The system of claim 1 wherein each representative electrogram is an average of a plurality of electrograms recorded during the defined time period.

3. The system of claim 1 wherein each representative electrogram is a single electrogram recorded during the defined time period.

4. The system of claim 1 wherein the representative electrograms are intrinsic electrograms.

5. The system of claim 1 wherein the representative electrograms are evoked response electrograms.

6. The system of claim 1 wherein representative electrograms are derived only from electrograms recorded during the defined time period when the heart range is within a specified range.

7. The system of claim 1 wherein the representative electrograms are displayed on a display screen of the external programmer.

8. The system of claim 1 wherein each of the representative electrograms is displayed as a graph of the electrogram'"'"'s magnitude with a shading or color of the graph identifying the defined time period represented by the representative electrogram.

9. The system of claim 1 wherein the controller is programmed to continuously generate representative electrograms for consecutive defined time periods.

10. The system of claim 9 wherein the controller is programmed to maintain a specified number of representative electrograms in memory with the oldest representative electrogram being discarded.

11. A system for recording and presenting electrophysiological data, comprising:

an implantable cardiac device having a first sensing channel for sensing cardiac electrical activity and generating electrogram signals;

wherein a controller of the implantable cardiac device is programmed to store a plurality of representative electrograms with respect to heart rate, with each such representative electrogram representing a defined heart rate range and being derived from one or more electrograms recorded when the heart rate is within the defined range; and

,

an external programmer configured to download representative electrograms from the implantable device and generate an aggregate display of the representative electrograms.

12. The system of claim 11 wherein each representative electrogram is a single electrogram recorded when the heart rate is within the defined range.

13. The system of claim 11 wherein each representative electrogram is an average of a plurality of electrograms recorded when the heart rate is within the defined range.

14. The system of claim 11 wherein the representative electrograms are intrinsic electrograms.

15. The system of claim 11 wherein the representative electrograms are evoked response electrograms and wherein heart rate refers to pacing rate.

16. The system of claim 11 wherein the representative electrograms are displayed on a display screen of the external programmer.

17. The system of claim 11 wherein each of the representative electrograms are displayed as a graph of magnitude versus time or sample number with a shading or color of the graph identifying the defined heart rate range represented by the representative electrogram.