Active implantable medical device with holter recording functions

• US 20050137488A1
• Filed: 12/03/2004
• Published: 06/23/2005
• Est. Priority Date: 12/03/2003
• Status: Active Grant

• Current Assignee: Sorin CRM USA (MicroPort Scientific Corp.)
• Original Assignee: Ela Medical S.A. (LivaNova Plc)
• Inventors: Henry, Christine, Poezevara, Yann
• Granted Patent: US 8,064,992 B2
• Time in Patent Office: Days
• US Class Current: 600/513
• CPC Class Codes: A61N 1/36521 the parameter being derived from measurement of an electrical impedance
• CPC Class Codes: A61N 1/3702 Physiological parameters A61N1/365 takes precedence; evoked response A61N1/371

Abstract

This device collects and analyzes general data on the state of the patient, and collects continuously a monitored signal representative of a physiological function. It includes a memory with a first zone for the durable memorizing of these data, and analyzes in real time the monitored signal to detect there the occurrence of a particular event. The memory includes a second zone for the continuous memorizing of the monitored signal over a first period of time, the memorizing being started on detection of a particular event. The device can also collect context information representative of circumstances possibly related to the occurrence of the particular event. The memory then includes a third zone, for the conditional memorizing of this information on detection of an event, for a second period of time shorter than the first period. The monitored signal can, for example, be a ventilatory signal, in which case the event is a hypopnea and/or a apnea, the context information include a ventricular and/or atrial electrogram, events markers of the heartbeat rate and/or a signal of the peak endocardial acceleration. The monitored signal can be also an electrogram signal, a signal of the peak endocardial acceleration, a series of events markers of the heartbeat rate and/or an intracardiac signal of bio-impedance. The event is then a preset disorder of the heartbeat rate and/or a disorder of atrio-ventricular conduction, the context information include the events markers of the heartbeat rate, a signal of the peak endocardial acceleration and/or a ventilatory signal.

Claims

1. An active implantable medical device with Holter recording functions, comprising:

means for collecting data relating to the state of the patient carrying the device and/or operation of this device, and means for analyzing the collected data to produce in response general representative information;

means for continuous collection of at least one monitored signal representative of a physiological function of the patient;

a data memory means, where the aforementioned general representative information is memorized in a durable way; and

means for analyzing the monitored signal in real time to detect the occurrence of at least one particular event; and

means for processing the memory means, operative in response to the means for analyzing to organize the memory, on detection of the occurrence of at least a particular event, in;

a first zone for memorizing said general information;

a second zone for continuous memorizing of said monitored signal; and

means able, on detection of the occurrence of said particular event by the analyzing means, for starting the aforementioned continuous memorizing of the monitored signal in the second storage area for a first period of time.

2. The active implantable medical device of claim 1, further comprising means for dynamically allocating the second zone, able to commutate the device between:

a standard configuration, wherein the second zone is allocated to memorizing a plurality of general information in complement of the first zone; and

a dedicated configuration, wherein the second zone is allocated to continuous memorizing of the monitored signal.

3. The active implantable medical device of claim 2, further comprising triggering means able, on reception of a command, to commutate the device to the dedicated configuration and to begin continuously memorizing the monitored signal in the second zone.

4. The active implantable medical device of claim 3, wherein said command is selected from among the group consisting of a signal indicating a beginning of phase of sleep of the patient;

a signal indicating a crossing of a preset threshold by the heart rate;

a command of external origin transmitted to the device by telemetry; and

a pre-programmed internal command generated by the device.

5. The active implantable medical device of claim 1, wherein said second zone includes the aforementioned first zone.

6. The active implantable medical device of claim 1 further comprising:

means for collecting a context information associated with said particular event;

means for processing the memory means, operative in response to the analyzing means, to organize the memory to comprise, in addition to the first zone and the second zone, a third zone, for conditional memorizing of said context information, and

wherein the device further comprises means able, on detection of the occurrence of said particular event by the analyzing means, to start said memorizing of context information in the third storage zone for a second period of time shorter than the said first period of time.

7. The active implantable medical device of claim 1, wherein said monitored signal representative of a physiological function of the patient is a ventilatory signal.

8. The active implantable medical device of claim 7, wherein said particular event whose occurrence is detected by the means for analyzing is a hypopnea.

9. The active implantable medical device of claim 7, wherein said particular event whose occurrence is detected by the means for analyzing is an apnea.

10. The active implantable medical device of claim 7, wherein said particular event whose occurrence is detected by the analyzing means is a repetitive predetermined template of the respiratory signal.

11. The active implantable medical device of claim 1, wherein said monitored signal representative of a physiological function of the patient comprises at least one of:

a ventricular electrogram;

an atrial electrogram;

a peak endocardial acceleration;

at least one event marker of the heartbeat rate; and

an intracardiac bio-impedance.

12. The active implantable medical device of claim 11, wherein said particular event whose occurrence is detected by the analyzing means is a preset heartbeat rate.

13. The active implantable medical device of claim 11, wherein said particular event whose occurrence is detected by the analyzing means is a disorder of an atrio-ventricular conduction.

14. The active implantable medical device of claim 1, further comprising means for tele-transmitting to an external programmer any contents of the second zone, for subsequent display and analysis by the programmer.

15. The active implantable medical device of claim 14, further comprising means for erasing the second and third zones after tele-transmission of their contents, for authorizing therein memorizing of new data.

16. The active implantable medical device of claim 14, further comprising means for tele-transmitting to an external programmer any contents of the second zone and the third zone for subsequent display and analysis by said programmer.

17. The active implantable medical device of claim 16, further comprising means for erasing the contents of the second and third zones in response to the tele-transmission of said contents for authorizing therein memorizing of new data.

18. The active implantable medical device of claim 1, wherein said first period and second period are predetermined periods of time.

19. The active implantable medical device of claim 18, wherein said first period of time is a single continuous period.

20. The active implantable medical device of claim 19, wherein said first period of time is a period split into a plurality of daily sub-periods.

21. The active implantable medical device of claim 19, wherein said first period of time is a 24 hour period.

22. The active implantable medical device of claim 19, wherein said second period of time is a period in relation to a moment of the occurrence of the aforesaid particular event.

23. The active implantable medical device of claim 18, wherein said second period of time is a 10 second period.

24. The active implantable medical device of claim 1, wherein said first and second periods of time are periods of time that last until saturation of the data in memory.

25. The active implantable medical device of claim 1, wherein said first and second periods of time are unspecified periods of time, whereby new data is recorded in the data memory until filled and the subsequent new data then replacing the older recorded data.