Method and apparatus for simultaneously presenting cardiac and neural signals

• US 20060241725A1
• Filed: 04/25/2005
• Published: 10/26/2006
• Est. Priority Date: 04/25/2005
• Status: Abandoned Application

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Stahmann, Jeffrey E., Kramer, Andrew P., Libbus, Imad, Linder, William J.
• Application Number:
  US11/114,246
• Publication Number:
  US 20060241725A1
• Time in Patent Office: Days
• US Class Current: 607/60
• CPC Class Codes: A61B 5/0006 ECG or EEG signals
• CPC Class Codes: A61B 5/339 Displays specially adapted therefor
• CPC Class Codes: A61B 5/4035 Evaluating the autonomic nervous system
• CPC Class Codes: A61B 5/4041 Evaluating nerves condition
• CPC Class Codes: A61B 5/4047 afferent nerves, i.e. nerves that relay impulses to the central nervous system
• CPC Class Codes: A61B 5/742 using visual displays A61B5/339 takes precedence
• CPC Class Codes: A61N 1/36114 Cardiac control, e.g. by vagal stimulation stimulating the heart A61N1/362
• CPC Class Codes: A61N 1/365 controlled by a physiological parameter, e.g. heart potential evoked response A61N1/371
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means
• CPC Class Codes: G16H 15/00 ICT specially adapted for medical reports, e.g. generation or transmission thereof
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: G16H 40/67 for remote operation

Abstract

A presentation device such as a display screen or a printer provides for simultaneous presentation of temporally aligned cardiac and neural signals. At least one cardiac signal in the form of a cardiac signal trace or cardiac event markers and at least one neural signal in the form of a neural signal trace or neural event markers are simultaneously presented. The cardiac signal indicates sensed cardiac electrical activities and/or cardiac stimulation pulse deliveries. The neural signal indicates sensed neural electrical activities and/or neural stimulation pulse deliveries. In one embodiment, the presentation device is part of an external system communicating with an implantable system that senses cardiac and/or neural signals and delivers cardiac and/or neural stimulation pulses.

Claims

1. A system for communicating with one or more implantable medical devices, the system comprising:

a telemetry circuit to receive data representative of cardiac and neural activities from the one or more implantable medical devices;

an external control circuit coupled to the telemetry circuit, the external control circuit including a presentation controller adapted to produce and temporally align one or more cardiac signals and one or more neural signals for visual presentation based on the received data; and

a presentation device coupled to the presentation controller, the presentation device adapted to simultaneously present the temporally aligned one or more cardiac signals and one or more neural signals.

2. The system of claim 1, wherein the presentation device comprises a display screen.

3. The system of claim 2, wherein the presentation device further comprises a printer.

4. The system of claim 2, wherein the external control circuit further comprises a physiologic parameter generator adapted to derive one or more physiologic parameters from the received data, and wherein the presentation device is further adapted to display the one or more physiologic parameters simultaneously with the one or more cardiac signals and one or more neural signals.

5. The system of claim 2, further comprising a user input to receive one or more user commands, and wherein the presentation controller is adapted to produce and temporally align the one or more cardiac signals and one or more neural signals according to the one or more user commands.

6. The system of claim 5, wherein the user input comprises a time range input device adapted to receive a user selection of a time range associated with the one or more cardiac signals and one or more neural signals

7. The system of claim 6, wherein the user input device comprises a format input device adapted to receive a user selection of a color or a gray scale for each signal of the one or more cardiac signals and one or more neural signals.

8. The system of claim 1, wherein the one or more cardiac signals comprise one or more of at least one cardiac signal trace representing a sensed cardiac signal and cardiac event markers each representative of a predetermined type cardiac event, and the one or more neural signals comprise one or more of at least one neural signal trace representing a sensed neural signal and neural event markers each representative of a predetermined type neural event, wherein the sensed cardiac and neural signals are sensed by the one or more implantable medical devices.

9. The system of claim 8, wherein the neural event markers comprise neural event markers each indicative of a neural stimulation period during which a burst of neural stimulation pulses is delivered.

10. The system of claim 9, wherein the presentation device is adapted to present rectangular bars each indicative of the neural stimulation period.

11. The system of claim 9, wherein the presentation device is adapted to present first columns each indicative of the neural stimulation period and second columns each indicative of a non-stimulation period during which no neural stimulation pulse is delivered.

12. The system of claim 8, wherein the presentation device is adapted to present the at least one cardiac signal trace and the neural event markers simultaneously.

13. The system of claim 12, wherein the presentation device is adapted to further present the cardiac event markers simultaneously with the at least one cardiac signal trace and the neural event markers.

14. The system of claim 12, wherein the presentation device is adapted to further present the at least one neural signal trace simultaneously with the at least one cardiac signal trace and the neural event markers.

15. The system of claim 8, wherein the presentation device is adapted to present the at least one neural signal trace and the cardiac event markers simultaneously.

16. The system of claim 15, wherein the presentation device is adapted to further present the neural event markers simultaneously with the at least one neural signal and the cardiac event markers.

17. The system of claim 15, wherein the presentation device is adapted to further present the at least one cardiac signal trace simultaneously with the at least one neural signal and the cardiac event markers.

18. The system of claim 8, wherein the presentation device is adapted to present the at least one cardiac signal trace and the at least one neural signal trace simultaneously.

19. The system of claim 8, wherein the presentation device is adapted to present the cardiac event markers and the neural event markers simultaneously.

20. A system, comprising:

an implantable system including;

a cardiac sensing circuit to sense at least one cardiac signal indicative of cardiac electrical activities;

a cardiac stimulation circuit to deliver cardiac stimulation pulses;

a neural sensing circuit to sense at least one neural signal indicative of neural electrical activities;

a neural stimulation circuit to deliver neural stimulation pulses;

an implant control circuit, coupled to the cardiac sensing circuit, the cardiac stimulation circuit, the neural sensing circuit, and the neural stimulation circuit, to produce data representative of the cardiac electrical activities, the delivered cardiac stimulation pulses, the neural electrical activities, and the delivered neural stimulation pulses; and

an implant telemetry circuit, coupled to the implant control circuit, to transmit the data; and

an external system communicatively coupled to the implant system via telemetry, the external system including;

an external telemetry circuit to receive the data; and

an external control circuit coupled to the external telemetry circuit, the external control circuit including a presentation controller adapted to produce and temporally align one or more cardiac signals and one or more neural signals, the one or more cardiac signals representative of at least one of the cardiac electrical activities and the delivered cardiac stimulation pulses, the one or more neural signals representative of at least one of the neural electrical activities and the delivered neural stimulation pulses; and

a presentation device coupled to the presentation controller, the presentation device adapted to simultaneously present the temporally aligned one or more cardiac signals and one or more neural signals.

21. The system of claim 20, wherein the implantable system comprises an implantable medical device including at least the cardiac sensing circuit, the cardiac stimulation circuit, the neural sensing circuit, and the neural stimulation circuit.

22. The system of claim 20, wherein the implantable system comprises:

an implantable cardiac rhythm management device including at least the cardiac sensing circuit and the cardiac stimulation circuit; and

an implantable neural stimulation device including at least the neural sensing circuit and the neural stimulation circuit.

23. The system of claim 22, wherein the implantable cardiac rhythm management device and the implantable neural stimulation device are each communicatively coupled to the external system via telemetry.

24. The system of claim 22, wherein at least one of the implantable cardiac rhythm management device and the implantable neural stimulation device is communicatively coupled to the external system via a first telemetry link, and the implantable cardiac rhythm management device is communicatively coupled to the implantable neural stimulation device via a second telemetry link.

25. The system of claim 20, wherein the presentation device comprises a display screen configured to simultaneously present the temporally aligned one or more cardiac signals and one or more neural signals, wherein the one or more cardiac signals include one or more of at least one cardiac signal trace and cardiac event markers representative of the cardiac electrical activities and the delivered cardiac stimulation pulses, and the one or more neural signals include one or more of at least one neural signal trace and neural event markers representative of the neural electrical activities and the delivered neural stimulation pulses.

26. The system of claim 25, wherein presentation controller is adapted to produce neural event markers indicative of neural stimulation periods each including a time period during which a burst of the neural stimulation pulses is delivered, and the display screen is configured to simultaneously present the one or more cardiac signals and the neural event markers indicative of the neural stimulation periods.

27. The system of claim 26, wherein the external system comprises a programmer adapted to program the implantable system, the programmer including the display screen.

28. The system of claim 26, wherein the external system comprises a patient management system including:

an external device including the external telemetry circuit;

a remote device; and

a telecommunication network to provide communication between the external device and the remote device,

wherein the remote device comprises the display screen.

29. A method, comprising:

receiving data representative of cardiac and neural activities from one or more implantable medical devices;

producing cardiac and neural signals for presentation based in the received data;

aligning the cardiac and neural signals temporally; and

presenting the temporally aligned cardiac and neural signals.

30. The method of claim 29, further comprising:

receiving one or more user commands; and

producing cardiac and neural signals for presentation according to the one or more user commands.

31. The method of claim 30, wherein receiving the one or more user commands comprises receiving a user command selecting a subset of the data representative of cardiac and neural activities occurring or detected during a specified period of time.

32. The method of claim 29, further comprising:

deriving one or more physiologic parameters from the received data; and

presenting the one or more physiologic parameters simultaneously with the temporally aligned cardiac and neural signals.

33. The method of claim 32, wherein deriving the one or more physiologic parameters comprises measuring a heart rate, and presenting the one or more physiologic parameters comprises presenting a signal trace representing the measured heart rate.

34. The method of claim 32, wherein deriving the one or more physiologic parameters comprises measuring a cardiac interval being a time interval between two predetermined type cardiac events, and presenting the one or more physiologic parameters comprises presenting a signal trace representing the measured cardiac interval.

35. The method of claim 29, wherein presenting the temporally aligned cardiac and neural signals comprises presenting the temporally aligned cardiac and neural signals in real time.

36. The method of claim 29, further comprising:

storing the received data; and

receiving a presentation request,

wherein presenting the temporally aligned cardiac and neural signals comprises presenting the temporally aligned cardiac and neural signals in response to the presentation request.

37. The method of claim 29, wherein presenting the temporally aligned cardiac and neural signals comprises:

displaying one or more of at least one cardiac signal trace and cardiac event markers; and

displaying one or more of at least one neural signal trace and neural event markers.

38. The method of claim 37, wherein presenting the temporally aligned cardiac and neural signals comprises presenting neural event markers indicative of neural stimulation periods each including a time period during which a burst of neural stimulation pulses is delivered.

39. The method of claim 38, wherein presenting the temporally aligned cardiac and neural signals comprises:

displaying the cardiac event markers;

displaying the at least one neural signal; and

displaying the neural event markers including the neural event markers indicative of the neural stimulation periods.

40. The method of claim 38, wherein presenting the temporally aligned cardiac and neural signals comprises:

displaying the at least one cardiac signal; and

displaying the neural event markers including the neural event markers indicative of the neural stimulation periods.