CARDIOVASCULAR PRESSURE ANNOTATIONS AND LOGBOOK

• US 20080195165A1
• Filed: 02/12/2007
• Published: 08/14/2008
• Est. Priority Date: 02/12/2007
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Stahmann, Jeffrey E., Maile, Keith R.
• Granted Patent: US 8,523,771 B2
• Time in Patent Office: Days
• US Class Current: 607/18
• CPC Class Codes: A61B 5/0031 Implanted circuitry
• CPC Class Codes: A61B 5/0205 Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
• CPC Class Codes: A61B 5/02055 Simultaneously evaluating both cardiovascular condition and temperature
• CPC Class Codes: A61B 5/02108 from analysis of pulse wave characteristics
• CPC Class Codes: A61B 5/0215 by means inserted into the body catheters A61M25/00
• CPC Class Codes: A61B 5/08 Detecting, measuring or recording devices for evaluating the respiratory organs A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/145 Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissuemeasuring of blood pressure or blood flow A61B5/02; non-radiation detecting or locating of foreign bodies in blood A61B5/06
• CPC Class Codes: A61B 5/14546 for measuring analytes not otherwise provided for, e.g. ions, cytochromes
• CPC Class Codes: A61N 1/36564 controlled by blood pressure
• CPC Class Codes: A61N 1/3702 Physiological parameters A61N1/365 takes precedence; evoked response A61N1/371
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means

Abstract

A system comprises an external medical device configured to communicate with a first implantable medical device (IMD). The external medical device includes a communication circuit and a display. The communication circuit is configured to receive information associated with cardiovascular pressure from the IMD. The external medical device is configured to annotate a waveform on the display to indicate one or more events associated with cardiovascular pressure.

Claims

1. A system comprising:

an external medical device configured to communicate with a first implantable medical device (IMD), the external medical device including;

a communication circuit configured to receive information from the first IMD associated with cardiovascular pressure; and

a display, wherein the external medical device is configured to annotate a waveform on the display to indicate one or more events associated with cardiovascular pressure.

2. The system of claim 1, wherein the information associated with cardiovascular pressure includes information related to pulmonary arterial (PA) pressure, and wherein the annotation indicates one or more events associated with PA pressure.

3. The system of claim 1, wherein the external medical device is configured to receive sampled signal data representative of cardiovascular pressure, and to display a cardiovascular pressure signal waveform together with at least one cardiovascular pressure marker annotating the displayed cardiovascular pressure waveform to indicate a detected event associated with cardiovascular pressure.

4. The system of claim 1, wherein the external medical device is configured to receive subject posture information from the IMD, and wherein the external medical device is configured to display a cardiovascular pressure signal waveform together with at least one indication of subject posture.

5. The system of claim 1, wherein the external medical device is configured to receive sampled signal data representative of at least one intrinsic heart signal from the first IMD, and to display an intrinsic heart signal waveform together with at least one cardiovascular pressure marker annotating the intrinsic heart signal waveform to indicate a detected event associated with cardiovascular pressure.

6. The system of claim 5, wherein the external medical device is further configured to receive sampled signal data representative of cardiovascular pressure from the first IMD, and to display a cardiovascular pressure signal waveform and the intrinsic heart signal waveform together with at least one cardiovascular pressure marker annotating at least one of the cardiovascular pressure waveform and the intrinsic heart signal waveform to indicate a detected event associated with cardiovascular pressure.

7. The system of claim 1, wherein the external medical device is further configured to:

receive sampled signal data from the first IMD that is representative of at least one second sensor signal produced by a second implantable sensor, wherein the second sensor signal is associated with a physiologic condition of a subject and is different from a cardiovascular pressure sensor; and

display a cardiovascular pressure signal waveform and a second sensor signal waveform together with at least one cardiovascular pressure marker annotating at least one of the cardiovascular pressure signal waveform and the second sensor signal waveform to indicate an event associated with cardiovascular pressure.

8. The system of claim 7, wherein the second implantable sensor includes at least one of:

a subject activity sensor;

a blood gas sensor;

a blood chemical sensor;

a blood flow sensor; and

a respiration sensor.

9. The system of claim 6, wherein the external medical device is communicatively coupled with at least one external sensor, the external sensor configured to produce an external sensor signal associated with a physiologic condition of a subject, and wherein the external medical device is configured to display an external sensor signal waveform together with at least one cardiovascular pressure marker annotating the external sensor signal waveform to indicate a detected event associated with cardiovascular pressure.

10. The system of claim 1, wherein the external medical device is configured to receive information associated with sensed intrinsic heart activity and information associated with cardiovascular pressure from the first IMD, and to display at least one cardiovascular pressure marker indicating a detected event associated with cardiovascular pressure and at least one event marker indicating a detected event associated with sensed intrinsic heart activity.

11. The system of claim 1, further comprising the first IMD, wherein the first IMD is configured to sense cardiovascular pressure.

12. The system of claim 11, further comprising:

at least one second implantable sensor configured to produce a second sensor signal related to a physiologic condition of the subject different from cardiovascular pressure; and

wherein the first IMD includes a memory and is configured to store markers indicating detected events associated with cardiovascular pressure in relation to sensor information obtained from the second implantable sensor.

13. The system of claim 1, further comprising a second IMD, the second IMD including a communication circuit and configured to sense cardiovascular pressure, and

wherein the first MD is configured to receive information associated with cardiovascular pressure from the second IMD.

14. The system of claim 1, wherein the first IMD is configured to deliver at least one of bradycardia therapy, tachycardia therapy, and cardiac resynchronization therapy.

15. A system comprising:

a first implantable medical device (IMD) comprising;

an implantable cardiovascular pressure sensor interface unit, the cardiovascular pressure interface unit configured to receive a sensor signal associated with cardiovascular pressure of a subject;

an implantable cardiac signal sensing circuit configured to receive at least one intrinsic heart signal from at least one implantable electrode;

a memory; and

a trigger detector coupled to the cardiovascular pressure sensor interface unit, the implantable cardiac signal sensing circuit, and the memory, wherein the trigger detector is configured to store at least one of cardiovascular pressure sensor signal data and detected cardiovascular pressure-associated event annotations in response to a triggering event detected from a sensed electrical cardiac signal.

16. The system of claim 15, wherein the implantable cardiovascular sensor interface unit includes a pulmonary arterial (PA) pressure sensor interface unit, and wherein the trigger detector is configured to store at least one of PA pressure sensor signal data and detected PA pressure-associated event annotations.

17. The system of claim 16, further comprising a PA pressure sensor communicatively coupled to the implantable PA pressure sensor interface unit.

18. The system of claim 15, further comprising a second IMD communicatively coupled to the first IMD, wherein the second IMD is configured to sense cardiovascular pressure.

19. The system of claim 15, wherein the first IMD is configured to deliver at least one of bradycardia therapy, tachycardia therapy, and cardiac resynchronization therapy.

20. The system of claim 15, wherein the trigger detector is configured to begin storing the data and detected event annotations in response to a detected episode of cardiac arrhythmia.

21. The system of claim 15, wherein the trigger detector is configured to begin storing the data and detected event annotations in response to a detected episode of cardiac ischemia.

22. The system of claim 15, wherein the first IMD includes a posture sensor coupled to the trigger detector, and wherein the trigger detector is configured to begin storing the data and detected event annotations in response to a detected episode of patient syncope.

23. The system of claim 22, wherein the first IMD includes a posture sensor coupled to the trigger detector, and wherein the trigger detector is configured to begin storing the data and detected event annotations in response to a detected episode of postural hypotension.

24. The system of claim 22, wherein the first IMD includes a respiration sensor coupled to the trigger detector, and wherein the trigger detector is configured to begin storing the data and detected event annotations in response to a detected episode of disordered breathing.

25. The system of claim 22, wherein the first IMD includes a magnetic field sensor coupled to the trigger detector, and wherein the trigger detector is configured to begin storing the data and detected event annotations in response to a detected magnetic field.

26. The system of claim 22, wherein the trigger detector is configured to store at least one entry in a log that includes at least first and second elements, wherein the first element includes the detected triggering event and the second element includes at least one of sampled signal data and detected event annotations associated with cardiovascular pressure.

27. The system of claim 26, further including an external device configured to communicate with the first IMD, and wherein the first IMD is adapted to communicate at least one log entry to the external device.

28. The system of claim 27, wherein the external device includes a remote server in communication with the first IMD over a communications or computer network.

29. A method comprising:

communicating information associated with cardiovascular pressure from an implantable medical device (IMD) to an external device; and

annotating a displayed waveform on the external device to indicate one or more detected events associated with cardiovascular pressure.

30. The method of claim 29, wherein communicating includes communicating information related to PA pressure and wherein annotating includes annotating to indicates one or more events associated with PA pressure.

31. The method of claim 29, further including displaying a cardiovascular pressure signal waveform together with at least one cardiovascular pressure marker annotating the cardiovascular pressure waveform to indicate a detected event associated with cardiovascular pressure.

32. The method of claim 31, further including displaying a cardiovascular pressure signal waveform together with at least one indication of patient posture.

33. The method of claim 29, further including displaying a second sensor signal together with at least one indication of one or more detected events associated with cardiovascular pressure, wherein the second sensor is related to a physiologic condition of the subject different from cardiovascular pressure.

34. The method of claim 33, wherein the displaying the second sensor signal includes displaying one or more of:

a sensed intrinsic heart signal;

an activity sensor signal;

a blood gas sensor signal;

a blood chemical sensor signal;

a blood flow sensor signal; and

a respiration signal.

35. A method comprising:

sensing one or more cardiac signals representative of intrinsic cardiac activity of a subject using an implantable medical device (IMD);

sensing cardiovascular pressure of the subject; and

storing at least one of sampled cardiovascular pressure sensor signal data and detected cardiovascular pressure-related event annotations in the IMD in response to a detected triggering event detected from a sensed cardiac signal.

36. The method of claim 35, wherein sensing cardiovascular pressure includes sensing PA pressure, and wherein storing includes storing at least one of sampled PA pressure sensor signal data and detected PA pressure-related event annotations.

37. The method of claim 35, wherein storing includes storing the sampled cardiovascular pressure sensor signal data and detected cardiovascular pressure-related event annotations in response to the IMD detecting an episode of cardiac arrhythmia.

38. The method of claim 35, wherein storing includes storing the sampled cardiovascular pressure sensor signal data and detected cardiovascular pressure-related event annotations in response to the IMD detecting an episode of cardiac ischemia.

39. The method of claim 35, wherein storing includes storing the sampled cardiovascular pressure sensor signal data and detected cardiovascular pressure-related event annotations in response to the IMD detecting an episode of patient syncope.

40. The method of claim 35, wherein storing includes storing the sampled cardiovascular pressure sensor signal data and detected cardiovascular pressure-related event annotations in response to the IMD detecting an episode of postural hypotension.

41. The method of claim 35, wherein storing includes storing the sampled cardiovascular pressure sensor signal data and detected cardiovascular pressure-related event annotations in response to the IMD detecting an episode of disordered breathing.

42. The method of claim 35, wherein storing includes storing the sampled cardiovascular pressure sensor signal data and detected cardiovascular pressure-related event annotations in response to the IMD detecting a presence of a magnetic field.

43. The method of claim 35, wherein storing includes storing at least one entry in a log having at least a first element that includes the detected triggering event and a second element that includes at least one of the sampled cardiovascular pressure sensor signal data and detected cardiovascular pressure-related event annotations.

44. The method of claim 35, further including communicating at least one log entry from the IMD to an external device.