METHOD AND APPARATUS FOR POST-PROCESSING OF EPISODES DETECTED BY A MEDICAL DEVICE

• US 20110112417A1
• Filed: 10/18/2010
• Published: 05/12/2011
• Est. Priority Date: 11/28/2005
• Status: Abandoned Application

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Brown, Mark L., Patel, Amisha Somabhai, Gunderson, Bruce D.
• Application Number:
  US12/906,821
• Publication Number:
  US 20110112417A1
• Time in Patent Office: Days
• US Class Current: 600/509
• CPC Class Codes: A61B 2560/0271 using a remote monitoring unit
• CPC Class Codes: A61B 5/0006 ECG or EEG signals
• CPC Class Codes: A61B 5/0031 Implanted circuitry
• CPC Class Codes: A61B 5/349 Detecting specific parameters of the electrocardiograph cycle
• CPC Class Codes: A61B 5/35 by template matching
• CPC Class Codes: A61N 1/368 comprising more than one electrode co-operating with different heart regions A61N1/3622, A61N1/3627 take precedence
• CPC Class Codes: A61N 1/3702 Physiological parameters A61N1/365 takes precedence; evoked response A61N1/371
• CPC Class Codes: A61N 1/3706 Pacemaker parameters stimulation threshold A61N1/371
• CPC Class Codes: A61N 1/37211 Means for communicating with stimulators
• CPC Class Codes: A61N 1/3925 Monitoring; Protecting
• CPC Class Codes: A61N 1/39622 Pacing therapy
• CPC Class Codes: G16H 40/67 for remote operation

Abstract

A method and system for determining undersensing during post-processing of sensing data generated by a medical device that includes transmitting a plurality of stored sensing data generated by the medical device to an access device, the stored sensing data including sensed atrial events and sensed ventricular events. The access device determines, in response to the transmitted data, instances where the medical device identified a cardiac event being detected in response to the sensing data, and determines whether one of a predetermined number of undersensing criteria have been met in response to the transmitted data.

Claims

1. A method of determining undersensing during post-processing of sensing data generated by and stored within an implantable medical device, comprising:

receiving the sensing data from the implantable medical device with an external access device, wherein the sensing data includes sensed atrial events and sensed ventricular events;

determining, with the external access device, in response to the received data, instances where the implantable medical device identified a cardiac event being detected in response to the sensing data; and

determining, with the external access device, whether one of a predetermined number of undersensing criteria have been met in response to the received data, wherein determining whether one of a predetermined number of undersensing criteria have been met comprises calculating a median AA interval in a sliding window of a predetermined number of intervals, and comparing at least one interval within the sliding window to the median AA interval.

2. The method of claim 1, wherein determining whether one of the predetermined number of undersensing criteria have been met further comprises:

determining whether the median AA interval is greater than a predetermined threshold.

3. The method of claim 2, wherein the predetermined threshold is 1300 milliseconds.

4. The method of claim 1, wherein determining whether one of the predetermined number of undersensing criteria have been met further comprises determining whether the median AA interval is greater than a first predetermined threshold, and a current atrial interval is greater than the median AA interval by a second predetermined threshold.

5. The method of claim 4, wherein the first predetermined threshold is 350 milliseconds and the second predetermined threshold is 1.7 times the median AA interval or more.

6. The method of claim 1, wherein determining whether one of the predetermined number of undersensing criteria have been met further comprises determining whether the median AA interval is within a predetermined range, and a current atrial interval is greater than the median AA interval by a predetermined threshold.

7. The method of claim 6, wherein the predetermined range comprises a range greater than 200 milliseconds and less than or equal to 359 milliseconds, and wherein the predetermined threshold is 1.9 times the median AA interval or more.

8. The method of claim 6, wherein the predetermined range comprises a range greater than 0 milliseconds and less than or equal to 200 milliseconds, and wherein the predetermined threshold is 3.25 times the median AA interval or more.

9. A system for post-processing of sensing data associated with identification of a cardiac event, comprising:

an implantable medical device generating and storing a plurality of sensing data, wherein the sensing data includes sensed atrial events and sensed ventricular events;

an access device located externally from the medical device; and

an interface for receiving the sensing data from the implantable medical device with the external access device, wherein the external access device determines whether one of a predetermined number of undersensing criteria have been met in response to the received data, calculates a median AA interval in a sliding window of a predetermined number of intervals, and compares at least one interval within the sliding window to the median AA interval.

10. The system of claim 9, wherein the external access device determines whether the median AA interval is greater than a predetermined threshold.

11. The system of claim 10, wherein the predetermined threshold is 1300 milliseconds.

12. The system of claim 9, wherein the external access device determines whether the median AA interval is greater than a first predetermined threshold, and a current atrial interval is greater than the median AA interval by a second predetermined threshold.

13. The system of claim 12, wherein the first predetermined threshold is 350 milliseconds and the second predetermined threshold is 1.7 times the median AA interval or more.

14. The system of claim 9, wherein the external access device determines whether the median AA interval is within a predetermined range, and whether a current atrial interval is greater than the median AA interval by a predetermined threshold.

15. The system of claim 14, wherein the predetermined range comprises a range greater than 200 milliseconds and less than or equal to 359 milliseconds, and wherein the predetermined threshold is 1.9 times the median AA interval or more.

16. The system of claim 14, wherein the predetermined range comprises a range greater than 0 milliseconds and less than or equal to 200 milliseconds, and wherein the predetermined threshold is 3.25 times the median AA interval or more.

17. A method of determining undersensing during post-processing of sensing data generated by and stored within an implantable medical device, comprising:

receiving the sensing data generated by the implantable medical device with an external access device, wherein the sensing data includes sensed atrial events and sensed ventricular events;

determining, with the external access device, in response to the received data, instances where the implantable medical device identified a cardiac event being detected in response to the sensing data; and

determining, with the external access device, whether one of a predetermined number of undersensing criteria have been met in response to the received data, wherein determining whether one of a predetermined number of undersensing criteria have been met comprises determining whether an atrial channel includes less than a predetermined number of events prior to the detection of the cardiac event.

18. A system for post-processing of sensing data associated with identification of a cardiac event, comprising:

an implantable medical device generating and storing a plurality of sensing data, wherein the sensing data includes sensed atrial events and sensed ventricular events;

an access device located externally from the medical device; and

an interface for receiving the sensing data from the medical device with the external access device, wherein the external access device determines whether one of a predetermined number of undersensing criteria have been met in response to the received data by at least determining whether an atrial channel includes less than a predetermined number of events prior to the detection of the cardiac event.