System for automatically performing a clinical assessment of an implanted pacer based on information that is telemetrically received

• US 4,825,869 A
• Filed: 09/28/1987
• Issued: 05/02/1989
• Est. Priority Date: 09/28/1987
• Status: Expired due to Term

• Current Assignee: Pacesetter Incorporated (Abbott Laboratories Incorporated)
• Original Assignee: Telectronics Incorporated
• Inventors: Smith, Edward D., Sasmor, Louis
• Primary Examiner(s): Jaworski, Francis
• Assistant Examiner(s): MANUEL, GEORGE C
• Application Number:
  US07/101,757
• Time in Patent Office: 582 Days
• Field of Search: 128/419 PT, 128/419 PG, 128/630, 128/631, 128/697, 128/903
• US Class Current: 607/27
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means
• CPC Class Codes: A61N 1/37252 Details of algorithms or data aspects of communication system, e.g. handshaking, transmitting specific data or segmenting data
• CPC Class Codes: G16H 10/65 stored on portable record carriers, e.g. on smartcards, RFID tags or CD
• 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 50/20 for computer-aided diagnosis, e.g. based on medical expert systems
• CPC Class Codes: Y10S 706/924 Medical

Abstract

A cardiac pacer analysis system which is external to the patient is provided for an implanted pacer having patient history stored within the pacer. Information is transmitted from the pacer, and is received, stored and processed. Events in the received information are identified and characterized, observed problems are identified, probable causes of observed problems are indicated and possible corrective actions are provided. The results of the analyses are displayed for the clinician.

Claims

1. A cardiac pacer analysis system, which comprises:

means for receiving and storing information telemetrically transmitted from an implanted pacer;

means for identifying and characterizing events in the received information;

means for identifying observed problems that are based on the events and on logical rules which express the functioning relationships incorporated in the operation of the implanted pacer;

means for automatically determining probable causes of observed problems and possible corrective actions; and

means for displaying the results of the automatic determinations to a clinician by including selected clinically relevant information.

2. A system as described in claim 1, in which the information received includes pacer parameter programmed values, pacer stored patient-related information, results of automatically performed pacer measurements, and a surface ECG signal presented as an analog signal.

3. A cardiac pacer analysis system as described in claim 1, including means for automatically providing a sampling segment, checking the sampling segment to determine if it is satisfactory for reference purpose, identifying proper pacing spikes and removing the improper spikes, detecting the cardiac activity, and correlating the detected cardiac activity with previously received information.

4. A cardiac pacer analysis system as described in claim 1, including means for automatically comparing observed events with model information that is previously stored in the analysis system, including means for automatically determining the initial state of the pacer, checking for missing events, determining if the pacer is functioning properly at each of the observed events, updating the stored model information to prepare for evaluating the next event, checking for state changes within the pacer, and providing an event list based on said comparison.

5. A cardiac pacer analysis system as described in claim 4, including means for automatically reducing the amount of received data, summarizing the events to produce a summary record, identifying the operational status of each of the pacer'"'"'s functions for each channel, noting any abnormal function, comparing abnormal functioning data with previously stored information to determine problem causes, and displaying recommended corrective action.

6. A cardiac pacer analysis system which comprises:

a signal receiving and storage means for accepting surface ECG and telemetrically transmitted information from the pacer and storing said information;

a digital signal processing means responsive for the signal receiving and storing means for identifying and characterizing the received ECG data;

an ECG event analysis means responsive to the digital signal processing means for automatically determining if the pacer functioned correctly and produced the clinically desired response from the patient at each ECG event;

a clinical analysis and advisor means responsive to the ECG event analysis means for automatically summarizing the results and identifying any observed problems and automatically providing probable causes and possible actions that a physician can take to alleviate the observed problem; and

a results output means for automatically presenting results of the ECG event analysis and the clinical event analysis by including selected relevant clinical information to a clinician.

7. A cardiac pacer analysis system for use with a cardiac pacer in which patient history information is stored within the pacer, which comprises:

storage means containing a knowledge base encompassing the functional characteristics of the pacer;

means for automatically receiving information including surface ECG information and telemetered ICEGs from the pacer;

means for automatically sorting by time and type of signal the received information signals and providing a sampling segment;

means for automatically examining each sampling segment to determine if the pacer functions properly; and

means for automatically analyzing the received information to provide a comprehensive assessment of the implanted pacer.

9. A cardiac pacer analysis system as described in claim 7, including means for automatically checking the sampling segment to determine if it is satisfactory for reference purpose, detecting the cardiac activity, and correlating the detected cardiac activity with previously received information.

10. A cardiac pacer analysis system as described in claim 7, including means for automatically comparing observed events with previously stored model information, including means for automatically determining the initial state of the pacer, checking for missing events, determining if the pacer is functioning properly at each of the observed events, updating the stored model information to prepare for evaluating the next event, checking for state changes within the pacer, and providing an event list based on said comparison.

11. A cardiac pacer analysis system as described in claim 10, including means for reducing the amount of received data, summarizing the events to produce a summary record, identifying the operational status of each of the pacer'"'"'s functions for each channel, noting any abnormal function, comparing abnormal functioning data with previously stored information to determine problem causes, and displaying recommended corrective action.

12. A cardiac pacer analysis system as described in claim 7, in which the pacer stored patient-related information includes the implant date, lead type and location, and pre-implant symptoms.

13. A cardiac pacer analysis system as described in claim 7, in which the pacer'"'"'s functions include sensing pacing timing and capture for each channel.

8. A system as described in claiim 7, in which the information received includes pacer parameter programmed values, pacer stored patient-related information, results of automatically performed pacer measurements, and a surface ECG signal presented as an analog signal.

14. A cardiac pacer analysis system which comprises:

means for receiving and storing telemetrically transmitted information, including pacer parameter programmed values, pacer stored patient-related information, results of automatically performed pacer measurements, and a surface ECG signal presented as an analog signal;

means for automatically sorting the signals and producing a sampling segment;

means for automatically detecting cardiac activity and correlating the detected cardiac activity with a previously identified pacer action;

means for automatically sorting the identified events;

means for automatically examining each event and determining if the pacer functions properly; and

means for automatically providing a comprehensive evaluation of the implanted pacer.

15. A cardiac pacer analysis system as described in claim 14, in which the providing means includes means for automatically reducing the amount of received data, summarizing the events to produce a summary record, identifying the operational status of each of the pacer'"'"'s functions for each channel, noting any abnormal functioning, comparing abnormal functioning data with previously stored information to determine problem causes, and displaying recommended corrective action.

16. A cardiac pacer analysis system as described in claim 14, including means for automatically comparing observed events with previously stored model information, said comparing means including means for automatically determining the initial state of the pacer, checking for missing events, determining if the pacer is functioning properly at the observed event, updating the stored model information to prepare for evaluating the next event, and checking for state changes within the pacer.