Multi-event bin heart rate histogram for use with and implantable pacemaker

• US 5,948,005 A
• Filed: 01/28/1997
• Issued: 09/07/1999
• Est. Priority Date: 01/28/1997
• Status: Expired due to Term

• Current Assignee: Pacesetter Incorporated (Abbott Laboratories)
• Original Assignee: Pacesetter Incorporated (Abbott Laboratories)
• Inventors: Valikai, Kenneth, Bevan, Gregory
• Primary Examiner(s): Kamm, William E.
• Assistant Examiner(s): LAYNO, CARL HERNANDZ
• Application Number:
  US08/789,865
• Time in Patent Office: 952 Days
• Field of Search: 607/9, 607/27, 607/28, 607/30, 607/32
• US Class Current: 607/32
• 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: A61N 1/37247 User interfaces, e.g. input or presentation means

Abstract

Event/rate data gathered by an implantable pacemaker is displayed in a histogram format as a function of heart rate and event type, with multiple events being included in the display of each rate bin of the histogram. Event types include a paced event, a sensed event, or a premature ventricular event (PVE). Two types of histograms are provided: (1) a heart rate histogram that shows the occurrence of each event type in each heart rate bin as a function of the percent of total events in all heart rate bins; and (2) a histogram that shows event type distribution by rate bin.

Claims

1. A pacing system comprising:

an implantable pacemaker having means for sensing and recording heart rate/event data, means responsive to receipt of a download request signal for downloading the heart rate/event data to a remote receiver, and means for receiving the download request signal; and

an external programmer comprising;

means for generating the download request signal and sending it to the implantable pacemaker,

means for receiving the heart rate/event data from the implantable pacemaker, and

means for displaying the heart rate/event data in a multi-event bin heart rate histogram;

the multi-event bin heart rate histogram comprising a two-dimensional graphical chart of the heart rate/event data that shows;

(a) a multiplicity of heart rate zones arranged in order of increasing heart rate along a first axis, (b) a graphic representation of the number of heart rate events that occur within each heart rate zone, and (c) an indication of which events in each heart rate zone are sensed events, which are paced events, and which are premature events.

2. The pacing system, as set forth in claim 1, wherein:

the graphic representation of the number of heart rate events that occur within each heart rate zone comprises a display bar for each heart rate zone that extends out from the first axis, and

the display bar for each heart rate zone has a length that is indicative of the total number of heart rate events that occur within the respective heart rate zone.

3. The pacing system, as set forth in claim 1, the graphic representation comprises a display bar for each heart rate zone that extends out from the first axis, wherein the display bar of each heart rate zone is segmented into first, second and third portions, and wherein:

the first portion has a segment length that represents the number of sensed events that have occurred within the corresponding heart rate zone,

the second portion has a segment length that represents the number of paced events that have occurred within the corresponding heart rate zone, and

the third portion has a segment length that represents the number of premature events that have occurred within the corresponding heart rate zone.

4. The pacing system, as set forth in claim 2, wherein the multi-event heart rate histogram further comprises an indication of the percent of the total events associated with each heart rate zone as compared to the total heart rate events from all of the heart rate zones.

5. The pacing system, as set forth in claim 1, wherein:

the graphic representation of the number of heart rate events that occur within each heart rate zone comprises a display bar for each heart rate zone that extends out from the first axis,

the display bar for each heart rate zone has a length that is representative of 100% of the number of heart rate events that have occurred within the respective heart rate zone,

the display bar of each heart rate zone is segmented into a plurality of portions, the plurality of portions including;

a first portion having a segment length indicative of the number of sensed events that have occurred within the corresponding heart rate zone as compared with all of the heart rate events that have occurred in that corresponding heart rate zone, and

a second portion having a segment length indicative of the number of paced events that have occurred within the corresponding heart rate zone as compared with all of the heart rate events that have occurred in that corresponding heart rate zone,

whereby the heart rate histogram provides a graphical indication of the heart rate event distribution by rate zone.

6. The pacing system, as set forth in claim 5, wherein the display bar of each heart rate zone further includes a third portion having a segment length indicative of the number of premature events that have occurred within the corresponding heart rate zone as compared with all of the heart rate events that have occurred in that corresponding heart rate zone.

7. The pacing system of claim 6, wherein the multi-event heart rate histogram further comprises an event-distribution-by-rate-zone table which displays the percentage of each heart rate event type within each heart rate zone, where the heart rate event types include sensed events, paced events, and premature events.

8. The pacing system of claim 1, wherein the implantable pacemaker comprises a dual-chamber pacemaker capable of sensing and pacing in both atrial and ventricular chambers, and wherein the heart rate event data sensed and recorded by the pacemaker includes:

(1) a P-wave followed by a V-pulse (referred to as a "PV" event);

(2) a P-wave followed by an R-wave (referred to as a "PR" event);

(3) an A-pulse followed by a V-pulse (referred to as an "AV" event);

(4) an A-pulse followed by an R-wave (referred to as an "AR" event); and

a premature ventricular event (referred to as a "PVE"), and further wherein all PV and PR events are considered to be sensed events, all AV and AR events are considered to be paced events, and all PVE events are considered to be premature events.

9. The pacing system of claim 1, wherein the implantable pacemaker comprises a dual-chamber pacemaker capable of sensing in both atrial and ventricular chambers, but capable of pacing in only the ventricular chamber, and wherein the heart rate event data sensed and recorded by the pacemaker includes:

(1) a P-wave followed by a V-pulse (referred to as a "PV" event);

(2) a P-wave followed by an R-wave (referred to as a "PR" event);

(3) a V-pulse (referred to as a "V" event) and (4) a premature ventricular event (referred to as a "PVE"), and further wherein all PV and PR events are considered to be sensed events, all V events are considered to be paced events, and all PVE events are considered to be premature events.

10. The pacing system of claim 1, wherein the implantable pacemaker comprises a single-chamber pacemaker capable of sensing and pacing in just one heart chamber, and wherein the heart rate event data sensed and recorded by the pacemaker includes:

(1) a sensed event (a P-wave or an R-wave, depending upon which heart chamber is being used); and

(2) a paced event (an A-pulse or a V-pulse, depending upon which heart chamber is being used).

11. An external programmer for use with an implantable pacemaker, the implantable pacemaker having means for sensing and recording heart rate event data, means responsive to receipt of an event data request signal for transferring the heart rate event data to the programmer, and means for receiving the event data request signal, said external programmer comprising:

means for generating the event data request signal and sending it to the implantable pacemaker;

means for receiving the heart rate event data from the implantable pacemaker; and

means for displaying the heart rate event data in a multi-event bin heart rate histogram, the multi-event bin heart rate histogram comprising a graphical chart of the heart rate event data that shows;

a multiplicity of heart rate bins arranged in order of increasing heart rate along a first axis,

a graphical representation of the number of heart rate events that occur within each heart rate bin, and

an indication of at least three types of heart rate events in each heart rate bin.

12. The external programmer, as set forth in claim 11, wherein:

the graphic representation of the number of heart rate events that occur within each heart rate bin comprises a display bar for each heart rate bin that extends out from the first axis, and

the length of the display bar for each heart rate bin is indicative of the total number of heart rate events that occur within the respective heart rate bin.

13. The external programmer, as set forth in claim 12, wherein the display bar of each heart rate bin is divided into a plurality of segments, with each segment having a length that represents the number of occurrences of a specific type of heart rate event within the corresponding heart rate bin.

14. The external programmer, as set forth in claim 13, wherein the multi-event bin heart rate histogram further provides an indication of the percent of the total events associated with each heart rate bin as compared to the total heart rate events from all of the heart rate bins.

15. The external programmer, as set forth in claim 13, wherein at least two of the at least three types of heart rate events that may be identified in each heart rate bin of the multi-event bin heart rate histogram comprise sensed events and paced events.

16. The external programmer, as set forth in claim 15, wherein at least one of the at least three types of heart rate events that may be identified in each heart rate bin of the multi-event bin heart rate histogram further comprise premature events.

17. The external programmer, as set forth in claim 16, wherein the implantable pacemaker comprises a dual-chamber pacemaker that includes means for sensing P-waves and R-waves, means for generating A-pulses and V-pulses, and means for sensing a premature ventricular event (PVE);

and further wherein the specific types of heart rate events that may be identified in each heart rate bin of the multi-event bin heart rate histogram comprise;

(1) a P-wave followed by a V-pulse (referred to as a "PV" event);

(2) a P-wave followed by an R-wave (referred to as a "PR" event);

(3) an A-pulse followed by a V-pulse (referred to as an "AV" event);

(4) an A-pulse followed by an R-wave (referred to as an "AR" event); and

(5) a PVE; and

further wherein all PV and PR events are considered to be sensed events, all AV and AR events are considered to be paced events, and all PVE events are considered to be premature events.

18. The external programmer, as set forth in claim 16, wherein the implantable pacemaker comprises a dual-chamber pacemaker that includes means for sensing P-waves and R-waves, means for generating V-pulses and means for sensing a premature ventricular event (PVE);

and further wherein the specific types of heart rate events that may be identified in each heart rate bin of the multi-event bin heart rate histogram comprise;

(1) a P-wave followed by a V-pulse (referred to as a "PV" event);

(2) a P-wave followed by an R-wave (referred to as a "PR" event);

(3) a V-pulse (referred to as a "V" event); and

(4) a PVE; and

further wherein all PV and PR events are considered to be sensed events, all V events are considered to be paced events, and all PVE events are considered to be premature events.

19. The external programmer, as set forth in claim 15, wherein the implantable pacemaker comprises a single-chamber pacemaker that includes means for sensing P-waves or R-waves, and means for generating A-pulses or V-pulses, depending upon which heart chamber is used;

and further wherein the specific types of heart rate events that may be identified in each heart rate bin of the multi-event bin heart rate histogram comprise;

(1) a P-wave or R-wave; and

(2) an A-pulse or a V-pulse; and

further wherein all P-waves or R-waves are considered to be sensed events, and all A-pulses or V-pulses are considered to be paced events.

20. The external programmer, as set forth in claim 11, wherein:

the graphical representation of the number of heart rate events that occur within each heart rate bin comprises a display bar for each heart rate bin that extends out from the first axis,

the display bar for each heart rate bin has a length that is representative of 100% of the number of heart rate events that have occurred within the respective heart rate bin, and

the display bar of each heart rate bin is divided into a plurality of segments, with each segment having a length indicative of the number of occurrences of a specific type of heart rate event within the corresponding heart rate bin as compared with all of the occurrences of all of the heart rate events in that corresponding heart rate bin;

whereby the heart rate histogram provides a graphical indication of the heart rate event distribution by rate bin.

21. The external programmer, as set forth in claim 20, wherein the specific types of heart rate events that may be identified in each heart rate bin of the multi-event bin heart rate histogram comprise sensed events and paced events.

22. The external programmer, as set forth in claim 21, wherein the implantable pacemaker comprises a single-chamber pacemaker that includes means for sensing P-waves or R-waves, and means for generating A-pulses or V-pulses, depending upon which heart chamber is used;

and further wherein the specific types of heart rate events that may be identified in each heart rate bin of the multi-event bin heart rate histogram comprise;

(1) a P-wave or R-wave; and

(2) an A-pulse or a V-pulse; and

further wherein all P-waves or R-waves are considered to be sensed events, and all A-pulses or V-pulses are considered to be paced events.

23. The external programmer, as set forth in claim 21, wherein the specific types of heart rate events that may be identified in each heart rate bin of the multi-event bin heart rate histogram further comprise premature events.

24. The external programmer, as set forth in claim 23, wherein the implantable pacemaker comprises a dual-chamber pacemaker that includes means for sensing P-waves and R-waves, means for generating A-pulses and V-pulses, and means for sensing a premature ventricular event (PVE);

and further wherein the specific types of heart rate events that may be identified in each heart rate bin of the multi-event heart rate histogram comprise;

(1) a P-wave followed by a V-pulse (referred to as a "PV" event);

(2) a P-wave followed by an R-wave (referred to as a "PR" event);

(3) an A-pulse followed by a V-pulse (referred to as an "AV" event);

(4) an A-pulse followed by an R-wave (referred to as an "AR" event); and

(5) a PVE; and

further wherein all PV and PR events are considered to be sensed events, all AV and AR events are considered to be paced events, and all PVE events are considered to be premature events.

25. The external programmer, as set forth in claim 23, wherein the implantable pacemaker comprises a dual-chamber pacemaker that includes means for sensing P-waves and R-waves, means for generating V-pulses, and means for sensing a premature ventricular event (PVE);

and further wherein the specific types of heart rate events that may be identified in each heart rate bin of the multi-event bin heart rate histogram comprise;

(1) a P-wave followed by a V-pulse (referred to as a "PV" event);

(2) a P-wave followed by an R-wave (referred to as a "PR" event);

(3) a V-pulse (referred to as a "V" event); and

(4) a PVE; and

further wherein all PV and PR events are considered to be sensed events, all V events are considered to be paced events, and all PVE events are considered to be premature events.

26. The external programmer, as set forth in claim 11, wherein the display means includes a printer which prints a copy of the multi-event bin heart rate histogram on paper which can be removed from the external programmer.

27. A method of generating a multi-event bin heart rate histogram that depicts heart rate event data that has been sensed and recorded within an implantable pacemaker, the method comprising:

(a) retrieving the heart rate event data from the implantable pacemaker,

(b) sorting the heart rate event data as a function of type of event and rate of event;

(c) displaying the sorted heart rate event data in a multi-event heart rate histogram that comprises a graphical chart of the heart rate event data, wherein the graphical chart is made by;

(1) providing a multiplicity of heart rate bins arranged in order of increasing heart rate along a first axis of the graphical chart,

(2) creating a graphical representation of the number of heart rate events that occur within each heart rate bin, and

(3) providing an indication of at least three types of heart rate events that occur within each heart rate bin.

28. The method as set forth in claim 27, wherein the step of creating the graphical representation of the number of heart rate events that occur within each heart rate bin comprises:

making a display bar for each heart rate bin that extends out from the first axis by a length that indicates of the total number of heart rate events that have occurred within the respective heart rate bin.

29. The method as set forth in claim 28, wherein the step of providing an indication of the at least three types of heart rate events that occurs within each heart rate bin comprises dividing the event bar into a plurality of segments, with each segment being uniquely identifiable, and with each segment corresponding to, and having a length that represents the number of occurrences of, a specific type of heart rate event within the corresponding heart rate bin.

30. The method as set forth in claim 29, wherein the step of providing an indication of the at least three types of heart rate events that occurs within each heart rate bin comprises indicating paced events and sensed events.

31. The method as set forth in claim 30, wherein the step of providing an indication of the at least three types of heart rate events that occurs within each heart rate bin further comprises indicating premature events.

32. The method as set forth in claim 27, wherein the step of creating the graphical representation of the number of heart rate events that occur within each heart rate bin comprises:

making a display bar for each heart rate zone that extends out from the first axis a prescribed length, and

designating the prescribed length of the display bar to be representative of 100% of the number of heart rate events that have occurred within the respective heart rate bin, and

dividing the heart rate bin into a plurality of segments, with each segment having a length relative to the prescribed length of the display bar that is indicative of the number of occurrences of a specific type of heart rate event within the corresponding heart rate bin as compared with all of the occurrences of all of the heart rate events in that corresponding heart rate bin;

whereby the heart rate histogram provides a graphical indication of the heart rate event distribution by rate bin.

33. The method as set forth in claim 32, wherein the step of dividing the heart rate bin into a plurality of segments comprises dividing the heart rate bin into respective segments indicative of paced events and sensed events.

34. The method as set forth in claim 33, wherein the step of dividing the heart rate bin into a plurality of segments comprises dividing the heart rate bin into respective segments indicative of paced events, sensed events, and premature events.

35. An external programmer for use with an implantable pacemaker, the implantable pacemaker having means for sensing and recording heart rate event data, telemetry means for transferring the heart rate event data to the programmer, the external programmer comprising:

telemetry means for receiving the heart rate event data from the implantable pacemaker; and

means for displaying the heart rate event data in a multi-event heart rate histogram as a function of heart rate zone, the multi-event heart rate histogram comprising a 100% stacked histogram, the histogram including;

a plurality of heart rate bins arranged as a function of heart rate zone along a first axis;

an indication of at least two types of heart rate events in each heart rate bin; and

a display bar, extending from the first axis, that has a length that is representative of 100% of the number of heart rate events that have occurred within a respective heart rate zone, wherein the display bar of each heart rate zone is segmented into at least two portions corresponding to the at least two types of heart rate events;

whereby the heart rate histogram provides a graphical indication of the heart rate event distribution by rate zone.

36. The external programmer, as set forth in claim 35, the display bar comprises at least one portion corresponding to the percentage of sensed events that have occurred within the corresponding heart rate zone.

37. The external programmer, as set forth in claim 35, the display bar comprises at least one portion corresponding to the percentage of paced events that have occurred within the corresponding heart rate zone.

38. The external programmer, as set forth in claim 35, the display bar comprises at least one portion corresponding to the percentage of premature events that have occurred within the corresponding heart rate zone.

39. The external programmer, as set forth in claim 35, the display bar comprises at least three portions corresponding to the at least three types of heart rate events.

40. The external programmer, as set forth in claim 35, the display bar comprises:

a first portion corresponding to the percentage of sensed events that have occurred within the corresponding heart rate zone;

a second portion corresponding to the percentage of paced events that have occurred within the corresponding heart rate zone; and

a third portion corresponding to the percentage of premature events that have occurred within the corresponding heart rate zone.