Method and apparatus for display of ventricular electrograms

• US 6,795,734 B2
• Filed: 12/26/2000
• Issued: 09/21/2004
• Est. Priority Date: 12/26/2000
• Status: Expired due to Fees

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Kalgren, James, Wentkowski, Rene H., Vanderlinde, Scott, Stahmann, Jeffrey E.
• Primary Examiner(s): Vo, Hieu T.
• Assistant Examiner(s): Hoang, Johnny H.
• Application Number:
  US09/748,723
• Publication Number:
  US 20020082662A1
• Time in Patent Office: 1,365 Days
• Field of Search: 600/509, 600/518, 600/523, 607/9, 607/14, 607/17, 607/19, 607/18, 607/31, 607/25, 607/27, 607/63, 607/2-5, 128/901, 128/903
• US Class Current: 607/27
• CPC Class Codes: A61N 1/3627 for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy
• CPC Class Codes: A61N 1/3684 for stimulating the heart at multiple sites of the ventricle or the atrium
• CPC Class Codes: A61N 1/36842 Multi-site stimulation in the same chamber
• CPC Class Codes: A61N 1/36843 Bi-ventricular stimulation
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means

Abstract

A cardiac rhythm management system that includes a pacemaker configured for resynchronization pacing and an external programmer with an associated display for displaying electrogram markers. The markers are designed to relate information to a user in a manner suited for biventricular or other resynchronization pacing.

Claims

1. A method for displaying electrogram data collected by a pacemaker wherein one heart chamber is paced through a rate sensing/pacing channel and another site in the same or contralateral chamber is paced through a synchronized sensing/pacing channel with the pacing mode being based upon senses and paces in the rate channel, comprising displaying markers representing sensing and pacing events spaced apart in accordance with their time sequence, wherein each marker indicates whether the event is a sense or a pace and in which channel the event occurred.

2. The method of claim 1 further comprising displaying an electrogram for each channel wherein each event marker is displayed with a corresponding deflection in the electrogram which represents the sensing or pacing event.

3. The method of claim 1 wherein the rate and synchronized channels are right and left ventricular channels.

4. The method of claim 1 wherein the rate and synchronized channels are right and left atrial channels.

5. The method of claim 1 wherein the pacemaker is operated with a plurality of synchronized channels and further comprising displaying markers for each such channel.

6. The method of claim 1 wherein a single marker is displayed indicating a biventricular pace when the pacemaker is operating in a biventricular pacing mode.

7. The method of claim 1 wherein a marker is displayed indicating a synchronized chamber pace in addition to a marker indicating where a rate chamber pace would have occurred if the rate chamber were paced when the pacemaker is operating in a synchronized chamber-only pacing mode based upon rate chamber senses.

8. The method of claim 1 wherein, when the pacemaker is operating in a synchronized chamber-only pacing mode based upon rate chamber senses and a synchronized chamber pace is inhibited by a synchronized chamber protective period, a marker is displayed indicating the inhibited synchronized chamber pace.

9. The method of claim 1 wherein, when the pacemaker is operating in a synchronized chamber-only pacing mode based upon rate chamber senses and a synchronized chamber pace is inhibited by a synchronized chamber protective period, a marker is displayed indicating a rate chamber safety pace.

10. The method of claim 1 wherein each marker indicating a pace additionally indicates whether the pace was delivered with an escape interval determined by a rate-adaptive sensor.

11. The method of claim 1 wherein each marker indicating a pace additionally indicates whether the pace was delivered with an escape interval determined by a hysteretic control algorithm.

12. The method of claim 1 wherein each marker indicating a rate channel pace additionally indicates whether the pace was delivered with an escape interval determined by a rate-adaptive sensor.

13. The method of claim 1 wherein each marker indicating a rate channel pace additionally indicates whether the pace was delivered with an escape interval determined by a hysteretic control algorithm.

14. The method of claim 1 wherein the displayed markers represent a sequence of sensing and pacing events recorded by the pacemaker and transmitted to an external programmer.

15. The method of claim 1 wherein the displayed markers represent sensing and pacing events occurring in real-time as transmitted to an external programmer by the pacemaker.

16. A cardiac rhythm management system, comprising:

a pacemaker having a rate sensing/pacing channel and a synchronized sensing/pacing channel, a controller for controlling the delivery of paces in accordance with a pacing mode based upon rate channel events, and a telemetry interface for transmitting signals representing rate and synchronized channel events; and

,

an external programmer with an associated electronic display or print output, wherein the programmer is configured to receive the signals transmitted by the pacemaker and output markers representing sensing and pacing events on the display spaced in accordance with their time sequence, wherein each marker indicates whether the event is a sense or a pace and in which channel the event occurred.

17. The system of claim 16 wherein the programmer is configured to display an electrogram for each channel and wherein each event marker is displayed with a corresponding deflection in the electrogram which represents the sensing or pacing event.

18. The system of claim 16 wherein the rate and synchronized channels are right and left ventricular channels.

19. The system of claim 16 wherein a single marker is displayed indicating a biventricular pace when the pacemaker is operating in a biventricular pacing mode.

20. The system of claim 16 wherein a marker is displayed indicating a synchronized chamber pace in addition to marker indicating where a rate chamber pace would have occurred if the rate chamber were paced when the pacemaker is operating in a synchronized chamber-only pacing mode based upon rate chamber senses.

21. The system of claim 16 wherein when the pacemaker is operating in a synchronized chamber-only pacing mode based upon rate chamber senses and a synchronized chamber pace is inhibited by a synchronized chamber protective period, markers are displayed indicating the inhibited synchronized chamber pace and a rate chamber safety pace.

22. The system of claim 16 wherein each marker indicating a pace additionally indicates whether the pace was delivered with an escape interval determined by a rate-adaptive sensor.

23. The system of claim 16 wherein each marker indicating a pace additionally indicates whether the pace was delivered with an escape interval determined by a hysteretic control algorithm.