System and method for detection enhancement programming

• US 7,532,931 B2
• Filed: 12/18/2001
• Issued: 05/12/2009
• Est. Priority Date: 08/20/1999
• Status: Expired due to Term

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Gilkerson, James O., Lang, Douglas J., Conley, Vickie L., Stubbs, Scott
• Primary Examiner(s): EVANISKO, GEORGE ROBERT
• Application Number:
  US10/025,958
• Publication Number:
  US 20020123768A1
• Time in Patent Office: 2,702 Days
• Field of Search: 607/4, 607/5, 607/30, 607/31, 607/14, 607/59, 607/60
• US Class Current: 607/30
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means
• CPC Class Codes: A61N 1/3925 Monitoring; Protecting
• CPC Class Codes: A61N 1/3987 characterised by the timing or triggering of the shock

Abstract

A system and method of enabling detection enhancements selected from a plurality of detection enhancements. In a system having a plurality of clinical rhythms, including a first clinical rhythm, where each of the detection enhancements is associated with the clinical rhythms, the first clinical rhythm is selected. The first clinical rhythm is associated with first and second detection enhancements. When the first clinical rhythm is selected, parameters of the first and second detection enhancements are set automatically. A determination is made as to whether changes are to be made to the parameters. If so, one or more of the parameters are modified under user control.

Claims

1. A programmer, comprising:

a selection module for receiving a selection of a clinical rhythm from a user, wherein the programmer is programmed to associate the clinical rhythm with available detection enhancements wherein the available detection enhancements are sets of rules used by a pulse generator to determine when the pulse generator is to deliver shock therapy and each detection enhancement includes at least one parameter, wherein the selection module is adapted to respond to the selection of the clinical rhythm by the user to make the available detection enhancements available for selection by the user for use by the pulse generator to determine when to deliver shock therapy for the selected clinical rhythm, wherein the selection module includes artificial intelligence adapted to automatically select a detection enhancement from the available detection enhancements, and automatically provide a setting for the at least one parameter for the automatically selected detection enhancement, the selection module being adapted to receive a user-provided selection of at least one other detection enhancement from the available detection enhancements in place of the detection enhancement automatically selected by artificial intelligence;

a parameter modification module for receiving a user input to change the automatically- provided setting for the at least one parameter of the selected detected enhancement; and

a communication module for communicating with a pulse generator to program the pulse generator with the automatically selected detection enhancement or the user-provided selection of at least one of the detection enhancements for use by the pulse generator to detect the clinical rhythm and the associated at least one detection enhancement,

wherein the available detection enhancements include a V Rate>

A Rate enhancement for delivering therapy when a detected ventricular rate is determined to be greater than a detected atrial rate.

2. The programmer of claim 1, wherein the selection module provides a capability for the user to select a number of tachyarrhythmia zones that are associated with the at least one parameter.

3. The programmer of claim 2, wherein the parameter modification module provides a capability for the user to change detection parameters for the number of tachyarrhythmia zones.

4. The programmer of claim 2, wherein the parameter modification module provides a capability for the user to change therapy parameters for the number of tachyarrhythmia zones.

5. The programmer of claim 1, wherein the parameter modification module provides at least one indicator for indicating whether a changed parameter has been programmed in the pulse generator.

6. The programmer of claim 1, wherein the artificial intelligence is adapted to track parameter interaction among the set parameters and the changed parameters, and provide at least one warning indicator for at least one parameter interaction.

7. The programmer of claim 1, wherein the at least one parameter includes at least one cardiac rhythm parameter that indicates when the at least one detection enhancement for the selected clinical rhythm applies.

8. A programmer, comprising:

a selection module for receiving a selection of a clinical rhythm from a user, wherein the programmer is programmed to associate the clinical rhythm with available detection enhancements wherein the available detection enhancements are sets of rules used by a pulse generator to determine when the pulse generator is to deliver shock therapy and each detection enhancement includes at least one parameter, wherein the selection module is adapted to respond to the selection of the clinical rhythm by the user to make the available detection enhancements available for selection by the user for use by the pulse generator to determine when to deliver shock therapy for the selected clinical rhythm, wherein the selection module includes artificial intelligence adapted to automatically select a detection enhancement from the available detection enhancements, and automatically provide a setting for the at least one parameter for the automatically selected detection enhancement, the selection module being adapted to receive a user-provided selection of at least one other detection enhancement from the available detection enhancements in place of the detection enhancement automatically selected by artificial intelligence;

a parameter modification module for receiving a user input to change the automatically-provided setting for the at least one parameter of the selected detected enhancement; and

a communication module for communicating with a pulse generator to program the pulse generator with the automatically selected detection enhancement or the user-provided selection of at least one of the detection enhancements for use by the pulse generator to detect the clinical rhythm and the associated at least one detection enhancement,

wherein the available detection enhancements made available by the selection module for selection by the user include an AFib Rate Threshold enhancement for inhibiting ventricular therapy when a detected atrial rhythm is determined to be faster than a threshold.

9. The programmer of claim 8, wherein the selection module provides a capability for the user to select a number of tachyarrhythmia zones that are associated with the at least one parameter.

10. The programmer of claim 9, wherein the parameter modification module provides a capability for the user to change detection parameters for the number of tachyarrhythmia zones.

11. The programmer of claim 9, wherein the parameter modification module provides a capability for the user to change therapy parameters for the number of tachyarrhythmia zones.

12. The programmer of claim 8, wherein the parameter modification module provides at least one indicator for indicating whether a changed parameter has been programmed in the pulse generator.

13. The programmer of claim 8, wherein the artificial intelligence is adapted to track parameter interaction among the set parameters and the changed parameters, and provide at least one warning indicator for at least one parameter interaction.

14. A programmer, comprising:

a selection module for receiving a selection of a clinical rhythm from a user, wherein the programmer is programmed to associate the clinical rhythm with available detection enhancements wherein the available detection enhancements are sets of rules used by a pulse generator to determine when the pulse generator is to deliver shock therapy and each detection enhancement includes at least one parameter, wherein the selection module is adapted to respond to the selection of the clinical rhythm by the user to make the available detection enhancements available for selection by the user for use by the pulse generator to determine when to deliver shock therapy for the selected clinical rhythm, wherein the selection module includes artificial intelligence adapted to automatically select a detection enhancement from the available detection enhancements, and automatically provide a setting for the at least one parameter for the automatically selected detection enhancement, the selection module being adapted to receive a user-provided selection of at least one other detection enhancement from the available detection enhancements in place of the detection enhancement automatically selected by artificial intelligence;

a parameter modification module for receiving a user input to change the automatically- provided setting for the at least one parameter of the selected detected enhancement; and

a communication module for communicating with a pulse generator to program the pulse generator with the automatically selected detection enhancement or the user-provided selection of at least one of the detection enhancements for use by the pulse generator to detect the clinical rhythm and the associated at least one detection enhancement,

wherein the available detection enhancements made available by the selection module for selection by the user include a Stability enhancement for inhibiting ventricular therapy when a detected atrial rhythm is determined to be unstable.

15. The programmer of claim 14, wherein the selection module provides a capability for the user to select a number of tachyarrhythmia zones that are associated with the at least one parameter.

16. The programmer of claim 15, wherein the parameter modification module provides a capability for the user to change detection parameters for the number of tachyarrhythmia zones.

17. The programmer of claim 15, wherein the parameter modification module provides a capability for the user to change therapy parameters for the number of tachyarrhythmia zones.

18. The programmer of claim 14, wherein the parameter modification module provides at least one indicator for indicating whether a changed parameter has been programmed in the pulse generator.

19. The programmer of claim 14, wherein the artificial intelligence is adapted to track parameter interaction among the set parameters and the changed parameters, and provide at least one warning indicator for at least one parameter interaction.

20. A programmer, comprising:

a selection module for receiving a selection of a clinical rhythm from a user, wherein the programmer is programmed to associate the clinical rhythm with available detection enhancements wherein the available detection enhancements are sets of rules used by a pulse generator to determine when the pulse generator is to deliver shock therapy and each detection enhancement includes at least one parameter, wherein the selection module is adapted to respond to the selection of the clinical rhythm by the user to make the available detection enhancements available for selection by the user for use by the pulse generator to determine when to deliver shock therapy for the selected clinical rhythm, wherein the selection module includes artificial intelligence adapted to automatically select a detection enhancement from the available detection enhancements, and automatically provide a setting for the at least one parameter for the automatically selected detection enhancement, the selection module being adapted to receive a user-provided selection of at least one other detection enhancement from the available detection enhancements in place of the detection enhancement automatically selected by artificial intelligence;

a parameter modification module for receiving a user input to change the automatically-provided setting for the at least one parameter of the selected detected enhancement; and

a communication module for communicating with a pulse generator to program the pulse generator with the automatically selected detection enhancement or the user-provided selection of at least one of the detection enhancements for use by the pulse generator to detect the clinical rhythm and the associated at least one detection enhancement,

wherein the available detection enhancements made available by the selection module for selection by the user include an Onset enhancement for inhibiting a therapy when a detected cardiac rate is determined to increase gradually.

21. The programmer of claim 20, wherein the selection module provides a capability for the user to select a number of tachyarrhythmia zones that are associated with the at least one parameter.

22. The programmer of claim 21, wherein the parameter modification module provides a capability for the user to change detection parameters for the number of tachyarrhythmia zones.

23. The programmer of claim 21, wherein the parameter modification module provides a capability for the user to change therapy parameters for the number of tachyarrhythmia zones.

24. The programmer of claim 20, wherein the parameter modification module provides at least one indicator for indicating whether a changed parameter has been programmed in the pulse generator.

25. The programmer of claim 20, wherein the artificial intelligence is adapted to track parameter interaction among the set parameters and the changed parameters, and provide at least one warning indicator for at least one parameter interaction.

26. A programmer, comprising:

a selection module for receiving a selection of a clinical rhythm from a user, wherein the programmer is programmed to associate the clinical rhythm with available detection enhancements wherein the available detection enhancements are sets of rules used by a pulse generator to determine when the pulse generator is to deliver shock therapy and each detection enhancement includes at least one parameter, wherein the selection module is adapted to respond to the selection of the clinical rhythm by the user to make the available detection enhancements available for selection by the user for use by the pulse generator to determine when to deliver shock therapy for the selected clinical rhythm, wherein the selection module includes artificial intelligence adapted to automatically select a detection enhancement from the available detection enhancements, and automatically provide a setting for the at least one parameter for the automatically selected detection enhancement, the selection module being adapted to receive a user-provided selection of at least one other detection enhancement from the available detection enhancements in place of the detection enhancement automatically selected by artificial intelligence;

a parameter modification module for receiving a user input to change the automatically-provided setting for the at least one parameter of the selected detected enhancement; and

a communication module for communicating with a pulse generator to program the pulse generator with the automatically selected detection enhancement or the user-provided selection of at least one of the detection enhancements for use by the pulse generator to detect the clinical rhythm and the associated at least one detection enhancement,

wherein the available detection enhancements made available by the selection module for selection by the user include a Shock If Unstable enhancement when a ventricular rhythm is determined to be unstable.

27. The programmer of claim 26, wherein the selection module provides a capability for the user to select a number of tachyarrhythmia zones that are associated with the at least one parameter.

28. The programmer of claim 27, wherein the parameter modification module provides a capability for the user to change detection parameters for the number of tachyarrhythmia zones.

29. The programmer of claim 27, wherein the parameter modification module provides a capability for the user to change therapy parameters for the number of tachyarrhythmia zones.

30. The programmer of claim 26, wherein the parameter modification module provides at least one indicator for indicating whether a changed parameter has been programmed in the pulse generator.

31. The programmer of claim 26, wherein the artificial intelligence is adapted to track parameter interaction among the set parameters and the changed parameters, and provide at least one warning indicator for at least one parameter interaction.

32. A programmer, comprising:

a selection module for receiving a selection of a clinical rhythm from a user, wherein the programmer is programmed to associate the clinical rhythm with available detection enhancements wherein the available detection enhancements are sets of rules used by a pulse generator to determine when the pulse generator is to deliver shock therapy and each detection enhancement includes at least one parameter, wherein the selection module is adapted to respond to the selection of the clinical rhythm by the user to make the available detection enhancements available for selection by the user for use by the pulse generator to determine when to deliver shock therapy for the selected clinical rhythm, wherein the selection module includes artificial intelligence adapted to automatically select a detection enhancement from the available detection enhancements, and automatically provide a setting for the at least one parameter for the automatically selected detection enhancement, the selection module being adapted to receive a user-provided selection of at least one other detection enhancement from the available detection enhancements in place of the detection enhancement automatically selected by artificial intelligence;

a parameter modification module for receiving a user input to change the automatically- provided setting for the at least one parameter of the selected detected enhancement; and

a communication module for communicating with a pulse generator to program the pulse generator with the automatically selected detection enhancement or the user-provided selection of at least one of the detection enhancements for use by the pulse generator to detect the clinical rhythm and the associated at least one detection enhancement,

wherein the available detection enhancements made available by the selection module for selection by the user include a Sustained Rate Duration (SRD) enhancement for overriding an inhibit therapy enhancement when a detected rate continues throughout a programmed time period.

33. The programmer of claim 32, wherein the selection module provides a capability for the user to select a number of tachyarrhythmia zones that are associated with the at least one parameter.

34. The programmer of claim 33, wherein the parameter modification module provides a capability for the user to change detection parameters for the number of tachyarrhythmia zones.

35. The programmer of claim 33, wherein the parameter modification module provides a capability for the user to change therapy parameters for the number of tachyarrhythmia zones.

36. The programmer of claim 32, wherein the parameter modification module provides at least one indicator for indicating whether a changed parameter has been programmed in the pulse generator.

37. The programmer of claim 32, wherein the artificial intelligence is adapted to track parameter interaction among the set parameters and the changed parameters, and provide at least one warning indicator for at least one parameter interaction.

38. A programmer for a user to program a pulse generator with detection enhancements for use by the pulse generator to detect a clinical rhythm and apply therapy for the detected clinical rhythm, comprising:

a communications module for communicating with the pulse generator;

control logic for programming the pulse generator using the communications module, wherein the control logic is adapted to program the pulse generator to detect and provide therapy for at least one clinical rhythm, to associate the clinical rhythm with available detection enhancements, to program the pulse generator with at least one selected detection enhancement from the available detection enhancements associated with the at least one clinical rhythm, and to program the pulse generator with at least one parameter for the at least one selected detection enhancement; and

a display connected to the control logic to provide a number of screen displays used by the user to select the at least one clinical rhythm and modify the selection of the at least one detection enhancement from at least one preprogrammed detection enhancement to at least one other detection enhancement from the available detection enhancements associated with the at least one clinical rhythm,

wherein the at least one selected detection enhancement is automatically seeded with a value for the at least one parameter, and the number of screen displays are used by the user to change the value for the at least one parameter,

wherein the number of screen displays are layered such a first screen display provides the user with the ability to select the at least one detection enhancement, and a second screen provides the user with the ability to change the value for the at least one parameter,

wherein the first screen includes a number of tachyarrhythmia zones, and the number of tachyarrhythmia zones ranges between one and three zones as determined by a user input, and

wherein each of the number of tachyarrhythmia zones includes a detection button, and selecting the detection button displays the second screen used to change detection parameters for at least one of the number of tachyarrhythmia zones.

39. The programmer of claim 38, wherein the first screen displays detection enhancement rhythm discrimination categories.

40. The programmer of claim 38, wherein the first screen provides an ECG display.

41. The programmer of claim 38, wherein the detection enhancements include at least one inhibit therapy enhancement for inhibiting the therapy for the at least one clinical rhythm.

42. The programmer of claim 38, wherein each of the number of tachyarrhythmia zones includes a therapy button, and selecting the therapy button displays the second screen used to change therapy parameters for the number of tachyarrhythmia zones.

43. A programmer for a user to program a pulse generator with detection enhancements for use by the pulse generator to detect a clinical rhythm and apply therapy for the detected clinical rhythm, comprising:

a communications module for communicating with the pulse generator;

control logic for programming the pulse generator using the communications module, wherein the control logic is adapted to program the pulse generator to detect and provide therapy for at least one clinical rhythm, to associate the clinical rhythm with available detection enhancements, to program the pulse generator with at least one selected detection enhancement from the available detection enhancements associated with the at least one clinical rhythm, and to program the pulse generator with at least one parameter for the at least one selected detection enhancement; and

a display connected to the control logic to provide a number of screen displays used by the user to select the at least one clinical rhythm and modify the selection of the at least one detection enhancement from at least one preprogrammed detection enhancement to at least one other detection enhancement from the available detection enhancements associated with the at least one clinical rhythm,

wherein the at least one selected detection enhancement is automatically seeded with a value for the at least one parameter, and the number of screen displays are used by the user to change the value for the at least one parameter,

wherein the number of screen displays are layered such a first screen display provides the user with the ability to select the at least one detection enhancement, and a second screen provides the user with the ability to change the value for the at least one parameter,

wherein the first screen includes a number of tachyarrhythmia zones, and the number of tachyarrhythmia zones ranges between one and three zones as determined by a user input, and

wherein each of the number of tachyarrhythmia zones includes a therapy button, and selecting the therapy button displays the second screen used to change therapy parameters for the number of tachyarrhythmia zones.

44. A programmer for a user to program a pulse generator with detection enhancements for use by the pulse generator to detect a clinical rhythm and apply therapy for the detected clinical rhythm, comprising:

a communications module for communicating with the pulse generator;

control logic for programming the pulse generator using the communications module, wherein the control logic is adapted to program the pulse generator to detect and provide therapy for at least one clinical rhythm, to associate the clinical rhythm with available detection enhancements, to program the pulse generator with at least one selected detection enhancement from the available detection enhancements associated with the at least one clinical rhythm, and to program the pulse generator with at least one parameter for the at least one selected detection enhancement; and

a display connected to the control logic to provide a number of screen displays used by the user to select the at least one clinical rhythm and modify the selection of the at least one detection enhancement from at least one preprogrammed detection enhancement to at least one other detection enhancement from the available detection enhancements associated with the at least one clinical rhythm,

wherein the detection enhancements include at least one inhibit therapy enhancement for inhibiting the therapy for the at least one clinical rhythm, and

wherein the detection enhancements include at least one override enhancement for overriding the inhibit therapy enhancement.

45. The programmer of claim 44, wherein the at least one inhibit therapy enhancement includes an AFib Rate Threshold enhancement for inhibiting ventricular therapy when a detected atrial rhythm is faster than a threshold.

46. The programmer of claim 44, wherein the at least one inhibit therapy enhancement includes a Stability enhancement for inhibiting ventricular therapy when a detected atrial rhythm is determined to be unstable.

47. The programmer of claim 44, wherein the at least one inhibit therapy enhancement includes an Onset enhancement for inhibiting a therapy when a detected rate increases gradually.

48. The programmer of claim 44, wherein the at least one override inhibit enhancement includes a V Rate >

A Rate enhancement for delivering therapy when a detected ventricular rate is greater than a detected atrial rate.

49. The programmer of claim 44, wherein the at least one override inhibit enhancement includes a Shock if Unstable enhancement when a ventricular rhythm is determined to be unstable.

50. The programmer of claim 44, wherein the at least one override inhibit enhancement includes a Sustained Rate Duration (SRD) enhancement for overriding an inhibit therapy enhancement when a detected rate continues throughout a programmed time period.