Methods of providing neural markers for sensed autonomic nervous system activity

• US 7,640,057 B2
• Filed: 04/25/2005
• Issued: 12/29/2009
• Est. Priority Date: 04/25/2005
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Stahmann, Jeffrey E., Kramer, Andrew P., Libbus, Imad, Linder, William J.
• Primary Examiner(s): Layno; Carl H
• Assistant Examiner(s): ANTHONY, JESSICA LYNN
• Application Number:
  US11/113,773
• Publication Number:
  US 20060241697A1
• Time in Patent Office: 1,709 Days
• Field of Search: 600544-546, 600300-301, 600/523, 607 44- 46, 607/48, 607/60, 607/62, 607/3
• US Class Current: 607/2
• CPC Class Codes: A61B 5/24 Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
• CPC Class Codes: A61B 5/4035 Evaluating the autonomic nervous system
• CPC Class Codes: A61B 5/4047 afferent nerves, i.e. nerves that relay impulses to the central nervous system
• CPC Class Codes: A61B 5/4052 efferent nerves, i.e. nerves that relay impulses from the central nervous system
• CPC Class Codes: A61B 5/726 using Wavelet transforms
• CPC Class Codes: A61N 1/36135 using physiological parameters
• 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 1/37 Monitoring; Protecting
• CPC Class Codes: A61N 1/3702 Physiological parameters A61N1/365 takes precedence; evoked response A61N1/371
• CPC Class Codes: A61N 1/37217 characterised by the communication link, e.g. acoustic or tactile
• CPC Class Codes: A61N 1/37235 Aspects of the external programmer

Abstract

In various method embodiments, a neural activity signal is sensed, a feature from the sensed neural activity signal is extracted, and a neural marker for the extracted feature is created. The neural marker includes information regarding the extracted feature. Various device embodiments comprise a port to receive a neural activity signal, and a feature extractor adapted to receive and process the neural activity signal to produce a neural marker that includes information for the neural activity signal. Various device embodiments comprise a display, a memory adapted to store a neural marker associated with a sensed neural activity signal, and a controller adapted to communicate with the memory and the display to provide a representation of the neural marker on the display.

Claims

1. A method, comprising:

sensing nerve traffic representative of autonomic nervous system (ANS) activity using an implantable medical device (IMD);

extracting features from the sensed nerve traffic;

creating ANS neural markers for the extracted features, the ANS neural markers including information for the ANS neural markers regarding the extracted features; and

displaying a list of the ANS neural markers using an external device, including displaying both labels for the ANS neural markers and the information for the ANS neural markers in the list, wherein displaying the information for the ANS neural markers in the list includes displaying events correlated with the ANS neural markers in the list.

2. The method of claim 1, wherein extracting features includes filtering the sensed nerve traffic.

3. The method of claim 2, wherein filtering includes applying a wavelet transformation to the sensed nerve traffic.

4. The method of claim 2, wherein filtering includes applying a frequency-based filter to the sensed nerve traffic.

5. The method of claim 2, wherein filtering includes rectifying the sensed nerve traffic.

6. The method of claim 2, wherein filtering includes applying a moving window average to the sensed nerve traffic.

7. The method of claim 2, wherein filtering includes applying a logarithmic averaging to the sensed nerve traffic.

8. The method of claim 2, wherein filtering includes averaging repeated signals that are aligned to an index event.

9. The method of claim 1, wherein extracting features includes correlating the sensed nerve traffic to an event.

10. The method of claim 9, wherein the event includes an application of a therapy.

11. The method of claim 9, wherein the event includes a sensed event.

12. The method of claim 1, wherein extracting features includes comparing a parameter of the sensed nerve traffic to at least one programmable value.

13. The method of claim 1, wherein the information includes labels for the extracted features.

14. The method of claim 1, wherein the information includes time stamps for the extracted features.

15. The method of claim 1, wherein the information includes an indicator of a location for the ANS activity.

16. The method of claim 1, wherein the information includes an indicator of a neural pathway type.

17. The method of claim 1, wherein the information includes information regarding a correlated event.

18. The method of claim 1, wherein the information includes information regarding at least one parameter of the sensed nerve traffic representative of ANS activity.

19. The method of claim 1, further comprising automatically adjusting an applied therapy based on the neural marker using the IMD or using the external device to communicate to the IMD, wherein the IMD is configured to apply the therapy.

20. The method of claim 1, further comprising automatically providing status information for an applied therapy based on the ANS neural markers using the IMD or using the external device to communicate to the IMD, wherein the IMD is configured to apply the therapy.

21. The method of claim 20, wherein displaying the information for the ANS neural markers includes displaying information regarding correlated events associated with the sensed nerve traffic.

22. The method of claim 20, further comprising forming ANS neurograms from the sensed nerve traffic, wherein displaying the information for the ANS neural markers includes displaying a segment of each of the ANS neurograms for a time period determined by a time stamp of the ANS neural markers.

23. The method of claim 1, further comprising storing the neural markers in a memory, including automatically storing a neural marker in the memory in response to a trigger produced for at least one predetermined feature extracted from the sensed nerve traffic.

24. The method of claim 23, further comprising storing the neural markers in the memory in response to a user-initiated trigger.

25. The method of claim 1, further comprising forming ANS neurograms from the sensed nerve traffic, and displaying portions of the ANS neurograms with a representation identifying the ANS neural markers within the ANS neurograms.

26. The method of claim 25, further comprising selecting one of the ANS neural markers in the list to display portions of one of the ANS neurograms corresponding to the selected ANS neural markers.

27. The method of claim 25, further comprising using a time stamp for the ANS neural markers to determine ANS neurogram segments to be displayed.

28. The method of claim 1, wherein displaying the information for the ANS neural markers in the list includes displaying time information for the ANS neural markers in the list.

29. The method of claim 1, wherein displaying the information for the ANS neural markers in the list includes displaying locations of the sensed nerve traffic from which the ANS neural markers are created.

30. The method of claim 1, wherein displaying the information for the ANS neural markers in the list includes displaying neural pathway identifiers to identify neural pathways of the sensed nerve traffic.

31. The method of claim 30, wherein the neural pathway identifiers include an afferent pathway identifier or an efferent pathway identifier.

32. The method of claim 1, wherein displaying the information for the ANS neural markers in the list includes displaying amplitudes of signals corresponding to the sensed nerve traffic.

33. The method of claim 1, wherein displaying the information for the ANS neural markers in the list includes displaying frequencies of signals corresponding to the sensed nerve traffic.

34. A method, comprising:

sensing nerve traffic representative of autonomic nervous system (ANS) activity using an implantable medical device (IMD);

extracting features from the sensed nerve traffic;

creating ANS neural markers for the extracted features, the ANS neural markers including information for the ANS neural markers regarding the extracted features;

displaying a list of the ANS neural markers using an external device, including displaying both labels for the ANS neural markers and the information for the ANS neural markers in the list; and

automatically providing status information for an applied therapy based on the ANS neural markers using the IMD or using the external device to communicate to the IMD, wherein the IMD is configured to apply the therapy.

35. The method of claim 34, wherein displaying the information for the ANS neural markers includes displaying information regarding correlated events associated with the sensed nerve traffic.

36. The method of claim 34, further comprising forming ANS neurograms from the sensed nerve traffic, wherein displaying the information for the ANS neural markers includes displaying a segment of each of the ANS neurograms for a time period determined by a time stamp of the ANS neural markers.

37. A method, comprising:

sensing nerve traffic representative of autonomic nervous system (ANS) activity using an implantable medical device (IMD);

extracting features from the sensed nerve traffic;

creating ANS neural markers for the extracted features, the ANS neural markers including information for the ANS neural markers regarding the extracted features;

displaying a list of the ANS neural markers using an external device, including displaying both labels for the ANS neural markers and the information for the ANS neural markers in the list;

forming ANS neurograms from the sensed nerve traffic; and

displaying portions of the ANS neurograms with a representation identifying the ANS neural markers within the ANS neurograms.

38. The method of claim 37, further comprising selecting one of the ANS neural markers in the list to display portions of one of the ANS neurograms corresponding to the selected ANS neural marker.

39. The method of claim 37, further comprising using a time stamp for the ANS neural markers to determine ANS neurogram segments to be displayed.

40. A method, comprising:

sensing nerve traffic representative of autonomic nervous system (ANS) activity using an implantable medical device (IMD);

extracting features from the sensed nerve traffic;

creating ANS neural markers for the extracted features, the ANS neural markers including information for the ANS neural markers regarding the extracted features; and

displaying a list of the ANS neural markers using an external device, including displaying both labels for the ANS neural markers and the information for the ANS neural markers in the list, wherein the information includes an indicator of a location for the ANS activity.

41. A method, comprising:

sensing nerve traffic representative of autonomic nervous system (ANS) activity using an implantable medical device (IMD);

extracting features from the sensed nerve traffic;

creating ANS neural markers for the extracted features, the ANS neural markers including information for the ANS neural markers regarding the extracted features; and

displaying a list of the ANS neural markers using an external device, including displaying both labels for the ANS neural markers and the information for the ANS neural markers in the list, wherein the information includes an indicator of a neural pathway type.

42. A method, comprising:

sensing nerve traffic representative of autonomic nervous system (ANS) activity using an implantable medical device (IDM);

extracting features from the sensed nerve traffic;

creating ANS neural markers for the extracted features, the ANS neural markers including information for the ANS neural markers regarding the extracted features; and

displaying a list of the ANS neural markers using an external device, including displaying both labels for the ANS neural markers and the information for the ANS neural markers in the list, wherein displaying the information for the ANS neural markers in the list includes displaying locations of the sensed nerve traffic from which the ANS neural markers are created.

43. A method, comprising:

sensing nerve traffic representative of autonomic nervous system (ANS) activity using an implantable medical device (IMD);

extracting features from the sensed nerve traffic;

creating ANS neural markers for the extracted features, the ANS neural markers including information for the ANS neural markers regarding the extracted features; and

displaying a list of the ANS neural markers using an external device, including displaying both labels for the ANS neural markers and the information for the ANS neural markers in the list, wherein displaying the information for the ANS neural markers in the list includes displaying neural pathway identifiers to identify neural pathways of the sensed nerve traffic.

44. The method of claim 43, wherein the neural pathway identifiers include an afferent pathway identifier or an efferent pathway identifier.

45. A method, comprising:

sensing nerve traffic representative of autonomic nervous system (ANS) activity using an implantable medical device (IMD);

extracting features from the sensed nerve traffic;

creating ANS neural markers for the extracted features, the ANS neural markers including information for the ANS neural markers regarding the extracted features; and

displaying a list of the ANS neural markers using an external device, including displaying both labels for the ANS neural markers and the information for the ANS neural markers in the list, wherein displaying the information for the ANS neural markers in the list includes displaying frequencies of signals corresponding to the sensed nerve traffic.