Method and apparatus for detecting noise in an implantable medical device

• US 7,715,906 B2
• Filed: 06/04/2007
• Issued: 05/11/2010
• Est. Priority Date: 06/04/2007
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Ritscher, David E., Kaszas, Cameron J., Hemming, Michael T., Kleckner, Karen J., Lu, Steven N., Krause, Paul G.
• Primary Examiner(s): Layno; Carl H
• Assistant Examiner(s): LEE, YUN H
• Application Number:
  US11/757,628
• Publication Number:
  US 20080300497A1
• Time in Patent Office: 1,072 Days
• Field of Search: 600/508, 600/509, 600/515
• US Class Current: 600/515
• CPC Class Codes: A61B 5/0031 Implanted circuitry
• CPC Class Codes: A61B 5/352 Detecting R peaks, e.g. for synchronising diagnostic apparatus; Estimating R-R interval
• CPC Class Codes: A61B 5/361 Detecting fibrillation
• CPC Class Codes: A61B 5/363 Detecting tachycardia or bradycardia
• CPC Class Codes: A61B 5/364 Detecting abnormal ECG interval, e.g. extrasystoles, ectopic heartbeats
• CPC Class Codes: A61B 5/7203 for noise prevention, reduction or removal
• CPC Class Codes: A61N 1/3704 Circuits specially adapted therefor, e.g. for sensitivity control
• CPC Class Codes: A61N 1/3925 Monitoring; Protecting
• CPC Class Codes: A61N 1/3956 Implantable devices for applying electric shocks to the heart, e.g. for cardioversion

Abstract

An implantable medical device and associated method monitor a physiological signal for sensing physiological events and detecting a physiological condition in response to the sensed physiological events. The device senses a first event from the physiological signal, senses a noise signal in the physiological signal and senses a next event from the physiological signal wherein the first event and the next event define a signal interval. The signal interval is declared as a noisy interval in response to the sensed noise signal.

Claims

1. An implantable medical device, comprising:

sensing circuitry for receiving a cardiac signal, sensing cardiac depolarization signals and measuring depolarization intervals occurring between the sensed cardiac depolarization signals;

an arrhythmia detection module for detecting arrhythmia events from the measured depolarization intervals; and

a noise detection module for sensing a noise signal in the cardiac electrical signal and declaring a depolarization interval defined by a first sensed cardiac depolarization signal and a next sensed cardiac depolarization signal as a noisy interval in response to the noise signal being sensed during the depolarization interval;

wherein the detection circuitry configured to inhibit detecting an arrhythmia event in response to the noisy depolarization interval.

2. The device of claim 1 wherein sensing the noise signal comprises sensing one or more signals exceeding a sensing threshold within a predetermined time interval of the first sensed cardiac depolarization signal.

3. The device of claim 2 further comprising threshold setting circuitry for setting the sensing threshold as an automatically adjusted threshold comprising a first threshold level and a second threshold level, the first and second threshold levels separated by a first linear decay rate and the second threshold level followed by a second linear decay rate different than the first linear decay rate.

4. The device of claim 1 wherein sensing the noise signal comprises sensing an over range signal.

5. The device of claim 4 wherein the sensing circuitry comprises an input amplifier and an analog-to-digital converter and the over range signal is a signal causing one of an input amplifier saturation, an analog-to-digital converter amplitude over range, and an analog-to-digital converter signal differential over range.

6. The device of claim 5 further comprising means for clearing the over range signal by shorting a differential feedback of the input amplifier to restore a zero input state of the input amplifier in response to the over range signal.

7. The device of claim 1 further comprising means for storing time markers of sensed signals and corresponding signal labels wherein the next sensed cardiac depolarization signal is assigned a unique label corresponding to a noisy interval.

8. The device of claim 1 wherein the arrhythmia detection module comprises an arrhythmia event interval counter that is incremented in response to a measured cardiac depolarization interval falling into a detection interval range, and

wherein the arrhythmia detection module inhibits detecting an arrhythmia event by not incrementing the arrhythmia event interval counter in response to the noisy interval.

9. The device of claim 8 wherein the arrhythmia event interval counter corresponds to one of an arrhythmia onset detection interval counter and an arrhythmia termination detection interval counter.

10. The device of claim 8 wherein not incrementing the arrhythmia event interval counter comprises decrementing the arrhythmia event interval counter by a predetermined integer.

11. The device of claim 10 wherein decrementing the arrhythmia event interval counter comprises reclassifying a most recent cardiac depolarization interval falling into the detection interval range as a non-detection interval.

12. The device of claim 1 wherein the arrhythmia detection module comprises an arrhythmia detection timer and detecting an arrhythmia event comprises starting the arrhythmia detection timer in response to the first sensed cardiac depolarization signal, and

wherein inhibiting detecting the arrhythmia event comprises restarting the arrhythmia detection timer upon the next sensed cardiac depolarization signal in response to the noisy interval.

13. The device of claim 12 wherein the arrhythmia detection module is configured to determine if the arrhythmia detection timer exceeds an arrhythmia event detection threshold in response to sensing the noise signal and detects the arrhythmia in response to the arrhythmia detection timer exceeding the detection threshold at the time of the sensed noise signal.

14. The device of claim 13 further comprising an arrhythmia duration timer and wherein the arrhythmia detection module restarts the arrhythmia duration timer upon a second next sensed cardiac depolarization signal occurring after the next sensed cardiac depolarization signal.

15. The device of claim 12 wherein the diagnostic module further configured to generate a trend in the noise burden and further comprising memory for storing cardiac signal data, wherein the diagnostic module is further configured to compare the noise burden to a trigger threshold and trigger storage of the monitored cardiac signal in the memory in response to the noise burden exceeding the trigger threshold.

16. The device of claim 12 wherein the diagnostic module further configured to determine a diagnostic metric corresponding to sensed cardiac depolarization signals and exclude the first and next sensed cardiac depolarization signals from the computing in response to the noisy interval.

17. The device of claim 1 further comprising a diagnostics module configured to determine a noise burden in response to the declared noisy interval.

18. The device of claim 17 wherein determining the noise burden comprises determining a total number of declared noisy intervals occurring over a predetermined time period.

19. The device of claim 17 wherein determining the noise burden comprises determining a total time duration of declared noisy intervals occurring over a predetermined time period.

20. The device of claim 17 wherein the diagnostics module further configured to compare the noise burden to a threshold and generate a warning in response to the noise burden exceeding the threshold.

21. A method for use in an implantable medical device, comprising:

monitoring a physiological signal for sensing physiological events and detecting a physiological condition in response to the sensed physiological events;

sensing a first event from the physiological signal;

sensing a noise signal in the physiological signal;

sensing a next event from the physiological signal wherein the first event and the next event define a signal interval;

declaring the signal interval as a noisy interval in response to the sensed noise signal occurring after the first event and prior to the next event; and

inhibiting detecting the physiological condition in response to the declared noisy interval.

22. The method of claim 21 wherein sensing the noise signal comprises sensing one or more signals exceeding a sensing threshold within a predetermined time interval of the first event.

23. The method of claim 22 wherein the sensing threshold is an automatically adjusted sensing threshold comprising a first threshold level and a second threshold level, the first and second threshold levels separated by a first linear decay rate and the second threshold level followed by a second linear decay rate different than the first linear decay rate.

24. The method of claim 22 wherein sensing the noise signal comprises detecting an over range signal, and wherein the over range signal is a signal causing one of an input amplifier saturation, an analog-to-digital converter amplitude over range, and an analog-to-digital converter signal differential over range.

25. The method of claim 24 further comprising clearing the over range signal by shorting a differential feedback of the input amplifier to restore a zero input state of the input amplifier in response to the over range signal.

26. The method of claim 21 wherein detecting the physiological condition comprises measuring the interval between sensed first event and next event and incrementing a detection counter when the measured interval corresponds to a physiological condition detection interval, and wherein inhibiting detecting the physiological condition comprises not incrementing the detection counter in response to the signal interval being declared a noisy interval.

27. The method of claim 26 wherein the detection counter corresponds to one of an onset detection counter and a termination detection counter.

28. The method of claim 26 wherein not incrementing the detection counter comprises decrementing the detection counter.