Method and apparatus for post-processing of episodes detected by a medical device

• US 7,894,883 B2
• Filed: 11/28/2006
• Issued: 02/22/2011
• Est. Priority Date: 11/28/2005
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Patel, Amisha Somabhai, Brown, Mark L., Gunderson, Bruce D.
• Primary Examiner(s): Layno; Carl H
• Assistant Examiner(s): Stice; Paula J
• Application Number:
  US11/564,120
• Publication Number:
  US 20070167986A1
• Time in Patent Office: 1,547 Days
• Field of Search: 600/509, 600/510, 600/518, 600/519, 600/523, 600/515, 607/27, 607/5, 607/6, 607/59
• US Class Current: 600/509
• CPC Class Codes: A61B 2560/0271 using a remote monitoring unit
• CPC Class Codes: A61B 5/0006 ECG or EEG signals
• CPC Class Codes: A61B 5/0031 Implanted circuitry
• CPC Class Codes: A61B 5/349 Detecting specific parameters of the electrocardiograph cycle
• CPC Class Codes: A61B 5/35 by template matching
• CPC Class Codes: A61N 1/368 comprising more than one electrode co-operating with different heart regions A61N1/3622, A61N1/3627 take precedence
• CPC Class Codes: A61N 1/3702 Physiological parameters A61N1/365 takes precedence; evoked response A61N1/371
• CPC Class Codes: A61N 1/3706 Pacemaker parameters stimulation threshold A61N1/371
• CPC Class Codes: A61N 1/37211 Means for communicating with stimulators
• CPC Class Codes: A61N 1/3925 Monitoring; Protecting
• CPC Class Codes: A61N 1/39622 Pacing therapy
• CPC Class Codes: G16H 40/67 for remote operation

Abstract

A system and method for post-processing of sensing data generated by a medical device that includes transmitting a plurality of stored sensing data generated by a medical device to an access device, the stored sensing data including sensed atrial events and sensed ventricular events. The access device determines, in response to the transmitted data, instances where the medical device identified a cardiac event being detected in response to the sensing data, and verifies, in response to the transmitted data, whether the determined instances should have been identified by the medical device as a cardiac event being detected.

Claims

1. A method of post-processing of sensing data generated by and stored within an implantable medical device, comprising:

receiving the sensing data from the implantable medical device with an external access device, wherein the sensing data includes sensed atrial events and sensed ventricular events;

determining, with the external access device, in response to the received data, instances where the implantable medical device identified a cardiac event being detected in response to the sensing data; and

verifying, with the external access device, in response to the received data, whether the determined instances should have been identified by the implantable medical device as the cardiac event being detected,

wherein verifying whether the determined instances should have been identified by the implantable medical device as the cardiac event being detected comprises classifying, with the external access device the cardiac event as one of ventricular tachycardia, ventricular fibrillation, supraventricular tachycardia, or unknown, wherein classifying the cardiac event is based on one or more of;

determining, with the external access device, whether the sensed atrial events were both spontaneous and regular;

determining, with the external access device, a ratio of sensed atrial events to sensed ventricular events in response to determining that the sensed atrial events were both spontaneous and regular;

determining, with the external access device, whether the sensed atrial events are evenly distributed with the sensed ventricular events in response to determining that the ratio of sensed atrial events to sensed ventricular events is 1;

1, wherein determining whether the sensed atrial events are evenly distributed with the sensed ventricular events comprises determining whether there is only one sensed atrial event located between each adjacent pair of sensed ventricular events;

determining, with the external access device, whether there was an abrupt onset of the cardiac event in response to determining that the sensed atrial events were not evenly distributed with the sensed ventricular events;

determining, with the external access device, whether one of the sensed ventricular events or the sensed atrial events initiated conduction of a heart associated with the sensing data during the cardiac event in response to determining that there was an abrupt onset of the cardiac event;

comparing, with the external access device, morphologies of intervals within the cardiac event in response to determining that the ratio of sensed atrial events to sensed ventricular events is not 1;

1.

2. The method of claim 1, wherein comparing morphologies of intervals further comprises generating a template in response to correlated morphologies of adjacent intervals prior to a detection interval corresponding to the cardiac being identified as the cardiac event and a morphology of the detection interval.

3. The method of claim 2, wherein generating a template comprises:

determining whether a morphology of a first interval has a predetermined correlation with a morphology of a detection interval, wherein the first interval is both prior in time to and immediately adjacent to the detection interval;

identifying the morphology of the first interval as being the same as the morphology of the detection interval in response to the morphology of the first interval having the predetermined correlation with the detection interval; and

identifying the morphology of the first interval as being other than the morphology of the detection interval in response to the morphology of the first interval not having the predetermined correlation with the detection interval.

4. The method of claim 3, wherein generating a template further comprises:

determining whether a morphology of a second interval has a predetermined correlation with one or more of the morphology of the detection interval or the morphology of the first interval, wherein the second interval is both prior in time to and immediately adjacent to the first interval;

identifying the morphology of the second interval as being the same as the morphology of the detection interval in response to the morphology of the second interval having the predetermined correlation with the detection interval;

identifying the morphology of the second interval as being the same as the morphology of the first interval in response to the morphology of the second interval having the predetermined correlation with the first interval; and

identifying the morphology of the first interval as being other than the morphology of the detection interval and the first interval in response to the morphology of the second interval not having the predetermined correlation with either of the detection interval and the first interval.

5. The method of claim 4, wherein generating a template further comprises:

determining a greatest correlation of the correlation of the morphology of the second interval with the morphology of the first interval and of the correlation of the morphology of the second interval with the morphology of the first interval; and

identifying the morphology of the second interval as being the same as the morphology determined to have the greatest correlation.

6. A system for post-processing of sensing data associated with identification of a cardiac event, comprising:

external means for receiving sensing data generated by an implantable medical device, the sensing data including sensed atrial events and sensed ventricular events;

external means for determining, in response to the received data, instances where the medical device identified a cardiac event being detected in response to the sensing data; and

external means for verifying, in response to the received data, whether the determined instances should have been identified by the implantable medical device as the cardiac event being detected,

wherein the external means for verifying the whether the determined instances should have been identified by the implantable medical device as the cardiac event being detected comprises means for classifying the cardiac event as one of ventricular tachycardia, ventricular fibrillation, supraventricular tachycardia or unknown based on one or more of means for;

determining whether the sensed atrial events are both spontaneous and regular;

determining the ratio of sensed atrial events to sensed ventricular events in response to determining that the sensed atrial events were both spontaneous and regular;

determining whether the sensed atrial events are evenly distributed with the sensed ventricular events in response to determining that the ratio of sensed atrial events to sensed ventricular events is 1;

1, wherein determining whether the sensed atrial events are evenly distributed with the sensed ventricular events comprises determining whether there is only one sensed atrial event located between each adjacent hair of sensed ventricular events;

determining whether there is an abrupt onset of the cardiac event in response to determining that the sensed atrial events were not evenly distributed with the sensed ventricular events;

determining whether one of the sensed ventricular events or the sensed atrial events is initiating conduction of a heart associated with the stored sensing data in response to determining that there was an abrupt onset of the cardiac event;

comparing, with the external access device, morphologies of intervals within the cardiac event in response to determining that the ratio of sensed atrial events to sensed ventricular events is not 1;

1.

7. The system of claim 6, wherein comparing morphologies of intervals further comprises means for generating a template in response to correlated morphologies of adjacent intervals prior to a detection interval corresponding to the cardiac being identified as the cardiac event and a morphology of the detection interval.

8. The system of claim 7, wherein the means for generating a template comprises;

means for determining whether a morphology of a first interval of the morphology of adjacent intervals has a predetermined correlation with the morphology of a detection window, wherein the adjacent intervals are both prior in time to and immediately adjacent to the detection interval;

means for identifying the morphology of the first interval as being the same as the morphology of the detection interval in response to the morphology of the first interval having the predetermined correlation with the detection interval; and

means for identifying the morphology of the first interval as being other than the morphology of the detection interval in response to the morphology of the first interval not having the predetermined correlation with the detection interval.

9. The system of claim 8, wherein the means for generating a template further comprises:

means for determining whether a morphology of a second interval of the morphology of adjacent intervals has a predetermined correlation with one or more of the morphology of a detection window and the morphology of the first interval, wherein the adjacent intervals are both prior in time to and immediately adjacent to the first interval;

means for identifying the morphology of the second interval as being the same as the morphology of the detection interval in response to the morphology of the second interval having the predetermined correlation with the detection interval;

means for identifying the morphology of the second interval as being the same as the morphology of the first interval in response to the morphology of the second interval having the predetermined correlation with the first interval; and

means for identifying the morphology of the first interval as being other than the morphology of the detection interval and the first interval in response to the morphology of the second interval not having the predetermined correlation with either of the detection interval and the first interval.

10. The system of claim 9, wherein the means for generating a template further comprises:

means for determining the greatest correlation of the correlation of the morphology of the second interval with the morphology of the first interval and of the correlation of the morphology of the second interval with the morphology of the first interval; and

means for identifying the morphology of the second interval as being the same as the morphology determined to have the greatest correlation.