Cardiac rhythm management system with exercise test interface

• US 8,027,726 B2
• Filed: 03/09/2009
• Issued: 09/27/2011
• Est. Priority Date: 09/22/2003
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Ternes, David
• Primary Examiner(s): EVANISKO, GEORGE ROBERT
• Application Number:
  US12/400,603
• Publication Number:
  US 20090177100A1
• Time in Patent Office: 932 Days
• Field of Search: 607 17- 19, 607/59, 607/30, 600/508, 600523-525, 600/519, 600/520, 600/513, 600/510
• US Class Current: 607/30
• CPC Class Codes: A61B 5/0006 ECG or EEG signals
• CPC Class Codes: A61B 5/0205 Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
• CPC Class Codes: A61B 5/021 Measuring pressure in heart or blood vessels A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/02405 Determining heart rate variability
• CPC Class Codes: A61B 5/029 Measuring or recording blood output from the heart, e.g. minute volume A61B8/065 takes precedence
• CPC Class Codes: A61B 5/11 Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb for measuring pulse A61B5/02 ;A61B5/1038 takes precedence; motion detection to correct for motion artifacts in physiological signals A61B5/721
• CPC Class Codes: A61B 5/333 Recording apparatus specially adapted therefor
• CPC Class Codes: A61B 5/35 by template matching
• 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 5/4884 inducing physiological or psychological stress, e.g. applications for stress testing
• CPC Class Codes: A61N 1/3702 Physiological parameters A61N1/365 takes precedence; evoked response A61N1/371

Abstract

This document discusses, among other things, cardiac rhythm management systems, devices, and methods providing an exercise test interface. A patient exercise episode is identified using at least one predetermined criteria. Data associated with the episode is obtained. A summary of the episode is displayed for a user. The displayed summary includes at least one prognostic indicator obtained from the data associated with the episode. Examples of prognostic indicators include, among other things, ectopic beats, runs of ectopic beats, rate of decrease of heart rate during a post-exercise recovery portion of the episode, a maximum attained heart rate for comparison to a maximum age-predicted heart rate, as well as other prognostic indicators.

Claims

1. A method comprising:

applying at least one predetermined criteria to physiological patient data;

automatically identifying a patient exercise episode using the at least one predetermined criteria applied to the physiological patient data, wherein the patient exercise episode includes an exercise period followed by a post-exercise recovery period;

obtaining heart contraction indicative data associated with the patient exercise episode;

identifying ectopic beats occurring during the post-exercise recovery period;

obtaining recovery ectopic beat data from the identified ectopic beats of the post-exercise recovery period; and

displaying a summary of the patient exercise episode, including displaying at least one prognostic indicator using or obtained from the recovery ectopic beat data associated with the post-exercise recovery period, the at least one prognostic indicator including a displayed computed number of ectopic beats occurring during the post-exercise recovery period of the patient exercise episode.

2. The method of claim 1, further comprising identifying ectopic beats occurring during the exercise period.

3. The method of claim 2, further comprising obtaining exercise ectopic beat data from the identified ectopic beats of the exercise period.

4. The method of claim 3, wherein displaying the summary of the patient exercise episode includes displaying at least one prognostic indicator obtained from the exercise ectopic beat data associated with the exercise period, the at least one prognostic indicator including a displayed computed number of ectopic beats occurring during the exercise period.

5. The method of claim 1, further comprising communicating the recovery ectopic beat data from an implantable cardiac rhythm management device within the patient.

6. The method of claim 1, wherein obtaining heart contraction indicative data includes obtaining heart rate data, wherein automatically identifying the patient exercise episode using at least one predetermined criteria includes using at least one heart rate threshold, and wherein heart rates that substantially continuously exceed the heart rate threshold define the patient exercise episode.

7. The method of claim 1, wherein displaying the at least one prognostic indicator includes displaying at least one indication of how many runs of sequential ectopic beats occurred during the patient exercise episode.

8. The method of claim 1, wherein displaying the at least one prognostic indicator includes displaying at least one indication of how many runs of sequential ectopic beats occurred during the exercise portion of the patient exercise episode.

9. The method of claim 1, wherein displaying the at least one prognostic indicator includes displaying at least one indication of how many runs of sequential ectopic beats occurred during the post-exercise recovery portion of the patient exercise episode.

10. The method of claim 1, wherein displaying the at least one prognostic indicator includes displaying an indication of a rate of decrease of the patient'"'"'s heart rate during a post-exercise recovery portion of the patient exercise episode.

11. The method of claim 1, further comprising storing the recovery ectopic beat data associated with the patient exercise episode.

12. The method of claim 1, wherein obtaining recovery ectopic beat data includes obtaining sequential ectopic beat data.

13. The method of claim 12, wherein displaying the summary of the patient exercise episode includes displaying the sequential ectopic beat data including differently displaying data indicating different numbers of sequentially-occurring ectopic beats.

14. The method of claim 13, wherein differently displaying the data includes color coding the data indicating different numbers of sequentially-occurring ectopic beats.

15. A non-transitory computer readable medium including instructions for:

applying at least one predetermined criteria to physiological patient data;

automatically identifying a patient exercise episode using the at least one predetermined criteria applied to the physiological patient data, wherein the patient exercise episode includes an exercise period followed by a post-exercise recovery period;

obtaining heart contraction indicative data associated with the patient exercise episode;

identifying ectopic beats occurring during the post-exercise recovery period;

obtaining recovery ectopic beat data from the identified ectopic beats of the post-exercise recovery period; and

displaying a summary of the patient exercise episode, including displaying at least one prognostic indicator using or obtained from the recovery ectopic beat data associated with the post-exercise recovery period, the at least one prognostic indicator including a displayed computed number of ectopic beats occurring during the post-exercise recovery period of the patient exercise episode.

16. The non-transitory computer readable medium of claim 15, further including instructions for identifying ectopic beats occurring during the exercise period.

17. The non-transitory computer readable medium of claim 16, further including instructions for obtaining exercise ectopic beat data from the identified ectopic beats of the exercise period.

18. The non-transitory computer readable medium of claim 17, wherein the instructions for displaying the summary of the patient exercise episode include displaying at least one prognostic indicator obtained from the exercise ectopic beat data associated with the exercise period, the at least one prognostic indicator including a displayed computed number of ectopic beats occurring during the exercise period.

19. The non-transitory computer readable medium of claim 18, wherein the instructions for displaying the at least one prognostic indicator includes displaying at least one indication of how many runs of sequential ectopic beats occurred during the exercise portion of the patient exercise episode.

20. The non-transitory computer readable medium of claim 15, wherein the instructions for displaying the at least one prognostic indicator includes displaying at least one indication of how many runs of sequential ectopic beats occurred during the post-exercise recovery portion of the patient exercise episode.