Techniques for data reporting in an implantable medical device

• US 8,478,417 B2
• Filed: 11/02/2005
• Issued: 07/02/2013
• Est. Priority Date: 11/02/2004
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Drew, Touby A., Giftakis, Jonathon E., Graves, Nina M., Werder, Jonathan C., Carlson, David L.
• Primary Examiner(s): Patel, Niketa
• Assistant Examiner(s): EL-KAISSI, HIBA CARINE
• Application Number:
  US11/264,860
• Publication Number:
  US 20060095092A1
• Time in Patent Office: 2,799 Days
• Field of Search: None
• US Class Current: 607/59
• CPC Class Codes: A61B 5/0006 ECG or EEG signals
• CPC Class Codes: A61B 5/0031 Implanted circuitry
• CPC Class Codes: A61B 5/02055 Simultaneously evaluating both cardiovascular condition and temperature
• CPC Class Codes: A61B 5/021 Measuring pressure in heart or blood vessels A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/024 Detecting, measuring or recording pulse rate or heart rate A61B5/0205, A61B5/021 take precedence
• CPC Class Codes: A61B 5/031 Intracranial pressure
• CPC Class Codes: A61B 5/0816 Measuring devices for examining respiratory frequency measuring frequency of electric signals G01R23/00
• CPC Class Codes: A61B 5/1118 Determining activity level
• CPC Class Codes: A61B 5/165 Evaluating the state of mind, e.g. depression, anxiety
• CPC Class Codes: A61B 5/24 Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
• CPC Class Codes: A61B 5/316 Modalities, i.e. specific diagnostic methods
• CPC Class Codes: A61B 5/33 specially adapted for cooperation with other devices
• CPC Class Codes: A61B 5/37 Intracranial electroencephalography [IC-EEG], e.g. electrocorticography [ECoG]
• CPC Class Codes: A61B 5/4082 Diagnosing or monitoring movement diseases, e.g. Parkinson, Huntington or Tourette
• CPC Class Codes: A61B 5/4094 Diagnosing or monitoring seizure diseases, e.g. epilepsy
• CPC Class Codes: A61B 5/686 Permanently implanted devices, e.g. pacemakers, other stimulators, biochips A61B5/6861 takes precedence
• CPC Class Codes: A61B 5/7232 involving compression of the physiological signal, e.g. to extend the signal recording period
• CPC Class Codes: A61B 5/7282 Event detection, e.g. detecting unique waveforms indicative of a medical condition A61B5/4094, A61B5/4818, A61B5/349, A61B5/0823 take precedence
• CPC Class Codes: A61N 1/36132 using patient feedback
• CPC Class Codes: A61N 1/3614 based on impedance measurement
• CPC Class Codes: A61N 1/36521 : the parameter being derived from measurement of an electrical impedance
• CPC Class Codes: A61N 1/36585 : controlled by two or more physical parameters
• CPC Class Codes: A61N 1/3702 : Physiological parameters A61N1/365 takes precedence; evoked response A61N1/371
• CPC Class Codes: A61N 1/37252 : Details of algorithms or data aspects of communication system, e.g. handshaking, transmitting specific data or segmenting data
• CPC Class Codes: A61N 1/37282 : characterised by communication with experts in remote locations using a network
• CPC Class Codes: G06F 16/2272 : Management thereof
• CPC Class Codes: G16H 10/60 : for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 10/65 : stored on portable record carriers, e.g. on smartcards, RFID tags or CD
• CPC Class Codes: G16H 20/30 : relating to physical therapies or activities, e.g. physiotherapy, acupressure or exercising
• CPC Class Codes: G16H 40/63 : for local operation
• CPC Class Codes: G16H 40/67 : for remote operation

Abstract

Methods and apparatus for storing data records associated with a medical monitoring event in a data structure. An implanted device obtains data and stores the data in the data record in a first data structure that is age-based. Before an oldest data record is lost, the oldest data record may be stored in a second data structure that is priority index-based. The priority index may be determined by a severity level and may be further determined by associated factors. The implanted device may organize, off-load, report, and/or display a plurality of data records based on an associated priority index. Additionally, the implanted device may select a subset or composite of physiologic channels from the available physiologic channels based on a selection criterion.

Claims

1. A method for reporting neurologic data of a plurality of-neurologic events from an implantable medical device to an external device, comprising:

(A) obtaining a plurality of data records which include indications of a plurality of neurologic events with the implantable medical device, the plurality of neurologic events associated with a seizure condition;

(B) respectively assigning a plurality of severity levels to the plurality of data records with the implantable medical device, the severity levels respectively assigned to the data records based upon the indications of the plurality of neurologic events, the plurality of severity levels indicative of relative severity of the plurality of neurologic events;

(C) determining a priority index for the plurality of data records with the implantable medical device, wherein the determination of the priority index depends upon the plurality of severity levels respectively assigned to the plurality of data records;

(D) selecting a set of data records from the plurality of data records for transferring to the external device, the selection based upon the data records of the selected set being higher in the priority index than the other data records of the plurality of data records; and

(E) communicating the set of selected data records from the implantable medical device to the external device via telemetry.

2. The method of claim 1, further comprising:

(F) displaying portions of at least one of the selected data records of the set.

3. The method of claim 1, wherein the severity level is determined based on a duration characteristic of the plurality of neurologic events.

4. The method of claim 1, wherein (D) comprises selecting the data records of the set by selecting the data records that are greater in the priority index than a predetermined level of the priority index.

5. The method of claim 1, wherein the severity level is determined based on a spread characteristic of the plurality of neurologic events.

6. The method of claim 1, wherein the priority index further depends on an external event that is associated with the plurality of neurologic events.

7. The method of claim 6, wherein the external event is selected from the group consisting of a cardiac event, a scheduling event, a patient-initiated event, a physician-initiated event, and a device-based event.

8. The method of claim 1, wherein (D) is performed such that the number of data records of the set is limited to a predetermined number.

9. The method of claim 1, wherein the severity level is determined based on a statistic of a neurological signal associated with the plurality of neurologic events.

10. The method of claim 1, wherein the priority index further depends on a correlated characteristic of the plurality of neurologic events.

11. The method of claim 10, wherein the correlated characteristic is selected from the group consisting of a related physiological event type, an external event type, and a corresponding severity level of a related physiological event.

12. The method of claim 1, wherein determining the priority index comprises:

determining the relative chronological occurrence of the plurality of neurologic events;

determining a composite severity measure based on the relative chronological occurrence of the plurality of neurologic events; and

determining the priority index using the composite severity measure.

13. The method of claim 1, wherein the number of data records of the set of data records is limited by information provided by a user.

14. The method of claim 1, wherein the severity level is determined based on seizure duration of the plurality of neurologic events.

15. The method of claim 14, wherein (C) comprises:

(E)(i) uplinking data associated with the selected data record.

16. The method of claim 15, further comprising:

repeating (D)(i) and (E)(i).

17. The method of claim 14, further comprising:

(F) releasing memory space previously allocated to the set of selected data records.

18. The method of claim 17, wherein (F) comprises:

(i) marking the memory space for deletion.

19. The method of claim 17, wherein (F) comprises:

(i) deleting the data associated with the set of selected data records.

20. The method of claim 1, further comprising:

(F) forming a collection of identified events from the plurality of data records;

(G) determining a composite severity measure of the collection of identified events;

and wherein the priority index is dependent on the determined composite severity measure of the collection of identified events.

21. The method of claim 19, wherein an identified event is selected from the group consisting of a cardiac event, a neurological event, a patient input, a caregiver input, and another physiologic event.

22. The method of claim 19, wherein determining the composite severity measure comprises determining the composite severity measure based on the severity level of each data record of the plurality of data records and a relative chronology of occurrence of the collection of identified events.

23. An implantable apparatus for reporting physiologic data of a plurality of neurologic events to an external component, comprising:

(A) a processing component;

(B) sensing circuitry configured to obtain a collection of data records which include indications of a plurality of neurologic events, the plurality of neurologic events associated with a seizure condition;

(C) memory;

(D) computer executable instructions stored in the memory and executable by the processing component to cause the implantable apparatus to;

(i) respectively assign a plurality of severity levels to the data records of the collection of data records, the severity levels respectively assigned to the data records based on the indications of the plurality of neurologic events, the plurality of severity levels indicative of relative severity of the plurality of neurologic events;

(ii) determine a priority index for the collection of data records, the priority index determined based on the plurality of severity levels of the collection of data records; and

(iii) select a number of data records from the collection of data records for transferring externally from the implantable apparatus, the selected data records being selected based on being higher in the priority index than the other data records of the collection of data records; and

(E) a telemetry module configured to communicate the selected data records to the external component via telemetry.

24. The implantable apparatus of claim 23, further comprising:

an external device configured to receive and display the data associated with the selected data records.

25. The implantable apparatus of claim 23, wherein the priority index determined in (D)(ii) is determined based on seizure duration of the plurality of neurologic events.