System and method for establishing episode profiles of detected tachycardia episodes

• US 8,483,813 B2
• Filed: 06/30/2010
• Issued: 07/09/2013
• Est. Priority Date: 06/30/2010
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Zhang, Xusheng, Stadler, Robert W., Hettrick, Douglas A.
• Primary Examiner(s): Bertram, Eric D.
• Application Number:
  US12/826,916
• Publication Number:
  US 20120004566A1
• Time in Patent Office: 1,105 Days
• Field of Search: 600/515, 607/14
• US Class Current: 600/515
• CPC Class Codes: A61B 5/363 Detecting tachycardia or bradycardia
• CPC Class Codes: A61N 1/3621 for treating or preventing abnormally high heart rate
• CPC Class Codes: A61N 1/39622 Pacing therapy

Abstract

A medical device and associated method sense a cardiac signal and initiate an arrhythmia episode detection process in response to the cardiac signal by enabling an arrhythmia detection counter to be adjusted during the detection process. Data is accumulated relating to cardiac events during the detection process. An arrhythmia episode profile is established using the accumulated data. The accumulated data includes a pattern of the adjustment of the detection counter during the detection process.

Claims

1. A method, comprising:

sensing a cardiac signal;

initiating an arrhythmia episode detection process in response to the cardiac signal by enabling an arrhythmia detection counter to be adjusted during the detection process;

accumulating data relating to cardiac events during the detection process;

establishing an arrhythmia episode profile using the accumulated data; and

discriminating between arrhythmia episode types in response to the established profile, wherein accumulating data comprises determining a pattern of the adjustment of the counter during the detection process, wherein determining the pattern of the adjustment comprises storing a notation on each cardiac cycle during the detection process indicating a direction of a counter value change as being one of up, down and no change.

2. The method of claim 1, wherein establishing the episode profile comprises storing a plurality of categorical and quantitative episode parameters using the accumulated data.

3. The method of claim 1, further comprising:

determining a correlation between a previously stored summary profile and the established episode profile; and

classifying the established episode profile in response to the correlation.

4. The method of claim 3, wherein the established episode profile comprises a plurality of profile parameters, and wherein determining the correlation comprises:

determining a correlation between each of the plurality of profile parameters of the established episode profile to a respective profile parameter of the summary profile; and

computing a distance between the established profile and the summary profile in response to the determined correlations of the plurality of profile parameters.

5. The method of claim 4, further comprising updating the stored summary profile in response to the correlation between the previously stored summary profile and the established episode profile.

6. The method of claim 5, further comprising:

storing the summary profile in an implantable medical device; and

transferring the summary profile to a replacement implantable medical device.

7. The method of claim 4, further comprising:

receiving expert truth input indicating a correct match between an individual profile and a previously stored summary profile; and

updating the stored summary profile in response to the expert truth input.

8. The method of claim 4, further comprising selecting a therapy in response to the correlation.

9. The method of claim 8, further comprising updating the established episode profile in response to the selected therapy and an outcome of the selected therapy.

10. The method of claim 9, further comprising:

updating the summary profile in response to the updated established profile; and

adjusting a programmed menu of therapies in response to the updated summary profile.

11. The method of claim 8, further comprising determining a profile trend in response to the updated summary profile.

12. The method of claim 4, further comprising cancelling a discrimination algorithm in response to the correlation.

13. The method of claim 1, further comprising deriving from the stored notations a summary metric indicating the pattern of adjustment.

14. A medical device, comprising:

a plurality of electrodes sensing a cardiac signal; and

a processor configured to initiate an arrhythmia episode detection process in response to the cardiac signal by enabling an arrhythmia detection counter to be adjusted during the detection process, accumulate data relating to cardiac events during the detection process, establish an arrhythmia episode profile using the accumulated data, and discriminate between arrhythmia episode types in response to the established profile, wherein accumulating data comprises determining a pattern of the adjustment of the counter during the detection process, wherein determining the pattern of the adjustment of the counter comprises storing a notation on each cardiac cycle during the detection process indicating a direction of a counter value change as being one of up, down and no change.

15. The device of claim 14, wherein establishing the episode profile comprises storing a plurality of categorical and quantitative episode parameters using the accumulated data.

16. The device of claim 14, wherein the processor is further configured to determine a correlation between a previously stored summary profile and the established episode profile, and classify the established episode profile in response to the correlation.

17. The device of claim 16, wherein the established episode profile comprises a plurality of profile parameters, and wherein the processor is further configured to determine a correlation between each of the plurality of profile parameters of the established episode profile to a respective profile parameter of the summary profile and compute a distance between the established profile and the summary profile in response to the determined correlations of the plurality of profile parameters.

18. The device of claim 17, wherein the processor is further configured to update the stored summary profile in response to the correlation between the previously stored summary profile and the established episode profile.

19. The device of claim 18, further comprising a telemetry circuit to transfer the summary profile to a replacement implantable medical device.

20. The device of claim 17 further comprising a user interface to receive expert truth input indicating a correct match between an individual profile and a previously stored summary profile, wherein the processor is further configured to update the stored summary profile in response to the expert truth input.

21. The device of claim 17, further comprising a therapy delivery module, wherein the processor is configured to select a therapy in response to the correlation.

22. The device of claim 21, wherein the processor is further configured to update the established episode profile in response to the selected therapy and an outcome of the selected therapy.

23. The device of claim 22, wherein the processor is further configured to update the summary profile in response to the updated established profile and adjust a programmed menu of therapies in response to the updated summary profile.

24. The device of claim 22, wherein the processor is further configured to determine a profile trend in response to the updated summary profile.

25. The device of claim 17, wherein the processor is further configured to cancel a discrimination algorithm in response to the correlation.

26. A non-transitory computer-readable medium storing a set of instructions which cause a processor of a medical device to:

sense a cardiac signal;

initiate an arrhythmia episode detection process in response to the cardiac signal by enabling an arrhythmia detection counter to be adjusted during the detection process;

accumulate data relating to cardiac events during the detection process;

establish an arrhythmia episode profile using the accumulated data; and

discriminate between arrhythmia episode types in response to the established profile, wherein accumulating data comprises determining a pattern of the adjustment of the counter during the detection process, wherein determining the pattern of the adjustment comprises storing a notation on each cardiac cycle during the detection process indicating a direction of a counter value change as being one of up, down and no change.