Systems and methods for the generation and display of fusion statistics

• US 8,494,619 B2
• Filed: 05/17/2010
• Issued: 07/23/2013
• Est. Priority Date: 05/27/2009
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Schulte, Theodore J., Dong, Yanting, Shome, Shibaji, Patangay, Abhilash
• Primary Examiner(s): Bertram, Eric D.
• Application Number:
  US12/781,411
• Publication Number:
  US 20100305646A1
• Time in Patent Office: 1,163 Days
• Field of Search: 600/509
• US Class Current: 600/509
• CPC Class Codes: A61B 5/35 by template matching
• CPC Class Codes: A61B 5/7264 Classification of physiological signals or data, e.g. using neural networks, statistical classifiers, expert systems or fuzzy systems neural networks per se G06N3/00; expert systems per se G06N5/00
• CPC Class Codes: A61N 1/3627 for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy
• CPC Class Codes: A61N 1/371 Capture, i.e. successful stimulation
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems

Abstract

In an example, a cardiac rhythm management system includes an implantable physiological data monitor, a processor, a memory, and a display. The implantable physiological data monitor can be configured to monitor a plurality of cardiac responses. The processor can be configured to classify the cardiac response into one of at least three classes including pace-dominant, fusion, and pseudo-fusion. The processor can also be configured to calculate statistical information regarding the classified cardiac responses. In this example, the pace-dominant, fusion, and pseudo-fusion classes correspond to a cardiac response resulting from a corresponding electrostimulation. The memory is configured to store the classified cardiac responses and calculated statistical information for future use by the processor or for display. The display is configured to display the statistical information stored in the memory for diagnostic and device programming purposes.

Claims

1. A cardiac rhythm management system, the system comprising:

an implantable physiological data monitor configured to monitor a plurality of cardiac responses and a physiological parameter including at least one of heart rate, respiration rate, blood pressure, or posture;

a processor configured to classify the cardiac responses into one of at least three classes including pace-dominant, fusion, and pseudo-fusion classes and calculate statistical information regarding the classified cardiac responses, wherein the pace-dominant, fusion, and pseudo-fusion classes correspond to a cardiac response resulting from a corresponding electrostimulation, wherein the processor is configured to correlate the calculated statistical information with the physiological parameter;

a memory configured to store the classified cardiac responses, the physiological parameter, and the calculated statistical information for future use by the processor or for display; and

a display configured to display in a graphical format the calculated statistical information in correlation with the physiological parameter.

2. The cardiac rhythm management system of claim 1, wherein the processor is further configured to use at least one of the cardiac responses stored in the memory to control a parameter of the implantable cardiac rhythm management device.

3. The cardiac rhythm management system of claim 1, wherein the processor is configured to use a series of cardiac responses stored in the memory to control a parameter of the implantable cardiac rhythm management device.

4. The cardiac rhythm management system of claim 1, wherein the processor is further configured to use the statistical information about the cardiac responses stored in the memory to control a parameter of the implantable cardiac rhythm management device.

5. The cardiac rhythm management system of claim 1, wherein the processor is further configured to use the statistical information about the cardiac responses stored in the memory to provide programming recommendations;

and

wherein the display is configured to display the programming recommendations.

6. The cardiac rhythm management system of claim 1, wherein the processor is further configured to use the statistical information about the cardiac responses stored in the memory to send an alert to the display.

7. The cardiac rhythm management system of claim 1, wherein the cardiac responses are measured using electrograms, each electrogram including a depolarization.

8. The cardiac rhythm management system of claim 7, wherein the implantable physiological data monitor is configured to monitor a plurality of sensed intrinsic depolarizations and a plurality of evoked response depolarizations, the processor is configured to classify the plurality of sensed intrinsic depolarizations and the plurality of evoked response depolarizations and calculate statistical information about the plurality of classified depolarizations, and the memory is configured to store at least the statistical information about the plurality of classified depolarizations.

9. The cardiac rhythm management system of claim 8, wherein:

the memory is configured to store the physiological parameter; and

an external computing device is configured to correlate the statistics with the physiological parameter and display the results in a graphical format.

10. The cardiac rhythm management system of claim 8, wherein the processor is further configured to classify the depolarizations according to at least one of heart chamber, right versus left side of heart, or atrial versus ventricular heart chamber.

11. The cardiac rhythm management system of claim 8, wherein the processor is further configured to classify the depolarizations by comparing the depolarization morphology to a template stored in the memory, wherein the stored template enables discrimination between classes.

12. A method comprising:

monitoring, using an implantable cardiac rhythm management device, a plurality of cardiac responses and a physiological parameter including at least one of heart rate, respiration rate, blood pressure, or posture;

classifying, using a processor, the cardiac responses into one of at least three classes including pace-dominant, fusion, and pseudo-fusion classes, wherein the pace-dominant, fusion, and pseudo-fusion classes correspond to a cardiac response resulting from a corresponding electrostimulation;

calculating statistical information about the classifications;

correlating the calculated statistical information with the physiological parameter;

storing the classified cardiac responses, the physiological parameter, and the calculated statistical information in a memory; and

displaying in a graphical format on an external device at least the calculated statistical information in correlation with the physiological parameter.

13. The method of claim 12, including programming a parameter of the implantable cardiac rhythm management device using the statistical information about the cardiac responses.

14. The method of claim 12, wherein the calculating includes trending the statistical information over an interval of time.

15. The method of claim 14, wherein the interval of time allows for monitoring, classifying and calculating over a period of time representative of a chronic condition.

16. The method of claim 12, wherein the displaying includes numeric displays and graphical displays.

17. The method of claim 12, wherein monitoring a plurality of cardiac responses includes collecting electrograms associated with each cardiac response, wherein each electrogram includes a depolarization.

18. The method of claim 17, wherein the monitoring comprises monitoring a plurality of sensed intrinsic depolarizations and a plurality of evoked response depolarizations, the classifying comprises classifying the plurality of sensed intrinsic depolarizations and the plurality of evoked response depolarizations, and calculating statistical information about the classifications.

19. The method of claim 17, wherein the classifying the depolarizations comprises also classifying according to at least one of heart chamber, right versus left side of heart, or atrial versus ventricular heart chamber.

20. The method of claim 17, wherein the classifying the depolarizations comprises comparing each depolarization morphology to a stored template, wherein the stored template enables discrimination between the classes.

21. The method of claim 17, wherein the classifying the depolarization comprises comparing a depolarization morphology to a plurality of stored templates, wherein each stored template enables identification of one or more of the classes.

22. The method of claim 12, further including automatically programming a parameter of the implantable cardiac rhythm management device using the calculated statistical information;

and

wherein the programmed parameter is displayed in association with the calculated statistical information used to program the parameter.