Morphology-based diagnostic monitoring of electrograms by implantable cardiac device

• US 8,509,897 B2
• Filed: 11/26/2003
• Issued: 08/13/2013
• Est. Priority Date: 09/19/2002
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Yonce, David J., Ternes, David
• Primary Examiner(s): Koharski, Christopher D
• Assistant Examiner(s): OROPEZA, FRANCES P
• Application Number:
  US10/723,254
• Publication Number:
  US 20040158165A1
• Time in Patent Office: 3,548 Days
• Field of Search: 600/373, 600/374, 600/393, 600/508, 600/509, 600/510, 600/516, 600/519, 600/521, 600/523, 607/4, 607/5, 607/9, 607/27, 607/28, 607/116, 607/119
• US Class Current: 607/28
• 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 1/3684 for stimulating the heart at multiple sites of the ventricle or the atrium
• CPC Class Codes: A61N 1/36842 Multi-site stimulation in the same chamber
• CPC Class Codes: A61N 1/36843 Bi-ventricular stimulation
• CPC Class Codes: A61N 1/3702 Physiological parameters A61N1/365 takes precedence; evoked response A61N1/371
• CPC Class Codes: A61N 1/3712 Auto-capture, i.e. automatic adjustment of the stimulation threshold
• CPC Class Codes: A61N 1/37217 characterised by the communication link, e.g. acoustic or tactile
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems

Abstract

A system and method is presented in which an implantable cardiac device is configured to generate representative electrograms which can be transmitted to an external programmer for display. A representative electrogram represents a patient'"'"'s typical electrogram during a defined time period or when a particular condition exists. Such representative electrograms may be averages or other statistical measures of electrograms recorded continuously or periodically during the defined time period or during the time when the particular condition exists.

Claims

1. A system for recording and presenting electrophysiological data, comprising:

an implantable cardiac device having a first sensing channel for sensing cardiac electrical activity and generating electrogram signals;

wherein a controller of the implantable cardiac device is programmed to;

record electrograms over a specified long-term period of time,

generate representative electrograms for each of a plurality of discrete time intervals within the specified long-term period of time, and

compute the representative electrogram for each discrete time interval as a time average of electrograms recorded during the discrete time interval only when the patient'"'"'s heart rate is within a specified range; and

,

an external programmer configured to download representative electrograms from the implantable device and display an aggregate of representative electrograms in graphical form as indexed by time.

2. The system of claim 1 wherein the representative electrograms are intrinsic electrograms.

3. The system of claim 1 wherein the representative electrograms are evoked response electrograms.

4. The system of claim 1 wherein the representative electrograms are displayed on a display screen of the external programmer.

5. The system of claim 1 wherein each of the representative electrograms is displayed as a graph of the electrogram'"'"'s magnitude with a shading or color of the graph identifying the defined time period represented by the representative electrogram.

6. The system of claim 1 wherein the controller is programmed to continuously generate representative electrograms for consecutive discrete time intervals within the long-term period of time.

7. The system of claim 6 wherein the controller is programmed to maintain a specified number of representative electrograms in memory with the oldest representative electrogram being discarded.

8. A system for recording and presenting electrophysiological data, comprising:

an implantable cardiac device having a first sensing channel for sensing cardiac electrical activity and generating electrogram signals;

wherein a controller of the implantable cardiac device is programmed to;

record electrograms over a specified long-term period of time,

generate representative electrograms for each of a plurality of heart rate ranges during the specified long-term period of time by computing each representative electrogram for a particular heart rate range as a time average of a plurality of electrograms recorded when a patient'"'"'s heart rate is within the particular heart rate range, and

compute the representative electrogram for a particular heart rate range from one or more electrograms recorded only when the patient'"'"'s heart rate is within the particular heart rate range; and

,

an external programmer configured to download representative electrograms from the implantable device and display an aggregate of representative electrograms in graphical form as indexed by the plurality of heart rate ranges.

9. The system of claim 8 wherein the representative electrograms are intrinsic electrograms.

10. The system of claim 8 wherein the representative electrograms are evoked response electrograms and wherein heart rate refers to pacing rate.

11. The system of claim 8 wherein the representative electrograms are displayed on a display screen of the external programmer.

12. The system of claim 8 wherein each of the representative electrograms are displayed as a graph of magnitude versus time or sample number with a shading or color of the graph identifying the defined heart rate range represented by the representative electrogram.