Electrogram summary

• US 8,744,560 B2
• Filed: 09/30/2011
• Issued: 06/03/2014
• Est. Priority Date: 09/30/2011
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Gunderson, Bruce D., Kleckner, Karen J., Ousdigian, Kevin T., Patel, Amisha S., Sanchez, Julian
• Primary Examiner(s): PATTON, AMANDA K
• Application Number:
  US13/250,676
• Publication Number:
  US 20130085406A1
• Time in Patent Office: 977 Days
• Field of Search: 600/518, 600/508
• US Class Current: 600/518
• CPC Class Codes: A61B 5/0031 Implanted circuitry
• CPC Class Codes: A61B 5/076 Permanent implantations telemetry using implanted circuitry A61B5/0031; implanted stimulators for therapy A61N1/3605, A61N1/362, A61N1/372
• CPC Class Codes: A61B 5/339 Displays specially adapted therefor
• CPC Class Codes: A61B 5/349 Detecting specific parameters of the electrocardiograph cycle
• 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 5/7217 of noise originating from a therapeutic or surgical apparatus, e.g. from a pacemaker
• 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 1/37247 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

The present disclosure is directed to generating and displaying an electrogram (EGM) summary for use by physicians or other clinicians. An implantable medical device (IMD) transmits EGM signal data for a number of cardiac episodes to an external computing device. The external computing device selects a subset of the cardiac episodes for which information or images are displayed to the user. In various examples, cardiac episodes may be selected for display based at least in part on a retrospective analysis classification of the cardiac episode.

Claims

1. A method comprising:

receiving cardiac electrogram (EGM) signal data from an implantable medical device (IMD), the EGM signal data including a plurality of detected cardiac episodes, each of the plurality of cardiac episodes classified by the IMD as at least one of a ventricular tachycardia/ventricular fibrillation (VT/VF) episode, a supraventricular tachycardia (SVT) episode, a ventricular tachycardia non-sustained (VTNS) episode, an atrial tachycardia/atrial fibrillation (AT/AF) episode, a monitored VT episode, or a ventricular oversensing (VOS) episode;

conducting a retrospective analysis of each of the plurality of cardiac episodes, the retrospective analysis providing a retrospective analysis classification;

using at least one processor, creating, for each cardiac episode category, a subset of the plurality of cardiac episodes, each subset including greater than or equal to one episode and less than or equal to a predetermined number of episodes; and

selecting, using the at least one processor, a respective subset of the plurality of cardiac episodes for display based at least in part on at least one of the IMD classification and the retrospective analysis classification.

2. The method of claim 1, further comprising displaying a thumbnail of a portion of the EGM signal for each of the subset of the plurality of cardiac episodes.

3. The method of claim 2, further comprising selecting the portion of the EGM signal in the thumbnail based on a portion of the EGM signal used to make the retrospective analysis classification.

4. The method of claim 1, further comprising displaying information associated with the respective subset of the plurality of cardiac episodes selected for display.

5. The method of claim 4, wherein the information displayed for the respective subset of the plurality of cardiac episodes includes an indication of the IMD classification and an indication of the retrospective analysis classification.

6. The method of claim 4, wherein the information displayed for the respective subset of the plurality of cardiac episodes includes notes, generated by a processor, regarding a basis for the retrospective analysis classification.

7. The method of claim 1, further comprising prioritizing each type of IMD classification based on EGM summary rules, and displaying the selected cardiac episodes based at least in part on the prioritization.

8. The method of claim 7, further comprising prioritizing the selected cardiac episodes within each IMD classification type based on EGM summary rules.

9. The method of claim 1, wherein selection of the respective subset of cardiac episodes is based at least in part on both the IMD classification and the retrospective analysis classification.

10. The method of claim 1, further comprising selecting, from the plurality of cardiac episodes, one or more VT/VF episodes with a unique morphology.

11. The method of claim 1, wherein the respective subset of the plurality of cardiac episodes comprises each of the plurality of cardiac episodes with a conflicting IMD classification and retrospective analysis classification.

12. The method of claim 1, wherein the predetermined number of episodes varies among each cardiac episode category.

13. The method of claim 1, wherein the predetermined number of episodes is substantially a same among each cardiac episode category.

14. The method of claim 1, wherein the predetermined number of episodes for a respective subset of a respective cardiac episode category is less than a total number of episodes for the respective cardiac episode category.

15. The method of claim 1, wherein selecting, using the processor, the respective subset of the plurality of cardiac episodes for display based at least in part on at least one of the IMD classification and the retrospective analysis classification comprises automatically selecting, using the processor, the respective subset of the plurality of cardiac episodes for display based at least in part on at least one of the IMD classification and the retrospective analysis classification.

16. A system comprising:

a communication module configured to receive electrogram (EGM) signal data from an implantable medical device, the EGM signal data including a plurality of cardiac episodes, each of the plurality of each of the plurality of cardiac episodes classified by the implantable medical device as at least one of a ventricular tachycardia/ventricular fibrillation (VT/VF) episode, a supraventricular tachycardia (SVT) episode, a ventricular tachycardia no stimulation (VTNS) episode, an atrial tachycardia/atrial fibrillation (AT/AF) episode, a monitored VT episode, or a ventricular oversensing (VOS) episode;

a processor configured to;

conduct a retrospective analysis for each of the plurality of cardiac episodes, the retrospective analysis providing a retrospective analysis classification;

create, for each cardiac episode category, a subset of the plurality of cardiac episodes, each subset including greater than or equal to one episode and less than or equal to a predetermined number of episodes; and

select a respective subset of the plurality of cardiac episodes for display based at least in part on at least one of the implantable medical device classification and the retrospective analysis classification; and

a graphical user interface configured to display a summary of the selected respective subset of the plurality of cardiac episodes.

17. The system of claim 16, wherein graphical user interface is further configured to display a thumbnail of a portion of the EGM signal for each of the subset of the plurality of cardiac episodes.

18. The system of claim 17, wherein the processor is further configured to select the portion of the EGM signal in the thumbnail based on a portion of the EGM signal used to make the retrospective analysis classification.

19. The system of claim 16, further comprising a graphical user interface configured to display information associated with each of the respective subset of the plurality of cardiac episodes selected for display.

20. The system of claim 19, wherein the information displayed for each of the respective subset of the plurality of cardiac episodes includes an indication of the IMD classification and an indication of the retrospective analysis classification.

21. The system of claim 19, wherein the information displayed for each of the respective subset of the plurality of cardiac episodes includes notes, generated by the processor, regarding a basis for the retrospective analysis classification.

22. The system of claim 16, wherein the processor is further configured to prioritize each type of IMD classification for display on the graphical user interface, and the graphical user interface is further configured to display the selected cardiac episodes based at least in part on the prioritization.

23. The system of claim 22, wherein the processor is further configured to prioritize each type of IMD classification based on EGM summary rules.

24. The system of claim 16, wherein the processor is further configured to select, from the plurality of cardiac episodes, one or more VT/VF episodes with a unique morphology.

25. The system of claim 16, wherein the processor is further configured to select as part of the subset each of the plurality of cardiac episodes with a conflicting IMD classification and retrospective analysis classification.

26. The system of claim 16, wherein the processor is further configured to select the respective subset of cardiac episodes is based at least in part on both the IMD classification and the retrospective analysis classification.

27. The system of claim 16, wherein the predetermined number of episodes varies among each cardiac episode category.

28. The system of claim 16, wherein the predetermined number of episodes is substantially a same among each cardiac episode category.

29. The system of claim 16, wherein the predetermined number of episodes for a respective subset of a respective cardiac episode category is less than a total number of episodes for the respective cardiac episode category.

30. The system of claim 16, wherein the processor is configured to automatically select the respective subset of the plurality of cardiac episodes for display based at least in part on at least one of the IMD classification and the retrospective analysis classification.

31. A computer-readable medium containing instructions, the instructions cause a programmable processor to:

receive cardiac electrogram (EGM) signal data from an implantable medical device (IMD), the EGM signal data including a plurality of detected cardiac episodes, each of the plurality of cardiac episodes classified by the IMD as at least one of a ventricular tachycardia/ventricular fibrillation (VT/VF) episode, a supraventricular tachycardia (SVT) episode, a ventricular tachycardia non-sustained (VTNS) episode, an atrial tachycardia/atrial fibrillation (AT/AF) episode, a monitored VT episode, or a ventricular oversensing (VOS) episode;

conduct a retrospective analysis of each of the plurality of cardiac episodes, the retrospective analysis providing a retrospective analysis classification;

create, for each cardiac episode category, a subset of the plurality of cardiac episodes, each subset including greater than or equal to one episode and less than or equal to a predetermined number of episodes; and

select a respective subset of the plurality of cardiac episodes for display based at least in part on at least one of the IMD classification and the retrospective analysis classification.

32. A system comprising

means for receiving cardiac electrogram (EGM) signal data from an implantable medical device (IMD), the EGM signal data including a plurality of detected cardiac episodes, each of the plurality of cardiac episodes classified by the IMD as at least one of a ventricular tachycardia/ventricular fibrillation (VT/VF) episode, a supraventricular tachycardia (SVT) episode, a ventricular tachycardia non-sustained (VTNS) episode, an atrial tachycardia/atrial fibrillation (AT/AF) episode, a monitored VT episode, or a ventricular oversensing (VOS) episode;

means for conducting a retrospective analysis of each of the plurality of cardiac episodes, the retrospective analysis providing a retrospective analysis classification;

means for creating, for each cardiac episode category, a subset of the plurality of cardiac episodes, each subset including greater than or equal to one episode and less than or equal to a predetermined number of episodes; and

means for selecting, using a processor, a subset of the plurality of cardiac episodes for display based at least in part on at least one of the IMD classification and the retrospective analysis classification.