System and method for determining atrial arrhythmia burden

• US 8,768,443 B2
• Filed: 03/03/2009
• Issued: 07/01/2014
• Est. Priority Date: 03/03/2008
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Lindh, Par, Fellows, Donovan Benton
• Primary Examiner(s): BOCKELMAN, MARK
• Application Number:
  US12/396,718
• Publication Number:
  US 20090222056A1
• Time in Patent Office: 1,946 Days
• Field of Search: 607/14, 607/15, 607/30, 600/515, 600/518
• US Class Current: 600/515
• CPC Class Codes: A61N 1/3621 for treating or preventing abnormally high heart rate
• CPC Class Codes: A61N 1/3624 occurring in the atrium, i.e. atrial tachycardia
• CPC Class Codes: A61N 1/37282 characterised by communication with experts in remote locations using a network

Abstract

A system and method for determining atrial arrhythmia burden is provided. Consecutive sets of parametric data regularly obtained from an implantable medical device through remote interrogation are centrally maintained. An atrial arrhythmia burden is determined. A cumulative atrial tachyarrhythmia (AT) duration is identified for each atrial arrhythmia episode recorded in the parametric data over a fixed look back period. One of an AT mode switch time and maximum atrial tachyarrhythmia AT duration are evaluated respectively subject to the duration between the consecutive sets being of sufficient length and a change having occurred to the maximum AT duration.

Claims

1. An external patient management system for determining atrial arrhythmia burden, comprising:

an external database configured to centrally maintain sets of parametric data obtained from an implantable medical device through interrogation;

the external patient management system configured to execute an analysis module to calculate an atrial arrhythmia burden, the analysis module comprising;

an episode submodule configured to identify a cumulative atrial tachyarrhythmia duration for each atrial tachyarrhythmia episode recorded in the parametric data over a look back period, wherein the duration of the look back period is measured from the time of the end of each atrial tachyarrhythmia episode if the atrial tachyarrhythmia episode has concluded before interrogation of the implanted device or from the time of interrogation of the implanted device if the most recent atrial tachyarrhythmia episode is still in progress at the time of interrogation; and

a counter submodule configured to evaluate therapy duration counter data obtained from the implantable medical device.

2. The system of claim 1, wherein the look back period comprises 12 hours.

3. The system of claim 1, wherein the look back period comprises 24 hours.

4. The system of claim 1, wherein the counter submodule only evaluates therapy duration counter data obtained from the implantable medical device if the analysis module fails to calculate an atrial arrhythmia burden exceeding a threshold value based on cumulative atrial tachyarrhythmia durations for each atrial tachyarrhythmia episode recorded in the parametric data over a look back period.

5. The system of claim 1, the therapy duration counter data comprising at least one selected from the group consisting of total atrial tachyarrhythmia mode switch time, lifetime maximum atrial tachyarrhythmia duration, and reset maximum atrial tachyarrhythmia duration.

6. The system of claim 5, wherein lifetime maximum atrial tachyarrhythmia duration is only evaluated if the analysis module fails to calculate an atrial arrhythmia burden exceeding a threshold value based on evaluation of total atrial tachyarrhythmia mode switch time.

7. The system of claim 6, wherein reset maximum atrial tachyarrhythmia duration is only evaluated if the analysis module fails to calculate an atrial arrhythmia burden exceeding a threshold value based on evaluation of lifetime maximum atrial tachyarrhythmia duration.

8. The system of claim 5, wherein a user-specifiable length of time must have elapsed between consecutive interrogations of the implantable medical device in order for the external patient management system to determine that an atrial arrhythmia burden threshold has been met.

9. The system of claim 5, further comprising:

an evaluation submodule configured to select the lifetime maximum atrial tachyarrhythmia duration counter value comprised in the most recent parametric data set as an atrial tachyarrhythmia duration for calculation of atrial arrhythmia burden, if the value of the lifetime maximum atrial tachyarrhythmia duration counter is greater than a recorded lifetime maximum atrial tachyarrhythmia duration counter value from a previous implantable medical device interrogation.

10. The system of claim 5, further comprising:

an evaluation submodule configured to select the reset maximum atrial tachyarrhythmia duration counter value comprised in the most recent parametric data set as an atrial tachyarrhythmia duration for calculation of atrial arrhythmia burden, if the value of the reset maximum atrial tachyarrhythmia duration counter is greater than a recorded reset maximum atrial tachyarrhythmia duration counter value from a previous implantable medical device interrogation.

11. The system of claim 1, the analysis module configured to generate an atrial arrhythmia burden alert if the atrial arrhythmia burden as calculated by the analysis module exceeds a threshold value.