Clustering with combined physiological signals

• US 8,768,446 B2
• Filed: 04/26/2006
• Issued: 07/01/2014
• Est. Priority Date: 11/02/2004
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Drew, Touby A., Werder, Jonathan C., Giftakis, Jonathon E., Panken, Eric J.
• Primary Examiner(s): Schaetzle, Kennedy
• Assistant Examiner(s): LEE, ERICA SHENGKAI
• Application Number:
  US11/411,712
• Publication Number:
  US 20060195039A1
• Time in Patent Office: 2,988 Days
• Field of Search: 600/509, 600/513, 600/523, 600/544, 607/30, 607/59
• US Class Current: 600/544
• CPC Class Codes: A61B 5/0006 ECG or EEG signals
• CPC Class Codes: A61B 5/0031 Implanted circuitry
• CPC Class Codes: A61B 5/24 Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
• CPC Class Codes: A61B 5/316 Modalities, i.e. specific diagnostic methods
• CPC Class Codes: A61B 5/4094 Diagnosing or monitoring seizure diseases, e.g. epilepsy
• CPC Class Codes: A61B 5/7232 involving compression of the physiological signal, e.g. to extend the signal recording period
• CPC Class Codes: A61N 1/3614 based on impedance measurement
• CPC Class Codes: A61N 1/36146 specified by the stimulation parameters
• CPC Class Codes: A61N 1/36521 the parameter being derived from measurement of an electrical impedance
• CPC Class Codes: A61N 1/36585 controlled by two or more physical parameters
• CPC Class Codes: A61N 1/3702 Physiological parameters A61N1/365 takes precedence; evoked response A61N1/371
• CPC Class Codes: A61N 1/37252 Details of algorithms or data aspects of communication system, e.g. handshaking, transmitting specific data or segmenting data
• CPC Class Codes: A61N 1/37282 characterised by communication with experts in remote locations using a network
• CPC Class Codes: A61N 1/3925 Monitoring; Protecting
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: G16H 40/67 for remote operation
• CPC Class Codes: G16H 50/70 for mining of medical data, e.g. analysing previous cases of other patients

Abstract

Methods of generating an extended cluster are disclosed. A first cluster including data representative of a first signal indicative of an abnormal physiological symptom is generated. A second signal is detected as representing a second abnormal physiological symptom and the second abnormal physiological symptom continues after the first abnormal physiological symptom ends. An extended cluster including the data from the first signal and the second signal is generated that extends from the time when the first abnormal physiological symptom occurs to the time when the second abnormal physiological symptom ends. The first and the extended cluster may include data of both the first and second signals the entire period of the clusters. If desired, the first signal or the second signal may be provided from a sensor implanted in a patient'"'"'s brain tissue.

Claims

1. A method of generating an extended cluster by an implanted medical device, comprising:

(A) beginning recording of data based on a first signal exceeding a first threshold, the first signal comprising a signal received from a first monitoring element in a first anatomical location, wherein the exceeding of the first threshold by the first signal indicates a first abnormal physiological symptom indicative of an epileptic seizure;

(B) determining that the first signal ceases to exceed the first threshold;

(C) checking whether a second signal from a second monitoring element located in a second anatomical location continues to exceed a second threshold once the first signal ceases to exceed the first threshold;

(D) combining the first and the second signals together to generate the extended cluster if the check determines that the second signal continues to exceed the second threshold, the extended cluster comprising;

(i) a first section of the first signal that exceeds the first threshold;

(ii) a section of the second signal that exceeds the second threshold; and

(iii) a second section of the first signal recorded when the second signal continued to exceed the second threshold but after the first signal ceased to exceed the first threshold; and

(E) saving the extended cluster in memory, wherein steps (A)-(E) are each performed at least in part by a medical device.

2. The method of claim 1, wherein the first monitoring element is selected from the list consisting of an EEG sensor, an ECG sensor, a pressure sensor, an acoustic sensor, an oxygen sensor;

a temperature sensor, a Doppler ultrasound sensor, a blood parameter sensor and a strain gauge sensor.

3. The method of claim 1, wherein at least one of the first threshold and the second threshold comprises a level of a parameter of a processed signal and a duration of time.

4. The method of claim 1, wherein one of the first and second anatomical locations is a patient'"'"'s head and the other of the first and second anatomical locations is the patient'"'"'s chest.

5. The method of claim 1, wherein the recording of the data in (A) comprises:

(i) sensing that the first signal from the first monitoring element has an elevated level; and

(ii) loop recording at least the first signal.

6. The method of claim 5, wherein the determining in (B) comprises determining that the loop recording is complete, and checking in (C) comprises sensing that the second signal received from the second monitoring element is indicative of the epileptic seizure.

7. The method of claim 1, wherein the second signal exceeding the second threshold is indicative of tachycardia.

8. The method of claim 1, wherein the recording of data comprises loop recording.

9. The method of claim 1, wherein the extended cluster is extended until the second signal ceases to exceed the second threshold.

10. A method of generating an extended seizure cluster, comprising:

(A) detecting a characteristic of a first signal from a first sensor implanted in a patient'"'"'s brain as exceeding a threshold level, wherein the exceeding of the first threshold by the first signal indicates an epileptic seizure;

(B) generating a first cluster including data representative of the first signal received from first sensor, the data representative of the epileptic seizure;

(C) determining that a second signal from a second sensor exceeds a second threshold after determining that the first cluster is complete based on the first signal ceasing to exceed the threshold level, the second sensor configured to detect a different physiological symptom than the first sensor;

(D) generating an extended cluster based on the determination that the second signal exceeds the second threshold, the extended cluster including the first cluster and data representative of a section of the second signal that exceeded the second threshold and a section of the first signal sensed after the first cluster was complete while the second signal exceeded the second threshold; and

(E) saving the extended cluster in memory, wherein steps (A)-(E) are each performed at least in part by a medical device.

11. The method of claim 10, wherein the characteristic of the first signal is selected from the group consisting of peak amplitude, rate of change in peak amplitude;

energy level, energy level in a frequency band, and wave shape.

12. The method of claim 10, wherein the first signal from the first sensor is a plurality of signals from a plurality of sensors and the first threshold level is a percentage of the plurality of signals having a signal parameter level above a predetermined level.

13. The method of claim 10, wherein the determining in (C) comprises:

(i) sensing the second signal exceeds the second threshold, the second threshold being indicative of a cardiac symptom; and

(ii) determining that the cardiac symptom is representative of a cardiac abnormality associated with the first signal.

14. The method of claim 10, wherein the generating in (D) comprises:

(i) recording the first and the second signals until the second signal level ceases to exceed the second threshold; and

(ii) combining the first signal and the second signal to form the extended cluster.

15. The method of claim 10, wherein the extended cluster is extended until the second signal ceases to exceed the second threshold.

16. The method of claim 10, wherein the second signal exceeding the second threshold is indicative of tachycardia.

17. A method of generating an extended cluster, comprising:

(A) recording a first signal from a first sensor based on the first signal indicating a first abnormal physiological symptom indicative of an epileptic seizure;

(B) detecting a second signal from a second sensor indicating a second abnormal physiological symptom;

(C) after the first signal ceases to indicate the first abnormal physiological symptom, recording at least the second signal and the first signal based on the second signal indicating the second abnormal symptom, wherein neither of the first and second signals are recorded following the first signal ceasing to indicate the first abnormal physiological symptom if the second signal does not indicate the second abnormal symptom;

(D) combining the recordings of the first signal and the second signal to create the extended cluster; and

(E) saving the extended cluster in memory, wherein steps (A)-(E) are each performed at least in part by a medical device;

wherein the second abnormal symptom is representative of tachycardia.

18. The method of claim 17, wherein the detecting in (B) comprises:

(i) determining that the first signal is no longer indicating that the first abnormal physiological symptom is ongoing; and

(ii) determining that the second signal is beginning to indicate the second abnormal physiological symptom.

19. The method of claim 17, wherein recording the first signal and recording the second signal comprises loop recording the first signal and the second signal.