Systems and methods to identify cardiac dysynchrony

• US 9,357,935 B2
• Filed: 01/24/2014
• Issued: 06/07/2016
• Est. Priority Date: 01/25/2013
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Gilkerson, James O., Hoyme, Kenneth P., Kalgren, James R., Perschbacher, David L., Peterson, Les N.
• Primary Examiner(s): Lavert, Nicole F
• Application Number:
  US14/163,087
• Publication Number:
  US 20140213859A1
• Time in Patent Office: 865 Days
• Field of Search: 600/301, 600/508
• US Class Current: 1/1
• CPC Class Codes: A61B 5/02405 Determining heart rate variability
• 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 5/686 Permanently implanted devices, e.g. pacemakers, other stimulators, biochips A61B5/6861 takes precedence
• CPC Class Codes: A61B 5/7282 Event detection, e.g. detecting unique waveforms indicative of a medical condition A61B5/4094, A61B5/4818, A61B5/349, A61B5/0823 take precedence
• CPC Class Codes: A61B 5/746 Alarms related to a physiological condition, e.g. details of setting alarm thresholds or avoiding false alarms alarms per se G08B
• CPC Class Codes: A61B 5/7475 User input or interface means, e.g. keyboard, pointing device, joystick
• CPC Class Codes: A61N 1/3627 for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy

Abstract

The current technology is relevant to a system having an implantable medical device, where the system is configured to identify a patient condition comprising cardiac dysynchrony, configured to notify a clinical user of the identified condition and configured to identify a therapy appropriate for the identified condition.

Claims

1. A method comprising:

identifying a patient condition comprising cardiac dysynchrony at intrinsic rates above a threshold using an implantable medical device;

notifying a clinical user of the identified condition;

identifying a therapy appropriate for the identified condition; and

presenting the clinical user with a selectable option to implement the therapy appropriate for the identified patient condition;

wherein identifying cardiac dysynchrony comprises analyzing at least one of heart rate variability data and cardiac output data and determining from the analysis that cardiac synchrony requires a heart rate that is greater than at least one of a programmed maximum tracking rate, a programmed maximum sensor rate and a programmed maximum pacing rate in a cardiac rhythm management device.

2. The method of claim 1, further comprising, in response to an input to disable or inappropriately modify the identified therapy, delivering an alert to a user communicating that the requested modification is inappropriate for the identified condition.

3. The method of claim 1, wherein identifying the condition comprises detecting a cardiac condition using a cardiac rhythm management device.

4. The method of claim 1, wherein notifying a clinical user of the identified condition comprises presenting an alert on a programmer.

5. The method of claim 1, wherein the threshold for intrinsic rates is the maximum tracking rate.

6. The method of claim 1 further comprising receiving data comprising at least one of patient symptom data, electronic medical record data and current programming parameters for the implantable medical device.

7. The method of claim 1 wherein notifying the clinical user of the identified condition further comprises displaying a textual rationale for the conclusion underlying the identified condition.

8. The method of claim 1, wherein the steps of the method are performed by one of a patient management system, a programming device and a remote programming device.

9. A method comprising:

identifying a patient condition comprising cardiac dysynchrony at intrinsic rates above a threshold using an implantable medical device, wherein the threshold for intrinsic rates is the maximum tracking rate;

notifying a clinical user of the identified condition;

identifying a therapy appropriate for the identified condition; and

presenting the clinical user with a selectable option to implement the therapy appropriate for the identified patient condition.

10. The method of claim 9, further comprising, in response to an input to disable or inappropriately modify the identified therapy, delivering an alert to a user communicating that the requested modification is inappropriate for the identified condition.

11. The method of claim 9, wherein identifying the condition comprises detecting a cardiac condition using a cardiac rhythm management device.

12. The method of claim 9, wherein notifying a clinical user of the identified condition comprises presenting an alert on a programmer.

13. The method of claim 9 further comprising receiving data comprising at least one of patient symptom data, electronic medical record data and current programming parameters for the implantable medical device.

14. The method of claim 9 wherein notifying the clinical user of the identified condition further comprises displaying a textual rationale for the conclusion underlying the identified condition.

15. A method comprising:

identifying a patient condition comprising cardiac dysynchrony at intrinsic rates above a threshold using an implantable medical device;

notifying a clinical user of the identified condition comprising displaying a textual rationale for the conclusion underlying the identified condition;

identifying a therapy appropriate for the identified condition; and

presenting the clinical user with a selectable option to implement the therapy appropriate for the identified patient condition.

16. The method of claim 15, further comprising, in response to an input to disable or inappropriately modify the identified therapy, delivering an alert to a user communicating that the requested modification is inappropriate for the identified condition.

17. The method of claim 15, wherein identifying the condition comprises detecting a cardiac condition using a cardiac rhythm management device.

18. The method of claim 15, wherein notifying a clinical user of the identified condition comprises presenting an alert on a programmer.

19. The method of claim 15 further comprising receiving data comprising at least one of patient symptom data, electronic medical record data and current programming parameters for the implantable medical device.

20. The method of claim 15, wherein the steps of the method are performed by one of a patient management system, a programming device and a remote programming device.