Visual representation of a cardiac signal sensing test

• US 9,468,385 B2
• Filed: 08/22/2014
• Issued: 10/18/2016
• Est. Priority Date: 08/22/2014
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Mazaeva, Natalia Y., Shallbetter, Janet L.
• Primary Examiner(s): Stice, Paula J
• Application Number:
  US14/465,984
• Publication Number:
  US 20160051159A1
• Time in Patent Office: 788 Days
• Field of Search: 600/512, 600/521, 600/523
• US Class Current: 1/1
• CPC Class Codes: A61B 5/0031 Implanted circuitry
• CPC Class Codes: A61B 5/29 for permanent or long-term implantation
• CPC Class Codes: A61B 5/341 Vectorcardiography [VCG]
• CPC Class Codes: A61B 5/7221 Determining signal validity, reliability or quality A61B5/7207 and A61B5/7217 take precedence
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means

Abstract

A medical device system for monitoring a patient'"'"'s heart includes an implantable medical device (IMD) configured to determine sensing vector data for multiple sensing vectors selected from electrodes coupled to the IMD. The system further includes an external device configured to receive the sensing vector data and provide at least a portion of the sensing vector data to a user display configured to display sensing vector criteria and the sensing vector data as part of a graphical user interface for programming a sensing vector used by the implantable medical device for monitoring a patient'"'"'s heart rhythm.

Claims

1. A method, comprising:

sensing cardiac electrical signals across a plurality of sensing vectors selected from a plurality of implantable electrodes coupled to an implantable medical device;

determining at least one sensing vector selection parameter from the sensed cardiac electrical signals for each of the plurality of sensing vectors;

wirelessly transmitting the determined sensing vector selection parameters by an implantable telemetry module;

receiving the transmitted sensing vector selection parameters by an external telemetry module of an external medical device;

providing, by an external processor coupled to the external telemetry module, sensing vector acceptability criteria and at least a portion of the sensing vector selection parameters to a user display, the sensing vector acceptability criteria comprising at least one vector acceptability threshold; and

displaying the sensing vector acceptability criteria and at least the portion of the sensing vector selection parameters as part of a graphical user interface for programming a sensing vector used by the implantable medical device for monitoring a patient'"'"'s heart rhythm,

wherein displaying the vector acceptability criteria comprises displaying the at least one vector acceptability threshold relative to at least the portion of the sensing vector selection parameters determined for each of the plurality of sensing vectors.

2. The method of claim 1, wherein providing the vector acceptability criteria further comprises providing a vector acceptability region of the vector selection parameter, the vector acceptability region defined at least in part by the vector acceptability threshold and an upper boundary,

the method further comprising displaying the sensing vector acceptability criteria as the vector acceptability region on a plot of at least the portion of the sensing vector data, the vector acceptability region representing the vector acceptability criteria.

3. The method of claim 1,

wherein displaying at least the portion of the sensing vector selection parameters comprises generating a plot of the vector selection parameters and displaying the sensing vector acceptability criteria as a region of the plot.

4. The method of claim 1, wherein determining the at least one sensing vector selection parameter comprises determining a parameter indicative of cardiac event signal strength for each of the plurality of sensing electrode vectors.

5. The method of claim 4, wherein determining the sensing vector selection parameter indicative of cardiac event signal strength comprises determining an R-wave amplitude.

6. The method of claim 1, wherein determining the at least one sensing vector selection parameter comprises determining a parameter indicative of a proportion of physiological signal content of the cardiac electrical signal for each of the plurality of sensing electrode vectors.

7. The method of claim 6, wherein determining the parameter indicative of the proportion of physiological signal content comprises determining, across a signal analysis window, a percentage of signal sample points that correspond to a slope that is less than a slope threshold.

8. The method of claim 1, further comprising automatically identifying at least one recommended sensing vector of the plurality of sensing vectors in response to the at least one sensing vector selection parameter and displaying the at least one recommended sensing vector as a pending sensing vector to be programmed in the implantable medical device by the external medical device.

9. The method of claim 1, further comprising:

determining a plurality of vector selection parameters from the sensing vector data for each of the plurality of sensing vectors;

determining a selection index from the vector selection parameters for each of the plurality of sensing vectors meeting the displayed vector acceptability criteria; and

selecting at least one recommended sensing vector of the plurality of sensing vectors in response to the determined selection indices;

displaying as part of the graphical user interface the at least one recommended sensing vector as a pending sensing vector to be programmed in the implantable medical device.

10. The method of claim 1, further comprising:

determining an R-wave amplitude from the sensing vector data for each of the plurality of sensing vectors;

determining a low slope content of the cardiac electrical signal by determining, across a cardiac signal analysis window, a proportion of cardiac electrical signal sample points corresponding to a slope that is less than a slope threshold for each of the plurality of sensing vectors,

wherein displaying at least a portion of the sensing vector data comprises displaying a point for each of the plurality of sensing vectors in a two-dimensional plot, each point for each respective one of the plurality of sensing vectors being defined by x-y coordinates corresponding to the R-wave amplitude and the determined low slope content determined for each respective one of the plurality of sensing vectors; and

displaying the vector acceptability criteria as a vector acceptability region of the two-dimensional plot, the vector acceptability region defined by an R-wave amplitude selection threshold and a low slope content selection threshold.

11. A system, comprising:

a plurality of implantable electrodes;

an implantable medical device comprising;

a sensing module configured to sense cardiac electrical signals across a plurality of sensing vectors selected from the plurality of electrodes,

a control module coupled to the sensing module and configured to determine at least one sensing vector selection parameter for each of the plurality of sensing vectors from the sensed cardiac electrical signals, and

a telemetry module configured to transmit the sensing vector selection parameters;

a user display;

an external telemetry module configured to receive the transmitted sensing vector selection parameters;

an external processor coupled to the user display and the external telemetry module, the external processor configured to provide sensing vector acceptability criteria and at least a portion of the sensing vector selection parameters to the user display, the sensing vector acceptability criteria comprising at least one vector acceptability threshold;

the user display configured to display the sensing vector acceptability criteria and the sensing vector selection parameters received from the external processor as part of a graphical user interface for programming a sensing vector used by the implantable medical device for monitoring a patient'"'"'s heart rhythm,

the user display configured to display the sensing vector acceptability criteria by displaying the at least one vector acceptability threshold relative to at least the portion of the sensing vector selection parameters determined for each of the plurality of sensing vectors.

12. The system of claim 11, wherein;

the external processor is configured to provide the sensing vector acceptability criteria by providing a vector acceptability region of the vector selection parameter, the vector acceptability region defined at least in part by the vector acceptability threshold and an upper boundary,

the user display is configured to display the sensing vector acceptability criteria by displaying the vector acceptability region on a plot of at least the portion of the sensing vector data, the vector acceptability region representing the vector acceptability criteria.

13. The system of claim 11,

wherein the user display is configured to display at least the portion of the sensing vector selection parameters by generating a plot of the vector selection parameters and to display the sensing vector acceptability criteria as a region of the plot.

14. The system of claim 11, wherein determining the at least one sensing vector selection parameter comprises determining a parameter indicative of cardiac event signal strength for each of the plurality of sensing electrode vectors.

15. The system of claim 14, wherein determining the sensing vector selection parameter indicative of cardiac event signal strength comprises determining an R-wave amplitude.

16. The system of claim 11, wherein determining the at least one sensing vector selection parameter comprises determining a parameter indicative of a proportion of physiological signal content of the cardiac electrical signal for each of the plurality of sensing electrode vectors.

17. The system of claim 16, wherein determining the parameter indicative of the proportion of physiological signal content comprises determining, across a signal analysis window, a percentage of signal sample points that correspond to a slope that is less than a slope threshold.

18. The system of claim 11, wherein the external processor is further configured to identify at least one recommended sensing vector of the plurality of sensing vectors in response to the at least one sensing vector selection parameter and provide the recommended sensing vector to the user display, the user display configured to display the recommended sensing vector as a pending sensing vector to be programmed in the implantable medical device.

19. The system of claim 11, wherein at least one of the control module of the implantable medical device and the external processor is configured to:

determine a plurality of vector selection parameters from the sensing vector data for each of the plurality of sensing vectors;

determine a selection index from the plurality of vector selection parameters for each of the plurality of sensing vectors meeting the vector acceptability criteria; and

select at least one recommended sensing vector of the plurality of sensing vectors in response to the determined selection indices;

provide the at least one recommended sensing vector to the user display;

wherein the user display is configured to display as part of the graphical user interface the at least one recommended sensing vector as a pending sensing vector to be programmed in the implantable medical device.

20. The system of claim 11, wherein at least one of the control module of the implantable medical device and the external processor is configured to:

determine an R-wave amplitude from the cardiac electrical signals for each of the plurality of sensing vectors, and

determine a low slope content of the cardiac electrical signal for each of the plurality of sensing vectors by determining, across a cardiac signal analysis window, a proportion of cardiac electrical signal sample points corresponding to a slope that is less than a slope threshold,

wherein the user display is configured to;

display a point for each of the plurality of sensing vectors in a two-dimensional plot, each point for each respective one of the plurality of sensing vectors being defined by x-y coordinates corresponding to the R-wave amplitude and the low slope content determined for each respective one of the plurality of sensing vectors, and

display the vector acceptability criteria as a vector acceptability region of the two-dimensional plot, the vector acceptability region defined by an R-wave amplitude selection threshold and a low slope content selection threshold.

21. The system of claim 11, wherein:

the user display is configured to;

display the sensing vector data by at least plotting the sensing vector acceptability parameter for each of the plurality of sensing vectors along an axis, and

display the sensing vector acceptability criteria by plotting a boundary of a vector acceptability region along the axis, the boundary defined by the vector acceptability threshold.

22. The system of claim 11, wherein the user display is configured to display the sensing vector acceptability criteria and the sensing vector data in a plot by:

displaying a point for each of the plurality of sensing vectors in the plot, each point for each respective one of the plurality of sensing vectors being defined by plot coordinates corresponding to the at least one sensing vector selection parameter determined for each respective one of the plurality of sensing vectors, and

displaying a boundary corresponding to the at least one vector acceptability threshold value in the plot relative to the displayed points.

23. A non-transitory, computer-readable medium storing a set of instructions, which when executed by a processor of a medical device system causes the system to:

sense cardiac electrical signals across a plurality of sensing vectors selected from a plurality of implantable electrodes coupled to an implantable medical device;

determine at least one sensing vector selection parameter from the sensed cardiac electrical signals for each of the plurality of sensing vectors;

wirelessly transmit the determined sensing vector selection parameters by an implantable telemetry module;

receive the transmitted sensing vector selection parameters by an external telemetry module of an external medical device;

provide, by an external processor coupled to the external telemetry module, sensing vector acceptability criteria and at least a portion of the sensing vector selection parameters to a user display, the sensing vector acceptability criteria comprising at least one vector acceptability threshold; and

display the sensing vector acceptability criteria and at least the portion of the sensing vector selection parameters as part of a graphical user interface for programming a sensing vector used by the implantable medical device for monitoring a patient'"'"'s heart rhythm,

wherein displaying the sensing vector acceptability criteria comprises displaying the at least one vector acceptability threshold relative to at least the portion of the sensing vector selection parameters determined for each of the plurality of sensing vectors.