Noninvasive cardiac therapy evaluation

• US 9,986,928 B2
• Filed: 03/27/2014
• Issued: 06/05/2018
• Est. Priority Date: 12/09/2013
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Gillberg, Jeffrey, Ghosh, Subham
• Primary Examiner(s): D ABREU, MICHAEL JOSEPH
• Application Number:
  US14/228,009
• Publication Number:
  US 20150157231A1
• Time in Patent Office: 1,531 Days
• CPC Class Codes: A61B 5/1107 Measuring contraction of parts of the body, e.g. organ, muscle apparatus for measuring work or force in general G01L
• CPC Class Codes: A61B 5/25 Bioelectric electrodes therefor
• CPC Class Codes: A61B 5/282 Holders for multiple electrodes for introduction into the body A61B5/287
• CPC Class Codes: A61B 5/318 Heart-related electrical modalities, e.g. electrocardiography [ECG]
• 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 5/366 Detecting abnormal QRS complex, e.g. widening
• CPC Class Codes: A61B 5/6823 Trunk, e.g., chest, back, abdomen, hip
• CPC Class Codes: A61B 5/743 Displaying an image simultaneously with additional graphical information, e.g. symbols, charts, function plots
• CPC Class Codes: A61N 1/3627 for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy
• CPC Class Codes: A61N 1/36507 controlled by gradient or slope of the heart potential
• CPC Class Codes: A61N 1/368 comprising more than one electrode co-operating with different heart regions A61N1/3622, A61N1/3627 take precedence
• CPC Class Codes: A61N 1/3702 Physiological parameters A61N1/365 takes precedence; evoked response A61N1/371
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 20/40 relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: G16H 50/30 for calculating health indices; for individual health risk assessment
• CPC Class Codes: G16H 50/70 for mining of medical data, e.g. analysing previous cases of other patients
• CPC Class Codes: G16Z 99/00 Subject matter not provided for in other main groups of this subclass

Abstract

Systems, methods, and interfaces are described herein for assisting a user in noninvasive evaluation of patients for cardiac therapy and noninvasive evaluation of cardiac therapy being delivered. The systems, methods, and interfaces may provide graphical representations of cardiac electrical activation times about one or more portions of human anatomy and one or more cardiac health metrics.

Claims

1. A system for assisting in noninvasive evaluation of a patient for cardiac therapy comprising:

electrode apparatus comprising a plurality of external surface electrodes positioned in an array, wherein the electrode apparatus is configured to locate the plurality of external surface electrodes proximate the skin of the patient;

a display apparatus comprising a graphical user interface configured to present cardiac electrical activation time information and cardiac health information; and

computing apparatus coupled to the electrode apparatus and the display apparatus and configured to provide the graphical user interface displayed on the display apparatus to assist a user in noninvasively evaluating the patient for cardiac therapy, wherein the computing apparatus is further configured to;

noninvasively measure surrogate cardiac electrical activation times using one or more external surface electrodes of the plurality of external surface electrodes of the electrode apparatus proximate the patient'"'"'s skin and proximate the patient'"'"'s heart without use of an implantable device, wherein the surrogate cardiac electrical activation times are representative of depolarization of cardiac tissue that propagates through the torso of the patient,

display, on the graphical user interface, a graphical depiction of a portion of human anatomy and a map of electrical activation about the portion of human anatomy based on the measured surrogate cardiac electrical activation times that were noninvasively measured using the one or more external surface electrodes of the plurality of external surface electrodes proximate the skin of the patient without use of an implantable device,

noninvasively measure at least one metric of the patient'"'"'s cardiac health using one or more external surface electrodes of the plurality of external surface electrodes of the electrode apparatus proximate the patient'"'"'s skin and proximate the patient'"'"'s heart without use of an implantable device,

display, on the graphical user interface, the at least one metric of the patient'"'"'s cardiac health that was noninvasively measured using the one or more external surface electrodes of the plurality of external surface electrodes proximate the skin of the patient without use of an implantable device, and

display, on the graphical user interface, a likelihood of whether cardiac therapy for the patient would be beneficial based on the noninvasive measurements using the one or more external surface electrodes of the plurality of external surface electrodes of the electrode apparatus without use of an implantable device.

2. The system of claim 1, wherein displaying the graphical depiction of the measured surrogate cardiac electrical activation times about the portion of human anatomy comprises displaying a graphical depiction of the measured surrogate cardiac electrical activation times about a graphical depiction of at least one of an anterior side of a human torso and a posterior side of a human torso.

3. The system of claim 1, wherein displaying the graphical depiction of the measured surrogate cardiac electrical activation times about the portion of human anatomy comprises displaying a graphical depiction of the measured surrogate cardiac electrical activation times about a graphical depiction of at least one of an anterior side of a heart and a posterior side of a heart.

4. The system of claim 1, wherein the at least one metric comprises QRS width and electrical dyssynchrony.

5. The system of claim 1, wherein the computing apparatus is further configured to display, on the graphical user interface, at least one electrocardiogram of the patient, wherein each of the at least one electrocardiogram are captured using at least one different electrode, and wherein the at least one electrocardiogram is time-aligned on the graphical user interface.

6. The system of claim 1, wherein the computing apparatus is further configured to store the surrogate cardiac electrical activation times, the at least one metric of the patient'"'"'s cardiac health, and the at least one electrocardiogram for use in comparisons at a later time.

7. The system of claim 1, wherein the plurality of external surface electrodes are configured to be located proximate the skin of the torso of the patient.

8. The system of claim 1, wherein displaying the graphical depiction of the measured surrogate cardiac electrical activation times about the portion of human anatomy comprises color scaling the portion of human anatomy on the graphical user interface according to the measured surrogate cardiac electrical activation times.

9. A computer-implemented method for assisting in noninvasive evaluation of a patient for cardiac therapy, the method comprising:

noninvasively measuring surrogate cardiac electrical activation times using one or more external surface electrodes proximate the skin of a patient and proximate the patient'"'"'s heart without use of an implantable device, wherein the surrogate cardiac electrical activation times are representative of depolarization of cardiac tissue that propagates through the torso of the patient;

displaying, on a graphical user interface, a graphical depiction of a portion of human anatomy and a map of electrical activation about the portion of human anatomy based on the measured surrogate cardiac electrical activation times that were noninvasively measured using the one or more external surface electrodes proximate the skin of the patient without use of an implantable device;

noninvasively measuring at least one metric of the patient'"'"'s cardiac health using one or more external surface electrodes proximate the skin of a patient and proximate the patient'"'"'s heart without use of an implantable device;

displaying, on the graphical user interface, the at least one metric of the patient'"'"'s cardiac health that was noninvasively measured using the one or more external surface electrodes proximate the skin of the patient without use of an implantable device; and

displaying, on the graphical user interface, a likelihood of whether cardiac therapy for the patient would be beneficial based on the noninvasive measurements using the one or more external surface electrodes without use of an implantable device.

10. The method of claim 9, wherein displaying the graphical depiction of the measured surrogate cardiac electrical activation times about the portion of human anatomy comprises displaying a graphical depiction of the measured surrogate cardiac electrical activation times about a graphical depiction of at least one of an anterior side of a human torso and a posterior side of a human torso.

11. The method of claim 9, wherein displaying the graphical depiction of the measured surrogate cardiac electrical activation times about the portion of human anatomy comprises displaying a graphical depiction of the measured surrogate cardiac electrical activation times about a graphical depiction of at least one of an anterior side of a heart and a posterior side of a heart.

12. The method of claim 9, wherein the at least one metric comprises QRS width and electrical dyssynchrony.

13. The method of claim 9, wherein the method further comprises displaying, on the graphical user interface, at least one electrocardiogram of the patient, wherein each of the at least one electrocardiogram are captured using at least one different electrode, and wherein the at least one electrocardiogram is time-aligned on the graphical user interface.

14. The method of claim 9, wherein the method further comprises storing the surrogate cardiac electrical activation times, the at least one metric of the patient'"'"'s cardiac health, and the at least one electrocardiogram for use in comparisons at a later time.

15. The method of claim 9, wherein the one or more external surface electrodes are located proximate the skin of the torso of the patient.

16. The method of claim 9, wherein displaying the graphical depiction of the measured surrogate cardiac electrical activation times about the portion of human anatomy comprises color scaling the portion of human anatomy on the graphical user interface according to the measured surrogate cardiac electrical activation times.

17. A system for assisting in noninvasive evaluation of a patient for cardiac therapy comprising:

means for noninvasively measuring surrogate cardiac electrical activation times representative of electrical activation times of a patient'"'"'s heart from the patient'"'"'s skin without use of an implantable device, wherein the surrogate cardiac electrical activation times are representative of depolarization of cardiac tissue that propagates through the torso of the patient;

means for noninvasively measuring at least one metric of the patient'"'"'s cardiac health from the patient'"'"'s skin without use of an implantable device; and

display means for displaying, on a graphical user interface, a graphical depiction of a portion of human anatomy and a map of electrical activation about the portion of human anatomy based on the measured surrogate cardiac electrical activation times, the at least one metric of the patient'"'"'s cardiac health, and a likelihood of whether cardiac therapy for the patient would be beneficial based on the noninvasive measurements from the patient'"'"'s skin without use of an implantable device.

18. The system of claim 17, wherein displaying the graphical depiction of the measured surrogate cardiac electrical activation times about the portion of human anatomy comprises displaying at least one of a graphical depiction of the measured surrogate cardiac electrical activation times about a graphical depiction of at least one of an anterior side of a human torso and a posterior side of a human torso and a graphical depiction of the measured surrogate cardiac electrical activation times about a graphical depiction of at least one of an anterior side of a heart and a posterior side of a heart.

19. The system of claim 17, wherein the at least one metric comprises QRS width and electrical dyssynchrony.

20. The system of claim 17, wherein the display means is further for displaying, on the graphical user interface, at least one electrocardiogram of the patient, wherein each of the at least one electrocardiogram are captured using at least one different electrode, and wherein the at least one electrocardiogram is time-aligned on the graphical user interface.