Noninvasive cardiac therapy evaluation

• US 9,993,172 B2
• Filed: 03/27/2014
• Issued: 06/12/2018
• 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:
  US14/228,024
• Publication Number:
  US 20150157232A1
• Time in Patent Office: 1,538 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 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 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 heart, wherein the surrogate cardiac electrical activation times are representative of depolarization of cardiac tissue that propagates through the torso of the patient,

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 heart,

determine whether cardiac therapy for the patient is beneficial based on a comparison of presently-measured noninvasive measurements made using the one or more external surface electrodes of the plurality of external surface electrodes and previously-measured noninvasive measurements made using the one or more external surface electrodes of the plurality of external surface electrodes of the electrode apparatus, and

simultaneously display, on the graphical user interface,

an indication of whether cardiac therapy for the patient is beneficial based on the comparison of presently-measured noninvasive measurements and previously-measured noninvasive measurements,

a graphical depiction of a portion of a first human anatomy and presently-measured surrogate cardiac electrical activation times about the first human anatomy portion 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,

a graphical depiction of a portion of a second human anatomy and previously-measured surrogate cardiac electrical activation times about the second human anatomy portion 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,

the at least one presently-measured 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, and

the at least one previously-measured 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.

2. The system of claim 1, wherein the indication of whether cardiac therapy for the patient is beneficial comprises a percentage improvement between the at least one previously-measured metric of the patient'"'"'s cardiac health and the at least one presently-measured metric of the patient'"'"'s cardiac health.

3. The system of claim 1, wherein the computing apparatus is further configured to allow the user to change at least one pacing parameter of an implantable medical device providing cardiac therapy to the patient.

4. The system of claim 3, wherein the at least one pacing parameter comprises at least one of a pacing timing interval, a pacing vector, and a pacing mode.

5. The system of claim 1, wherein the computing apparatus is further configured to display, on the graphical user interface, mechanical motion information of one or more regions of at least a portion of blood vessel anatomy of the patient'"'"'s heart.

6. The system of claim 1, wherein the first human anatomy portion and the second human anatomy portion depict the same human anatomy.

7. The system of claim 1, wherein displaying graphical depictions of the measured surrogate cardiac electrical activation times about the first and second human anatomy portions comprises displaying graphical depictions of the measured surrogate cardiac electrical activation times about graphical depictions of at least one of an anterior side of a human torso and a posterior side of a human torso.

8. The system of claim 1, wherein displaying graphical depictions of the measured surrogate cardiac electrical activation times about the first and second human anatomy portions comprises displaying graphical depictions of the measured surrogate cardiac electrical activation times about graphical depictions of at least one of an anterior side of a heart and a posterior side of a heart.

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

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

11. 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.

21. The system of claim 1, wherein the indication of whether cardiac therapy for the patient is beneficial comprises one or more of an indication that a location of an implantable lead delivering cardiac therapy is providing beneficial cardiac therapy to the patient, an indication that one or more settings of the cardiac therapy being delivered to the patient are beneficial, and an indication that one or more adjustments to the cardiac therapy are beneficial to the patient.

12. A method for assisting in noninvasive evaluation of cardiac therapy comprising:

noninvasively measuring surrogate cardiac electrical activation times using one or more external surface electrodes proximate the skin of the patient and proximate the patient'"'"'s heart, wherein the surrogate cardiac electrical activation times are representative of depolarization of cardiac tissue that propagates through the torso of the patient;

noninvasively measuring at least one metric of the patient'"'"'s cardiac health using one or more external surface electrodes proximate the skin of the patient and proximate the patient'"'"'s heart;

determining whether cardiac therapy for the patient is beneficial based on a comparison of presently-measured noninvasive measurements made using the one or more external surface electrodes proximate the skin of the patient and previously-measured noninvasive measurements made using the one or more external surface electrodes proximate the skin of the patient; and

simultaneously displaying, on a graphical user interface,

an indication of whether cardiac therapy for the patient is beneficial based on the comparison,

a graphical depiction of a portion of a first human anatomy and the presently-measured surrogate cardiac electrical activation times about the first human anatomy portion that were noninvasively measured using the one or more external surface electrodes proximate the skin of the patient,

a graphical depiction of a portion of a second human anatomy and the previously-measured surrogate cardiac electrical activation times about the second human anatomy portion that were noninvasively measured using the one or more external surface electrodes proximate the skin of the patient,

the at least one presently-measured 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, and

the at least one previously-measured 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.

13. The method of claim 12, wherein the indication of whether cardiac therapy for the patient is beneficial comprises a percentage improvement between the at least one previously-measured metric of the patient'"'"'s cardiac health and the at least one presently-measured metric of the patient'"'"'s cardiac health.

14. The method of claim 12, wherein the method further comprises allowing the user to change at least one pacing parameter of an implantable medical device providing cardiac therapy to the patient.

15. The method of claim 12, wherein the method further comprises displaying, on the graphical user interface, mechanical motion information of one or more regions of at least a portion of blood vessel anatomy of the patient'"'"'s heart.

16. The method of claim 12, wherein displaying graphical depictions of the measured surrogate cardiac electrical activation times about the first and second human anatomy portions comprises displaying graphical depictions of the measured surrogate cardiac electrical activation times about graphical depictions of at least one of an anterior side of a human torso, a posterior side of a human torso, an anterior side of a heart, and a posterior side of a heart.

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

18. The method of claim 12, wherein displaying the graphical depictions of the measured surrogate cardiac electrical activation times about a portion of human anatomy comprises color scaling the portions of human anatomy on the graphical user interface according to the measured surrogate cardiac electrical activation times.

19. The method of claim 12, 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.

20. 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;

means for noninvasively measuring at least one metric of the patient'"'"'s cardiac health from the patient'"'"'s skin, wherein the surrogate cardiac electrical activation times are representative of depolarization of cardiac tissue that propagates through the torso of the patient;

means for determining whether cardiac therapy for the patient is beneficial based on a comparison of presently-measured noninvasive measurements made and previously-measured noninvasive measurements that were noninvasively measured from the patient'"'"'s skin; and

display means for simultaneously displaying, on a graphical user interface,

a graphical depiction of a portion of a first human anatomy and presently-measured surrogate cardiac electrical activation times about the first human anatomy portion that were noninvasively measured from the patient'"'"'s skin,

a graphical depiction of a portion of a second human anatomy and previously-measured surrogate cardiac electrical activation times about the second human anatomy portion that were noninvasively measured from the patient'"'"'s skin,

the at least one presently-measured metric of the patient'"'"'s cardiac health that was noninvasively measured from the patient'"'"'s skin,

the at least one previously-measured metric of the patient'"'"'s cardiac health that was noninvasively measured from the patient'"'"'s skin, and

an indication of whether cardiac therapy for the patient is beneficial based on the comparison.