Patient event marking in combination with physiological signals

• US 20060235489A1
• Filed: 04/26/2006
• Published: 10/19/2006
• 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., Giftakis, Jonathon E., Graves, Nina M.
• Granted Patent: US 7,917,199 B2
• Time in Patent Office: Days
• US Class Current: 607/60
• 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 1/36132 using patient feedback
• 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 for receiving a patient mark in an implanted device. A patient may experience symptoms that indicative of a neurological event or are common precursors to more severe clinical symptoms. The patient may activate a patient activator. Activation of the patient activator can cause the patient activator to transmit the patient mark to an implanted device. The implanted device may adjust physiological data being stored in response to the patient mark, including data before and after the patient mark. The patient mark may be used to fine tune the detection algorithms and otherwise tune the detection capability of the implanted device and may also be used as an aid in statistical analysis of the stored physiological data.

Claims

1. A method of linking clusters detected by an implanted medical device comprising:

(A) recording a first cluster with the implanted device;

(B) recording a second cluster with the implanted device that is distinct from the first cluster;

(C) receiving a patient mark in the implanted device that is in close temporal proximity to the first and second cluster; and

(D) linking the first and second cluster in response to the patient mark.

2. The method of claim 1, wherein the patient mark occurs between an end of the first cluster and a start of the second cluster.

3. The method of claim 1, wherein the receiving of the patient mark in (C) comprises:

(i) receiving a signal via telemetry from a patient activator; and

(ii) storing a record of the signal in memory, the record including a time stamp.

4. The method of claim 1, further comprising:

(E) storing the linked clusters in a memory of the implanted device as a single cluster.

5. The method of claim 1, wherein the mark occurs during one of the first or second clusters.

6. The method of claim 1, wherein the linking in (D) comprises:

(i) combining the first and second cluster so as to generate a third cluster that includes the first and second clusters.

7. The method of claim 6, wherein the third cluster includes data representative of the period of time between the end of the first cluster and the start of the second cluster.

8. A method of using a patient mark to improve analysis of events detected by an implanted device, the method comprising:

(A) receiving a patient mark in an implanted device via telemetry;

(B) comparing the patient mark to detection results provided by the implanted device; and

(C) determining a relevance of the detection results.

9. The method of claim 8, wherein (A)-(C) is performed by the implanted device.

10. The method of claim 8, wherein the detection results do not include a cluster associated with a detected seizure.

11. The method of claim 8, wherein the relevance is selected from a list consisting of true positive and false negative.

12. The method of claim 8, wherein the receiving in (A) comprises:

(i) storing the patient mark in memory.

13. The method of claim 8, wherein the receiving in (A) comprises:

(i) receiving a signal via telemetry; and

(ii) creating a record of the signal in memory that includes a time stamp.

14. The method of claim 8, further comprising:

(D) adjusting the detection algorithm in response to the relevance.

15. The method of claim 8, further comprising:

(D) storing data representative of physiological signals that were detected before and after the patient mark in response to the determination of relevance.

16. A method of recording physiological signals detected from a patient, comprising:

(A) transmitting a patient mark indicative of an onset of clinical symptoms related to a neurological event from a patient activator;

(B) receiving the patient mark in an implanted device;

(C) storing the patient mark in memory; and

(D) if the implanted device is not already storing physiological data, storing the physiological data before and after the patient mark.

17. The method of claim 16, wherein the storing of physiological data in (D) comprises:

(i) storing a first cluster from a first electrode; and

(ii) storing a second cluster from a second electrode, wherein the first and second electrode are positioned in different anatomical locations.

18. The method of claim 16, further comprising:

(E) if the implanted device is storing physiological data, increasing a priority of the physiological data.

19. The method of claim 16, further comprising:

(E) displaying a summary of an impact of the patient mark to the stored data.

20. The method of claim 16, wherein the storing in (C) comprises:

(i) creating a time stamped record indicating that the patient mark was received; and

(ii) saving the time stamped record in memory.