METHODS AND SYSTEMS FOR IMPROVED ARRHYTHMIA DISCRIMINATION

• US 20090287268A1
• Filed: 05/14/2008
• Published: 11/19/2009
• Est. Priority Date: 05/14/2008
• Status: Active Grant

• Current Assignee: Pacesetter Incorporated (Abbott Laboratories Incorporated)
• Original Assignee: Pacesetter Incorporated (Abbott Laboratories Incorporated)
• Inventors: Donnay, Rafael, Nabutovsky, Yelena, Xi, Cecilia Qin
• Granted Patent: US 8,249,707 B2
• Time in Patent Office: Days
• US Class Current: 607/14
• CPC Class Codes: A61N 1/3622 comprising two or more electrodes co-operating with different heart regions
• CPC Class Codes: A61N 1/3624 occurring in the atrium, i.e. atrial tachycardia

Abstract

A non-implanted system receives, from an implantable cardiac device implanted within a patient, data corresponding to detected potential episodes of tachycardia. A representation of the data corresponding to the detected potential episodes of tachycardia is displayed to a user, and the user that observes the displayed representation of the data is allowed to enter a user diagnosis for each of the detected potential episodes of tachycardia. The non-implanted system simulates how the implantable cardiac device can use its discriminators to produce device diagnoses, based on the data for the detected potential episodes of tachycardia, including how adjustments to the discriminators affect how the device diagnoses match the user diagnoses. Thereafter, the non-implanted system can reprogram the implantable cardiac device to increase a likelihood that future device diagnoses produced by the implantable cardiac device would more closely match future user diagnoses produced by the user.

Claims

1. A method for use by a non-implanted system configured to communicate with an implantable cardiac device implanted within a patient, wherein the implantable cardiac device is configured to detect potential episodes of tachycardia and to store data corresponding to the detected potential episodes of tachycardia, and wherein the implantable cardiac device has programmable arrhythmia discriminators that the device can use to discriminate between different types of tachycardia, the method comprising:

(a) receiving, from the implantable cardiac device implanted within the patient, data corresponding to detected potential episodes of tachycardia;

(b) displaying a representation of the data corresponding to the detected potential episodes of tachycardia;

(c) allowing a user that observes the displayed representation of the data to enter a user diagnosis for each of the detected potential episodes of tachycardia; and

(d) simulating how the implantable cardiac device can use its discriminators to produce device diagnoses, based on the data for the detected potential episodes of tachycardia, including simulating how adjustments to the discriminators affect how the device diagnoses match the user diagnoses.

2. The method of claim 1, wherein step (d) includes automatically adjusting one or more of the discriminators to thereby cause the simulated device diagnoses to more closely match that user diagnoses.

3. The method of claim 2, wherein step (d) includes automatically adjusting one or more of the discriminators until the simulated device diagnoses match the user diagnoses to within a specified tolerance.

4. The method of claim 2, further comprising:

(e) sending instructions, to the implantable cardiac device, specifying adjustments to the discriminators that increase a likelihood that future device diagnoses produced by the implantable device would more closely match future user diagnoses produced by the user.

5. The method of claim 2, wherein step (d) includes automatically adjusting one or more of the following settings:

which discriminators are used;

when discriminators are used;

how discriminators are used;

an order in which discriminators are used;

how many discriminators must be satisfied for a rhythm to be characterized as a specific type of tachycardia; and

a value of a parameter of at least one of the discriminators.

6. The method of claim 5, wherein step (d) includes, if more than one setting for one of the discriminators results in the same match between the simulated device diagnosis and the user diagnosis, selecting the setting that provides the greatest allowance for error.

7. The method of claim 6, wherein step (d) includes, if more than one setting for one of the discriminators results in the same match between the simulated device diagnosis and the user diagnosis, and results in the same allowance for error, selecting the setting that is the same as or closest to the default setting of the implantable cardiac device.

8. The method of claim 5, wherein step (d) includes, if more than one setting for one of the discriminators results in the same match between the simulated device diagnosis and the user diagnosis, selecting the setting that is the same as or closest to the default setting of the implantable cardiac device.

9. The method of claim 5, wherein step (d) includes, if more than one setting for one of the discriminators results in the same match between the simulated device diagnosis and the user diagnosis, selecting the setting that is the same as or closest to the current setting of the implantable cardiac device.

10. The method of claim 1, wherein step (b) includes displaying EGM and/or ECG waveforms corresponding to the detected potential episodes of tachycardia.

11. The method of claim 10, step (b) includes displaying attribute information about the displayed EGM and/or ECG waveforms corresponding to the detected potential episodes of tachycardia.

12. The method of claim 10, wherein:

step (a) includes receiving, from the implantable cardiac device implanted within the patient, physiologic data corresponding to detected potential episodes of tachycardia, the physiologic data obtained using one or more physiologic sensor;

step (b) includes displaying, along with the EGM and/or ECG waveforms, a representation of the physiologic data that corresponds to the detected potential episodes of tachycardia.

13. The method of claim 1, wherein:

step (c) includes allowing the user to select from among at least VT and SVT user diagnosis options for each of the detected episodes of tachycardia.

14. A non-implanted system configured to communicate with an implantable cardiac device implanted within a patient, wherein the implantable cardiac device is configured to detect potential episodes of tachycardia and to store data corresponding to the detected potential episodes of tachycardia, and wherein the implantable cardiac device has programmable arrhythmia discriminators that the device can use to discriminate between different types of tachycardia, the non-implanted system comprising:

a telemetry subsystem to receive, from the implantable cardiac device implanted within the patient, data corresponding to detected potential episodes of tachycardia;

a display to display a representation of the data corresponding to the detected potential episodes of tachycardia;

an input device to accept, from a user that observes the displayed representation of the data, a user diagnosis for each of the detected potential episodes of tachycardia;

one or more processor to simulate how the implantable cardiac device would use its discriminators to produce device diagnoses, based on the data for the detected potential episodes of tachycardia, including how adjustments to the discriminators affect how the device diagnoses match the user diagnoses.

15. The system of claim 14, wherein the one or more processor automatically adjusts one or more of the discriminators to thereby cause the simulated device diagnoses to more closely match that user diagnoses.

16. The system of claim 15, wherein the one or more processor automatically adjusts one or more of the discriminators until the simulated device diagnoses match the user diagnoses to within a specified tolerance.

17. The system of claim 15, wherein:

the telemetry subsystem also sends instructions, to the implantable cardiac device, specifying adjustments to the discriminators that increase a likelihood that future device diagnoses produced by the implantable cardiac device would more closely match future user diagnoses produced by the user.

18. A method for use by a non-implanted system configured to communicate with an implantable cardiac device implanted within a patient, wherein the implantable cardiac device is configured to detect potential episodes of tachycardia and to store data corresponding to the detected potential episodes of tachycardia, and wherein the implantable cardiac device has programmable arrhythmia discriminators that the device can use to discriminate between different types of tachycardia, the method comprising:

causing a representation of data corresponding to detected potential episodes of tachycardia to be displayed, the data uploaded from the implantable cardiac device;

accepting user diagnoses for the detected potential episodes of tachycardia; and

causing the implantable cardiac device to be reprogrammed to increase a likelihood that future device diagnoses produced by the implantable cardiac device would more closely match future user diagnoses produced by the user.

19. The method of claim 18, further comprising:

performing simulations to identify at least some adjustments to the discriminators that increase the likelihood that future device diagnoses produced by the implantable cardiac device would more closely match future user diagnoses produced by the user.

20. The method of claim 18, wherein adjustments to the discriminators related to one or more of the following:

which discriminators are used;

when discriminators are used;

an order in which discriminators are used;

how discriminators are used;

how many discriminators must be satisfied for a rhythm to be characterized as a specific type of tachycardia; and

a value of a parameter of at least one of the discriminators.

21. The method of claim 18, wherein the step of causing a representation of data corresponding to detected potential episodes of tachycardia to be displayed includes causing EGM and/or ECG waveforms corresponding to the detected potential episodes of tachycardia to be displayed.