IMPLANTABLE SHOCK ELECTRODE LINE AND IMPLANTABLE DEFIBRILLATION ARRANGEMENT

• US 20090292330A1
• Filed: 04/22/2009
• Published: 11/26/2009
• Est. Priority Date: 05/20/2008
• Status: Active Grant

• Current Assignee: Biotronik SE & Company KG
• Original Assignee: Biotronik VI Patent AG (Biotronik SE & Company KG)
• Inventors: Doerr, Thomas
• Granted Patent: US 8,014,857 B2
• Time in Patent Office: Days
• US Class Current: 607/5
• CPC Class Codes: A61M 5/14276 specially adapted for implantation
• CPC Class Codes: A61N 1/3962 in combination with another heart therapy

Abstract

An implantable shock electrode line having a proximal terminal for connection to an implantable defibrillator, an elongated flexible line body, and a shock electrode and a drug delivery device arranged at or near the distal end of the line body. A drug depot connected to the drug delivery device is provided in the shock electrode line, and the terminal is designed as a purely electric standard terminal. The drug delivery device is designed for control by an electric pulse transmitted over the electric terminal to the shock electrode line.

Claims

1. A device (10) for processing electrocardiogram signals and marker signals including:

a. an input interface (30) receiving electrocardiogram signals and marker signals detected by an implantable medical device;

b. an analyzer unit (32) connected to the input interface (30), the analyzer unit (32);

(1) processing the electrocardiogram signals and marker signals, and

(2) detecting particular features in one or more of the electrocardiogram signals and marker signals on the basis of predefined detection criteria, and

(3) assigning priority rankings to detected particular features; and

c. an output interface (34) connected to the analyzer unit (32), the output interface (34) outputting data representing an analytical report, the analytical report containing at least a listing of the detected particular features.

2. The device of claim 1 further including a second input interface (40) connected to the analyzer unit (32), the second input interface (40) receiving user specifications influencing the processing the electrocardiogram signals and marker signals by the analyzer unit (32).

3. The device of claim 1 wherein the analyzer unit (32) includes a noise detector (50) detecting sections of the electrocardiogram signals having a noise level beyond a predefined limit value.

4. The device of claim 1 wherein the analyzer unit (32) includes an artifact detector (52) detecting sections of the electrocardiogram signals having polarization or other artifacts.

5. The device of claim 1 wherein the analyzer unit (32) includes an event detector (54) detecting sections of the electrocardiogram signals characteristic of depolarization of the myocardium.

6. The device of claim 5 wherein the event detector (54) is in communication with a morphology classification unit (58) performing signal shape analysis of the electrocardiogram signals.

7. The device of claim 5 wherein the analyzer unit (32) includes a marker correlator (56) determining correlations in time between detected cardiac events and corresponding markers in the marker signals.

8. The device of claim 1 wherein the analyzer unit (32) includes an oversensing classification unit (66) detecting sections of the electrocardiogram signals having characteristics indicative of oversensing.

9. The device of claim 1 wherein the analyzer unit (32):

a. generates analyzer marker signals marking at least some of the detected particular features of the electrocardiogram signals, and

b. compares the input marker signals and analyzer marker signals for differences.

10. The device of claim 9 wherein:

a. the input marker signals and analyzer marker signals are compared for differences in timing along the of the electrocardiogram signals, and

b. the analyzer unit (32) generates;

(1) an output indicative of oversensing if the input marker signals are greater in number than the analyzer marker signals, and

(2) an output indicative of undersensing if the input marker signals are fewer in number than the analyzer marker signals.

11. The device of claim 1 further including an evaluation unit (72) in communication with the analyzer unit (32), the evaluation unit (72):

a. evaluating detected particular features with regard to their importance on the basis of predefined priority ranking criteria, and

b. assigning the priority rankings to the detected particular features.

12. The device of claim 1 further including a recommendation unit (74) in communication with the analyzer unit (32), the recommendation unit (74) generating a treatment recommendation based on the particular features detected by the analyzer unit (32).

13. The device of claim 1 wherein the listing of the detected particular features is supplemented by one or more of:

a. a graphic reproduction of at least a section of the electrocardiogram signals,

b. a graphic reproduction of at least a section of the marker signals, whereupon one or more of the detected particular features are marked.

14. A device (10) for processing electrocardiogram signals and marker signals including:

a. an input interface (30) in communication with an implantable medical device, the input interface (30) receiving

(1) electrocardiogram signals, and

(2) input marker signals marking features of the electrocardiogram signals,

from the implantable medical device;

b. an analyzer unit (32) receiving the electrocardiogram signals and input marker signals from the input interface (30), the analyzer unit (32);

(1) applying predefined detection criteria to one or more of the electrocardiogram signals and input marker signals, thereby identifying particular features in one or more of the electrocardiogram signals and input marker signals which meet the predefined detection criteria;

(2) applying predefined priority ranking criteria to the identified particular features, thereby assigning priority rankings to the identified particular features;

(3) generating an output report containing at least a listing of the identified particular features having the highest priority rankings.

15. The device of claim 14 wherein:

a. the analyzer unit (32) generates a treatment recommendation corresponding to one or more of the identified particular features having the highest priority rankings, and

b. the output report further contains the generated treatment recommendation.

16. The device of claim 15 wherein:

a. the output report further contains a graphic reproduction of;

(1) at least some of the electrocardiogram signals,

(2) at least some of the marker signals,

b. at least one of the identified particular features having the highest priority rankings is illustrated on the graphic reproduction.

17. The device of claim 14 wherein the analyzer unit (32):

a. generates analyzer marker signals marking particular features identified within the electrocardiogram signals;

b. compares the input marker signals and analyzer marker signals for differences; and

c. provides, within the output report;

(1) an indication of oversensing if the input marker signals are greater in number than the analyzer marker signals, and

(2) an indication of undersensing if the input marker signals are fewer in number than the analyzer marker signals.

19. The device (10) of claim 17 wherein the analytical report includes a recommendation regarding adjustment of the implantable medical device if the input marker signals and analyzer marker signals differ in their number and time of occurrence over the electrocardiogram signals.

20. The device (10) of claim 17 wherein:

a. the input marker signals from the implantable medical device, and

b. the analyzer marker signals generated by the analyzer unit (32), are generated by different detection algorithms.

18. A device (10) for processing electrocardiogram signals and marker signals including:

a. an input interface (30) in communication with an implantable medical device, the input interface (30) receiving

(1) electrocardiogram signals, and

(2) input marker signals marking features of the electrocardiogram signals,

from the implantable medical device;

b. an analyzer unit (32) in communication with the input interface (30), the analyzer unit (32);

(1) detecting particular features in the electrocardiogram signals, and

(2) generating analyzer marker signals marking the detected particular features of the electrocardiogram signals,

(3) comparing the input marker signals and analyzer marker signals for differences; and

c. an output interface (34) connected to the analyzer unit (32), the output interface (34) outputting data representing an analytical report, the analytical report containing at least a listing of some of the detected particular features for which both input marker signals and analyzer marker signals exist.