Cardiac event detection over varying time scale

• US 8,024,028 B2
• Filed: 02/26/2009
• Issued: 09/20/2011
• Est. Priority Date: 11/26/2003
• Status: Active Grant

• Current Assignee: Angel Medical Systems, Inc.
• Original Assignee: Angel Medical Systems, Inc.
• Inventors: Johnson, Steven R., Fischell, David R., Fischell, Robert E., Harwood, Jonathan
• Primary Examiner(s): Manuel; George
• Assistant Examiner(s): Wieland; Robert N
• Application Number:
  US12/379,627
• Publication Number:
  US 20090192397A1
• Time in Patent Office: 936 Days
• Field of Search: 600/509, 600/515, 600/517
• US Class Current: 600/509
• CPC Class Codes: A61B 5/0031 Implanted circuitry
• CPC Class Codes: A61B 5/349 Detecting specific parameters of the electrocardiograph cycle
• CPC Class Codes: A61B 5/355 Detecting T-waves
• CPC Class Codes: A61B 5/358 Detecting ST segments
• CPC Class Codes: A61B 5/366 Detecting abnormal QRS complex, e.g. widening
• CPC Class Codes: A61B 5/413 Monitoring transplanted tissue or organ, e.g. for possible rejection reactions after a transplant
• CPC Class Codes: A61N 1/025 Digital circuitry features of electrotherapy devices, e.g. memory, clocks, processors
• CPC Class Codes: A61N 1/37235 Aspects of the external programmer
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means

Abstract

Disclosed is a “tracker system” that includes implanted electrical leads which are part of an implanted cardiotracker plus external equipment that includes external alarm means and a physician'"'"'s programmer. The tracker system is designed to monitor the degradation of a patient'"'"'s cardiovascular condition from one or more causes. These causes include the rejection of a transplanted heart and/or the progression of a stenosis in a coronary artery. As one or more stenoses in a coronary artery become progressively more narrow thereby causing reduced blood flow to the heart muscle coronary circulation, the tracker system can alert the patient by either or both internal and/or external alarm means to take the appropriate medical action. The physician'"'"'s programmer can be used to display histograms of key heart signal parameters that are indicative of the patient'"'"'s cardiovascular condition.

Claims

1. A system for tracking the cardiovascular condition of a human patient the system including:

at least two electrodes positioned to sense the electrical signal from the patient'"'"'s heart, the electrical signal consisting of a multiplicity of beats;

a histogram memory including memory capacity to store at least one histogram, the at least one histogram including at least two bins, each bin being a counter; and

a processor to compute the amplitude of the ST segment of the electrical signal for at least a portion of the multiplicity of beats, each beat of the portion of the multiplicity of beats that is processed being a processed beat, the processor also being designed to compute the R-R interval for each processed beat, the processor further being designed to increment one of the at least two bins of the at least one histogram where the choice of bin to be incremented is dependent on the computed amplitude of the ST segment for one or more processed beats, a histogram only being incremented when a computed R-R interval associated with the one or more of the processed beats is within a particular heart rate range, any histogram stored in the histogram memory being incremented by the processor only for a data collection time period.

2. The system of claim 1 wherein the current data collection time period is 24 hours.

3. The system of claim 1 wherein the histogram memory is divided into a plurality of sections, and wherein one of the plurality of sections stores a current histogram, and wherein another of the plurality of sections stores a past histogram associated with a prior data collection time period.

4. The system of claim 3 wherein the processor is configured to obtain a new histogram during a new data collection time period by overwriting the oldest of the plurality of sections.

5. The system of claim 1 wherein the ST segment amplitude is computed as the difference between ST segment potential and PQ segment potential.

6. The system of claim 1 wherein the ST segment amplitude is normalized to R wave amplitude.

7. The system of claim 1 wherein the particular heart rate range is a range of normal heart rates.

8. The system of claim 1 wherein the particular heart rate range is a range of elevated heart rates.

9. The system of claim 1 wherein the processor updates a current histogram separately for each of the processed beats.

10. The system of claim 9 wherein the R-R interval is computed based on the period between a beat and a preceding beat.

11. The system of claim 10 wherein the R-R interval is computed by calculating the period between QRS fiducial points between successive beats.

12. The system of claim 1 wherein the electrodes are configured to be implanted within a body.

13. The system of claim 12 wherein at least one of the implanted electrodes is adapted to be disposed in the heart.

14. The system of claim 13 wherein the at least one of the implanted electrodes is adapted to be disposed in the RV apex.

15. The system of claim 1 wherein at least one of the electrodes is attached to the patient'"'"'s skin.

16. The system of claim 1 where the RR interval is calculated based on the heart rate measured for one or more processed beats.

17. The system of claim 1 further comprising a housing adapted for implantation into a human body, and wherein the processor is disposed within the housing.

18. The system of claim 1 wherein the processor is configured to periodically sample the electrical signal, thereby defining electrical signal segments.

19. The system of claim 1 wherein each of the at least two bins has the same width.