Evaluation of implantable medical device data

• US 8,229,559 B2
• Filed: 07/15/2010
• Issued: 07/24/2012
• Est. Priority Date: 07/15/2010
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Westendorp, Hendrikus A., Chan, Cygni, Patel, Amisha S., Dirnberger, Denise, Ringold, Jean K., Ousdigian, Kevin T., Trojan, Robert B., Soken, Nelson H., Kleckner, Karen J.
• Primary Examiner(s): Manuel, George
• Assistant Examiner(s): Wieland, Robert N
• Application Number:
  US12/837,320
• Publication Number:
  US 20120016432A1
• Time in Patent Office: 740 Days
• Field of Search: 607/9, 607/4, 607/5, 607/17, 600/510, 600/515, 600/518, 600/529, 705/2
• US Class Current: 607/9
• 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 5/7217 of noise originating from a therapeutic or surgical apparatus, e.g. from a pacemaker
• CPC Class Codes: A61B 5/7475 User input or interface means, e.g. keyboard, pointing device, joystick
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means
• CPC Class Codes: A61N 1/39622 Pacing therapy
• CPC Class Codes: G16H 20/30 relating to physical therapies or activities, e.g. physiotherapy, acupressure or exercising
• CPC Class Codes: G16H 40/40 for the management of medical equipment or devices, e.g. scheduling maintenance or upgrades
• CPC Class Codes: G16H 40/67 for remote operation

Abstract

A system includes an episode classification module and a data retrieval module. The episode classification module receives electrograms (EGMs) from N implantable medical devices (IMDs) and determines whether the EGMs are associated with deliveries of therapy by the N IMDs. The episode classification module analyzes at least some of the EGMs and determines whether the deliveries or non-deliveries of therapy by the IMDs were appropriate. The data retrieval module receives a request from a computing device, via a network, that indicates at least two groups of the N IMDs. The data retrieval module provides to the computing device via the network, in response to the request, data for presentation to a user that indicates for each of the groups, at least one of how many of the one or more deliveries or non-deliveries were appropriate, or how many of the one or more deliveries or non-deliveries were inappropriate.

Claims

1. A system comprising:

an episode classification module that;

receives electrogram waveforms (EGMs) from N implantable medical devices (IMDs), wherein N is an integer greater than 1;

determines whether the EGMs are associated with one or more deliveries of therapy by the N IMDs;

analyzes at least some of the EGMs; and

determines whether the one or more deliveries or non-deliveries of therapy by the IMDs in response to rhythms included in the EGMs were appropriate based on the analysis; and

a data retrieval module that;

receives a comparison request from a computing device, via a network, the comparison request indicating at least two groups of the N IMDs and a type of comparison to be made between the at least two groups; and

provides to the computing device via the network, in response to the comparison request, data for presentation of a comparison between the at least two groups on the computing device, wherein the data indicates, for each of the groups, at least one of how many of the one or more deliveries or non-deliveries of therapy were appropriate, or how many of the one or more deliveries or non-deliveries of therapy were inappropriate.

2. The system of claim 1, wherein the EGMs include cardiac electrograms, the N IMDs include implantable cardioverter-defibrillators, and the deliveries of therapy include deliveries of at least one of defibrillation shocks or cardioversion shocks.

3. The system of claim 2, wherein the episode classification module determines whether the EGMs indicate ventricular tachyarrhythmia based on the analysis, and determines whether the one or more deliveries or non-deliveries of therapy were appropriate based on the determinations.

4. The system of claim 3, wherein the episode classification module determines whether the EGMs indicate ventricular tachycardia, ventricular fibrillation, supraventricular tachycardia, oversensing, or undersensing based on the analysis, and determines whether the one or more deliveries or non-deliveries of therapy were appropriate based on the determinations.

5. The system of claim 2, wherein the episode classification module determines whether the EGMs indicate one of atrial fibrillation, sinus tachycardia, atrial flutter, atrial tachycardia, or lead fracture noise based on the analysis, and wherein the episode classification module determines whether the one or more deliveries or non-deliveries of therapy were appropriate based on the determinations.

6. The system of claim 1, wherein the episode classification module classifies at least one of the one or more deliveries of therapy as indeterminate to indicate that the delivery may not be accurately classified by the episode classification module as appropriate or inappropriate.

7. The system of claim 1, wherein the episode classification module receives at least one of the EGMs via the network.

8. The system of claim 1, wherein the network includes the Internet.

9. The system of claim 1, wherein the episode classification module determines which of the EGMs are associated with one or more deliveries of therapy based on marker channel data from the N IMDs.

10. The system of claim 1, wherein a first group of the at least two groups is associated with a first clinic, wherein a second group of the at least two groups is associated with a plurality of patients associated with other clinics, and wherein the data retrieval module provides data for presentation of a comparison between the first group and the second group.

11. The system of claim 1, wherein the data retrieval module provides to the computing device data indicating, for each of the groups, how many of the EGMs precipitated deliveries of therapy.

12. The system of claim 1, wherein a first group of the at least two groups is associated with a particular clinic or clinician.

13. The system of claim 12, wherein a second group of the at least two groups is associated with IMDs other than those in the first group, and wherein the data retrieval module provides data for presentation of a comparison between the first group and the second group.

14. The system of claim 1, wherein the comparison request includes at least one selection parameter, and wherein one of the at least two groups is defined by the selection parameter.

15. The system of claim 14, wherein the at least one selection parameter includes at least one of a geographical area, a patient demographic, a number of patients associated with a clinic, an IMD type, an IMD model, a lead model, an amount of time implanted for the IMDs, a disease or disorder indication, an atrial fibrillation burden, an average or peak ventricular rate during atrial fibrillation, a percent of right ventricular pacing, a fluid index, or a rehospitalization rate of the patient.

16. A method comprising:

receiving electrogram waveforms (EGMs) from N implantable medical devices (IMDs), wherein N is an integer greater than 1;

determining whether the EGMs are associated with one or more deliveries of therapy by the N IMDs;

analyzing at least some of the EGMs;

determining whether the one or more deliveries or non-deliveries of therapy by the IMDs in response to rhythms included in the EGMs were appropriate based on the analysis;

receiving a comparison request from a computing device, via a network, the comparison request indicating at least two groups of the N IMDs and a type of comparison to be made between the at least two groups; and

providing to the computing device via the network, in response to the comparison request, data for presentation of a comparison between the at least two groups on the computing device, wherein the data indicates, for each of the groups, at least one of how many of the one or more deliveries or non-deliveries of therapy were appropriate, or how many of the one or more deliveries or non-deliveries of therapy were inappropriate.

17. The method of claim 16, wherein the EGMs include cardiac electrograms, the N IMDs include implantable cardioverter-defibrillators, and the deliveries of therapy include deliveries of at least one of defibrillation shocks or cardioversion shocks.

18. The method of claim 17, further comprising:

determining whether the EGMs indicate ventricular tachyarrhythmia based on the analysis; and

determining whether the one or more deliveries or non-deliveries of therapy were appropriate based on the determinations.

19. The method of claim 18, further comprising:

determining whether the EGMs indicate ventricular tachycardia, ventricular fibrillation, supraventricular tachycardia, oversensing, or undersensing based on the analysis; and

determining whether the one or more deliveries or non-deliveries of therapy were appropriate based on the determinations.

20. The method of claim 17, further comprising:

determining whether the EGMs indicate one of atrial fibrillation, sinus tachycardia, atrial flutter, atrial tachycardia, or lead fracture noise based on the analysis; and

determining whether the one or more deliveries or non-deliveries of therapy were appropriate based on the determinations.

21. The method of claim 16, further comprising classifying at least one of the one or more deliveries of therapy as indeterminate to indicate that the delivery may not be accurately classified as appropriate or inappropriate.

22. The method of claim 16, further comprising receiving at least one of the EGMs via the network.

23. The method of claim 16, further comprising determining which of the EGMs are associated with one or more deliveries of therapy based on marker channel data from the N IMDs.

24. The method of claim 16, wherein a first group of the at least two groups is associated with a first clinic, wherein a second group of the at least two groups is associated with a plurality of patients associated with other clinics, and wherein providing data for presentation further comprises providing data for presentation of a comparison between the first group and the second group.

25. A system comprising:

means for receiving electrogram waveforms (EGMs) from N implantable medical devices (IMDs), wherein N is an integer greater than 1;

means for determining whether the EGMs are associated with one or more deliveries of therapy by the N IMDs;

means for analyzing at least some of the EGMs;

means for determining whether the one or more deliveries or non-deliveries of therapy by the IMDs in response to rhythms included in the EGMs were appropriate based on the analysis;

means for receiving a comparison request from a computing device, via a network, the comparison request indicating at least two groups of the N IMDs and a type of comparison to be made between the at least two groups; and

means for providing to the computing device via the network, in response to the comparison request, data for presentation of a comparison between the at least two groups on the computing device, wherein the data indicates, for each of the groups, at least one of how many of the one or more deliveries or non-deliveries of therapy were appropriate, or how many of the one or more deliveries or non-deliveries of therapy were inappropriate.

26. The system of claim 25, wherein the EGMs include cardiac electrograms, the N IMDs include implantable cardioverter-defibrillators, and the deliveries of therapy include deliveries of at least one of defibrillation shocks or cardioversion shocks.

27. The system of claim 26, further comprising:

means for determining whether the EGMs indicate ventricular tachyarrhythmia based on the analysis; and

means for determining whether the one or more deliveries or non-deliveries of therapy were appropriate based on the determinations.

28. The system of claim 27, further comprising:

means for determining whether the EGMs indicate ventricular tachycardia, ventricular fibrillation, supraventricular tachycardia, oversensing, or undersensing based on the analysis; and

means for determining whether the one or more deliveries or non-deliveries of therapy were appropriate based on the determinations.

29. A computer-readable storage medium comprising instructions that cause a programmable processor to:

receive electrogram waveforms (EGMs) from N implantable medical devices (IMDs), wherein N is an integer greater than 1;

determine whether the EGMs are associated with one or more deliveries of therapy by the N IMDs;

analyze at least some of the EGMs;

determine whether the one or more deliveries or non-deliveries of therapy by the IMDs in response to rhythms included in the EGMs were appropriate based on the analysis;

receive a comparison request from a computing device, via a network, the comparison request indicating at least two groups of the N IMDs and a type of comparison to be made between the at least two groups; and

provide to the computing device via the network, in response to the comparison request, data for presentation of a comparison between the at least two groups on the computing device, wherein the data indicates, for each of the groups, at least one of how many of the one or more deliveries or non-deliveries of therapy were appropriate, or how many of the one or more deliveries or non-deliveries of therapy were inappropriate.

30. The computer-readable storage medium of claim 29, wherein the EGMs include cardiac electrograms, the N IMDs include implantable cardioverter-defibrillators, and the deliveries of therapy include deliveries of at least one of defibrillation shocks or cardioversion shocks.

31. The computer-readable storage medium of claim 30, further comprising instructions that cause the programmable processor to:

determine whether the EGMs indicate ventricular tachyarrhythmia based on the analysis; and

determine whether the one or more deliveries or non-deliveries of therapy were appropriate based on the determinations.

32. The computer-readable storage medium of claim 31, further comprising instructions that cause the programmable processor to:

determine whether the EGMs indicate ventricular tachycardia, ventricular fibrillation, supraventricular tachycardia, oversensing, or undersensing based on the analysis; and

determine whether the one or more deliveries or non-deliveries of therapy were appropriate based on the determinations.