WO1995005868B1 - Programming system for a patient's cardiac signal - Google Patents

Programming system for a patient's cardiac signal

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Publication number
WO1995005868B1
WO1995005868B1 PCT/US1994/009715 US9409715W WO9505868B1 WO 1995005868 B1 WO1995005868 B1 WO 1995005868B1 US 9409715 W US9409715 W US 9409715W WO 9505868 B1 WO9505868 B1 WO 9505868B1
Authority
WO
WIPO (PCT)
Prior art keywords
cardiac
cardiac signal
arrhythmia
signal
parameters
Prior art date
Application number
PCT/US1994/009715
Other languages
French (fr)
Other versions
WO1995005868A1 (en
Filing date
Publication date
Priority claimed from US08/113,540 external-priority patent/US5421830A/en
Application filed filed Critical
Priority to EP94926040A priority Critical patent/EP0669841A4/en
Priority to AU76050/94A priority patent/AU7605094A/en
Priority to JP7507782A priority patent/JPH08504656A/en
Publication of WO1995005868A1 publication Critical patent/WO1995005868A1/en
Publication of WO1995005868B1 publication Critical patent/WO1995005868B1/en

Links

Abstract

A programming system (10) optimizes the settings of various arrhythmia detection criteria and/or parameters related to the hemodynamic performance to be programmed into the implanted cardiac stimulating device (12) attached to the patient's heart (16) with a lead (18). The system (10) comprises a control unit (20), an input interface (22), a display (24), a program storage unit (28) and a printer (26). The system (10) is linked to a cardiac stimulating device (12) via a telemetry head (14). The system is capable of recording the patient's cardiac signals and/or sensor data.

Claims

AMENDED CLAIMS[received by the International Bureau on 2 March 1995 (02.03.95); original claims 1-61 replaced by amended claims 1-61 (15 pages)]
1. A programming system for programming and optimizing a plurality of programmed parameters for use in a cardiac stimulating device, the cardiac stimulating device being capable of applying a corresponding therapy to a patient's heart based on the plurality of programmed parameters, the programming system comprising: means for recording a patient's cardiac signal for play back; means for playing back the patient's cardiac signal; means for analyzing the response of the cardiac stimulating device to the played back cardiac signal based on the plurality of parameters, the analyzing means comprising means for determining an optimal value for each of the plurality of parameters, wherein: the plurality of parameters comprises a set of arrhythmia detection criteria; the cardiac stimulating device is capable of detecting an episode of arrhythmia based on the set of arrhythmia detection criteria; and wherein the analyzing means further comprises means for adjusting the value of each parameter in the set of arrhythmia detection criteria until detection of the arrhythmia is optimized; and means for generating a simulated cardiac signal.
2. The programming system of Claim 1, wherein the analyzing means further comprises means for displaying a plurality of recommended values for the plurality of parameters in response to the determining means.
3. The programming system of Claim 1, wherein the set of arrhythmia detection criteria comprises at least one of rate, rate stability, sudden onset delta, probability density function, morphology detection, slew rate, a specific number of intervals, signal amplitudes, frequency content and activation sequence.
4. The programming system of Claim 1, wherein the recording means comprises means for recording an actual arrhythmia episode of the patient.
5. The programming system of Claim 1, wherein the recording means comprises means for recording an induced arrhythmia episode of the patient.
6. The programming system of Claim 1, wherein the generating means comprises: means for selecting cardiac parameters; and means for producing a simulated cardiac signal based on the cardiac parameters.
7. The programming system of Claim 1, further comprising: means for displaying the cardiac signal; and means for editing the displayed cardiac signal.
8. The programming system of Claim 1, wherein the analyzing means comprises an external cardiac simulating device for receiving the played back cardiac signal.
9. The programming system of Claim 1, wherein the analyzing means comprises: means for receiving the played back cardiac signal; and means for simulating the response of the cardiac stimulating device to the played back cardiac signal.
10. The programming system of Claim 1, wherein: the recording means includes means for recording a hemodynamic sensor signal coincident with the patient's cardiac signal; the plurality of parameters comprises a set of hemodynamic parameters which cooperate to detect and control cardiac output; the cardiac stimulating device is capable of detecting the hemodynamic state of the patient based on the set of hemodynamic parameters; and the analyzing means comprises means for adjusting the value of each parameter in the set of hemodynamic parameters until the patient's cardiac output is optimized.
11. The programming system of Claim 1, wherein: the recording means includes means for recording a hemodynamic sensor signal coincident with the patient's cardiac signal; and the analyzing means includes means for determining whether the cardiac signal is physiological or pathological based on the value of the sensor signal.
12. The programming system of Claim 1, wherein: the recording means includes means for recording a physiological sensor signal coincident with the patient's cardiac signal; 3 7
the plurality of parameters comprises a set of rate-responsive parameters which cooperate to detect and control cardiac output during exercise; the cardiac stimulating device is capable of detecting the exercise state of the patient based on the set of rate-responsive parameters; and the analyzing means comprises means for adjusting the value of each parameter in the set of rate-responsive parameters until the patient's cardiac output is optimized during exercise.
13. The programming system of Claim 12, wherein the rate-responsive parameters comprises at least one of pacing rate, sensor gain, slope, threshold, minimum rate, maximum rate, reaction time, recovery time, A-V delay, and hysteresis.
14. A programming system for optimizing a set of arrhythmia detection criteria for use in a cardiac stimulating device, the cardiac stimulating device being capable of detecting an episode of arrhythmia based on the set of arrhythmia detection criteria, and of applying a corresponding antiarrhythmia therapy to a patient's heart, the programming system comprising: means, within the cardiac stimulating device, for recording a patient's cardiac signal; means for playing back the cardiac signal; and means for analyzing the response of the cardiac stimulating device to the played back cardiac signal and determining a set of optimized arrhythmia detection criteria, wherein the analyzing means comprises means for adjusting the value of each parameter in the set of arrhythmia detection criteria until detection of the arrhythmia is optimal; and 38
means for simulating the response of the cardiac stimulating device to the played back cardiac signal.
15. The programming system of Claim 14, wherein the set of arrhythmia detection criteria comprises at least one of rate, rate stability, sudden onset delta, probability density function, morphology detection, slew rate, a specific number of intervals, signal amplitudes, frequency content and activation sequence.
16. The programming system of Claim 14, further comprising: means for displaying the cardiac signal; and means for editing the displayed cardiac signal.
17. The programming system of Claim 14, further comprising: means for producing a default cardiac signal; and means for displaying the default cardiac signal when desired.
18. The programming system of Claim 17, further comprising: means for selecting cardiac parameters; and means for producing a simulated cardiac signal based on the cardiac parameters.
19. The programming system of Claim 14, wherein the simulating means comprises an external cardiac simulating device having means for receiving the played back cardiac signal. 39
20. The programming system of Claim 14, wherein: the recording means includes means for receiving a recorded sensor signal coincident with the cardiac signal; and the analyzing means includes means for determining whether the cardiac signal is physiological or pathological based on the value of the sensor signal.
21. The programming system of Claim 14, further comprising: means for analyzing the cardiac signal; and means for creating recommended arrhythmia detection criteria responsive to the means for analyzing.
22. A method for optimizing a plurality of programmable parameters for use in a cardiac stimulating device, the cardiac stimulating device being capable of applying a corresponding therapy to a patient's heart based on a plurality of programmable parameters selected, the method comprising the steps of: recording a patient's cardiac signal to play bac ; playing back the cardiac signal; analyzing the response of the cardiac stimulating device to the played back cardiac signal based on the plurality of programmable parameters selected; producing a default cardiac signal; and displaying the default cardiac signal when desired.
23. The method of Claim 22, wherein the plurality of parameters comprises a set of arrhythmia 4 0
device is capable of detecting an episode of arrhythmia based on the set of arrhythmia detection criteria, wherein the analyzing step comprises the step of: adjusting the value of each parameter in the set of arrhythmia detection criteria until detection of the arrhythmia is optimal.
24. The method of Claim 23, wherein the adjusting step comprises the step of: adjusting the value of at least one of rate, rate stability, sudden onset delta, probability density function, morphology detection, slew rate, a specific number of intervals, signal amplitudes, frequency content and activation sequence.
25. The method of Claim 22, wherein the step of recording comprises the step of: recording an actual arrhythmia episode of the patient as sensed by a cardiac stimulating device.
26. The method of Claim 22, wherein the step of recording comprises the step of: recording an induced arrhythmia episode from a cardiac stimulating device.
27. The method of Claim 22, further comprising the step of editing the cardiac signal.
28. The method of Claim 22, further comprising the steps of: selecting cardiac parameters; and producing a simulated cardiac signal based on the cardiac parameters. 4 1
29. The method of Claim 22, wherein the step of analyzing comprises the step of transmitting the played back cardiac signal to an external cardiac stimulating device.
30. The method of Claim 22, wherein the step of analyzing comprises the steps of: receiving the played back cardiac signal; and simulating the response of the cardiac stimulating device to the played back cardiac signal.
31. The method of Claim 22, further comprising the steps of: analyzing the cardiac signal; and creating recommended arrhythmia detection criteria in response to the analyzing of the cardiac signal.
32. The method of Claim 22, wherein the plurality of parameters comprises a set hemodynamic responsive parameters, and wherein the cardiac stimulating device is capable of affecting the patient's cardiac output based on the adjustment of the set of hemodynamic responsive parameters, wherein the analyzing step comprises the step of: adjusting the value of each parameter in the set of hemodynamic responsive parameters until the patient's cardiac output is optimized.
33. The method of Claim 32, wherein the adjusting step comprises the step of: adjusting the value of at least one of sensor gain, slope, threshold, minimum rate, maximum rate, reaction time, recovery time, A-V delay, hysteresis, and rate. 4 2
34. A method for optimizing a set of arrhythmia detection criteria for use in a cardiac stimulating device, the cardiac stimulating device being capable of detecting an episode of arrhythmia in a patient based on the set of arrhythmia detection criteria, and of applying a corresponding antiarrhythmia therapy to a patient's heart, the method comprising the steps of: recording the episode of arrhythmia as a cardiac signal; receiving the recorded cardiac signal; playing back the cardiac signal; analyzing the response of the cardiac stimulating device to the played back cardiac signal based on the set of arrhythmia detection criteria; analyzing the cardiac signal; and creating recommended arrhythmia detection criteria accordingly.
35. The method of Claim 34, wherein the analyzing step comprises the step of: adjusting the value of each parameter in the set of arrhythmia detection criteria until detection of the arrhythmia is optimal.
36. The method of Claim 35, wherein the adjusting step comprises the step of: adjusting the value of at least one of rate, rate stability, sudden onset delta, probability density function, morphology detection, slew rate, a specific number of intervals, signal amplitudes, frequency content and activation sequence.
37. The method of Claim 34, wherein the analyzing step comprises the steps of: 43
receiving the played back cardiac signal; and simulating the response of the cardiac stimulating device to the played back cardiac signal.
38. The method of Claim 37, further comprising the step of editing the recorded cardiac signal.
39. The method of Claim 34, wherein the recording step comprises the step of recording an actual cardiac signal of the patient.
40. The method of Claim 34, wherein the recording step comprises the step of recording the cardiac signal during an episode of induced arrhythmia.
41. The method of Claim 34, further comprising the steps of: producing a default cardiac signal; and displaying the default cardiac signal when desired.
42. The method of Claim 34, further comprising the steps of: selecting cardiac parameters; and producing a simulated cardiac signal based on the cardiac parameters.
43. The method of Claim 34, wherein the analyzing step comprises the step of receiving the played back cardiac signal with an external cardiac stimulating device.
44. A programmer for programming a cardiac stimulating device with arrhythmia detection criteria, 4 4
the cardiac stimulating device being capable of detecting an episode of arrhythmia based on the set of arrhythmia detection criteria, the cardiac stimulating device applying a corresponding antiarrhythmia therapy to a patient's heart, the programmer comprising: a control unit for implementing a programming system; a telemetry head connected to the control unit for communicating with the cardiac stimulating device via telemetry; a program storage unit connected to the control unit for storing programs and data; an input interface connected to the control unit for receiving commands from a user; a display connected to the control unit, the control unit playing back a cardiac signal that is representative of an intracardiac electrogram of an episode of arrhythmia to test the response of the cardiac stimulating device; means for receiving a recorded cardiac signal from a cardiac stimulating device; and means for simulating the response of the medical device to the recorded cardiac signal based on the set of arrhythmia detection criteria.
45. The programming system of Claim 44, wherein: the receiving means includes means for receiving a recorded sensor signal coincident with the recorded cardiac signal; and the control unit includes means for determining whether the cardiac signal is physiological or pathological based on the value of the sensor signal. 4 5
46. The programming system of Claim 45, wherein: the cardiac stimulating device is capable of increasing stimulation rate based on a set of rate- response parameters; and the control unit further includes means for adjusting the value of each parameter in the set of rate-response parameters until the stimulation rate is optimized during exercise.
47. The programmer of Claim 46, further comprising: means for selecting cardiac parameters; and means for simulating the cardiac signal based on the cardiac parameters.
48. The programmer of Claim 47, further comprising: means for receiving the simulated cardiac signal; and means for simulating the response of the cardiac stimulating device to the simulated cardiac signal based on the set of arrhythmia detection criteria.
49. The programmer of Claim 44, further comprising: means for producing a default cardiac signal; and means for simulating the response of the cardiac stimulating device to the default cardiac signal based on the set of arrhythmia detection criteria.
50. The programmer of Claim 44, further comprising: 4 6
means for editing the cardiac signal prior to playing back the cardiac signal; and means for displaying the edited cardiac signal on the display.
51. The programmer of Claim 44, further comprising: means for analyzing the cardiac signal; and means for creating recommended arrhythmia detection criteria according to the means for analyzing.
52. The programmer of Claim 51, wherein the analyzing means comprises: means for adjusting the value of each parameter in the set of arrhythmia detection criteria until detection of the arrhythmia is optimized.
53. The programmer of Claim 52, wherein the set of arrhythmia detection criteria comprises at least one of rate, rate stability, sudden onset delta, probability density function, morphology detection, slew rate, a specific number of intervals, signal amplitudes, frequency content and activation sequence,
54. A programming system for programming and optimizing a plurality of programmed parameters for use in a cardiac stimulating device, the cardiac stimulating device being capable of applying a corresponding therapy to a patient's heart based on the plurality of programmed parameters, the programming system comprising: means for recording a patient's cardiac signal over a predetermined time interval for playback; 47
means for playing back such cardiac signal; first telemetry means for telemetering the recorded cardiac signal; and external programmer means comprising: second telemetering means for receiving the telemetered recorded cardiac signal; and means for analyzing the response of the cardiac stimulating device to the played back cardiac signal based on the plurality of programmed parameters.
55. The programming system of Claim 54, wherein the external programmer means further comprises means for repetitively replaying the recorded cardiac signal and for determining the optimal value for each of the plurality of programmed parameters.
56. The programming system of Claim 55, wherein the plurality of programmed parameters includes detection criteria for the cardiac stimulating device and wherein the external programmer means includes means for simulating the detection response of the cardiac stimulating device for optimizing the detection criteria.
57. The programming system of Claim 56, further comprising means for reprogramming the cardiac stimulating device with the optimized detection criteria.
58. The programming system of Claim 57, wherein the cardiac signal comprises an episode of arrhythmia and the detection criteria comprises arrhythmia detection criteria. 4 8 •
59. The programming system of Claim 54, further comprising means for editing the played back cardiac signal.
60. A programming system for programming and optimizing a plurality of programmed parameters comprising arrhythmia detection criteria for use in a cardiac stimulating device, the cardiac stimulating device being capable of applying a corresponding therapy to a patient's heart based upon the arrhythmia detection criteria, the programming system comprising: means for recording a patient's cardiac signal over a predetermined time interval for playback, the cardiac signal comprising an episode of arrhythmia; means for playing back such recorded arrhythmia signal; first telemetry means for telemetering the recorded arrhythmia signal; and external programmer means comprising: second telemetry means for receiving the telemetered recorded arrhythmia signal; and means for analyzing the response of the cardiac stimulating device to the played back arrhythmia signals based on the arrhythmia detection criteria for optimizing such arrhythmia criteria.
61. The programming system of Claim 60, further comprising means for generating a simulated cardiac signal.
Figure imgf000018_0001
PCT/US1994/009715 1993-08-27 1994-08-25 Programming system for a patient's cardiac signal WO1995005868A1 (en)

Priority Applications (3)

Application Number Priority Date Filing Date Title
EP94926040A EP0669841A4 (en) 1993-08-27 1994-08-25 Programming system for a patient's cardiac signal.
AU76050/94A AU7605094A (en) 1993-08-27 1994-08-25 Programming system for a patient's cardiac signal
JP7507782A JPH08504656A (en) 1993-08-27 1994-08-25 Programming system for patient heart signals

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US08/113,540 1993-08-27
US08/113,540 US5421830A (en) 1993-08-27 1993-08-27 Programming system having means for recording and analyzing a patient's cardiac signal

Publications (2)

Publication Number Publication Date
WO1995005868A1 WO1995005868A1 (en) 1995-03-02
WO1995005868B1 true WO1995005868B1 (en) 1995-03-30

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PCT/US1994/009715 WO1995005868A1 (en) 1993-08-27 1994-08-25 Programming system for a patient's cardiac signal

Country Status (5)

Country Link
US (2) US5421830A (en)
EP (1) EP0669841A4 (en)
JP (1) JPH08504656A (en)
AU (1) AU7605094A (en)
WO (1) WO1995005868A1 (en)

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