US20070027397A1 - System for patient alerting associated with a cardiac event - Google Patents
System for patient alerting associated with a cardiac event Download PDFInfo
- Publication number
- US20070027397A1 US20070027397A1 US11/493,555 US49355506A US2007027397A1 US 20070027397 A1 US20070027397 A1 US 20070027397A1 US 49355506 A US49355506 A US 49355506A US 2007027397 A1 US2007027397 A1 US 2007027397A1
- Authority
- US
- United States
- Prior art keywords
- recited
- capability
- alarm signal
- human patient
- events occurring
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Abandoned
Links
Images
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
- A61B5/316—Modalities, i.e. specific diagnostic methods
- A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
- A61B5/346—Analysis of electrocardiograms
- A61B5/349—Detecting specific parameters of the electrocardiograph cycle
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/07—Endoradiosondes
- A61B5/076—Permanent implantations
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/103—Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
- A61B5/11—Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb
- A61B5/1112—Global tracking of patients, e.g. by using GPS
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/0002—Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network
- A61B5/0031—Implanted circuitry
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
- A61B5/316—Modalities, i.e. specific diagnostic methods
- A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
- A61B5/346—Analysis of electrocardiograms
- A61B5/349—Detecting specific parameters of the electrocardiograph cycle
- A61B5/363—Detecting tachycardia or bradycardia
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
- A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
- A61B5/6847—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive mounted on an invasive device
- A61B5/686—Permanently implanted devices, e.g. pacemakers, other stimulators, biochips
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Engineering & Computer Science (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- Pathology (AREA)
- Physics & Mathematics (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Cardiology (AREA)
- Surgery (AREA)
- Biophysics (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Radar, Positioning & Navigation (AREA)
- Physiology (AREA)
- Dentistry (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Electrotherapy Devices (AREA)
Abstract
A system for the detection of cardiac events occurring in a human patient is provided. At least two electrodes are included in the system for obtaining an electrical signal from a patient's heart. An electrical signal processor is electrically coupled to the electrodes for processing the electrical signal and a patient alarm means is further provided and electrically coupled to the electrical signal processor. The patient alarm means generates an escalating sensory alarm signal over a predetermined time period subsequent to the electrical signal processor if the processor detects a cardiac event. The patient alarm means may be further applied to a pacemaker or defibrillator system.
Description
- This invention is in the field of implantable medical device systems that monitor a patient's cardiovascular condition.
- Heart disease is the leading cause of death in the United States. A heart attack (also known as an acute myocardial infarction (AMI)) typically results from a thrombus (i.e., a blood clot) that obstructs blood flow in one or more coronary arteries. AMI is a common and life-threatening complication of coronary artery disease. Coronary ischemia is caused by an insufficiency of oxygen to the heart muscle. Ischemia is typically provoked by physical activity or other causes of increased heart rate when one or more of the coronary arteries is narrowed by atherosclerosis. AMI, which is typically the result of a completely blocked coronary artery, is the most extreme form of ischemia. Patients will often (but not always) experience chest discomfort (angina) when the heart muscle is experiencing ischemia. Those with coronary atherosclerosis are at higher risk for AMI if the plaque becomes further obstructed by thrombus.
- The current treatment for a coronary artery narrowing (a stenosis) is the insertion of a drug-eluting stent such as the Cypher™ sirolimus-eluting stent from Cordis Corporation or the Taxus™ paclitaxel-eluting stent from the Boston Scientific Corporation. The insertion of a stent into a stenosed coronary artery is a reliable medical treatment to eliminate or reduce coronary ischernia and to prevent the complete blockage of a coronary artery, which blockage can result in an AMI.
- Acute myocardial infarction and ischemia may be detected from a patient's electrocardiogram (ECG) by noting an ST segment shift (i.e., voltage change). However, without knowing the patient's normal ECG pattern, detection from a standard 12 lead ECG can be unreliable.
- Fischell et al. in U.S. Pat. Nos. 6,112,116, 6,272,379 and 6,609,023 describe implantable systems and algorithms for detecting the onset of acute myocardial infarction and providing both patient alerting and treatment. The Fischell et al. patents describe how the electrical signal from inside the heart (which is called an “electrogram”) can be used to determine various states of myocardial ischemia.
- The Reveal™ subcutaneous loop Holter monitor sold by Medtronic, Inc., uses two case electrodes spaced about 3 inches apart to record electrocardiogram information. Recording can be triggered automatically when arrhythmias are detected or upon patient initiation using an external device. The Reveal is designed to record electrogram data only and does not include a patient alerting capability. The Reveal also does not have the capability to measure or alert the patient if there is an ST segment shift. In fact, the Reveal's high pass filtering and electrode'spacing preclude accurate detection of changes in the low frequency aspects of the heart's electrical signal such as the ST segment of the electrogram.
- While pacemakers and Implantable Cardioverter Defibrillators (ICDs) monitor the patient's electrogram, they do not currently detect ST segment changes nor provide patient alerting.
- The term “medical practitioner” shall be used herein to mean any person who might be involved in the medical treatment of a patient. Such a medical practitioner would include, but is not limited to, a medical doctor (e.g., a general practice physician, an internist or a cardiologist), a medical technician, a paramedic, a nurse or an electrogram analyst. Although the masculine pronouns “he” and “his” are used herein, it should be understood that the patient, physician or medical practitioner could be a man or a woman. A “cardiac event” includes an acute myocardial infarction, ischemia caused by effort (such as exercise) and/or an elevated heart rate, bradycardia, tachycardia or an arrhythmia such as atrial fibrillation, atrial flutter, ventricular fibrillation, and premature ventricular or atrial contractions (PVCs or PACs respectively).
- It is generally understood that the term “electrocardiogram” is defined as the heart's electrical signals sensed by means of skin surface electrodes that are placed in a position to indicate the heart's electrical activity (depolarization and repolarization). An electrocardiogram segment refers to a portion of electrocardiogram signal that extends for either a specific length of time, such as 10 seconds, or a specific number of heart beats, such as 10 beats. A beat is defined as a sub-segment of an electrogram or electrocardiogram segment containing exactly one R wave. As used herein, the PQ segment of a patient's electrocardiogram or electrogram is the typically straight segment of a beat of an electrocardiogram or electrogram that occurs just before the R wave and the ST segment is a typically straight segment that occurs just after the R wave.
- Although often described as an electrocardiogram (ECG), the electrical signal from the heart as measured from electrodes within the body is properly termed an “electrogram”. As defined herein, the term “electrogram” is the heart's electrical signal voltage as sensed from one or more implanted electrode(s) that are placed in a position to indicate the heart's electrical activity (depolarization and repolarization). An electrogram segment refers to a portion of the electrogram signal for either a specific length of time, such as 10 seconds, or a specific number of heart beats, such as 10 beats. For the purposes of this specification, the terms “detection” and “identification” of a cardiac event have the same meaning.
- A heart signal parameter is defined to be a measured or calculated value created during the processing of one or more beats of the electrogram (or electrocardiogram). Heart signal parameters include the following: ST deviation (ST segment average value minus PQ segment average value), ST shift (ST deviation compared to a baseline average ST deviation), average signal strength, T wave peak height, T wave average value, T wave deviation, QRS complex width, number of PVCs per unit time, heart rate and R-R interval.
- The present invention system for the detection of coronary ischemia (including AMI) as described herein shall be called the “Guardian” system. The Guardian system detects cardiac events using an implanted sub-system called a “cardiosaver system” which is designed to detect cardiac events including arrhythmias and coronary ischemia. A “cardiac event” can be an acute myocardial infarction, ischemia caused by effort (such as exercise) and/or an elevated heart rate, bradycardia, tachycardia or an arrhythmia such as atrial fibrillation, atrial flutter, ventricular fibrillation, and premature ventricular or atrial contractions (PVCs or PACs respectively). The present invention cardiosaver system is designed to detect ischemia (including AMI) by identifying ST segment changes in a positive direction (ST elevation) or negative direction (ST depression).
- The cardiosaver system includes electrodes placed to advantageously sense electrical signals from the heart that is the electrogram. The electrodes can be placed within the heart and/or subcutaneously. The implanted portion of the Guardian system is the cardiosaver system as described by Fischell et al. in U.S. Pat. Nos. 6,112,116, 6,272,379 and 6,609,023, each of these patents being incorporated herein by reference. The Guardian system also includes external equipment that can include a physician's programmer and an external alarm device also described in the Fischell et al. patents.
- The present invention is a cardiosaver system that utilizes techniques for patient alerting designed to ensure the patient knows what is happening without startling the patient, which could cause an unwanted rise in heart rate at the time of a cardiac event when it is important to remain calm.
- In the Fischell et al. patents mentioned above, the concept of internal and external alarm signals is discussed, including the technique of using different patterns of sound, vibration or electrical tickle to assist the patient in differentiating between an emergency (major or critical) alarm where immediate medical attention is needed and a “see your doctor” alert where an appointment should be scheduled as soon as convenient.
- The present invention alerting system improves upon the Fischell et al. concepts by using alert escalation techniques that will communicate the emergency alarm, see doctor alert and/or other patient alert messages without startling or scaring the patient. One embodiment of the present invention uses an increasing amplitude of vibration over time from an internal alarm signal within the implanted cardiosaver. For example, the vibration amplitude might increase over a period of several minutes until it reaches a pre-set level. The escalating amplitude technique can also be applied if the internal alarm uses an electrical tickle or other means of alerting the patient. Also the present invention Guardian system may include an increasing amplitude for the external alarm signal generated by the external alarm system mentioned by Fischell et al. The external alarm signal can be a sound, vibration or visual display with sound being the preferred embodiment.
- It is also envisioned that not only can the amplitude of the internal and/or external alarm signals be increased over time, but the pattern and frequency of the signal might change. For example, the internal alarm might use sets of three successive vibrations with a short time between vibrations within a set and a longer time between sets where the time between sets of vibrations might decrease over time. The time between vibrations within a set might also decrease as the alert escalates. Another example might have the external alarm signal using a tone or tone sequence that increases in the pitch of the tones as the alert escalates. Finally, if a visual display using sets of light flashes is used as the external alarm signal, then the escalation might include the brightness of the flashes, an increase in the number of the flashes within a set, a decrease in the time between sets and a change in the color of the flashes.
- For the purposes of this invention, the term “alarm signal” refers to the complete signal internally or externally generated to alert the patient to the detection of a cardiac event. An alarm signal will continue until a timer turns it off after a pre-set time period (e.g., 5 minutes) or an alarm silence command is provided to the source generating the alarm. A typical alarm signal will be made up of a sequence of short (less than 10 seconds long) alerting signals. The alerting signals may be produced in sets with an inter-set time interval defined as the time interval between sets of alerting signals and the intra-set time interval defined as the time between alerting signals within a set of alerting signals.
- So in summary, the present invention is an implanted system for the detection of cardiac events having any combination of internal alarm signals and external alarm signals where, over the initial period of patient alerting, the alarm signals escalate by any or all of the following:
- a) An increase in amplitude of alerting signals over time;
- b) An increase in the number of alerting signals per set;
- c) A decrease in the time between alerting signals within a set;
- d) A decrease in the time between sets of alerting signals;
- e) A change in the frequency (vibrational frequency, sound pitch, color) of the alerting signals; and,
- f) An increase in the frequency, length and/or amplitude of each alerting signal within a set (including a set of one alerting signal).
- Another embodiment of the present invention is an implanted ischemia detection device with patient alerting that also includes pacemaker circuitry to pace the patient's heart as needed. Still another embodiment is an implanted ischemia detection device with patient alerting that includes Implantable Cardiac Defibrillator (ICD) circuitry to defibrillate the patient's heart as needed. Yet another embodiment is an implanted ischemia detection device with patient alerting that includes a combination of pacemaker and ICD circuitry.
- It is also envisioned that there could be an escalating pattern where the number of alerting signals in each set increases while the length of each alerting signal decreases.
- It is also envisioned that the escalation of alerting might involve the sequencing of internal and external alarms. For example, the external alarm signal might begin first as people who are used to phones ringing are less likely to be startled by external alerting sounds. After a preset period of time, the internal alarm signal might begin. Neither, either or both the external and internal alarm signals in such a sequential activation might use one or more alarm signals that escalate by the means described above.
- Thus it is an object of this invention to have a Guardian system that can alert a patient to the detection of a cardiac event without causing a startle response.
- Another object of this invention is to have a Guardian system that can alert a patient to the detection of a cardiac event where the alarm signal escalates over time.
- Still another object of this invention is to have a Guardian system that can alert a patient to the detection of a cardiac event where the alarm signal escalates by increasing amplitude over time.
- Still another object of this invention is to have a Guardian system that can alert a patient to the detection of a cardiac event where the alarm signal escalates by increasing frequency over time.
- Yet another object of this invention is to have a Guardian system that can alert a patient to the detection of a cardiac event where the alarm signal escalates by decreasing the time between alerting signals within sets of the alarm signal.
- Yet another object of this invention is to have a Guardian system that can alert a patient to the detection of a cardiac event where the alarm signal escalates by decreasing the time between sets of alerting signals within the alarm signal.
- Yet another object of this invention is to have a Guardian system that can alert a patient to the detection of a cardiac event where the alarm signal escalates by increasing the number of alerting signals within sets of the alarm signal.
- Yet another object of this invention is to have a Guardian system that can alert a patient to the detection of a cardiac event where the alarm signal escalates by increasing the frequency, length and/or amplitude of each alerting signal with a set (including a set of one alerting signal).
- Yet another object of the present invention is to have a Guardian system with an implanted component having the capability to generate an internal alarm signal and an external alarm system capable of generating an external alarm signal where the patient alert initiates the external alarm signal before the internal alarm.
- Yet another object of the present invention is to have a Guardian system with an implanted component having the capability to generate an internal alarm signal and an external alarm system capable of generating an external alarm signal where the patient alert initiates the internal alarm signal before the external alarm.
- These and other objects and advantages of this invention will become obvious to a person of ordinary skill in this art upon reading of the detailed description of this invention including the associated drawings as presented herein.
-
FIG. 1 illustrates a Guardian system for the detection of a cardiac event such as an ST segment shift indicative of coronary ischemia and for warning the patient that a cardiac event is occurring; -
FIG. 2 is a block diagram of the implanted cardiosaver system; -
FIG. 3 illustrates an increase in amplitude of an alarm signal as the patient alert escalates; -
FIG. 4 illustrates a change in the number of alerting signals per set as the patient alert escalates; -
FIG. 5 illustrates a decrease in the time between alerting signals within a set of alerting signals as the patient alert escalates; -
FIG. 6 illustrates a decrease in the time between sets of alerting signals as the patient alert escalates; -
FIG. 7 illustrates a change in frequency of alerting signals as the patient alert escalates; -
FIG. 8 illustrates a change in the length of each alerting signal within a set of alerting signals as the patient alert escalates; -
FIG. 9 illustrates a progressive increase in the alerting signals within each set of alerting signals of an alarm signal; and, -
FIG. 10 illustrates an escalating patient alert with increasing intensity, increasing number of alerting signals per set, decreasing time between alerting signals within a set and decreasing time between sets of alerting signals. -
FIG. 1 illustrates one embodiment of theGuardian system 10 consisting of an implantedcardiosaver system 5 andexternal equipment 7. Thecardiosaver system 5 includes acardiosaver 11, anantenna 6 and anelectrode 4 that is part of alead 2. Thecardiosaver 11 includes electronic circuitry that can detect a cardiac event such as an acute myocardial infarction or arrhythmia and can warn the patient when a cardiac event occurs. Thecardiosaver 11 can store the patient's electrogram for later readout and can send and receivewireless signals 3 to and from theexternal equipment 7 via the implantedantenna 6 and theexternal antenna 25. The functioning of thecardiosaver system 5 will be explained in greater detail with the assistance ofFIG. 2 . - The
cardiosaver system 5 has at least onelead 2 with at least oneelectrode 4. In fact, thecardiosaver system 5 could utilize as few as one lead or as many as three and each lead could have as few as one electrode or as many as eight electrodes. Thelead 2 inFIG. 1 could advantageously be placed subcutaneously or through the patient's vascular system with theelectrode 4 being placed into the apex of the right ventricle. For example, thelead 2 could be placed in the right ventricle or right atrium or the superior vena cava similar to the placement of leads for pacemakers and ICDs. The metal case of thecardiosaver 11 could serve as an indifferent electrode with theelectrode 4 being the active electrode. Alternately, thelead 2 inFIG. 1 could be placed through the patient's vascular system with theelectrode 4 being placed into the apex of the left ventricle. - The
lead 2 could advantageously be placed subcutaneously at any location where theelectrode 4 would provide a good electrogram signal indicative of the electrical activity of the heart. Again for thelead 2, the case of thecardiosaver 11 of thecardiosaver system 5 could be an indifferent electrode and theelectrode 4 would be the active electrode. Although theGuardian system 10 described herein can readily'operate with only two electrodes, or one electrode and the case of the cardiosaver being the other electrode, it is envisioned that multiple electrodes used in monopolar or bipolar configurations could be used. -
FIG. 1 also shows theexternal equipment 7 that consists of anexternal alarm transceiver 20, a physician'sprogrammer 18, apocket PC 12, an emergency roomdiagnostic system 16 and theequipment 14 in a remote diagnostic center. Theexternal equipment 7 provides the means to interact with thecardiosaver system 5. These interactions include programming thecardiosaver 11, retrieving data collected by thecardiosaver system 5, and handling alarms generated by thecardiosaver 11. It should be understood that thecardiosaver system 5 could operate with some but not all of theexternal equipment 7. - The
external alarm transceiver 20 includes abattery 21, an alarm disable/panic button 22, aradio frequency transceiver 23, amicrophone 27, an alarm-speaker 24, anantenna 25, aGPS satellite receiver 26, and astandard interface 28 for providing wired or wireless communication with thepocket PC 12, emergency roomdiagnostic system 16, or physician'sprogrammer 18. A long distance voice/data communications interface 29 provides connectivity to the remotediagnostic center equipment 14 through voice and data telecommunications networks. For example, themicrophone 27 andspeaker 24 could be used for wired or wireless telephone calls to and from a medical practitioner at the remote diagnostic center. A built-in modem as part of theinterface 29 would allow data to be transmitted to and from the remotediagnostic center equipment 14 over a voice connection. Alternately, a data communications capability of theinterface 29 could allow data to be sent or received through a wired or wireless data network. Theexternal alarm transceiver 20 may be a separate unit that can be carried by the patient and used by the patient's physician as the data interface to thecardiosaver system 5 or it may also be built into thepocket PC 12, physician'sprogrammer 18 or emergency roomdiagnostic system 16 - The pocket PC also described by Fischell et al. in U.S. Pat. No. 6,609,023 can provide the patient or physician the ability to check the status of the
cardiosaver 11 and display a limited set of electrogram data uploaded from thecardiosaver 11. - The emergency room
diagnostic system 16 is a more sophisticated system that can upload and display any of the data stored within thecardiosaver 11 and would, in its preferred embodiment, use a touch screen display to facilitate triage of patients arriving in an emergency room who have thecardiosaver system 5. This should greatly reduce the time from arrival at the emergency room until treatment for cardiosaver system patients having a cardiac event. - The purpose of the physician's
programmer 18 shown inFIG. 1 is to set and/or change the operating parameters of the implantedcardiosaver system 5 and to read out data stored in the memory of thecardiosaver 11 such as stored electrogram segments as described by Fischell et al. in U.S. Pat. No. 6,609,023. - The
external alarm transceiver 20 would typically be a pager-sized device that the patient would carry on his person or keep in close proximity. If a cardiac event is detected by thecardiosaver system 5, an alarm message is sent by awireless signal 3 to thealarm transceiver 20 via theantennas alarm transceiver 20, a patient alerting sound is played through theloudspeaker 24 to warn the patient that a cardiac event has occurred. Examples of such sounds include a periodic buzzing, a sequence of tones and/or a speech message that instructs the patient as to what actions should be taken. Furthermore, thealarm transceiver 20 can, depending upon the nature of thesignal 3, send an outgoing message to the remotediagnostic center equipment 14 to alert medical practitioners that a cardiosaver system alarm has occurred. The medical practitioners can then utilize the voice communications capabilities of the remotediagnostic center equipment 14 to call back the patient similar to the call that occurs to car drivers through the ONSTAR service when their car's air bags deploy in an accident. Theoptional GPS receiver 26 would allow the data sent to the remotediagnostic center equipment 14 to include patient location to facilitate the summoning of emergency medical services. - The alarm disable/
panic button 22 will turn off both the internal alarm of theimplant 5 and the sound being emitted from theloudspeaker 24. If no alarm is occurring, then pressing the alarm disable/panic button 22 will place a voice and/or data call to the remote diagnostic center similar to the call that is placed when the ONSTAR button is pressed in a car equipped to access the ONSTAR service. GPS information and a subset of patient electrogram data may be sent as well to the medical practitioners at the remote diagnostic center. The remotely located medical practitioner could then analyze the electrogram data and call the patient back to offer advice as to whether there is an emergency situation or the situation could be routinely handled by the patient's personal physician at some later time. -
FIG. 2 is a block diagram of thecardiosaver system 5. Thelead 2 includes theelectrode 4 and thewire 12. Thewire 12 connects theelectrode 4 to theamplifier circuit 36 that is also connected by thewire 15 to thecardiosaver case 8 acting as an indifferent electrode. The amplified electrogram signals 37 from theamplifier circuit 36 are converted todigital signals 38 by the analog-to-digital converter 41. The digital electrogram signals 38 are then sent to theelectrical signal processor 44. Theprocessor 44 in conjunction with thememory 47 can process thedigital signals 38 according to the programming instructions stored in theprogram memory 45. This programming (i.e. software) enables thecardiosaver system 5 to detect the occurrence of a cardiac event such as an ST segment elevation that is indicative of an acute myocardial infarction. - A clock/
timing sub-system 49 provides the means for timing specific activities of thecardiosaver system 5 including the absolute or relative time stamping of detected cardiac events. The clock/timing sub-system 49 can also facilitate power savings by causing components of thecardiosaver system 5 to go into a low power stand-by mode in between times for electrogram signal collection and processing. Such cycled power savings techniques are often used in implantable pacemakers and defibrillators. In an alternative embodiment, the clock/timing sub-system can be provided by a program subroutine run by thecentral processing unit 44. It is also envisioned that theprocessor 44 may include an integral or external First-In-First-Out (FIFO) buffer memory to allow saving of data from before the detection of a cardiac event. - Techniques for detecting cardiac events by the
processor 44 are described by Fischell et al. in U.S. Pat. No. 6,609,023. - An important aspect of the present invention is the filtering of the electrical signals sensed by the
electrodes FIG. 1 ) will include high pass and/or low pass filtering of the electrical signals in theamplifier circuit 36. An alternative embodiment would introduce filtering in any one, two or all of the following locations: - 1. a separate analog filter between the
amplifier circuit 36 and analog-to-digital converter 41, - 2. a separate digital filter circuit placed between the analog-to-
digital converter 41 and theprocessor 44, and/or - 3. digital filtering performed by the
processor 44 on thedigital signals 38. - The
memory 47 includes specific memory locations for patient data, electrogram segment data and any other relevant data. - It is envisioned that the
cardiosaver system 5 could also containpacemaker circuitry 170 and/ordefibrillator circuitry 180 similar to the cardiosaver system described by Fischell et al. in U.S. Pat. No. 6,240,049. - The
alarm sub-system 48 contains the circuitry and transducers to produce the internal alarm signals for the cardiosaver 11 (FIG. 1 ). The internal alarm signal can be a mechanical vibration, a sound or a subcutaneous electrical tickle or shock. - The
telemetry sub-system 46 withantenna 6 provides thecardiosaver system 5 with the means for two-way wireless communication to and from theexternal equipment 7 ofFIG. 1 . It is also envisioned that short-range telemetry such as that typically used in pacemakers and defibrillators could also be applied to thecardiosaver system 5. It is also envisioned that standard wireless protocols such as Bluetooth and 802.11a or 802.11b might be used to provide communication with a wider group of peripheral devices. - A
magnet sensor 190 may be incorporated into thecardiosaver system 5. The primary purpose for amagnet sensor 190 is to keep thecardiosaver system 5 in an off condition until it is checked out just before it is implanted into a patient. This can prevent depletion of the battery life in the period between the time that thecardiosaver system 5 is packaged at the factory and the day it is implanted. - The preferred embodiment of the present invention associated with a pacemaker/ICD or combined pacemaker/ICD would have the event detection and alerting function integrated within the pacemaker, ICD or combined pacemaker/ICD. It is also envisioned that the lead might connect both to a standard pacemaker, ICD or combined pacemaker/ICD and a cardiosaver having an electrical signal processor for cardiac event detection and the ability to generate an escalating patient alert.
-
FIG. 3 is an example of use of increasing the amplitude of an alarm signal to provide an escalating patient alert.FIG. 3 shows the progression over time of the three successive sets of alertingsignals alarm signal 30. The pattern displayed inFIG. 3 can be applied to internal and/or external alarm signals using vibration, sound, electrical stimulation (tickle) or a visual display. Theset 31 has alertingsignals set 31 having anamplitude 315, aduration 316, and a time interval between the alertingsignals set 32 has alertingsignals set 32 having anamplitude 325, aduration 326 and a time interval between the alertingsignals set 33 has alertingsignals set 33 having anamplitude 335, aduration 336 and a time interval between the alertingsignals sets sets alarm signal 30 provides an escalating patient alert by progressively increasing the amplitude over time as theamplitude 335 is greater than theamplitude 325 which is greater than theamplitude 315. Ideally, such an escalating amplitude alert would start at level barely detectable by the patient and increase to a level that cannot be ignored. The physician'sprogrammer 18 ofFIG. 1 would typically provide the capability to test different patterns and intensities of both internal and external alarm signals with the patient to set a patient alert that cannot be missed while also reducing the potential to startle the patient. It is also envisioned that the amplitude might also increase for successive alerting signals within a set. The present invention includes any increase in amplitude over time in any type of internal or external alarm signal. It is also envisioned that after a preset escalation period, the amplitude would reach a pre-set level and no longer increase. An important feature of theprogrammer 18 would be to set the initial alerting signal amplitude so that it is just barely perceptible and to set the highest alerting signal amplitude at a level that cannot be missed. AlthoughFIG. 3 shows a constant duration of the alerting signals (316, 326 and 336), a constant time between sets (312 and 323) and constant times between alerting signals within a set (311, 321 and 331) they need not be constant. The times between alertingsignals sets -
FIG. 4 is an example of use of increasing number of alerting signals within each set of alerting signals of an alarm signal to provide an escalating patient alert.FIG. 4 shows the progression over time of the four successive sets of alertingsignals alarm signal 40. The pattern displayed inFIG. 4 can be applied to internal and/or external alarm signals using vibration, sound, electrical stimulation (tickle) or a visual display. Theset 41 has onealerting signal 41A, the alertingsignal 41A having anamplitude 45 and aduration 46. Theset 42 has two alertingsignals set 42 having anamplitude 45, aduration 46 and a time interval between the alertingsignals set 43 has three alertingsignals set 43 having anamplitude 45, aduration 46 and a time interval between the alertingsignals set 44 has four alertingsignals set 44 having anamplitude 45, aduration 46, and a time interval between the alertingsignals sets sets sets alarm signal 40 provides an escalating patient alert by progressively increasing the number of alerting signals per set over time. - Although the pattern shown in
FIG. 4 shows an increase by one of the number of alerting signals in successive sets, it is envisioned that an increase in the number of alerting signals per set could occur faster, e.g. an increase by two from one set to the next. It is also envisioned that the increase in the number of alerting signals per set could occur more slowly, e.g. an increase by one after every two sets. Ideally, such an escalating alert would start with a single alerting signal in a set such as theset 41 and increase to a preset number of alerting signals per set. The present invention includes any progressive increase in the number of alerting signals per set in an internal or external alarm signal. It is also envisioned that after a preset escalation period, the number of alerting signals per set would reach a pre-set level and no longer increase. AlthoughFIG. 4 shows aconstant amplitude 45, a constant duration of the alerting signals 46, a constant time between sets (412,423 and 434) and constant times between alerting signals within a set (421, 431 and 441), they need not be constant. The times between alertingsignals sets duration 46 of the alerting signals might decrease. This will subsequently reduce the total time for sets of alerting signals as the number of alerting signals increases. -
FIG. 5 is an example of use of decreasing time between alerting signals within a set of alerting signals of an alarm signal to provide an escalating patient alert.FIG. 5 shows the progression over time of the three successive sets of alertingsignals alarm signal 50. The pattern displayed inFIG. 5 can be applied to internal and/or external alarm signals using vibration, sound, electrical stimulation (tickle) or a visual display. The set 51 has alertingsignals amplitude 55, aduration 516 and a time interval between the alertingsignals set 52 has alertingsignals set 52 having anamplitude 55, aduration 526 and a time interval between the alertingsignals set 53 has alertingsignals set 53 having anamplitude 55, aduration 536 and a time interval between the alertingsignals 53A and 53B and the alerting signals 53B and 53C of 531. The time interval between thesets 51 and 52 is 512 and the time interval between thesets alarm signal 50 provides an escalating patient alert by progressively decreasing the time between alerting signals within successive sets over time as thetime 511 is greater than thetime 521 which is greater than thetime 531. It is also envisioned that the time between alerting signals might decrease for successive alerting signals within a set. The present invention includes any progressive decrease in the time between successive alerting signals in an internal or external alarm signal. It is also envisioned that after a preset escalation period, the time between alerting signals would reach a pre-set level and no longer decrease. AlthoughFIG. 5 shows aconstant amplitude 55, a constant duration of the alerting signals (516, 526 and 536) and a constant time between sets (512 and 523) they need not be constant. The times between alertingsignals sets -
FIG. 6 is an example of use of decreasing time between sets of alerting signals of an alarm signal to provide an escalating patient alert.FIG. 6 shows the progression over time of the four successive sets of alertingsignals alarm signal 60. The pattern displayed inFIG. 6 can be applied to internal and/or external alarm signals using vibration, sound, electrical stimulation (tickle) or a visual display. Theset 61 has alertingsignals set 61 having anamplitude 65, aduration 616 and a time interval between the alertingsignals set 62 has alertingsignals set 62 having anamplitude 65, aduration 626 and a time interval between the alertingsignals set 63 has alertingsignals set 63 having anamplitude 65, a duration 636 and a time interval between the alertingsignals set 64 has alertingsignals set 64 having anamplitude 65, aduration 646 and a time interval between the alertingsignals sets sets sets alarm signal 60 provides an escalating patient alert by progressively decreasing the time between sets of alerting signals over time as thetime 612 is greater than thetime 623 which is greater than thetime 634. The present invention includes any progressive decrease in the time between successive sets of alerting signals in an internal or external alarm signal. It is also envisioned that after a preset escalation period, the time between sets of alerting signals would reach a pre-set level and no longer decrease. AlthoughFIG. 6 shows aconstant amplitude 65, a constant duration of the alerting signals (616, 626, 636 and 646) and a constant time between alerting signals within each set (611, 621, 631 and 641), they need not be constant. The times between alertingsignals sets -
FIG. 7 is an example of use of increasing frequency (decrease in wavelength) for successive sets of alerting signals of an alarm signal to provide an escalating patient alert.FIG. 7 shows the progression over time of the three successive sets of alertingsignals alarm signal 70. The pattern displayed inFIG. 7 can be applied to internal and/or external alarm signals using vibration, sound, electrical stimulation (tickle) or a visual display. For a visual display a change in frequency would typically entail a change in color. The set 71 has alertingsignals 71A and 71B, each alerting signal within the set 71 having awavelength 717, anamplitude 75, aduration 716 and a time interval between the alertingsignals 71A and 71B of 711. Theset 72 has alertingsignals 72A and 72B, each alerting signal within theset 72 having awavelength 727, anamplitude 75, aduration 726 and a time interval between the alertingsignals 72A and 72B of 721. Theset 73 has alertingsignals set 73 having awavelength 737, anamplitude 75, aduration 736 and a time interval between thesignals sets 71 and 72 is 712 and the time interval between thesets alarm signal 70 provides an escalating patient alert by progressively decreasing the wavelength (increasing the frequency) of the alerting signals within successive sets over time as thewavelength 717 is greater than thewavelength 727 which is greater than thewavelength 737. It is also envisioned that the wavelength of the alerting signals might progressively decrease for successive alerting signals within a set. The present invention includes any use of a progressive decrease in the wavelength (which is equivalent to an increase in frequency) of alerting signals in an internal or external alarm signal. It is also envisioned that after a preset escalation period, the frequency of the alerting signals would reach a pre-set level and no longer change. AlthoughFIG. 7 shows aconstant amplitude 75, a constant duration of the alerting signals (716, 726 and 736), a constant time between alerting signals within each set (711, 721, and 731) and a constant time between sets (712 and 723), they need not be constant. The times between alertingsignals sets FIGS. 2 through 6 are shown as square waves, it is envisioned that any wave structure including sine waves and triangular waves could be used by thecardiosaver system 5 ofFIG. 1 . -
FIG. 8 is an example of use of progressively increasing the duration of the alerting signals for successive sets of alerting signals of an alarm signal to provide an escalating patient alert.FIG. 8 shows the progression over time of the three successive sets of alertingsignals alarm signal 80. The pattern displayed inFIG. 8 can be applied to internal and/or external alarm signals using vibration, sound, electrical stimulation (tickle) or a visual display. Theset 81 has alertingsignals set 81 having anamplitude 85, aduration 816 and a time interval between the alertingsignals set 82 has alertingsignals set 82 having anamplitude 85, aduration 826 and a time interval between the alertingsignals set 83 has alertingsignals set 83 having anamplitude 85, aduration 836 and a time interval between the alertingsignals sets sets alarm signal 80 provides an escalating patient alert by progressively increasing the duration of the alerting signals for successive sets over time as theduration 836 is greater than theduration 826 which is greater than theduration 816. It is also envisioned that the duration of alerting signals might increase for successive alerting signals within a set. The present invention includes any progressive increase in the duration of alerting signals in an internal or external alarm signal. It is also envisioned that after a preset escalation period, the duration of the alerting signals would reach a pre-set level and no longer increase. AlthoughFIG. 8 shows aconstant amplitude 85, a constant time between alerting signals within each set (811, 821 and 831) and a constant time between sets (812 and 823) they need not be constant. The times between alertingsignals sets -
FIG. 9 is an alternative to thealarm signal 30 ofFIG. 3 as an example of use of increasing amplitude of an alarm signal to provide an escalating patient alert.FIG. 9 . shows the progression over time of the three successive sets of alertingsignals alarm signal 90. The pattern displayed inFIG. 9 can be applied to internal and/or external alarm signals using vibration, sound, electrical stimulation (tickle) or a visual display. Theset 91 has alertingsignals amplitudes set 91 has aduration 916 and a time interval between the alertingsignals set 92 has alertingsignals amplitudes set 92 has aduration 926 and a time interval between the alertingsignals set 93 has alertingsignals amplitudes set 93 has aduration 936 and a time interval between the alertingsignals sets sets alarm signal 90 provides an escalating patient alert by progressively increasing the amplitude over time as the amplitude increases with each successive alerting signal within each set, e.g. 915C is greater than theamplitude 915B which is greater than theamplitude 915A. There is also shown a progressive increase in amplitude betweensets programmer 18 ofFIG. 1 would typically provide the capability to test different patterns and intensities of both internal and external alarm signals with the patient to set a patient alert that cannot be missed while also reducing the potential to startle the patient. It is also envisioned that after a pre-set escalation period, the amplitude would reach a pre-set level and no longer increase. AlthoughFIG. 9 shows a constant duration of the alerting signals (916, 926 and 936), a constant time between sets (912 and 923) and constant times between alerting signals within a set (911, 921 and 931) they need not be constant. The times between alertingsignals sets -
FIG. 10 is an example of use of a combination of progressive escalating features of an alarm signal to provide an escalating patient alert.FIG. 10 shows the progression over time of the three successive sets of alertingsignals alarm signal 100. The pattern displayed inFIG. 10 can be applied to internal and/or external alarm signals using vibration, sound, electrical stimulation (tickle) or a visual display. Theset 101 has two alertingsignals set 101 having anamplitude 1015, aduration 1016 and a time interval between the alertingsignals set 102 has three alertingsignals set 102 having anamplitude 1025, aduration 1026 and a time interval between the alertingsignals set 103 has four alertingsignals set 103 having anamplitude 1035, aduration 1036 and a time interval between the alertingsignals sets sets alarm signal 100 provides an escalating patient alert by combining several of the escalating features seen in FIGS. 3 though 7 including: - a) progressively increasing the amplitude of the alerting signals over time as the
amplitude 1035 is greater than theamplitude 1025 which is greater than theamplitude 1015; - b) progressively increasing the number of alerting signals in each set as the
set 101 contains two alerting signals, theset 102 contains 3 alerting signals and theset 103 contains 4 alerting signals; - c) progressively decreasing the time interval between alerting signals within each set as the
time interval 1011 is greater than thetime interval 1021 which is greater than thetime interval 1031; and, - d) progressively decreasing the time interval between sets of alerting signals as the
time interval 1012 is greater than thetime interval 1023, - Although the
alarm signal 100 shows a combination of four different escalation features of the alarm signals 30, 40, 50 and 60, it is envisioned that an escalating signal could include any combination of two, three or more of the escalation techniques shown in the examples ofFIGS. 3 through 10 . It is also envisioned that the present invention would also include any escalating alerting pattern that would over time become more and more perceptible to a patient. - Although the techniques for escalating patient alerting has been discussed with respect to an implanted system for the detection of cardiac events, it is also envisioned that these techniques are equally applicable to systems for the detection of cardiac events that are entirely external to the patient. For clarity, the time interval between alerting signals within a set is hereby termed as the intra-set time interval and the time interval between sets of alerting signals is hereby termed the inter-set time interval.
- Various other modifications, adaptations, and alternative designs are of course possible in light of the above teachings. Therefore, it should be understood at this time that, within the scope of the appended claims, the invention can be practiced otherwise than as specifically described herein.
Claims (89)
1-40. (canceled)
41. An implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient comprising: (a) a pacemaker adapted for insertion into the human patient; (b) a pacemaker lead coupled to the pacemaker for obtaining an electrogram electrical signal from the patient's heart; (c) an electrical signal processor coupled to the pacemaker lead for processing the electrogram electrical signal and detecting a cardiac event; and, (d) patient alarm means coupled to the electrical signal processor for generating an escalating sensory alarm signal received by the patient over a predetermined time period subsequent to the electrical signal processor detecting the cardiac event.
42. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 41 wherein the cardiac event is coronary ischemia indicated by a change in the ST segment of the electrogram.
43. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 41 wherein the cardiac event is coronary ischemia indicated by a change in the ST segment of the electrogram at an elevated heart rate.
44. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 41 wherein the cardiac event is an arrhythmia.
45. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 44 wherein the arrhythmia is high heart rate.
46. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 44 wherein the arrhythmia is low heart rate.
47. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 44 wherein the arrhythmia is an unsteady heart rate.
48. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 47 wherein the unsteady heart rate is the result of PVCs.
49. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 47 wherein the unsteady heart rate is the result of atrial fibrillation.
50. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 41 wherein the escalating alarm signal progressively increases in amplitude over time.
51. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 50 wherein the escalating alarm signal increases in amplitude over time only for a preset time period.
52. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 50 wherein the escalating alarm signal includes a multiplicity of successive alerting signals spaced in time by a time interval, the successive alerting signals increasing in amplitude over time.
53. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 41 wherein the escalating alarm signal includes a multiplicity of successive sets of alerting signals, each set including two or more alerting signals the alerting signals within each set spaced apart in time by an intra-set time interval.
54. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 43 wherein the escalating alarm signal is produced by a decreasing intra-set time interval in successive sets of alerting signals.
55. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 43 wherein the sets of two or more alerting signals are spaced apart in time by an inter-set time interval.
56. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 55 wherein the inter-set time interval is longer than the intra-set time interval.
57. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 55 wherein the inter-set time interval is greater than one second.
58. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 55 wherein the intra-set time interval is less than 1 second.
59. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 41 wherein the escalating alarm signal includes a multiplicity of successive sets of alerting signals, the sets spaced apart in time by an inter-set time interval.
60. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 59 wherein the escalating alarm signal is produced by a progressively decreasing inter-set time interval between successive sets of alerting signals.
61. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 41 wherein the escalating alarm signal includes a multiplicity of successive sets of alerting signals, each set including one or more alerting signals, the number of alerting signals in each set increasing over time.
62. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 61 wherein the time interval between alerting signals in sets of alerting signals including 2 or more alerting signals progressively decreases over time.
63. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 41 wherein the escalating alarm signal includes a multiplicity of alerting signals, the alerting signals increasing in duration over time.
64. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 41 wherein the escalating alarm signal includes a multiplicity of alerting signals, the alerting signals progressively increasing in frequency over time.
65. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 41 wherein the escalating alarm signal includes an internal alarm signal originating from an implanted medical device.
66. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 65 wherein the internal alarm signal is includes a vibration.
67. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 65 wherein the internal alarm signal includes an electrical tickle.
68. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 65 wherein the internal alarm signal includes a sound.
69. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 65 further including an escalating external alarm signal.
70. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 65 further including an external alarm signal generated by an external alarm system is of constant level of perceptibility to the patient.
71. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 65 further including an external alarm signal generated by an external alarm system, the external alarm signal being initiated at a preset time before the initiation of the escalating internal alarm signal.
72. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 71 wherein the external alarm is an escalating alarm signal.
73. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 65 further including an external alarm signal generated by an external alarm system, the external alarm signal being initiated at a preset time after the initiation of the escalating internal alarm signal.
74. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 73 wherein the external alarm signal is an escalating alarm signal.
75. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 41 wherein the escalating alarm signal includes an external alarm signal originating from an external alarm system.
76. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 76 wherein the internal alarm signal includes a vibration.
77. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 76 wherein the internal alarm signal includes a visual display.
78. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 76 wherein the internal alarm signal includes a sound.
79. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 76 further including an internal alarm signal generated by an implanted medical device, the internal alarm signal being of constant level of perceptibility to the patient.
80. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 79 wherein the escalating external alarm signal is initiated at a preset time before the initiation of the constant internal alarm signal.
81. An implantable cardiac defibrillator having capability of detecting cardiac events occurring in a human patient comprising: (a) a defibrillator adapted for insertion into the human patient; (b) at least one lead coupled to the defibrillator for obtaining an electrogram electrical signal from the patient's heart; (c) an electrical signal processor electrically coupled to said electrode for processing the electrogram electrical system and detecting a cardiac event; and, (d) patient alarm means coupled to the electrical signal processor for generating an escalating sensor alarm signal received by the patient over a predetermined time period subsequent to the electrical signal processor detecting the cardiac event.
82. The implantable cardiac defibrillator system having capability of detecting cardiac events occurring in a human patient as recited in claim 81 wherein the cardiac event is coronary ischemia indicated by a change in the ST segment of the electrogram.
83. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 81 wherein the cardiac event is coronary ischemia indicated by a change in the ST segment of the electrogram at an elevated heart rate.
84. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 81 wherein the cardiac event is an arrhythmia.
85. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 84 wherein the arrhythmia is high heart rate.
86. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 84 wherein the arrhythmia is low heart rate.
87. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 84 wherein the arrhythmia is an unsteady heart rate.
88. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 87 wherein the unsteady heart rate is the result of PVCs.
89. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 87 wherein the unsteady heart rate is the result of atrial fibrillation.
90. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 81 wherein the escalating alarm signal progressively increases in amplitude over time.
91. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 90 wherein the escalating alarm signal increases in amplitude over time only for a preset time period.
92. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 90 wherein the escalating alarm signal includes a multiplicity of successive alerting signals spaced in time by a time interval, the successive alerting signals increasing in amplitude over time.
93. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 81 wherein the escalating alarm signal includes a multiplicity of successive sets of alerting signals, each set including two or more alerting signals the alerting signals within each set spaced apart in time by an intra-set time interval.
94. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 93 wherein the escalating alarm signal is produced by a decreasing intra-set time interval in successive sets of alerting signals.
95. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 93 wherein the sets of two or more alerting signals are spaced apart in time by an inter-set time interval.
96. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 95 wherein the inter-set time interval is longer than the intra-set time interval.
97. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 95 wherein the inter-set time interval is greater than one second.
98. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 95 wherein the intra-set time interval is less than 1 second.
99. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 81 wherein the escalating alarm signal includes a multiplicity of successive sets of alerting signals, the sets spaced apart in time by an inter-set time interval.
100. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 99 wherein the escalating alarm signal is produced by a progressively decreasing inter-set time interval between successive sets of alerting signals.
101. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 81 wherein the escalating alarm signal includes a multiplicity of successive sets of alerting signals, each set including one or more alerting signals, the number of alerting signals in each set increasing over time.
102. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 101 wherein the time interval between alerting signals in sets of alerting signals including 2 or more alerting signals progressively decreases over time.
103. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 81 wherein the escalating alarm signal includes a multiplicity of alerting signals, the alerting signals increasing in duration over time.
104. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 81 wherein the escalating alarm signal includes a multiplicity of alerting signals, the alerting signals progressively increasing in frequency over time.
105. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 81 wherein the escalating alarm signal includes an internal alarm signal originating from an implanted medical device.
106. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 105 wherein the internal alarm signal is-includes a vibration.
107. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 105 wherein the internal alarm signal includes an electrical tickle.
108. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 105 wherein the internal alarm signal includes a sound.
109. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 105 further including an escalating external alarm signal.
110. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 105 further including an external alarm signal generated by an external alarm system is of constant level of perceptibility to the patient.
111. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 105 further including an external alarm signal generated by an external alarm system, the external alarm signal being initiated at a preset time before the initiation of the escalating internal alarm signal.
112. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 111 wherein the external alarm is an escalating alarm signal.
113. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 105 further including an external alarm signal generated by an external alarm system, the external alarm signal being initiated at a preset time after the initiation of the escalating internal alarm signal.
114. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 113 wherein the external alarm signal is an escalating alarm signal.
115. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 81 wherein the escalating alarm signal includes an external alarm signal originating from an external alarm system.
116. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 116 wherein the internal alarm signal includes a vibration.
117. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 116 wherein the internal alarm signal includes a visual display.
118. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 116 wherein the internal alarm signal includes a sound.
119. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 116 further including an internal alarm signal generated by an implanted medical device, the internal alarm signal being of constant level of perceptibility to the patient.
120. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 119 wherein the escalating external alarm signal is initiated at a preset time before the initiation of the constant internal alarm signal.
121. The implantable pacemaker system having the capability of detecting cardiac events occurring in a human patient as recited in claim 81 wherein the implantable cardiac defibrillator also includes the capability to pace the heart of the human patient.
122. A method of sensing cardiac events occurring in a human patient including the steps of: (a) establishing at least two electrodes for obtaining an electrical signal from the patient's heart; (b) providing an electrical signal processor coupled to said electrodes for processing the electrical signal; and, (c) generating an escalating sensory alarm signal received by the patient over a predetermined time period subsequent to the electrical signal processor detecting a cardiac event.
123. The method of sensing cardiac events as recited in claim 122 wherein said escalating sensory alarm signal increases in amplitude over time only for a preset time period.
124. The method of sensing cardiac events as recited in claim 122 wherein said escalating sensory alarm signal is non-continuous for providing successive alerting signals increasing over a predetermined time interval.
125. The method of sensing cardiac events as recited in claim 122 wherein the step of generating the escalating alarm signal includes the step of establishing an internal alarm signal originating from an implanted medical device.
126. The method of sensing cardiac events as recited in claim 125 where the step of establishing the internal alarm signal includes the step of providing a vibratory internal alarm signal.
127. The method of sensing cardiac events as recited in claim 126 where the step of establishing the internal alarm signal includes the step providing an electrical signal tickle.
128. The method of sensing cardiac events as recited in claim 125 where the step of establishing the internal alarm signal includes the step of providing a visual display.
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US11/493,555 US20070027397A1 (en) | 2004-01-28 | 2006-07-27 | System for patient alerting associated with a cardiac event |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US10/765,040 US7107096B2 (en) | 2004-01-28 | 2004-01-28 | System for patient alerting associated with a cardiac event |
US11/493,555 US20070027397A1 (en) | 2004-01-28 | 2006-07-27 | System for patient alerting associated with a cardiac event |
Related Parent Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US10/765,040 Division US7107096B2 (en) | 2004-01-28 | 2004-01-28 | System for patient alerting associated with a cardiac event |
Publications (1)
Publication Number | Publication Date |
---|---|
US20070027397A1 true US20070027397A1 (en) | 2007-02-01 |
Family
ID=34795399
Family Applications (2)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US10/765,040 Expired - Lifetime US7107096B2 (en) | 2004-01-28 | 2004-01-28 | System for patient alerting associated with a cardiac event |
US11/493,555 Abandoned US20070027397A1 (en) | 2004-01-28 | 2006-07-27 | System for patient alerting associated with a cardiac event |
Family Applications Before (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US10/765,040 Expired - Lifetime US7107096B2 (en) | 2004-01-28 | 2004-01-28 | System for patient alerting associated with a cardiac event |
Country Status (1)
Country | Link |
---|---|
US (2) | US7107096B2 (en) |
Cited By (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN109976517A (en) * | 2014-09-02 | 2019-07-05 | 苹果公司 | Pre- sharp prompt is provided to the user of electronic equipment |
US11260235B2 (en) * | 2019-09-26 | 2022-03-01 | CereGate GmbH | Neuronal signal system, method and computer program for device status signaling |
US11344725B2 (en) | 2019-02-27 | 2022-05-31 | CereGate GmbH | Neuronal communication system |
US11642516B2 (en) | 2019-06-24 | 2023-05-09 | CereGate GmbH | Neuronal signal system for behavior modification |
US11738194B2 (en) | 2020-08-21 | 2023-08-29 | CereGate GmbH | Closed loop computer-brain interface device |
Families Citing this family (35)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US7801596B2 (en) * | 2002-09-20 | 2010-09-21 | Angel Medical Systems, Inc. | Physician's programmer for implantable devices having cardiac diagnostic and patient alerting capabilities |
US20070016089A1 (en) * | 2005-07-15 | 2007-01-18 | Fischell David R | Implantable device for vital signs monitoring |
US20080288023A1 (en) * | 2005-08-31 | 2008-11-20 | Michael Sasha John | Medical treatment using patient states, patient alerts, and hierarchical algorithms |
US9089713B2 (en) * | 2005-08-31 | 2015-07-28 | Michael Sasha John | Methods and systems for semi-automatic adjustment of medical monitoring and treatment |
US8965509B2 (en) | 2005-08-31 | 2015-02-24 | Michael Sasha John | Methods and systems for semi-automatic adjustment of medical monitoring and treatment |
US20070106126A1 (en) | 2005-09-30 | 2007-05-10 | Mannheimer Paul D | Patient monitoring alarm escalation system and method |
US20070239140A1 (en) * | 2006-03-22 | 2007-10-11 | Revascular Therapeutics Inc. | Controller system for crossing vascular occlusions |
US7774056B2 (en) | 2006-04-28 | 2010-08-10 | Medtronic, Inc. | Device site stimulation for notification |
US20070255347A1 (en) * | 2006-04-28 | 2007-11-01 | Medtronic, Inc. | Inhibition of stimulation notification |
US20080294229A1 (en) * | 2006-10-17 | 2008-11-27 | Friedman Paul A | Helical Electrodes for Intramyocardial Pacing and Sensing |
US20080129517A1 (en) * | 2006-11-24 | 2008-06-05 | Ventrassist Pty Ltd | Control System With Alarm |
US20080154318A1 (en) * | 2006-12-21 | 2008-06-26 | Marco Albus | Implantable medical device |
US8265739B1 (en) | 2007-01-19 | 2012-09-11 | Pacesetter, Inc. | Systems and methods for distinguishing cardiac ischemia from systemic influences on IEGM morphology using an implantable medical device |
AU2008217463B2 (en) * | 2007-02-16 | 2013-01-17 | Sun Medical-Scientific (Shanghai) Co., Ltd. | Non-electrode-lead ultra-thin micro multifunctional heart rate adjusting device |
WO2008141509A1 (en) * | 2007-05-22 | 2008-11-27 | Teda Orking Hi-Tech Co. Ltd | Electrocardiograph data processing system and method thereof |
US7769436B1 (en) | 2007-06-04 | 2010-08-03 | Pacesetter, Inc. | System and method for adaptively adjusting cardiac ischemia detection thresholds and other detection thresholds used by an implantable medical device |
US8636670B2 (en) | 2008-05-13 | 2014-01-28 | The Invention Science Fund I, Llc | Circulatory monitoring systems and methods |
US20090287120A1 (en) | 2007-12-18 | 2009-11-19 | Searete Llc, A Limited Liability Corporation Of The State Of Delaware | Circulatory monitoring systems and methods |
US9717896B2 (en) | 2007-12-18 | 2017-08-01 | Gearbox, Llc | Treatment indications informed by a priori implant information |
US20100016746A1 (en) * | 2008-07-15 | 2010-01-21 | Hampton David R | Personal alerting device for use with diagnostic device |
US9301698B2 (en) | 2008-10-31 | 2016-04-05 | Medtronic, Inc. | Method and apparatus to detect ischemia with a pressure sensor |
US8657821B2 (en) | 2008-11-14 | 2014-02-25 | Revascular Therapeutics Inc. | Method and system for reversibly controlled drilling of luminal occlusions |
US8162891B2 (en) | 2008-11-26 | 2012-04-24 | Revascular Therapeutics, Inc. | Delivery and exchange catheter for storing guidewire |
US9072890B2 (en) | 2009-09-03 | 2015-07-07 | Mayo Foundation For Medical Education And Research | Pacing, sensing or defibrillator leads for implantation into the myocardium |
US8452404B1 (en) * | 2009-11-24 | 2013-05-28 | Angel Medical Systems, Inc. | Ischemia detection systems for paced-patients having three different detection modes |
US8989852B2 (en) | 2011-08-10 | 2015-03-24 | Pacesetter, Inc. | Systems and methods for use by implantable medical devices for detecting and discriminating stroke and cardiac ischemia using electrocardiac signals |
CN205549235U (en) | 2013-08-01 | 2016-09-07 | 卓尔医疗公司 | Wearable medical equipment and system |
JP6361872B2 (en) * | 2014-07-09 | 2018-07-25 | 任天堂株式会社 | Vibration generation system, vibration generation device, vibration signal generation program, and vibration generation method |
EP3182881B1 (en) * | 2014-08-20 | 2023-11-29 | California Baptist University | Systems for monitoring eye health |
EP3892198B1 (en) | 2014-11-14 | 2024-03-06 | ZOLL Medical Corporation | Medical premonitory event estimation |
US9913988B2 (en) * | 2015-02-27 | 2018-03-13 | Medtronic, Inc. | Systems, apparatus, methods and computer-readable storage media facilitating telemetry with an implantable device |
US11009870B2 (en) | 2017-06-06 | 2021-05-18 | Zoll Medical Corporation | Vehicle compatible ambulatory defibrillator |
US10957445B2 (en) * | 2017-10-05 | 2021-03-23 | Hill-Rom Services, Inc. | Caregiver and staff information system |
JP2021131234A (en) * | 2020-02-18 | 2021-09-09 | 富士フイルムビジネスイノベーション株式会社 | Light emitting device and program |
US11806078B1 (en) | 2022-05-01 | 2023-11-07 | Globe Biomedical, Inc. | Tear meniscus detection and evaluation system |
Citations (23)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3794022A (en) * | 1972-06-30 | 1974-02-26 | E Nawracaj | Dual oscillator, variable pulse duration electrotherapeutic device |
US4234944A (en) * | 1977-12-08 | 1980-11-18 | Kabushiki Kaisha Daini Seikosha | Alarm electronic timepiece |
US5076272A (en) * | 1990-06-15 | 1991-12-31 | Telectronics Pacing Systems, Inc. | Autocontrollable pacemaker with alarm |
US5251626A (en) * | 1990-07-03 | 1993-10-12 | Telectronics Pacing Systems, Inc. | Apparatus and method for the detection and treatment of arrhythmias using a neural network |
US6067473A (en) * | 1998-04-29 | 2000-05-23 | Medtronic, Inc. | Implantable medical device using audible sound communication to provide warnings |
US6095984A (en) * | 1996-04-17 | 2000-08-01 | Seiko Epson Corporation | Arrhythmia detecting apparatus |
US6112116A (en) * | 1999-02-22 | 2000-08-29 | Cathco, Inc. | Implantable responsive system for sensing and treating acute myocardial infarction |
US6128526A (en) * | 1999-03-29 | 2000-10-03 | Medtronic, Inc. | Method for ischemia detection and apparatus for using same |
US6171237B1 (en) * | 1998-03-30 | 2001-01-09 | Boaz Avitall | Remote health monitoring system |
US6230049B1 (en) * | 1999-08-13 | 2001-05-08 | Neuro Pace, Inc. | Integrated system for EEG monitoring and electrical stimulation with a multiplicity of electrodes |
US6272379B1 (en) * | 1999-03-17 | 2001-08-07 | Cathco, Inc. | Implantable electronic system with acute myocardial infarction detection and patient warning capabilities |
US20010041831A1 (en) * | 2000-01-21 | 2001-11-15 | Starkweather Timothy J. | Ambulatory medical apparatus and method having telemetry modifiable control software |
US20020099550A1 (en) * | 2001-01-19 | 2002-07-25 | Emerick John J. | Alarm clock variable by an external data source |
US20020107476A1 (en) * | 1998-08-18 | 2002-08-08 | Minimed Inc. | External infusion device with remote programming, bolus estimator and/or vibration alarm capabilities |
US20020165590A1 (en) * | 2001-01-16 | 2002-11-07 | Crowe Louis Michael | Apparatus for stimulating a muscle of a subject |
US20030045805A1 (en) * | 2001-08-30 | 2003-03-06 | Medtronic, Inc. | Ischemia detection |
US20030050566A1 (en) * | 2001-09-07 | 2003-03-13 | Medtronic, Inc. | Arrhythmia notification |
US20030095476A1 (en) * | 2001-11-20 | 2003-05-22 | Mollicone Daniel Joseph | Method and apparatus for a waking control system |
US6609023B1 (en) * | 2002-09-20 | 2003-08-19 | Angel Medical Systems, Inc. | System for the detection of cardiac events |
US20040243193A1 (en) * | 2003-05-30 | 2004-12-02 | Ballis Joseph J. | Electromagnetic interference alarm |
US6922585B2 (en) * | 2002-04-05 | 2005-07-26 | Medtronic, Inc. | Method and apparatus for predicting recurring ventricular arrhythmias |
US7010344B2 (en) * | 2002-04-26 | 2006-03-07 | Medtronic, Inc. | Method and apparatus for delaying a ventricular tachycardia therapy |
US7089059B1 (en) * | 2000-11-03 | 2006-08-08 | Pless Benjamin D | Predicting susceptibility to neurological dysfunction based on measured neural electrophysiology |
-
2004
- 2004-01-28 US US10/765,040 patent/US7107096B2/en not_active Expired - Lifetime
-
2006
- 2006-07-27 US US11/493,555 patent/US20070027397A1/en not_active Abandoned
Patent Citations (24)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3794022A (en) * | 1972-06-30 | 1974-02-26 | E Nawracaj | Dual oscillator, variable pulse duration electrotherapeutic device |
US4234944A (en) * | 1977-12-08 | 1980-11-18 | Kabushiki Kaisha Daini Seikosha | Alarm electronic timepiece |
US5076272A (en) * | 1990-06-15 | 1991-12-31 | Telectronics Pacing Systems, Inc. | Autocontrollable pacemaker with alarm |
US5251626A (en) * | 1990-07-03 | 1993-10-12 | Telectronics Pacing Systems, Inc. | Apparatus and method for the detection and treatment of arrhythmias using a neural network |
US6095984A (en) * | 1996-04-17 | 2000-08-01 | Seiko Epson Corporation | Arrhythmia detecting apparatus |
US6171237B1 (en) * | 1998-03-30 | 2001-01-09 | Boaz Avitall | Remote health monitoring system |
US6067473A (en) * | 1998-04-29 | 2000-05-23 | Medtronic, Inc. | Implantable medical device using audible sound communication to provide warnings |
US20020107476A1 (en) * | 1998-08-18 | 2002-08-08 | Minimed Inc. | External infusion device with remote programming, bolus estimator and/or vibration alarm capabilities |
US6112116A (en) * | 1999-02-22 | 2000-08-29 | Cathco, Inc. | Implantable responsive system for sensing and treating acute myocardial infarction |
US6272379B1 (en) * | 1999-03-17 | 2001-08-07 | Cathco, Inc. | Implantable electronic system with acute myocardial infarction detection and patient warning capabilities |
US6128526A (en) * | 1999-03-29 | 2000-10-03 | Medtronic, Inc. | Method for ischemia detection and apparatus for using same |
US6230049B1 (en) * | 1999-08-13 | 2001-05-08 | Neuro Pace, Inc. | Integrated system for EEG monitoring and electrical stimulation with a multiplicity of electrodes |
US6571128B2 (en) * | 2000-01-21 | 2003-05-27 | Medtronic Minimed, Inc. | Microprocessor controlled ambulatory medical apparatus with hand held communication device |
US20010041831A1 (en) * | 2000-01-21 | 2001-11-15 | Starkweather Timothy J. | Ambulatory medical apparatus and method having telemetry modifiable control software |
US7089059B1 (en) * | 2000-11-03 | 2006-08-08 | Pless Benjamin D | Predicting susceptibility to neurological dysfunction based on measured neural electrophysiology |
US20020165590A1 (en) * | 2001-01-16 | 2002-11-07 | Crowe Louis Michael | Apparatus for stimulating a muscle of a subject |
US20020099550A1 (en) * | 2001-01-19 | 2002-07-25 | Emerick John J. | Alarm clock variable by an external data source |
US20030045805A1 (en) * | 2001-08-30 | 2003-03-06 | Medtronic, Inc. | Ischemia detection |
US20030050566A1 (en) * | 2001-09-07 | 2003-03-13 | Medtronic, Inc. | Arrhythmia notification |
US20030095476A1 (en) * | 2001-11-20 | 2003-05-22 | Mollicone Daniel Joseph | Method and apparatus for a waking control system |
US6922585B2 (en) * | 2002-04-05 | 2005-07-26 | Medtronic, Inc. | Method and apparatus for predicting recurring ventricular arrhythmias |
US7010344B2 (en) * | 2002-04-26 | 2006-03-07 | Medtronic, Inc. | Method and apparatus for delaying a ventricular tachycardia therapy |
US6609023B1 (en) * | 2002-09-20 | 2003-08-19 | Angel Medical Systems, Inc. | System for the detection of cardiac events |
US20040243193A1 (en) * | 2003-05-30 | 2004-12-02 | Ballis Joseph J. | Electromagnetic interference alarm |
Cited By (7)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN109976517A (en) * | 2014-09-02 | 2019-07-05 | 苹果公司 | Pre- sharp prompt is provided to the user of electronic equipment |
US11521477B2 (en) | 2014-09-02 | 2022-12-06 | Apple Inc. | Providing priming cues to a user of an electronic device |
US11344725B2 (en) | 2019-02-27 | 2022-05-31 | CereGate GmbH | Neuronal communication system |
US11642516B2 (en) | 2019-06-24 | 2023-05-09 | CereGate GmbH | Neuronal signal system for behavior modification |
US11260235B2 (en) * | 2019-09-26 | 2022-03-01 | CereGate GmbH | Neuronal signal system, method and computer program for device status signaling |
US11918818B2 (en) | 2019-09-26 | 2024-03-05 | CereGate GmbH | Neuronal signal system, method and computer program for device status signaling |
US11738194B2 (en) | 2020-08-21 | 2023-08-29 | CereGate GmbH | Closed loop computer-brain interface device |
Also Published As
Publication number | Publication date |
---|---|
US20050165321A1 (en) | 2005-07-28 |
US7107096B2 (en) | 2006-09-12 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
US7107096B2 (en) | System for patient alerting associated with a cardiac event | |
US20050137483A1 (en) | Electrogram signal filtering in systems for detecting ischemia | |
US8512257B2 (en) | Implantable cardiac event detection device with an adaptive sleep state | |
US7558623B2 (en) | Means and method for the detection of cardiac events | |
US8965494B2 (en) | Means and method for the detection of cardiac events | |
US7991460B2 (en) | Methods and apparatus for detecting cardiac events based on heart rate sensitive parameters | |
US8024028B2 (en) | Cardiac event detection over varying time scale | |
US9005130B2 (en) | Histogram based generation of cardiac state detection thresholds | |
US20080139954A1 (en) | System for at least two types of patient alerting associated with cardiac events | |
US20050256417A1 (en) | Emergency room triage system | |
US20060212085A1 (en) | Emergency room triage system | |
US20070213626A1 (en) | Baseline correction in systems for detecting ischemia |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
STCB | Information on status: application discontinuation |
Free format text: ABANDONED -- FAILURE TO RESPOND TO AN OFFICE ACTION |