IP Library › Granted Patent US 12,226,217
Granted Patent B2
US 12,226,217 · App. 18/621,766 · Granted Feb 18, 2025

Triggering storage of electrocardiogramar detected premature ventricular contractions (PVCS)

Inventors: John E. Burnes (Blaine, MN); Shantanu Sarkar (Roseville, MN); Gautham Rajagopal (Minneapolis, MN)
Assignee: Medtronic, Inc.
A61B5/333A61B5/316A61B5/339A61B5/349A61B5/352G16H50/70
View Patent ↗
Loading inventors, assignments & file history…
Monitor This Case
Get email alerts when status or documents change.
Order Certified Copies
Most orders are placed with the USPTO same day — all within 24 business hours.
Order via The Patent Place →
Pre-filled with this patent's details
Quick Facts
Patent No.
US 12,226,217
App. No.
18/621,766
Filed
Mar 29, 2024
Granted
Feb 18, 2025
Kind
B2
Art Unit
3792
USPC
600/515
Abstract

Techniques for triggering the storage or transmission of cardiac electrogram (EGM) signals associated with a premature ventricular contractions (PVC) include sensing a cardiac EGM signal of a patient via a plurality of electrodes, detecting a premature ventricular contraction (PVC) within the cardiac EGM signal, determining whether PVC storage criteria is met, in response to a determination that the PVC storage criteria is met, storing a portion of the cardiac EGM signal associated with the PVC, and in response to a determination that the PVC storage criteria is not met, eschewing storing the portion of the cardiac EGM signal associated with the PVC.

Claims (67)

1. A system comprising:

an insertable cardiac monitor comprising a plurality of electrodes;

one or more memories; and

processing circuitry in communication with the one or more memories, wherein the processing circuitry is configured to:

detect, in a cardiac signal sensed by the insertable cardiac monitor via the plurality of electrodes, a set of premature ventricular contractions (PVCs) of a heart of a patient;

compare, for each respective PVC of the set of PVCs, a PVC morphology of the respective PVC to a respective PVC morphology of a set of one or more patient-based waveforms;

determine, based on the comparison, a first one or more PVCs of the set of PVCs that meet at least one PVC criterion and a second one or more PVCs of the set of PVCs that do not meet the at least one PVC criterion;

send, via communication circuitry and to an external device and based on the first one or more PVCs of the set of PVCs meeting the at least one PVC criterion, for each respective PVC of the first one or more PVCs of the set of PVCs, a portion of an electrogram (EGM) associated with the respective PVC of the first one or more PVCs of the set of PVCs; and

refrain from sending, via the communication circuitry and to the external device and based on the second one or more PVCs of the set of PVCs not meeting the at least one PVC criterion, for each respective PVC of the second one or more PVCs of the set of PVCs, a portion of an EGM associated with the respective PVC of the second one or more PVCs of the set of PVCs.

2. The system of claim 1 , wherein the set of one or more patient-based waveforms is adaptive.

3. The system of claim 1 , wherein the processing circuitry is configured to determine a type of each of the first one or more PVCs from among a plurality of PVC types.

4. The system of claim 3 , wherein the plurality of PVC types comprise couplets and triplets.

5. The system of claim 3 , wherein the processing circuitry is further configured to determine a daily PVC burden for at least one of the plurality of PVC types.

6. The system of claim 1 , wherein as part of determining that the first one or more PVCs of the set of PVCs meet the at least one PVC criterion, the processing circuitry is further configured to determine a daily PVC burden based on the first one or more PVCs of the set of PVCs.

7. The system of claim 6 , wherein the processing circuitry is further configured to determine a daily PVC burden tend based on the daily PVC burden.

8. The system of claim 1 , wherein the at least one PVC criterion comprises a PVC burden threshold, and wherein as part of determining that the first one or more PVCs of the set of PVCs meet the at least one PVC criterion, the processing circuitry is configured to:

determine a PVC burden based on the first one or more PVCs of the set of PVCs; and

determine that the PVC burden meets the PVC burden threshold.

9. The system of claim 1 , wherein as part of detecting the set of PVCs, the processing circuitry is configured to determine at least one of an R-R interval or an R-wave amplitude.

10. The system of claim 1 , wherein as part of detecting the set of PVCs, the processing circuitry is configured to monitor via the plurality of electrodes an EMG of the heart of the patient during a PVC burden monitoring period of time.

11. The system of claim 10 , wherein the PVC burden monitoring period of time comprises a day, a week, or a month.

12. The system of claim 1 , further comprising an application configured to execute on the external device, wherein the external device comprises a cellular phone or a smartphone, the application being configured to receive, for each PVC of the first one or more PVCs of the set of PVCs, the portion of the EGM associated with the respective PVC.

13. The system of claim 1 , wherein the at least one PVC criterion comprises a daily PVC burden threshold, and wherein as part of determining that the first one or more PVCs of the set of PVCs meet the at least one PVC criterion, the processing circuitry is configured to:

determine a corresponding daily PVC burden based on the first one or more PVCs of the set of PVCs for each of a plurality of days; and

determine that a first corresponding daily PVC burden meets the PVC burden threshold.

14. The system of claim 13 , wherein the set of one or more patient-based waveforms is adaptive, wherein the first one or more PVCs of the set of PVCs comprise at least one couplet and at least one triplet, and wherein as part of detecting the set of PVCs, the processing circuitry is configured to monitor via the plurality of electrodes an EMG of the heart of the patient during a PVC burden monitoring period of time of a week or a month.

15. A method comprising:

detecting, by processing circuitry of an insertable cardiac monitor and in a cardiac signal sensed by the insertable cardiac monitor via a plurality of electrodes, a set of premature ventricular contractions (PVCs) of a heart of a patient;

comparing, by the processing circuitry and for each respective PVC of the set of PVCs, a PVC morphology of the respective PVC to a respective PVC morphology of a set of one or more patient-based waveforms;

determining, by the processing circuitry and based on the comparison, a first one or more PVCs of the set of PVCs that meet at least one PVC criterion and a second one or more PVCs of the set of PVCs that do not meet the at least one PVC criterion;

sending, via communication circuitry and to an external device and based on the first one or more PVCs of the set of PVCs meeting the at least one PVC criterion, for each respective PVC of the first one or more PVCs of the set of PVCs, a portion of an electrogram (EGM) associated with the respective PVC of the first one or more PVCs of the set of PVCs; and

refraining from sending, via the communication circuitry and to the external device and based on the second one or more PVCs of the set of PVCs not meeting the at least one PVC criterion, for each respective PVC of the second one or more PVCs of the set of PVCs, a portion of an electrogram (EGM) associated with the respective PVC of the second one or more PVCs of the set of PVCs.

16. The method of claim 15 , wherein the set of one or more patient-based waveforms is adaptive.

17. The method of claim 15 , further comprising, determining, by the processing circuitry, a type of each of the first one or more PVCs of the set of PVCs from among a plurality of PVC types.

18. The method of claim 17 , wherein the plurality of PVC types comprise couplets and triplets.

19. The method of claim 17 , further comprising determining, by the processing circuitry, a daily PVC burden for at least one of the plurality of PVC types.

20. The method of claim 15 , wherein determining that the first one or more PVCs of the set of PVCs meet the at least one PVC criterion comprises determining a daily PVC burden based on the first one or more PVCs of the set of PVCs.

21. The method of claim 20 , further comprising determining, by the processing circuitry, a daily PVC burden tend based on the daily PVC burden.

22. The method of claim 15 , wherein the at least one PVC criterion comprises a PVC burden threshold, and wherein determining that the first one or more PVCs of the set of PVCs meet the at least one PVC criterion comprises:

determining, by the processing circuitry, a PVC burden based on the first one or more PVCs of the set of PVCs; and

determining, by the processing circuitry, that the PVC burden meets a PVC burden threshold.

23. The method of claim 15 , wherein detecting the set of PVCs comprises determining at least one of an R-R interval or an R-wave amplitude.

24. The method of claim 15 , wherein the at least one PVC criterion comprises a daily PVC burden threshold, and wherein determining that the first one or more PVCs of the set of PVCs meet the at least one PVC criterion comprises:

determining a respective daily PVC burden based on the first one or more PVCs of the set of PVCs for each of a plurality of days; and

determining that a first respective daily PVC burden meets a PVC burden threshold.

25. The method of claim 15 , wherein the set of one or more patient-based waveforms is adaptive, wherein the first one or more PVCs of the set of PVCs comprise at least one couplet and at least one triplet, and wherein detecting the set of PVCs comprises monitoring, via the plurality of electrodes, an EMG of the heart of the patient during a PVC burden monitoring period of time of a week or a month.

26. Non-transitory computer-readable media comprising instructions for causing processing circuitry of an insertable cardiac monitor having a plurality of electrodes to:

detect, in a cardiac signal sensed via the plurality of electrodes, a set of premature ventricular contractions (PVCs) of a heart of a patient;

compare, for each respective PVC of the set of PVCs, a PVC morphology of the respective PVC to a respective PVC morphology of a set of one or more patient-based waveforms;

determine, based on the comparison, a first one or more PVCs of the set of PVCs that meet at least one PVC criterion and a second one or more PVCs of the set of PVCs that do not meet the at least one PVC criterion;

send, via communication circuitry and to an external device and based on the first one or more PVCs of the set of PVCs meeting the at least one PVC criterion, for each respective PVC of the first one or more PVCs of the set of PVCs, a portion of an electrogram (EGM) associated with the respective PVC of the first one or more PVCs of the set of PVCs; and refrain from sending, via the communication circuitry and to the external device and based on the second one or more PVCs of the set of PVCs not meeting the at least one PVC criterion, for each respective PVC of the second one or more PVCs of the set of PVCs, a portion of an electrogram (EGM) associated with the respective PVC of the second one or more PVCs of the set of PVCs.

27. The non-transitory computer-readable media of claim 26 , wherein the set of one or more patient-based waveforms is adaptive.

28. The non-transitory computer-readable media of claim 26 , wherein the instructions further cause the processing circuitry to determine a type of each of the first one or more PVCs of the set of PVCs from among a plurality of PVC types, wherein the plurality of PVC types comprise couplets and triplets.

29. The non-transitory computer-readable media of claim 26 , wherein the at least one PVC criterion comprises a daily PVC burden threshold, wherein the set of one or more patient-based waveforms is adaptive, wherein the first one or more PVCs of the set of PVCs comprise at least one couplet and at least one triplet, and wherein as part of detecting the set of PVCs, the instructions cause the processing circuitry to monitor via the plurality of electrodes an EMG of the heart of the patient during a PVC burden monitoring period of time of a week or a month, and wherein as part of determining that the first one or more PVCs of the set of PVCs meet the at least one PVC criterion, the instructions cause the processing circuitry to:

determine a corresponding daily PVC burden based on the first one or more PVCs of the set of PVCs for each of a plurality of days; and

determine that a first corresponding daily PVC burden meets the PVC burden threshold.

30. A system comprising:

an insertable cardiac monitor comprising a plurality of electrodes;

one or more memories; and

processing circuitry in communication with the one or more memories, wherein the processing circuitry is configured to:

detect, in a cardiac signal sensed by the insertable cardiac monitor via the plurality of electrodes, a set of premature ventricular contractions (PVCs) of a heart of a patient;

compare, for each respective PVC of the set of PVCs, a PVC morphology of the respective PVC to a respective PVC morphology of a set of one or more patient-based waveforms;

determine, based on the comparison, a first one or more PVCs of the set of PVCs that meet at least one PVC criterion and a second one or more PVCs of the set of PVCs that do not meet the at least one PVC criterion;

determine, based on the first one or more PVCs of the set of PVCs, a daily PVC burden;

determine that the daily PVC burden meets a PVC burden threshold;

send, via communication circuitry and to an external device and based on the daily PVC burden meeting the PVC burden threshold, for each PVC of the first one or more PVCs of the set of PVCs, a portion of an electrogram (EGM) associated with the respective PVC; and

refrain from sending, via the communication circuitry and to the external device and based on the second one or more PVCs of the set of PVCs not meeting the at least one PVC criterion, for each respective PVC of the second one or more PVCs of the set of PVCs, a portion of an EGM associated with the respective PVC of the second one or more PVCs of the set of PVCs.

Assignments (1)
ASSIGNMENT OF ASSIGNOR'S INTEREST Recorded Mar 29, 2024
From: BURNES, JOHN E.; SARKAR, SHANTANU; RAJAGOPAL, GAUTHAM
To: MEDTRONIC, INC.
Reel/Frame 066950/0507 →
Continuity (4)
Continuation 18348040 · Jul 6, 2023
Continuation 16921346 · Jul 6, 2020
Provisional Application 62927932 · Oct 30, 2019
Related Publication 20240237935A1 · Jul 18, 2024
References Cited (60)
US 4531527A · Reinhold, Jr. et al. · 1985 [cited by applicant]
US 4552154A · Hartlaub · 1985 [cited by applicant]
US 5159932A · Zanetti et al. · 1992 [cited by applicant]
US 6453192B1 · Ding et al. · 2002 [cited by applicant]
US 6954671B1 · Hoijer et al. · 2005 [cited by applicant]
US 7027858B2 · Cao et al. · 2006 [cited by applicant]
US 7751876B2 · Healey · 2010 [cited by applicant]
US 7778699B1 · Ferrise et al. · 2010 [cited by applicant]
US 8027722B1 · Nabutovsky · 2011 [cited by applicant]
US 8380294B2 · Messier et al. · 2013 [cited by applicant]
US 8457728B2 · Schneider et al. · 2013 [cited by applicant]
US 8704688B2 · Shen et al. · 2014 [cited by applicant]
US 8855755B2 · Zhang et al. · 2014 [cited by applicant]
US 8989852B2 · Gill et al. · 2015 [cited by applicant]
US 9427594B1 · Bornzin et al. · 2016 [cited by applicant]
US 9492138B2 · Kapoor · 2016 [cited by applicant]
US 9675270B2 · Sarkar · 2017 [cited by applicant]
US 9706938B2 · Chakravarthy et al. · 2017 [cited by applicant]
US 9936890B2 · Sarkar · 2018 [cited by applicant]
US 9968274B2 · Korzinov et al. · 2018 [cited by applicant]
US 10779744B2 · Rapin et al. · 2020 [cited by applicant]
US 11234629B2 · Liu et al. · 2022 [cited by applicant]
US 11717208B2 · Burnes et al. · 2023 [cited by applicant]
US 20070255345A1 · Krause · 2007 [cited by applicant]
US 20100274148A1 · Zhang et al. · 2010 [cited by applicant]
US 20120277608A1 · Schneider et al. · 2012 [cited by applicant]
US 20140107723A1 · Hou et al. · 2014 [cited by applicant]
US 20140276928A1 · Vanderpool et al. · 2014 [cited by applicant]
US 20150335894A1 · Bornzin et al. · 2015 [cited by applicant]
US 20160135706A1 · Sullivan et al. · 2016 [cited by applicant]
US 20160310029A1 · Sarkar · 2016 [cited by applicant]
US 20160310031A1 · Sarkar · 2016 [cited by examiner]
US 20170119274A1 · Chakravarthy et al. · 2017 [cited by applicant]
US 20180303345A1 · Adler · 2018 [cited by applicant]
US 20190051393A1 · Whiting et al. · 2019 [cited by applicant]
US 20190216350A1 · Sullivan et al. · 2019 [cited by applicant]
US 20190336032A1 · Gill et al. · 2019 [cited by applicant]
US 20200237314A1 · Qu et al. · 2020 [cited by applicant]
US 20200357519A1 · Chakravarthy et al. · 2020 [cited by applicant]
US 20200383597A1 · Rajagopal et al. · 2020 [cited by applicant]
US 20210128005A1 · Burnes et al. · 2021 [cited by applicant]
US 20230346287A1 · Burnes et al. · 2023 [cited by applicant]
WO 2004096353A1 · 2004 [cited by applicant]
Alqarawi et al., “Identifying and Managing Premature Ventricular Contraction-Induced Cardiomyopathy: What, Why, and How?,” Canadian Journal of Cardiology, vol. 33, Feb. 2017, pp. 287-290. [cited by applicant]
Callans, “Premature Ventricular Contraction-induced Cardiomyopathy,” Arrhythmia & Electrophysiology Review, vol. 6, Dec. 2017, pp. 153-155. [cited by applicant]
Cho et al., “PVC Classification Algorithm Through Efficient R Wave Detection,” Journal of Sensor Science and Technology, vol. 22, No. 5, Sep. 30, 2013, pp. 338-345. [cited by applicant]
International Search Report and Written Opinion of International Application No. PCT/US2020/054895, mailed Jan. 21, 2021, 11 pp. [cited by applicant]
Kaya et al., “Classification of Premature Ventricular Contraction in ECG”, International Journal of Advanced Computer Science and Applications, vol. 6, No. 7, 2015, pp. 34-40, Retrieved from the Internet on Jan. 31, 202… [cited by applicant]
Mazidi et al., “Detection of premature ventricular contraction (PVC) using linear and nonlinear techniques: an experimental study”, Cluster Computing, vol. 23, No. 2, Springer Science+Business Media, LLC, Jul. 11, 2019,… [cited by applicant]
Panela et al., “Ablation of frequent PVC in patients meeting criteria for primary prevention ICD implant: Safety of withholding the implant,” Heart Rhythm Society, vol. 12, No. 12, Dec. 2015, pp. 2434-2442. [cited by applicant]
Panela et al., “Clinical recognition of pure premature ventricular complex-induced cardiomyopathy at presentation,” Heart Rhythm Society, vol. 14, No. 12, Dec. 2017, pp. 1864-1870. [cited by applicant]
Panela et al., “Neurohormonal, Structural, and Functional Recovery Pattern After Premature Ventricular Complex Ablation is Independent of Structural Heart Disease Status in Patients with Depressed Left Ventricular Eject… [cited by applicant]
Prosecution History from U.S. Appl. No. 16/436,012, dated Dec. 1, 2020 through May 1, 2024, 411 pp. [cited by applicant]
Prosecution History from U.S. Appl. No. 16/921,346, dated Dec. 30, 2021 through Mar. 30, 2023, 93 pp. [cited by applicant]
Rodrigues De Oliveira et al., , “Geometrical Features for Premature Ventricular Contraction Recognition with Analytic Hierarchy Process Based Machine Learning Algorithms Selection,” Computer Methods and Programs in Biom… [cited by applicant]
Talbi, M.L. et al., “PVC discrimination using the QRS power spectrum and self-organizing maps,” Computer Methods and Programs in Biomedicine, Elsevier, Masterdam, NL, vol. 94, No. 3, Jun. 1, 2009, pp. 223-231. [cited by applicant]
U.S. Appl. No. 18/050,814, filed Oct. 28, 2022, naming inventors Rajagopal et al. [cited by applicant]
Zhang et al., “Premature Ventricular Contractions' Detection Based on Active Learning”, Scientific Programming, vol. 2021, Mar. 8, 2021, 14 pp., URL: https://www.hindawi.com/journals/sp/2021/5556011/. [cited by applicant]
Zhou, “Automatic Detection of Premature Ventricular Contraction Using Quantum Neural Networks”, Automatic detection of premature Third IEEE Symposium on Bioinformatics and Bioengineering, IEEE, Mar. 12, 2003, pp. 169-17… [cited by applicant]
Office Action from U.S. Appl. No. 18/348,040 dated Nov. 26, 2024, 6 pp. [cited by applicant]