阅读说明：本技术 非侵入性心脏治疗评估 (Non-invasive cardiac therapy assessment ) 是由 J·吉尔伯格 S·戈什 于 2014-12-09 设计创作，主要内容包括：在此描述了用于辅助用户针对心脏治疗对患者进行非侵入性评估以及对正被递送的心脏治疗进行非侵入性评估的系统、方法和界面。这些系统、方法和界面可以提供关于一个或多个人体解剖学部分的心脏电激活时间和一个或多个心脏健康度量的图形表示。(Systems, methods, and interfaces are described herein for assisting a user in non-invasive assessment of a patient for cardiac therapy and non-invasive assessment of cardiac therapy being delivered. The systems, methods, and interfaces may provide a graphical representation of electrical activation time of the heart and one or more measures of cardiac health for one or more portions of the human anatomy.)

1. A system for assisting in noninvasive evaluation of cardiac therapy, the system comprising:

an electrode arrangement comprising a plurality of external electrodes configured to be positioned adjacent tissue of a patient;

a display device including a graphical user interface configured to present cardiac electrical activation time information and cardiac health information; and

a computing device coupled to the electrode device and the display device and configured to provide the graphical user interface displayed on the display device, wherein the computing device is further configured to:

measuring surrogate cardiac electrical activation times using one or more of the plurality of external electrodes of the electrode arrangement that are adjacent to the patient's heart,

measuring at least one measure of the patient's cardiac health using one or more of the plurality of external electrodes of the electrode device that are proximate to the patient's heart,

allowing a user to select one of an initial examination mode for assisting the user in non-invasively evaluating the patient for cardiac therapy and a follow-up examination mode for assisting the user in non-invasively evaluating cardiac therapy after implantation of cardiac therapy,

while in an initial examination mode, displaying on the graphical user interface a graphical representation of measured surrogate cardiac electrical activation times for a portion of human anatomy, at least one metric of the patient's cardiac health, and a likelihood of whether cardiac therapy for the patient may be beneficial, and

while in the follow-up examination mode, a graphical representation of a currently measured surrogate cardiac electrical activation time for the first human anatomy portion and a graphical representation of a previously measured surrogate cardiac electrical activation time for the second human anatomy portion are displayed on the graphical user interface along with at least one currently measured metric of the patient's cardiac health, at least one previously measured metric of the patient's cardiac health, and an indication of whether cardiac therapy for the patient appears beneficial.

2. The system of claim 1, wherein the computing device is further configured to allow a user to select an implantation review mode, the implantation review mode for assisting the user in non-invasively evaluating cardiac therapy during implantation and configuration of cardiac therapy,

wherein the computing device is further configured to display, on a graphical user interface, a graphical representation of a currently measured surrogate cardiac electrical activation time for the first human anatomy portion and a graphical representation of a previously measured surrogate cardiac electrical activation time for the second human anatomy portion, and at least one currently measured metric of the patient's cardiac health, at least one previously measured metric of the patient's cardiac health, and an indication of whether cardiac therapy for the patient appears beneficial when in the implant examination mode.

3. The system of claim 2, wherein the computing device is further configured to allow a user to change at least one pacing parameter of an implantable medical device providing cardiac therapy to the patient.

4. The system of any one of claims 1-3, wherein the at least one metric includes QRS width and electrical dyssynchrony.

5. The system of any one of claims 1-4, wherein when in one of the initial examination mode and the follow-up examination mode, the computing device is further configured to display mechanical motion information of one or more regions in at least a portion of vascular anatomy of the patient's heart on the graphical user interface.

6. The system of any of claims 1-5, wherein displaying a graphical representation of measured surrogate cardiac electrical activation times about a portion of human anatomy includes color scaling the portion of human anatomy on the graphical user interface as a function of measured surrogate cardiac electrical activation times.

7. The system of any one of claims 1-6, wherein when in one of the initial examination mode and the follow-up examination mode, the computing device is further configured to display at least one electrocardiogram of the patient on the graphical user interface, wherein each of the at least one electrocardiogram is captured using at least one different electrode, and wherein the at least one electrocardiogram is time-aligned on the graphical user interface.

8. A system for assisting in the non-invasive assessment of a patient for cardiac therapy, the system comprising:

an electrode arrangement comprising a plurality of external electrodes configured to be positioned adjacent tissue of a patient;

a display device including a graphical user interface configured to present cardiac electrical activation time information and cardiac health information; and

a computing device coupled to the electrode device and the display device and configured to provide the graphical user interface displayed on the display device to assist a user in non-invasively evaluating the patient for cardiac therapy, wherein the computing device is further configured to:

measuring surrogate cardiac electrical activation times using one or more of the plurality of external electrodes of the electrode arrangement that are adjacent to the patient's heart,

displaying a graphical representation of the measured surrogate cardiac electrical activation times about a portion of human anatomy on the graphical user interface,

measuring at least one measure of the patient's cardiac health using one or more of the plurality of external electrodes of the electrode device that are proximate to the patient's heart,

displaying on the graphical user interface whether cardiac therapy for the patient may be beneficial.

9. A system for assisting in noninvasive evaluation of cardiac therapy, the system comprising:

an electrode arrangement comprising a plurality of external electrodes configured to be positioned adjacent tissue of a patient;

a display device including a graphical user interface configured to present cardiac electrical activation time information and cardiac health information; and

a computing device coupled to the electrode device and the display device and configured to provide the graphical user interface displayed on the display device to assist a user in non-invasively evaluating cardiac therapy, wherein the computing device is further configured to:

measuring surrogate cardiac electrical activation times using one or more of the plurality of external electrodes of the electrode arrangement that are adjacent to the patient's heart,

displaying on the graphical user interface a graphical representation of a currently measured surrogate cardiac electrical activation time for a first human anatomy portion and a graphical representation of a previously measured surrogate cardiac electrical activation time for a second human anatomy portion,

measuring at least one measure of the patient's cardiac health using one or more of the plurality of external electrodes of the electrode device that are proximate to the patient's heart,

displaying on the graphical user interface at least one currently measured metric of the patient's cardiac health and at least one previously measured metric of the patient's cardiac health,

determining whether cardiac therapy for the patient is beneficial based on a comparison of a currently measured measurement to a previously measured measurement, an

An indication is displayed on the graphical user interface of whether cardiac therapy for the patient is presented as beneficial.

Background

The disclosure herein relates to systems, methods, and interfaces for use in non-invasive assessment of a patient for cardiac therapy and non-invasive assessment of cardiac therapy being performed on the patient.

Cardiac therapy, such as Cardiac Resynchronization Therapy (CRT), may correct symptoms of electrical dyssynchrony in a patient's heart by providing pacing therapy to one or both ventricles or atria, e.g., by providing pacing to stimulate early activation of the left or right ventricle. By pacing the contraction of the ventricles, the ventricles can be controlled such that they contract synchronously. Some patients undergoing cardiac therapy have experienced improved ejection fraction, increased exercise capacity, and improved wellness.

Providing cardiac therapy to a patient may involve: the method includes determining whether the patient will benefit from the cardiac therapy prior to implantation of a cardiac rhythm device, determining an optimal site for placement of one or more ventricular pacing leads, and programming device parameters, such as selection of electrodes on a multipolar right or left ventricular lead, and selection of timing of pacing pulses delivered to the electrodes, such as atrioventricular (a-V) and interventricular (V-V) delays.

SUMMARY

The example systems, methods, and interfaces described herein may be configured to assist a user (e.g., a physician) in evaluating a patient for cardiac therapy and/or evaluating ongoing cardiac therapy (e.g., cardiac therapy being performed on a patient). These systems, methods, and interfaces may be described as non-invasive. For example, these systems, methods, and interfaces may not use implantable devices, such as leads, probes, catheters, and the like, to evaluate a patient for cardiac therapy and/or to evaluate cardiac therapy being performed. Alternatively, the systems, methods, and interfaces may use non-invasively conducted electrical measurements using, for example, external electrodes attached to the patient's skin around the torso of the patient.

More specifically, exemplary systems and methods may provide a graphical user interface configured to assist a user in ascertaining or assessing whether a patient may benefit from cardiac therapy and/or whether cardiac therapy being delivered to the patient is beneficial. An exemplary graphical user interface may be configured to display an indication of electrical activation times for one or more portions of human anatomy (anatomy), one or more metrics of cardiac health of a patient, and whether cardiac therapy may be beneficial to the patient and/or whether ongoing cardiac therapy appears to be (apear to be) beneficial (e.g., when compared to cardiac health of the patient prior to cardiac therapy, etc.).

An exemplary system for assisting in the non-invasive assessment of a patient for cardiac therapy may include an electrode device, a display device, and a computing device coupled to the electrode device and the display device. The electrode device may include a plurality of external electrodes configured to be positioned adjacent patient tissue (e.g., surface electrodes positioned in an array configured to be positioned adjacent skin of the torso of the patient). The display device may include a graphical user interface configured to present cardiac electrical activation time information and cardiac health information. The computing device may be configured to provide a graphical user interface displayed on the display device to assist a user in non-invasively evaluating the patient for cardiac therapy. The computing device may be further configured to: measuring surrogate cardiac electrical activation times using one or more of the plurality of external electrodes of the electrode arrangement that are adjacent to the patient's heart, displaying on the graphical user interface a graphical representation of measured surrogate cardiac electrical activation times for a portion of human anatomy (e.g., color-scaling the portion of human anatomy on the graphical user interface as a function of the measured surrogate cardiac electrical activation times), measuring at least one measure of the patient's cardiac health (e.g., QRS width, electrical dyssynchrony, etc.) using one or more of the plurality of external electrodes of the electrode arrangement that are proximate to the patient's heart, the at least one metric of the patient's cardiac health is displayed on the graphical user interface, and an indication of whether cardiac therapy for the patient may be beneficial is displayed on the graphical user interface.

An exemplary computer-implemented method for assisting in noninvasive evaluation of a patient for cardiac therapy may comprise: measuring surrogate cardiac electrical activation times using one or more external electrodes adjacent to the patient's heart (e.g., surface electrodes positioned in an array configured to be positioned adjacent to the skin of the torso of the patient), displaying a graphical representation of the measured surrogate cardiac electrical activation times about a portion of human anatomy on a graphical user interface (e.g., color-scaling the portion of human anatomy on the graphical user interface as a function of the measured surrogate cardiac electrical activation times), measuring at least one metric of the patient's cardiac health (e.g., QRS width, electrical dyssynchrony, etc.) using one or more external electrodes proximate the patient's heart, the at least one metric of the patient's cardiac health is displayed on the graphical user interface, and an indication of whether cardiac therapy for the patient may be beneficial is displayed on the graphical user interface.

Another exemplary system for assisting in noninvasive evaluation of a patient for cardiac therapy may include: means for measuring surrogate cardiac electrical activation times representing electrical activation times of a heart of a patient; means for measuring at least one metric of the patient's cardiac health (e.g., QRS width, electrical dyssynchrony, etc.); display means for displaying on a graphical user interface a graphical representation of measured surrogate cardiac electrical activation times for a portion of human anatomy (e.g., color-scaling the portion of human anatomy on the graphical user interface as a function of the measured surrogate cardiac electrical activation times), the at least one metric of cardiac health of the patient, and an indication of whether cardiac therapy for the patient may be beneficial.

In one or more exemplary embodiments, displaying a graphical representation of measured surrogate cardiac electrical activation times about a portion of the human anatomy may include displaying a graphical representation of measured surrogate cardiac electrical activation times about a graphical representation of at least one of an anterior side of a human torso and a posterior side of a human torso.

In one or more exemplary embodiments, displaying a graphical representation of measured surrogate cardiac electrical activation times about a portion of human anatomy may include displaying a graphical representation of measured surrogate cardiac electrical activation times about a graphical representation of at least one of an anterior side of a heart and a posterior side of a heart.

One or more exemplary embodiments may further include displaying at least one electrocardiogram of the patient on the graphical user interface, wherein each of the at least one electrocardiogram is captured using at least one different electrode, and wherein the at least one electrocardiogram is time-aligned on the graphical user interface and/or the surrogate cardiac electrical activation times, the at least one measure of the patient's cardiac health, and the at least one electrocardiogram are stored for use in later comparisons.

An exemplary system for assisting in noninvasive evaluation of cardiac therapy may include an electrode device, a display device, and a computing device coupled to the electrode device and the display device. The electrode device may include a plurality of external electrodes configured to be positioned adjacent patient tissue (e.g., surface electrodes positioned in an array configured to be positioned adjacent skin of the torso of the patient). The display device may include a graphical user interface configured to present cardiac electrical activation time information and cardiac health information. The computing device may be configured to provide a graphical user interface displayed on the display device to assist a user in non-invasively evaluating cardiac therapy. The computing device may be further configured to: measuring surrogate cardiac electrical activation times using one or more of the plurality of external electrodes of the electrode apparatus that are proximate to the patient's heart, displaying on the graphical user interface a currently measured graphical representation of surrogate cardiac electrical activation times about a first human anatomy portion and a previously measured graphical representation of surrogate cardiac electrical activation times about a second human anatomy portion (e.g., the first human anatomy portion and the second human anatomy portion may depict the same human anatomy), measuring at least one metric of the patient's cardiac health (e.g., QRS width, electrical dyssynchrony, etc.) using one or more of the plurality of external electrodes of the electrode apparatus that are proximate to the patient's heart, displaying on the graphical user interface at least one currently measured metric of the patient's cardiac health and at least one previously measured metric of the patient's cardiac health, and displaying an indication on the graphical user interface of whether cardiac therapy for the patient appears beneficial (e.g., a percentage improvement between the at least one previously measured metric of the patient's cardiac health and the at least one currently measured metric of the patient's cardiac health).

One exemplary method for assisting in noninvasive evaluation of cardiac therapy may include measuring surrogate cardiac electrical activation times using one or more external electrodes proximate the patient's heart and displaying a graphical user interface. The graphical user interface may include a graphical representation of currently measured surrogate cardiac electrical activation times for a first human anatomy portion and a graphical representation of previously measured surrogate cardiac electrical activation times for a second human anatomy portion (e.g., the first human anatomy portion and the second human anatomy portion may depict the same human anatomy). The exemplary method may further comprise: the method further includes measuring at least one metric of the patient's cardiac health (e.g., QRS width, electrical dyssynchrony, etc.) using one or more external electrodes proximate the patient's heart, and displaying on the graphical user interface at least one currently measured metric of the patient's cardiac health and at least one previously measured metric of the patient's cardiac health, and displaying on the graphical user interface an indication of whether cardiac therapy for the patient is present as beneficial (e.g., a percentage improvement between the at least one previously measured metric of the patient's cardiac health and the at least one currently measured metric of the patient's cardiac health).

One exemplary system for assisting in the non-invasive assessment of a patient for cardiac therapy may include: means for measuring surrogate cardiac electrical activation times representing electrical activation times of a heart of a patient; means for measuring at least one metric of the patient's cardiac health (e.g., QRS width, electrical dyssynchrony, etc.); and display means for displaying on a graphical user interface a graphical representation of currently measured surrogate cardiac electrical activation times for a first human anatomy portion and a graphical representation of previously measured surrogate cardiac electrical activation times for a second human anatomy portion (e.g., the first human anatomy portion and the second human anatomy portion may depict the same human anatomy), at least one currently measured metric of the patient's cardiac health and at least one previously measured metric of the patient's cardiac health, and an indication of whether cardiac therapy for the patient appears beneficial (e.g., a percentage improvement between the at least one previously measured metric of the patient's cardiac health and the at least one currently measured metric of the patient's cardiac health).

One or more exemplary embodiments may further include allowing the user to change at least one pacing parameter (e.g., at least one of a pacing timing interval, a pacing vector, and a pacing mode) of an implantable medical device providing cardiac therapy to the patient and/or to display mechanical motion information of one or more regions of at least a portion of a vascular anatomy of the patient's heart on the graphical user interface.

In one or more exemplary embodiments, displaying the graphical representation of the measured surrogate cardiac electrical activation times about the first and second human anatomical portions may include displaying a graphical representation of the measured surrogate cardiac electrical activation times about a graphical representation of at least one of an anterior side of a human torso and a posterior side of the human torso.

In one or more exemplary embodiments, displaying the graphical representation of the measured surrogate cardiac electrical activation times about the first and second human anatomical portions may include displaying a graphical representation of the measured surrogate cardiac electrical activation times about a graphical representation of at least one of an anterior side of a heart and a posterior side of a heart.

In one or more exemplary embodiments, displaying a graphical representation of measured surrogate cardiac electrical activation times for a portion of human anatomy may include color scaling the portion of human anatomy on the graphical user interface as a function of the measured surrogate cardiac electrical activation times.

One or more exemplary embodiments may further include displaying at least one electrocardiogram of the patient on a graphical user interface. Each of the at least one electrocardiogram may be captured using at least one different electrode and may be time aligned on the graphical user interface.

One exemplary system for assisting in noninvasive evaluation of cardiac therapy can include an electrode device (e.g., including a plurality of external electrodes configured to be positioned adjacent patient tissue), a display device (e.g., including a graphical user interface configured to present cardiac electrical activation time information and cardiac health information), and a computing device coupled to the electrode device and the display device. The computing device may be configured to provide a graphical user interface displayed on the display device. The computing device may be further configured to: measuring surrogate cardiac electrical activation times using one or more of the plurality of external electrodes of the electrode apparatus that are proximate to the patient's heart, measuring at least one metric of the patient's cardiac health using one or more of the plurality of external electrodes of the electrode apparatus that are proximate to the patient's heart, and allowing a user to select one of an initial examination mode for assisting a user in non-invasive assessment of the patient for cardiac therapy and a follow-up examination mode for assisting a user in non-invasive assessment of cardiac therapy after implantation of cardiac therapy. When in the initial inspection mode, the computing device may be configured to display on the graphical user interface: a graphical representation of measured surrogate cardiac electrical activation times about a portion of human anatomy, at least one metric of the patient's cardiac health, and an indication of whether cardiac therapy for the patient may be beneficial. When in the follow-up examination mode, the computing device may be configured to display on the graphical user interface: a graphical representation of currently measured surrogate cardiac electrical activation times for a first human anatomy portion and a graphical representation of previously measured surrogate cardiac electrical activation times for a second human anatomy portion and at least one currently measured metric of the patient's cardiac health, at least one previously measured metric of the patient's cardiac health, and an indication of whether cardiac therapy for the patient appears beneficial.

One exemplary computer-implemented method for assisting in noninvasive evaluation of a patient for cardiac therapy may comprise: measuring surrogate cardiac electrical activation times using one or more external electrodes proximate the patient's heart, measuring at least one metric of the patient's cardiac health using one or more external electrodes proximate the patient's heart, and allowing a user to select one of an initial examination mode and a follow-up examination mode. The initial examination mode may be configured to assist a user in non-invasively evaluating the patient for cardiac therapy and the follow-up examination mode may be configured to assist a user in non-invasively evaluating cardiac therapy after implantation of the cardiac therapy. While in the initial inspection mode, the exemplary method displays on the graphical user interface: a graphical representation of measured surrogate cardiac electrical activation times about a portion of human anatomy, at least one metric of the patient's cardiac health, and an indication of whether cardiac therapy for the patient may be beneficial. While in the follow-up examination mode, the exemplary method displays on the graphical user interface: a graphical representation of currently measured surrogate cardiac electrical activation times for a first human anatomy portion and a graphical representation of previously measured surrogate cardiac electrical activation times for a second human anatomy portion and at least one currently measured metric of the patient's cardiac health, at least one previously measured metric of the patient's cardiac health, and an indication of whether cardiac therapy for the patient appears beneficial.

Another exemplary system for assisting in the non-invasive assessment of a patient for cardiac therapy may include: the system includes means for measuring surrogate cardiac electrical activation times representing electrical activation times of a patient's heart, means for measuring at least one metric of the patient's cardiac health, and computing means for allowing a user to select one of an initial examination mode and a follow-up examination mode. The initial examination mode may be configured to assist a user in non-invasively evaluating the patient for cardiac therapy and the follow-up examination mode may be configured to assist a user in non-invasively evaluating cardiac therapy after implantation of cardiac therapy. The exemplary system may further comprise a display device for: when in the initial examination mode, displaying on a graphical user interface a graphical representation of measured surrogate cardiac electrical activation times for the human anatomy portion, at least one metric of the patient's cardiac health, and an indication of whether cardiac therapy for the patient may be beneficial, and when in the follow-up examination mode, displaying on the graphical user interface a graphical representation of a currently measured surrogate cardiac electrical activation time for the first human anatomy portion and a graphical representation of a previously measured surrogate cardiac electrical activation time for the second human anatomy portion and at least one currently measured metric of the patient's cardiac health, at least one previously measured metric of the patient's cardiac health, and an indication of whether cardiac therapy for the patient appears to be beneficial.

In one or more exemplary embodiments, a user may be allowed to select an implantation examination mode for assisting the user in non-invasively evaluating cardiac therapy during implantation and configuration of cardiac therapy. When in the implant examination mode, a graphical user interface may display: a graphical representation of currently measured surrogate cardiac electrical activation times for a first human anatomy portion and a graphical representation of previously measured surrogate cardiac electrical activation times for a second human anatomy portion and at least one currently measured metric of the patient's cardiac health, at least one previously measured metric of the patient's cardiac health, and an indication of whether cardiac therapy for the patient appears beneficial. In at least one embodiment, a user may be allowed to change at least one pacing parameter of an implantable medical device that provides cardiac therapy to the patient.

The above summary is not intended to describe each embodiment or every implementation of the present disclosure. A more complete understanding thereof will become apparent and appreciated by reference to the following detailed description and claims when considered in conjunction with the accompanying drawings.