Hemodynamic assessment/adjustment

Abstract

A method and system for gathering, creating and utilizing signal-processed ECG and acoustic signals for assessing, via presenting a highly intuitive, multi-component, common-time-base, real-time output display of selected (1) timing, (2) relative timing, and (3) other significant heart-behavioral elements relevant to such an assessment, both a non-pacemaker patient's, and a pacemaker patient's, hemodynamic condition. The method and system offer an important option and capability for automatic, and/or manual, medical-treatment and/or pacemaker-control feedback, in real time, to improve a patient's hemodynamic status, with such a patient's resulting hemodynamic-behavioral/status changes caused by such feedback being viewable immediately in the invention's produced output display,

1 . A method utilizing signal-processed ECG-electrical and heart-sound acoustic signal information for assessing a patient's hemodynamic condition comprising 
 collecting, over a selected time span, for transmission for hemodynamic-condition signal processing, simultaneous ECG-electrical and heart-sound acoustic signals, and    based on said processing, producing a comprehensive time-based display including (a) ECG and acoustic waveforms, and (b) geometric graphical indicia generally keyed to these waveforms, whereby the produced-display waveforms and graphical indicia collectively present a visual description of the patient's hemodynamic condition.    
   
   
       2 . The method of  claim 1 , wherein said producing of geometric graphical indicia includes establishing an intuitive heart-sound marker display designating the time locations of at least one of heart sounds S 1 , S 2 , S 3  and S 4 .  
   
   
       3 . The method of  claim 2 , wherein said establishing of an intuitive heart-sound marker display includes placing therein (a) systolically-associated sound markers which are presented above a neutral axis line, and (b) diastolically-associated sound markers which are displayed below the same neutral axis line.  
   
   
       4 . The method of  claim 3 , wherein said producing of a display presenting hemodynamic condition information involves including in that display elements relating to (a) electromechanical activation time, (b) LV systolic time, (c) pre-atrial diastolic time, and (d) accelerated atrial filling time.  
   
   
       5 . The method of  claim 1 , wherein said producing of a display presenting hemodynamic condition information involves including in that display elements relating to (a) electromechanical activation time, (b) LV systolic time, (c) pre-atrial diastolic time, and (d) accelerated atrial filling time.  
   
   
       6 . The method of  claim 1  which further comprises utilizing collected ECG-electrical and heart-sound acoustic signals in a feedback manner to effect changes in the operation of the patient's medical treatment in a fashion aimed at improving the patient's hemodynamic status.  
   
   
       7 . A method utilizing signal-processed ECG and heart-sound signal information for assessing a pacemaker patient's hemodynamic condition comprising 
 collecting, over a selected time span, for transmission for hemodynamic-condition signal processing, simultaneous ECG-electrical and heart-sound acoustic signals,    while so collecting, detecting, electrically, pacemaker-induced ventricular stimulation, and    on detecting such stimulation, creating and applying a selected blanking time which effectively prevents hemodynamic-condition signal-processing of acoustic signals that are collected during that blanking time.    
   
   
       8 . The method of  claim 7  which further comprises generating, substantially simultaneously with respect to the beginning of the created and applied blanking time, an acoustic window which permits examining, during that window, of any collected and thus windowed acoustic signal to determine whether it represents an acoustic artifact produced by pacemaker-induced phrenic nerve stimulation.  
   
   
       9 . The method of  claim 8  which further comprises selectively using the determination of the presence of phrenic nerve stimulation to modify the operation of the patient's pacemaker.  
   
   
       10 . The method of  claim 7  which further comprises, in relation to application of a blanking time, producing a time-based graphical display containing indicia which are visually descriptive of selective components of the patient's hemodynamic condition.  
   
   
       11 . The method of  claim 10 , wherein said producing includes establishing (a) an ECG-signal display component, (b) a heart-sound acoustic signal display component, and (c) an intuitive, heart-sound marker display component designating the time locations of at least one of heart sounds S 1 , S 2 , S 3  and S 4 .  
   
   
       12 . The method of  claim 11 , wherein said establishing of an intuitive heart-sound marker display includes placing therein (a) systolically-associated sound markers which are presented above a neutral axis line, and (b) diastolically-associated sound markers which are displayed below the same neutral axis line.  
   
   
       13 . The method of  claim 12 , wherein said producing of a display presenting hemodynamic condition information involves including in that display elements relating to (a) electromechanical activation time, (b) LV systolic time, (c) pre-atrial diastolic time, and (d) accelerated atrial filling time.  
   
   
       14 . The method of  claim 7  which further comprises utilizing collected ECG-electrical and heart-sound acoustic signals in a feedback manner to effect changes in the operation of the patient's pacemaker in a fashion aimed at improving the patient's hemodynamic status.  
   
   
       15 . A system for assessing a patient's hemodynamic condition comprising 
 sensor structure for collecting, over a selected time span, for hemodynamic-condition signal-processing, simultaneous ECG-electrical and heart-sound acoustic signals,    signal-processing structure operatively connected to said sensor structure for receiving therefrom and processing such collected ECG-electrical and heart-sound acoustic signals, and    display structure operatively connected to said signal-processing structure for producing, based on processing performed by said signal-processing structure, a comprehensive time-based display including (a) ECG and acoustic waveforms, and (b) geometric graphical indicia generally keyed to these waveforms, whereby the produced-display waveforms and graphical indicia collectively present a visual description of the patient's hemodynamic condition.    
   
   
       16 . The system of  claim 15 , wherein said display structure, in relation to production of the time-based display of geometric graphical indicia, includes, in that indicia, display elements relating to (a) electromechanical activation time, (b) LV systolic time, (c) pre-atrial diastolic time, and (d) accelerated atrial filling time  
   
   
       17 . A system for assessing a pacemaker patient's hemodynamic condition comprising 
 sensor structure for collecting, over a selected time span, for hemodynamic-condition signal-processing, simultaneous ECG-electrical and heart-sound acoustic signals,    signal-processing structure operatively connected to said sensor structure for receiving therefrom and processing such collected ECG-electrical and heart-sound acoustic signals,    detecting structure operatively connected to said sensor structure and to said signal-processing structure for detecting, electrically, pacemaker-induced ventricular stimulation, and on detecting such stimulation, for creating and applying a selected blanking time which effectively prevents hemodynamic-condition signal-processing by said signal-processing structure of acoustic signals that are collected during that blanking time, and    display structure operatively connected to said signal-processing structure for producing, based on processing performed by said signal-processing structure, and in relation to the creation and application of such a blanking time, a time-based graphical display containing indicia which are visually descriptive of selected components of the patient's hemodynamic condition.    
   
   
       18 . The system of  claim 17 , wherein said display structure is constructed to produce such a display which includes (a) ECG and acoustic waveforms, and (b) geometric graphical indicia generally keyed to these waveforms, whereby the included ECG and acoustic waveforms, and the geometric graphical indicia, collectively present a visual description of the patient's hemodynamic condition.  
   
   
       19 . The system of  claim 18 , wherein the geometric graphical indicia includes elements relating to (a) electromechanical activation time, (b) LV systolic time, (c) pre-atrial diastolic time, and (d) accelerated atrial filling time.