System for patient alerting associated with a cardiac event

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.

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.