Method and apparatus for identifying patients with wide QRS complexes

Abstract

A medical device programmer or other external system capable of programming an implantable CRM device includes a wide-QRS detection and alerting system. Upon detection of a wide QRS complex, a wide-QRS indicator produces a visual indication of the detection using one or more presentation devices such as a display screen and a printer to alert a physician or other caregiver.

1 . An external system configured to be communicatively coupled to an implantable medical device, the external system comprising: 
 an external telemetry circuit configured to communicate with the implantable medical device;    a user interface coupled to the external telemetry circuit, the user interface including a screen; and    a wide-QRS detection and alerting circuit coupled to the user interface, the wide-QRS detection and alerting circuit including: 
 a wide-QRS detector including a signal input to receive an electrocardiogram (ECG) signal, a QRS width measurement module configured to measure the QRS width using the received ECG signal, and a QRS width comparator having a first input to receive the measured QRS width, a second input to receive a threshold QRS width, and an output indicative of a detection of a wide QRS complex when the measured QRS width exceeds the threshold QRS width; and  
 a wide-QRS indicator coupled to the wide-QRS detector, the wide-QRS indicator including an image generator configured to present a message window on the screen in response to the detection of the wide QRS complex, the message window displaying a message indicative of the detection of the wide QRS complex.  
   
   
   
       2 . The system of  claim 1 , further comprising a programming circuit coupled to the external telemetry circuit and the user interface, the programming circuit configured to program the implantable medical device, and the user interface comprises a programming input device configured to receive user input from a user, the user input related to programming of the implantable medical device.  
   
   
       3 . The system of  claim 1 , further comprising a surface ECG sensing circuit configured to sense a surface ECG signal using surface ECG electrodes, and wherein the signal input is programmable for receiving one of the surface ECG signal and a wireless ECG signal transmitted from the implantable medical device, the wireless ECG signal being a signal sensed by the implantable medical device using implantable electrodes.  
   
   
       4 . The system of  claim 1 , wherein the user interface comprises a threshold input device configured to receive the threshold QRS width from a user.  
   
   
       5 . The system of  claim 4 , wherein the threshold input device is configured to allow the user to type in the threshold QRS width.  
   
   
       6 . The system of  claim 4 , wherein the threshold input device is configured to allow the user to select from a plurality of predetermined threshold QRS widths.  
   
   
       7 . The system of  claim 1 , comprising an external device communicatively coupled to the implantable medical device via the telemetry, a remote device, and a telecommunication network coupled between the external device and the remote device.  
   
   
       8 . The system of  claim 7 , wherein the remote device comprises the screen.  
   
   
       9 . The system of  claim 1 , wherein the image generator is configured to cause a text message to be displayed in the message window, the text message directly indicative of the detection of the wide QRS complex.  
   
   
       10 . The system of  claim 9 , wherein the image generator is configured to cause the measured QRS width to be displayed in the message window.  
   
   
       11 . The system of  claim 9 , wherein the user interface comprises a printer, and the wide-QRS indicator comprises a message generator configured to produce a message indicative of the detection of the wide QRS complex to be printed by the printer.  
   
   
       12 . A method for operating an external system configured to communicate with an implantable medical device implanted in a patient, the method comprising: 
 receiving an electrocardiogram (ECG) signal sensed from the patient;    measuring a QRS width from the received ECG signal;    detecting a wide QRS complex by comparing the measured QRS width to a threshold QRS width; and    presenting a message window on a display screen of the external system in response to a detection of the wide QRS complex, the message window displaying a message indicative of the detection of the wide QRS complex.    
   
   
       13 . The method of  claim 12 , comprising sensing a surface ECG signal using surface ECG electrodes attached onto an exterior surface of the patient's skin, and wherein receiving the ECG signal comprises receiving the sensed surface ECG signal.  
   
   
       14 . The method of  claim 12 , comprising sensing a wireless ECG signal using the implantable medical device and implantable ECG electrodes implanted in the patient, and wherein receiving the ECG signal comprises receiving the sensed wireless ECG signal from the implantable medical device via telemetry.  
   
   
       15 . The method of  claim 14 , wherein sensing the wireless ECG signal comprises sensing the wireless ECG signal using subcutaneous electrodes attached to the implantable medical device.  
   
   
       16 . The method of  claim 12 , further comprising programming the implantable medical device to adjust one or more therapy parameters in response to the detection of the wide QRS complex.  
   
   
       17 . The method of  claim 12 , comprising receiving the threshold QRS width from a user using a user input device of the external system.  
   
   
       18 . The method of  claim 12 , comprising displaying a text message in the message window, the text message directly indicative of the detection of the wide QRS complex.  
   
   
       19 . The method of  claim 18 , comprising displaying the measured QRS width in the message window.  
   
   
       20 . The method of  claim 18 , comprising printing a message indicative of the detection of the wide QRS complex using a printer of the external system.