Abstract: A distributed system of network programmers is described for use with implantable medical devices. The system includes a set of network programmers each having a processor for performing functions directed to programming an implantable medical device and having a transceiver for communicating with the implantable medical device in response to those functions. The system also includes a remotely located network server. The network server has a processor for performing additional functions directed to analyzing information received from the network programmers and to transmitting the results of analyses to selected network programmers. By providing network programmers configured to perform only limited functions in conjunction with a network server, the individual network programmers can be considerably less costly to manufacture and maintain.

Abstract: A system for analyzing cardiac waveforms is provided that allows a physician to accurately measure specific portions of a displayed IEGM or EKG signal. By examining the cardiac waveform with the analyzing system, the physician can quickly and accurately determine whether the device is operating properly. The physician may use one or two cursors or an icon or pointer to define a specific portion of the cardiac waveform to be analyzed. Various waveform characteristics such as relative waveform amplitude, maximum slew rate, power spectral density, and time elapsed can be determined for the specific portion of the cardiac waveform. If desired, the waveform characteristic determined for the specific portion of the cardiac waveform can be compared to statistical waveform data (e.g., in the form of a histogram).

Abstract: An implantable device programmer includes a variety of features for allowing a clinician to perform an automated and customized follow-up examination of a patient having an implanted cardiac implantable device, the implantable device being of the type which captures and stores various types of diagnostic data for subsequent retrieval and evaluation. A custom protocol feature of the programmer allows the clinician pre-specify and then semi-automatically follow an ordered sequence of protocol steps, each protocol step involving the interrogation of the implantable device and the display by the programmer of associated implantable device data (such as a heart rate histogram, or the results of a ventricular capture test). When the clinician initiates a custom protocol, the programmer automatically retrieves all of the diagnostic data records of the protocol in the protocol order.

Abstract: Methods and apparatus for controlling an implantable medical device, such as an implantable cardiac stimulating device, using voice commands are provided. A voice command given by a user is converted into digital data. The digital data are processed in order to recognize the voice command. Once the voice command is recognized, it is telemetered to the implantable device. In a preferred embodiment, the voice command must be confirmed by the user before it is executed.

Abstract: A system and method for ambulatory monitoring and programming of an implantable medical device are provided. The system enables ambulatory communication between a modified programmer/analyzer and an implantable medical device having telemetric communication capability. This is accomplished through the use of an ambulatory interface unit which may be conveniently attached to the patient's body using a belt or harness. The ambulatory interface unit wirelessly communicates with both the programmer/analyzer and the implantable medical device thereby providing for improved patient mobility. The ambulatory interface unit may include an integral telemetry head or may be connected to the telemetry head by a communication cable.

Abstract: A retractable pen tether and a method for connecting a digitizer pen to a hand-held computer or other digitizer housing are provided. A tether attaches a digitizer pen to the digitizer to prevent the accidental loss of the digitizer pen. The tether length is variable so that an individual user can choose the desired amount of tether. The tether can be caused to retract into a cavity within the digitizer pen. The addition of the tether does not prevent storing the digitizer pen within a pen storage chamber of the digitizer housing. The tether mechanism and tether anchor are designed so that existing digitizer housings can be upgraded with tethered pens without extensive modifications to the digitizer housing.

Abstract: Methods and apparatus are provided for annotating medical data in an implantable device programmer using digitally recorded sound. A display screen of the implantable device programmer preferably displays at least a portion of a patient data set. A user preferably designates a connection point of the patient data set. Voice signals from the user are received by a transducer and converted to electrical signals, which are then converted to digital data by an analog to digital converter. The digital voice data preferably are stored within a memory device of the implantable device programmer and preferably are linked to the connection point. A marker preferably is displayed on the display screen at a location corresponding to the connection point. The physician is able to listen to the voice annotation by selecting a playback button displayed on the display screen. Voice annotations preferably can be transcribed into text which preferably is displayed in a text window when the voice annotation marker is selected.

Abstract: An apparatus and a method for an improved user interface for communicating with implantable medical devices are described. An integrated digitizer display screen and a digitizer pen serve as the primary input devices to a tablet computer adapted to receive real-time and stored medical data. The pen is used to select programming options by tapping portions of the digitizer based on visual images on the display. Additionally, the pen may be used to manipulate the medical data through the use of gestures, or be used to enter free form annotations concerning the medical data. An additional aspect of the user interface is the use of a questionnaire card to input information into the tablet computer by tapping the pen on the marked answers on the questionnaire card.

Abstract: A system and method for acquiring medical data, integrating recently acquired medical data with previously acquired medical data, storing the integrated medical data, and displaying the integrated medical data to a medical practitioner in a convenient format appropriate for the type of data stored are provided. Recently acquired medical data are integrated with historical medical data in an implantable medical device programmer. The data may be initially displayed in graphical and text formats during a patient's follow-up visits. The historical medical data may be stored in the programmer, in the implantable medical device or both. Medical data may include physiologic data pertaining to the patient's medical condition, parametric data pertaining to the operational characteristics of the implantable medical device, identification data, including patient's background information, and comments including the medical practitioner's comments.

Abstract: A monitoring system is provided that monitors the condition of a patient by analyzing physiological data received from implantable medical devices. The monitoring system has at least one monitoring unit, which preferably is suitable for stand-alone operation, or which may be connected to a central monitoring station. The monitoring unit, which receives the physiological data from the implantable medical devices via telemetry, determines whether a patient's physiological condition warrants attention. If the patient's condition is determined to be abnormal, the monitoring unit generates an audible alarm signal or generates an alarm signal that is transmitted to the central monitoring station.

Abstract: A method and system are provided for organizing, viewing and manipulating information in an implantable device programmer. The information includes programmable parameters which are divided into key parameters and subordinate parameters. Each key parameter has one or more associated subordinate parameters which are displayed when the user selects the key parameter, but which are not displayed when a different key parameter is selected. Subordinate parameters can be made sticky by the user. A sticky subordinate parameter is displayed regardless of whether or not the user has selected its associated key parameter. Certain parameters are linked so that when the user selects any one of the linked parameters, all linked parameters are displayed. Certain parameters are designated as inactive because of interactions with other parameters.

Abstract: This invention provides a therapy decision support system and method for guiding physicians and medical technicians in optimizing a set of adjustable parameters that define the operating characteristics of implantable cardiac stimulating devices. The invention also provides an implantable cardiac stimulating device programmer which can furnish therapy decision support as well as telemetric data retrieval and telemetric programming capabilities.

Abstract: An apparatus for annotating physiological waveforms is provided. The apparatus comprises an implantable medical device, which may be a pacemaker or a cardioverter/defibrillator, and a programmer for use with the implantable medical device. The implantable medical device may be modeled as a finite state machine. Whenever the implantable medical device enters a new state, a state transition vector or a current state vector is transmitted to the programmer. The programmer implements a state machine model of the implantable medical device to determine the current state of the device based on the received state vectors. Because the exact state of the implantable medical device is known, the programmer can annotate the physiological waveform more completely than has previously been possible. For example, when the behavior of the implantable medical device is unclear, the programmer can place an explanatory label adjacent to the displayed physiological waveform.