# US 11,304,641 B2 · Systems, methods, and interfaces for use in cardiac evaluation

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- Number: US 11,304,641 B2
- Document ID: US11304641B2
- Status: Granted
- Kind: B2
- Application number: 15/995,661
- Filed: 2018-06-01
- Published: 2019-12-05
- Granted: 2022-04-19
- Earliest claimed: 2018-06-01
- Assignees: Medtronic, Inc.
- Applicants: Medtronic, Inc.
- Inventors: Subham Ghosh; Karen Kleckner; Melissa Rhodes; Jordyn Reich
- Web page: https://patentgrep.com/patent/US11304641B2

## CPC

- A61B 5/282: Holders for multiple electrodes (for introduction into the body A61B5/287)
- A61N 1/0476: {Array electrodes (including any electrode arrangement with more than one electrode for at least one of the polarities)}
- A61B 5/318: Heart-related electrical modalities, e.g. electrocardiography [ECG]
- A61N 1/0484: {Garment electrodes worn by the patient}
- A61N 1/3627: {for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy}
- A61N 1/3682: {with a variable atrioventricular delay}
- A61N 1/3684: {for stimulating the heart at multiple sites of the ventricle or the atrium}
- A61N 1/3702: {Physiological parameters (A61N1/365 takes precedence; evoked response A61N1/371)}
- A61N 1/37211: {Means for communicating with stimulators}
- A61N 1/3956: {Implantable devices for applying electric shocks to the heart, e.g. for cardioversion}
- A61B 5/4833: {Assessment of subject's compliance to treatment}
- A61B 2562/046: in a matrix array
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- A61N: ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY (measurement of bioelectric currents A61B; surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body A61B18/00; anaesthetic apparatus in general A61M; incandescent lamps H01K; infrared radiators for heating H05B)

## Abstract

Systems, interfaces, and methods are described herein for evaluation and adjustment cardiac therapy. The systems, interfaces, and methods may utilize, or include, a graphical user interface to display various information with respect to a plurality of external electrodes and electrical activity monitored using such external electrodes and to allow a user to adjust what information to display.

## Claims

### Claim 1

A system for use in cardiac evaluation comprising:
electrode apparatus comprising a plurality of external electrodes to be located proximate a patient's skin;
display comprising a graphical user interface to present information for use in assisting a user in at least one of assessing the patient's cardiac health, evaluating and adjusting cardiac therapy delivered to the patient, and navigating at least one implantable electrode to a region of the patient's heart; and
computing apparatus comprising processing circuitry, the computing apparatus operably coupled to the electrode apparatus and the display, the computing apparatus configured to:
monitor electrical activity from the patient's skin using the plurality of external electrodes for each of a plurality of different cardiac therapy scenarios,
generate electrical heterogeneity information for each of the plurality of different cardiac therapy scenarios based on the monitored electrical activity,
display, on the graphical user interface, a cardiac therapy scenario selection region depicting the plurality of different cardiac therapy scenarios to allow a user to select one or more of the plurality of different cardiac therapy scenarios, wherein a depiction of a cardiac therapy scenario of the plurality of different cardiac therapy scenarios includes an indication of at least one of a pacing configuration, an AV delay, and an LV pacing site of a cardiac therapy associated with the respective cardiac therapy scenario, and
display a ranking of the selected cardiac therapy scenarios based on the generated electrical heterogeneity information, wherein the ranking includes a ranked list of the selected cardiac therapy scenarios and the generated electrical heterogeneity information corresponding to each of the selected cardiac therapy scenarios.

### Claim 2 (depends on 1)

The system of claim 1, wherein the electrical heterogeneity information comprises a global standard deviation of surrogate electrical activation times monitored by the plurality of external electrodes.

### Claim 3 (depends on 1)

The system of claim 1, wherein the plurality of electrodes comprises two or more left external electrodes configured to be located proximate the left side of the patient, wherein the electrical heterogeneity information comprises an average of electrical activation times monitored by the two or more left external electrodes.

### Claim 4 (depends on 1)

The system of claim 1, wherein the selected cardiac therapy scenarios are ranked based on a primary metric of electrical heterogeneity.

### Claim 5 (depends on 4)

The system of claim 4, wherein two or more of the selected cardiac therapy scenarios are further ranked based on a secondary metric of electrical heterogeneity if the primary metric of electrical heterogeneity of the two more selected cardiac therapy scenarios are within a selected threshold from each other.

### Claim 6 (depends on 1)

The system of claim 1, wherein displaying a ranking of the selected cardiac therapy scenarios based on the generated cardiac heterogeneity information comprises displaying a plurality of rankings of different groups of selected cardiac therapy scenarios.

### Claim 7

A method comprising:
providing a plurality of external electrodes to be located proximate a patient's skin;
monitoring electrical activity from the patient's skin using the plurality of external electrodes for each of a plurality of different cardiac therapy scenarios;
generating electrical heterogeneity information for each of the plurality of different cardiac therapy scenarios based on the monitored electrical activity;
displaying, on a graphical user interface, a cardiac therapy scenario selection region a cardiac therapy scenario selection region depicting the plurality of different cardiac therapy scenarios to allow a user to select one or more of the plurality of different cardiac therapy scenarios, wherein a depiction of a cardiac therapy scenario of the plurality of different cardiac therapy scenarios includes an indication of at least one of a pacing configuration, an AV delay, and an LV pacing site of a cardiac therapy associated with the respective cardiac therapy scenario; and
displaying a ranking of the selected cardiac therapy scenarios based on the generated electrical heterogeneity information, wherein the ranking includes a ranked list of the selected cardiac therapy scenarios and the generated electrical heterogeneity information corresponding to each of the selected cardiac therapy scenarios.

### Claim 8 (depends on 7)

The method of claim 7, wherein the electrical heterogeneity information comprises a global standard deviation of surrogate electrical activation times monitored by the plurality of external electrodes.

### Claim 9 (depends on 7)

The method of claim 7, wherein the plurality of electrodes comprises two or more left external electrodes configured to be located proximate the left side of the patient, wherein the electrical heterogeneity information comprises an average of electrical activation times monitored by the two or more left external electrodes.

### Claim 10 (depends on 7)

The method of claim 7, wherein the selected cardiac therapy scenarios are ranked based on a primary metric of electrical heterogeneity.

### Claim 11 (depends on 10)

The method of claim 10, wherein two or more of the selected cardiac therapy scenarios are further ranked based on a secondary metric of electrical heterogeneity if the primary metric of electrical heterogeneity of the two more selected cardiac therapy scenarios are within a selected threshold from each other.

### Claim 12 (depends on 7)

The method of claim 7, wherein displaying a ranking of the selected cardiac therapy scenarios based on the generated cardiac heterogeneity information comprises displaying a plurality of rankings of different groups of selected cardiac therapy scenarios.