# US 2021/0344880 A1 · Post operative implantation site monitoring

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- Number: US 2021/0344880 A1
- Document ID: US20210344880A1
- Status: Published application
- Kind: A1
- Application number: 17/215,419
- Filed: 2021-03-29
- Published: 2021-11-04
- Earliest claimed: 2020-04-30
- Assignees: Medtronic, Inc.
- Applicants: Medtronic, Inc.
- Inventors: Rodolphe Katra; Amie Bucksa; Niranjan Chakravarthy
- Web page: https://patentgrep.com/patent/US20210344880A1

## CPC

- H04N 7/188: {Capturing isolated or intermittent images triggered by the occurrence of a predetermined event, e.g. an object reaching a predetermined position (signal generation from motion picture films H04N5/253)}
- A61B 5/0022: {Monitoring a patient using a global network, e.g. telephone networks, internet}
- A61B 5/0031: {Implanted circuitry}
- A61B 5/0077: {Devices for viewing the surface of the body, e.g. camera, magnifying lens}
- A61B 5/346: Analysis of electrocardiograms
- A61B 5/445: {Evaluating skin irritation or skin trauma, e.g. rash, eczema, wound, bed sore}
- A61B 5/4848: {Monitoring or testing the effects of treatment, e.g. of medication}
- A61B 5/6898: {Portable consumer electronic devices, e.g. music players, telephones, tablet computers}
- A61B 5/7267: {involving training the classification device}
- A61B 5/743: {Displaying an image simultaneously with additional graphical information, e.g. symbols, charts, function plots}
- A61B 5/744: {Displaying an avatar, e.g. an animated cartoon character}
- A61B 90/361: {Image-producing devices, e.g. surgical cameras}
- A61B 90/98: using electromagnetic means, e.g. transponders
- G06N 20/00: Machine learning
- G06T 7/0012: {Biomedical image inspection}
- G06T 7/0016: {involving temporal comparison}
- G16H 10/20: for electronic clinical trials or questionnaires
- G16H 10/60: for patient-specific data, e.g. for electronic patient records
- G16H 30/20: for handling medical images, e.g. DICOM, HL7 or PACS
- G16H 30/40: for processing medical images, e.g. editing
- G16H 40/40: for the management of medical equipment or devices, e.g. scheduling maintenance or upgrades
- G16H 40/63: for local operation
- G16H 40/67: for remote operation
- G16H 50/70: for mining of medical data, e.g. analysing previous cases of other patients
- H04N 23/60: Control of cameras or camera modules
- H04N 23/61: based on recognised objects
- H04N 23/62: Control of parameters via user interfaces
- H04N 23/631: {Graphical user interfaces [GUI] specially adapted for controlling image capture or setting capture parameters}
- H04N 23/667: Camera operation mode switching, e.g. between still and video, sport and normal or high- and low-resolution modes
- A61B 5/1032: {Determining colour of tissue for diagnostic purposes}
- A61B 5/7465: {Arrangements for interactive communication between patient and care services, e.g. by using a telephone network (telemetry of measured physiological signal A61B5/0002)}
- A61B 34/25: {User interfaces for surgical systems}
- A61B 90/90: Identification means for patients or instruments, e.g. tags
- A61B 2090/365: {augmented reality, i.e. correlating a live optical image with another image}
- A61B 2090/372: {Details of monitor hardware}
- A61B 2562/08: Sensors provided with means for identification, e.g. barcodes or memory chips
- A61N 1/0484: {Garment electrodes worn by the patient}
- A61N 1/0509: {Stomach and intestinal electrodes}
- A61N 1/0514: {Electrodes for the urinary tract}
- A61N 1/0534: {Electrodes for deep brain stimulation}
- A61N 1/0541: {Cochlear electrodes}
- A61N 1/36003: {of motor muscles, e.g. for walking assistance}
- A61N 1/36007: {of urogenital or gastrointestinal organs, e.g. for incontinence control}
- A61N 1/36038: {Cochlear stimulation}
- A61N 1/3605: {Implantable neurostimulators for stimulating central or peripheral nerve system}
- A61N 1/36062: {Spinal stimulation}
- A61N 1/362: Heart stimulators (heart defibrillators A61N1/39)
- A61N 1/3622: {comprising two or more electrodes co-operating with different heart regions}
- A61N 1/37: Monitoring; Protecting
- A61N 1/37211: {Means for communicating with stimulators}
- A61N 1/3904: {External heart defibrillators [EHD]}
- A61N 1/3956: {Implantable devices for applying electric shocks to the heart, e.g. for cardioversion}
- G06T 2207/10016: Video; Image sequence
- G06T 2207/20084: Artificial neural networks [ANN]
- G06T 2207/30004: Biomedical image processing
- G06T 2207/30052: Implant; Prosthesis
- G16H 15/00: ICT specially adapted for medical reports, e.g. generation or transmission thereof
- G16H 40/20: for the management or administration of healthcare resources or facilities, e.g. managing hospital staff or surgery rooms
- G16H 50/20: for computer-aided diagnosis, e.g. based on medical expert systems
- H04N: PICTORIAL COMMUNICATION, e.g. TELEVISION
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- G06N: COMPUTING ARRANGEMENTS BASED ON SPECIFIC COMPUTATIONAL MODELS
- G06T: IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
- G16H: HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- 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

Techniques for remote monitoring of a patient and corresponding medical device(s) are described. The remote monitoring comprises determining identification data and identifying implantable medical device (IMD) information, initiating an imaging device and determining an imaging program, receiving one or more frames of image data including image(s) of an implantation site, identifying an abnormality at the implantation site, triggering a supplemental image capture mode, receiving one or more supplemental images of the implantation site, and outputting the one or more supplemental images of the implantation site.

## Claims

### Claim 1

A method of monitoring an implantation site of a patient of an implantable medical device (IMD), the method comprising:
determining, via a computing device, identification data for the patient;
identifying, based at least in part on the identification data, IMD information that corresponds to the IMD;
determining, based at least in part on the IMD information, an imaging program that defines one or more parameters for imaging the implantation site;
initiating, by the computing device, an imaging device, the imaging device configured to capture, in accordance with the imaging program, one or more frames of image data;
receiving, via the imaging device, at least one frame of the one or more frames, the at least one frame including an image of the implantation site;
identifying, from the at least one frame of the image data, an abnormality at the implantation site;
in response to identifying the abnormality, automatically triggering a supplemental image capture mode, wherein the imaging device, when operating in the supplemental image capture mode, is configured to capture one or more supplemental images of the implantation site;
subsequent to triggering the supplemental image capture mode, receiving, by the computing device, the one or more supplemental images of the implantation site; and
outputting, via the computing device, the one or more supplemental images of the implantation site.

### Claim 2 (depends on 1)

The method of claim 1, wherein the abnormality at the implantation site includes one or more of: a potential infection at the implantation site, abnormal healing at the implantation site, or device migration at the implantation site.

### Claim 3 (depends on 2)

The method of claim 2, wherein identifying the abnormality comprises:
determining, from the at least one frame, the presence of the potential infection at the implantation site; and
determining, based at least in part on the at least one frame, a likelihood of an actual infection evidenced by the presence of an infectious agent at the implantation site.

### Claim 4 (depends on 1, 2, 3)

The method of any one or more of claims 1-3, wherein initiating the imaging device comprises:
prior to receiving the at least one frame, receiving at least one initial frame of the one or more frames of the image data;
determining, from the at least one initial frame, a target adjustment of the imaging device; and
prompting a user, via a user interface of the computing device, to adjust a position of the imaging device according to the target adjustment.

### Claim 5 (depends on 1, 2, 3, 4)

The method of any one or more of claims 1-4, wherein the at least one frame comprises a plurality of frames of the image data, and wherein receiving the plurality of frames of the image data comprises:
receiving a first frame relative to a first perspective view of the implantation site; and
subsequent to receiving the first frame, receiving a second frame relative to a second perspective view of the implantation site, wherein the first perspective view and the second perspective view differ from one another.

### Claim 6 (depends on 5)

The method of claim 5, wherein identifying the abnormality comprises:
subsequent to receiving the first frame, identifying, from the second frame of the image data, the abnormality at the implantation site.

### Claim 7 (depends on 1, 2, 3, 4)

The method of any one or more of claims 1-4, wherein the at least one frame comprises a first frame representing a first perspective view, wherein receiving the one or more supplemental images of the implantation site comprises:
prompting a user, during the supplemental image capture mode, to adjust the imaging device to capture a second frame representing a second perspective view; and
identifying, from the one or more supplemental images of the implantation site, the second frame representing the second perspective view.

### Claim 8 (depends on 1, 2, 3, 4, 5, 6, 7)

The method of any one or more of claims 1-7, wherein receiving the one or more supplemental images of the implantation site comprises:
determining, from the at least one frame, a view of the implantation site that is depicted by the at least one frame; and
identifying the one or more supplemental images based at least in part on the view of the at least one frame.

### Claim 9 (depends on 1, 2, 3, 4, 5, 6, 7, 8)

The method of any one or more of claims 1-8, wherein determining the imaging program comprises:
determining a proficiency level of a user, the proficiency level indicative of a proficiency of the user with imaging implantation sites of IMDs;
determining, based on the proficiency level, an imaging mode; and
capturing, according to the imaging mode, the at least one frame.

### Claim 10 (depends on 1, 2, 3, 4, 5, 6, 7, 8, 9)

The method of any one or more of claims 1-9, wherein the supplemental image capture mode comprises a video capture mode, and wherein outputting the one or more supplemental images of the implantation site comprises:
outputting, via the computing device, an imaging sequence, the imaging sequence based at least in part on the one or more supplemental images of the implantation site.

### Claim 11 (depends on 10)

The method of claim 10, wherein the imaging device is configured to, in accordance with the video capture mode, produce the imaging sequence such that the imaging sequence satisfies a particular video resolution parameter.

### Claim 12 (depends on 11)

The method of claim 11, wherein the particular video resolution parameter comprises a variable video resolution parameter, and wherein automatically triggering the video capture mode comprises:
determining a confidence interval for the identification of the abnormality; and
determining, based on the confidence interval, a first value for the variable video resolution parameter.

### Claim 13 (depends on 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12)

The method of any one or more of claims 1-12, wherein the computing device comprises the imaging device.

### Claim 14

A system for monitoring an implantation site of a patient of an implantable medical device (IMD), the system comprising:
a memory configured to store image data; and
one or more processors in communication with the memory, the one or more processors configured to:
determine identification data for the patient;
identify, based at least in part on the identification data, IMD information that corresponds to the IMD;
determine, based at least in part on the IMD information, an imaging program that defines one or more parameters for imaging the implantation site;
initiate an imaging device, the imaging device configured to capture, in accordance with the imaging program, one or more frames of the image data;
receive, from the imaging device, at least one frame of the one or more frames, the at least one frame including an image of the implantation site;
identify, from the at least one frame of the image data, an abnormality at the implantation site;
in response to identifying the abnormality, automatically trigger a supplemental image capture mode, wherein the imaging device, when operating in the supplemental image capture mode, is configured to capture one or more supplemental images of the implantation site;
subsequent to triggering the supplemental image capture mode, receive the one or more supplemental images of the implantation site; and
output the one or more supplemental images of the implantation site.

### Claim 15 (depends on 14)

The system of claim 14, wherein the abnormality includes a potential infection at the implantation site, wherein to identify the abnormality, the one or more processors are configured to:
determine, from the at least one frame, the presence of the potential infection at the implantation site; and
determine, based at least in part on the at least one frame, a likelihood of an actual infection evidenced by the presence of an infectious agent at the implantation site.

### Claim 16 (depends on 14, 15)

The system of any one or more of claim 14 or 15, wherein the at least one frame comprises a plurality of frames of the image data, and wherein to receive the plurality of frames of the image data, the one or more processors are configured to:
receive a first frame relative to a first perspective view of the implantation site; and
subsequent to receiving the first frame, receive a second frame relative to a second perspective view of the implantation site, wherein the first perspective view and the second perspective view differ from one another.

### Claim 17 (depends on 16)

The system of claim 16, wherein to identify the abnormality, the one or more processors are configured to:
subsequent to receiving the first frame, identify, from the second frame of the image data, the abnormality at the implantation site.

### Claim 18 (depends on 14, 15, 16, 17)

The system of any one or more of claims 14-17, wherein the supplemental image capture mode comprises a video capture mode, and wherein to output the one or more supplemental images of the implantation site, the one or more processors are configured to:
output an imaging sequence, the imaging sequence based at least in part on the one or more supplemental images of the implantation site.

### Claim 19 (depends on 14, 15, 16, 17, 18)

The system of any one or more of claims 14-18, wherein to determine the identification data for the patient, the one or more processors are configured to:
receive authentication data identifying a user of the imaging program;
authorize the user to access the imaging program;
subsequent to authorizing the user to access the imaging program, receive input data that identifies the patient of the IMD; and
determine, from the input, the identification data for the patient.

### Claim 20

A non-transitory computer-readable storage medium having stored thereon instructions that, when executed, cause one or more processors to:
determine identification data for a patient, the patient having an implantable medical device (IMD);
identify, based at least in part on the identification data, IMD information that corresponds to the IMD;
determine, based at least in part on the IMD information, an imaging program that defines one or more parameters for imaging an implantation site;
initiate an imaging device, the imaging device configured to capture, in accordance with the imaging program, one or more frames of image data;
receive, via the imaging device, at least one frame of the one or more frames, the at least one frame including an image of the implantation site;
identify, from the at least one frame of the image data, an abnormality at the implantation site;
in response to identifying the abnormality, automatically trigger a supplemental image capture mode, wherein the imaging device, when operating in the supplemental image capture mode, is configured to capture one or more supplemental images of the implantation site;
subsequent to triggering the supplemental image capture mode, receive the one or more supplemental images of the implantation site; and
output the one or more supplemental images of the implantation site.