Method and system for performing a remote stress ECG
Patent Information
- Authority / Receiving Office
- EP · EP
- Patent Type
- Applications
- Current Assignee / Owner
- BIOTRONIK SE & CO KG
- Filing Date
- 2024-07-29
- Publication Date
- 2026-06-24
AI Technical Summary
Current stress ECG procedures require in-office visits, which are time-consuming and inefficient, as they involve patient travel, preparation by medical staff, and prolonged waiting periods.
A computer-implemented method and system that enables remote stress ECG performance by sending a stress ECG request through a remote network service to a patient communication device, which then initiates the recording of stress ECG data by an implantable medical device and transmits it in real-time or with a defined time-delay to the patient communication device or a relay device, and subsequently to a remote network service.
This solution allows for timely and efficient access to stress ECG data, reducing the burden on patients and medical staff, minimizing preparation time, and enabling rapid decision-making by physicians.
Smart Images
Figure EP2024071429_20022025_PF_FP_ABST
Abstract
Description
[0001] Method and system for performing a remote stress ECG
[0002] The invention relates to a computer-implemented method for performing a remote stress ECG.
[0003] Furthermore, the invention relates to a system for performing a remote stress ECG.
[0004] Currently, any stress ECG needs to be performed in-office. An appointment needs to be made, the medical staff has to prepare for it, the patient needs to travel. All in all, this procedure takes days or weeks for an action that can be performed within minutes.
[0005] US 2019 / 0365228 Al discloses a method comprising establishing communication between a therapy device implantable in a patient and a consumer electronic device operable by the patient, controlling, by the consumer electronic device, a predetermined set of therapy device functions in response to patient inputs to the consumer electronic device, transmitting therapy data from the therapy device to the consumer electronic device, and presenting therapy data on a display of the consumer electronic device.
[0006] The above-mentioned disclosure however does not enable performing a remote stress ECG.
[0007] It is therefore an object of the present invention to provide an improved method and system for performing a remote stress ECG on demand such that a physician has timely access to requested stress ECG data in order to adapt a patient therapy and / or prevent an adverse patient clinical event.
[0008] The object is solved by a computer-implemented method for performing a remote stress ECG having the features of claim 1. Furthermore, the object is solved by a system for performing a remote stress ECG having the features of claim 13.
[0009] Moreover, the object is solved by a computer program having the features of claim 14 and by a computer-readable data carrier having the features of claim 15.
[0010] Further developments and advantageous embodiments are defined in the dependent claims.
[0011] The present invention provides a computer-implemented method for performing a remote stress ECG. The method comprises sending a stress ECG request to a patient communication device by means of a remote network service, and upon receipt of the stress ECG request, sending a stress ECG start command to an implantable medical device by means of the patient communication device.
[0012] In addition, the method comprises, upon receipt of the start stress ECG command, recording stress ECG data by means of the implantable medical device and transmitting the stress ECG data, in particular in real-time or with a definable time-delay, to the patient communication device or a relay device, and transmitting the received stress ECG data to the remote network service by means of the patient communication device or the relay device.
[0013] Moreover, the present invention provides a system for performing a remote stress ECG comprising a remote network service configured to send a stress ECG request to a patient communication device.
[0014] The system further comprises a patient communication device configured to, upon receipt of the stress ECG request from the remote network service, send a stress ECG start command to an implantable medical device.
[0015] In addition, the system comprises an implantable medical device configured to, upon receipt of the start stress ECG command, record stress ECG data and transmit the stress ECG data, in particular in real-time or with a definable time-delay, to the patient communication device or a relay device, and wherein the patient communication device or the relay device is further configured to transmit the received stress ECG data to the remote network service.
[0016] Furthermore, the present invention provides a computer program with program code to perform the method according to the present invention when the computer program is executed on a computer. Moreover, the present invention provides data carrier containing program code of a computer program for performing the method according to the present invention when the computer program is executed on a computer.
[0017] An idea of the present invention is to provide an improved method and system for performing a remote stress ECG, wherein a physician may request a remote ECG e.g., based on a review of current patient medical data. The physician can trigger a request for a remote ECG via an interface, for example a web-interface and subsequently examine the received remote ECG data using said web-interface.
[0018] No time demanding in-office stress ECG execution is thus needed. The patient does not need to travel (potentially hours) to the physician, the physicians and the medical staff do not need to spent time for said execution.
[0019] Further, the time period from requesting a remote stress ECG to receiving its results can be very short. The physicians are thus able to obtain the ECG data in a short time frame.
[0020] This invention therefore uses the abilities of CRM implants together with a digital process to reduce an effort for the patient and the physician / medical staff and minimize a time span of preparation for performing the ECG.
[0021] According to an aspect of the invention, the patient communication device stores information regarding a user-selected physical activity during which the stress ECG is performed, in particular jogging, swimming, going for a walk or riding a bike.
[0022] Options can be a static list or calculated e.g. according to patient age (young age would not show “Going for a walk” option as valid stress ECG option). According to a further aspect of the invention, upon receiving the start stress ECG command, the implantable medical device terminates an active permanent program and sets a temporary stress ECG program, wherein when in the stress ECG program, shocks - in particular in case that the implantable medical device is an implantable cardioverter-defibrillator (ICD) - are disabled, continuous data collection is started and / or an increased data resolution is used for recording the stress ECG.
[0023] This automatic process advantageously prevents the occurrence of unintended setting changes of the implantable medical device while also simplifying the process of initiating the remote ECG recording.
[0024] According to a further aspect of the invention, after completing the stress ECG recording, the implantable medical device terminates the temporary stress ECG program and reverts to the previously active program. Thus, a continuous operation of the implantable medical device can be insured when changing program settings.
[0025] According to a further aspect of the invention, the recording of the stress ECG is stopped after a predetermined time period or by transmitting a first manual stop-command from the patient communication device to the implantable medical device.
[0026] The manual stop-command means that a user of the patient communication device, i.e. a patient manually enters said stop-command using a patient app installed on the patient communication device in order to stop the recording of the stress ECG.
[0027] According to a further aspect of the invention, the patient communication device sends a start command to a wearable device, in particular a sports watch, a smart watch or a blood pressure gauge, wherein upon receipt of the start command, data recorded by the wearable device is transmitted, in particular in real-time or with a definable time-delay, to the patient communication device. Thus optionally, if the patient communication device of the user is connected to a wearable, the user can start data recording on the wearable as well, ideally right before confirming to start the stress ECG.
[0028] According to a further aspect of the invention, recording of wearable device data is stopped after a predetermined time period, in particular at an end of a stress ECG timeframe, or by transmitting a second manual stop-command from the patient communication device to the wearable device.
[0029] Once the stress ECG is completed, data recording on the wearable is thus stopped manually or automatically. An automatic stop can be e.g. executed by the patient app on the patient communication device. When the stress ECG is stopped, the app can send a command to the wearable device to also stop recording data. The app then collects all wearable data from that period and transmits it to remote network service where it is displayed along the implant recorded data.
[0030] According to a further aspect of the invention, after sending the start stress ECG command to the implantable medical device, the patient communication device transmits a keep-alive- signal at predetermined time intervals to the implantable medical device.
[0031] By regularly transmitting the keep-alive-signal to the implantable medical device unnecessary stress ECG recording in case of e.g. a loss of connection between the implantable medical device and the patient communication device can be prevented.
[0032] According to a further aspect of the invention, upon receipt of the keep-alive-signal, the implantable medical device transmits a confirmation signal to the patient communication device, wherein if the implantable medical device does not receive any keep-alive-signal from the patient communication device within a defined time period and / or after sending a predetermined number of keep-alive-signals, the implantable medical device automatically terminates the temporary stress ECG program and resumes the previously active permanent program. The automatic termination of the stress ECG recording thus advantageously prevents unnecessary battery usage.
[0033] According to a further aspect of the invention, the implantable medical device tags the recorded stress ECG data such that the patient communication device, the relay device and / or the remote network service can identify the received data as stress ECG data.
[0034] This enables an effective communication between the remote network service, the patient communication device and the implantable medical device without the need to manually label the stress ECG data.
[0035] According to a further aspect of the invention, if a memory of the implantable medical device is insufficient for storing the complete stress ECG data, the stress ECG is split into a defined number of segments, wherein a segment size is determined depending on a memory size of the implantable medical device.
[0036] The stress ECG having any user-defined length and data size can thus be continuously recorded irrespective of a memory limitation of the implantable medical device.
[0037] According to a further aspect of the invention, the implantable medical device sets a limit on stress ECG runs, wherein the stress ECG can be performed only a predetermined number to times in a given time period. This advantageously prevents excessive battery usage by preventing too many stress ECGs being performed.
[0038] The herein described features of the computer-implemented method for performing a remote stress ECG are also disclosed for the system for performing a remote stress ECG and vice versa.
[0039] For a more complete understanding of the present invention and advantages thereof, reference is now made to the following description taken in conjunction with the accompanying drawings. The invention is explained in more detail below using exemplary embodiments, which are specified in the schematic figures of the drawings, in which: Fig. 1 shows a flowchart of a computer-implemented method for performing a remote stress ECG according to a preferred embodiment of the invention; and
[0040] Fig. 2 shows a diagram of a system for performing a remote stress ECG according to the preferred embodiment of the invention.
[0041] The computer-implemented method for performing a remote stress ECG shown in Fig. 1 comprises sending SI a stress ECG request 10 to a patient communication device 12 by means of a remote network service 14. The method further comprises, upon receipt of the stress ECG request 10, sending S2 a stress ECG start command Cl to an implantable medical device 16 by means of the patient communication device 12.
[0042] Moreover, the method comprises, upon receipt of the start stress ECG command Cl, recording S3 stress ECG data DI by means of the implantable medical device 16 and transmitting S4 the stress ECG data DI, in particular in real-time or with a definable timedelay, to the patient communication device 12 or a relay device 18, and transmitting S5 the received stress ECG data DI to the remote network service 14 by means of the patient communication device 12 or the relay device 18.
[0043] The patient communication device 12 furthermore stores information regarding a user- selected physical activity during which the stress ECG is performed, in particular jogging, swimming, going for a walk or riding a bike.
[0044] Upon receiving the start stress ECG command Cl, the implantable medical device 16 terminates an active permanent program Pl and sets a temporary stress ECG program P2, wherein when in the temporary stress ECG program P2, shocks are disabled (in particular if the implantable medical device 16 is an implantable cardioverter-defibrillator (ICD)), continuous data collection is started and / or an increased data resolution is used for recording the stress ECG. After completing the stress ECG recording, the implantable medical device 16 terminates the temporary stress ECG program P2 and reverts to the previously active program. Moreover, the recording of the stress ECG is stopped after a predetermined time period or by transmitting a first manual stop-command 22 from the patient communication device 12 to the implantable medical device 16.
[0045] The patient communication device 12 further optionally sends a start command C2 to a wearable device 20, in particular a sports watch, a smart watch or a blood pressure gauge, wherein upon receipt of the start command C2, data recorded by the wearable device 20 is transmitted, in particular in real-time or with a definable time-delay, to the patient communication device 12.
[0046] Recording of wearable device data D2 is stopped after a predetermined time period, in particular at an end of a stress ECG timeframe, or by transmitting a second manual stopcommand 24 from the patient communication device 12 to the wearable device 20.
[0047] After sending the start stress ECG command Cl to the implantable medical device 16, the patient communication device 12 transmits a keep-alive-signal 26 at predetermined time intervals to the implantable medical device 16.
[0048] According to a further aspect of the invention, upon receipt of the keep-alive-signal 26, the implantable medical device 16 transmits a confirmation signal 28 to the patient communication device 12, wherein if the implantable medical device 16 does not receive any keep-alive-signal 26 from the patient communication device 12 within a defined time period and / or after sending a predetermined number of keep-alive-signals 26, the implantable medical device 16 automatically terminates the temporary stress ECG program P2 and resumes the previously active permanent program Pl.
[0049] Furthermore, the implantable medical device 16 tags the recorded stress ECG data DI such that the patient communication device 12, the relay device 18 and / or the remote network service 14 can identify the received data as stress ECG data DI. If a memory 30 of the implantable medical device 16 is insufficient for storing the complete stress ECG data DI, the stress ECG is split into a defined number of segments 32, wherein a segment size is determined depending on a memory size of the implantable medical device 16.
[0050] In addition, the implantable medical device 16 sets a limit on stress ECG runs, wherein the stress ECG can be performed only a predetermined number to times in a given time period.
[0051] Fig. 2 shows a diagram of a system for performing a remote stress ECG according to the preferred embodiment of the invention.
[0052] The system 1 comprises a remote network service 14 configured to send a stress ECG request 10 to a patient communication device 12 and a patient communication device 12 configured to, upon receipt of the stress ECG request 10 from the remote network service 14, send a start stress ECG command Cl to an implantable medical device 16.
[0053] Moreover, the system 1 comprises an implantable medical device 16 configured to, upon receipt of the start stress ECG command Cl, record stress ECG data DI and transmit the stress ECG data DI, in particular in real-time or with a definable time-delay, to the patient communication device 12 or a relay device 18, and wherein the patient communication device 12 or the relay device 18 is further configured to transmit the received stress ECG data DI to the remote network service 14.
[0054] Reference Signs
[0055] 1 system
[0056] 10 stress ECG request
[0057] 12 patient communication device
[0058] 14 remote network service
[0059] 16 implantable medical device
[0060] 18 relay device
[0061] 20 wearable device
[0062] 22 first manual stop-command
[0063] 24 second manual stop-command
[0064] 26 keep-alive-signal
[0065] 28 confirmation signal
[0066] 30 memory
[0067] Cl start stress ECG command
[0068] C2 start command
[0069] DI stress ECG data
[0070] D2 wearable device data
[0071] Pl permanent program
[0072] P2 temporary stress ECG program
[0073] SI - S5 method steps
Claims
Claims1. Computer-implemented method for performing a remote stress ECG comprising the steps of: sending (SI) a stress ECG request (10) to a patient communication device (12) by means of a remote network service (14); upon receipt of the stress ECG request (10), sending (S2) a start stress ECG command (Cl) to an implantable medical device (16), in particular a leadless pacer, by means of the patient communication device (12); upon receipt of the start stress ECG command (Cl), recording (S3) stress ECG data (DI) by means of the implantable medical device (16) and transmitting (S4) the stress ECG data (DI), in particular in real-time or with a definable time-delay, to the patient communication device (12) or a relay device (18); and transmitting (S5) the received stress ECG data (DI) to the remote network service (14) by means of the patient communication device (12) or the relay device (18).
2. Computer-implemented method of claim 1, wherein the patient communication device (12) stores information regarding a user-selected physical activity during which the stress ECG is performed, in particular jogging, swimming, going for a walk or riding a bike.
3. Computer-implemented method of claim 1 or 2, wherein upon receiving the start stress ECG command (Cl), the implantable medical device (16) terminates an active permanent program (Pl) and sets a temporary stress ECG program (P2), wherein when in the temporary stress ECG program (P2), shocks are disabled, continuous data collection is started and / or an increased data resolution is used for recording the stress ECG.
4. Computer-implemented method of claim 3, wherein after completing the stress ECG recording, the implantable medical device (16) terminates the temporary stress ECG program (P2) and reverts to the previousls active permanent program (Pl).
5. Computer-implemented method of any one of the preceding claims, wherein the recording of the stress ECG is stopped after a predetermined time period or by transmitting a first manual stop-command (22) from the patient communication device (12) to the implantable medical device (16).
6. Computer-implemented method of any one of the preceding claims, wherein the patient communication device (12) sends a start command (C2) to a wearable device (20), in particular a sports watch, a smart watch or a blood pressure gauge, wherein upon receipt of the start command (C2), data recorded by the wearable device (20) is transmitted, in particular in real-time or with a definable time-delay, to the patient communication device (12).
7. Computer-implemented method of claim 6, wherein recording of wearable device data (D2) is stopped after a predetermined time period, in particular at an end of a stress ECG timeframe, or by transmitting a second manual stop-command (24) from the patient communication device (12) to the wearable device (20).
8. Computer-implemented method of any one of the preceding claims, wherein after sending the start stress ECG command (Cl) to the implantable medical device (16), the patient communication device (12) transmits a keep-alive-signal (26) at predetermined time intervals to the implantable medical device (16).
9. Computer-implemented method of claim 8, wherein upon receipt of the keep-alive- signal (26), the implantable medical device (16) transmits a confirmation signal (28) to the patient communication device (12), wherein if the implantable medical device (16) does not receive any keep-alive-signal (26) from the patient communication device (12) within a defined time period and / or after sending a predetermined number of keep-alive-signals (26), the implantable medical device (16) automatically terminates the temporary stress ECG program (P2) and resumes the previously active permanent program (Pl).
10. Computer-implemented method of any one of the preceding claims, wherein the implantable medical device (16) tags the recorded stress ECG data (DI) such that the patient communication device (12), the relay device (18) and / or the remote network service (14) can identify the received data as stress ECG data (DI).
11. Computer-implemented method of any one of the preceding claims, wherein if a memory (30) of the implantable medical device (16) is insufficient for storing the complete stress ECG data (DI), the stress ECG is split into a defined number of segments (32), wherein a segment size is determined depending on a memory (30) size of the implantable medical device (16).
12. Computer-implemented method of any one of the preceding claims, wherein the implantable medical device (16) sets a limit on stress ECG runs, wherein the stress ECG can be performed only a predetermined number to times in a given time period.
13. System (1) for performing a remote stress ECG comprising: a remote network service (14) configured to send a stress ECG request (10) to a patient communication device (12); a patient communication device (12) configured to, upon receipt of the stress ECG request (10) from the remote network service (14), send a start stress ECG command (Cl) to an implantable medical device (16); and an implantable medical device (16) configured to, upon receipt of the start stress ECG command (Cl), record stress ECG data (DI) and transmit the stress ECG data (DI), in particular in real-time or with a definable time-delay, to the patient communication device (12) or a relay device (18), and wherein the patient communication device (12) or the relay device (18) is further configured to transmit the received stress ECG data (DI) to the remote network service (14).
14. Computer program with program code to perform the method of any one of claims 1 to 12 when the computer program is executed on a computer.
15. Computer-readable data carrier containing program code of a computer program for performing the method of any one of claims 1 to 12 when the computer program is executed on a computer.