Surgery – Diagnostic testing – Cardiovascular
Reexamination Certificate
2000-12-29
2003-06-03
Nasser, Robert L. (Department: 3736)
Surgery
Diagnostic testing
Cardiovascular
C600S300000, C600S508000
Reexamination Certificate
active
06572556
ABSTRACT:
BACKGROUND OF THE INVENTION
1. Field of the Invention
The present invention relates generally to a distributed multi-user system for real time data access during cardiology procedures and, more particularly, to an interactive computer network which can be used to simultaneously display and manipulate data from a cardiology procedure on a plurality of devices and at a plurality of locations during the cardiology procedure.
2. Background of the Related Art
State of the art test and treatment facilities are essential to providing accurate monitoring, diagnoses, and treatment of heart disease. Medical facilities are often equipped to monitor and diagnose both mechanical and electrical defects in the heart. The present invention relates to the monitoring of the heart's electrical activity.
The heart is a muscle and, like other muscles, it contracts when it is electrically stimulated. Unlike other muscles, however, the heart has its own electrical system which can generate electrical impulses to stimulate the contraction of the muscle and thus keep the heart beating in rhythmic sequence so the blood is continually pumped throughout the body.
An electrophysiology study (EPS) is an invasive test involving the monitoring of the electrical signals in the heart. When defects in the heart tissue interfere with the normal formation or conduction of the heart's electrical activity, abnormal heart rhythms, known as cardiac arrhythmias, may develop. Cardiac arrhythmias may be caused by congenital defects, tissue damage due to heart attacks, or diseases such as arteriosclerosis (the deposition of fatty substances in the inner layer of the arteries) for instance, which accelerate, delay, or redirect the transmission of electrical activity, thereby disrupting the normal rhythmic contractions of the chambers of the heart. The electrophysiology study is used to assist in evaluating cardiac arrhythmias.
The basic electrophysiology procedure involves the recording and pacing of electrical signals within localized areas of the heart. During this study, catheters are placed near critical areas of the heart to record the heart's electrical signals. The heart is paced in various ways to study the speed and location of the flow of electricity within the heart. Typically, the study is used to determine if the heart has a tendency to pump faster or slower than normal and if the rhythm is dangerously irregular and thus requires treatment. Therapies for various rhythm disorders include medication, catheter ablation of the pathway, pacemakers, and defibrillators.
Tachycardia is an arrhythmia characterized by an abnormally fast heart rate (more than one-hundred beats per minute). Tachycardia falls into two categories, ventricular tachycardia (VT) and supra-ventricular tachycardia (SVT). VT is tachycardia that originates in the ventricles of the heart. SVT originates in the atria or at the junction between the atria and the ventricles of the heart. VT is a potentially life-threatening condition caused by either abnormally rapid impulse formation or by slow ventricular conduction which interferes with the heart's normal electrical activity and causes abnormally frequent contractions in the ventricles. Rapid ventricular contractions often result in significantly reduced cardiac output due to the inefficient pumping of the blood from the heart. As a result, the body receives an inadequate supply of oxygen which may cause dizziness, unconsciousness, cardiac arrest, or death.
Patients suspected of suffering from VT are initially screened by a cardiologist (doctor specializing in the heart) by means of external cardiac monitoring, typically in the form of an electrocardiogram. An electocardiogram captures electrical activity from surface leads placed on the patient's chest for twenty-four hours. When further testing is warranted, the patient is referred to a cardiac electrophysiologist (cardiologist who specializes in the electrical functioning of the heart) for an EPS.
An EPS evaluates the electrical integrity of the heart by stimulating multiple intra-cardiac sites and recording the electrical response. During an EPS, a patient's clinical tachycardia is induced in a controlled setting to diagnose the tachycardia and select an appropriate treatment or combination of treatments. EP studies using currently available technology are often lengthy and tedious procedures which include probing the interior of two or more chambers of the heart with single point contact catheters causing significant discomfort for the patient. However, single point contact catheters have limited utility in diagnosing complex tachycardia. The limited data produced in point by point mapping often fails to provide the electrophysiologist with sufficient diagnostic power for a complete understanding of the tachycardia.
One form of treatment of VT and SVT type arrhythmias which is becoming increasingly popular is catheter ablation. During the ablation (or “elimination”) procedure, which is similar to the procedure used in the EPS, a special catheter is inserted into the patient to deliver energy, such as radio frequency (RF) energy, to the precise areas of the heart which have been identified to cause the abnormal heartbeat. The tip of the catheter heats up and destroys the surrounding tissue thereby correcting the anomalous circuit within the heart which is causing the abnormal electrical activity. Catheter ablation is a potentially curative treatment which is continually being developed.
To perform procedures such as the EPS or catheter ablation, a cardiac catheterization lab is provided in which multiple clinicians can diagnose and treat heart conditions. These clinicians need to interact with, manipulate, and document observations on the clinical data in the study record. It would be advantageous for clinicians to be able to interact with and manipulate the clinical data simultaneously during a EP procedure. Such clinicians may include a primary physician, nurse, anesthesiologist, cardiovascular technician, radiology technician, consulting physician, and so forth. For example, it may be necessary for a cardiovascular technician, a primary physician, and a nurse to view the same information simultaneously during an EP procedure. However, each clinician may be located in a different part of the cardiac catheterization lab. Further, consulting physicians who may be located remotely may need to view the same clinical data during an EP procedure to provide real-time consultation on a particular procedure. Current techniques to accommodate the complex workflow in a cardiac catheterization lab are insufficient to meet these needs. Up to 128 channels of data may need to be recorded at a rate of 1K-byte/sec making the acquisition, displaying and manipulation of such data difficult to manage.
Prior techniques which have been employed in cardiac catheterization labs may not permit viewing of an EPS in real time on a system other than the acquisition station during the procedure, nor do they provide the capability of providing simultaneous access by different clinicians. FAX machines are currently used to employ the help of a consulting physician at a remote location. During an EPS, certain data and diagrams may be printed. These pages may then be delivered to a remote location via facsimile. Disadvantageously, this process is slow and tedious. The time it takes to exchange information between clinicians using the current techniques may be critical during an EPS. Further, the lack of simultaneous viewing capability of an EPS which is currently being conducted may result in critical delays in diagnoses and treatment of heart anomalies.
The present technique may address one or more of the problems set forth above.
SUMMARY OF THE INVENTION
The present technique describes a distributed multi-user system for real time data access during cardiology procedures. The system includes an interactive computer network which can be used to simultaneously display data from a cardiology procedure on a plurality of devices and at a pluralit
Kiser Ewin Michael
Stoycos Stephen T.
Fletcher Yoder & Van Someren
GE Medical Systems Information Technologies
Mallari Patricia C.
Nasser Robert L.
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