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Implantable Cardiac Devices - Status and Recent Activities

IEEE 11073-10103 IDC Nomenclature April 2013. Implantable Cardiac Devices - Status and Recent Activities. PCD Face-2-Face April 2013. Agenda. IDCO – Overview Status Current Activities. IDCO – Overview. IDCO – Implantable Device-Cardiology-Observation

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Implantable Cardiac Devices - Status and Recent Activities

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  1. IEEE 11073-10103IDC NomenclatureApril 2013 Implantable Cardiac Devices -Status and Recent Activities PCD Face-2-Face April 2013

  2. Agenda • IDCO – Overview • Status • Current Activities

  3. IDCO – Overview • IDCO – Implantable Device-Cardiology-Observation • Profile started in Cardiology Domain (2005?) • Funding and logistics limitations moved IDCO to PCD Domain • Current version is tailored toward Pacemakers, implantable defibrillators, and implantable loop recorders

  4. IDCO Activities • 2012 was a successful year! • IDCO Profile updated and approved • IEEE Nomenclature 11073-10103 approved • ISO Approval is forthcoming • Looking to add to our successes: • Extend IEEE 11073 nomenclature with new parameters • Assess Data transmission Triggers concept • Evaluate options for digitized waveforms

  5. Extend IEEE Nomenclature • Objectives • Add more detailed parameters (approx. 40) • Cardiac event details • New device information (MRI; multi-pacing leads) • Activities • Reviewed/discussed with HRS-HITS Physician panel • Completing 1st round of development • Aiming for rough draft at Physician meeting May 11th

  6. MAX MIN MEDIAN Importance Rating11 physician reviews (Oct 2012) HIGH …Importance LOW Recent device programming date/time and/or program counter Mean ventricular heart rate at atrial burden Lead/Device recall information Multisite Left Ventricular Pacing parameters Counters for shocks started/successful and ATPs successful Number and energy of shocks applied per episode (machine readable) Number of ATPs applied per episode (machine readable) Message triggers / alert summary (urgency) RV pacing avoidance algorithm name and status Message trigger categories MRI parameters Patient Pacemaker Dependant? (YES/NO) Message triggers / alert summary (compact) Shock waveform parameters PVARP Patient activity Message triggers / alert summary (long) RA/RV/LV sensing configuration More vendor specific entries in lists of episode types, brady modes. Thoracic impedance Mean A/V heart rate at rest/night AF Suppression algorithm info (ON/OFF) PVARP after PVC/PAC PVAB / Far-field protection window after Pace PVAB / Far-field protection window after Sense Patient comments if stored in device / system (medication, indication,…) Date of the next scheduled in clinic / remote follow-up(s) Rate adaptation settings (for brady pacing) LVPP / TWPP (ON/OFF) Post shock pacing settings (brady mode, basic rate, ...) RVB LVB RARP (ARP) RABP RVRP (VRP) LVRP Rate adaptation sensor type (coded and machine readable) IVRP LVPP / TWPP Respiratory Rate Heart Rate Variability (HRV)

  7. Data Transmission Triggers • Current IDCO provides the ‘What’ but buried the ‘Why’ • Physician request for device vendors to provide details on why a data transmission occurred • Why are they receiving this transmission? • What is it’s importance level? • Team reviewed options including existing standards (e.g. ACM) • Trying to keep any level of urgency in the hands of the physician • Physicians should determine ranking of each transmission type

  8. Digitized Waveforms • Current IDCO Profile contains PDF reports of waveforms • PDFs met original intent of IDCO (data review and billing) • Physicians are asking for greater flexibility with waveforms • Digitized waveforms allow greater opportunities to use tools • Zoom, calipers, comments, etc. Meeting with HRS-HITS Physician panel next month • Discuss Use Cases to drive development

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