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Implantable Cardiac Devices - Status and Recent Activities

This IEEE document outlines the current activities and future objectives of the IDCO project focused on improving the nomenclature for implantable cardiac devices. The goal is to expand parameters related to cardiac events, new device information, and facilitate data transmission triggers and digitized waveforms for enhanced analysis. The document also highlights the importance of physician involvement in determining urgency levels and the need for detailed waveform flexibility.

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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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