Cardiac monitor system and method for home and telemedicine application

• US 10,111,643 B2
• Filed: 03/17/2016
• Issued: 10/30/2018
• Est. Priority Date: 03/17/2016
• Status: Active Grant

• Current Assignee: Medtronic Vascular, Inc. (Medtronic Plc)
• Original Assignee: Medtronic Vascular, Inc. (Medtronic Plc)
• Inventors: Schulhauser, Randal, Brown, Richard, Bast, Gerard, Dominiack, Dorothy, Harding, William, Kinzie, Patrick, Cherry, Jeff, Saikia, Sneha
• Primary Examiner(s): Patel, Niketa
• Assistant Examiner(s): PHAM, MINH DUC GIA
• Application Number:
  US15/072,937
• Publication Number:
  US 20170265838A1
• Time in Patent Office: 957 Days
• Field of Search: 600513
• CPC Class Codes: A61B 5/103 Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes A61B5/08 takes precedence; measuring aids for tailors A41H1/00; measuring instruments specially adapted for dentistry A61C19/04
• CPC Class Codes: A61B 5/1116 Determining posture transitions
• CPC Class Codes: A61B 5/352 Detecting R peaks, e.g. for synchronising diagnostic apparatus; Estimating R-R interval
• CPC Class Codes: A61B 5/746 Alarms related to a physiological condition, e.g. details of setting alarm thresholds or avoiding false alarms alarms per se G08B
• CPC Class Codes: A61B 7/00 Instruments for auscultation
• CPC Class Codes: A61B 7/04 Electric stethoscopes microphones, acoustic transducers therefor H04R

Abstract

A system for detecting valvular malfunction includes a monitoring device and a processor. The monitoring device includes a heart sound sensor configured to detect heart sounds of the patient, and a signal processor. The processor is configured to receive a signal representative of the detected heart sounds from the signal processor, wherein the processor is configured to compare the signal to a baseline signal stored in memory. The processor may be part of the monitoring device or may be part of an external device, or both.

Claims

1. A system for detecting aortic stenosis comprising:

a monitoring device configured to be coupled to a patient, the monitoring device including a heart sound sensor configured to detect heart sounds of the patient, and a signal processor; and

a processor configured to

receive a signal representative of the detected heart sounds from the signal processor and process the signal representative of detected heart sounds to determine tested values of at least one of,

peak frequencies of a first heart sound, a second heart sound, and a third heart sound of the patient, wherein the first heart sound is detected at closure of a mitral valve of the patient, the second heart sound is detected at the closure of an aortic valve and a pulmonary valve of the patient, and the third heart sound is detected at passive diastolic filling of ventricles of the patient,

a ratio of a first time period from the second heart sound in a first cardiac cycle to the first heart sound in a second cardiac cycle and a second time period from the first heart sound in the second cardiac cycle to the second heart sound in the second cardiac cycle, and

a heart beat cycle period including a systole period and a diastole period, and

compare at least one of the tested values to corresponding baseline values of the peak frequencies, the ratio, and the heart beat cycle periods stored in memory.

2. The system of claim 1, further comprising an alert coupled to the processor, wherein the processor is configured to activate the alert if the at least one of the tested values deviates from the corresponding baseline value in a predetermined manner.

3. The system of claim 2, wherein the alert is an audio alert.

4. The system of claim 2, wherein the alert is a display in communication with the processor.

5. The system of claim 1, further comprising a second sensor configured to sense electrical activity of the patient'"'"'s heart, wherein the processor is configured to receive electrical activity signals from the second sensor.

6. The system of claim 5, further comprising an event trigger device transmitting a trigger signal to the monitoring device and the processor, wherein the processor is further configured to generate a first heart sound sensing time period and a second heart sound sensing time period, and wherein the heart sound sensor is configured to detect the first heart sound within the first heart sound sensing time period and the second heart sound within the second heart sound sensing time period, and wherein the processor is configured to store data corresponding to the first heart sound and the second heart sound in response to the trigger signal.

7. The system of claim 6, wherein the first heart sound sensing time period is configured to commence in response to the second sensor sensing an R-wave in the electrical activity of the patient'"'"'s heart.

8. The system of claim 7, wherein the second heart sound sensing time is configured to commence in response to the second sensor sensing a T-wave in the electrical activity of the patient'"'"'s heart.

9. The system of claim 1, wherein the monitoring device further includes a posture sensor.

10. The system of claim 9, wherein the posture sensor includes an accelerometer, wherein the posture sensor is configured to communicate with the processor to ensure that the patient is in a desired position.

11. The system of claim 1, wherein the processor is determine the tested values of each of the peak frequencies, the ratio, and the heart beat cycle periods, and

wherein the processor is configured to compare the tested values of each of the peak frequencies, the ratio, and the heart beat cycle periods to the corresponding baseline values of the peak frequencies, the ratio, and the heart beat cycle periods.

12. The system of claim 1,

wherein the monitoring device further includes a second sensor configured to sense electrical activity of the patient'"'"'s heart,

wherein the processor is further configured to

receive electrical activity signals from the second sensor,

detect an R-wave in the patient'"'"'s heart cycle,

measure a first time period from the detection of the R-wave to an end of the first heart sound,

measure a second time period from the end of the first heart sound to a start of the second heart sound,

calculate a tested ejection fraction by dividing the first time period by the second time period, and

compare the tested ejection fraction to a baseline ejection fraction.

13. A method for detecting valvular malfunction in a patient comprising the steps of:

utilizing a cardiac monitor for in-home sensing of the patient'"'"'s heart sounds;

processing the sensed heart sounds to determine tested values of at least one of,

peak frequencies of a first heart sound, a second heart sound, and a third heart sound of the patient, wherein the first heart sound is detected at closure of a mitral valve of the patient, the second heart sound is detected at the closure of an aortic valve and a pulmonary valve of the patient, and the third heart sound is detected at passive diastolic filling of ventricles of the patient,

a ratio of a first time period from the second heart sound in a first cardiac cycle to the first heart sound in a second cardiac cycle and a second time period from the first heart sound in the second cardiac cycle to the second heart sound in the second cardiac cycle, and

a heart beat cycle period including a systole period and a diastole period,

comparing at least one of the tested values the heart sound signals to corresponding baseline values of the peak frequencies, the ratio, and the heart beat cycle periods; and

alerting the patient if at least one the tested values deviates from the corresponding baseline value in a pre-determined manner.

14. The method of claim 13, further comprising uplinking data corresponding to the heart sound signals to an external device, wherein the comparing step is at the external device.

15. The method of claim 13, further comprising the steps of:

detecting an R-wave and a T-wave in the patient'"'"'s heart using a second sensor;

starting a first heart sound sensing time period in response to detecting the R-wave, wherein the first heart sound is sensed within the first heart sound sensing time period;

starting a second heart sound sensing time period in response to detecting the T-wave, wherein the second heart sound is sensed within the second heart sound sensing time period.

16. The method of claim 13, further comprising the step of sensing a position of the patient such that the position of the patient is the same during the step of sensing heart sound signals and when the baseline heart sound signals were measured.

17. The method of claim 13, wherein the step of processing the sensed heart sound signals includes determining the tested values of each of the peak frequencies, the ratio, and the heart beat cycle periods is determined, and

wherein the comparing step includes comparing the tested values of each of the peak frequencies, the ratio, and the heart beat cycle periods to the corresponding baseline values of the peak frequencies, the ratio, and the heart beat cycle periods.

18. The method of claim 13, further comprising the steps of:

detecting an R-wave in the patient'"'"'s heart cycle using a second sensor;

measuring a first time period from the detection of the R-wave to an end of the first heart sound;

measuring a second time period from the end of the first heart sound to a start of the second heart sound;

calculating a tested ejection fraction by dividing the first time period by the second time period; and

comparing the tested ejection fraction to a baseline ejection fraction.

19. The method of claim 13, wherein the corresponding baseline values are normal values for persons in a same category as the patient.

20. The method of claim 13, wherein the corresponding baseline values are values previously measured from the patient.