Systems and methods for behaviorally responsive signal detection and therapy delivery

• US 10,137,305 B2
• Filed: 08/24/2016
• Issued: 11/27/2018
• Est. Priority Date: 08/28/2015
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Kane, Michael J., Linder, William J., Juffer, Lance Eric, Haasl, Benjamin J., Schmidt, Brian L., Huelskamp, Paul, Maile, Keith R.
• Primary Examiner(s): Tejani, Ankit D
• Application Number:
  US15/246,172
• Publication Number:
  US 20170056664A1
• Time in Patent Office: 825 Days
• Field of Search: None
• CPC Class Codes: A61B 2560/0209 adapted for power saving
• CPC Class Codes: A61B 5/1116 Determining posture transitions
• CPC Class Codes: A61B 5/1118 Determining activity level
• CPC Class Codes: A61N 1/36521 the parameter being derived from measurement of an electrical impedance
• CPC Class Codes: A61N 1/36535 controlled by body position or posture
• CPC Class Codes: A61N 1/36542 controlled by body motion, e.g. acceleration
• CPC Class Codes: A61N 1/3655 controlled by body or blood temperature
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means
• CPC Class Codes: A61N 1/3756 Casings with electrodes thereon, e.g. leadless stimulators
• CPC Class Codes: A61N 1/378 Electrical supply

Abstract

Systems, devices, and methods for adjusting functionality of an implantable medical device based on posture are disclosed. In some instances, a method for operating a leadless cardiac pacemaker implanted into a patient, where the patient has two or more predefined behavioral states, may include detecting a change in the behavioral state of the patient, and in response, changing a sampling rate of a sensor signal generated by a sensor of the leadless cardiac pacemaker. In some embodiments, the method may further include using the sampled sensor signal to determine an updated pacing rate of the leadless cardiac pacemaker and providing pacing to the patient at the updated pacing rate.

Claims

1. A method for operating a leadless cardiac pacemaker implanted into a patient, the patient having two or more predefined behavioral states including a first predefined behavioral state and a second predefined behavioral state, the method comprising:

the leadless cardiac pacemaker detecting a change in the behavioral state of the patient from the first predefined behavioral state to the second predefined behavioral state, and in response, the leadless cardiac pacemaker changing a sampling rate of a sensor signal generated by a sensor of the leadless cardiac pacemaker from a first sampling rate to a second sampling rate;

the leadless cardiac pacemaker using the sampled sensor signal at the second sampling rate to determine an updated pacing rate of the leadless cardiac pacemaker; and

the leadless cardiac pacemaker providing pacing to the patient at the updated pacing rate.

2. The method of claim 1, wherein the sensor has a lower power mode and a higher power mode, and wherein the leadless cardiac pacemaker uses the sensor in the lower power mode to detect the change in the behavioral state of the patient from the first predefined behavioral state to the second predefined behavioral state, and in response to detecting the change in the behavioral state of the patient, the leadless cardiac pacemaker switching the sensor to the higher power mode.

3. The method of claim 2, wherein the lower power mode is a low power sleep mode, and the higher power mode is an awake mode.

4. The method of claim 1, wherein the change in the behavioral state of the patient from the first predefined behavioral state to the second predefined behavioral state corresponds to a change in a posture of the patient.

5. The method of claim 1, wherein the change in the behavioral state of the patient from the first predefined behavioral state to the second predefined behavioral state corresponds to a change in an activity level of the patient.

6. The method of claim 1, wherein the sensor is an accelerometer.

7. The method of claim 1, wherein the sensor is one or more of an impedance sensor, a pressure sensor, a flow sensor, a temperature sensor, a gyroscope, an acoustic sensor and a blood oxygenation sensor.

8. The method of claim 1, wherein, in response to detecting the change in the behavioral state of the patient from the first predefined behavioral state to the second predefined behavioral state, the leadless cardiac pacemaker further changing a sampling time window for sampling the sensor signal generated by the sensor of the leadless cardiac pacemaker.

9. The method of claim 1, wherein upon detecting a change from an inactive behavioral state as the first predefined behavioral state to an active behavioral state as the second predefined behavioral state, the leadless cardiac pacemaker determines an updated pacing rate that is increased to reduce orthostatic tension in the patient.

10. The method of claim 9, wherein upon detecting a change from the active behavioral state to the inactive behavioral state, the leadless cardiac pacemaker determines an updated pacing rate that is decreased.

11. The method of claim 9, wherein upon detecting a change from the active behavioral state to the inactive behavioral state, the leadless cardiac pacemaker decreasing the sampling rate of the sensor signal generated by the sensor of the leadless cardiac pacemaker.

12. The method of claim 10, wherein upon detecting a change from the inactive behavioral state to the active behavioral state, the leadless cardiac pacemaker increasing the sampling rate of the sensor signal generated by the sensor of the leadless cardiac pacemaker.

13. The method of claim 10, wherein upon detecting a change from the active behavioral state to the inactive behavioral state, the leadless cardiac pacemaker lowers the lower-rate-limit (LRL), and upon detecting a change from the inactive behavioral state to the active behavioral state, the leadless cardiac pacemaker raises the lower-rate-limit (LRL).

14. The method of claim 1, further comprises receiving an input from a user that defines one or more of the behavioral states, wherein the input is received via communication messages from an external programmer.

15. A method for operating a leadless cardiac pacemaker implanted into a patient, the patient having two or more predefined postures, the method comprising:

the leadless cardiac pacemaker sensing a predetermined physiological parameter using a sensor, the leadless cardiac pacemaker capable of sensing the predetermined physiological parameter in a lower power sensing mode with less resolution and a higher power sensing mode with more resolution;

the leadless cardiac pacemaker detecting a change from a first one of the two or more predefined postures to a second one of the two or more predefined postures, and in response, the leadless cardiac pacemaker changing from the lower power sensing mode to the higher power sensing mode;

the leadless cardiac pacemaker using the sensed physiological parameter to determine an updated pacing rate of the leadless cardiac pacemaker; and

the leadless cardiac pacemaker providing pacing to the patient at the updated pacing rate.

16. The method of claim 15, wherein:

the leadless cardiac pacemaker detecting a change from the second one of the two or more predefined postures to the first one of the two or more predefined postures, and in response, the leadless cardiac pacemaker changing from the higher power sensing mode to the lower power sensing mode.

17. A leadless cardiac pacemaker (LCP), comprising:

a plurality of electrodes;

an accelerometer;

a controller connected to the plurality of electrodes and the accelerometer, the controller configured to;

sense an acceleration signal generated by the accelerometer, the controller capable of sensing the acceleration signal in a lower power sensing mode with less resolution and a higher power sensing mode with more resolution;

detect a change from a first one of two or more predefined postures via the acceleration signal to a second one of the two or more predefined postures, and in response, change from the lower power sensing mode to the higher power sensing mode;

using the sensed acceleration signal to determine an updated pacing rate; and

providing pacing to the patient at the updated pacing rate.

18. The leadless cardiac pacemaker (LCP) of claim 17, wherein in the higher power sensing mode, the acceleration signal is sampled at a higher sampling rate than in the lower power sensing mode.

19. The leadless cardiac pacemaker (LCP) of claim 17, wherein in the higher power sensing mode, the acceleration signal is sampled in a longer sampling time window than in the lower power sensing mode.

20. The leadless cardiac pacemaker (LCP) of claim 17, wherein the pacing is provided via two or more of the plurality of electrodes.