Detecting heart tones to identify heart deterioration

• US 20040215264A1
• Filed: 04/23/2003
• Published: 10/28/2004
• Est. Priority Date: 04/23/2003
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: van Bentem, Maarten
• Granted Patent: US 6,999,816 B2
• Time in Patent Office: Days
• US Class Current: 607/17
• CPC Class Codes: A61B 5/026 Measuring blood flow A61B3/1233, A61B3/1241 take precedence
• CPC Class Codes: A61B 7/045 Detection of Korotkoff sounds A61B5/0225 takes precedence; measuring blood pressure A61B5/021
• CPC Class Codes: A61N 1/36542 controlled by body motion, e.g. acceleration
• CPC Class Codes: A61N 1/36578 controlled by mechanical motion of the heart wall, e.g. measured by an accelerometer or microphone

Abstract

The invention is directed to an implantable medical device (IMD) that includes an accelerometer. The accelerometer is used to detect heart tones associated with blood flow through one or more cardiac valves. In particular, the IMD measures durations of the heart tones detected by the accelerometer, and uses the measured durations to identify deterioration of the heart. In this manner, the IMD facilitates early detection of cardiac deterioration so that proper therapy can be delivered to the patient to remedy and combat such deterioration.

Claims

1. An implantable medical device comprising:

an accelerometer to detect heart tones associated with blood flow through a cardiac valve; and

a heart tone unit to measure durations of the detected heart tones.

2. The implantable medical device of claim 1, wherein the heart tone unit identifies a change in the durations of the heart tones.

3. The implantable medical device of claim 1, wherein the heart tone unit identifies an increase in the durations of the heart tones relative to a threshold duration.

4. The implantable medical device of claim 3, further comprising a memory coupled to the heart tone unit, wherein the heart tone unit stores a value in the memory to indicate the increase in the durations of the heart tones relative to the threshold duration.

5. The implantable medical device of claim 4, further comprising a telemetry unit to telemetrically communicate information relating to the durations of the heart tones when the value is stored in the memory.

6. The implantable medical device of claim 1, wherein the heart tone unit includes:

an amplifier to amplify output of the accelerometer;

a filter associated with the cardiac valve to filter output of the amplifier; and

a duration detector to detect the durations based on output of the filter.

7. The implantable medical device of claim 6, further comprising:

a plurality of filters associated with each of a plurality of cardiac valves; and

a multiplexer to select output from one of the filters to monitor one of the valves and provide the selected output from one of the filters to the duration detector.

8. The implantable medical device of claim 6, further comprising:

an analog to digital converter to convert the output of the filter to digital values;

a digital signal processor to process the digital values; and

a pacing unit to adjust delivery of pacing pulses by the implantable medical device based on output of the digital signal processor.

9. The implantable medical device of claim 1, wherein the device comprises a pacemaker.

10. The implantable medical device of claim 1, wherein the heart tone unit further measures frequencies associated with the detected heart tones.

11. The implantable medical device of claim 1, wherein the heart tone unit further measures frequency variations associated with the detected heart tones.

12. The implantable medical device of claim 1, wherein the heart tone unit further measures amplitudes associated with the detected heart tones.

13. A method comprising:

measuring durations of heart tones associated with blood flow through a cardiac valve of a heart using an accelerometer of an implantable medical device; and

identifying a change in the measured durations of the heart tones.

14. The method of claim 13, wherein identifying the change comprises identifying an increase in the durations of the heart tones.

15. The method of claim 14, further comprising storing a value in the implantable medical device to indicate the increase in the durations of the heart tones.

16. The method of claim 14, wherein identifying the increase in the durations comprises comparing the measured durations to a threshold duration and storing a value in the implantable medical device when at least one of the measured durations exceeds the threshold duration.

17. The method of claim 14, further comprising telemetrically communicating to a programmer an indication that the increase in the durations was identified.

18. The method of claim 13, further comprising measuring durations of heart tones associated with blood flow through a plurality of cardiac valves using the accelerometer;

and

identifying an increase in the durations of the heart tones associated with one of the plurality of cardiac valves.

19. The method of claim 13, further comprising delivering therapy to the patient in response to identifying the change in the durations of the heart tones.

20. The method of claim 13, further comprising delivering pacing pulses to the heart.

21. The method of claim 13, further comprising measuring frequencies associated with the heart tones.

22. The method of claim 13, further comprising measuring frequency variations associated with the heart tones.

23. The method of claim 13, further comprising measuring amplitudes associated with the heart tones.

24. A system comprising:

an implantable medical device programmer; and

an implantable medical device that telemetrically communicates with the programmer including;

an accelerometer to detect heart tones associated with blood flow through a cardiac valve;

a heart tone unit to identify an increase in durations of the heart tones relative to a threshold duration;

a memory coupled to the heart tone unit, wherein the heart tone unit stores a value in the memory to indicate the increase in the durations of the heart tones relative to the threshold duration; and

a telemetry unit to telemetrically communicate information relating to the durations of the heart tones to the programmer when the value is stored in the memory.

25. The system of claim 24, wherein the heart tone unit of the implantable medical device includes:

an amplifier to amplify output of the accelerometer;

a filter to filter output of the amplifier; and

a duration detector to detect the durations based on output of the filter.

26. The system of claim 24, wherein the heart tone unit of the implantable medical device further includes:

a plurality of filters associated with each of a plurality of cardiac valves; and

a multiplexer to select output from one of the filters based on which of the cardiac valves is being currently monitored and provide the selected output from one of the filters to the duration detector.

27. An apparatus comprising:

an accelerometer for measuring durations of heart tones associated with blood flow through a cardiac valve of a heart; and

means for identifying a change in the measured durations of the heart tones.

28. The apparatus of claim 27, further comprising means for identifying an increase in the durations of the heart tones.

29. The apparatus of claim 27, further comprising means for storing a value in an implantable medical device to indicate the change in the durations of the heart tones.

30. The apparatus of claim 27, further comprising means for communicating to a programmer of the implantable medical device an indication that the change in the durations was identified.