Cardiac sensing and detection using subcutaneous ECG signals and heart sounds

• US 20060241702A1
• Filed: 04/22/2005
• Published: 10/26/2006
• Est. Priority Date: 04/22/2005
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Gillberg, Jeffrey M.
• Granted Patent: US 7,559,900 B2
• Time in Patent Office: Days
• US Class Current: 607/9
• CPC Class Codes: A61B 5/361 Detecting fibrillation
• CPC Class Codes: A61B 5/363 Detecting tachycardia or bradycardia
• CPC Class Codes: A61B 5/364 Detecting abnormal ECG interval, e.g. extrasystoles, ectopic heartbeats
• CPC Class Codes: A61N 1/056 Transvascular endocardial electrode systems
• CPC Class Codes: A61N 1/3622 comprising two or more electrodes co-operating with different heart regions
• CPC Class Codes: A61N 1/36542 controlled by body motion, e.g. acceleration
• CPC Class Codes: A61N 1/3756 Casings with electrodes thereon, e.g. leadless stimulators
• CPC Class Codes: A61N 1/39622 Pacing therapy
• CPC Class Codes: A61N 2001/0585 Coronary sinus electrodes

Abstract

A method and device for detecting cardiac signals that includes a first plurality of electrodes that senses cardiac signals and delivers therapy, and a second plurality of electrodes that senses the cardiac signals. A microprocessor detects a cardiac event in response to the sensing by the first plurality of electrodes, and verifies the cardiac event in response to the sensing by the second plurality of electrodes.

Claims

1. A medical device, comprising;

a first plurality of electrodes sensing cardiac signals and delivering therapy;

a second plurality of electrodes sensing the cardiac signals; and

a microprocessor detecting a cardiac event in response to the sensing by the first plurality of electrodes, wherein the microprocessor verifies the cardiac event in response to the sensing by the second plurality of electrodes.

2. The device of claim 1, further comprising a device housing capable of being subcutaneously positioned within a patient, the microprocessor being positioned within the device housing, wherein the first plurality of electrodes and the second plurality of electrodes are positioned along the device housing.

3. The device of claim 1, further comprising:

a device housing capable of being subcutaneously positioned within a patient, the microprocessor being positioned within the device housing; and

a lead body extending from the device housing, wherein the first plurality of electrodes are positioned along the lead body and the second plurality of electrodes are positioned along the device housing.

4. The device of claim 3, wherein the lead body is capable of being subcutaneously positioned within the patient.

5. The device of claim 1, wherein the second plurality of electrodes include an acoustic sensor.

6. The device of claim 1, further comprising:

a device housing capable of being subcutaneously positioned within a patient, the microprocessor being positioned within the device housing;

a header block positioned on the device housing; and

a lead body extending from the header block and capable of being subcutaneously positioned within the patient, wherein the first plurality of electrodes are positioned along one of the device housing and the lead body and the second plurality of electrodes are positioned along the header block.

7. The device of claim 1, further comprising:

a device housing capable of being subcutaneously positioned within a patient, the microprocessor being positioned within the device housing;

a header block positioned on the device housing;

a first lead body extending from the header block; and

a second lead body extending from the header block, wherein the first plurality of electrodes are positioned along one of the device housing and the first lead body and the second plurality of electrodes are positioned along one of the header block and the second lead body.

8. The device of claim 1, further comprising:

control circuitry controlling output from the first plurality of electrodes and the second plurality of electrodes, wherein the control circuitry initiates sensing of the cardiac signals by the second plurality of electrodes in response to the microprocessor detecting the cardiac event.

9. The device of claim 1, wherein the microprocessor generates a first sensed signal from cardiac signals sensed by the second plurality of electrodes concomitant to the sensing by the first plurality of electrodes and determines whether the first sensed signal has one of a frequency less than signals associated with the sensing by the first plurality of electrodes and a regular beat pattern relative to the sensing by the first plurality of electrodes.

10. The device of claim 1, wherein the microprocessor generates a first sensed signal from cardiac signals sensed by the second plurality of electrodes concomitant to the sensing by the first plurality of electrodes, determines whether a timing of the first sensed signal is approximately equal to signals associated with the sensing by the first plurality of electrodes and determines whether the first sensed signal indicates a change in patient status.

11. The device of claim 10, wherein the change in patient status corresponds to one of decreased patient activity, decreased hemodynamic output, and decreased local tissue perfusion.

12. A method of detecting cardiac signals, comprising:

sensing cardiac signals via a first plurality of electrodes to generate a sensed signal;

determining whether the first sensed signal corresponds to a cardiac event;

sensing the cardiac signals via a second plurality of electrodes; and

verifying the cardiac event in response to the sensing via the second plurality of electrodes.

13. The method of claim 12, wherein the first plurality of electrodes and the second plurality of electrodes are positioned along a device housing capable of being subcutaneously implanted within a patient.

14. The method of claim 12, wherein the second plurality of electrodes are positioned along a device housing capable of being subcutaneously positioned within a patient and the first plurality of electrodes are positioned along a lead body extending from the device housing.

15. The method of claim 14, wherein the lead body is capable of being subcutaneously positioned within the patient.

16. The method of claim 12, wherein the second plurality of electrodes include an acoustic sensor.

17. The method of claim 12, wherein the first plurality of electrodes are positioned along one of a device housing capable of being subcutaneously positioned within a patient and a lead body extending from a header block positioned on the device housing, and the second plurality of electrodes are positioned along the header block.

18. The method of claim 12, wherein the first plurality of electrodes are positioned along one of a device housing capable of being subcutaneously positioned within a patient and a first lead body extending from a header block positioned on the device housing, and the second plurality of electrodes are positioned along one of the header block and a second lead body extending from the header block.

19. The method of claim 12, further comprising generating a first sensed signal from cardiac signals sensed by the second plurality of electrodes concomitant to the sensing by the first plurality of electrodes and determining whether the first sensed signal has one of a frequency less than signals associated with the sensing by the first plurality of electrodes and a regular beat pattern relative to the sensing by the first plurality of electrodes.

20. The method of claim 12, further comprising:

generating a first sensed signal from cardiac signals sensed by the second plurality of electrodes concomitant to the sensing by the first plurality of electrodes;

determining whether a timing of the first sensed signal is approximately equal to signals associated with the sensing by the first plurality of electrodes; and

determining whether the first sensed signal indicates a change in patient status.

21. The method of claim 20, wherein the change in patient status corresponds to one of decreased patient activity, decreased hemodynamic output, and decreased local tissue perfusion.