Implantable ultrasound system for maintaining vessel patency and perfusion

• US 20090082781A1
• Filed: 09/24/2007
• Published: 03/26/2009
• Est. Priority Date: 09/24/2007
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Tran, Binh C., Kwok, Jonathan, Salo, Rodney W., Chavan, Abhi
• Granted Patent: US 7,922,663 B2
• Time in Patent Office: Days
• US Class Current: 606/128
• CPC Class Codes: A61B 17/2202 the ultrasound transducer being inside patient's body at the distal end of the catheter
• CPC Class Codes: A61B 2017/22027 Features of transducers

Abstract

An apparatus comprising an implantable acoustic transducer, an acoustic transducer interface circuit communicatively coupled to the acoustic transducer, and a controller circuit communicatively coupled to the acoustic transducer interface circuit. The controller is configured to, in response to receiving an indication of a patient condition associated with a development of a blood vessel obstruction, initiate delivery of acoustic energy that mitigates the blood vessel obstruction. Other systems and methods are described.

Claims

1. Apparatus comprising:

an implantable acoustic transducer;

an acoustic transducer interface circuit communicatively coupled to the acoustic transducer; and

a controller circuit, communicatively coupled to the acoustic transducer interface circuit, wherein the controller is configured to, in response to receiving an indication of a patient condition associated with a development of a blood vessel obstruction, initiate delivery of acoustic energy that mitigates the blood vessel obstruction.

2. The apparatus of claim 1, including an atrial fibrillation detection circuit communicatively coupled to the controller circuit to provide the indication upon detecting atrial fibrillation.

3. The apparatus of claim 1, including an ischemia detection circuit communicatively coupled to the controller circuit to provide the indication upon detecting ischemia.

4. The apparatus of claim 1, wherein the controller circuit is configured to:

initiate the application of acoustic energy at a first frequency to detect the patient condition; and

initiate the application of acoustic energy at a lower second frequency to mitigate the blood vessel obstruction in response to receiving the indication.

5. The apparatus of claim 4, including a detection circuit communicatively coupled to the controller circuit, wherein the detection circuit includes a blood flow velocity measurement circuit configured to:

receive ultrasonic information using ultrasonic energy at the first frequency; and

generate a blood flow velocity measurement from the ultrasonic information; and

wherein the indication includes a blood flow velocity measurement that is less than a blood flow velocity threshold.

6. The apparatus of claim 1, including a detection circuit coupled to the controller circuit, configured to detect an indication of a patient condition associated with a development of a blood vessel obstruction, and wherein the controller circuit is configured to apply the acoustic energy while the detection circuit indicates the patient condition.

7. The apparatus of claim 1, including a communication circuit communicatively coupled to the controller circuit, wherein the controller circuit is configured to communicate with a separate second device using the communication circuit and to receive the indication from the separate second device.

8. The apparatus of claim 7, wherein the indication includes at least one of an increase in blood viscosity, thrombosis, atrial fibrillation, ischemia, a decrease in blood velocity, and a decrease in local perfusion.

9. The apparatus of claim 1, wherein the acoustic transducer is included in an implantable lead, wherein the implantable lead is configured for placement in or near a blood vessel.

10. The apparatus of claim 1, wherein the acoustic transducer is included in an implantable lead, wherein the implantable lead is configured for placement in or near a localized region of a heart.

11. The apparatus of claim 1, wherein the acoustic transducer is included in a housing of the implantable medical device.

12. The apparatus of claim 1, including an implantable lead configured for placement in or near a blood vessel, and wherein the acoustic transducer is included in a housing of the implantable medical device and delivers the acoustic energy towards the implantable lead.

13. The apparatus of claim 12, wherein the implantable lead includes an acoustic energy sensor.

14. The apparatus of claim 12, including a placement guidewire configured for insertion into the implantable lead, wherein the guidewire includes an acoustic energy sensor.

15. A method comprising:

receiving an indication of a patient condition into an implantable medical device (IMD), wherein the patient condition is associated with a development of a blood vessel obstruction; and

applying, in response to receiving the indication of the patient condition, acoustic energy that mitigates the blood vessel obstruction using the IMD.

16. The method of claim 15, wherein receiving the indication of a patient condition includes detecting with the IMD at least one of atrial fibrillation, a decrease in blood flow velocity, or ischemia.

17. The method of claim 15, wherein receiving the indication of a patient condition includes receiving an indication of at least one of thrombosis, an increase in blood viscosity, or a decrease in regional perfusion.

18. The method of claim 15, including:

applying acoustic energy at a first frequency to detect the patient condition; and

applying acoustic energy at a lower second frequency to mitigate the blood vessel obstruction when the patient condition is detected.

19. The method of claim 18, wherein:

applying acoustic energy at a first frequency includes applying ultrasound energy at a frequency greater than two megahertz (2 MHz) to measure blood flow velocity; and

wherein applying acoustic energy at a lower second frequency includes applying ultrasound energy at a frequency of about 500 kilohertz (kHz) or less to mitigate the blood vessel obstruction.

20. The method of claim 15, wherein the applying acoustic energy includes applying localized ultrasound energy to a blood vessel in the thorax region of the patient.

21. The method of claim 15, wherein the applying acoustic energy includes applying ultrasound energy locally to a region of the heart.

22. The method of claim 15, wherein the applying acoustic energy includes applying ultrasound energy globally to the thorax region.

23. The method of claim 15, wherein the applying acoustic energy includes applying localized ultrasound energy to a region containing a second separate implantable device.

24. The method of claim 15, wherein the applying acoustic energy includes initiating the applying acoustic energy by the implantable medical device using a separate second device.

25. The method of claim 15, wherein receiving the indication includes detecting the patient condition associated with a development of a blood vessel obstruction using the IMD,

wherein applying acoustic energy includes applying the acoustic energy in response to detecting the patient condition, and

wherein the method includes continuing the applying acoustic energy while the detected condition is present.