IMPLANTABLE MYOCARDIAL ISCHEMIA DETECTION, INDICATION AND ACTION TECHNOLOGY

• US 20110230929A1
• Filed: 05/31/2011
• Published: 09/22/2011
• Est. Priority Date: 08/07/1998
• Status: Active Grant

• Current Assignee: Ananth Natarajan, Nitish V. Thakor
• Original Assignee: Ananth Natarajan, Nitish V. Thakor
• Inventors: Thakor, Nitish V., NATARAJAN, Ananth
• Granted Patent: US 8,755,870 B2
• Time in Patent Office: Days
• US Class Current: 607/17
• CPC Class Codes: A61B 5/287 Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61B 5/349 Detecting specific parameters of the electrocardiograph cycle
• CPC Class Codes: A61B 5/4836 Diagnosis combined with treatment in closed-loop systems or methods A61B5/0036 takes precedence
• CPC Class Codes: A61B 5/726 using Wavelet transforms
• CPC Class Codes: A61M 5/1723 using feedback of body parameters, e.g. blood-sugar, pressure measurement of body parameters A61B5/00
• CPC Class Codes: A61N 1/3627 for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy
• CPC Class Codes: A61N 1/365 controlled by a physiological parameter, e.g. heart potential evoked response A61N1/371
• CPC Class Codes: A61N 1/37 Monitoring; Protecting
• CPC Class Codes: A61N 1/3962 in combination with another heart therapy

Abstract

One embodiment enables detection of MI/I and emerging infarction in an implantable system. A plurality of devices may be used to gather and interpret data from within the heart, from the heart surface, and/or from the thoracic cavity. The apparatus may further alert the patient and/or communicate the condition to an external device or medical caregiver. Additionally, the implanted apparatus may initiate therapy of MI/I and emerging infarction.

Claims

1. A method of monitoring a heart for evidence of myocardial ischemia/infarction (MI/I), comprising:

monitoring the heart using a pacemaker device implanted into a subject, the pacemaker device including a pacing electrode and a plurality of electrical sensors adapted to sense an electrogram signal, the electrical sensors being positioned at locations including the heart and vascular system, wherein only one of the electrical sensors adapted to sense an electrogram signal is positioned in the heart; and

determining whether evidence of MI/I is present in the subject, using the electrogram signal;

wherein at least some of the electrical sensors used in determining whether evidence of MI/I is present in the subject are also used to sense a need to pace the heart.

2. The method of claim 1, further comprising alerting the subject when a determination is made that there is evidence of MI/I present in the subject.

3. The method of claim 1, further comprising wirelessly communicating from the device implanted into the subject to a device external of the subject.

4. The method of claim 1, wherein the pacemaker device implanted into the subject is a first device, the method further comprising:

wirelessly communicating from the first device to a second device, the second device external to the subject; and

communicating from the second device to a third device using an internet communication scheme.

5. The method of claim 1, further comprising initiating therapy within the subject after detecting evidence of MI/I in the subject.

6. The method of claim 1, further comprising providing a supply of a medicine as part of the device implanted into the subject, and supplying a dose of the medicine to the subject after the device makes a determination that there is evidence that MI/I is present in the subject.

7. A method of monitoring a heart for evidence of myocardial ischemia/infarction (MI/I), comprising:

monitoring the heart using a pacemaker device implanted into a subject, the pacemaker device including a pacing electrode and plurality of electrical sensors adapted to sense an electrogram signal, wherein all the electrical sensors adapted to sense an electrogram signal are positioned within the heart; and

determining whether evidence of MI/I is present in the subject, using the electrogram signal;

wherein at least some of the electrical sensors used in determining whether evidence of MI/I is present in the subject are also used to sense a need to pace the heart.

8. The method of claim 7, further comprising alerting the subject when a determination is made that there is evidence of MI/I present in the subject.

9. The method of claim 7, further comprising wirelessly communicating from the device implanted into the subject to a device external of the subject.

10. The method of claim 7, wherein the device implanted into the subject is a first device, the method further comprising:

wirelessly communicating from the first device to a second device, the second device external to the subject; and

communicating from the second device to a third device using an internet communication scheme.

11. The method of claim 7, further comprising initiating therapy within the subject after detecting evidence of MI/I in the subject.

12. The method of claim 7, further comprising providing a supply of a medicine as part of the device implanted into the subject, and supplying a dose of the medicine to the subject after the device makes a determination that there is evidence that MI/I is present in the subject.

13. An implantable pacemaker adapted to monitor a heart for evidence of myocardial ischemia/infarction (MI/I), comprising:

a pacing electrode and plurality of electrical sensors adapted to sense an electrogram signal, the electrical sensors adapted to be positioned at locations including the heart and vascular system, wherein only one of the electrical sensors adapted to sense an electrogram signal is adapted to be positioned in the heart; and

a computer adapted to determine whether evidence of MI/I is present in the subject, using the electrogram signal obtained using the electrical sensors;

wherein the pacemaker is configured so that at least some of the sensors used in the determining whether evidence of MI/I is present in the subject are also used to sense a need to pace the heart.

14. The implantable pacemaker of claim 13, wherein the computer uses at least one of the depolarization and the repolarization portions of the electrogram signal to determine whether evidence of MI/I is present in the subject, wherein if the depolarization portion is used, the depolarization portion is analyzed in at least one of time, frequency, and time-frequency domains, and wherein if the repolarization portion is used, the repolarization portion is analyzed in at least one of time, frequency, and time-frequency domains.

15. The implantable pacemaker of claim 13, wherein the sensors are positioned in a unipolar configuration.

16. The implantable pacemaker of claim 13, wherein the sensors are positioned in a bipolar configuration.

17. The implantable pacemaker of claim 13, further comprising a device adapted to alert the subject when a determination is made that there is evidence of MI/I present in the subject.

18. The implantable pacemaker of claim 13, further comprising a device adapted to wirelessly communicate with a device external to the implantable pacemaker.

19. The implantable pacemaker of claim 18, wherein the device is adapted to wirelessly communication with a device external to the implantable pacemaker using an internet communication scheme.

20. The implantable pacemaker of claim 13, further comprising a supply of a medicine as part of the implantable pacemaker, and a device to deliver a dose of the medicine to the subject after the computer makes a determination that there is evidence that MI/I is present in the subject.