IMPLANTABLE CARDIAC MONITOR

• US 20180078771A1
• Filed: 09/20/2017
• Published: 03/22/2018
• Est. Priority Date: 09/21/2016
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Koop, Brendan Early, Juffer, Lance Eric, Kane, Michael J., Haasl, Benjamin J., Maile, Keith R., Foster, Arthur J.
• Granted Patent: US 10,994,145 B2
• Time in Patent Office: Days
• CPC Class Codes: A61B 2562/0204 Acoustic sensors
• CPC Class Codes: A61B 2562/0219 Inertial sensors, e.g. accelerometers, gyroscopes, tilt switches
• CPC Class Codes: A61B 2562/0247 Pressure sensors
• CPC Class Codes: A61B 2562/04 Arrangements of multiple sensors of the same type
• CPC Class Codes: A61B 2562/162 Capsule shaped sensor housings, e.g. for swallowing or implantation
• CPC Class Codes: A61B 5/0028 Body tissue as transmission medium, i.e. transmission systems where the medium is the human body
• CPC Class Codes: A61B 5/0031 Implanted circuitry
• CPC Class Codes: A61B 5/076 Permanent implantations telemetry using implanted circuitry A61B5/0031; implanted stimulators for therapy A61N1/3605, A61N1/362, A61N1/372
• CPC Class Codes: A61B 5/287 Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61B 5/318 Heart-related electrical modalities, e.g. electrocardiography [ECG]
• 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 5/6823 Trunk, e.g., chest, back, abdomen, hip
• CPC Class Codes: A61B 5/686 Permanently implanted devices, e.g. pacemakers, other stimulators, biochips A61B5/6861 takes precedence
• CPC Class Codes: A61B 5/6861 Capsules, e.g. for swallowing or implanting
• CPC Class Codes: A61B 5/6869 Heart
• CPC Class Codes: A61B 5/6886 Monitoring or controlling distance between sensor and tissue
• CPC Class Codes: A61N 1/37 Monitoring; Protecting
• CPC Class Codes: A61N 1/37211 Means for communicating with stimulators
• CPC Class Codes: A61N 1/3756 Casings with electrodes thereon, e.g. leadless stimulators

Abstract

An implantable cardiac monitor (ICM) may be configured to be deployed subcutaneous, submuscular, or substernal at a position that enables the ICM to detect cardiac activity. In some cases, the ICM includes a housing that includes a body portion and a tail portion. A first electrode may be disposed adjacent a first end of the body portion, a second electrode may be disposed adjacent a second end of the body portion and a third electrode may be disposed adjacent a tail end of the tail portion. A controller may be disposed within the housing and may be operably coupled to the first electrode, the second electrode and the third electrode. The controller may be configured to select a pair of the first electrode, the second electrode and the third electrode to use for sensing cardiac electrical activity and to communicate information about the sensed activity to a second medical device.

Claims

1. An implantable cardiac monitor (ICM) configured to be deployed subcutaneous, submuscular, or substernal at a position that enables the ICM to detect cardiac activity, the ICM comprising:

a first electrode secured relative to the ICM;

a second electrode secured relative to the ICM and spaced from the first electrode;

a third electrode secured relative to the ICM and spaced from the first electrode and the second electrode;

a housing that is configured for subcutaneous, submuscular or substernal deployment and to support the first electrode, the second electrode and the third electrode, the housing comprising;

a body portion having a first end and a second end;

a tail portion extending from the body portion to a tail end;

the first electrode disposed adjacent the first end of the body portion;

the second electrode disposed adjacent the second end of the body portion;

the third electrode disposed adjacent the tail end of the tail portion;

a controller disposed within the housing and operably coupled to the first electrode, the second electrode and the third electrode;

the controller configured to select a pair of the first electrode, the second electrode and the third electrode to use for sensing P-waves resulting from atrial contraction; and

the controller configured to communicate information about the sensed P-waves to a second medical device.

2. The ICM of claim 1, wherein the tail portion is more flexible than the body portion.

3. The ICM of claim 2, wherein the body portion comprises a hermitically sealed metallic enclosure that houses the controller, and the tail portion comprises a polymeric body carrying the third electrode.

4. The ICM of claim 3, further comprises an antenna wherein the antenna is embedded in the polymeric body of the tail portion.

5. The ICM of claim 3, wherein the polymeric body of the tail portion comprises a biocompatible polyurethane and/or a biocompatible polyethylene.

6. The ICM of claim 3, wherein the polymeric body is secured relative to the hermitically sealed metallic enclosure.

7. The ICM of claim 2, further comprises an antenna wherein the antenna is carried by the tail portion.

8. The ICM of claim 7, wherein the antenna is operatively coupled to the controller and is used to communicate with an external programmer.

9. The ICM of claim 1, wherein the controller is configured to communicate information about the sensed P-waves to the second medical device via conducted communication using two of the first electrode, the second electrode and the third electrode.

10. The ICM of claim 9, wherein the controller is configured to select which two of the first electrode, the second electrode and the third electrode to use for conducted communication with the second medical device.

13. The ICM of claim 1, further comprising an accelerometer disposed within the housing, wherein the controller is configured to communicate accelerometer information.

14. The ICM of claim 1, further comprising a heart sound sensor, wherein the controller is configured to communicate heart sound information.

15. The ICM of claim 1, wherein the controller is configured to provide a signal to the second medical device that is suitable for the second medical device to determine a measure of minute ventilation and/or lung fluid volume.

11. The ICM of claim 11, wherein the controller is configured to communicate information about the sensed P-waves to the second medical device via conducted communication using a pair of the first electrode, the second electrode and the third electrode.

12. The ICM of claim 12, wherein the controller is configured to select which two of the first electrode, the second electrode and the third electrode to use for conducted communication with the second medical device.

16. An implantable cardiac monitor (ICM) configured to be deployed subcutaneous, submuscular or substernal at a position that enables the ICM to detect signs of cardiac activity, the ICM comprising:

a housing;

a first electrode secured relative to the housing;

a second electrode secured relative to the housing and spaced from the first electrode;

a third electrode secured relative to the housing and spaced from the first electrode and the second electrode;

a controller disposed within the housing and operably coupled to the first electrode, the second electrode and the third electrode;

the controller configured to select a pair of the first electrode, the second electrode and the third electrode for sensing cardiac electrical activity; and

the controller configured to select a pair of the first electrode, the second electrode and the third electrode for communication with a second medical device.

17. The ICM of claim 16, wherein:

the controller selects which electrodes to use for sensing cardiac electrical activity based on which pair of electrodes provides a satisfactory sensing vector; and

the controller selects which electrodes to use for communication with a second medical device based on which pair of electrodes provides a satisfactory communications vector with the second medical device.

18. The ICM of claim 16, wherein the controller is configured to detect an atrial contraction using the pair of electrodes selected for sensing cardiac electrical activity, and is further configured to communicate information about a detected atrial contraction to the second medical device using the pair of electrodes selected for communication with the second medical device.

19. The ICM of claim 16, wherein the controller is configured to select a different pair of electrodes for sensing cardiac electrical activity than for communication with the second medical device.

20. An implantable cardiac monitor (ICM) configured to be deployed subcutaneous, submuscular, or substernal at a position that enables the ICM to detect cardiac activity, the ICM comprising:

a first electrode secured relative to the ICM;

a second electrode secured relative to the ICM and spaced from the first electrode;

a third electrode secured relative to the ICM and spaced from the first electrode and the second electrode;

a controller operably coupled to the first electrode, the second electrode and the third electrode;

a housing that is configured for subcutaneous, submuscular or substernal deployment and to support the first electrode, the second electrode and the third electrode, the housing comprising;

a body portion having a first end and a second end, wherein the body portion comprises a hermitically sealed metallic enclosure that houses the controller;

a flexible tail portion extending from the body portion to a tail end, the flexible tail portion comprises a polymeric body carrying the third electrode;

the controller configured to use a selected pair of the first electrode, the second electrode and the third electrode for sensing cardiac activity; and

the controller configured to communicate information about the cardiac activity to a second medical device.