System and method for detecting cardiac arrhythmias using a cardiac wall acceleration sensor signal

• US 5,496,361 A
• Filed: 07/21/1994
• Issued: 03/05/1996
• Est. Priority Date: 07/14/1993
• Status: Expired due to Term

• Current Assignee: Pacesetter Incorporated (Abbott Laboratories Incorporated)
• Original Assignee: Pacesetter Incorporated (Abbott Laboratories Incorporated)
• Inventors: Moberg, Sheldon B., Causey, James D. III
• Primary Examiner(s): Kamm, William E.
• Assistant Examiner(s): Parker, Marianne
• Application Number:
  US08/278,346
• Time in Patent Office: 593 Days
• Field of Search: 128/642, 128/698, 128/714, 128/782, 607/9, 607/19-20, 607/23-24, 607/119, 607/122, 607/129
• US Class Current: 607/122
• 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
• CPC Class Codes: A61N 1/36585 controlled by two or more physical parameters

Abstract

Implantable leads incorporating accelerometer-based cardiac wall motion sensors, and a method of fabricating such leads, are provided. The cardiac wall motion sensors transduce accelerations of cardiac tissue to provide electrical signals indicative of cardiac wall motion to an implantable cardiac stimulating device. The implantable cardiac stimulating device may use the electrical signals indicative of cardiac wall motion to detect and discriminate among potentially malignant cardiac arrhythmias. In response to a detected abnormal cardiac rhythm, the cardiac stimulating device may deliver therapeutic electrical stimulation to selected regions of cardiac tissue.

Claims

1. An implantable system for detecting and discriminating among cardiac arrhythmias and for providing therapeutic electrical stimulation to cardiac tissue in response to detected cardiac arrhythmias, said implantable system comprising:

an implantable lead including electrode means for delivering therapeutic electrical stimulation pulses to said cardiac tissue and for transmitting a signal indicative of cardiac electrical activity to said implantable system, said implantable lead further including a cardiac wall acceleration sensor for providing a signal indicative of cardiac wall accelerations;

acceleration signal analyzing means for receiving said signal indicative of cardiac wall acceleration and for using said signal to detect and discriminate among cardiac arrhythmias; and

pulse generating means for generating said therapeutic electrical stimulation pulses for delivery to said cardiac tissue by said electrode means in response to cardiac arrhythmias detected by said cardiac wall acceleration signal analyzing means.

2. The implantable system of claim 1, further comprising:

electrical activity analyzing means for receiving said signal indicative of cardiac electrical activity transmitted by said electrode means and for using said signal indicative of cardiac electrical activity to detect and discriminate among cardiac arrhythmias; and

control means for enabling said pulse generating means to respond primarily to one of said acceleration signal analyzing means and said electrical activity analyzing means.

3. The implantable system of claim 1, wherein said cardiac wall acceleration sensor comprises an accelerometer.

4. The implantable system of claim 3, wherein said accelerometer includes a central axis, said accelerometer being responsive to cardiac wall accelerations along said central axis and to accelerations perpendicular to said central axis.

5. The implantable system of claim 3, wherein said implantable lead comprises a plurality of conductors for connecting said accelerometer to said acceleration signal analyzing means and for connecting said electrode means to said pulse generating means.

6. The implantable system of claim 3, wherein said implantable lead comprises a flexible patch, and said accelerometer and said electrode means are disposed within said patch.

7. The implantable system of claim 3, wherein:

said implantable lead comprises a substantially inflexible myocardial electrode mount, said electrode mount having an active-fixation helix protruding therefrom; and

said accelerometer is secured to said electrode mount.

8. The implantable system of claim 3, wherein:

said implantable lead comprises an elongated lead body for transvenous placement within a patient, the lead body having a distal end;

said electrode means comprises a tip and a ring electrode disposed at a distal end of said lead body, wherein said ring electrode comprises an interior chamber; and

said accelerometer is disposed within said interior chamber of said ring electrode.

9. The implantable system of claim 8, wherein said ring electrode includes a first end and a second end, wherein said ring electrode further comprises:

a plug at said first end of said ring electrode and a hermetic feedthrough at said second end of said ring electrode for hermetically sealing said accelerometer within said ring electrode.

14. The implantable system of claim 5, wherein said accelerometer comprises:

a mounting surface attached to the electrode means;

a first cantilever beam having a free end, an end affixed to said mounting surface, and a planar surface, said first cantilever beam comprising a material having an electrical characteristic that varies measurably when a mechanical stress or strain is exerted on said material to provide said signal indicative of said accelerations; and

a first mass disposed on said free end of said first cantilever beam for inducing a mechanical stress or strain in said material of said first cantilever beam when said first means is accelerated.

15. The implantable system of claim 14, wherein:

said first cantilever beam has a first and a second axis, said first axis extending from said fixed end to said free end of said first cantilever beam, said second axis being perpendicular to said planar surface of said first cantilever beam;

said first mass is disposed on said free end of said first cantilever beam so as to be offset with respect to said planar surface, so that a mechanical stress or strain is exerted on said material in response to accelerations along said first axis and in response to accelerations along said second axis; and

said plurality of conductors comprises at least two wires for conducting said signal indicative of cardiac wall accelerations to said implantable cardiac stimulation device.

16. The implantable system of claim 5, wherein:

said electrode means includes a tip and a ring electrode;

said accelerometer has an output terminal and a ground terminal, said ground terminal being electrically connected to said ring electrode;

said plurality of conductors includes a first wire connected to said output terminal, and a second and third wire for connecting said tip and ring electrodes, respectively, said third wire being a shared wire between said ring electrode and said ground terminal of said accelerometer.

10. A method of detecting and discriminating among cardiac arrhythmias using a signal indicative of cardiac wall accelerations provided by a cardiac wall acceleration sensor delivered to a cardiac wall using an implantable lead, and for providing therapeutic electrical stimulation pulses to cardiac tissue in response to detected cardiac arrhythmias, said method comprising the steps of:

generating said signal indicative of cardiac wall acceleration;

analyzing said signal indicative of cardiac wall acceleration to detect and discriminate among cardiac arrhythmias;

generating said therapeutic electrical stimulation pulses in response to detected cardiac arrhythmias; and

delivering said therapeutic electrical stimulation pulses to cardiac tissue using an electrode delivered to said cardiac tissue by said implantable lead.

11. The method of claim 10, wherein said cardiac wall acceleration sensor comprises a cantilever beam having a central axis, and said step of generating said signal indicative of cardiac wall acceleration comprises:

generating a signal indicative of accelerations of said cardiac wall along said central axis and perpendicular to said central axis.

12. The method of claim 11, further comprising the steps of:

sensing cardiac electrical activity to provide a signal indicative of said cardiac electrical activity; and

detecting a cardiac arrhythmia using a primary indicating signal, said primary indicating signal being a selected one of said signal indicative of cardiac wall accelerations or said signal indicative of cardiac electrical activity.

13. The method of claim 12, further comprising the step of:

confirming a cardiac arrhythmia detected by said primary indicating signal using a secondary indicating signal, said secondary indicating signal being different from said primary indicating signal, said secondary indicating signal being a selected one of said signal indicative of cardiac wall accelerations or said signal indicative of cardiac electrical activity.