Acoustic physiological sensor

• US 7,479,112 B2
• Filed: 08/26/2003
• Issued: 01/20/2009
• Est. Priority Date: 08/26/2003
• Status: Expired due to Fees

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Sweeney, Robert J., Daum, Douglas R.
• Primary Examiner(s): Manuel; George
• Assistant Examiner(s): Flory; Christopher A
• Application Number:
  US10/648,837
• Publication Number:
  US 20050049492A1
• Time in Patent Office: 1,974 Days
• Field of Search: 600/411, 600/437, 600/528
• US Class Current: 600/528
• CPC Class Codes: A61B 7/00 Instruments for auscultation
• CPC Class Codes: A61N 1/3622 comprising two or more electrodes co-operating with different heart regions
• CPC Class Codes: A61N 1/36557 controlled by chemical substances in blood
• CPC Class Codes: A61N 1/3684 for stimulating the heart at multiple sites of the ventricle or the atrium

Abstract

This document describes, among other things, a body having at least one acoustically detectable property that changes in response to a change in a physiological condition, such as ischemia. The body is positioned with respect to a desired tissue region. At least one acoustic transducer is used to acoustically detect a change in physical property. In one example, the body is pH sensitive and/or ion selective. A shape or dimension of the body changes in response to pH and/or ionic concentration changes resulting from a change in an ischemia state. An indication of the physiological condition is provided to a user.

Claims

1. An apparatus comprising:

an implantable transducer; and

a physiological sensor that includes at least one biocompatible body, the body sized and shaped to be implanted into and within a myocardial wall of a subject, at least a portion of the body including a material having at least one physical property that changes in response to a physiological condition of the subject, wherein the change in the at least one physical property is responsive to at least one of a change in pH or a change in an ion concentration, wherein the portion of the body is sized and shaped such that the change in the physical property is chronically detectable using acoustic energy supplied by the implantable transducer to provide an indication of the physiological condition.

2. The apparatus of claim 1, in which the change in the physical property includes a change in size.

3. The apparatus of claim 1, in which the change in the physical property includes a change in stiffness.

4. The apparatus of claim 1, in which the change in the physical property includes a change in acoustic reflection from the body.

5. The apparatus of claim 1, in which the change in the physical property includes a change in acoustic transmission by the body.

6. The apparatus of claim 1, in which the change in the physical property includes a change in acoustic attenuation by the body

7. The apparatus of claim 1, in which the body is sized and shaped to be less than or equal to 50 micrometers in diameter.

8. The apparatus of claim 1, in which the body includes a sphere.

9. The apparatus of claim 1, in which the body comprises at least a portion of a catheter.

10. The apparatus of claim 1, further comprising an acoustic receiver to receive acoustic energy from at least one of the body and the myocardium to detect the change in the physical property of the body in response to the change in the physiological condition of the subject.

11. The apparatus of claim 10, further comprising a signal processor circuit coupled to the acoustic receiver.

12. The apparatus of claim 11, further comprising a user interface, coupled to the signal processor circuit, the user interface comprising a display that includes at least one indicator that includes information about at least one of the change in the physiological condition and the change in the physical property.

13. The apparatus of claim 12, in which the user interface includes an external programmer.

14. The apparatus of claim 12, in which the user interface includes a computer that is communicatively coupled to the signal processor circuit at least in part over a computer network or telephony network.

15. The apparatus of claim 1, in which the at least one biocompatible body is pH sensitive.

16. The apparatus of claim 1, in which the at least one biocompatible body is ion selective.

17. The apparatus of claim 1, in which the material includes at least one electrical property that changes in response to a physiological condition.

18. The apparatus of claim 1, in which the body is sized and shaped to be introduced within a vein or artery of a subject.

19. The system of claim 1, wherein the physical property changes in response to a physiological condition that is predictive of a tachyarrhythmia.

20. A system comprising:

a plurality of biocompatible spheres, each sphere sized and shaped to be introduced into and within a myocardial wall of a subject, each sphere including at least one physical property that changes in response to a physiological condition of the subject, the at least one physical property being responsive to at least one of a change in pH or a change in an ion concentration;

an implantable acoustic transmitter, to provide energy to the spheres and the myocardium; and

an acoustic receiver, to receive energy from at least one of the spheres and the myocardium, wherein the change in the at least one physical property is chronically detectable using the energy to provide an indication of the physiological condition.

21. The system of claim 20, comprising an implantable medical device including a state that is altered using a change in the physical property.

22. The apparatus of claim 20, further comprising a controller circuit coupled to the acoustic receiver.

23. The apparatus of claim 22, further comprising an external interface, coupled to the controller circuit, the external interface configured to receive information based on the change in the physical property.

24. A method comprising:

introducing a physiological sensor into and within a myocardial wall of a subject, the physiological sensor includes at least one body having at least one physical property that changes in response to at least one of a change in pH or a change in an ion concentration;

transmitting acoustic energy to the body and the myocardium, the acoustic energy transmitted using an implantable transducer;

receiving transmitted acoustic energy for detecting the change in the physical property of the body; and

detecting and providing an indication of the physiological change by chronically detecting the change in the physical property of the body.

25. The method of claim 24, in which the introducing the at least one body includes introducing at least one pH sensitive body.

26. The method of claim 24, in which the introducing at least one body includes introducing at least one ion sensitive body.

27. The method of claim 24, in which the physical property that changes is a size of the body.

28. The method of claim 24, in which the physical property that changes is a stiffness of the body.

29. The method of claim 24, in which the physical property that changes is an acoustic reflection of the body.

30. The method of claim 24, in which the physical property that changes is an acoustic transmission of the body.

31. The method of claim 24, in which the physical property that changes is an acoustic attenuation of the body.

32. The method of claim 24, in which the detecting the change in the physical property of the body comprises detecting an acoustic reflection of the body.

33. The method of claim 24, in which the detecting the change in the physical property of the body comprises detecting an acoustic transmission of the body.

34. The method of claim 24, in which the detecting the change in the physical property of the body comprises detecting an acoustic attenuation of the body.

35. The method of claim 24, in which the introducing the at least one body includes introducing at least one sphere.

36. The method of claim 24, in which the introducing the at least one body includes introducing a catheter.

37. The method of claim 24, in which the introducing the at least one body includes introducing at least one body sized and shaped to be less than or equal to 50 micrometers in diameter.

38. The method of claim 24, in which the detecting the physiological change using the detected change in the physical property of the body comprises detecting ischemia using the detected change in the physical property of the body.

39. The method of claim 24, in which the detecting the physiological change using the chronically detected change in the physical property of the body comprises detecting blood flow using the chronically detected change in the physical property of the body.

40. The method of claim 24, further comprising introducing a catheter for at least one of the transmitting the acoustic energy and the receiving the acoustic energy.

41. A system comprising:

a physiological sensor that includes one or more biocompatible bodies, the one or more bodies sized and shaped to be implanted into and within a myocardial wall of a subject, at least a portion of the one or more bodies including a material having at least one physical property that changes in response to a physiological condition of the subject, wherein the change in the at least one physical property is responsive to at least one of a change in pH or a change in an ion concentration, and wherein the at least a portion of the one or more bodies is sized and shaped such that the change in the physical property is chronically detectable using acoustic energy to provide an indication of the physiological condition; and

an implantable medical device, including one or more acoustic transducers configured to provide acoustic energy to the one or more bodies and to receive responsive acoustic energy, the implantable medical device configured to detect and provide an indication of a change in the physiological condition by using the responsive acoustic energy to detect the change in the physical property of the one or more bodies.

42. The system of claim 41, wherein the implantable medical device includes an intravascular lead that includes one or more acoustic transducers.

43. The system of claim 41, comprising:

a first acoustic transducer, disposed within the implantable medical device; and

a second acoustic transducer, disposed on a lead or catheter coupled with the implantable medical device.

44. The system of claim 41, wherein the implantable medical device includes a controller that initiates or modifies a therapy using the detected change in the physiological condition obtained from the responsive acoustic energy.

45. The system of claim 41, wherein the implantable medical device includes a controller that is adapted to determine whether ischemia is present in response to a change in physical property obtained from the responsive acoustic energy.

46. The system of claim 45, comprising:

multiple pacing electrodes disposed at different locations within a subject, the electrodes communicatively coupled with the controller; and

wherein the controller is adapted to modify the selected electrodes or timing of pacing pulses delivered by the electrodes in response to a determination of ischemia.