Apparatus and method for outputting heart sounds

• US 7,883,470 B2
• Filed: 01/18/2005
• Issued: 02/08/2011
• Est. Priority Date: 04/11/2001
• Status: Expired due to Term

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Olive, Arthur L., Villalta, Don, Scheiner, Avram, Zhu, Qingsheng
• Primary Examiner(s): Patel; Niketa I
• Assistant Examiner(s): STOKLOSA, JOSEPH A
• Application Number:
  US11/037,276
• Publication Number:
  US 20050137490A1
• Time in Patent Office: 2,212 Days
• Field of Search: 600/528, 607/17
• US Class Current: 600/528
• CPC Class Codes: A61B 5/0002 Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network A61B5/07 takes precedence; transmission systems for measured values G08C; transmission H04B; transmission of digital information H04L; wireless communication networks H04W
• CPC Class Codes: A61B 5/0031 Implanted circuitry
• CPC Class Codes: A61B 5/1118 Determining activity level
• CPC Class Codes: A61B 5/283 Invasive
• CPC Class Codes: A61B 5/316 Modalities, i.e. specific diagnostic methods
• CPC Class Codes: A61B 5/318 Heart-related electrical modalities, e.g. electrocardiography [ECG]
• CPC Class Codes: A61B 5/339 Displays specially adapted therefor
• CPC Class Codes: A61B 5/349 Detecting specific parameters of the electrocardiograph cycle
• CPC Class Codes: A61B 5/742 using visual displays A61B5/339 takes precedence
• CPC Class Codes: A61B 7/00 Instruments for auscultation
• CPC Class Codes: A61B 7/023 for introduction into the body, e.g. into the oesophagus oesophageal ECG probes A61B5/285
• CPC Class Codes: A61B 7/04 Electric stethoscopes microphones, acoustic transducers therefor H04R

Abstract

An apparatus for outputting heart sounds includes an implantable system and an external system. The implantable system includes a sensor for generating sensed signals representing detected heart sounds, an interface circuit and a control circuit for receiving the sensed signals, generating data representing the heart sounds therefrom, and transmitting the data to the external system via the interface circuit. The external system includes an interface circuit for communicating with the implantable system, and a control circuit for receiving the data representing the heart sounds and for generating control signals that cause an output device to generate outputs representing the sounds. The implantable system may also include a sensor(s) for detecting cardiac electrical signals. In this case, outputs representing the cardiac electrical signals are also output.

Claims

1. An external system for communicating with an implantable system sensing an accelerometer signal indicative of heart sounds and cardiac electrical signals indicative electrical cardiac events, the external system comprising:

an external device communicatively coupled to the implantable system, the external device including;

an interface circuit configured to communicate with the implantable system;

a control circuit, coupled to the interface circuit, configured to receive data representing the heart sounds and the cardiac electrical signals telemetered from the implantable system, detect the heart sounds and the electrical cardiac events from the received data, and calculate timing differences each between a heart sound of the detected heart sounds and an electrical cardiac event of the detected electrical cardiac events; and

an output device coupled to the control circuit, the output device including a screen display including;

a plurality of horizontal traces including simultaneously displayed one or more accelerometer traces related to the heart sounds and one or more cardiac electrical signal traces each showing one of the cardiac electrical signals;

visual indicia indicative of the heart sounds, the visual indicia displayed in association with locations of the heart sounds on at least one of the displayed one or more accelerometer traces; and

the calculated timing differences.

2. The external system of claim 1, wherein the screen display further includes a pair of horizontally movable vertical lines for comparing timing between any traces of the plurality of horizontal traces.

3. The external system of claim 1, further comprising one or more input devices coupled to the interface circuit, the one or more input devices adapted to allow for vertically moving a trace of the plurality of horizontal traces to superimpose that trace over another trace of the plurality of horizontal traces.

4. The external system of claim 1, further comprising a further output device and a transmission media coupled between the interface circuit and the further output device, the further output device adapted to display the data representing the heart sounds and the cardiac electrical signals.

5. The external system of claim 1, wherein the one or more accelerometer traces comprise a processed accelerometer trace showing the accelerometer signal after being processed by the external system.

6. The external system of claim 5, wherein the one or more cardiac electrical signal traces comprise one or more electrogram (EGM) traces.

7. The external system of claim 6, wherein the visual indicia are indicative of the heart sounds displayed in association with locations of the heart sounds on the processed accelerometer trace.

8. The external system of claim 7, wherein the screen display further includes visual indicia indicative of electrical cardiac events displayed in association with locations of electrical cardiac events on the displayed one or more EGM traces.

9. The external system of claim 7, further comprising an surface electrocardiogram (ECG) system coupled to the interface circuit, and wherein the control circuit further receives a surface ECG signal, and the plurality of horizontal traces further includes a surface ECG trace showing the surface ECG signal simultaneously displayed with the one or more accelerometer traces and the one or more EGM traces.

10. The external system of claim 9, wherein the screen display further includes visual indicia indicative of electrical cardiac events displayed in association with locations of electrical cardiac events on one or more of the displayed one or more EGM traces and the displayed surface ECG trace.

11. The external system of claim 10, wherein the output device further comprises an audio device adapted to generate audio outputs representative of the heart sounds.

12. An external system for communicating with an implantable system sensing an accelerometer signal indicative of heart sounds and cardiac electrical signals indicative of electrical cardiac events, the external system comprising:

an external device communicatively coupled to the implantable system, the external device including;

means for receiving data representing the heart sounds and the cardiac electrical signals telemetered from the implantable system;

means for calculating time differences between the electrical cardiac events and the heart sounds;

means for simultaneously displaying signals including at least the accelerometer signal and the cardiac electrical signals and the calculated time differences;

means for receiving user selection of the time differences for displaying;

means for providing timing comparison information indicating timing between the displayed signals; and

means for visually indicating the heart sounds on the displayed accelerometer signal.

13. The external system of claim 12, further comprising means for superimposing one signal of the displayed signals over another signal of the displayed signals.

14. The external system of claim 13, further comprising means for sensing a surface electrocardiogram (ECG) signal, and wherein the means for simultaneously displaying signals comprises means for simultaneously displaying signals including the accelerometer signal, electrogram (EGM) signals, and the surface ECG signal.

15. The external system of claim 12, further comprising means for indicating cardiac events on one or more of the EGM signals and the surface ECG signal.

16. The external system of claim 15, further comprising means for presenting the heart sounds in audio domain.

17. A system, comprising:

an implantable device including;

a first sensor for detecting heart sounds and for generating first sensed signals representative of the heart sounds;

a second sensor for detecting first cardiac electrical signals and for generating second sensed signals representative of the first cardiac electrical signals;

a third sensor for detecting second cardiac electrical signals and for generating third sensed signals representative of the second cardiac electrical signals;

a first interface circuit; and

a control circuit coupled to the first, second, and third sensors and the interface circuit, configured to receive the first, second, and third signals, and including an ensemble averager and a systole detector, the systole detector configured to detect systole, the ensemble averager configured to produce an ensemble average of the first sensed signals triggered by detection of the systole, the control circuit configured to generate first data representative of the heart sounds including the ensemble average of the first sensed signals, generate second data representative of the first cardiac electrical signals from the second sensed signals, generate third data representative of the second cardiac electrical signals from the third sensed signals, and telemeter the first, second and third data via the first interface circuit; and

an external device communicatively coupled to the implantable device, the external device including;

a second interface circuit;

an output device including a screen display configured to simultaneously display multiple signals; and

a second control circuit, coupled to the second interface circuit and the output device, configured to receive the first, second, and third data telemetered from the implantable device via the second interface circuit, process the first data to detect predetermined type heart sounds, and generate control signals causing the screen display to simultaneously display at least the first, second, and third sensed signals and visual indicia indicative of the detected predetermined type heart sounds and associated with locations of the predetermined type heart sounds in the first sensed signal.

18. The system of claim 17, wherein the first sensor includes an accelerometer.

19. The system of claim 17, wherein the second sensor includes an atrial sensing electrode, and the third sensor includes a ventricular sensing electrode.

20. The system of claim 17, wherein the second control circuit is configured to process the second and third data to detect predetermined type electrical cardiac events, calculate timing differences each between a heart sound of the detected predetermined type heart sounds and an electrical cardiac event of the detected predetermined type electrical cardiac events, and generate control signals causing the screen display to display the calculated timing differences.