Method and apparatus for controlling cardiac therapy using ultrasound transducer
First Claim
1. A system for applying electrical stimulation to a living body having a heart having boundary surfaces and a right atrium (RA), a left atrium (LA), a right ventricle (RV), a left ventricle (LV), and a coronary vein, the system comprising:
- one or more implantable ultrasound transducers adapted to sense one or more ultrasound signals indicative of one or more cardiac dimensions, the one or more implantable ultrasound transducers each including a transceiver adapted to transmit a signal and receive a reflected signal being the signal transmitted by the transceiver and reflected from one of the boundary surfaces; and
an implantable medical device comprising;
a stimulation output circuit to deliver the electrical stimulation;
a cardiac size analyzer adapted to receive the one or more ultrasound signals and produce one or more cardiac size parameters using the one or more ultrasound signals, the one or more cardiac size parameters including one or more of;
an infarct size parameter representative of an estimated size of an infarct region;
a parameter indicative of change in the infarct size parameter; and
a parameter indicative of rate of change in the infarct size parameter; and
a stimulation controller coupled to the stimulation output circuit, the stimulation controller including;
a stimulation delivery controller adapted to control the delivery of the electrical stimulation using stimulation parameters; and
a stimulation adjustor adapted to adjust the stimulation parameters using the one or more cardiac size parameters.
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Accused Products
Abstract
A cardiac rhythm management (CRM) system provides for post-myocardial infarction (MI) therapy with closed-loop control using one or more ultrasound transducers sensing one or more ultrasound signals indicative of cardiac dimensions. Cardiac size parameters are produced using the one or more ultrasound signals to represent, for example, cardiac chamber diameter, cardiac chamber volume, cardiac wall thickness, infarct size, and degree of change in any of these parameters over time or between measurements. In various embodiments, such cardiac size parameters provide for titration, safety check, and acute optimization of the post-MI therapy.
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Citations
32 Claims
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1. A system for applying electrical stimulation to a living body having a heart having boundary surfaces and a right atrium (RA), a left atrium (LA), a right ventricle (RV), a left ventricle (LV), and a coronary vein, the system comprising:
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one or more implantable ultrasound transducers adapted to sense one or more ultrasound signals indicative of one or more cardiac dimensions, the one or more implantable ultrasound transducers each including a transceiver adapted to transmit a signal and receive a reflected signal being the signal transmitted by the transceiver and reflected from one of the boundary surfaces; and an implantable medical device comprising; a stimulation output circuit to deliver the electrical stimulation; a cardiac size analyzer adapted to receive the one or more ultrasound signals and produce one or more cardiac size parameters using the one or more ultrasound signals, the one or more cardiac size parameters including one or more of; an infarct size parameter representative of an estimated size of an infarct region; a parameter indicative of change in the infarct size parameter; and a parameter indicative of rate of change in the infarct size parameter; and a stimulation controller coupled to the stimulation output circuit, the stimulation controller including; a stimulation delivery controller adapted to control the delivery of the electrical stimulation using stimulation parameters; and a stimulation adjustor adapted to adjust the stimulation parameters using the one or more cardiac size parameters. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25)
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26. A system for applying electrical stimulation to a living body having a heart having boundary surfaces and an infarct region, the system comprising:
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one or more implantable ultrasound transducers adapted to sense one or more ultrasound signals indicative of one or more cardiac dimensions, the one or more implantable ultrasound transducers each including a transceiver adapted to transmit a signal and receive a reflected signal being the signal transmitted by the transceiver and reflected from one of the boundary surfaces; and an implantable medical device comprising; a stimulation output circuit to deliver the electrical stimulation; one or more of a cardiac sensing circuit to sense a cardiac signal, a heart sound sensing circuit to sense a heart sound signal, and an impedance sensing circuit to sense an intracardiac impedance signal; a cardiac size analyzer including an event detector adapted to detect one or more predetermined type cardiac events from one or more of the cardiac signal, the heart sound signal, and the intracardiac impedance signal, the cardiac size analyzer adapted to receive the one or more ultrasound signals and produce one or more cardiac size parameters including an infarct size parameter representative of an estimated size of the infarct region by sampling the one or more ultrasound signals in response to the detection of the one or more predetermined type cardiac events; and a stimulation controller coupled to the stimulation output circuit, the stimulation controller including; a stimulation delivery controller adapted to control the delivery of the electrical stimulation using stimulation parameters; and a stimulation adjustor adapted to adjust the stimulation parameters using the one or more cardiac size parameters. - View Dependent Claims (27, 28, 29, 30, 31, 32)
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Specification