Implantable tissue perfusion sensing system and method

• US 8,090,432 B2
• Filed: 02/28/2008
• Issued: 01/03/2012
• Est. Priority Date: 02/28/2007
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Cinbis, Can, Carney, James K.
• Primary Examiner(s): Layno, Carl H
• Assistant Examiner(s): Patel, Natasha
• Application Number:
  US12/039,294
• Publication Number:
  US 20080208021A1
• Time in Patent Office: 1,405 Days
• Field of Search: 600/513, 600/507, 600/473, 600/476, 600/323
• US Class Current: 600/473
• CPC Class Codes: A61B 5/0059 using light, e.g. diagnosis by transillumination, diascopy, fluorescence A61B5/0093, A61B5/1455, A61B5/02416 and A61B5/0261 take precedence
• CPC Class Codes: A61B 5/024 Detecting, measuring or recording pulse rate or heart rate A61B5/0205, A61B5/021 take precedence
• CPC Class Codes: A61B 5/14542 for measuring blood gases A61B5/14551 takes precedence
• CPC Class Codes: A61B 5/1459 invasive, e.g. introduced into the body by a catheter A61B5/1464 takes precedence
• CPC Class Codes: A61B 5/361 Detecting fibrillation
• CPC Class Codes: A61B 5/363 Detecting tachycardia or bradycardia
• CPC Class Codes: A61B 5/7214 using signal cancellation, e.g. based on input of two identical physiological sensors spaced apart, or based on two signals derived from the same sensor, for different optical wavelengths
• CPC Class Codes: A61N 1/3925 Monitoring; Protecting

Abstract

A medical device for sensing cardiac events that includes a plurality of electrodes sensing cardiac signals utilized to identify a cardiac event, a plurality of light sources capable of emitting light at a plurality of wavelengths, and a detector to detect the emitted light. A processor determines a plurality of light measurements in response to the emitted light detected by the detector, an isobestic blood volume index in response to determined light measurements of the plurality of light measurements from a first light source of the plurality of light sources emitting light at an isobestic wavelength, determines an oxygen index associated with light measurements of the plurality of light measurements from a light source of the plurality of light sources other than the first light source, and verifies the identifying of the cardiac event in response to the determined isobestic blood volume index and the determined oxygen index.

Claims

1. A medical device for sensing cardiac events, comprising:

a plurality of electrodes sensing cardiac signals utilized to identify a cardiac event;

a plurality of light sources capable of emitting light at a plurality of wavelengths;

a detector to detect the emitted light; and

a processor configured to determine a plurality of light measurements in response to the emitted light detected by the detector, to determine an isobestic blood volume index in response to determined light measurements of the plurality of light measurements from a first light source of the plurality of light sources emitting light at an isobestic wavelength, to determine an oxygen index in response to a difference between a light measurement of the plurality of light measurements from a light source of the plurality of light sources emitting light at a non-isobestic wavelength and a product of the determined isobestic blood volume index and a correction factor determined for the non-isobestic wavelength, and to verify the identifying of the cardiac event in response to the determined isobestic blood volume index and the determined oxygen index.

2. The device of claim 1, wherein the processor determines an isobestic baseline in response to light detected from the first light source and determines a corresponding isobestic blood volume index by comparing current light measurements from the first light source to the isobestic baseline.

3. The device of claim 2, wherein the isobestic baseline corresponds to a first light measurement from the first light source emitted during a current verifying of a cardiac event.

4. The device of claim 2, wherein the processor determines a scaling factor corresponding to a light source other than the first light source, and determines a second blood volume index for the light source other than the first light source in response to a product of the scaling factor and the isobestic blood volume index.

5. The device of claim 4, wherein the processor determines the oxygen index in response to a difference between a normalized value of light measurements from the light source other than the first light source.

6. The device of claim 4, wherein the processor verifies the identifying of the cardiac event in response to a decrease in the determined oxygen index over a predetermined time period exceeding a predetermined threshold.

7. The device of claim 6, wherein the processor determines corrections for light measurements determined in response to emitted light detected by the detector for effects of one or more of ambient light, tissue encapsulation, and mechanical motion, compares the determined corrections to the predetermined threshold, and applies the corrections in response to the comparing.

8. The device of claim 4, wherein the scaling factor is approximately 0.5 for arterial blood oxygenation of 98% and the light source of the plurality of light sources emitting light at a red light wavelength of approximately 660 nm and the light source of the plurality of light sources emitting light at an isobestic wavelength of approximately 800 nm.

9. A medical device for sensing cardiac events, comprising:

a plurality of electrodes sensing cardiac signals utilized to identify a cardiac event;

a plurality of light sources capable of emitting light at a plurality of wavelengths;

a detector to detect the emitted light; and

a processor configured to determine a plurality of light measurements in response to the emitted light detected by the detector, to determine an isobestic blood volume index in response to determined light measurements of the plurality of light measurements from a first light source of the plurality of light sources emitting light at an isobestic wavelength, to determine a first oxygen index in response to differences between a light measurement of the plurality of light measurements from a second light source and a third light source of the plurality of light sources emitting light at a non-isobestic wavelength and a product of the determined isobestic blood volue index and a correction factor determined for the non-isobestic wavelength of the second light source, to determine a second oxygen index in response to differences between a light measurement of the plurality of light measurements from a third light source of the plurality of light sources emitting light at a non-isobestic wavelength and a product of the determined isobestic blood volume index and a correction factor determined for the non-isobestic wavelength of the third light source, and to verify the identifying of the cardiac event in response to the determined isobestic blood volume index and a ratio-metric combination of the first oxygen index and the second oxygen index.

10. The device of claim 9, wherein the processor determines an isobestic baseline in response to light detected from the first light source, determines a corresponding isobestic blood volume index by comparing current light measurements from the first light source to the isobestic baseline, and determines, for each of the second light source and the third light source, a respective scaling factor and a respective blood volume index in response to a product of the scaling factor and the isobestic blood volume index.

11. The device of claim 10, wherein the processor determines the first oxygen index and the second oxygen index in response to a difference between a normalized value of light measurements from the respective second and third light source.

12. The device of claim 10, wherein the scaling factor is approximately 0.5 for arterial blood oxygenation of 98% and the second light source emitting light at a red light wavelength of approximately 660 nm and the first light source emitting light at an isobestic wavelength of approximately 800 nm.

13. A method for verifying sensing of a cardiac event by a medical device, comprising:

identifying the cardiac event in response to sensed cardiac signals;

determining light emitted by a plurality of light sources at a plurality of wavelengths;

determining a plurality of light measurements in response to the detected emitted light;

determining an isobestic blood volume index in response to determined light measurements of the plurality of light measurements from a first light source of the plurality of light sources emitting light at an isobestic wavelength;

determining an oxygen index in response to a difference between a light measurement of the plurality of light measurements from a light source of the plurality of light sources emitting light at a non-isobestic wavelength and a product of the determined isobestic blood volume index and a correction factor determined for the non-isobestic wavelength; and

verifying the identifying of the cardiac event in response to the determined isobestic blood volume index and the determined oxygen index.

14. The method of claim 13, further comprising;

determining an isobestic baseline in response to light detected from the first light source;

comparing current light measurements from the first light source to the isobestic baseline; and

determining a corresponding isobestic blood volume index in response to the comparing.

15. The method of claim 14, wherein the isobestic baseline corresponds to a first light measurement from the first light source emitted during a current verifying of a cardiac event.

16. The method of claim 14, further comprising determining a scaling factor corresponding to a light source other than the first light source;

and

determining a second blood volume index for the light source other than the first light source in response to a product of the scaling factor and the isobestic blood volume index.

17. The method of claim 16, further comprising determining the oxygen index in response to a difference between a normalized value of light measurements from the light source other than the first light source.

18. The method of claim 16, further comprising verifying the identifying of the cardiac event in response to a decrease in the determined oxygen index over a predetermined time period exceeding a predetermined threshold.

19. The method of claim 18, further comprising:

determining corrections for light measurements determined in response to emitted light detected by the detector for effects of one or more of ambient light, tissue encapsulation, and mechanical motion;

comparing the determined corrections to the predetermined threshold; and

applying the corrections in response to the comparing.

20. The method of claim 16, wherein the scaling factor is approximately 0.5 for arterial blood oxygenation of 98% and the light source of the plurality of light sources emitting light at a red light wavelength of approximately 660 nm and the light source of the plurality of light sources emitting light at an isobestic wavelength of approximately 800 nm.