Adaptive sampling of heart sounds

• US 8,096,954 B2
• Filed: 11/29/2006
• Issued: 01/17/2012
• Est. Priority Date: 11/29/2006
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Stahmann, Jeffrey E., Siejko, Krzysztof Z., Haro, Carlos, Patangay, Abhilash, Carlson, Gerrard M., Belalcazar, Andres
• Primary Examiner(s): Layno, Carl H
• Assistant Examiner(s): Bays, Pamela M
• Application Number:
  US11/564,637
• Publication Number:
  US 20080125820A1
• Time in Patent Office: 1,875 Days
• Field of Search: 607/4, 607/18, 600/439, 600/485, 600/500, 600/513, 600/514, 600/528
• US Class Current: 600/528
• CPC Class Codes: A61B 5/0031 Implanted circuitry
• CPC Class Codes: A61B 5/021 Measuring pressure in heart or blood vessels A61B5/0205 takes 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 5/053 Measuring electrical impedance or conductance of a portion of the body
• CPC Class Codes: A61B 5/08 Detecting, measuring or recording devices for evaluating the respiratory organs A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/0816 Measuring devices for examining respiratory frequency measuring frequency of electric signals G01R23/00
• CPC Class Codes: A61B 5/1116 Determining posture transitions
• CPC Class Codes: A61B 5/4806 Sleep evaluation A61B5/4821 takes precedence; devices for inducing sleep A61M21/02
• CPC Class Codes: A61B 5/686 Permanently implanted devices, e.g. pacemakers, other stimulators, biochips A61B5/6861 takes precedence
• CPC Class Codes: A61B 5/7275 Determining trends in physiological measurement data; Predicting development of a medical condition based on physiological measurements, e.g. determining a risk factor
• CPC Class Codes: A61B 7/00 Instruments for auscultation
• CPC Class Codes: A61B 7/04 Electric stethoscopes microphones, acoustic transducers therefor H04R
• CPC Class Codes: A61N 1/36514 controlled by a physiological quantity other than heart potential, e.g. blood pressure controlled by two or more physical parameters A61N1/36585
• CPC Class Codes: A61N 1/36578 controlled by mechanical motion of the heart wall, e.g. measured by an accelerometer or microphone

Abstract

A system and method to sense heart sounds with one or more implantable medical devices according to one or more parameters. The system alters one or more of the parameters as a function of one or more triggering events. The system then senses heart sounds with the one or more implantable medical devices according to at least the one or more altered parameters.

Claims

1. A system comprising:

a first implantable medical device comprising;

a control circuit;

a sensor, coupled to the control circuit, the sensor configured to sense energy and produce a signal indicative of heart sounds;

a heart sound detector, coupled to the sensor and the control circuit, the heart sound detector adapted to detect heart sounds within the signal indicative of heart sounds;

a parameter circuit, coupled to the control circuit, the parameter circuit configured to store one or more heart sound signal processing parameters, wherein the device acquires and processes heart sound information as a function of the one or more heart sound signal processing parameters, wherein the heart sound signal processing parameter includes one or more of a sampling frequency, a data acquisition interval, one or more characteristics of an ensemble average, a bit resolution, a noise blanking interval, and a retry interval;

a triggering circuit, coupled to the control circuit, the triggering circuit configured to transmit a triggering circuit signal to the control circuit upon device detection of a physiologic triggering event, and

wherein the control circuit is configured to change one or more of the heart sound signal processing parameters in response to receipt of the triggering circuit signal.

2. The system of claim 1, wherein the sensor is an acoustic sensor that senses acoustic energy and produces an acoustic signal.

3. The system of claim 1, wherein the one or more triggering events is a function of one or more of a heart rate, a cardiac cycle phase, a respiration rate, a respiration phase, a posture, a time of day, a noise level, an activity level, a patient risk factor, a sleep state, a body weight, a change in health status, a predetermined interval, a result of a prior data acquisition, a pacing status, a sensing status, a pressure level, an impedance, a heart rate variability, a heart sound amplitude, a heart sound interval, and a heart sound duration.

4. The system of claim 3, wherein the patient risk factor includes one of more of a heart failure decompensation risk factor, an increase in an occurrence or intensity of one or more of an S3 heart sound and an S4 heart sound, and an occurrence or change in a splitting of an S1 heart sound or an occurrence or change in a splitting of an S2 heart sound.

5. The system of claim 1, wherein the triggering circuit transmits the signal as a function of one or more of an onset, a termination, an increase, a decrease, a presence, an absence, a probability of occurrence, a probability of frequency, and a rate of change of the one or more triggering events.

6. The system of claim 1, further comprising:

a telemetry circuit coupled to the control circuit; and

an external device wirelessly coupled to the telemetry circuit;

wherein the telemetry circuit is configured to include one or more of the functions of transmitting and receiving one or more of data related to the use of and acquisition of heart sound data.

7. The system of claim 6, further comprising an external data base coupled to the external device, the external data base for receiving and storing the heart sound data.

8. The system of claim 1, further comprising:

a telemetry circuit coupled to the control circuit; and

a second implantable medical device;

wherein the telemetry circuit communicatively couples the first and second implantable medical devices.

9. The system of claim 8, further comprising a therapy circuit, wherein the therapy circuit is configured to provide therapy to a patient.

10. The system of claim 9, wherein the therapy circuit is configured to provide one or more of pacing, defibrillation, cardioversion, cardiac resynchronization, and neural stimulation therapy.

11. A system comprising:

a first implantable medical device comprising;

a control circuit;

a sensor, coupled to the control circuit, the sensor configured to sense energy and produce a signal indicative of heart sounds;

a heart sound detector, coupled to the sensor and the control circuit, the heart sound detector adapted to detect heart sounds within the signal indicative of heart sounds;

a parameter circuit, coupled to the control circuit, the parameter circuit configured to store one or more heart sound signal processing parameters, wherein the device acquires and processes heart sound information as a function of the one or more heart sound signal processing parameters;

a triggering circuit, coupled to the control circuit, the triggering circuit configured to transmit a triggering circuit signal to the control circuit upon device detection of a physiologic triggering event, and

wherein the control circuit is configured to;

identify a specified heart sound to sense according to the detected physiologic triggering event; and

change a signal sampling frequency based on the identified heart sound.

12. The system of claim 11, wherein the control circuit is configured to select a first signal sampling frequency if the identified heart sound is an S3 heart sound and select a second different signal sampling frequency if the identified heart sound is an S1 heart sound.

13. The system of claim 11, wherein the control circuit is configured to select a first signal sampling frequency for the identified heart sound at a first determined heart rate and select a second signal sampling frequency for the identified heart sound at a second determined heart rate.

14. A system comprising:

a first implantable medical device comprising;

a control circuit;

a sensor, coupled to the control circuit, the sensor configured to sense energy and produce a signal indicative of heart sounds;

a heart sound detector, coupled to the sensor and the control circuit, the heart sound detector adapted to detect heart sounds within the signal indicative of heart sounds;

a parameter circuit, coupled to the control circuit, the parameter circuit configured to store one or more heart sound signal processing parameters, wherein the device acquires and processes heart sound information as a function of the one or more heart sound signal processing parameters;

a triggering circuit, coupled to the control circuit, the triggering circuit configured to transmit a triggering circuit signal to the control circuit upon device detection of a physiologic triggering event, and

wherein the control circuit is configured to;

identify a specified heart sound to sense according to the detected physiologic triggering event; and

change a signal sampling bit resolution based on the identified heart sound.

15. A system comprising:

a first implantable medical device comprising;

a control circuit;

a sensor, coupled to the control circuit, the sensor configured to sense energy and produce a signal indicative of heart sounds;

a heart sound detector, coupled to the sensor and the control circuit, the heart sound detector adapted to detect heart sounds within the signal indicative of heart sounds;

a parameter circuit, coupled to the control circuit, the parameter circuit configured to store one or more heart sound signal processing parameters, wherein the device acquires and processes heart sound information as a function of the one or more heart sound signal processing parameters;

a triggering circuit, coupled to the control circuit, the triggering circuit configured to transmit a triggering circuit signal to the control circuit upon device detection of a physiologic triggering event, and

wherein the control circuit is configured to;

identify a specified heart sound to sense according to the detected physiologic triggering event; and

change a noise blanking interval based on the identified heart sound.

16. A system comprising:

a first implantable medical device comprising;

a control circuit;

a sensor, coupled to the control circuit, the sensor configured to sense energy and produce a signal indicative of heart sounds;

a heart sound detector, coupled to the sensor and the control circuit, the heart sound detector adapted to detect heart sounds within the signal indicative of heart sounds;

a parameter circuit, coupled to the control circuit, the parameter circuit configured to store one or more heart sound signal processing parameters, wherein the device acquires and processes heart sound information as a function of the one or more heart sound signal processing parameters;

a triggering circuit, coupled to the control circuit, the triggering circuit configured to transmit a triggering circuit signal to the control circuit upon device detection of a physiologic triggering event, and

wherein the control circuit is configured to;

identify a specified heart sound to sense according to the detected physiologic triggering event; and

change a data acquisition buffer length based on the identified heart sound.

17. A system comprising:

a first implantable medical device comprising;

a control circuit;

a sensor, coupled to the control circuit, the sensor configured to sense energy and produce a signal indicative of heart sounds;

a heart sound detector, coupled to the sensor and the control circuit, the heart sound detector adapted to detect heart sounds within the signal indicative of heart sounds;

a parameter circuit, coupled to the control circuit, the parameter circuit configured to store one or more heart sound signal processing parameters, wherein the device acquires and processes heart sound information as a function of the one or more heart sound signal processing parameters;

a triggering circuit, coupled to the control circuit, the triggering circuit configured to transmit a triggering circuit signal to the control circuit upon device detection of a physiologic triggering event, and

wherein the control circuit is configured to;

sample heart beats in response to the detected physiologic triggering event; and

select heart beats for inclusion in a calculated ensemble average according to the detected physiologic triggering event.