Implantable device with cardiac event audio playback

• US 8,116,868 B2
• Filed: 03/15/2004
• Issued: 02/14/2012
• Est. Priority Date: 04/11/2003
• Status: Expired due to Fees

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Haefner, Paul
• Primary Examiner(s): KAHELIN, MICHAEL WILLIAM
• Application Number:
  US10/801,139
• Publication Number:
  US 20040230249A1
• Time in Patent Office: 2,892 Days
• Field of Search: 607/17, 600/513, 600/528
• US Class Current: 607/17
• CPC Class Codes: A61B 5/0006 ECG or EEG signals
• CPC Class Codes: A61B 5/0031 Implanted circuitry
• CPC Class Codes: A61B 5/02 Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
• CPC Class Codes: A61B 5/11 Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb for measuring pulse A61B5/02 ;A61B5/1038 takes precedence; motion detection to correct for motion artifacts in physiological signals A61B5/721
• 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
• CPC Class Codes: A61N 1/05 for implantation or insertion into the body, e.g. heart electrode A61N1/06 takes precedence
• CPC Class Codes: A61N 1/0568 with drug delivery
• CPC Class Codes: A61N 1/0587 Epicardial electrode systems; Endocardial electrodes piercing the pericardium
• CPC Class Codes: A61N 1/36542 controlled by body motion, e.g. acceleration
• CPC Class Codes: A61N 1/36578 controlled by mechanical motion of the heart wall, e.g. measured by an accelerometer or microphone
• CPC Class Codes: A61N 1/36585 controlled by two or more physical parameters
• CPC Class Codes: A61N 1/3956 Implantable devices for applying electric shocks to the heart, e.g. for cardioversion
• CPC Class Codes: A61N 1/39622 Pacing therapy

Abstract

Cardiac monitoring and stimulation methods and systems provide audio playback of cardiac events and transthoracic monitoring and therapy. A medical system includes a housing and electrodes configured for sensing cardiac electrical activity. Another sensor may be configured to sense heart movement and produce a signal in response, such as an audio signal. Memory stores the audio signal and the cardiac electrical signal. A controller and communications circuitry telemeter the cardiac electrical signal and the audio signal to a patient-external device. Energy delivery circuitry may deliver cardiac therapy. The device may further include a patient actuatable trigger configured to communicate to the controller via the communications circuitry. The controller may initiate storing of the cardiac electrical signal and the audio signal in response to the trigger. The patient-external device may further include a storage media.

Claims

1. A medical system, comprising:

a patient-implantable device, comprising;

a housing;

a plurality of electrodes coupled to the housing and configured for sensing cardiac electrical activity and electrical activity having an origin other than a heart;

detection circuitry provided in the housing and coupled to at least some of the plurality of electrodes, the detection circuitry producing electrical signals in response to the sensed electrical activity and a cardiac electrical signal in response to the sensed cardiac electrical activity;

a sensor configured to sense movement of the heart and produce a sensor signal in response to the sensed heart movement;

sensor circuitry provided in the housing and coupled to the sensor, the sensor circuitry configured to produce an audio signal in response to the sensor signal;

memory provided in the housing and coupled to the detection circuitry and sensor circuitry, the memory configured to store the audio signal and the cardiac electrical signal;

a controller provided in the housing and coupled to the memory, detection circuitry, and sensor circuitry, the controller configured to detect heart sounds from the audio signal, select the cardiac electrical signal from the electrical signals having an origin other than the heart based on temporal correlation of S1 heart sounds of the audio signal with QRS complexes of the cardiac electrical signal, discriminate between normal cardiac function and cardiac tachyarrhythmia based on the cardiac electrical signal and the audio signal, and provide an output based on the discrimination between normal cardiac function and cardiac tachyarrhythmia, the controller configured to open a correlation window based on a cardiac cycle feature fiducial point of the cardiac electrical signal to correlate heart sounds with cardiac cycle features of the same heart beat over a plurality of cardiac cycles, and to discriminate between normal cardiac function and cardiac tachyarrhythmia based on temporal correlation between heart sounds and cardiac cycle features over the plurality of cardiac cycles; and

communications circuitry provided in the housing and coupled to the controller, the communications circuitry configured to telemeter the cardiac electrical signal and the audio signal; and

a patient-external device comprising;

patient-external communications circuitry configured to receive the cardiac electrical signal and the audio signal telemetered from the patient-implantable device;

a storage media to store the cardiac electrical signal and the audio signal telemetered from the patient-implantable device; and

a user interface coupled to the patient-external communications circuitry, the user interface configured for providing a visual output representative of the cardiac electrical signal and an audio output representative of the audio signal.

2. The medical system of claim 1, wherein discrimination between normal cardiac function and cardiac arrhythmia comprises discrimination between normal heart rate and arrhythmic heart rate, wherein:

the controller indicates the heart rate to be normal and the cardiac electrical signal subject to electrical noise if the cardiac electrical signal indicates high heart rate and the audio signal indicates normal heart sounds; and

the controller indicates the heart rate to be arrhythmic if the cardiac electrical signal indicates high heart rate and the audio signal indicates modified heart sounds.

3. The medical system of claim 1, wherein:

the controller determines the cardiac function to be normal if the cardiac electrical signal indicates abnormal cardiac morphology and the audio signal indicates normal heart sounds; and

the controller determines the cardiac function to be arrhythmic if the cardiac electrical signal indicates abnormal cardiac morphology and the audio signal indicates modified heart sounds.

4. The medical system of claim 1, wherein discrimination between normal cardiac function and cardiac arrhythmia comprises identification of electrical noise and wherein the controller indicates the presence of noise if the cardiac electrical signal indicates high heart rate and the audio signal indicates normal heart sounds.

5. The medical system of claim 1, wherein discrimination between normal cardiac function and cardiac arrhythmia comprises discrimination between normal sinus rhythm and one or both of ventricular tachycardia and fibrillation based on temporal correlation of cardiac sound features of the audio signal with features of the cardiac electrical signal.

6. The medical system of claim 1, further comprising a human input, wherein production of the audio signal by the sensor circuitry is initiated based on triggering of the human input.

7. The medical system of claim 1, wherein the output comprises transmission of an indication of the discrimination between normal cardiac function and cardiac arrhythmia by the communications circuitry to the patient-external communications circuitry and storage of the indication in memory.

8. The medical system of claim 1, wherein the sensor is disposed on a lead connected to the patient-implantable device.

9. The medical system of claim 1, wherein the sensor is at least partially contained within the housing, and the housing and the plurality of electrodes form a rigid unitary structure.