Devices and methods for accelerometer-based characterization of cardiac function and identification of LV target pacing zones

• US 8,118,751 B2
• Filed: 03/02/2009
• Issued: 02/21/2012
• Est. Priority Date: 02/07/2005
• Status: Expired due to Fees

• Current Assignee: Cardiosync, Inc.
• Original Assignee: Cardiosync, Inc.
• Inventors: Dobak, John D. III
• Primary Examiner(s): Getzow, Scott
• Assistant Examiner(s): PATTON, AMANDA K
• Application Number:
  US12/396,420
• Publication Number:
  US 20100049063A1
• Time in Patent Office: 1,086 Days
• Field of Search: 607/17, 607/18, 607/24, 600/528
• US Class Current: 600/528
• CPC Class Codes: A61B 2562/0219 Inertial sensors, e.g. accelerometers, gyroscopes, tilt switches
• CPC Class Codes: A61B 2562/028 Microscale sensors, e.g. electromechanical sensors [MEMS]
• 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 5/352 Detecting R peaks, e.g. for synchronising diagnostic apparatus; Estimating R-R interval
• CPC Class Codes: A61B 7/00 Instruments for auscultation
• CPC Class Codes: A61N 1/056 Transvascular endocardial electrode systems
• CPC Class Codes: A61N 1/3627 for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy
• CPC Class Codes: A61N 1/36542 controlled by body motion, e.g. acceleration
• CPC Class Codes: A61N 1/36585 controlled by two or more physical parameters
• CPC Class Codes: A61N 2001/0585 Coronary sinus electrodes

Abstract

Systems according to the invention employ an acceleration sensor to characterize displacement and vibrational LV motion, and uses this motion data to characterize the different phases of the LV cycle for analyzing LV function. Systems may identify a target pacing region or regions in the LV or RV using the acceleration sensor by localizing regions of late onset of motion relative to the QRS, or isovolumic contraction, or mitral valve closure, or by pacing of target regions and measuring LV function in response to pacing. Systems further provide an implantable or non-implantable acceleration sensor device for measuring LV motion and characterizing LV function. An implantable myocardial acceleration sensing system (“IAD”) includes at least one acceleration sensor, a data acquisition and processing device, and an electromagnetic, e.g., RF, communication device. The IAD may be integrated into the pacing lead of a CRT device and can operate independently of the CRT IPG.

Claims

1. A device for monitoring cardiac function, comprising:

a. a single multi-axis acceleration sensor configured for disposition within the coronary sinus;

b. wherein the acceleration sensor is configured to characterize left ventricular function by simultaneously monitoring both cardiac vibration corresponding to mitral regurgitation and left ventricular longitudinal displacement motion;

c. a circuit implemented in hardware or software, or both, for receiving signals indicative of left ventricular function including signals corresponding to cardiac vibration caused by mitral regurgitation and signals corresponding to left ventricular longitudinal displacement motion, the circuit further mathematically singly integrating the received signals to obtain velocity information about left ventricular function and the circuit further mathematically doubly integrating the received signals to obtain displacement information about left ventricular function, wherein the single and double integrations are performed using only data from the single multi-axis acceleration sensor.

2. The device of claim 1, wherein the acceleration sensor is designed to detect vibrational frequencies between about 20 Hz and 150 Hz and displacement motion frequencies less than about 20 Hz.

3. The device of claim 1, wherein the acceleration sensor is designed to detect vibrational frequencies related to mitral regurgitation greater than about 150 Hz.

4. The device of claim 1, further comprising an endovascular catheter, and wherein the sensor is disposed on the endovascular catheter.

5. The device of claim 4, wherein the endovascular catheter is a coronary sinus catheter, and further comprising an occlusion balloon coupled to the catheter.

6. The device of claim 4, wherein the endovascular catheter is a coronary sinus catheter, and further comprising a pacing electrode coupled to the catheter guidewire lumen formed in the coronary sinus catheter.

7. The device of claim 1, further comprising an LV pacing lead, and wherein the sensor is disposed on the LV pacing lead.

8. A device for monitoring cardiac function, comprising:

a. a catheter including a single three-axis acceleration sensor for disposition within the coronary sinus, wherein the acceleration sensor is configured to characterize left ventricular function by simultaneously monitoring both cardiac vibration corresponding to mitral regurgitation and left ventricular longitudinal displacement motion;

b. a guide wire lumen formed within the catheter; and

c. a circuit implemented in hardware or software, or both, for receiving signals indicative of left ventricular function including signals corresponding to cardiac vibration caused by mitral regurgitation and signals corresponding to left ventricular longitudinal displacement motion, the circuit further mathematically singly integrating the received signals to obtain velocity information about left ventricular function and the circuit further mathematically doubly integrating the received signals to obtain displacement information about left ventricular function, wherein the single and double integrations are performed using only data from the single multi-axis acceleration sensor,

d. such that said device is configured to identify LV pacing regions.

9. A device for monitoring cardiac function, comprising:

a. a catheter including a single three-axis acceleration sensor for disposition within the coronary sinus, wherein the acceleration sensor is configured to characterize left ventricular function by simultaneously monitoring both cardiac vibration corresponding to mitral regurgitation and left ventricular longitudinal displacement motion; and

b. a circuit implemented in hardware or software, or both, for receiving signals indicative of left ventricular function including signals corresponding to cardiac vibration caused by mitral regurgitation and signals corresponding to left ventricular longitudinal displacement motion, the circuit further mathematically singly integrating the received signals to obtain velocity information about left ventricular function and the circuit further mathematically doubly integrating the received signals to obtain displacement information about left ventricular function, wherein the single and double integrations are performed using only data from the single multi-axis acceleration sensor,

c. such that said device is configured to measure motion to characterize LV function.