Optical sensor and method for detecting a patient condition

• US 8,260,415 B2
• Filed: 12/21/2007
• Issued: 09/04/2012
• Est. Priority Date: 12/21/2007
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Donofrio, William T.
• Primary Examiner(s): Holmes, Rex R
• Application Number:
  US11/963,045
• Publication Number:
  US 20090163969A1
• Time in Patent Office: 1,719 Days
• Field of Search: 607/6, 607/3, 607 17- 22, 600/333, 600/301, 600322-324, 600/500
• US Class Current: 607/6
• CPC Class Codes: A61B 5/0084 for introduction into the body, e.g. by catheters A61B5/1459 takes precedence
• CPC Class Codes: A61B 5/02028 Determining haemodynamic parameters not otherwise provided for, e.g. cardiac contractility or left ventricular ejection fraction
• CPC Class Codes: A61B 5/0215 by means inserted into the body catheters A61M25/00
• CPC Class Codes: A61B 5/0261 using optical means, e.g. infrared light
• 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 5/14551 for measuring blood gases
• CPC Class Codes: A61B 5/1459 invasive, e.g. introduced into the body by a catheter A61B5/1464 takes precedence
• CPC Class Codes: A61B 5/318 Heart-related electrical modalities, e.g. electrocardiography [ECG]
• CPC Class Codes: A61B 5/33 specially adapted for cooperation with other devices
• CPC Class Codes: A61B 5/6846 specially adapted to be brought in contact with an internal body part, i.e. invasive
• CPC Class Codes: A61N 1/3925 Monitoring; Protecting

Abstract

An implantable medical device for monitoring tissue perfusion that includes a light source emitting a light signal and a light detector receiving emitted light scattered by a volume of body tissue. The light detector emits a signal having an alternating current component corresponding to the pulsatility of blood flow in the body tissue volume. A processor receives the current signal and determines a patient condition in response to the alternating component of the current signal.

Claims

1. An implantable medical device for monitoring blood flow pulsatility in a volume of body tissue in a patient, the device comprising:

at least two electrodes for sensing cardiac electrical signals;

a light source for emitting a light signal, and

a light detector for receiving the light signal emitted by the light source and scattered by the volume of body tissue, the light detector emitting a signal correlated to the received light signal, the light detector signal having an alternating current component correlated to pulsatility of blood flow within the volume of body tissue; and

a processor configured to receive the cardiac electrical signals, sense events as R-wave events from the cardiac electrical signals, gate the light detector signal for monitoring the alternating current component at a time delay following a sensed R-wave event, receive the gated light detector signal, determine a patient condition in response to the alternating current component of the gated light detector signal, and detect T-wave oversensing in response to the gated light detector signal.

2. The device of claim 1 wherein the processor is further configured for receiving the cardiac electrical signals and detecting a heart rhythm in response to the cardiac electrical signals and wherein determining the patient condition comprises confirming the heart rhythm in response to the alternating current component of the light detector signal.

3. The device of claim 2, further comprising:

a therapy delivery module; and

a control module coupled to the processor and the therapy delivery module and causing the therapy delivery module to deliver a therapy in response to the determined patient condition;

the patient condition being ventricular fibrillation and the therapy being a defibrillation therapy.

4. The device of claim 1 further comprising a filter for filtering the light detector signal to a range of frequencies corresponding to an expected range of patient heart rates.

5. The device of claim 4 further comprising a signal modulator modulating the emitted light signal wherein the processor demodulates light detector signal.

6. The device of claim 5 wherein the emitted light signal is modulated at a carrier frequency of approximately 100 to 10,000 Hz.

7. The device of claim 1 wherein the light detector is a photo darlington device.

8. The device of claim 2 wherein the processor determines one of a frequency of the alternating current component and a peak-to-peak amplitude difference of the alternating current component.

9. The device of claim 8 wherein the processor determines a heart rate from the cardiac electrical signals and compares the determined heart rate to the frequency of the alternating current component.

10. The device of claim 2 wherein the processor further determines the presence of a motion artifact in the light detector signal.

21. The device of claim 1 wherein the processor is configured to gate the light detector signal by gating light emission by the light source.

22. The device of claim 1 wherein the processor is configured to gate the light detector signal by gating light detection by the light detector.

23. The device of claim 1 wherein the processor is further configured to:

detect a normal sinus rhythm in response to the cardiac signals, and

define a normal pulsatile signal morphology using the gated light detector signal,

wherein determining the patient condition comprises distinguishing between the normal pulsatile signal morphology and an altered pulsatile signal morphology.

24. The device of claim 23 further comprising defining a normal pulsatile signal morphology for a plurality of heart rates.

25. The device of claim 1 further comprising a light filter for filtering the light wavelengths received by the light detector.

11. A method for use in an implantable medical device, comprising:

sensing cardiac electrical signals and sensing events as R-wave events from the cardiac electrical signals;

controlling a light source driver signal to cause a light signal to be emitted from a light source;

receiving a current signal by a light detector in response to receiving the emitted light signal scattered by a volume of body tissue, the current signal comprising an alternating current component correlated to a pulsatility of blood flow within the volume of body tissue;

gating the light detector signal for monitoring the alternating current component at a time delay following a sensed R-wave event;

determining a patient condition in response to the alternating current component of the gated light detector signal; and

detecting T-wave oversensing in response to the gated light detector signal.

12. The method of claim 11, further comprising:

detecting a heart rhythm in response to the cardiac electrical signals and wherein determining the patient condition comprises confirming the heart rhythm in response to the alternating current component.

13. The method of claim 12, further comprising delivering a therapy in response to the determined patient condition, the patient condition being ventricular fibrillation and the therapy being a defibrillation therapy.

14. The method of claim 11 further comprising filtering the current signal to a range of frequencies corresponding to an expected range of patient heart rates.

15. The method of claim 14 further comprising modulating the emitted light signal and demodulating the current signal.

16. The method of claim 15 wherein the emitted light signal is modulated at a carrier frequency of approximately 100 to 10,000 Hz.

17. The method of claim 12 wherein determining the patient condition comprises determining one of a frequency of the alternating current component and a peak-to-peak amplitude difference of the alternating current component.

18. The method of claim 17 further comprising determining a heart rate from the cardiac electrical signals and wherein determining the patient condition comprises comparing the frequency of the alternating current component to the determined heart rate.

19. The method of claim 11 further comprising detecting a motion artifact present in the light detector signal for use in determining the patient condition.

20. The method of claim 11 wherein gating the light detector signal comprises gating the emitted light signal to the sensed R-waves.