Method and apparatus for sensing mechanical energy of an implantable lead

• US 8,301,267 B2
• Filed: 09/07/2010
• Issued: 10/30/2012
• Est. Priority Date: 09/18/2009
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Shuros, Allan C., Li, Dan, Siejko, Krzysztof Z., Tangren, John H.
• Primary Examiner(s): Gedeon, Brian T
• Application Number:
  US12/876,426
• Publication Number:
  US 20110071411A1
• Time in Patent Office: 784 Days
• Field of Search: 607/115, 607/116, 607/119
• US Class Current: 607/119
• CPC Class Codes: A61B 5/02133 by using induced vibration of the blood vessel
• CPC Class Codes: A61B 5/02158 provided with two or more sensor elements
• CPC Class Codes: A61B 5/02405 Determining heart rate variability
• 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

An apparatus comprises an implantable sensor and a signal analyzer circuit communicatively coupled to the implantable sensor. The implantable sensor is configured for coupling to an implantable lead and the implantable sensor provides an electrical vibration sensor signal representative of mechanical vibration of the implantable lead. The signal analyzer circuit is configured to determine a baseline of the vibration sensor signal, detect a change in the vibration sensor signal from the baseline vibration sensor signal, and provide an indication of the change to a user or process.

Claims

1. An apparatus comprising:

an implantable sensor configured for coupling to an implantable lead, wherein the implantable lead is configured for placement through a heart valve, and wherein the implantable sensor provides an electrical vibration sensor signal representative of mechanical vibration induced on the implantable lead by the heart valve impacting the implantable lead;

a signal analyzer circuit communicatively coupled to the implantable sensor, wherein the signal analyzer circuit is configured to;

determine a baseline of the vibration sensor signal induced by the heart valve;

detect a change in the vibration sensor signal from the baseline vibration sensor signal; and

provide an indication of the change to a user or process.

2. The apparatus of claim 1, including:

a hermetically sealed housing; and

a header attached to the hermetically sealed housing to receive the implantable lead, wherein the implantable sensor is located within the header adjacent to, and in mechanical communication with, a proximal end of the implantable lead.

3. The apparatus of claim 1, including:

a hermetically sealed housing; and

a header attached to the hermetically sealed housing to receive the implantable lead, wherein the implantable sensor is configured to be attached to the implantable lead outside of the header and hermetically sealed housing and at a proximal end of the implantable lead.

4. The apparatus of claim 1, including a hermetically sealed housing, and wherein the implantable sensor is located within the hermetically sealed housing.

5. The apparatus of claim 1, including:

a therapy circuit, configured to provide electrical pacing therapy to the heart using the same or a different implantable lead; and

a controller communicatively coupled to the therapy circuit and the signal analyzer circuit, wherein the controller is configured to initiate delivery of the electrical pacing therapy, and wherein the signal analyzer circuit is configured to verify, using the vibration sensor signal induced by the heart valve, that the electrical pacing therapy induces a depolarization of the heart.

6. The apparatus of claim 1, including:

a cardiac signal sensing circuit communicatively coupled to the signal analyzer circuit and configured to provide a sensed cardiac signal representative of cardiac depolarization events of a subject;

a therapy circuit, configured to provide high-energy cardioversion or defibrillation shock therapy to the heart using the same or a different implantable lead; and

a controller communicatively coupled to the therapy circuit and the signal analyzer circuit, wherein the signal analyzer circuit is configured to;

detect a tachyarrhythmia using the cardiac signal; and

determine, using the vibration signal, whether the detected tachyarrhythmia is hemodynamically stable or hemodynamically unstable, and

wherein the controller is configured to initiate delivery of shock therapy when the detected tachyarrhythmia is determined to be unstable.

7. The apparatus of claim 1, including:

a therapy circuit, configured to provide electrical resynchronization pacing therapy to the heart using the same or a different implantable lead; and

a controller communicatively coupled to the therapy circuit and the signal analyzer circuit, wherein the controller is configured to initiate delivery of the electrical resynchronization pacing therapy, and wherein the signal analyzer circuit is configured to determine, using the vibration sensor signal induced by the heart valve, an efficacy of the of the electrical resynchronization therapy.

8. The apparatus of claim 1, wherein the implantable sensor is a first implantable sensor providing a first vibration sensor signal, and where the apparatus includes:

a hermetically sealed housing; and

a second implantable sensor configured to provide a second electrical sensor signal representative of mechanical vibration at the hermetically sealed housing, and

wherein the first vibration sensor signal includes a composite electrical signal representative of the mechanical vibration induced on the implantable lead by a heart valve impacting the implantable lead and of mechanical vibration at the hermetically sealed housing, and

wherein the signal analyzer circuit is configured to extract a vibration signal substantially only induced on the implantable lead by the heart valve by a comparison of the first and second vibration sensor signals.

9. The apparatus of claim 1, wherein the signal analyzer circuit is configured to:

determine a resonant frequency of the implantable lead;

detect a change in the amplitude of the vibration sensor signal at the resonant frequency; and

provide the indication when the change in the amplitude of the vibration sensor signal satisfies a specified amplitude change threshold.

10. An apparatus comprising:

an implantable sensor configured for coupling to an implantable lead, wherein the implantable sensor provides an electrical vibration sensor signal representative of mechanical vibration of the implantable lead;

an actuating device to induce the mechanical vibration on the implantable lead, wherein the electrical vibration sensor signal is representative of a reflection on the implantable lead of the mechanical vibration induced by the actuating device; and

a signal analyzer circuit communicatively coupled to the implantable sensor, wherein the signal analyzer circuit is configured to;

determine a baseline of the vibration sensor signal;

detect a change in the vibration sensor signal from the baseline vibration sensor signal; and

provide an indication of the change to a user or process.

11. The apparatus of claim 10, wherein the signal analyzer circuit is configured to:

determine a resonant frequency of the implantable lead;

detect a change in the amplitude of the vibration sensor signal at the resonant frequency; and

provide the indication when the change in the amplitude of the vibration sensor signal satisfies a specified amplitude change threshold.

12. The apparatus of claim 10, wherein the actuating device is configured to receive operating power from energy telemetered by a separate device.

13. A method comprising:

obtaining, using an implantable sensor of an implantable medical device (IMD), an electrical vibration signal representative of mechanical vibration induced on an implantable lead by a heart valve impacting the implantable lead, wherein the implantable lead is coupled to the IMD;

determining, using a signal analyzer circuit, a baseline vibration signal;

detecting a change in the electrical vibration signal from the baseline vibration signal; and

providing an indication of the change to a user or process.

14. The method of claim 13, including:

delivering electrical pacing therapy with the IMD; and

verifying, using the vibration signal, that the electrical pacing therapy induces a depolarization of the heart.

15. The method of claim 13, including:

sensing a cardiac signal using the IMD, wherein the cardiac signal is representative of cardiac depolarization events of a subject;

detecting a tachyarrhythmia using the cardiac signal; and

determining, using the vibration signal, whether the detected tachyarrhythmia is hemodynamically stable or hemodynamically unstable.

16. The method of claim 13,

wherein obtaining the vibration signal includes obtaining a first composite electrical vibration signal representative of the mechanical vibration induced on the implantable lead by a heart valve impacting the implantable lead and of mechanical vibration at a housing of the IMD, and

wherein the method includes:

obtaining, with the IMD, a second electrical signal representative of mechanical vibration that is induced at a housing of the IMD; and

extracting a vibration signal representative of vibration substantially only induced on the implantable lead by the heart valve by a comparison of the first and second vibration signals.

17. The method of claim 13,

wherein determining a baseline vibration signal includes determining a resonant frequency of the implantable lead,

wherein detecting a change in the vibration signal includes detecting a change in amplitude of the vibration signal at the resonant frequency from an amplitude of the baseline vibration signal, and

wherein providing an indication of the change to a user or process includes providing an alert to a user or process upon detecting a change in the amplitude of the vibration signal that satisfies a specified amplitude change threshold.

18. A method comprising:

inducing a mechanical vibration on the implantable lead using an actuating device of an implantable medical device (IMD);

obtaining, using an implantable sensor of an implantable medical device (IMD), an electrical vibration signal representative of a reflection of the induced mechanical vibration on the implantable lead, wherein the implantable lead is coupled to the IMD;

evaluating, using a signal analyzer circuit communicatively coupled to the implantable sensor, lead integrity using the reflected electrical vibration signal; and

providing an indication of the lead integrity to a user or process.

19. The method of claim 18, including:

determining a baseline reflected vibration signal; and

detecting a change in the reflected vibration signal from the baseline reflected vibration signal,

wherein evaluating lead integrity includes evaluating lead integrity using the detected change in the reflected vibration signal.

20. The method of claim 19,

wherein inducing a mechanical vibration includes inducing a resonant mechanical vibration on the implantable lead,

wherein determining a baseline vibration signal includes establishing a baseline vibration signal of the reflected electrical vibration signal at the resonant frequency, and

wherein evaluating lead integrity includes obtaining a reflected electrical vibration signal at the resonant frequency and determining whether there is a change in the electrical vibration signal from the baseline vibration signal at the resonant frequency.