Cardiac force sensor and methods of use

• US 8,417,355 B2
• Filed: 11/05/2010
• Issued: 04/09/2013
• Est. Priority Date: 11/14/2006
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Zhang, Yongxing, Zhang, Yunlong, Wei, Xuan
• Primary Examiner(s): Layno, Carl H
• Assistant Examiner(s): Stice, Paula J
• Application Number:
  US12/940,172
• Publication Number:
  US 20110046496A1
• Time in Patent Office: 886 Days
• Field of Search: 607 24- 25, 607 1- 5, 607/17
• US Class Current: 607/122
• 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 5/224 Measuring muscular strength
• CPC Class Codes: A61B 5/363 Detecting tachycardia or bradycardia
• CPC Class Codes: A61B 5/6846 specially adapted to be brought in contact with an internal body part, i.e. invasive
• CPC Class Codes: A61B 5/686 Permanently implanted devices, e.g. pacemakers, other stimulators, biochips A61B5/6861 takes precedence
• CPC Class Codes: A61B 5/6869 Heart
• CPC Class Codes: A61N 1/3627 for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy

Abstract

A method and apparatus permit sensing one or more forces exerted by one or more portions of a heart. A force transducer and displacement sensor are disclosed. A movement of one or more portions of a heart can be translated into one or more signals indicative of force. These signals can be used to provide information such as to diagnose or treat one or more conditions.

Claims

1. A method comprising:

sensing one or more forces exerted by at least a portion of a heart by detecting a compression or expansion of an implanted intracardiac element;

obtaining sensed force signal responsive to the one or more forces by measuring a displacement of the compression or expansion of the implanted intracardiac element, wherein the implanted intracardiac element includes a force sensor including;

a displacement sensor configured to sense a displacement of the portion of the heart during a heart movement, the displacement sensor including a first portion movable with respect to a second portion along an axial direction and in response to the displacement of the portion of the heart axial movement of the first portion with respect to the second portion being representative of the displacement of the portion of the heart, the displacement sensor being configured to provide an output displacement signal indicative of the displacement sensed; and

a contractile structure separate from the displacement sensor, the contractile structure being configured to axially expand or axially contract an axial distance representative of the axial movement of the first portion of the displacement sensor with respect to the second portion, wherein the force sensor is configured to provide the sensed force signal indicative of a force with which at least the portion of the heart moves during the heart movement, the force sensor configured to determine the force as a function of the distance that the contractile structure axially expands or axially contracts; and

communicating sensed force signal to an electronics unit of an implantable medical device.

2. The method of claim 1, wherein sensing the one or more forces exerted by at least the portion of the heart by detecting the compression or expansion of the implanted intracardiac element includes using the force sensor of the implanted intracardiac element, the force sensor associated with a distal portion of a fully implantable intravascular cardiac lead of the implanted intracardiac element.

3. The method of claim 1, comprising determining a value of the one or more forces exerted by at least the portion of the heart by using a force-displacement relationship of the implanted intracardiac element and the displacement of the compression or expansion.

4. The method of claim 3, comprising determining a pressure exerted on the implanted intracardiac element by at least the portion of the heart using the sensed one or more forces exerted by at least the portion of the heart.

5. The method of claim 1, comprising selecting at least one of a pacing voltage and a pacing location based on the sensed one or more forces exerted by at least the portion of the heart.

6. The method of claim 1, comprising determining a paradoxical heart movement using the sensed one or more forces exerted by at least the portion of the heart.

7. The method of claim 1, comprising:

storing an indication of the electrical signal over more than one cardiac cycle; and

detecting a change in the indication of the electrical signal over a time period that spans more than one cardiac cycle.

8. The method of claim 1, comprising determining at least one of a minimum value, a maximum value, a minimum time rate of change, and a maximum time rate of change of the sensed one or more forces.

9. The method of claim 1, comprising determining an undersensing condition, the determining the undersensing condition including:

sensing an electrogram signal to detect electrical cardiac conduction; and

declaring the undersensing condition to exist when the sensed one or more forces indicates at least one conduction that is absent from the sensed electrogram signal.

10. The method of claim 1, comprising determining an oversensing condition, the determining the oversensing condition including:

sensing an electrogram signal to detect electrical cardiac conduction; and

declaring the oversensing condition to exist when the sensed one or more forces indicate an absence of a mechanically-indicated contraction corresponding to at least one electrically-indicated contraction.

11. A method comprising:

sensing a force exerted by a portion of a heart using a force sensor associated with an implanted intracardiac element, the force sensor including;

a displacement sensor configured to sense a displacement of the portion of the heart during a heart movement, the displacement sensor including a first portion movable with respect to a second portion along an axial direction of a portion of the implanted intracardiac element and in response to the displacement of the portion of the heart, axial movement of the first portion with respect to the second portion being representative of the displacement of the portion of the heart, the displacement sensor being configured to provide an output displacement signal indicative of the displacement sensed; and

a contractile structure separate from the displacement sensor, the contractile structure being configured to axially expand or axially contract an axial distance representative of the axial movement of the first portion of the displacement sensor with respect to the second portion, wherein the force sensor is configured to provide a sensed force signal indicative of a force with which at least the portion of the heart moves during the heart movement, the force sensor configured to determine the force as a function of the distance that the contractile structure axially expands or axially contracts; and

communicating the sensed force signal to an electronics unit of an implantable medical device.

12. The method of claim 11, wherein sensing the force includes sensing the force using the force sensor associated with a distal portion of a fully implantable intravascular cardiac lead of the implanted intracardiac element.

13. The method of claim 11, comprising determining the force with which the portion of the heart moves using a specified force-displacement relationship of the contractile structure.

14. The method of claim 11, comprising initiating or adjusting a delivered electrical energy or a delivered substance in response to the sensed force signal.

15. The method of claim 11, comprising using the sensed force signal to determine at least one of:

a ventricular uptake;

a ventricular relaxation behavior;

an interventricular mechanical delay;

an interventricular dyssynchrony;

a ventricular output;

an electromechanical delay;

an evoked response;

a pacing voltage;

a pacing location;

a paradoxical movement; and

a respiratory signal.

16. A method comprising:

sensing a force exerted by a portion of a heart using a force sensor associated with an implanted intracardiac element, the force sensor including;

a displacement sensor configured to sense a displacement of the portion of the heart during a heart movement, the displacement sensor being configured to provide an output displacement signal indicative of the displacement sensed, the force sensor including a first portion movable with respect to a second portion along an axial direction and in response to the displacement of the portion of the heart, axial movement of the first portion with respect to the second portion being representative of the displacement of the portion of the heart; and

a contractile structure separate from the displacement sensor, the contractile structure being configured to axially expand or axially contract an axial distance representative of the displacement sensed by the displacement sensor, wherein the force sensor is configured to provide a sensed force signal indicative of a force with which at least the portion of the heart moves during the heart movement, the force sensor configured to determine the force as a function of the distance that the contractile structure axially expands or axially contracts, wherein the contractile structure is configured to axially expand or axially contract the axial distance representative of the axial movement of the first portion of the displacement sensor with respect to the second portion.

17. The method of claim 16, comprising communicating the sensed force signal to an electronics unit of an implantable medical device, wherein sensing the force includes sensing the force using the force sensor associated with a distal portion of a fully implantable intravascular cardiac lead of the implanted intracardiac element.

18. The method of claim 16, comprising determining a paradoxical movement of the heart using the sensed force signal.

19. The method of claim 16, comprising initiating or adjusting a delivered electrical energy or a delivered substance in response to the sensed force signal.

20. The method of claim 16, comprising using the sensed force signal to determine at least one of:

a ventricular uptake;

a ventricular relaxation behavior;

an interventricular mechanical delay;

an interventricular dyssynchrony;

a ventricular output;

an electromechanical delay;

an evoked response;

a pacing voltage;

a pacing location; and

a respiratory signal.

21. A method comprising:

sensing one or more forces exerted by at least a portion of a heart by detecting a compression or expansion of an implanted intracardiac element;

obtaining a sensed force signal responsive to the one or more forces by measuring a displacement of the compression or expansion of the implanted intracardiac element, the obtaining including;

sensing a displacement of a first element of the implanted intracardiac element with respect to second element of the implanted intracardiac element along an axial direction and in response to a displacement of the portion of the heart;

sensing an axial contraction of a contractile structure of the implanted intracardiac element separate from the first element and the second element; and

using the sensed displacement and the sensed axial contraction information to determine the sensed force signal; and

communicating the sensed force signal to an electronics unit of an implantable medical device.