Cardiac mechanical vibration monitor using information indicative of lead motion

• US 8,532,770 B2
• Filed: 06/24/2011
• Issued: 09/10/2013
• Est. Priority Date: 06/29/2010
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Sweeney, Robert J., Shuros, Allan C., Siejko, Krzysztof Z., Olson, David C., Ingle, Frank
• Primary Examiner(s): Holmes, Rex R
• Application Number:
  US13/168,547
• Publication Number:
  US 20110319782A1
• Time in Patent Office: 809 Days
• Field of Search: 607 17- 18, 600508-509
• US Class Current: 607/17
• CPC Class Codes: A61B 5/02133 by using induced vibration of the blood vessel
• CPC Class Codes: A61B 5/026 Measuring blood flow A61B3/1233, A61B3/1241 take precedence
• CPC Class Codes: A61N 1/36142 for improving safety
• 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

Systems and methods to monitor cardiac mechanical vibrations using information indicative of lead motion are described. In an example, a system including an implantable medical device can include an excitation circuit configured to provide a non-tissue stimulating, non-therapeutic electrical excitation signal to a portion of an implantable lead. A receiver circuit can be configured to obtain information indicative of a mechanical vibration of the implantable lead due at least in part to one or more of an impact of at least a portion of the heart to the implantable lead, or friction contact between the implantable lead and cardiac tissue. The system can include a processor circuit configured to determine one or more of a lead mechanical status, or information indicative of valvular activity using the information indicative of the mechanical vibration of the implantable lead.

Claims

1. An apparatus including an implantable medical device (IMD), the IMD including:

an excitation circuit configured to provide a non-tissue stimulating, non-therapeutic electrical excitation signal to a conductor comprising a portion of an implantable lead, the excitation signal comprising a time-varying signal including a first range of frequencies;

a receiver circuit electrically coupled to the conductor, the receiver circuit configured to receive, in response to the excitation signal, a response signal modulated according to a change in an electrical characteristic of the conductor, the response signal including information about the excited conductor itself that is indicative of a mechanical vibration of the implantable lead due at least in part to one or more of impact of at least a portion of a heart to the implantable lead or friction between the implantable lead and cardiac tissue; and

a processor circuit configured to determine one or more of a lead mechanical status, or information indicative of valvular activity, using the information about the excited conductor itself that is indicative of the mechanical vibration of the implantable lead.

2. The apparatus of claim 1, wherein the processor circuit is configured to determine the lead mechanical status using the information indicative of the mechanical vibration of the implantable lead.

3. The apparatus of claim 1, wherein the processor circuit is configured to determine the information indicative of valvular activity using the information indicative of the mechanical vibration of the implantable lead.

4. The apparatus of claim 1, wherein the processor is configured to obtain frequency components including or above an audio frequency range, the frequency components including energy corresponding to impact or frictional contact of the implantable lead with at least a portion of the heart.

5. The apparatus of claim 1, wherein the processor is configured to determine the lead mechanical status including one or more of lead fault information or lead maturity information.

6. The apparatus of claim 5, wherein the lead fault information comprises a lead dislodgement indication, including information indicative of a partial dislodgement or information indicative of a full dislodgement, determined at least in part using the information indicative of the mechanical vibration of the implantable lead to determine information about a connection of the implantable lead to at least a portion of the heart.

7. The apparatus of claim 1, wherein the information indicative of valvular activity comprises information indicative of a mechanical vibration of a heart valve, the mechanical vibration of the heart valve coupled to the implantable lead when the implantable lead is located within or near the heart.

8. The apparatus of claim 7, wherein the mechanical vibration of the heart valve comprises information indicative of a valve impacting the implantable lead within the heart, including information indicative of at least one of valve closure, or valve opening.

9. The apparatus of claim 7, comprising a heart sound sensing circuit, the heart sound sensing circuit configured to determine heart sound information using the information indicative of the mechanical vibration of a heart valve.

10. The apparatus of claim 9, wherein the heart sound sensing circuit is configured to determine heart sound information using information indicative of radial compression of at least a portion of the implantable lead, the compression correlative to blood pressure.

11. The apparatus of claim 1, further comprising the implantable lead, wherein the implantable lead is configured to be located within or near the heart, and wherein the implantable lead comprises a piezoelectric acoustic transducer configured to receive acoustic information indicative of the mechanical vibration of the implantable lead, the piezoelectric acoustic transducer coupled to the conductor included in the implantable lead.

12. The apparatus of claim 11, further comprising the conductor, wherein the conductor comprises one or more of a cardiac therapy delivery conductor or a cardiac electrical activity sensing conductor, the conductor configured to be coupled to an implantable electrode included as a portion of the implantable lead.

13. The apparatus of claim 1, wherein the information indicative of the mechanical vibration of the implantable lead includes one or more of magnitude information, or phase information, corresponding to one or more frequencies included in the first range of frequencies, the magnitude information, or phase information, determined at least in part using an electrical response signal provided by the implantable lead in response to the excitation signal and the mechanical vibration of the implantable lead.

14. The apparatus of claim 13, wherein one or more of the magnitude information, or the phase information, includes a time-varying portion corresponding to the mechanical vibration of the implantable lead.

15. The apparatus of claim 1, further comprising the implantable lead including the conductor, the implantable lead configured to be located within or near the heart.

16. A processor-readable medium comprising instructions that, when performed by a processor, cause the processor to:

provide a non-tissue stimulating, non-therapeutic electrical excitation signal to a conductor comprising a portion of an implantable lead, the excitation signal comprising a time-varying signal including a first range of frequencies;

receive, in response to the excitation signal, a response signal modulated according to a change in an electrical characteristic of the conductor, the response signal including information about the excited conductor itself that is indicative of a mechanical vibration of the implantable lead due at least in part to one or more of impact of at least a portion of a heart with the implantable lead or friction between the implantable lead and cardiac tissue; and

determine one or more of a lead mechanical status, or information indicative of valvular activity using the information about the excited conductor itself that is indicative of the mechanical vibration of the implantable lead.

17. The processor-readable medium of claim 16, comprising instructions that, when performed by the processor, cause the processor to obtain frequency components including or above an audio frequency range, the frequency components including energy corresponding to impact or frictional contact of the implantable lead with at least a portion of the heart.

18. The processor-readable medium of claim 16, wherein the instructions to determine the lead mechanical status include instructions to determine one or more of lead fault information or lead maturity information.

19. The processor-readable medium of claim 16, comprising instructions that, when performed by the processor, cause the processor to determine heart sound information using the information indicative of the mechanical vibration of the implantable lead.

20. The processor-readable medium of claim 19, wherein the instructions to determine heart sound information include instructions to use information indicative radial compression on at least a portion of the implantable lead, the compression corresponding to a blood pressure when the implantable lead is located in or near a blood vessel.

21. A system, comprising:

a means for providing a non-tissue stimulating, non-therapeutic electrical excitation signal to a conductor comprising a portion of an implantable lead, the excitation signal comprising a time-varying signal including a first range of frequencies;

a means for receiving, in response to the excitation signal, a response signal modulated according to a change in an electrical characteristic of the conductor, the response signal including information about the excited conductor itself that is indicative of a mechanical vibration of the implantable lead due at least in part to one or more of impact of at least a portion of a heart with the implantable lead or friction between the implantable lead and cardiac tissue; and

a means for detecting one or more of a lead mechanical status, or information indicative of valvular activity using the information about the excited conductor itself that is indicative of the mechanical vibration of the implantable lead.