Cardiac function monitor using information indicative of lead motion

• US 8,649,853 B2
• Filed: 06/24/2011
• Issued: 02/11/2014
• 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): Patel, Niketa
• Assistant Examiner(s): Hankins, Lindsey G
• Application Number:
  US13/168,531
• Publication Number:
  US 20110319778A1
• Time in Patent Office: 963 Days
• Field of Search: 623 31- 33, 600/16, 600/37, 600/513, 606/232, 607/18
• US Class Current: 600/513
• 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 function using information indicative of lead motion are described. In an example, a system including an implantable medical device can include a receiver circuit configured to be electrically coupled to conductor comprising a portion of an implantable lead and be configured to obtain information indicative of a movement of the implantable lead due at least in part to a motion of a heart. The system can include a sensing circuit configured to obtain information indicative of cardiac electrical activity. The system can include a processor circuit configured to construct a template representative of a contraction of the heart, where the template can be constructed using the information indicative of the movement of the implantable lead due at least in part to the motion of the heart during the contraction, and using the information indicative of the cardiac electrical activity sensed during the contraction.

Claims

1. A system comprising:

an implantable medical device (IMD) including;

a receiver circuit, configured to be electrically coupled to a conductor comprising a portion of an implantable lead, the receiver circuit configured to receive a response to an excitation signal applied to the conductor of the lead, the response modulated according to a change in an electrical characteristic of at least one conductor in the lead to provide information indicative of a movement of the implantable lead due at least in part to a motion of a heart; and

a sensing circuit configured to obtain information indicative of cardiac electrical activity; and

a processor circuit configured to construct a template representative of a contraction of the heart, the template constructed using the information indicative of the movement of the implantable lead due at least in part to the motion of the heart during the contraction, and using the information indicative of cardiac electrical activity sensed during the contraction.

2. The system of claim 1, wherein the processor circuit is configured to construct a composite template using information about multiple contractions.

3. The system of claim 1, wherein the processor circuit is configured to construct the template at least in part via relating the information indicative of the movement of the implantable lead sampled during a specified interval of time to cardiac electrical activity information sampled during a similar interval of time, wherein the template is a two-dimensional template.

4. The system of claim 3, wherein the processor circuit is configured to determine a contraction metric using the two-dimensional template.

5. The system of claim 4, wherein the processor circuit is configured to determine the contraction metric via estimating an area enclosed by a shape formed by plotting the information indicative of the movement of the implantable lead received during the contraction with respect to the information indicative of cardiac electrical activity sensed during the contraction.

6. The system of claim 4, wherein the processor circuit is configured to determine the contraction metric via estimating a spatial central tendency of a shape formed by plotting the information indicative of the movement of the implantable lead received during the contraction with respect to the information indicative of cardiac electrical activity sensed during the contraction.

7. The system of claim 4, wherein the processor circuit is configured to determine the contraction metric via estimating a spatial dispersion between a first template corresponding to a first cardiac contraction and a second template corresponding to a second cardiac contraction.

8. The system of claim 1, further comprising an implantable lead configured to be located within or near the heart, wherein the implantable lead comprises a piezoelectric acoustic transducer configured to receive acoustic information indicative of the movement of the implantable lead, the piezoelectric acoustic transducer coupled to the conductor included in the implantable lead.

9. The system of claim 1, wherein the IMD comprises an excitation circuit configured to provide the excitation signal as a non-tissue stimulating, non-therapeutic electrical excitation signal to the conductor of the implantable lead, the signal comprising a time-varying signal including a first range of frequencies.

10. The system of claim 9, wherein the information indicative of the movement 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, wherein the magnitude information, or phase information, is determined at least in part using the response to the excitation signal.

11. The system of claim 10, wherein the one or more of the magnitude information, or the phase information, includes a time-varying portion corresponding to the movement of the implantable lead.

12. The system of claim 1, wherein the IMD comprises the processor circuit.

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

14. The system of claim 13, 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.

15. The system of claim 13, further comprising a first lead located within or near a first location of the heart;

and

a second lead located within or near a second location of the heart.

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

receive, using a receiver circuit, a response to an excitation signal applied to a conductor in an implantable lead, the response modulated according to a change in an electrical characteristic of the conductor in the lead to provide information indicative of the movement of the implantable lead, wherein the conductor is electrically coupled to the receiver circuit, the receiver circuit included as a portion of an implantable medical device (IMD), and the movement due at least in part to a motion of a heart;

obtain information indicative of cardiac electrical activity using a sensing circuit; and

construct a template representative of a contraction of the heart, the template constructed using information indicative of the movement of the implantable lead due at least in part to the motion of the heart during the contraction, and using the information indicative of cardiac electrical activity sensed during the contraction.

17. The processor-readable medium of claim 16, wherein the instructions to construct the template include instructions to construct a two-dimensional template relating the information indicative of the lead movement sampled during a specified interval of time to the information indicative of cardiac electrical activity sampled during a similar interval of time.

18. The processor-readable medium of claim 16, wherein the processor-readable medium comprises instructions that, when executed by the processor, cause the processor to determine a contraction metric using the two dimensional template.

19. The processor-readable medium of claim 18, wherein the processor-readable medium comprises instructions that, when executed by the processor, cause the processor to determine the contraction metric via estimating an area enclosed by a shape formed by plotting the information indicative of the movement of the implantable lead received during the contraction with respect to the information indicative of cardiac electrical activity sensed during the contraction.

20. The processor-readable medium of claim 18, wherein the processor-readable medium comprises instructions that, when executed by the processor, cause the processor to determine the contraction metric via estimating a spatial central tendency of a shape formed by plotting the information indicative of the movement of the implantable lead received during the contraction with respect to the information indicative of cardiac electrical activity sensed during the contraction.

21. The processor-readable medium of claim 16, wherein the processor-readable medium comprises instructions that, when executed by the processor, cause the processor to determine a contraction metric via estimating a spatial dispersion between a first template corresponding to a first cardiac contraction and a second template corresponding to a second cardiac contraction.

22. A system, comprising:

means for receiving a response to an excitation signal applied to a conductor in an implantable lead, the response modulated according to a change in an electrical characteristic of the conductor in the lead to provide information indicative of movement of the implantable lead, the conductor electrically coupled to a receiver circuit, the receiver circuit included as a portion of an implantable medical device (IMD), and the movement due at least in part to a motion of a heart;

means for obtaining information indicative of cardiac electrical activity using a sensing circuit; and

means for constructing a template representative of a contraction of the heart, the template constructed using the information indicative of the movement of the implantable lead due at least in part to the motion of the heart during the contraction, and using the information indicative of cardiac electrical activity sensed during the contraction.