Medical device for detecting pulmonary artery pressure

• US 8,679,026 B2
• Filed: 11/08/2007
• Issued: 03/25/2014
• Est. Priority Date: 09/24/2007
• Status: Active Grant

• Current Assignee: St. Jude Medical AB (Abbott Laboratories)
• Original Assignee: St. Jude Medical AB (Abbott Laboratories)
• Inventors: Blomqvist, Andreas
• Primary Examiner(s): Natnithithadha, Navin
• Assistant Examiner(s): WEARE, MEREDITH H
• Application Number:
  US12/679,711
• Publication Number:
  US 20100286535A1
• Time in Patent Office: 2,329 Days
• Field of Search: 600/481, 600485-488, 607 17- 26
• US Class Current: 600/486
• 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 5/053 Measuring electrical impedance or conductance of a portion of the body
• CPC Class Codes: A61B 5/0538 invasively, e.g. using a catheter
• CPC Class Codes: A61N 1/36521 the parameter being derived from measurement of an electrical impedance
• CPC Class Codes: A61N 1/36564 controlled by blood pressure

Abstract

In a medical device and method to monitor pulmonary artery pressure of a patient, a first parameter related to the right ventricular straight volume of the patient'"'"'s is detected, and a second parameter related to the right ventricular ejection rate of the patient'"'"'s heart, or related to the workload of the patient'"'"'s heart, is also determined. A pulmonary pressure index is determined by combining the first and second parameters, with variations of the pulmonary pressure index indicating variations in the pulmonary artery pressure. Pulmonary artery hypertension can be monitored with such a device and method.

Claims

1. A medical device to monitor pulmonary artery pressure (PAP) of a patient, comprising:

a first detector configured to measure and determine a first parameter (SV_R) indicative of a right ventricular stroke volume of the patient'"'"'s heart;

a second detector configured to measure and determine a second parameter (ER_R) indicative of speed of blood ejected from a right ventricle of the patient'"'"'s heart; and

a processing unit configured to determine a pulmonary pressure index (I_P) by combining the first and second parameters, with variations of the pulmonary pressure index indicating variations of PAP.

2. Medical device according to claim 1, wherein said processing unit is configured to use the determined pulmonary pressure index (I_P) to detect pulmonary artery hypertension (PAH).

3. Medical device according to claim 1, wherein said processing unit is configured to use the determined pulmonary pressure index (I_P) to monitor left ventricular end diastolic pressure.

4. Medical device according to claim 1, wherein said processing unit is configured to determine the pulmonary pressure index as a ratio between the first parameter and the second parameter.

5. Medical device according to claim 1, further comprising a control unit that controls said first and second detectors to respectively measure said first and second parameters during a predetermined time-period.

6. Medical device according to claim 5 wherein the control unit controls said first and second detectors to respectively measure said first and second parameters as consecutive measurements performed at regular intervals.

7. Medical device according to claim 1, further comprising a control unit that controls said first and second detectors to respectively measure said first and second parameters during a predetermined number of heart cycles.

8. A medical device as claimed in claim 7 wherein the control unit controls said first and second detectors to respectively measure said first and second parameters as consecutive measurements performed at regular intervals.

9. Medical device according to claim 1, further comprising a storage unit, in communication with the output of the processing unit, that stores values that are determined for the pulmonary pressure index during a number of heart cycles.

10. Medical device according to claim 1, further comprising a comparator that compares a calculated I_P to one or many specified PAP thresholds representing different levels of PAP, and generates a PAP indication signal in result of said comparison.

11. Medical device according to claim 10, wherein the comparator employs, as said one or many specified PAP thresholds, a threshold that represents a dangerous level of PAP, and when the I_P value is higher than the PAP threshold an alert function is activated that generates an alarm signal to notify the patient.

12. Medical device according to claim 10, wherein at least one of the specified PAP thresholds represents pulmonary artery hypertension (PAH).

13. Medical device according to claim 12, wherein said processing unit is configured to determine if the pulmonary pressure index increases over time and, if so, to emit a signal indicating a higher degree of PAH exists.

14. Medical device according to claim 1, wherein the first detector is an impedance measurement means measures intra cardiac impedance of the right ventricle, and the first parameter is determined in dependence of the measured impedance.

15. Medical device according to claim 1, wherein the first and second detectors are impedance measurement means that measure intra cardiac impedance of the right ventricle, and the first and second parameters are determined in dependence of the measured impedance.

16. Medical device according to claim 1, wherein said first and second detectors and said processing unit are configured to be implantable.

17. Medical device according to claim 1, further comprising a telemetry unit connected to said output of said processing unit that communicates determined I_P-values via telemetry to an external programming device.

18. A medical device as claimed in claim 1 further comprising a pulse generator and at least one electrode lead configured to generate and deliver stimulation pulses in vivo to the patient'"'"'s heart, and a pacing control unit connected to said output of said processing unit and configured to control generation of said stimulation pulses dependent on said pulmonary pressure index.

19. Method in a medical device adapted to monitor pulmonary artery pressure (PAP) of a patient, the method comprises the steps of:

a) measuring and determining, by a first detector, a first parameter (SV_R) indicative of the right ventricular stroke volume of the patient'"'"'s heart;

b) measuring and determining, by a second detector, a second parameter (ER_R) indicative of speed of blood ejected from a right ventricle of the patient'"'"'s heart; and

c) in a processor, combining the first and second parameters to determine a pulmonary pressure index (I_P), with variations of the pulmonary pressure index indicating variations of PAP.

20. Method according to claim 19, further comprising using said pulmonary pressure index to detect and monitor pulmonary artery hypertension (PAH).

21. Method according to claim 19, further comprising using the determined pulmonary pressure index (I_P) to monitor left ventricular end diastolic pressure.

22. Method according to claim 19, further comprising determining the pulmonary pressure index has the ratio between the first and the second parameter.

23. Method according to claim 19, further comprising measuring said first and second parameters during a predetermined time-period.

24. Method according to claim 19, further comprising measuring said first and second parameters during a predetermined number of heart cycles.

25. Method according to claim 19, further comprising measuring intra cardiac impedance of the right ventricle, and determining the first and second parameters dependent on the measured impedance.

26. A medical device to monitor pulmonary artery pressure (PAP) of a patient, comprising:

a first detector configured to measure and determine a first parameter (SV_R) indicative of the right ventricular stroke volume of the patient'"'"'s heart;

a second detector configured to measure and determine a second parameter (W_R) indicative of the workload of the patient'"'"'s heart; and

a processing unit configured to determine a pulmonary pressure index (I_P) by combining the first and second parameters, with variations of the pulmonary pressure index indicating variations of PAP.

27. Medical device according to claim 26, wherein said processing unit is configured to determine the pulmonary pressure index as the product of the first and the second parameter.

28. Medical device according to claim 26, wherein the second detector is selected from the group consisting of a strain gauge, a temperature sensor or a contractility sensor.

29. Method in a medical device adapted to monitor pulmonary artery pressure (PAP) of a patient, the method comprises the steps of:

a) measuring and determining, by a first detector a first parameter (SV_R) indicative of the right ventricular stroke volume of the patient'"'"'s heart;

b) measuring and determining, by a second, detector, a second parameter (W_R) indicative of the workload of the patient'"'"'s heart; and

c) in a processor, combining the first and second parameters to determine a pulmonary pressure index (I_P), with variations of the pulmonary pressure index indicating variations of PAP.