Cardiac contraction detection using information indicative of lead motion

• US 8,738,111 B2
• Filed: 06/24/2011
• Issued: 05/27/2014
• 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:
  US13/168,507
• Publication Number:
  US 20110319776A1
• Time in Patent Office: 1,068 Days
• Field of Search: 607 4- 38, 607119-132, 600373-375, 600449-450, 600481-503, 600508-528, 600/381, 600/547
• US Class Current: 600/381
• 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 for cardiac contraction detection using information indicative of lead motion are described. In an example, 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 device can include a processor circuit configured to determine whether a cardiac mechanical contraction occurred during a specified interval included in the obtained information indicative of the movement of the implantable lead. The processor circuit can be configured to determine information about the cardiac mechanical contraction using the obtained information indicative of the movement of the implantable lead.

Claims

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

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 of the conductor of the implantable lead to an excitation signal applied to excite the conductor of the implantable lead, the response based on the excitation signal and modulated according to a change in an electrical characteristic of the conductor itself, to obtain information about the excited conductor itself that is indicative of a movement of the implantable lead due at least in part to a motion of a heart; and

a processor circuit configured to determine one or more of (1) whether a cardiac mechanical contraction occurred during a specified interval included in the obtained information indicative of the movement of the implantable lead, or (2) information about the cardiac mechanical contraction using the obtained information indicative of the movement of the implantable lead.

2. The apparatus of claim 1, wherein the processor circuit is configured to determine whether a cardiac mechanical contraction occurred during a specified interval included in the obtained information indicative of the movement of the implantable lead.

3. The apparatus of claim 1, wherein the processor circuit is configured to determine information about a cardiac mechanical contraction using the obtained information indicative of the movement of the implantable lead.

4. The apparatus 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.

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

6. The apparatus of claim 5, 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, 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 movement of the implantable lead.

7. The apparatus of claim 6, wherein one or more of the magnitude information, or the phase information, includes a time-varying portion corresponding to the movement of the implantable lead.

8. The apparatus of claim 1, wherein the processor circuit is configured to determine information about the mechanical contraction via determining one or more of (1) an interval between two loci included in a mechanical contraction waveform, (2) an amplitude corresponding to a portion of the mechanical contraction waveform, or (3) information indicative of a rate of change of a portion of the mechanical contraction waveform, wherein the processor circuit is configured to obtain the mechanical contraction waveform at least in part via filtering the information indicative of the movement of the implantable lead.

9. The apparatus of claim 8, wherein the processor is configured to determine the amplitude corresponding to a portion of the mechanical contraction waveform using one or more of a central tendency, a peak-to-peak determination, a peak determination, a root-mean-square determination, a statistical ranking, or an absolute value of at least a portion of the mechanical contraction waveform.

10. The apparatus of claim 8, wherein the two loci include a first locus corresponding to a feature at or near an initiation of a cardiac contraction on the mechanical contraction waveform, or a second locus corresponding to a feature at or near a peak of the mechanical contraction waveform.

11. The apparatus of claim 1, further comprising an electrostimulation therapy circuit configured to provide an electrostimulation therapy to the heart;

wherein, in response to information about whether a cardiac mechanical contraction occurred, the processor circuit is configured to automatically adjust one or more of an electrostimulation pulse width, an electrostimulation pulse amplitude, or a timing of delivery of electrostimulation therapy to be provided by the electrostimulation therapy circuit.

12. The apparatus of claim 1, further comprising an implantable lead configured to be located within or near the heart, the implantable lead including an electrode configured to provide one or more of electrostimulation to the heart or to sense cardiac electrical activity.

13. The apparatus of claim 12, 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.

14. The apparatus of claim 13, wherein the information indicative of a movement of the implantable lead due at least in part to a motion of the heart comprises a composite mechanical contraction waveform obtained using a first mechanical contraction waveform obtained from the first lead and a second mechanical contraction waveform obtained from the second lead.

15. The apparatus of claim 1, 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.

16. An implantable medical device (IMD) including a non-transitory processor-readable medium comprising instructions that, when executed by the processor, cause the IMD to:

obtain information indicative of movement of a conductor of an implantable lead, using a response of the conductor to an excitation signal applied to excite the conductor of the implantable lead, the response based on the excitation signal and modulated according to a change in an electrical characteristic of the conductor itself, the conductor electrically coupled to a receiver circuit, the receiver circuit included as a portion of the IMD, and the movement due at least in part to a motion of a heart; and

determine one or more of (1) whether a cardiac mechanical contraction occurred during a specified interval included in the obtained information indicative of the movement of the implantable lead, or (2) information about the cardiac mechanical contraction using the obtained information indicative of the movement of the implantable lead.

17. The IMD of claim 16, wherein the non-transitory processor-readable medium comprises instructions that, when executed by the processor, cause the IMD to filter the information indicative of the movement of the implantable lead to obtain a mechanical contraction waveform.

18. The IMD of claim 17, wherein the non-transitory processor-readable medium comprises instructions that, when executed by the processor, cause the IMD to determine information about the mechanical contraction via determining one or more of (1) an interval between two loci included in the mechanical contraction waveform, (2) an amplitude corresponding to a portion of the mechanical contraction waveform, or (3) information indicative of a rate of change of a portion of the mechanical contraction waveform.

19. The IMD of claim 18, wherein the non-transitory processor-readable medium comprises instructions that, when executed by the processor, cause the IMD to determine the amplitude corresponding to a portion of the mechanical contraction waveform using one or more of a central tendency, a peak-to-peak determination, a peak determination, a root-mean-square determination, a statistical ranking, or an absolute value of at least a portion of the mechanical contraction waveform.

20. The IMD of claim 18, wherein the two loci include a first locus corresponding to a feature at or near initiation of a cardiac contraction on the mechanical contraction waveform, or a second locus corresponding to a feature at or near a peak of the mechanical contraction waveform.

21. The IMD of claim 16, wherein the non-transitory processor-readable medium comprises instructions that, when executed by the processor cause the IMD to automatically adjust one or more of an electrostimulation pulse width, an electrostimulation pulse amplitude, or a timing of delivery of electrostimulation therapy to be provided by the electrostimulation therapy circuit, in response to the determination of whether a cardiac mechanical contraction occurred.

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

means for obtaining information indicative of movement of a conductor of an implantable lead, using a response of the conductor to an excitation signal applied to excite the conductor of the implantable lead, the response based on the excitation signal and modulated according to a change in an electrical characteristic of the conductor itself, the conductor electrically coupled to a receiver circuit, the receiver circuit included as a portion of the IMD, and the movement due at least in part to a motion of a heart; and

means for determining one or more of (1) whether a cardiac mechanical contraction occurred during a specified interval included in the obtained information indicative of the movement of the implantable lead, or (2) information about the cardiac mechanical contraction using the obtained information indicative of the movement of the implantable lead.

23. The apparatus of claim 22, wherein the IMD comprises means for automatically adjusting one or more of an electrostimulation pulse width, an electrostimulation pulse amplitude, or a timing of delivery of electrostimulation therapy to be provided by the electrostimulation therapy circuit, in response to information about whether a cardiac mechanical contraction occurred.