Heart sound monitoring of pulmonary hypertension

• US 8,764,674 B2
• Filed: 03/06/2013
• Issued: 07/01/2014
• Est. Priority Date: 03/08/2012
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Song, Zhendong, Zhou, Xiaohong
• Primary Examiner(s): Koharski, Christopher D.
• Assistant Examiner(s): CAREY, MICHAEL JAMES
• Application Number:
  US13/786,736
• Publication Number:
  US 20130237862A1
• Time in Patent Office: 482 Days
• Field of Search: 600/528, 600/486
• US Class Current: 600/528
• CPC Class Codes: A61B 5/0205 Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
• CPC Class Codes: A61B 5/021 Measuring pressure in heart or blood vessels A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/0215 by means inserted into the body catheters A61M25/00
• CPC Class Codes: A61B 5/352 Detecting R peaks, e.g. for synchronising diagnostic apparatus; Estimating R-R interval
• CPC Class Codes: A61B 5/7285 for synchronising or triggering a physiological measurement or image acquisition with a physiological event or waveform, e.g. an ECG signal A61B6/5205, A61B6/541, A61B8/5207, A61B8/543 take precedence
• CPC Class Codes: A61B 7/00 Instruments for auscultation
• CPC Class Codes: A61B 7/003 Detecting lung or respiration noise
• CPC Class Codes: A61M 5/1723 using feedback of body parameters, e.g. blood-sugar, pressure measurement of body parameters A61B5/00
• CPC Class Codes: A61N 1/36585 controlled by two or more physical parameters

Abstract

A medical device system and method that includes receiving an A2 heart sound signal from a first external acoustic sensor, receiving a P2 heart sound signal from a second external acoustic sensor, determining at least one A2 heart sound signal parameter from the A2 heart sound signal, determining at least one P2 heart sound signal parameter from the P2 heart sound signal, and based on the at least one P2 heart sound signal parameter, estimating pulmonary arterial pressure.

Claims

1. A method comprising:

receiving an A2 heart sound signal from a first external acoustic sensor;

receiving a P2 heart sound signal from a second external acoustic sensor;

determining at least one A2 heart sound signal parameter from the A2 heart sound signal;

determining at least one P2 heart sound signal parameter from the P2 heart sound signal;

based on the at least one P2 heart sound signal parameter, estimating pulmonary arterial pressure;

receiving a pulmonary pressure signal from a pressure catheter; and

calibrating the at least one P2 heart sound signal parameter with the pulmonary pressure signal.

2. The method of claim 1, further comprising:

comparing the at least one A2 heart sound signal parameter and the at least one P2 heart sound signal parameter; and

determining an indication of pulmonary hypertension based on the comparison.

3. The method of claim 1, further comprising:

receiving an arterial blood pressure signal from an external blood pressure monitor; and

associating the at least one A2 heart sound signal parameter with the arterial blood pressure signal.

4. The method of claim 1, further comprising:

determining a post QRS window; and

identifying the P2 heart sound signal occurring within the post QRS window.

5. The method of claim 4, further comprising;

determining one of a time of day and a patient activity level; and

activating the first external acoustic sensor and the second external acoustic sensor in response to the determined one of a time of day and a patient activity level.

6. The method of claim 1, further comprising, in response to an indication of pulmonary hypertension, generating a third set of therapy parameters.

7. The method of claim 1, wherein the first external acoustic sensor is oriented to receive the A2 heart sound signal and the second external acoustic sensor is oriented to receive the P2 heart sound signal.

8. A method comprising:

receiving an A2 heart sound signal from a first external acoustic sensor;

receiving a P2 heart sound signal from a second external acoustic sensor;

determining at least one A2 heart sound signal parameter from the A2 heart sound signal;

determining at least one P2 heart sound signal parameter from the P2 heart sound signal;

based on the at least one P2 heart sound signal parameter, estimating pulmonary arterial pressure;

determining whether an amplitude of the P2 heart sound signal is greater than a predetermined threshold;

comparing the P2 heart sound signal and a predetermined heart failure signature; and

determining pulmonary hypertension induced heart failure progression in response to the comparing.

9. The method of claim 8, further comprising analyzing a split between A2 heart sound and a P2 heart sound in an S2 heart sound.

10. A medical device system comprising:

a first external acoustic sensor configured to receive an A2 heart sound signal;

a second external acoustic sensor configured to receive a P2 heart sound signal;

a processor configured to;

determine at least one A2 heart sound signal parameter from the A2 heart sound signal,

determine at least one P2 heart sound signal parameter from the P2 heart sound signal, and

estimate pulmonary arterial pressure in response to the at least one P2 heart sound signal parameter;

an external blood pressure sensor; and

a telemetry module configured to receive an arterial blood pressure signal from external blood pressure sensor, wherein the processor is further configured to associate the at least one A2 heart sound signal parameter with the arterial blood pressure signal.

11. The system of claim 10, wherein the processor is further configured to compare the at least one A2 heart sound signal parameter and the at least one P2 heart sound signal parameter, and provide an indication of pulmonary hypertension based on the comparison.

12. The system of claim 10, wherein the processor is further configured to, in response to an indication of pulmonary hypertension, generate a third set of therapy parameters.

13. A medical device system comprising:

a first external acoustic sensor configured to receive an A2 heart sound signal;

a second external acoustic sensor configured to receive a P2 heart sound signal;

a processor configured to;

determine at least one A2 heart sound signal parameter from the A2 heart sound signal,

determine at least one P2 heart sound signal parameter from the P2 heart sound signal, and

estimate pulmonary arterial pressure in response to the at least one P2 heart sound signal parameter;

a pressure catheter; and

a telemetry module configured to receive a pulmonary pressure signal from the pressure catheter, wherein the processor is further configured to calibrate the at least one P2 heart sound signal parameter with the pulmonary pressure signal.

14. A medical device system comprising:

a first external acoustic sensor configured to receive an A2 heart sound signal;

a second external acoustic sensor configured to receive a P2 heart sound signal;

a processor configured to;

determine at least one A2 heart sound signal parameter from the A2 heart sound signal,

determine at least one P2 heart sound signal parameter from the P2 heart sound signal, and

estimate pulmonary arterial pressure in response to the at least one P2 heart sound signal parameter, wherein the processor is further configured to determine determining a post QRS window, and identify the P2 heart sound signal occurring within the post QRS window.

15. The system of claim 14, wherein the processor is further configured to determine one of a time of day and a patient activity level, and activate the first external acoustic sensor and the second external acoustic sensor in response to the determined one of a time of day and a patient activity level.

16. A medical device system comprising:

a first external acoustic sensor configured to receive an A2 heart sound signal;

a second external acoustic sensor configured to receive a P2 heart sound signal;

a processor configured to;

determine at least one A2 heart sound signal parameter from the A2 heart sound signal,

determine at least one P2 heart sound signal parameter from the P2 heart sound signal, and

estimate pulmonary arterial pressure in response to the at least one P2 heart sound signal parameter, wherein the processor is further configured to determine whether an amplitude of the P2 heart sound signal is greater than a predetermined threshold, compare the P2 heart sound signal and a predetermined heart failure signature, and determine pulmonary hypertension induced heart failure progression in response to the comparing.

17. The system of claim 16, wherein the processor is further configured to analyze a split between A2 heart sound and a P2 heart sound in an S2 heart sound.

18. A non-transitory computer-readable medium comprising instructions for causing a programmable processor to:

receive an A2 heart sound signal from a first external acoustic sensor;

receive a P2 heart sound signal form a second external acoustic sensor;

determine at least one A2 heart sound signal parameter from the A2 heart sound signal;

determine at least one P2 heart sound signal parameter from the P2 heart sound signal;

estimate pulmonary arterial pressure in response to the at least one P2 heart sound signal parameter;

determine whether an amplitude of the P2 heart sound signal is greater than a predetermined threshold;

compare the P2 heart sound signal and a predetermined heart failure signature; and

determine pulmonary hypertension induced heart failure progression in response to the comparing.