Systems and methods for myocardial ischemia detection

• US 8,864,677 B2
• Filed: 03/11/2009
• Issued: 10/21/2014
• Est. Priority Date: 03/13/2008
• Status: Expired due to Fees

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Li, Dan, Sachanandani, Haresh G., Kane, Michael John, Zhang, Yi
• Primary Examiner(s): Natnithithadha, Navin
• Assistant Examiner(s): BLOCH, MICHAEL RYAN
• Application Number:
  US12/402,224
• Publication Number:
  US 20090234211A1
• Time in Patent Office: 2,050 Days
• Field of Search: 600/345, 600/347, 600/483, 600/513
• US Class Current: 600/483
• CPC Class Codes: A61B 5/14532 for measuring glucose, e.g. by tissue impedance measurement
• CPC Class Codes: A61B 5/14546 for measuring analytes not otherwise provided for, e.g. ions, cytochromes
• CPC Class Codes: A61B 5/1459 invasive, e.g. introduced into the body by a catheter A61B5/1464 takes precedence
• CPC Class Codes: A61B 5/318 Heart-related electrical modalities, e.g. electrocardiography [ECG]
• CPC Class Codes: A61B 5/364 Detecting abnormal ECG interval, e.g. extrasystoles, ectopic heartbeats
• CPC Class Codes: A61N 1/3627 for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy
• CPC Class Codes: A61N 1/36585 controlled by two or more physical parameters

Abstract

Embodiments of the invention are related to devices and methods for myocardial ischemia detection, amongst other things. In an embodiment, the invention includes an implantable medical device including control circuitry, an electrical field sensor in communication with the control circuitry, the electrical field sensor configured to generate a signal corresponding to cardiac electrical fields. The implantable medical device can also include a chemical sensor in communication with the control circuitry, the chemical sensor configured to generate a signal corresponding to the concentration of a physiological analyte that affects cardiac electrical field waveform morphology. The control circuitry can be configured to monitor for the presence of myocardial ischemia by evaluating both the signal generated by the electrical field sensor and the signal generated by the chemical sensor. Other embodiments are also included herein.

Claims

1. An implantable medical device comprising:

control circuitry;

an electrical field sensor in communication with the control circuitry, the electrical field sensor configured to generate a signal corresponding to cardiac electrical fields;

a chemical sensor in communication with the control circuitry, the chemical sensor configured to generate a signal corresponding to the concentration of a physiological analyte that affects cardiac electrical field waveform morphology; and

a template bank;

the control circuitry configured to monitor for the presence of myocardial ischemia by evaluating both the signal generated by the electrical field sensor and the signal generated by the chemical sensor;

the control circuitry configured to generate a cardiac electrical field morphological template including data from the signal corresponding to cardiac electrical fields and chemical concentration data from the signal corresponding to the concentration of potassium and store the cardiac electrical field morphological template in the template bank;

wherein the control circuitry stores the cardiac electrical field template as a hypo-level template if the potassium concentration is abnormally high, a normal level template if the potassium concentration is normal, and a hyper-level template if the potassium concentration is abnormally high.

2. The implantable medical device of claim 1, the electrical field sensor comprising a first electrode and a second electrode.

3. The implantable medical device of claim 1, the chemical sensor comprising an optical chemical sensor.

4. The implantable medical device of claim 3, the optical chemical sensor comprising a light source, a light detector, and a chemical sensing element.

5. The implantable medical device of claim 1, the control circuitry configured to identify episodes of myocardial ischemia with the signal generated by the electrical field sensor and confirm the accuracy of such identification with the signal generated by the chemical sensor.

6. The implantable medical device of claim 5, wherein episodes of myocardial ischemia are identified based on ST-segment deviation.

7. The implantable medical device of claim 5, wherein episodes of myocardial ischemia are confirmed based on a concentration of potassium between about 3.8 meq and about 5.0 meq.

8. The implantable medical device of claim 1, the control circuitry further configured to generate an alert when myocardial ischemia is present based on evaluating both the signal generated by the electrical field sensor and the signal generated by the chemical sensor.

9. The implantable medical device of claim 1, wherein the chemical sensor is chronically implantable.

10. The implantable medical device of claim 1, the control circuitry configured to initiate therapy to alleviate chemical imbalance.

11. The implantable medical device of claim 1, the control circuitry configured to adjust a ST/T morphology weighting parameter to make it less likely that an observed ST/T morphology as derived from the signal corresponding to cardiac electrical fields is deemed abnormal if a chemical imbalance is detected.

12. The implantable medical device of claim 1, the control circuitry configured to selectively activate the chemical sensor based on the signal generated by the electrical field sensor.

13. The implanted medical device of claim 1, the signal corresponding to cardiac electrical fields comprising an ST/T morphology, the control circuitry configured to compare the ST/T morphology with a previously stored hypo-level template or hyper-level template.

14. The implanted medical device of claim 13, the device configured to send an alert regarding a probable chemical abnormality if the ST/T morphology matches with the previously stored hypo-level template or the hyper-level template.