Techniques for mitigating motion artifacts from implantable physiological sensors

• US 8,886,311 B2
• Filed: 01/27/2012
• Issued: 11/11/2014
• Est. Priority Date: 01/27/2012
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Anderson, David A., Barka, Noah D., Grassl, Erin D., Bonner, Matthew D.
• Primary Examiner(s): EVANISKO, GEORGE ROBERT
• Application Number:
  US13/360,149
• Publication Number:
  US 20130197597A1
• Time in Patent Office: 1,019 Days
• Field of Search: 607 17- 26
• US Class Current: 607/18
• CPC Class Codes: A61B 5/0006 ECG or EEG signals
• 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 5/026 Measuring blood flow A61B3/1233, A61B3/1241 take precedence
• CPC Class Codes: A61B 5/0261 using optical means, e.g. infrared light
• CPC Class Codes: A61B 5/0538 invasively, e.g. using a catheter
• CPC Class Codes: A61B 5/11 Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb for measuring pulse A61B5/02 ;A61B5/1038 takes precedence; motion detection to correct for motion artifacts in physiological signals A61B5/721
• CPC Class Codes: A61B 5/1116 Determining posture transitions
• CPC Class Codes: A61B 5/14552 Details of sensors specially adapted therefor
• CPC Class Codes: A61B 5/29 for permanent or long-term implantation
• CPC Class Codes: A61B 5/361 Detecting fibrillation
• CPC Class Codes: A61B 5/6867 specially adapted to be attached or implanted in a specific body part A61B5/6847 takes precedence
• CPC Class Codes: A61B 5/7207 of noise induced by motion artifacts
• CPC Class Codes: A61B 7/003 Detecting lung or respiration noise
• CPC Class Codes: A61B 7/023 for introduction into the body, e.g. into the oesophagus oesophageal ECG probes A61B5/285
• CPC Class Codes: A61B 7/04 Electric stethoscopes microphones, acoustic transducers therefor H04R
• CPC Class Codes: A61N 1/3622 comprising two or more electrodes co-operating with different heart regions
• 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 1/36514 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 1/36521 the parameter being derived from measurement of an electrical impedance
• CPC Class Codes: A61N 1/36557 controlled by chemical substances in blood
• CPC Class Codes: A61N 1/36571 : controlled by blood flow rate, e.g. blood velocity or cardiac output
• CPC Class Codes: A61N 1/36578 : controlled by mechanical motion of the heart wall, e.g. measured by an accelerometer or microphone
• CPC Class Codes: A61N 1/36585 : controlled by two or more physical parameters

Abstract

Disclosed techniques include monitoring a physiological characteristic of a patient with a sensor that is mounted to an inner wall of a thoracic cavity of the patient, and sending a signal based on the monitored physiological characteristic from the sensor to a remote device.

Claims

1. A method comprising:

accessing a thoracic cavity of a patient;

controlling air pressure within the thoracic cavity of the patient via a vacuum to mitigate a risk of lung collapse during implantation of a sensor, wherein the sensor comprises a sound sensor;

positioning the sensor within the thoracic cavity of the patient;

securing the sensor to an inner wall of the thoracic cavity;

monitoring a physiological characteristic of a patient with the sensor secured to the inner wall of the thoracic cavity of the patient; and

sending a signal based on the monitored physiological characteristic from the sensor to a remote device.

2. The method of claim 1, wherein the remote device is an implantable medical device implanted within the patient.

3. The method of claim 1, wherein securing the sensor to the inner wall of the thoracic cavity includes securing the sensor beneath the xyphoid process of the patient.

4. The method of claim 1, wherein the sound sensor includes a sound sensing element, the method further comprising monitoring heart sounds of the patient with the sound sensing element.

5. The method of claim 1, wherein the sensor includes an electrical sensing element, the method further comprising sensing an ECG of the heart of the patient with the electrical sensing element.

6. The method of claim 1, wherein the sensor includes an electrical sensing element, the method further comprising sensing an impedance of at least one of tissue or fluid of the patient with the electrical sensing element.

7. The method of claim 1, wherein the sensor includes an electrical sensing element, the method further comprising sensing an impedance of at least one of a cardiac tissue or blood of the patient with the electrical sensing element.

8. The method of claim 1, wherein the sensor includes an optical sensing element, the method further comprising monitoring blood flow in a vasculature of the patient with the optical sensing element.

9. The method of claim 1, wherein the sensor includes an optical sensing element, the method further comprising monitoring blood oxygenation in a vasculature of the patient with the optical sensing element.

10. The method of claim 1, wherein the sensor includes two or more sensing elements selected from a group consisting of:

an accelerometer;

an optical sensing element

an electrical sensing element; and

a sound sensing element.

11. The method of claim 1, wherein securing the sound sensor to the inner wall of the thoracic cavity comprises securing the sound sensor using at least one of a group consisting of:

a suture;

a cement;

a glue; and

vacuum.

12. The method of claim 1, wherein securing the sensor to the inner wall of the thoracic cavity comprises clamping the sensor to the inner wall of the thoracic cavity using a clamping tool by compressing the sensor and patient tissue forming the inner wall of the thoracic cavity between two levers of the clamping tool.

13. The method of claim 1,

wherein accessing the thoracic cavity of the patient includes cutting tissue of the patient to form an incision adjacent to a target implant location for the sound sensor, the method further comprising:

inserting a surgical tool into the incision to spread the cut tissue to provide access to the target implant location by creating an access space sufficiently wide to receive the sensor;

positioning the sensor proximate to the target implant location within the thoracic cavity via the access space;

securing the sensor to the target implant location within the thoracic cavity, wherein the target implant location is proximate at least one of a sternum, a rib cage, or a xiphoid process of the patient by at least one of a clamp, a cement, a glue, or a suture;

checking the sensor to verify proper function and operation with an implantable medical device once it is secured to the inner wall of the thoracic cavity;

retracting the surgical tool from the spread cut; and

suturing the cut tissue closed at the incision location.

14. The method of claim 13, wherein the surgical tool comprises a clamping tool comprising:

a first lever with; and

a second lever pivotally mounted to the first lever,

wherein securing the sensor to the inner wall of the thoracic cavity comprises clamping the sensor to the inner wall of the thoracic cavity using the clamping tool by compressing the sensor and patient tissue forming the inner wall of the thoracic cavity between the first and second levers of the clamping tool such that a distal end of the first lever presses on an exterior side of the patient while a distal end of the second lever presses on the sensor within the thoracic cavity.

15. A method comprising:

accessing a thoracic cavity of a patient;

controlling air pressure within the thoracic cavity of the patient via a vacuum to mitigate a risk of lung collapse during implantation of a sound sensor;

positioning the sound sensor within the thoracic cavity of the patient;

securing the sound sensor to an inner wall of the thoracic cavity;

monitoring sounds with the sound sensor secured to the inner wall of the thoracic cavity of the patient; and

sending a sound signal based on the monitored sounds from the sound sensor to a controller of an implantable medical device implanted within the patient.

16. The method of claim 15, wherein the monitored sounds include monitored heart sounds, the method further comprising generating at least one cardiac metric based on the monitored heart sounds.

17. The method of claim 15, further comprising:

monitoring posture of the patient with a posture sensor; and

generating at least one cardiac metric by analyzing the sound signal in combination with the monitored posture.

18. The method of claim 15, further comprising:

sensing a cardiac electrogram signal with the implantable medical device; and

analyzing the sound signal in combination with the cardiac electrogram signal to generate the at least one cardiac metric.

19. The method of claim 18, wherein sensing the sound signal with the implantable medical device and analyzing the sound signal in combination with the cardiac electrogram signal to generate the at least one cardiac metric includes generating one or more acoustic cardiographic metrics based on the heart sounds and the cardiac electrogram signal.

20. The method of claim 15, wherein the sound sensor is included in an integrated sensor assembly, wherein the integrated sensor assembly further includes at least one of a group consisting of:

an accelerometer;

an ECG sensor;

an optical sensor;

a posture sensor; and

an impedance sensor.

21. The method of claim 15, wherein the sound sensor is implanted on a patient tissue selected from a group consisting of:

a sternum of the patient;

a rib cage of the patient; and

a xiphoid process of the patient.

22. The method of claim 15, wherein the monitored sounds include monitored lung sounds, the method further comprising generating a respiration metric based on the monitored lung sounds.

23. The method of claim 15, wherein securing the sound sensor to the inner wall of the thoracic cavity comprises clamping the sound sensor to the inner wall of the thoracic cavity using a clamping tool by compressing the sound sensor and patient tissue forming the inner wall of the thoracic cavity between two levers of the clamping tool.