Method and apparatus for cardiac function monitoring

• US 8,926,523 B2
• Filed: 03/12/2013
• Issued: 01/06/2015
• Est. Priority Date: 04/27/2012
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Song, Zhendong, Zhou, Xiaohong
• Primary Examiner(s): VOORHEES, CATHERINE M
• Application Number:
  US13/794,898
• Publication Number:
  US 20130289430A1
• Time in Patent Office: 665 Days
• Field of Search: 600/528, 607/6
• US Class Current: 600/528
• CPC Class Codes: A61B 5/02158 provided with two or more sensor elements
• CPC Class Codes: A61B 5/0245 by using sensing means generating electric signals, i.e. ECG signals
• CPC Class Codes: A61B 6/12 Arrangements for detecting or locating foreign bodies
• CPC Class Codes: A61B 6/487 involving fluoroscopy
• CPC Class Codes: A61B 7/00 Instruments for auscultation
• CPC Class Codes: A61B 7/04 Electric stethoscopes microphones, acoustic transducers therefor H04R
• CPC Class Codes: A61N 1/056 Transvascular endocardial electrode systems
• CPC Class Codes: A61N 1/362 Heart stimulators heart defibrillators A61N1/39
• CPC Class Codes: A61N 1/36564 controlled by blood pressure
• 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

An implantable medical device that includes a first elongated lead body having an outer surface and an opening along the outer surface, a sensor positioned along the lead body and configured to receive acoustic signals through the opening of the first lead body and generate an electrical signal representative of sounds produced at a targeted location along a patient'"'"'s cardiovascular system. A therapy delivery module is capable of delivering a cardiac therapy via predetermined electrodes of a plurality of electrodes, and a processor is configured to detect a cardiac event in response to the sensed cardiac electrical signals, determine a plurality of time intervals between the electrical signals and acoustic signals, determine a correlation between the electrical signals and the acoustic signals, and control the therapy delivery module to deliver therapy in response to the determined correlation.

Claims

1. A medical device, comprising:

a first elongated lead body having an outer surface and an opening along the outer surface;

a first sensor positioned along the lead body and configured to receive acoustic signals through the opening of the first lead body and generate an electrical signal representative of sounds produced at a targeted location along a patient'"'"'s cardiovascular system;

a plurality of electrodes for sensing cardiac electrical signals;

a therapy delivery module for delivering a cardiac therapy via predetermined electrodes of the plurality of electrodes; and

a processor configured to;

detect a plurality of first cardiac events in response to the sensed cardiac electrical signals,

detect a plurality of second cardiac events in response to the acoustic signals;

determine a first plurality of time intervals between the plurality of first cardiac events and the plurality of second cardiac events,

determine a first correlation between the plurality of first cardiac events and the plurality of second cardiac events in response to the first plurality of time intervals,

responsive to the plurality of first cardiac events and the plurality of second cardiac events being correlated, detect a plurality of third cardiac events and a plurality of fourth cardiac events, wherein at least one of the plurality of third cardiac events and the plurality of fourth cardiac events are detected from the acoustic signals;

determine a second plurality of time intervals between the plurality of third cardiac events and the plurality of fourth cardiac events;

determine a second correlation between the plurality of third cardiac events and the plurality of fourth cardiac events in response to the second plurality of time intervals, and

control the therapy delivery module to deliver therapy in response to the determined second correlation.

2. The medical device of claim 1, wherein the first sensor comprises a hydrophone and the outer surface of the first lead body comprises a shaped contour for directing the opening for receiving the sounds from a direction of the first targeted location.

3. The medical device of claim 1, wherein the first sensor comprises a hydrophone and the cardiac electrical signals comprise atrial electrical signal events, and wherein the processor is configured to determine the second plurality of time intervals between the atrial electrical signal events and acoustic signal events, determine the second correlation between the atrial electrical signal events and the acoustic signal events, and control the therapy delivery module to withhold a tachyarrhythmia therapy in response to the determined second correlation.

4. The medical device of claim 1, further comprising:

a second elongated lead body having an outer surface and an opening along the outer surface; and

a second sensor positioned along the second lead body and configured to receive acoustic signals through the opening of the second lead body and generate an electrical signal representative of sounds produced at a second targeted location along a patient'"'"'s cardiovascular system, wherein the first targeted location corresponds to a first heart chamber and the second targeted location corresponds to a second heart chamber different than the first heart chamber, and wherein the processor is configured to detect the plurality of second cardiac events in response to features of the acoustic signals from the first sensor and detect at least one of the plurality of third cardiac events and the plurality of the fourth cardiac events in response to features of the acoustic signals from the second sensor.

5. The medical device of claim 4, wherein the processor is further configured to determine the first plurality of time intervals between the first cardiac events detected from the cardiac electrical signal and the second cardiac events detected from acoustical signals from one of the first sensor and the second sensor, and, responsive to the determined first plurality of time intervals being outside a predetermined time interval range, adjusting a time interval controlling delivery of therapy via the therapy delivery module.

6. The medical device of claim 5, wherein the processor is further configured to

determine the second plurality of time intervals between the plurality of third cardiac events detected from the first sensor and the plurality of fourth cardiac events detected from the second sensor;

and

responsive to the determined second plurality of time intervals being outside a predetermined time interval range, adjusting a time interval controlling delivery of therapy via the therapy delivery module.

7. The medical device of claim 1, wherein the outer surface of the lead body comprises a shaped contour for directing the opening for receiving the acoustic signals from a direction of the targeted location.

8. The medical device of claim 1, wherein the sensor comprises a hydrophone, the hydrophone comprising a plurality of transducers each responsive to a distinct sound frequency range and generating an electrical signal representative of sounds produced at the targeted location in the respective distinct sound frequency range.

9. The medical device of claim 8, wherein the plurality of transducers comprises a piezoelectric transducer having an associated piezoelectric axis, the axis aligned in a direction corresponding to an origination direction corresponding to the targeted location when the first lead body is positioned in the patient'"'"'s body.

10. The medical device of claim 1, further comprising a second sensor positioned along the lead body and configured to receive acoustic signals, wherein the elongated body comprises:

a proximal end, a distal end, an outer side extending between the proximal end and the distal end, and a J-shaped bend near the distal end,

a first opening distal to the J-shaped bend of the elongated body;

a second opening along the outer side proximal to the J-shaped bend; and

at least one recessed surface along the outer surface of the lead body and one of the first opening and the second opening extending along the recessed surface, and wherein the first sensor is positioned along the first opening and the second sensor is positioned along the second opening.

11. A method for determining a cardiac condition in a medical device, comprising:

positioning a first elongated lead body at a targeted location along a patient'"'"'s cardiovascular system, the first elongated lead body comprising an outer surface and an opening along the outer surface and a first sensor positioned along the lead body and configured to receive acoustic signals through the opening of the first lead body;

sensing cardiac electrical signals via a plurality of electrodes;

detecting a plurality of first cardiac events in response to the sensed cardiac electrical signals;

detecting a plurality of second cardiac events in response to the acoustic signals;

determining a first plurality of time intervals between the plurality of first cardiac events and the plurality of second cardiac events;

determining a first correlation between the plurality of first cardiac events and the plurality of second cardiac events in response to the first plurality of time intervals;

responsive to the plurality of first cardiac events and the plurality of second cardiac events being correlated, detecting a plurality of third cardiac events and a plurality of fourth cardiac events, wherein at least one of the plurality of third cardiac events and the plurality of fourth cardiac events are detected from the acoustic signals;

determining a second plurality of time intervals between the plurality of third cardiac events and the plurality of fourth cardiac events;

determining a second correlation between the plurality of third cardiac events and the plurality of fourth cardiac events in response to the second plurality of time intervals, and

controlling delivery of therapy by the device in response to the determined second correlation.

12. The method of claim 11, wherein the first sensor comprises a hydrophone and is positioned along a first targeted location, and the outer surface of the first lead body comprises a shaped contour for directing the opening for receiving the sounds from a direction of the first targeted location.

13. The method of claim 11, wherein the first sensor comprises a hydrophone and the cardiac electrical signals comprise atrial electrical signal events,

wherein determining the second plurality of time intervals comprises determining time intervals between the atrial electrical signal events and acoustic signal events;

determining the second correlation comprises determining a correlation between the atrial electrical signal events and the acoustic signal events; and

controlling the delivery of therapy comprises withholding a tachyarrhythmia therapy in response to the determined second correlation.

14. The method of claim 11, further comprising:

positioning a second elongated lead body at a second targeted location along a patient'"'"'s cardiovascular system, the second elongated lead body comprising an outer surface and an opening along the outer surface and a second sensor positioned along the second lead body and configured to receive acoustic signals through the opening of the second lead body, wherein the first targeted location corresponds to a first heart chamber and the second targeted location corresponds to a second heart chamber different than the first heart chamber;

detecting the plurality of second cardiac events in response to features of the acoustic signals from the first sensor; and

detecting at least one of the plurality third cardiac events and the plurality of fourth cardiac events in response to features of the acoustic signals from the second sensor.

15. The method of claim 14, further comprising:

determining the first plurality of time intervals between the plurality of first cardiac events from the cardiac electrical signals and the plurality of second cardiac events detected from acoustical signals from one of the first sensor and the second sensor; and

responsive to the determined first plurality of time intervals being outside a predetermined time interval range, adjusting a time interval controlling delivery of therapy by the device.

16. The method of claim 15, further comprising:

determining the second plurality of time intervals between the plurality of third cardiac events detected from the first sensor and the plurality of fourth cardiac events detected from the second sensor; and

,

responsive to the determined second plurality of time intervals being outside a predetermined time interval range, adjusting a time interval controlling delivery of therapy via the therapy delivery module.

17. The method of claim 11, wherein the outer surface of the lead body comprises a shaped contour for directing the opening for receiving the acoustic signals from a direction of the targeted location.

18. The method of claim 11, wherein the sensor comprises a hydrophone, the hydrophone comprising a plurality of transducers each responsive to a distinct sound frequency range and generating an electrical signal representative of sounds produced at the targeted location in the respective distinct sound frequency range.

19. The method of claim 18, wherein the plurality of transducers comprises a piezoelectric transducer having an associated piezoelectric axis, the axis aligned in a direction corresponding to an origination direction corresponding to the targeted location when the lead body is implanted in the patient'"'"'s body.

20. A non-transitory computer readable medium having computer executable instructions for performing a method, the method comprising:

positioning a first elongated lead body at a targeted location along a patient'"'"'s cardiovascular system, the first elongated lead body comprising an outer surface and an opening along the outer surface and a first sensor positioned along the lead body and configured to receive acoustic signals through the opening of the first lead body;

sensing cardiac electrical signals via a plurality of electrodes;

detecting a plurality of first cardiac events in response to the sensed cardiac electrical signals;

detecting a plurality of second cardiac events in response to the acoustic signals;

determining a first plurality of time intervals between the plurality of first cardiac events and the plurality of second cardiac events;

determining a first correlation between the plurality of first cardiac events and the plurality of second cardiac events in response to the first plurality of time intervals;

responsive to the plurality of first cardiac events and the plurality of second cardiac events being correlated, detecting a plurality of third cardiac events and a plurality of fourth cardiac events, wherein at least one of the plurality of third cardiac events and the plurality of fourth cardiac events are detected from the acoustic signals;

determining a second plurality of time intervals between the plurality of third cardiac events and the plurality of fourth cardiac events;

determining a second correlation between the plurality of third cardiac events and the plurality of fourth cardiac events in response to the second plurality of time intervals, and

controlling delivery of therapy by the device in response to the determined second correlation.