Physiological vibration detection in an implanted medical device

• US 8,934,970 B2
• Filed: 10/28/2013
• Issued: 01/13/2015
• Est. Priority Date: 07/15/2009
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Ternes, David J., Siejko, Krzysztof Z., Ruble, Stephen B., Hamann, Jason J.
• Primary Examiner(s): Holmes, Rex R
• Application Number:
  US14/064,920
• Publication Number:
  US 20140052209A1
• Time in Patent Office: 442 Days
• Field of Search: 600/529, 600/532, 600/533, 600/538, 600/539, 600/586, 607/2, 607/7, 607/9, 607/27, 607/28, 607/42, 607/62, 607/66
• US Class Current: 607/9
• CPC Class Codes: A61B 2562/0219 Inertial sensors, e.g. accelerometers, gyroscopes, tilt switches
• CPC Class Codes: A61B 5/024 Detecting, measuring or recording pulse rate or heart rate A61B5/0205, A61B5/021 take precedence
• CPC Class Codes: A61B 5/02405 Determining heart rate variability
• CPC Class Codes: A61B 5/349 Detecting specific parameters of the electrocardiograph cycle
• CPC Class Codes: A61B 5/352 Detecting R peaks, e.g. for synchronising diagnostic apparatus; Estimating R-R interval
• CPC Class Codes: A61B 5/363 Detecting tachycardia or bradycardia
• CPC Class Codes: A61B 7/00 Instruments for auscultation
• CPC Class Codes: A61B 7/003 Detecting lung or respiration noise
• CPC Class Codes: A61B 7/04 Electric stethoscopes microphones, acoustic transducers therefor H04R
• CPC Class Codes: A61N 1/3601 of respiratory organs
• CPC Class Codes: A61N 1/36114 Cardiac control, e.g. by vagal stimulation stimulating the heart A61N1/362
• CPC Class Codes: A61N 1/36117 for treating hypertension
• 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 embodiment of an implantable system configured to be implanted in a patient includes an accelerometer, a neural stimulator, and a controller. The neural stimulator is configured to deliver neural stimulation to a neural target. The controller is configured to use the accelerometer to detect laryngeal vibration or coughing, and is configured to deliver a programmed neural stimulation therapy using the neural stimulator and using detected laryngeal vibration or detected coughing as an input to the programmed neural stimulation therapy.

Claims

1. An implantable system configured to be implanted in a patient, comprising:

an accelerometer;

a neural stimulator configured to deliver neural stimulation to a neural target; and

a controller configured to use the accelerometer to detect laryngeal vibration and to also use the accelerometer to detect at least one of heart sounds or respiration, and configured to deliver a programmed neural stimulation therapy using the neural stimulator and using at least detected laryngeal vibration as an input to the programmed neural stimulation therapy.

2. The system of claim 1, wherein the controller is configured to use the accelerometer to detect laryngeal vibration, to detect heart sounds, and to detect respiration.

3. The system of claim 2, wherein the controller s configured to compensate for heart sounds when detecting respiration.

4. The system of claim 1, wherein the controller is configured to use the accelerometer to detect respiration to detect a respiratory event.

5. The system of claim 4, wherein the controller is configured to use the detected respiratory event to control the programmed neural stimulation therapy.

6. The system of claim 4, wherein the controller is configured to use the detected respiratory event to determine respiration diagnostics for the programmed neural stimulation therapy.

7. The system of claim 1, wherein the controller is configured to use the accelerometer to detect a respiratory rate.

8. The system of claim 7, wherein the controller is configured to use the detected respiratory rate to control the programmed neural stimulation therapy.

9. The system of claim 7, wherein the controller is configured to use the detected respiratory rate to determine respiration diagnostics for the programmed neural stimulation therapy.

10. The system of claim 1, wherein the controller is configured to use the accelerometer to detect respiration to detect apnea.

11. The system of claim 10, wherein the controller is configured to use the detected apnea to control the programmed neural stimulation therapy.

12. The system of claim 10, wherein the controller is configured to use the detected apnea to determine respiration diagnostics for the programmed neural stimulation therapy.

13. A method, comprising:

using an accelerometer to detect laryngeal vibration and to also detect at least one of heart sounds or respiration; and

delivering a programmed neural stimulation therapy using a neural stimulator and using at least detected laryngeal vibration as an input to the programmed neural stimulation therapy.

14. The method of claim 13, wherein:

using the accelerometer includes using the accelerometer to detect laryngeal vibration, heart sounds, and respiration; and

the method further comprises compensating for heart sounds when detecting respiration.

15. The method of claim 13, wherein using the accelerometer includes using the accelerometer to detect a respiratory event, the method further comprising using the detected respiratory event to:

control the programmed neural stimulation therapy or determine respiration diagnostics for the programmed neural stimulation therapy.

16. The method of claim 13, wherein using the accelerometer includes using the accelerometer to detect respiration to detect a respiratory rate, the method further comprising using the detected respiratory rate to:

control the programmed neural stimulation therapy or determine respiration diagnostics for the programmed neural stimulation therapy.

17. The method of claim 13, wherein using the accelerometer includes using the accelerometer to detect respiration to detect apnea, the method further comprising using the detected apnea to:

control the programmed neural stimulation therapy or determine respiration diagnostics for the programmed neural stimulation therapy.

18. An implantable system configured to be implanted in a patient, comprising:

an accelerometer;

a neural stimulator configured to deliver neural stimulation to a neural target; and

a controller configured to use the accelerometer to detect laryngeal vibration, and configured to deliver a programmed neural stimulation therapy using the neural stimulator and using detected laryngeal vibration as an input to the programmed neural stimulation therapy, and

wherein the controller is configured to use the accelerometer to detect cough, to deliver the neural stimulation with a programmed duty cycle including a stimulation ON portion and a stimulation OFF portion, to monitor an accelerometer signal for a cough during the ON portion, and to titrate the neural stimulation therapy if the cough occurs during the ON portion of the neural stimulation therapy.

19. The system of claim 18, wherein the neural stimulator is configured to deliver the neural stimulation at a neural stimulation frequency, and the system is configured to use the accelerometer to detect laryngeal vibration modulated at the neural stimulation frequency.

20. The system of claim 19, wherein the controller is further configured to monitor for laryngeal vibration after each neural stimulation pulse during the stimulation ON portion, and to titrate the neural stimulation therapy if laryngeal vibration occurs more than a threshold number of times during the stimulation ON portion, wherein the controller is configured to adjust an intensity of the neural stimulation therapy to a level where laryngeal vibration is detected and cough is not detected.