Method and apparatus for cardiac function monitoring

• US 9,675,315 B2
• Filed: 03/12/2013
• Issued: 06/13/2017
• 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): Mallari, Patricia
• Assistant Examiner(s): WEARE, MEREDITH H
• Application Number:
  US13/794,973
• Publication Number:
  US 20130289379A1
• Time in Patent Office: 1,554 Days
• 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 an elongated lead body having an outer surface and a first opening along the outer surface, a first sensor positioned along the lead body and configured to receive first acoustic signals through the first opening of the lead body and generate an electrical signal representative of sounds produced at a first targeted location along a patient'"'"'s cardiovascular system, and a processor configured to determine an intensity of the first acoustic signals, and determine changes in blood pressure in response to the determined intensity.

Claims

1. A medical device, comprising:

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

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

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

a plurality of electrodes carried by the elongated lead body;

a therapy delivery module configured to be coupled to the plurality of electrodes; and

a processor configured to;

detect a change in an intensity of the first acoustic signals,

monitor the second acoustic signals in response to detecting the change in intensity of the first acoustic signals;

determine changes in blood pressure in response to the change in intensity of the first acoustic signals and the monitored second acoustic signals, and

control the therapy delivery module in response to determining a change in blood pressure.

2. The medical device of claim 1, wherein the first sensor comprises a plurality of transducers each responsive to one of a plurality of frequency ranges of the first acoustic signals;

and

the processor is further configured to;

determine an intensity of the first acoustic signals by determining whether there is an increase in the intensity of a selected one of the plurality of frequency ranges of the first acoustic signals, and

monitor the second acoustic signals in response to detecting the increase in intensity of the selected one of the plurality of frequency ranges.

3. The medical device of claim 2, wherein the processor is configured to control the therapy delivery module to deliver a neurostimulation therapy via the plurality of electrodes in response to the determined changes in blood pressure to cause vasodilation.

4. The medical device of claim 3, wherein the first targeted location comprises a heart valve and the processor is configured to select the one of the plurality of frequency ranges as a frequency specific to closure of the heart valve.

5. The medical device of claim 1, wherein, the processor is further configured to:

detect an increase in intensity of the first acoustic signals;

monitor the second acoustic signals by determining changes in the second acoustic signals in response to detecting the increase in intensity of the first acoustic signals; and

determine changes in blood pressure in response to the determined changes in the second acoustic signals.

6. The medical device of claim 5, wherein the first targeted location comprises a heart valve and the second targeted location comprises an artery.

7. The medical device of claim 6, wherein the processor is configured to determine whether an increased intensity of the first acoustic signals corresponding to valve closure is occurring, and determine changes in blood pressure by determining whether an intensity of the second acoustic signals increases greater than an intensity threshold in response to determining an increase in intensity of the first acoustic signals corresponding to valve closure.

8. The medical device of claim 7, wherein the processor is configured to control the therapy delivery module to deliver the therapy via the plurality of electrodes in response to determining increased intensity of the second acoustic signals greater than the intensity threshold.

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

determine the changes in blood pressure in response to the determined changes in the second acoustic signals by determining at least one frequency component of the second acoustic signals;

determine a blood flow velocity correlated to the frequency component; and

determine an arterial blood pressure in response to the blood flow velocity.

10. The medical device of claim 5, wherein the first sensor comprises a first plurality of transducers each responsive to a distinct sound frequency range and generating an electrical signal representative of sounds produced at the first targeted location in the respective distinct sound frequency range and the second sensor comprises a second plurality of transducers each responsive to a distinct sound frequency range and generating an electrical signal representative of sounds produced at the second targeted location in the respective distinct sound frequency range, wherein a transducer of the first plurality of transducers comprises an associated first piezoelectric axis, the first piezoelectric axis aligned in a direction corresponding to an origination direction corresponding to the first targeted location and a transducer of the second plurality of transducers comprises an associated second piezoelectric axis, the second piezoelectric axis aligned in a direction corresponding to an origination direction corresponding to the second targeted location;

wherein the processor is configured to determine the changes in the second acoustic signals by examining at least one of the second plurality of transducer sound frequency ranges for evidence of increased arterial blood flow velocity.

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

sensing first acoustic signals produced at a first targeted location along a patient'"'"'s cardiovascular system via a first sensor positioned along an elongated lead body, the lead body comprising an outer surface and a first opening along the outer surface for receiving the first acoustic signals by the first sensor from the first targeted location;

sensing second acoustic signals produced at a second targeted location along the patient'"'"'s cardiovascular system different than the first targeted location via a second sensor positioned along the elongated lead body, the lead body comprising a second opening along the outer surface for receiving the second acoustic signals by the second sensor from the second targeted location;

detecting by a processor of the medical device a change in an intensity of the first acoustic signals;

monitoring the second acoustic signals in response to the detected change in intensity of the first acoustic signals;

determining changes in blood pressure in response to the intensity of the first acoustic signals and the monitored second acoustic signals; and

controlling a therapy delivery module in response to determining a change in blood pressure.

12. The method of claim 11, further comprising:

determining by the processor whether there is an increase in the intensity of a selected one of a plurality of frequency ranges of the first acoustic signals; and

monitoring by the processor the second acoustic signals in response to detecting the increase in intensity of the selected one of the plurality of frequency ranges.

13. The method of claim 12, wherein the first targeted location comprises a heart valve and determining whether there is an increase in the intensity of the selected one of the plurality of frequency ranges comprises selecting the one of the plurality of frequency ranges as a frequency specific to closure of the heart valve.

14. The method of claim 11, wherein delivering the therapy comprises delivering a neurostimulation therapy via the plurality of electrodes in response to the determined changes in blood pressure to cause vasodilation.

15. The method of claim 11, further comprising:

detecting by the processor an increase in intensity of the first acoustic signals;

monitoring by the processor the second acoustic signals by determining changes in the second acoustic signals in response to detecting the increase in intensity of the first acoustic signals; and

determining changes in blood pressure in response to the determined changes in the second acoustic signals.

16. The method of claim 15, wherein:

the first targeted location comprises a heart valve and detecting an increase in intensity of the first acoustic signals comprises detecting an increase in intensity of a valve sound; and

the second targeted location comprises an artery and monitoring the second acoustic signals comprises monitoring an arterial blood flow sound.

17. The method of claim 16, further comprising:

determining whether an increased intensity of the first acoustic signals corresponding to valve closure is occurring; and

determining changes in blood pressure by determining whether an intensity of the second acoustic signal increases greater than an intensity threshold in response to determining an increase in intensity of the first acoustic signals corresponding to valve closure.

18. The method of claim 17, further comprising delivering the therapy via the plurality of electrodes in response to determining increased intensity of the second acoustic signals greater than the intensity threshold.

19. The method of claim 15, further comprising;

determining the changes in blood pressure in response to the determined changes in the second acoustic signals by determining at least one frequency component of the second acoustic signals;

determining a blood flow velocity correlated to the frequency component; and

determining an arterial blood pressure in response to the blood flow velocity.

20. The method of claim 15, wherein the first sensor comprises a first 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 and the second sensor comprises a second 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, wherein a transducer of the first plurality of transducers comprises an associated first piezoelectric axis, the first piezoelectric axis aligned in a direction corresponding to an origination direction corresponding to the first targeted location and a transducer of the second plurality of transducers comprises an associated second piezoelectric axis, the second piezoelectric axis aligned in a direction corresponding to an origination direction corresponding to the second targeted location,

wherein determining the changes in the second acoustic signals comprises examining at least one of the second plurality of transducer sound frequency ranges for evidence of increased arterial blood flow velocity.

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

sensing first acoustic signals produced at a first targeted location along a patient'"'"'s cardiovascular system via a first sensor positioned along an elongated lead body, the lead body comprising an outer surface and a first opening along the outer surface for receiving the first acoustic signals by the first sensor from the first targeted location;

sensing second acoustic signals produced at a second targeted location along the patient'"'"'s cardiovascular system different than the first targeted location via a second sensor positioned along the elongated lead body, the lead body comprising a second opening along the outer surface for receiving the second acoustic signals by the second sensor from the second targeted location;

determining a change in an intensity of the first acoustic signals;

monitoring the second acoustic signals in response to detecting the change in the intensity of the first acoustic signals;

determining changes in blood pressure in response to the intensity of the first acoustic signals and the monitored second acoustic signals; and

controlling a therapy delivery module in response to determining a change in blood pressure.