Temporal configuration of a motion sensor in an implantable medical device

• US 9,956,414 B2
• Filed: 08/22/2016
• Issued: 05/01/2018
• Est. Priority Date: 08/27/2015
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Kane, Michael J., Linder, William J., Haasl, Benjamin J., Huelskamp, Paul, Maile, Keith R., Balczewski, Ron A., Mi, Bin, Hatlestad, John D., Shuros, Allan Charles
• Primary Examiner(s): Gedeon, Brian T
• Application Number:
  US15/243,524
• Publication Number:
  US 20170056665A1
• Time in Patent Office: 617 Days
• Field of Search: None
• CPC Class Codes: A61B 2562/0219 Inertial sensors, e.g. accelerometers, gyroscopes, tilt switches
• CPC Class Codes: A61B 5/1107 Measuring contraction of parts of the body, e.g. organ, muscle apparatus for measuring work or force in general G01L
• CPC Class Codes: A61B 5/1118 Determining activity level
• CPC Class Codes: A61B 5/349 Detecting specific parameters of the electrocardiograph cycle
• CPC Class Codes: A61B 5/686 Permanently implanted devices, e.g. pacemakers, other stimulators, biochips A61B5/6861 takes precedence
• CPC Class Codes: A61B 5/6869 Heart
• CPC Class Codes: A61N 1/36542 controlled by body motion, e.g. acceleration
• 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 1/3684 for stimulating the heart at multiple sites of the ventricle or the atrium
• CPC Class Codes: A61N 1/371 Capture, i.e. successful stimulation
• CPC Class Codes: A61N 1/37205 Microstimulators, e.g. implantable through a cannula
• CPC Class Codes: A61N 1/3756 Casings with electrodes thereon, e.g. leadless stimulators

Abstract

Methods and devices for configuring the use of a motion sensor in an implantable cardiac device. The electrical signals of the patient'"'"'s heart are observed and may be correlated to the physical motion of the heart as detected by the motion sensor of the implantable cardiac device in order to facilitate temporal configuration of motion sensor data collection that avoids detecting cardiac motion in favor of overall motion of the patient.

Claims

1. A method of operating a motion sensor in an implantable device (ID) for disposition within the heart of a patient, the ID comprising a motion sensor for detecting movement of the patient, the method comprising:

the ID determining a predefined event has occurred in the heart of the patient; and

the ID waiting a predetermined period of time after the predefined event and sampling an output of the motion sensor.

2. The method of claim 1 further comprising duty cycling the motion sensor to operate in a window corresponding to the sampling step and otherwise be in a low-power state.

3. The method of claim 1 wherein the predefined event is one of an R-wave, a pacing pulse, or a QRS complex, and the predetermined time period is selected to expire prior to occurrence of a P-wave.

4. The method of claim 1 further comprising using the output of the motion sensor to determine whether the patient is physically active to facilitate a rate-responsive pacing therapy by the ID.

5. The method of claim 1 further comprising using the output of the motion sensor to determine an increase or decrease in cardiac contractility to facilitate a rate-responsive pacing therapy by the ID.

6. The method of claim 1 further comprising determining the predetermined period of time by initializing the ID by capturing a plurality of outputs from the motion sensor over a period of time including several heart beats to determine a mechanically quiet period in the patient'"'"'s cardiac cycle relative to the predefined event.

7. The method of claim 1 wherein the predefined event is one of a P-wave, an R-wave, a QRS complex, a T-wave, or a quiescent period.

8. The method of claim 1 wherein the predefined event is delivery of a pacing stimulus.

9. The method of claim 1 further comprising analyzing a cardiac electrical signal of the patient during at least the predetermined period of time to observe whether a specified cardiac electrical event occurs and, if so, discarding the sampled output of the motion sensor.

10. The method of claim 9 wherein the specified cardiac event is a ventricular contraction.

11. An implantable medical device adapted for implantation within the heart of a patient and comprising:

a plurality of electrodes adapted for one or more of sensing electrical cardiac activity and delivering therapy;

a motion sensor for detecting movement of the patient; and

a processing module configured to receive signals from the motion sensor and from the plurality of electrodes to determine patient status, wherein the processing module is configured to enhance the operation of the device by;

determining that a predetermined event has occurred in the heart of the patient; and

waiting a predetermined period of time after the predefined event and sampling an output of the motion sensor after the predetermined period of time has expired.

12. The implantable medical device of claim 11 wherein the processing module is configured to control the motion sensor by duty cycling the motion sensor to operate in a window corresponding to the sampling step and otherwise be in a low-power state.

13. The implantable medical device of claim 11 wherein the processing module is configured such that the predefined event is one of an R-wave, a pacing pulse, or a QRS complex, and the predetermined time period is selected to expire prior to occurrence of a P-wave of a subsequent cardiac cycle.

14. The implantable medical device of claim 11 further comprising a pacing therapy output circuit, wherein the processing module is configured to use the output of the motion sensor to determine whether the patient is physically active and, if so, to facilitate a rate-responsive pacing therapy for delivery by the pacing therapy output circuit.

15. The implantable medical device of claim 11 further comprising a pacing therapy output circuit, wherein the processing module is further configured to use the output of the motion sensor to determine an increase or decrease in cardiac contractility and in response thereto, to facilitate a rate-responsive pacing therapy for delivery by the pacing therapy output circuit.

16. The implantable medical device of claim 11 wherein the processing module is further configured to calculate the predetermined period of time by capturing a plurality of outputs from the motion sensor over a period of time including several heart beats to determine a mechanically quiet period in the patient'"'"'s cardiac cycle relative to the predefined event.

17. The implantable medical device of claim 11 wherein the processing module is further configured such that the predefined event is one of a P-wave, an R-wave, a QRS complex, a T-wave, or a quiescent period.

18. The implantable medical device of claim 11 wherein the predefined event is delivery of a pacing stimulus to the patient'"'"'s heart.

19. The implantable medical device of claim 11 wherein the processing module is further configured to analyze a cardiac electrical signal of the patient during at least the predetermined period of time to observe whether a specified cardiac electrical event occurs and, if so, to discard the sampled output of the motion sensor.

20. The implantable medical device of claim 19 wherein the specified cardiac event is a ventricular contraction.