System and method for detecting tamponade

• US 10,159,842 B2
• Filed: 08/23/2016
• Issued: 12/25/2018
• Est. Priority Date: 08/28/2015
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Kane, Michael J., Shuros, Allan Charles, Schmidt, Brian L., Maile, Keith R., Haasl, Benjamin J.
• Primary Examiner(s): Lee, Erica
• Application Number:
  US15/244,571
• Publication Number:
  US 20170056671A1
• Time in Patent Office: 854 Days
• Field of Search: None
• CPC Class Codes: A61B 2562/0219 Inertial sensors, e.g. accelerometers, gyroscopes, tilt switches
• CPC Class Codes: A61B 5/0031 Implanted circuitry
• CPC Class Codes: A61B 5/02028 Determining haemodynamic parameters not otherwise provided for, e.g. cardiac contractility or left ventricular ejection fraction
• 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 5/029 Measuring or recording blood output from the heart, e.g. minute volume A61B8/065 takes precedence
• 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 5/6869 Heart
• CPC Class Codes: A61N 1/057 Anchoring means; Means for fixing the head inside the heart
• CPC Class Codes: A61N 1/3704 Circuits specially adapted therefor, e.g. for sensitivity control
• CPC Class Codes: A61N 1/3756 Casings with electrodes thereon, e.g. leadless stimulators

Abstract

Systems, methods, and devices for determining occurrences of a tamponade condition are disclosed. One exemplary method includes monitoring an accelerometer signal of a leadless cardiac pacemaker attached to a heart wall, determining if a tamponade condition of the patient'"'"'s heart is indicated based at least in part on the monitored accelerometer signal, and in response to determining that the tamponade condition is indicated, providing a notification of the tamponade condition for use by a physician to take corrective action.

Claims

1. A method for detecting a tamponade condition of a patient'"'"'s heart after attachment of a leadless cardiac pacemaker to the patient'"'"'s heart, the leadless cardiac pacemaker having an accelerometer that produces an accelerometer signal, the method comprising:

monitoring the accelerometer signal of the leadless cardiac pacemaker;

determining if a tamponade condition of the patient'"'"'s heart is indicated based at least in part on the monitored accelerometer signal, including;

identifying a characteristic of the accelerometer signal;

determining if the identified characteristic diminishes over time; and

determining that the tamponade condition is indicated if the identified characteristics of the accelerometer signal diminishes over time; and

in response to determining that the tamponade condition is indicated, providing a notification of the tamponade condition for use by a physician to take corrective action.

2. The method of claim 1, wherein the identified characteristic comprises a peak amplitude of the accelerometer signal.

3. The method of claim 1 wherein the identified characteristic comprises a peak amplitude of an integral of the accelerometer signal.

4. The method of claim 1, wherein the accelerometer signal represents one axis of a multi-axis accelerometer.

5. The method of claim 1, wherein the accelerometer signal represents a summed signal of all axes of a multi-axis accelerometer.

6. The method of claim 1, wherein determining if the identified characteristic diminishes over time comprises determining if the identified characteristic falls below a predetermined threshold.

7. The method of claim 1, wherein the leadless cardiac pacemaker performs the monitoring, determining and providing steps.

8. The method of claim 1, wherein the leadless cardiac pacemaker performs the monitoring step.

9. The method of claim 1, wherein an external device programmer performs one or more of the monitoring, determining and providing steps.

10. The method of claim 1, wherein providing the notification comprises communicating a message from the leadless cardiac pacemaker for reception by an external device programmer.

11. A leadless cardiac pacemaker for use in pacing a patient'"'"'s heart, comprising:

a plurality of electrodes;

an accelerometer for providing an accelerometer signal;

a controller operatively coupled to the plurality of electrodes and the accelerometer, the controller configured to;

monitor the accelerometer signal of the accelerometer over time;

determine if a tamponade condition of the patient'"'"'s heart is indicated based at least in part on the monitored accelerometer signal, including;

identifying a characteristic of the accelerometer signal;

determining if the identified characteristic diminishes over time; and

determining that the tamponade condition is indicated if the identified characteristic of the accelerometer signal diminishes over time; and

in response to determining that the tamponade condition is indicated, communicate a notification of the tamponade condition for use by a physician to take corrective action.

12. The leadless cardiac pacemaker of claim 11, wherein the notification of the tamponade condition is communicated using two or more of the plurality of electrodes of the leadless cardiac pacemaker.

13. The leadless cardiac pacemaker of claim 11, wherein the identified characteristic comprises a peak amplitude of the accelerometer signal.

14. The leadless cardiac pacemaker of claim 11, wherein the identified characteristic comprises a peak amplitude of an integral of the accelerometer signal.

15. A leadless cardiac pacemaker, comprising:

a plurality of electrodes;

an accelerometer for providing an accelerometer signal;

a controller operatively coupled to the plurality of electrodes and the accelerometer, the controller configured to;

monitor an indication of a range of physical motion of a patient'"'"'s heart over time using the accelerometer signal;

determine if the indication of the range of physical motion of the patient'"'"'s heart reduces over time by at least a predefined amount; and

if it is determined that the indication of the range of physical motion of the patient'"'"'s heart has reduced over time by at least the predefined amount, communicate a notification of a possible tamponade condition for reception by a remote device that is remote from the leadless cardiac pacemaker.

16. The leadless cardiac pacemaker of claim 15, wherein the controller is further configured to monitor a heart rate of the patient'"'"'s heart over time and to determine if the heart rate increases over time by at least a predetermined heart rate amount.

17. The leadless cardiac pacemaker of claim 16, wherein the controller only communicates a notification of the possible tamponade condition if it is determined that the indication of the range of physical motion of the patient'"'"'s heart has reduced over time by at least the predefined amount and the heart rate of the patient'"'"'s heart has increased over time by at least the predetermined heart rate amount.

18. The leadless cardiac pacemaker of claim 15, wherein the notification of the possible tamponade condition is communicated using two or more of the plurality of electrodes of the leadless cardiac pacemaker.