Systems and methods for multi-axis cardiac vibration measurements

• US 7,424,321 B2
• Filed: 05/24/2005
• Issued: 09/09/2008
• Est. Priority Date: 05/24/2005
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Wariar, Ramesh, Carlson, Gerrard M., Stahmann, Jeffrey E., Siejko, Krzysztof Z.
• Primary Examiner(s): Layno; Carl H.
• Assistant Examiner(s): Heller; Tammie K.
• Application Number:
  US11/135,985
• Publication Number:
  US 20060270939A1
• Time in Patent Office: 1,204 Days
• Field of Search: 600/493, 600/514, 600/528, 600/586, 607/17, 607/18
• US Class Current: 600/514
• CPC Class Codes: A61B 7/00 Instruments for auscultation
• CPC Class Codes: A61B 7/04 Electric stethoscopes microphones, acoustic transducers therefor H04R

Abstract

A system to monitor heart sounds, such as to detect a worsening condition of heart failure decompensation. The system comprises a medical device that includes an implantable multi-axis heart sound sensor, operable to produce, for each of at least two nonparallel axes, an electrical signal representative of at least one heart sound, the heart sound associated with mechanical activity of a patient'"'"'s heart. The device further includes a controller circuit coupled to the heart sound sensor. The controller circuit measures components of the heart sound that respectively correspond to each of the axes.

Claims

1. A system comprising:

a medical device including;

at least one implantable multi-axis heart sound sensor, configured to produce a first electrical signal and a second electrical signal representative of respective components for respective first and second non-parallel axes of at least one heart sound, the heart sound associated with mechanical activity of a patient'"'"'s heart; and

a controller circuit, coupled to the heart sound sensor, the controller circuit configured to;

measure components of the heart sound that respectively correspond to each of the axes;

use the components to produce a heart sound vector representative of the heart sound, wherein the heart sound vector includes heart sound magnitude and heart sound directional information; and

use the heart sound directional information to provide a physiological diagnostic indication.

2. The system of claim 1, the medical device further including a storage circuit coupled to the controller circuit, the storage circuit operable to store, for each of the first and second axes, information representative of the measured component of the heart sound corresponding to that one of the first and second axes.

3. The system of claim 1, further including a heart sound sensor interface circuit, coupled to the heart sound sensor, the heart sound sensor interface circuit including signal processing circuitry corresponding to each of the first and second axes for processing the corresponding electrical signal.

4. The system of claim 3, wherein the signal processing circuitry includes filter circuits to remove components of the electrical signals associated with breathing sounds.

5. The system of claim 1, wherein the multi-axis heart sound sensor is operable to produce first, second, and third electrical signals representative of respective components of the heart sound for respective orthogonal first, second, and third axes, and wherein the controller circuit is operable to measure components of the heart sound that respectively correspond to each of the respective orthogonal first, second, and third axes.

6. The system of claim 1, wherein the controller circuit is operable to combine the first, second, and third electrical signals together to produce a heart sound vector including heart sound directional information.

7. The system of claim 1, wherein the multi-axis heart sound sensor includes a multi-axis accelerometer.

8. The system of claim 7, wherein at least one axis of the multi-axis heart sound sensor produces an electrical signal indicative of the patient'"'"'s physical activity.

9. The system of claim 1, wherein the medical device further includes a communication circuit, wherein the system further includes a second device operable to communicate with the medical device to obtain multi-axis heart sound information, and wherein the second device is in communication with a computer network.

10. The system of claim 1, wherein the medical device further includes a communication circuit and wherein the system further includes a second device operable to communicate with the medical device, wherein the second device includes a display, and wherein the second device is operable to display the multi-axis heart sound information in relation to at least one of the axes.

11. The system of claim 10, wherein the second device is operable to display trending over time of the multi-axis heart sound information.

12. The system of claim 11, wherein the trending is combined with one or more measurements of one or more other physiologic sensors to form a single decision as to whether to generate an alarm.

13. The system of claim 11, wherein the second device is operable to perform signal processing on the multi-axis heart sound information prior to trending and to display processed heart sound information.

14. The system of claim 10, wherein the medical device is operable to communicate an alarm indicating heart failure decompensation.

15. The system of claim 1, wherein the controller circuit is operable to measure components of the heart sound using an average of electrical signals.

16. The system of claim 1, wherein the controller circuit is operable to measure components of the heart sound using an ordering of electrical signals.

17. The system of claim 1, wherein the controller circuit is further operable to deem that heart failure decompensation occurred when an amplitude of the measured component of the heart sounds exceeds a threshold amplitude and wherein the controller circuit is operable to provide an indication of the heart failure decompensation.

18. The system of claim 1, wherein the physiological diagnostic indication includes an indication of a change in heart contractility.

19. The system of claim 1, wherein the physiological diagnostic indication includes an indication of heart failure decompensation.

20. The system of claim 1, wherein the implantable medical device further includes a communication circuit and wherein the system further includes a second device configured to communicate with the medical device, wherein the second device is configured to trend a heart sound vector, including the directional information, to detect an indication of heart failure.

21. A method comprising:

sensing at least one heart sound, which is representative of mechanical activity of a patient'"'"'s heart, along first and second nonparallel axes, the sensing including using an implantable medical device and producing a first electrical signal and a second electrical signal representative of respective components for the respective first and second non-parallel axes;

measuring components of the heart sound that respectively correspond to each of the axes;

using the components to produce a vector representative of the heart sound, wherein the heart sound vector includes heart sound magnitude and heart sound directional information; and

using the heart sound directional information to provide a physiological diagnostic indication.

22. The method of claim 21, wherein sensing at least one heart sound includes sensing first, second, and third electrical signals representative of respective components of the heart sound for respective orthogonal first, second, and third axes.

23. The method of claim 22, further including combining the first, second, and third electrical signals to determine a heart sound vector.

24. The method of claim 21, further including communicating information about the measured components in correspondence with the axes to an external device.

25. The method of claim 24, further including displaying on the external device information about the components of the multi-axis heart sound measurement.

26. The method of claim 21, further including storing trending information about the components of the heart sound.

27. The method of claim 21, further including displaying the trending information.

28. The method of claim 21, further including monitoring a heart rate, and wherein the measuring the components of the heart sound includes measuring the components of the heart sound when the heart rate is below a predetermined heart rate threshold value.

29. The method of claim 21, further including determining a posture of the patient, and wherein the measuring the components of the heart sound includes measuring the components of the heart sound contingent on or corresponding to a specified posture.

30. The method of claim 21, further including determining a time of day, and wherein the measuring the heart sound includes measuring the heart sound according to the time of day.

31. The method of claim 21, further including sensing a heart depolarization event using an implantable cardiac signal sensing circuit, and wherein the measuring the heart sound includes measuring the heart sound in correspondence with a sensed heart depolarization event.

32. The method of claim 21, further including:

predicting heart failure decompensation of the patient using the measured components of the heart sound; and

providing an indication of the heart failure decompensation.

33. The method of claim 32, wherein predicting heart failure decompensation includes detecting that an amplitude of a heart sound exceeds a threshold amplitude.