Determining a patient's posture from mechanical vibrations of the heart

• US 7,559,901 B2
• Filed: 07/28/2004
• Issued: 07/14/2009
• Est. Priority Date: 07/28/2004
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Siejko, Krzysztof Z., Maile, Keith R.
• Primary Examiner(s): BOCKELMAN, MARK
• Application Number:
  US10/900,570
• Publication Number:
  US 20060025699A1
• Time in Patent Office: 1,812 Days
• Field of Search: 600/528, 607 17- 19
• US Class Current: 600/528
• 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 1/36535 controlled by body position or posture
• 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

Abstract

A system for determining a patient'"'"'s posture by monitoring heart sounds. The system comprises an implantable medical device that includes a sensor operable to produce an electrical signal representative of heart sounds, a sensor interface circuit coupled to the sensor to produce a heart sound signal, and a controller circuit coupled to the sensor interface circuit. The heart sounds are associated with mechanical activity of a patient'"'"'s heart and the controller circuit is operable to detect a posture of the patient from a heart sound signal.

Claims

1. A system comprising:

an implantable medical device comprising;

a sensor operable to produce an electrical signal representative of heart sounds, the heart sounds associated with mechanical activity of a patient'"'"'s heart;

a sensor interface circuit coupled to the sensor to produce a heart sound signal; and

a controller circuit, coupled to the sensor interface circuit, wherein the controller circuit is operable to;

discriminate a posture of the patient from among a plurality of postures using the heart sound signal; and

provide an indication of the patient posture to user or process.

2. The system of claim 1, wherein the controller circuit is operable to detect a posture of the patient from change in a frequency spectrum of the heart sound signal.

3. The system of claim 2, wherein the controller circuit is operable to perform a spectral analysis of energy of the heart sound signals to detect the change in the frequency spectrum.

4. The system of claim 3, wherein the spectral analysis includes a fast Fourier transform.

5. The system of claim 1, wherein the controller circuit is operable to detect a posture of the patient from an amplitude of the heart sound signal.

6. The system of claim 5, wherein the sensor interface circuit includes a peak detector circuit, and wherein the controller circuit detects a posture of the patient by detecting a change in amplitude of the heart sound signals using an output of the peak detector circuit.

7. The system of claim 5, wherein the sensor interface circuit includes an analog-to-digital converter to convert the heart sound signal into digital values, and wherein the controller detects a posture of the patient from a change in amplitude of the heart sound signal, and wherein the change in amplitude is determined using the digital values.

8. The system of claim 7, wherein the implantable medical device further includes a memory and the digital values are stored in the memory.

9. The system of claim 1, wherein the implantable medical device further includes a tilt sensor coupled to the controller, the tilt sensor operable to produce an electrical signal related to a patient posture, and wherein the controller circuit is operable to detect the posture of the patient from both the heart sound signal and the tilt sensor signal.

10. The system of claim 1, wherein the sensor is operable to produce electrical signals representative of both heart sounds and patient activity.

11. The system of claim 1, wherein the system further includes a pressure sensor coupled to the implantable medical device, wherein the pressure sensor is operable to produce electrical signals related to thoracic pressure of a patient, and wherein the controller circuit is operable to use both posture information and pressure information to provide a congestive heart failure status indicator.

12. The system of claim 1, wherein the system further includes a transthoracic impedance measurement circuit coupled to the implantable medical device, wherein the transthoracic impedance measurement circuit is operable to measure impedance across a thorax of the patient, and wherein the controller circuit uses posture information and transthoracic impedance information to provide a congestive heart failure status indicator.

13. The system of claim 1, wherein the implantable medical device includes a cardiac rhythm management device.

14. The system of claim 1, wherein the system further includes an external device operable to communicate with the implantable device, wherein the external device includes a display, and wherein the external device is further operable to display patient posture information obtained from the heart sound signal.

15. The system of claim 14, wherein the patient posture information includes a histogram of patient posture.

16. The system of claim 14, wherein the patient posture information includes trending information of patient posture.

17. The system of claim 14, wherein the external device is operable to communicate with a computer network.

18. A system comprising:

a sensor operable to produce an electrical heart sound signal representative of heart sounds associated with mechanical activity of a patient'"'"'s heart; and

a controller circuit configured to;

determine a change from a baseline for the heart sound signal;

discriminate a posture of the patient from among a plurality of postures using the change from the baseline of the heart sound signal; and

provide an indication of the patient posture to a user or process.

19. The system of claim 18, wherein the change from the baseline is a change in amplitude of the heart sound signal.

20. The system of claim 18, wherein the change from the baseline is a change in a frequency spectrum of the heart sound signal.