Spatial configuration of a motion sensor in an implantable medical device

• US 9,968,787 B2
• Filed: 08/22/2016
• Issued: 05/15/2018
• 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., Balczewski, Ron A., Mi, Bin, Hatlestad, John D., Huelskamp, Paul, Maile, Keith R.
• Primary Examiner(s): Gedeon, Brian T
• Application Number:
  US15/243,550
• Publication Number:
  US 20170056666A1
• Time in Patent Office: 631 Days
• Field of Search: None
• 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 5/1116 Determining posture transitions
• CPC Class Codes: A61B 5/1118 Determining activity level
• CPC Class Codes: A61B 5/318 Heart-related electrical modalities, e.g. electrocardiography [ECG]
• CPC Class Codes: A61B 5/6869 Heart
• CPC Class Codes: A61B 7/04 Electric stethoscopes microphones, acoustic transducers therefor H04R
• CPC Class Codes: A61N 1/36514 controlled by a physiological quantity other than heart potential, e.g. blood pressure controlled by two or more physical parameters A61N1/36585
• 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 1/36585 controlled by two or more physical parameters
• CPC Class Codes: A61N 1/3702 Physiological parameters A61N1/365 takes precedence; evoked response A61N1/371
• CPC Class Codes: A61N 1/37205 Microstimulators, e.g. implantable through a cannula
• CPC Class Codes: A61N 1/37235 Aspects of the external programmer
• CPC Class Codes: A61N 1/3756 Casings with electrodes thereon, e.g. leadless stimulators

Abstract

Implantable devices having motion sensors. In some examples the a configuration is generated for the implantable device to use the motion sensor in an energy preserving mode in which one or more axis of detection of the motion sensor is disabled or ignored. In some examples the motion sensor outputs along multiple axes are analyzed to determine which axes best correspond to certain patient parameters including patient motion/activity and/or cardiac contractility. In other examples the output of the motion sensor is observed across patient movements or postures to develop conversion parameters to determine a patient standard frame of reference relative to outputs of the motion sensor of an implanted device.

Claims

1. A method of operation in an implantable device configured for placement inside the heart of a patient, the implantable device comprising a motion sensor, the method comprising:

selecting a first parameter;

observing at least first and second outputs of the motion sensor, the first and second outputs relating to respective first and second axes of measurement for the motion sensor;

correlating at least one of the at least first and second outputs, or a combination thereof, to the first parameter;

storing a first configuration of the at least first and second outputs of the motion detector for measuring the first parameter;

applying the first configuration to outputs of the motion sensor to monitor characteristics of the first parameter.

2. The method of claim 1 further comprising selecting a second parameter and repeating the observing, and correlating steps, and then:

storing a second configuration of the at least first and second outputs of the motion detector corresponding to the second parameter;

applying the second configuration to outputs of the motion sensor to monitor characteristics of the second parameter.

3. The method of claim 2 wherein the first parameter is cardiac contractility, and the second parameter is patient motion;

further comprising;

using the first configuration to monitor the cardiac contractility of the patient and generate diagnostic data therefrom for use by a physician; and

using the second configuration to monitor the activity level of the patient and facilitate a rate responsive pacing output regimen for the patient.

4. The method of claim 3 further comprising the implantable device delivering the rate responsive pacing output regimen to the patient.

5. The method of claim 1 wherein the first parameter is patient motion and the method further comprises:

delivering pacing therapy to the patient via the implantable medical device; and

using the first configuration to facilitate a rate responsive pacing output regimen for the patient in which the rate at which pacing therapy is delivered adjusts in view of patient activity.

6. The method of claim 1 wherein the implantable device includes a sensing circuit for sensing cardiac electrical signals of the patient, and the method further comprises:

using a sensed cardiac electrical signal, determining that a cardiac event took place;

using the stored configuration, analyzing one or more outputs from the motion sensor to determine a state of the parameter during the cardiac event.

7. The implantable medical device of claim 1 wherein:

the operational circuitry is configured to select a second parameter, observe the at least first and second outputs of the motion sensor, and correlate at least one of the at least first and second outputs, or a combination thereof, to the second parameter, and then;

store a second configuration of the at least first and second outputs of the motion detector corresponding to the second parameter, and apply the second configuration to outputs of the motion sensor to monitor characteristics of the second parameter.

8. The implantable medical device of claim 7 wherein:

the first parameter is cardiac contractility, and the second parameter is patient motion;

the operational circuitry is configured to use the first configuration to monitor the cardiac contractility of the patient and generate diagnostic data therefrom for use by a physician; and

the operational circuitry is configured to use the second configuration to monitor the activity level of the patient and facilitate a rate responsive pacing output regimen for the patient.

9. The implantable medical device of claim 8 wherein the operational circuitry is configured to deliver the rate responsive pacing output regimen to the patient using the electrodes.

10. The method of claim 1 further comprising obtaining a data input from a source other than the motion sensor in order to establish the correlation, and the first configuration defines a relationship, established using the second data input, between the outputs of the motion sensor and the first parameter, wherein the first parameter is cardiac contractility and the data input comprises information from one of a cardiac electrogram, a surface electrocardiogram, an imaging system, or a blood pressure monitor.

11. The method of claim 1 further comprising obtaining a data input from a source other than the motion sensor in order to establish the correlation, and the first configuration defines a relationship, established using the second data input, between the outputs of the motion sensor and the first parameter, wherein the first parameter is patient movement, and the data input is obtained from a programmer adapted to communicate with the implantable medical device, wherein the data input is an indication from the programmer whether the patient is moving or not.

12. An implantable medical device comprising:

a power source;

a plurality of electrodes for use in one or more of biological signal monitoring or providing an electrical therapy;

a motion sensor having at least first and second axes of sensitivity; and

operational circuitry configured to control the use of the electrodes and motion sensor for one or more of;

capturing biological signal data, capturing patient motion data, and/or providing electrical therapy;

wherein;

the operational circuitry is configured to select a first parameter;

the operational circuitry is configured to observe at least first and second outputs of the motion sensor, the first and second outputs relating to respective first and second axes of measurement for the motion sensor;

the operational circuitry is configured to correlate at least one of the at least first and second outputs, or a combination thereof, to the first parameter;

the operational circuitry is configured to store a first configuration of the at least first and second outputs of the motion detector for measuring the first parameter; and

the operational circuitry is configured to apply the first configuration to outputs of the motion sensor to monitor characteristics of the first parameter.

13. The implantable medical device of claim 12 wherein:

the first parameter is patient motion;

the operational circuitry is configured to deliver pacing therapy to the patient using the electrodes; and

the operational circuitry is configured to use the first configuration to facilitate a rate responsive pacing output regimen for the patient in which the rate at which pacing therapy is delivered adjusts in view of patient activity.

14. The implantable medical device of claim 12 wherein:

the operational circuitry is configured to use signals from the electrodes for sensing cardiac electrical signals of the patient;

the operational circuitry is configured to use a sensed cardiac electrical signal to determine that a cardiac event took place; and

the operational circuitry is configured to use the stored configuration to analyze one or more outputs from the motion sensor to determine a state of the parameter during the cardiac event.

15. An implantable leadless cardiac pacemaker taking the form of an implantable medical device as in claim 12.

16. An implantable cardiac monitor taking the form of an implantable medical device as in claim 12.

17. An implantable neuromodulation device taking the form of an implantable medical device as in claim 12.

18. The implantable medical device of claim 12 wherein the operational circuitry is configured to obtain a data input from a source other than the motion sensor in order to establish the correlation, and the first configuration defines a relationship, established using the data input, between the outputs of the motion sensor and the first parameter, wherein the first parameter is cardiac contractility and the data input comprises information from one of a cardiac electrogram, a surface electrocardiogram, an imaging system, or a blood pressure monitor.

19. The implantable medical device of claim 12 wherein the operational circuitry is configured to obtain a data input from a source other than the motion sensor in order to establish the correlation, and the first configuration defines a relationship, established using the data input, between the outputs of the motion sensor and the first parameter, wherein the first parameter is patient movement, and the data input is obtained from a programmer adapted to communicate with the implantable medical device, wherein the data input is an indication from the programmer whether the patient is moving or not.