Left ventricular assist device adjustment and evaluation

Patent metadata

Field	Value
Publication number	US-2019298903-A1
Application number	US-201916369913-A
Country	US
Kind code	A1
Filing date	Mar 29, 2019
Priority date	Mar 29, 2018
Publication date	Oct 3, 2019
Grant date	—

Abstract

Systems and methods are described herein for evaluation and adjustment of a left ventricular assist device (LVAD). The systems and methods may utilize at least a plurality of external electrodes to monitor cardiac electrical activity before and during LVAD therapy. The cardiac electrical activity as well as other information such cardiac sound information may be used to determine and adjust one or more LVAD output parameters such as pump speed.

First claim

What is claimed:

1 . A system comprising:
electrode apparatus comprising a plurality of external electrodes to monitor cardiac electrical activity from tissue of a patient; and computing apparatus comprising processing circuitry and coupled to the electrode apparatus and configured to:
monitor cardiac electrical activity using the plurality of external electrodes at least during delivery of cardiac therapy using a left ventricular assist device (LVAD);
generate electrical heterogeneity information based on the monitored electrical activity; and
determine an output parameter for the LVAD based the generated electrical heterogeneity information.

2 . The system of claim 1 , wherein the plurality of external electrodes comprises surface electrodes positioned in an array configured to be located proximate skin of a torso of the patient.

3 . The system of claim 1 , wherein the system further comprises a display, wherein the display comprises a graphical user interface configured to assist a user in evaluating patient cardiac health, wherein the computing apparatus is further configured to display electrical heterogeneity information and the determined output parameter for the LVAD on the graphical user interface.

4 . The system of claim 1 , wherein the computing apparatus is further configured to adjust the LVAD in accordance with the determined output parameter.

5 . The system of claim 1 , wherein the electrical heterogeneity information comprises right ventricular electrical heterogeneity information indicative of right ventricular dyssynchrony generated using electrical activity monitored by a right set of external electrodes of the plurality of external electrodes positioned proximate the right torso of the patient.

6 . The system of claim 5 , wherein the electrical heterogeneity information comprises a mean of the right ventricular electrical activation times monitored by the right set of external electrodes.

7 . The system of claim 1 , wherein the electrical heterogeneity information comprises septal electrical heterogeneity information indicative of septal dyssynchrony generated using electrical activity monitored by a central set of external electrodes of the plurality of external electrodes positioned proximate the sternum or spine of the patient.

8 . The system of claim 7 , wherein determining an output parameter for the LVAD based the generated electrical heterogeneity information comprises comparing the septal central electrical heterogeneity information to other electrical heterogeneity information generated from a set of external electrodes to the right or left of the sternum or spine of the patient.

9 . The system of claim 1 , wherein the system is further configured to determine one or more cardiac pacing parameters to be used in cardiac pacing therapy in conjunction with the LVAD based on the generated electrical heterogeneity information.

10 . The system of claim 9 , wherein the one or more pacing parameters comprises right ventricular preexcitation.

11 . The system of claim 1 , wherein the system further comprises an acoustic sensor comprising at least one transducer to monitor cardiac sounds of the patient, wherein the computing apparatus is further configured to determine the output parameter for the LVAD based on the monitored cardiac sounds of the patient during delivery of cardiac therapy using the LVAD.

12 . The system of claim 11 , wherein determining the output parameter for the LVAD based on the monitored cardiac sounds of the patient during delivery of cardiac therapy using the LVAD comprises:
determining whether heart valves are open or closed based on the monitored cardiac sounds; and adjusting the output parameter for the LVAD to allow at least some opening of the heart valves.

13 . The system of claim 11 , wherein the system further comprises a display, wherein the display comprises a graphical user interface configured to assist a user in evaluating patient cardiac health, wherein the computing apparatus is further configured to display cardiac sound information based on the monitored cardiac sounds of the patient during delivery of cardiac therapy using the LVAD.

14 . A method comprising:
monitoring electrical activity from tissue of a patient using a plurality of electrodes at least during delivery of cardiac therapy using a left ventricular assist device (LVAD); generating electrical heterogeneity information based on the monitored electrical activity; and determining an output parameter for the LVAD based the generated electrical heterogeneity information.

15 . The method of claim 14 , wherein the plurality of external electrodes comprises surface electrodes positioned in an array configured to be located proximate skin of a torso of the patient.

16 . The method of claim 14 , the method further comprising displaying electrical heterogeneity information and the determined output parameter for the LVAD on a graphical user interface to assist a user in evaluating patient cardiac health.

17 . The method of claim 14 , the method further comprising adjusting the LVAD in accordance with the determined output parameter.

18 . The method of claim 14 , wherein the electrical heterogeneity information comprises right ventricular electrical heterogeneity information indicative of right ventricular dyssynchrony generated using electrical activity monitored by a right set of external electrodes of the plurality of external electrodes positioned proximate the right torso of the patient.

19 . The method of claim 18 , wherein the electrical heterogeneity information comprises a mean of the right ventricular electrical activation times monitored by the right set of external electrodes.

20 . The method of claim 14 , wherein the electrical heterogeneity information comprises septal electrical heterogeneity information indicative of septal dyssynchrony generated using electrical activity monitored by a central set of external electrodes of the plurality of external electrodes positioned proximate the sternum or spine of the patient.

21 . The method of claim 20 , wherein determining an output parameter for the LVAD based the generated electrical heterogeneity information comprises comparing the septal central electrical heterogeneity information to other electrical heterogeneity information generated from a set of external electrodes to the right or left of the sternum or spine of the patient.

22 . The method of claim 14 , the method further comprising determining one or more cardiac pacing parameters to be used in cardiac pacing therapy in conjunction with the LVAD based on the generated electrical heterogeneity information.

23 . The method of claim 22 , wherein the one or more pacing parameters comprises right ventricular preexcitation.

24 . The method of claim 14 , the method further comprising:
monitoring cardiac sounds of the patient using an acoustic sensor during delivery of cardiac therapy using the LVAD; and determining the output parameter for the LVAD based on monitored cardiac sounds of the patient during delivery of cardiac therapy using the LVAD.

25 . The method of claim 24 , wherein determining the output parameter for the LVAD based on the monitored cardiac sounds of the patient during delivery of cardiac therapy using the LVAD comprises:
determining whether heart valves are open or closed based on the monitored cardiac sounds; and adju

Assignees

• Medtronic Inc

Inventors

• Gillberg Jeffrey M
• Ghosh Subham
• Hess Michael F
• Jackson Troy E

Classifications

• A61B5/28

  for electrocardiography [ECG] · CPC title

• A61B5/256

  Wearable electrodes, e.g. having straps or bands · CPC title

• A61B5/349

  Detecting specific parameters of the electrocardiograph cycle · CPC title

• A61B5/339

  Displays specially adapted therefor · CPC title

• A61B2562/0209

  Special features of electrodes classified in A61B5/24, A61B5/25, A61B5/283, A61B5/291, A61B5/296, A61B5/053 · CPC title