# US 12,303,696 B2 · Cardiac pacing sensing and control

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- Number: US 12,303,696 B2
- Document ID: US12303696B2
- Status: Granted
- Kind: B2
- Application number: 17/939,671
- Filed: 2022-09-07
- Published: 2023-01-05
- Granted: 2025-05-20
- Earliest claimed: 2014-11-24
- Assignees: AtaCor Medical, Inc.
- Applicants: AtaCor Medical, Inc.
- Inventors: Rick Sanghera; Alan Marcovecchio; Sean P. McGeehan
- Web page: https://patentgrep.com/patent/US12303696B2

## CPC

- A61B 5/1116: {Determining posture transitions}
- A61N 1/36585: {controlled by two or more physical parameters}
- A61B 5/0205: Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
- A61B 5/686: {Permanently implanted devices, e.g. pacemakers, other stimulators, biochips (A61B5/6861 takes precedence)}
- A61N 1/0504: {Subcutaneous electrodes}
- A61N 1/0587: {Epicardial electrode systems; Endocardial electrodes piercing the pericardium}
- A61N 1/059: {Anchoring means}
- A61N 1/362: Heart stimulators (heart defibrillators A61N1/39)
- A61N 1/3627: {for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy}
- 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)}
- A61N 1/36557: {controlled by chemical substances in blood}
- A61N 1/36564: {controlled by blood pressure}
- A61N 1/3752: {Details of casing-lead connections}
- A61B 2562/0219: Inertial sensors, e.g. accelerometers, gyroscopes, tilt switches
- A61N 1/36535: {controlled by body position or posture}
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- A61N: ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY (measurement of bioelectric currents A61B; surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body A61B18/00; anaesthetic apparatus in general A61M; incandescent lamps H01K; infrared radiators for heating H05B)

## Abstract

A cardiac pacing system having a pulse generator for generating therapeutic electric pulses, a lead electrically coupled with the pulse generator having an electrode, a first sensor configured to monitor a physiological characteristic of a patient, a second sensor configured to monitor a second physiological characteristic of a patient and a controller. The controller can determine a pacing vector based on variables including a signal received from the second sensor, and cause the pulse generator to deliver the therapeutic electrical pulses according to the determined pacing vector. The controller can also modify pacing characteristics based on variables including a signal received from the second sensor.

## Claims

### Claim 1

A system comprising:
a pulse generator including a housing, the pulse generator configured to generate therapeutic electrical pulses;
at least one lead configured to electrically couple with the pulse generator, the at least one lead including an electrode;
sensors configured to monitor a physiological characteristic of a patient; and
a controller configured to:
receive input signals from the sensors;
apply a signal selection algorithm to select from the input signals the input signal(s) that result in the highest sensitivity or specificity for detecting a heartbeat, the applying generating selected signal(s); and
generate the therapeutic electrical pulses based at least partially on the selected signal(s).

### Claim 2 (depends on 1)

The system of claim 1, wherein the sensors are configured to monitor the patient's electrocardiogram, respiration, blood oximetry, or temperature.

### Claim 3 (depends on 1)

The system of claim 1, wherein the input signals comprise multiple signals for the same physiological characteristic.

### Claim 4 (depends on 3)

The system of claim 3, wherein the multiple signals are respiratory rate signals from two different sensors.

### Claim 5 (depends on 1)

The system of claim 1, wherein the signal selection algorithm applies greater weight to the input signal(s) that are more deterministic for heartbeat detections.

### Claim 6 (depends on 5)

The system of claim 5, wherein the application of the greater weight is based on a predetermined preference order.

### Claim 7 (depends on 5)

The system of claim 5, wherein the application of the greater weight is based on signal amplitude, signal-to-noise ratio, signal width, and/or timing ratios.

### Claim 8 (depends on 1)

The system of claim 1, wherein the generation of the selected signal(s) includes combining two or more of the input signals.

### Claim 9 (depends on 1)

The system of claim 1, wherein the generation of the selected signal(s) includes applying mathematical processes to the input signals.

### Claim 10 (depends on 9)

The system of claim 9, wherein the mathematical processes include one or more of summing/subtracting the input signals, multiplying or dividing one input signal from another input signal, combining a differentiated or integrated input signal from other of the input signals.

### Claim 11 (depends on 1)

The system of claim 1, the controller further configured to:
compare the input signals against acceptability requirements comprising one or more of signal amplitudes, signal-to-noise ratios, signal widths, frequency spectrum, or timing ratios; and
discard any of the input signals that are below the acceptability requirements.

### Claim 12 (depends on 11)

The system of claim 11, the controller further configured to modify the acceptability requirements based on heart rate, posture, or time of day.

### Claim 13

A non-transitory, machine-readable medium storing instructions which, when executed by at least one programmable processor, cause the at least one programmable processor to perform operations comprising:
receiving input signals from sensors configured to monitor a physiological characteristic of a patient;
applying a signal selection algorithm to select from the input signals the input signal(s) that result in the highest sensitivity or specificity for detecting a heartbeat, the applying generating selected signal(s); and
generating therapeutic electrical pulses based at least partially on the selected signal(s), the therapeutic electrical pulses generated by a pulse generator.

### Claim 14 (depends on 13)

The machine-readable medium of claim 13, the operations further comprising applying, by the signal selection algorithm, greater weight to the input signal(s) that are more deterministic for heartbeat detections.

### Claim 15 (depends on 13)

The machine-readable medium of claim 13, the operations further comprising:
comparing the input signals against acceptability requirements comprising one or more of signal amplitudes, signal-to-noise ratios, signal widths, frequency spectrum, or timing ratios; and
discarding any of the input signals that are below the acceptability requirements.

### Claim 16 (depends on 15)

The machine-readable medium of claim 15, the operations further comprising modifying the acceptability requirements based on heart rate, posture, or time of day.