# US 2014/0155707 A1 · Methods and systems that monitor for an impending myocardial infarction

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- Number: US 2014/0155707 A1
- Document ID: US20140155707A1
- Status: Published application
- Kind: A1
- Application number: 14/172,776
- Filed: 2014-02-04
- Published: 2014-06-05
- Earliest claimed: 2009-07-08
- Assignees: Pacesetter, Inc.
- Applicants: Pacesetter, Inc.
- Inventors: Timothy A. Fayram; Daniell Dokko; Taraneh Ghaffari Farazi; Mark Carlson
- Web page: https://patentgrep.com/patent/US20140155707A1

## CPC

- A61B 5/686: {Permanently implanted devices, e.g. pacemakers, other stimulators, biochips (A61B5/6861 takes precedence)}
- A61B 5/0084: {for introduction into the body, e.g. by catheters (A61B5/1459 takes precedence)}
- A61B 5/02007: {Evaluating blood vessel condition, e.g. elasticity, compliance}
- A61B 5/0205: Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
- A61B 5/02125: {of pulse wave propagation time}
- A61B 5/02154: {by optical transmission}
- A61B 5/0295: using plethysmography, i.e. measuring the variations in the volume of a body part as modified by the circulation of blood therethrough, e.g. impedance plethysmography
- A61B 5/0538: invasively, e.g. using a catheter
- A61B 5/1459: invasive, e.g. introduced into the body by a catheter
- A61B 5/318: Heart-related electrical modalities, e.g. electrocardiography [ECG]
- A61B 5/4836: {Diagnosis combined with treatment in closed-loop systems or methods (A61B5/0036 takes precedence)}
- A61B 5/746: {Alarms related to a physiological condition, e.g. details of setting alarm thresholds or avoiding false alarms}
- A61B 5/02416: {using photoplethysmograph signals, e.g. generated by infrared radiation (A61B5/14552 takes precedence)}
- A61B 5/026: Measuring blood flow {(A61B3/1233, A61B3/1241 take precedence)}
- A61B 5/7242: {using integration}
- A61N 1/36521: {the parameter being derived from measurement of an electrical impedance}
- A61N 1/36557: {controlled by chemical substances in blood}
- 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

Implantable systems, and methods for use therewith, are provided for monitoring for an impending myocardial infarction. A signal indicative of changes in arterial blood volume is obtained. Such a signal can be a photoplethysmography signal or an impedance plethysmography signal. For each of a plurality of periods of time, a metric indicative of the areas under the curve of the signal or number of inflections in the signal is determined. An impending myocardial infarction is monitored for based on changes in the metric indicative of the area under the curve of the signal or number of inflections in the signal, and an alert and/or therapy is triggered in response to an impending myocardial infarction being predicted.

## Claims

### Claim 1

For use with a chronically implanted device, a method for monitoring for an impending myocardial infarction (MI), comprising:
(a) obtaining
a first signal indicative of changes arterial volume, the first signal comprising one of a photoplethysmography (PPG) signal and an impedance-plethysmography (IPG) signal, and
a second signal indicative of electrical cardiac activity, the second signal comprising one of an electrocardiogram (ECG) signal and an intracardiac electrogram (IEGM) signal;
(b) determining, based on the first and second signals, a metric indicative of aortic pulse wave velocity (PWV);
(c) determining, based on the first signal, a metric indicative of diastolic blood pressure (DBP);
(d) determining, based on at least one of the first and second signals, a metric indicative of heart rate (HR);
(a) determining, based on the first signal, a metric indicative of vascular stiffness (VS);
(f) monitoring for an impending MI based on the metrics indicative of PWV, DBP, HR and VS; and
(g) triggering an alert and/or therapy in response to an impending MI being detected at step (f).

### Claim 2 (depends on 1)

The method of claim 1, wherein step (f) comprises detecting an impending MI if the metrics indicative of PWV, DBP, HR and VS each satisfies a corresponding criteria indicative of an impending MI.

### Claim 3 (depends on 1)

The method of claim 1, wherein step (f) comprises detecting an impending MI if a majority of the metrics indicative of MAN, DBP, HR and VS each satisfies a corresponding criteria indicative of an impending MI.