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EP-4736757-A2 - LAP SIGNAL PROCESSING TO AUTOMATICALLY CALCULATE A/V RATIO

EP4736757A2EP 4736757 A2EP4736757 A2EP 4736757A2EP-4736757-A2

Abstract

Systems and methods for cardiac monitoring and treatment using left atrial pressure are described herein. In many aspects, a pressure sensor implantable into the left atria, of a patient's heart records a pressure signal. The left atrial pressure can be used to calculate an A/V ratio, which has clinical significance, and in turn can be used to guide treatment and/or as part of an open or closed loop automated treatment system.

Inventors

  • KEIDAR, YARON

Assignees

  • Edwards Lifesciences Corporation

Dates

Publication Date
20260506
Application Date
20221206

Claims (15)

  1. A cardiac patient exertion monitoring system, comprising: an atrial cardiac sensor configured to be implanted in a left atrium of a patient to record: a first blood pressure signal during a rest state of the patient; and a second blood pressure signal during an exertion state of the patient; and a cardiac signal processor configured to: receive the first and second blood pressure signals; calculate a first plurality of cardiac metrics based on the first blood pressure signal; calculate a second plurality of cardiac metrics based on the second blood pressure signals; and provide a warning indicating a health state of the patient based on a change between the first and second plurality of cardiac metrics.
  2. The cardiac patient exertion monitoring system of claim 1, further comprising a transceiver configured to: obtain the first and second blood pressure signals from the atrial cardiac sensor; and transmit the first and second blood pressure signals to the cardiac signal processor.
  3. The cardiac patient exertion monitoring system of claim 2, wherein the transceiver is further configured to power the atrial cardiac sensor.
  4. The cardiac patient exertion monitoring system of any preceding claim, wherein powering the atrial cardiac sensor triggers the atrial cardiac sensor to record the first cardiac signal.
  5. The cardiac patient exertion monitoring system of any preceding claim, further comprising an infusion pump; and wherein the cardiac signal processor is further configured to automatically deliver a drug to the patient via the infusion pump based on the health state of the patient.
  6. The cardiac patient exertion monitoring system of any preceding claim, wherein the first and second blood pressure signals are left atrial pressure signals.
  7. The cardiac patient exertion monitoring system of any preceding claim, wherein the first plurality of cardiac metrics and the second plurality of cardiac metrics comprise an A/V ratio.
  8. The cardiac patient exertion monitoring system of any of claims 1 to 6, wherein the first plurality of cardiac metrics and the second plurality of cardiac metrics comprise a respiration rate.
  9. The cardiac patient exertion monitoring system of any of claims 1 to 6, wherein the first plurality of cardiac metrics and the second plurality of cardiac metrics comprise a heart rate.
  10. A process for exertion monitoring, comprising: receiving, at a cardiac signal processor, a first blood pressure signal recorded by an atrial cardiac sensor implanted in a left atrium of a patient during a rest state of the patient; receiving, at the cardiac signal processor, a second blood pressure signal recorded by an atrial cardiac sensor implanted in a left atrium of a patient during an exertion state of the patient; calculating, using the cardiac signal processor, a first plurality of cardiac metrics based on the first blood pressure signal; calculating, using the cardiac signal processor, a second plurality of cardiac metrics based on the second blood pressure signals; and providing, using the cardiac signal processor, a warning indicating a health state of the patient based on a change between the first and second plurality of cardiac metrics.
  11. The process of claim 10, further comprising: obtaining, using a transceiver, the first and second blood pressure signals from the atrial cardiac sensor; and transmitting, using the transceiver, the first and second blood pressure signals to the cardiac signal processor.
  12. The process of claim 11, wherein the transceiver is further configured to power the atrial cardiac sensor.
  13. The process of claim 12, wherein powering the atrial cardiac sensor triggers the atrial cardiac sensor to record the first cardiac signal.
  14. The process of any of claims 10 to 13, wherein the first and second blood pressure signals are left atrial pressure signals.
  15. The process of any of claims 10 to 14, wherein the first plurality of cardiac metrics and the second plurality of cardiac metrics comprise: a) an A/V ratio; b) a respiration rate; or c) a heart rate.

Description

CROSS-REFERENCE TO RELATED APPLICATIONS The current application claims the benefit of and priority under 35 U.S.C. § 119(e) to U.S. Provisional Patent Application No. 63/287,003 entitled "LAP SIGNAL PROCESSING TO AUTOMATICALLY CALCULATE A/V RATIO" filed December 7, 2021, to U.S. Provisional Patent Application No. 63/287,009 entitled "EXERTION RESPONSE DETECTION BY AN IMPLANTABLE SENSOR" filed December 7, 2021, U.S. Provisional Patent Application No. 63/287,016 entitled "IMPROVED SIGNAL PROCESSING OF BLOOD PRESSURE FROM AN IMPLANTABLE SENSOR BY PRE-CLASSIFICATION OF PATIENTS" filed December 7, 2021, U.S. Provisional Patent Application No. 63/291,253 entitled "SYSTEMS AND METHODS FOR HEART VALVE MONITORING AND REPLACEMENT" filed December 17, 2021, and U.S. Provisional Patent Application No. 63/291,270 entitled "SYSTEMS AND METHODS FOR PUMONARY CONGESTION MONITORING AND TREATMENT" filed December 17, 2021. The disclosures of U.S. Provisional Patent Application Nos. 63/287,003, 63/287,009, 63/287,016, 63/291,253, and 63/291,270 are hereby incorporated by reference in their entireties for all purposes. FIELD OF THE INVENTION This invention generally relates to using cardiac signals to monitor patient health, and more specifically to using left atrial pressure signals to anticipate and treat heart conditions. BACKGROUND The human heart has four chambers. A left and right atrium, and a left and right ventricle. The atria receive blood from veins, and the ventricles discharge blood to arteries. The right-side structures receive deoxygenated blood from the body and send it to the lungs to be oxygenated. The left-side structures receive the newly oxygenated blood from the lungs and send it to the rest of the body. The heart similarly contains four major valves: the mitral (bicuspid) valve, the tricuspid valve, the aortic valve, and the pulmonary valve. Artificial heart valves are life-saving medical devices which can be implanted into a heart in order to replicate the functionality of natural heart valves when they fail. SUMMARY OF THE INVENTION Systems and methods for LAP signal processing in accordance with aspects of the invention are illustrated. One aspect includes a method of treating a heart condition of a patient, including: obtaining a left atrial pressure (LAP) signal using an atrial cardiac sensor implanted into a left atrium of a patient, identifying a set of A-waves and a set of V-waves in the LAP signal, calculating an A/V ratio based on a mean pressure amplitude of the set of A-waves and a mean pressure amplitude of the set of V-waves, determining an appropriate treatment for the patient based on the A/V ratio, and providing the appropriate treatment to the patient. BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is an atrial implanted cardiac monitoring system in accordance with an aspect of the invention.FIG. 2 is a block diagram for a cardiac signal processor in accordance with an aspect of the invention.FIG. 3A is a chart illustrating an example A-Wave and V-wave in accordance with an aspect of the invention.FIG. 3B is a chart illustrating key points on the example A-Wave and V-wave in accordance with an aspect of the invention.FIG. 4 is a flow chart illustrating a process for calculating an A/V in accordance with an aspect of the invention.FIG. 5 is an example left atrial pressure (LAP) signal in accordance with an aspect of the invention.FIG. 6 is an example spectral analysis of a typical LAP signal in accordance with an aspect of the invention.FIG. 7A and 7B illustrate a LAP signal reflective of large slow respiration and shallow fast respiration, respectively, in accordance with an aspect of the invention.FIG. 8 is a de-noised LAP signal in accordance with an aspect of the invention.FIG. 9 is a parsed LAP signal in accordance with an aspect of the invention.FIG. 10 illustrates the relationship between an LAP signal and an electrocardiogram (EKG) signal in accordance with an aspect of the invention.FIG. 11 illustrates a labeled, parsed LAP signal in accordance with an aspect of the invention.FIG. 12A and FIG. 12B illustrate a baseline V-Wave and an elevated V-wave, respectively, in accordance with an aspect of the invention.FIG. 13A and 13B illustrates a single A-V cycle, and a longer time-scale LAP signal of a patient in atrial fibrillation, respectively, in accordance with an aspect of the invention.FIG. 14 is a flow chart illustrating a process for determining cardiac changes over different exertion states in accordance with an aspect of the invention.FIG. 15 is a chart illustrating change in LAP as a function of change in heart rate in accordance with an aspect of the invention.FIG. 16 is a chart illustrating change in respiration rate as a function of change in heart rate in accordance with an aspect of the invention.FIG. 17 is a chart illustrating change in A/V ratio as a function of change in heart rate in accordance with an aspect of the invention.FIG. 18 is a flow chart illustrating a process f