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WO2000009012A1 - Procede pour mesurer les mouvements du coeur - Google Patents

Procede pour mesurer les mouvements du coeur Download PDF

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Publication number
WO2000009012A1
WO2000009012A1 PCT/EP1999/005870 EP9905870W WO0009012A1 WO 2000009012 A1 WO2000009012 A1 WO 2000009012A1 EP 9905870 W EP9905870 W EP 9905870W WO 0009012 A1 WO0009012 A1 WO 0009012A1
Authority
WO
WIPO (PCT)
Prior art keywords
light
light guide
heart
end section
control unit
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/EP1999/005870
Other languages
German (de)
English (en)
Inventor
Karsten Hoeland
Jürgen Werner
Gerd Nowak
Mathias Meine
Martin Hexamer
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
Original Assignee
Individual
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Individual filed Critical Individual
Priority to AU56213/99A priority Critical patent/AU5621399A/en
Publication of WO2000009012A1 publication Critical patent/WO2000009012A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/0059—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
    • A61B5/0082—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence adapted for particular medical purposes
    • A61B5/0084—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence adapted for particular medical purposes for introduction into the body, e.g. by catheters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/103—Measuring devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
    • A61B5/11—Measuring movement of the entire body or parts thereof, e.g. head or hand tremor or mobility of a limb
    • A61B5/1107—Measuring contraction of parts of the body, e.g. organ or muscle
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/362—Heart stimulators
    • A61N1/365—Heart stimulators controlled by a physiological parameter, e.g. heart potential
    • A61N1/36514—Heart stimulators controlled by a physiological parameter, e.g. heart potential controlled by a physiological quantity other than heart potential, e.g. blood pressure
    • A61N1/36542—Heart stimulators controlled by a physiological parameter, e.g. heart potential controlled by a physiological quantity other than heart potential, e.g. blood pressure controlled by body motion, e.g. acceleration
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2562/00—Details of sensors; Constructional details of sensor housings or probes; Accessories for sensors
    • A61B2562/02—Details of sensors specially adapted for in-vivo measurements
    • A61B2562/0261—Strain gauges
    • A61B2562/0266—Optical strain gauges
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
    • A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
    • A61B5/6867—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive specially adapted to be attached or implanted in a specific body part
    • A61B5/6869—Heart
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
    • A61B5/7203—Signal processing specially adapted for physiological signals or for diagnostic purposes for noise prevention, reduction or removal

Definitions

  • the invention relates to a method for measuring movements which are caused by the action of the heart, in particular myocardial contractions and / or myocardial relaxations, the movements generating signals which are modulated in the frequency of the heartbeat.
  • physiological parameters of the heart such as the beat frequency, the stroke volume, the contraction speed, the rate of excitation propagation, the oxygen saturation and the like are recorded for diagnostic and therapeutic purposes.
  • Various methods are known for measuring the parameters.
  • imaging methods such as ultrasound or X-ray examinations and, on the other hand, intracardiac measurements of the pressure, the myocardial acceleration or the impedance for volume determination are carried out.
  • electrical fields generated by the heart e.g. recorded as an electrocardiogram (EKG).
  • the central idea of the method according to the invention is to measure the movements of the heart by means of the varying bends of a fiber optic sensor caused by the heartbeat.
  • the known effect of an optical fiber line is used that when the fiber is bent, the optical attenuation changes due to the variable amount of light emitted or the phase of the light in the fiber shifts due to the change in length.
  • These significant changes in the light can be measured and further processed as measurement signals.
  • a particular advantage of the method is that no electrical components are required within the heart, so that a high degree of system reliability and high precision of the measurement results are guaranteed.
  • a flexible light guide in particular an optical fiber or a fiber bundle, is at least partially fixed in or on the heart with an end region of, for example, a few centimeters in length, so that a contraction of the heart causes the light guide to bend.
  • an end region of, for example, a few centimeters in length
  • the light guide is at least partially fixed in or on the heart with an end region of, for example, a few centimeters in length, so that a contraction of the heart causes the light guide to bend.
  • the outcoupled light is modulated in intensity due to the pulsating movement of the light guide and has a varying phase shift compared to the incoupled light.
  • a particularly precise measurement is possible if the coherent light of a laser or a laser diode is used as the light source.
  • the method according to the invention for the measurement in the heart there is only a thin and thus less disturbing fiber-optic waveguide as a sensor. This is insensitive to electrical interference, so that the movement of the heart can be measured without interference from external or internal electrical signals at any time during a cardiac cycle.
  • the measurement results can be used for any diagnostic or therapeutic purposes.
  • the measurements of the heart parameters can thus be used directly for diagnostic purposes.
  • the light guide is guided to the heart with a cardiac catheter, for example.
  • the signals can be used particularly advantageously for the control or regulation of cardiac pacemakers or defibrillators, for example for determining the manipulated variable. Since the components for recording the measurement signals and converting the measurement signals into an electrical signal are very small, they can easily be installed in the housing of an implanted pacemaker or defibrillator, so that these devices can work in a simple manner with the method according to the invention.
  • the light guides can thus remain inside the body. It is particularly advantageous here To integrate the light guide in the pacemaker and ICD therapy (implantable cardioverter defibrillator) anyway fixed at one end in the heart wall and led out of the heart through a vein or artery, which bends periodically in the chambers due to the movement of the heart .
  • the mechanical deformation of the heart can be measured by measuring the optical change in attenuation caused by the curvature of the line.
  • FIG. 1 the structure of one of the fiber optic measuring devices
  • FIG. 2 a structure with two measuring fibers
  • Figure 3 Measuring fibers in a universal measuring cable
  • Figure 4 an arrangement for coupling higher modes into a fiber optic waveguide
  • FIG. 1 shows a flexible optical fiber 1, one end 2 of which is processed in such a way that total reflection of the light coupled into the fiber 1 occurs.
  • the end face of the fiber 1 can be mirrored or pointed at an angle of 45 °, so that a cone with a cone angle of 90 ° is formed.
  • the fiber 1 forms a first end section of a flexible light guide which is to provide the desired bending information.
  • the length of the fiber 1 can be chosen to suit the requirements.
  • a second piece of fiber 3 with different damping properties is attached to the fiber 1 by welding or gluing in such a way that an optical transition 1A is produced.
  • the length of the fiber 3 can in turn be chosen as required.
  • the fiber 3 is connected to the input or output of an optical coupler 5 or beam splitter via an optical connector system 4.
  • an additional piece of fiber 6 can be inserted between the connector 4 and the coupler 5.
  • a transmitter 7 and a receiver 8 are connected to the other input or output of the coupler 5, an additional piece of fiber 6 being inserted between the coupler 5 and the transmitter 7 or between the coupler 5 and the receiver 8 for extension is.
  • the transmitter 7 is a light source, the light of which is coupled into the fiber 6, which represents the second end region of the light guide.
  • the receiver 8 has a light-sensitive sensor which measures the intensity of the light coupled out of the fiber.
  • Transmitter 7 and receiver 8 form a transceiver unit which has means for coupling and decoupling the light from the light source and means for analyzing the intensity fluctuations and / or the phase shift.
  • An additional receiver 9 corresponding to the receiver 8 or an optical sump is connected to the free input or output of the coupler 5.
  • components 1 to 4 form measuring section 10, which is located in or at the heart, while components 4 to 9 represent the second end section and thus the detection unit.
  • the plug 4 forms the transition between the two components or between the first and the second end region.
  • a second detection unit 11 and a fiber 12 are added to the embodiment shown in FIG.
  • This fiber 12 is mirrored in accordance with the end 2 of the fiber 1 at the end 13 and connected to the detection unit 11 via a plug system 14.
  • the fiber 12 has no fiber forming the first end region, so that the components 12 to 14 form a reference path 15.
  • the fibers 3 and 12 are mounted closely in parallel, so that the signals from the receivers 8 of the two detection units 11 deliver two signals, the difference of which only contains the signal portion of the measuring section 1 which runs at least partially in or on the heart. In the manner described, even shorter measuring fibers can be added so that differential signals can also be formed for other sections.
  • the detection unit 11 can be part of a control unit and / or control unit of a cardiac pacemaker or an ICD. The control unit and / or control unit calculates parameters for the operation of the pacemaker or the ICD from the signals supplied by the detection unit 11.
  • FIG. 3 shows an embodiment in which the measuring section 10 and the reference section 15 are integrated in a common measuring cable 16.
  • a device 17 for fixing the cable 16 to the heart wall.
  • the measuring section 10 and the reference section 15 can be freely displaceable in the longitudinal direction 18 within the measuring cable 16, so that the fiber 1 can be positioned for better detection of the heart movement.
  • the optical connectors 4 and 14, and optionally connector 19 for electrical contacts. These plugs 4, 14 and 19 can also be combined into one or two plugs.
  • the measurement cable 16 can be integrated in the signal line of a pacemaker or an ICD.
  • FIG. 4 shows an arrangement of optical components in which, in order to increase the sensitivity of the attenuation measurement in the case of bends, essentially higher-quality modes are injected into the fiber-optic light guide.
  • This arrangement can be integrated in the transmission unit 7. It consists of a light source 20, a lens arrangement 21, and an annular diaphragm 22 which only couples a light ring into the fiber. Alternatively, a parallel light beam can be coupled in at a freely selectable angle to the fiber center line.
  • the fiber ends 2 or 1 A can be cut at an angle, polished and mirrored by evaporating metal. Such processing shifts the modes in the reflection.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • Cardiology (AREA)
  • Veterinary Medicine (AREA)
  • Biophysics (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Public Health (AREA)
  • General Health & Medical Sciences (AREA)
  • Physiology (AREA)
  • Physics & Mathematics (AREA)
  • Pathology (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Surgery (AREA)
  • Radiology & Medical Imaging (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Hematology (AREA)
  • Dentistry (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Investigating Or Analysing Materials By Optical Means (AREA)
  • Measurement Of The Respiration, Hearing Ability, Form, And Blood Characteristics Of Living Organisms (AREA)

Abstract

Lors des battement du coeur, notamment lors de contractions du myocarde et/ou lors de relaxations du myocarde, des signaux modulés sont produits au rythme des battements du coeur. Une fibre optique flexible (1, 3, 6) est fixée dans ou sur le coeur par la partie d'extrémité distale (1), de sorte qu'une contraction provoque une flexion de la fibre optique (1). La lumière d'une source lumineuse (7) est injectée dans la partie proximale (6) de la fibre optique. Ensuite, la modulation, provoquée par la flexion de la fibre optique, de l'intensité et/ou du déphasage de la lumière sortant de la fibre optique (6) est mesurée.
PCT/EP1999/005870 1998-08-12 1999-08-12 Procede pour mesurer les mouvements du coeur Ceased WO2000009012A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU56213/99A AU5621399A (en) 1998-08-12 1999-08-12 Method for measuring the movements of the heart

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE1998136496 DE19836496A1 (de) 1998-08-12 1998-08-12 Faseroptische Messung der Myokardkontraktion
DE19836496.2 1998-08-12

Publications (1)

Publication Number Publication Date
WO2000009012A1 true WO2000009012A1 (fr) 2000-02-24

Family

ID=7877277

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/EP1999/005870 Ceased WO2000009012A1 (fr) 1998-08-12 1999-08-12 Procede pour mesurer les mouvements du coeur

Country Status (3)

Country Link
AU (1) AU5621399A (fr)
DE (1) DE19836496A1 (fr)
WO (1) WO2000009012A1 (fr)

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8068909B2 (en) 2007-06-27 2011-11-29 Cardiac Pacemakers, Inc. Measurement of cardiac performance with movement sensors and related methods
US8290592B2 (en) 2006-09-21 2012-10-16 Cardiac Pacemakers, Inc. Implantable medical device header with optical interface
US8406879B2 (en) 2006-12-20 2013-03-26 Cardiac Pacemakers, Inc. Rate adaptive cardiac pacing systems and methods

Families Citing this family (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP3829426A1 (fr) * 2018-08-03 2021-06-09 Chelak Medical Solution Inc. Détermination non barométrique d'effets hémodynamiques d'arythmies cardiaques à l'aide de signaux détectés par un dispositif implantable
US11903683B2 (en) 2018-08-03 2024-02-20 Chelak Medical Solutions Inc Non-barometric determination of hemodynamic effects of cardiac arrhythmias using signals sensed by an implantable device
EP4515193A1 (fr) 2022-04-29 2025-03-05 Chelak Medical Solutions Inc Systèmes, dispositifs et procédés de miniaturisation d'interrogation de réseau de bragg sur fibre pour intégration dans des dispositifs implantables

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE2717659A1 (de) * 1977-04-21 1978-10-26 Alexander Dr Med Wirtzfeld Herzschrittmacher
EP0253559A1 (fr) * 1986-07-14 1988-01-20 C.R. Bard, Inc. Détecteur pour mesurer la concentration d'une composante gazeuse dans un liquide par absorption
US5134281A (en) * 1990-01-31 1992-07-28 E.L. Bryenton & Associates Inc. Microbend optic sensor with fiber being sewn thereto in a sinuously looped disposition
WO1992015008A1 (fr) * 1991-02-26 1992-09-03 Massachusetts Institute Of Technology Systemes et procedes de spectroscopie moleculaire, permettant d'etablir le diagnostic des tissus

Family Cites Families (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4428378A (en) * 1981-11-19 1984-01-31 Medtronic, Inc. Rate adaptive pacer
US4566456A (en) * 1984-10-18 1986-01-28 Cordis Corporation Apparatus and method for adjusting heart/pacer rate relative to right ventricular systolic pressure to obtain a required cardiac output

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE2717659A1 (de) * 1977-04-21 1978-10-26 Alexander Dr Med Wirtzfeld Herzschrittmacher
EP0253559A1 (fr) * 1986-07-14 1988-01-20 C.R. Bard, Inc. Détecteur pour mesurer la concentration d'une composante gazeuse dans un liquide par absorption
US5134281A (en) * 1990-01-31 1992-07-28 E.L. Bryenton & Associates Inc. Microbend optic sensor with fiber being sewn thereto in a sinuously looped disposition
WO1992015008A1 (fr) * 1991-02-26 1992-09-03 Massachusetts Institute Of Technology Systemes et procedes de spectroscopie moleculaire, permettant d'etablir le diagnostic des tissus

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8290592B2 (en) 2006-09-21 2012-10-16 Cardiac Pacemakers, Inc. Implantable medical device header with optical interface
US8406879B2 (en) 2006-12-20 2013-03-26 Cardiac Pacemakers, Inc. Rate adaptive cardiac pacing systems and methods
US8738133B2 (en) 2006-12-20 2014-05-27 Cardiac Pacemakers, Inc. Rate adaptive cardiac pacing systems and methods
US8068909B2 (en) 2007-06-27 2011-11-29 Cardiac Pacemakers, Inc. Measurement of cardiac performance with movement sensors and related methods

Also Published As

Publication number Publication date
DE19836496A1 (de) 2000-02-17
AU5621399A (en) 2000-03-06

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