All publications and patent applications mentioned in this specification are herein incorporated by reference to the same extent as if each individual publication or patent application was specifically and individually indicated to be incorporated by reference.
This disclosure relates generally to implantable monitoring and sensing devices. More specifically, this disclosure relates to implantable, untethered, wireless monitoring and sensing devices for diagnostic purposes, and devices capable of control for therapeutic purposes.
Cardiac arrhythmias affect more than 5 million people nationwide, and result in more than 1.2 million hospitalizations and 400,000 deaths each year in the United States. Atrial fibrillation (AF) and ventricular tachycardia (VT) account for most of the curable episodes if precise 3D mapping of the depolarization pattern is accessible. In the past five decades, various mapping systems have been proposed and developed. They can provide some but not all of the desired properties of an ideal mapping system.
The most common (AF) and the most lethal (VT) electrical disturbances of the heart are both caused by altered electrical conduction patterns. Therefore, the 3D mapping of the depolarization pattern has been an area of research for more than 5 decades. While conventional electrocardiogram (ECG) provides some ability to localize the pattern of depolarization, a more precise method would be highly desirable.
Methods like magnetocardiography (MCG) require highly specialized equipment and biomagnetic inversion problem is inherently ill-posed mathematically. MCG is a non-invasive mapping technique. But it requires the use of highly sensitive SQUID detector and suffers from sensitivity to noise due to the ill-posed inversion problem. Noninvasive techniques such as MCG have therefore been found unreliable for even investigative use.
Invasive intracardiac mapping is a laborious point-by-point mapping procedure that provides the only reliable analysis of the propagation electrical wavefront. Catheter-based activation and pacing in conjunction with surface electrocardiography and x-ray fluoroscopy is the most commonly used mapping technique in a clinical setting. However, the limitations of this technique are threefold. First, arrhythmia induction is often necessary for precise mapping. Patients who have structural heart disease (SHD) often have poor hemodynamic tolerance to the induced arrhythmia. Second, sequential recording is performed by a single or few electrode catheters maneuvered in the heart chamber. There is an implicit assumption that activations repeat in the same way from cycle to cycle at each site. This might not be a valid assumption in complex rhythms such as polymorphic arrhythmia. Thus, the procedure could last for several hours. Third, the mapping itself is limited to the reachable endocardial surface of the heart. Thus, local electrograms are not true representations of the depolarization pattern, especially in the thicker myocardium of the ventricles. Ideally, high-density maps of cardiac depolarization can be obtained without prolonged mapping.
Electrodes and stents have been implanted in human hearts for several decades. They have been deployed in the cardiac chambers as well as cardiac venous and arterial structures. Electrodes are currently millimeters in size and usually require a direct wired connection for operation. Stents measuring 50-100 microns in thickness are deployed routinely in the coronary arteries but lack of the ability to report back information from the local environment.
In the past few decades, newer mapping techniques have been proposed and developed. CARTO is the first 3D mapping system in electrophysiology (EP) testing. It utilizes a magnetic field sensor incorporated in the tip of the mapping catheter and an external magnetic field emitter located under the patient beneath the operating table. An electroanatomical map is generated when the mapping catheter is maneuvered in the heart chamber. The CARTO system, however, shares the same limitation of sequential recording and hence incurs long procedural time.
Non-contact multi-electrode mapping entails simultaneously recording of electrical activity at multiple sites. Other companies have developed a multi-electrode array with up to 64 electrodes in the shape of a balloon for endocardial mapping. Because the electrodes do not touch the endocardium, the mapping accuracy is limited.
In the UnEmap system developed by a group of researches in the University of Auckland, an epicardial electrode sock with over 100 electrodes is fitted over the heart. It is used extensively in experiments to better understand the underlying mechanisms of cardiac arrhythmias, but is seldom used in the clinical setting due to the invasiveness.
Optical mapping technique advances our understanding of cardiac electrophysiology in ways that have not been accomplished by other approaches. This technique uses a voltage-sensitive dye, invented by Nobel laureate Roger Tsien, to translate voltage changes into an optical signal, and provides better temporal and spatial resolution than other mapping techniques. Additionally, it allows simultaneous recording of membrane potential in the whole heart. Developed on experimental preparations using various species, these optical mapping techniques have recently been applied to the ex vivo human heart. These studies lead to the explanation of ventricular excitation and arrhythmias in terms of the hidden spatio-temporal patterns of propagation within the ventricular wall. However, the voltage-sensitive dyes are toxic. Therefore, optical mapping is not suitable for clinical use.
Table 1 summarizes the properties and limitations of the newer mapping techniques as compared with the conventional catheter-based technique and the invention disclosed herein.
A patient monitoring system is provided, comprising a plurality of implantable, wirelessly powered sensing devices, each sensing device comprising an antenna configured to receive wireless power, at least one sensor configured to sense a bodily parameter of the patient, and electronics coupled to the antenna and the sensor and configured to communicate the sensed bodily parameter, and at least one external device configured to provide wireless power to the antennae of the sensing devices and configured to receive the sensed bodily parameters from the sensing devices.
In some embodiments, the at least sensor is selected from the group consisting of electrical sensor, pressure sensor, optical sensor, mechanical sensor, and temperature sensor.
In another embodiment, each sensing device measures less than 1 mm×1 mm×1 mm in size.
In some embodiments, each antenna comprises a 3D coil.
In one embodiment, each of the sensing devices comprises an energy harvesting mechanism that is selected from the group consisting of magnetic harvesting mechanism, optical harvesting mechanism, mechanical harvesting mechanism, thermal harvesting mechanism, and chemical harvesting mechanism.
In some embodiments, the system further comprises a therapy element configured to apply therapy to the patient. In some embodiments, the therapy element is selected from the group consisting of electrode, optical element, ultrasound transducer, chemical element, and magnetic element.
An implantable, untethered sensing device is provided, the untethered sensing device comprising an antenna configured to receive wireless power from a power source external to a patient, at least one sensor configured to sense a bodily parameter of the patient, and electronics coupled to the antenna and the at least one sensor and configured to communicate the sensed bodily parameter to a device external to the patient.
In one embodiment, the at least sensor is selected from the group consisting of electrical sensor, pressure sensor, optical sensor, mechanical sensor, and temperature sensor.
In some embodiments, the device measures less than 1 mm×1 mm×1 mm in size.
In another embodiment, the antenna comprises a 3D coil.
In some embodiments, each of the sensing devices comprises an energy harvesting mechanism that is selected from the group consisting of magnetic harvesting mechanism, optical harvesting mechanism, mechanical harvesting mechanism, thermal harvesting mechanism, and chemical harvesting mechanism.
In one embodiment, the sensing device further comprises a therapy element configured to apply therapy to the patient. In some embodiments, the therapy element is selected from the group consisting of electrode, optical element, ultrasound transducer, chemical element, and magnetic element.
A method of monitoring a patient parameter is also provided, comprising implanting at least one wirelessly powered sensing device into a patient, providing wireless power to the at least one sensing device with an external device, sensing a bodily parameter of the patient with the at least one sensing device, and communicating the sensed bodily parameter from the at least one sensing device to the external device.
In some embodiments, the at least one sensing device is implanted into a part of the body selected from the group consisting of a heart, brain, vascular system, and abdomen of the patient.
In another embodiment, the bodily parameter is selected from the group consisting of an EEG, EKG, ECG, blood pressure, core temperature, blood flow, resistance, impedance, and pressure of fluid within the patient.
In some embodiments, the method further comprises providing therapy to the patient with the sensing device. In some embodiments, the therapy comprises electrical stimulation, chemical stimulation, optical stimulation, or magnetic stimulation, or mechanical stimulation.
In some embodiments of the systems and methods disclosed herein, the sensing devices do not comprise a battery. In some embodiments, the sensing devices are powered only when receiving wireless power from the external device.
In some embodiments, the sensing devices receive wireless power in the mid-field where energy is exchanged through a combination of inductive and radiative modes.
In one embodiment, the sensing devices receive wireless power at an operating frequency ranging from approximately 100 MHz to 5 GHz.
The novel features of the invention are set forth with particularity in the claims that follow. A better understanding of the features and advantages of the present invention will be obtained by reference to the following detailed description that sets forth illustrative embodiments, in which the principles of the invention are utilized, and the accompanying drawings of which:
This disclosure describes methods and apparatus for replacing large “dumb” and tethered electrode sensing devices with multiple implantable or injectable “smart” untethered wireless-powered sensing devices. These untethered sensors can include electronics comprising integrated circuit (IC) chips configured to sense body parameters (e.g., an electrogram), a wireless interface to transmit the sensed body parameters to an external device or detector, and a unique identification to locate each sensor. The systems described herein can include control over the types of body parameters to monitor, the duration of monitoring, and the number of locations within the body to monitor simultaneously.
This disclosure provides a novel mapping system comprising a plurality of implantable, wirelessly powered sensing and control devices configured to create a high-density map in real time or on demand of sensed body parameters (e.g., cardiac depolarization) using simple and minimally invasive procedures and sensing devices without the need for prolonged mapping time.
An array of untethered, wirelessly-powered, small, and individually addressable electrode sensing devices can be implanted or injected into the body, such as into the circulatory system or into an organ, muscle, skin or body cavity of the patient. In a cardiac application, these sensing devices can be configured to detect the local depolarization patterns which can then be simultaneously interrogated by an external detector. The external detector can be adapted to demultiplex signals from these sensing devices at different locations, and reconstruct the depolarization map in real time. This mapping system can revolutionize the way of measuring bodily parameters such intracardiac electrical activities, assist cardiologists to ablate complicated arrhythmias, and reduce the procedural time of electrophysiology (EP) testing. In addition, it can provide medical researches a flexible tool to better understand the electrical signal propagation and test out new hypothesis of the initiation of arrhythmias in cardiac tissue.
Wireless sensing and/or therapy devices disclosed herein can integrate the various circuit components of a wireless sensing device (e.g., wireless powering circuits, telemetry circuits, and the electrode sensors) into a single sensor IC chip. The sensing devices disclosed herein can include optimized designs for the implanted antenna, electrode configurations, 3D packaging of the entire probe, and the external detector. It is a goal of the systems described herein to minimize the effect of biological reaction to the presence of implanted wireless sensing devices.
As will be described in more detail below, the sensing devices can be untethered, wirelessly powered sensing devices configured to sense a body parameter of a patient and wirelessly communicate the sensed information to an external device. In some embodiments, the sensing devices can be configured to sense one or more of the following: parameters of the body, such as ECG, EKG, EEG, resistance, or impedance, pressure parameters of the body such as the pressure of fluids within a lumen or an organ, temperature of the body or of bodily fluids, or optical parameters of the body, glucose content, or other chemical, biological, or particular molecular content in the blood or other organs. In some cases, certain composition of material can be sensed, such as presence of blood, puss, or bacterial infection. This can be achieved by including appropriate sensors on the sensing devices, such as electrodes, pressure sensors, temperature sensors, optical sensors, etc.
In one embodiment, a plurality of implanted sensing devices forms a network of sensing and stimulating devices that can operate in coordinated manner to close the loop for action with respect to measured quantities. For instance, in one embodiment, a device could measure cardiac output such as blood flow out of heart and another device could stimulate the heart to regulate the cardiac output.
In some embodiments, when the sensing devices are implanted within the heart of a patient, as shown in
In some embodiments, the sensor 102 can comprise an electrode, but it should be noted that in other embodiments the sensor can be any type of sensor adapted to measure a bodily parameter, such as a pressure sensor, optical sensor, temperature sensor, etc. The sensing device can optionally include other features, such as a power source (e.g., a battery, a capacitor, etc.). In some embodiments, each sensing device can include a unique identification (ID) so as to identify the individual sensors. The unique ID can be used by the IC chip 108, or by an external detector (such as external detector 104) to identify the measurements taken by that individual sensor or induce localized stimulation to a particular region of the organ.
The IC chip 108 can be configured to provide signal processing directly on the sensing device. In some situations, it can be cheaper and more efficient to process the measured data on the sensing device itself, and transmit the processed data to the external device. Processing locally can be more efficient if the processing can be done with fairly simple analog or digital circuitry. The IC chip can include an energy harvesting and power management block, a matching network, a transceiver for telemetry with external reader, a sensor interface with signal conditioning circuitry, a signal conditioning and pulse generation block for stimulation, data conversion circuits, auxiliary circuit blocks, such as power-on-reset circuits, and a controller. Integrating all the electronics described into a single IC chip leads to having fewer discrete components and therefore allows the sensing devices to be miniaturized to the sizes described herein.
The controller can manage the localized device operation, process commands from the external reader, packetize and send out sensed data back to the external reader. The controller can also contain digital or analog signal processing blocks which can analyze and process sensed data and can adjust the device's course of action or performance based on the processed information. For instance, if the controller determines that its analog-to-digital converter resolution is too low, it can increase its effective resolution or adjust gain of signal conditioning circuit to improve the performance, without engagement of the external reader. One other example for adjustment of performance is to automatically tune the cutoff frequencies of the filters in the sensor signal conditioning block in order to pass only the desired frequency components and filter out the interfering signals and noise. This may be done by the IC chip autonomously if all the necessary signal processing components are integrated on chip. Alternatively, the device can send raw data to the external reader. The reader can process the data and adjust the necessary parameters of the IC chip based on the information it receives by sending configuration commands to the IC chip.
Electronics and mechanical systems, empowered by modern CMOS, MEMS, and nanofabrication technologies, have been miniaturized faster than electro-chemical energy storage. As a result, embedded batteries typically dominate the size and weight of implanted medical devices. To combat this, in some embodiments the sensing devices of the present disclosure can be powered externally by the external power source and detector via transcutaneous wireless power transfer. The external detector 102 can include a transmit coil that can be coupled to a receive coil on each sensing device. The receive coil can be, for example, the antenna 106 illustrated in
The transmit coil of the external detector and the receive coil of the sensing device can form a coupled circuit, whereby current flowing in the transmit coil can create a magnetic field which induces current to flow in the receive coil of the one or more sensing devices. This induced current can then be used to power the sensing devices. In some embodiments, the sensing devices can be configured to operate and measure bodily parameters only when they are in the presence of a magnetic field formed by the external device. Thus, the sensing device 102 can be miniaturized by not including a battery or energy source. When the antenna of the sensing device is in the presence of the magnetic field formed by the external device, the sensing device can turn on or “wake up” and collect or information relating to body parameters. The sensing device can also communicate this sensed information externally while receiving wireless power.
Traditional wireless power transfer across human tissue operates in the near-field, where the transmit and receive coils include inductively coupled coils. Recently proposed systems for mid-range power transfer over air and through tissue also occur in the near-field; high efficiency can be obtained by tuning identical resonators to operate in the strongly coupled regime. Power transfer to medical implants, however, typically operates in the weakly coupled regime due to the asymmetry between a large external transmit coil and the small receive coil on the implant. In this configuration, it has been shown that optimal power transfer occurs in the mid-field where energy is exchanged through a combination of inductive and radiative modes.
Typical implantable devices rely on inductive coupling to harvest power and communicate with the external transmitter. This often implies large coil antennas for both the external transmitter and the implant device antenna. One of the key disadvantages of the inductive coupling is that these antennas cannot be significantly miniaturized because they become very inefficient. Increasing the frequency of operation increases the tissue absorption and tissue heating, however, it also increases antenna efficiency for very small antennas. Therefore, there is an optimal frequency at which enough power can be delivered to the small antennas, while limiting tissue heating to safe levels. In some embodiments, an optimal frequency of operation for the implantable sensors disclosed herein can be from approximately 100 MHz up to 5 GHz, depending on implantable device design, operating environment, required power and voltage, and device size.
Operating the implantable sensing devices of this disclosure for mid-range power transfer over high operating frequencies allows for miniaturization of the sensing devices that would not be possible in a system that uses inductive coupling. For example, sensing devices of the present disclosure can be miniaturized to have a total volume on the order of 1 mm×1 mm×1 mm. Another benefit of higher frequency of operation is the higher available bandwidth that can be used to achieve higher data rates for communication. Also, higher frequency of operation desensitizes power transfer efficiency to alignment and orientation between external and implant device antennas.
Wirelessly powering the sensing devices of the present disclosure eliminates the need for leads extending through the skin, which simplifies the implantation procedure and reduces the risk of infection. The sensing devices described herein are therefore less invasive, and safer in the long term for a patient. This is especially important in applications such as brain or cardiac monitoring, where the risk of infection is so great. This also enables longer-lasting implantable devices by eliminating the need for a patient to undergo another surgery to replace a battery. This can be achieved by recharging a battery or energy storage element.
Although it can be advantageous to eliminate the size and weight of conventional chemical batteries, in some embodiments the sensing devices can include an energy source, such as a battery or a capacitor, which can be configured to store energy from the external device and power the sensing devices even when the external device is not wirelessly transmitting power to the sensing devices. This type of configuration can allow the sensing devices to monitor the patient even in the absence of an external charging device.
The sensing devices of
Referring to
Compact, wirelessly powered, untethered sensing devices such as those described herein can be used in any number of medical applications. As described above, an array of sensing devices can be used to measure and map the electrical properties of the heart, and communicate that information wirelessly outside of the body to an external device. Uses within the heart are not limited to electrical properties, however, and the sensing devices can also be used to monitor blood flow, heart rate, core temperature, and more.
In another embodiment, a plurality of sensing devices outfitted with pressure sensors can be implanted within the venous system of a patient (e.g., within the pulmonary arteries) to measure the pressure of blood or the flow rate of blood at various points in the venous system.
In another embodiment, a plurality of sensing devices outfitted with electrical sensors or electrodes can be disposed on or near coronary stents and be configured to measure a resistance of blood inside the coronary stents as a way to monitor the degree of stenosis inside the stent. In this embodiment, the sensing devices could be used to report when a stent is wearing down and due for replacement. Thus, the sensing devices of the present disclosure can be used to monitor the effectiveness and lifetime of other medical devices implanted in the body.
The sensing devices described herein can also be implanted on or within the brain to measure various parameters relating to electrical activity, blood flow, or pressure in the brain. For example, in some situations surgeons need info on the local perfusion of the brain, since swelling after surgery can compromise that part of the brain. In this particular embodiment, sensing devices can be implanted in the brain to measure blood flow or other brain parameters as a way of monitoring the patient after surgery. The sensing devices described herein allow for measurement of brain activity directly without having leads that extend out through the skull, thereby reducing infection risk.
Until this point, the sensing devices have been described entirely as sensing or measurement devices. However, in some embodiments, the sensing devices can also include a therapy element, such as a stimulation electrode, configured to provide therapy to a patient. For example, the sensors 110 of
As for additional details pertinent to the present invention, materials and manufacturing techniques may be employed as within the level of those with skill in the relevant art. The same may hold true with respect to method-based aspects of the invention in terms of additional acts commonly or logically employed. Also, it is contemplated that any optional feature of the inventive variations described may be set forth and claimed independently, or in combination with any one or more of the features described herein. Likewise, reference to a singular item, includes the possibility that there are plural of the same items present. More specifically, as used herein and in the appended claims, the singular forms “a,” “and,” “said,” and “the” include plural referents unless the context clearly dictates otherwise. It is further noted that the claims may be drafted to exclude any optional element. As such, this statement is intended to serve as antecedent basis for use of such exclusive terminology as “solely,” “only” and the like in connection with the recitation of claim elements, or use of a “negative” limitation. Unless defined otherwise herein, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. The breadth of the present invention is not to be limited by the subject specification, but rather only by the plain meaning of the claim terms employed.
This application is a continuation of U.S. application Ser. No. 14/424,303, filed Feb. 6, 2015, titled “Wireless Implantable Sensing Devices”, which application is the national stage under 35 USC 371 of International Application No. PCT/US2013/067882, filed Oct. 31, 2013, which claims the benefit under 35 USC 119 of U.S. Provisional Application No. 61/720,827, filed Oct. 31, 2012, titled “Wireless Implantable Sensing Devices”, which applications are incorporated by reference as if fully set forth herein.
Number | Date | Country | |
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61720827 | Oct 2012 | US |
Number | Date | Country | |
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Parent | 14424303 | Feb 2015 | US |
Child | 16505425 | US |