公开(公告)号：US6078835A

公开(公告)日：2000-06-20

申请号：US242278

申请日：1998-02-12

申请人： Sven-Erik Hedberg ,  Karin Jarverud ,  Kjell Noren ,  Staffan Bowald

发明人： Sven-Erik Hedberg ,  Karin Jarverud ,  Kjell Noren ,  Staffan Bowald

IPC分类号： A61N1/365

CPC分类号： A61N1/36564

摘要： A pacemaker has control circuits contained in an enclosure and a lead containing an electrical conductor connected to an electrode for delivering electrical stimulation pulses to a heart. The stretching of a wall in the ventricle, corresponding to adequate filling of the ventricle in the heart, is determined in order to identify a time of emitting the stimulation pulses. This stretching is measured indirectly by measurement of pressure in the ventricle using a pressure sensor disposed near the lead in the ventricle. The signal from the sensor is supplied via the lead to circuitry in the enclosure, wherein the signal is amplified and is supplied to an edge detector, which detects an increasing or positive edge of the signal. The edge detector compares the incoming signal with a threshold value, and when the pressure indicated by the signal increases so as to exceed the threshold value, the edge detector supplies a signal to the control circuit which, in turn, triggers the emission of a stimulation pulse from a pulse generator, with or without a delay. The aforementioned stretching can also be measured using a strain gauge or a distance sensor attached to the ventricle wall.

摘要翻译： PCT No.PCT / SE97 / 01239 Sec。 371日期1999年2月12日 102（e）1999年2月12日PCT PCT 1997年7月4日PCT公布。 公开号WO98 / 06454 日期1998年2月19日起搏器具有包含在外壳中的控制电路和包含连接到电极的电导体的引线，用于将电刺激脉冲传递到心脏。 为了确定发射刺激脉冲的时间，确定对应于心脏中心室充分填充的心室中的壁的拉伸。 使用设置在心室中的引线附近的压力传感器通过测量心室中的压力来间接测量该拉伸。 来自传感器的信号通过导线提供给外壳中的电路，其中信号被放大并被提供给检测信号的增加或上升沿的边缘检测器。 边缘检测器将输入信号与阈值进行比较，并且当信号指示的压力增加以超过阈值时，边缘检测器向控制电路提供信号，该信号又触发了刺激的发射 来自脉冲发生器的脉冲，有或没有延迟。 上述拉伸也可以使用附着于心室壁的应变计或距离传感器来测量。

公开(公告)号：US20080091239A1

公开(公告)日：2008-04-17

申请号：US11582211

申请日：2006-10-16

申请人： Anna-Karin Johansson ,  Kenth Nilsson ,  Cecilia Tuvstedt ,  Kjell Noren ,  Anders Bjorling ,  Andreas Blomqvist ,  Berit Larsson ,  Sven-Erik Hedberg ,  Karin Jarverud ,  Nils Holmstrom

发明人： Anna-Karin Johansson ,  Kenth Nilsson ,  Cecilia Tuvstedt ,  Kjell Noren ,  Anders Bjorling ,  Andreas Blomqvist ,  Berit Larsson ,  Sven-Erik Hedberg ,  Karin Jarverud ,  Nils Holmstrom

IPC分类号： A61N1/36 ,  A61N1/362 ,  A61N1/39

CPC分类号： A61N1/36514 ,  A61N1/3956

摘要： In a cardiac assist device and method, a microphone is placed in contact with the epicardium of the heart of a patient, and heart and lung sounds are simultaneously detected at the placement location of the microphone. The heart and lung sounds are automatically analyzed to set an appropriate cardiac therapy for the patient.

摘要翻译： 在心脏辅助装置和方法中，将麦克风放置成与患者心脏的心外膜接触，并且在麦克风的放置位置同时检测心脏和肺部的声音。 自动分析心脏和肺部声音，为患者设定适当的心脏治疗。

公开(公告)号：US20140257423A1

公开(公告)日：2014-09-11

申请号：US13508968

申请日：2011-05-31

申请人： Sven-Erik Hedberg ,  Nils Holmstrom ,  Karin Jarverud

发明人： Sven-Erik Hedberg ,  Nils Holmstrom ,  Karin Jarverud

IPC分类号： A61N1/368

CPC分类号： A61N1/368 ,  A61N1/3622 ,  A61N1/3682 ,  A61N1/3684

摘要： The present invention relates generally to implantable medical devices and more particularly to systems and methods for stimulating a heart of a patient. A first ventricle is activated by delivering stimulation to at least one stimulation site, a point of time for arrival at the AV node for at least one depolarization wave resulting from the stimulation in the first ventricle is estimated and a first activation time interval substantially corresponding to the time interval required for at least one depolarization wave to travel from the stimulation site in the first ventricle to the AV node using the estimated point of time for arrival of the depolarization wave and a point of time for delivery of stimulation is computed. Thereafter, the other ventricle is stimulated by delivering stimulation to at least one stimulation site. A point of time for arrival at the AV node for at least one depolarization wave resulting from the stimulation in the other ventricle is then estimated and a second activation time interval substantially corresponding to the time required for at least one depolarization wave to travel from the stimulation site in the other ventricle to the AV node using the estimated arrival of the depolarization wave and the point of time for delivery of stimulation is computed. Based on these activation time intervals and a difference between the intervals, a pacing therapy can be determined, wherein the first ventricle is paced prior to activation of the other ventricle if the activation time difference indicates that the first activation time interval is longer than the second activation time interval and the other ventricle is paced prior to activation of the first ventricle if the activation time difference indicates that the second activation time interval is longer than the first activation time interval.

摘要翻译： 本发明一般涉及可植入医疗装置，更具体地涉及用于刺激患者心脏的系统和方法。 通过向至少一个刺激部位递送刺激来激活第一脑室，估计到达在第一脑室刺激产生的至少一个去极化波的AV节点的时间点，并且基本对应于 计算使用去极化波的到达的估计时间点和用于递送刺激的时间点的至少一个去极化波从第一脑室的刺激部位行进到AV节点所需的时间间隔。 此后，通过将刺激递送至至少一个刺激部位刺激另一个心室。 然后估计到达AV节点对于在另一个心室中的刺激产生的至少一个去极化波的时间点，并且基本对应于至少一个去极化波从刺激行进所需的时间的第二激活时间间隔 计算使用去极化波的估计到达和输送刺激的时间点在AV节点的另一脑室中的位置。 基于这些激活时间间隔和间隔之间的差异，可以确定起搏治疗，其中如果激活时间差指示第一激活时间间隔长于第二心室第二激活时间间隔，则第一心室在另一心室激活之前起搏 如果所述激活时间差指示所述第二激活时间间隔长于所述第一激活时间间隔，则所述激活时间间隔和所述另一个心室在所述第一心室激活之前起步。

公开(公告)号：US20080294216A1

公开(公告)日：2008-11-27

申请号：US12094543

申请日：2005-11-30

申请人： Karin Jarverud ,  Kenth Nilsson ,  Sven-Erik Hedberg

发明人： Karin Jarverud ,  Kenth Nilsson ,  Sven-Erik Hedberg

IPC分类号： A61N1/368

CPC分类号： A61N1/3627 ,  A61B5/1107 ,  A61B5/6869 ,  A61B2562/0219 ,  A61N1/36514 ,  A61N1/36578

摘要： In a system and method for monitoring cardiac synchrony in a human heart, a first sensor is positioned at a first cardiac wall location of a heart that is subject to movements related to longitudinal valve plane movements along the longitudinal axis of the heart, and the first sensor measures said cardiac wall movements at the first cardiac wall location and emits a first sensor output signal corresponding thereto, a second sensor is positioned at a second cardiac wall location of the heart that is subject to movements related to longitudinal valve plane movements along the longitudinal axis of the heart, and the second sensor measures the cardiac wall movements at the second cardiac wall location and emits a second sensor output signal corresponding thereto. A lead arrangement is electrically connected to the first and second sensors and conducts the first and second sensor output signals therefrom to processing circuitry that processes the first and second sensor output signals to produce a synchronization signal therefrom indicative of synchrony in the respective valve plane movements at the first and second cardiac wall locations.

摘要翻译： 在用于监测人心脏心脏同步的系统和方法中，第一传感器位于心脏的第一心脏壁位置处，所述第一心脏壁位置受到与沿着心脏的纵向轴线的纵向瓣膜平面运动有关的运动，第一传感器 传感器测量在第一心脏壁位置处的心脏壁运动，并且发射与其对应的第一传感器输出信号，第二传感器定位在心脏的第二心脏壁位置处，该第二心脏壁位置受到与沿着纵向的纵向瓣膜平面运动相关的运动 并且第二传感器测量第二心脏壁位置处的心脏壁移动，并且发出与其对应的第二传感器输出信号。 引线装置电连接到第一和第二传感器，并将第一和第二传感器输出信号传送到处理电路，处理电路处理第一和第二传感器输出信号以产生同步信号，表示在各个阀平面运动中同步的同步信号 第一和第二心脏壁位置。

公开(公告)号：US09162066B2

公开(公告)日：2015-10-20

申请号：US13508968

申请日：2011-05-31

申请人： Sven-Erik Hedberg ,  Nils Holmstrom ,  Karin Jarverud

发明人： Sven-Erik Hedberg ,  Nils Holmstrom ,  Karin Jarverud

IPC分类号： A61N1/368 ,  A61N1/362

CPC分类号： A61N1/368 ,  A61N1/3622 ,  A61N1/3682 ,  A61N1/3684

摘要： A first ventricle is stimulated at a stimulation site, a point of time for arrival at the AV node for at least one depolarization wave resulting from the stimulation is estimated and a first activation time interval substantially corresponding to the time interval required for at least one depolarization wave to travel from the stimulation site in the first ventricle to the AV node is computed. A similar process is used to compute a second activation time interval for the other ventricle. Based on these activation time intervals and a difference between the intervals, a pacing therapy can be determined.

摘要翻译： 在刺激部位刺激第一脑室，估计从刺激产生的至少一个去极化波到达AV节点的时间点，并且基本对应于至少一个去极化所需的时间间隔的第一激活时间间隔 计算从第一脑室的刺激部位到AV节点的波。 使用类似的过程来计算另一个心室的第二激活时间间隔。 基于这些激活时间间隔和间隔之间的差异，可以确定起搏治疗。

公开(公告)号：US07085602B2

公开(公告)日：2006-08-01

申请号：US10720449

申请日：2003-11-24

申请人： Sven-Erik Hedberg ,  Asa Uhrenius ,  Karin Jarverud ,  Hans Strandberg ,  Nils Holmström ,  Anders Björling ,  Göran Budgifvars

发明人： Sven-Erik Hedberg ,  Asa Uhrenius ,  Karin Jarverud ,  Hans Strandberg ,  Nils Holmström ,  Anders Björling ,  Göran Budgifvars

IPC分类号： A61N1/365

CPC分类号： A61N1/368 ,  A61N1/056 ,  A61N1/3684 ,  A61N2001/0585

摘要： An implantable bi-ventricular heart stimulating device (10) has a control circuit with first and second sensing circuits for respectively sensing in the two ventricles and first and second stimulation circuits for respectively stimulating the two ventricles. The control circuit determines whether a signal, sensed by said second sensing circuit, occurs essentially simultaneously with a signal sensed by the first sensing circuit. Furthermore, the control circuit determines whether a further signal is sensed by said second sensing circuit within a predetermined time interval which follows after the signal sensed by the second sensing circuit but within the same time cycle as that signal. If this occurs, the control circuit determines whether the sensed signals represent actual cardiac events, or are likely the result of far field detection.

摘要翻译： 可植入式双心室心脏刺激装置（10）具有控制电路，该控制电路具有用于分别感测两个心室的第一和第二感测电路以及分别刺激两个脑室的第一和第二刺激电路。 控制电路确定由所述第二感测电路检测到的信号是否基本上与由第一感测电路感测的信号同时发生。 此外，控制电路确定在由第二感测电路感测到的信号之后但在与该信号相同的时间周期内的预定时间间隔内，所述第二感测电路是否感测到另外的信号。 如果发生这种情况，则控制电路确定感测到的信号是否代表实际的心脏事件，或者很可能是远场检测的结果。

公开(公告)号：US09436801B2

公开(公告)日：2016-09-06

申请号：US14000844

申请日：2011-03-18

申请人： Karin Jarverud ,  Anders Bjorling ,  Malin Hollmark ,  Kjell Noren ,  Tomas Svensson ,  Stefan Hjelm

发明人： Karin Jarverud ,  Anders Bjorling ,  Malin Hollmark ,  Kjell Noren ,  Tomas Svensson ,  Stefan Hjelm

IPC分类号： G01N33/48 ,  G01N33/50 ,  G06F19/00 ,  A61B5/053 ,  A61N1/365 ,  G06F19/24 ,  G06F19/12 ,  A61B5/0464

CPC分类号： G06F19/34 ,  A61B5/0464 ,  A61B5/0538 ,  A61N1/36521 ,  A61N1/36535 ,  G06F19/00 ,  G06F19/12 ,  G06F19/24 ,  G16H50/50

摘要： A patient-specific hemodyanmic status model is determined from impedance data collected during periods of normal and abnormal hemodynamic status by deriving parameter values of a set of multiple impedance-derivable parameters from impedance signals collected during periods of normal hemodynamic status and in connection with periods of abnormal hemodynamic status. The parameter values are employed to estimate coefficients of a linear parametric status model. These coefficients can then be used together with parameter values determined from impedance signals determined during status assessment periods in order to determine a current hemdoynamic status of the patient.

摘要翻译： 通过从正常血液动力学状态期间收集的阻抗信号中导出一组多个阻抗可导出参数的参数值，并与正常血液动力学状态期间相关联的时期，从正常和异常血液动力学状态期间收集的阻抗数据确定患者特异性血液动力学状态模型 异常血液动力学状态。 参数值用于估计线性参数状态模型的系数。 然后可以将这些系数与在状态评估期间确定的阻抗信号确定的参数值一起使用，以便确定患者的当前血液动力学状态。

公开(公告)号：US5556419A

公开(公告)日：1996-09-17

申请号：US342051

申请日：1994-11-17

申请人： Karin Jarverud ,  Kjell Noren

发明人： Karin Jarverud ,  Kjell Noren

IPC分类号： A61B5/0402 ,  A61B5/0452 ,  A61N1/362 ,  A61N1/365 ,  A61B5/04 ,  A61N1/36

CPC分类号： A61N1/3622

摘要： A device for identifying abnormal conditions in a heart retrograde conduction and tachyarrhythmias in particular, includes a differentiating circuit electrically connected to a heart to be monitored in order to differentiate ECG signals from the heart. The differentiated signal is plotted against the ECG signal. The radius (distance from a point on the resulting curve from the origin of the plot axes) in the resulting curve is calculated in a calculator unit. The radius obtained is then compared with a threshold value in a comparator and a sequence for the progression of the radius in relation to the threshold value is obtained and compared with previously obtained sequences stored in a sequence analyzer.

摘要翻译： 特别是用于识别心脏逆行传导和快速性心律失常的异常状况的装置，包括电连接到要被监测的心脏的微分电路，以便将ECG信号与心脏区分开来。 差分信号相对于ECG信号绘制。 在计算器单元中计算所得曲线中的半径（来自曲线轴的原点上的点的距离）。 然后将获得的半径与比较器中的阈值进行比较，并获得相对于阈值进行半径的序列，并与存储在序列分析器中的先前获得的序列进行比较。

公开(公告)号：US09119545B2

公开(公告)日：2015-09-01

申请号：US13076627

申请日：2011-03-31

申请人： Anders Bjorling ,  Malin Hollmark ,  Tomas Svensson ,  Stefan Hjelm ,  Kjell Noren ,  Karin Jarverud

发明人： Anders Bjorling ,  Malin Hollmark ,  Tomas Svensson ,  Stefan Hjelm ,  Kjell Noren ,  Karin Jarverud

IPC分类号： A61B5/04 ,  A61B5/0456 ,  A61B5/00 ,  A61B5/053 ,  A61N1/362 ,  A61N1/365 ,  A61N1/37 ,  A61N1/39

CPC分类号： A61B5/0456 ,  A61B5/0031 ,  A61B5/053 ,  A61B5/7264 ,  A61N1/3621 ,  A61N1/36521 ,  A61N1/3702 ,  A61N1/3925 ,  A61N1/3962

摘要： An implantable medical device, is designed to collect a signal representative of the electric activity of the heart and determine a cardiogenic impedance signal for at least a portion of the heart. An R-wave detector of the IMD detects the timing of an R-wave during a cardiac cycle based on the signal representative of the electric activity. A minimum detector detects the timing of a cardiogenic impedance minimum in the cardiogenic impedance signal and within a systolic time window of the cardiac cycle. A detected arrhythmia is then classified by the IMD based on the timing of the R-wave detected by the R-wave detector and the timing of the cardiogenic impedance minimum detected by the minimum detector.

摘要翻译： 可植入医疗装置被设计成收集表示心脏的电活动的信号，并确定至少一部分心脏的心源性阻抗信号。 基于代表电活动的信号，IMD的R波检测器在心动周期中检测R波的定时。 最小检测器检测心源性阻抗信号中心源性阻抗最小值的定时，并在心动周期的收缩时间窗内检测。 然后，基于由R波检测器检测到的R波的定时和由最小检测器检测的心源阻抗最小值的定时，通过IMD对检测到的心律失常进行分类。

公开(公告)号：US20130046194A1

公开(公告)日：2013-02-21

申请号：US13643068

申请日：2010-04-27

申请人： Anders Bjolring ,  Malin Hollmark ,  Tomas Svensson ,  Stefan Hjelm ,  Kjell Noren ,  Karin Jarverud

发明人： Anders Bjolring ,  Malin Hollmark ,  Tomas Svensson ,  Stefan Hjelm ,  Kjell Noren ,  Karin Jarverud

IPC分类号： A61B5/0452 ,  A61N1/39

CPC分类号： A61B5/0452 ,  A61B5/053 ,  A61B5/0538 ,  A61B5/7257 ,  A61B5/7264 ,  A61N1/3622 ,  A61N1/36521 ,  A61N1/36564 ,  A61N1/36585 ,  A61N1/3962

摘要： An implantable medical device (100) is configured for generating a cardiogenic impedance signal representative of the cardiogenic impedance of at least a portion of a heart (10) of a subject (20) during multiple cardiac cycles. A transform processor (132) generates a spectrum signal by applying a time-to-frequency transform to the cardiogenic impedance signal. The spectrum signal is processed by a distribution processor (133) configured to calculate a distribution parameter indicative of a distribution in at least a portion of the spectrum signal. The calculated distribution parameter is of high diagnostic value and is employed by an arrhythmia classifier (134) in order to classify a detected arrhythmia of the heart (10), such as discriminate between hemodynamically stable or unstable arrhythmias and/or supraventricular or ventricular tachycardia.

摘要翻译： 可植入医疗装置（100）被配置为在多个心动周期期间产生代表受试者（20）的心脏（10）的至少一部分的心源阻抗的心源阻抗信号。 变换处理器（132）通过对心源阻抗信号施加时间 - 频率变换来产生频谱信号。 频谱信号由分配处理器（133）处理，分配处理器（133）被配置为计算指示频谱信号的至少一部分中的分布的分布参数。 计算出的分布参数具有很高的诊断价值，并被心律失常分类器（134）采用，以便将检测到的心脏心律不齐（10）进行分类，例如区分血流动力学稳定或不稳定的心律失常和/或室上或室性心动过速。