公开(公告)号：US07212862B2

公开(公告)日：2007-05-01

申请号：US10247137

申请日：2002-09-18

申请人： Euljoon Park ,  Steve Koh ,  Gene A. Bornzin

发明人： Euljoon Park ,  Steve Koh ,  Gene A. Bornzin

IPC分类号： A61N1/365

CPC分类号： A61N1/36585 ,  A61N1/3601 ,  A61N1/36542 ,  A61N1/36557

摘要： An implantable cardiac stimulation device comprises a physiologic sensor and one or more pulse generators. The physiologic sensor is capable of sensing a physiologic parameter. The pulse generators can generate cardiac pacing pulses with a timing based on the physiologic parameter. The timed cardiac pacing pulses can prevent a sleep apnea condition. In one example, a cardiac stimulation device has a physiologic sensor and can be configured to pace a patient's heart according to a rest mode of operation. The cardiac stimulation device uses measurements from the physiologic sensor to prevent and treat sleep apnea using a revised rest mode of operation. The revised rest mode operates under a presumption that sleep apnea is primary to a reduced heart rate, rather than secondary, so that pacing at a rate higher than the natural cardiac rate during sleep will prevent sleep apnea.

摘要翻译： 植入式心脏刺激装置包括生理传感器和一个或多个脉冲发生器。 生理传感器能感测生理参数。 脉冲发生器可以产生基于生理参数的定时的心脏起搏脉冲。 定时的心脏起搏脉冲可以防止睡眠呼吸暂停状态。 在一个示例中，心脏刺激装置具有生理传感器，并且可以被配置为根据休息的操作模式来对患者的心脏进行加速。 心脏刺激装置使用来自生理传感器的测量来使用修改的休息模式来预防和治疗睡眠呼吸暂停。 修改后的休息模式的作用是假设睡眠呼吸暂停是降低心率而不是继发性睡眠呼吸暂停的原因，因此在睡眠期间以高于自然心率的速率起搏将防止睡眠呼吸暂停。

公开(公告)号：US07149584B1

公开(公告)日：2006-12-12

申请号：US10328642

申请日：2002-12-23

申请人： Steve Koh ,  Mark W. Kroll ,  Euljoon Park ,  Gene A. Bornzin

发明人： Steve Koh ,  Mark W. Kroll ,  Euljoon Park ,  Gene A. Bornzin

IPC分类号： A61N1/00

CPC分类号： A61N1/37252 ,  A61N1/36535 ,  A61N1/36542 ,  A61N1/37235

摘要： Time-varying spatial signals are detected by accelerometers mounted within the patient. The signals, representative of the actual 3-D trajectory of the patient, are compared with information representative of expected trajectories retrieved from memory to identify a current patient posture, which may be either a dynamic posture such as walking or running or a change in posture such as rising from a seated position to a standing position. In this manner, a change in posture of the patient is identified based upon a full 3-D trajectory, rather than merely the orientation of the patient at the beginning and the end of the change in posture. In an example described herein, the implantable device stores information representative of expected 3-D trajectories in the form of pre-calculated comparison matrices derived from orthonormal kernels employing Laguerre functions or Lagrange functions. A technique is also described for use by an external programmer for pre-calculating comparison matrices so as to reduce the processing burden within the implanted device during posture detection.

公开(公告)号：US06999817B2

公开(公告)日：2006-02-14

申请号：US10077660

申请日：2002-02-14

申请人： Euljoon Park ,  Steve Koh ,  Gene A. Bornzin

发明人： Euljoon Park ,  Steve Koh ,  Gene A. Bornzin

IPC分类号： A61N1/36

CPC分类号： A61N1/365 ,  A61N1/36557

摘要： An implantable cardiac stimulation device comprises a physiologic sensor and one or more pulse generators. The physiologic sensor is capable of sensing a physiologic parameter. The pulse generators can generate cardiac pacing pulses with a timing based on the physiologic parameter. The timed cardiac pacing pulses can prevent a sleep apnea condition. In one example, a cardiac stimulation device has a physiologic sensor and can be configured to pace a patient's heart according to a rest mode of operation. The cardiac stimulation device uses measurements from the physiologic sensor to prevent and treat sleep apnea using a revised rest mode of operation. The revised rest mode operates under a presumption that sleep apnea is primary to a reduced heart rate, rather than secondary, so that pacing at a rate higher than the natural cardiac rate during sleep will prevent sleep apnea.

公开(公告)号：US20050277992A1

公开(公告)日：2005-12-15

申请号：US10866422

申请日：2004-06-10

申请人： Steve Koh ,  Euljoon Park ,  Gene Bornzin

发明人： Steve Koh ,  Euljoon Park ,  Gene Bornzin

IPC分类号： A61N1/362 ,  A61B5/0402

CPC分类号： A61N1/3627 ,  A61B5/0245 ,  A61B5/4035

摘要： An exemplary method includes selecting a cross-correlation frequency having an associated cross-correlation period, detecting and binning a heart rate in a heart rate bin, detecting and binning an activity state in an activity state bin, repeating the detecting and binning a heart rate and the detecting and binning an activity state during a cross-correlation period, and summing the products a bin count of the heart rate bins and a bin count of the activity state bins to provide a cross-correlation index for the cross-correlation period. Other exemplary algorithms, methods, devices, systems, etc., are also disclosed.

摘要翻译： 一种示例性方法包括选择具有相关联的相关周期的互相关频率，检测和归纳心率仓中的心率，检测和归纳活动状态仓中的活动状态，重复检测和归纳心率 以及在互相关时段期间检测和归纳活动状态，并且将乘积与心率仓的仓计数和活动状态仓的箱数相加，以提供互相关周期的互相关指数。 还公开了其它示例性算法，方法，设备，系统等。

公开(公告)号：US20050055060A1

公开(公告)日：2005-03-10

申请号：US10656540

申请日：2003-09-05

申请人： Steve Koh ,  Euljoon Park ,  Gene Bornzin

发明人： Steve Koh ,  Euljoon Park ,  Gene Bornzin

IPC分类号： A61B5/08 ,  A61B5/113 ,  A61N1/365

CPC分类号： A61N1/365 ,  A61B5/08 ,  A61B5/113 ,  A61B5/4818

摘要： Exemplary methods and devices for determining respiratory and/or autonomic characteristics based at least in part on atrioventricular conduction and/or one or more atrioventricular conduction interval times. Other methods, devices and/or systems are also disclosed.

摘要翻译： 用于至少部分地基于房室传导和/或一个或多个房室传导间隔时间来确定呼吸和/或自主特征的示例性方法和装置。 还公开了其它方法，装置和/或系统。

公开(公告)号：US09462959B2

公开(公告)日：2016-10-11

申请号：US12649665

申请日：2009-12-30

申请人： Yelena Nabutovsky ,  Fujian Qu ,  Steve Koh ,  Dan E. Gutfinger ,  Alex Soriano

发明人： Yelena Nabutovsky ,  Fujian Qu ,  Steve Koh ,  Dan E. Gutfinger ,  Alex Soriano

IPC分类号： A61N1/00 ,  A61B5/053 ,  A61B5/021 ,  A61B5/11 ,  A61B5/00 ,  A61N1/362 ,  A61N1/365 ,  A61N1/372 ,  A61N1/368 ,  A61N1/37 ,  A61N1/39

CPC分类号： A61B5/053 ,  A61B5/021 ,  A61B5/1116 ,  A61B5/4878 ,  A61B5/686 ,  A61B5/7275 ,  A61N1/3627 ,  A61N1/36521 ,  A61N1/36564 ,  A61N1/36585 ,  A61N1/3684 ,  A61N1/3702 ,  A61N1/37258 ,  A61N1/3962

摘要： In specific embodiments, a method to monitor left atrial pressure and/or intra-thoracic fluid volume of a patient, comprises (a) monitoring posture of the patient using a posture sensor implanted within the patient, and (b) using portions of an impedance signal, obtained using implanted electrodes, to monitor the left atrial pressure and/or intra-thoracic fluid volume of the patient. Each portion of the impedance signal used to monitor the left atrial pressure and/or intra-thoracic fluid volume of the patient corresponds to a period after which the patient has maintained a predetermined posture for at least a predetermined period of time, and during which the patient has remained in the predetermined posture.

摘要翻译： 在具体实施例中，监测患者的左心房压力和/或胸腔内体积的方法包括（a）使用植入患者体内的姿势传感器来监测患者的姿势，以及（b）使用部分阻抗 信号，使用植入电极获得，以监测患者的左心房压力和/或胸腔内体积。 用于监测患者的左心房压力和/或胸腔内液体体积的阻抗信号的每个部分对应于患者已经保持预定姿势至少预定时间段的时间段，在此期间 患者保持在预定的姿势。

公开(公告)号：US08626278B2

公开(公告)日：2014-01-07

申请号：US12901296

申请日：2010-10-08

申请人： Euljoon Park ,  Steve Koh ,  Gene A. Bornzin

发明人： Euljoon Park ,  Steve Koh ,  Gene A. Bornzin

IPC分类号： A61B5/0464 ,  A61B5/053

CPC分类号： A61B5/046 ,  A61B5/0006 ,  A61B5/0031 ,  A61B5/02028 ,  A61B5/0205 ,  A61B5/029 ,  A61B5/0402 ,  A61B5/0422 ,  A61B5/0468 ,  A61B5/0538 ,  A61B5/0816 ,  A61B5/1116 ,  A61B5/1118 ,  A61B5/686 ,  A61B5/6869 ,  A61N1/3624 ,  A61N1/36521 ,  A61N1/36592

摘要： A medical device is provided that comprises a lead assembly. The lead assembly includes at least one intra-cardiac (IC) electrode, an extra-cardiac (EC) electrode and a subcutaneous remote-cardiac (RC) electrode. The IC electrode is configured to be located within the heart. The EC electrode is configured to be positioned proximate to at least one of a superior vena cava (SVC) and a left ventricle (LV) of a heart. The RC electrode is configured to be located remote from the heart. An extra-cardiac impedance (ECI) module is configured to measure extra-cardiac impedance along an ECI vector between the EC and RC electrodes to obtain ECI measurements. An arrhythmia monitoring module is configured to declare a potential atrial arrhythmia to be an atrial arrhythmia based on the hemodynamic performance determined from the ECI measurements. The hemodynamic performance assessment module is further enabled to compare a current ECI pattern with a prior baseline ECI waveform.

摘要翻译： 提供了包括引线组件的医疗装置。 引线组件包括至少一个心脏内（IC）电极，心外（EC）电极和皮下远心电（RC）电极）。 IC电极被配置为位于心脏内。 EC电极配置成靠近心脏的上腔静脉（SVC）和左心室（LV）中的至少一个定位。 RC电极被配置为远离心脏。 心脏外阻抗（ECI）模块被配置为测量EC和RC电极之间的ECI向量的心外阻抗，以获得ECI测量值。 心律失常监测模块被配置为基于从ECI测量确定的血液动力学性能来将潜在心房心律失常宣告为房性心律失常。 血液动力学性能评估模块还能够将当前ECI模式与先前的基线ECI波形进行比较。

公开(公告)号：US20130053913A1

公开(公告)日：2013-02-28

申请号：US13223117

申请日：2011-08-31

申请人： Steve Koh ,  Gene A. Bornzin ,  Jeffery D. Snell

发明人： Steve Koh ,  Gene A. Bornzin ,  Jeffery D. Snell

IPC分类号： A61N1/368

CPC分类号： A61N1/368 ,  A61B7/00 ,  A61B7/04 ,  A61N1/36585

摘要： A method is provided to determine pacing parameters for an implantable medical device (IMD) and collects heart sounds during the cardiac cycles. The method comprises changing a value for a pacing parameter between the cardiac cycles and analyzing a characteristic of interest from the heart sounds. The method comprises setting a desired value for the pacing parameter based on the characteristic of interest from the heart sounds. The system comprises inputs configured to be coupled to at least one lead having electrodes to sense intrinsic events and to deliver pacing pulses over cardiac cycles. The system has a sensor for collecting heart sounds during cardiac cycles and controller to control delivery of pacing pulses based on pacing parameters. The controller changes a value for at least one of the pacing parameters between the cardiac cycles and provides an analysis module to analyze a characteristic of interest from the heart sounds.

摘要翻译： 提供了一种用于确定可植入医疗装置（IMD）的起搏参数并在心脏周期期间收集心脏声音的方法。 该方法包括在心脏周期之间改变起搏参数的值并且从心脏声音分析感兴趣的特征。 该方法包括基于来自心音的感兴趣的特征来设置起搏参数的期望值。 该系统包括被配置为耦合到具有电极以感测固有事件并且在心动周期上传送起搏脉冲的至少一个引线的输入。 该系统具有用于在心动周期期间收集心脏声音的传感器和控制器，以根据起搏参数控制起搏脉冲的传递。 控制器改变心脏周期之间的至少一个起搏参数的值，并提供分析模块来分析来自心脏声音的兴趣特征。

公开(公告)号：US08343059B1

公开(公告)日：2013-01-01

申请号：US11678401

申请日：2007-02-23

申请人： Steve Koh

发明人： Steve Koh

IPC分类号： A61B5/02 ,  A61B5/08

CPC分类号： A61B5/686 ,  A61B5/0205 ,  A61B5/0215

摘要： A signal indicative of left atrial pressure in the heart of a patient is analyzed to identify a signal component that is related to the respiration of the patient. An indication relating to the left atrial pressure may be generated based on the presence, absence, or magnitude of the respiratory component. In some embodiments the indication may be used to indicate high left atrial pressure. In some embodiments the indication may be used to indicate heart failure. In some embodiments the indication may be used in conjunction with verifying the operation of a left atrial pressure sensor. In the event of high left atrial pressure or an incorrect pressure reading an appropriate warning may be generated. In the event of an incorrect pressure reading the left atrial pressure sensor may be recalibrated.

摘要翻译： 分析指示患者心脏中的左心房压力的信号以识别与患者的呼吸相关的信号分量。 可以基于呼吸成分的存在，不存在或大小产生与左心房压力有关的指示。 在一些实施例中，该指示可用于指示高的左心房压力。 在一些实施例中，该指示可用于指示心力衰竭。 在一些实施例中，指示可以与验证左心房压力传感器的操作结合使用。 在左心房压力高或压力读数不正确的情况下，可能会产生适当的警告。 在压力读数不正确的情况下，可以重新校准左心房压力传感器。

公开(公告)号：US08323205B2

公开(公告)日：2012-12-04

申请号：US12368916

申请日：2009-02-10

申请人： Euljoon Park ,  Steve Koh

发明人： Euljoon Park ,  Steve Koh

IPC分类号： A61B5/0205

CPC分类号： A61B5/0537 ,  A61B5/4878 ,  A61N1/36521

摘要： A method of identifying a potential cause of pulmonary edema is provided. The method includes obtaining one or more impedance vectors between predetermined combinations of the electrodes positioned proximate the heart. At least one of the impedance vectors is representative of a thoracic fluid level. The method also includes applying a stimulation pulse to the heart and sensing cardiac signals of the heart that are representative of an electrophysiological response to the stimulation pulse. The method further includes monitoring the cardiac signals and at least one of the impedance vectors with respect to time to identify the potential cause of pulmonary edema.

摘要翻译： 提供了鉴定肺水肿潜在原因的方法。 该方法包括在定位在心脏附近的电极的预定组合之间获得一个或多个阻抗矢量。 阻抗向量中的至少一个代表胸水液位。 该方法还包括向心脏施加刺激脉冲并感测代表对刺激脉冲的电生理响应的心脏心脏信号。 该方法还包括相对于时间监测心脏信号和阻抗向量中的至少一个以识别肺水肿的潜在原因。