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91.发明申请公开(公告)号：US20100030093A1
公开(公告)日：2010-02-04
申请号：US12183950
申请日：2008-07-31
申请人： Xusheng Zhang , Raja N. Ghanem , Robert W. Stadler
发明人： Xusheng Zhang , Raja N. Ghanem , Robert W. Stadler
IPC分类号： A61B5/0464 , A61N1/362
CPC分类号： A61N1/3621 , A61B5/0464 , A61B5/7221 , A61B5/7239 , A61N1/36507 , A61N1/3925 , A61N1/3962
摘要： Techniques for determining whether artifacts are present in a cardiac electrogram are described. According to one example, a medical device senses a cardiac electrogram via electrodes. The medical device determines a derivative, e.g., a second order derivative, the electrogram. The medical device detects beats within the derivative, e.g., by comparing a rectified version of the derivative to one or more thresholds determined based on a maximum of the rectified derivative. The medical device determines whether the beats are periodic, and determines whether artifacts are present in the cardiac electrogram based on the determination of whether the beats are periodic. The medical device may further determine whether tachyarrhythmia is present and/or whether the cardiac rhythm of the patient is treatable based on the determination of whether the beats are periodic. For example, the medical device may determine that an electrogram is not treatable when the beats are periodic.
摘要翻译： 描述了用于确定伪像是否存在于心电图中的技术。 根据一个示例，医疗装置通过电极感测心电图。 医疗设备确定导数，例如二阶导数，电描记图。 医疗设备检测导数内的跳动，例如通过将导数的整流版本与基于校正导数的最大值确定的一个或多个阈值进行比较。 医疗器械确定节拍是否是周期性的，并且基于确定节拍是否是周期性的确定来确定心脏电图中是否存在假象。 医疗装置可以基于是否是周期性的确定来进一步确定是否存在快速性心律失常和/或患者的心律是否可治疗。 例如，当节拍是周期性的时，医疗装置可以确定电描记图是不可治疗的。
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92.发明申请公开(公告)号：US20070232944A1
公开(公告)日：2007-10-04
申请号：US11461269
申请日：2006-07-31
申请人： Raja N. Ghanem , Robert W. Stadler , Xusheng Zhang
发明人： Raja N. Ghanem , Robert W. Stadler , Xusheng Zhang
IPC分类号： A61B5/04
CPC分类号： A61N1/3956 , A61B5/046 , A61B5/0464 , A61B5/7239 , A61N1/3621
摘要： A method and apparatus for detecting a cardiac event in a medical device that includes sensing cardiac signals from a plurality of electrodes forming a first sensing vector and a second sensing vector, advancing from a first state to a second state in response to processing of an interval associated with a cardiac cycle of the sensed cardiac signals, and advancing from the second state in response to processing of a cardiac signal sensed during a predetermined sensing window.
摘要翻译： 一种用于检测医疗设备中的心脏事件的方法和装置，包括：感测来自形成第一感测向量的多个电极的心脏信号和响应于间隔的处理从第一状态进入第二状态的第二感测向量 与感测的心脏信号的心动周期相关联，并且响应于在预定感测窗口期间感测的心脏信号的处理而从第二状态前进。
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公开(公告)号：US07181268B2
公开(公告)日：2007-02-20
申请号：US10304112
申请日：2002-11-25
IPC分类号： A61B5/0402
CPC分类号： A61N1/368 , A61N1/3627 , A61N1/36585
摘要： Techniques for detection and treatment of myocardial ischemia are described that monitor both the electrical and dynamic mechanical activity of the heart to detect and verify the occurrence of myocardial ischemia in a more reliable manner. The occurrence of myocardial ischemia can be detected by monitoring changes in an electrical signal such as an ECG or EGM, and changes in dynamic mechanical activity of the heart that are sensed by an accelerometer sensor. The heart acceleration signal can be obtained from an single- or multiple-axis accelerometer and/or a pressure sensor deployed within or near the heart. The techniques correlate contractility changes detected by an accelerometer or pressure sensor with changes in the ST electrogram segment detected by the electrodes to increase the reliability of ischemia detection.
摘要翻译： 描述了用于检测和治疗心肌缺血的技术，其监测心脏的电和动态机械活性以更可靠的方式检测和验证心肌缺血的发生。 可以通过监测诸如ECG或EGM的电信号的变化以及由加速度计传感器感测到的心脏的动态机械活动的变化来检测心肌缺血的发生。 心脏加速度信号可以从部署在心脏内部或附近的单轴或多轴加速度计和/或压力传感器获得。 该技术将由加速度计或压力传感器检测到的收缩性变化与由电极检测到的ST电描绘部分的变化相关联，以增加缺血检测的可靠性。
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94.发明授权公开(公告)号：US07066891B2
公开(公告)日：2006-06-27
申请号：US10325076
申请日：2002-12-20
申请人： Robert W. Stadler , Steven N. Lu , Gary W. King , Thomas R. Moore
发明人： Robert W. Stadler , Steven N. Lu , Gary W. King , Thomas R. Moore
IPC分类号： A61B5/02
CPC分类号： A61B5/0452 , A61N1/362 , G06F19/00
摘要： An implantable medical device (IMD) for gauging the severity of ischemia in a patient's heart includes a data collection module configured to receive data about the patient's heart, a data processing module configured to process the data to identify an episode of ischemia in the patient and to determine if the episode is stable or unstable, and a reporting module configured to provide an alarm to the patient if the episode is unstable. A method executable by an implantable medical device to detect ischemia in a human heart suitably includes the steps of receiving data about the heart at the implantable medical device, processing the data within the implantable medical device to determine the severity of ischemia, and providing a response from the implantable medical device to the patient if ischemia is indicated.
摘要翻译： 用于测量患者心脏的严重程度的可植入医疗装置（IMD）包括：数据收集模块，被配置为接收关于患者心脏的数据;数据处理模块，被配置为处理所述数据以识别患者的局部缺血发作;以及 以确定剧集是否稳定或不稳定，并且报告模块被配置为如果发作不稳定则向患者提供警报。 可植入医疗装置可检测人心脏缺血的方法适当地包括以下步骤：在可植入医疗装置处接收关于心脏的数据，处理可植入医疗装置内的数据以确定局部缺血的严重性，并提供反应 从可植入的医疗装置到患者，如果指示缺血。
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公开(公告)号：US06937899B2
公开(公告)日：2005-08-30
申请号：US09945179
申请日：2001-08-30
CPC分类号： A61B5/4839 , A61B5/04011 , A61B5/0452 , A61B5/1107 , A61B5/6869 , A61B5/7203 , A61B2562/028 , A61B2562/222 , A61N1/36542 , A61N1/368
摘要： Techniques for detection and treatment of myocardial ischemia are described that monitor both the electrical and dynamic mechanical activity of the heart to detect and verify the occurrence of myocardial ischemia in a more reliable manner. The occurrence of myocardial ischemia can be detected by monitoring changes in an electrical signal such as an ECG or EGM, and changes in dynamic mechanical activity of the heart. Dynamic mechanical activity can be represented, for example, by a heart acceleration signal or pressure signal. The electrical signal can be obtained from a set of implanted or external electrodes. The heart acceleration signal can be obtained from an accelerometer or pressure sensor deployed within or near the heart. The techniques correlate contractility changes detected by an accelerometer or pressure sensor with changes in the ST electrogram segment detected by the electrodes to increase the reliability of ischemia detection.
摘要翻译： 描述了用于检测和治疗心肌缺血的技术，其监测心脏的电和动态机械活性以更可靠的方式检测和验证心肌缺血的发生。 可以通过监测诸如ECG或EGM的电信号的变化以及心脏的动态机械活动的变化来检测心肌缺血的发生。 动态机械活动可以例如通过心脏加速度信号或压力信号来表示。 电信号可以从一组植入电极或外部电极获得。 可以从部署在心脏内部或附近的加速度计或压力传感器获得心脏加速度信号。 该技术将由加速度计或压力传感器检测到的收缩性变化与由电极检测到的ST电描绘部分的变化相关联，以增加缺血检测的可靠性。
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公开(公告)号：US09037238B2
公开(公告)日：2015-05-19
申请号：US13301084
申请日：2011-11-21
CPC分类号： A61N1/3684 , A61N1/368 , A61N1/3686 , A61N1/3712
摘要： An implantable device and associated method for delivering a multi-site pacing therapy includes electrodes for sensing cardiac signals and delivering cardiac pacing pulses to a first pacing site along a heart chamber and a therapy delivery module for delivering cardiac pacing pulses to a patient's heart via the electrodes. A sensing module measures an activation time at multiple pacing electrode sites along the heart chamber in response to delivering pacing pulses at the first pacing site. A controller is configured to identify a second pacing site from the plurality of pacing electrode sites in response to the activation times measured during pacing at the first site.
摘要翻译： 用于递送多部位起搏治疗的可植入装置和相关联的方法包括用于感测心脏信号并将心脏起搏脉冲输送到沿着心脏室的第一起搏部位的电极和用于经由心脏起搏器将心脏起搏脉冲输送到患者心脏的治疗递送模块 电极。 响应于在第一起搏部位输送起搏脉冲，感测模块测量沿着心室的多个起搏电极部位的激活时间。 控制器被配置为响应于在第一站点的起搏期间测量的激活时间，从多个起搏电极位置识别第二起搏部位。
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97.发明授权Implanted multichamber cardiac device with selective use of reliable atrial information 有权植入式多室心脏装置可选择性使用可靠的心房信息公开(公告)号：US08750976B2
公开(公告)日：2014-06-10
申请号：US13038664
申请日：2011-03-02
申请人： Robert W. Stadler , Mark L. Brown
发明人： Robert W. Stadler , Mark L. Brown
CPC分类号： A61N1/3622 , A61B5/046 , A61B5/0464 , A61B5/686 , A61B5/7221 , A61B5/7282 , A61N1/3704
摘要： An implantable medical device acquires a first cardiac signal in a first heart chamber and a second cardiac signal in a second heart chamber. The device determines if the first signal is unreliable. In response to determining the first signal to be unreliable, the device switches from a first cardiac arrhythmia detection mode of operation to a second cardiac arrhythmia detection mode of operation, the first detection mode requiring the use of both the first cardiac signal and the second cardiac signal and the second detection mode requiring the use of the second cardiac signal and not requiring the use of the first cardiac signal.
摘要翻译： 可植入医疗装置获取第一心室中的第一心脏信号和第二心室中的第二心脏信号。 设备确定第一个信号是否不可靠。 响应于确定第一信号不可靠，设备从第一心律失常检测操作模式切换到第二心律失常检测操作模式，第一检测模式需要使用第一心脏信号和第二心脏 信号和第二检测模式，需要使用第二心脏信号，并且不需要使用第一心脏信号。
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公开(公告)号：US08682433B2
公开(公告)日：2014-03-25
申请号：US13301113
申请日：2011-11-21
IPC分类号： A61N1/368
CPC分类号： A61N1/3627 , A61N1/3686 , A61N1/371
摘要： An implantable device and associated method for delivering a multi-site pacing therapy includes electrodes for sensing cardiac signals and delivering cardiac pacing pulses. Electrodes positioned at first and second selected pacing sites are used to deliver pacing pulses to a first heart chamber using a bipole comprising the first electrode and the second electrode. A controller is configured to determine if anodal and cathodal capture can be achieved during pacing using the bipole. Responsive to anodal and cathodal capture being achieved, the controller selects a multi-site pacing configuration comprising the bipole for singly pacing the first and second pacing sites.
摘要翻译： 用于递送多部位起搏治疗的可植入装置和相关联的方法包括用于感测心脏信号和递送心脏起搏脉冲的电极。 使用位于第一和第二选定的起搏部位的电极，使用包括第一电极和第二电极的双极将起搏脉冲输送到第一心室。 控制器被配置为确定在使用双极的起搏期间是否可以实现阳极和阴极捕获。 响应于实现阳极和阴极捕获，控制器选择包括用于单步起搏第一和第二起搏部位的双极的多位置起搏配置。
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99.发明授权Method and apparatus for adaptive cardiac resynchronization therapy employing a multipolar left ventricular lead 有权使用多极左心室导联的自适应心脏再同步治疗的方法和装置公开(公告)号：US08639333B2
公开(公告)日：2014-01-28
申请号：US13301012
申请日：2011-11-21
IPC分类号： A61N1/365
CPC分类号： A61N1/3627 , A61N1/3684 , A61N1/3686 , A61N1/3688
摘要： A medical device and associated method control the delivery of a cardiac pacing therapy by selecting first and second pacing sites along a first ventricle of a patient's heart and delivering the pacing therapy by pacing the first ventricle using the first pacing site during the periods of a first ventricular pacing mode and using the second pacing site during periods of a second ventricular pacing mode. In one embodiment, the device determines activation times at multiple sites along a ventricle in response to pacing pulses being delivered to the opposite ventricle. A first pacing site is selected in response to the activation time determination. The device delivers the pacing therapy by pacing the first ventricle using the first pacing site during periods of the first ventricular pacing mode.
摘要翻译： 医疗装置和相关联的方法通过沿着患者心脏的第一脑室选择第一和第二起搏部位来控制心脏起搏治疗的递送，并且通过在第一时间段期间使用第一起搏部位起搏第一心室来递送起搏治疗 心室起搏模式，并且在第二心室起搏模式期间使用第二起搏部位。 在一个实施例中，该装置响应于递送到相对心室的起搏脉冲，沿着心室确定多个部位的激活时间。 响应于激活时间确定选择第一起搏站点。 该装置通过在第一次心室起搏模式期间使用第一起搏部位起搏第一脑室来进行起搏治疗。
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公开(公告)号：US08626291B2
公开(公告)日：2014-01-07
申请号：US13192713
申请日：2011-07-28
IPC分类号： A61N1/365
CPC分类号： A61N1/371 , A61N1/3684 , A61N1/3686 , A61N1/3712
摘要： An implantable device and associated method detect anodal capture during electrical stimulation. A first pacing pulse is delivered using a first cathode and a first anode. A second pacing pulse is delivered using the first cathode and a second anode. A first response to the first pacing pulse and a second response to the second pacing pulse are measured. Anodal capture of the first pacing pulse at the first anode is detected in response to a first difference between the first response and the second response.
摘要翻译： 可植入装置和相关方法在电刺激期间检测阳极捕获。 使用第一阴极和第一阳极传送第一起搏脉冲。 使用第一阴极和第二阳极传送第二起搏脉冲。 测量对第一起搏脉冲的第一响应和对第二起搏脉冲的第二响应。 响应于第一响应和第二响应之间的第一差异来检测在第一阳极处的第一起搏脉冲的阳极捕获。
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