公开(公告)号：US08554338B2

公开(公告)日：2013-10-08

申请号：US12613435

申请日：2009-11-05

申请人： Phong D. Doan ,  Xiaoyi Min ,  Ingmar Viohl ,  Xiangqun Chen ,  Jose Lepe

发明人： Phong D. Doan ,  Xiaoyi Min ,  Ingmar Viohl ,  Xiangqun Chen ,  Jose Lepe

IPC分类号： A61N1/04

CPC分类号： A61N1/056 ,  A61N1/086 ,  A61N1/36071

摘要： An implantable lead is provided that comprises a lead body and a header assembly. The lead body has a distal end and a proximal end. The lead body is configured to be implanted in a patient. The header assembly is provided at the distal end of the lead body and includes an internal chamber and a tissue engaging end. An electrode is provided on the header assembly. The electrode is configured to deliver a stimulating pulse. A resonant inductor is located within the chamber in the header assembly. An electrically floating heat spreader is provided on the header assembly. The heat spreader is located proximate to the resonant inductor and is positioned on the header assembly to cover at least a portion of the resonant inductor. The heat spreader is thermally coupled to the resonant inductor to convey thermal energy away from the header assembly.

摘要翻译： 提供了一种可植入引线，其包括引线本体和插头组件。 引线体具有远端和近端。 引线体配置为植入患者体内。 头部组件设置在引线主体的远端，并且包括内部腔室和组织接合端。 在头部组件上设置电极。 电极被配置为递送刺激脉冲。 谐振电感器位于集管组件中的室内。 在头部组件上设置电浮动散热器。 散热器位于谐振电感附近，并且位于集管组件上以覆盖谐振电感器的至少一部分。 散热器热耦合到谐振电感器以将热能传送到头部组件。

公开(公告)号：US20130138006A1

公开(公告)日：2013-05-30

申请号：US13485534

申请日：2012-05-31

申请人： Gene A. Bornzin ,  Xiaoyi Min ,  John W. Poore ,  Zoltan Somogyi

发明人： Gene A. Bornzin ,  Xiaoyi Min ,  John W. Poore ,  Zoltan Somogyi

IPC分类号： A61B5/042

CPC分类号： A61B5/042 ,  A61B5/6869 ,  A61N1/368 ,  A61N1/3756

摘要： A leadless intra-cardiac medical device (LIMD) includes multiple electrodes that allow for stimulation and sensing of the right ventricle (RV) and sensing of the right atrium (RA), even though it is entirely located in the RV. The LIMD includes a housing having a proximal end configured to engage local tissue in the local chamber and electrodes located at multiple locations along the housing. Sensing circuitry is configured to define a far field (FF) channel between a first combination of the electrodes to sense FF signals occurring in the adjacent chamber. The sensing circuitry is configured to define a near field (NF) channel between a second combination of the electrodes to sense NF signals occurring in the local chamber. A controller is configured to analyze the NF and FF signals to determine whether the NF and FF signals collectively indicate that a validated event of interest occurred in the adjacent chamber.

摘要翻译： 无引线心脏内心脏医疗器械（LIMD）包括多个电极，即使完全位于RV中，也能够对右心室（RV）进行刺激和感测，并检测右心房（RA）。 LIMD包括壳体，其具有被配置为接合局部室中的局部组织的近端和位于沿壳体的多个位置处的电极。 感测电路被配置为在电极的第一组合之间定义远场（FF）通道，以感测在相邻室中发生的FF信号。 感测电路被配置为在电极的第二组合之间限定近场（NF）通道，以感测在局部室中发生的NF信号。 控制器被配置为分析NF和FF信号以确定NF和FF信号是否共同表示在邻近室中发生了有效的感兴趣事件。

公开(公告)号：US08391977B2

公开(公告)日：2013-03-05

申请号：US13351624

申请日：2012-01-17

申请人： Xiaoyi Min

发明人： Xiaoyi Min

IPC分类号： A61N1/365

CPC分类号： A61N1/3627 ,  A61N1/368 ,  A61N1/3682

摘要： An exemplary method includes delivering a cardiac pacing therapy that includes an atrio-ventricular delay and an interventricular delay, providing a paced propagation delay associated with delivery of a stimulus to a ventricle, delivering a stimulus to the ventricle, sensing an event in the other ventricle caused by the stimulus, determining an interventricular conduction delay value based on the delivering and the sensing, determining a interventricular delay (ΔSur) based on the interventricular conduction delay and the paced propagation delay and determining an atrio-ventricular delay based at least in part on the interventricular delay (ΔSur). Other exemplary methods, devices, systems, etc., are also disclosed.

摘要翻译： 一种示例性方法包括递送心脏起搏疗法，其包括心室延迟和室间延迟，提供与将刺激递送到心室相关联的节奏传播延迟，向脑室递送刺激，感测另一脑室中的事件 由刺激引起的，基于递送和感测来确定心室间传导延迟值，基于室间传导延迟和节奏传播延迟来确定心室间延迟（＆Dgr; Sur），并且基于至少在 部分在室间延迟（＆Dgr; Sur）。 还公开了其它示例性方法，装置，系统等。

公开(公告)号：US20130053912A1

公开(公告)日：2013-02-28

申请号：US13217554

申请日：2011-08-25

申请人： Gene A. Bornzin ,  Xiaoyi Min ,  Laurence S. Sloman ,  Steve Koh

发明人： Gene A. Bornzin ,  Xiaoyi Min ,  Laurence S. Sloman ,  Steve Koh

IPC分类号： A61N1/368

CPC分类号： A61B5/053 ,  A61B5/0205 ,  A61B5/0538 ,  A61B5/686 ,  A61N1/36185 ,  A61N1/3627 ,  A61N1/3686

摘要： Techniques are provided for use with an implantable medical device for detecting and assessing heart failure and for controlling cardiac resynchronization therapy (CRT) based on impedance signals obtained using hybrid impedance configurations. The hybrid configurations exploit right atrial (RA)-based impedance measurement vectors and/or left ventricular (LV)-based impedance measurement vectors. In one example, current is injected between the device case and a ring electrode in the right ventricle (RV) or RA. RA-based impedance values are measured along vectors between the device case and an RA electrode. LV-based impedance values are measured along vectors between the device case and one or more electrodes of the LV. Heart failure and other cardiac conditions are detected and tracked using the measured impedance values. CRT delay parameters are also optimized based impedance. In this manner, multiple hybrid impedance measurement configurations are exploited whereby different vectors are used to inject current and measure impedance.

摘要翻译： 提供技术用于可植入医疗装置，用于基于使用混合阻抗配置获得的阻抗信号来检测和评估心力衰竭并用于控制心脏再同步治疗（CRT）。 混合配置利用基于右心房（RA）的阻抗测量向量和/或左心室（LV））的阻抗测量向量。 在一个示例中，电流注入到装置壳体和右心室（RV）或RA中的环形电极之间。 基于RA的阻抗值是沿器件壳体和RA电极之间的矢量测量的。 基于LV的阻抗值在器件壳体和LV的一个或多个电极之间的矢量上测量。 使用测量的阻抗值检测和跟踪心力衰竭和其他心脏状况。 CRT延迟参数也是基于阻抗的优化。 以这种方式，利用多个混合阻抗测量配置，由此使用不同的矢量来注入电流并测量阻抗。

公开(公告)号：US20120203090A1

公开(公告)日：2012-08-09

申请号：US13023408

申请日：2011-02-08

申请人： Xiaoyi Min

发明人： Xiaoyi Min

IPC分类号： A61B5/042 ,  A61N1/365

CPC分类号： A61N1/36521 ,  A61B5/0031 ,  A61B5/029 ,  A61B5/0295 ,  A61B5/0422 ,  A61B5/0535 ,  A61B5/0538 ,  A61B5/686 ,  A61B5/6869 ,  A61N1/3627

摘要： Techniques are provided for use with an implantable medical device for assessing stroke volume or related cardiac function parameters such as cardiac output based on impedance signals obtained using hybrid impedance configurations that exploit a multi-pole cardiac pacing/sensing lead implanted near the left ventricle. In one example, current is injected between a large and stable reference electrode and a ring electrode in the RV. The reference electrode may be, e.g., a coil electrode implanted within the superior vena cava (SVC). Impedance values are measured along a set of different sensing vectors between the reference electrode and each of the electrodes of the multi-pole LV lead. Stroke volume is then estimated and tracked within the patient using the impedance values. In this manner, a hybrid impedance detection configuration is exploited whereby one vector is used to inject current and other vectors are used to measure impedance.

摘要翻译： 技术被提供用于与可植入医疗装置一起使用，用于评估卒中体积或相关的心脏功能参数，例如基于使用混合阻抗配置获得的阻抗信号的心输出量，其利用在左心室附近植入的多极心脏起搏/感测引线。 在一个示例中，电流被注入到RV中的大的和稳定的参考电极和环形电极之间。 参考电极可以是例如植入上腔静脉（SVC）内的线圈电极。 沿参考电极和多极LV引线的每个电极之间的一组不同的感测向量测量阻抗值。 然后使用阻抗值估计和跟踪患者的中风量。 以这种方式，利用混合阻抗检测配置，由此使用一个矢量来注入电流，并且使用其他矢量来测量阻抗。

公开(公告)号：US08204592B1

公开(公告)日：2012-06-19

申请号：US11949532

申请日：2007-12-03

申请人： Eliot L. Ostrow ,  Jay Snell ,  Xiaoyi Min

发明人： Eliot L. Ostrow ,  Jay Snell ,  Xiaoyi Min

IPC分类号： A61N1/36

CPC分类号： A61B5/0464 ,  A61B5/686 ,  A61N1/36585 ,  A61N1/37258 ,  G06F19/00 ,  G06F19/3418 ,  G06F19/3468 ,  G06F19/3481

摘要： Techniques are described for generating diagnostic information to aid in determining whether cardiac ischemia within a patient is clinically actionable. In one example, a pacemaker or implantable cardioverter/defibrillator (ICD) detects information pertaining to arrhythmia precursors and to episodes of sustained arrhythmias, as well as information pertaining to episodes of cardiac ischemia. The implanted device then correlates the arrhythmia precursors and the sustained arrhythmias with the episodes of cardiac ischemia so as to generate diagnostics permitting a physician reviewing the diagnostics to determine whether the ischemia is clinically actionable. In some implementations, the diagnostics are instead generated by an external system based on raw data provided by the implanted device. In some implementations, the device itself determines whether the ischemia is clinically actionable and automatically controls therapy or generates warning signals accordingly.

摘要翻译： 描述了用于产生诊断信息以帮助确定患者心脏缺血是否具有临床可行性的技术。 在一个示例中，起搏器或植入式心律转复除颤器（ICD）检测与心律失常前体有关的信息和持续性心律不齐的发作以及与心脏缺血发作有关的信息。 然后植入的装置将心律失常前体和持续性心律失常与心脏缺血发作相关联，以便产生诊断，允许医师检查诊断以确定缺血是否具有临床可操作性。 在一些实施方式中，诊断代替地由外部系统基于植入设备提供的原始数据生成。 在一些实施方案中，装置本身确定缺血是否具有临床作用并且自动控制治疗或相应地产生警告信号。

公开(公告)号：US08175707B1

公开(公告)日：2012-05-08

申请号：US11951928

申请日：2007-12-06

申请人： Connie Wright ,  Xiaoyi Min ,  Euljoon Park ,  Scott Simon

发明人： Connie Wright ,  Xiaoyi Min ,  Euljoon Park ,  Scott Simon

IPC分类号： A61N1/365

CPC分类号： A61N1/3627 ,  A61N1/36521 ,  A61N1/36542 ,  A61N1/3682 ,  A61N1/3684

摘要： An exemplary method includes delivering a cardiac resynchronization therapy using an atrio-ventricular delay and an interventricular delay, monitoring patient activity, optimizing the atrio-ventricular delay and the interventricular delay for a plurality of patient activity states to generate a plurality of optimal atrio-ventricular delays and a plurality of optimal interventricular delays, storing the optimal atrio-ventricular delays and the optimal interventricular delays in association with corresponding patient activity states, detecting a change in patient activity, adjusting an atrial pacing rate in response to the detected change in patient activity based at least in part on a heart failure status and setting the atrio-ventricular delay and the interventricular delay, in response to the detected change in patient activity, using a stored optimal atrio-ventricular delay that corresponds to the patient activity and a stored optimal interventricular delay that corresponds to the patient activity. Other exemplary technologies are also disclosed.

摘要翻译： 示例性方法包括使用心室延迟和心室间延迟来递送心脏再同步治疗，监测患者活动，优化多个患者活动状态的心房延迟和室间延迟以产生多个最佳心房室 延迟和多个最佳心室间延迟，存储与相应的患者活动状态相关联的最佳心室延迟和最佳心室延迟，检测患者活动的变化，响应于检测到的患者活动变化来调整心房起搏速率 至少部分地基于心力衰竭状态，并且响应于检测到的患者活动的变化来设置心室延迟和室间延迟，使用存储的对应于患者活动的最佳心室延迟和存储的最佳 室间延迟对应于pa 活跃。 还公开了其它示例性技术。

公开(公告)号：US20120109244A1

公开(公告)日：2012-05-03

申请号：US12938579

申请日：2010-11-03

申请人： Dave Anderson ,  Xiaoyi Min

发明人： Dave Anderson ,  Xiaoyi Min

IPC分类号： A61N1/365

CPC分类号： A61N1/36521 ,  A61N1/3627 ,  A61N1/36585 ,  A61N1/3682 ,  A61N1/3684

摘要： An exemplary method includes analyzing data from multiple parameters detected by an implantable cardiac device and determining an extent of heart failure (HF) progression. The parameters may include electrical synchrony, mechanical synchrony, and/or electromechanical delay (EMD). A change in a width of the native and/or paced QRS complex may provide a measure of electrical synchrony. Characterization of a delay between local cardiac impedance (CI) and global CI may provide a mechanical dyssynchrony index. A delay between the timing of a peak of the QRS complex and LV contraction (e.g., detected by SVC-CAN impedance) may provide a measure for EMD. Each of the parameters may be analyzed independently or collectively to assess HF progression. Based on the analysis, one or more pacing delays (e.g. AV/PV and/or VV) of the implantable cardiac device may be modified. Other exemplary methods, devices, systems, etc., are also disclosed.

摘要翻译： 示例性方法包括分析由可植入心脏装置检测的多个参数的数据，并确定心力衰竭（HF）进展的程度。 这些参数可以包括电同步，机械同步和/或机电延迟（EMD）。 天体和/或起搏QRS波段的宽度变化可以提供电同步的测量。 局部心脏阻抗（CI）和全局CI之间的延迟的表征可以提供机械不同步指数。 QRS波段的峰值定时与LV收缩之间的延迟（例如，通过SVC-CAN阻抗检测）之间的延迟可以提供EMD的度量。 可以单独或共同分析每个参数以评估HF进展。 基于分析，可以修改可植入心脏装置的一个或多个起搏延迟（例如AV / PV和/或VV）。 还公开了其它示例性方法，装置，系统等。

公开(公告)号：US08090443B2

公开(公告)日：2012-01-03

申请号：US12210880

申请日：2008-09-15

申请人： Xiaoyi Min ,  Zaffer Syed

发明人： Xiaoyi Min ,  Zaffer Syed

IPC分类号： A61N1/365

CPC分类号： A61N1/3627 ,  A61N1/36585 ,  A61N1/3682

摘要： An exemplary method includes delivering a cardiac resynchronization therapy using an atrio-ventricular delay parameter and an interventricular delay parameter, measuring an atrio-ventricular conduction delay, measuring an interventricular conduction delay, assessing heart failure and/or cardiac resynchronization therapy performance based at least in part on the measured atrio-ventricular conduction delay and the measured interventricular conduction delay and determining at least one of an atrio-ventricular delay parameter value and an interventricular delay parameter value based at least in part on the measured atrio-ventricular conduction delay and the measured interventricular conduction delay. Other exemplary technologies are also disclosed.

摘要翻译： 示例性方法包括使用心室延迟参数和心室间延迟参数，测量心室传导延迟，测量室间传导延迟，评估心力衰竭和/或心脏再同步治疗性能来递送心脏再同步治疗，至少基于 测量的心房传导延迟和测量的室间传导延迟的部分，并且至少部分地基于测量的心室传导延迟和所测量的心室传导延迟来确定心房延迟参数值和心室间延迟参数值中的至少一个 室间传导延迟。 还公开了其它示例性技术。

公开(公告)号：US20110301676A1

公开(公告)日：2011-12-08

申请号：US12792616

申请日：2010-06-02

申请人： Jin Zhang ,  Xiaoyi Min ,  Ingmar Viohl ,  Gabriel A. Mouchawar ,  Xiangqun Chen

发明人： Jin Zhang ,  Xiaoyi Min ,  Ingmar Viohl ,  Gabriel A. Mouchawar ,  Xiangqun Chen

IPC分类号： A61N1/05 ,  H01R43/20

CPC分类号： A61N1/0573 ,  A61N1/086 ,  Y10T29/49208

摘要： An implantable medical lead configured to reduce resonant currents in a resonating circuit during MRI scans and a method of manufacturing the same are disclosed herein. The method of manufacturing includes providing a medical lead comprising an electrical pathway from a tip electrode located at a distal end of the lead to a lead connector located at a proximal end and coupling a resonating circuit to the tip electrode such that the resonating circuit is in the electrical pathway for the tip electrode. Further, the method includes coupling a capacitive element to a proximal end of the resonating circuit. The capacitive element is configured to shunt at least part of an RF current induced on the electrical pathway into surrounding tissue or fluid and also works as a heat sink to spread the heat from the internal LC resonant circuit.

摘要翻译： 本文公开了一种被配置为在MRI扫描期间减小谐振电路中的谐振电流的可植入医疗引线及其制造方法。 该制造方法包括提供一种医疗引线，其包括从位于引线的远端处的尖端电极到位于近端处的引线连接器的电路径，并将谐振电路耦合到尖端电极，使得谐振电路处于 尖端电极的电路。 此外，该方法包括将电容元件耦合到谐振电路的近端。 电容元件被配置为将在电通路上感应的RF电流的至少一部分分流到周围的组织或流体中，并且还用作散热器以散热来自内部LC谐振电路的热量。