公开(公告)号：US20130053906A1

公开(公告)日：2013-02-28

申请号：US13561967

申请日：2012-07-30

申请人： Subham Ghosh ,  Jeffrey M. Gillberg

发明人： Subham Ghosh ,  Jeffrey M. Gillberg

IPC分类号： A61N1/365 ,  A61N1/39

CPC分类号： A61N1/3702 ,  A61N1/3621 ,  A61N1/3925 ,  A61N1/3962

摘要： One or more embodiments of the present disclosure relates to a method and/or system for classifying and/or treating heart rhythms. The present disclosure involves sensing electrical signals associated with depolarizations of a patient's heart. The sensed electrical signals are converted to digital values and storing the digital values. Normalizing solely a maximum and a minimum value of the stored digital values associated with a depolarization of the patient's heart without normalizing other stored digital values of the depolarization is another aspect of the present disclosure. The maximum and minimum values associated with the depolarization are compared to maximum and minimum values associated with a template derived from signals indicative of a heart depolarization of known type. A determination is made as to whether a match exists between the maximum and minimum values associated with the depolarization to the maximum and minimum values associated with a template.

摘要翻译： 本公开的一个或多个实施方案涉及用于分类和/或治疗心律的方法和/或系统。 本公开涉及感测与患者心脏的去极化相关联的电信号。 感测的电信号被转换成数字值并存储数字值。 仅对与患者心脏去极化相关联的存储数字值的最大值和最小值进行归一化，而不对其他存储的去极化数字值进行归一化，这是本发明的另一方面。 将与去极化相关联的最大值和最小值与与从指示已知类型的心脏去极化的信号衍生的模板相关联的最大值和最小值进行比较。 确定在与去极化相关联的最大值和最小值与与模板相关联的最大值和最小值之间是否存在匹配。

公开(公告)号：US20120289845A1

公开(公告)日：2012-11-15

申请号：US13104794

申请日：2011-05-10

申请人： Subham Ghosh ,  Jeffrey M. Gillberg

发明人： Subham Ghosh ,  Jeffrey M. Gillberg

IPC分类号： A61B5/0452 ,  A61N1/365

CPC分类号： A61B5/686 ,  A61B5/04012 ,  A61B5/0452 ,  A61N1/3621

摘要： A method includes retrieving electrogram (EGM) data for N cardiac cycles from a memory of an implantable medical device. N is an integer greater than 1. The method further include categorizing each of the N cardiac cycles into one of a plurality of categories based on a morphology of the N cardiac cycles and performing comparisons between pairs of the N cardiac cycles. Each of the comparisons between two cardiac cycles includes detecting a mismatch between the two cardiac cycles when the two cardiac cycles are in different categories, and detecting a match between the two cardiac cycles when the two cardiac cycles are in the same category. Additionally, the method includes classifying the rhythm of the N cardiac cycles based on a number of detected matches and detected mismatches.

摘要翻译： 一种方法包括从可植入医疗装置的存储器检索N个心动周期的电描记图（EGM）数据。 N是大于1的整数。该方法还包括基于N个心动周期的形态将N个心动周期中的每一个分类为多个类别中的一个，并且执行N个心动周期对之间的比较。 两个心动周期之间的每个比较包括当两个心动周期处于不同类别时检测两个心动周期之间的不匹配，以及当两个心动周期处于相同类别时检测两个心动周期之间的匹配。 另外，该方法包括基于检测到的匹配次数和检测到的错配来对N个心动周期的节奏进行分类。

公开(公告)号：US20120283587A1

公开(公告)日：2012-11-08

申请号：US13462404

申请日：2012-05-02

申请人： Subham Gosh ,  Jeffrey M. Gillberg ,  Robert W. Stadler

发明人： Subham Gosh ,  Jeffrey M. Gillberg ,  Robert W. Stadler

IPC分类号： A61B5/044 ,  A61B5/0402

CPC分类号： A61B5/04012 ,  A61B5/02 ,  A61B5/0402 ,  A61B5/04085 ,  A61B5/044 ,  A61B5/0452 ,  A61B5/05 ,  A61B5/742 ,  A61N1/0476 ,  A61N1/0484 ,  A61N1/3627 ,  A61N1/3682 ,  A61N1/3684

摘要： Techniques for evaluating cardiac electrical dyssynchrony are described. In some examples, an activation time is determined for each of a plurality of torso-surface potential signals. The dispersion or sequence of these activation times may be analyzed or presented to provide variety of indications of the electrical dyssynchrony of the heart of the patient. In some examples, the locations of the electrodes of the set of electrodes, and thus the locations at which the torso-surface potential signals were sensed, may be projected on the surface of a model torso that includes a model heart. The inverse problem of electrocardiography may be solved to determine electrical activation times for regions of the model heart based on the torso-surface potential signals sensed from the patient.

摘要翻译： 描述了评估心脏电气不同步的技术。 在一些示例中，为多个躯干表面电位信号中的每一个确定激活时间。 可以分析或呈现这些激活时间的分散或序列以提供患者心脏的电不同步的各种指征。 在一些示例中，电极组的电极的位置以及因此感测躯干表面电位信号的位置可以投影在包括模型心脏的模型躯干的表面上。 可以基于从患者感测到的躯干表面电位信号来解决心电图的逆问题，以确定模型心脏区域的电激活时间。

公开(公告)号：US20120232605A1

公开(公告)日：2012-09-13

申请号：US13357646

申请日：2012-01-25

申请人： Yong-Fu Xiao ,  Jeffrey M. Gillberg ,  Paul J. DeGroot ,  Eduardo N. Warman ,  Scott J. Brabec ,  John L. Sommer ,  Jon F. Urban ,  Lepeng Zeng

发明人： Yong-Fu Xiao ,  Jeffrey M. Gillberg ,  Paul J. DeGroot ,  Eduardo N. Warman ,  Scott J. Brabec ,  John L. Sommer ,  Jon F. Urban ,  Lepeng Zeng

IPC分类号： A61N1/365

CPC分类号： A61N1/365 ,  A61N1/3622 ,  A61N1/36585

摘要： An apparatus and method to discriminate cardiac events by sensing atrial and ventricular depolarizations having associated refractory periods thereafter. A fast ventricular rate is detected in response to the sensed ventricular depolarizations. Responsive to detecting the fast ventricular rate, at least one stimulus pulse is delivered to atrial tissue within the associated refractory period of the ventricle but outside of an associated refractory period of the stimulated atrial tissue. A ventricular response to the atrial tissue stimulus pulse is determined, and the cardiac event is discriminated based on the ventricular response to the atrial tissue stimulus pulse.

摘要翻译： 通过感应心房和心室去极化来区分心脏事件的装置和方法，其后具有相关联的不良期。 响应于感测到的心室去极化，检测到快速心室率。 响应于检测快速心室率，至少一个刺激脉冲被输送到心室的相关不应期内但在受刺激的心房组织的相关不应期内之外的心房组织。 确定对心房组织刺激脉冲的心室反应，并且基于对心房组织刺激脉冲的心室响应来区分心脏事件。

公开(公告)号：US08145308B2

公开(公告)日：2012-03-27

申请号：US12047951

申请日：2008-03-13

申请人： Aleksandre T Sambelashvili ,  Thomas J Mullen ,  Jeffrey M. Gillberg

发明人： Aleksandre T Sambelashvili ,  Thomas J Mullen ,  Jeffrey M. Gillberg

IPC分类号： A61N1/368

CPC分类号： A61N1/365 ,  A61B5/04525 ,  A61N1/36185 ,  A61N1/3627 ,  A61N1/36507 ,  A61N1/3684 ,  A61N1/3686

摘要： A medical device and method for determining a parameter for delivery of a predetermined pacing therapy that includes a plurality of electrodes to deliver a pacing therapy, including the predetermined pacing therapy, and a control unit to control the timing of the delivery of the pacing therapy, including the predetermined pacing therapy, by the electrodes. A processor generates a first template in response to the pacing therapy being delivered to only one of a right ventricle and a left ventricle, and a second template in response to the pacing therapy being delivered to only the other of the right ventricle and the left ventricle, and determines the parameter in response to a comparing of subsequently delivered pacing therapy to the first template and the second template.

摘要翻译： 一种用于确定用于递送预定起搏疗法的参数的医疗装置和方法，所述起搏疗法包括多个电极以递送包括所述预定起搏治疗的起搏疗法，以及控制所述起搏治疗递送时间的控制单元， 包括预定的起搏治疗。 处理器响应于起搏治疗仅递送到右心室和左心室中的一个而产生第一模板，并且第二模板响应于起搏治疗被递送到仅右心室和左心室中的另一个 并且响应于随后发送的起搏治疗与第一模板和第二模板的比较来确定参数。

公开(公告)号：US20090192398A1

公开(公告)日：2009-07-30

申请号：US11871405

申请日：2007-10-12

申请人： Xiaohong Zhou ,  Jeffrey M. Gillberg

发明人： Xiaohong Zhou ,  Jeffrey M. Gillberg

IPC分类号： A61B5/0452

CPC分类号： A61B5/0452 ,  A61B5/021 ,  A61N1/3702

摘要： An implantable medical device and associated method assess T-wave alternans by sensing a cardiac electrogram (EGM) signal and selecting a pair of consecutive T-wave signals from the EGM signal. A first amplitude and a second amplitude from each of the consecutive T-wave signals are determined. The differences between the first amplitudes and the second amplitudes of the consecutive T-wave signal pairs are used to compute a T-wave alternans metric.

摘要翻译： 可植入医疗装置和相关方法通过感测心电图（EGM）信号和从EGM信号中选择一对连续的T波信号来评估T波交替。 确定来自每个连续T波信号的第一幅度和第二幅度。 使用连续T波信号对的第一幅度和第二幅度之间的差异来计算T波交替量度。

公开(公告)号：US07559900B2

公开(公告)日：2009-07-14

申请号：US11112072

申请日：2005-04-22

申请人： Jeffrey M. Gillberg

发明人： Jeffrey M. Gillberg

IPC分类号： A61B5/04

CPC分类号： A61N1/3962 ,  A61B5/046 ,  A61B5/0464 ,  A61B5/0468 ,  A61N1/056 ,  A61N1/3622 ,  A61N1/36542 ,  A61N1/3756 ,  A61N2001/0585

摘要： A method and device for detecting cardiac signals that includes a first plurality of electrodes that senses cardiac signals and delivers therapy, and a second plurality of electrodes that senses the cardiac signals. A microprocessor detects a cardiac event in response to the sensing by the first plurality of electrodes, and verifies the cardiac event in response to the sensing by the second plurality of electrodes.

摘要翻译： 一种用于检测包括感测心脏信号并递送治疗的第一多个电极的心脏信号的方法和装置，以及感测心脏信号的第二多个电极。 微处理器响应于第一多个电极的感测来检测心脏事件，并且响应于第二多个电极的感测来验证心脏事件。

公开(公告)号：US07062322B2

公开(公告)日：2006-06-13

申请号：US10023234

申请日：2001-12-18

申请人： Robert W. Stadler ,  Jeffrey M. Gillberg

发明人： Robert W. Stadler ,  Jeffrey M. Gillberg

IPC分类号： A61N1/365

CPC分类号： A61N1/3622 ,  A61N1/3956

摘要： In a medical device that monitors and/or treats ventricular arrhythmia, the invention provides for a “normal” processing mode of operation and a “guarded” processing mode of operation. The transition between the two modes is a function of cardiac rhythm. Benign rhythms are processed in the normal processing mode and non-benign rhythms are processed in the guarded processing mode. In normal processing mode, the device performs functions that are not computationally demanding, but in guarded processing mode, the device performs the computationally demanding operations that classify arrhythmias. If therapy is deemed necessary, the device may provide the therapy in guarded processing mode.

公开(公告)号：US06745068B2

公开(公告)日：2004-06-01

申请号：US09995176

申请日：2001-11-26

申请人： Lev A. Koyrakh ,  Eugene Davydov ,  Jeffrey M. Gillberg

发明人： Lev A. Koyrakh ,  Eugene Davydov ,  Jeffrey M. Gillberg

IPC分类号： A61B50464

CPC分类号： A61N1/3956 ,  A61N1/3622 ,  A61N1/3702

摘要： A method of generating a template in an implantable medical device for implantation within a patient, and a processor readable medium for performing the method, that includes generating a template corresponding to a supraventricular rhythm of the patient, determining whether the template is valid, and monitoring the template to determine whether the template is an accurate representation of the supraventricular rhythm. The template is created from non-paced R waves that are below a predetermined heart rate, and a statistical validation of the template is performed by evaluating the template based on matches against ongoing slow heart rhythm. The quality of the template is continuously monitored, similar to the statistical validation, with the exception that one thousand beats are evaluated and once more than thirty out of the last one hundred beats do not match the template within the threshold, an attempt is made to create a new template.

摘要翻译： 一种在用于植入患者体内的可植入医疗装置中产生模板的方法，以及用于执行该方法的处理器可读介质，其包括生成对应于患者的室上节律的模板，确定模板是否有效，以及监视 模板来确定模板是否准确地表示室上节律。 该模板是通过低于预定心率的非步进R波形创建的，并且通过基于与正在进行的慢心律的匹配来评估模板来执行模板的统计验证。 连续监控模板的质量，类似于统计验证，除了对千次拍子进行评估，并且在最后一百次拍摄中超过三十次与阈值内的模板不匹配，尝试进行 创建一个新模板。

公开(公告)号：US6052620A

公开(公告)日：2000-04-18

申请号：US47649

申请日：1998-03-25

申请人： Jeffrey M. Gillberg ,  Walter H. Olson

发明人： Jeffrey M. Gillberg ,  Walter H. Olson

IPC分类号： A61N1/362

CPC分类号： A61N1/3622 ,  A61B5/042 ,  A61B5/046 ,  A61B5/0464 ,  A61B5/7264

摘要： An implantable anti-tachyarrhythmia device which delivers anti-tachyarrhythmia therapies to a patient's heart in response to detection of tachyarrhythmias. The device defines first criteria indicating the presence of atrial tachycardia and second criteria indicating the presence of atrial fibrillation, and compares the time elapsed since the either the first or second criteria were initially met to a defined time duration. In response to the defined duration having passed and either of the first or second criteria being met, the device triggers delivery of an appropriate anti-tachyarrhythmia therapy. The timer is reset on detection of termination of atrial tachyarrhythmia, but not on failure of the first and second criteria to be met. The first and second criteria are defined such that they can not be concurrently met.

摘要翻译： 一种可植入的抗快速性心律失常装置，其响应于快速性心律失常的检测而向患者的心脏递送抗快速性心律失常疗法。 该装置定义了指示心房性心动过速存在的第一标准和指示心房颤动存在的第二标准，并且比较了从第一或第二标准开始满足到限定的持续时间之后经过的时间。 响应于已经通过的限定的持续时间并满足第一或第二标准中的任一个，该装置触发适当的抗快速性心律失常治疗的递送。 在检测到心房性心律失常终止时，定时器复位，但不符合第一和第二标准的失败。 第一和第二个标准被定义为不能同时满足。