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    DEVICES, SYSTEMS AND METHODS TO PERFORM ARRHYTHMIA DISCRIMINATION BASED ON R-R INTERVAL STABILITY CORRESPONDING TO A PLURALITY OF VENTRICULAR REGIONS
    101.
    发明申请
    DEVICES, SYSTEMS AND METHODS TO PERFORM ARRHYTHMIA DISCRIMINATION BASED ON R-R INTERVAL STABILITY CORRESPONDING TO A PLURALITY OF VENTRICULAR REGIONS 有权
    基于R-R间隔稳定性相对于多个地区的ARRHYTHMIA辨别的设备，系统和方法

    公开(公告)号：US20130030312A1

    公开(公告)日：2013-01-31

    申请号：US13194732

    申请日：2011-07-29

    申请人： Allen J. Keel ,  Kyungmoo Ryu ,  Stuart Rosenberg

    发明人： Allen J. Keel ,  Kyungmoo Ryu ,  Stuart Rosenberg

    IPC分类号： A61B5/046 ,  A61N1/365 ,  A61N1/39 ,  A61B5/0456

    CPC分类号： A61B5/0422 ,  A61B5/0452 ,  A61B5/0456 ,  A61B5/0464 ,  A61N1/3627 ,  A61N1/3684 ,  A61N1/3686

    摘要： Described herein are implantable systems and devices, and methods for use therewith, that can be used to perform arrhythmia discrimination. A plurality of different sensing vectors are used to obtain a plurality of different IEGMs, each of which is indicative of cardiac electrical activity at a different ventricular region. The plurality of different IEGMs can include, e.g., an IEGM indicative of cardiac electrical activity at a first region of the patient's left ventricular (LV) chamber and an IEGM indicative of cardiac electrical activity at a second region of the patient's LV chamber. Additionally, the plurality of different IEGMs can further include an IEGM indicative of cardiac electrical activity at a region of a patient's right ventricular (RV) chamber. For each of the IEGMs, there is a determination of a corresponding localized R-R interval stability metric indicative of the R-R interval stability at the corresponding ventricular region. This can include, e.g., determining, for each of the IEGMs, a plurality of R-R intervals corresponding to a plurality of consecutive cardiac cycles of the IEGM. For each IEGM, a measure of variation (e.g., standard deviation, range or variance, but not limited thereto) can then be determined for the plurality of R-R intervals to thereby determine the localized R-R interval stability metric for the IEGM. Arrhythmia discrimination is then performed using the plurality of determined localized R-R interval stability metrics.

    摘要翻译： 本文描述了可用于执行心律失常鉴别的可植入系统和装置及其使用方法。 使用多个不同的感测向量来获得多个不同的IEGM，每个IEGM指示在不同心室区域处的心脏电活动。 多个不同的IEGM可以包括例如指示患者左心室（LV）室的第一区域处的心脏电活动的IEGM和指示患者LV室的第二区域处的心脏电活动的IEGM。 另外，多个不同的IEGM还可以包括指示患者右心室（RV）室的区域处的心脏电活动的IEGM。 对于每个IEGM，存在确定相应的局部R-R间期稳定性度量，其指示相应心室区域处的R-R间期稳定性。 这可以包括例如为每个IEGM确定对应于IEGM的多个连续心脏周期的多个R-R间隔。 对于每个IEGM，然后可以为多个R-R间隔确定变化量（例如，标准偏差，范围或方差，但不限于此），从而确定IEGM的局部R-R间隔稳定性度量。 然后使用多个确定的局部R-R间期稳定性度量进行心律失常鉴别。

    SYSTEMS AND METHODS FOR SELECTIVELY LIMITING MULTI-SITE VENTRICULAR PACING DELAYS DURING OPTIMIZATION OF CARDIAC RESYNCHRONIZATION THERAPY PARAMETERS
    102.
    发明申请
    SYSTEMS AND METHODS FOR SELECTIVELY LIMITING MULTI-SITE VENTRICULAR PACING DELAYS DURING OPTIMIZATION OF CARDIAC RESYNCHRONIZATION THERAPY PARAMETERS 有权
    在优化心脏再生治疗参数的过程中，选择性限制多位置静态延迟的系统和方法

    公开(公告)号：US20120185012A1

    公开(公告)日：2012-07-19

    申请号：US13009404

    申请日：2011-01-19

    申请人： Kyungmoo Ryu ,  Allen Keel ,  Heidi Hellman ,  Tomas Svensson

    发明人： Kyungmoo Ryu ,  Allen Keel ,  Heidi Hellman ,  Tomas Svensson

    IPC分类号： A61N1/365

    CPC分类号： A61N1/3627 ,  A61N1/3684 ,  A61N1/3712

    摘要： Techniques are provided for use with implantable cardiac stimulation devices equipped for multi-site left ventricular (MSLV) cardiac pacing. Briefly, intraventricular and interventricular conduction delays are detected for paced cardiac events. Maximum pacing time delays are determined for use with MSLV pacing where the maximum pacing time delays are set based on the conduction delays to values sufficient to avoid capture problems due to wavefront propagation, such as fusion or lack of capture. MSLV pacing delays are then set to values no greater than the maximum pacing delays and cardiac resynchronization therapy (CRT) is delivered using the MSLV pacing delays. In an example where an optimal interventricular pacing delay (VV) is determined in advance using intracardiac electrogram-based or hemodynamic-based optimization techniques, the optimal value for VV can be used as a limiting factor when determining the maximum MSLV pacing time delays.

    摘要翻译： 提供技术用于配备用于多部位左心室（MSLV）心脏起搏的可植入心脏刺激装置。 简而言之，对于心跳事件，检测到心室内和室间传导延迟。 确定最大起搏时间延迟用于MSLV起搏，其中最大起搏时间延迟基于导通延迟设置为足以避免由于波前传播引起的捕获问题，例如融合或缺乏捕获。 然后将MSLV起搏延迟设置为不大于最大起搏延迟的值，并使用MSLV起搏延迟传递心脏再同步治疗（CRT）。 在使用基于心脏电图或基于血液动力学的优化技术预先确定最佳心室起搏延迟（VV）的示例中，当确定最大MSLV起搏时间延迟时，可以将VV的最佳值用作限制因素。

    ELECTRODE CONFIGURATIONS FOR LEADS OR CATHETERS TO ENHANCE LOCALIZATION USING A LOCALIZATION SYSTEM
    106.
    发明申请
    ELECTRODE CONFIGURATIONS FOR LEADS OR CATHETERS TO ENHANCE LOCALIZATION USING A LOCALIZATION SYSTEM 有权
    用于使用本地化系统增强本地化的导线或导线的电极配置

    公开(公告)号：US20110184274A1

    公开(公告)日：2011-07-28

    申请号：US12695815

    申请日：2010-01-28

    申请人： Stuart Rosenberg ,  Thao Thu Nguyen ,  Kyungmoo Ryu ,  Kjell Noren ,  Allen Keel ,  Wenbo Hou ,  Steve Koh ,  Michael Yang

    发明人： Stuart Rosenberg ,  Thao Thu Nguyen ,  Kyungmoo Ryu ,  Kjell Noren ,  Allen Keel ,  Wenbo Hou ,  Steve Koh ,  Michael Yang

    IPC分类号： A61B5/05 ,  A61N1/05

    CPC分类号： A61B5/0538 ,  A61B5/0536 ,  A61B2562/0209 ,  A61N1/05 ,  A61N1/056

    摘要： An exemplary method includes positioning a lead in a patient where the lead has a longitudinal axis that extends from a proximal end to a distal end and where the lead includes an electrode with an electrical center offset from the longitudinal axis of the lead body; measuring electrical potential in a three-dimensional potential field using the electrode; and based on the measuring and the offset of the electrical center, determining lead roll about the longitudinal axis of the lead body where lead roll may be used for correction of field heterogeneity, placement or navigation of the lead or physiological monitoring (e.g., cardiac function, respiration, etc.). Various other methods, devices, systems, etc., are also disclosed.

    摘要翻译： 一种示例性方法包括将引线定位在患者体内，其中引线具有从近端延伸到远端的纵向轴线，并且其中引线包括具有偏离引线主体的纵向轴线的电中心的电极; 使用所述电极测量三维势场中的电位; 并且基于电气中心的测量和偏移，确定围绕引线主体的纵轴的引导辊，其中引导辊可用于校正磁场异质性，引线的放置或导航或生理监测（例如，心脏功能 ，呼吸等）。 还公开了各种其它方法，装置，系统等。

    ELECTRODE AND LEAD STABILITY INDEXES AND STABILITY MAPS BASED ON LOCALIZATION SYSTEM DATA
    108.
    发明申请
    ELECTRODE AND LEAD STABILITY INDEXES AND STABILITY MAPS BASED ON LOCALIZATION SYSTEM DATA 有权
    基于本地化系统数据的电极和引线稳定性指标和稳定性

    公开(公告)号：US20110066201A1

    公开(公告)日：2011-03-17

    申请号：US12562003

    申请日：2009-09-17

    申请人： Stuart Rosenberg ,  Thao Thu Nguyen ,  Kyungmoo Ryu ,  Kjell Norèn ,  Allen Keel ,  Wenbo Hou ,  Michael Yang

    发明人： Stuart Rosenberg ,  Thao Thu Nguyen ,  Kyungmoo Ryu ,  Kjell Norèn ,  Allen Keel ,  Wenbo Hou ,  Michael Yang

    IPC分类号： A61N1/00

    CPC分类号： A61N1/3702 ,  A61B5/042 ,  A61B5/0424 ,  A61B2560/0276 ,  A61N1/368 ,  A61N1/371

    摘要： A method includes selecting an electrode located in a patient; acquiring position information with respect to time for the electrode where the acquiring uses the electrode for repeatedly measuring electrical potentials in an electrical localization field established in the patient; calculating a stability metric for the electrode based on the acquired position information with respect to time; and deciding if the selected electrode, as located in the patient, has a stable location for sensing biological electrical activity, for delivering electrical energy or for sensing biological electrical activity and delivering electrical energy. Position information may be acquired during one or both of intrinsic or paced activation of a heart and respective stability indexes calculated for each activation type.

    摘要翻译： 一种方法包括选择位于患者体内的电极; 获取相对于所述电极的时间的位置信息，其中所述电极在所述患者中建立的电定位场中使用所述电极重复测量电位; 基于获取的相对于时间的位置信息计算电极的稳定性度量; 并且确定位于患者体内的所选择的电极是否具有用于感测生物电活动的稳定位置，用于传递电能或用于感测生物电活动和递送电能。 位置信息可以在心脏的固有或起搏激活和对于每种激活类型计算的各个稳定性指标的一个或两个期间获取。

    THERAPY OPTIMIZATION VIA MULTI-DIMENSIONAL MAPPING
    110.
    发明申请
    THERAPY OPTIMIZATION VIA MULTI-DIMENSIONAL MAPPING 有权
    通过多维映射进行治疗优化

    公开(公告)号：US20100268059A1

    公开(公告)日：2010-10-21

    申请号：US12755366

    申请日：2010-04-06

    申请人： Kyungmoo Ryu ,  Stuart Rosenberg ,  Allen Keel ,  Wenbo Hou ,  Thao Thu Nguyen ,  Steve Koh ,  Kjell Noren ,  Michael Yang

    发明人： Kyungmoo Ryu ,  Stuart Rosenberg ,  Allen Keel ,  Wenbo Hou ,  Thao Thu Nguyen ,  Steve Koh ,  Kjell Noren ,  Michael Yang

    IPC分类号： A61B5/05

    CPC分类号： A61B5/042 ,  A61B5/7203 ,  A61N1/3627 ,  A61N1/36521 ,  A61N1/36535 ,  A61N1/36542 ,  A61N1/36578 ,  A61N1/3684 ,  A61N1/37258 ,  A61N1/37264

    摘要： An exemplary method includes accessing cardiac information acquired via a catheter located at various positions in a venous network of a heart of a patient where the cardiac information comprises position information, electrical information and mechanical information; mapping local electrical activation times to anatomic positions to generate an electrical activation time map; mapping local mechanical activation times to anatomic positions to generate a mechanical activation time map; generating an electromechanical delay map by subtracting local electrical activation times from corresponding local mechanical activation times; and rendering at least the electromechanical delay map to a display. Various other methods, devices, systems, etc., are also disclosed.

    摘要翻译： 一种示例性方法包括访问位于患者心脏的静脉网络中的各个位置处的导管获取的心脏信息，其中所述心脏信息包括位置信息，电信息和机械信息; 将局部电激活时间映射到解剖位置以产生电激活时间图; 将局部机械激活时间映射到解剖位置以产生机械激活时间图; 通过从相应的局部机械激活时间减去局部电激活时间来产生机电延迟图; 并将至少机电延迟图呈现给显示器。 还公开了各种其它方法，装置，系统等。