公开(公告)号：US08386024B2

公开(公告)日：2013-02-26

申请号：US12476733

申请日：2009-06-02

申请人： Bruce D. Gunderson ,  Amisha S. Patel ,  Chad A. Bounds ,  Mark L. Brown

发明人： Bruce D. Gunderson ,  Amisha S. Patel ,  Chad A. Bounds ,  Mark L. Brown

IPC分类号： A61B5/0456

CPC分类号： A61B5/0456 ,  A61B5/0464 ,  A61B5/7217 ,  A61B5/7239 ,  A61B5/7264 ,  A61N1/3622 ,  A61N1/3702 ,  A61N1/3704

摘要： A method for identifying and classifying various types of oversensing in implantable medical devices (IMDs), such as implantable cardioverter defibrillators (ICDs), to assist a physician in choosing corrective action to reduce the likelihood of oversensing and inappropriate therapy delivery. Far-field electrogram (EGM) signals are analyzed to detect the occurrence of R-waves, and the result is compared to the number and pattern of R-waves sensed by the IMD and indicated on the marker channel. A marker channel with more sensed R-waves than indicated by analysis of the far-field EGM indicates the presence of oversensing, including double-counting of R-waves, T-wave oversensing, lead malfunction or failure, poor lead connections, noise associated with electromagnetic interference, non-cardiac myopotentials, etc. Identification of the type of oversensing may be determined by analysis of the number and pattern of marker channel sensed R-waves with respect to the timing of the R-waves detected from the far-field EGM.

公开(公告)号：US08229559B2

公开(公告)日：2012-07-24

申请号：US12837320

申请日：2010-07-15

申请人： Hendrikus A. Westendorp ,  Cygni Chan ,  Amisha S. Patel ,  Denise Dirnberger ,  Jean K. Ringold ,  Kevin T. Ousdigian ,  Robert B. Trojan ,  Nelson H. Soken ,  Karen J. Kleckner

发明人： Hendrikus A. Westendorp ,  Cygni Chan ,  Amisha S. Patel ,  Denise Dirnberger ,  Jean K. Ringold ,  Kevin T. Ousdigian ,  Robert B. Trojan ,  Nelson H. Soken ,  Karen J. Kleckner

IPC分类号： A61N1/00

CPC分类号： A61N1/37247 ,  A61B5/0031 ,  A61B5/0452 ,  A61B5/7217 ,  A61B5/7475 ,  A61N1/3962 ,  G06F19/00 ,  G06F19/3481 ,  G16H40/40

摘要： A system includes an episode classification module and a data retrieval module. The episode classification module receives electrograms (EGMs) from N implantable medical devices (IMDs) and determines whether the EGMs are associated with deliveries of therapy by the N IMDs. The episode classification module analyzes at least some of the EGMs and determines whether the deliveries or non-deliveries of therapy by the IMDs were appropriate. The data retrieval module receives a request from a computing device, via a network, that indicates at least two groups of the N IMDs. The data retrieval module provides to the computing device via the network, in response to the request, data for presentation to a user that indicates for each of the groups, at least one of how many of the one or more deliveries or non-deliveries were appropriate, or how many of the one or more deliveries or non-deliveries were inappropriate.

摘要翻译： 系统包括剧集分类模块和数据检索模块。 情节分类模块从N个植入式医疗设备（IMD）接收电描记图（EGM），并确定EGM是否与N IMD的治疗交付相关联。 情节分类模块分析至少一些EGMs，并确定IMD的分娩或非递送治疗是否合适。 数据检索模块经由网络从计算设备接收指示N个IMD的至少两组的请求。 数据检索模块经由网络向计算设备提供响应于该请求的用于呈现给用户的用于指示每个组的数据的数据，所述一个或多个传送或非传送中的至少一个是 适当的，或者一个或多个交付或不交付是不适当的。

公开(公告)号：US08942795B2

公开(公告)日：2015-01-27

申请号：US11096851

申请日：2005-03-31

申请人： Bruce D. Gunderson ,  Amisha S. Patel ,  Chad A. Bounds

发明人： Bruce D. Gunderson ,  Amisha S. Patel ,  Chad A. Bounds

IPC分类号： A61B5/0452 ,  A61N1/362 ,  A61B5/0464 ,  A61N1/37 ,  A61N1/39

CPC分类号： A61N1/3621 ,  A61B5/04525 ,  A61B5/0464 ,  A61N1/3702 ,  A61N1/3925

摘要： An implantable cardioverter defibrillator (ICD) senses ventricular depolarizations (R-waves) in an electrogram signal to detect a ventricular tachycardia or fibrillation episodes. The EGM signal is also monitored in real time for characteristics that uniquely identify instances of T-wave oversensing. The ICD determines whether detection of a tachycardia or fibrillation episode is appropriate based upon counts of each of the unique characteristics evidencing T-wave oversensing.

摘要翻译： 植入式心脏复律除颤器（ICD）感测电描记信号中的心室去极化（R波），以检测室性心动过速或纤维性颤动发作。 还可以实时监控EGM信号，以获得唯一识别T波过度传感的特性。 ICD确定是否根据证明T波过度感染的每个独特特征的计数来检测心动过速或颤动发作是否合适。

公开(公告)号：US08774909B2

公开(公告)日：2014-07-08

申请号：US13245585

申请日：2011-09-26

申请人： Amisha S. Patel ,  Bruce D. Gunderson ,  Mark L. Brown

发明人： Amisha S. Patel ,  Bruce D. Gunderson ,  Mark L. Brown

IPC分类号： A61B5/04

CPC分类号： A61B5/04 ,  A61B5/046 ,  A61B5/0464 ,  A61N1/3702

摘要： The present disclosure is directed to the classification of cardiac episodes using an algorithm. In various examples, an episode classification algorithm evaluates electrogram signal data from a near-field channel and a far-field channel. The episode classification algorithm classifies the cardiac episode based on the evaluation of the electrogram signal data for at least one of the near-field and far-field channels. In some examples, a cardiac episode being classified may be an episode that resulted in treatment being provided by an implantable medical device. Possible classifications of the cardiac episode may include, for example, unknown, inappropriate, appropriate, supraventricular tachycardia, ventricular tachycardia, ventricular fibrillation or ventricular over-sensing.

摘要翻译： 本公开涉及使用算法对心脏发作的分类。 在各种示例中，事件分类算法从近场信道和远场信道评估电描记图信号数据。 情节分类算法基于对近场和远场信道中的至少一个的电描记图信号数据的评估来分类心脏发作。 在一些实例中，分类的心脏发作可能是导致由可植入医疗装置提供的治疗的发作。 心脏事件的可能分类可能包括例如未知的，不适当的，适当的，室上性心动过速，室性心动过速，心室颤动或心室过度感测。

公开(公告)号：US08521281B2

公开(公告)日：2013-08-27

申请号：US13273962

申请日：2011-10-14

申请人： Amisha S. Patel ,  Jian Cao ,  Karen J. Kleckner

发明人： Amisha S. Patel ,  Jian Cao ,  Karen J. Kleckner

IPC分类号： A61N1/362

CPC分类号： A61B5/046 ,  A61B5/0031 ,  A61B5/0464 ,  A61B5/0468 ,  A61N1/37 ,  A61N1/3962

摘要： The present disclosure is directed to the classification of cardiac episodes using an algorithm. In various examples, an episode classification algorithm evaluates electrogram signal data using a probabilistic ventricular oversensing algorithm. The algorithm may look at a plurality of factors weighing for and against a determination of ventricular oversensing. In some examples, the algorithm may also determine whether the cardiac episode includes atrial sensing issues.

摘要翻译： 本公开涉及使用算法对心脏发作的分类。 在各种示例中，发作分类算法使用概率性心室过敏算法来评估电描记图信号数据。 该算法可以考虑多个因素来衡量和抵抗心室过敏的确定。 在一些示例中，算法还可以确定心脏发作是否包括心房感测问题。

公开(公告)号：US08437840B2

公开(公告)日：2013-05-07

申请号：US13245632

申请日：2011-09-26

申请人： Amisha S. Patel ,  Bruce D. Gunderson ,  Mark L. Brown

发明人： Amisha S. Patel ,  Bruce D. Gunderson ,  Mark L. Brown

IPC分类号： A61B5/04

CPC分类号： A61B5/0464 ,  A61B5/04525 ,  A61B5/686 ,  A61N1/3621 ,  A61N1/36507

摘要： The present disclosure is directed to the classification of cardiac episodes using an algorithm. In various examples, an episode classification algorithm evaluates electrogram signal data collected by an implantable medical device. The episode classification algorithm may classify may include a sinus template and a comparison of the electrogram signal to the sinus template. Possible classifications of the cardiac episode may include, for example, unknown, inappropriate, appropriate, supraventricular tachycardia, ventricular tachycardia, ventricular fibrillation or ventricular over-sensing.

摘要翻译： 本公开涉及使用算法对心脏发作的分类。 在各种示例中，情节分类算法评估由可植入医疗装置收集的电描记图信号数据。 可以分类的发作分类算法可以包括窦模板和电描记信号与窦模板的比较。 心脏事件的可能分类可能包括例如未知的，不适当的，适当的，室上性心动过速，室性心动过速，心室颤动或心室过度感测。

公开(公告)号：US20130085403A1

公开(公告)日：2013-04-04

申请号：US13250515

申请日：2011-09-30

申请人： Bruce D. Gunderson ,  Karen J. Kleckner ,  Kevin T. Ousdigian ,  Amisha S. Patel ,  Julian Sanchez

发明人： Bruce D. Gunderson ,  Karen J. Kleckner ,  Kevin T. Ousdigian ,  Amisha S. Patel ,  Julian Sanchez

IPC分类号： A61B5/044 ,  A61B5/046 ,  A61B5/0464

CPC分类号： A61B5/044 ,  A61B5/046 ,  A61B5/0464 ,  A61B5/7217

摘要： The present disclosure is directed to an electrogram summary. In various examples, a subset of cardiac episodes are selected and displayed based on a set of summary rules. The subset of cardiac episodes includes at least one episode from each of a plurality of episode categories with at least one cardiac episode. In some examples, the order in which the cardiac episodes selected are displayed is based on the set of summary rules. The electrogram summary may include images or information regarding each of the selected cardiac episodes.

摘要翻译： 本公开涉及电描记图。 在各种示例中，基于一组汇总规则来选择和显示心脏发作的一个子集。 心脏发作的子集包括来自具有至少一个心脏发作的多个发作类别中的每一个的至少一个情节。 在一些示例中，显示所选择的心脏发作的顺序是基于汇总规则的集合。 电描记图可以包括关于所选心脏发作中的每一个的图像或信息。

公开(公告)号：US20130079651A1

公开(公告)日：2013-03-28

申请号：US13245632

申请日：2011-09-26

申请人： Amisha S. Patel ,  Bruce D. Gunderson ,  Mark L. Brown

发明人： Amisha S. Patel ,  Bruce D. Gunderson ,  Mark L. Brown

IPC分类号： A61B5/0464

CPC分类号： A61B5/0464 ,  A61B5/04525 ,  A61B5/686 ,  A61N1/3621 ,  A61N1/36507

摘要： The present disclosure is directed to the classification of cardiac episodes using an algorithm. In various examples, an episode classification algorithm evaluates electrogram signal data collected by an implantable medical device. The episode classification algorithm may classify may include a sinus template and a comparison of the electrogram signal to the sinus template. Possible classifications of the cardiac episode may include, for example, unknown, inappropriate, appropriate, supraventricular tachycardia, ventricular tachycardia, ventricular fibrillation or ventricular over-sensing.

摘要翻译： 本公开涉及使用算法对心脏发作的分类。 在各种示例中，情节分类算法评估由可植入医疗装置收集的电描记图信号数据。 可以分类的发作分类算法可以包括窦模板和电描记信号与窦模板的比较。 心脏事件的可能分类可能包括例如未知的，不适当的，适当的，室上性心动过速，室性心动过速，心室颤动或心室过度感测。

公开(公告)号：US08290791B2

公开(公告)日：2012-10-16

申请号：US12181429

申请日：2008-07-29

申请人： Amisha S. Patel ,  Luc Roland Mongeon ,  Susan Heilman Kilbane ,  James E. Willenbring ,  Christopher John Gennaro

发明人： Amisha S. Patel ,  Luc Roland Mongeon ,  Susan Heilman Kilbane ,  James E. Willenbring ,  Christopher John Gennaro

IPC分类号： G06Q50/00

CPC分类号： G06F19/3418 ,  G06F19/00 ,  G06Q50/22 ,  G06Q50/24

摘要： Embodiments of the present invention provide a system in which a medical device selects less than all of its stored information and provides the selected subset of information to a data mart for storage, processing, and/or communication to one or more interested parties. In many embodiments, customers, patients, or even components of the medical device or of the remote patient management system can access selected medical device information (e.g., customers can access medical device information tailored to the care they are providing to one or more patients). In many embodiments, customers can receive such medical device information according to a schedule that best suits their care (or whenever they desire such information, irrespective of a schedule). In many embodiments, providing less than full transmissions to the data mart reduces the strain on medical device batteries.

摘要翻译： 本发明的实施例提供一种系统，其中医疗设备选择少于其所有存储的信息，并将所选择的信息子集提供给数据集市以用于存储，处理和/或与一个或多个有关方面的通信。 在许多实施例中，医疗设备或远程患者管理系统的客户，患者或甚至组件可以访问所选择的医疗设备信息（例如，客户可以访问为他们提供给一个或多个患者的护理而定制的医疗设备信息） 。 在许多实施例中，客户可以根据最适合其照顾的时间表（或每当他们希望这样的信息，而不管时间表）接收这样的医疗设备信息。 在许多实施例中，向数据集市提供少于完整的传输减少了医疗设备电池的压力。

公开(公告)号：US20090292331A1

公开(公告)日：2009-11-26

申请号：US12476733

申请日：2009-06-02

申请人： BRUCE D. GUNDERSON ,  AMISHA S. PATEL ,  CHAD A. BOUNDS ,  MARK L. BROWN

发明人： BRUCE D. GUNDERSON ,  AMISHA S. PATEL ,  CHAD A. BOUNDS ,  MARK L. BROWN

IPC分类号： A61N1/39

CPC分类号： A61B5/0456 ,  A61B5/0464 ,  A61B5/7217 ,  A61B5/7239 ,  A61B5/7264 ,  A61N1/3622 ,  A61N1/3702 ,  A61N1/3704

摘要： A method for identifying and classifying various types of oversensing in implantable medical devices (IMDs), such as implantable cardioverter defibrillators (ICDs), to assist a physician in choosing corrective action to reduce the likelihood of oversensing and inappropriate therapy delivery. Far-field electrogram (EGM) signals are analyzed to detect the occurrence of R-waves, and the result is compared to the number and pattern of R-waves sensed by the IMD and indicated on the marker channel. A marker channel with more sensed R-waves than indicated by analysis of the far-field EGM indicates the presence of oversensing, including double-counting of R-waves, T-wave oversensing, lead malfunction or failure, poor lead connections, noise associated with electromagnetic interference, non-cardiac myopotentials, etc. Identification of the type of oversensing may be determined by analysis of the number and pattern of marker channel sensed R-waves with respect to the timing of the R-waves detected from the far-field EGM.

摘要翻译： 用于识别和分类可植入医疗装置（IMD）中的各种类型的过度感染的方法，例如可植入的心律转复除颤器（ICD），以协助医师选择矫正动作以减少过度和不适当的治疗递送的可能性。 分析远场电描记图（EGM）信号以检测R波的发生，并将结果与​​由IMD感测并在标记通道上指示的R波的数量和模式进行比较。 具有比通过远场EGM分析指示的更多的感测R波的标记通道表示存在过敏，包括R波的双重计数，T波超检测，导线故障或故障，导线连接不良，噪声相关 具有电磁干扰，非心脏近视等。过敏类型的识别可以通过对从远场检测到的R波的定时的标记信道感测R波的数量和模式的分析来确定 股东特别大会