公开(公告)号：US08972011B2

公开(公告)日：2015-03-03

申请号：US13486990

申请日：2012-06-01

Applicant: Stuart O. Schecter

Inventor： Stuart O. Schecter

IPC: A61N1/00 ,  G06F9/45

CPC classification number: G06F8/4451 ,  A61B5/04525 ,  A61N1/3627 ,  A61N1/36521

Abstract: A method of determining pacing therapy for an individual patient including determining representative electromechanical physiologic characteristics for a plurality of normal patients having a range of anatomical dimensions and developing a plurality of normal templates. Each template indicates the representative electromechanical physiologic characteristics of a group of normal patients having similar anatomical dimensions. The method can include measuring the anatomical dimensions of a dysfunctional patient, matching the dysfunctional patient with a template for normal patients having similar anatomical dimensions as the dysfunctional patient, determining the physiologic characteristics for the dysfunctional patient, determining indicated correction factors corresponding to any differences between the dysfunctional patient's physiologic characteristics and those of the matched template, and adjusting therapy delivery by any indicated correction factors to stimulate the patient in a pattern more closely matched to the physiologic characteristics of the matched template.

Abstract translation: 一种确定个体患者的起搏治疗的方法，包括确定具有解剖尺寸范围的多个正常患者的代表性机电生理特​​征，并开发多个正常模板。 每个模板指示具有相似解剖尺寸的一组正常患者的代表性机电生理特​​征。 该方法可以包括测量功能障碍患者的解剖尺寸，使功能障碍患者与具有与功能障碍患者相似的解剖尺寸的正常患者的模板匹配，确定功能障碍患者的生理特征，确定对应于任何差异的指示的校正因子 功能障碍患者的生理特征和匹配模板的生理特征，以及通过任何指示的校正因子调整治疗递送，以以与匹配模板的生理特征更接近的模式刺激患者。

公开(公告)号：US08956304B2

公开(公告)日：2015-02-17

申请号：US14105749

申请日：2013-12-13

Applicant: Stuart O. Schecter

Inventor： Stuart O. Schecter

IPC: A61B5/02 ,  A61B5/11 ,  A61B5/00 ,  A61B5/029 ,  A61B8/08

CPC classification number: A61B5/1102 ,  A61B5/0031 ,  A61B5/029 ,  A61B8/08

Abstract: Cardiac tissue motion characteristics acquired by novel cardiac sensors are analyzed and processed for the derivation of physiological indices. The indices are output to a hand held local or remote volumetric haptic display and enable an operator to obtain motion related dynamic characteristics of cardiac tissues. The ability to tactually sense the motion of cardiac tissue and the affect on such motion from inserted cardiovascular instrumentation enhances the operator's performance of procedures including the positioning and placement of implanted catheters/sensors, extraction of permanently implanted leads and delivery of cardiovascular therapies. Optimal haptic rendering is achieved by using computational techniques to reconstruct the physically and perceptually relevant aspects of acquired signals and bridge the gap between the inserted catheter and operator's hand/catheter handle.

Abstract translation: 分析和处理由新型心脏传感器获得的心脏组织运动特征，用于推导生理指标。 指数输出到手持本地或远程体积触觉显示，并使操作者能够获得心脏组织的运动相关动态特征。 从插入的心血管仪器手术感觉心脏组织的运动和对这种运动的影响的能力增强了操作者的程序性能，包括植入的导管/传感器的定位和放置，永久植入的引线的提取和心血管疗法的递送。 通过使用计算技术来重建获取的信号的物理和感知相关方面并桥接插入的导管和操作者的手/导管手柄之间的间隙来实现最佳触觉渲染。

公开(公告)号：US08328728B2

公开(公告)日：2012-12-11

申请号：US12196632

申请日：2008-08-22

Applicant: Stuart O. Schecter

Inventor： Stuart O. Schecter

IPC: A61B5/02 ,  A61B5/04

CPC classification number: A61B5/0215 ,  A61B5/02116 ,  A61B5/02125 ,  A61B5/1459

Abstract: Provided herein are implantable systems that include an implantable photoplethysmography (PPG) sensor, which can be used to obtain an arterial PPG waveform. In an embodiment, a metric of a terminal portion of an arterial PPG waveform is determined, and a metric of an initial portion of the arterial PPG waveform is determined, and a surrogate of mean arterial pressure is determined based on the metric of the terminal portion and the metric of the initial portion. In another embodiment, a surrogate of diastolic pressure is determined based on a metric of a terminal portion of an arterial PPG waveform. In a further embodiment, a surrogate of cardiac afterload is determined based on a metric of a terminal portion of an arterial PPG waveform.

Abstract translation: 本文提供了可植入系统，其包括可用于获得动脉PPG波形的可植入光谱体积描记术（PPG）传感器。 在一个实施例中，确定动脉PPG波形的终端部分的度量，并且确定动脉PPG波形的初始部分的度量，并且基于终端部分的度量来确定平均动脉压的替代 和初始部分的度量。 在另一个实施方案中，基于动脉PPG波形的末端部分的度量来确定舒张压的替代物。 在另一实施例中，基于动脉PPG波形的终端部分的度量来确定心脏后负荷的替代物。

公开(公告)号：US20120265076A1

公开(公告)日：2012-10-18

申请号：US13337807

申请日：2011-12-27

Applicant: Stuart O. Schecter

Inventor： Stuart O. Schecter

IPC: A61B5/02 ,  A61N1/365 ,  A61B8/02 ,  A61N1/05 ,  A61B18/00 ,  A61B6/00 ,  A61B8/06 ,  B82Y5/00

CPC classification number: A61B5/0031 ,  A61B5/02 ,  A61B5/029 ,  A61B5/1076 ,  A61B5/1107 ,  A61B5/6852 ,  A61B5/7455 ,  A61B8/08 ,  A61N1/36007 ,  A61N1/3627 ,  A61N1/37205

Abstract: The cross-correlation of corresponding signals facilitates the development of sensor nanotechnologies including a catheter for performing ablation of cardiac arrhythmias and a biocompatible electrical interface with monitoring capabilities. Cross-correlation of data acquired with differing techniques enables system calibration and design, as well as, validation of the data acquired with next generation sensors. In a preferred mode of the invention, novel cardiac nanosensors enable an operator to differentiate one individual patient's cardiac tissue mechanical properties from others by using a sense of touch much as clinicians today use auditory cues with a stethoscope.

Abstract translation: 相应信号的互相关有利于传感器纳米技术的发展，包括用于进行心律失常消融的导管和具有监测能力的生物相容电接口。 使用不同技术获取的数据的互相关可使系统校准和设计，以及使用下一代传感器获取的数据的验证。 在本发明的优选模式中，新颖的心脏纳米传感器使得操作者能够通过使用触感来区分一个患者的心脏组织的机械性质，这与临床医生今天使用听诊器使用听觉提示一样。

公开(公告)号：US07963925B1

公开(公告)日：2011-06-21

申请号：US11686602

申请日：2007-03-15

Applicant: Stuart O. Schecter

Inventor： Stuart O. Schecter

IPC: A61B5/02

CPC classification number: A61B5/0031 ,  A61B5/029 ,  A61B8/08 ,  A61N1/3627 ,  A61N1/37211 ,  G06F19/00

Abstract: This invention describes methods and algorithms for processing a plurality of relevant signals/data intrinsic to a patient and/or derived from external diagnostic equipment for management of atrial arrhythmias. The intrinsic signals are acquired from intracardiac leads/sensors and analogous extrinsic data obtained from imaging equipment and patient demographics. These data are input into software algorithms that use digital signal processing to output informational data of clinical and technical relevance after comparisons are made to patients with access to this technology whose outcome under varying treatments is known. These combined data are used to define prognosis, make treatment suggestions, direct programming of cardiac devices and digitally convert intrinsically and extrinsically derived indices into a common metric. In a preferred embodiment, the intrinsically and extrinsically acquired data is utilized in the design of catheters and software algorithms for performing intracardiac procedures such as ablation of atrial arrhythmias.

Abstract translation: 本发明描述了用于处理患者固有的多个相关信号/数据和/或从用于管理心房心律失常的外部诊断设备导出的方法和算法。 固有信号是从心内引线/传感器获取的，以及从成像设备和患者人口统计学获得的类似外在数据。 这些数据被输入到使用数字信号处理的软件算法中输出具有临床和技术相关性的信息数据，与获得该技术的患者进行比较，其在不同治疗方面的结果是已知的。 这些组合数据用于定义预后，提供治疗建议，心脏设备的直接编程，以及将固有和外推衍生指数数字转换为常用指标。 在优选实施例中，本质和外部获取的数据被用于导管和软件算法的设计中，用于执行心内手术，例如房性心律失常的消融。

公开(公告)号：US07805194B1

公开(公告)日：2010-09-28

申请号：US11556552

申请日：2006-11-03

Applicant: Stuart O. Schecter

Inventor： Stuart O. Schecter

IPC: A61N1/00

CPC classification number: A61N1/36585 ,  A61N1/3627 ,  A61N1/36521 ,  A61N1/368 ,  A61N1/3682 ,  A61N1/3684

Abstract: A system and method of adjusting therapy delivery in an implantable cardiac stimulation device including establishing a plurality of setting combinations for at least two variable parameters of the implantable cardiac stimulation device affecting delivery of therapy. At least one aspect of a patient's physiologic performance is evaluated under individual ones of the plurality of setting combinations selected such that at least one of the two variable parameters vary among the plurality of combinations. A setting combination providing more optimal patient physiologic performance is programmed for future delivery of therapy. An external device can provide measurements indicative of cardiac performance. Measurements of cardiac performance can also be obtained by an implantable device.

Abstract translation: 一种调节可植入心脏刺激装置中的治疗递送的系统和方法，包括为影响治疗递送的可植入心脏刺激装置的至少两个可变参数建立多个设定组合。 在所选择的多个设置组合中的个别评估组合下评估患者的生理表现的至少一个方面，使得两个可变参数中的至少一个在多个组合中变化。 提供更优化的患者生理表现的设置组合被编程用于将来的治疗传递。 外部设备可以提供指示心脏性能的测量。 也可以通过可植入装置获得心脏性能的测量。

公开(公告)号：US20100234913A1

公开(公告)日：2010-09-16

申请号：US12788003

申请日：2010-05-26

Applicant: Stuart O. Schecter

Inventor： Stuart O. Schecter

IPC: A61N1/365

CPC classification number: A61N1/3627 ,  A61B5/0031 ,  A61B5/0452 ,  A61B5/05 ,  A61B5/7285 ,  A61N1/36521 ,  A61N1/36585 ,  A61N1/3682 ,  A61N1/37247

Abstract: An implantable therapy system including implantable stimulation and control components. The implantable components operate under a set of variable parameters that can be adjusted for improved performance for an individual patient. The implantable components are adapted to self-evaluate the patients physiologic performance and autonomously adjust an existing set of parameters to improve performance throughout an implantation period without requiring intervention of a clinician, for example with a physicians programmer. The implantable components can compare a patient's exhibited activity to a desired template of that activity to determine when adjustments are indicated. The template can be based on observations of one or more third parties exhibiting normal activity. The implantable components can adjust the operating parameters to improve synchrony of multiple heart chambers and/or to increase a peak contractility.

Abstract translation: 一种植入式治疗系统，包括可植入的刺激和控制组件。 可植入组件在一组可变参数下操作，可以针对单个患者进行调整以改善性能。 可植入组件适于自我评估患者的生理表现并自主地调整现有参数集以改善整个植入期间的性能，而不需要例如与医生程序员的临床医生的干预。 可植入组件可以将患者的展示活动与该活动的期望模板进行比较，以确定何时显示调整。 模板可以基于一个或多个表现正常活动的第三方的观察结果。 可植入部件可以调整操作参数以改善多个心室的同步和/或增加峰值收缩性。

公开(公告)号：US20100152796A1

公开(公告)日：2010-06-17

申请号：US12333157

申请日：2008-12-11

Applicant: Stuart O. Schecter

Inventor： Stuart O. Schecter

IPC: A61N1/39 ,  A61N1/365

CPC classification number: A61N1/3627 ,  A61N1/36514 ,  A61N1/3684 ,  A61N1/3702

Abstract: A system with an implantable cardiac stimulation device having an implantable stimulation generator, at least one implantable lead adapted for connection to the implantable stimulation generator and further adapted for at least one of sensing physiologic activity and delivery of therapy, memory, and a controller in communication with the memory and with the at least one implantable lead and stimulation generator. The controller is configured to automatically evaluate a patient's physiologic status and selectively induce delivery of therapeutic stimulation under variable timing parameters. The system also has a measurement system adapted to measure at least one of strain and velocity of myocardial tissue and is adapted to evaluate strain and/or velocity measures and adjust the variable timing parameters of the implantable stimulation device to increase mechanical synchrony of the myocardial tissue.

Abstract translation: 具有植入式心脏刺激装置的系统，其具有可植入式刺激发生器，至少一个可植入导线，其适于连接到所述可植入刺激发生器，并且还适用于感测生理活动和治疗递送，存储器和通信中的控制器中的至少一个 与存储器和至少一个可植入引线和刺激发生器。 控制器被配置为自动评估患者的生理状态并选择性地诱导在可变时间参数下的治疗刺激递送。 该系统还具有适于测量心肌组织的应变和速度中的至少一个的测量系统，并且适于评估应变和/或速度测量并调整可植入刺激装置的可变定时参数以增加心肌组织的机械同步 。

公开(公告)号：US20100121401A1

公开(公告)日：2010-05-13

申请号：US12267390

申请日：2008-11-07

Applicant: Xiaoyi Min ,  Stuart O. Schecter

Inventor： Xiaoyi Min ,  Stuart O. Schecter

IPC: A61N1/368

CPC classification number: A61N1/368 ,  A61N1/3627 ,  A61N1/3684 ,  A61N1/3702

Abstract: An exemplary method includes delivering stimulation energy via a right ventricular site; sensing an evoked response caused by the delivered stimulation energy at the right ventricular site; calculating a paced propagation delay for the right ventricular site (PPDRV); delivering stimulation energy via a left ventricular site; sensing an evoked response caused by the delivered stimulation energy at the left ventricular site; calculating a paced propagation delay for the left ventricular site (PPDLV); and determining an interventricular delay time (VV) for delivery of a bi-ventricular pacing therapy based in part on the paced propagation delay for the right ventricular site (PPDRV) and the paced propagation delay for the left ventricular site (PPDLV). Other exemplary methods, devices, systems, etc., are also disclosed.

Abstract translation: 示例性方法包括经由右心室部位递送刺激能量; 感测由右心室位置传递的刺激能量引起的诱发反应; 计算右心室位点（PPDRV）的节奏传播延迟; 通过左心室部位传递刺激能量; 感测由左心室部位传递的刺激能量引起的诱发反应; 计算左心室位点（PPDLV）的节奏传播延迟; 以及部分地基于右心室部位（PPDRV）的节奏传播延迟和左心室部位（PPDLV）的起搏传播延迟来确定用于递送双心室起搏治疗的室间延迟时间（VV）。 还公开了其它示例性方法，装置，系统等。

公开(公告)号：US20080288013A1

公开(公告)日：2008-11-20

申请号：US11734137

申请日：2007-04-11

Applicant: Stuart O. Schecter

Inventor： Stuart O. Schecter

IPC: A61N1/368

CPC classification number: A61B5/0215 ,  A61B5/02116 ,  A61B5/053 ,  A61B5/0816 ,  A61B5/11 ,  A61B7/00 ,  A61B8/0858 ,  A61N1/36514 ,  A61N1/368

Abstract: Devices, methods, and systems for determining a systolic pulmonary artery pressure index (PAPi) corresponding to pulmonary artery pressure (PAP) and/or right ventricular systolic pressure (RVSP) use lead-based electronic sensors detecting right heart valvular events. Suitable sensors include impedance sensors, accelerometers, cardiomechanical electric sensors, and sonomicrometers.

Abstract translation: 用于确定对应于肺动脉压（PAP）和/或右心室收缩压（RVSP）的收缩期肺动脉压指数（PAPi）的装置，方法和系统使用检测右心瓣膜事件的基于铅的电子传感器。 合适的传感器包括阻抗传感器，加速度计，心机电传感器和经济测量仪。