公开(公告)号：US06839591B2

公开(公告)日：2005-01-04

申请号：US10396946

申请日：2003-03-24

申请人： Bruce H. KenKnight ,  William Hsu ,  Yayun Lin ,  Janice Jones

发明人： Bruce H. KenKnight ,  William Hsu ,  Yayun Lin ,  Janice Jones

IPC分类号： A61N1/39

CPC分类号： A61N1/3962

摘要： A method and system for ventricular defibrillation by coordinating the delivery of defibrillation shocks with sensed ventricular fibrillation complexes in a way which improves the probability of success of the defibrillation shock. Ventricular electrical activity is monitored in two ventricular locations during ventricular fibrillation to detect coarse ventricular fibrillation complexes and contractions of the ventricular cardiac tissue. The defibrillation shock is delivered in coordination with the occurrence of coarse ventricular fibrillation complexes and the contractions of ventricular cardiac tissue, and specifically to occur on the up-slope portion thereof, for optimal probability of success.

公开(公告)号：US06505082B1

公开(公告)日：2003-01-07

申请号：US09643125

申请日：2000-08-21

申请人： Avram Scheiner ,  William Hsu ,  David M. Flynn ,  Qingsheng Zhu ,  John E. Heil ,  Ronald W. Heil, Jr. ,  Curtis C. Lindstrom ,  Robert S. Booker, III ,  Yayun Lin ,  Peter T. Kelley ,  Jay A. Warren ,  Gerrard M. Carlson ,  Carol Werlein ,  Aaron W. Janke ,  Mary Lee Cole ,  Jeffrey T. Bartig ,  Gary W Goebel ,  Douglas A Heitkamp ,  Randall M. Peterfeso

发明人： Avram Scheiner ,  William Hsu ,  David M. Flynn ,  Qingsheng Zhu ,  John E. Heil ,  Ronald W. Heil, Jr. ,  Curtis C. Lindstrom ,  Robert S. Booker, III ,  Yayun Lin ,  Peter T. Kelley ,  Jay A. Warren ,  Gerrard M. Carlson ,  Carol Werlein ,  Aaron W. Janke ,  Mary Lee Cole ,  Jeffrey T. Bartig ,  Gary W Goebel ,  Douglas A Heitkamp ,  Randall M. Peterfeso

IPC分类号： A61N105

CPC分类号： A61N1/0573 ,  A61N1/0563

摘要： A single-pass endocardial lead electrode adapted for implantation in, on or about the heart and for connection to a system for monitoring or stimulating cardiac activity includes a lead body which is adapted for implantation within a single chamber of the heart, or multiple chambers of the heart. The lead includes a first distal end electrode which has a first electrical conducting surface. The lead body also has a second electrode which has a second electrical conducting surface. The first and second electrodes are either passively or actively attached to the wall of the heart. The lead body also includes a curved portion which facilitates the positioning of the second electrode. The main lead body alternatively includes a recess into which an atrial lead body and an active fixation element attached to one end can travel from a recessed position to a position for fixation to the wall of the heart. The active fixation element can also be moved by turning the terminal pin. The lead body can also include multiple legs, each leg carrying an electrode. The lead is attached to a pulse generator for producing pulses to the multiple sites within the heart. A movement assembly for advancing a helix is also included within the legs and comprises an externally threaded collar which engages with an internally threaded housing or housing insert. The lead further includes a helical tip which has high impedance. The electrode has at least one features of the group: the helix having a coating of an insulating material on its surface, the helix having its surface beyond the distal end of the electrode and the distal end of the electrode having a porous conductive surface at a base of the helix, a porous conductive element at a base of the helix, and a porous conductive element at the end of the electrode having an insulating coating cover from 5-95% of the surface of the porous conductive element. The porous element may further provide a guiding mechanism for the helix as it travels out of the electrode for securing the electrode to the heart.

公开(公告)号：US06275732B1

公开(公告)日：2001-08-14

申请号：US09098654

申请日：1998-06-17

申请人： William Hsu ,  Alan F. Marcovecchio

发明人： William Hsu ,  Alan F. Marcovecchio

IPC分类号： A61N136

CPC分类号： A61B5/0464 ,  A61B5/7264 ,  A61N1/3956

摘要： A system for detecting ventricular tachycardia and supraventricular tachycardia using a multiple stage morphology based system. Cardiac signals are sensed from a patient's heart and analyzed for the occurrence of a tachycardia event. When a tachycardia event is detected, the method and system analyzes a plurality of features of the sensed cardiac signals in two or more discrimination stages. Each of the two or more discrimination stages classify the tachycardia event as either a ventricular tachycardia or a candidate supraventricular tachycardia event. When a discrimination stage detects the occurrence of a ventricular tachycardia, therapy is delivered to the heart to treat the ventricular tachycardia.

公开(公告)号：US6112117A

公开(公告)日：2000-08-29

申请号：US852103

申请日：1997-05-06

申请人： Bruce H. KenKnight ,  William Hsu ,  Yayun Lin ,  Janice Jones

发明人： Bruce H. KenKnight ,  William Hsu ,  Yayun Lin ,  Janice Jones

IPC分类号： A61N1/39

CPC分类号： A61N1/3962

摘要： A method and system for ventricular defibrillation by coordinating the delivery of defibrillation shocks with sensed ventricular fibrillation complexes in a way which improves the probability of success of the defibrillation shock. Ventricular electrical activity is monitored in two ventricular locations during ventricular fibrillation to detect coarse ventricular fibrillation complexes and contractions of the ventricular cardiac tissue. The defibrillation shock is delivered in coordination with the occurrence of coarse ventricular fibrillation complexes and the contractions of ventricular cardiac tissue, and specifically to occur on the up-slope portion thereof, for optimal probability of success.

公开(公告)号：US5632766A

公开(公告)日：1997-05-27

申请号：US513685

申请日：1995-08-11

申请人： William Hsu ,  Yayun Lin

发明人： William Hsu ,  Yayun Lin

IPC分类号： A61N1/39

CPC分类号： A61N1/3956

摘要： A method and system for ventricular defibrillation by coordinating the delivery of defibrillation shocks with sensed ventricular fibrillation complexes in a way which improves the probability of success of the defibrillation shock. Ventricular electrical activity is monitored during VF to detect coarse VF complexes. The defibrillation shock is delivered in coordination with the occurrence of coarse VF complexes, and specifically to occur on the upslope portion thereof, for optimal probability of success. Preferably, DF shock is delivered on the nth occurring coarse VF complex, wherein n is equal to or greater than 2 and less than or equal to about 9.

摘要翻译： 通过以提高除颤休克成功的可能性的方式协调将感染的心室颤动复合物的除颤电击的递送来协调心室除颤的方法和系统。 在VF期间监测心室电活动以检测粗VF复合物。 与除了VF组合物的发生相一致地进行除颤休克，特别是在其上坡部分发生，以获得最佳的成功概率。 优选地，DF冲击在第n个出现的粗VF复合物上递送，其中n等于或大于2且小于或等于约9。

公开(公告)号：USD357528S

公开(公告)日：1995-04-18

申请号：US18137

申请日：1994-01-31

申请人： William Hsu

设计人： William Hsu

公开(公告)号：US09002450B2

公开(公告)日：2015-04-07

申请号：US12975085

申请日：2010-12-21

申请人： Stuart Rosenberg ,  Yelena Nabutovsky ,  Cecilia Qin Xi ,  Jong Gill ,  Kyungmoo Ryu ,  Brian Jeffrey Wenzel ,  William Hsu

发明人： Stuart Rosenberg ,  Yelena Nabutovsky ,  Cecilia Qin Xi ,  Jong Gill ,  Kyungmoo Ryu ,  Brian Jeffrey Wenzel ,  William Hsu

IPC分类号： A61N1/00 ,  A61N1/362 ,  A61N1/365 ,  A61N1/368 ,  A61N1/39

CPC分类号： A61N1/3627 ,  A61N1/36521 ,  A61N1/3684 ,  A61N1/3686 ,  A61N1/3962

摘要： Techniques are provided for use with an implantable medical device for assessing left ventricular (LV) sphericity and atrial dimensional extent based on impedance measurements for the purposes of detecting and tracking heart failure and related conditions such as volume overload or mitral regurgitation. In some examples described herein, various short-axis and long-axis impedance vectors are exploited that pass through portions of the LV for the purposes of assessing LV sphericity. In other examples, impedance measurements taken along a vector between a right atrial (RA) ring electrode and an LV electrode implanted near the atrioventricular (AV) groove are exploited to assess LA extent, biatrial extent or mitral annular diameter. The assessment techniques can be employed alone or in conjunction with other heart failure detection techniques, such as those based on left atrial pressure (LAP.)

摘要翻译： 提供技术用于可植入医疗装置，用于基于阻抗测量来评估左心室（LV）球形度和心房尺寸范围，以便检测和跟踪心力衰竭和相关状况（例如体积过载或二尖瓣反流）。 在本文描述的一些示例中，为了评估LV球形度的目的，利用穿过LV的部分的各种短轴和长轴阻抗矢量。 在其他示例中，利用沿右心房（RA）环电极和植入在房室（AV）槽附近的LV电极之间的载体进行的阻抗测量来评估LA范围，生物学程度或二尖瓣环直径。 评估技术可以单独使用或与其他心力衰竭检测技术结合使用，例如基于左心房压力（LAP）的那些。

公开(公告)号：US08315697B2

公开(公告)日：2012-11-20

申请号：US13285483

申请日：2011-10-31

申请人： William Hsu

发明人： William Hsu

IPC分类号： A61B5/0464

CPC分类号： A61B5/0464 ,  A61B5/7264

摘要： A system and method for classifying cardiac complexes sensed during a tachycardia episode. A first cardiac signal and a second cardiac signal are sensed, where the first cardiac signal has a voltage. A first cardiac complex and a second cardiac complex of a cardiac cycle are detected in the first and second cardiac signal, respectively. A predetermined alignment feature is identified in the second cardiac complex. A datum is defined, or positioned, at a specified interval from the predetermined alignment feature of the second cardiac complex. Voltage values are then measured from the first cardiac complex at each of two or more measurement intervals from the datum. The voltage values are then compared voltage values measured from NSR cardiac complexes to classify the first cardiac complex is either a ventricular tachycardia complex or a supraventricular tachycardiac complex.

摘要翻译： 在心动过速发作期间感测到的心脏复合物的分类系统和方法。 感测第一心脏信号和第二心脏信号，其中第一心脏信号具有电压。 分别在第一和第二心脏信号中检测心脏周期的第一心脏复合体和第二心脏复合体。 在第二心脏复合物中识别预定的对准特征。 以与第二心脏复合体的预定对准特征相对的规定间隔定义或定位基准。 然后从基准的两个或更多个测量间隔中的每一个处测量来自第一心脏复合物的电压值。 然后将电压值比较从NSR心脏复合物测量的电压值，以分类第一心脏复合物是室性心动过速复合物或室上性心动过速复合物。

公开(公告)号：US20120221066A1

公开(公告)日：2012-08-30

申请号：US13035773

申请日：2011-02-25

申请人： Stuart Rosenberg ,  Cecilia Qin Xi ,  Yelena Nabutovsky ,  Brian Jeffrey Wenzel ,  Jong Gill ,  William Hsu

发明人： Stuart Rosenberg ,  Cecilia Qin Xi ,  Yelena Nabutovsky ,  Brian Jeffrey Wenzel ,  Jong Gill ,  William Hsu

IPC分类号： A61N1/36

CPC分类号： A61N1/3627 ,  A61N1/3702 ,  A61N1/372

摘要： Techniques are provided for use with implantable medical devices for addressing encapsulation effects, particularly in the detection of cardiac decompensation events such as heart failure (HF) or cardiogenic pulmonary edema (PE.) In one example, during an acute interval following device implant, cardiac decompensation is detected using heart rate variability (HRV), ventricular evoked response (ER) or various other non-impedance-based parameters that are insensitive to component encapsulation effects. During the subsequent chronic interval, decompensation is detected using intracardiac or transthoracic impedance signals. In another example, the degree of maturation of encapsulation of implanted components is assessed using impedance frequency-response measurements or based on the frequency bandwidth of heart sounds or other physiological signals. In this manner, impedance-based HF/PE detection systems can be activated as soon as component encapsulation has matured, without necessarily waiting until completion of a preset post-implant maturation interval, often set to forty-five days or more.

摘要翻译： 提供技术用于可植入医疗装置，用于解决封装效应，特别是在心脏代偿失调事件如心力衰竭（HF）或心源性肺水肿（PE）的检测中。在一个实例中，在装置植入后的急性期间，心脏 使用心率变异性（HRV），心室诱发反应（ER）或对组件封装效应不敏感的各种其他基于非阻抗的参数来检测代偿失调。 在随后的慢性间隔期间，使用心内或经胸阻抗信号检测代偿失调。 在另一示例中，使用阻抗频率响应测量值或基于心脏声音或其他生理信号的频率带宽来评估植入部件的封装的成熟程度。 以这种方式，一旦组件封装已经成熟，就可以激活基于阻抗的HF / PE检测系统，而不必等待直到完成植入后成熟间隔的预设，通常设置为四十五天或更长时间。

公开(公告)号：US20120190957A1

公开(公告)日：2012-07-26

申请号：US13010535

申请日：2011-01-20

申请人： Jong Gill ,  Cecilia Qin Xi ,  Stuart Rosenberg ,  Yelena Nabutovsky ,  Brian Jeffrey Wenzel ,  William Hsu

发明人： Jong Gill ,  Cecilia Qin Xi ,  Stuart Rosenberg ,  Yelena Nabutovsky ,  Brian Jeffrey Wenzel ,  William Hsu

IPC分类号： A61B5/042 ,  A61B5/0408 ,  A61B5/0402

CPC分类号： A61B5/0452 ,  A61B5/4842 ,  A61N1/3627 ,  A61N1/36507

摘要： A method of monitoring progression of cardiac disease includes applying stimulus pulses to the heart and sensing electrophysiological responses of the heart at a plurality of different monitoring locations of the heart. The method also includes comparing a previously and subsequently sensed electrophysiological responses that are sensed near a first location of the monitoring locations and comparing previously and subsequently sensed electrophysiological responses that are sensed near a second location of the monitoring locations. The method further includes identifying a change in progression of cardiac disease of the heart based on a difference between the previously and subsequently sensed electrophysiological responses at the first location and based on a difference between the previously and subsequently sensed electrophysiological responses at the second location.

摘要翻译： 监测心脏疾病进展的方法包括向心脏施加刺激脉冲并感测在心脏的多个不同监测位置的心脏的电生理反应。 该方法还包括比较在监测位置的第一位置附近感测的先前和随后感测到的电生理反应，并比较先前和随后感测到的在监测位置的第二位置附近感测到的电生理反应。 该方法还包括基于在第一位置处的先前感测和随后感测的电生理反应之间的差异，并且基于在第二位置处的先前感知和随后感测到的电生理反应之间的差异来识别心脏的心脏疾病进展的变化。