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    Cardiovascular Autonomic Neuropathy Testing Utilizing an Implantable Medical Device
    12.
    发明申请
    Cardiovascular Autonomic Neuropathy Testing Utilizing an Implantable Medical Device 审中-公开
    使用植入式医疗器械的心血管自主神经病变测试

    公开(公告)号：US20090018404A1

    公开(公告)日：2009-01-15

    申请号：US11776744

    申请日：2007-07-12

    申请人： Lahn M. Fendelander ,  Lizbeth M. Mino ,  Aaron R. McCabe

    发明人： Lahn M. Fendelander ,  Lizbeth M. Mino ,  Aaron R. McCabe

    IPC分类号： A61B5/00

    CPC分类号： A61B5/02405 ,  A61B5/0031 ,  A61B5/0205 ,  A61B5/4035 ,  A61N1/36514 ,  A61N1/3702

    摘要： A test system and method for cardiovascular autonomic neuropathy that incorporates an implanted medical device. One aspect of the invention relates to a system for performing cardiovascular autonomic neuropathy (CAN) testing in a diabetic patient having an implantable medical device (IMD) that includes a plurality of implantable physiological sensors and that is configured to transmit a wireless signal corresponding to a sensed physiological activity and to receive wireless signals. The system further includes one or more non-implantable physiological sensors, where the non-implantable physiological sensors are each configured to transmit a signal corresponding to a sensed physiological parameter, and a monitor device having a patient interface. The monitor device is configured to interface with a patient, including directing the patient to answer health related questions and use one or more of the non-implantable physiological sensors. The monitor device is also configured to receive signals, including signals from the IMD and the non-implantable physiological sensors. The system is configured to provide an indication of the presence or progression of CAN.

    摘要翻译： 一种纳入植入式医疗设备的心血管自主神经病变的测试系统和方法。 本发明的一个方面涉及一种用于在具有植入式医疗装置（IMD）的糖尿病患者中进行心血管自主神经病变（CAN）测试的系统，所述植入式医疗装置包括多个可植入的生理传感器，并且被配置为发送对应于 感知生理活动并接收无线信号。 该系统还包括一个或多个不可植入的生理传感器，其中非植入式生理传感器各自被配置为传送对应于所感测的生理参数的信号，以及具有患者接口的监测装置。 监视器装置被配置为与患者接口，包括引导患者回答健康相关问题并使用一个或多个非植入式生理传感器。 监视器装置还被配置为接收包括来自IMD和非植入式生理传感器的信号的信号。 该系统被配置为提供CAN的存在或进展的指示。

    Local and non-local sensing for cardiac pacing
    13.
    发明申请
    Local and non-local sensing for cardiac pacing 有权
    心脏起搏的局部和非局部感觉

    公开(公告)号：US20080009909A1

    公开(公告)日：2008-01-10

    申请号：US11478286

    申请日：2006-06-29

    申请人： Alok S. Sathaye ,  Aaron R. McCabe ,  Yinghong Yu

    发明人： Alok S. Sathaye ,  Aaron R. McCabe ,  Yinghong Yu

    IPC分类号： A61N1/00

    CPC分类号： A61B5/0452 ,  A61N1/36585 ,  A61N1/368 ,  A61N1/3682 ,  A61N1/3684

    摘要： Systems and methods for determining pacing timing intervals based on the temporal relationship between the timing of local and non-local cardiac signal features are described. A device includes a plurality of implantable electrodes electrically coupled to the heart and configured to sense local and non-local cardiac signals. Sense circuitry coupled to first and second electrode pairs senses a local cardiac signal via a first electrode pair and a non-local cardiac signal via a second electrode pair. Detection circuitry is used to detect a feature of the local signal associated with activation of a heart chamber and to detect a feature of the non-local signal associated with activation of the heart chamber. A control processor times delivery of one or more pacing pulses based on a temporal relationship between timing of the local signal feature and timing of the non-local signal feature.

    摘要翻译： 描述了基于局部和非局部心脏信号特征的定时之间的时间关系来确定起搏定时间隔的系统和方法。 一种装置包括电耦合到心脏并被配置为感测局部和非局部心脏信号的多个可植入电极。 耦合到第一和第二电极对的感测电路经由第二电极对经由第一电极对和非局部心脏信号感测局部心脏信号。 检测电路用于检测与心室的激活相关联的局部信号的特征，并且检测与心室的激活相关的非局部信号的特征。 控制处理器基于本地信号特征的定时和非本地信号特征的定时之间的时间关系来递送一个或多个起搏脉冲的递送。

    Cardiac activation sequence monitoring for ischemia detection
    16.
    发明授权
    Cardiac activation sequence monitoring for ischemia detection 失效
    心脏激活序列监测缺血检测

    公开(公告)号：US08626276B2

    公开(公告)日：2014-01-07

    申请号：US12847657

    申请日：2010-07-30

    申请人： Yi Zhang ,  Scott A. Meyer ,  Jeffrey E. Stahmann ,  Carlos Alberto Ricci ,  Marina Brockway ,  Aaron R. McCabe ,  Yinghong Yu ,  Donald L. Hopper

    发明人： Yi Zhang ,  Scott A. Meyer ,  Jeffrey E. Stahmann ,  Carlos Alberto Ricci ,  Marina Brockway ,  Aaron R. McCabe ,  Yinghong Yu ,  Donald L. Hopper

    IPC分类号： A61B5/04

    CPC分类号： A61N1/3702 ,  A61B5/0452 ,  A61B5/7203

    摘要： Cardiac monitoring and/or stimulation methods and systems that provide one or more of monitoring, diagnosing, defibrillation, and pacing. Cardiac signal separation is employed to detect, monitor, track and/or trend ischemia using cardiac activation sequence information. Ischemia detection may involve sensing composite cardiac signals using implantable electrodes, and performing a signal separation that produces one or more cardiac activation signal vectors associated with one or more cardiac activation sequences. A change in the signal vector may be detected using subsequent separations. The change may be an elevation or depression of the ST segment of a cardiac cycle or other change indicative of myocardial ischemia, myocardial infarction, or other pathological change. The change may be used to predict, quantify, and/or qualify an event such as an arrhythmia, a myocardial infarction, or other pathologic change. Information associated with the vectors may be stored and used to track the vectors.

    摘要翻译： 提供一种或多种监测，诊断，除颤和起搏的心脏监测和/或刺激方法和系统。 使用心脏信号分离来使用心脏激活序列信息来检测，监测，跟踪和/或趋势性缺血。 缺血检测可以涉及使用可植入电极感测复合心脏信号，并且执行产生与一个或多个心脏激活序列相关联的一个或多个心脏激活信号载体的信号分离。 可以使用后续分离来检测信号矢量的变化。 该变化可以是心​​脏周期的ST段的升高或抑制或指示心肌缺血，心肌梗死或其他病理变化的其它变化。 该变化可用于预测，量化和/或限定诸如心律失常，心肌梗死或其它病理变化的事件。 与矢量相关联的信息可以被存储并用于跟踪矢量。

    Estimation of dedicated bipolar pacing vector threshold
    17.
    发明授权
    Estimation of dedicated bipolar pacing vector threshold 有权
    专用双极起搏矢量阈值的估计

    公开(公告)号：US08521285B2

    公开(公告)日：2013-08-27

    申请号：US12906855

    申请日：2010-10-18

    申请人： Amy Jean Brisben ,  Aaron R. McCabe ,  Clayton S. Foster ,  David W. Yost ,  Kevin John Stalsberg ,  Jacob I. Laughner

    发明人： Amy Jean Brisben ,  Aaron R. McCabe ,  Clayton S. Foster ,  David W. Yost ,  Kevin John Stalsberg ,  Jacob I. Laughner

    IPC分类号： A61N1/36

    CPC分类号： A61N1/3712 ,  A61N1/3627

    摘要： Methods and devices are described that allow estimation of an electrostimulation capture threshold, such as a dedicated bipolar pacing vector threshold. In an example, an equal-energy assumption between first and second pacing vectors can be used to estimate an electrostimulation capture threshold of a second pacing vector from a measured electrostimulation capture threshold of the first pacing vector and impedances of the first and second pacing vectors. In an example, a relationship between first and second pacing vectors can be determined from measured data, and a parameter of the relationship can be used with a measurement of an electrostimulation capture threshold of the first pacing vector to estimate an electrostimulation capture threshold of the second pacing vector.

    摘要翻译： 描述了允许估计电刺激捕获阈值（例如专用双极起搏矢量阈值）的方法和装置。 在一个示例中，可以使用第一和第二起搏向量之间的等能量假设从第一起搏向量的测量的电刺激捕获阈值和第一和第二起搏向量的阻抗来估计第二起搏向量的电刺激捕获阈值。 在一个示例中，可以从测量数据确定第一和第二起搏向量之间的关系，并且可以使用关系的参数与第一起搏向量的电刺激捕获阈值的测量来估计第二起搏向量的电刺激捕获阈值 起搏向量

    OPTIMIZATION OF LV AND RV LEAD PLACEMENT BASED ON ELECTRICAL DELAYS
    18.
    发明申请
    OPTIMIZATION OF LV AND RV LEAD PLACEMENT BASED ON ELECTRICAL DELAYS 有权
    基于电延迟优化LV和RV导线放置

    公开(公告)号：US20130190636A1

    公开(公告)日：2013-07-25

    申请号：US13552996

    申请日：2012-07-19

    申请人： Shibaji Shome ,  Pramodsingh Hirasingh Thakur ,  Yinghong Yu ,  Keith L. Herrmann ,  Aaron R. McCabe ,  Jiang Ding

    发明人： Shibaji Shome ,  Pramodsingh Hirasingh Thakur ,  Yinghong Yu ,  Keith L. Herrmann ,  Aaron R. McCabe ,  Jiang Ding

    IPC分类号： A61B5/0456 ,  A61B5/04

    CPC分类号： A61B5/0456 ,  A61B5/04012 ,  A61N1/3684 ,  A61N1/3686 ,  A61N1/3702 ,  A61N1/37247 ,  A61N1/3918

    摘要： A system comprises a cardiac signal sensing and a processing circuit. The cardiac signal sensing circuit senses a first cardiac signal segment that includes a QRS complex and a second cardiac signal segment that includes a fiducial indicative of local ventricular activation. The processor circuit includes a site activation timer circuit configured to determine a time duration between a fiducial of the QRS complex of the first cardiac signal segment and the fiducial of the second cardiac signal segment. The processor circuit is configured to generate, using the determined time duration, an indication of optimality of placement of one or more electrodes for delivering therapy and provide the indication to at least one of a user or process.

    摘要翻译： 一种系统包括心脏信号感测和处理电路。 心脏信号感测电路感测包括QRS复合物的第一心脏信号片段和包括指示局部心室激活的基准的第二心脏信号片段。 处理器电路包括站点激活定时器电路，其被配置为确定第一心脏信号段的QRS复合体的基准点与第二心脏信号段的基准点之间的持续时间。 处理器电路被配置为使用所确定的持续时间来生成用于递送治疗的一个或多个电极的放置的最佳化的指示，并向至少一个用户或过程提供指示。

    Automatic electrode integrity management systems and methods
    19.
    发明授权
    Automatic electrode integrity management systems and methods 有权
    自动电极完整性管理系统和方法

    公开(公告)号：US08442635B2

    公开(公告)日：2013-05-14

    申请号：US13031762

    申请日：2011-02-22

    申请人： Derek D. Bohn ,  M. Jason Brooke ,  Rajesh K. Gandhi ,  Alok S. Sathaye ,  Aaron R. McCabe

    发明人： Derek D. Bohn ,  M. Jason Brooke ,  Rajesh K. Gandhi ,  Alok S. Sathaye ,  Aaron R. McCabe

    IPC分类号： A61N1/08

    CPC分类号： A61N1/37282 ,  A61N1/368 ,  A61N1/3684 ,  A61N1/3706 ,  A61N2001/083

    摘要： This document discusses, among other things, systems and methods for automatic electrode integrity management. Interelectrode impedance is measured for various electrode combinations of an implantable cardiac function management device. The impedance data is processed, such as at an external remote server, to determine whether an electrode is failing or has failed, to select an alternate electrode configuration, to alert a physician or patient, to predict a time-to-failure such as by using population data, or to reprogram electrode configuration or other device parameters of the implantable cardiac function management device.

    摘要翻译： 本文件还讨论了自动电极完整性管理的系统和方法。 测量可植入心脏功能管理装置的各种电极组合的电极内阻抗。 处理阻抗数据，例如在外部远程服务器处，以确定电极是否发生故障或失败，选择备用电极配置，以警告医师或患者预测失效时间，例如通过 使用种群数据，或重新编程可植入心脏功能管理装置的电极配置或其他装置参数。

    Anodal stimulation detection and avoidance
    20.
    发明授权
    Anodal stimulation detection and avoidance 有权
    阳极刺激检测和避免

    公开(公告)号：US08401639B2

    公开(公告)日：2013-03-19

    申请号：US12724729

    申请日：2010-03-16

    申请人： Aaron R. McCabe ,  Shibaji Shome ,  Yanting Dong ,  Amy Jean Brisben

    发明人： Aaron R. McCabe ,  Shibaji Shome ,  Yanting Dong ,  Amy Jean Brisben

    IPC分类号： A61N1/39

    CPC分类号： A61N1/3627 ,  A61N1/3712

    摘要： Cardiac resynchronization therapy is delivered to a heart using an extended bipolar electrode configuration in accordance with programmed pacing parameters including a non-zero intraventricular delay. The extended bipolar electrode configuration comprises a left ventricular electrode defining a cathode of the extended bipolar electrode configuration and a right ventricular electrode defining an anode of the extended bipolar electrode configuration. A pace pulse is delivered to the left ventricular electrode and anodal stimulation of the right ventricle is detected based on the sensed response to the pace pulse.

    摘要翻译： 使用扩展双极电极配置将心脏再同步治疗按照已编程的起搏参数（包括非零心室延迟）递送至心脏。 扩展双极电极配置包括限定扩展双极电极配置的阴极的左心室电极和限定延伸双极电极配置的阳极的右心室电极。 步速脉冲输送到左心室电极，并且基于感测到的对步速脉冲的响应来检测右心室的阳极刺激。