公开(公告)号：US07599738B2

公开(公告)日：2009-10-06

申请号：US11130671

申请日：2005-05-17

申请人： Jaeho Kim ,  Joseph M. Bocek ,  Anthony S. Harrington

发明人： Jaeho Kim ,  Joseph M. Bocek ,  Anthony S. Harrington

IPC分类号： A61N1/362

CPC分类号： A61N1/3622 ,  A61N1/3682

摘要： Methods and systems are described that involve synchronized ventricular pacing that promotes sensing of atrial events. The atrioventricular pacing delay is modified based on characteristics of previously sensed atrial events. The modified AV delay is implemented relative to a first atrial event. A second AV delay is implemented relative to a second atrial event if the second atrial event is sensed during the modified AV delay. A ventricular pacing pulse is delivered following the second AV delay.

摘要翻译： 描述了涉及促进心房事件感测的同步心室起搏的方法和系统。 房室起搏延时根据以前感测到的心房事件的特征进行修改。 修改的AV延迟相对于第一次心房事件实现。 如果在修改的AV延迟期间感测到第二心房事件，则相对于第二心房事件实施第二AV延迟。 在第二次AV延迟之后递送心室起搏脉冲。

公开(公告)号：US07580740B2

公开(公告)日：2009-08-25

申请号：US11126594

申请日：2005-05-11

申请人： Jaeho Kim ,  Joseph M. Bocek ,  Anthony S. Harrington ,  Harley G. White

发明人： Jaeho Kim ,  Joseph M. Bocek ,  Anthony S. Harrington ,  Harley G. White

IPC分类号： A61N1/37 ,  A61N1/362

CPC分类号： A61N1/3702 ,  A61B5/0464 ,  A61N1/3622

摘要： Methods and systems are directed to detecting atrial tachyarrhythmia. A plurality of A-A intervals is detected. The detected A-A intervals are selected and used to detect atrial tachyarrhythmia. Selecting A-A intervals may be based on determining that A-A intervals are qualified. Qualified A-A intervals may be determined if a duration of the particular A-A interval falls outside a predetermined duration range, for example. Qualified A-A intervals may also be determined based on events occurring between consecutively sensed atrial events of the particular A-A interval, and whether the duration of the particular A-A interval falls within the predetermined duration range, for example.

摘要翻译： 方法和系统旨在检测房性快速性心律失常。 检测到多个A-A间隔。 检测到的A-A间隔被选择并用于检测房性快速性心律失常。 选择A-A间隔可以基于确定A-A间隔是合格的。 例如，如果特定A-A间隔的持续时间落在预定的持续时间范围之外，则可以确定合格的A-A间隔。 也可以基于特定A-A间隔的连续感测的心房事件之间发生的事件以及特定A-A间隔的持续时间是否落入预定持续时间范围内来确定合格的A-A间隔。

公开(公告)号：US20080243201A1

公开(公告)日：2008-10-02

申请号：US12135709

申请日：2008-06-09

申请人： Joseph M. Bocek ,  Richard M. Dujmovic ,  Phil Foshee ,  Harley White ,  Jaeho Kim ,  Anthony Harrington ,  Richard S. Sanders ,  Douglas R. Daum ,  Paul De Coriolis ,  Joseph Smith ,  Richard Fogoros

发明人： Joseph M. Bocek ,  Richard M. Dujmovic ,  Phil Foshee ,  Harley White ,  Jaeho Kim ,  Anthony Harrington ,  Richard S. Sanders ,  Douglas R. Daum ,  Paul De Coriolis ,  Joseph Smith ,  Richard Fogoros

IPC分类号： A61N1/39 ,  A61N1/362

CPC分类号： A61N1/3956 ,  A61N1/3962

摘要： A combination pacer/defibrillator is tailored for bradycardia patients. In one example, its shock-delivery specificity exceeds its sensitivity to shockable ventricular tachyarrhythmias. In another example, its specificity exceeds 95%, or 99%, or even 99.5%. Sensitivity is programmed to a high desired sensitivity value, but only if it can be done without decreasing the specificity below the desired specificity threshold value. This can be conceptualized as “avoiding at all costs” delivering false shocks, even at the expense of failing to deliver a shock to a treatable ventricular tachyarrhythmia. Specificity enhancements include, among other things, inhibiting shock delivery when the patient is breathing or not supine, using multiple channels or a high rate VT/VF detection threshold. The present pacer/defibrillator device could potentially save the lives of bradyarrhythmia patients who are not presently clinically indicated for a defibrillator/pacer, but who have an increased risk of sudden cardiac death due to one or more risk factors.

摘要翻译： 组合起搏器/除颤器是为心动过缓患者量身打造的。 在一个例子中，其冲击传递特异性超过其对可震荡室性快速性心律失常的敏感性。 在另一个实例中，其特异性超过95％，或99％，甚至99.5％。 灵敏度被编程为高期望的灵敏度值，但是只有在不降低低于所需特异性阈值的特异性的情况下才能进行。 这可以被概念化为“不惜一切代价”，提供虚假的冲击，即使以不能对可治疗的室性快速性心律失常发生冲击为代价。 特异性增强包括，当患者呼吸或不仰卧时，使用多个通道或高速率的VT / VF检测阈值来抑制冲击输送。 本发明的起搏器/除颤器装置可能潜在地节省目前临床指示用于除颤器/止痛器但是由于一个或多个危险因素引起的心脏猝死风险增加的缓慢心律失常患者的生命。

公开(公告)号：US07031764B2

公开(公告)日：2006-04-18

申请号：US10291200

申请日：2002-11-08

申请人： Mark Schwartz ,  Joseph M. Bocek ,  Jaeho Kim

发明人： Mark Schwartz ,  Joseph M. Bocek ,  Jaeho Kim

IPC分类号： A61B5/452 ,  A61N1/365

CPC分类号： A61N1/3956 ,  A61B5/04525

摘要： Multiple morphology templates for discliminating between rhythms have been used, such as supraventricular tachyarrhythmias (SVTs) and ventricular tachyarrhythmias (VTs), for delivering a countershock in response to a VT episode, but withholding delivery of such a countershock in response to an SVT episode. In certain examples, the particular morphology used for storing morphological features is selected at least in part using a sensor-indicated activity level of a subject, or a metabolic need of the subject.

摘要翻译： 已经使用用于在节律之间进行偏离的多个形态学模板，例如室上性快速性心律失常（SVT）和室性快速性心律失常（VT），用于响应于VT发作而产生反冲突，但是为了响应于SVT发作而扣留了这种反冲。 在某些实例中，用于存储形态特征的特定形态至少部分地使用受试者的传感器指示的活动水平或受试者的代谢需要。

公开(公告)号：US06584350B2

公开(公告)日：2003-06-24

申请号：US09828461

申请日：2001-04-06

申请人： Jaeho Kim ,  Joseph M. Bocek

发明人： Jaeho Kim ,  Joseph M. Bocek

IPC分类号： A61N139

CPC分类号： A61N1/3956 ,  A61N1/36592 ,  A61N1/3987

摘要： An apparatus and method for delivering electrical shock therapy in order to treat atrial tachyarrhythmias such as fibrillation utilizes a dynamically varying threshold to detect R-waves and synchronously deliver a defibrillation shock.

公开(公告)号：US08386039B2

公开(公告)日：2013-02-26

申请号：US12825618

申请日：2010-06-29

申请人： Jaeho Kim ,  Joseph M. Bocek

发明人： Jaeho Kim ,  Joseph M. Bocek

IPC分类号： A61B5/0464

CPC分类号： A61B5/0464 ,  A61B5/7264 ,  A61N1/3622 ,  A61N1/3925 ,  A61N1/3962 ,  G06F19/00

摘要： This document discusses, among other things, systems and methods to discriminate between a ventricular tachyarrhythmia (VT) and a supraventricular tachyarrhythmia (SVT), such as upon detecting sudden onset and one-to-one tachycardia. In certain examples, a detected tachyarrhythmia is analyzed to determine whether it is sudden onset and 1:1. If so, a first fast beat is identified. One or more ventricular intervals in close proximity to the first fast beat are analyzed to determine an initial classification of either VT or SVT. The initial classification is used to adjust a morphological feature correlation coefficient (FCC) threshold. A morphology analysis is performed with the adjusted FCC threshold value to yield a secondary classification.

摘要翻译： 本文件尤其涉及区分心室性心律失常（VT）和室上性快速性心律失常（SVT）的系统和方法，例如在检测到突发性发作和一对一心动过速时。 在某些实例中，分析检测到的快速性心律失常以确定其是否突然发作和1：1。 如果是这样，首先确定快节拍。 分析紧邻第一快节拍的一个或多个心室间隔以确定VT或SVT的初始分类。 初始分类用于调整形态特征相关系数（FCC）阈值。 用调整的FCC阈值进行形态分析以产生次级分类。

公开(公告)号：US08364262B2

公开(公告)日：2013-01-29

申请号：US12849714

申请日：2010-08-03

申请人： Jaeho Kim ,  Joseph M. Bocek

发明人： Jaeho Kim ,  Joseph M. Bocek

IPC分类号： A61N1/00

CPC分类号： A61N1/3621 ,  A61N1/3925

摘要： This document discusses, among other things, detection of a sudden onset of a tachyarrhythmia. A sudden onset of tachyarrhythmia is determined by monitoring changes in intrinsic ventricular rate, such as by using one or more sensing channels in the ICD. A lowest tachyarrhythmia rate threshold is accompanied by a slightly lower “hysteresis tachyarrhythmia rate threshold.” If a sudden onset of tachyarrhythmia is declared, the sudden onset status is not reset by the ventricular rate falling below the lowest tachyarrhythmia rate threshold, but is instead reset by the ventricular rate falling below the slightly lower hysteresis tachyarrhythmia rate threshold.

摘要翻译： 本文件尤其涉及突发性快速性心律失常发作的检测。 通过监测内在心室率的变化，例如通过使用ICD中的一个或多个感测通道来确定快速性心律失常的突然发作。 最低的快速性心律失常率阈值伴随着稍低的滞后快速性心律失常率阈值。 如果突然出现快速性心律失常，突发发作状态不会因心律失常率低于最低心律失常率阈值而复位，而是由心律失常复位，低于滞后快速性心律失常率阈值。

公开(公告)号：US20100324613A1

公开(公告)日：2010-12-23

申请号：US12871337

申请日：2010-08-30

申请人： Bijan Elahi ,  Joseph M. Bocek ,  Jaeho Kim

发明人： Bijan Elahi ,  Joseph M. Bocek ,  Jaeho Kim

IPC分类号： A61N1/39

CPC分类号： A61N1/3962 ,  A61N1/3622

摘要： An implantable cardioverter/defibrillator (ICD) executes a rate accuracy enhancement algorithm to select measured atrial and ventricular intervals for classifying a detected tachycardia based on average atrial and ventricular rates calculated from the selected atrial and ventricular intervals. The detected tachycardia is classified as ventricular tachycardia (VT) if the average ventricular rate is substantially higher than the average atrial rate.

摘要翻译： 植入式心脏复律/除颤器（ICD）执行速率精度增强算法，以根据从所选择的心房和心室间隔计算的平均心房和心室率来选择测量的心房和心室间隔以分类检测到的心动过速。 如果平均心室率显着高于平均心房率，则检测到的心动过速分类为室性心动过速（VT）。

公开(公告)号：US07797037B2

公开(公告)日：2010-09-14

申请号：US12069451

申请日：2008-02-08

申请人： Bijan Elahi ,  Joseph M. Bocek ,  Jaeho Kim

发明人： Bijan Elahi ,  Joseph M. Bocek ,  Jaeho Kim

IPC分类号： A61B5/0464

CPC分类号： A61N1/3962 ,  A61N1/3622

摘要： An implantable cardioverter/defibrillator (ICD) executes a rate accuracy enhancement algorithm to select measured atrial and ventricular intervals for classifying a detected tachycardia based on average atrial and ventricular rates calculated from the selected atrial and ventricular intervals. The detected tachycardia is classified as ventricular tachycardia (VT) if the average ventricular rate is substantially higher than the average atrial rate.

摘要翻译： 植入式心脏复律/除颤器（ICD）执行速率精度增强算法，以根据从所选择的心房和心室间隔计算的平均心房和心室率来选择测量的心房和心室间隔以分类检测到的心动过速。 如果平均心室率显着高于平均心房率，则检测到的心动过速分类为室性心动过速（VT）。

公开(公告)号：US20100168597A1

公开(公告)日：2010-07-01

申请号：US12723805

申请日：2010-03-15

申请人： Jaeho Kim ,  Joseph M. Bocek ,  Karl Stoklosa ,  Scott Walczak

发明人： Jaeho Kim ,  Joseph M. Bocek ,  Karl Stoklosa ,  Scott Walczak

IPC分类号： A61B5/0464

CPC分类号： A61N1/3956 ,  A61B5/046 ,  A61N1/0504

摘要： A method of using an implantable medical device (IMD) comprising monitoring a ventricular contraction rate of a subject, monitoring an atrial contraction rate of the subject, declaring tachyarrhythmia if the ventricular contraction rate exceeds the atrial contraction rate, and declaring a slow tachyarrhythmia when the ventricular rate is less than a specified tachyarrhythmia detection rate.

摘要翻译： 一种使用可植入医疗装置（IMD）的方法，包括监测受试者的心室收缩速率，监测受试者的心房收缩率，如果心室收缩率超过心房收缩率，则宣布快速性心律失常，以及当心律失常 心室率低于指定的快速心律失常检出率。