公开(公告)号：US08812109B2

公开(公告)日：2014-08-19

申请号：US13593334

申请日：2012-08-23

申请人： Andreas Blomqvist ,  Kjell Noren

发明人： Andreas Blomqvist ,  Kjell Noren

IPC分类号： A61N1/00

CPC分类号： A61N1/00 ,  A61N1/3627 ,  A61N1/36514 ,  A61N1/36564 ,  A61N1/3682 ,  A61N1/3684

摘要： In an implantable medical device and a method for stimulating a heart of a patient, at least one left atrial pressure (LAP) signal over a cardiac cycle is obtained. The A-wave is identified using the LAP signal and a maximum positive rate of change of the A-wave of the LAP signal is determined. The maximum positive rate of change of the A-wave corresponds to the rate which the pressure in the atrium raises as the atria contraction forces more blood into the ventricle during the very last stage of diastole. Further, AV and/or VV delay is adjusted in response to the maximum positive rate of change of the A-wave, wherein a reduction of the maximum positive rate of change of the A-wave indicates an AV and/or VV delay providing an enhanced hemodynamic performance.

摘要翻译： 在可植入医疗装置和刺激患者心脏的方法中，获得心动周期上的至少一个左心房压力（LAP）信号。 使用LAP信号识别A波，并确定LAP信号的A波的最大正比率。 A波的最大阳性变化率对应于心房收缩期间压力升高的速率，因为心房收缩在舒张期的最后阶段迫使更多的血液进入心室。 此外，AV和/或VV延迟响应于A波的最大正的变化速率而被调整，其中A波的最大正的变化率的减小表示AV和/或VV延迟提供 增强血液动力学性能。

公开(公告)号：US08211032B2

公开(公告)日：2012-07-03

申请号：US13191253

申请日：2011-07-26

申请人： Stuart O. Schecter ,  Kjell Noren

发明人： Stuart O. Schecter ,  Kjell Noren

IPC分类号： A61B5/0452

CPC分类号： A61N1/36514 ,  A61N1/36578

摘要： A first lead provides therapeutic stimulation to the heart and includes a first mechanical sensor that measures physical contraction and relaxation of the heart. A controller induces delivery of therapeutic stimulation via the first lead. The controller receives signals from the first mechanical sensor indicative of the contraction and relaxation; develops a template signal that corresponds to the contraction and relaxation; and uses the template signal to modify the delivery of therapeutic stimulations. In another arrangement, a second lead, with a second mechanical sensor also provides signals to the controller indicative of contraction and relaxation. The first mechanical sensor is adapted to be positioned at the interventricular septal region of the heart, and the second mechanical sensor is adapted to be positioned in the lateral region of the left ventricle. The controller processes the signals from the first mechanical sensor and the second mechanical sensor to develop a dysynchrony index.

摘要翻译： 第一个引线提供对心脏的治疗刺激，并且包括测量心脏的身体收缩和松弛的第一机械传感器。 控制器通过第一引线诱导治疗性刺激。 控制器从第一机械传感器接收指示收缩和松弛的信号; 开发对应于收缩和放松的模板信号; 并使用模板信号修改治疗刺激的递送。 在另一种布置中，具有第二机械传感器的第二引线还向控制器提供指示收缩和松弛的信号。 第一机械传感器适于定位在心脏的室间隔区域，并且第二机械传感器适于定位在左心室的侧向区域中。 控制器处理来自第一机械传感器和第二机械传感器的信号以产生异步指数。

公开(公告)号：US20110245701A1

公开(公告)日：2011-10-06

申请号：US13076627

申请日：2011-03-31

申请人： Anders Bjorling ,  Malin Hollmark ,  Tomas Svensson ,  Stefan Hjelm ,  Kjell Noren ,  Karin Jarverud

发明人： Anders Bjorling ,  Malin Hollmark ,  Tomas Svensson ,  Stefan Hjelm ,  Kjell Noren ,  Karin Jarverud

IPC分类号： A61B5/0456 ,  A61N1/39

CPC分类号： A61B5/0456 ,  A61B5/0031 ,  A61B5/053 ,  A61B5/7264 ,  A61N1/3621 ,  A61N1/36521 ,  A61N1/3702 ,  A61N1/3925 ,  A61N1/3962

摘要： An implantable medical device, is designed to collect a signal representative of the electric activity of the heart and determine a cardiogenic impedance signal for at least a portion of the heart. An R-wave detector of the IMD detects the timing of an R-wave during a cardiac cycle based on the signal representative of the electric activity. A minimum detector detects the timing of a cardiogenic impedance minimum in the cardiogenic impedance signal and within a systolic time window of the cardiac cycle. A detected arrhythmia is then classified by the IMD based on the timing of the R-wave detected by the R-wave detector and the timing of the cardiogenic impedance minimum detected by the minimum detector.

摘要翻译： 可植入医疗装置被设计成收集表示心脏的电活动的信号，并确定至少一部分心脏的心源性阻抗信号。 基于代表电活动的信号，IMD的R波检测器在心动周期中检测R波的定时。 最小检测器检测心源性阻抗信号中心源性阻抗最小值的定时，并在心动周期的收缩时间窗内检测。 然后，基于由R波检测器检测到的R波的定时和由最小检测器检测的心源阻抗最小值的定时，通过IMD对检测到的心律失常进行分类。

公开(公告)号：US07970473B2

公开(公告)日：2011-06-28

申请号：US12244607

申请日：2008-10-02

申请人： Yelena Nabutovsky ,  Taraneh Ghaffari Farazi ,  Anders Bjorling ,  Kjell Noren ,  Gene A. Bornzin

发明人： Yelena Nabutovsky ,  Taraneh Ghaffari Farazi ,  Anders Bjorling ,  Kjell Noren ,  Gene A. Bornzin

IPC分类号： A61N1/00

CPC分类号： A61B5/046 ,  A61B5/04011 ,  A61B5/0464 ,  A61N1/3702 ,  A61N1/3956

摘要： Methods and systems are provided for performing ventricular arrhythmia monitoring using at least two sensing channels that are each associated with different sensing vectors, for example by different pairs of extracardiac remote sensing electrodes. Myopotential associated with each of the sensing channels in monitored, and a ventricular arrhythmia monitoring mode is selected based thereon (e.g., based on determined myopotential levels). Ventricular arrhythmia monitoring is then performed using the selected monitoring mode.

摘要翻译： 提供的方法和系统用于使用至少两个感测通道进行心室心律失常监测，每个感测通道各自与不同的感测向量相关联，例如通过不同的心外感测电极对。 与监测的每个感测通道相关联的神经电位和基于（例如，基于确定的电位电平）来选择心室心律失常监测模式。 然后使用所选择的监测模式进行室性心律失常监测。

公开(公告)号：US20100249864A1

公开(公告)日：2010-09-30

申请号：US12438397

申请日：2006-08-28

申请人： Karin Järverud ,  Kjell Noren

发明人： Karin Järverud ,  Kjell Noren

IPC分类号： A61N1/362 ,  A61B5/103

CPC分类号： A61B5/0205 ,  A61B5/0031 ,  A61B5/02028 ,  A61B5/0215 ,  A61B5/1116 ,  A61B5/686 ,  A61B5/7239 ,  A61N1/36564 ,  A61N1/3702

摘要： An apparatus for determining variation over time of a medical parameter of a human being obtained from a sensed signal has a sensor implantable in the human being for sensing the signal. A comparator compares at least one characteristic property, derived from the sensed signal obtained for at least one predetermined first level of activity of the human being, with corresponding reference property of a sensed reference signal, obtained for a predetermined reference level of activity of the human being, for determining a relation between the characteristic property of the sensed signal and the reference property. A trend determining unit determines trends in the medical parameter by analyzing the relation between the characteristic property of the sensed signal obtained at different times and the reference property. A corresponding method also function an implant for heart failure diagnostics also function as described. A sensor is then arranged to pick up dynamic mechanical information from the heart of the human being and generate a corresponding signal. A heart stimulator includes such an implant and a control unit arranged to control stimulation of the heart depending on determined trends in the medical parameter.

摘要翻译： 用于确定从感测信号获得的人的医学参数随时间变化的装置具有可植入人体的用于感测信号的传感器。 比较器比较从针对人的至少一个预定的第一活动水平获得的感测信号导出的至少一个特征属性与针对人的预定参考活动水平获得的感测参考信号的相应参考特性 用于确定感测信号的特性与参考属性之间的关系。 趋势确定单元通过分析在不同时间获得的感测信号的特性与参考属性之间的关系来确定医疗参数的趋势。 相应的方法也可以用于心力衰竭诊断的植入物也起到所述的作用。 然后设置传感器以从人的心脏拾取动态机械信息并产生相应的信号。 心脏刺激器包括这样的植入物和控制单元，其被布置成根据医学参数中确定的趋势来控制心脏的刺激。

公开(公告)号：US20080294213A1

公开(公告)日：2008-11-27

申请号：US12094534

申请日：2005-11-30

申请人： Nils Holmstrom ,  Kjell Noren

发明人： Nils Holmstrom ,  Kjell Noren

IPC分类号： A61N1/365

CPC分类号： A61N1/36514 ,  A61B7/04 ,  A61N1/3627 ,  A61N1/36578 ,  A61N1/3684

摘要： A method for operating an implantable medical device to obtain substantially synchronized closure of the mitral and tricuspid valves based on sensed heart sounds includes sensing an acoustic energy; producing signals indicative of heart sounds of the heart of the patient over predetermined periods of a cardiac cycle during successive cardiac cycles; calculating a pulse width of such a signal; and iteratively controlling a delivery of the ventricular pacing pulses based on calculated pulse widths of successive heart sound signals to identify an RV interval or VV interval that causes a substantially synchronized closure of the mitral and tricuspid valve. A medical device for optimizing an RV interval or VV interval based on sensed heart sounds implements such a method and a computer readable medium encoded with instructions causes a computer to perform such a method.

摘要翻译： 用于操作可植入医疗装置以基于感测到的心脏声音获得二尖瓣和三尖瓣的基本上同步闭合的方法包括感测声能; 在连续心脏周期期间产生指示心脏周期的预定周期的患者心脏的心脏声音的信号; 计算这种信号的脉冲宽度; 并且基于计算的连续心脏声音信号的脉冲宽度迭代地控制心室起搏脉冲的递送，以识别导致二尖瓣和三尖瓣的基本上同步闭合的RV间隔或VV间隔。 基于感测到的心脏声音优化RV间隔或VV间隔的医疗装置实现了这样的方法，并且用指令编码的计算机可读介质使得计算机执行这种方法。

公开(公告)号：US20060235325A1

公开(公告)日：2006-10-19

申请号：US10524196

申请日：2003-06-23

申请人： Nils Holmstrom ,  Martin Obel ,  Anna Norlin ,  Kenneth Dahlberg ,  Anders Bjorling ,  Sven Kalling ,  Karin Ljungstrom ,  Kjell Noren

发明人： Nils Holmstrom ,  Martin Obel ,  Anna Norlin ,  Kenneth Dahlberg ,  Anders Bjorling ,  Sven Kalling ,  Karin Ljungstrom ,  Kjell Noren

IPC分类号： A61B5/05 ,  A61B5/02

CPC分类号： A61B5/0538 ,  A61B5/053 ,  A61N1/3627

摘要： A congestive heart failure monitor has an impedance measuring unit that measures the impedance between at least two electrodes implanted in a patient, to use a detected change of the measured impedance as an indication of a change in the left atrium volume. Any analyzing unit analyzes the measured impedance and detects insipient congestive heart failure dependent on a quotient of a maximum value of the measured impedance and a minimum value of the measured impedance during a cardiac cycle.

摘要翻译： 充血性心力衰竭监测器具有阻抗测量单元，其测量植入患者中的至少两个电极之间的阻抗，以使用检测到的测量阻抗的变化作为左心房体积变化的指示。 任何分析单元分析所测量的阻抗，并根据所测量的阻抗的最大值和心动周期内所测量的阻抗的最小值来检测不利的充血性心力衰竭。

公开(公告)号：US20050107836A1

公开(公告)日：2005-05-19

申请号：US10505013

申请日：2003-02-27

申请人： Kjell Noren

发明人： Kjell Noren

IPC分类号： A61B5/0452 ,  A61B5/046 ,  A61B5/0464 ,  A61N1/362 ,  A61B5/04

CPC分类号： A61N1/3622 ,  A61B5/0452 ,  A61B5/046 ,  A61B5/0464 ,  A61B5/7257

摘要： In a device and a method for determining a cardiac condition from a detected cardiac signal, an input signal is formed from the detected cardiac signal and supplied to an analysis unit. The analysis unit forms an analysis signal from the input signal, having a real part substantially corresponding to the input signal and an imaginary part that is a predetermined transformation of the input signal. A calculation unit operates on the analysis signal to calculated at least two heart-related parameters therefrom. The heart-related parameters are supplied to a processing unit that combines the heart-related parameters in a predetermined manner for identifying a cardiac condition.

摘要翻译： 在根据检测到的心脏信号确定心脏状况的装置和方法中，根据检测到的心脏信号形成输入信号并提供给分析单元。 分析单元从输入信号形成分析信号，其具有基本对应于输入信号的实部和作为输入信号的预定变换的虚部。 计算单元对分析信号进行操作以从其计算至少两个心脏相关参数。 将心脏相关参数提供给处理单元，该处理单元以预定方式组合心脏相关参数以识别心脏状况。

公开(公告)号：US6134472A

公开(公告)日：2000-10-17

申请号：US269347

申请日：1999-11-26

申请人： Hans Strandberg ,  Johan Lidman ,  Kjell Noren

发明人： Hans Strandberg ,  Johan Lidman ,  Kjell Noren

IPC分类号： A61N1/362 ,  A61N1/365

CPC分类号： A61N1/36521 ,  A61N1/3627

摘要： In the determination of an optimal rate for the delivery of stimulation pulses to a heart, the stroke volume (SV) of a heart ventricle is measured as a function of heart rate (HR), e.g. by determination of impedance in individual heart cycles whose duration is varied from the duration corresponding to the prevailing rate or the basic rate regarded as optimal for stimulation. The optimal rate should lie at the knee of this function. A corresponding knee is also found in the curve for cardiac output (CO). This rate is determined by calculation of an auxiliary function, e.g. HF=HR.times.CO, which displays a peak at the heart rate at which the knee is located, and the heart rate is determined which yields this maximum. The heart rate determined in this manner is subsequently employed as a basic rate.

摘要翻译： PCT No.PCT / SE97 / 01590 Sec。 371日期1999年11月26日 102（e）1999年11月26日PCT PCT 1997年9月22日PCT公布。 公开号WO98 / 14240 日期1998年4月9日在确定将心脏刺激脉冲递送到最佳速率时，测量心室的搏动体积（SV）作为心率（HR）的函数，例如心率。 通过确定其持续时间从对应于当前速率或被认为是刺激最佳的基本速率的持续时间变化的各个心脏周期中的阻抗的确定。 最佳速率应该在这个功能的膝盖上。 在心输出量（CO）曲线中也发现了相应的膝盖。 该速率通过辅助功能的计算来确定，例如， HF = HRxCO，其以膝盖所处的心率显示峰值，并且确定产生该最大值的心率。 以这种方式确定的心率随后用作基本速率。

公开(公告)号：US5632267A

公开(公告)日：1997-05-27

申请号：US521039

申请日：1995-08-29

申请人： Kurt Hognelid ,  Kjell Noren

发明人： Kurt Hognelid ,  Kjell Noren

IPC分类号： A61N1/05 ,  A61N1/362 ,  A61N1/38 ,  A61N1/39

CPC分类号： A61N1/3956 ,  A61N1/3621 ,  A61N1/385

摘要： An implantable heart defibrillator contains a pulse generator controlled by a control unit for emitting a number of heart stimulation pulses at a rate of several Hertz or more. The control unit causes the pulse generator to emit heart stimulation pulses with an energy content of the same, or somewhat greater, magnitude than conventional pacemaker pulses for a period of time long enough for the entire heart to become refractory.

摘要翻译： 可植入心脏除颤器包含由控制单元控制的脉冲发生器，用于以几赫兹或更高的速率发射多个心脏刺激脉冲。 控制单元使得脉冲发生器发出心脏刺激脉冲，该心脏刺激脉冲的能量含量与常规心脏起搏器脉冲相同或稍大一些，足够长的时间足以使整个心脏变得难治性。