公开(公告)号：US07979113B2

公开(公告)日：2011-07-12

申请号：US12435896

申请日：2009-05-05

申请人： Yanting Dong ,  Scott A. Meyer ,  Qingsheng Zhu

发明人： Yanting Dong ,  Scott A. Meyer ,  Qingsheng Zhu

IPC分类号： A61B5/04

CPC分类号： A61N1/371 ,  A61B5/04525 ,  A61B5/7217 ,  A61B5/7264

摘要： Methods and systems involve classifying the cardiac response to pacing using a multi-channel approach. Multiple cardiac response signals are sensed via multiple sense channels. Each sense channel comprises a distinct combination of electrodes and sensing circuitry. The cardiac response to the pacing pulse is classified based on the morphology of the cardiac response signals. Classifying the cardiac response involves discriminating between capture, fusion, non-capture, and non-capture with intrinsic activity.

摘要翻译： 方法和系统包括使用多通道方法对心脏起搏应答进行分类。 通过多个感测通道感测多个心脏反应信号。 每个感测通道包括电极和感测电路的不同组合。 基于心脏反应信号的形态对起搏脉搏的心脏反应进行分类。 分类心脏反应包括区分捕获，融合，非捕获和非捕获与内在活动。

公开(公告)号：US07917215B2

公开(公告)日：2011-03-29

申请号：US12276070

申请日：2008-11-21

申请人： Yi Zhang ,  Yinghong Yu ,  Aaron McCabe ,  Jiang Ding ,  Jeffrey E. Stahmann ,  Carlos A. Ricci ,  Scott A. Meyer

发明人： Yi Zhang ,  Yinghong Yu ,  Aaron McCabe ,  Jiang Ding ,  Jeffrey E. Stahmann ,  Carlos A. Ricci ,  Scott A. Meyer

IPC分类号： A61N1/00

CPC分类号： A61N1/3712 ,  A61N1/3627 ,  A61N1/365 ,  G06F19/00

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 closed-loop cardiac resynchronization therapy using cardiac activation sequence information. Devices and methods involve sensing a plurality of composite cardiac signals using a plurality of electrodes, the electrodes configured for implantation in a patient. A source separation is performed using the sensed plurality of composite cardiac signals, producing one or more cardiac signal vectors associated with all or a portion of one or more cardiac activation sequences. A cardiac resynchronization therapy is adjusted using one or both of the one or more cardiac signal vectors and the signals associated with the one or more cardiac signal vectors. In further embodiments, the cardiac resynchronization therapy may be initiated, terminated, or one or more parameters of the resynchronization therapy may be altered.

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。 心脏信号分离用于使用心脏激活序列信息来检测，监测，跟踪和/或趋势闭环心脏再同步治疗。 设备和方法包括使用多个电极感测多个复合心脏信号，所述电极被配置用于植入患者体内。 使用所感测的多个复合心脏信号进行源分离，产生与一个或多个心脏激活序列的全部或一部分相关联的一个或多个心脏信号载体。 使用一个或多个心脏信号向量和与一个或多个心脏信号载体相关联的信号中的一个或两个来调整心脏再同步治疗。 在另外的实施方案中，心脏再同步治疗可以被启动，终止，或者可以改变再同步治疗的一个或多个参数。

公开(公告)号：US20100305650A1

公开(公告)日：2010-12-02

申请号：US12787868

申请日：2010-05-26

申请人： Barun Maskara ,  Lili Liu ,  Guy Alvarez ,  Scott A. Meyer

发明人： Barun Maskara ,  Lili Liu ,  Guy Alvarez ,  Scott A. Meyer

IPC分类号： A61N1/365

CPC分类号： A61N1/36564 ,  A61N1/36542 ,  A61N1/36585

摘要： A system and method for pacing rate control in a cardiac rhythm management (CRM) system. The method includes acquiring a pressure signal representative of coronary venous pressure (CVP) from a pressure sensor implanted within a coronary vein of the patient and generating a CVP waveform from the pressure signal. A pacing stimulus is applied to the patient's heart, and the pacing rate is increased in response to increases in patient's metabolic demand. The CVP index is monitored during the pacing rate increase, and the CRM system detects a reduction in the patient's hemodynamic performance based on the CVP index and establishes a maximum rate setting based on the pacing rate corresponding to the reduction in the patient's hemodynamic performance.

摘要翻译： 用于心律管理（CRM）系统中起搏速率控制的系统和方法。 该方法包括从植入患者冠状静脉内的压力传感器获取代表冠状静脉压（CVP）的压力信号，并从压力信号产生CVP波形。 对患者的心脏施加起搏刺激，并且响应于患者代谢需求的增加而起搏速率增加。 在起搏速率增加期间监测CVP指数，并且CRM系统基于CVP指数检测患者血液动力学性能的降低，并且基于与患者血液动力学性能的降低相对应的起搏速率建立最大速率设置。

公开(公告)号：US20090312810A1

公开(公告)日：2009-12-17

申请号：US12545643

申请日：2009-08-21

申请人： David J. Yonce ,  Scott A. Meyer ,  David J. Ternes

发明人： David J. Yonce ,  Scott A. Meyer ,  David J. Ternes

IPC分类号： A61N1/39 ,  A61N1/37

CPC分类号： A61N1/3962 ,  A61B5/04525 ,  A61N1/3712 ,  A61N1/3943

摘要： Systems and methods of managing features or functions of an implantable cardiac device involve forming a baseline evoked response template prior to delivery of defibrillation therapy to a patient's heart, and acquiring a post-shock evoked response signal subsequent to defibrillation therapy delivery. The baseline evoked response template is compared to the post-shock evoked response signal. A determination is made whether to enable, disable or adjust a cardiac device feature based on the comparison. The cardiac device feature may be a therapy feature, a monitoring feature, or a diagnostic feature.

摘要翻译： 管理可植入心脏装置的特征或功能的系统和方法包括在将除颤疗法递送到患者心脏之前形成基线诱发反应模板，以及在除颤治疗递送之后获得后休克诱发反应信号。 将基线诱发反应模板与震后诱发反应信号进行比较。 基于比较确定是否启用，禁用或调整心脏设备特征。 心脏装置特征可以是治疗特征，监测特征或诊断特征。

公开(公告)号：US20090240301A1

公开(公告)日：2009-09-24

申请号：US12435896

申请日：2009-05-05

申请人： Yanting Dong ,  Scott A. Meyer ,  Qingsheng Zhu

发明人： Yanting Dong ,  Scott A. Meyer ,  Qingsheng Zhu

IPC分类号： A61N1/08

CPC分类号： A61N1/371 ,  A61B5/04525 ,  A61B5/7217 ,  A61B5/7264

摘要： Methods and systems involve classifying the cardiac response to pacing using a multi-channel approach. Multiple cardiac response signals are sensed via multiple sense channels. Each sense channel comprises a distinct combination of electrodes and sensing circuitry. The cardiac response to the pacing pulse is classified based on the morphology of the cardiac response signals. Classifying the cardiac response involves discriminating between capture, fusion, non-capture, and non-capture with intrinsic activity.

摘要翻译： 方法和系统包括使用多通道方法对心脏起搏应答进行分类。 通过多个感测通道感测多个心脏反应信号。 每个感测通道包括电极和感测电路的不同组合。 基于心脏反应信号的形态对起搏脉搏的心脏反应进行分类。 分类心脏反应包括区分捕获，融合，非捕获和非捕获与内在活动。

公开(公告)号：US07593771B2

公开(公告)日：2009-09-22

申请号：US11157244

申请日：2005-06-21

申请人： David J. Yonce ,  Scott A. Meyer ,  David J. Ternes

发明人： David J. Yonce ,  Scott A. Meyer ,  David J. Ternes

IPC分类号： A61N1/00

CPC分类号： A61N1/3962 ,  A61B5/04525 ,  A61N1/3712 ,  A61N1/3943

摘要： Systems and methods of managing features or functions of an implantable cardiac device involve forming a baseline evoked response template prior to delivery of defibrillation therapy to a patient's heart, and acquiring a post-shock evoked response signal subsequent to defibrillation therapy delivery. The baseline evoked response template is compared to the post-shock evoked response signal. A determination is made whether to enable, disable or adjust a cardiac device feature based on the comparison. The cardiac device feature may be a therapy feature, a monitoring feature, or a diagnostic feature.

摘要翻译： 管理可植入心脏装置的特征或功能的系统和方法包括在将除颤疗法递送到患者心脏之前形成基线诱发反应模板，以及在除颤治疗递送之后获得后休克诱发反应信号。 将基线诱发反应模板与震后诱发反应信号进行比较。 基于比较确定是否启用，禁用或调整心脏设备特征。 心脏装置特征可以是治疗特征，监测特征或诊断特征。

公开(公告)号：US20090073387A1

公开(公告)日：2009-03-19

申请号：US12207303

申请日：2008-09-09

申请人： Scott A. Meyer ,  Mary K. Durbin ,  Paul F. Stetson ,  Bagrat Amirbekian

发明人： Scott A. Meyer ,  Mary K. Durbin ,  Paul F. Stetson ,  Bagrat Amirbekian

IPC分类号： A61B3/12 ,  A61B3/10

CPC分类号： A61B3/12 ,  A61B3/1241

摘要： One embodiment of the present invention accounts for individual anatomical variation when evaluating optical nerve fiber measurements. In one aspect, contextual information is used to compensate or correct measurement data. In another aspect, reference coordinates are remapped for improved comparison or visualization. In one embodiment of this latter aspect, the method uses measurements of nerve fiber capacity and maps of nerve fiber retinal service to improve sensitivity and specificity in eye function metrics. In one instance, we use the birefringence of nerve fibers to determine the orientation of the fibers within the RNFL. Orientation of the fibers about the ONH is indicative of the service provided by the fibers and is used to improve the interpretation of thickness measurements of the nerve fiber layer. Normalized nerve fiber measurements about the optic nerve head improve specificity and sensitivity as compared to the standard model. These improvements are a result of partitioning the normative database or modifying the measurement data prior to comparison. Statistics on normalized measurements of nerve fiber bundles also show improvements in specificity and sensitivity.

摘要翻译： 评估光学神经纤维测量时，本发明的一个实施例解释了个体解剖学变化。 在一个方面，使用上下文信息来补偿或校正测量数据。 在另一方面，重新映射参考坐标以改善比较或可视化。 在后一方面的一个实施例中，该方法使用神经纤维能力的测量和神经纤维视网膜服务的图来提高眼睛功能度量中的灵敏度和特异性。 在一种情况下，我们使用神经纤维的双折射来确定RNFL内纤维的取向。 关于ONH的纤维的取向指示由纤维提供的服务，并且用于改善对神经纤维层的厚度测量的解释。 与标准模型相比，关于视神经头的规范化神经纤维测量提高了特异性和灵敏度。 这些改进是在比较之前划分规范性数据库或修改测量数据的结果。 关于神经纤维束的归一化测量的统计数据也显示出特异性和灵敏度的改善。

公开(公告)号：US20080228093A1

公开(公告)日：2008-09-18

申请号：US11717482

申请日：2007-03-13

申请人： Yanting Dong ,  Jeremy J. Maniak ,  Scott A. Meyer ,  Kevin John Stalsberg ,  Alok S. Sathaye ,  Benjamin Ettori

发明人： Yanting Dong ,  Jeremy J. Maniak ,  Scott A. Meyer ,  Kevin John Stalsberg ,  Alok S. Sathaye ,  Benjamin Ettori

IPC分类号： A61B5/0464

CPC分类号： A61B5/04525 ,  A61B5/0464 ,  A61B5/7203 ,  A61B5/7264 ,  A61N1/371

摘要： Methods and devices used to classify cardiac events based on morphological analysis of sensed signals are described. A signal comprising a cardiac signal component and a noise signal component is sensed. The sensed signal is processed to preferentially alter morphology of the cardiac signal component. The altered morphology of the cardiac signal component enhances detection of one or more features of the cardiac signal component. The features of the cardiac signal component are detected and the cardiac event is classified using the detected features. Processing the sensed signal may involve the use of adaptable signal processing parameters. For example, the signal processing parameters may be selected to accentuate one or more desirable features of the cardiac signal component or to mitigate one or more undesirable features of the cardiac signal component.

摘要翻译： 描述了基于感测信号的形态学分析来分类心脏事件的方法和装置。 检测包括心脏信号分量和噪声信号分量的信号。 处理感测到的信号以优先改变心脏信号分量的形态。 心脏信号分量改变的形态增强了对心脏信号分量的一个或多个特征的检测。 检测心脏信号分量的特征，并使用检测到的特征对心脏事件进行分类。 处理感测信号可能涉及使用适应性信号处理参数。 例如，可以选择信号处理参数以强调心脏信号分量的一个或多个期望特征或减轻心脏信号分量的一个或多个不期望的特征。

公开(公告)号：US20080140145A1

公开(公告)日：2008-06-12

申请号：US12070004

申请日：2008-02-14

申请人： Scott A. Meyer ,  Yanting Dong ,  Kevin John Stalsberg

发明人： Scott A. Meyer ,  Yanting Dong ,  Kevin John Stalsberg

IPC分类号： A61N1/365

CPC分类号： A61B5/0452 ,  A61B5/7264 ,  A61N1/362 ,  A61N1/371

摘要： Cardiac devices and methods involve the detection of cardiac signals features in adjacent classification intervals. Portions of the cardiac signal features detected in adjacent classification intervals are associated and are used to classify the cardiac response to a pacing pulse. Associating the portions of the cardiac signal features may be based on expected signal morphology.

公开(公告)号：US5479744A

公开(公告)日：1996-01-02

申请号：US251895

申请日：1994-06-01

申请人： Scott A. Meyer

发明人： Scott A. Meyer

IPC分类号： A01G9/16

CPC分类号： A01G9/16

摘要： A utility greenhouse (10) has a frame (30) comprised of electrical metal tubing (EMT) sections. Main frame members (12) bear the majority of the building's load. Main frame members (12), long side members (14) and short side members (16) all embed into the ground and are shaped to extend vertically upward for a wall height distance then curve upwards and inward so that a pronounced rounded appearance for the frame (30) results. The main frame members (12) and the long frame members (14) intersect the short frame members (16). Ties (26) secure the intersecting frame members together. A continuous sheet plastic skin (24) overlies the frame. The skin (24) is held to the frame (30) at an outer cover brace (18), an inner cover brace (20), and through ties (26) which secure skin (24) to the long and short frame members (14, 16). A door (54) is formed by cutting the skin (24).

摘要翻译： 实用温室（10）具有由电气金属管（EMT）部分组成的框架（30）。 主架构件（12）占建筑物的大部分负荷。 主框架构件（12），长边构件（14）和短边构件（16）全部嵌入地面，并且成形为垂直向上延伸以达到壁高度距离，然后向上和向内弯曲，使得对于 框（30）结果。 主框架构件（12）和长框架构件（14）与短框架构件（16）相交。 领带（26）将交叉的框架构件固定在一起。 连续的片状塑料皮肤（24）覆盖在框架上。 皮肤（24）在外盖支架（18），内盖支架（20）和穿过连接件（26）的框架（30）处固定，该皮带将皮肤（24）固定到长和短框架构件 14，16）。 通过切割皮肤（24）形成门（54）。