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公开(公告)号：US09044245B2
公开(公告)日：2015-06-02
申请号：US12984675
申请日：2011-01-05
CPC分类号： A61B18/1492 , A61B2018/00029 , A61B2018/00267 , A61B2018/00363 , A61B2018/00577 , A61B2018/00821 , A61B2018/1407 , A61B2018/1467 , A61B2218/002
摘要： A method of ablating an epicardial tissue region, including positioning a medical device adjacent the epicardial tissue region, the medical device having a first electrode, a second electrode, and a third electrode located in between the first and second electrodes; delivering an irrigation fluid to the tissue region; and ablating at least a portion of the tissue region by sequentially activating the third electrode in a monopolar radiofrequency delivery mode and activating the first and second electrodes in a bipolar radiofrequency delivery mode.
摘要翻译： 一种消融心外膜组织区域的方法，包括定位邻近心外膜组织区域的医疗装置，所述医疗装置具有位于第一和第二电极之间的第一电极，第二电极和第三电极; 向组织区域输送冲洗流体; 以及通过以单极射频递送模式顺序启动所述第三电极并且以双极射频递送模式激活所述第一和第二电极，从而消融所述组织区域的至少一部分。
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12.发明申请METHOD AND APPARATUS TO DETECT AND MONITOR THE FREQUENCY OF OBSTRUCTIVE SLEEP APNEA 有权检测和监测阻塞性睡眠呼吸暂停频率的方法和装置公开(公告)号：US20120209127A1
公开(公告)日：2012-08-16
申请号：US13456568
申请日：2012-04-26
IPC分类号： A61B5/0205 , A61B5/0464
CPC分类号： A61B5/0538 , A61B5/04 , A61B5/0809 , A61B5/1118 , A61B5/4818
摘要： The present invention provides a method and apparatus for detecting and monitoring obstructive sleep apnea. The apparatus measures sinus tachycardia and a change in the atrial-ventricular conduction, and includes a controller for receiving the measurement of the sinus tachycardia and the change in the atrial-ventricular conduction to detect obstructive sleep apnea based upon the sinus tachycardia and the change in the atrial-ventricular conduction.
摘要翻译： 本发明提供一种用于检测和监测阻塞性睡眠呼吸暂停的方法和装置。 该装置测量窦性心动过速和心房 - 心室传导的变化，并且包括用于接收窦性心动过速的测量和心房 - 心室传导的变化的控制器，以基于窦性心动过速和变化来检测阻塞性睡眠呼吸暂停 心房传导。
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13.发明授权Method and apparatus to detect and monitor the frequency of obstructive sleep apnea 有权检测和监测阻塞性睡眠呼吸暂停频率的方法和装置公开(公告)号：US08187200B2
公开(公告)日：2012-05-29
申请号：US12369899
申请日：2009-02-12
IPC分类号： A61B5/085
CPC分类号： A61B5/0538 , A61B5/04 , A61B5/0809 , A61B5/1118 , A61B5/4818
摘要： The present invention provides a method and apparatus for detecting and monitoring obstructive sleep apnea. The apparatus includes an intracardiac impedance sensor to measure intracardiac impedance, a movement sensor to measure an amount of movement of a patient, and a controller operatively coupled to said intracardiac impedance sensor and said movement sensor, said controller adapted to receive at least one of an intracardiac impedance and the amount of movement of the patient and detect obstructive sleep apnea based upon said intracardiac impedance and said movement.
摘要翻译： 本发明提供一种用于检测和监测阻塞性睡眠呼吸暂停的方法和装置。 该装置包括用于测量心内阻抗的心内阻抗传感器，用于测量患者的移动量的运动传感器以及可操作地耦合到所述心内阻抗传感器和所述运动传感器的控制器，所述控制器适于接收至少一个 心内阻抗和患者的运动量，并且基于所述心内阻塞和所述移动来检测阻塞性睡眠呼吸暂停。
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公开(公告)号：US20120123400A1
公开(公告)日：2012-05-17
申请号：US13104483
申请日：2011-05-10
CPC分类号： A61B18/12 , A61B18/1492 , A61B34/10 , A61B2018/00291 , A61B2018/00642 , A61B2018/00648 , A61B2018/00702 , A61B2018/00791 , A61B2018/00875 , A61B2034/101
摘要： System and method for ablating tissue of a heart of a patient. The tissue is characterized, then a predetermined ablation procedure is selected based on the characterization, ablation energy is delivered according to procedure with the ablation device, and a temperature of the tissue and an impedance of the tissue are determined. Delivery of ablation energy is ceased at a time based, at least in part, on when at least one of an accumulated effective temperature of the tissue over time exceeds a thermal dose threshold and an accumulated effective energy of the tissue over time exceeds an effective energy threshold. Else, the ablation energy delivered is modified by adjusting the energy level based, at least in part, on at least one of the temperature being outside of a predetermined temperature range and the impedance being outside of an impedance range.
摘要翻译： 用于烧蚀患者心脏的组织的系统和方法。 表征组织，然后基于表征选择预定的消融程序，根据消融装置的程序递送消融能量，并且确定组织的温度和组织的阻抗。 至少部分地基于时间上的组织的累积有效温度中的至少一个超过热剂量阈值并且随着时间的推移，组织的积累的有效能量超过有效能量时，消除能量的递送停止 阈。 否则，通过至少部分地基于至少一个温度在预定温度范围之外并且阻抗在阻抗范围之外来调节能量水平来改变所传送的消融能量。
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公开(公告)号：US20100030289A1
公开(公告)日：2010-02-04
申请号：US12183971
申请日：2008-07-31
CPC分类号： A61N1/385 , A61N1/3622 , A61N1/368 , A61N1/3686 , A61N1/3704 , G06F19/00 , G06F19/3418
摘要： Multiple sensing configurations may be qualified based on one induced tachyarrhythmia, e.g., ventricular fibrillation, or other qualification event during an implantation procedure. Each sensing configuration comprises a different combination of two or more electrodes used for sensing electrical signals of the heart of the patient. In some examples, an implantable medical device or other device generates qualification information for each sensing configuration, which may indicate whether the sensing configuration is qualified for subsequent cardiac event detection based on an accuracy of the cardiac event detection for the sensing configuration during the qualification event. One of the qualified configurations may initially be selected as a primary sensing configuration for subsequent cardiac event detection. Switching to an alternate sensing configuration, e.g., upon identification of any sensing integrity condition of the primary sensing configuration, may be expedited by the previous collection of qualification data for at least one other sensing configuration.
摘要翻译： 可以基于一种诱导的快速性心律失常，例如心室颤动或植入手术期间的其他鉴定事件来限定多个感测构造。 每个感测配置包括用于感测患者心脏的电信号的两个或更多个电极的不同组合。 在一些示例中，可植入医疗装置或其他装置产生用于每个感测配置的鉴定信息，其可以基于在资格事件期间的感测配置的心脏事件检测的精度来指示感测配置是否适合于随后的心脏事件检测 。 最初可以选择其中一个合格配置作为随后的心脏事件检测的主感测配置。 例如在识别主要感测配置的任何感测完整性状况时，切换到备选感测配置可以通过先前收集的至少一个其他感测配置的限定数据来加速。
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16.发明授权公开(公告)号：US07123965B2
公开(公告)日：2006-10-17
申请号：US10137171
申请日：2002-04-30
申请人： Catherine R. Condie , Gerald A. Portzline , Yong Kyun Cho , John S. Brandstetter , Luc R. Mongeon , Lucy M. Nichols , Steve R Hornberger
发明人： Catherine R. Condie , Gerald A. Portzline , Yong Kyun Cho , John S. Brandstetter , Luc R. Mongeon , Lucy M. Nichols , Steve R Hornberger
IPC分类号： A61N1/365
CPC分类号： A61N1/37252 , A61N1/36514 , A61N1/37264 , G06F19/00
摘要： A method and an apparatus for performing implementing external data into an implantable medical device. A first stress test is performed using an external sensor. External data resulting from the initial stress test is acquired. An external data injection process is performed. The external data injection process includes providing the external data to the implantable medical device. A second stress test is performed, the second stress test being substantially similar to the first stress test. Internal data resulting from the second stress test is acquired. Internal data resulting from the second stress test along with the external data resulting from the first stress test, are processed.
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公开(公告)号：US06885891B2
公开(公告)日：2005-04-26
申请号：US10040120
申请日：2001-12-31
申请人： Yong Kyun Cho , Catherine R. Condie
发明人： Yong Kyun Cho , Catherine R. Condie
CPC分类号： A61N1/36585
摘要： An automatic rate response sensor mode switch is implemented in an implantable medical device to monitor and isolate any sensor in an integrated sensor scheme. The isolated sensor is based on identification of problems associated with the sensor. The implantable medical device will switch to operate with the remainder sensor(s). Specifically, an algorithm tests and determines sensor status to initiate and operate the sensor mode switch. The software continuously monitors, isolates or qualifies a sensor to come back on-line automatically.
摘要翻译： 在可植入医疗设备中实现自动速率响应传感器模式开关，以监测和隔离集成传感器方案中的任何传感器。 隔离传感器基于与传感器相关的问题的识别。 可植入医疗设备将切换到与其余传感器一起操作。 具体来说，算法测试并确定传感器状态以启动和操作传感器模式开关。 该软件可以连续监测，隔离或限定传感器自动返回在线。
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18.发明授权Implantable medical device (IMD) system configurable to subject a patient to a stress test and to detect myocardial ischemia within the patient 有权可植入医疗装置（IMD）系统可配置为使患者进行压力测试并检测患者内的心肌缺血公开(公告)号：US06882883B2
公开(公告)日：2005-04-19
申请号：US09945195
申请日：2001-08-31
IPC分类号： A61B5/0472 , A61N1/362 , A61N1/372
CPC分类号： A61B5/4884 , A61B5/0472 , A61N1/362
摘要： Various implantable medical devices (IMDs) are disclosed for implantation in a patient. The IMD includes pacing circuitry configured to selectively produce pacing pulses at a programmable pacing rate. In one embodiment, the IMD is configurable to subject a patient to a stress test. The IMD may be configurable to subject the patient to the stress test at the time specified by stored timing information, or in response to a signal (e.g., from a patient activator). Another embodiment of the implantable medical device (IMD) includes sensor circuitry, a memory for storing data, and a control unit. The sensor circuitry produces sensor data relating to cardiac condition. The control unit is configurable to store the sensor data in the memory until a trigger signal is received. Methods are described for performing a stress test in a patient with an IMD, and for subsequently reproducing cardiac operational states.
摘要翻译： 公开了用于植入患者体内的各种植入式医疗装置（IMD）。 IMD包括起搏电路，其配置成以可编程起搏速率选择性地产生起搏脉冲。 在一个实施例中，IMD可配置为使患者进行压力测试。 IMD可以被配置为使患者在由存储的定时信息指定的时间或者响应于信号（例如来自患者激活器）的时间对患者进行压力测试。 可植入医疗装置（IMD）的另一实施例包括传感器电路，用于存储数据的存储器和控制单元。 传感器电路产生有关心脏状况的传感器数据。 控制单元可配置为将传感器数据存储在存储器中，直到接收到触发信号。 描述了用于在具有IMD的患者中进行压力测试并且随后再现心脏操作状态的方法。
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公开(公告)号：US5824019A
公开(公告)日：1998-10-20
申请号：US729465
申请日：1996-10-11
CPC分类号： A61N1/368 , A61N1/36521
摘要： There is provided an improved pacing system and method which monitors when the ventricle has become appropriately filled with blood and controls the delivery of each ventricular pace pulse to substantially coincide with desired ventricular filling, e.g., when the chamber has substantially filled. By this technique, the desired time for delivering the ventricular pace pulse is determined on a beat-by-beat basis, providing an improved physiologically optimum mode of pacing. The physiologically ventricular pacing technique of this invention is applicable either to a single chamber pacemaker, or to a dual chamber pacemaker, and in either case enables the important improvement of delivering the pace pulse at the most physiologically appropriate time. In a first embodiment, the moment when the ventricle has substantially filled with blood is determined by monitoring impedance variations which vary inversely with ventricular volume, such that filling of the ventricle corresponds to the time when the impedance waveform bottoms out, or reaches a minimum level. Other sensor arrangements which provide information as to the state of or rate of change of ventricular volume can likewise be used. The invention enables a single lead-single chamber pacemaker which achieves effective synchrony with atrial contractions, or a dual chamber pacemaker which does not require programming of an AV interval.
摘要翻译： 提供了一种改进的起搏系统和方法，其监测心室何时已经适当地充满血液，并且控制每个心室起搏脉冲的输送与期望的心室充盈基本一致，例如当腔基本上被填充时。 通过这种技术，用于递送心室起搏脉冲的期望时间是以逐拍为基础确定的，从而提供改善的生理上最佳的起搏模式。 本发明的生理心室起搏技术可应用于单室起搏器或双室心脏起搏器，并且在任一情况下都能够在最生理适当的时间提供步速脉冲的重要改进。 在第一实施例中，通过监测与心室容积成反比变化的阻抗变化来确定心室基本上充满血液的时刻，使得心室的填充对应于阻抗波形底部流出或达到最小水平的时间 。 同样可以使用提供关于心室容积的变化状态或速度变化信息的其它传感器装置。 本发明使得能够实现与心房收缩有效同步的单个单体室起搏器，或者不需要编程AV间隔的双室心脏起搏器。
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公开(公告)号：US09216050B2
公开(公告)日：2015-12-22
申请号：US13460864
申请日：2012-05-01
CPC分类号： A61B18/1206 , A61B18/1492 , A61B2018/00267 , A61B2018/00577 , A61B2018/00642 , A61B2018/00666 , A61B2018/00678 , A61B2018/00702 , A61B2018/00708 , A61B2018/00779 , A61B2018/00875 , A61B2018/00898
摘要： A method and system for detecting microbubble formation during a radiofrequency ablation procedure. The method includes measuring an impedance of a pair of electrodes, at least one electrode in the pair of electrodes being coupled to a treatment assembly of a medical device. Radiofrequency ablation energy is transmitted between the pair of electrodes. The transmission of radiofrequency ablation energy between the pair of electrodes is terminated when after a predetermined period of time the measured impedance in either of the electrodes in the pair of electrodes is a predetermined percentage above a measured minimum impedance and a measured power is above a predetermined power threshold. An alert is generated indicating at least one of the formation and release of microbubbles proximate the pair of electrodes.
摘要翻译： 一种用于在射频消融过程中检测微泡形成的方法和系统。 该方法包括测量一对电极的阻抗，该对电极中的至少一个电极耦合到医疗装置的治疗组件。 射频消融能量在一对电极之间传输。 在一对电极之间的射频消融能量的传输终止，在预定时间段之后，该对电极中的任一个电极中的测量阻抗比测量的最小阻抗高出预定百分比，并且测量的功率高于预定的时间 功率阈值。 产生警报，指示邻近该对电极的微泡的形成和释放中的至少一个。
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