公开(公告)号：US20170143976A1

公开(公告)日：2017-05-25

申请号：US15368199

申请日：2016-12-02

Applicant: Medtronic, Inc.

Inventor： Subham Ghosh

IPC: A61N1/365 ,  A61B5/04 ,  A61N1/368 ,  A61N1/362 ,  A61B5/11 ,  A61B5/00 ,  A61B5/0408 ,  A61B5/0452

CPC classification number: A61N1/36507 ,  A61B5/04017 ,  A61B5/0402 ,  A61B5/04085 ,  A61B5/0452 ,  A61B5/1107 ,  A61B5/4836 ,  A61B2562/043 ,  A61B2562/046 ,  A61N1/3627 ,  A61N1/3684

Abstract: An exemplary computer-implemented method is disclosed for detection of onset of depolarization on far-field electrograms (EGMs) or electrocardiogram (ECG)-or ECG-like signals. The method includes determining a baseline rhythm using a plurality of body-surface electrodes. The baseline rhythm includes an atrial marker and a ventricular marker. A pre-specified window is defined as being between the atrial marker and the ventricular marker. A low pass filter is applied to a signal within the window. A rectified slope of the signal within the window is determined. A determination is made as to whether a time point (t1) is present such that the rectified slope exceeds 10% of a maximum value of the rectified slope. A point of onset of a depolarization complex in the signal is determined. The point of onset occurs at a largest curvature in the signal within the window.

公开(公告)号：US20170120058A1

公开(公告)日：2017-05-04

申请号：US14926359

申请日：2015-10-29

Applicant: Medtronic, Inc.

Inventor： Subham Ghosh ,  Kushagr Gupta

IPC: A61N1/365 ,  A61N1/39 ,  A61N1/372 ,  A61N1/368 ,  A61N1/37

CPC classification number: A61N1/36514 ,  A61N1/365 ,  A61N1/36507 ,  A61N1/368 ,  A61N1/3702 ,  A61N1/37288 ,  A61N1/3956

Abstract: A medical device system for controlling ventricular pacing therapy during cardiac resynchronization therapy that includes a sensing device to sense a cardiac signal and emit a trigger signal in response to the sensed cardiac signal, a therapy delivery device to deliver the ventricular pacing in response to the emitted trigger signal, and a processor configured to identify a fiducial point of the cardiac signal sensed in real-time, set a window comprising a start point positioned a first distance prior to the fiducial point and an endpoint positioned a second distance less than the first distance subsequent to the fiducial point, determine a signal characteristic of the cardiac signal within the window, determine whether a P-wave is detected in response to the signal characteristic, determine whether an atrio-ventricular interval timer has expired, and emit a trigger signal to deliver the ventricular pacing timed off of the local maximum in response to the P-wave being detected and not timed off of the local maximum in response to the timer being expired.

公开(公告)号：US09604064B2

公开(公告)日：2017-03-28

申请号：US13772840

申请日：2013-02-21

Applicant: Medtronic, Inc.

Inventor： Subham Ghosh ,  Robert W Stadler

IPC: A61N1/368 ,  A61N1/37 ,  A61N1/362

CPC classification number: A61N1/3686 ,  A61N1/3627 ,  A61N1/3684 ,  A61N1/3712

Abstract: Generally, the disclosure is directed one or more methods or systems of cardiac pacing employing a plurality of left ventricular electrodes. Pacing using a first one of the left ventricular electrodes and measuring activation times at other ones of the left and right ventricular electrodes. Pacing using a second one of the ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes. Employing weighted sums of the measured activation times to measure a fusion index and select one of the left ventricular electrodes for delivery of subsequent pacing pulses based on comparing fusion indices during pacing from different LV electrodes. One or more embodiments use the same fusion index to select an optimal A-V delay by comparing fusion indices during pacing with different A-V delays at resting atrial rates as well as rates above the resting rate.

公开(公告)号：US09603651B2

公开(公告)日：2017-03-28

申请号：US14694292

申请日：2015-04-23

Applicant: Medtronic, Inc.

Inventor： Subham Ghosh

IPC: A61B5/04 ,  A61B18/12 ,  A61B5/042 ,  A61B5/0432 ,  A61B5/044 ,  A61B5/046 ,  A61B5/00 ,  A61B5/0452 ,  A61B18/14 ,  A61N1/05 ,  A61B18/00

CPC classification number: A61B18/12 ,  A61B5/04012 ,  A61B5/0422 ,  A61B5/0432 ,  A61B5/044 ,  A61B5/0452 ,  A61B5/046 ,  A61B5/7246 ,  A61B18/1492 ,  A61B2018/00214 ,  A61B2018/00267 ,  A61B2018/00577 ,  A61B2018/00839 ,  A61N1/05

Abstract: A base cardiac electrogram signal at a base electrode is recorded for a predetermined amount of time. A plurality of cardiac electrogram signals at a plurality of electrodes other than the base electrode are recorded for the predetermined amount of time. The base cardiac electrogram signal is compared with each of the plurality of cardiac electrogram signals. The similarities between the base cardiac electrogram signal and each of the plurality of cardiac electrogram signals is determined. A specific area of cardiac tissue where the base electrode is positioned is mapped based at least in part on the determined similarities.

公开(公告)号：US09586050B2

公开(公告)日：2017-03-07

申请号：US14703365

申请日：2015-05-04

Applicant: Medtronic, Inc.

Inventor： Subham Ghosh ,  Jeffrey Gillberg

IPC: A61N1/00 ,  A61N1/368 ,  A61N1/365 ,  A61N1/372 ,  A61B5/0408 ,  A61B5/00

CPC classification number: A61N1/3684 ,  A61B5/04085 ,  A61B5/6823 ,  A61N1/365 ,  A61N1/36514 ,  A61N1/3682 ,  A61N1/37247 ,  A61N1/37264

Abstract: Systems and methods are described herein for assisting a user in identification and/or optimization of an atrioventricular (A-V) interval for use in cardiac therapy. The systems and methods may monitor electrical activity of a patient using external electrode apparatus to provide electrical heterogeneity information for a plurality of different A-V intervals and may identify an A-V interval based on the electrical heterogeneity information.

Abstract translation: 本文描述了用于帮助用户识别和/或优化用于心脏治疗的房室（A-V）间隔的系统和方法。 系统和方法可以使用外部电极装置来监测患者的电活动，以提供用于多个不同A-V间隔的电异质信息，并且可以基于电异质性信息识别A-V间隔。

公开(公告)号：US20170028205A1

公开(公告)日：2017-02-02

申请号：US15056366

申请日：2016-02-29

Applicant: Medtronic, Inc.

Inventor： Subham Ghosh

IPC: A61N1/365 ,  A61N1/362 ,  A61B5/0408

CPC classification number: A61N1/36585 ,  A61B5/04085 ,  A61N1/36185 ,  A61N1/362 ,  A61N1/372

Abstract: A system and method select a pacing site for a cardiac pacing therapy. A change from a baseline mechanical activity is extracted from a signal of mechanical heart activity during pacing at each one of multiple pacing sites along a heart chamber. A change from a baseline electrical activity is extracted from a signal of electrical heart activity during pacing at each of the of pacing sites. The pacing sites are sorted in a first order based upon the changes in mechanical heart activity and in a second order based upon the changes in electrical heart activity. A pacing site is selected from the multiple pacing sites as a common pacing site between the first order and the second order.

Abstract translation: 系统和方法选择心脏起搏治疗的起搏部位。 在心脏室的多个起搏部位的每一个起搏期间，从机械心脏活动的信号中提取与基线机械活动的变化。 在每个起搏部位的起搏期间，从电气心脏活动的信号中提取基线电活动的变化。 基于机械心脏活动的变化和基于电心脏活动的变化的第二阶段，起搏部位按照第一顺序排序。 从多个起搏站点中选择起始站点作为第一个订单和第二个订单之间的普通起始站点。

公开(公告)号：US09526435B2

公开(公告)日：2016-12-27

申请号：US14597472

申请日：2015-01-15

Applicant: Medtronic, Inc.

Inventor： Subham Ghosh

IPC: A61B5/04 ,  A61B5/046 ,  A61B5/042 ,  A61B5/0432 ,  A61B5/044 ,  A61B5/00 ,  A61B5/0456

CPC classification number: A61B5/046 ,  A61B5/04012 ,  A61B5/0422 ,  A61B5/0432 ,  A61B5/044 ,  A61B5/0456 ,  A61B5/7239

Abstract: A method and system for determining activation times for electric potentials from complex electrograms to identify the location of arrhythmic sources or drivers. The method includes counting a number deflections in a recorded cardiac electrogram signal from at least one electrode for a predetermined amount of time. A deflection time is identified for each of the counted number of deflections. A most negative slope is identified between each of the identified deflections times. Each of the identified most negative slopes is correlated to a possible activation time. Each possible activation time is associated with a corresponding electrode from the at least one electrode. A spatial voltage gradient at each corresponding electrode is calculated for each possible activation time. The greatest spatial voltage gradient is identified. The greatest spatial voltage gradient is correlated to an activation time.

公开(公告)号：US20160317840A1

公开(公告)日：2016-11-03

申请号：US15009817

申请日：2016-01-28

Applicant: Medtronic, Inc.

Inventor： Robert W. Stadler ,  Subham Ghosh

IPC: A61N7/00 ,  A61N1/362 ,  A61B5/0408

CPC classification number: A61N7/00 ,  A61B5/0053 ,  A61B5/04085 ,  A61B5/04286 ,  A61B5/0472 ,  A61B5/1107 ,  A61B5/4848 ,  A61B5/743 ,  A61B2505/05 ,  A61N1/362 ,  A61N1/3627 ,  A61N7/02 ,  A61N2007/0004 ,  A61N2007/0026 ,  A61N2007/0056

Abstract: Systems, methods, and interfaces are described herein for noninvasively determining whether a patient can benefit from cardiac resynchronization therapy. One exemplary method involves delivering ultrasonic energy to cardiac tissue. In response to delivering ultrasonic energy to the cardiac tissue, receiving, with a processing unit, a torso-surface potential signal from each of a plurality of electrodes distributed on a torso of a patient. For at least a subset of the plurality of electrodes, calculating, with the processing unit, a torso-surface activation time based on the signal sensed from the electrode. Presenting, by the processing unit, to a user, an indication of a degree of dyssynchrony of the torso-surface activation times via a display.

Abstract translation: 本文描述了系统，方法和界面，用于非侵入性地确定患者是否可以从心脏再同步治疗中受益。 一种示例性方法涉及将超声能量递送到心脏组织。 响应于向心脏组织递送超声能量，用处理单元接收分布在患者躯干上的多个电极中的每一个的躯干表面电位信号。 对于多个电极的至少一个子集，基于从电极感测的信号，利用处理单元计算躯干表面激活时间。 由处理单元向用户呈现经由显示器的躯干表面激活时间的不同步程度的指示。

公开(公告)号：US20160213928A1

公开(公告)日：2016-07-28

申请号：US15004487

申请日：2016-01-22

Applicant: Medtronic, Inc.

Inventor： Subham Ghosh

IPC: A61N1/368 ,  A61N1/365 ,  A61N1/05

CPC classification number: A61N1/3684 ,  A61B5/04085 ,  A61B5/0452 ,  A61B5/0464 ,  A61N1/36514 ,  A61N1/3682

Abstract: A system and method for identifying whether local tissue latency is present. The system and method comprises an implanted lead having a first electrode for cardiac pacing and sensing. A sensing module for sensing heart activity with the first electrode to produce an electrogram (EGM) waveform. A processor is configured to receive the EGM waveform and extract two or more features from the EGM waveform representative of heart activity in response to monoventricular or biventricular pacing stimulus at the electrode and identify local tissue latency at a site of the first electrode based upon at least two of the extracted features indicating local tissue latency.

Abstract translation: 用于识别是否存在局部组织潜伏期的系统和方法。 该系统和方法包括具有用于心脏起搏和感测的第一电极的植入引线。 用于感测与第一电极的心脏活动以产生电描记图（EGM）波形的感测模块。 处理器被配置为接收EGM波形并且响应于电极处的单心室或双心室起搏刺激从表示心脏活动的EGM波形中提取两个或更多个特征，并且基于至少基于第一电极的位置识别局部组织潜伏期 提取的两个特征指示局部组织潜伏期。

公开(公告)号：US09381362B2

公开(公告)日：2016-07-05

申请号：US13744038

申请日：2013-01-17

Applicant: Medtronic, Inc.

Inventor： Subham Ghosh ,  Robert W Stadler

IPC: A61N1/362 ,  A61N1/365 ,  A61N1/368

CPC classification number: A61N1/3682 ,  A61N1/3622 ,  A61N1/3627 ,  A61N1/36514 ,  A61N1/36592 ,  A61N1/3684

Abstract: Methods and/or devices may be configured to monitor ventricular activation times and modify an atrioventricular delay (AV delay) based on the monitored ventricular activation times. Further, the methods and/or devices may determine whether the AV delay should be modified based on the measured activation times before modifying the AV delay.

Abstract translation: 方法和/或设备可以被配置为基于所监测的心室激活时间来监测心室激活时间并修改房室延迟（AV延迟）。 此外，方法和/或设备可以基于在修改AV延迟之前测量的激活时间来确定AV延迟是否应该被修改。