公开(公告)号：US06741885B1

公开(公告)日：2004-05-25

申请号：US09908179

申请日：2001-07-17

申请人： Euljoon Park ,  Eric Falkenberg ,  Gene A. Bornzin ,  Junyu Mai

发明人： Euljoon Park ,  Eric Falkenberg ,  Gene A. Bornzin ,  Junyu Mai

IPC分类号： A61B504

CPC分类号： A61N1/3627 ,  A61N1/36514

摘要： An implantable cardiac device detects a progression or regression in heart disease such as congestive heart failure. An activity sensor and a respiration sensor generate raw signals indicative of the patient's activity level and respiration level. Degradation or improvement of the patient's activity and respiration over a predetermined time corresponds to an indication of the progression or regression of the heart disease. A processor coupled to the sensors is programmed to process the raw sensor signals over the predetermined time and stores the processed sensor signals in a memory having a data storage area. A telemetry circuit coupled to the memory is configured to transmit the stored sensor signals to an external monitor for subsequent display. The processor further controls pacing of the heart, adjusts pacing therapy responsive to the process signals, and process the raw respiration signals when the patient is in a number of different active states.

摘要翻译： 可植入的心脏装置检测心脏病的进展或消退，例如充血性心力衰竭。 活动传感器和呼吸传感器产生指示患者的活动水平和呼吸水平的原始信号。 在预定时间内降低或改善患者的活动和呼吸对应于心脏病的进展或消退的指征。 耦合到传感器的处理器被编程为在预定时间内处理原始传感器信号，并将经处理的传感器信号存储在具有数据存储区域的存储器中。 耦合到存储器的遥测电路被配置为将存储的传感器信号发送到外部监视器用于随后的显示。 处理器进一步控制心脏的起搏，响应于过程信号调整起搏治疗，并且当患者处于多个不同的活动状态时处理原始呼吸信号。

公开(公告)号：US20120053470A1

公开(公告)日：2012-03-01

申请号：US13149507

申请日：2011-05-31

申请人： Louis Wong ,  Cem Shaquer ,  Gene A. Bornzin ,  Euljoon Park ,  Andre Walker ,  Dorin Panescu ,  Jiong Xia ,  Shahrooz Shahparnia

发明人： Louis Wong ,  Cem Shaquer ,  Gene A. Bornzin ,  Euljoon Park ,  Andre Walker ,  Dorin Panescu ,  Jiong Xia ,  Shahrooz Shahparnia

IPC分类号： A61B5/053 ,  A61B5/085

CPC分类号： A61B5/02028 ,  A61B5/0031 ,  A61B5/029 ,  A61B5/0538 ,  A61B5/08 ,  A61B5/4878 ,  A61N1/3627 ,  A61N1/36521 ,  A61N1/3702

摘要： An implantable system acquires intracardiac impedance with an implantable lead system. In one implementation, the system generates frequency-rich, low energy, multi-phasic waveforms that provide a net-zero charge and a net-zero voltage. When applied to bodily tissues, current pulses or voltage pulses having the multi-phasic waveform provide increased specificity and sensitivity in probing tissue. The effects of the applied pulses are sensed as a corresponding waveform. The waveforms of the applied and sensed pulses can be integrated to obtain corresponding area values that represent the current and voltage across a spectrum of frequencies. These areas can be compared to obtain a reliable impedance value for the tissue. Frequency response, phase delay, and response to modulated pulse width can also be measured to determine a relative capacitance of the tissue, indicative of infarcted tissue, blood to tissue ratio, degree of edema, and other physiological parameters.

摘要翻译： 可植入系统采用可植入引线系统获得心内阻抗。 在一个实现中，该系统产生提供净零电荷和净零电压的富频率，低能量，多相波形。 当应用于身体组织时，具有多相波形的电流脉冲或电压脉冲在探测组织中提供增加的特异性和灵敏度。 所施加的脉冲的影响被感测为对应的波形。 施加和感测的脉冲的波形可以被积分，以获得表示频谱范围内的电流和电压的相应面积值。 可以比较这些区域以获得组织的可靠的阻抗值。 还可以测量频率响应，相位延迟和对调制脉冲宽度的响应，以确定组织的相对电容，指示梗死组织，血液与组织之比，水肿程度和其他生理参数。

公开(公告)号：US08065005B1

公开(公告)日：2011-11-22

申请号：US11684688

申请日：2007-03-12

申请人： Louis Wong ,  Cem Shaquer ,  Gene A. Bornzin ,  Euljoon Park ,  Andre Walker ,  Dorin Panescu ,  Jiong Xia ,  Shahrooz Shahparnia

发明人： Louis Wong ,  Cem Shaquer ,  Gene A. Bornzin ,  Euljoon Park ,  Andre Walker ,  Dorin Panescu ,  Jiong Xia ,  Shahrooz Shahparnia

IPC分类号： A61N1/18

CPC分类号： A61B5/02028 ,  A61B5/0031 ,  A61B5/029 ,  A61B5/0538 ,  A61B5/08 ,  A61B5/4878 ,  A61N1/3627 ,  A61N1/36521 ,  A61N1/3702

摘要： An implantable system acquires intracardiac impedance with an implantable lead system. In one implementation, the system generates frequency-rich, low energy, multi-phasic waveforms that provide a net-zero charge and a net-zero voltage. When applied to bodily tissues, current pulses or voltage pulses having the multi-phasic waveform provide increased specificity and sensitivity in probing tissue. The effects of the applied pulses are sensed as a corresponding waveform. The waveforms of the applied and sensed pulses can be integrated to obtain corresponding area values that represent the current and voltage across a spectrum of frequencies. These areas can be compared to obtain a reliable impedance value for the tissue. Frequency response, phase delay, and response to modulated pulse width can also be measured to determine a relative capacitance of the tissue, indicative of infarcted tissue, blood to tissue ratio, degree of edema, and other physiological parameters.

公开(公告)号：US08010196B1

公开(公告)日：2011-08-30

申请号：US11684671

申请日：2007-03-12

申请人： Louis Wong ,  Cem Shaquer ,  Gene A. Bornzin ,  Euljoon Park ,  Andre Walker ,  Dorin Panescu ,  Jiong Xia ,  Shahrooz Shahparnia

发明人： Louis Wong ,  Cem Shaquer ,  Gene A. Bornzin ,  Euljoon Park ,  Andre Walker ,  Dorin Panescu ,  Jiong Xia ,  Shahrooz Shahparnia

IPC分类号： A61N1/18

CPC分类号： A61B5/02028 ,  A61B5/0031 ,  A61B5/029 ,  A61B5/0538 ,  A61B5/08 ,  A61B5/4878 ,  A61N1/3627 ,  A61N1/36521 ,  A61N1/3702

摘要： An implantable system acquires intracardiac impedance with an implantable lead system. In one implementation, the system generates frequency-rich, low energy, multi-phasic waveforms that provide a net-zero charge and a net-zero voltage. When applied to bodily tissues, current pulses or voltage pulses having the multi-phasic waveform provide increased specificity and sensitivity in probing tissue. The effects of the applied pulses are sensed as a corresponding waveform. The waveforms of the applied and sensed pulses can be integrated to obtain corresponding area values that represent the current and voltage across a spectrum of frequencies. These areas can be compared to obtain a reliable impedance value for the tissue. Frequency response, phase delay, and response to modulated pulse width can also be measured to determine a relative capacitance of the tissue, indicative of infarcted tissue, blood to tissue ratio, degree of edema, and other physiological parameters.

公开(公告)号：US07548785B2

公开(公告)日：2009-06-16

申请号：US10866422

申请日：2004-06-10

申请人： Steve Koh ,  Euljoon Park ,  Gene A. Bornzin

发明人： Steve Koh ,  Euljoon Park ,  Gene A. Bornzin

IPC分类号： A61N1/362

CPC分类号： A61N1/3627 ,  A61B5/0245 ,  A61B5/4035

摘要： An exemplary method includes selecting a cross-correlation frequency having an associated cross-correlation period, detecting and binning a heart rate in a heart rate bin, detecting and binning an activity state in an activity state bin, repeating the detecting and binning a heart rate and the detecting and binning an activity state during a cross-correlation period, and summing the products a bin count of the heart rate bins and a bin count of the activity state bins to provide a cross-correlation index for the cross-correlation period. Other exemplary algorithms, methods, devices, systems, etc., are also disclosed.

摘要翻译： 一种示例性方法包括选择具有相关联的相关周期的互相关频率，检测和归纳心率仓中的心率，检测和归纳活动状态仓中的活动状态，重复检测和归纳心率 以及在互相关时段期间检测和归纳活动状态，并且将乘积与心率仓的仓计数和活动状态仓的箱数相加，以提供互相关周期的互相关指数。 还公开了其它示例性算法，方法，设备，系统等。

公开(公告)号：US07505813B1

公开(公告)日：2009-03-17

申请号：US11199619

申请日：2005-08-08

申请人： Jong Gill ,  Alexander Huemmer ,  Gene A. Bornzin ,  Euljoon Park

发明人： Jong Gill ,  Alexander Huemmer ,  Gene A. Bornzin ,  Euljoon Park

IPC分类号： A61N1/00

CPC分类号： A61N1/368 ,  A61N1/3682

摘要： Techniques are provided for use by an implantable medical device for determining optimal or preferred atrioventricular (AV) pacing delay values for use in pacing the heart. Briefly, the atria and ventricles are paced using an initial AV pacing delay set to a value less than an intrinsic AV conduction delay so that intrinsic ventricular depolarizations are avoided. An internal electrical cardiac signal is sensed and atrial evoked responses and subsequent ventricular evoked responses are identified therein. Time delays between the atrial and ventricular evoked responses are measured and then a preferred or optimal AV pacing delay value is determined based on: the initial AV pacing delay; the measured time delays between the atrial and ventricular evoked responses; and on a predetermined preferred time delay to be achieved between atrial and ventricular evoked responses. Similar procedures are employed in connection with atrial sensed events. A calibration procedure is also described.

摘要翻译： 技术被提供用于由可植入医疗装置用于确定用于起搏心脏的最佳或优选房室（AV）起搏延迟值。 简而言之，心房和心室使用初始AV起搏延迟设定为小于固有AV传导延迟的值来进行起搏，从而避免内在的心室去极化。 感测到内部电气心脏信号，并在其中识别心房诱发反应和随后的心室诱发反应。 测量心房和心室诱发反应之间的时间延迟，然后基于：初始AV起搏延迟确定优选的或最佳的AV起搏延迟值; 测量心房和心室诱发反应之间的时间延迟; 并且在心房和心室诱发反应之间达到预定的优选时间延迟。 与心房感觉事件有关的类似手术。 还描述了校准过程。

公开(公告)号：US06904320B2

公开(公告)日：2005-06-07

申请号：US10077053

申请日：2002-02-14

申请人： Euljoon Park ,  Gene A. Bornzin ,  Paul A. Levine ,  Eric Falkenberg

发明人： Euljoon Park ,  Gene A. Bornzin ,  Paul A. Levine ,  Eric Falkenberg

IPC分类号： A61N1/365 ,  A61N1/18

CPC分类号： A61N1/365 ,  A61N1/36557

摘要： A cardiac stimulation device uses dynamic overdrive pacing to prevent sleep apnea. In another aspect, the device can use dynamic overdrive pacing to terminate sleep apnea after detection. An implantable cardiac stimulation device comprises a sensor and one or more pulse generators. The sensor senses intrinsic cardiac electrical phenomena. The pulse generators can generate cardiac pacing pulses with timing based on the sensed intrinsic cardiac electrical phenomena to dynamically overdrive the intrinsic cardiac electrical phenomena. The timed cardiac pacing pulses can prevent a sleep apnea condition.

摘要翻译： 心脏刺激装置使用动态超速起搏来预防睡眠呼吸暂停。 另一方面，该设备可以使用动态超速起搏来终止检测后的睡眠呼吸暂停。 可植入心脏刺激装置包括传感器和一个或多个脉冲发生器。 传感器感测内在的心脏电学现象。 脉冲发生器可以基于感测到的固有心脏电现象产生心脏起搏脉冲，以动态地过度驱动固有的心脏电学现象。 定时的心脏起搏脉冲可以防止睡眠呼吸暂停状态。

公开(公告)号：US08989852B2

公开(公告)日：2015-03-24

申请号：US13207307

申请日：2011-08-10

申请人： Jong Gill ,  Rupinder Bharmi ,  Edward Karst ,  Ryan Rooke ,  Riddhi Shah ,  Fujian Qu ,  Gene A. Bornzin ,  Taraneh G. Farazi ,  Euljoon Park

发明人： Jong Gill ,  Rupinder Bharmi ,  Edward Karst ,  Ryan Rooke ,  Riddhi Shah ,  Fujian Qu ,  Gene A. Bornzin ,  Taraneh G. Farazi ,  Euljoon Park

IPC分类号： A61B5/0452 ,  A61B5/0468 ,  A61B5/00 ,  A61B5/0205 ,  A61B5/0215 ,  A61B5/042 ,  A61N1/37 ,  A61B5/024 ,  A61B5/0295

CPC分类号： A61B5/0468 ,  A61B5/0031 ,  A61B5/0205 ,  A61B5/02158 ,  A61B5/02405 ,  A61B5/0295 ,  A61B5/0422 ,  A61B5/4839 ,  A61N1/3702

摘要： Techniques are provided for detecting and distinguishing stroke and cardiac ischemia based on electrocardiac signals. In one example, the device senses atrial and ventricular signals within the patient along a set of unipolar sensing vectors and identifies certain morphological features within the signals such as PR intervals, ST intervals, QT intervals, T-waves, etc. The device detects changes, if any, within the morphological features such as significant shifts in ST interval elevation or an inversion in T-wave shape, which are indicative of stroke or cardiac ischemia. By selectively comparing changes detected along different unipolar sensing vectors, the device distinguishes or discriminates stroke from cardiac ischemia within the patient. The discrimination may be corroborated using various physiological and hemodynamic parameters. In some examples, the device further identifies the location of the ischemia within the heart. In still other examples, the device detects cardiac ischemia occurring during stroke.

摘要翻译： 提供了用于基于心电信号检测和区分中风和心脏缺血的技术。 在一个示例中，该装置沿着一组单极感测向量感测患者内的心房和心室信号，并且识别信号内的某些形态特征，例如PR间隔，ST间隔，QT间隔，T波等。该装置检测变化 （如果有的话）在形态学特征之中，例如ST间隔升高的显着变化或T波形的反转，其指示中风或心脏缺血。 通过选择性地比较沿着不同的单极性感测向量检测的变化，该装置区分或区分患者体内的心脏缺血的中风。 可以使用各种生理和血液动力学参数来确认辨别。 在一些实例中，该装置还识别心脏内局部缺血的位置。 在另外的例子中，该装置检测在中风期间发生的心脏缺血。

公开(公告)号：US20130041274A1

公开(公告)日：2013-02-14

申请号：US13207307

申请日：2011-08-10

申请人： Jong Gill ,  Rupinder Bharmi ,  Edward Karst ,  Ryan Rooke ,  Riddhi Shah ,  Fujian Qu ,  Gene A. Bornzin ,  Taraneh Ghaffari Farazi ,  Euljoon Park

发明人： Jong Gill ,  Rupinder Bharmi ,  Edward Karst ,  Ryan Rooke ,  Riddhi Shah ,  Fujian Qu ,  Gene A. Bornzin ,  Taraneh Ghaffari Farazi ,  Euljoon Park

IPC分类号： A61B5/0468

CPC分类号： A61B5/0468 ,  A61B5/0031 ,  A61B5/0205 ,  A61B5/02158 ,  A61B5/02405 ,  A61B5/0295 ,  A61B5/0422 ,  A61B5/4839 ,  A61N1/3702

摘要： Techniques are provided for detecting and distinguishing stroke and cardiac ischemia based on electrocardiac signals. In one example, the device senses atrial and ventricular signals within the patient along a set of unipolar sensing vectors and identifies certain morphological features within the signals such as PR intervals, ST intervals, QT intervals, T-waves, etc. The device detects changes, if any, within the morphological features such as significant shifts in ST interval elevation or an inversion in T-wave shape, which are indicative of stroke or cardiac ischemia. By selectively comparing changes detected along different unipolar sensing vectors, the device distinguishes or discriminates stroke from cardiac ischemia within the patient. The discrimination may be corroborated using various physiological and hemodynamic parameters. In some examples, the device further identifies the location of the ischemia within the heart. In still other examples, the device detects cardiac ischemia occurring during stroke.

摘要翻译： 提供了用于基于心电信号检测和区分中风和心脏缺血的技术。 在一个示例中，该装置沿着一组单极感测向量感测患者内的心房和心室信号，并且识别信号内的某些形态特征，例如PR间隔，ST间隔，QT间隔，T波等。该装置检测变化 （如果有的话）在形态学特征之中，例如ST间期升高的显着变化或T波形的反转，其指示中风或心脏缺血。 通过选择性地比较沿着不同的单极性感测向量检测的变化，该装置区分或区分患者体内的心脏缺血的中风。 可以使用各种生理和血液动力学参数来确认辨别。 在一些实例中，该装置还识别心脏内局部缺血的位置。 在另外的例子中，该装置检测在中风期间发生的心脏缺血。

公开(公告)号：US08032212B2

公开(公告)日：2011-10-04

申请号：US12210848

申请日：2008-09-15

申请人： Gene A. Bornzin ,  Steve Koh ,  Euljoon Park

发明人： Gene A. Bornzin ,  Steve Koh ,  Euljoon Park

IPC分类号： A61B5/02 ,  A61B5/08 ,  A61B5/05 ,  A61N1/00

CPC分类号： A61N1/36521 ,  A61B5/0537 ,  A61B5/4869

摘要： Techniques are provided for monitoring thoracic fluid levels based on thoracic impedance (ZT) and cardiogenic impedance (ZC). In one example, the implantable device tracks the maximum time rate of change in cardiogenic impedance (i.e. max(dZC/dt)) to detect trends toward hypervolemic or hypovolemic states within the patient based on changes in heart contractility. The detection of these trends in combination with trends in thoracic impedance allows for a determination of whether the thoracic cavity of the patient is generally “too wet” or “too dry,” and thus allows for the titration of diuretics to avoid such extremes. In particular, a decrease in thoracic impedance (ZT) in combination with a decrease in max (dZC/dt) is indicative of the thorax being “too wet” (i.e. a fluid overload). Conversely, an increase in thoracic impedance (ZT) in combination with a decrease in max (dZC/dt) is indicative of the thorax being “too dry” (i.e. a fluid underload).

摘要翻译： 提供了基于胸部阻抗（ZT）和心源阻抗（ZC）监测胸水水平的技术。 在一个示例中，可植入装置跟踪心源性阻抗的最大时间变化率（即max（dZC / dt）），以基于心脏收缩力的变化来检测患者内的高血容量或低血容量状态的趋势。 这些趋势的检测结合胸部阻抗趋势可以确定患者的胸腔通常是否“太湿”或“太干”，从而允许滴定利尿剂以避免这种极端。 特别地，胸部阻抗（ZT）的降低与最大值（dZC / dt）的降低相结合表明胸部“太湿”（即流体过载）。 相反，胸部阻抗（ZT）的增加与最大（dZC / dt）的降低相结合，表明胸部“太干”（即，流体欠载）。