公开(公告)号：US08060196B2

公开(公告)日：2011-11-15

申请号：US11293398

申请日：2005-12-02

申请人： Michael Lippert ,  Gerald Czygan

发明人： Michael Lippert ,  Gerald Czygan

IPC分类号： A61B5/05 ,  G01R27/00 ,  G01R27/02

CPC分类号： A61B5/0031 ,  A61B5/0537

摘要： An electromedical implant includes a measuring signal generator, an impedance measuring unit to determine the impedance of human or animal tissue, a control unit which, for controlling the measuring signal generator and the impedance measuring unit, is at least indirectly connected to the measuring signal generator and to the impedance measuring unit, as well as an electrode arrangement comprising at least two electrodes which can be directly or indirectly connected or at least temporarily connected to the measuring signal generator and to the impedance measuring unit, or to a connection for such an electrode arrangement. The measuring signal generator is designed to generate and emit a current pulse or a series of current pulses, and the control unit is designed at a specific point in time to cause the measuring signal generator (to generate and emit a current pulse, and to cause the impedance measuring unit to measure the voltage that is present between the electrodes connected to the measuring signal generator and the impedance measuring unit after the passing of at least two time periods of different length that start with commencement of the current pulse being emitted and end before the end of emitting the current pulse, and to issue a voltage value which in each case represents the measured voltage.

摘要翻译： 电动植入物包括测量信号发生器，用于确定人体或动物组织的阻抗的阻抗测量单元，用于控制测量信号发生器和阻抗测量单元的控制单元至少间接连接到测量信号发生器 和阻抗测量单元，以及包括至少两个电极的电极装置，所述至少两个电极可以直接或间接连接或至少临时连接到测量信号发生器和阻抗测量单元，或者连接到这种电极 安排。 测量信号发生器被设计成产生和发出电流脉冲或一系列电流脉冲，并且控制单元被设计在特定的时间点，以使得测量信号发生器（产生和发射电流脉冲，并引起 所述阻抗测量单元用于测量在连接到所述测量信号发生器的电极与所述阻抗测量单元之间存在的电压，所述电压在经过所述至少两个不同长度的时间段之后，所述至少两个不同长度的时间段从所述当前脉冲的开始开始并被发射 发射电流脉冲的结束，并发出在每种情况下表示测量电压的电压值。

公开(公告)号：US20110112598A1

公开(公告)日：2011-05-12

申请号：US12941767

申请日：2010-11-08

申请人： Michael Vollkron ,  Thomas Kraemer ,  Michael Lippert ,  Gerald Czygan

发明人： Michael Vollkron ,  Thomas Kraemer ,  Michael Lippert ,  Gerald Czygan

IPC分类号： A61N1/08 ,  A61N1/362

CPC分类号： A61N1/368 ,  A61N1/3682 ,  A61N1/3684

摘要： A biventricular cardiac stimulator is disclosed, comprising a right ventricular stimulation unit, a left ventricular stimulation unit, and a pacemaker timer. In order to detect the effect of a particular atrioventricular delay time (AVD) and a particular interventricular delay time (VVD), the cardiac stimulator has a detector for sensing a hemodynamic benefit. To optimize AVD and VVD, the pacemaker timer is connected to a memory for a particular instantaneous value for the atrioventricular delay time (AVDinst) and the interventricular delay time (VVDinst), and may be used to trigger at certain points in time at least one right ventricular trigger signal and one left ventricular trigger signal, based on new values for the atrioventricular delay time (AVDtest) and the interventricular delay time (VVDtest) which differ from the instantaneous values for the atrioventricular delay time (AVDinst) and the interventricular delay time (VVDinst).

摘要翻译： 公开了一种双心室心脏刺激器，其包括右心室刺激单元，左心室刺激单元和起搏器计时器。 为了检测特定房室延迟时间（AVD）和特定室间延迟时间（VVD）的影响，心脏刺激器具有用于感测血液动力学益处的检测器。 为了优化AVD和VVD，起搏器定时器连接到存储器用于房室延迟时间（AVDinst）和室间延迟时间（VVDinst）的特定瞬时值，并且可以用于在某些时间点触发至少一个 基于房室延迟时间（AVDtest）和室间延迟时间（VVDtest）的新值，与房室延迟时间（AVDinst）和心室间延迟时间（AVDinst）的瞬时值不同的右心室触发信号和一个左心室触发信号 （VVDinst）。

公开(公告)号：US07883469B2

公开(公告)日：2011-02-08

申请号：US11517155

申请日：2006-09-07

申请人： Michael Lippert ,  Gerald Czygan ,  Stefan Paule

发明人： Michael Lippert ,  Gerald Czygan ,  Stefan Paule

IPC分类号： A61B5/0452

CPC分类号： A61B5/0535 ,  A61B5/7239 ,  A61N1/36521

摘要： A device for detecting the state of a heart on the basis of intracardial impedance measurement. The device has an impedance measuring unit, which has electrical terminals, configured to be electrically connected or to be connected to electrodes for delivering and detecting a current or voltage, and is implemented to ascertain an impedance on the basis of the dimension of the delivered current or voltage and the voltage drop caused by the current or the current caused by the voltage, as well as an analysis unit, which is connected to the impedance measuring unit and is implemented to derive a cardiac function parameter from a time curve of the impedance ascertained using the impedance measuring unit. The analysis unit analyzes the impedance curve assigned to a diastole and derives a cardiac function parameter characterizing the behavior of a heart during the diastole (filling phase of the ventricle).

摘要翻译： 一种用于基于心内阻抗测量来检测心脏状态的装置。 该装置具有阻抗测量单元，其具有电端子，其被配置为电连接或连接到用于传送和检测电流或电压的电极，并且被实现为基于所传送的电流的尺寸来确定阻抗 或电压以及由电压引起的电流或电流导致的电压降以及分析单元，该分析单元连接到阻抗测量单元，并被实现为从所确定的阻抗的时间曲线导出心脏功能参数 使用阻抗测量单元。 分析单元分析舒张期的阻抗曲线，得出表征心脏舒张期（心室充盈期）心脏功能的参数。

公开(公告)号：US07519422B2

公开(公告)日：2009-04-14

申请号：US11104275

申请日：2005-04-12

申请人： Michael Lippert ,  Gerald Czygan

发明人： Michael Lippert ,  Gerald Czygan

IPC分类号： A61N1/362

CPC分类号： A61N1/3627 ,  A61N1/36521 ,  A61N1/3682 ,  A61N1/3684

摘要： Certain embodiments of the present invention disclose an implantable electrotherapy device comprising a housing in which are arranged an activity sensor, an impedance or conductivity measuring unit and an evaluation unit, wherein the evaluation unit is connected to the impedance or conductivity measuring unit and to the activity sensor and is adapted to evaluate the impedance or conductivity signal produced by the impedance or conductivity measuring unit and the respectively time-associated activity level signal and for producing and outputting a contractility signal, in such a way that the contractility signal is derived from the impedance or conductivity signal and the activity level signal and reflects the respective contractile state of a heart associated with an activity level signal value.

摘要翻译： 本发明的某些实施例公开了一种植入式电疗装置，其包括壳体，其中布置有活动传感器，阻抗或电导率测量单元和评估单元，其中评估单元连接到阻抗或电导率测量单元和活动 传感器，并且适于评估由阻抗或电导率测量单元产生的阻抗或电导率信号以及分别与时间相关的活动电平信号并用于产生和输出收缩信号，使得收缩信号从阻抗 或电导率信号和活动度信号，并且反映与活动度信号值相关联的心脏的相应收缩状态。

公开(公告)号：US20080146934A1

公开(公告)日：2008-06-19

申请号：US11948935

申请日：2007-11-30

申请人： Gerald Czygan ,  Michael Lippert ,  Tibor Nappholz

发明人： Gerald Czygan ,  Michael Lippert ,  Tibor Nappholz

IPC分类号： A61B8/00 ,  A61N1/00

CPC分类号： A61B8/12 ,  A61B8/06 ,  A61N1/36528 ,  A61N1/36571

摘要： A heart stimulation system comprises an electrode lead comprising at least one stimulation electrode a stimulation pulse generator adapted to generate electric stimulation pulses and being connected to said electrode lead for delivering electric stimulation pulses to at least one chamber of a heart via said stimulation electrode, and a control unit that is connected to said stimulation pulse generator. The electrode lead is a coronary sinus lead adapted to be placed inside the coronary sinus of a human heart and comprises an ultrasonic transducer that is adapted to measure a velocity of blood flow across a mitral valve of a human heart and that is placed on said coronary sinus lead such that the ultrasonic transducer is placed in the coronary sinus or the great cardiac vein when the coronary sinus lead is in its implanted state.

摘要翻译： 心脏刺激系统包括电极引线，其包括至少一个刺激电极，刺激脉冲发生器适于产生电刺激脉冲并且连接到所述电极引线，用于经由所述刺激电极将电刺激脉冲传送到心脏的至少一个腔室;以及 连接到所述刺激脉冲发生器的控制单元。 电极引线是适于放置在人心脏冠状窦内的冠状窦引线，并且包括超声换能器，其适于测量穿过人心脏二尖瓣的血液流速并且放置在所述冠状动脉 窦导线，使得当冠状窦导管处于其植入状态时，超声换能器被放置在冠状窦或大心静脉中。

公开(公告)号：US08939904B2

公开(公告)日：2015-01-27

申请号：US13041025

申请日：2011-03-04

申请人： Michael Lippert ,  Michael Vollkron ,  Gerald Czygan ,  Stefan Paule

发明人： Michael Lippert ,  Michael Vollkron ,  Gerald Czygan ,  Stefan Paule

IPC分类号： A61B5/02 ,  A61B5/0205 ,  A61B5/00 ,  A61N1/37 ,  A61N1/365

CPC分类号： A61B5/0205 ,  A61B5/02028 ,  A61B5/6846 ,  A61B5/7275 ,  A61N1/365 ,  A61N1/3702 ,  G06F19/00

摘要： A monitoring device for a patient for predicting a cardiovascular anomaly and a method for operating a monitoring device is provided. Furthermore, an implantable electrotherapy device, such as an implantable cardiac pacemaker, an implantable cardioverter, or an implantable defibrillator, having a monitoring device are also provided. In an embodiment, the monitoring device acquires a value change of a hemodynamic parameter, which occurs as a result of a detected value change of a state parameter, for example, as a result of an activation or deactivation of a cardiac resynchronization therapy. By suitable evaluation of the value change of the hemodynamic parameter, the monitoring device can output an evaluation result signal which is indicative of an imminence of a cardiovascular anomaly, such as a cardiac decompensation, long beforehand and with high specificity.

摘要翻译： 提供了一种用于预测心血管异常的患者的监测装置和用于操作监测装置的方法。 此外，还提供了具有监测装置的可植入电疗设备，例如可植入心脏起搏器，植入式心律转复器或可植入除颤器。 在一个实施例中，监测装置获取血液动力学参数的值变化，其作为状态参数的检测值变化的结果，例如作为心脏再同步治疗的激活或停用的结果而发生。 通过对血液动力学参数的值变化的适当评价，监视装置可以预先长时间地以高特异性输出表示心血管异常的心血管异常现象的评价结果​​信号，例如心脏代偿失调。

公开(公告)号：US07395114B2

公开(公告)日：2008-07-01

申请号：US10923117

申请日：2004-08-20

申请人： Gerald Czygan ,  Michael Lippert

发明人： Gerald Czygan ,  Michael Lippert

IPC分类号： A61N1/00

CPC分类号： A61B5/0538 ,  A61B5/0031 ,  A61B5/02028 ,  A61B5/0535 ,  A61B5/7285 ,  A61N1/36521

摘要： Certain embodiments of the present invention disclose an implant with electrode line connections for the connection of intracardial and/or epicardial electrode lines, wherein the electrode line connections have together at least three electrical contacts of which at least one is associated with a right-ventricular electrode and another is associated with a left-ventricular electrode, an impedance determining unit (IMP) which has a current or voltage source (I) and a measuring device (U) for a corresponding voltage or current measurement operation, which is connected to the electrical contacts and possibly a housing electrode of the implant, in such a way as to afford a tri- or quadrupolar impedance measuring arrangement which includes exclusively ventricular electrodes and in addition possibly the housing electrode, wherein the impedance measuring arrangement produces impedance measurement values and is connected to an evaluation unit (EVAL) and the evaluation unit (EVAL) is adapted to ascertain a minimum of the impedance measurement values within a first time window (defined relative to a ventricular event) as end-diastolic impedance (EDZ) and a maximum of the impedance measurement values within a second time window as end-systolic impedance (ESZ).

摘要翻译： 本发明的某些实施例公开了具有用于连接心内和/或心外膜电极线的电极线连接的植入物，其中电极线连接具有至少三个电触点，其至少一个与右心室电极 另一个与左心室电极相关联，具有电流或电压源（I）的阻抗确定单元（IMP）和用于相应的电压或电流测量操作的测量装置（U），其连接到电气 触点和可能的植入物的壳体电极，以便提供三极或四极阻抗测量装置，其包括专门的心室电极，另外可能包括壳体电极，其中阻抗测量装置产生阻抗测量值并且被连接 到评估单元（EVAL）和评估单元（EVAL） 确定作为舒张末期阻抗（EDZ）的第一时间窗口（相对于心室事件定义）中的阻抗测量值的最小值和作为收缩末阻抗（ESZ）的第二时间窗内的阻抗测量值的最大值， 。

公开(公告)号：US08521282B2

公开(公告)日：2013-08-27

申请号：US11948935

申请日：2007-11-30

申请人： Gerald Czygan ,  Michael Lippert ,  Tibor Nappholz

发明人： Gerald Czygan ,  Michael Lippert ,  Tibor Nappholz

IPC分类号： A61N1/365

CPC分类号： A61B8/12 ,  A61B8/06 ,  A61N1/36528 ,  A61N1/36571

摘要： A heart stimulation system comprises an electrode lead comprising at least one stimulation electrode a stimulation pulse generator adapted to generate electric stimulation pulses and being connected to said electrode lead for delivering electric stimulation pulses to at least one chamber of a heart via said stimulation electrode, and a control unit that is connected to said stimulation pulse generator. The electrode lead is a coronary sinus lead adapted to be placed inside the coronary sinus of a human heart and comprises an ultrasonic transducer that is adapted to measure a velocity of blood flow across a mitral valve of a human heart and that is placed on said coronary sinus lead such that the ultrasonic transducer is placed in the coronary sinus or the great cardiac vein when the coronary sinus lead is in its implanted state.

摘要翻译： 心脏刺激系统包括电极引线，其包括至少一个刺激电极，刺激脉冲发生器适于产生电刺激脉冲并且连接到所述电极引线，用于经由所述刺激电极将电刺激脉冲传送到心脏的至少一个腔室;以及 连接到所述刺激脉冲发生器的控制单元。 电极引线是适于放置在人心脏冠状窦内的冠状窦引线，并且包括超声换能器，其适于测量穿过人心脏二尖瓣的血液流速并且放置在所述冠状动脉 窦导线，使得当冠状窦导管处于其植入状态时，超声换能器被放置在冠状窦或大心静脉中。

公开(公告)号：US07844335B2

公开(公告)日：2010-11-30

申请号：US12061796

申请日：2008-04-03

申请人： Michael Lippert ,  Gerald Czygan ,  Stefan Paule

发明人： Michael Lippert ,  Gerald Czygan ,  Stefan Paule

IPC分类号： A61N1/00

CPC分类号： A61N1/3627 ,  A61B5/053 ,  A61N1/368 ,  A61N1/3682 ,  A61N1/37 ,  A61N1/37241 ,  A61N2001/0585

摘要： A device is connected to electrode leads which performs intracardiac impedance measurements, conducts a transient pacing protocol, analyses the impedance measurements, and generates an LV lead position quality factor. The transient pacing protocol includes a repeated change (“transitions”) between ventricular intrinsic rhythm and biventricular paced rhythm and may also include a variation of the atrioventricular delay (AVD) and/or the interventricular delay (VVD). The quality factor expresses the degree to which hemodynamic properties have improved due to BiV stimulation for the current LV lead position compared to intrinsic ventricular rhythm.

摘要翻译： 器件连接到执行心内阻抗测量的电极引线，执行瞬态起搏协议，分析阻抗测量值，并产生LV引线位置品质因数。 瞬时起搏方案包括心室内心节律与双心室起搏节律之间的重复变化（“转变”），还可包括房室延迟（AVD）和/或心室间延迟（VVD）的变化。 质量因子表现出与本征心室节律相比，由于针对当前LV引导位置的BiV刺激，血液动力学特性得到改善的程度。

公开(公告)号：US20080249585A1

公开(公告)日：2008-10-09

申请号：US12061796

申请日：2008-04-03

申请人： Michael Lippert ,  Gerald Czygan ,  Stefan Paule

发明人： Michael Lippert ,  Gerald Czygan ,  Stefan Paule

IPC分类号： A61N1/365

CPC分类号： A61N1/3627 ,  A61B5/053 ,  A61N1/368 ,  A61N1/3682 ,  A61N1/37 ,  A61N1/37241 ,  A61N2001/0585

摘要： A device is connected to electrode leads which performs intracardiac impedance measurements, conducts a transient pacing protocol, analyses the impedance measurements, and generates an LV lead position quality factor. The transient pacing protocol includes a repeated change (“transitions”) between ventricular intrinsic rhythm and biventricular paced rhythm and may also include a variation of the atrioventricular delay (AVD) and/or the interventricular delay (VVD). The quality factor expresses the degree to which hemodynamic properties have improved due to BiV stimulation for the current LV lead position compared to intrinsic ventricular rhythm.

摘要翻译： 器件连接到执行心内阻抗测量的电极引线，执行瞬态起搏协议，分析阻抗测量值，并产生LV引线位置品质因数。 瞬时起搏方案包括心室内心节律与双心室起搏节律之间的重复变化（“转变”），还可包括房室延迟（AVD）和/或心室间延迟（VVD）的变化。 质量因子表现出与本征心室节律相比，由于针对当前LV引导位置的BiV刺激，血液动力学特性得到改善的程度。