公开(公告)号：US08571641B2

公开(公告)日：2013-10-29

申请号：US12757307

申请日：2010-04-09

申请人： Thomas Kraemer ,  Michael Lippert ,  Olaf Skerl ,  Gerald Czygan ,  Stefan Paule

发明人： Thomas Kraemer ,  Michael Lippert ,  Olaf Skerl ,  Gerald Czygan ,  Stefan Paule

IPC分类号： A61B5/04

CPC分类号： A61B5/0537 ,  A61B5/0031 ,  A61B5/1116 ,  A61B5/4869 ,  A61B5/4878 ,  A61B5/6846 ,  A61B5/686 ,  A61B2562/0219 ,  A61N1/36521 ,  A61N1/36542 ,  A61N1/3655 ,  A61N1/36564 ,  A61N1/36571

摘要： A monitoring apparatus having a signal input for signals representing measurement values of one or more physiological parameters, and an evaluation and processing unit connected to the signal input. The evaluation and processing unit is designed to select, or differently weight, individual values from the values received for further processing based on one or more criteria such that measurement values raising doubts as to the validity thereof are not selected or given a very low weighting.

摘要翻译： 一种具有用于表示一个或多个生理参数的测量值的信号的信号输入的监视装置，以及连接到所述信号输入的评估和处理单元。 评估和处理单元被设计为基于一个或多个标准从接收到的值中选择或不同地权重的值，以使得对其有效性产生怀疑的测量值不被选择或给出非常低的加权。

公开(公告)号：US20110224527A1

公开(公告)日：2011-09-15

申请号：US13038428

申请日：2011-03-02

申请人： Gerald Czygan ,  Michael Lippert ,  Olaf Skerl

发明人： Gerald Czygan ,  Michael Lippert ,  Olaf Skerl

IPC分类号： A61B5/0245

CPC分类号： A61B5/0535 ,  A61B5/029 ,  A61B5/0295 ,  A61B5/0402 ,  A61B5/6846 ,  A61B5/721 ,  A61B5/7214 ,  A61B5/7275

摘要： An electromedical implant (100, 101, 102, 103) for monitoring a cardiac blood flow (B1) of a patient includes a detector (10, 10′, 10″) which obtains a first measurement signal (S1) associated with the cardiac blood flow (B1) and a second measurement signal (S2) associated with the epithoracic, peripheral blood flow (B2). A monitoring assembly (20) then generates a first parameter (P1) from the first measurement signal (S1) which is indicative of a time (tsys) at which blood is ejected from the heart, and a second parameter (2) from the second measurement signal (S2) which is indicative of a time (tgef) of a blood pulse in the thoracic tissue which is associated with the ejection of blood. An evaluation unit (30) then generates a pulse transit time (Δt=tgef−tsys) from the first parameter (P1) and the second parameter (P2). The detector (10, 10′, 10″) includes an impedance measuring unit (12) having an electrode assembly (11, 11′) for detection of at least the second measurement signal (S2) in the form of an impedance signal.

摘要翻译： 用于监测患者的心脏血流（B1）的电植入物（100,101,102,103）包括检测器（10,10'，10“），其获得与心脏血液相关联的第一测量信号（S1） 流量（B1）和与外部血液流（B2）相关联的第二测量信号（S2）。 监测组件（20）然后从第一测量信号（S1）产生指示从心脏喷出血液的时间（tsys）的第一参数（P1），以及来自第二测量信号的第二参数（2） 测量信号（S2），其指示与血液喷射相关联的胸部组织中的血液脉冲的时间（tgef）。 然后，评估单元（30）从第一参数（P1）和第二参数（P2）生成脉冲传播时间（＆Dgr; t = tgef-tsys）。 检测器（10,10'，10“）包括阻抗测量单元（12），其具有用于以阻抗信号的形式检测至少第二测量信号（S2）的电极组件（11,11'）。

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：US20100268041A1

公开(公告)日：2010-10-21

申请号：US12757307

申请日：2010-04-09

申请人： Thomas KRAEMER ,  Michael Lippert ,  Olaf Skerl ,  Gerald Czygan ,  Stefan Paule

发明人： Thomas KRAEMER ,  Michael Lippert ,  Olaf Skerl ,  Gerald Czygan ,  Stefan Paule

IPC分类号： A61B5/00

CPC分类号： A61B5/0537 ,  A61B5/0031 ,  A61B5/1116 ,  A61B5/4869 ,  A61B5/4878 ,  A61B5/6846 ,  A61B5/686 ,  A61B2562/0219 ,  A61N1/36521 ,  A61N1/36542 ,  A61N1/3655 ,  A61N1/36564 ,  A61N1/36571

摘要： A monitoring apparatus having a signal input for signals representing measurement values of one or more physiological parameters, and an evaluation and processing unit connected to the signal input. The evaluation and processing unit is designed to select, or differently weight, individual values from the values received for further processing based on one or more criteria such that measurement values raising doubts as to the validity thereof are not selected or given a very low weighting.

摘要翻译： 一种具有用于表示一个或多个生理参数的测量值的信号的信号输入的监视装置，以及连接到所述信号输入的评估和处理单元。 评估和处理单元被设计为基于一个或多个标准从接收到的值中选择或不同地对各个值进行选择，以使得对其有效性产生怀疑的测量值不被选择或给出非常低的权重。

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。

公开(公告)号：US20080195162A1

公开(公告)日：2008-08-14

申请号：US11970662

申请日：2008-01-08

申请人： Michael Lippert ,  Olaf Skerl ,  Stefan Paule ,  Bernhard Fahn ,  Gerald Czygan ,  Heinrich Reinke ,  Albrecht Urbaszek

发明人： Michael Lippert ,  Olaf Skerl ,  Stefan Paule ,  Bernhard Fahn ,  Gerald Czygan ,  Heinrich Reinke ,  Albrecht Urbaszek

IPC分类号： A61B5/053 ,  A61N1/362

CPC分类号： A61B5/053 ,  A61B5/0538 ,  A61B5/14535 ,  A61B5/7207

摘要： An implantable medical device has an impedance or admittance determination unit, an alternating current or voltage source, a measuring unit, and an analysis unit which is connected to the alternating current or AC voltage source and the measuring unit to calculate an impedance value or an admittance value at different times. The impedance or admittance determination unit may generate measuring current having two different frequencies (preferably below 100 kHz), and the analysis unit may calculate pairs of impedance or admittance values which are chronologically assigned to one another for different frequencies of the measuring current, and calculate a value for a blood impedance or blood admittance component which is independent of the impedance of the body tissue surrounding a particular blood vessel, The analysis unit may also determine trends in this value over time as an indicator for a change of blood hematocrit value.

摘要翻译： 可植入医疗装置具有阻抗或导纳确定单元，交流或电压源，测量单元和分析单元，其连接到交流电压源或交流电压源和测量单元以计算阻抗值或导纳 价值在不同的时间。 阻抗或导纳确定单元可以产生具有两个不同频率（优选低于100kHz）的测量电流，并且分析单元可以计算针对测量电流的不同频率按时间顺序分配给彼此的阻抗或导纳值对，并且计算 血液阻抗或血液导入分量的值，其独立于围绕特定血管的身体组织的阻抗。分析单元还可以确定该值随时间的趋势作为血液血细胞比容值变化的指标。

公开(公告)号：US20070150012A1

公开(公告)日：2007-06-28

申请号：US11559626

申请日：2006-11-14

申请人： Gerald Czygan ,  Michael Lippert

发明人： Gerald Czygan ,  Michael Lippert

IPC分类号： A61N1/00

CPC分类号： A61N1/3627

摘要： The invention concerns implantable cardiac stimulation devices in general which have at least one stimulation pulse generator (A-STIM; RV-STIM; LV-STIM) to selectively generate a stimulation pulse for delivery to one of at least two different chambers of a heart, said chambers include right and left atria and right and left ventricles, at least one impedance measuring stage (I, U, IMP) being connected to electrodes or connectors for such electrodes to measure an intracardiac impedance when in use, a control unit (CTRL) connected to the stimulation pulse generator and to the impedance measuring unit and being adapted to process a minimum impedance value for a heart cycle to trigger stimulation pulses for two different chambers of the heart with an adjustable time delay (VVD; AVD) and to adjust said time delay depending upon the measured intracardiac impedance minimum value. According to the invention the control unit is adapted to adjust the time delay such that the minimum value of the intracardiac impedance during one heart cycle is minimized or such that the AVD delay is equal to the time interval between an atrial event and the point of time when the minimum impedance value occurs after said atrial contraction.

摘要翻译： 本发明涉及一般具有至少一个刺激脉冲发生器（A-STIM; RV-STIM; LV-STIM）的可植入心脏刺激装置，以选择性地产生用于递送至心脏的至少两个不同室中的一个的刺激脉冲， 所述腔室包括右心房和左心房以及右心室和左心室，至少一个阻抗测量平台（I，U，IMP）连接到用于这种电极的电极或连接器，用于在使用时测量心内阻抗，控制单元（CTRL） 连接到刺激脉冲发生器和阻抗测量单元，并且适于处理用于心脏周期的最小阻抗值以用可调节的时间延迟（VVD; AVD）触发心脏的两个不同腔室的刺激脉冲，并且调整所述 时间延迟取决于测量的心内阻抗最小值。 根据本发明，控制单元适于调整时间延迟，使得在一个心脏周期期间心内阻抗的最小值被最小化或使得AVD延迟等于心房事件与时间点之间的时间间隔 当在所述心房收缩之后发生最小阻抗值时。

公开(公告)号：US20070055170A1

公开(公告)日：2007-03-08

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： A61B5/05

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：US20050240233A1

公开(公告)日：2005-10-27

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 ,  A61N1/365 ,  A61N1/368 ,  A61N1/18 ,  A61B5/05 ,  A61N1/20 ,  A61N1/28 ,  A61N1/39

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：US20050049646A1

公开(公告)日：2005-03-03

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： A61B5/00 ,  A61B5/053 ,  A61N1/365 ,  A61N1/37

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， 。