公开(公告)号：US08712507B2

公开(公告)日：2014-04-29

申请号：US11643220

申请日：2006-12-21

申请人： Shelley Cazares ,  Aaron McCabe ,  Alok Sathaye ,  Dan Li

发明人： Shelley Cazares ,  Aaron McCabe ,  Alok Sathaye ,  Dan Li

IPC分类号： A61B5/04

CPC分类号： A61B5/0464 ,  A61B5/726

摘要： Methods and systems for arranging and labeling cardiac episodes based on acquired cardiac episode data are described. Cardiac episodes are algorithmically arranged based on one or more discriminating features of the episode data. A user is presented with at least one episode selected from the arrangement of cardiac episodes. The user inputs a label that characterizes the selected episode. The label is algorithmically appended to the data of the selected episode and to other episodes of the arrangement of cardiac episodes based on the discriminating features.

摘要翻译： 描述了基于获得性心脏病发作数据来安排和标记心脏发作的方法和系统。 基于事件数据的一个或多个鉴别特征，算术地布置心脏事件。 向用户呈现从心脏发作的排列中选出的至少一个情节。 用户输入表征所选剧集的标签。 基于鉴别特征，标签被算法地附加到所选事件的数据和心脏发作的安排的其他发作。

公开(公告)号：US20110160551A1

公开(公告)日：2011-06-30

申请号：US13043346

申请日：2011-03-08

申请人： Dan Li ,  Shelley Cazares ,  Jaeho Kim ,  Kent Lee

发明人： Dan Li ,  Shelley Cazares ,  Jaeho Kim ,  Kent Lee

IPC分类号： A61B5/02

CPC分类号： A61B5/0464 ,  A61B5/7264 ,  A61N1/3621 ,  A61N1/36521 ,  A61N1/36542 ,  A61N1/36564 ,  A61N1/36571 ,  A61N1/36578 ,  A61N1/36585 ,  A61N1/3925 ,  A61N1/3962

摘要： A tachyarrhythmia detection and classification system classifies tachyarrhythmias based on an analysis of morphological features of a cardiac signal enhanced by using one or more physiological parameters indicative of hemodynamic stability and/or activity level. The tachyarrhythmia detection and classification system computes a measure of similarity between an arrhythmic waveform of the cardiac signal, a template waveform for that cardiac signal, such as a correlation coefficient representative of the correlation between morphological features of the arrhythmic waveform and morphological features of the template waveform. A detected tachyarrhythmia episode is classified by comparing the measure of similarity to a threshold that is dynamically adjusted using the one or more physiological parameters.

摘要翻译： 快速心律失常检测和分类系统基于通过使用指示血液动力学稳定性和/或活动水平的一个或多个生理参数来增强的心脏信号的形态学特征的分析来分类快速性心律失常。 快速心律失常检测和分类系统计算心脏信号的心律失常波形与该心脏信号的模板波形之间的相似性的度量，例如表示心律失常波形的形态特征与模板的形态特征之间的相关性的相关系数 波形 通过将相似性测量值与使用一个或多个生理参数动态调整的阈值进行比较来分类检测到的快速性心律失常发作。

公开(公告)号：US07653431B2

公开(公告)日：2010-01-26

申请号：US11312280

申请日：2005-12-20

申请人： Shelley Cazares ,  Jaeho Kim ,  Yayun Lin ,  Carlos Ricci

发明人： Shelley Cazares ,  Jaeho Kim ,  Yayun Lin ,  Carlos Ricci

IPC分类号： A61B5/04

CPC分类号： A61B5/0464 ,  A61B5/04525 ,  A61B5/7264

摘要： Cardiac systems and methods provide for discriminating between supraventricular tachyarrhythmia and ventricular tachyarrhythmia based on a determination that the patient's supraventricular rhythm exhibits rate dependency. One approach involves determining if a patient's supraventricular rhythm exhibits rate dependent morphology. If the patient's supraventricular rhythm is determined to exhibit rate dependent morphology, an implantable device classifies a detected tachyarrhythmia episode based on one or more templates selected from a plurality of rate-indexed templates stored in the device. Determining if the supraventricular rhythm exhibits rate dependent morphology may also include determining one or more rates at which the rate dependent morphology occurs.

摘要翻译： 心脏系统和方法基于确定患者的室上节律表现出速率依赖性，确定了室上性快速性心律失常与室性快速性心律失常之间的区别。 一种方法涉及确定患者的室上节律是否表现出速率依赖性形态。 如果确定患者的室上节律表现出与速率相关的形态，则可植入装置基于从存储在装置中的多个速率索引模板中选择的一个或多个模板来分类检测到的快速性心律失常发作。 确定室性心律显示出速率依赖性形态还可以包括确定发生速率依赖形态的一个或多个速率。

公开(公告)号：US20060111751A1

公开(公告)日：2006-05-25

申请号：US10995655

申请日：2004-11-23

申请人： Shelley Cazares

发明人： Shelley Cazares

IPC分类号： A61N1/362

CPC分类号： A61N1/3925 ,  A61B5/04525 ,  A61B5/046 ,  A61B5/0464 ,  A61N1/3622 ,  A61N1/365 ,  A61N1/3962

摘要： Cardiac treatment methods and devices providing templates representative of past tachyarrythmia events, each template associated with a therapy. A cardiac waveform is detected, and if it corresponds to a particular template associated with a previous therapy that was satisfactory in terminating a past event, the previous therapy is delivered again. If unsatisfactory, the previous therapy is eliminated as an option. If, for example, the previous therapy was an antitachycardia pacing therapy unsatisfactory in terminating the past tachyarrythmia event, delivery of the antitachycardia pacing therapy is eliminated as an option. Instead of ATP therapy, one or more of a cardioversion, defibrillation, or alternate anti-tachycardia pacing therapy may be associated with the particular template. Cardiac waveforms and templates may correspond in terms of one or more of morphology, timing, drug regimen, medication, neural activity, patient activity, hemodynamic status, cardiac tissue impedance, transthoracic impedance, or other information corresponding to the episode.

摘要翻译： 心脏治疗方法和设备提供代表过去快速性事件的模板，每个模板与治疗相关联。 检测到心脏波形，并且如果它对应于与先前疗法相关联的特定模板，其在终止过去事件时令人满意，则再次传送先前的治疗。 如果不满意，以前的治疗作为一种选择被消除。 例如，如果以前的治疗是抗心动过速起搏治疗在终止过去的快速性心律失常事件中不能令人满意，则作为选择消除了抗心动过速起搏治疗的递送。 代替ATP治疗，可以将一种或多种心脏复律，除颤或替代的抗心动过速起搏治疗与特定模板相关联。 心脏波形和模板可以对应于形态，时间，药物方案，药物，神经活动，患者活动，血液动力学状态，心脏组织阻抗，经胸阻抗或对应于该发作的其他信息中的一种或多种。

公开(公告)号：US08868183B2

公开(公告)日：2014-10-21

申请号：US11614578

申请日：2006-12-21

申请人： Alok S. Sathaye ,  Shelley Cazares ,  Andrew P. Kramer

发明人： Alok S. Sathaye ,  Shelley Cazares ,  Andrew P. Kramer

IPC分类号： A61N1/37 ,  A61N1/372

CPC分类号： A61N1/37264

摘要： An implantable cardiac function management device including a programmable controller can be used to include a user-specifiable therapy control parameter set. The therapy control parameter set may then be configured to include at least one therapy control parameter that is user-configurable to automatically switch from a first parameter value to a second parameter value at a time that occurs between separate user programming sessions of the device. Various attributes of physiological measures may allow for refinement of the parameter sets to adapt to changed conditions of the subject. Methods of use are also presented.

摘要翻译： 包括可编程控制器的可植入心脏功能管理装置可用于包括用户可指定的治疗控制参数组。 治疗控制参数集合然后可被配置为包括用户可配置的至少一个治疗控制参数，以便在设备的不同的用户编程会话之间发生的时刻自动地从第一参数值切换到第二参数值。 生理测量的各种属性可以允许细化参数集以适应被摄体的变化的条件。 还介绍了使用方法。

公开(公告)号：US08532762B2

公开(公告)日：2013-09-10

申请号：US11312279

申请日：2005-12-20

申请人： Shelley Cazares ,  Carlos Ricci ,  Dan Li ,  Yayun Lin ,  Yi Zhang ,  Jaeho Kim ,  Joseph Bocek

发明人： Shelley Cazares ,  Carlos Ricci ,  Dan Li ,  Yayun Lin ,  Yi Zhang ,  Jaeho Kim ,  Joseph Bocek

IPC分类号： A61N1/365

CPC分类号： A61N1/3622 ,  A61B5/04525 ,  A61B5/046 ,  A61B5/0464 ,  A61B5/0472 ,  A61B5/7264 ,  A61N1/3702 ,  A61N1/3962

摘要： Cardiac arrhythmias are classified based on the morphology of the arrhythmia episode beats. Templates are formed using morphological features of the cardiac beats of the episode. The arrhythmia episode is classified as a monomorphic tachyarrhythmia or polymorphic tachyarrhythmia based on the one or more templates. The arrhythmia episode may be classified based on a number templates formed from the arrhythmia episode. The templates are formed by determining a measure of similarity between morphological features of a cardiac beat to a template. The similarities can be determined based on a pairing rule that determines which beat morphologies are compared. Selection of therapy for treating the arrhythmia episode may depend on the historical success of a therapy at mitigating previous arrhythmias of the same type as the arrhythmia episode.

摘要翻译： 心律失常根据心律失常发作的形态进行分类。 使用情节心脏搏动的形态学特征形成模板。 基于一个或多个模板，心律失常发作被分类为单形性快速性心律失常或多态性快速性心律失常。 心律失常发作可以基于由心律失常发作形成的数字模板进行分类。 模板通过确定心跳的形态特征与模板之间的相似性的度量来形成。 可以基于确定哪些拍子形态进行比较的配对规则来确定相似度。 选择治疗心律失常发作的治疗可能取决于治疗在缓解与心律失常事件相同类型的以前心律失常方面的历史成功。

公开(公告)号：US20100211125A1

公开(公告)日：2010-08-19

申请号：US12769851

申请日：2010-04-29

申请人： Christopher Dale Johnson ,  Alok Sathaye ,  Shelley Cazares

发明人： Christopher Dale Johnson ,  Alok Sathaye ,  Shelley Cazares

IPC分类号： A61N1/362 ,  A61N1/39

CPC分类号： A61B5/7264 ,  A61B5/02405 ,  A61B5/0245 ,  A61B5/04 ,  A61B5/04525 ,  A61B5/0464 ,  A61B5/6846 ,  A61B5/726 ,  A61N1/37247 ,  G06F19/00 ,  G06F19/3481

摘要： An implantable cardiac device is configured to classify cardiac arrhythmias using a plurality of arrhythmia discrimination algorithms. Data is provided that is associated with a plurality of cardiac arrhythmic episodes for which a cardiac electrical therapy was delivered or withheld by the implantable medical device based on the plurality of arrhythmia discrimination algorithms. A metric for each of the arrhythmic episodes is computed. The metric defines a measure by which the implantable cardiac device properly classified the arrhythmia. Potentially misclassified arrhythmic episodes of the plurality of cardiac arrhythmic episodes for which cardiac electrical therapy was inappropriately delivered or withheld are algorithmically identified using the metric.

摘要翻译： 可植入心脏装置被配置为使用多个心律失常鉴别算法对心律失常进行分类。 提供了与多个心律失常发作相关联的数据，根据多种心律不齐判别算法，心脏电疗法由可植入医疗装置递送或保留。 计算每个心律失常发作的指标。 该度量定义了可植入心脏装置适当分类心律失常的措施。 使用度量来算法地识别心电图治疗被不适当地递送或禁止的多个心律失调发作的潜在的错误分类的心律失常发作。

公开(公告)号：US20080051843A1

公开(公告)日：2008-02-28

申请号：US11467421

申请日：2006-08-25

申请人： Dan Li ,  Shelley Cazares

发明人： Dan Li ,  Shelley Cazares

IPC分类号： A61N1/362

CPC分类号： A61N1/3624 ,  A61B5/046 ,  A61B5/0464 ,  A61B5/7275 ,  A61N1/3622 ,  A61N1/3925 ,  A61N1/3962 ,  A61N1/3987

摘要： A cardiac rhythm management (CRM) system delivers anti-tachyarrhythmia therapies and uses patient-specific and/or tachyarrhythmia event-specific information to automatically set and adjust one or more arrhythmia detection durations. In one embodiment, the CRM system initializes and updates the one or more arrhythmia detection durations using patient-specific information such as medical history and recent medical trends. In another embodiment, the CRM dynamically adjusts the one or more arrhythmia detection durations using the patient's hemodynamic performance. One example of such an arrhythmia detection duration is a sustained rate duration (SRD) that starts when a tachyarrhythmia such as a supraventricular tachyarrhythmia is detected. An anti-tachyarrhythmia therapy is delivered only if the tachyarrhythmia sustains throughout the SRD.

摘要翻译： 心律管理（CRM）系统提供抗心律失常疗法，并使用患者特异性和/或快速性心律失常事件特定信息来自动设置和调整一种或多种心律失常检测持续时间。 在一个实施例中，CRM系统使用患者特定信息（例如病史和最近的医疗趋势）来初始化和更新一个或多个心律失常检测持续时间。 在另一个实施例中，CRM使用患者的血液动力学性能来动态地调整一个或多个心律失常检测持续时间。 这种心律失常检测持续时间的一个例子是当检测到诸如室上性快速性心律失常之类的快速性心律失常时开始的持续速率持续时间（SRD）。 仅在快速性心律失常在整个SRD中持续时才能进行抗快速性心律失常治疗。

公开(公告)号：US20070149890A1

公开(公告)日：2007-06-28

申请号：US11316332

申请日：2005-12-22

申请人： Dan Li ,  Shelley Cazares ,  Jaeho Kim ,  Kent Lee

发明人： Dan Li ,  Shelley Cazares ,  Jaeho Kim ,  Kent Lee

IPC分类号： A61B5/04

CPC分类号： A61B5/0464 ,  A61B5/7264 ,  A61N1/3621 ,  A61N1/36521 ,  A61N1/36542 ,  A61N1/36564 ,  A61N1/36571 ,  A61N1/36578 ,  A61N1/36585 ,  A61N1/3925 ,  A61N1/3962

摘要： A tachyarrhythmia detection and classification system classifies tachyarrhythmias based on an analysis of morphological features of a cardiac signal enhanced by using one or more physiological parameters indicative of hemodynamic stability and/or activity level. The tachyarrhythmia detection and classification system computes a measure of similarity between an arrhythmic waveform of the cardiac signal a template waveform for that cardiac signal, such as a correlation coefficient representative of the correlation between morphological features of the arrhythmic waveform and morphological features of the template waveform. A detected tachyarrhythmia episode is classified by comparing the measure of similarity to a threshold that is dynamically adjusted using the one or more physiological parameters.

摘要翻译： 快速心律失常检测和分类系统基于通过使用指示血液动力学稳定性和/或活动水平的一个或多个生理参数来增强的心脏信号的形态学特征的分析来分类快速性心律失常。 快速心律失常检测和分类系统计算心脏信号的心律失常波形与该心脏信号的模板波形之间的相似性的度量，例如表示心律失常波形的形态特征与模板波形的形态特征之间的相关性的相关系数 。 通过将相似性测量值与使用一个或多个生理参数动态调整的阈值进行比较来分类检测到的快速性心律失常发作。

公开(公告)号：US20070142737A1

公开(公告)日：2007-06-21

申请号：US11312280

申请日：2005-12-20

申请人： Shelley Cazares ,  Jaeho Kim ,  Yayun Lin ,  Carlos Ricci

发明人： Shelley Cazares ,  Jaeho Kim ,  Yayun Lin ,  Carlos Ricci

IPC分类号： A61B5/04

CPC分类号： A61B5/0464 ,  A61B5/04525 ,  A61B5/7264

摘要： Cardiac systems and methods provide for discriminating between supraventricular tachyarrhythmia and ventricular tachyarrhythmia based on a determination that the patient's supraventricular rhythm exhibits rate dependency. One approach involves determining if a patient's supraventricular rhythm exhibits rate dependent morphology. If the patient's supraventricular rhythm is determined to exhibit rate dependent morphology, an implantable device classifies a detected tachyarrhythmia episode based on one or more templates selected from a plurality of rate-indexed templates stored in the device. Determining if the supraventricular rhythm exhibits rate dependent morphology may also include determining one or more rates at which the rate dependent morphology occurs.

摘要翻译： 心脏系统和方法基于确定患者的室上节律表现出速率依赖性，确定了室上性快速性心律失常与室性快速性心律失常之间的区别。 一种方法涉及确定患者的室上节律是否表现出速率依赖性形态。 如果确定患者的室上节律表现出与速率相关的形态，则可植入装置基于从存储在装置中的多个速率索引模板中选择的一个或多个模板来分类检测到的快速性心律失常发作。 确定室性心律显示出速率依赖性形态还可以包括确定发生速率依赖形态的一个或多个速率。