公开(公告)号：US20110098774A1

公开(公告)日：2011-04-28

申请号：US12906855

申请日：2010-10-18

申请人： Amy Jean Brisben ,  Aaron R. McCabe ,  Clayton S. Foster ,  David W. Yost ,  Kevin John Stalsberg ,  Jacob I. Laughner

发明人： Amy Jean Brisben ,  Aaron R. McCabe ,  Clayton S. Foster ,  David W. Yost ,  Kevin John Stalsberg ,  Jacob I. Laughner

IPC分类号： A61N1/08

CPC分类号： A61N1/3712 ,  A61N1/3627

摘要： Methods and devices are described that allow estimation of an electrostimulation capture threshold, such as a dedicated bipolar pacing vector threshold. In an example, an equal-energy assumption between first and second pacing vectors can be used to estimate an electrostimulation capture threshold of a second pacing vector from a measured electrostimulation capture threshold of the first pacing vector and impedances of the first and second pacing vectors. In an example, a relationship between first and second pacing vectors can be determined from measured data, and a parameter of the relationship can be used with a measurement of an electrostimulation capture threshold of the first pacing vector to estimate an electrostimulation capture threshold of the second pacing vector.

公开(公告)号：US07917196B2

公开(公告)日：2011-03-29

申请号：US11125020

申请日：2005-05-09

申请人： Yi Zhang ,  Carlos Alberto Ricci ,  Jeffrey E. Stahmann ,  Aaron R. McCabe ,  Scott A. Meyer ,  Yinghong Yu

发明人： Yi Zhang ,  Carlos Alberto Ricci ,  Jeffrey E. Stahmann ,  Aaron R. McCabe ,  Scott A. Meyer ,  Yinghong Yu

IPC分类号： A61B5/0464

CPC分类号： A61B5/04011 ,  A61B5/7203

摘要： Cardiac monitoring and/or stimulation methods and systems provide for monitoring, diagnosing, defibrillation and pacing therapies, or a combination of these capabilities, including cardiac systems incorporating or cooperating with neuro-stimulating devices, drug pumps, or other therapies. Embodiments relate generally to implantable medical devices employing automated cardiac activation sequence monitoring and/or tracking for arrhythmia discrimination. Embodiments are directed to devices and methods involving sensing a plurality of composite cardiac signals using a plurality of implantable electrodes. A source separation is performed using the sensed plurality of composite cardiac signals and the separation produces one or more cardiac signal vectors associated with one or more cardiac activation sequences that is indicative of ischemia. A change of the one or more cardiac signal vectors is detected using the one or more cardiac signal vectors. Cardiac arrhythmias are discriminated using the one or more cardiac signal vectors.

摘要翻译： 心脏监测和/或刺激方法和系统提供监测，诊断，除颤和起搏治疗，或这些能力的组合，包括结合或与神经刺激装置，药物泵或其他疗法组合的心脏系统。 实施例一般涉及使用自动心脏激活序列监测和/或跟踪用于心律失常鉴别的可植入医疗装置。 实施例涉及使用多个可植入电极感测多个复合心脏信号的装置和方法。 使用感测的多个复合心脏信号进行源分离，并且分离产生与指示缺血的一个或多个心脏激活序列相关联的一个或多个心脏信号载体。 使用一个或多个心脏信号矢量检测一个或多个心脏信号矢量的改变。 使用一个或多个心脏信号载体来区分心律失常。

公开(公告)号：US20100262204A1

公开(公告)日：2010-10-14

申请号：US12724729

申请日：2010-03-16

申请人： Aaron R. McCabe ,  Shibaji Shome ,  Yanting Dong ,  Amy Jean Brisben

发明人： Aaron R. McCabe ,  Shibaji Shome ,  Yanting Dong ,  Amy Jean Brisben

IPC分类号： A61N1/368

CPC分类号： A61N1/3627 ,  A61N1/3712

摘要： Cardiac resynchronization therapy is delivered to a heart using an extended bipolar electrode configuration in accordance with programmed pacing parameters including a non-zero intraventricular delay. The extended bipolar electrode configuration comprises a left ventricular electrode defining a cathode of the extended bipolar electrode configuration and a right ventricular electrode defining an anode of the extended bipolar electrode configuration. A pace pulse is delivered to the left ventricular electrode and anodal stimulation of the right ventricle is detected based on the sensed response to the pace pulse.

摘要翻译： 使用扩展双极电极配置将心脏再同步治疗按照已编程的起搏参数（包括非零心室延迟）递送至心脏。 扩展双极电极配置包括限定扩展双极电极配置的阴极的左心室电极和限定延伸双极电极配置的阳极的右心室电极。 步速脉冲输送到左心室电极，并且基于感测到的对步速脉冲的响应来检测右心室的阳极刺激。

公开(公告)号：US07457664B2

公开(公告)日：2008-11-25

申请号：US11125068

申请日：2005-05-09

申请人： Yi Zhang ,  Yinghong Yu ,  Aaron R. McCabe ,  Jiang Ding ,  Jeffrey E. Stahmann ,  Carlos Alberto Ricci ,  Scott A. Meyer

发明人： Yi Zhang ,  Yinghong Yu ,  Aaron R. McCabe ,  Jiang Ding ,  Jeffrey E. Stahmann ,  Carlos Alberto Ricci ,  Scott A. Meyer

IPC分类号： A61N1/365

CPC分类号： A61N1/3712 ,  A61N1/3627 ,  A61N1/365 ,  G06F19/00

摘要： Cardiac monitoring and/or stimulation methods and systems that provide one or more of monitoring, diagnosing, defibrillation, and pacing. Cardiac signal separation is employed to detect, monitor, track, and/or trend closed-loop cardiac resynchronization therapy using cardiac activation sequence information. Devices and methods involve sensing a plurality of composite cardiac signals using a plurality of electrodes, the electrodes configured for implantation in a patient. A source separation is performed using the sensed plurality of composite cardiac signals, producing one or more cardiac signal vectors associated with all or a portion of one or more cardiac activation sequences. A cardiac resynchronization therapy is adjusted using one or both of the one or more cardiac signal vectors and the signals associated with the one or more cardiac signal vectors. In further embodiments, the cardiac resynchronization therapy may be initiated, terminated, or one or more parameters of the resynchronization therapy may be altered.

摘要翻译： 提供一种或多种监测，诊断，除颤和起搏的心脏监测和/或刺激方法和系统。 心脏信号分离用于使用心脏激活序列信息来检测，监测，跟踪和/或趋向闭环心脏再同步治疗。 设备和方法包括使用多个电极感测多个复合心脏信号，所述电极被配置用于植入患者体内。 使用所感测的多个复合心脏信号进行源分离，产生与一个或多个心脏激活序列的全部或一部分相关联的一个或多个心脏信号载体。 使用一个或多个心脏信号向量和与一个或多个心脏信号载体相关联的信号中的一个或两个来调整心脏再同步治疗。 在另外的实施方案中，心脏再同步治疗可以被启动，终止，或者可以改变再同步治疗的一个或多个参数。

公开(公告)号：US09149642B2

公开(公告)日：2015-10-06

申请号：US12787557

申请日：2010-05-26

申请人： Aaron R. McCabe ,  Holly E. Rockweiler ,  Jacob L. Laughner

发明人： Aaron R. McCabe ,  Holly E. Rockweiler ,  Jacob L. Laughner

IPC分类号： A61N1/362 ,  A61N1/37 ,  A61N1/365

CPC分类号： A61N1/3706 ,  A61N1/36521 ,  A61N1/36542

摘要： The present invention concerns phrenic nerve activation detection algorithms for characterization of phrenic nerve activation and phrenic nerve activation avoidance in cardiac pacing therapy.Various embodiments concern receiving a respiration signal indicative of respiratory activity of the patient, identifying respiratory phases based on the respiration signal, delivering cardiac pacing pulses within each of the identified respiratory phases, receiving a phrenic nerve activation signal indicative of activation of the patient's phrenic nerve, analyzing the phrenic nerve stimulation signal to determine if one or more of the pacing pulses activated the phrenic nerve of the patient, and determining if at least one of the delivered pacing pulses activated the phrenic nerve of the patient based on the phrenic nerve activation signal indicating activation of the patient's phrenic nerve associated with delivery of the at least one cardiac pacing pulse.

摘要翻译： 本发明涉及用于表征心脏起搏治疗中的膈神经激活和膈神经激活避免的膈神经激活检测算法。 各种实施方案涉及接收指示患者的呼吸活动的呼吸信号，基于呼吸信号识别呼吸相位，在每个所识别的呼吸相中输送心脏起搏脉冲，接收指示患者膈神经激活的膈神经激活信号 分析膈神经刺激信号以确定一个或多个起搏脉冲是否激活了患者的膈神经，并且基于膈神经激活信号确定所输送的起搏脉冲中的至少一个是否激活了患者的膈神经 指示与递送至少一个心脏起搏脉冲相关的患者膈神经的活化。

公开(公告)号：US08527048B2

公开(公告)日：2013-09-03

申请号：US11478286

申请日：2006-06-29

申请人： Alok S. Sathaye ,  Aaron R. McCabe ,  Yinghong Yu

发明人： Alok S. Sathaye ,  Aaron R. McCabe ,  Yinghong Yu

IPC分类号： A61N1/365

CPC分类号： A61B5/0452 ,  A61N1/36585 ,  A61N1/368 ,  A61N1/3682 ,  A61N1/3684

摘要： Systems and methods for determining pacing timing intervals based on the temporal relationship between the timing of local and non-local cardiac signal features are described. A device includes a plurality of implantable electrodes electrically coupled to the heart and configured to sense local and non-local cardiac signals. Sense circuitry coupled to first and second electrode pairs senses a local cardiac signal via a first electrode pair and a non-local cardiac signal via a second electrode pair. Detection circuitry is used to detect a feature of the local signal associated with activation of a heart chamber and to detect a feature of the non-local signal associated with activation of the heart chamber. A control processor times delivery of one or more pacing pulses based on a temporal relationship between timing of the local signal feature and timing of the non-local signal feature.

摘要翻译： 描述了基于局部和非局部心脏信号特征的定时之间的时间关系来确定起搏定时间隔的系统和方法。 一种装置包括电耦合到心脏并被配置为感测局部和非局部心脏信号的多个可植入电极。 耦合到第一和第二电极对的感测电路经由第二电极对经由第一电极对和非局部心脏信号感测局部心脏信号。 检测电路用于检测与心室的激活相关联的局部信号的特征，并且检测与心室的激活相关的非局部信号的特征。 控制处理器基于本地信号特征的定时和非本地信号特征的定时之间的时间关系来递送一个或多个起搏脉冲的递送。

公开(公告)号：US20130138175A1

公开(公告)日：2013-05-30

申请号：US13684821

申请日：2012-11-26

申请人： Aaron R. McCabe ,  Deepa Mahajan ,  David W. Yost ,  Clayton S. Foster ,  Shibaji Shome ,  Amy Jean Brisben

发明人： Aaron R. McCabe ,  Deepa Mahajan ,  David W. Yost ,  Clayton S. Foster ,  Shibaji Shome ,  Amy Jean Brisben

IPC分类号： A61N1/37

CPC分类号： A61N1/371 ,  A61N1/056 ,  A61N1/3712

摘要： An apparatus comprises a control circuit that initiates a normal pacing mode for delivery of electrostimulation energy to the heart chamber. In response to an indication to initiate a threshold test, the control circuit determines an electrode configuration used to deliver the electrostimulation energy in the normal pacing mode, selects a first threshold test mode when a sensing electrode independent from the set of pacing electrodes is unavailable for the heart chamber, wherein a cardiac activity signal is sensed using a set of sensing electrodes that includes an electrode common to the set of pacing electrodes, and selects a second threshold test mode when a sensing electrode independent from the set of pacing electrodes is available for the heart chamber, wherein the cardiac activity signal is sensed using a set of sensing electrodes that excludes an electrode common to the set of pacing electrodes.

摘要翻译： 一种装置包括控制电路，该控制电路启动用于向心室输送电刺激能量的正常起搏模式。 响应于启动阈值测试的指示，控制电路确定用于在正常起搏模式中传送电刺激能量的电极配置，当独立于起搏电极组的感测电极不可用于当前起搏模式时，选择第一阈值测试模式 心室，其中使用包括所述起搏电极组共同的电极的一组感测电极来感测心脏活动信号，并且当独立于所述起搏电极组的感测电极可用于第二阈值测试模式时，选择第二阈值测试模式 所述心室，其中使用排除所述起搏电极组共同的电极的一组感测电极感测所述心脏活动信号。

公开(公告)号：US20120035685A1

公开(公告)日：2012-02-09

申请号：US13198499

申请日：2011-08-04

申请人： Sunipa Saha ,  Kenneth N. Hayes ,  Keith L. Herrmann ,  James Kalgren ,  Aaron R. McCabe ,  Holly Rockweiler ,  Shibaji Shome ,  Krzysztof Z. Siejko

发明人： Sunipa Saha ,  Kenneth N. Hayes ,  Keith L. Herrmann ,  James Kalgren ,  Aaron R. McCabe ,  Holly Rockweiler ,  Shibaji Shome ,  Krzysztof Z. Siejko

IPC分类号： A61N1/362 ,  A61N1/05 ,  A61N1/04

CPC分类号： A61N1/37247 ,  A61N1/056 ,  A61N1/36185 ,  A61N1/3686 ,  A61N1/37241

摘要： An interactive representation of electrostimulation electrodes or vectors can be provided, such as for configuring combinations of electrostimulation electrodes. In an example, electrodes or test parameters can be presented graphically or in a table. A user interface can be configured to receive user-input designating electrode combinations or vectors for test or for use in programming an implantable or ambulatory medical device. The interface can be used to indicate suggested electrode combinations or vectors in response to a first selection of an electrode. Tests can be performed on electrode combinations and vectors, and the results of the tests can be presented to a user using the interactive representation. In an example, test results can be analyzed by a processor and optionally used to program an implantable or ambulatory medical device.

摘要翻译： 可以提供电刺激电极或载体的交互式表示，例如用于配置电刺激电极的组合。 在一个示例中，电极或测试参数可以图形化或在表中呈现。 用户界面可以被配置为接收用户输入的指定电极组合或矢量，用于测试或用于编程可植入或动态医疗设备。 该界面可用于响应于电极的第一选择来指示建议的电极组合或载体。 可以对电极组合和载体进行测试，并且可以使用交互式表示向使用者呈现测试结果。 在一个示例中，测试结果可以由处理器分析，并且可选地用于编程可植入或动态医疗设备。

公开(公告)号：US08055332B2

公开(公告)日：2011-11-08

申请号：US12893127

申请日：2010-09-29

申请人： Aaron R. McCabe ,  Avram Scheiner ,  Geng Zhang ,  Quan Ni ,  Douglas R. Daum ,  Yi Zhang

发明人： Aaron R. McCabe ,  Avram Scheiner ,  Geng Zhang ,  Quan Ni ,  Douglas R. Daum ,  Yi Zhang

IPC分类号： A61B5/04

CPC分类号： A61B5/0402 ,  A61N1/365 ,  A61N1/3756

摘要： An implantable medical device such as an implantable pacemaker or implantable cardioverter/defibrillator includes a programmable sensing circuit providing for sensing of a signal approximating a surface electrocardiogram (ECG) through implanted electrodes. With various electrode configurations, signals approximating various standard surface ECG signals are acquired without the need for attaching electrodes with cables onto the skin. The various electrode configurations include, but are not limited to, various combinations of intracardiac pacing electrodes, portions of the implantable medical device contacting tissue, and electrodes incorporated onto the surface of the implantable medical device.

摘要翻译： 诸如可植入起搏器或植入式心律转复/除颤器的可植入医疗装置包括可编程感测电路，用于通过植入电极感测接近表面心电图（ECG）的信号。 通过各种电极配置，获取近似各种标准表面ECG信号的信号，而不需要将电极与电缆连接在皮肤上。 各种电极配置包括但不限于心脏内起搏电极，可植入医疗器械接触组织的部分和结合到可植入医疗装置的表面上的电极的各种组合。

公开(公告)号：US20100305638A1

公开(公告)日：2010-12-02

申请号：US12787557

申请日：2010-05-26

申请人： Aaron R. McCabe ,  Holly E. Rockweiler ,  Jacob L. Laughner

发明人： Aaron R. McCabe ,  Holly E. Rockweiler ,  Jacob L. Laughner

IPC分类号： A61N1/36

CPC分类号： A61N1/3706 ,  A61N1/36521 ,  A61N1/36542

摘要： The present invention concerns phrenic nerve activation detection algorithms for characterization of phrenic nerve activation and phrenic nerve activation avoidance in cardiac pacing therapy.Various embodiments concern receiving a respiration signal indicative of respiratory activity of the patient, identifying respiratory phases based on the respiration signal, delivering cardiac pacing pulses within each of the identified respiratory phases, receiving a phrenic nerve activation signal indicative of activation of the patient's phrenic nerve, analyzing the phrenic nerve stimulation signal to determine if one or more of the pacing pulses activated the phrenic nerve of the patient, and determining if at least one of the delivered pacing pulses activated the phrenic nerve of the patient based on the phrenic nerve activation signal indicating activation of the patient's phrenic nerve associated with delivery of the at least one cardiac pacing pulse.

摘要翻译： 本发明涉及用于表征心脏起搏治疗中的膈神经激活和膈神经激活避免的膈神经激活检测算法。 各种实施方案涉及接收指示患者的呼吸活动的呼吸信号，基于呼吸信号识别呼吸相位，在每个所识别的呼吸相中输送心脏起搏脉冲，接收指示患者膈神经激活的膈神经激活信号 分析膈神经刺激信号以确定一个或多个起搏脉冲是否激活了患者的膈神经，并且基于膈神经激活信号确定所输送的起搏脉冲中的至少一个是否激活了患者的膈神经 指示与递送至少一个心脏起搏脉冲相关的患者膈神经的活化。