公开(公告)号：US09205264B2

公开(公告)日：2015-12-08

申请号：US14276516

申请日：2014-05-13

Applicant: Medtronic, Inc.

Inventor： Kenneth T. Heruth ,  Keith A. Miesel

IPC: A61B5/00 ,  A61N1/36 ,  A61B5/11 ,  A61M5/142 ,  A61M5/172 ,  A61B5/0476 ,  A61N1/365

CPC classification number: A61N1/36139 ,  A61B3/113 ,  A61B5/01 ,  A61B5/0402 ,  A61B5/0476 ,  A61B5/1116 ,  A61B5/1118 ,  A61B5/4815 ,  A61B5/6826 ,  A61B5/686 ,  A61M5/14276 ,  A61M5/1723 ,  A61N1/36071 ,  A61N1/36078 ,  A61N1/36135 ,  A61N1/36514 ,  A61N1/36521 ,  A61N1/36542 ,  A61N1/36557 ,  A61N1/3702 ,  A61N1/37247

Abstract: At least one of a medical device, such as an implantable medical device, and a programming device determines values for one or more metrics that indicate the quality of a patient's sleep. Sleep efficiency, sleep latency, and time spent in deeper sleep states are example sleep quality metrics for which values may be determined. In some embodiments, determined sleep quality metric values are associated with a current therapy parameter set. In some embodiments, a programming device presents sleep quality information to a user based on determined sleep quality metric values. A clinician, for example, may use the sleep quality information presented by the programming device to evaluate the effectiveness of therapy delivered to the patient by the medical device, to adjust the therapy delivered by the medical device, or to prescribe a therapy not delivered by the medical device in order to improve the quality of the patient's sleep.

Abstract translation: 诸如可植入医疗设备的医疗设备和编程设备中的至少一个确定了指示患者睡眠质量的一个或多个度量的值。 睡眠效率，睡眠延迟和在更深的睡眠状态中花费的时间是可以确定值的示例性睡眠质量度量。 在一些实施例中，确定的睡眠质量度量值与当前治疗参数组相关联。 在一些实施例中，编程设备基于确定的睡眠质量度量值向用户呈现睡眠质量信息。 例如，临床医生可以使用编程设备呈现的睡眠质量信息来评估由医疗设备递送给患者的治疗的有效性，以调整由医疗设备递送的治疗，或者开出不由 医疗器械为了提高病人的睡眠质量。

公开(公告)号：US20140276573A1

公开(公告)日：2014-09-18

申请号：US13840718

申请日：2013-03-15

Applicant: Medtronic, Inc.

Inventor： Keith A. Miesel ,  Scott A. Sarkinen ,  Emem D. Akpan ,  Douglas E. Hentges ,  Mark E. Dunlap ,  Darrin Schauble ,  Cindy Konen ,  Mark R. Bilitz

IPC: A61B17/34

CPC classification number: A61B17/3417 ,  A61M5/329 ,  A61M5/46 ,  A61M39/0208 ,  A61M2039/0226 ,  A61M2039/0244

Abstract: Transdermal insertion of a transcutaneous filling apparatus, for the purpose of filling a fill chamber of an implanted therapy delivery device, is monitored by measuring each impedance between pairs of electrodes of a needle of the apparatus, and comparing each to a threshold impedance; the electrodes, preferably at least three in number, are isolated and spaced apart from one another along a length of the needle. A confirmation signal is generated when at least one of the measured impedances is greater than the threshold impedance, and another is less than the threshold, the condition indicating that one of the electrodes is located within a non-conductive septum, through which the apparatus must pass to access the fill chamber. A detection circuit, which may be located in a housing of the apparatus that is attached to a proximal end of the needle, measures and compares the impedances.

Abstract translation: 通过测量装置针的电极对之间的每个阻抗，并将每个阻抗与阈值阻抗进行比较来监测用于填充植入的治疗输送装置的填充室的经皮填充装置的经皮插入。 优选地，至少三个数量的电极沿着针的长度被隔离并彼此间隔开。 当所测量的阻抗中的至少一个大于阈值阻抗，另一个小于阈值时，产生确认信号，该条件指示电极中的一个位于非导电隔膜内，该装置必须通过该阻塞 通过进入填充室。 可以位于装置的外壳中的检测电路，其连接到针的近端，测量并比较阻抗。

公开(公告)号：US20140222101A1

公开(公告)日：2014-08-07

申请号：US14247923

申请日：2014-04-08

Applicant: Medtronic, Inc.

Inventor： Keith A. Miesel ,  Kenneth T. Heruth ,  Jonathan C. Werder ,  Steve R. LaPorte ,  Nina M. Graves

IPC: A61N1/36

CPC classification number: A61N1/36135 ,  A61B3/113 ,  A61B5/0031 ,  A61B5/0205 ,  A61B5/0476 ,  A61B5/0816 ,  A61B5/1116 ,  A61B5/1118 ,  A61B5/145 ,  A61B5/4815 ,  A61B5/4818 ,  A61B5/6814 ,  A61B5/6823 ,  A61B5/6825 ,  A61B5/686 ,  A61B2562/0219 ,  A61M5/14276 ,  A61M5/1723 ,  A61N1/36025 ,  A61N1/36064 ,  A61N1/36067 ,  A61N1/36071 ,  A61N1/36082 ,  A61N1/36521 ,  A61N1/36542 ,  A61N1/36557 ,  A61N1/37247

Abstract: A device determines values for one or more metrics that indicate the quality of a patient's sleep based on sensed physiological parameter values. Sleep efficiency, sleep latency, and time spent in deeper sleep states are example sleep quality metrics for which values may be determined. The sleep quality metric values may be used, for example, to evaluate the effectiveness of a therapy delivered to the patient by a medical device. In some embodiments, determined sleep quality metric values are automatically associated with the therapy parameter sets according to which the medical device delivered the therapy when the physiological parameter values were sensed, and used to evaluate the effectiveness of the various therapy parameter sets. The medical device may deliver the therapy to treat a non-respiratory neurological disorder, such as epilepsy, a movement disorder, or a psychological disorder. The therapy may be, for example, deep brain stimulation (DBS) therapy.

Abstract translation: 设备基于感测到的生理参数值来确定指示患者睡眠质量的一个或多个度量的值。 睡眠效率，睡眠延迟和在更深的睡眠状态中花费的时间是可以确定值的示例性睡眠质量度量。 例如，可以使用睡眠质量度量值来评估由医疗装置递送给患者的治疗的有效性。 在一些实施例中，确定的睡眠质量量度值与治疗参数组自动相关联，当感测到生理参数值时医疗设备根据该参数设置递送治疗，并且用于评估各种治疗参数组的有效性。 医疗装置可以递送治疗以治疗非呼吸神经障碍，例如癫痫，运动障碍或心理障碍。 治疗可以是例如深部脑刺激（DBS）治疗。

公开(公告)号：US08792982B2

公开(公告)日：2014-07-29

申请号：US13898197

申请日：2013-05-20

Applicant: Medtronic, Inc.

Inventor： Keith A. Miesel ,  Kenneth T. Heruth

IPC: A61N1/36

CPC classification number: A61B5/4848 ,  A61B5/103 ,  A61B5/1116 ,  A61B5/4082 ,  A61B5/6825 ,  A61B5/686 ,  A61M5/14276 ,  A61N1/0531 ,  A61N1/0534 ,  A61N1/36071 ,  A61N1/36082 ,  A61N1/36514 ,  A61N1/36521 ,  A61N1/36535 ,  A61N1/36542 ,  A61N1/36557 ,  A61N1/37235

Abstract: A medical device delivers a therapy to a patient. Posture events are identified, e.g., a posture of the patient is periodically determined and/or posture transitions by the patient are identified, and each determined posture event is associated with a current therapy parameter set. A value of at least one posture metric is determined for each of a plurality of therapy parameter sets based on the posture events associated with that therapy parameter set. A list of the therapy parameter sets is presented to a user, such as a clinician, for evaluation of the relative efficacy of the therapy parameter sets. The list may be ordered according to the one or more posture metric values to aid in evaluation of the therapy parameter sets. Where values are determined for a plurality of posture metrics, the list may be ordered according to the one of the posture metrics selected by the user.

Abstract translation: 医疗设备向患者传递治疗。 识别姿势事件，例如，周期性地确定患者的姿势和/或患者的姿势转换，并且每个确定的姿势事件与当前治疗参数组相关联。 基于与该治疗参数组相关联的姿势事件，为多个治疗参数组中的每一个确定至少一个姿势度量的值。 将治疗参数组的列表呈现给诸如临床医师的用户，用于评估治疗参数组的相对功效。 可以根据一个或多个姿势度量值对列表进行排序，以帮助评估治疗参数组。 在针对多个姿势度量确定值的情况下，可以根据用户选择的姿势度量中的一个排序列表。

公开(公告)号：US20130289446A1

公开(公告)日：2013-10-31

申请号：US13764911

申请日：2013-02-12

Applicant: MEDTRONIC, INC.

Inventor： Richard T. Stone ,  Keith A. Miesel

IPC: A61B5/20 ,  A61N1/05 ,  A61N1/36 ,  A61B7/00 ,  A61B5/11 ,  A61B5/00

CPC classification number: A61B5/204 ,  A61B5/0002 ,  A61B5/11 ,  A61B5/4836 ,  A61B5/686 ,  A61B5/725 ,  A61B5/7278 ,  A61B5/7405 ,  A61B5/742 ,  A61B5/7455 ,  A61B5/746 ,  A61B5/7475 ,  A61B7/00 ,  A61N1/0521 ,  A61N1/36007 ,  A61N1/3606

Abstract: A bladder fullness level of a patient may be determined based on a frequency of mechanical oscillations of the bladder of the patient. The bladder may mechanically oscillate in response to the occurrence of non-micturition contractions of the bladder of the patient, which are contractions not associated with urine release. The frequency at which the bladder oscillates, e.g., following a non-micturition contraction, may have a correlation to the bladder fullness level. In some examples, a medical device may be configured to control the delivery of electrical stimulation therapy to the patient based on the oscillation frequency of the bladder. In addition, or instead to controlling therapy based on the oscillation frequency of the bladder, a notification, such as a patient or patient caretaker notification, may be generated (e.g., automatically by a processor of a device) based on the oscillation frequency of the bladder.

Abstract translation: 可以基于患者膀胱的机械振荡的频率来确定患者的膀胱充满度水平。 膀胱可以响应于患者的膀胱的非排尿收缩的发生而发生机械振荡，其是与尿液释放不相关的收缩。 膀胱振荡的频率，例如在非排尿收缩之后，可以与膀胱充满度水平相关。 在一些示例中，医疗装置可以被配置为基于膀胱的振荡频率来控制对患者的电刺激治疗的递送。 另外，或者替代地，基于膀胱的振荡频率来控制治疗，可以基于所述膀胱的振荡频率来生成例如患者或病人看管者通知的通知（例如，由设备的处理器自动地） 膀胱。

公开(公告)号：US10300283B2

公开(公告)日：2019-05-28

申请号：US14247923

申请日：2014-04-08

Applicant: Medtronic, Inc.

Inventor： Keith A. Miesel ,  Kenneth T. Heruth ,  Jonathan C. Werder ,  Steve R. LaPorte ,  Nina M. Graves

IPC: A61N1/36 ,  A61B5/0205 ,  A61B5/11 ,  A61B5/00 ,  A61M5/142 ,  A61M5/172 ,  A61B3/113 ,  A61B5/0476 ,  A61B5/08 ,  A61B5/145 ,  A61N1/365 ,  A61N1/372

Abstract: A device determines values for one or more metrics that indicate the quality of a patient's sleep based on sensed physiological parameter values. Sleep efficiency, sleep latency, and time spent in deeper sleep states are example sleep quality metrics for which values may be determined. The sleep quality metric values may be used, for example, to evaluate the effectiveness of a therapy delivered to the patient by a medical device. In some embodiments, determined sleep quality metric values are automatically associated with the therapy parameter sets according to which the medical device delivered the therapy when the physiological parameter values were sensed, and used to evaluate the effectiveness of the various therapy parameter sets. The medical device may deliver the therapy to treat a non-respiratory neurological disorder, such as epilepsy, a movement disorder, or a psychological disorder. The therapy may be, for example, deep brain stimulation (DBS) therapy.

公开(公告)号：US09919159B2

公开(公告)日：2018-03-20

申请号：US15258756

申请日：2016-09-07

Applicant: Medtronic, Inc.

Inventor： Dennis M. Skelton ,  Jon P. Davis ,  Rajeev M. Sahasrabudhe ,  Shyam Gokaldas ,  Joseph J. Nolan ,  Dennis J. Bourget ,  Duane L. Bourget ,  Keith A. Miesel ,  James Zimmerman

IPC: A61N1/365 ,  A61N1/372 ,  A61B5/11 ,  A61N1/36 ,  G06F19/00

CPC classification number: A61N1/37247 ,  A61B5/1116 ,  A61B5/1118 ,  A61B2562/0219 ,  A61N1/36071 ,  A61N1/36132 ,  A61N1/36135 ,  A61N1/36542 ,  G06F19/00 ,  G06F19/3418 ,  G06F19/3481 ,  G16H20/10 ,  G16H40/63 ,  G16H50/20 ,  G16H80/00

Abstract: A programming session for an implantable medical device that includes a posture responsive therapy mode includes at least two phases. In a first phase, a first set of therapy parameter values are modified while the posture responsive therapy mode is deactivated. In the posture responsive therapy mode, the medical device automatically selects one or more therapy parameter values that define therapy delivered to a patient based on a detected posture state. In a second phase, the posture responsive therapy mode is activated and a second set of therapy parameter values are adjusted after observing a patient response to the posture responsive therapy delivered with the first set of therapy parameter values selected during the first phase. The second set of therapy parameter values may, for example, define the patient posture states or the modification profiles with which the medical device adjusts therapy upon detecting a posture state transition.

公开(公告)号：US09592379B2

公开(公告)日：2017-03-14

申请号：US14278821

申请日：2014-05-15

Applicant: Medtronic, Inc.

Inventor： Kenneth T. Heruth ,  Keith A. Miesel ,  Gregory F. Molnar

IPC: A61N1/37 ,  A61N1/36 ,  A61B5/103 ,  A61B5/00 ,  A61B5/0488

CPC classification number: A61B5/4836 ,  A61B5/0022 ,  A61B5/0031 ,  A61B5/031 ,  A61B5/0488 ,  A61B5/1038 ,  A61B5/112 ,  A61B5/1123 ,  A61B5/4082 ,  A61B5/4094 ,  A61B5/7246 ,  A61B5/7275 ,  A61B5/7282 ,  A61B5/7405 ,  A61B5/742 ,  A61B5/7455 ,  A61B2562/0219 ,  A61M5/1723 ,  A61N1/36003 ,  A61N1/36067 ,  A61N1/36082 ,  A61N1/3615 ,  G06F19/00

Abstract: A medical device delivers a therapy to a patient. The medical device or another device may periodically determine an activity level or gait parameter of the patient, and associate each determined level or parameter with a current therapy parameter set. A value of at least one activity metric is determined for each of a plurality of therapy parameter sets based on the activity levels or parameters associated with that therapy parameter set. Whether the patient is currently experiencing or anticipated to experience gait freeze caused by their neurological disorder, such as Parkinson's disease, may also be determined. Gait freeze events may be associated with current therapy parameters and used to determine activity metric values. In some examples, the activity metric associated with certain therapy parameters may be presented to a user.

Abstract translation: 医疗设备向患者传递治疗。 医疗装置或另一装置可以周期性地确定患者的活动水平或步态参数，并将每个确定的水平或参数与当前治疗参数组相关联。 基于与该治疗参数组相关联的活动水平或参数，确定多个治疗参数组中的每一个的至少一个活动度量的值。 患者目前是否经历或预期会经历由神经障碍引起的步态冻结，如帕金森病，也可能被确定。 步态冻结事件可能与当前治疗参数相关联，并用于确定活动度量值。 在一些示例中，可以向用户呈现与某些治疗参数相关联的活动度量。

公开(公告)号：US09433783B2

公开(公告)日：2016-09-06

申请号：US14880066

申请日：2015-10-09

Applicant: Medtronic, Inc.

Inventor： Xuan K. Wei ,  Eric H. Bonde ,  Keith A. Miesel ,  Mark S. Lent ,  Gregory F. Molnar

IPC: A61N1/00 ,  A61N1/36 ,  A61N1/05 ,  A61N1/372

CPC classification number: A61N1/36007 ,  A61N1/0514 ,  A61N1/0551 ,  A61N1/36128 ,  A61N1/36135 ,  A61N1/37235 ,  A61N1/37252

Abstract: Techniques for managing urinary or fecal incontinence include delivering a first type of therapy to generate a first physiological response and, upon detecting a trigger event, delivering a second type of therapy to generate a second physiological response. The first type of therapy can be delivered on a substantially regular basis, while the second type of therapy is delivered as needed to provide an additional boost of therapy. The trigger event for activating the delivery of the second type of therapy may include input from a sensor that indicates a bladder condition, patient activity level or patient posture, or patient input. In some examples, the therapy is stimulation therapy.

公开(公告)号：US09381039B2

公开(公告)日：2016-07-05

申请号：US13840718

申请日：2013-03-15

Applicant: Medtronic, Inc.

Inventor： Keith A. Miesel ,  Scott A. Sarkinen ,  Emem D. Akpan ,  Douglas E. Hentges ,  Mark E. Dunlap ,  Darrin Schauble ,  Cindy Konen ,  Mark R. Bilitz

IPC: A61B17/34 ,  A61M39/02

CPC classification number: A61B17/3417 ,  A61M5/329 ,  A61M5/46 ,  A61M39/0208 ,  A61M2039/0226 ,  A61M2039/0244

Abstract: Transdermal insertion of a transcutaneous filling apparatus, for the purpose of filling a fill chamber of an implanted therapy delivery device, is monitored by measuring each impedance between pairs of electrodes of a needle of the apparatus, and comparing each to a threshold impedance; the electrodes, preferably at least three in number, are isolated and spaced apart from one another along a length of the needle. A confirmation signal is generated when at least one of the measured impedances is greater than the threshold impedance, and another is less than the threshold, the condition indicating that one of the electrodes is located within a non-conductive septum, through which the apparatus must pass to access the fill chamber. A detection circuit, which may be located in a housing of the apparatus that is attached to a proximal end of the needle, measures and compares the impedances.

Abstract translation: 通过测量装置针的电极对之间的每个阻抗，并将每个阻抗与阈值阻抗进行比较来监测用于填充植入的治疗输送装置的填充室的经皮填充装置的经皮插入。 优选地，至少三个数量的电极沿着针的长度被隔离并彼此间隔开。 当所测量的阻抗中的至少一个大于阈值阻抗，另一个小于阈值时，产生确认信号，该条件指示电极中的一个位于非导电隔膜内，该装置必须通过该阻塞 通过进入填充室。 可以位于装置的外壳中的检测电路，其连接到针的近端，测量并比较阻抗。