公开(公告)号：US11413470B2

公开(公告)日：2022-08-16

申请号：US16714921

申请日：2019-12-16

Applicant: Medtronic, Inc.

Inventor： Xusheng Zhang ,  Jian L. Cao ,  Saul E. Greenhut ,  Robert W. Stadler

IPC: A61N1/39 ,  A61B5/352 ,  A61B5/00 ,  A61B5/283 ,  A61B5/363

Abstract: An extra-cardiovascular implantable cardioverter defibrillator senses R-waves from a first cardiac electrical signal by a first sensing channel and stores a time segment of a second cardiac electrical signal in response to each sensed R-wave. The ICD determines intervals between successively sensed R-waves and, in response to at least a predetermined number of the intervals being less than a tachyarrhythmia detection interval, analyzes at least a portion of the time segment of the second cardiac electrical signal corresponding to a most recent one of the sensed R-waves to confirm the most recent one of the R-waves. The ICD updates an unconfirmed beat count in response to the most recent one of the R-waves not being confirmed and withholds detection of a tachyarrhythmia episode in response to the unconfirmed beat count being equal to or greater than a rejection threshold.

公开(公告)号：US20210251551A1

公开(公告)日：2021-08-19

申请号：US17172770

申请日：2021-02-10

Applicant: Medtronic, Inc.

Inventor： Xusheng Zhang ,  Saul E. Greenhut ,  Yuanzhen Liu

IPC: A61B5/363 ,  A61B5/00 ,  A61B5/29

Abstract: A medical device is configured to sense an electrical signal and determine that signal to noise criteria are met based on electrical signal segments stored in response to sensed electrophysiological events. The medical device is configured to determine an increased gain signal segment from one of the stored electrical signal segments in response to determining that the signal to noise criteria are met. The medical device determines a noise metric from the increased gain signal segment. The stored electrical signal segment associated with the increased gain signal segment may be classified as a noise segment in response to the noise metric meeting noise detection criteria.

公开(公告)号：US10765870B2

公开(公告)日：2020-09-08

申请号：US16196320

申请日：2018-11-20

Applicant: Medtronic, Inc.

Inventor： Saul E. Greenhut ,  Michael T. Hemming

IPC: A61N1/00 ,  A61N1/37 ,  A61N1/39 ,  A61B5/0452 ,  A61N1/362 ,  A61B5/00 ,  A61B5/042 ,  A61B5/0464 ,  G06K9/00 ,  A61B5/021 ,  A61B5/0408 ,  A61B5/0456 ,  A61B5/11

Abstract: A medical device is configured to deliver a high-energy electrical stimulation pulse to a patient that produces a post-stimulation polarization signal. A cardiac signal analyzer of the medical device is configured to detect a cardiac electrical signal superimposed on the post-stimulation polarization signal, determine at least one feature of the detected cardiac electrical signal, compare the feature to criteria that differentiate an intrinsic cardiac event during the post-stimulation polarization signal from an evoked response signal and identify the detected cardiac electrical signal as the intrinsic cardiac event if the feature meets the criteria.

公开(公告)号：US10507332B2

公开(公告)日：2019-12-17

申请号：US15964182

申请日：2018-04-27

Applicant: Medtronic, Inc.

Inventor： Xusheng Zhang ,  Jian Cao ,  Saul E. Greenhut ,  Robert W. Stadler

IPC: A61N1/39 ,  A61B5/0456 ,  A61B5/042 ,  A61B5/0464 ,  A61B5/00

Abstract: An extra-cardiovascular implantable cardioverter defibrillator senses R-waves from a first cardiac electrical signal by a first sensing channel and stores a time segment of a second cardiac electrical signal in response to each sensed R-wave. The ICD determines intervals between successively sensed R-waves and, in response to at least a predetermined number of the intervals being less than a tachyarrhythmia detection interval, analyzes at least a portion of the time segment of the second cardiac electrical signal corresponding to a most recent one of the sensed R-waves to confirm the most recent one of the R-waves. The ICD updates an unconfirmed beat count in response to the most recent one of the R-waves not being confirmed and withholds detection of a tachyarrhythmia episode in response to the unconfirmed beat count being equal to or greater than a rejection threshold.

公开(公告)号：US20190350467A1

公开(公告)日：2019-11-21

申请号：US16524360

申请日：2019-07-29

Applicant: Medtronic, Inc.

Inventor： Saul E. Greenhut

IPC: A61B5/0215 ,  A61N1/365 ,  A61M5/172 ,  A61N1/08 ,  A61B5/021 ,  A61B5/00

Abstract: A method and apparatus for monitoring a cardiovascular pressure signal in a medical device that includes determining whether the sensed pressure signal is greater than a first pressure threshold, determining a first metric of the pressure signal in response to the sensed pressure signal being greater than the first pressure threshold, determining whether the sensed pressure signal is greater than a second pressure threshold not equal to the first pressure threshold, determining a second metric of the pressure signal in response to the sensed pressure signal being greater than the first pressure threshold, and determining at least one of a systolic pressure or a diastolic pressure, wherein the at least one of a systolic pressure or a diastolic pressure is determined based on the first metric in response to the pressure signal not being greater than the second threshold, and based on the second metric in response to the pressure signal being greater than the second threshold.

公开(公告)号：US20180289964A1

公开(公告)日：2018-10-11

申请号：US16005943

申请日：2018-06-12

Applicant: Medtronic, Inc.

Inventor： Subham Ghosh ,  Juan Du ,  Saul E. Greenhut ,  Michael T. Hemming

IPC: A61N1/368 ,  A61B5/00 ,  A61B5/0452 ,  A61B5/042

Abstract: A medical device and medical device system for controlling delivery of therapeutic stimulation pulses that includes a sensing device to sense a cardiac signal and emit a trigger signal in response to the sensed cardiac signal, a therapy delivery device to receive the trigger signal and deliver therapy to the patient in response to the emitted trigger signal, and a processor positioned within the sensing device, the processor configured to determine whether the sensed cardiac signal exceeds a possible P-wave threshold, compare a portion of the sensed cardiac signal to a P-wave template having a sensing window having a length less than a width of the P-wave, confirm an occurrence of a P-wave signal in response to the comparing, emit the trigger signal in response to the occurrence of a P-wave signal being confirmed, and inhibit delivery of the emitting signal in response to the occurrence of a P-wave signal not being confirmed.

公开(公告)号：US09566012B2

公开(公告)日：2017-02-14

申请号：US14524090

申请日：2014-10-27

Applicant: Medtronic, Inc.

Inventor： Saul E. Greenhut ,  Xusheng Zhang ,  Robert W. Stadler

IPC: A61B5/04 ,  A61N1/39 ,  A61B5/042 ,  A61B5/0456 ,  A61B5/0452 ,  A61B5/0472 ,  A61B5/00 ,  A61B5/0205 ,  A61N1/37 ,  A61B5/0245

CPC classification number: A61B5/04011 ,  A61B5/0205 ,  A61B5/0245 ,  A61B5/04012 ,  A61B5/0422 ,  A61B5/0452 ,  A61B5/04525 ,  A61B5/0456 ,  A61B5/0472 ,  A61B5/4836 ,  A61B5/7275 ,  A61B5/7282 ,  A61N1/3702 ,  A61N1/3925 ,  A61N1/3956 ,  A61N1/3962 ,  A61N1/3987

Abstract: A medical device is configured to receive at least two physical cardiac electrical signals from a patient's heart via electrodes defining at least two physical sensing vectors. The medical device determines a signal feature for each of a plurality of virtual sensing vectors extending at a plurality of angles relative to one of the at least two physical sensing vectors during a known cardiac rhythm, compares the determined signal features and establishes criteria for confirming a suspected condition in response to the comparing.

Abstract translation: 医疗设备被配置为经由定义至少两个物理感测向量的电极从患者的心脏接收至少两个物理心脏电信号。 医疗设备确定在已知心律期间相对于所述至少两个物理感测向量之一以多个角度延伸的多个虚拟感测向量中的每一个的信号特征，比较确定的信号特征并建立用于确认 怀疑病情反应比较。

公开(公告)号：US09492677B2

公开(公告)日：2016-11-15

申请号：US14789008

申请日：2015-07-01

Applicant: Medtronic, Inc.

Inventor： Saul E. Greenhut ,  Robert J. Nehls ,  Walter H. Olson ,  Xusheng Zhang ,  Wade M. Demmer ,  Troy E. Jackson ,  James D. Reinke

IPC: A61N1/00 ,  A61N1/39 ,  A61N1/372 ,  A61N1/375 ,  A61N1/362 ,  A61N1/05 ,  A61N1/365

CPC classification number: A61N1/3962 ,  A61N1/056 ,  A61N1/3621 ,  A61N1/36585 ,  A61N1/37288 ,  A61N1/3756 ,  A61N1/3987

Abstract: Techniques and systems for monitoring cardiac arrhythmias and delivering electrical stimulation therapy using a subcutaneous implantable cardioverter defibrillator (SICD) and a leadless pacing device (LPD) are described. For example, the SICD may detect a tachyarrhythmia within a first electrical signal from a heart and determine, based on the tachyarrhythmia, to deliver anti-tachyarrhythmia shock therapy to the patient to treat the detected arrhythmia. The LPD may receive communication from the SICD requesting the LPD deliver anti-tachycardia pacing to the heart and determine, based on a second electrical signal from the heart sensed by the LPD, whether to deliver anti-tachycardia pacing (ATP) to the heart. In this manner, the SICD and LPD may communicate to coordinate ATP and/or cardioversion/defibrillation therapy. In another example, the LPD may be configured to deliver post-shock pacing after detecting delivery of anti-tachyarrhythmia shock therapy.

公开(公告)号：US09486637B2

公开(公告)日：2016-11-08

申请号：US14339833

申请日：2014-07-24

Applicant: Medtronic, Inc.

Inventor： Saul E. Greenhut ,  Robert W. Stadler ,  Xusheng Zhang

IPC: A61B5/04 ,  A61N1/39 ,  A61B5/0452 ,  A61N1/362 ,  A61N1/37 ,  A61B5/0464 ,  A61B5/00

CPC classification number: A61N1/3987 ,  A61B5/04525 ,  A61B5/0464 ,  A61B5/686 ,  A61N1/3622 ,  A61N1/3624 ,  A61N1/37 ,  A61N1/3925 ,  A61N1/3962

Abstract: An implantable medical device system includes an implantable cardioverter defibrillator (ICD) for detecting and treating ventricular tachycardia (VT). The ICD includes a sensing module for sensing a cardiac signal from selected cardiac signal sensing vectors. A control module generates morphology templates of the cardiac signals for multiple patient postures for each of the available sensing vectors. A cardiac signal received during an unknown cardiac rhythm is compared to the morphology templates without determining a current posture of the patient. The unknown cardiac rhythm is detected and classified as supraventricular tachycardia in response to the cardiac signal matching at least one of the morphology templates.

Abstract translation: 可植入医疗装置系统包括用于检测和治疗室性心动过速（VT）的可植入式心律转复除颤器（ICD）。 ICD包括用于感测来自所选择的心脏信号感测向量的心脏信号的感测模块。 控制模块为每个可用的感测向量生成用于多个患者姿势的心脏信号的形态学模板。 将未知心脏节律期间接收的心脏信号与形态学模板进行比较，而不确定患者的当前姿势。 检测未知的心律并将其分类为室上性心动过速，以响应心脏信号匹配至少一个形态学模板。

公开(公告)号：US20160220825A1

公开(公告)日：2016-08-04

申请号：US15005533

申请日：2016-01-25

Applicant: Medtronic, Inc.

Inventor： Saul E. Greenhut ,  Robert T. Taepke ,  David R. Bloem ,  Yong K. Cho ,  Donna M. Salmi

IPC: A61N1/365 ,  A61N1/39 ,  A61M5/172 ,  A61B5/0215 ,  A61B5/00

CPC classification number: A61N1/36564 ,  A61B5/0031 ,  A61B5/0215 ,  A61B5/024 ,  A61B5/0422 ,  A61B5/6847 ,  A61B5/686 ,  A61B5/6869 ,  A61B5/6876 ,  A61B5/7239 ,  A61M5/14276 ,  A61M5/1723 ,  A61M2205/054 ,  A61M2210/125 ,  A61N1/37247 ,  A61N1/3962 ,  A61N1/3987

Abstract: Various techniques for measuring cardiac cycle length and pressure metrics based on pulmonary artery pressures are described. One example method described includes identifying a point within a derivative signal of a cardiovascular pressure signal without reference to electrical activity of a heart, initiating a time window from the identified point in the derivative signal, identifying a point within the cardiovascular signal within the time window, and determining at least one of a systolic pressure or diastolic pressure based on the identified point.

Abstract translation: 描述了基于肺动脉压力测量心脏周期长度和压力指标的各种技术。 所描述的一个示例性方法包括识别心血管压力信号的导数信号内的点，而不参考心脏的电活动，从导数信号中的识别点开始时间窗口，识别时间窗内的心血管信号内的点 并且基于所识别的点来确定收缩压或舒张压中的至少一个。