公开(公告)号：US07792572B1

公开(公告)日：2010-09-07

申请号：US11130858

申请日：2005-05-16

申请人： Jong Gill ,  Peter Boileau ,  Gene A. Bornzin ,  Joseph J. Florio ,  Mohssen Fard

发明人： Jong Gill ,  Peter Boileau ,  Gene A. Bornzin ,  Joseph J. Florio ,  Mohssen Fard

IPC分类号： A61B5/0452

CPC分类号： A61B5/0452 ,  A61B5/7203 ,  A61B5/7264 ,  Y10S128/92

摘要： An implanted cardiac rhythm management device is disclosed that is operative to detect myocardial ischemia. This is done by evaluating electrogram features to detect an electrocardiographic change; specifically, changes in electrogram segment during the early part of an ST segment. The early part of the ST segment is chosen to avoid the T-wave.

摘要翻译： 公开了可用于检测心肌缺血的植入式心律管理装置。 这通过评估电描记图特征来检测心电图变化来完成; 具体来说，在ST段的早期部分的电描绘片段的变化。 选择ST段的早期部分以避免T波。

公开(公告)号：US20100081952A1

公开(公告)日：2010-04-01

申请号：US12632689

申请日：2009-12-07

申请人： Jong Gill ,  Peter Boileau ,  Gene A. Bornzin ,  Joseph J. Florio ,  Xiaoyi Min

发明人： Jong Gill ,  Peter Boileau ,  Gene A. Bornzin ,  Joseph J. Florio ,  Xiaoyi Min

IPC分类号： A61B5/0402

CPC分类号： A61B5/0215 ,  A61B5/0031 ,  A61B5/042 ,  A61B5/7239 ,  A61N1/36564

摘要： Methods and systems are presented for using an ICD to detect myocardial ischemia. One such method includes sensing via an implantable cardiac-rhythm-management device (ICRMD) a signal indicative of cardiac pressure; determining via a processor associated with the ICRMD, a derivative signal that is a first derivative of the sensed signal; measuring via the processor, a maximum positive value of the derivative signal; measuring via the processor, a maximum negative value of the derivative signal; and indicating via the processor, an ischemia based on a comparison of a ratio of the maximum positive value to the maximum negative value with a predetermined value.

摘要翻译： 提出了使用ICD检测心肌缺血的方法和系统。 一种这样的方法包括通过可植入心律管理装置（ICRMD）感测指示心脏压力的信号; 通过与ICRMD相关联的处理器确定作为感测信号的一阶导数的导数信号; 通过处理器测量导数信号的最大正值; 通过处理器测量导数信号的最大负值; 并且经由处理器指示基于将最大正值与最大负值的比率与预定值进行比较的缺血。

公开(公告)号：US06731985B2

公开(公告)日：2004-05-04

申请号：US09981555

申请日：2001-10-16

申请人： John W. Poore ,  Kerry Bradley ,  Laurence S. Sloman ,  Gene A. Bornzin ,  Joseph J. Florio

发明人： John W. Poore ,  Kerry Bradley ,  Laurence S. Sloman ,  Gene A. Bornzin ,  Joseph J. Florio

IPC分类号： A61N1362

CPC分类号： A61N1/3712

摘要： An implantable cardiac stimulation device and associated method perform an automatic calibration procedure for evaluating whether automatic capture verification can be recommended. The calibration procedure calculates and displays a number of variables for use by a medical practitioner in programming automatic capture operating parameters. An average paced depolarization integral (PDI) is determined from the cardiac signals following delivery of multiple stimulation pulse below and above capture threshold such that both pure lead polarization signals and evoked response signals may be analyzed. From the paced depolarization integral data, a capture threshold, a stimulation response curve, a minimum evoked response, a maximum lead polarization, an evoked response sensitivity, an evoked response safety margin, and a polarization safety margin are determined. Based on these variables, the calibration procedure determines if automatic capture verification can be recommended. If so, the stimulation device calculates a capture detection threshold. The automatic capture verification recommendation and the estimated calibration variables are displayed.

摘要翻译： 可植入心脏刺激装置和相关方法执行自动校准程序，以评估是否可以推荐自动捕获验证。 校准程序计算并显示许多变量，供医生在编程自动捕获操作参数时使用。 平均节奏去极化积分（PDI）是在多次刺激脉冲传递后低于和高于捕获阈值的心脏信号确定的，以便可以分析纯铅极化信号和诱发响应信号。 从起搏去极化积分数据中，确定捕获阈值，刺激响应曲线，最小诱发响应，最大引线极化，诱发响应灵敏度，诱发响应安全裕度和极化安全裕度。 基于这些变量，校准过程确定是否可以推荐自动捕获验证。 如果是，则刺激装置计算捕获检测阈值。 显示自动捕获验证建议和估计的校准变量。

公开(公告)号：US06658283B1

公开(公告)日：2003-12-02

申请号：US09963207

申请日：2001-09-25

申请人： Gene A. Bornzin ,  Joseph J. Florio ,  Kerry Bradley

发明人： Gene A. Bornzin ,  Joseph J. Florio ,  Kerry Bradley

IPC分类号： A61B50402

CPC分类号： A61N1/3702 ,  A61N1/368

摘要： An implantable cardiac stimulation system and method provides an external display of a heart activity signal sensed internally by an implantable cardiac stimulation device which has the appearance of a surface EKG. The heart activity signal is sensed by the implanted device and is processed by the device or the external display to have frequency characteristics resembling that of a surface EKG. The heart activity signal to be displayed takes the form of an intracardiac electrogram signal with a low frequency roll-on of no greater than 0.4 Hz and a high frequency cutoff of no less than 20 Hz. This provides a heart activity signal for display which has the appearance and most attributes of a surface EKG.

摘要翻译： 可植入心脏刺激系统和方法提供外部显示心脏活动信号，该心脏活动信号由具有表面EKG外观的可植入心脏刺激装置内部感测。 心脏活动信号由植入装置感测，并被装置或外部显示器处理以具有类似于表面EKG的频率特性。 要显示的心脏活动信号采取心内电图信号的形式，具有不大于0.4Hz的低频滚动和不小于20Hz的高频截止。 这提供了用于显示的心脏活动信号，其具有表面EKG的外观和大多数属性。

公开(公告)号：US06512953B2

公开(公告)日：2003-01-28

申请号：US09844189

申请日：2001-04-26

申请人： Joseph J. Florio ,  Euljoon Park ,  Kerry Bradley ,  Gene A. Bornzin

发明人： Joseph J. Florio ,  Euljoon Park ,  Kerry Bradley ,  Gene A. Bornzin

IPC分类号： A61N1365

CPC分类号： A61N1/3712 ,  A61N1/3627

摘要： A system and corresponding method are provided to reliably detect capture during multi-chamber stimulation, and to further monitor the progression of congestive heart failure. The system provides a method by which intracardiac electrogram (IEGM) characteristics representing single-chamber capture and bi-ventricular capture are stored in memory and displayed. The annotation of the displayed waveforms is such that events associated with loss of capture, single-chamber capture, and bi-ventricular capture are clearly marked for ready interpretation by the physician. In a first situation, a stimulation pulse is followed by a time delay window and a subsequent depolarization complex that represents intrinsic responses of the chambers that have not been captured. In a second situation, a stimulation pulse is followed almost immediately by an evoked response that represents capture of one chamber, and a subsequent depolarization complex that represents an intrinsic response of one chamber that has not been captured. In a third situation, a stimulation pulse is almost immediately followed by an evoked response that represents simultaneous capture of two chambers.

摘要翻译： 提供了一种系统和相应的方法来可靠地检测多室刺激期间的捕获，并进一步监测充血性心力衰竭的进展。 该系统提供了一种表示单室捕获和双心室捕获的心内电图（IEGM）特征存储在存储器中并显示的方法。 显示的波形的注释使得与丢失捕获，单室捕获和双心室捕获相关联的事件被清楚地标记以供医师准备解释。 在第一种情况下，刺激脉冲之后是时间延迟窗口和随后的去极化复合体，其表示未被捕获的室的内在响应。 在第二种情况下，刺激脉冲几乎立即被跟随表示一个腔室的捕获的诱发反应，以及后续的去极化复合体，其表示一个未被捕获的腔室的固有响应。 在第三种情况下，刺激脉冲几乎紧随其后，表示同时捕获两个腔室的诱发反应。

公开(公告)号：US5991661A

公开(公告)日：1999-11-23

申请号：US954326

申请日：1997-10-17

申请人： Euljoon Park ,  Gene A. Bornzin ,  Joseph J. Florio ,  Kerry Bradley

发明人： Euljoon Park ,  Gene A. Bornzin ,  Joseph J. Florio ,  Kerry Bradley

IPC分类号： A61N1/365

CPC分类号： A61N1/36542

摘要： An implantable cardiac stimulation device, such as a pacemaker or an implantable cardioverter-defibrillator, that includes an accelerometer-based activity sensor that processes one or more signals from the activity sensor to obtain parameters that are indicative of the heartbeat of the patient. The implantable cardiac stimulation device determines when the patient is at rest and the activity sensor provides a signal that corresponds to the acceleration of the sensor due to the heartbeat of the patient. This acceleration signal is integrated over time once to provide a contractility parameter, which is indicative of the contractility of the heart and is integrated over time twice to provide a displacement parameter, which is indicative of the displacement of the heart wall during the heartbeat. This displacement parameter is thereby indicative of the volume of blood pumped by the heart. A microprocessor uses either the contractility parameter, the displacement parameter or both to modify the delivery of therapeutic stimulation pulses to the heart.

摘要翻译： 可植入心脏刺激装置，例如起搏器或植入式心律转复除颤器，其包括基于加速度计的活动传感器，其处理来自活动传感器的一个或多个信号以获得指示患者心跳的参数。 可植入心脏刺激装置确定患者何时休息，并且活动传感器提供对应于由于患者心跳引起的传感器的加速度的信号。 该加速度信号随着时间一度被积分以提供收缩性参数，其表示心脏的收缩性并且随时间积分两次以提供位移参数，其指示在心跳期间心脏壁的位移。 因此，该位移参数指示由心脏泵送的血液的体积。 微处理器使用收缩性参数，位移参数或两者来修改对心脏的治疗刺激脉冲的递送。

公开(公告)号：US08265739B1

公开(公告)日：2012-09-11

申请号：US12016166

申请日：2008-01-17

申请人： Peter Boileau ,  Xiaoyi Min ,  Jong Gill ,  Rupinder Bharmi ,  Joseph J. Florio ,  Michael E. Benser ,  Gene A. Bornzin

发明人： Peter Boileau ,  Xiaoyi Min ,  Jong Gill ,  Rupinder Bharmi ,  Joseph J. Florio ,  Michael E. Benser ,  Gene A. Bornzin

IPC分类号： A61B5/0402 ,  A61B5/0428 ,  A61B5/0452

CPC分类号： A61B5/0452 ,  A61B5/0428 ,  A61B5/0468 ,  A61B5/0472 ,  A61B5/14532 ,  A61B5/7282

摘要： Techniques are provided for use in a pacemaker or implantable cardioverter/defibrillator (ICD) for distinguishing cardiac ischemia from other conditions affecting the morphology of electrical cardiac signals sensed within a patient, such as hypoglycemia, hyperglycemia or other systemic conditions. In one example, the device detects changes in morphological features of cardiac signals indicative of possible cardiac ischemia within the patient, such as changes in ST segment elevation within an intracardiac electrogram (IEGM). The device determines whether the changes in the morphological features are the result of spatially localized changes within a portion of the heart and then distinguishes cardiac ischemia from other conditions affecting the morphology of electrical cardiac signals based on that determination. In another example, the device exploits the interval between the peak of a T-wave (Tmax) and the end of the T-wave (Tend). A significant increase in the Tend−Tmax interval is indicative of ischemia rather than a systemic condition.

摘要翻译： 提供了用于起搏器或植入式心律转复除颤器（ICD）的技术，用于区分心脏缺血与影响患者体内感测的电心电信号形态的其他状况，如低血糖，高血糖或其他系统性疾病。 在一个示例中，该装置检测指示患者可能的心脏缺血的心脏信号的形态学特征的变化，例如心内电描记图（IEGM）内ST段抬高的变化。 该装置确定形态特征的变化是否是心脏部分内的空间局部变化的结果，然后基于该确定将心脏缺血与影响电心电信号形态的其它状况区分开。 在另一个例子中，器件利用了T波峰值（Tmax）和T波（Tend）结束之间的间隔。 Tend-Tmax间期的显着增加指示缺血而不是全身状况。

公开(公告)号：US20120197149A1

公开(公告)日：2012-08-02

申请号：US13444733

申请日：2012-04-11

申请人： Jong Gill ,  Peter Boileau ,  Rupinder Bharmi ,  Xiaoyi Min ,  Joseph J. Florio ,  Michael E. Benser ,  Gene A. Bornzin

发明人： Jong Gill ,  Peter Boileau ,  Rupinder Bharmi ,  Xiaoyi Min ,  Joseph J. Florio ,  Michael E. Benser ,  Gene A. Bornzin

IPC分类号： A61B5/0468 ,  A61B5/0452

CPC分类号： A61N1/3962 ,  A61B5/0452 ,  A61B5/0468 ,  A61B5/14532 ,  A61N1/3621 ,  A61N1/3627 ,  A61N1/36557 ,  A61N1/3925

摘要： Techniques are described for detecting ischemia, hypoglycemia or hyperglycemia based on intracardiac electrogram (IEGM) signals. Ischemia is detected based on a shortening of the interval between the QRS complex and the end of a T-wave (QTmax), alone or in combination with a change in ST segment elevation. Alternatively, ischemia is detected based on a change in ST segment elevation combined with minimal change in the interval between the QRS complex and the end of the T-wave (QTend). Hypoglycemia is detected based on a change in ST segment elevation along with a lengthening of either QTmax or QTend. Hyperglycemia is detected based on a change in ST segment elevation along with minimal change in QTmax and in QTend. By exploiting QTmax and QTend in combination with ST segment elevation, changes in ST segment elevation caused by hypo/hyperglycemia can be properly distinguished from changes caused by ischemia.

摘要翻译： 描述了基于心内电描记图（IEGM）信号检测缺血，低血糖或高血糖的技术。 基于QRS复合体与T波结束（QTmax）之间的间隔的缩短单独或与ST段抬高的变化相结合来检测局部缺血。 或者，基于ST段抬高的变化结合QRS复合体与T波结束（QTend）之间的间隔的最小变化来检测局部缺血。 基于ST段抬高的变化以及QTmax或QTend的延长来检测低血糖。 基于ST段抬高的变化以及QTmax和QTend中的最小变化来检测高血糖。 通过利用QTmax和QTend与ST段抬高相结合，可以将由低/高血糖引起的ST段抬高的变化与缺血引起的变化进行适当区分。

公开(公告)号：US08162842B2

公开(公告)日：2012-04-24

申请号：US12632689

申请日：2009-12-07

申请人： Jong Gill ,  Peter Boileau ,  Gene A. Bornzin ,  Joseph J. Florio ,  Xiaoyi Min

发明人： Jong Gill ,  Peter Boileau ,  Gene A. Bornzin ,  Joseph J. Florio ,  Xiaoyi Min

IPC分类号： A61B5/04

CPC分类号： A61B5/0215 ,  A61B5/0031 ,  A61B5/042 ,  A61B5/7239 ,  A61N1/36564

摘要： Methods and systems are presented for using an ICD to detect myocardial ischemia. One such method includes sensing via an implantable cardiac-rhythm-management device (ICRMD) a signal indicative of cardiac pressure; determining via a processor associated with the ICRMD, a derivative signal that is a first derivative of the sensed signal; measuring via the processor, a maximum positive value of the derivative signal; measuring via the processor, a maximum negative value of the derivative signal; and indicating via the processor, an ischemia based on a comparison of a ratio of the maximum positive value to the maximum negative value with a predetermined value.

摘要翻译： 提出了使用ICD检测心肌缺血的方法和系统。 一种这样的方法包括通过可植入心律管理装置（ICRMD）感测指示心脏压力的信号; 通过与ICRMD相关联的处理器确定作为感测信号的一阶导数的导数信号; 通过处理器测量导数信号的最大正值; 通过处理器测量导数信号的最大负值; 并且经由处理器指示基于将最大正值与最大负值的比率与预定值进行比较的缺血。

公开(公告)号：US20090177104A1

公开(公告)日：2009-07-09

申请号：US12360822

申请日：2009-01-27

申请人： Jong Gill ,  Peter Boileau ,  Rupinder Bharmi ,  Xiaoyi Min ,  Joseph J. Florio ,  Michael E. Benser ,  Gene A. Bornzin

发明人： Jong Gill ,  Peter Boileau ,  Rupinder Bharmi ,  Xiaoyi Min ,  Joseph J. Florio ,  Michael E. Benser ,  Gene A. Bornzin

IPC分类号： A61B5/0472

CPC分类号： A61N1/3962 ,  A61B5/0452 ,  A61B5/0468 ,  A61B5/14532 ,  A61N1/3621 ,  A61N1/3627 ,  A61N1/36557 ,  A61N1/3925

摘要： Techniques are described for detecting ischemia, hypoglycemia or hyperglycemia based on intracardiac electrogram (IEGM) signals. Ischemia is detected based on a shortening of the interval between the QRS complex and the end of a T-wave (QTmax), alone or in combination with a change in ST segment elevation. Alternatively, ischemia is detected based on a change in ST segment elevation combined with minimal change in the interval between the QRS complex and the end of the T-wave (QTend). Hypoglycemia is detected based on a change in ST segment elevation along with a lengthening of either QTmax or QTend. Hyperglycemia is detected based on a change in ST segment elevation along with minimal change in QTmax and in QTend. By exploiting QTmax and QTend in combination with ST segment elevation, changes in ST segment elevation caused by hypo/hyperglycemia can be properly distinguished from changes caused by ischemia.

摘要翻译： 描述了基于心内电描记图（IEGM）信号检测缺血，低血糖或高血糖的技术。 基于QRS复合体与T波结束（QTmax）之间的间隔的缩短单独或与ST段抬高的变化相结合来检测局部缺血。 或者，基于ST段抬高的变化结合QRS复合体与T波结束（QTend）之间的间隔的最小变化来检测局部缺血。 基于ST段抬高的变化以及QTmax或QTend的延长来检测低血糖。 基于ST段抬高的变化以及QTmax和QTend中的最小变化来检测高血糖。 通过利用QTmax和QTend与ST段抬高相结合，可以将由低/高血糖引起的ST段抬高的变化与缺血引起的变化进行适当区分。