公开(公告)号：US20110270107A1

公开(公告)日：2011-11-03

申请号：US12768835

申请日：2010-04-28

申请人： Xusheng Zhang ,  Robert W. Stadler ,  Jeffrey M. Gillberg

发明人： Xusheng Zhang ,  Robert W. Stadler ,  Jeffrey M. Gillberg

IPC分类号： A61B5/0464 ,  A61B5/0452

CPC分类号： A61B5/0464 ,  A61B5/04525 ,  A61B5/686 ,  A61B5/6869 ,  A61B5/7203 ,  A61N1/3621 ,  A61N1/3624 ,  A61N1/3962

摘要： A medical device and associated method for discriminating cardiac events includes determining whether a first match score is within a first match zone having a first correlation with a non-treatable cardiac event, a second match zone having a second correlation with the non-treatable cardiac event less than the first correlation, a third match zone having a first correlation with a treatable cardiac event, and a fourth match zone having a second correlation with the treatable cardiac event greater than the first correlation with the treatable cardiac event. In response to the first match score being within one of the first and second match zones, a determination is made whether consecutive match scores are within the first match zone and whether a break in the treatable cardiac event has occurred. Cardiac evidence is accumulated in response to determining whether a break has occurred and utilized to discriminate cardiac events.

摘要翻译： 用于鉴别心脏事件的医疗装置和相关联的方法包括确定第一匹配得分是否在与不可治疗心脏事件具有第一相关性的第一匹配区域内，与不可治疗心脏事件具有第二相关性的第二匹配区域 小于第一相关性，具有与可治疗心脏事件的第一相关性的第三匹配区，以及与可治疗心脏事件具有大于与可治疗心脏事件的第一相关性的第二相关性的第四匹配区。 响应于第一匹配分数在第一和第二匹配区域之一内，确定连续匹配分数是否在第一匹配区域内，以及是否发生了可治疗心脏事件中断。 响应于确定是否发生休息并利用心脏事件来积累心脏证据。

公开(公告)号：US08050751B2

公开(公告)日：2011-11-01

申请号：US12183950

申请日：2008-07-31

申请人： Xusheng Zhang ,  Raja N. Ghanem ,  Robert W. Stadler

发明人： Xusheng Zhang ,  Raja N. Ghanem ,  Robert W. Stadler

IPC分类号： A61B5/0464

CPC分类号： A61N1/3621 ,  A61B5/0464 ,  A61B5/7221 ,  A61B5/7239 ,  A61N1/36507 ,  A61N1/3925 ,  A61N1/3962

摘要： Techniques for determining whether artifacts are present in a cardiac electrogram are described. According to one example, a medical device senses a cardiac electrogram via electrodes. The medical device determines a derivative, e.g., a second order derivative, the electrogram. The medical device detects beats within the derivative, e.g., by comparing a rectified version of the derivative to one or more thresholds determined based on a maximum of the rectified derivative. The medical device determines whether the beats are periodic, and determines whether artifacts are present in the cardiac electrogram based on the determination of whether the beats are periodic. The medical device may further determine whether tachyarrhythmia is present and/or whether the cardiac rhythm of the patient is treatable based on the determination of whether the beats are periodic. For example, the medical device may determine that an electrogram is not treatable when the beats are periodic.

摘要翻译： 描述了用于确定伪像是否存在于心电图中的技术。 根据一个示例，医疗装置通过电极感测心电图。 医疗设备确定导数，例如二阶导数，电描记图。 医疗设备检测导数内的跳动，例如通过将导数的整流版本与基于校正导数的最大值确定的一个或多个阈值进行比较。 医疗器械确定节拍是否是周期性的，并且基于确定节拍是否是周期性的确定来确定心脏电图中是否存在假象。 医疗装置可以基于是否是周期性的确定来进一步确定是否存在快速性心律失常和/或患者的心律是否可治疗。 例如，当节拍是周期性的时，医疗装置可以确定电描记图是不可治疗的。

公开(公告)号：US07991471B2

公开(公告)日：2011-08-02

申请号：US11461269

申请日：2006-07-31

申请人： Raja N. Ghanem ,  Robert W. Stadler ,  Xusheng Zhang

发明人： Raja N. Ghanem ,  Robert W. Stadler ,  Xusheng Zhang

IPC分类号： A61N1/368

CPC分类号： A61N1/3956 ,  A61B5/046 ,  A61B5/0464 ,  A61B5/7239 ,  A61N1/3621

摘要： A method and apparatus for detecting a cardiac event in a medical device that includes sensing cardiac signals from a plurality of electrodes forming a first sensing vector and a second sensing vector, advancing from a first state to a second state in response to processing of an interval associated with a cardiac cycle of the sensed cardiac signals, and advancing from the second state in response to processing of a cardiac signal sensed during a predetermined sensing window.

摘要翻译： 一种用于检测医疗设备中的心脏事件的方法和装置，包括：感测来自形成第一感测向量的多个电极的心脏信号和响应于间隔的处理从第一状态进入第二状态的第二感测向量 与感测的心脏信号的心动周期相关联，并且响应于在预定感测窗口期间感测的心脏信号的处理而从第二状态前进。

公开(公告)号：US20100331903A1

公开(公告)日：2010-12-30

申请号：US12495204

申请日：2009-06-30

申请人： Xusheng Zhang ,  David A. Anderson ,  Jeffrey M. Huston ,  Jeffrey M. Gillberg

发明人： Xusheng Zhang ,  David A. Anderson ,  Jeffrey M. Huston ,  Jeffrey M. Gillberg

IPC分类号： A61N1/39 ,  A61B5/02

CPC分类号： A61N1/3621 ,  A61N1/3624 ,  A61N1/36528 ,  A61N1/36535

摘要： Techniques for detecting heart sounds to reduce inappropriate tachyarrhythmia therapy are described. In some examples, a medical device determines that a cardiac rhythm of the patient is treatable with a therapy, such as a defibrillation pulse, based on a cardiac electrogram (EGM). The medical device analyzes detected heart sounds, and withholds or allows the therapy based on the analysis of the heart sounds.

摘要翻译： 描述了用于检测心音以减少不适当的快速性心律失常治疗的技术。 在一些示例中，医疗装置通过基于心电图（EGM）的治疗，例如除颤脉冲来确定患者的心律是可治疗的。 医疗器械分析检测到的心脏声音，并根据对心脏声音的分析，保留或允许进行治疗。

公开(公告)号：US07734333B2

公开(公告)日：2010-06-08

申请号：US11380815

申请日：2006-04-28

申请人： Raja N. Ghanem ,  Robert W. Stadler ,  Xusheng Zhang

发明人： Raja N. Ghanem ,  Robert W. Stadler ,  Xusheng Zhang

IPC分类号： A61B5/04

CPC分类号： A61N1/3987 ,  A61B5/04011 ,  A61B5/0422 ,  A61B5/0456 ,  A61B5/046 ,  A61B5/0464 ,  A61B5/0468 ,  A61B5/4836 ,  A61B5/686 ,  A61B5/7203 ,  A61B5/7221 ,  A61B5/7239 ,  A61N1/05 ,  A61N1/3621 ,  A61N1/3925 ,  A61N1/3956 ,  Y10S128/901 ,  Y10S128/902

摘要： A method of detecting a cardiac event in a medical device that includes sensing a cardiac signal from a plurality of electrodes, determining amplitudes of the sensed cardiac signal during a predetermined sensing window, determining a noise to signal ratio corresponding to the determined amplitudes, and determining the sensed cardiac signal during the predetermined sensing window is corrupted by noise in response to the determined noise to signal ratio being greater than a noise to signal ratio threshold.

摘要翻译： 一种检测医疗装置中的心脏事件的方法，包括感测来自多个电极的心脏信号，确定在预定感测窗口期间检测到的心脏信号的幅度，确定对应于所确定的幅度的噪声信号比，以及确定 响应于所确定的噪声信号比大于噪声信号比阈值，在预定感测窗口期间感测到的心脏信号被噪声破坏。

公开(公告)号：US20080275518A1

公开(公告)日：2008-11-06

申请号：US11742616

申请日：2007-05-01

申请人： Raja N. Ghanem ,  Robert W. Stadler ,  Xusheng Zhang ,  Karen J. Kleckner ,  Paul G. Krause

发明人： Raja N. Ghanem ,  Robert W. Stadler ,  Xusheng Zhang ,  Karen J. Kleckner ,  Paul G. Krause

IPC分类号： A61N1/00

CPC分类号： A61N1/3704 ,  A61N1/3925

摘要： A method and apparatus for determining oversensing of cardiac signals that includes a housing containing electronic circuitry, an electrode coupled to the electronic circuitry to sense cardiac signals, and a processor, positioned within the housing, to determine an oversensing characteristic associated with the cardiac signals sensed over a predetermined sensing window, and to identify oversensing in response to the determined oversensing characteristic.

摘要翻译： 一种用于确定心脏信号过度感测的方法和装置，其包括包含电子电路的壳体，耦合到电子电路以感测心脏信号的电极以及位于壳体内的处理器，以确定与感测到的心脏信号相关联的过度感应特性 在预定的感测窗口上，并且响应于所确定的过敏特性来识别过敏。

公开(公告)号：US20080275517A1

公开(公告)日：2008-11-06

申请号：US11742628

申请日：2007-05-01

申请人： Raja N. Ghanem ,  Robert W. Stadler ,  Xusheng Zhang ,  Karen J. Kleckner ,  Paul G. Krause

发明人： Raja N. Ghanem ,  Robert W. Stadler ,  Xusheng Zhang ,  Karen J. Kleckner ,  Paul G. Krause

IPC分类号： A61N1/00

CPC分类号： A61N1/3925 ,  A61N1/3704

摘要： A method and apparatus for determining oversensing in a medical device that includes sensing cardiac signals, determining an oversensing characteristic associated with cardiac signals sensed during a predetermined sensing window, identifying oversensing in response to the oversensing characteristic, determining, in response to oversensing being identified, an adjusting characteristic associated with cardiac signals sensed during the predetermined sensing window, and updating a sensing parameter in response to the determined adjusting characteristic.

摘要翻译： 一种用于确定医疗装置中的过度感测的方法和装置，包括感测心脏信号，确定与在预定感测窗口期间感测到的心脏信号相关联的过度感应特征，响应于过敏特性识别过敏，响应于被识别的过冷而确定， 与在预定感测窗口期间感测到的心脏信号相关联的调整特性，以及响应于确定的调整特性来更新感测参数。

公开(公告)号：US20070233198A1

公开(公告)日：2007-10-04

申请号：US11554346

申请日：2006-10-30

申请人： Raja N. Ghanem ,  Robert W. Stadler ,  Xusheng Zhang

发明人： Raja N. Ghanem ,  Robert W. Stadler ,  Xusheng Zhang

IPC分类号： A61N1/00

CPC分类号： A61N1/3987 ,  A61B5/04011 ,  A61B5/0422 ,  A61B5/0456 ,  A61B5/046 ,  A61B5/0464 ,  A61B5/0468 ,  A61B5/4836 ,  A61B5/686 ,  A61B5/7203 ,  A61B5/7221 ,  A61B5/7239 ,  A61N1/05 ,  A61N1/3621 ,  A61N1/3925 ,  A61N1/3956 ,  Y10S128/901 ,  Y10S128/902

摘要： A method and apparatus for detecting a cardiac event in a medical device that includes sensing cardiac signals from a plurality of electrodes, the plurality of electrodes forming a first sensing vector and a second sensing vector, initiating charging of an energy storage device in response to the sensed cardiac signals, and determining whether a predetermined number of morphologies associated with cardiac signals sensed along the first sensing vector and the second sensing vector during corresponding sensing windows are indicative of the cardiac event.

摘要翻译： 一种用于检测医疗设备中的心脏事件的方法和装置，包括感测来自多个电极的心脏信号，所述多个电极形成第一感测向量和第二感测向量，响应于所述第一感测向量和第二感测向量开始对能量存储装置的充电 感测的心脏信号，以及确定在对应的感测窗口期间沿着第一感测向量和第二感测向量感测的与心脏信号相关联的预定数量的形态是否指示心脏事件。

公开(公告)号：US20070232948A1

公开(公告)日：2007-10-04

申请号：US11687094

申请日：2007-03-16

申请人： Robert W. Stadler ,  Raja N. Ghanem ,  Xusheng Zhang

发明人： Robert W. Stadler ,  Raja N. Ghanem ,  Xusheng Zhang

IPC分类号： A61B5/04

CPC分类号： A61N1/3987 ,  A61B5/04011 ,  A61B5/0422 ,  A61B5/0456 ,  A61B5/046 ,  A61B5/0464 ,  A61B5/0468 ,  A61B5/4836 ,  A61B5/686 ,  A61B5/7203 ,  A61B5/7221 ,  A61B5/7239 ,  A61N1/05 ,  A61N1/3621 ,  A61N1/3925 ,  A61N1/3956 ,  Y10S128/901 ,  Y10S128/902

摘要： A method and apparatus for detecting a cardiac event in a medical device that includes sensing cardiac signals from a plurality of electrodes, determining a relationship between a plurality of characteristics associated with a morphology of the cardiac signals sensed during a predetermined sensing window, generating a threshold in response to the determined relationship, comparing a first characteristic of the plurality of characteristics with the threshold, and determining whether the sensed cardiac signals are associated with the cardiac event in response to the comparing of the first characteristic.

摘要翻译： 一种用于检测医疗设备中的心脏事件的方法和装置，包括感测来自多个电极的心脏信号，确定与在预定感测窗口期间感测到的心脏信号的形态有关的多个特征之间的关系，产生阈值 响应于所确定的关系，将所述多个特征的第一特征与所述阈值进行比较，并且响应于所述第一特征的比较，确定所感测的心脏信号是否与心脏事件相关联。

公开(公告)号：US09643014B2

公开(公告)日：2017-05-09

申请号：US13296605

申请日：2011-11-15

申请人： Xusheng Zhang ,  Jeffrey M. Gillberg ,  Thomas J. Mullen

发明人： Xusheng Zhang ,  Jeffrey M. Gillberg ,  Thomas J. Mullen

IPC分类号： A61N1/365 ,  A61N1/37 ,  A61N1/372 ,  A61N1/362 ,  A61N1/368

CPC分类号： A61N1/3627 ,  A61N1/36578 ,  A61N1/3682 ,  A61N1/3684 ,  A61N1/3686 ,  A61N1/3702 ,  A61N1/37247 ,  A61N1/37264

摘要： A medical device system and associated method predict a patient response to a cardiac therapy. The system includes for delivering cardiac pacing pulses to a patient's heart coupled to a cardiac sensing module and a cardiac pacing module for generating cardiac pacing pulses and controlling delivery of the pacing pulses at multiple pace parameter settings. An acoustical sensor obtains heart sound signals. A processor is enabled to receive the heart sound signals, derive a plurality of heart sound signal parameters from the heart sound signals, and determine a trend of each of the plurality of heart sound signal parameters with respect to the plurality of pace parameter settings. An external display is configured to present the trend of at least one heart sound parameter with respect to the plurality of pace parameter settings.