公开(公告)号：US07149579B1

公开(公告)日：2006-12-12

申请号：US10329233

申请日：2002-12-23

申请人： Steve Koh ,  Mark W. Kroll ,  Euljoon Park ,  Gene A. Bornzin

发明人： Steve Koh ,  Mark W. Kroll ,  Euljoon Park ,  Gene A. Bornzin

IPC分类号： A61N1/00

CPC分类号： A61N1/3925 ,  A61N1/36535 ,  A61N1/36542

摘要： Time-varying spatial signals are detected by accelerometers mounted within the patient. The signals, representative of the actual 3-D trajectory of the patient, are compared with information representative of expected trajectories retrieved from memory to identify a current patient posture, which may be either a dynamic posture such as walking or running or a change in posture such as rising from a seated position to a standing position. In this manner, a change in posture of the patient is identified based upon a full 3-D trajectory, rather than merely the orientation of the patient at the beginning and the end of the change in posture. In an example described herein, the implantable device stores information representative of expected 3-D trajectories in the form of pre-calculated comparison matrices derived from orthonormal kernels employing Laguerre functions or Lagrange functions. A technique is also described for use by an external programmer for pre-calculating comparison matrices so as to reduce the processing burden within the implanted device during posture detection.

摘要翻译： 时变空间信号由安装在患者体内的加速度计检测。 将代表患者的实际3-D轨迹的信号与表示从存储器检索到的预期轨迹的信息进行比较，以识别当前患者姿势，其可以是动态姿势，例如步行或跑步或姿势变化 例如从就座位置升高到站立位置。 以这种方式，基于完整的3-D轨迹来识别患者姿势的变化，而不仅仅是患者在姿势改变的开始和结束时的取向。 在本文所描述的示例中，可植入装置以使用拉格朗日函数或拉格朗日函数的从正常内核导出的预先计算的比较矩阵的形式存储表示预期3-D轨迹的信息。 还描述了一种用于外部编程器用于预计算比较矩阵的技术，以便在姿势检测期间减少植入装置内的处理负担。

公开(公告)号：US06928324B2

公开(公告)日：2005-08-09

申请号：US10077048

申请日：2002-02-14

申请人： Euljoon Park ,  Steve Koh ,  Gene A. Bornzin

发明人： Euljoon Park ,  Steve Koh ,  Gene A. Bornzin

IPC分类号： A61N1/36 ,  A61N1/365

CPC分类号： A61N1/36585 ,  A61N1/3601 ,  A61N1/36542 ,  A61N1/36557

摘要： An implantable cardiac stimulation device comprises a metabolic demand sensor, an activity sensor, and one or more pulse generators. The metabolic demand sensor and activity sensor can sense metabolic demand and physical activity parameters, respectively. The pulse generators can generate cardiac pacing pulses with timing based on a comparison of the metabolic demand and physical activity parameters. The timed cardiac pacing pulses can prevent a sleep apnea condition.

摘要翻译： 可植入心脏刺激装置包括代谢需求传感器，活动传感器和一个或多个脉冲发生器。 代谢需求传感器和活动传感器可以分别感测代谢需求和身体活动参数。 基于代谢需求和身体活动参数的比较，脉冲发生器可以产生具有定时的心脏起搏脉冲。 定时的心脏起搏脉冲可以防止睡眠呼吸暂停状态。

公开(公告)号：US08603004B2

公开(公告)日：2013-12-10

申请号：US12835518

申请日：2010-07-13

申请人： Steve Koh ,  Stuart Rosenberg ,  Kyungmoo Ryu

发明人： Steve Koh ,  Stuart Rosenberg ,  Kyungmoo Ryu

IPC分类号： A61B5/08 ,  A61B5/05

CPC分类号： A61B5/063 ,  A61B5/113 ,  A61B5/721 ,  A61B90/36 ,  A61B2017/00053 ,  A61B2034/2048 ,  A61B2034/2051 ,  A61B2034/2053 ,  A61B2562/0219

摘要： A method of filtering respiration noise from a localization signal includes acquiring a localization signal from at least one position measurement sensor within a localization field and acquiring an acceleration signal for at least one localization field generator (e.g., a patch electrode). A displacement signal for the field generator is calculated, for example by integrating the acceleration signal twice, and transformed into the frequency domain in order to calculate a fractional power indicative of patient respiration. The fractional power can then be compared to a threshold value, and the localization signal can be filtered if the fractional power exceeds the threshold value. Alternatively, the acquired acceleration signal can be used to gate collection of data points from the localization signal.

摘要翻译： 从定位信号过滤呼吸噪声的方法包括从定位场内的至少一个位置测量传感器获取定位信号，并获取至少一个定位场发生器（例如，贴片电极）的加速度信号。 计算场发生器的位移信号，例如通过对加速度信号进行两次积分，并将其变换到频域以便计算指示患者呼吸的分数功率。 然后可以将分数功率与阈值进行比较，如果分数功率超过阈值，则可以对定位信号进行滤波。 或者，获取的加速度信号可以用于从定位信号门控收集数据点。

公开(公告)号：US08571652B2

公开(公告)日：2013-10-29

申请号：US12701816

申请日：2010-02-08

申请人： Steve Koh

发明人： Steve Koh

IPC分类号： A61N1/362

CPC分类号： A61N1/36514 ,  A61B5/0215 ,  A61B5/028 ,  A61B5/029 ,  A61B5/0295 ,  A61B5/686 ,  A61N1/36564 ,  A61N1/36571 ,  A61N1/3682

摘要： Adaptively creating a table of optimal, patient-specific atrioventricular (AV) delays for a an implantable medical device (IMD) begins as the IMD detects the patient entering a target heart rates within a defined range of elevated heart rates. On detection, the device begins testing AV delays by pacing the heart at a number of different AV delays. The IMD selects the optimal AV delay based on a comparison of measurements of cardiac output obtained during each delay's test pacing period. The optimal AV delay corresponds to the one which resulted in the highest cardiac output. The device selects this optimal AV delay and stores it in an AV delay table on the device. The process continues as the device detects the patient entering the other target heart rates in order to complete the table.

摘要翻译： 随着IMD检测到患者在确定的升高的心率范围内进入目标心率，自适应地创建用于可植入医疗装置（IMD）的最佳患者特异性房室（AV）延迟的表格。 在检测时，设备通过在许多不同的AV延迟进行心脏起搏来开始测试AV延迟。 IMD基于每个延迟的测试起搏期间获得的心输出量测量值的比较来选择最佳的AV延迟。 最佳AV延迟对应于导致心输出量最高的延迟。 该设备选择此最佳AV延迟并将其存储在设备上的AV延迟表中。 该过程继续，因为设备检测到患者进入其他目标心率以完成该表。

公开(公告)号：US20130103108A1

公开(公告)日：2013-04-25

申请号：US13277020

申请日：2011-10-19

申请人： Steve Koh ,  Gene A. Bornzin

发明人： Steve Koh ,  Gene A. Bornzin

IPC分类号： A61N1/365

CPC分类号： A61N1/3627 ,  A61N1/36542

摘要： A method of synchronizing a heart rate with an activity rate of a patient includes determining the activity rate of the patient. The method also includes synchronizing a pacing pulse with a phase of the activity rate to improve a cardiac stroke volume of the patient. The synchronizing includes lowering the heart rate during down motion associated with the activity rate and increasing the heart rate during an up motion associated with the activity rate when a stride rate is slower than a target heart rate.

摘要翻译： 将心率同步于患者的活动率的方法包括确定患者的活动率。 该方法还包括将起搏脉冲与活动率的相位同步以改善患者的心脏搏动量。 同步包括在与活动速率相关联的下降运动期间降低心率，并且当步幅率低于目标心率时，在与活动速率相关联的向上运动期间增加心率。

公开(公告)号：US08282562B2

公开(公告)日：2012-10-09

申请号：US12411262

申请日：2009-03-25

申请人： Steve Koh

发明人： Steve Koh

IPC分类号： A61B5/08 ,  A61B5/02

CPC分类号： A61B5/0537 ,  A61B5/0538 ,  A61B5/418 ,  A61B5/4878 ,  A61N1/3621 ,  A61N1/3627 ,  A61N1/36521 ,  A61N1/3962

摘要： Techniques are provided for use by a pacemaker or other implantable medical device for detecting and tracking trends in cardiopulmonary fluid transfer rates—such as heart-to-lung fluid perfusion rates and lung-to-lymphatic system fluid excretion rates—and for detecting heart failure, dyspnea or other cardiopulmonary conditions. In one example, the device periodically measures transthoracic admittance values. A first exponential time-constant (k1) is determined using curve-fitting from admittance values obtained while the patient is in a sleep posture. Time-constant k1 is representative of the fluid perfusion rate. A second exponential time-constant (k2) is determined based on admittance values obtained while the patient is standing/walking/sitting. The second exponential time-constant (k2) is representative of the fluid excretion rate from the lungs. The device then detects trends, if any, in the time-constants (or in “DC” baseline values) to detect or predict medical conditions such as an imminent heart failure exacerbation.

摘要翻译： 技术被提供供起搏器或其他可植入医疗装置用于检测和跟踪心肺流体转移速率的趋势，例如心脏 - 肺液体灌注速率和肺对淋巴系统的流体排泄速率，并用于检测心力衰竭 ，呼吸困难或其他心肺病。 在一个示例中，设备周期性地测量经胸导管值。 使用在患者处于睡眠姿势时获得的导纳值的曲线拟合来确定第一指数时间常数（k1）。 时间常数k1代表流体灌注速率。 第二指数时间常数（k2）基于患者站立/行走/坐着时获得的导纳值来确定。 第二指数时间常数（k2）代表来自肺的流体排泄率。 然后，该装置检测时间常数（或DC基线值）中的趋势（如果有的话），以检测或预测诸如即将来临的心力衰竭加重之类的医疗状况。

公开(公告)号：US20120253359A1

公开(公告)日：2012-10-04

申请号：US13076104

申请日：2011-03-30

申请人： Steve Koh ,  Gene A. Bornzin

发明人： Steve Koh ,  Gene A. Bornzin

IPC分类号： A61N1/05 ,  A61B19/00 ,  A61N1/36

CPC分类号： A61N1/37241 ,  A61N1/368

摘要： Disclosed herein is a method of optimizing the implantation of an implantable medical lead into a patient to optimize electrotherapy administered via the lead. The method includes: inserting the lead into the patient, the lead including a first electrode; providing a second electrode in the patient, wherein the second electrode is not part of the lead; generating an electrical vector between the first electrode and second electrode, the electrical vector being generated as the lead is being implanted; analyzing the electrical vector as the lead is being implanted; and optimizing the implantation of the lead based off of the analysis of the electrical vector to optimize electrotherapy administered via the lead.

摘要翻译： 本文公开了一种优化植入医疗引线到患者体内以优化通过引线施用的电疗的方法。 该方法包括：将引线插入患者体内，引线包括第一电极; 在患者中提供第二电极，其中所述第二电极不是所述引线的一部分; 在所述第一电极和所述第二电极之间产生电子矢量，所述电子矢量在所述铅被植入时产生; 在植入铅的情况下分析电子矢量; 并根据电矢量的分析优化引线的植入，以优化通过引线施加的电疗。

公开(公告)号：US20120046564A1

公开(公告)日：2012-02-23

申请号：US12861573

申请日：2010-08-23

申请人： Steve Koh ,  Michael Yang ,  Ryan Rooke ,  Stuart Rosenberg ,  Wenbo Hou

发明人： Steve Koh ,  Michael Yang ,  Ryan Rooke ,  Stuart Rosenberg ,  Wenbo Hou

IPC分类号： A61B5/0402

CPC分类号： A61B5/0422 ,  A61B5/686 ,  A61B5/7282 ,  A61B2576/023 ,  A61N1/365 ,  A61N1/3702

摘要： A system and method are provided for monitoring ischemic development. The system and method identify a non-physiologic event and obtain cardiac signals along multiple sensing vectors, wherein at least a portion of the sensing vectors extend to or from electrodes located proximate to the left ventricle. The system and method monitor a segment of interest in the cardiac signals obtained along the multiple sensing vectors to identify deviations in the segment of interest from a baseline. The system and method record at least one of timing or segment shift information associated with the deviations in the segments of interest; and identify at least one of size, direction of development or rate of progression of an ischemia region based on the at least one of timing or segment shift information.

摘要翻译： 提供了一种用于监测缺血发育的系统和方法。 系统和方法识别非生理事件并且沿着多个感测向量获得心脏信号，其中至少一部分感测向量延伸到位于靠近左心室的电极。 系统和方法监测沿着多个感测向量获得的心脏信号中的感兴趣区段，以识别感兴趣区段中的偏离基线。 系统和方法记录与感兴趣的部分中的偏差相关联的定时或分段移位信息中的至少一个; 并且基于定时或段位移信息中的至少一个来识别缺血区域的大小，发育方向或进展速度中的至少一个。

公开(公告)号：US20120016253A1

公开(公告)日：2012-01-19

申请号：US12835518

申请日：2010-07-13

申请人： Steve Koh ,  Stuart Rosenberg ,  Kyungmoo Ryu

发明人： Steve Koh ,  Stuart Rosenberg ,  Kyungmoo Ryu

IPC分类号： A61B5/08

CPC分类号： A61B5/063 ,  A61B5/113 ,  A61B5/721 ,  A61B90/36 ,  A61B2017/00053 ,  A61B2034/2048 ,  A61B2034/2051 ,  A61B2034/2053 ,  A61B2562/0219

摘要： A method of filtering respiration noise from a localization signal includes acquiring a localization signal from at least one position measurement sensor within a localization field and acquiring an acceleration signal for at least one localization field generator (e.g., a patch electrode). A displacement signal for the field generator is calculated, for example by integrating the acceleration signal twice, and transformed into the frequency domain in order to calculate a fractional power indicative of patient respiration. The fractional power can then be compared to a threshold value, and the localization signal can be filtered if the fractional power exceeds the threshold value. Alternatively, the acquired acceleration signal can be used to gate collection of data points from the localization signal.

摘要翻译： 从定位信号过滤呼吸噪声的方法包括从定位场内的至少一个位置测量传感器获取定位信号，并获取至少一个定位场发生器（例如，贴片电极）的加速度信号。 计算场发生器的位移信号，例如通过对加速度信号进行两次积分，并将其变换到频域以便计算指示患者呼吸的分数功率。 然后可以将分数功率与阈值进行比较，如果分数功率超过阈值，则可以对定位信号进行滤波。 或者，获取的加速度信号可以用于从定位信号门控收集数据点。

公开(公告)号：US20110125207A1

公开(公告)日：2011-05-26

申请号：US12649665

申请日：2009-12-30

申请人： Yelena Nabutovsky ,  Fujian Qu ,  Steve Koh ,  Dan E. Gutfinger ,  Alex Soriano

发明人： Yelena Nabutovsky ,  Fujian Qu ,  Steve Koh ,  Dan E. Gutfinger ,  Alex Soriano

IPC分类号： A61N1/39 ,  A61B5/0215

CPC分类号： A61B5/053 ,  A61B5/021 ,  A61B5/1116 ,  A61B5/4878 ,  A61B5/686 ,  A61B5/7275 ,  A61N1/3627 ,  A61N1/36521 ,  A61N1/36564 ,  A61N1/36585 ,  A61N1/3684 ,  A61N1/3702 ,  A61N1/37258 ,  A61N1/3962

摘要： In specific embodiments, a method to monitor left atrial pressure and/or intra-thoracic fluid volume of a patient, comprises (a) monitoring posture of the patient using a posture sensor implanted within the patient, and (b) using portions of an impedance signal, obtained using implanted electrodes, to monitor the left atrial pressure and/or intra-thoracic fluid volume of the patient. Each portion of the impedance signal used to monitor the left atrial pressure and/or intra-thoracic fluid volume of the patient corresponds to a period after which the patient has maintained a predetermined posture for at least a predetermined period of time, and during which the patient has remained in the predetermined posture.

摘要翻译： 在具体实施例中，监测患者的左心房压力和/或胸腔内体积的方法包括（a）使用植入患者体内的姿势传感器来监测患者的姿势，以及（b）使用部分阻抗 信号，使用植入电极获得，以监测患者的左心房压力和/或胸腔内体积。 用于监测患者的左心房压力和/或胸腔内液体体积的阻抗信号的每个部分对应于患者已经保持预定姿势至少预定时间段的时间段，在此期间 患者保持在预定的姿势。