公开(公告)号：US07933643B1

公开(公告)日：2011-04-26

申请号：US11030380

申请日：2005-01-05

申请人： Jong Gill ,  George Walls ,  Gene A. Bornzin ,  Peter Boileau ,  Euljoon Park

发明人： Jong Gill ,  George Walls ,  Gene A. Bornzin ,  Peter Boileau ,  Euljoon Park

IPC分类号： A61B5/04

CPC分类号： A61B5/0402 ,  A61N1/3702 ,  A61N1/37235

摘要： A surface electrocardiogram (EKG) is emulated using signals detected by the internal leads of an implanted device. In one example, the emulation is performed using a technique that concatenates portions of signals sensed using different electrodes. In another example, the emulation is performed using a technique that selectively amplifies or attenuates portions of a single cardiac signal sensed using a single pair of electrodes. The surface EKG emulation may be performed by the implanted device itself or by an external device, such as a programmer, based on cardiac signals transmitted thereto. The external device then displays the emulated surface EKG along with an intracardiac electrogram (IEGM) and set of event markers. Alternatively, the external device displays an entire set of emulated EKGs that had been generated based on the same patient input data but using different emulation techniques. The emulated EKGs are displayed along with an actual surface EKG for the patient so that a physician may easily identify the optimal emulation technique for that patient.

摘要翻译： 使用由植入装置的内部引线检测的信号来模拟表面心电图（EKG）。 在一个示例中，使用连接使用不同电极感测的信号的部分的技术来执行仿真。 在另一示例中，使用选择性地放大或衰减使用单对电极感测的单个心脏信号的部分的技术来执行仿真。 表面EKG仿真可以由植入装置本身或外部设备（例如编程器）基于发送到其上的心脏信号来执行。 然后，外部设备显示仿真表面EKG以及心内电描记图（IEGM）和一组事件标记。 或者，外部设备显示已经基于相同的患者输入数据而使用不同的仿真技术生成的整套仿真EKG。 仿真的EKG与患者的实际表面EKG一起显示，使得医生可以容易地识别该患者的最佳仿真技术。

公开(公告)号：US07856266B1

公开(公告)日：2010-12-21

申请号：US11756283

申请日：2007-05-31

申请人： Gene A. Bornzin ,  Michael E. Benser ,  Euljoon Park ,  Taraneh Ghaffari Farazi

发明人： Gene A. Bornzin ,  Michael E. Benser ,  Euljoon Park ,  Taraneh Ghaffari Farazi

IPC分类号： A61N1/39

CPC分类号： A61N1/3962 ,  A61N1/3622 ,  A61N1/36521 ,  A61N1/3943

摘要： An implantable cardiac defibrillation device provides pre-shock stimuli to reduce the defibrillation threshold (DFT). The device includes an arrhythmia detector that detects fibrillation of a fibrillating chamber of a heart and a pulse generator that provides a fibrillation therapy output responsive to the arrhythmia detector detecting fibrillation of the fibrillating chamber of the heart. The therapy output includes a defibrillating shock having an output magnitude exceeding a temporary defibrillation threshold of the fibrillating chamber and at least one pre-defibrillating shock output pulse that reduces an initial defibrillation threshold of the fibrillating chamber to the temporary defibrillation threshold. An electrode system having at least two defibrillation electrodes delivers both the at least one pre-defibrillating shock output pulse to the heart and the defibrillating shock to the fibrillating chamber of the heart.

摘要翻译： 植入式心脏除颤装置提供预冲击刺激以减少除颤阈值（DFT）。 该装置包括心律失常检测器，其检测心脏的原纤化室的原纤维和脉冲发生器，其提供响应于心律失常检测器检测心脏原纤化室的纤颤的原纤维化治疗输出。 治疗输出包括具有超过原纤化室的暂时除颤阈值的输出量值的至少一个除纤颤前冲击输出脉冲，其将原纤化室的初始除颤阈值降低到临时除颤阈值。 具有至少两个除颤电极的电极系统将至少一个除颤前的冲击输出脉冲和心脏的去纤维化颤动传递给心脏的原纤维室。

公开(公告)号：US20100069778A1

公开(公告)日：2010-03-18

申请号：US12210848

申请日：2008-09-15

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

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

IPC分类号： A61B5/053

CPC分类号： A61N1/36521 ,  A61B5/0537 ,  A61B5/4869

摘要： Techniques are provided for monitoring thoracic fluid levels based on thoracic impedance (ZT) and cardiogenic impedance (ZC). In one example, the implantable device tracks the maximum time rate of change in cardiogenic impedance (i.e. max(dZC/dt)) to detect trends toward hypervolemic or hypovolemic states within the patient based on changes in heart contractility. The detection of these trends in combination with trends in thoracic impedance allows for a determination of whether the thoracic cavity of the patient is generally “too wet” or “too dry,” and thus allows for the titration of diuretics to avoid such extremes. In particular, a decrease in thoracic impedance (ZT) in combination with a decrease in max (dZC/dt) is indicative of the thorax being “too wet” (i.e. a fluid overload). Conversely, an increase in thoracic impedance (ZT) in combination with a decrease in max (dZC/dt) is indicative of the thorax being “too dry” (i.e. a fluid underload).

摘要翻译： 提供了基于胸部阻抗（ZT）和心源阻抗（ZC）监测胸水水平的技术。 在一个示例中，可植入装置跟踪心源性阻抗的最大时间变化率（即max（dZC / dt）），以基于心脏收缩力的变化来检测患者内的高血容量或低血容量状态的趋势。 这些趋势的检测结合胸部阻抗的趋势可以确定患者的胸腔通常是否“太湿”或“太干”，从而允许滴定利尿剂以避免这种极端。 特别地，胸部阻抗（ZT）的降低与最大值（dZC / dt）的降低相结合表明胸部“太湿”（即流体过载）。 相反，胸部阻抗（ZT）的增加与最大（dZC / dt）的降低相结合，表明胸部“太干”（即，流体欠载）。

公开(公告)号：US07505814B2

公开(公告)日：2009-03-17

申请号：US10810437

申请日：2004-03-26

申请人： Gene A. Bornzin ,  Euljoon Park

发明人： Gene A. Bornzin ,  Euljoon Park

IPC分类号： A61N1/08 ,  A61B5/053

CPC分类号： A61N1/36521 ,  A61B5/02028 ,  A61B5/0215 ,  A61B5/0422 ,  A61B5/0464 ,  A61B5/053 ,  A61B5/0538 ,  A61B5/4839 ,  A61B5/7207 ,  A61N1/3627

摘要： Briefly, values representative of ventricular end-diastolic volume (EDV) are detected using ventricular electrodes and then heart failure, if occurring within the patient, is evaluated based on ventricular EDV. In this manner, ventricular EDV is used as a proxy for ventricular end-diastolic pressure. By using ventricular EDV instead of ventricular end-diastolic pressure, heart failure is detected and evaluated without requiring sophisticated sensors or complex algorithms. Instead, ventricular EDV is easily and reliably measured using impedance signals sensed by implanted ventricular pacing/sensing electrodes. The severity of heart failure is also evaluated based on ventricular EDV values and heart failure progression is tracked based on changes, if any, in ventricular EDV values over time.

摘要翻译： 简而言之，使用心室电极检测代表心室舒张末期容积（EDV）的值，然后如果发生在患者体内，则基于心室EDV评估心力衰竭。 以这种方式，使用心室EDV作为心室舒张末期压力的代表。 通过使用心室EDV而不是心室舒张末期压力，可以检测和评估心力衰竭，而不需要复杂的传感器或复杂的算法。 相反，使用由植入式心室起搏/感测电极感测的阻抗信号容易且可靠地测量心室EDV。 还根据心室EDV值评估心力衰竭的严重程度，并且基于心室EDV值随时间的变化（如果有的话）跟踪心力衰竭进展。

公开(公告)号：US07283873B1

公开(公告)日：2007-10-16

申请号：US10838692

申请日：2004-05-03

申请人： Euljoon Park ,  Gene A. Bornzin

发明人： Euljoon Park ,  Gene A. Bornzin

IPC分类号： A61N1/362

CPC分类号： A61N1/3627 ,  A61N1/3682

摘要： An implantable cardiac stimulation device is configured to measure selected ventricular contraction parameters and apply stimulation therapy based on an analysis of the ventricular contraction parameters. The ventricular contraction parameters may include impedance values that correspond to the volume of fluid in the right ventricle and the left ventricle. The ventricular contraction parameters may include motion values that correspond to heart sounds/motion in the right ventricle and the left ventricle. The ventricular contraction parameters can be used to form a ventricular parameter loop associated with one or more cardiac cycles. The total area within the resulting loop should be maintained below a threshold value through the application of applicable stimulation therapy and/or further physician assistance.

摘要翻译： 可植入心脏刺激装置被配置为测量所选择的心室收缩参数并且基于对心室收缩参数的分析来应用刺激疗法。 心室收缩参数可以包括对应于右心室和左心室中的流体体积的阻抗值。 心室收缩参数可以包括对应于右心室和左心室的心音/运动的运动值。 心室收缩参数可用于形成与一个或多个心动周期相关的心室参数循环。 通过应用适用的刺激疗法和/或进一步的医师帮助，所得环路内的总面积应保持在阈值以下。

公开(公告)号：US07212861B1

公开(公告)日：2007-05-01

申请号：US10838939

申请日：2004-05-03

申请人： Euljoon Park ,  Gene A. Bornzin ,  Robert G. Turcott

发明人： Euljoon Park ,  Gene A. Bornzin ,  Robert G. Turcott

IPC分类号： A61N1/00

CPC分类号： A61N1/36585 ,  A61N1/3627

摘要： An implantable cardiac stimulation device is configured to measure selected ventricular contraction parameters and possibly apply stimulation therapy based on the ventricular contraction parameters. In accordance with one aspect, the ventricular contraction parameters include impedance values that correspond to the volume of fluid in the right ventricle and the left ventricle. In accordance with another aspect, the ventricular contraction parameters include motion values that correspond to heart sounds/motion in the right ventricle and the left ventricle. The ventricular contraction parameters can be used to form pseudo P-V loop from which treatment decisions can be made.

摘要翻译： 可植入心脏刺激装置被配置为测量所选择的心室收缩参数，并且可以基于心室收缩参数应用刺激治疗。 根据一个方面，心室收缩参数包括对应于右心室和左心室中的流体体积的阻抗值。 根据另一方面，心室收缩参数包括对应于右心室和左心室中的心音/运动的运动值。 心室收缩参数可用于形成伪P-V循环，从中可以进行治疗决定。

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：US06351672B1

公开(公告)日：2002-02-26

申请号：US09359025

申请日：1999-07-22

申请人： Euljoon Park ,  Gene A. Bornzin ,  Junyu Mai

发明人： Euljoon Park ,  Gene A. Bornzin ,  Junyu Mai

IPC分类号： A61N1365

CPC分类号： A61N1/36542

摘要： A system and method are provided for compensating for the drop in blood pressure upon standing. Upon transition from prolonged sitting, lying down, or standing position, the pacemaker abruptly increasing its pacing rate upon postural transition. The pacing rate is abruptly increased to about 80-100 bpm in 20 seconds-one minute. The pacing rate then decreases slowly to another high rate in two or three minutes and then follows the metabolically indicated rate. This pacing rate is triggered whenever a patient stands after a prolonged reclined or supine/prone position as indicated by activity variance measurements.

摘要翻译： 提供了一种用于补偿静置时血压下降的系统和方法。 从长时间的坐姿，躺下或站姿转移时，起搏器在姿势转换时突然增加起搏速度。 起搏速度在20秒内突然增加到约80-100 bpm（一分钟）。 然后起搏速度在两分钟或三分钟内缓慢下降到另一个高速率，然后遵循代谢指示的速率。 如果患者在经过长时间倾斜或仰卧/俯卧位置后站立时进行起搏速度，如活动方差测量所示。

公开(公告)号：US08306623B2

公开(公告)日：2012-11-06

申请号：US13149507

申请日：2011-05-31

申请人： Louis Wong ,  Cem Shaquer ,  Gene A. Bornzin ,  Euljoon Park ,  Andre Walker ,  Dorin Panescu ,  Jiong Xia ,  Shahrooz Shahparnia

发明人： Louis Wong ,  Cem Shaquer ,  Gene A. Bornzin ,  Euljoon Park ,  Andre Walker ,  Dorin Panescu ,  Jiong Xia ,  Shahrooz Shahparnia

IPC分类号： A61N1/18

CPC分类号： A61B5/02028 ,  A61B5/0031 ,  A61B5/029 ,  A61B5/0538 ,  A61B5/08 ,  A61B5/4878 ,  A61N1/3627 ,  A61N1/36521 ,  A61N1/3702

摘要： An implantable system acquires intracardiac impedance with an implantable lead system. In one implementation, the system generates frequency-rich, low energy, multi-phasic waveforms that provide a net-zero charge and a net-zero voltage. When applied to bodily tissues, current pulses or voltage pulses having the multi-phasic waveform provide increased specificity and sensitivity in probing tissue. The effects of the applied pulses are sensed as a corresponding waveform. The waveforms of the applied and sensed pulses can be integrated to obtain corresponding area values that represent the current and voltage across a spectrum of frequencies. These areas can be compared to obtain a reliable impedance value for the tissue. Frequency response, phase delay, and response to modulated pulse width can also be measured to determine a relative capacitance of the tissue, indicative of infarcted tissue, blood to tissue ratio, degree of edema, and other physiological parameters.

摘要翻译： 可植入系统采用可植入引线系统获得心内阻抗。 在一个实现中，该系统产生提供净零电荷和净零电压的富频率，低能量，多相波形。 当应用于身体组织时，具有多相波形的电流脉冲或电压脉冲在探测组织中提供增加的特异性和灵敏度。 所施加的脉冲的影响被感测为对应的波形。 施加和感测的脉冲的波形可以被积分，以获得表示频谱范围内的电流和电压的相应面积值。 可以比较这些区域以获得组织的可靠的阻抗值。 还可以测量频率响应，相位延迟和对调制脉冲宽度的响应，以确定组织的相对电容，指示梗死组织，血液与组织之比，水肿程度和其他生理参数。