公开(公告)号：US07440804B1

公开(公告)日：2008-10-21

申请号：US11025220

申请日：2004-12-28

申请人： Xiaoyi Min ,  Steve Koh

发明人： Xiaoyi Min ,  Steve Koh

IPC分类号： A61N1/378

CPC分类号： A61N1/3712 ,  A61N1/3622 ,  A61N1/3627

摘要： Techniques are provided for measuring ventricular evoked response within the heart of a patient during atrial fibrillation. An intrinsic ventricular depolarization (i.e. a QRS complex) is sensed within the right ventricle and then a pacing pulse is applied to the left ventricle prior to intrinsic depolarization thereof. In this manner, the left ventricle contracts solely in response to the pacing pulse and possible fusion between the pacing pulse and a conducted P-wave/A-pulse from the atria is avoided. The evoked response generated in the left ventricle is then measured by the pacemaker. The technique permits reliable detection of left ventricular evoked response, even during atrial fibrillation when atrial contractions are frequent and erratic, but the technique may also be employed during normal sinus rhythm. Features of the evoked response are analyzed to detect heart failure, evaluate its severity and track its progression. Appropriate therapy is then automatically delivered to the patient.

摘要翻译： 提供了用于在心房颤动期间测量患者心脏内心室诱发反应的技术。 在右心室内检测到内部心室去极化（即QRS复合物），然后在其内部去极化之前将起搏脉冲施加到左心室。 以这种方式，左心室仅响应于起搏脉冲而收缩，并避免起搏脉冲与从心房传导的P波/ A脉冲之间的融合。 然后由起搏器测量在左心室产生的诱发反应。 该技术允许可靠地检测左心室诱发反应，即使在心房收缩频繁且不稳定的心房颤动期间，该技术也可在正常窦性心律中使用。 分析诱发反应的特征以检测心力衰竭，评估其严重程度并跟踪其进展。 然后将适当的治疗自动递送给患者。

公开(公告)号：US20070027489A1

公开(公告)日：2007-02-01

申请号：US11192538

申请日：2005-07-28

申请人： Jong Gill ,  Xiaoyi Min

发明人： Jong Gill ,  Xiaoyi Min

IPC分类号： A61N1/00

CPC分类号： A61N1/365 ,  A61B5/0031 ,  A61B5/0215 ,  A61B5/0452 ,  A61N1/36521 ,  A61N1/36578 ,  A61N1/3682 ,  A61N1/3684

摘要： A method and device for evaluating the progression of a patient's condition, which in certain applications can include heart failure, on an ongoing manner which reduces the need for immediate attention from skilled clinicians or expensive diagnostic equipment. The method and device analyze relative timing between electrical and mechanical properties of the heart. Detection of an elongated delay between corresponding electrical and mechanical activity is interpreted as indicating a worsening heart failure condition. The analysis and data corresponding thereto can be stored for further analysis and/or telemetrically communicated to an external device. Therapy provided by the device can be altered based on the evaluation of the patient's condition.

摘要翻译： 一种用于评估患者状况进展的方法和装置，其在某些应用中可以包括心力衰竭，以持续的方式减少熟练临床医生或昂贵诊断设备立即关注的需要。 该方法和装置分析心脏的电气和机械性质之间的相对时间。 在对应的电和机械活动之间的延长延迟的检测被解释为指示恶化的心力衰竭状况。 可以存储对应于其的分析和数据用于进一步分析和/或遥测地传送到外部设备。 可以根据对患者状况的评估来改变设备提供的治疗。

公开(公告)号：US07155282B1

公开(公告)日：2006-12-26

申请号：US10719307

申请日：2003-11-21

申请人： Xiaoyi Min ,  Gene A. Bornzin ,  Jeffery D. Snell

发明人： Xiaoyi Min ,  Gene A. Bornzin ,  Jeffery D. Snell

IPC分类号： A61N1/362

CPC分类号： A61N1/3704 ,  A61B5/0452 ,  A61B5/0456

摘要： A threshold sensing control for use in an implantable cardiac stimulation device controls the sensing of cardiac activity during a current cardiac cycle of a heart while avoiding sensing a T wave. The system includes a sensing circuit that senses cardiac activity of the heart during a cardiac cycle preceding the current cardiac cycle, a detector that measures selected T wave and R wave characteristics of the cardiac activity and a control circuit that varies the sensing threshold based upon the measured selected R wave and T wave characteristics. The sensing threshold control may be implemented for both intrinsic and paced beats.

摘要翻译： 用于可植入心脏刺激装置的阈值感测控制器控制在心脏的当前心动周期期间对心脏活动的感测，同时避免感测T波。 该系统包括感测电路，该感测电路在当前心动周期之前的心动周期期间感测心脏的心脏活动，测量心脏活动的所选T波和R波特征的检测器以及基于 测量选定的R波和T波特性。 感测阈值控制可以针对内部节奏和节奏节拍实现。

公开(公告)号：US20050216067A1

公开(公告)日：2005-09-29

申请号：US11014276

申请日：2004-12-15

申请人： Xiaoyi Min ,  Gene Bornzin ,  Euljoon Park

发明人： Xiaoyi Min ,  Gene Bornzin ,  Euljoon Park

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

CPC分类号： A61N1/36521 ,  A61B5/0538 ,  A61N1/3627 ,  A61N1/371

摘要： Techniques are provided for predicting the onset of a heart condition within a patient based on impedance measurements. Briefly, overloads in fluid levels in the thorax and in ventricular myocardial mass within the patient are detected based on impedance signals sensed using implanted electrodes. The onset of certain heart conditions is then predicted based on the overloads. For example, pulmonary edema arising due to diastolic heart failure is predicted based on the detection of on-going overloads in both fluid levels and ventricular mass. Ventricular hypertrophy is detected based on an on-going ventricular mass overload without a sustained fluid overload. Various other heart conditions may also be predicted based on specific combinations of recent or on-going overloads. Evoked response is exploited to corroborate the predictions. Appropriate warning signals are generated and preemptive therapy is initiated.

摘要翻译： 提供了基于阻抗测量来预测患者心脏病状发作的技术。 简单地说，基于使用植入电极感测到的阻抗信号来检测患者胸部液位水平和心室心肌质量的过载。 然后基于过载来预测某些心脏状况的发作。 例如，由于舒张性心力衰竭引起的肺水肿基于检测流体水平和心室质量中的持续过载而被预测。 基于正在进行的心室质量超载而无持续的流体超载检测出心室肥大。 还可以基于最近或正在进行的过载的特定组合来预测各种其他心脏状况。 被诱发的反应被利用来证实预测。 产生适当的警告信号并开始抢先治疗。

公开(公告)号：US06949097B2

公开(公告)日：2005-09-27

申请号：US10414800

申请日：2003-04-16

申请人： Mark T. Stewart ,  William J. Flickinger ,  David E. Francischelli ,  Rahul Mehra ,  Xiaoyi Min

发明人： Mark T. Stewart ,  William J. Flickinger ,  David E. Francischelli ,  Rahul Mehra ,  Xiaoyi Min

IPC分类号： A61B17/00 ,  A61B18/14

CPC分类号： A61B18/1492 ,  A61B2017/00044 ,  A61B2017/00243 ,  A61B2017/00867 ,  A61B2018/00214 ,  A61B2018/1407 ,  A61B2018/1435

摘要： A catheter body of a catheter assembly includes a proximal portion, an intermediate portion extending from the proximal portion, a distal portion extending from the intermediate portion, and a locating device including a distal tip extending from the distal portion of the catheter body. The intermediate portion defines a longitudinal axis and the distal portion forms a loop including one or more loop segments formed around a central loop axis. The central loop axis is substantially parallel with the longitudinal axis and the one or more loop segments include at least one ablation electrode coupled thereto and adapted to create a lesion, the lesion electrically isolating a vessel from a chamber for treatment of a cardiac arrhythmia. The distal tip of the locating device is substantially parallel with the central loop axis.

摘要翻译： 导管组件的导管主体包括近端部分，从近侧部分延伸的中间部分，从中间部分延伸的远侧部分和定位装置，该定位装置包括从导管主体的远端部分延伸的远侧末端。 中间部分限定纵向轴线，并且远侧部分形成包括围绕中心环轴线形成的一个或多个环形部分的环。 中心回路轴线基本上与纵向轴线平行，并且一个或多个环路段包括耦合到其上的适于产生病变的至少一个消融电极，所述损伤使血管与腔室电隔离以治疗心律失常。 定位装置的远端基本上与中心环轴平行。

公开(公告)号：US20050149138A1

公开(公告)日：2005-07-07

申请号：US10745841

申请日：2003-12-24

申请人： Xiaoyi Min ,  Michael Yang ,  Kevin Morgan ,  Eric Falkenberg

发明人： Xiaoyi Min ,  Michael Yang ,  Kevin Morgan ,  Eric Falkenberg

IPC分类号： A61B5/04 ,  A61N1/05 ,  A61N1/08 ,  A61N1/362 ,  A61N1/365 ,  A61N1/368 ,  A61N1/37

CPC分类号： A61N1/36514 ,  A61B5/04012 ,  A61N1/056 ,  A61N1/0587 ,  A61N1/08 ,  A61N1/3627

摘要： The optimal location for delivering pacing pulses to a given cardiac chamber (such as the left ventricle) is determined by identifying the last electrically or mechanically activated site within the chamber. For example, the last site within the left ventricular myocardium to depolarize during an intrinsic ventricular contraction triggered by an initial atrial depolarization is identified as being the optimal pacing location for the left ventricle. A pacing electrode is then implanted as close as possible to that location. The technique is particularly effective for use in identifying optimal epicardial pacing locations for mounting satellite pacing devices for use in delivering cardiac resynchronization therapy. However, the techniques may also be applied to identify locations for mounting endocardial electrodes as well. Capture thresholds may also be taken into account in determining the optimal location. Examples are described for both master/satellite pacing systems as well as biventricular single device systems.

摘要翻译： 通过识别腔室内最后一个电或机械激活的位置来确定向给定心室（如左心室）输送起搏脉冲的最佳位置。 例如，在由初始心房去极化触发的内在心室收缩期间左心室心肌内去极化的最后位置被确定为左心室的最佳起搏位置。 然后将起搏电极植入尽可能靠近该位置。 该技术特别有效地用于鉴定用于安装用于递送心脏再同步治疗的卫星起搏装置的最佳心外膜起搏位置。 然而，这些技术也可以应用于识别用于安装心内膜电极的位置。 在确定最佳位置时也可以考虑采集阈值。 描述了主/卫星起搏系统以及双心室单一设备系统的示例。

公开(公告)号：US06321123B1

公开(公告)日：2001-11-20

申请号：US09264609

申请日：1999-03-08

申请人： Mary M. Morris ,  Xiaoyi Min

发明人： Mary M. Morris ,  Xiaoyi Min

IPC分类号： A61N105

CPC分类号： A61N1/056 ,  A61N2001/0585

摘要： The lead configuration enhances the sensing characteristics of the lead and provides for stable location of the electrodes in the coronary sinus. The J-shaped bend in the distal portion of the lead body spaces the distal tip of the lead body less than about 0.9 inches laterally from the portion of the lead body that is proximal to the bend. The tip of the lead body is provided with a pacing/sensing electrode and the curved portion of the J-shaped bend carries an elongated coil electrode that serves as an indifferent electrode for pacing and sensing. For left atrial pacing, the lead tip electrode is located adjacent the wall of the coronary sinus closest to the left atrium, and the indifferent electrode is located adjacent the opposite wall of the coronary sinus, closer to the left ventricle. To enhance spatial distribution of the indifferent electrode and provide for greater averaging of the ventricular signal, which in turn reduces the far field of the ventricular signal, the indifferent electrode extends over 10-50 millimeters or multiple spaced indifferent electrodes are used.

摘要翻译： 引线配置增强引线的感测特性，并提供电极在冠状窦中的稳定位置。 引线主体的远端部分中的J形弯曲部分使引线主体的远端部从导线本体的靠近弯头的部分横向偏离约0.9英寸。 引线体的尖端设置有起搏/感测电极，并且J形弯曲部的弯曲部分承载用作起搏和感测的无关电极的细长线圈电极。 对于左心房起搏，引导尖端电极位于最靠近左心房的冠状窦壁附近，而无关电极位于冠状窦的相对壁附近，靠近左心室。 为了增强无关电极的空间分布，并提供更大的心室信号的平均值，这进一步减少心室信号的远场，无差异的电极延伸超过10-50毫米或使用多个间隔的无关电极。

公开(公告)号：US6038472A

公开(公告)日：2000-03-14

申请号：US840691

申请日：1997-04-29

申请人： Terrell M. Williams ,  Peter M. J. Mulier ,  John G. Keimel ,  Timothy G. Laske ,  Gregory A. Boser ,  Mary M. Morris ,  Xiaoyi Min

发明人： Terrell M. Williams ,  Peter M. J. Mulier ,  John G. Keimel ,  Timothy G. Laske ,  Gregory A. Boser ,  Mary M. Morris ,  Xiaoyi Min

IPC分类号： A61N1/04 ,  A61N1/05 ,  A61N1/39

CPC分类号： A61N1/0565 ,  A61N1/0563

摘要： A lead and a lead system for dispersion of a cardioversion/defibrillation electrode formed of one or more small diameter defibrillation electrodes in a heart chamber and for attaching a pace/sense electrode in contact with the heart. The small diameter defibrillation electrode or electrodes extend distally from the distal end of the lead body. If multiple electrodes are employed, they are preferably biased to spread apart when unrestrained and have a cross-section size small enough to be inserted into interstices of trabeculae in the ventricular chamber. The distal ends of the defibrillation electrodes may be free of attachment to the lead body or may be attached by a weak bond to the distal portion of the lead.

摘要翻译： 一种用于在心室中由一个或多个小直径除颤电极形成的复律/除颤电极的分散的引线和引导系统，并且用于附接与心脏接触的步调/感测电极。 小直径除颤电极或电极从引线体的远端向远端延伸。 如果使用多个电极，则它们优选地被偏置以在不受限制的情况下展开，并且具有足够小的横截面尺寸以插入心室中的小梁的间隙中。 除颤电极的远端可以没有附着到引线体，或者可以通过弱接合附着到引线的远端部分。

公开(公告)号：US20190105496A1

公开(公告)日：2019-04-11

申请号：US15937427

申请日：2018-03-27

申请人： Xiaoyi Min ,  Alexander Kent ,  Richard Williamson

发明人： Xiaoyi Min ,  Alexander Kent ,  Richard Williamson

IPC分类号： A61N1/36 ,  A61N1/372 ,  A61N1/05

摘要： A computer implemented method and system is provided for managing neural stimulation therapy. The method comprises under control of one or more processors configured with program instructions. The method delivers a series of candidate stimulation waveforms having varied stimulation intensities to at least one electrode located proximate to nervous tissue of interest. A parameter defines the candidate stimulation waveforms is changed to vary the stimulation intensity. The method identifies a first candidate stimulation waveform that induces a paresthesia-abatement effect, while continuing to induce a select analgesic effect. The method further identifies a second candidate stimulation waveform that does not induce the select analgesic effect. The method sets a stimulation therapy based on the first and second candidate stimulation waveforms.

公开(公告)号：US10016607B2

公开(公告)日：2018-07-10

申请号：US13023408

申请日：2011-02-08

申请人： Xiaoyi Min

发明人： Xiaoyi Min

IPC分类号： A61N1/365 ,  A61B5/029 ,  A61B5/053 ,  A61B5/0295 ,  A61B5/00 ,  A61B5/042 ,  A61N1/362

CPC分类号： A61N1/36521 ,  A61B5/0031 ,  A61B5/029 ,  A61B5/0295 ,  A61B5/0422 ,  A61B5/0535 ,  A61B5/0538 ,  A61B5/686 ,  A61B5/6869 ,  A61N1/3627

摘要： Techniques are provided for use with an implantable medical device for assessing stroke volume or related cardiac function parameters such as cardiac output based on impedance signals obtained using hybrid impedance configurations that exploit a multi-pole cardiac pacing/sensing lead implanted near the left ventricle. In one example, current is injected between a large and stable reference electrode and a ring electrode in the RV. The reference electrode may be, e.g., a coil electrode implanted within the superior vena cava (SVC). Impedance values are measured along a set of different sensing vectors between the reference electrode and each of the electrodes of the multi-pole LV lead. Stroke volume is then estimated and tracked within the patient using the impedance values. In this manner, a hybrid impedance detection configuration is exploited whereby one vector is used to inject current and other vectors are used to measure impedance.