公开(公告)号：US07133719B1

公开(公告)日：2006-11-07

申请号：US10868331

申请日：2004-06-14

申请人： Gene A. Bornzin ,  Peter Boileau

发明人： Gene A. Bornzin ,  Peter Boileau

IPC分类号： A61N1/36

CPC分类号： A61N1/3622 ,  A61N1/365

摘要： An exemplary method includes providing an overdrive pacing rate, based at least in part on the overdrive pacing rate, determining an incidence limit for incidence of intrinsic atrial activity events, determining an incidence of intrinsic atrial activity events, comparing the incidence of intrinsic atrial activity events to the incidence limit and, based at least on the comparing, deciding whether to adjust the overdrive pacing rate. According to this exemplary method, the incidence limit is optionally a function of overdrive pacing rate. Another exemplary method includes determining a dwell limit wherein the dwell limit is optionally a function of overdrive pacing rate. Other exemplary methods, devices, systems, etc., are also disclosed.

公开(公告)号：US07945314B1

公开(公告)日：2011-05-17

申请号：US11432636

申请日：2006-05-10

申请人： Jeffery D. Snell ,  Jong Gill ,  Gene A. Bornzin ,  Peter Boileau ,  Euljoon Park

发明人： Jeffery D. Snell ,  Jong Gill ,  Gene A. Bornzin ,  Peter Boileau ,  Euljoon Park

IPC分类号： A61B5/04

CPC分类号： A61B5/0402 ,  A61B5/0006 ,  A61N1/3702 ,  A61N1/37235 ,  A61N1/37282

摘要： A surface electrocardiogram (EKG) is emulated using signals detected by internal leads of an implanted device. In one example, emulation is performed using a technique that concatenates portions of signals sensed using different electrodes, such as by combining far-field ventricular signals sensed in the atria with far-field atrial signals sensed in the ventricles. In another example, emulation is performed using a technique that selectively amplifies or attenuates portions of a single signal, such as by attenuating near-field portions of an atrial unipolar signal relative to far-field portions of the same signal. The surface EKG emulation may be performed by the implanted device itself or by an external programmer based on cardiac signals transmitted thereto. A transtelephonic monitoring network is also described, wherein the emulated surface EKG (or raw data used to emulate the EKG) is relayed from an implanted device to a remote monitor, typically installed in a physician's office.

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，使用将使用不同电极感测的信号的部分连接的技术来执行仿真，例如通过将在心房中感测到的远场心室信号与在心室中感测到的远场心房信号组合。 在另一示例中，使用选择性地放大或衰减单个信号的部分的技术来执行仿真，例如通过衰减相对于相同信号的远场部分的心房单极信号的近场部分。 表面EKG仿真可以由植入装置本身或外部编程器基于发送到其上的心脏信号执行。 还描述了一种跨耳监测网络，其中仿真表面EKG（或用于模拟EKG的原始数据）从植入装置中继到通常安装在医师办公室中的远程监视器。

公开(公告)号：US20100318148A1

公开(公告)日：2010-12-16

申请号：US12851515

申请日：2010-08-05

申请人： Gene A. Bornzin ,  Peter Boileau

发明人： Gene A. Bornzin ,  Peter Boileau

IPC分类号： A61N1/365

CPC分类号： A61N1/3627 ,  A61N1/3624 ,  A61N1/3712 ,  A61N1/3714

摘要： An implantable cardiac device is programmed to detect and classify premature atrial contractions (PACs) and administer responsive pacing therapy. The responsive pacing therapy is in the form of an atrial extrastimulus, which is intended to preempt initiation of a reentrant tachycardia. The atrial extrastimulus is timed to occur late enough after a PAC to ensure atrial capture, but early enough that the resulting atrial depolarization does not conduct through the AV node to the ventricles if the PAC has already done so. If both of these criteria cannot be met, the device may be configured to inhibit the atrial extrastimulus.

摘要翻译： 可植入心脏装置被编程以检测和分类早产性心房收缩（PAC）并进行响应性起搏治疗。 响应性起搏治疗是以心房超激发的形式，其旨在抢先引发折返性心动过速。 房间超激发定时发生在PAC后足够晚，以确保心房捕获，但足够早，如果PAC已经这样做，所产生的心房去极化不会通过AV节点进入心室。 如果这两个标准都不能满足，则可以将该装置配置成抑制心房再刺激。

公开(公告)号：US07813791B1

公开(公告)日：2010-10-12

申请号：US11841350

申请日：2007-08-20

申请人： Jong Gill ,  Peter Boileau ,  Gene A. Bornzin

发明人： Jong Gill ,  Peter Boileau ,  Gene A. Bornzin

IPC分类号： A61B5/0456

CPC分类号： A61B5/0452 ,  A61B5/0464 ,  A61B5/7257 ,  A61N1/3621

摘要： A Fast Fourier Transform (FFT) converts time-varying event waveforms into the frequency domain waveforms to thereby decompose the events into their spectral components, which are analyzed to distinguish R-waves from T-waves. In some embodiments, the FFT is only activated if a ventricular tachyarrhythmia is already indicated. For example, an initial ventricular rate may be derived from a ventricular IEGM based on all events detected therein. The initial ventricular rate is compared against one or more thresholds representative of ventricular tachycardia (VT) and/or ventricular fibrillation (VF) to determine if VT/VF is indicated. If so, the FFT is activated to distinguish R-waves from T-waves and, in particular, to detect and eliminate T-wave oversensing. Then, the ventricular rate is re-determined based only on the rate of true R-waves. Therapy is delivered if VT/VF is still detected.

摘要翻译： 快速傅里叶变换（FFT）将时变事件波形转换成频域波形，从而将事件分解为其频谱分量，分析其以区分R波和T波。 在一些实施例中，仅当已经指示心室快速性心律失常时才激活FFT。 例如，可以基于其中检测到的所有事件从心室IEGM导出初始心室率。 将初始心室率与代表室性心动过速（VT）和/或心室颤动（VF）的一个或多个阈值进行比较，以确定是否指示VT / VF。 如果是这样，则FFT被激活以区分R波和T波，特别是检测和消除T波超检测。 然后，仅根据真正的R波的速率重新确定心室率。 如果仍然检测到VT / VF，则进行治疗。

公开(公告)号：US07606618B1

公开(公告)日：2009-10-20

申请号：US11400114

申请日：2006-04-07

申请人： Gene A. Bornzin ,  Peter Boileau ,  Paul A. Levine ,  Corey L. Brown

发明人： Gene A. Bornzin ,  Peter Boileau ,  Paul A. Levine ,  Corey L. Brown

IPC分类号： A61N1/00

CPC分类号： A61N1/3962 ,  A61N1/3621 ,  A61N1/37258

摘要： An implantable medical device with a notification system. The device monitors itself and an implantee for one or more condition indicating notification and delivers the notification at a time the patient is determined to be wakeful and, optionally, at relative rest. The notification can be repeated periodically until acknowledged by the user or the system is evaluated and reprogrammed by the physician. A user input can be included to provide the device confirmation of receipt of the notification as well as to delay delivery of any indicated subsequent notifications. The notification is provided without requiring any additional or special dedicated hardware.

摘要翻译： 具有通知系统的可植入医疗设备。 该装置监视自身和一个植入物，用于指示通知的一个或多个状况，并且在患者被确定为被唤醒并且可选地处于相对静止状态时递送通知。 可以定期重复通知，直到用户确认或者由医师评估系统并对其进行重新编程。 可以包括用户输入以提供装置确认通知的接收以及延迟所指示的后续通知的传送。 提供通知而不需要任何额外的或特殊的专用硬件。

公开(公告)号：US07474921B1

公开(公告)日：2009-01-06

申请号：US10868732

申请日：2004-06-14

申请人： Gene A. Bornzin ,  Peter Boileau

发明人： Gene A. Bornzin ,  Peter Boileau

IPC分类号： A61N1/362

CPC分类号： A61N1/3622 ,  A61N1/368

摘要： An exemplary method includes providing an overdrive pacing rate and, determining an incidence limit for incidence of intrinsic atrial activity events, as well as the incidence of intrinsic atrial activity events The exemplary, method further includes comparing the incidence of intrinsic atrial activity events to the incidence limit and, based at least on the comparing, deciding whether to adjust the overdrive pacing rate. According to this exemplary method, the incidence limit is optionally a function of overdrive pacing rate. Another exemplary method includes determining a dwell limit wherein the dwell limit is optionally a function of overdrive pacing rate. Other exemplary methods, devices, systems, etc., are also disclosed.

摘要翻译： 示例性方法包括提供超速起搏速率和确定固有心房活动事件的发生率的发生率以及固有心房活动事件的发生率。示例性的方法还包括将内在心房活动事件的发生率与发生率 至少基于比较，决定是否调整超速起搏率。 根据该示例性方法，入射限制可选地是超速起搏速率的函数。 另一示例性方法包括确定停留极限，其中停留极限可选地是超速起搏速率的函数。 还公开了其它示例性方法，装置，系统等。

公开(公告)号：US07349732B1

公开(公告)日：2008-03-25

申请号：US10735944

申请日：2003-12-12

申请人： Jong Kil ,  Gene A. Bornzin ,  Peter Boileau ,  Euljoon Park

发明人： Jong Kil ,  Gene A. Bornzin ,  Peter Boileau ,  Euljoon Park

IPC分类号： A61B5/0402

CPC分类号： A61B5/042 ,  A61B5/04011

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, such as by combining far-field ventricular signals sensed in the atria with far-field atrial signals sensed in the ventricles or by combining near-field signals sensed in the atria with near-field signals sensed in the ventricles. In another example, the emulation is performed using a technique that selectively amplifies or attenuates portions of a single signal sensed using a single pair of electrodes, such as by attenuating near-field portions of an atrial unipolar signal relative to far-field portions of the same signal or by attenuating atrial portions of a cross-chamber signal relative to ventricular portions to the same signal. The surface EKG emulation may be performed by the implanted device itself or by an external programmer based on cardiac signals transmitted thereto.

公开(公告)号：US07024241B1

公开(公告)日：2006-04-04

申请号：US10313684

申请日：2002-12-05

申请人： Gene A. Bornzin ,  Peter Boileau

发明人： Gene A. Bornzin ,  Peter Boileau

IPC分类号： A61N1/362

CPC分类号： A61N1/37 ,  A61N1/362 ,  A61N1/3906 ,  A61N1/3956

摘要： An implantable cardiac stimulation device is configured to generate multiphasic stimulation pulse waveforms. These multiphasic stimulation pulse waveforms are configured such that they can be substantially rejected within the intracardiac signal sensing circuitry. In certain implementations this allows for simultaneous stimulation therapy and sensing and analysis of intracardiac signals. In other implementations, the blanking interval associated with the intracardiac signal sensing circuitry may be reduced or eliminated. Furthermore, the fast recharge period may be reduced or eliminated, and/or the polarization at lead-tissue interface may be reduced or effectively eliminated by using multiphasic stimulation pulse waveforms. Such cardiac stimulation techniques are particularly useful in providing antitachycardia pacing (ATP) therapy, wherein pacing during a T wave can lead to fibrillation being triggered.

摘要翻译： 可植入心脏刺激装置被配置为产生多相刺激脉冲波形。 这些多相刺激脉冲波形被配置为使得它们可以在心内信号感测电路中基本上被拒绝。 在某些实施方式中，这允许同时进行刺激治疗和心内信号的感测和分析。 在其他实现中，可以减少或消除与心内信号感测电路相关联的消隐间隔。 此外，可以减少或消除快速充电周期，和/或可以通过使用多相刺激脉冲波形来减少或有效地消除引线 - 组织界面处的极化。 这种心脏刺激技术在提供抗心动过速起搏（ATP）治疗中是特别有用的，其中T波期间的起搏可导致引发颤动。

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：US07769436B1

公开(公告)日：2010-08-03

申请号：US11757796

申请日：2007-06-04

申请人： Peter Boileau ,  Jay Snell ,  Rupinder Bharmi ,  Laleh Jalali ,  Gene A. Bornzin

发明人： Peter Boileau ,  Jay Snell ,  Rupinder Bharmi ,  Laleh Jalali ,  Gene A. Bornzin

IPC分类号： A61B5/04 ,  A61B5/0402 ,  A61B5/0452

CPC分类号： A61B5/0452 ,  A61B5/0422 ,  A61B5/053 ,  A61N1/36585

摘要： Techniques are described for adaptively adjusting detection thresholds for use in detecting cardiac ischemia and other abnormal physiological conditions based on morphological parameters derived from intracardiac electrogram (IEGM) signals, impedance measurements, or other signals. In one example, where ST segment elevation is used to detect cardiac ischemia, default detection thresholds are determined in advance from an examination of variations in ST segment elevations occurring within a population of patients. Thereafter, an individual pacemaker or other implantable medical device uses the default thresholds during an initial learning period to detect ischemia within the patient in which the device is implanted. During the initial learning period, the pacemaker also collects data representative of the range of variation in ST segment elevations occurring within the patient. The pacemaker then adaptively adjusts the thresholds based on the range of variation so as to improve detection specificity within the patient.

摘要翻译： 描述了基于从心脏电图（IEGM）信号，阻抗测量或其它信号得出的形态学参数自适应地调整检测阈值用于检测心脏缺血和其他异常生理状况的技术。 在一个例子中，使用ST段抬高来检测心脏缺血，默认检测阈值是从对患者群体内发生的ST段抬高的变化的检查预先确定的。 此后，单个起搏器或其它可植入医疗装置在初始学习期间使用默认阈值来检测装置植入的患者内的局部缺血。 在初始学习期间，起搏器还收集代表病人ST段抬高范围变化的数据。 起搏器然后根据变异范围自适应地调整阈值，以提高患者内的检测特异性。