公开(公告)号：US08260409B2

公开(公告)日：2012-09-04

申请号：US13018682

申请日：2011-02-01

申请人： Jaeho Kim ,  Joseph M. Bocek ,  Dan Li

发明人： Jaeho Kim ,  Joseph M. Bocek ,  Dan Li

IPC分类号： A61B5/0402

CPC分类号： A61B5/0422 ,  A61N1/3622 ,  A61N1/3931 ,  A61N1/3962

摘要： An apparatus comprises first and second sensing circuits, a template generator circuit, and a correlation circuit. The correlation circuit is configured to identify a first fiducial position in a third cardiac signal sensed using the first sensing circuit during a detected rhythm with elevated ventricular rate, align the template correlation features and the correlation features of a fourth cardiac signal using the first fiducial position, calculate a correlation using the correlation features of the template and the correlation features of the fourth cardiac signal, and iteratively searching for a replacement to the first fiducial position in the third cardiac signal according to the calculated correlation.

摘要翻译： 一种装置包括第一和第二感测电路，模板发生器电路和相关电路。 相关电路被配置为在检测到的具有升高的心室率的节律期间识别在使用第一感测电路感测的第三心脏信号中的第一基准位置，使用第一基准位置对准模板相关特征和第四心脏信号的相关特征 使用模板的相关特征和第四心脏信号的相关特征来计算相关性，并且根据所计算的相关性迭代地搜索第三心脏信号中的第一基准位置的替换。

公开(公告)号：US08214038B2

公开(公告)日：2012-07-03

申请号：US13195425

申请日：2011-08-01

申请人： Jaeho Kim ,  Joseph M. Bocek ,  Eric G. Lovett

发明人： Jaeho Kim ,  Joseph M. Bocek ,  Eric G. Lovett

IPC分类号： A61N1/362

CPC分类号： A61B5/0464 ,  A61N1/3925 ,  A61N1/3962

摘要： A cardiac rhythm management device is configured to discriminate between ventricular and supraventricular tachycardias (referred to as SVT/VT discrimination) by utilizing a morphology criterion in which the morphology of electrogram waveforms during ventricular beats are analyzed to determine if the beats are normally conducted. After the delivery of a cardioversion/defibrillation shock, however, the intraventricular conduction system is left in a modified state which alters the subsequently generated electrogram signal. Use of the morphology criterion for SVT/VT discrimination is discontinued after delivery of such a shock and resumed after a predetermined minimum number of normally conducted ventricular beats has been detected.

摘要翻译： 心律管理装置被配置为通过利用形态学标准来区分心室和室上性心动过速（称为SVT / VT鉴别），其中分析心室搏动时的电描记图波形的形态以确定节拍是否正常进行。 然而，在输出心脏复律/除颤休克之后，心室内传导系统处于改变随后产生的电描记图信号的修改状态。 在发生这种休克后，停止使用SVT / VT鉴别的形态学标准，并且在检测到预定的最小数量的正常进行的心室搏动之后恢复。

公开(公告)号：US08032217B2

公开(公告)日：2011-10-04

申请号：US12723805

申请日：2010-03-15

申请人： Jaeho Kim ,  Joseph M. Bocek ,  Karl Stoklosa ,  Scott Walczak

发明人： Jaeho Kim ,  Joseph M. Bocek ,  Karl Stoklosa ,  Scott Walczak

IPC分类号： A61N1/362

CPC分类号： A61N1/3956 ,  A61B5/046 ,  A61N1/0504

摘要： A method of using an implantable medical device (IMD) to monitor a ventricular contraction rate of a subject, monitor an atrial contraction rate of the subject, declare tachyarrhythmia if the ventricular contraction rate exceeds the atrial contraction rate, and declare a slow tachyarrhythmia when the ventricular rate exceeds the atrial rate and the ventricular rate is less than a specified maximum pacing rate.

摘要翻译： 使用可植入医疗装置（IMD）来监测受试者的心室收缩率的方法，监测受试者的心房收缩率，如果心室收缩率超过心房收缩率，则宣布快速性心律失常，并且当心律失常 心室率超过心房率，心室率低于规定的最大起搏率。

公开(公告)号：US07702384B2

公开(公告)日：2010-04-20

申请号：US11301716

申请日：2005-12-13

申请人： Jaeho Kim ,  Joseph M. Bocek ,  Karl Stoklosa ,  Scott Walczak

发明人： Jaeho Kim ,  Joseph M. Bocek ,  Karl Stoklosa ,  Scott Walczak

IPC分类号： A61B5/04

CPC分类号： A61N1/3956 ,  A61B5/046 ,  A61N1/0504

摘要： A system including an implantable medical device (IMD). The IMD includes a ventricular contraction sensing circuit that provides a sensed ventricular contraction signal, a timer circuit that provides a ventricular time interval between ventricular contractions, and a controller circuit coupled to the timer circuit, the controller circuit determines the ventricular contraction rate using the ventricular time interval. The controller circuit further includes a tachyarrhythmia detection module that declares tachyarrhythmia, in response to detecting a sudden rate increase, without comparing a ventricular rate or time interval to a respective tachyarrhythmia detection rate or time interval threshold.

摘要翻译： 一种包括可植入医疗装置（IMD）的系统。 IMD包括提供感测到的心室收缩信号的心室收缩感测电路，提供心室收缩之间的心室时间间隔的定时器电路和耦合到定时器电路的控制器电路，控制器电路使用心室来确定心室收缩率 时间间隔。 控制器电路还包括快速性心律失常检测模块，其响应于检测到突然的速率增加而声明快速性心律失常，而不将心室率或时间间隔与相应的快速性心律失常检测率或时间间隔阈值进行比较。

公开(公告)号：US20100057152A1

公开(公告)日：2010-03-04

申请号：US12552614

申请日：2009-09-02

申请人： Jaeho Kim ,  Dan Li ,  Joseph M. Bocek

发明人： Jaeho Kim ,  Dan Li ,  Joseph M. Bocek

IPC分类号： A61N1/365 ,  A61N1/39 ,  A61B5/0464

CPC分类号： A61N1/3621 ,  A61B5/0464 ,  A61N1/365 ,  A61N1/3962

摘要： An apparatus comprises an implantable ventricular depolarization sensing circuit configured to provide a sensed ventricular depolarization signal, a timer circuit configured to provide a ventricular time interval between ventricular depolarizations, and a controller circuit communicatively coupled to the ventricular depolarization sensing circuit and the timer circuit. The controller circuit includes a ventricular tachycardia (VT) detection circuit configured to declare an episode of VT when a number of accelerated beats are detected, calculate a hysteresis VT detection threshold interval, and deem whether the episode of VT persists using the hysteresis VT detection threshold interval.

摘要翻译： 一种装置包括可植入心室去极化感测电路，其被配置为提供感测到的心室去极化信号，定时器电路，其被配置为提供心室去极化之间的心室时间间隔，以及通信地耦合到心室去极化感测电路和定时器电路的控制器电路。 所述控制器电路包括心室性心动过速（VT）检测电路，其被配置为当检测到多个加速搏动时声明VT的发作，计算滞后VT检测阈值间隔，并且使用滞后VT检测阈值来确定VT的发作是否持续 间隔。

公开(公告)号：US07650182B2

公开(公告)日：2010-01-19

申请号：US11177230

申请日：2005-07-08

申请人： Jaeho Kim ,  Joseph M. Bocek

发明人： Jaeho Kim ,  Joseph M. Bocek

IPC分类号： A61B5/0464

CPC分类号： A61N1/3622 ,  A61B5/04011 ,  A61B5/0464

摘要： A system detects events related to cardiac activity. The system comprises a primary cardiac signal sensing circuit, at least one secondary cardiac signal sensing circuit having a higher sensitivity than the primary sensing circuit, and a controller circuit coupled to the primary and secondary cardiac signal sensing circuits. The controller circuit determines a rate of depolarization using the primary sensing circuit and detects tachyarrhythmia using the rate. The controller circuit also detects tachyarrhythmia using the secondary sensing circuit and also deems the tachyarrhythmia valid if the controller circuit detects the tachyarrhythmia using both the primary and secondary sensing circuit.

摘要翻译： 系统检测与心脏活动相关的事件。 所述系统包括主要心脏信号感测电路，至少一个具有比初级感测电路更高灵敏度的次级心脏信号感测电路，以及耦合到主要和次要心脏信号感测电路的控制器电路。 控制器电路使用主感测电路确定去极化率，并使用该速率检测快速性心律失常。 控制器电路还使用次级感测电路检测快速性心律失常，并且如果控制器电路使用主感测电路和次感测电路检测到快速性心律失常，则认为快速性心律失常是有效的。

公开(公告)号：US20090216289A1

公开(公告)日：2009-08-27

申请号：US12431633

申请日：2009-04-28

申请人： Mark Schwartz ,  Joseph M. Bocek ,  Jaeho Kim

发明人： Mark Schwartz ,  Joseph M. Bocek ,  Jaeho Kim

IPC分类号： A61N1/365 ,  A61N1/39

CPC分类号： A61N1/3956 ,  A61B5/04525

摘要： This document describes systems, devices, and methods that use multiple morphology templates for discriminating between rhythms, such as supraventricular tachyarrhythmias (SVTs) and ventricular tachyarrhythmias (VTs), for delivering a countershock in response to a VT episode, but withholding delivery of such a countershock in response to an SVT episode. In certain examples, the particular morphology used for storing morphological features is selected at least in part using a sensor-indicated activity level of a subject, or a metabolic need of the subject.

摘要翻译： 本文档描述了使用多种形态学模板来区分节律（例如室上性快速性心律失常（SVT））和室性快速性心律失常（VT）的系统，装置和方法，用于响应于VT发作而产生反冲突，但是不提供这种 反应SVT情节。 在某些实例中，用于存储形态特征的特定形态至少部分地使用受试者的传感器指示的活动水平或受试者的代谢需要。

公开(公告)号：US20090099616A1

公开(公告)日：2009-04-16

申请号：US12234840

申请日：2008-09-22

申请人： Dan Li ,  Jaeho Kim ,  Joseph M. Bocek

发明人： Dan Li ,  Jaeho Kim ,  Joseph M. Bocek

IPC分类号： A61N1/365

CPC分类号： A61N1/3621 ,  A61N1/368 ,  A61N1/3688

摘要： An implantable medical device delivers anti-tachyarrhythmia therapies including anti-tachycardia pacing (ATP). If a detected tachyarrhythmia is classified as a type suitable for treatment using ATP, the implantable medical device selects one of an atrial ATP (A-ATP) mode, a ventricular ATP (V-ATP) mode, and a concurrent atrio-ventricular ATP (concurrent AV-ATP) mode according to the characteristics of the detected tachyarrhythmia. The concurrent ATP mode is an ATP mode during which the atrial pacing pulses and the ventricular pacing pulses are delivered concurrently. In one embodiment, the concurrent AV-ATP mode includes a synchronized atrio-ventricular ATP (synchronized AV-ATP) mode during which atrial and ventricular pacing pulses are delivered synchronously and an independent atrio-ventricular ATP (independent AV-ATP) mode during which atrial and ventricular pacing pulses are delivered concurrently but timed independently.

摘要翻译： 植入式医疗装置提供抗心律失常疗法，包括抗心动过速起搏（ATP）。 如果检测到的快速性心律失常被分类为适合于使用ATP治疗的类型，则可植入医疗装置选择心房ATP（A-ATP）模式，心室ATP（V-ATP）模式和并发心室ATP 并发AV-ATP）模式根据检测到的快速性心律失常的特点。 并发ATP模式是ATP模式，其中心房起搏脉冲和心室起搏脉冲同时传递。 在一个实施方案中，并发的AV-ATP模式包括同步的心房ATP（同步的AV-ATP）模式，其中同步递送心房和心室起搏脉冲以及独立的心房ATP（独立的AV-ATP）模式，在此期间 心房和心室起搏脉冲同时传递，但可以独立计时。

公开(公告)号：US20080288009A1

公开(公告)日：2008-11-20

申请号：US11749283

申请日：2007-05-16

申请人： Jaeho Kim ,  Joseph M. Bocek

发明人： Jaeho Kim ,  Joseph M. Bocek

IPC分类号： A61N1/362

CPC分类号： A61B5/0422 ,  A61N1/3622 ,  A61N1/3931 ,  A61N1/3962

摘要： An apparatus comprising an implantable cardiac signal sensing circuit configured for sensing an intrinsic cardiac signal, a memory to store a template of a morphology of normal atrial-ventricular conduction, and a controller that includes a tachyarrhythmia detection circuit and a correlation circuit. The tachyarrhythmia detection circuit is configured for detecting a rhythm with elevated ventricular rate using the sensed intrinsic cardiac signal. The correlation circuit is configured for iteratively calculating a correlation between the sensed intrinsic cardiac signal and the template, and comparing the calculated correlation to a variable correlation threshold to determine whether the detected rhythm correlates to the template. The apparatus also includes a therapy circuit configured for inhibiting a ventricular tachycardia therapy when the detected rhythm correlates to the template. Other apparatuses and methods are described.

摘要翻译： 一种装置，包括被配置为感测本征心脏信号的可植入心脏信号感测电路，存储器以存储正常心室传导形态的模板，以及包括快速性心律失常检测电路和相关电路的控制器。 快速心律失常检测电路被配置为使用感测到的本征心脏信号来检测具有升高的心室率的节律。 相关电路被配置为迭代地计算所感测的本征心脏信号与模板之间的相关性，并将所计算的相关性与可变相关阈值进行比较，以确定检测到的节律是否与模板相关。 该装置还包括治疗电路，其被配置为当检测到的节律与模板相关时抑制室性心动过速治疗。 描述其他设备和方法。

公开(公告)号：US20080177340A1

公开(公告)日：2008-07-24

申请号：US12056684

申请日：2008-03-27

申请人： Jaeho Kim ,  Joseph M. Bocek ,  Eric G. Lovett

发明人： Jaeho Kim ,  Joseph M. Bocek ,  Eric G. Lovett

IPC分类号： A61N1/39 ,  A61N1/365

CPC分类号： A61B5/0464 ,  A61N1/3925 ,  A61N1/3962

摘要： A cardiac rhythm management device is configured to discriminate between ventricular and supraventricular tachycardias (referred to as SVT/VT discrimination) by utilizing a morphology criterion in which the morphology of electrogram waveforms during ventricular beats are analyzed to determine if the beats are normally conducted. After the delivery of a cardioversion/defibrillation shock, however, the intraventricular conduction system is left in a modified state which alters the subsequently generated electrogram signal. Use of the morphology criterion for SVT/VT discrimination is discontinued after delivery of such a shock and resumed after a predetermined minimum number of normally conducted ventricular beats has been detected.

摘要翻译： 心律管理装置被配置为通过利用形态学标准来区分心室和室上性心动过速（称为SVT / VT鉴别），其中分析心室搏动时的电描记图波形的形态以确定节拍是否正常进行。 然而，在输出心脏复律/除颤休克之后，心室内传导系统处于改变随后产生的电描记图信号的修改状态。 在发生这种休克后，停止使用SVT / VT鉴别的形态学标准，并且在检测到预定的最小数量的正常进行的心室搏动之后恢复。