公开(公告)号：US08014864B2

公开(公告)日：2011-09-06

申请号：US12140862

申请日：2008-06-17

申请人： Stuart O. Schecter ,  Kjell Noren

发明人： Stuart O. Schecter ,  Kjell Noren

IPC分类号： A61N1/08

CPC分类号： A61N1/36514 ,  A61N1/36578

摘要： A first lead provides therapeutic stimulation to the heart and includes a first mechanical sensor that measures physical contraction and relaxation of the heart. A controller induces delivery of therapeutic stimulation via the first lead. The controller receives signals from the first mechanical sensor indicative of the contraction and relaxation; develops a template signal that corresponds to the contraction and relaxation; and uses the template signal to modify the delivery of therapeutic stimulations. In another arrangement, a second lead, with a second mechanical sensor also provides signals to the controller indicative of contraction and relaxation. The first mechanical sensor is adapted to be positioned at the interventricular septal region of the heart, and the second mechanical sensor is adapted to be positioned in the lateral region of the left ventricle. The controller processes the signals from the first mechanical sensor and the second mechanical sensor to develop a dysynchrony index.

摘要翻译： 第一个引线提供对心脏的治疗刺激，并且包括测量心脏的身体收缩和松弛的第一机械传感器。 控制器通过第一引线诱导治疗性刺激。 控制器从第一机械传感器接收指示收缩和松弛的信号; 开发对应于收缩和放松的模板信号; 并使用模板信号修改治疗刺激的递送。 在另一种布置中，具有第二机械传感器的第二引线还向控制器提供指示收缩和松弛的信号。 第一机械传感器适于定位在心脏的室间隔区域，并且第二机械传感器适于定位在左心室的侧向区域中。 控制器处理来自第一机械传感器和第二机械传感器的信号以产生异步指数。

公开(公告)号：US20110054559A1

公开(公告)日：2011-03-03

申请号：US12553413

申请日：2009-09-03

申请人： Stuart Rosenberg ,  Kyungmoo Ryu ,  Allen Keel ,  Wenbo Hou ,  Thao Thu Nguyen ,  Steve Koh ,  Kjell Noren ,  Michael Yang

发明人： Stuart Rosenberg ,  Kyungmoo Ryu ,  Allen Keel ,  Wenbo Hou ,  Thao Thu Nguyen ,  Steve Koh ,  Kjell Noren ,  Michael Yang

IPC分类号： A61N1/08 ,  A61N1/362

CPC分类号： A61N1/3627 ,  A61N1/36521 ,  A61N1/36585 ,  A61N1/368 ,  A61N1/3684

摘要： An exemplary method generates a map of a pacing parameter, a sensing parameter or one or more other parameters based in part on location information acquired using a localization system configured to locate electrodes in vivo (i.e., within a patient's body). Various examples map capture thresholds, qualification criteria for algorithms, undesirable conditions and sensing capabilities. Various other methods, devices, systems, etc., are also disclosed.

摘要翻译： 一种示例性方法基于部分地基于使用配置成在体内（即，在患者体内）定位电极的定位系统获取的位置信息来生成起搏参数，感测参数或一个或多个其它参数的图。 各种示例映射捕获阈值，算法的资格标准，不良条件和感测能力。 还公开了各种其它方法，装置，系统等。

公开(公告)号：US20090312814A1

公开(公告)日：2009-12-17

申请号：US12140862

申请日：2008-06-17

申请人： Stuart O. Schecter ,  Kjell Noren

发明人： Stuart O. Schecter ,  Kjell Noren

IPC分类号： A61N1/365

CPC分类号： A61N1/36514 ,  A61N1/36578

摘要： A first lead provides therapeutic stimulation to the heart and includes a first mechanical sensor that measures physical contraction and relaxation of the heart. A controller induces delivery of therapeutic stimulation via the first lead. The controller receives signals from the first mechanical sensor indicative of the contraction and relaxation; develops a template signal that corresponds to the contraction and relaxation; and uses the template signal to modify the delivery of therapeutic stimulations. In another arrangement, a second lead, with a second mechanical sensor also provides signals to the controller indicative of contraction and relaxation. The first mechanical sensor is adapted to be positioned at the interventricular septal region of the heart, and the second mechanical sensor is adapted to be positioned in the lateral region of the left ventricle. The controller processes the signals from the first mechanical sensor and the second mechanical sensor to develop a dysynchrony index.

摘要翻译： 第一个引线提供对心脏的治疗刺激，并且包括测量心脏的身体收缩和松弛的第一机械传感器。 控制器通过第一引线诱导治疗性刺激。 控制器从第一机械传感器接收指示收缩和松弛的信号; 开发对应于收缩和放松的模板信号; 并使用模板信号修改治疗刺激的递送。 在另一种布置中，具有第二机械传感器的第二引线还向控制器提供指示收缩和松弛的信号。 第一机械传感器适于定位在心脏的室间隔区域，并且第二机械传感器适于定位在左心室的侧向区域中。 控制器处理来自第一机械传感器和第二机械传感器的信号以产生异步指数。

公开(公告)号：US20080306566A1

公开(公告)日：2008-12-11

申请号：US12095216

申请日：2005-12-16

申请人： Nils Holmstrom ,  Kjell Noren

发明人： Nils Holmstrom ,  Kjell Noren

IPC分类号： A61N1/365

CPC分类号： A61B7/00 ,  A61B7/04 ,  A61N1/36514 ,  A61N1/36578

摘要： A method for detecting a condition of a heart of a patient using an implantable medical device including the steps of sensing acoustic signals indicative of heart sounds of the heart of the patient; extracting signals corresponding to a first heart sound (S1) and a second heart sound (S2) from sensed signals; calculating an energy value corresponding to a signal corresponding to the first heart sound (S1) and an energy value corresponding to the second heart sound (S2); calculating a relation between the energy value corresponding to the first heart sound and the energy value corresponding to the second heart sound for successive cardiac cycles; and using at least one relation to detect the condition or a change of the condition. A medical device for determining the posture of a patient and a computer readable medium encoded with instructions are used to perform the inventive method.

摘要翻译： 一种使用可植入医疗装置检测患者心脏状况的方法，包括以下步骤：感测指示患者心脏心脏的声音的声信号; 从感测信号中提取对应于第一心音（S1）和第二心音（S2）的信号; 计算对应于对应于第一心音（S1）的信号的能量值和对应于第二心音（S2）的能量值; 计算对应于第一心音的能量值与对应于第二心音的能量值之间的关系，用于连续的心动周期; 并使用至少一个关系来检测条件或条件的变化。 用于确定患者姿势的医疗装置和用指令编码的计算机可读介质用于执行本发明的方法。

公开(公告)号：US07403813B1

公开(公告)日：2008-07-22

申请号：US10998026

申请日：2004-11-24

申请人： Taraneh Ghaffari Farazi ,  Gene A. Bornzin ,  Anders Bjorling ,  Yelena Nabutovsky ,  Kjell Noren

发明人： Taraneh Ghaffari Farazi ,  Gene A. Bornzin ,  Anders Bjorling ,  Yelena Nabutovsky ,  Kjell Noren

IPC分类号： A61B5/0468

CPC分类号： A61B5/0468 ,  A61N1/3621 ,  A61N1/36535 ,  A61N1/36542 ,  A61N1/36564

摘要： Methods and systems are provided for performing ventricular arrhythmia monitoring using at least two sensing channels that are each associated with different sensing vectors, for example by different pairs of extracardiac remote sensing electrodes. Myopotential associated with each of the sensing channels in monitored, and a ventricular arrhythmia monitoring mode is selected based thereon (e.g., based on determined myopotential levels). Ventricular arrhythmia monitoring is then performed using the selected monitoring mode. This description is not intended to be a complete description of, or limit the scope of, the invention. Other features, aspects, and objects of the invention can be obtained from a review of the specification, the figures, and the claims.

公开(公告)号：US5722994A

公开(公告)日：1998-03-03

申请号：US714310

申请日：1996-09-18

申请人： Kjell Noren ,  Pia Hagel

发明人： Kjell Noren ,  Pia Hagel

IPC分类号： A61N1/39

CPC分类号： A61N1/3956

摘要： An implantable defibrillator has an electrode lead system a sensing unit for sensing the condition of the heart and emitting a condition signal corresponding to that condition, a control unit for determining the heart's condition from the condition signal and, if a state of fibrillation is present, sending a command signal to a shock pulse generator, which, depending on the command signal, delivers at least one defibrillation shock to the heart via the electrode lead system. The shock being formal of one or more low-energy pulses with an energy less than 2 Joules and a very high voltage, i.e. more than 1,000 Volts. Each low-energy pulse thus has a voltage greatly exceeding the voltage in a conventional defibrillation shock and less energy than the energy in a conventional defibrillation shock.

摘要翻译： 可植入除颤器具有电极引导系统，用于感测心脏状况并发出与该状态相对应的状态信号的感测单元，用于根据状态信号确定心脏状况的控制单元，如果存在原纤维状态， 向冲击脉冲发生器发送命令信号，该脉冲发生器根据命令信号经由电极引导系统向心脏传递至少一次除颤电击。 一种或多种能量小于2焦耳的低能量脉冲和非常高的电压（即大于1000伏特）的形式的冲击。 因此，每个低能量脉冲具有大大超过常规除颤电击中的电压的电压和比常规除颤电击中的能量更少的能量。

公开(公告)号：US5615684A

公开(公告)日：1997-04-01

申请号：US429614

申请日：1995-04-27

申请人： Pia Hagel ,  Kjell Noren ,  Kurt Hoegnelid

发明人： Pia Hagel ,  Kjell Noren ,  Kurt Hoegnelid

IPC分类号： A61B5/022 ,  A61N1/362 ,  A61N1/365 ,  A61N1/39 ,  A61B5/021

CPC分类号： A61N1/36564 ,  A61N1/3621 ,  A61N1/3956

摘要： A device for detecting hemodynamic conditions in a heart, in particular conditions corresponding to dangerous arrhythmias contains a sensing unit for a physiological variable, such as blood pressure, the unit emitting a signal on the basis of the variable having an average value, a signal conditioning unit connected to the sensing unit, a calculation unit connected to the signal conditioning unit and a comparator after the calculation unit. The calculation unit is devised to calculate a variability measure relative to the signal's average value, the variability measure being correlated to average blood pressure, and the variability measure is compared in the comparator to an adjustable threshold value corresponding to a specific hemodynamic condition, whereupon the comparator emits an indication signal when the variability measure falls below the threshold value.

摘要翻译： 用于检测心脏中的血液动力学状况的装置，特别是与危险性心律失常相对应的条件包括用于生理变量例如血压的感测单元，该单元基于具有平均值的变量发出信号，信号调理 连接到感测单元的单元，连接到信号调节单元的计算单元和计算单元之后的比较器。 计算单元被设计为计算相对于信号平均值的可变性度量，可变性度量与平均血压相关，并且可变性度量在比较器中被比较到对应于特定血液动力学条件的可调阈值， 当可变性测量值低于阈值时，比较器发出指示信号。

公开(公告)号：US4905696A

公开(公告)日：1990-03-06

申请号：US105671

申请日：1987-10-07

申请人： Dave Amundson ,  Asa Hedin ,  Kjell Noren

发明人： Dave Amundson ,  Asa Hedin ,  Kjell Noren

IPC分类号： A61N1/365

CPC分类号： A61N1/36521

摘要： An impedance measurement, used for controlling the pulse generation rate of the pacer, is obtained by placing an electrode in the ventricular portion, rather than the atrial portion, of the heart. The characteristic p-wave in the electrocardiogram is detected as a rapid inflection or notch in the impedance signal, with a stimulation pulse being generated with a time delay following detection of such a notch.

公开(公告)号：US20130325359A1

公开(公告)日：2013-12-05

申请号：US14000844

申请日：2011-03-18

申请人： Karin Jarverud ,  Anders Bjorling ,  Malin Hollmark ,  Kjell Noren ,  Tomas Svensson ,  Stefan Hjelm

发明人： Karin Jarverud ,  Anders Bjorling ,  Malin Hollmark ,  Kjell Noren ,  Tomas Svensson ,  Stefan Hjelm

IPC分类号： G06F19/00

CPC分类号： G06F19/34 ,  A61B5/0464 ,  A61B5/0538 ,  A61N1/36521 ,  A61N1/36535 ,  G06F19/00 ,  G06F19/12 ,  G06F19/24 ,  G16H50/50

摘要： A patient-specific hemodyanmic status model is determined from impedance data collected during periods of normal and abnormal hemodynamic status by deriving parameter values of a set of multiple impedance-derivable parameters from impedance signals collected during periods of normal hemodynamic status and in connection with periods of abnormal hemodynamic status. The parameter values are employed to estimate coefficients of a linear parametric status model. These coefficients can then be used together with parameter values determined from impedance signals determined during status assessment periods in order to determine a current hemdoynamic status of the patient.

摘要翻译： 通过从正常血液动力学状态期间收集的阻抗信号中导出一组多个阻抗可导出参数的参数值，并与正常血液动力学状态期间相关联的时期，从正常和异常血液动力学状态期间收集的阻抗数据确定患者特异性血液动力学状态模型 异常血液动力学状态。 参数值用于估计线性参数状态模型的系数。 然后可以将这些系数与在状态评估周期期间确定的阻抗信号确定的参数值一起使用，以便确定患者的当前血液动力学状态。

公开(公告)号：US20130158620A1

公开(公告)日：2013-06-20

申请号：US13593334

申请日：2012-08-23

申请人： Andreas Blomqvist ,  Kjell Noren

发明人： Andreas Blomqvist ,  Kjell Noren

IPC分类号： A61N1/365

CPC分类号： A61N1/00 ,  A61N1/3627 ,  A61N1/36514 ,  A61N1/36564 ,  A61N1/3682 ,  A61N1/3684

摘要： In an implantable medical device and a method for stimulating a heart of a patient, at least one left atrial pressure (LAP) signal over a cardiac cycle is obtained. The A-wave is identified using the LAP signal and a maximum positive rate of change of the A-wave of the LAP signal is determined. The maximum positive rate of change of the A-wave corresponds to the rate which the pressure in the atrium raises as the atria contraction forces more blood into the ventricle during the very last stage of diastole. Further, AV and/or VV delay is adjusted in response to the maximum positive rate of change of the A-wave, wherein a reduction of the maximum positive rate of change of the A-wave indicates an AV and/or VV delay providing an enhanced hemodynamic performance.

摘要翻译： 在可植入医疗装置和刺激患者心脏的方法中，获得心动周期上的至少一个左心房压力（LAP）信号。 使用LAP信号识别A波，并确定LAP信号的A波的最大正比率。 A波的最大阳性变化率对应于心房收缩期间压力升高的速率，因为心房收缩在舒张期的最后阶段迫使更多的血液进入心室。 此外，AV和/或VV延迟响应于A波的最大正的变化速率而被调整，其中A波的最大正的变化率的减小表示AV和/或VV延迟提供 增强血液动力学性能。