公开(公告)号：US20120197149A1

公开(公告)日：2012-08-02

申请号：US13444733

申请日：2012-04-11

申请人： Jong Gill ,  Peter Boileau ,  Rupinder Bharmi ,  Xiaoyi Min ,  Joseph J. Florio ,  Michael E. Benser ,  Gene A. Bornzin

发明人： Jong Gill ,  Peter Boileau ,  Rupinder Bharmi ,  Xiaoyi Min ,  Joseph J. Florio ,  Michael E. Benser ,  Gene A. Bornzin

IPC分类号： A61B5/0468 ,  A61B5/0452

CPC分类号： A61N1/3962 ,  A61B5/0452 ,  A61B5/0468 ,  A61B5/14532 ,  A61N1/3621 ,  A61N1/3627 ,  A61N1/36557 ,  A61N1/3925

摘要： Techniques are described for detecting ischemia, hypoglycemia or hyperglycemia based on intracardiac electrogram (IEGM) signals. Ischemia is detected based on a shortening of the interval between the QRS complex and the end of a T-wave (QTmax), alone or in combination with a change in ST segment elevation. Alternatively, ischemia is detected based on a change in ST segment elevation combined with minimal change in the interval between the QRS complex and the end of the T-wave (QTend). Hypoglycemia is detected based on a change in ST segment elevation along with a lengthening of either QTmax or QTend. Hyperglycemia is detected based on a change in ST segment elevation along with minimal change in QTmax and in QTend. By exploiting QTmax and QTend in combination with ST segment elevation, changes in ST segment elevation caused by hypo/hyperglycemia can be properly distinguished from changes caused by ischemia.

摘要翻译： 描述了基于心内电描记图（IEGM）信号检测缺血，低血糖或高血糖的技术。 基于QRS复合体与T波结束（QTmax）之间的间隔的缩短单独或与ST段抬高的变化相结合来检测局部缺血。 或者，基于ST段抬高的变化结合QRS复合体与T波结束（QTend）之间的间隔的最小变化来检测局部缺血。 基于ST段抬高的变化以及QTmax或QTend的延长来检测低血糖。 基于ST段抬高的变化以及QTmax和QTend中的最小变化来检测高血糖。 通过利用QTmax和QTend与ST段抬高相结合，可以将由低/高血糖引起的ST段抬高的变化与缺血引起的变化进行适当区分。

公开(公告)号：US08165664B1

公开(公告)日：2012-04-24

申请号：US11928233

申请日：2007-10-30

申请人： Taraneh Ghaffari Farazi ,  Rupinder Bharmi ,  Brian Jeffrey Wenzel

发明人： Taraneh Ghaffari Farazi ,  Rupinder Bharmi ,  Brian Jeffrey Wenzel

IPC分类号： A61B5/0402

CPC分类号： A61B5/0452 ,  A61B5/4842 ,  A61B5/686 ,  A61N1/365

摘要： Specific embodiments provided herein relate to diagnosing, with improved specificity, occurrences of episodes relating to disorders that are known to affect T-wave morphology. One or more propensity metric is obtained, each of which is indicative of a patient's propensity for a specific disorder that is known to affect T-wave morphology. T-wave variability is monitored. Additionally, there is monitoring for a specific change in T-wave morphology that is known to be indicative of episodes relating to a disorder. When the specific change in T-wave morphology is detected, a diagnosis is determined for detecting the specific change in T-wave morphology, taking into account the propensity metric(s) and the T-wave variability.

摘要翻译： 本文提供的具体实施方案涉及具有改善的特异性诊断与已知影响T波形态的病症相关的发作的发生。 获得一个或多个倾向度量，每个倾向度量指示患者对已知影响T波形态的特定病症的倾向。 监测T波变化。 另外，监测T波形态的具体变化已知是指示与病症相关的发作。 当检测到T波形态的具体变化时，考虑到倾向度量和T波变异性，确定检测T波形态的具体变化的诊断。

公开(公告)号：US08108035B1

公开(公告)日：2012-01-31

申请号：US11550744

申请日：2006-10-18

申请人： Rupinder Bharmi

发明人： Rupinder Bharmi

IPC分类号： A61B5/0402

CPC分类号： A61B5/042 ,  A61B5/0006 ,  A61B5/1116 ,  A61B5/4836 ,  A61B5/686 ,  A61N1/36535 ,  A61N1/36542

摘要： Techniques are described for detecting changes in posture; detecting cardiac ischemia while accounting for changes in posture; and delivering therapy or warning signals in response thereto using the implantable medical device. In one example, the device detects variations in the electrical cardiac signals indicative of a possible episode of cardiac ischemia. Changes in patient posture are detected as well using an accelerometer or similar device. Then, an episode of cardiac ischemia is detected based on the variations in the cardiac signals while distinguishing variations due to changes in posture. In another example, the device instead detects changes in posture based on transient changes in morphological features of electrical cardiac signals.

摘要翻译： 描述了用于检测姿势变化的技术; 检测心肌缺血同时考虑姿势变化; 以及使用可植入医疗装置响应于此而递送治疗或警告信号。 在一个示例中，该装置检测指示心脏缺血可能发作的电心脏信号的变化。 也可以使用加速度计或类似设备检测患者姿势的变化。 然后，基于心脏信号的变化来检测心脏缺血发作，同时区分由于姿势变化引起的变化。 在另一示例中，装置根据电心脏信号的形态特征的瞬时变化来检测姿势的变化。

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。

公开(公告)号：US20100114194A1

公开(公告)日：2010-05-06

申请号：US12264131

申请日：2008-11-03

申请人： Rupinder Bharmi ,  Jeffery D. Snell

发明人： Rupinder Bharmi ,  Jeffery D. Snell

IPC分类号： A61N1/37

CPC分类号： A61N1/3704 ,  A61B5/04012 ,  A61B5/04525 ,  A61B5/0456

摘要： A system and method provide precise detection of the time of occurrence of a cardiac event of a heart. The method comprises the steps of sensing electrical activity of the heart to generate an electrogram of the heart and applying the electrogram to an event detector having a plurality of spaced apart thresholds. The thresholds are selected such that the electrogram has an amplitude for crossing at least one of the thresholds. The method further comprises determining a characteristic identifying feature of the electrogram at each threshold crossing of the electrogram, comparing the determined characteristic identifying features to an electrogram template, and identifying the time of occurrence of the cardiac event based upon the comparison.

摘要翻译： 系统和方法提供对心脏心脏事件发生时间的精确检测。 该方法包括以下步骤：感测心脏的电活动以产生心脏的电描记图，并将电描记图应用于具有多个间隔开的阈值的事件检测器。 选择阈值使得电描记图具有用于与至少一个阈值交叉的幅度。 该方法还包括在电描记图的每个阈值交叉处确定电描记图的特征识别特征，将所确定的特征识别特征与电描记图模板进行比较，以及基于该比较来识别心脏事件的发生时间。

公开(公告)号：US20090177104A1

公开(公告)日：2009-07-09

申请号：US12360822

申请日：2009-01-27

申请人： Jong Gill ,  Peter Boileau ,  Rupinder Bharmi ,  Xiaoyi Min ,  Joseph J. Florio ,  Michael E. Benser ,  Gene A. Bornzin

发明人： Jong Gill ,  Peter Boileau ,  Rupinder Bharmi ,  Xiaoyi Min ,  Joseph J. Florio ,  Michael E. Benser ,  Gene A. Bornzin

IPC分类号： A61B5/0472

CPC分类号： A61N1/3962 ,  A61B5/0452 ,  A61B5/0468 ,  A61B5/14532 ,  A61N1/3621 ,  A61N1/3627 ,  A61N1/36557 ,  A61N1/3925

摘要： Techniques are described for detecting ischemia, hypoglycemia or hyperglycemia based on intracardiac electrogram (IEGM) signals. Ischemia is detected based on a shortening of the interval between the QRS complex and the end of a T-wave (QTmax), alone or in combination with a change in ST segment elevation. Alternatively, ischemia is detected based on a change in ST segment elevation combined with minimal change in the interval between the QRS complex and the end of the T-wave (QTend). Hypoglycemia is detected based on a change in ST segment elevation along with a lengthening of either QTmax or QTend. Hyperglycemia is detected based on a change in ST segment elevation along with minimal change in QTmax and in QTend. By exploiting QTmax and QTend in combination with ST segment elevation, changes in ST segment elevation caused by hypo/hyperglycemia can be properly distinguished from changes caused by ischemia.

摘要翻译： 描述了基于心内电描记图（IEGM）信号检测缺血，低血糖或高血糖的技术。 基于QRS复合体与T波结束（QTmax）之间的间隔的缩短单独或与ST段抬高的变化相结合来检测局部缺血。 或者，基于ST段抬高的变化结合QRS复合体与T波结束（QTend）之间的间隔的最小变化来检测局部缺血。 基于ST段抬高的变化以及QTmax或QTend的延长来检测低血糖。 基于ST段抬高的变化以及QTmax和QTend中的最小变化来检测高血糖。 通过利用QTmax和QTend与ST段抬高相结合，可以将由低/高血糖引起的ST段抬高的变化与缺血引起的变化进行适当区分。

公开(公告)号：US07539539B1

公开(公告)日：2009-05-26

申请号：US11248888

申请日：2005-10-11

申请人： Rupinder Bharmi

发明人： Rupinder Bharmi

IPC分类号： A61N1/365 ,  A61B5/08

CPC分类号： A61B5/0452 ,  A61B5/053 ,  A61B5/0816 ,  A61B5/087 ,  A61N1/36585

摘要： A method of providing cardiac stimulation therapy and a device for providing the therapy. A patient's cardiac activity as well as cyclical respiration is monitored. Cardiac stimulation is provided as indicated as therapeutic intervention for a variety of cardiac arrhythmias according to variable timing parameters. One or more of the timing parameters under which cardiac pacing stimulations are provided is varied or modulated with the cyclical variations in respiration. The one or more timing parameters are generally shortened or elongated in concert with the alternating inspiration/exhalation phases of respiration. In certain implementations, the patient's respiration is inferred from cardiac based physiologic signals. The methods and devices for providing cardiac stimulation therapy more accurately emulate natural healthy physiologic activity.

摘要翻译： 提供心脏刺激治疗的方法和用于提供治疗的装置。 监测患者的心脏活动以及周期性呼吸。 根据可变时间参数，为各种心律失常治疗干预提供心脏刺激。 提供心脏起搏刺激的一个或多个时间参数随着呼吸的周期性变化而变化或调节。 与呼吸的交替的吸气/呼气阶段一致地，一个或多个时间参数通常缩短或延长。 在某些实施方式中，从基于心脏的生理信号推断患者的呼吸。 提供心脏刺激治疗的方法和设备更准确地模拟天然健康的生理活动。

公开(公告)号：US07524287B2

公开(公告)日：2009-04-28

申请号：US11127370

申请日：2005-05-11

申请人： Rupinder Bharmi

发明人： Rupinder Bharmi

IPC分类号： A61B5/0452

CPC分类号： A61N1/3962 ,  A61B5/0452 ,  A61B5/0468 ,  A61B5/14532 ,  A61N1/3621 ,  A61N1/3627 ,  A61N1/36557 ,  A61N1/3925

摘要： Techniques are described for detecting and distinguishing among ischemia, hypoglycemia or hyperglycemia based on intracardiac electrogram (IEGM) signals. In one technique, these conditions are detected and distinguished based on an analysis of: the interval between the QRS complex and the peak of a T-wave (QTmax), the interval between the QRS complex and the end of a T-wave (QTend), alone or in combination with a change in ST segment elevation. By exploiting QTmax and QTend in combination with ST segment elevation, changes in ST segment elevation caused by hypo/hyperglycemia can be properly distinguished from changes caused by cardiac ischemia. In another technique, hyperglycemia and hypoglycemia are predicted, detected and/or distinguished from one another based on an analysis of the amplitudes of P-waves, QRS-complexes and T-waves within the IEGM. Appropriate warning signals are delivered and therapy is automatically adjusted.

摘要翻译： 描述了基于心脏电图（IEGM）信号检测和区分缺血，低血糖或高血糖的技术。 在一种技术中，基于以下分析来检测和区分这些条件：QRS复数与T波峰值之间的间隔（QTmax），QRS波形与T波结束之间的间隔（QTend ），单独或与ST段抬高的变化组合。 通过利用QTmax和QTend与ST段抬高相结合，可以将由低/高血糖引起的ST段抬高的变化与心脏缺血引起的变化进行适当区分。 在另一种技术中，基于对IEGM内的P波，QRS复合物和T波的振幅的分析，预测，检测和/或区分高血糖和低血糖。 交付适当的警告信号，治疗自动调整。

公开(公告)号：US07502644B2

公开(公告)日：2009-03-10

申请号：US11043612

申请日：2005-01-25

申请人： Jong Gill ,  Peter Boileau ,  Rupinder Bharmi ,  Xiaoyi Min ,  Joseph J. Florio ,  Michael Benser ,  Gene A. Bornzin

发明人： Jong Gill ,  Peter Boileau ,  Rupinder Bharmi ,  Xiaoyi Min ,  Joseph J. Florio ,  Michael Benser ,  Gene A. Bornzin

IPC分类号： A61B5/0468

CPC分类号： A61N1/3962 ,  A61B5/0452 ,  A61B5/0468 ,  A61B5/14532 ,  A61N1/3621 ,  A61N1/3627 ,  A61N1/36557 ,  A61N1/3925

摘要： Techniques are described for detecting ischemia, hypoglycemia or hyperglycemia based on intracardiac electrogram (IEGM) signals. Ischemia is detected based on a shortening of the interval between the QRS complex and the end of a T-wave (QTmax), alone or in combination with a change in ST segment elevation. Alternatively, ischemia is detected based on a change in ST segment elevation combined with minimal change in the interval between the QRS complex and the end of the T-wave (QTend). Hypoglycemia is detected based on a change in ST segment elevation along with a lengthening of either QTmax or QTend. Hyperglycemia is detected based on a change in ST segment elevation along with minimal change in QTmax and in QTend. By exploiting QTmax and QTend in combination with ST segment elevation, changes in ST segment elevation caused by hypo/hyperglycemia can be properly distinguished from changes caused by ischemia.

摘要翻译： 描述了基于心内电描记图（IEGM）信号检测缺血，低血糖或高血糖的技术。 基于QRS复合体与T波结束（QTmax）之间的间隔的缩短单独或与ST段抬高的变化相结合来检测局部缺血。 或者，基于ST段抬高的变化结合QRS复合体与T波结束（QTend）之间的间隔的最小变化来检测局部缺血。 基于ST段抬高的变化以及QTmax或QTend的延长来检测低血糖。 基于ST段抬高的变化以及QTmax和QTend中的最小变化来检测高血糖。 通过利用QTmax和QTend与ST段抬高相结合，可以将由低/高血糖引起的ST段抬高的变化与缺血引起的变化进行适当区分。

公开(公告)号：US07297114B2

公开(公告)日：2007-11-20

申请号：US11043804

申请日：2005-01-25

申请人： Jong Gill ,  Peter Boileau ,  Rupinder Bharmi ,  Xiaoyi Min ,  Joseph J. Florio ,  Michael Benser ,  Gene A. Bornzin

发明人： Jong Gill ,  Peter Boileau ,  Rupinder Bharmi ,  Xiaoyi Min ,  Joseph J. Florio ,  Michael Benser ,  Gene A. Bornzin

IPC分类号： A61B5/0452

CPC分类号： A61N1/3962 ,  A61B5/0452 ,  A61B5/0468 ,  A61B5/14532 ,  A61N1/3621 ,  A61N1/3627 ,  A61N1/36557 ,  A61N1/3925

摘要： Techniques are described for detecting ischemia, hypoglycemia or hyperglycemia based on intracardiac electrogram (IEGM) signals. Ischemia is detected based on a shortening of the interval between the QRS complex and the end of a T-wave (QTmax), alone or in combination with a change in ST segment elevation. Alternatively, ischemia is detected based on a change in ST segment elevation combined with minimal change in the interval between the QRS complex and the end of the T-wave (QTend). Hypoglycemia is detected based on a change in ST segment elevation along with a lengthening of either QTmax or QTend. Hyperglycemia is detected based on a change in ST segment elevation along with minimal change in QTmax and in QTend. By exploiting QTmax and QTend in combination with ST segment elevation, changes in ST segment elevation caused by hypo/hyperglycemia can be properly distinguished from changes caused by ischemia.

摘要翻译： 描述了基于心内电描记图（IEGM）信号检测缺血，低血糖或高血糖的技术。 基于QRS复合体与T波结束（QTmax）之间的间隔的缩短单独或与ST段抬高的变化相结合来检测局部缺血。 或者，基于ST段抬高的变化结合QRS复合体与T波结束（QTend）之间的间隔的最小变化来检测局部缺血。 基于ST段抬高的变化以及QTmax或QTend的延长来检测低血糖。 基于ST段抬高的变化以及QTmax和QTend中的最小变化来检测高血糖。 通过利用QTmax和QTend与ST段抬高相结合，可以将由低/高血糖引起的ST段抬高的变化与缺血引起的变化进行适当区分。