公开(公告)号：US20120330371A1

公开(公告)日：2012-12-27

申请号：US13601569

申请日：2012-08-31

申请人： Allen Keel ,  Steve Koh ,  Taraneh Ghaffari Farazi

发明人： Allen Keel ,  Steve Koh ,  Taraneh Ghaffari Farazi

IPC分类号： A61N1/365

CPC分类号： A61N1/3702 ,  A61N1/3627 ,  A61N1/36507 ,  A61N1/368 ,  A61N1/3712

摘要： Diastolic function is monitored within a patient using a pacemaker or other implantable medical device. In one example, the implantable device uses morphological parameters derived from the T-wave evoked response waveform as proxies for ventricular relaxation rate and ventricular compliance. In particular, the magnitude of the peak of the T-wave evoked response is employed as a proxy for ventricular compliance. The maximum slew rate of the T-wave evoked response following its peak is employed as a proxy for ventricular relaxation. A metric is derived from these proxy values to represent diastolic function. The metric is tracked over time to evaluate changes in diastolic function. In other examples, specific values for ventricular compliance and ventricular relaxation are derived for the patient based on the T-wave evoked response parameters.

摘要翻译： 使用起搏器或其他可植入医疗器械在患者体内监测舒张功能。 在一个示例中，可植入装置使用从T波诱发反应波形导出的形态参数作为心室松弛率和心室顺应性的代理。 特别地，T波诱发反应的峰值的大小被用作心室顺应性的代表。 其峰值后的T波诱发反应的最大压摆率被用作心室松弛的代用品。 来自这些代理值的度量来表示舒张功能。 随着时间的推移跟踪度量以评估舒张功能的变化。 在其他实例中，基于T波诱发反应参数为患者导出心室顺应性和心室松弛的具体值。

公开(公告)号：US20120191154A1

公开(公告)日：2012-07-26

申请号：US13012574

申请日：2011-01-24

申请人： Kyungmoo Ryu ,  Stuart Rosenberg ,  Allen Keel ,  Taraneh Ghaffari Farazi ,  Richard Williamson ,  Mark Carlson

发明人： Kyungmoo Ryu ,  Stuart Rosenberg ,  Allen Keel ,  Taraneh Ghaffari Farazi ,  Richard Williamson ,  Mark Carlson

IPC分类号： A61N1/365

CPC分类号： A61N1/36521 ,  A61N1/3622 ,  A61N1/3684 ,  A61N1/3686 ,  A61N1/3962

摘要： An implantable medical device includes a lead configured to be located proximate to the left ventricle (LV) of the heart, the lead including multiple LV electrodes to sense cardiac activity at multiple LV sensing sites. The a detection module to detect an arrhythmia that represents at least one of a tachycardia and fibrillation based at least in part on the cardiac activity sensed at the multiple LV sensing sites. The ATP therapy module to identify at least one of an ATP configuration or an ATP therapy site based on the cardiac sensed activity at the LV sensing sites, the ATP therapy module to control delivery of antitachycardia pacing (ATP) therapy at the ATP therapy site. The ATP therapy module delivers a stimulus to electrodes at one or more of an LV site, right ventricular (RV) site and right atrial (RA) site, the detection module to sense evoked responses at the LV sensing sites, the ATP therapy module to designate the ATP therapy site to include at least the LV sensing site with a shortest activation time relative to the one or more LV site, RV site and RA site where the stimulus is delivered.

摘要翻译： 可植入医疗装置包括被配置为位于心脏左心室（LV）附近的引线，该引线包括多个LV电极以感测多个LV感测部位的心脏活动。 该检测模块至少部分地基于在多个LV感测位点处感测到的心脏活动来检测代表心动过速和颤动中的至少一种的心律失常。 ATP治疗模块基于LV感测位点处的心脏感测活动来鉴定ATP配置或ATP治疗部位中的至少一个，ATP治疗模块用于控制ATP治疗部位的抗心动过速起搏（ATP）治疗的递送。 ATP治疗模块向LV位点，右心室（RV）位点和右心房（RA）位点的一个或多个处的电极施加刺激，检测模块用于感测LV感测位点处的诱发反应，ATP治疗模块 指定ATP治疗部位至少包括相对于传递刺激物的一个或多个LV部位，RV部位和RA部位具有最短激活时间的LV感测部位。

公开(公告)号：US08175668B1

公开(公告)日：2012-05-08

申请号：US11877056

申请日：2007-10-23

申请人： Yelena Nabutovsky ,  Gene A. Bornzin ,  Taraneh Ghaffari Farazi ,  John W. Poore

发明人： Yelena Nabutovsky ,  Gene A. Bornzin ,  Taraneh Ghaffari Farazi ,  John W. Poore

IPC分类号： A61B5/1455

CPC分类号： A61B5/14552 ,  A61B5/1459 ,  A61N1/36557

摘要： An intravenous implantable optical sensor assesses the relative absorbance of multiple wavelengths of light in order to determine oxygen saturation. The calculation of oxygen saturation is enhanced by use of a function of hematocrit which is derived from the relative absorbance of light of an isobestic wavelength along two different length paths through the blood. The use of the hematocrit-dependent term and multiple wavelengths of light to calculate oxygen saturation provides results that are less susceptible to noise and variation in hematocrit and thus provides a more accurate measure of oxygen saturation over a wider range of conditions than previously possible. The optical sensor may form part of an implantable system which performs the calculation of oxygen saturation and uses the results for a diagnostic or therapeutic purpose.

摘要翻译： 静脉注射光学传感器评估多个波长的光的相对吸光度以确定氧饱和度。 通过使用血细胞比容的功能来提高氧饱和度的计算，血细胞比容的功能来源于通过血液的两条不同长度路径的异质波长的光的相对吸光度。 使用血细胞比容相关术语和多个波长的光来计算氧饱和度提供的结果不太容易受噪声和血细胞比容的变化，因此在比以前可能的更宽的条件下提供更准确的氧饱和度测量。 光学传感器可以形成可执行氧饱和度的计算的可植入系统的一部分，并将结果用于诊断或治疗目的。

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：US08032213B1

公开(公告)日：2011-10-04

申请号：US11753890

申请日：2007-05-25

申请人： Fujian Qu ,  Taraneh Ghaffari Farazi

发明人： Fujian Qu ,  Taraneh Ghaffari Farazi

IPC分类号： A61N1/08

CPC分类号： A61N1/3943 ,  A61N1/3962

摘要： Systems and methods are provided for estimating a patient's ventricular defibrillation threshold (VDFT). Stimulation pulses, which are of at least three different energy levels up to 2 Joules, are delivered to the patient's right ventricle during a window defined between an R-wave and a vulnerable period that follows the R-wave. Voltage potentials, induced in response to the delivered RV stimulation pulses, are measured at a location of the patient's left ventricle (LV) where it is predicted that potential gradients induced in response to RV stimulation pulses will be lowest. Potential gradients are computed using the measured voltage potentials. The patient's VDFT can then be estimated by estimating, based on the computed potential gradients, the RV stimulation energy level that would be required to achieve a minimum acceptable potential gradient at the location of the patient's LV where it is predicted that potential gradients induced in response to RV stimulation pulses will be lowest.

摘要翻译： 提供了用于估计患者的心室除颤阈值（VDFT）的系统和方法。 具有至少三个不同能量级别至多2个焦耳的刺激脉冲在R波和R波之后的易受伤害的时期内界定的窗口内传送到患者的右心室。 在患者的左心室（LV）的位置处测量响应于递送的RV刺激脉冲诱导的电压电位，其中预测响应RV刺激脉冲诱导的电位梯度将最低。 使用测量的电压电位计算电位梯度。 然后可以通过基于计算的潜在梯度估计在患者LV的位置处达到最小可接受电位梯度所需的RV刺激能量水平来估计患者的VDFT，其中预测响应中诱发的潜在梯度 RV刺激脉冲最低。

公开(公告)号：US08005533B1

公开(公告)日：2011-08-23

申请号：US11669744

申请日：2007-01-31

申请人： Taraneh Ghaffari Farazi

发明人： Taraneh Ghaffari Farazi

IPC分类号： A61B5/0452

CPC分类号： A61B5/0452 ,  A61N1/36114 ,  A61N1/3621 ,  A61N1/3702 ,  A61N1/3925 ,  A61N1/3962

摘要： Embodiments of the present invention relate to implantable systems, and methods for use therewith, for assessing a patients' myocardial electrical stability. Implanted electrodes are used to obtain an electrogram (EGM) signal, which is used to identify periods when the patient experiences T-wave alternans. Additionally, the EGM signal is used to determine whether premature ventricular contractions (PVCs) cause phase reversals of the T-wave alternans. The patient's myocardial electrical stability is assessed based on whether, and in a specific embodiment the extent to which, PVCs cause phase reversals of the T-wave alternans. This abstract is not intended to be a complete description of, or limit the scope of, the invention.

摘要翻译： 本发明的实施例涉及用于评估患者心肌电稳定性的可植入系统及其使用的方法。 植入电极用于获得电描记图（EGM）信号，用于识别患者经历T波交替的时期。 此外，EGM信号用于确定是否过早的心室收缩（PVC）引起T波交替的相逆转。 基于在特定实施方案中，PVC在多大程度上导致T波交替发生相位反转的程度来评估患者的心肌电稳定性。 本摘要不是对本发明的完整描述或限制本发明的范围。

公开(公告)号：US20110196442A1

公开(公告)日：2011-08-11

申请号：US12703094

申请日：2010-02-09

申请人： Kyungmoo Ryu ,  Stuart Rosenberg ,  Allen Keel ,  Taraneh Ghaffari Farazi ,  Xiaoyi Min

发明人： Kyungmoo Ryu ,  Stuart Rosenberg ,  Allen Keel ,  Taraneh Ghaffari Farazi ,  Xiaoyi Min

IPC分类号： A61N1/365

CPC分类号： A61N1/37247 ,  A61N1/36507 ,  A61N1/36521 ,  A61N1/3682 ,  A61N1/3684 ,  A61N1/37282

摘要： Techniques are provided for use with an implantable cardiac stimulation device equipped for multi-site left ventricular (MSLV) pacing using a multi-pole LV lead. In one example, referred to herein as QuickStim, cardiac pacing configurations are optimized based on an assessment of hemodynamic benefit and device longevity. In another example, referred to herein as QuickSense, cardiac sensing configurations are optimized based on sensing profiles input by a clinician. Various virtual sensing channels are also described that provide for the multiplexing or gating of sensed signals. Anisotropic oversampling is also described.

摘要翻译： 提供技术用于使用多极LV引线配备用于多位点左心室（MSLV）起搏的可植入心脏刺激装置。 在一个例子中，本文称为QuickStim，基于对血液动力学益处和器械寿命的评估来优化心脏起搏配置。 在另一个例子中，本文称为QuickSense，基于由临床医生输入的感测曲线来优化心脏感测配置。 还描述了各种虚拟感测通道，其提供感测信号的复用或门控。 还描述了各向异性过采样。

公开(公告)号：US20110196254A1

公开(公告)日：2011-08-11

申请号：US13088223

申请日：2011-04-15

申请人： Brian Jeffrey Wenzel ,  Taraneh Ghaffari Farazi

发明人： Brian Jeffrey Wenzel ,  Taraneh Ghaffari Farazi

IPC分类号： A61N1/365 ,  A61N1/36 ,  A61B5/04

CPC分类号： A61B5/04001 ,  A61B5/4047 ,  A61B5/4818 ,  A61B5/4866 ,  A61B5/7264 ,  A61N1/36117 ,  A61N1/365 ,  A61N1/3702

摘要： An exemplary includes acquiring an electroneurogram of the right carotid sinus nerve or the left carotid sinus nerve, analyzing the electroneurogram for at least one of chemosensory information and barosensory information and calling for one or more therapeutic actions based at least in part on the analyzing. Therapeutic actions may aim to treat conditions such as sleep apnea, an increase in metabolic demand, hypoglycemia, hypertension, renal failure, and congestive heart failure. Other exemplary methods, devices, systems, etc., are also disclosed.

公开(公告)号：US20110098546A1

公开(公告)日：2011-04-28

申请号：US12976493

申请日：2010-12-22

申请人： Taraneh Ghaffari Farazi ,  Gene A. Bornzin ,  Yelena Nabutovsky ,  Kyungmoo Ryu ,  Keith Victorine ,  Xiaoyi Min ,  John W. Poore

发明人： Taraneh Ghaffari Farazi ,  Gene A. Bornzin ,  Yelena Nabutovsky ,  Kyungmoo Ryu ,  Keith Victorine ,  Xiaoyi Min ,  John W. Poore

IPC分类号： A61B5/1459

CPC分类号： A61B5/1459 ,  A61B5/0031 ,  A61B5/0205 ,  A61B5/021 ,  A61B5/029 ,  A61B5/04001 ,  A61B5/0464 ,  A61B5/0816 ,  A61B5/14535 ,  A61B5/14539 ,  A61B5/7285 ,  A61N1/36557 ,  A61N1/36564 ,  A61N1/36585

摘要： Methods for assessing, diagnosing and treating medical conditions using SvO2 and hematocrit measurements alone, or in combination with other measurements related to cardiac activity are provided. These includes methods for distinguishing true anemia from diluted anemia, methods for anemia detection, methods for measuring disease progression based on anemia trending, methods for managing therapy delivery, methods for managing heart failure drug therapies, methods for cardiac output optimization based on SvO2, methods for cardiac resynchronization therapy lead placement, method for detection of heart failure decompensation, and methods to monitor and treat systolic versus diastolic heart failure are provided.

摘要翻译： 提供了使用SvO2和血细胞比容测量单独评估，诊断和治疗医疗条件或与心脏活动相关的其他测量结合的方法。 这些包括区分真正贫血与稀释性贫血的方法，贫血检测方法，基于贫血趋势测量疾病进展的方法，管理治疗递送的方法，管理心力衰竭药物治疗的方法，基于SvO2的心输出优化方法 用于心脏再同步治疗铅放置，心脏失代偿失代偿检测方法以及监测和治疗心脏收缩期与舒张性心力衰竭的方法。

公开(公告)号：US20110009755A1

公开(公告)日：2011-01-13

申请号：US12637574

申请日：2009-12-14

申请人： Brian Jeffrey Wenzel ,  Timothy A. Fayram ,  Allen J. Keel ,  Edward Karst ,  Wenbo Hou ,  Taraneh Ghaffari Farazi

发明人： Brian Jeffrey Wenzel ,  Timothy A. Fayram ,  Allen J. Keel ,  Edward Karst ,  Wenbo Hou ,  Taraneh Ghaffari Farazi

IPC分类号： A61B5/0215

CPC分类号： A61N1/36585 ,  A61B5/02125 ,  A61B5/0215 ,  A61B5/0295 ,  A61B5/0535 ,  A61B5/1459 ,  A61B5/7239 ,  A61N1/08 ,  B82Y10/00 ,  B82Y40/00 ,  G03F7/0002

摘要： Provided herein are implantable systems, and methods for use therewith, for monitoring a patient's arterial blood pressure while a patient's heart is being paced. A signal (e.g., PPG or IPG signal) indicative of changes in arterial blood volume remote from the patient's heart is obtained using a sensor or electrodes that are implanted remote from the patient's heart. One or more metrics indicative of pulse arrival time (PAT) are determined, where each metric can be determined by determining a time from a paced cardiac event to one or more predetermined features of the signal indicative of changes in arterial blood volume. Based on at the metric(s) indicative of PAT, arterial blood pressure is estimated, which can include determining values indicative of systolic blood pressure, diastolic blood pressure, pulse pressure and/or mean arterial blood pressure, and/or changes in such values.

摘要翻译： 本文提供了可植入系统及其使用的方法，用于在患者的心脏起搏时监测患者的动脉血压。 使用远离患者心脏植入的传感器或电极获得指示远离患者心脏的动脉血容量变化的信号（例如，PPG或IPG信号）。 确定指示脉冲到达时间（PAT）的一个或多个度量，其中可以通过确定从起搏心脏事件到指示动脉血容量变化的信号的一个或多个预定特征的时间来确定每个度量。 基于指示PAT的度量，估计动脉血压，其可以包括确定指示收缩压，舒张压，脉压和/或平均动脉血压的值，和/或这些值的变化 。