公开(公告)号：US08731665B1

公开(公告)日：2014-05-20

申请号：US11923286

申请日：2007-10-24

申请人： Xiaoyi Min ,  Laleh Jalali ,  Steve Koh ,  Gene A. Bornzin ,  Euljoon Park

发明人： Xiaoyi Min ,  Laleh Jalali ,  Steve Koh ,  Gene A. Bornzin ,  Euljoon Park

IPC分类号： A61N1/00

CPC分类号： A61N1/365 ,  A61N1/36535

摘要： Systems and methods are provided for detecting the orientation and/or movement of a patient having an implantable cardiac stimulation device and evaluating whether a change in the patient's cardiac activity can be at least in part due to a change in the patient's orientation. In one particular embodiment, signals from an orientation sensor and/or a pressure sensor are evaluated to determine static positional orientation of the patient and determine based on the static orientation whether the patient's cardiac activity is abnormal.

摘要翻译： 提供了用于检测具有可植入心脏刺激装置的患者的取向和/或运动的系统和方法，并且评估患者的心脏活动的变化是否可以至少部分地由于患者取向的改变而变化。 在一个特定实施例中，评估来自定向传感器和/或压力传感器的信号以确定患者的静态位置取向，并且基于静态取向来确定患者的心脏活动是否异常。

公开(公告)号：US08447389B2

公开(公告)日：2013-05-21

申请号：US12861573

申请日：2010-08-23

申请人： Steve Koh ,  Michael Yang ,  Ryan Rooke ,  Stuart Rosenberg ,  Wenbo Hou

发明人： Steve Koh ,  Michael Yang ,  Ryan Rooke ,  Stuart Rosenberg ,  Wenbo Hou

IPC分类号： A61B5/0452

CPC分类号： A61B5/0422 ,  A61B5/686 ,  A61B5/7282 ,  A61B2576/023 ,  A61N1/365 ,  A61N1/3702

摘要： A system and method are provided for monitoring ischemic development. The system and method identify a non-physiologic event and obtain cardiac signals along multiple sensing vectors, wherein at least a portion of the sensing vectors extend to or from electrodes located proximate to the left ventricle. The system and method monitor a segment of interest in the cardiac signals obtained along the multiple sensing vectors to identify deviations in the segment of interest from a baseline. The system and method record at least one of timing or segment shift information associated with the deviations in the segments of interest; and identify at least one of size, direction of development or rate of progression of an ischemia region based on the at least one of timing or segment shift information.

摘要翻译： 提供了一种用于监测缺血发育的系统和方法。 系统和方法识别非生理事件并且沿着多个感测向量获得心脏信号，其中至少一部分感测向量延伸到位于靠近左心室的电极。 系统和方法监测沿着多个感测向量获得的心脏信号中的感兴趣区段，以识别感兴趣区段中的偏离基线。 系统和方法记录与感兴趣的部分中的偏差相关联的定时或分段移位信息中的至少一个; 并且基于定时或段位移信息中的至少一个来识别缺血区域的大小，发育方向或进展速度中的至少一个。

公开(公告)号：US20130053912A1

公开(公告)日：2013-02-28

申请号：US13217554

申请日：2011-08-25

申请人： Gene A. Bornzin ,  Xiaoyi Min ,  Laurence S. Sloman ,  Steve Koh

发明人： Gene A. Bornzin ,  Xiaoyi Min ,  Laurence S. Sloman ,  Steve Koh

IPC分类号： A61N1/368

CPC分类号： A61B5/053 ,  A61B5/0205 ,  A61B5/0538 ,  A61B5/686 ,  A61N1/36185 ,  A61N1/3627 ,  A61N1/3686

摘要： Techniques are provided for use with an implantable medical device for detecting and assessing heart failure and for controlling cardiac resynchronization therapy (CRT) based on impedance signals obtained using hybrid impedance configurations. The hybrid configurations exploit right atrial (RA)-based impedance measurement vectors and/or left ventricular (LV)-based impedance measurement vectors. In one example, current is injected between the device case and a ring electrode in the right ventricle (RV) or RA. RA-based impedance values are measured along vectors between the device case and an RA electrode. LV-based impedance values are measured along vectors between the device case and one or more electrodes of the LV. Heart failure and other cardiac conditions are detected and tracked using the measured impedance values. CRT delay parameters are also optimized based impedance. In this manner, multiple hybrid impedance measurement configurations are exploited whereby different vectors are used to inject current and measure impedance.

摘要翻译： 提供技术用于可植入医疗装置，用于基于使用混合阻抗配置获得的阻抗信号来检测和评估心力衰竭并用于控制心脏再同步治疗（CRT）。 混合配置利用基于右心房（RA）的阻抗测量向量和/或左心室（LV））的阻抗测量向量。 在一个示例中，电流注入到装置壳体和右心室（RV）或RA中的环形电极之间。 基于RA的阻抗值是沿器件壳体和RA电极之间的矢量测量的。 基于LV的阻抗值在器件壳体和LV的一个或多个电极之间的矢量上测量。 使用测量的阻抗值检测和跟踪心力衰竭和其他心脏状况。 CRT延迟参数也是基于阻抗的优化。 以这种方式，利用多个混合阻抗测量配置，由此使用不同的矢量来注入电流并测量阻抗。

公开(公告)号：US20120215274A1

公开(公告)日：2012-08-23

申请号：US13032509

申请日：2011-02-22

申请人： Steve Koh ,  Gene A. Bornzin

发明人： Steve Koh ,  Gene A. Bornzin

IPC分类号： A61N1/365

CPC分类号： A61N1/36578

摘要： An implantable medical device (“IMD”) processes and analyzes valuable clinical information regarding cardiac performance. A database or correlator is pre-customized to the specific patient, by correlating signals received by a remote accelerometer associated with heart movements with accurate heart sounds recorded from a microphone to provide a more effective and customized basis for estimating heart sound. The information is then used to better control an implantable medical device.

摘要翻译： 可植入医疗设备（“IMD”）处理和分析有关心脏性能的有价值的临床信息。 通过将与心脏移动相关联的远程加速度计所接收的信号与从麦克风记录的精确心脏声音相关联，以提供用于估计心脏声音的更有效和定制的基础，将数据库或相关器预先定制到特定患者。 然后将该信息用于更好地控制可植入医疗装置。

公开(公告)号：US08249706B2

公开(公告)日：2012-08-21

申请号：US12694098

申请日：2010-01-26

申请人： Steve Koh

发明人： Steve Koh

IPC分类号： A61N1/365

CPC分类号： A61N1/36514

摘要： Selection of an appropriate rate programming control (RPC) setting in an implantable medical device (IMD), uses analysis of VA coupling surrogate conditions. The VA coupling surrogate conditions are derived from signals such as cardiogenic impedance, blood pressure, and the pulsatile components of PPG. By analyzing a waveform of the measured surrogate condition, the IMD estimates wall stiffness, through the slope of the waveform, and peripheral arterial pressure, through the reflection time between the main wave and reflection wave of the waveform. These values are plotted against each other on a VA coupling coordinate plane. Based on the location and orientation of the resulting VA coupling plot, the IMD selects an appropriate RPC setting.

摘要翻译： 在可植入医疗设备（IMD）中选择适当的速率编程控制（RPC）设置，使用VA耦合替代条件的分析。 VA耦合替代条件来自诸如心源阻抗，血压和PPG脉冲成分的信号。 通过分析测量的替代条件的波形，IMD通过波形的波形和反射波之间的反射时间来估计壁面刚度，通过波形斜率和外周动脉压力。 这些值在VA耦合坐标平面上相互绘图。 根据所得的VA耦合图的位置和方向，IMD选择适当的RPC设置。

公开(公告)号：US20120190991A1

公开(公告)日：2012-07-26

申请号：US13012595

申请日：2011-01-24

申请人： Gene A. Bornzin ,  Steve Koh ,  James S. Whiting ,  Neal L. Eigler ,  Brian M. Mann

发明人： Gene A. Bornzin ,  Steve Koh ,  James S. Whiting ,  Neal L. Eigler ,  Brian M. Mann

IPC分类号： A61B5/021

CPC分类号： A61B5/4878 ,  A61B5/0215 ,  A61B5/686

摘要： Techniques are provided for detecting a clinically-significant pulmonary fluid accumulation within a patient using a pacemaker or other implantable medical device. Briefly, the device detects left atrial pressure (LAP) within the patient and tracks changes in the LAP values over time that are indicative of possible pulmonary fluid accumulation within the patient. The device determines whether the changes in LAP values are sufficiently elevated and prolonged to warrant clinical intervention using, e.g., a predictor model-based technique. If the fluid accumulation is clinically significant, the device then generates warning signals, records diagnostics, controls therapy and/or titrates diuretics. False positive detections of pulmonary edema due to transients in LAP are avoided with this technique. Pulmonary artery pressure (PAP)-based techniques are also described.

摘要翻译： 提供技术用于使用起搏器或其他可植入医疗装置来检测患者内的临床上重要的肺液积聚。 简而言之，该装置检测患者内的左心房压力（LAP），跟踪随时间推移的LAP值的变化，其指示患者内可能的肺液体积聚。 该装置使用例如基于预测器模型的技术来确定LAP值的变化是否足够提高和延长以保证临床干预。 如果液体积聚在临床上显着，那么该装置然后产生警告信号，记录诊断，控制治疗和/或滴定利尿剂。 用这种技术避免了由于LAP瞬变引起的肺水肿的虚假阳性检测。 还描述了基于肺动脉压（PAP）的技术。

公开(公告)号：US08192360B2

公开(公告)日：2012-06-05

申请号：US11861028

申请日：2007-09-25

申请人： Steve Koh ,  Jonathan T. Losk

发明人： Steve Koh ,  Jonathan T. Losk

IPC分类号： A61B5/00 ,  C12M1/00

CPC分类号： G01N21/6454 ,  A61B5/0031 ,  A61B5/0071 ,  A61B5/0075 ,  A61B5/0084 ,  A61B5/411 ,  A61B2562/028 ,  G01N21/05 ,  G01N21/6428 ,  G01N2021/0328 ,  G01N2021/0346 ,  G01N2021/058 ,  G01N2021/6482

摘要： An exemplary implantable microarray device includes an inlet for a body fluid, a plurality of individual reaction cell arrays where each reaction cell array includes a series of reaction cells configured to receive the body fluid, a sensor array to sense a reaction result for an individual reaction cell array where the reaction result corresponds to a reaction between the body fluid and at least one reagent in each of the reaction cells of the individual reaction cell array and a positioning mechanism to position an individual reaction cell array with respect to the sensor array. Various other exemplary technologies are also disclosed.

摘要翻译： 示例性可植入微阵列装置包括用于体液的入口，多个单独的反应池阵列，其中每个反应池阵列包括一系列被配置为接纳体液的反应池，感测器阵列以感测各个反应的反应结果 其中反应结果对应于体液和单个反应池阵列的每个反应池中的至少一个试剂之间的反应以及相对于传感器阵列定位单个反应池阵列的定位机构。 还公开了各种其它示例性技术。

公开(公告)号：US08016812B2

公开(公告)日：2011-09-13

申请号：US12841944

申请日：2010-07-22

申请人： Steve Koh

发明人： Steve Koh

IPC分类号： A61M31/00

CPC分类号： A61N1/326 ,  A61M5/14276 ,  A61M5/1723 ,  A61M2210/125 ,  A61M2230/04 ,  A61N1/3621 ,  A61N1/371

摘要： An exemplary method includes acquiring cardiac electrical activity information, detecting a T wave and, based on the detecting, calling for delivery of matter to the heart where the matter may include one or more of stem cells, progenitor cells, nutrients and drugs. Another exemplary method includes calling for delivery of electrical energy to cells destined for implantation in the body or cells already implanted in the body. Such delivery may be timed according to cardiac electrical activity and/or delivered at an energy level below a capture threshold of neighboring tissue. Various other exemplary technologies are also disclosed.

摘要翻译： 一种示例性方法包括获取心脏电活动信息，检测T波，并且基于检测要求将物质递送到心脏，其中物质可以包括干细胞，祖细胞，营养物和药物中的一种或多种。 另一个示例性方法包括要求将电能递送到注入体内的细胞或已经植入体内的细胞中。 这种递送可以根据心脏电活动定时和/或在低于相邻组织的捕获阈值的能量水平下递送。 还公开了各种其它示例性技术。

公开(公告)号：US20110196440A1

公开(公告)日：2011-08-11

申请号：US12701816

申请日：2010-02-08

申请人： Steve Koh

发明人： Steve Koh

IPC分类号： A61N1/365

CPC分类号： A61N1/36514 ,  A61B5/0215 ,  A61B5/028 ,  A61B5/029 ,  A61B5/0295 ,  A61B5/686 ,  A61N1/36564 ,  A61N1/36571 ,  A61N1/3682

摘要： Adaptively creating a table of optimal, patient-specific atrioventricular (AV) delays for a an implantable medical device (IMD) begins as the IMD detects the patient entering a target heart rates within a defined range of elevated heart rates. On detection, the device begins testing AV delays by pacing the heart at a number of different AV delays. The IMD selects the optimal AV delay based on a comparison of measurements of cardiac output obtained during each delay's test pacing period. The optimal AV delay corresponds to the one which resulted in the highest cardiac output. The device selects this optimal AV delay and stores it in an AV delay table on the device. The process continues as the device detects the patient entering the other target heart rates in order to complete the table.

摘要翻译： 随着IMD检测到患者在确定的升高的心率范围内进入目标心率，自适应地创建用于可植入医疗装置（IMD）的最佳患者特异性房室（AV）延迟的表格。 在检测时，设备通过在许多不同的AV延迟进行心脏起搏来开始测试AV延迟。 IMD基于每个延迟的测试起搏期间获得的心输出量测量值的比较来选择最佳的AV延迟。 最佳AV延迟对应于导致心输出量最高的延迟。 该设备选择此最佳AV延迟并将其存储在设备上的AV延迟表中。 该过程继续，因为设备检测到患者进入其他目标心率以完成该表。

公开(公告)号：US20110184485A1

公开(公告)日：2011-07-28

申请号：US12694098

申请日：2010-01-26

申请人： Steve Koh

发明人： Steve Koh

IPC分类号： A61N1/365

CPC分类号： A61N1/36514

摘要： Selection of an appropriate rate programming control (RPC) setting in an implantable medical device (IMD), uses analysis of VA coupling surrogate conditions. The VA coupling surrogate conditions are derived from signals such as cardiogenic impedance, blood pressure, and the pulsatile components of PPG. By analyzing a waveform of the measured surrogate condition, the IMD estimates wall stiffness, through the slope of the waveform, and peripheral arterial pressure, through the reflection time between the main wave and reflection wave of the waveform. These values are plotted against each other on a VA coupling coordinate plane. Based on the location and orientation of the resulting VA coupling plot, the IMD selects an appropriate RPC setting.

摘要翻译： 在可植入医疗设备（IMD）中选择适当的速率编程控制（RPC）设置，使用VA耦合替代条件的分析。 VA耦合替代条件来自诸如心源阻抗，血压和PPG脉冲成分的信号。 通过分析测量的替代条件的波形，IMD通过波形的波形和反射波之间的反射时间来估计壁面刚度，通过波形斜率和外周动脉压力。 这些值在VA耦合坐标平面上相互绘图。 根据所得的VA耦合图的位置和方向，IMD选择适当的RPC设置。