公开(公告)号：US08626278B2

公开(公告)日：2014-01-07

申请号：US12901296

申请日：2010-10-08

申请人： Euljoon Park ,  Steve Koh ,  Gene A. Bornzin

发明人： Euljoon Park ,  Steve Koh ,  Gene A. Bornzin

IPC分类号： A61B5/0464 ,  A61B5/053

CPC分类号： A61B5/046 ,  A61B5/0006 ,  A61B5/0031 ,  A61B5/02028 ,  A61B5/0205 ,  A61B5/029 ,  A61B5/0402 ,  A61B5/0422 ,  A61B5/0468 ,  A61B5/0538 ,  A61B5/0816 ,  A61B5/1116 ,  A61B5/1118 ,  A61B5/686 ,  A61B5/6869 ,  A61N1/3624 ,  A61N1/36521 ,  A61N1/36592

摘要： A medical device is provided that comprises a lead assembly. The lead assembly includes at least one intra-cardiac (IC) electrode, an extra-cardiac (EC) electrode and a subcutaneous remote-cardiac (RC) electrode. The IC electrode is configured to be located within the heart. The EC electrode is configured to be positioned proximate to at least one of a superior vena cava (SVC) and a left ventricle (LV) of a heart. The RC electrode is configured to be located remote from the heart. An extra-cardiac impedance (ECI) module is configured to measure extra-cardiac impedance along an ECI vector between the EC and RC electrodes to obtain ECI measurements. An arrhythmia monitoring module is configured to declare a potential atrial arrhythmia to be an atrial arrhythmia based on the hemodynamic performance determined from the ECI measurements. The hemodynamic performance assessment module is further enabled to compare a current ECI pattern with a prior baseline ECI waveform.

摘要翻译： 提供了包括引线组件的医疗装置。 引线组件包括至少一个心脏内（IC）电极，心外（EC）电极和皮下远心电（RC）电极）。 IC电极被配置为位于心脏内。 EC电极配置成靠近心脏的上腔静脉（SVC）和左心室（LV）中的至少一个定位。 RC电极被配置为远离心脏。 心脏外阻抗（ECI）模块被配置为测量EC和RC电极之间的ECI向量的心外阻抗，以获得ECI测量值。 心律失常监测模块被配置为基于从ECI测量确定的血液动力学性能来将潜在心房心律失常宣告为房性心律失常。 血液动力学性能评估模块还能够将当前ECI模式与先前的基线ECI波形进行比较。

公开(公告)号：US20120089032A1

公开(公告)日：2012-04-12

申请号：US12901296

申请日：2010-10-08

申请人： Euljoon Park ,  Steve Koh ,  Gene A. Bornzin

发明人： Euljoon Park ,  Steve Koh ,  Gene A. Bornzin

IPC分类号： A61B5/042 ,  A61B5/0205

CPC分类号： A61B5/046 ,  A61B5/0006 ,  A61B5/0031 ,  A61B5/02028 ,  A61B5/0205 ,  A61B5/029 ,  A61B5/0402 ,  A61B5/0422 ,  A61B5/0468 ,  A61B5/0538 ,  A61B5/0816 ,  A61B5/1116 ,  A61B5/1118 ,  A61B5/686 ,  A61B5/6869 ,  A61N1/3624 ,  A61N1/36521 ,  A61N1/36592

摘要： A medical device is provided that comprises a lead assembly. The lead assembly includes at least one intra-cardiac (IC) electrode, an extra-cardiac (EC) electrode and a subcutaneous remote-cardiac (RC) electrode. The IC electrode is configured to be located within the heart. The EC electrode is configured to be positioned proximate to at least one of a superior vena cava (SVC) and a left ventricle (LV) of a heart. The RC electrode is configured to be located remote from the heart. An arrhythmia monitoring module is configured to analyze intra-cardiac electrogram (IEGM) signals from the at least one IC electrode to identify a potential atrial arrhythmia. An extra-cardiac impedance (ECI) module is configured to measure extra-cardiac impedance along an ECI vector between the EC and RC electrodes to obtain ECI measurements. The hemodynamic performance (HDP) assessment module is configured to determine a hemodynamic performance based on the ECI measurements. The arrhythmia monitoring module is configured to declare the potential atrial arrhythmia to be an atrial arrhythmia based on the hemodynamic performance determined from the ECI measurements. The medical device further provides the HDP assessment module that derives a current ECI waveform from current ECI measurements and compares the current ECI pattern with a prior ECI waveform that is derived from prior ECI measurements.

摘要翻译： 提供了包括引线组件的医疗装置。 引线组件包括至少一个心脏内（IC）电极，心外（EC）电极和皮下远心电（RC）电极）。 IC电极被配置为位于心脏内。 EC电极配置成靠近心脏的上腔静脉（SVC）和左心室（LV）中的至少一个定位。 RC电极被配置为远离心脏。 心律失常监测模块被配置为分析来自至少一个IC电极的心脏内电针（IEGM）信号以识别潜在的心房心律失常。 心脏外阻抗（ECI）模块被配置为测量EC和RC电极之间的ECI向量的心外阻抗，以获得ECI测量值。 血液动力学性能（HDP）评估模块被配置为基于ECI测量来确定血液动力学性能。 心律失常监测模块被配置为基于从ECI测量确定的血流动力学性能来将潜在心房心律失常宣告为心房心律失常。 医疗设备还提供HDP评估模块，其从当前ECI测量中导出当前ECI波形，并将当前ECI模式与从先前ECI测量得到的先前ECI波形进行比较。

公开(公告)号：US07945314B1

公开(公告)日：2011-05-17

申请号：US11432636

申请日：2006-05-10

申请人： Jeffery D. Snell ,  Jong Gill ,  Gene A. Bornzin ,  Peter Boileau ,  Euljoon Park

发明人： Jeffery D. Snell ,  Jong Gill ,  Gene A. Bornzin ,  Peter Boileau ,  Euljoon Park

IPC分类号： A61B5/04

CPC分类号： A61B5/0402 ,  A61B5/0006 ,  A61N1/3702 ,  A61N1/37235 ,  A61N1/37282

摘要： A surface electrocardiogram (EKG) is emulated using signals detected by internal leads of an implanted device. In one example, emulation is performed using a technique that concatenates portions of signals sensed using different electrodes, such as by combining far-field ventricular signals sensed in the atria with far-field atrial signals sensed in the ventricles. In another example, emulation is performed using a technique that selectively amplifies or attenuates portions of a single signal, such as by attenuating near-field portions of an atrial unipolar signal relative to far-field portions of the same signal. The surface EKG emulation may be performed by the implanted device itself or by an external programmer based on cardiac signals transmitted thereto. A transtelephonic monitoring network is also described, wherein the emulated surface EKG (or raw data used to emulate the EKG) is relayed from an implanted device to a remote monitor, typically installed in a physician's office.

摘要翻译： 使用由植入装置的内部引线检测的信号来模拟表面心电图（EKG）。 在一个示例中，使用将使用不同电极感测的信号的部分连接的技术来执行仿真，例如通过将在心房中感测到的远场心室信号与在心室中感测到的远场心房信号组合。 在另一示例中，使用选择性地放大或衰减单个信号的部分的技术来执行仿真，例如通过衰减相对于相同信号的远场部分的心房单极信号的近场部分。 表面EKG仿真可以由植入装置本身或外部编程器基于发送到其上的心脏信号执行。 还描述了一种跨耳监测网络，其中仿真表面EKG（或用于模拟EKG的原始数据）从植入装置中继到通常安装在医师办公室中的远程监视器。

公开(公告)号：US07925349B1

公开(公告)日：2011-04-12

申请号：US11684681

申请日：2007-03-12

申请人： Louis Wong ,  Cem Shaquer ,  Gene A. Bornzin ,  Euljoon Park ,  Andre Walker ,  Dorin Panescu ,  Jiong Xia

发明人： Louis Wong ,  Cem Shaquer ,  Gene A. Bornzin ,  Euljoon Park ,  Andre Walker ,  Dorin Panescu ,  Jiong Xia

IPC分类号： A61N1/37

CPC分类号： A61B5/02028 ,  A61B5/0031 ,  A61B5/029 ,  A61B5/0538 ,  A61B5/08 ,  A61B5/4878 ,  A61N1/3627 ,  A61N1/36521 ,  A61N1/3702

摘要： An implantable system acquires intracardiac impedance with an implantable lead system. In one implementation, the system generates frequency-rich, low energy, multi-phasic waveforms that provide a net-zero charge and a net-zero voltage. When applied to bodily tissues, current pulses or voltage pulses having the multi-phasic waveform provide increased specificity and sensitivity in probing tissue. The effects of the applied pulses are sensed as a corresponding waveform. The waveforms of the applied and sensed pulses can be integrated to obtain corresponding area values that represent the current and voltage across a spectrum of frequencies. These areas can be compared to obtain a reliable impedance value for the tissue. Frequency response, phase delay, and response to modulated pulse width can also be measured to determine a relative capacitance of the tissue, indicative of infarcted tissue, blood to tissue ratio, degree of edema, and other physiological parameters.

公开(公告)号：US07899522B1

公开(公告)日：2011-03-01

申请号：US11549569

申请日：2006-10-13

申请人： Steve Koh ,  Gene A. Bornzin ,  Euljoon Park

发明人： Steve Koh ,  Gene A. Bornzin ,  Euljoon Park

IPC分类号： A61B5/04

CPC分类号： A61B5/0452 ,  A61B5/0472 ,  A61N1/3627 ,  A61N1/36521 ,  A61N1/36585 ,  A61N1/37258 ,  A61N1/37282

摘要： Techniques are provided for evaluating heart failure within a patient. In one example, the implantable device detects a decrease, if any, in selected morphological parameters derived from the intracardiac electrogram (IEGM) that are indicative of possible heart failure, such as paced depolarization integrals (PDI) or peak-to-peak amplitudes of QRS-complexes. The device also detects a decrease, if any, in transthoracic impedance, which is also indicative of possible heart failure. Acute heart failure is indicated if there is a decrease in the morphological IEGM parameters but no significant decrease in transthoracic impedance. Chronic heart failure is indicated if there is a decrease in transthoracic impedance but no significant decrease in the morphological IEGM parameters. If both transthoracic impedance and the morphological IEGM parameters are found to be decreasing significantly, the device issues a warning of severe heart failure.

摘要翻译： 提供了用于评估患者心脏衰竭的技术。 在一个示例中，可植入装置检测出来自指示可能的心力衰竭的心内电描记图（IEGM）的选定形态学参数中的减少（如果有的话），例如节奏去极化积分（PDI）或峰 - 峰幅度 QRS复合物。 该器件还检测经胸阻抗的减少（如果有的话），这也表示可能的心力衰竭。 如果形态学IEGM参数有降低但经胸阻抗无显着降低，则表示急性心力衰竭。 如果经胸阻抗降低但形态学IEGM参数无明显降低，则表示慢性心力衰竭。 如果发现经胸阻抗和形态学IEGM参数均明显下降，则该装置发出严重心力衰竭的警告。

公开(公告)号：US07725181B1

公开(公告)日：2010-05-25

申请号：US11291310

申请日：2005-11-30

申请人： Gene A. Bornzin ,  Euljoon Park

发明人： Gene A. Bornzin ,  Euljoon Park

IPC分类号： A61N1/00

CPC分类号： A61N1/368 ,  A61B5/113 ,  A61B5/4818 ,  A61N1/36514 ,  A61N1/3682

摘要： An implantable cardiac device minimizes apnea burden. In one implementation, the device administers a series of cardiac pacing trials using a different value for a pacing parameter in each trial and then measures an apnea burden corresponding to each trial in order to determine a value which reduces apnea burden when used for ongoing cardiac pacing. In one implementation the implantable cardiac device performs series of trials in cycles, during which a first series of trials determines a value for a first pacing parameter for reducing apnea burden while other pacing parameters are held constant. Subsequent series of trials subject the other pacing parameters, in turn, to their own series of pacing trials while holding the non-subjected pacing parameters constant. Through multiple cycles, the device optimizes each parameter in turn based on continually improving values for the other pacing parameters.

摘要翻译： 可植入的心脏装置使呼吸暂停负担最小化。 在一个实施方案中，该装置使用每个试验中的起搏参数使用不同的值进行一系列心脏起搏试验，然后测量与每次试验相对应的呼吸暂停负担，以便确定当用于持续心脏起搏时减少呼吸暂停负担的值 。 在一个实施方案中，可植入心脏装置以周期执行一系列试验，在此期间，第一系列试验确定第一起搏参数的值以减少呼吸暂停负担，而其他起搏参数保持恒定。 随后的一系列试验将其他起搏参数反过来归因于其自己的一系列起搏试验，同时保持不受起搏的起搏参数不变。 通过多个循环，设备会根据其他起搏参数的持续改进值轮流优化每个参数。

公开(公告)号：US07349732B1

公开(公告)日：2008-03-25

申请号：US10735944

申请日：2003-12-12

申请人： Jong Kil ,  Gene A. Bornzin ,  Peter Boileau ,  Euljoon Park

发明人： Jong Kil ,  Gene A. Bornzin ,  Peter Boileau ,  Euljoon Park

IPC分类号： A61B5/0402

CPC分类号： A61B5/042 ,  A61B5/04011

摘要： A surface electrocardiogram (EKG) is emulated using signals detected by the internal leads of an implanted device. In one example, the emulation is performed using a technique that concatenates portions of signals sensed using different electrodes, such as by combining far-field ventricular signals sensed in the atria with far-field atrial signals sensed in the ventricles or by combining near-field signals sensed in the atria with near-field signals sensed in the ventricles. In another example, the emulation is performed using a technique that selectively amplifies or attenuates portions of a single signal sensed using a single pair of electrodes, such as by attenuating near-field portions of an atrial unipolar signal relative to far-field portions of the same signal or by attenuating atrial portions of a cross-chamber signal relative to ventricular portions to the same signal. The surface EKG emulation may be performed by the implanted device itself or by an external programmer based on cardiac signals transmitted thereto.

公开(公告)号：US07272443B2

公开(公告)日：2007-09-18

申请号：US11014276

申请日：2004-12-15

申请人： Xiaoyi Min ,  Gene A. Bornzin ,  Euljoon Park

发明人： Xiaoyi Min ,  Gene A. Bornzin ,  Euljoon Park

IPC分类号： A61N1/365

CPC分类号： A61N1/36521 ,  A61B5/0538 ,  A61N1/3627 ,  A61N1/371

摘要： Techniques are provided for predicting the onset of a heart condition within a patient based on impedance measurements. Briefly, overloads in fluid levels in the thorax and in ventricular myocardial mass within the patient are detected based on impedance signals sensed using implanted electrodes. The onset of certain heart conditions is then predicted based on the overloads. For example, pulmonary edema arising due to diastolic heart failure is predicted based on the detection of on-going overloads in both fluid levels and ventricular mass. Ventricular hypertrophy is detected based on an on-going ventricular mass overload without a sustained fluid overload. Various other heart conditions may also be predicted based on specific combinations of recent or on-going overloads. Evoked response is exploited to corroborate the predictions. Appropriate warning signals are generated and preemptive therapy is initiated.

摘要翻译： 提供了基于阻抗测量来预测患者心脏病状发作的技术。 简单地说，基于使用植入电极感测到的阻抗信号来检测患者胸部液位水平和心室心肌质量的过载。 然后基于过载来预测某些心脏状况的发作。 例如，由于舒张性心力衰竭引起的肺水肿基于检测流体水平和心室质量中的持续过载而被预测。 基于正在进行的心室质量超载而无持续的流体超载检测出心室肥大。 还可以基于最近或正在进行的过载的特定组合来预测各种其他心脏状况。 被诱发的反应被利用来证实预测。 产生适当的警告信号并开始抢先治疗。

公开(公告)号：US06466821B1

公开(公告)日：2002-10-15

申请号：US09457451

申请日：1999-12-08

申请人： Anne M. Pianca ,  Gene A. Bornzin ,  Euljoon Park ,  Joseph J. Florio ,  Alan B. Vogel ,  Lee Jay Mandell ,  Junyu Mai

发明人： Anne M. Pianca ,  Gene A. Bornzin ,  Euljoon Park ,  Joseph J. Florio ,  Alan B. Vogel ,  Lee Jay Mandell ,  Junyu Mai

IPC分类号： A61N1362

CPC分类号： A61N1/36542

摘要： An implantable cardiac stimulation device which determines stimulation based upon the patient's body position and activity level while eliminating special implantation or calibration procedures. To eliminate such special implantation and calibration procedures, the stimulation device correlates the patient's body position using a multi-axis DC accelerometer or other sensor during times of high activity and determines a patient's standing position value. During other times, the stimulation device compares the signals from the accelerometer to the standing position value to determine the patient's current body position. Based upon the current body position and the activity level, the stimulation device determines the necessary stimulation to deliver to the patient.

摘要翻译： 一种可植入心脏刺激装置，其基于患者的身体位置和活动水平确定刺激，同时消​​除特殊植入或校准过程。 为了消除这种特殊的植入和校准过程，刺激装置在高活动时间期间使用多轴DC加速度计或其他传感器来关联患者的身体位置并且确定患者的站立位置值。 在其他时间，刺激装置将来自加速度计的信号与站立位置值进行比较，以确定患者的当前身体位置。 基于当前身体位置和活动水平，刺激装置确定必要的刺激以递送给患者。

公开(公告)号：US06269264B1

公开(公告)日：2001-07-31

申请号：US09325312

申请日：1999-06-03

申请人： Robert R. Weyant ,  Jason A. Sholder ,  Euljoon Park ,  Gene A. Bornzin ,  Joseph J. Florio ,  Said Mortazavi

发明人： Robert R. Weyant ,  Jason A. Sholder ,  Euljoon Park ,  Gene A. Bornzin ,  Joseph J. Florio ,  Said Mortazavi

IPC分类号： A61B505

CPC分类号： A61N1/36521

摘要： Methods and apparatus are provided for measuring the impedance of a patient's body. Pulse generating circuitry within a rate-responsive pacemaker is used to generate an impedance measurement signal that is applied to the body of the patient with conventional pacemaker leads. The impedance measurement signal contains a series of multiphasic impedance measurement waveforms, which have no net DC value and zero value after second integration. The impedance measurement signal allows the impedance of the body to be measured without interfering with external cardiac monitoring equipment such as electrocardiogram machines.

摘要翻译： 提供了用于测量患者身体阻抗的方法和装置。 速率响应起搏器内的脉冲发生电路用于产生用常规起搏器引线施加到患者身体的阻抗测量信号。 阻抗测量信号包含一系列多相阻抗测量波形，其在第二次积分后不具有净DC值和零值。 阻抗测量信号允许测量身体的阻抗，而不会干扰外部心脏监测设备，如心电图仪。