公开(公告)号：US06964641B2

公开(公告)日：2005-11-15

申请号：US10746814

申请日：2003-12-24

申请人： Yong Kyun Cho ,  Eduardo N. Warman ,  Todd J. Sheldon

发明人： Yong Kyun Cho ,  Eduardo N. Warman ,  Todd J. Sheldon

IPC分类号： A61B5/00 ,  A61B5/0205 ,  A61B5/0215 ,  A61B5/022 ,  A61B5/0245 ,  A61B5/0456 ,  A61B5/0464 ,  A61B5/0476 ,  A61B5/08 ,  A61B5/083 ,  A61B5/087 ,  A61B5/11 ,  A61B5/113 ,  A61B7/00 ,  A61N1/36 ,  A61N1/365

CPC分类号： A61N1/3601 ,  A61B5/0031 ,  A61B5/01 ,  A61B5/0205 ,  A61B5/0215 ,  A61B5/022 ,  A61B5/0245 ,  A61B5/0456 ,  A61B5/0464 ,  A61B5/0476 ,  A61B5/0809 ,  A61B5/0816 ,  A61B5/0833 ,  A61B5/0836 ,  A61B5/087 ,  A61B5/0878 ,  A61B5/1116 ,  A61B5/1118 ,  A61B5/1135 ,  A61B5/4818 ,  A61B7/003 ,  A61N1/36521 ,  A61N1/36557

摘要： An implantable medical device (IMD) includes a sensor for monitoring parameters indicative of sleep disordered breathing. The IMD also includes a position sensor that indicates the relative position and/or activity level of the patient. The position sensor data is used in one or more ways in conjunction with the SDB sensing. The position data is used to confirm that such sensed data is likely indicative of SDB or to select the appropriate criteria for comparison.

公开(公告)号：US06926669B1

公开(公告)日：2005-08-09

申请号：US09685193

申请日：2000-10-10

申请人： Mark T. Stewart ,  Johnson E. Goode ,  James M. Speckien ,  Mark A. Taube ,  Eduardo N. Warman

发明人： Mark T. Stewart ,  Johnson E. Goode ,  James M. Speckien ,  Mark A. Taube ,  Eduardo N. Warman

IPC分类号： A61B17/00 ,  A61B18/14 ,  A61M25/01 ,  A61B8/00

CPC分类号： A61M25/0147 ,  A61B18/1492 ,  A61B2017/00243 ,  A61B2018/00916 ,  A61M25/0152 ,  A61M2025/015 ,  A61M2025/0161

摘要： Steerable electrophysiology catheters for use in mapping and/or ablation of accessory pathways in myocardial tissue of the heart wall and methods of use thereof are disclosed. The catheter comprises a catheter body and handle, the catheter body having a proximal section and a distal section and manipulators that enable the deflection of a distal segment of the distal tip section with respect to the independently formed curvature of a proximal segment of the distal tip section through a bending or knuckle motion of an intermediate segment between the proximal and distal segments. A wide angular range of deflection within a very small curve or bend radius in the intermediate segment is obtained. At least one distal tip electrode is preferably confined to the distal segment which can have a straight axis extending distally from the intermediate segment. The curvature of the proximal segment and the bending angle of the intermediate segment are independently selectable. The axial alignment of the distal segment with respect to the nominal axis of the proximal shaft section of the catheter body can be varied between substantially axially aligned (0° curvature) in an abrupt knuckle bend through a range of about −90° to about +180° within a bending radius of between about 2.0 mm and 7.0 mm and preferably less than 5.0 mm. The proximal segment curve can be independently formed in a about +180° through about +270° with respect to the axis of the proximal shaft section to provide an optimum angular orientation of the distal electrode(s). The distal segment can comprise a highly flexible elongated distal segment body and electrode(s) that conform with the shape and curvature of the heart wall.

摘要翻译： 公开了用于在心壁的心肌组织中辅助通路的测绘和/或消融的可操纵的电生理学导管及其使用方法。 导管包括导管主体和手柄，导管主体具有近端部分和远端部分以及操纵器，其能够相对于远端尖端的近端段的独立形成的曲率偏转远侧末端部分的远端部分 通过近端段和远端段之间的中间段的弯曲或转向关节运动。 获得在中间段内的非常小的曲线或弯曲半径内的宽的角度范围的偏转。 至少一个远端末端电极优选地限制在远端段，该远段可以具有从中间段向远侧延伸的直轴。 近端段的曲率和中间段的弯曲角度是可独立选择的。 远侧段相对于导管主体的近端轴部分的标称轴线的轴向对准可以在突变关节弯曲部中的大致轴向对准（0°曲率）之间变化约-90°至约+ 弯曲半径为约2.0mm至7.0mm，优选小于5.0mm的180°。 近端段曲线可相对于近轴部分的轴线独立地形成在约-180°至约+ 270°的范围内，以提供远端电极的最佳角度取向。 远端段可以包括高度柔性的细长远端段体和符合心壁的形状和曲率的电极。

公开(公告)号：US06311088B1

公开(公告)日：2001-10-30

申请号：US09290967

申请日：1999-04-13

申请人： Robert A. Betzold ,  Eduardo N. Warman

发明人： Robert A. Betzold ,  Eduardo N. Warman

IPC分类号： A61N1362

CPC分类号： A61N1/3622

摘要： A pacemaker and a method of employing a pacemaker to pace a patient's heart. The method of operation of the pacemaker includes defining a post ventricular atrial refractory period having a first duration responsive to ventricular events, during which period the pacemaker does not initiate timing of an AV delay responsive to detected atrial depolarizations and in response to events which a may disrupt AV synchrony, such as PVC's, mode changes and the like, defining a post ventricular atrial refractory period having a second duration less than the first duration. The shortened post ventricular atrial refractory period remains in effect only temporarily, for example for one cardiac cycle, and may be initiated on a ventricular event which is the disrupting event or immediately follows the disrupting event, or may be initiated following a later ventricular event.

摘要翻译： 起搏器和采用起搏器来调节患者心脏的方法。 起搏器的操作方法包括定义具有响应于心室事件的第一持续时间的心室后心房不应期，在此期间起搏器不响应于检测到的心房去极化而启动AV延迟的定时，并且响应于可能的事件 扰乱AV同步，如PVC，模式变化等，定义了第二持续时间小于第一个持续时间的心室后不应期。 缩短的室后心房不良期仅仅暂时有效，例如一个心动周期，并且可以在作为中断事件的心室事件或者紧随着扰乱事件之后开始，或者可以在随后的心室事件之后启动。

公开(公告)号：US6091988A

公开(公告)日：2000-07-18

申请号：US70690

申请日：1998-04-30

申请人： Eduardo N. Warman ,  Michael R. S. Hill ,  David K. L. Peterson ,  Rahul Mehra ,  Luc R. Mongeon

发明人： Eduardo N. Warman ,  Michael R. S. Hill ,  David K. L. Peterson ,  Rahul Mehra ,  Luc R. Mongeon

IPC分类号： A61N1/362 ,  A61N1/39

CPC分类号： A61N1/3956 ,  A61N1/3622 ,  A61N1/3987

摘要： An implantable anti-tachyarrhythmia device which delivers atrial cardioversion or defibrillation pulses heart in response to detection of atrial tachyarrhythmias. The pulses are synchronized to atrial and ventricular events in such a fashion as to assure they occur outside of the vulnerable periods associated with both chambers. The device is provided with a pulse synchronizer which defines a first synchronization interval initiated following a sensed atrial event and a second synchronization interval initiated responsive to a sensed ventricular event and a pulse triggerer which triggers delivery of a cardioversion or defibrillation pulse responsive to the first and second synchronization intervals simultaneously being underway. In particular, the pulse triggerer may be responsive to initiation of the first synchronization interval during the second synchronization interval. In addition, the synchronizer may also define minimum time intervals following ventricular events and the triggerer may additionally be responsive to expiration of a defined minimum time interval following a ventricular event preceding the sensed ventricular event which initiated the second synchronization interval currently underway.

摘要翻译： 一种可植入的抗快速性心律失常装置，其响应于心房快速性心律失常的检测而传送心房心脏复律或除颤脉冲心脏。 这些脉冲以这样的方式与心房和心室事件同步，以确保它们发生在与两个腔室相关联的脆弱周期之外。 该装置设置有脉冲同步器，该脉冲同步器限定在感测的心房事件之后启动的第一同步间隔和响应于感测到的心室事件而发起的第二同步间隔和脉冲触发器，其响应于第一和第二同步间隔触发心脏复律或除颤脉冲的传递 第二同步间隔同时进行。 特别地，脉冲触发器可以响应于在第二同步间隔期间启动第一同步间隔。 此外，同步器还可以定义心室事件之后的最小时间间隔，并且触发器可以另外响应于起始于当前正在进行的第二同步区间的感测的心室事件之前的心室事件之后的限定的最小时间间隔的到期。

公开(公告)号：US06021354A

公开(公告)日：2000-02-01

申请号：US224739

申请日：1998-12-31

申请人： Eduardo N. Warman ,  Matthew D. Bonner

发明人： Eduardo N. Warman ,  Matthew D. Bonner

IPC分类号： A61N1/05

CPC分类号： A61N1/056

摘要： A cardiac pacing lead for pacing the atria and a method of its use. The lead is provided with a mechanism for maintaining an atrial pacing electrode adjacent stimulable tissue in a patient's superior vena cava and an additional electrode locatable in the right ventricle or elsewhere when the atrial electrode is so located. One such mechanism for maintaining the atrial electrode's position may be a lead body displaying pre-formed laterally extending curves sized to span a patient's superior vena cava, with the atrial electrode located thereon.

摘要翻译： 用于起搏心房的心脏起搏线及其使用方法。 该引线设置有用于将心房起搏电极维持在患者上腔静脉中的可刺激组织旁边的机构，以及当心房电极如此定位时位于右心室或别处的附加电极。 用于维持心房电极的位置的一种这样的机构可以是引导体，其显示预先形成的横向延伸的曲线，其尺寸跨越患者的上腔静脉，心房电极位于其上。

公开(公告)号：US5968079A

公开(公告)日：1999-10-19

申请号：US40544

申请日：1998-03-18

申请人： Eduardo N. Warman ,  Rahul Mehra

发明人： Eduardo N. Warman ,  Rahul Mehra

IPC分类号： A61N1/39 ,  A61N1/368

CPC分类号： A61N1/3962 ,  A61N1/395

摘要： An implantable medical device which senses atrial electrograms, detects atrial tachyarrhythmias and delivers atrial cardioversion/defibrillation pulses in response thereto, which employ a correlation analysis to assist in detection of arrhythmias and/or timing of delivery of cardioversion/defibrillation shocks. The device includes an electrogram recorder which stores atrial electrogram segments associated with R--R intervals extending over multiple atrial depolarizations and a correlator which measures correlation of successive stored atrial electrogram segments. The device may use the measured corellation meeting a defined threshold value to detect the occurrence of a defined tachyarrhythmia such as atrial fibrillation or allow delivery of a cardioversion/defibrillation pulse.

摘要翻译： 感测心房电图的可植入医疗装置，检测心房快速性心律失常并响应于此传递心房复律/除颤脉冲，其使用相关分析来辅助检测心律不齐和/或转发/除颤电击的递送时机。 该装置包括电描记录记录器，其存储与跨多个心房去极化延伸的R-R间隔相关联的心房电描绘片段，以及测量连续存储的心房电描记图片段的相关性的相关器。 该装置可以使用满足定义的阈值的测量的核心数来检测定义的心律失常的发生，例如心房颤动或允许递送心脏复律/除颤脉冲。

公开(公告)号：US08977350B2

公开(公告)日：2015-03-10

申请号：US13050091

申请日：2011-03-17

申请人： Shantanu Sarkar ,  Eduardo N. Warman

发明人： Shantanu Sarkar ,  Eduardo N. Warman

IPC分类号： A61B5/04 ,  A61B5/02 ,  A61B5/0468 ,  A61N1/362 ,  A61N1/39 ,  A61B5/00

CPC分类号： A61B5/0468 ,  A61B5/7282 ,  A61N1/3624 ,  A61N1/395

摘要： A medical device performs a method to classify a cardiac rhythm. Differences between cycle lengths in a first heart chamber are determined during an established time interval. Evidence of ectopy associated with irregular coupling intervals is detected from the signal during the established time interval. A rhythm classification output corresponding to a second heart chamber at the expiration of the established time interval is provided in response to the consecutive cycle length differences and the evidence of ectopy associated with irregular coupling intervals.

摘要翻译： 医疗器械执行心律的分类方法。 在建立的时间间隔期间确定第一心室中的循环长度之间的差异。 在建立的时间间隔期间从信号中检测到与不规则耦合间隔相关的异常的证据。 响应于连续循环长度差异和与不规则耦合间隔相关联的异常的证据，提供对应于在建立的时间间隔期满时的第二心室的节律分类输出。

公开(公告)号：US20120302898A1

公开(公告)日：2012-11-29

申请号：US13114838

申请日：2011-05-24

申请人： Xusheng Zhang ,  Vinod Sharma ,  Eduardo N. Warman

发明人： Xusheng Zhang ,  Vinod Sharma ,  Eduardo N. Warman

IPC分类号： A61B5/0205 ,  A61N1/365 ,  A61B5/11

CPC分类号： A61B5/0823 ,  A61B5/0205 ,  A61B5/11 ,  A61B5/686 ,  A61B2562/0204 ,  A61B2562/0219 ,  A61N1/3621 ,  A61N1/3627

摘要： The present disclosure is directed to the detection of coughs and coughing episodes using acoustic signals. In various examples, an implantable medical device processes an acoustic signal obtained from an acoustic sensor to determine whether a patient has coughed. In some examples, the implantable medical device also performs a cough severity assessment. In some examples, the cough severity assessment may include a determination of the depth of the cough, the duration of the coughing episode, or whether the cough was wet or dry.

摘要翻译： 本公开涉及使用声信号检测咳嗽和咳嗽发作。 在各种示例中，可植入医疗装置处理从声传感器获得的声信号，以确定患者是否已经咳嗽。 在一些示例中，可植入医疗装置还执行咳嗽严重度评估。 在一些实例中，咳嗽严重度评估可以包括确定咳嗽的深度，咳嗽发作的持续时间，或者咳嗽是湿还是干燥。

公开(公告)号：US20120253207A1

公开(公告)日：2012-10-04

申请号：US13436408

申请日：2012-03-30

申请人： Shantanu Sarkar ,  Jodi L. Redemske ,  Eduardo N. Warman ,  Douglas A. Hettrick ,  Kevin T. Ousdigian

发明人： Shantanu Sarkar ,  Jodi L. Redemske ,  Eduardo N. Warman ,  Douglas A. Hettrick ,  Kevin T. Ousdigian

IPC分类号： A61B5/0205

CPC分类号： A61B5/0006 ,  A61B5/0004 ,  A61B5/7275 ,  G06F19/3418 ,  G16H40/40 ,  G16H50/30

摘要： Techniques for transmitting diagnostic information stored in an implantable medical device (IMD) based on patient hospitalization are described. For example, the IMD may transmit higher resolution diagnostic information to a clinician and/or an external device during a hospitalization period to aid the clinician in evaluating heart failure treatment and when discharge is proper. This higher resolution diagnostic information may include one or more patient metrics automatically generated and transmitted by the IMD at least once every two hours. During a post-hospitalization period, the IMD may transmit lower resolution diagnostic information to a clinician that indicates a risk level of re-hospitalization. The lower resolution diagnostic information may include the risk level and/or patient metrics once a day, for example. In this manner, the IMD transmitted diagnostic information may be tailored to the specific heart failure monitoring needed by the patient.

摘要翻译： 描述了基于患者住院时间传送存储在可植入医疗装置（IMD）中的诊断信息的技术。 例如，IMD可以在住院期间向临床医师和/或外部设备传送更高分辨率的诊断信息，以帮助临床医师评价心力衰竭治疗以及放电是否合适。 该更高分辨率的诊断信息可以包括由IMD自动生成和发送的至少每两小时一次的一个或多个患者度量。 在住院后期间，IMD可以向临床医生传递较低分辨率的诊断信息，指示重新住院的风险水平。 例如，较低分辨率诊断信息可以包括一天一次的风险水平和/或患者度量。 以这种方式，IMD传输的诊断信息可以针对患者所需的特定心力衰竭监测。

公开(公告)号：US20120232605A1

公开(公告)日：2012-09-13

申请号：US13357646

申请日：2012-01-25

申请人： Yong-Fu Xiao ,  Jeffrey M. Gillberg ,  Paul J. DeGroot ,  Eduardo N. Warman ,  Scott J. Brabec ,  John L. Sommer ,  Jon F. Urban ,  Lepeng Zeng

发明人： Yong-Fu Xiao ,  Jeffrey M. Gillberg ,  Paul J. DeGroot ,  Eduardo N. Warman ,  Scott J. Brabec ,  John L. Sommer ,  Jon F. Urban ,  Lepeng Zeng

IPC分类号： A61N1/365

CPC分类号： A61N1/365 ,  A61N1/3622 ,  A61N1/36585

摘要： An apparatus and method to discriminate cardiac events by sensing atrial and ventricular depolarizations having associated refractory periods thereafter. A fast ventricular rate is detected in response to the sensed ventricular depolarizations. Responsive to detecting the fast ventricular rate, at least one stimulus pulse is delivered to atrial tissue within the associated refractory period of the ventricle but outside of an associated refractory period of the stimulated atrial tissue. A ventricular response to the atrial tissue stimulus pulse is determined, and the cardiac event is discriminated based on the ventricular response to the atrial tissue stimulus pulse.

摘要翻译： 通过感应心房和心室去极化来区分心脏事件的装置和方法，其后具有相关联的不良期。 响应于感测到的心室去极化，检测到快速心室率。 响应于检测快速心室率，至少一个刺激脉冲被输送到心室的相关不应期内但在受刺激的心房组织的相关不应期内之外的心房组织。 确定对心房组织刺激脉冲的心室反应，并且基于对心房组织刺激脉冲的心室响应来区分心脏事件。