公开(公告)号：US08504152B2

公开(公告)日：2013-08-06

申请号：US11779350

申请日：2007-07-18

申请人： Brian Jeffrey Wenzel ,  Dan E. Gutfinger ,  Mihir Naware ,  Xiaoyi Min ,  Jeffery Siou ,  Anders Bjorling ,  Dorin Panescu

发明人： Brian Jeffrey Wenzel ,  Dan E. Gutfinger ,  Mihir Naware ,  Xiaoyi Min ,  Jeffery Siou ,  Anders Bjorling ,  Dorin Panescu

IPC分类号： A61N1/365

CPC分类号： A61B5/02156 ,  A61B5/0215 ,  A61B5/72 ,  A61N1/365 ,  A61N1/36564 ,  A61N1/36578 ,  A61N1/3682 ,  A61N1/3684 ,  A61N1/37258

摘要： Techniques are provided for estimating left atrial pressure (LAP) or other cardiac performance parameters based on measured conduction delays. In particular, LAP is estimated based interventricular conduction delays. Predetermined conversion factors stored within the device are used to convert the various the conduction delays into LAP values or other appropriate cardiac performance parameters. The conversion factors may be, for example, slope and baseline values derived during an initial calibration procedure performed by an external system, such as an external programmer. In some examples, the slope and baseline values may be periodically re-calibrated by the implantable device itself. Techniques are also described for adaptively adjusting pacing parameters based on estimated LAP or other cardiac performance parameters. Still further, techniques are described for estimating conduction delays based on impedance or admittance values and for tracking heart failure therefrom.

公开(公告)号：US08473055B2

公开(公告)日：2013-06-25

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： A61B5/04

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：US08452389B2

公开(公告)日：2013-05-28

申请号：US12498948

申请日：2009-07-07

申请人： Xiaoyi Min

发明人： Xiaoyi Min

IPC分类号： A61B5/00 ,  A61B5/02 ,  A61B5/05 ,  A61B5/08

CPC分类号： A61B5/053 ,  A61B5/02028 ,  A61B5/0205 ,  A61B5/0538 ,  A61B5/4878 ,  A61N1/36521 ,  A61N1/3702 ,  A61N1/3943 ,  A61N1/3962 ,  A61N2001/083

摘要： An exemplary method includes providing information (e.g., a left atrial pressure, a NYHA class, echocardiographic information, etc.), based at least in part on the information, determining a weight and, based at least in part on the weight, determining a threshold for use in intrathoracic impedance monitoring. Such an exemplary method may include comparing an intrathoracic impedance to the threshold, comparing an intrathoracic impedance change to the threshold, or comparing a product of intrathoracic impedance and time to the threshold. Various exemplary methods, devices, systems, etc., are disclosed.

公开(公告)号：US20130131527A1

公开(公告)日：2013-05-23

申请号：US13301500

申请日：2011-11-21

申请人： Xiaoyi Min ,  Anna Raskin ,  Kevin L. Morgan ,  Stephanie Toy ,  Joyce Tao

发明人： Xiaoyi Min ,  Anna Raskin ,  Kevin L. Morgan ,  Stephanie Toy ,  Joyce Tao

IPC分类号： A61B5/0408

CPC分类号： A61B5/042 ,  A61B5/0422 ,  A61B5/046 ,  A61B5/0464 ,  A61B5/06 ,  A61B5/7221

摘要： A first cardiac signal associated with an activity of a first implant site of a heart during a cardiac cycle is sensed. A second cardiac signal is sensed using an intrapericardial lead located on an epicardial surface proximate a second implant site of the heart. The second cardiac signal is associated with an activity of the second implant site during the cardiac cycle. A timing delay between the activity of the first implant site and the activity of the second implant site is obtained and analyzed to determine if the intrapericardial lead location is appropriate. The preceding is repeated until an appropriate intrapericardial lead location is determined. Other measurements obtained during implant determine whether the intrapericardial lead location is at or near slow conduction zone and whether the intrapericardial lead is placed at the location having the greatest mechanical delay. Post implant measurements determine whether the intrapericardial lead has migrated.

摘要翻译： 感测到在心脏周期期间与心脏的第一植入部位的活动相关联的第一心脏信号。 使用位于靠近心脏的第二植入部位的心外膜表面上的心包内引线来感测第二心脏信号。 第二心脏信号与心动周期期间的第二植入部位的活动相关联。 获得并分析第一植入部位的活动与第二植入部位的活动之间的时间延迟，以确定心包内引导位置是否合适。 重复前述操作，直到确定适当的心包内引导位置。 在植入期间获得的其他测量确定心包内引导位置是否处于或接近慢导电区，以及心包内引线是否放置在具有最大机械延迟的位置。 后植入物测量确定心包内导联是否已经迁移。

公开(公告)号：US20130116741A1

公开(公告)日：2013-05-09

申请号：US13352136

申请日：2012-01-17

申请人： Gene A. Bornzin ,  Gabriel A. Mouchawar ,  Xiaoyi Min ,  John W. Poore ,  Edward Karst ,  Richard Samade ,  Zoltan Somogyi ,  Didier Theret

发明人： Gene A. Bornzin ,  Gabriel A. Mouchawar ,  Xiaoyi Min ,  John W. Poore ,  Edward Karst ,  Richard Samade ,  Zoltan Somogyi ,  Didier Theret

IPC分类号： A61N1/362

CPC分类号： A61N1/056 ,  A61N1/057 ,  A61N1/0573 ,  A61N1/3622 ,  A61N1/368 ,  A61N1/3684 ,  A61N1/3688 ,  A61N1/3756

摘要： A leadless intra-cardiac medical device includes a housing that is configured to be implanted entirely within a single local chamber of the heart. A first electrode is provided on the housing at a first position such that when the housing is implanted in the local chamber, the first electrode engages the local wall tissue at a local activation site within the conduction network of the local chamber. An intra-cardiac extension is coupled to the housing and configured to extend from the local chamber into an adjacent chamber of the heart. A stabilization arm of the intra-cardiac extension engages the adjacent chamber. A second electrode on the intra-cardiac extension engages distal wall tissue at a distal activation site within the conduction network of the adjacent chamber.

摘要翻译： 无引线心脏内心脏医疗设备包括被配置为完全植入心脏的单个局部腔室内的壳体。 第一电极在第一位置处设置在壳体上，使得当壳体被植入局部腔室时，第一电极在局部腔室的传导网络内的局部激活位置接合局部壁组织。 心脏内延伸部分耦合到壳体并且构造成从局部腔室延伸到心脏的相邻室中。 心脏内延伸部的稳定臂与相邻的腔室相接合。 心脏延伸部分上的第二个电极与相邻腔室的传导网络内的远端活化位点处的远端壁组织接合。

公开(公告)号：US08265738B1

公开(公告)日：2012-09-11

申请号：US13020574

申请日：2011-02-03

申请人： Xiaoyi Min ,  Josh Reiss

发明人： Xiaoyi Min ,  Josh Reiss

IPC分类号： A61B5/0452

CPC分类号： A61N1/3627 ,  A61B5/0452 ,  A61B5/091 ,  A61N1/3684 ,  A61N1/37247 ,  A61N1/3962

摘要： An exemplary method includes detecting a QRS complex using cutaneous electrodes, during the QRS complex, detecting an R-wave of a ventricle using an intracardiac electrode, determining if the R-wave occurred during a first, predetermined percentage of the QRS complex width and, based at least in part on the determining, deciding whether a patient is likely to respond to cardiac resynchronization therapy. Such a method may set the predetermined percentage to approximately 50%. An exemplary model includes a parameter for a percentage for the timing of an EGM R-wave with respect to the total width of an ECG QRS complex. Various other exemplary methods, devices, systems, etc. are also disclosed.

摘要翻译： 一种示例性方法包括在QRS复合物期间使用皮肤电极检测QRS复合物，使用心内电极检测心室的R波，确定在QRS复合宽度的第一，预定百分比期间是否发生R波， 至少部分地基于确定，决定患者是否可能对心脏再同步治疗做出反应。 这种方法可以将预定百分比设置为大约50％。 示例性模型包括关于EGM R波的定时相对于ECG QRS复合体的总宽度的百分比的参数。 还公开了各种其它示例性方法，装置，系统等。

公开(公告)号：US08244375B2

公开(公告)日：2012-08-14

申请号：US12197957

申请日：2008-08-25

申请人： Xiaoyi Min ,  J. Christopher Moulder ,  Yong D. Zhao ,  Kevin L. Morgan ,  Martin Cholette ,  Phong D. Doan

发明人： Xiaoyi Min ,  J. Christopher Moulder ,  Yong D. Zhao ,  Kevin L. Morgan ,  Martin Cholette ,  Phong D. Doan

IPC分类号： A61N1/05

CPC分类号： A61N1/0563 ,  A61N1/086

摘要： Disclosed herein is an implantable medical lead. In one embodiment, the lead includes a ring electrode, a tip electrode, first and second helically wound coaxial conductor coils, and a distal coil transition. The coils extend between the proximal and distal ends of the lead. The distal coil transition is proximal to the ring electrode and near the distal end and is where the first coil transitions from being outside the second coil proximal of the distal coil transition to being inside the second coil distal of the distal coil transition.

摘要翻译： 本文公开了可植入医疗引线。 在一个实施例中，引线包括环形电极，尖端电极，第一和第二螺旋缠绕的同轴导体线圈和远端线圈转变。 线圈在引线的近端和远端之间延伸。 远侧线圈转变靠近环形电极并且靠近远端，并且是第一线圈从远端线圈过渡处的第二线圈的外侧转变到远端线圈转变远端的第二线圈内部的位置。

公开(公告)号：US20120165890A1

公开(公告)日：2012-06-28

申请号：US12976419

申请日：2010-12-22

申请人： Xiaoyi Min

发明人： Xiaoyi Min

IPC分类号： A61N1/365

CPC分类号： A61N1/36585 ,  A61N1/3627 ,  A61N1/36521 ,  A61N1/36564 ,  A61N1/36578 ,  A61N1/3684

摘要： Techniques are provided for use with implantable medical devices such as pacemakers for optimizing interventricular (VV) pacing delays for use with cardiac resynchronization therapy (CRT). In one example, ventricular electrical depolarization events are detected within a patient in which the device is implanted. The onset of isovolumic ventricular mechanical contraction is also detected based on cardiomechanical signals detected by the device, such as cardiogenic impedance (Z) signals, S1 heart sounds or left atrial pressure (LAP) signals. Then, an electromechanical time delay (T_QtoVC) between ventricular electrical depolarization and the onset of isovolumic ventricular mechanical contraction is determined. VV pacing delays are set to minimize the time delay to the onset of isovolumic ventricular mechanical contraction. Various techniques for identifying the onset of isovolumic ventricular contraction based on Z, S1 or LAP or other cardiomechanical signals are described. In some examples, CRT nonresponders are specifically identified and/or heart failure progression is tracked.

摘要翻译： 提供技术用于可植入医疗装置，例如用于优化用于心脏再同步治疗（CRT）的室间（VV）起搏延迟）的起搏器。 在一个示例中，在装置被植入的患者内检测到心室电去极化事件。 基于由器械检测到的心脏机械信号，例如心源阻抗（Z）信号，S1心脏音或左心房压力（LAP）信号，也检测到等容性心室机械收缩的发作。 然后，确定心室电去极化与等容性心室机械收缩发作之间的机电时间延迟（T_QtoVC）。 设定VV起搏延迟以最小化等容性心室机械收缩发作的时间延迟。 描述了基于Z，S1或LAP或其他心脏机械信号鉴别等容性心室收缩发作的各种技术。 在一些示例中，CRT无应答者被特异性识别和/或跟踪心力衰竭进展。

公开(公告)号：US08170687B2

公开(公告)日：2012-05-01

申请号：US12537880

申请日：2009-08-07

申请人： Xiaoyi Min ,  Peter A. Nichols

发明人： Xiaoyi Min ,  Peter A. Nichols

IPC分类号： A61N1/00

CPC分类号： A61N1/056 ,  A61N1/086

摘要： To provide radio-frequency (RF) bandstop filtering within an implantable lead, such as a pacemaker lead, one or more segments of the tip and ring conductors of the lead are formed as insulated coils to function as inductive band stop filters. By forming segments of the conductors into insulated coils, a separate set of discrete or distributed inductors is not required, yet RF filtering is achieved to, e.g., reduce lead heating during magnetic resonance imaging (MRI) procedures. To enhance the degree of bandstop filtering at the RF signal frequencies of MRIs, additional capacitive elements are added. In one example, the ring electrode of the lead is configured to provide capacitive shunting to the tip conductor. In another example, a capacitive transition is provided between the outer insulated coil and proximal portions of the ring conductor. In still other examples, conducting polymers are provided to enhance capacitive shunting. The insulated coils may be spaced at ¼ wavelength locations.

摘要翻译： 为了在诸如起搏器引线的可植入引线内提供射频（RF）带阻滤波，引线的尖端和环形导体中的一个或多个段形成为用作电感带阻滤波器的绝缘线圈。 通过将导体的段形成为绝缘线圈，不需要单独的一组离散或分布式电感器，但是实现RF滤波以例如在磁共振成像（MRI）程序期间减少引线加热。 为了增强MRI的RF信号频率下的带阻滤波的程度，增加了附加的电容元件。 在一个示例中，引线的环形电极被配置为向尖端导体提供电容分流。 在另一示例中，在外绝缘线圈和环形导体的近端部分之间提供电容性跃迁。 在其它实例中，提供导电聚合物以增强电容分流。 绝缘线圈可以在1/4波长位置间隔开。

公开(公告)号：US20110152990A1

公开(公告)日：2011-06-23

申请号：US12645252

申请日：2009-12-22

申请人： Ramez Shehada ,  Xiaoyi Min ,  Jin Zhang ,  Benjamin Coppola ,  Dave Anderson ,  Gene A. Bornzin ,  Phong D. Doan

发明人： Ramez Shehada ,  Xiaoyi Min ,  Jin Zhang ,  Benjamin Coppola ,  Dave Anderson ,  Gene A. Bornzin ,  Phong D. Doan

IPC分类号： A61N1/05 ,  H03H7/01

CPC分类号： A61N1/05 ,  A61N1/086 ,  H03H7/0115 ,  H03H2007/013

摘要： An implantable medical lead is disclosed herein. The lead includes a first electrode and a first electrical circuit. The first electrode is near a distal portion of the lead. The first electrical circuit extends through the lead to the first electrode and includes at least one conductor and a first band stop filter coupled between the distal end of the conductor and the electrode. The first band stop filter includes a first group of inductors in parallel and a second group of inductors in parallel. The first group is in series with the second group. The first group of inductors may include a self resonant L. The first group of inductors may include a self resonant tank LC. The first group of inductors may include a miniature self resonant L or miniature self resonant tank LC. The first group of inductors may include an integrated circuit of L and C components.

摘要翻译： 本文公开了可植入医疗引线。 引线包括第一电极和第一电路。 第一电极靠近导线的远端部分。 第一电路通过引线延伸到第一电极并且包括耦合在导体的远端和电极之间的至少一个导体和第一带阻滤波器。 第一带阻滤波器包括并联的第一组电感器和并联的第二组电感器。 第一组与第二组合作。 第一组电感器可以包括自谐振L。第一组电感器可以包括自谐振槽LC。 第一组电感器可以包括微型自谐振L或微型自谐振箱LC。 第一组电感器可以包括L和C组件的集成电路。