公开(公告)号：US20130041274A1

公开(公告)日：2013-02-14

申请号：US13207307

申请日：2011-08-10

申请人： Jong Gill ,  Rupinder Bharmi ,  Edward Karst ,  Ryan Rooke ,  Riddhi Shah ,  Fujian Qu ,  Gene A. Bornzin ,  Taraneh Ghaffari Farazi ,  Euljoon Park

发明人： Jong Gill ,  Rupinder Bharmi ,  Edward Karst ,  Ryan Rooke ,  Riddhi Shah ,  Fujian Qu ,  Gene A. Bornzin ,  Taraneh Ghaffari Farazi ,  Euljoon Park

IPC分类号： A61B5/0468

CPC分类号： A61B5/0468 ,  A61B5/0031 ,  A61B5/0205 ,  A61B5/02158 ,  A61B5/02405 ,  A61B5/0295 ,  A61B5/0422 ,  A61B5/4839 ,  A61N1/3702

摘要： Techniques are provided for detecting and distinguishing stroke and cardiac ischemia based on electrocardiac signals. In one example, the device senses atrial and ventricular signals within the patient along a set of unipolar sensing vectors and identifies certain morphological features within the signals such as PR intervals, ST intervals, QT intervals, T-waves, etc. The device detects changes, if any, within the morphological features such as significant shifts in ST interval elevation or an inversion in T-wave shape, which are indicative of stroke or cardiac ischemia. By selectively comparing changes detected along different unipolar sensing vectors, the device distinguishes or discriminates stroke from cardiac ischemia within the patient. The discrimination may be corroborated using various physiological and hemodynamic parameters. In some examples, the device further identifies the location of the ischemia within the heart. In still other examples, the device detects cardiac ischemia occurring during stroke.

摘要翻译： 提供了用于基于心电信号检测和区分中风和心脏缺血的技术。 在一个示例中，该装置沿着一组单极感测向量感测患者内的心房和心室信号，并且识别信号内的某些形态特征，例如PR间隔，ST间隔，QT间隔，T波等。该装置检测变化 （如果有的话）在形态学特征之中，例如ST间期升高的显着变化或T波形的反转，其指示中风或心脏缺血。 通过选择性地比较沿着不同的单极性感测向量检测的变化，该装置区分或区分患者体内的心脏缺血的中风。 可以使用各种生理和血液动力学参数来确认辨别。 在一些实例中，该装置还识别心脏内局部缺血的位置。 在另外的例子中，该装置检测在中风期间发生的心脏缺血。

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：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 。

公开(公告)号：US20110009754A1

公开(公告)日：2011-01-13

申请号：US12637489

申请日：2009-12-14

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

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

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. Electrode(s) implanting within and/or on the patient's heart are used to obtain a cardiogenic impedance (CI) signal indicative of cardiac contractile activity. Additionally, 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 one of the detected features of the CI signal to one of the detected features of the signal indicative of changes in arterial blood volume. Based on at least one of 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，用于监测患者的动脉血压。 使用植入在患者心脏内和/或患者心脏上的电极来获得指示心脏收缩活动的心源阻抗（CI）信号。 此外，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CI信号的检测到的特征之一到检测到的指示动脉血液变化的特征之一的时间来确定每个度量 卷。 基于指示PAT的指标中的至少一个，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/或变化 在这样的价值观。

公开(公告)号：US07856266B1

公开(公告)日：2010-12-21

申请号：US11756283

申请日：2007-05-31

申请人： Gene A. Bornzin ,  Michael E. Benser ,  Euljoon Park ,  Taraneh Ghaffari Farazi

发明人： Gene A. Bornzin ,  Michael E. Benser ,  Euljoon Park ,  Taraneh Ghaffari Farazi

IPC分类号： A61N1/39

CPC分类号： A61N1/3962 ,  A61N1/3622 ,  A61N1/36521 ,  A61N1/3943

摘要： An implantable cardiac defibrillation device provides pre-shock stimuli to reduce the defibrillation threshold (DFT). The device includes an arrhythmia detector that detects fibrillation of a fibrillating chamber of a heart and a pulse generator that provides a fibrillation therapy output responsive to the arrhythmia detector detecting fibrillation of the fibrillating chamber of the heart. The therapy output includes a defibrillating shock having an output magnitude exceeding a temporary defibrillation threshold of the fibrillating chamber and at least one pre-defibrillating shock output pulse that reduces an initial defibrillation threshold of the fibrillating chamber to the temporary defibrillation threshold. An electrode system having at least two defibrillation electrodes delivers both the at least one pre-defibrillating shock output pulse to the heart and the defibrillating shock to the fibrillating chamber of the heart.

摘要翻译： 植入式心脏除颤装置提供预冲击刺激以减少除颤阈值（DFT）。 该装置包括心律失常检测器，其检测心脏的原纤化室的原纤维和脉冲发生器，其提供响应于心律失常检测器检测心脏原纤化室的纤颤的原纤维化治疗输出。 治疗输出包括具有超过原纤化室的暂时除颤阈值的输出量值的至少一个除纤颤前冲击输出脉冲，其将原纤化室的初始除颤阈值降低到临时除颤阈值。 具有至少两个除颤电极的电极系统将至少一个除颤前的冲击输出脉冲和心脏的去纤维化颤动传递给心脏的原纤维室。