摘要:
A method for assessing cardiac function suitable for incorporation into an implantable cardiac rhythm management device. By measuring daily exertion levels in accordance with the invention, an assessment of cardiac function can be made that has been found to correlate well with conventional clinical classifications. The invention also provides for assessing cardiac function in conjunction with different pacing schemes designed to treat heart failure and using the assessment to select the best such scheme for the patient.
摘要:
A method and apparatus for delivering anti-tachycardia pacing in an adaptive manner is disclosed. A cardiac rhythm management device, such as an implantable pacemaker, having anti-tachycardia pacing capability delivers anti-tachycardia pacing therapy in accordance with a selected pacing protocol upon detection of a terminable arrhythmia. The protocol is selected from a library of available protocols. A record of the successes and failures of each available protocol in converting tachyarrhythmias is maintained in a result table for use in selecting the protocol.
摘要:
A microstrip RF telemetry antenna is formed on or within the exterior surface of an implantable medical device housing that is formed either of a conductive metal or of a non-conductive dielectric material. The microstrip antenna is formed of an electrically conductive radiator patch layer that is laminated upon an exterior facing side of a dielectric substrate layer of relatively constant thickness. A conductive ground plane layer is formed on the opposite side of the dielectric substrate layer to extend parallel to and at least coextensively with the radiator patch layer. The radiator patch layer is coupled to the transceiver circuitry within the implantable medical device housing by a feedthrough extending through the dielectric substrate layer, the ground plane layer and the implantable medical device housing side wall. If the implantable medical device housing is conductive it may form the ground plane layer over which the dielectric substrate layer and the radiator patch layer are formed through deposition or other techniques. If the implantable medical device housing is formed of a suitable non-conductive dielectric material, the ground plane layer is formed on an interior surface thereof and the radiator patch layer is formed on an exterior housing surface thereof, preferably by deposition techniques. The ground plane layer may be recessed to form a cavity backed ground plane that receives the dielectric layer and radiator patch layer within the cavity. The exterior surfaces of the radiator patch layer, the dielectric layer and any exposed surface of the ground plane layer may be electrically insulated by a radome layer.
摘要:
This is a method and apparatus for the automated discrimination of cardiac events of interest, including P-waves, R-waves, T-waves, and specific arrhythmic sequences, in EGM signals for data storage in an implantable monitor or to control operations of an implantable cardiac stimulator through the use of Hidden Markov Modeling techniques and a reduced set of observations. The number of computations and computation time during a heart cycle is reduced by timing the frames of A-EGM samples to the detection of A-SENSE events by the atrial sense amplifier. The A-EGM sample frame is defined in a window preceding and following each A-SENSE event. The A-EGM sample frames are wavelet transformed, and a number of selected W.T. coefficients for each sample frame are saved in a buffer. Each set of saved W.T. coefficients therefore represents either a P-wave or an intrinsic or paced far field R-wave (including fusion beats) unless noise continuously causes A-SENSE events to occur. When the V-SENSE event occurs, an R-trigger is generated, and each set of saved W.T. coefficients is subjected to the HMM algorithm for a determination as to whether the preceding (and any concurrent) A-SENSE events from which the saved W.T. coefficients were derived are P-waves or R-waves. In addition, when the V-SENSE occurs, the HMM algorithm determines stochastically whether or not the successive sets of saved W.T. coefficients represent P-P sequences, far field R-R sequences or P-R sequences or the like.
摘要:
A DMUX 11 outputs data in a digital FM signal in a circulation to produce signals S1 to S4. An MUX 14 alternately outputs inverted signals of the signals S1 and S3, obtaining a signal Si.sub.(k). An MUX 15 alternately outputs inverted signals of the signals S2 and S4, obtaining a signal Sq.sub.(k). An interpolation circuit 17 inserts data having a value of zero between individual data in the output signal of the MUX 14, and cuts off the high-frequency component of the resultant signal, obtaining a signal Si.sub.(i). A second interpolation circuit 19 inserts data having a value of zero between individual data in the output signal of the MUX 15, and cuts off the high-frequency component of the resultant signal, obtaining a signal Sq.sub.(i). An arithmetic operation circuit 2 computes SI.sub.(i-1) .multidot.SQ.sub.(i) -SI.sub.(i) .multidot.Sq.sub.(i-1), and integrates it to obtain a digital demodulated signal.
摘要:
The filter coefficients of a digital band pass elliptic filter can be approximated to a linear function of the center frequency of the pass band width. The filter coefficients of a band pass digital filter having a predetermined center frequency and the slope of this linear function are stored in first and second memories. A central processing unit (CPU) obtains the difference between a desired center frequency and a predetermined center frequency. A multiplier multiplies the slope stored in the second memory by the difference obtained by the CPU. An adder adds each of the filter coefficients stored in the first memory to an associated one of the products output from the multiplier. The adding results become the filter coefficients for obtaining the desired center frequency. Those filter coefficients are set in a digital filter.
摘要:
Methods for determining the presence or absence of expansion of CGG repeat sequence in the FMR1 gene presence or absence of expansion of CCG repeat sequence in the FMR2 gene are provided. The methods are useful in identifying an individual with normal/intermediate, versus premutation or full mutation allele of FMR1 gene and FMR2 gene due to the expansion of CGG repeats and CCG repeats in the 5′-untranslated region respectively. The methods are also useful for screening newborns for fragile X syndrome or for screening women to determine heterozygosity status with full premutation of the CCG repeat tract. The methods are also useful in estimating the premutation and full mutation carrier frequency and estimating the prevalence of FXTAS AND FXPOI in a population. The methods are simple, rapid and require small amount of sample.
摘要:
To reduce the RF losses associated with high RF loss plating, such as, for example, Ni/Pd/Au plating, the solder mask is reconfigured to prevent the edges and sidewalls of the wire-bond areas from being plated in some embodiments. Leaving the edges and sidewalls of the wire-bond areas free from high RF loss plating, such as Ni/Pd/Au plating, provides a path for the RF current to flow around the high resistivity material, which reduces the RF signal loss associated with the high resistivity plating material.
摘要:
A cardiac rhythm management device predicts defibrillation thresholds without any need to apply defibrillation shocks or subjecting the patient to fibrillation. Intravascular defibrillation electrodes are implanted in a heart. By applying a small test energy, an electric field near one of the defibrillation electrodes is determined by measuring a voltage at a sensing electrode offset from the defibrillation electrode by a known distance. A desired minimum value of electric field at the heart periphery is established. A distance between a defibrillation electrodes and the heart periphery is measured, either fluoroscopically or by measuring a voltage at an electrode at or near the heart periphery. Using the measured electric field and the measured distance to the periphery of the heart, the defibrillation energy needed to obtain the desired electric field at the heart periphery is estimated. In an example, the device also includes a defibrillation shock circuit and a stimulation circuit.
摘要:
The methods, compositions and kits disclosed herein relate generally to the detection of nucleic acids and nucleic acid mutations, such as mutations that may be correlated with disease. More specifically, the methods, compositions and kits relate to the detection of mutations in the α-globin gene cluster, to determining the gene dosage of α-globin in a subject, and to diagnosing the subject based on the presence or absence of mutations and/or gene dosage determination.