公开(公告)号：US07103409B2

公开(公告)日：2006-09-05

申请号：US10434612

申请日：2003-05-09

申请人： Jay A. Warren

发明人： Jay A. Warren

IPC分类号： A61N1/362

CPC分类号： A61N1/3622 ,  A61N1/3918 ,  A61N1/3925 ,  A61N1/3956

摘要： A cardiac rhythm management system, such as an implantable cardioverter-defibrillator (ICD), provides atrial anti-tachyarrhythmia therapy, such as a bipolar or unipolar electrical cardioversion countershock, or provides both atrial and ventricular anti-tachyarrhythmia therapy. The atrial and ventricular anti-tachyarrhythmia therapies have independent cardioversion-defibrillation energy levels and other parameters. The system provides an endocardial lead that is convenient to implant for providing the anti-tachyarrhythmia therapy. The endocardial lead includes a first supraventricular electrode disposed in the atrium and superior vena cava, and optionally includes a first ventricular electrode and ICD housing electrode.

公开(公告)号：US6119043A

公开(公告)日：2000-09-12

申请号：US129348

申请日：1998-08-05

申请人： William Hsu ,  Jay A. Warren ,  Gerrard M. Carlson

发明人： William Hsu ,  Jay A. Warren ,  Gerrard M. Carlson

IPC分类号： A61N1/362 ,  A61N1/00

CPC分类号： A61N1/3622

摘要： A method and system for discriminating atrial and ventricular signal components from a single heart lead, and for using this information for identifying an arrhythmia condition as being atrial or ventricular in origin. The invention is effective in identifying P waves occurring in complex signal which includes relatively stronger R waves or other ventricular artifacts which mask the P waves. The contribution of the R wave signal to the complex signal is obtained by filtering, time windowing and transfer function estimation, then the R wave estimate is subtracted from the combined signal to leave the P wave. The ratio of P waves to R waves, P--P and R--R intervals, and their ratios to one another and to fixed values can be estimated, and used in a comparison to discriminate between atrial and ventricular arrhythmia, to thereby enable appropriate treatment.

摘要翻译： 用于区分来自单个心脏引线的心房和心室信号分量的方法和系统，以及用于将该信息用于将心律失常状态识别为心房或心室起源的方法和系统。 本发明有效地识别出复杂信号中出现的P波，其中包含相对较强的R波或掩蔽P波的其他心室伪像。 通过滤波，时间窗口和传递函数估计得到R波信号对复信号的贡献，然后将R波估计从组合信号中减去离开P波。 可以估计P波与R波，P-P和R-R间隔的比率以及它们彼此之间的比值和固定值，并用于比较以区分心房和心室心律不齐，从而使得能够进行适当的治疗。

公开(公告)号：US6067471A

公开(公告)日：2000-05-23

申请号：US130087

申请日：1998-08-07

申请人： Jay A. Warren

发明人： Jay A. Warren

IPC分类号： A61N1/39

CPC分类号： A61N1/3622 ,  A61N1/3918 ,  A61N1/3925 ,  A61N1/3956

摘要： A cardiac rhythm management system, such as an implantable cardioverter-defibrillator (ICD), provides atrial anti-tachyarrhythmia therapy, such as a bipolar or unipolar electrical cardioversion countershock, or provides both atrial and ventricular anti-tachyarrhythmia therapy. The atrial and ventricular anti-tachyarrhythmia therapies have independent cardioversion-defibrillation energy levels and other parameters. The system provides an endocardial lead that is convenient to implant for providing the anti-tachyarrhythmia therapy. The endocardial lead includes a first supraventricular electrode disposed in the atrium and superior vena cava, and optionally includes a first ventricular electrode and ICD housing electrode.

公开(公告)号：US5776072A

公开(公告)日：1998-07-07

申请号：US579872

申请日：1995-12-28

申请人： William Hsu ,  Jay A. Warren ,  Gerrard M. Carlson

发明人： William Hsu ,  Jay A. Warren ,  Gerrard M. Carlson

IPC分类号： A61N1/362 ,  A61B5/046

CPC分类号： A61N1/3622

摘要： A method and system for discriminating atrial and ventricular signal components from a single heart lead, and for using this information for identifying an arrhythmia condition as being atrial or ventricular in origin. The invention is effective in identifying P waves occurring in complex signal which includes relatively stronger R waves or other ventricular artifacts which mask the P waves. The contribution of the R wave signal to the complex signal is obtained by filtering, time windowing and transfer function estimation, then the R wave estimate is subtracted from the combined signal to leave the P wave. The ratio of P waves to R waves, P--P and R--R intervals, and their ratios to one another and to fixed values can be estimated, and used in a comparison to discriminate between atrial and ventricular arrhythmia, to thereby enable appropriate treatment.

公开(公告)号：US5156147A

公开(公告)日：1992-10-20

申请号：US651318

申请日：1991-02-05

申请人： Jay A. Warren ,  Jay O. Millerhagen ,  Julio C. Spinelli

发明人： Jay A. Warren ,  Jay O. Millerhagen ,  Julio C. Spinelli

IPC分类号： A61N1/365

CPC分类号： A61N1/36585

摘要： A rate adaptive pacemaker of the type having a variable rate cardiac stimulating pulse generator and a sensor for monitoring some physiologic parameter whereby the pulse generator stimulating rate can be adjusted to meet physiologic demand is further provided with a hemodynamic sensor which is operative to provide an output signal representing the pumping performance of the heart in response to the pacing stimulation. The signal from the hemodynamic sensor is processed and then used in an algorithm to determine whether further rate increase should be permitted based upon whether the rate increase would be accompanied by a further increase in cardiac output, a plateau or a decrease in cardiac output. Hence, the adaptive rate pacemaker is provided with a real-time, hemodynamic maximum pacing rate instead of a preprogrammed, fixed, maximum rate.

公开(公告)号：US20120232415A1

公开(公告)日：2012-09-13

申请号：US13476313

申请日：2012-05-21

申请人： Surekha Palreddy ,  Jay A. Warren ,  James W. Phillips

发明人： Surekha Palreddy ,  Jay A. Warren ,  James W. Phillips

IPC分类号： A61B5/0402

CPC分类号： A61N1/365 ,  A61B5/0031 ,  A61B5/0422 ,  A61B5/04525 ,  A61B5/7207 ,  A61B5/7239 ,  A61N1/3622 ,  A61N1/368

摘要： Implementations of various technologies described herein are directed toward a sensing architecture for use in cardiac rhythm management devices. The sensing architecture may provide a method and means for certifying detected events by the cardiac rhythm management device. Moreover, by exploiting the enhanced capability to accurately identifying only those sensed events that are desirable, and preventing the use of events marked as suspect, the sensing architecture can better discriminate between rhythms appropriate for device therapy and those that are not.

摘要翻译： 本文描述的各种技术的实现针对用于心律管理装置的感测架构。 感测架构可以提供用于通过心律管理装置认证检测到的事件的方法和装置。 此外，通过利用增强的能力来准确地仅识别那些感兴趣的事件，并且防止使用标记为可疑的事件，感测体系结构可以更好地区分适合于设备治疗的节律和不适合于设备治疗的节律。

公开(公告)号：US08249702B2

公开(公告)日：2012-08-21

申请号：US12359072

申请日：2009-01-23

申请人： Jay A. Warren ,  Gust H. Bardy

发明人： Jay A. Warren ,  Gust H. Bardy

IPC分类号： A61N1/372

CPC分类号： A61N1/3621 ,  A61N1/3943 ,  A61N1/3956

摘要： Adaptive methods for initiating charging of the high power capacitors of an implantable medical device for therapy delivery after the patient experiences a non-sustained arrhythmia. The adaptive methods adjust persistence criteria used to analyze an arrhythmia prior to initiating a charging sequence to deliver therapy.

摘要翻译： 用于在患者经历不持续性心律失常之后启动用于治疗递送的可植入医疗装置的大功率电容器的充电的自适应方法。 适应性方法调整持续性标准，用于在启动充电序列之前分析心律失常以提供治疗。

公开(公告)号：US07953489B2

公开(公告)日：2011-05-31

申请号：US12627861

申请日：2009-11-30

申请人： Jay A. Warren ,  Gust H. Bardy

发明人： Jay A. Warren ,  Gust H. Bardy

IPC分类号： A61N1/00

CPC分类号： A61B5/0424 ,  A61B5/0402 ,  A61B5/042 ,  A61B5/04288 ,  A61B5/076 ,  A61B5/7207 ,  A61N1/3622 ,  A61N1/3925

摘要： The implantable cardiac treatment system of the present invention is capable of choosing the most appropriate electrode vector to sense within a particular patient. In certain embodiments, the implantable cardiac treatment system determines the most appropriate electrode vector for continuous sensing based on which electrode vector results in the greatest signal amplitude, or some other useful metric such as signal-to-noise ratio (SNR). The electrode vector possessing the highest quality as measured using the metric is then set as the default electrode vector for sensing. Additionally, in certain embodiments of the present invention, a next alternative electrode vector is selected based on being generally orthogonal to the default electrode vector. In yet other embodiments of the present invention, the next alternative electrode vector is selected based on possessing the next highest quality metric after the default electrode vector. In some embodiments, if analysis of the default vector is ambiguous, the next alternative electrode vector is analyzed to reduce ambiguity.

摘要翻译： 本发明的可植入心脏治疗系统能够选择最合适的电极载体以在特定患者体内感测。 在某些实施例中，可植入心脏治疗系统基于哪个电极向量导致最大的信号幅度或诸如信噪比（SNR）的一些其他有用的度量来确定用于连续感测的最合适的电极向量。 使用度量测量的具有最高质量的电极矢量然后被设置为用于感测的默认电极矢量。 另外，在本发明的某些实施例中，基于大致正交于默认电极向量来选择下一个备选电极矢量。 在本发明的其它实施例中，基于在默认电极向量之后拥有下一个最高质量度量来选择下一个备选电极矢量。 在一些实施例中，如果默认矢量的分析是不明确的，则分析下一个替代电极矢量以减少模糊度。

公开(公告)号：US20080132965A1

公开(公告)日：2008-06-05

申请号：US12029272

申请日：2008-02-11

申请人： Alan H. Ostroff ,  Jay A. Warren ,  Gust H. Bardy

发明人： Alan H. Ostroff ,  Jay A. Warren ,  Gust H. Bardy

IPC分类号： A61N1/365

CPC分类号： A61N1/3956 ,  A61B5/0422 ,  A61B5/04525 ,  A61B5/0464 ,  A61B5/686 ,  A61N1/3925 ,  A61N1/3987

摘要： The present invention is directed toward a detection architecture for use in implantable cardiac rhythm devices. The detection architecture of the present invention provides methods and devices for discriminating between arrhythmias. Moreover, by exploiting the enhanced specificity in the origin of the identified arrhythmia, the detection architecture can better discriminate between rhythms appropriate for device therapy and those that are not.

摘要翻译： 本发明涉及用于可植入心律装置的检测架构。 本发明的检测架构提供了用于区分心律失常的方法和装置。 此外，通过利用识别的心律失常起源的增强的特异性，检测架构可以更好地区分适合于设备治疗的节律和不适合的治疗节律。

公开(公告)号：US20080119748A1

公开(公告)日：2008-05-22

申请号：US11941781

申请日：2007-11-16

申请人： Surekha Palreddy ,  Jay A. Warren ,  Alan H. Ostroff

发明人： Surekha Palreddy ,  Jay A. Warren ,  Alan H. Ostroff

IPC分类号： A61B5/04

CPC分类号： A61B5/04525 ,  A61B5/0472

摘要： Template formation methods for use in implantable cardiac rhythm management devices. In an illustrative method, a signal is captured in an implanted cardiac rhythm management device, and parameters for analysis of the captured signal are then defined. Then, in the example, additional signals can be captured and used to either verify or discard the captured signal defined parameters. The template formation methods provide for creating a robust template to compare with sensed cardiac complexes. Devices and systems configured to perform template formation and verification methods are also shown.

摘要翻译： 用于植入式心律管理装置的模板形成方法。 在说明性方法中，在植入的心律管理装置中捕获信号，然后定义用于分析捕获信号的参数。 然后，在该示例中，可以捕获附加信号并用于验证或丢弃所捕获的信号定义参数。 模板形成方法提供了创建一个可靠的模板来与感觉到的心脏复合物进行比较。 还显示了配置为执行模板形成和验证方法的设备和系统。