公开(公告)号：US08437840B2

公开(公告)日：2013-05-07

申请号：US13245632

申请日：2011-09-26

申请人： Amisha S. Patel ,  Bruce D. Gunderson ,  Mark L. Brown

发明人： Amisha S. Patel ,  Bruce D. Gunderson ,  Mark L. Brown

IPC分类号： A61B5/04

CPC分类号： A61B5/0464 ,  A61B5/04525 ,  A61B5/686 ,  A61N1/3621 ,  A61N1/36507

摘要： The present disclosure is directed to the classification of cardiac episodes using an algorithm. In various examples, an episode classification algorithm evaluates electrogram signal data collected by an implantable medical device. The episode classification algorithm may classify may include a sinus template and a comparison of the electrogram signal to the sinus template. Possible classifications of the cardiac episode may include, for example, unknown, inappropriate, appropriate, supraventricular tachycardia, ventricular tachycardia, ventricular fibrillation or ventricular over-sensing.

摘要翻译： 本公开涉及使用算法对心脏发作的分类。 在各种示例中，情节分类算法评估由可植入医疗装置收集的电描记图信号数据。 可以分类的发作分类算法可以包括窦模板和电描记信号与窦模板的比较。 心脏事件的可能分类可能包括例如未知的，不适当的，适当的，室上性心动过速，室性心动过速，心室颤动或心室过度感测。

公开(公告)号：US20130085403A1

公开(公告)日：2013-04-04

申请号：US13250515

申请日：2011-09-30

申请人： Bruce D. Gunderson ,  Karen J. Kleckner ,  Kevin T. Ousdigian ,  Amisha S. Patel ,  Julian Sanchez

发明人： Bruce D. Gunderson ,  Karen J. Kleckner ,  Kevin T. Ousdigian ,  Amisha S. Patel ,  Julian Sanchez

IPC分类号： A61B5/044 ,  A61B5/046 ,  A61B5/0464

CPC分类号： A61B5/044 ,  A61B5/046 ,  A61B5/0464 ,  A61B5/7217

摘要： The present disclosure is directed to an electrogram summary. In various examples, a subset of cardiac episodes are selected and displayed based on a set of summary rules. The subset of cardiac episodes includes at least one episode from each of a plurality of episode categories with at least one cardiac episode. In some examples, the order in which the cardiac episodes selected are displayed is based on the set of summary rules. The electrogram summary may include images or information regarding each of the selected cardiac episodes.

摘要翻译： 本公开涉及电描记图。 在各种示例中，基于一组汇总规则来选择和显示心脏发作的一个子集。 心脏发作的子集包括来自具有至少一个心脏发作的多个发作类别中的每一个的至少一个情节。 在一些示例中，显示所选择的心脏发作的顺序是基于汇总规则的集合。 电描记图可以包括关于所选心脏发作中的每一个的图像或信息。

公开(公告)号：US20130079651A1

公开(公告)日：2013-03-28

申请号：US13245632

申请日：2011-09-26

申请人： Amisha S. Patel ,  Bruce D. Gunderson ,  Mark L. Brown

发明人： Amisha S. Patel ,  Bruce D. Gunderson ,  Mark L. Brown

IPC分类号： A61B5/0464

CPC分类号： A61B5/0464 ,  A61B5/04525 ,  A61B5/686 ,  A61N1/3621 ,  A61N1/36507

摘要： The present disclosure is directed to the classification of cardiac episodes using an algorithm. In various examples, an episode classification algorithm evaluates electrogram signal data collected by an implantable medical device. The episode classification algorithm may classify may include a sinus template and a comparison of the electrogram signal to the sinus template. Possible classifications of the cardiac episode may include, for example, unknown, inappropriate, appropriate, supraventricular tachycardia, ventricular tachycardia, ventricular fibrillation or ventricular over-sensing.

摘要翻译： 本公开涉及使用算法对心脏发作的分类。 在各种示例中，情节分类算法评估由可植入医疗装置收集的电描记图信号数据。 可以分类的发作分类算法可以包括窦模板和电描记信号与窦模板的比较。 心脏事件的可能分类可能包括例如未知的，不适当的，适当的，室上性心动过速，室性心动过速，心室颤动或心室过度感测。

公开(公告)号：US08260419B2

公开(公告)日：2012-09-04

申请号：US12606899

申请日：2009-10-27

申请人： Bruce D. Gunderson

发明人： Bruce D. Gunderson

IPC分类号： A61N1/365

CPC分类号： A61B5/0422 ,  A61B5/0031 ,  A61B5/0424 ,  A61B5/0452 ,  A61B5/0464 ,  A61B2560/0276 ,  A61N1/3702 ,  A61N2001/083

摘要： Techniques for determining whether a lead related condition exists based on analysis of a cardiac electrical signal associated with a non-sustained tachyarrhythmia (NST) are described. In some examples, the techniques include determining the duration of intervals between consecutive cardiac events, e.g., R-R intervals, during an NST. The techniques may further include determining one or more metrics based on the durations of the intervals during the NST. Examples of metrics include an average, a minimum, a maximum, a range, a median, a mode, or a mean. A lead related condition is identified based on the values of the one or more metrics, e.g., by comparison to respective thresholds. In some examples, an alert is provided or a therapy modification is suggested if a lead related condition is identified.

摘要翻译： 描述了基于与非持续性快速性心律失常（NST）相关的心脏电信号的分析来确定是否存在与铅相关的病症的技术。 在一些示例中，技术包括在NST期间确定连续心脏事件之间的间隔的持续时间，例如R-R间隔。 所述技术还可以包括基于在NST期间间隔的持续时间确定一个或多个度量。 度量的示例包括平均值，最小值，最大值，范围，中值，模式或平均值。 基于一个或多个度量的值，例如通过与相应的阈值进行比较来识别引线相关条件。 在一些示例中，如果识别出铅相关病症，则提供警报或建议进行治疗修改。

公开(公告)号：US20120191153A1

公开(公告)日：2012-07-26

申请号：US13011559

申请日：2011-01-21

申请人： Charles D. Swerdlow ,  Haresh G. Sachanandani ,  Bruce D. Gunderson

发明人： Charles D. Swerdlow ,  Haresh G. Sachanandani ,  Bruce D. Gunderson

IPC分类号： A61N1/37 ,  G01R27/28 ,  A61N1/39

CPC分类号： A61N1/37 ,  A61N1/372 ,  A61N2001/083

摘要： Techniques for diagnosing lead fractures and lead connection problems are described. One or more medical leads may be coupled to an implantable medical device (IMD) to position electrodes or other sensors at different locations within a patient than the IMD. The IMD may include a lead diagnostic module configured to diagnose problems with a coupled lead and automatically select between a lead fracture problem and a lead connection problem based on the diagnosis. The diagnosis of either lead fracture problems or lead connection problems may be based on a timing of an increased impedance value with respect to connection of the lead to the IMD, a return to baseline impedance values after the increased impedance value, an abrupt rise of the increased impedance value, maximum impedance values, or oversensing. An external device may present the diagnosis to a user to facilitate appropriate corrective action.

摘要翻译： 描述了用于诊断铅骨折和铅连接问题的技术。 可以将一个或多个医疗引线耦合到可植入医疗装置（IMD），以将电极或其它传感器定位在患者内不同于IMD的位置。 IMD可以包括引导诊断模块，其被配置为诊断耦合引线的问题，并且基于诊断自动选择引线断裂问题和引线连接问题。 铅断裂问题或引线连接问题的诊断可能是基于相对于引线与IMD的连接的增加的阻抗值的时序，在增加的阻抗值之后返回到基线阻抗值，突然上升 增加的阻抗值，最大阻抗值或过强。 外部设备可以向用户呈现诊断以促进适当的校正动作。

公开(公告)号：US20120071944A1

公开(公告)日：2012-03-22

申请号：US13301619

申请日：2011-11-21

申请人： Bruce D. Gunderson ,  Donald James Ruzin

发明人： Bruce D. Gunderson ,  Donald James Ruzin

IPC分类号： A61N1/365

CPC分类号： A61N1/3704 ,  A61N1/3622

摘要： In general, the disclosure is directed to techniques for identification and remediation of oversensed cardiac events using far-field electrograms (FFEGMs). Identification of oversensed cardiac events can be used in an ICD to prevent ventricular fibrillation (VF) detection, and thereby avoid delivery of an unnecessary defibrillation shock. Alternatively, or additionally, identification of oversensed cardiac events can be used in an ICD to support delivery of bradycardia pacing during an oversensing condition. In some cases, bradycardia pacing delivered in response to detection of oversensed cardiac events may include pacing pulses from multiple vectors to provide redundancy in the event the oversensing may be due to a lead-related condition.

摘要翻译： 一般来说，本公开涉及使用远场电描记图（FFEGM）识别和补救超级心脏事件的技术。 识别超重心脏事件可用于ICD以防止心室颤动（VF）检测，从而避免不必要的除颤休克的传递。 或者或另外，过度心脏事件的识别可用于ICD以支持在过度状态期间心动过缓起搏的传送。 在一些情况下，响应于超大心脏事件的检测而发送的心动过缓起搏可以包括来自多个向量的起搏脉冲，以在超引线可能由于引线相关状况而提供冗余。

公开(公告)号：US08073537B2

公开(公告)日：2011-12-06

申请号：US11564156

申请日：2006-11-28

申请人： Bruce D. Gunderson ,  Mark L. Brown ,  Amisha Somabhai Patel

发明人： Bruce D. Gunderson ,  Mark L. Brown ,  Amisha Somabhai Patel

IPC分类号： A61N1/362

CPC分类号： A61B5/0452 ,  A61B5/0006 ,  A61B5/0031 ,  A61B5/04525 ,  A61B2560/0271 ,  A61N1/368 ,  A61N1/3702 ,  A61N1/3706 ,  A61N1/37211 ,  A61N1/3925 ,  A61N1/3962 ,  G06F19/00 ,  G06F19/3418

摘要： A system and method for determining oversensing during post-processing of sensing data generated by a medical device that includes transmitting a plurality of stored sensing data generated by the medical device to an access device, the stored sensing data including sensed atrial events and sensed ventricular events. The access device determines, in response to the transmitted data, instances where the medical device identified a cardiac event being detected in response to the sensing data, identifies and removes suspected far-field R-waves, and determines whether a signal including the removed suspected far-field R-waves is regular.

摘要翻译： 一种用于在由医疗设备产生的感测数据的后处理期间确定过敏的系统和方法，包括将由医疗设备生成的多个存储的感测数据发送到接入设备，所存储的感测数据包括感测的心房事件和感测的心室事件 。 接入装置响应于所发送的数据确定响应于感测数据识别出正在检测的心脏事件的情况，识别并移除可疑的远场R波，并且确定包括被移除的可疑的信号的信号 远场R波是正常的。

公开(公告)号：US08073536B2

公开(公告)日：2011-12-06

申请号：US11564147

申请日：2006-11-28

申请人： Bruce D. Gunderson ,  Mark L. Brown ,  Amisha Somabhai Patel

发明人： Bruce D. Gunderson ,  Mark L. Brown ,  Amisha Somabhai Patel

IPC分类号： A61N1/362

CPC分类号： A61B5/0452 ,  A61B5/0006 ,  A61B5/0031 ,  A61B5/04525 ,  A61B2560/0271 ,  A61N1/368 ,  A61N1/3702 ,  A61N1/3706 ,  A61N1/37211 ,  A61N1/3925 ,  A61N1/3962 ,  G06F19/00 ,  G06F19/3418

摘要： A method and system for determining undersensing during post-processing of sensing data generated by a medical device that includes transmitting a plurality of stored sensing data generated by the medical device to an access device, the stored sensing data including sensed atrial events and sensed ventricular events. The access device determines, in response to the transmitted data, instances where the medical device identified a cardiac event being detected in response to the sensing data, and determines whether one of a predetermined number of undersensing criteria have been met in response to the transmitted data.

摘要翻译： 一种用于在由医疗设备产生的感测数据的后处理期间确定不足感的方法和系统，包括将由医疗设备生成的多个存储的感测数据发送到接入设备，所存储的感测数据包括感测到的心房事件和感测到的心室事件 。 接入装置响应于所发送的数据确定医疗装置响应于感测数据识别出正在检测的心脏事件并且确定响应于所发送的数据是否已经满足预定数量的不足的标准中的一个 。

公开(公告)号：US20100023084A1

公开(公告)日：2010-01-28

申请号：US12180911

申请日：2008-07-28

申请人： Bruce D. Gunderson

发明人： Bruce D. Gunderson

IPC分类号： A61N1/37

CPC分类号： A61N1/3706 ,  A61N1/3702 ,  A61N2001/083

摘要： Techniques for performing a lead integrity test in response to, e.g., during or after saturation of a sensed signal, e.g., a cardiac electrogram (EGM) signal, are described. A lead integrity test may comprise one or more impedance measurements for one or more leads. Possible causes of saturation of a sensed signal include lead conductor or connector issues, or other lead related conditions. A lead integrity test triggered in response to the saturation may be able to detect any lead related condition causing the saturation. A lead integrity test triggered in response to the saturation may advantageously be able to detect an intermittent lead related condition, due to the temporal proximity of the test to the saturation.

摘要翻译： 描述了响应例如感测信号例如心电图（EGM）信号的饱和期间或之后执行引线完整性测试的技术。 引线完整性测试可以包括对一个或多个引线的一个或多个阻抗测量。 可能的感测信号的饱和原因包括引线导体或连接器问题，或其他引线相关的条件。 触发响应于饱和度的引线完整性测试可能能够检测导致饱和的任何引线相关状况。 由于测试与饱和度的时间接近，响应于饱和而触发的引线完整性测试可以有利地能够检测间歇的引线相关状况。

公开(公告)号：US07369893B2

公开(公告)日：2008-05-06

申请号：US11115607

申请日：2005-04-27

申请人： Bruce D. Gunderson

发明人： Bruce D. Gunderson

IPC分类号： A61N1/08

CPC分类号： A61N1/3704 ,  A61N1/3621 ,  A61N1/3706 ,  A61N1/3925 ,  A61N2001/083

摘要： A method for delivering therapy in a medical device that includes a two-tiered approach of determining the presence of a lead-related condition, and determining, in response to a lead-related condition being present, the presence of oversensing. Deliver of therapy by the medical device is controlled in response to determining that both the lead-related condition and oversensing are present.

摘要翻译： 一种用于在包括确定引线相关状况的存在的双层方法的医疗设备中进行治疗的方法，以及响应于存在的与引线相关的状况来确定过敏的存在。 响应于确定引线相关状况和过敏两者存在，由医疗设备进行治疗的控制。