公开(公告)号：US20120053470A1

公开(公告)日：2012-03-01

申请号：US13149507

申请日：2011-05-31

申请人： Louis Wong ,  Cem Shaquer ,  Gene A. Bornzin ,  Euljoon Park ,  Andre Walker ,  Dorin Panescu ,  Jiong Xia ,  Shahrooz Shahparnia

发明人： Louis Wong ,  Cem Shaquer ,  Gene A. Bornzin ,  Euljoon Park ,  Andre Walker ,  Dorin Panescu ,  Jiong Xia ,  Shahrooz Shahparnia

IPC分类号： A61B5/053 ,  A61B5/085

CPC分类号： A61B5/02028 ,  A61B5/0031 ,  A61B5/029 ,  A61B5/0538 ,  A61B5/08 ,  A61B5/4878 ,  A61N1/3627 ,  A61N1/36521 ,  A61N1/3702

摘要： An implantable system acquires intracardiac impedance with an implantable lead system. In one implementation, the system generates frequency-rich, low energy, multi-phasic waveforms that provide a net-zero charge and a net-zero voltage. When applied to bodily tissues, current pulses or voltage pulses having the multi-phasic waveform provide increased specificity and sensitivity in probing tissue. The effects of the applied pulses are sensed as a corresponding waveform. The waveforms of the applied and sensed pulses can be integrated to obtain corresponding area values that represent the current and voltage across a spectrum of frequencies. These areas can be compared to obtain a reliable impedance value for the tissue. Frequency response, phase delay, and response to modulated pulse width can also be measured to determine a relative capacitance of the tissue, indicative of infarcted tissue, blood to tissue ratio, degree of edema, and other physiological parameters.

摘要翻译： 可植入系统采用可植入引线系统获得心内阻抗。 在一个实现中，该系统产生提供净零电荷和净零电压的富频率，低能量，多相波形。 当应用于身体组织时，具有多相波形的电流脉冲或电压脉冲在探测组织中提供增加的特异性和灵敏度。 所施加的脉冲的影响被感测为对应的波形。 施加和感测的脉冲的波形可以被积分，以获得表示频谱范围内的电流和电压的相应面积值。 可以比较这些区域以获得组织的可靠的阻抗值。 还可以测量频率响应，相位延迟和对调制脉冲宽度的响应，以确定组织的相对电容，指示梗死组织，血液与组织之比，水肿程度和其他生理参数。

公开(公告)号：US08065005B1

公开(公告)日：2011-11-22

申请号：US11684688

申请日：2007-03-12

申请人： Louis Wong ,  Cem Shaquer ,  Gene A. Bornzin ,  Euljoon Park ,  Andre Walker ,  Dorin Panescu ,  Jiong Xia ,  Shahrooz Shahparnia

发明人： Louis Wong ,  Cem Shaquer ,  Gene A. Bornzin ,  Euljoon Park ,  Andre Walker ,  Dorin Panescu ,  Jiong Xia ,  Shahrooz Shahparnia

IPC分类号： A61N1/18

CPC分类号： A61B5/02028 ,  A61B5/0031 ,  A61B5/029 ,  A61B5/0538 ,  A61B5/08 ,  A61B5/4878 ,  A61N1/3627 ,  A61N1/36521 ,  A61N1/3702

摘要： An implantable system acquires intracardiac impedance with an implantable lead system. In one implementation, the system generates frequency-rich, low energy, multi-phasic waveforms that provide a net-zero charge and a net-zero voltage. When applied to bodily tissues, current pulses or voltage pulses having the multi-phasic waveform provide increased specificity and sensitivity in probing tissue. The effects of the applied pulses are sensed as a corresponding waveform. The waveforms of the applied and sensed pulses can be integrated to obtain corresponding area values that represent the current and voltage across a spectrum of frequencies. These areas can be compared to obtain a reliable impedance value for the tissue. Frequency response, phase delay, and response to modulated pulse width can also be measured to determine a relative capacitance of the tissue, indicative of infarcted tissue, blood to tissue ratio, degree of edema, and other physiological parameters.

公开(公告)号：US08010196B1

公开(公告)日：2011-08-30

申请号：US11684671

申请日：2007-03-12

申请人： Louis Wong ,  Cem Shaquer ,  Gene A. Bornzin ,  Euljoon Park ,  Andre Walker ,  Dorin Panescu ,  Jiong Xia ,  Shahrooz Shahparnia

发明人： Louis Wong ,  Cem Shaquer ,  Gene A. Bornzin ,  Euljoon Park ,  Andre Walker ,  Dorin Panescu ,  Jiong Xia ,  Shahrooz Shahparnia

IPC分类号： A61N1/18

CPC分类号： A61B5/02028 ,  A61B5/0031 ,  A61B5/029 ,  A61B5/0538 ,  A61B5/08 ,  A61B5/4878 ,  A61N1/3627 ,  A61N1/36521 ,  A61N1/3702

摘要： An implantable system acquires intracardiac impedance with an implantable lead system. In one implementation, the system generates frequency-rich, low energy, multi-phasic waveforms that provide a net-zero charge and a net-zero voltage. When applied to bodily tissues, current pulses or voltage pulses having the multi-phasic waveform provide increased specificity and sensitivity in probing tissue. The effects of the applied pulses are sensed as a corresponding waveform. The waveforms of the applied and sensed pulses can be integrated to obtain corresponding area values that represent the current and voltage across a spectrum of frequencies. These areas can be compared to obtain a reliable impedance value for the tissue. Frequency response, phase delay, and response to modulated pulse width can also be measured to determine a relative capacitance of the tissue, indicative of infarcted tissue, blood to tissue ratio, degree of edema, and other physiological parameters.

公开(公告)号：US07548785B2

公开(公告)日：2009-06-16

申请号：US10866422

申请日：2004-06-10

申请人： Steve Koh ,  Euljoon Park ,  Gene A. Bornzin

发明人： Steve Koh ,  Euljoon Park ,  Gene A. Bornzin

IPC分类号： A61N1/362

CPC分类号： A61N1/3627 ,  A61B5/0245 ,  A61B5/4035

摘要： An exemplary method includes selecting a cross-correlation frequency having an associated cross-correlation period, detecting and binning a heart rate in a heart rate bin, detecting and binning an activity state in an activity state bin, repeating the detecting and binning a heart rate and the detecting and binning an activity state during a cross-correlation period, and summing the products a bin count of the heart rate bins and a bin count of the activity state bins to provide a cross-correlation index for the cross-correlation period. Other exemplary algorithms, methods, devices, systems, etc., are also disclosed.

摘要翻译： 一种示例性方法包括选择具有相关联的相关周期的互相关频率，检测和归纳心率仓中的心率，检测和归纳活动状态仓中的活动状态，重复检测和归纳心率 以及在互相关时段期间检测和归纳活动状态，并且将乘积与心率仓的仓计数和活动状态仓的箱数相加，以提供互相关周期的互相关指数。 还公开了其它示例性算法，方法，设备，系统等。

公开(公告)号：US07505813B1

公开(公告)日：2009-03-17

申请号：US11199619

申请日：2005-08-08

申请人： Jong Gill ,  Alexander Huemmer ,  Gene A. Bornzin ,  Euljoon Park

发明人： Jong Gill ,  Alexander Huemmer ,  Gene A. Bornzin ,  Euljoon Park

IPC分类号： A61N1/00

CPC分类号： A61N1/368 ,  A61N1/3682

摘要： Techniques are provided for use by an implantable medical device for determining optimal or preferred atrioventricular (AV) pacing delay values for use in pacing the heart. Briefly, the atria and ventricles are paced using an initial AV pacing delay set to a value less than an intrinsic AV conduction delay so that intrinsic ventricular depolarizations are avoided. An internal electrical cardiac signal is sensed and atrial evoked responses and subsequent ventricular evoked responses are identified therein. Time delays between the atrial and ventricular evoked responses are measured and then a preferred or optimal AV pacing delay value is determined based on: the initial AV pacing delay; the measured time delays between the atrial and ventricular evoked responses; and on a predetermined preferred time delay to be achieved between atrial and ventricular evoked responses. Similar procedures are employed in connection with atrial sensed events. A calibration procedure is also described.

摘要翻译： 技术被提供用于由可植入医疗装置用于确定用于起搏心脏的最佳或优选房室（AV）起搏延迟值。 简而言之，心房和心室使用初始AV起搏延迟设定为小于固有AV传导延迟的值来进行起搏，从而避免内在的心室去极化。 感测到内部电气心脏信号，并在其中识别心房诱发反应和随后的心室诱发反应。 测量心房和心室诱发反应之间的时间延迟，然后基于：初始AV起搏延迟确定优选的或最佳的AV起搏延迟值; 测量心房和心室诱发反应之间的时间延迟; 并且在心房和心室诱发反应之间达到预定的优选时间延迟。 与心房感觉事件有关的类似手术。 还描述了校准过程。

公开(公告)号：US07308306B1

公开(公告)日：2007-12-11

申请号：US10456060

申请日：2003-06-06

申请人： Euljoon Park ,  Peter Boileau ,  Joseph J. Florio ,  Gene A. Bornzin ,  Eric Falkenberg

发明人： Euljoon Park ,  Peter Boileau ,  Joseph J. Florio ,  Gene A. Bornzin ,  Eric Falkenberg

IPC分类号： A61N1/368

CPC分类号： A61N1/3621 ,  A61N1/365

摘要： Techniques are provided for overdrive pacing the ventricles using a pacemaker wherein an increase in an overdrive pacing rate is performed primarily to achieve a high degree of rate smoothing. The ventricles are paced at an overdrive pacing rate selected to permit the detection of the least some intrinsic ventricular pulses and then the overdrive pacing rate is dynamically adjusted based on the detected intrinsic ventricular pulses. In one example, an increase in the ventricular overdrive rate is performed only in response to detection of at least two intrinsic ventricular beats within a predetermined search period. If at least two intrinsic ventricular beats are not detected within the search period, the overdrive pacing rate is decreased. Various techniques are also provided for determining when to activate ventricular overdrive pacing depending, in part, on the capabilities of the particular pacemaker, the current mode of operation, the density of premature ventricular contractions, the degree of heart rate stability, and the presence of atrial fibrillation. Adaptive techniques for automatically adjusting ventricular overdrive pacing control parameters are also described.

摘要翻译： 提供技术用于使用起搏器超速起搏心室，其中主要执行超速起搏速率的增加以实现高程度的速率平滑。 心室以选择的超速起搏速度进行起搏，以允许检测至少一些内在的心室脉冲，然后基于检测到的内在心室脉冲来动态地调整超速起搏速率。 在一个示例中，仅在响应于在预定搜索周期内检测到至少两个本征心室搏动来执行心室超速率的增加。 如果在搜索期内未检测到至少两个内在心室搏动，则超速起搏速率降低。 还提供了各种技术来确定何时激活心室过度起搏起搏，其部分取决于特定起搏器的能力，当前的手术方式，早期心室收缩的密度，心率稳定程度以及是否存在 心房颤动。 还描述了用于自动调节心室超速起搏控制参数的自适应技术。

公开(公告)号：US07103411B1

公开(公告)日：2006-09-05

申请号：US10206483

申请日：2002-07-26

申请人： Euljoon Park ,  Gene A. Bornzin ,  Joseph J. Florio ,  John W. Poore ,  Douglas T. Kurschinski

发明人： Euljoon Park ,  Gene A. Bornzin ,  Joseph J. Florio ,  John W. Poore ,  Douglas T. Kurschinski

IPC分类号： A61N1/368

CPC分类号： A61N1/3622 ,  A61N1/3684

摘要： Techniques are described for pacing multiple sites in a patient's heart using overdrive pacing the heart using a pacemaker including techniques where the overdrive pacing rate only increases when at least two intrinsic beats are detected within a determined search period. In one specific technique, an increase in the pacing rate occurs only if two P-waves are detected within X cardiac cycles. In another specific technique, the overdrive pacing rate is increased only if at least two P-waves are detected within a block of N cardiac cycles. In both techniques, the overdrive pacing rate is decreased if no increase has occurred in the last Z cardiac cycles. By increasing the overdrive pacing rate only in response to detection of at least two P-waves within a determined number of cardiac cycles, an excessively high overdrive pacing rate is avoided. Other techniques are described for adaptively adjusting overdrive pacing parameters so as to achieve a determined target degree of pacing of, for example, 95% paced beats. By adaptively adjusting overdrive parameters to maintain a target degree of pacing, the average overdrive pacing rate is minimized while still maintaining a high number of paced beats, thereby reducing the risk of a tachyarrhythmia occurring within the patient.

公开(公告)号：US06904320B2

公开(公告)日：2005-06-07

申请号：US10077053

申请日：2002-02-14

申请人： Euljoon Park ,  Gene A. Bornzin ,  Paul A. Levine ,  Eric Falkenberg

发明人： Euljoon Park ,  Gene A. Bornzin ,  Paul A. Levine ,  Eric Falkenberg

IPC分类号： A61N1/365 ,  A61N1/18

CPC分类号： A61N1/365 ,  A61N1/36557

摘要： A cardiac stimulation device uses dynamic overdrive pacing to prevent sleep apnea. In another aspect, the device can use dynamic overdrive pacing to terminate sleep apnea after detection. An implantable cardiac stimulation device comprises a sensor and one or more pulse generators. The sensor senses intrinsic cardiac electrical phenomena. The pulse generators can generate cardiac pacing pulses with timing based on the sensed intrinsic cardiac electrical phenomena to dynamically overdrive the intrinsic cardiac electrical phenomena. The timed cardiac pacing pulses can prevent a sleep apnea condition.

摘要翻译： 心脏刺激装置使用动态超速起搏来预防睡眠呼吸暂停。 另一方面，该设备可以使用动态超速起搏来终止检测后的睡眠呼吸暂停。 可植入心脏刺激装置包括传感器和一个或多个脉冲发生器。 传感器感测内在的心脏电学现象。 脉冲发生器可以基于感测到的固有心脏电现象产生心脏起搏脉冲，以动态地过度驱动固有的心脏电学现象。 定时的心脏起搏脉冲可以防止睡眠呼吸暂停状态。

公开(公告)号：US06748261B1

公开(公告)日：2004-06-08

申请号：US09675462

申请日：2000-09-28

申请人： Mark W. Kroll ,  Joseph J. Florio ,  Gene A. Bornzin ,  Euljoon Park ,  Kerry A. Bradley

发明人： Mark W. Kroll ,  Joseph J. Florio ,  Gene A. Bornzin ,  Euljoon Park ,  Kerry A. Bradley

IPC分类号： A61B504

CPC分类号： A61N1/3627 ,  A61B5/0031 ,  A61B5/0456 ,  A61B5/046 ,  A61N1/3684

摘要： A system and method, for use in an implantable cardiac stimulation device, monitors progression or regression in heart disease such as congestive heart failure. The system includes a sensing circuit that derives an electrogram signal indicative of the electrical activity of the patient's heart. A processor processes the electrogram signal to determine interchamber conduction delays which are then stored in memory. The stored interchamber conduction delays may be later retrieved by way of a telemetry circuit. Relative changes in the interchamber conduction delays, over time, are indicative of progression or regression in the heart disease. The relative changes in the interchamber conduction delays may be further used to automatically adjust pacing parameters of the implantable cardiac stimulation device.

摘要翻译： 用于可植入心脏刺激装置的系统和方法监测心脏疾病如充血性心力衰竭的进展或消退。 该系统包括感测电路，其导出指示患者心脏的电活动的电描绘信号。 处理器处理电描记图信号以确定然后存储在存储器中的车间传导延迟。 存储的车间传导延迟可以稍后通过遥测电路检索。 随着时间的推移，间歇传导延迟的相对变化表明心脏病发展或消退。 室间传导延迟的相对变化可以进一步用于自动调整可植入心脏刺激装置的起搏参数。

公开(公告)号：US06456880B1

公开(公告)日：2002-09-24

申请号：US09712861

申请日：2000-11-14

申请人： Euljoon Park ,  Joseph J. Florio ,  Kerry Bradley ,  Gene A. Bornzin ,  Laurence S. Sloman

发明人： Euljoon Park ,  Joseph J. Florio ,  Kerry Bradley ,  Gene A. Bornzin ,  Laurence S. Sloman

IPC分类号： A61N1365

CPC分类号： A61N1/3702 ,  A61N1/365

摘要： An implantable cardiac stimulation device includes a system that monitors progression or regression of a patient's heart condition. The system includes a plurality of electrode configurations for sensing cardiac activity of the heart. A sensing circuit provides an electrical signal representing electrical activity of the heart from each of the sensing electrode configurations. A processor coupled to the sensing circuit determines, at spaced apart times, and over time, a ventricular repolarization interval in each of the electrical signals and a corresponding ventricular repolarization interval dispersion. A memory stores the ventricular repolarization interval dispersions for transmission by a telemetry circuit to an external receiver for analysis.

摘要翻译： 可植入心脏刺激装置包括监测患者心脏状况的进展或消退的系统。 该系统包括用于感测心脏的心脏活动的多个电极配置。 感测电路从每个感测电极配置提供表示心脏的电活动的电信号。 耦合到感测电路的处理器在间隔开的时间和时间上确定每个电信号中的心室复极间隔和对应的心室复极间隔分散。 存储器存储用于通过遥测电路传输到外部接收器用于分析的心室复极间隔分散体。