公开(公告)号：US09656087B2

公开(公告)日：2017-05-23

申请号：US14919912

申请日：2015-10-22

Applicant: Medtronic, Inc.

Inventor： Subham Ghosh

IPC: A61N1/00 ,  A61N1/368 ,  A61N1/05 ,  A61N1/375 ,  A61N1/39

CPC classification number: A61N1/3684 ,  A61B5/042 ,  A61B5/04525 ,  A61B5/0456 ,  A61B5/0468 ,  A61B5/4836 ,  A61N1/056 ,  A61N1/3627 ,  A61N1/36514 ,  A61N1/3682 ,  A61N1/3688 ,  A61N1/371 ,  A61N1/3712 ,  A61N1/37223 ,  A61N1/3756 ,  A61N1/3956

Abstract: An implantable medical device and medical device system for delivering a bi-ventricular pacing therapy that includes a plurality of electrodes to sense a cardiac signal, an emitting device to emit a trigger signal to control delivery of the bi-ventricular pacing, and a processor configured to compare the sensed cardiac signal associated with the delivered bi-ventricular pacing to at least one of an intrinsic beat template and an RV template associated with a morphology of RV-only pacing therapy, determine whether an offset interval associated with the bi-ventricular pacing therapy is set to a maximum offset interval level in response to the comparing, adjust the offset interval in response to the offset interval not being set to the maximum offset interval level, and generate the trigger signal to be emitted by the emitting device to subsequently deliver the bi-ventricular pacing therapy having the adjusted offset interval.

公开(公告)号：US09610045B2

公开(公告)日：2017-04-04

申请号：US14815537

申请日：2015-07-31

Applicant: Medtronic, Inc.

Inventor： Juan Du ,  Subham Ghosh

IPC: A61B5/04 ,  A61B5/00 ,  A61B5/0408 ,  A61B5/044 ,  A61N1/37

CPC classification number: A61B5/7221 ,  A61B5/04012 ,  A61B5/04085 ,  A61B5/044 ,  A61B5/0452 ,  A61B5/0464 ,  A61B5/6823 ,  A61B5/7239 ,  A61N1/3702 ,  A61N1/3704

Abstract: A system and associated method is disclosed for determining whether signal is valid. The system comprises an electrode apparatus comprising a plurality of electrodes configured to be located proximate tissue of a patient. A display apparatus comprising a graphical user interface, wherein the graphical user interface is configured to present information to a user. A computing apparatus coupled to the electrode apparatus and display apparatus, wherein the computing apparatus is configured to determine whether a signal acquired from a channel associated with an electrode from the plurality of electrodes is valid and sufficiently strong by i) calculating a first derivative of the signal; ii) determining a minimum and maximum derivative from the first derivative; iii) determining whether signs of the minimum and maximum derivative are different; and in response to determining whether the signs of the minimum and maximum derivative are different, displaying on a display apparatus whether the signal is valid.

公开(公告)号：US09591982B2

公开(公告)日：2017-03-14

申请号：US14695412

申请日：2015-04-24

Applicant: Medtronic, Inc.

Inventor： Subham Ghosh ,  Jeffrey Gillberg

IPC: A61B5/00 ,  A61B5/0408 ,  A61N1/37 ,  A61N1/372 ,  A61N1/39 ,  A61N1/362

CPC classification number: A61B5/04085 ,  A61B5/4833 ,  A61B2562/046 ,  A61N1/3627 ,  A61N1/37 ,  A61N1/372 ,  A61N1/3956

Abstract: Systems and methods are described herein for assisting a user in evaluation of cardiac therapy. The systems and methods may monitor electrical activity of a patient using external electrode apparatus to provide baseline cardiac information and therapy cardiac information and determine whether the cardiac pacing, or therapy, location is acceptable. If the cardiac pacing, or therapy, location is unacceptable, location information representative of a location that may more effective may be generated based on the therapy cardiac information.

Abstract translation: 本文描述了用于帮助用户评估心脏治疗的系统和方法。 系统和方法可以使用外部电极装置监测患者的电活动，以提供基线心脏信息和治疗心脏信息，并确定心脏起搏或治疗位置是否可接受。 如果心脏起搏或治疗位置是不可接受的，则可以基于治疗心脏信息产生代表可能更有效的位置的位置信息。

公开(公告)号：US20170027524A1

公开(公告)日：2017-02-02

申请号：US14815537

申请日：2015-07-31

Applicant: Medtronic, Inc.

Inventor： Juan Du ,  Subham Ghosh

IPC: A61B5/00 ,  A61N1/37 ,  A61B5/044 ,  A61B5/04 ,  A61B5/0408

CPC classification number: A61B5/7221 ,  A61B5/04012 ,  A61B5/04085 ,  A61B5/044 ,  A61B5/0452 ,  A61B5/0464 ,  A61B5/6823 ,  A61B5/7239 ,  A61N1/3702 ,  A61N1/3704

Abstract: A system and associated method is disclosed for determining whether signal is valid. The system comprises an electrode apparatus comprising a plurality of electrodes configured to be located proximate tissue of a patient. A display apparatus comprising a graphical user interface, wherein the graphical user interface is configured to present information to a user. A computing apparatus coupled to the electrode apparatus and display apparatus, wherein the computing apparatus is configured to determine whether a signal acquired from a channel associated with an electrode from the plurality of electrodes is valid and sufficiently strong by i) calculating a first derivative of the signal; ii) determining a minimum and maximum derivative from the first derivative; iii) determining whether signs of the minimum and maximum derivative are different; and in response to determining whether the signs of the minimum and maximum derivative are different, displaying on a display apparatus whether the signal is valid.

Abstract translation: 公开了一种用于确定信号是否有效的系统和相关方法。 该系统包括电极装置，该电极装置包括被配置为位于患者的组织附近的多个电极。 一种显示装置，包括图形用户界面，其中所述图形用户界面被配置为向用户呈现信息。 一种耦合到所述电极装置和显示装置的计算装置，其中所述计算装置被配置为确定从与所述多个电极中的电极相关联的通道获取的信号是否有效并且足够强，i）计算所述电极装置的显示装置的一阶导数 信号; ii）确定一阶导数的最小和最大导数; iii）确定最小和最大导数的符号是​​否不同; 并且响应于确定最小和最大导数的符号是​​否不同，在显示装置上显示信号是否有效。

公开(公告)号：US20170027463A1

公开(公告)日：2017-02-02

申请号：US14815478

申请日：2015-07-31

Applicant: Medtronic, Inc.

Inventor： Juan Du ,  Subham Ghosh ,  Jeffrey M. Gillberg

IPC: A61B5/04 ,  A61B5/00 ,  A61B5/0408

CPC classification number: A61B5/04012 ,  A61B5/04085 ,  A61B5/0456 ,  A61B5/6823 ,  A61B5/7221 ,  A61B5/7239 ,  A61B5/7435 ,  A61N1/36507

Abstract: A system and associated method is disclosed for determining whether a signal is ambiguous. The system comprises an electrode apparatus comprising a plurality of electrodes configured to be located proximate tissue of a patient. A display apparatus comprises a graphical user interface. The graphical user interface is configured to present information to a user. A computing apparatus coupled to the electrode apparatus and display apparatus, is configured to determine whether a signal acquired from a channel associated with an electrode from the plurality of electrodes is ambiguous. The computing apparatus is configured to calculate a first derivative of the signal, determine a first minimum from the first derivative, determine a second minimum from the second derivative and a second index within a window, calculate a ratio of the first and second derivatives, calculate a difference between a first and second index. In response to determining the ratio and the difference between the first and second index, the display apparatus displays whether the signal is ambiguous.

Abstract translation: 公开了一种用于确定信号是不明确的系统和相关方法。 该系统包括电极装置，该电极装置包括被配置为位于患者的组织附近的多个电极。 显示装置包括图形用户界面。 图形用户界面被配置为向用户呈现信息。 耦合到电极装置和显示装置的计算装置被配置为确定从与多个电极中的电极相关联的通道获取的信号是否是不明确的。 计算装置被配置为计算信号的一阶导数，从一阶导数确定第一最小值，从二阶导数确定第二最小值，以及确定窗口内的第二索引，计算第一和第二导数的比率，计算 第一和第二个索引之间的差异。 响应于确定第一和第二索引之间的比率和差异，显示装置显示信号是否模糊。

公开(公告)号：US20160339247A1

公开(公告)日：2016-11-24

申请号：US15176958

申请日：2016-06-08

Applicant: Medtronic, Inc.

Inventor： Subham Ghosh ,  Robert W Stadler

IPC: A61N1/368 ,  A61N1/365 ,  A61N1/362

CPC classification number: A61N1/3682 ,  A61N1/3622 ,  A61N1/3627 ,  A61N1/36514 ,  A61N1/36592 ,  A61N1/3684

Abstract: Methods and/or devices may be configured to monitor ventricular activation times and modify an atrioventricular delay (AV delay) based on the monitored ventricular activation times. Further, the methods and/or devices may determine whether the AV delay should be modified based on the measured activation times before modifying the AV delay.

公开(公告)号：US09486151B2

公开(公告)日：2016-11-08

申请号：US14190508

申请日：2014-02-26

Applicant: Medtronic, Inc.

Inventor： Subham Ghosh ,  Jeffrey M Gillberg

IPC: A61N1/365 ,  A61B5/0408 ,  A61B5/00 ,  A61B5/0452 ,  A61N1/362 ,  A61N1/368

CPC classification number: A61B5/04085 ,  A61B5/0452 ,  A61B5/6805 ,  A61B5/7282 ,  A61N1/3627 ,  A61N1/3682 ,  A61N1/3684

Abstract: A method and system of cardiac pacing is disclosed. A baseline rhythm is determined using a plurality of body-surface electrodes. A set of baseline functional electrical metrics is determined in response to determining the baseline rhythm. Resynchronization pacing is delivered using a right ventricular electrode and a pacing left ventricular electrode or only with a left ventricular electrode. A set of functional electrical metrics relating to cardiac depolarization and repolarization is determined in response to resynchronization pacing. A determination is made as to whether relative reduction of at least one functional electrical metric from the set of functional electrical metrics exceeds X % of its corresponding value from the set of baseline functional electrical metrics. A determination is made as to whether an absolute value of at least one electrical metric from the set of the functional electrical metrics is less than Y ms. A determination is made as to whether a site is responsive to cardiac resynchronization therapy (CRT).

Abstract translation: 公开了一种心脏起搏方法和系统。 使用多个体表电极确定基线节奏。 响应于确定基线节奏来确定一组基线功能电度量。 使用右心室电极和起搏左心室电极或仅与左心室电极进行重新同步起搏。 与心脏去极化和复极化相关的一组功能性电气指标是响应于再同步起搏而确定的。 确定至少一个功能电度量的相对减小是否来自该组功能电气度量值是否从基准功能电气度量集合的相应值的X％超过其相应值的X％。 确定来自该功能电度量集合的至少一个电度量的绝对值是否小于Y ms。 确定一个部位是否对心脏再同步治疗（CRT）有反应。

公开(公告)号：US09474457B2

公开(公告)日：2016-10-25

申请号：US14190578

申请日：2014-02-26

Applicant: Medtronic, Inc.

Inventor： Subham Ghosh ,  Jeffrey M Gillberg

IPC: A61N1/37 ,  A61B5/0408 ,  A61B5/00 ,  A61B5/0452 ,  A61N1/362 ,  A61N1/368

CPC classification number: A61B5/04085 ,  A61B5/0452 ,  A61B5/6805 ,  A61B5/7282 ,  A61N1/3627 ,  A61N1/3682 ,  A61N1/3684

Abstract: A method and system of cardiac pacing is disclosed. A baseline rhythm is determined using a plurality of body-surface electrodes. A set of baseline functional electrical metrics is determined in response to determining the baseline rhythm. Resynchronization pacing is delivered using a right ventricular electrode and a pacing left ventricular electrode or only with a left ventricular electrode. A set of functional electrical metrics relating to cardiac depolarization and repolarization is determined in response to resynchronization pacing. A determination is made as to whether relative reduction of at least one functional electrical metric from the set of functional electrical metrics exceeds X % of its corresponding value from the set of baseline functional electrical metrics. A determination is made as to whether an absolute value of at least one electrical metric from the set of the functional electrical metrics is less than Y ms. A determination is made as to whether a site is responsive to cardiac resynchronization therapy (CRT).

公开(公告)号：US20160166834A1

公开(公告)日：2016-06-16

申请号：US14880840

申请日：2015-10-12

Applicant: Medtronic, Inc.

Inventor： Subham Ghosh ,  Robert W. Stadler

IPC: A61N1/368 ,  A61N1/37

CPC classification number: A61N1/3686 ,  A61B5/0452 ,  A61N1/3684 ,  A61N1/3702 ,  A61N1/3706

Abstract: Generally, the disclosure is directed one or more methods or systems of cardiac pacing employing a right ventricular electrode and a plurality of left ventricular electrodes. Pacing using the right ventricular electrode and a first one of the left ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes. Pacing using the right ventricular electrode and a second one of the ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes. Computing a first degree of resynchronization based on a sum of differences of activation times and corresponding activation times. Pacing using the right ventricular electrode and a second one of the ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes. Computing a second degree of resynchronization based on the sum of differences of activation times and corresponding activation times. Selecting one of the left ventricular electrodes for delivery of subsequent pacing pulses based on the computed degrees of resynchronization.

Abstract translation: 通常，本公开涉及使用右心室电极和多个左心室电极的一个或多个心脏起搏方法或系统。 使用右心室电极和左心室电极中的第一个进行起搏，并测量其他左心室电极的活化时间。 使用右心室电极和第二个心室电​​极进行起搏，并测量其他左心室电极的活化时间。 基于激活时间的差异和相应的激活时间的总和来计算第一程度的再同步。 使用右心室电极和第二个心室电​​极进行起搏，并测量其他左心室电极的活化时间。 基于激活时间的差异和相应的激活时间的总和计算第二度的再同步度。 基于所计算的再同步程度，选择左心室电极之一用于递送随后的起搏脉冲。

公开(公告)号：US09339656B2

公开(公告)日：2016-05-17

申请号：US14193186

申请日：2014-02-28

Applicant: Medtronic, Inc.

Inventor： Subham Ghosh

IPC: A61N1/37 ,  A61N1/05 ,  A61N1/36 ,  A61B5/00 ,  A61B5/0452 ,  A61N1/372

CPC classification number: A61N1/3712 ,  A61B5/04525 ,  A61B5/4836 ,  A61B5/6869 ,  A61B5/7282 ,  A61N1/37247

Abstract: The present disclosure pertains to cardiac pacing methods and systems, and, more particularly, to cardiac resynchronization therapy (CRT). In particular, the present disclosure pertains to determining the efficacy of CRT through use of an effective capture test (ECT). One or more embodiments comprises sensing a signal in response to a ventricular pacing stimulus. Through signal processing, a number of features are parsed from the signal. Exemplary features parsed from the signal include a maximum amplitude, a maximum time associated with the maximum amplitude, a minimum amplitude, and a minimum time associated with the minimum amplitude. The data is evaluated through use of the ECT. By employing the ECT, efficacy of CRT is easily and automatically evaluated. In one or more other embodiments, the reason for ineffective capture is displayed to the user. Exemplary reasons for ineffective capture include pseudo-fusion pacing and lack of capture of the ventricle.

Abstract translation: 本公开涉及心脏起搏方法和系统，更具体地，涉及心脏再同步治疗（CRT）。 特别地，本公开涉及通过使用有效捕获测试（ECT）来确定CRT的功效。 一个或多个实施例包括响应于心室起搏刺激来感测信号。 通过信号处理，从信号中解析出许多特征。 从信号解析的示范性特征包括最大幅度，与最大幅度相关联的最大时间，最小幅度以及与最小幅度相关联的最小时间。 通过使用ECT评估数据。 通过使用ECT，CRT的功效易于自动评估。 在一个或多个其他实施例中，向用户显示无效捕获的原因。 无效捕获的示例性原因包括伪融合起搏和缺乏心室的捕获。