公开(公告)号：US10188867B2

公开(公告)日：2019-01-29

申请号：US14604260

申请日：2015-01-23

Applicant: Medtronic, Inc.

Inventor： Xusheng Zhang

IPC: A61N1/39 ,  A61B5/0452 ,  A61N1/37 ,  A61B5/00 ,  A61N1/362 ,  A61N1/365

Abstract: A method and medical device for generating a template that includes sensing a cardiac signal from a plurality of electrodes, determining a plurality of beats in response to the sensed cardiac signal, determining whether to store a beat of the plurality of beats in a subgroup of a plurality of subgroups for storing beats, determining whether a number of beats stored in one of the plurality of subgroups exceeds a subgroup threshold, and generating a template in response to beats stored in the one of the plurality of subgroups that exceeds the subgroup threshold.

公开(公告)号：US09795312B2

公开(公告)日：2017-10-24

申请号：US14340189

申请日：2014-07-24

Applicant: Medtronic, Inc.

Inventor： Saul E Greenhut ,  Robert W Stadler ,  Xusheng Zhang

IPC: A61B5/04 ,  A61B5/0408 ,  A61B5/042 ,  A61B5/0456

CPC classification number: A61B5/04011 ,  A61B5/0408 ,  A61B5/042 ,  A61B5/0456

Abstract: A method and medical device for determining sensing vectors that includes sensing cardiac signals from a plurality of electrodes, the plurality of electrodes forming a plurality of sensing vectors, setting a blanking period and a blanking period adjustment window for the plurality of sensing vectors in response to the sensed cardiac signals, determining first signal differences during the blanking period adjustment window, and adjusting the blanking period in response to the determined first signal differences.

公开(公告)号：US09707399B2

公开(公告)日：2017-07-18

申请号：US15204464

申请日：2016-07-07

Applicant: Medtronic, Inc.

Inventor： Todd M. Zielinski ,  Yong Kyun Cho ,  Douglas Hettrick ,  Xusheng Zhang

IPC: A61N1/00 ,  A61N1/365 ,  A61N1/368 ,  A61B5/053

CPC classification number: A61N1/36585 ,  A61B5/0535 ,  A61B5/0538 ,  A61N1/36521 ,  A61N1/3682 ,  A61N1/3684 ,  A61N1/3686

Abstract: Methods and/or devices used in delivering cardiac resynchronization therapy based on a plurality of device parameters (e.g., A-V delay, V-V delay, etc.) are optimized by setting a device parameter based on selection data. The selection data may be acquired by acquiring temporal fiducial points (e.g., heart sounds) associated with at least a part of a systolic portion of at least one cardiac cycle and/or temporal fiducial points associated with at least a part of a diastolic portion of the at least one cardiac cycle for each of a plurality of electrode vector configurations, and extracting measurements from the intracardiac impedance signal acquired for each of a plurality of electrode vector configurations based on the temporal fiducial points. The acquired selection data may be scored and used to optimize the device parameter.

公开(公告)号：US09597525B2

公开(公告)日：2017-03-21

申请号：US14705010

申请日：2015-05-06

Applicant: Medtronic, Inc.

Inventor： Jian Cao ,  Xusheng Zhang ,  Robert W. Stadler

IPC: A61N1/00 ,  A61N1/39 ,  A61B5/0452 ,  A61B5/04

CPC classification number: A61N1/3987 ,  A61B5/04012 ,  A61B5/0452 ,  A61B5/7264 ,  A61N1/3925 ,  A61N1/3956

Abstract: A medical device coupled to extracardiac electrodes is configured to analyze a cardiac electrical signal over a signal analysis segment to determine if shockable rhythm classification criteria are met, determine that TWOS detection criteria are met for the signal analysis segment when a predetermined number of TWOS analysis windows are classified as TWOS, and classify the signal analysis segment as non-shockable in response to determining that the TWOS detection criteria are met.

公开(公告)号：US09526908B2

公开(公告)日：2016-12-27

申请号：US14242536

申请日：2014-04-01

Applicant: Medtronic, Inc.

Inventor： Xusheng Zhang ,  Robert W Stadler

IPC: A61N1/39 ,  A61B5/0464 ,  A61B5/0452 ,  A61B5/046

CPC classification number: A61N1/3925 ,  A61B5/04525 ,  A61B5/046 ,  A61B5/0464

Abstract: A method and medical device for detecting a cardiac event that includes sensing cardiac signals from a plurality of electrodes, the plurality of electrodes forming a first sensing vector and a second sensing vector, determining, in response to the cardiac event being identified as a shockable event, a first R-wave morphology corresponding to R-waves of a next interval subsequently sensed along the first sensing vector during the predetermined sensing window and a second R-wave morphology corresponding to R-waves of a next interval subsequently sensed along the second sensing vector, determining whether the next interval subsequently sensed along the first sensing vector and the next interval subsequently sensed along the second sensing vector satisfy a morphology metric, and identifying the cardiac event as one of a monomorphic ventricular tachycardia and a polymorphic ventricular tachycardia in response to the determined first R-wave morphology, second R-wave morphology, and the next interval subsequently sensed along the first sensing vector and the next interval subsequently sensed along the second sensing vector not satisfying the morphology metric.

Abstract translation: 一种用于检测心脏事件的方法和医疗装置，其包括感测来自多个电极的心脏信号，所述多个电极形成第一感测向量和第二感测向量，响应于心脏事件被确定为可震荡事件 ，对应于在预定感测窗口期间沿着第一感测矢量随后感测的下一个间隔的R波的第一R波形态和对应于随后沿着第二感测感测的下一个间隔的R波的第二R波形态 确定随后沿着第一感测矢量感测到的下一个间隔和随后沿着第二感测向量感测的下一个间隔是否满足形态度量，以及将心脏事件识别为单形室性心动过速和多形性室性心动过速之一，以响应于 确定的第一个R波形态，第二个R波形态和下一个 随后沿着第一感测向量感测到间隔，并且随后沿着不满足形态度量的第二感测向量感测到下一个间隔。

公开(公告)号：US20160023013A1

公开(公告)日：2016-01-28

申请号：US14339833

申请日：2014-07-24

Applicant: Medtronic, Inc.

Inventor： Saul E. Greenhut ,  Robert W. Stadler ,  Xusheng Zhang

IPC: A61N1/39 ,  A61B5/0464

CPC classification number: A61N1/3987 ,  A61B5/04525 ,  A61B5/0464 ,  A61B5/686 ,  A61N1/3622 ,  A61N1/3624 ,  A61N1/37 ,  A61N1/3925 ,  A61N1/3962

Abstract: An implantable medical device system includes an implantable cardioverter defibrillator (ICD) for detecting and treating ventricular tachycardia (VT). The ICD includes a sensing module for sensing a cardiac signal from selected cardiac signal sensing vectors. A control module generates morphology templates of the cardiac signals for multiple patient postures for each of the available sensing vectors. A cardiac signal received during an unknown cardiac rhythm is compared to the morphology templates without determining a current posture of the patient. The unknown cardiac rhythm is detected and classified as supraventricular tachycardia in response to the cardiac signal matching at least one of the morphology templates.

Abstract translation: 可植入医疗装置系统包括用于检测和治疗室性心动过速（VT）的可植入式心律转复除颤器（ICD）。 ICD包括用于感测来自所选择的心脏信号感测向量的心脏信号的感测模块。 控制模块为每个可用的感测向量生成用于多个患者姿势的心脏信号的形态学模板。 将未知心脏节律期间接收到的心脏信号与形态学模板进行比较，而不确定患者的当前姿势。 检测未知的心律并将其分类为室上性心动过速，以响应心脏信号匹配至少一个形态学模板。

公开(公告)号：US20150305639A1

公开(公告)日：2015-10-29

申请号：US14340189

申请日：2014-07-24

Applicant: Medtronic, Inc.

Inventor： Saul E. Greenhut ,  Robert W. Stadler ,  Xusheng Zhang

IPC: A61B5/04 ,  A61B5/0408

CPC classification number: A61B5/04011 ,  A61B5/0408 ,  A61B5/042 ,  A61B5/0456

Abstract: A method and medical device for determining sensing vectors that includes sensing cardiac signals from a plurality of electrodes, the plurality of electrodes forming a plurality of sensing vectors, setting a blanking period and a blanking period adjustment window for the plurality of sensing vectors in response to the sensed cardiac signals, determining first signal differences during the blanking period adjustment window, and adjusting the blanking period in response to the determined first signal differences.

Abstract translation: 一种用于确定感测向量的方法和医疗装置，其包括感测来自多个电极的心脏信号，所述多个电极形成多个感测矢量，响应于所述多个感测矢量设置消隐周期和消隐周期调整窗口 感测到的心脏信号，在消隐期调整窗口期间确定第一信号差，并响应于所确定的第一信号差调整消隐周期。

公开(公告)号：US20150202443A1

公开(公告)日：2015-07-23

申请号：US14158533

申请日：2014-01-17

Applicant: Medtronic, Inc.

Inventor： Todd M. Zielinski ,  Yong Kyun Cho ,  Douglas Hettrick ,  Xusheng Zhang

IPC: A61N1/368 ,  A61N1/365

CPC classification number: A61N1/36585 ,  A61B5/0535 ,  A61B5/0538 ,  A61N1/36521 ,  A61N1/3682 ,  A61N1/3684 ,  A61N1/3686

Abstract: Methods and/or devices used in delivering cardiac resynchronization therapy based on a plurality of device parameters (e.g., A-V delay, V-V delay, etc.) are optimized by setting a device parameter based on selection data. The selection data may be acquired by acquiring temporal fiducial points (e.g., heart sounds) associated with at least a part of a systolic portion of at least one cardiac cycle and/or temporal fiducial points associated with at least a part of a diastolic portion of the at least one cardiac cycle for each of a plurality of electrode vector configurations, and extracting measurements from the intracardiac impedance signal acquired for each of a plurality of electrode vector configurations based on the temporal fiducial points. The acquired selection data may be scored and used to optimize the device parameter.

Abstract translation: 通过基于选择数据设置设备参数来优化基于多个设备参数（例如，A-V延迟，V-V延迟等）递送心脏再同步治疗的方法和/或设备。 选择数据可以通过获取与至少一个心动周期的收缩期部分的至少一部分相关联的时间基准点（例如，心音）和/或与至少一个心动周期的舒张部分的至少一部分相关联的时间基准点来获取 所述至少一个心脏周期用于多个电极向量配置中的每一个，并且基于所述时间基准点从针对多个电极向量配置中的每一个获取的心脏内阻抗信号提取测量值。 可以对所获取的选择数据进行评分并用于优化设备参数。

公开(公告)号：US20140276158A1

公开(公告)日：2014-09-18

申请号：US13804816

申请日：2013-03-14

Applicant: MEDTRONIC, INC.

Inventor： Xusheng Zhang

IPC: A61B5/0464 ,  A61B5/0472

CPC classification number: A61B5/0464 ,  A61B5/04525 ,  A61B5/0472 ,  A61N1/3622 ,  A61N1/36507

Abstract: A medical device and associated method for classifying an unknown cardiac signal operate to sense a cardiac signal over known cardiac cycles and generate a template of the known cardiac cycles. An unknown cardiac signal is sensed over an unknown cardiac cycle. A template alignment point and an unknown cardiac signal alignment point are identified by using a fourth order difference signal. The template and the unknown cardiac signal are aligned across an alignment window by aligning the template alignment point and the unknown cardiac signal alignment point. A morphology match metric measuring a similarity between the aligned template and the unknown cardiac signal is computed.

Abstract translation: 用于分类未知心脏信号的医疗装置和相关联的方法用于在已知心脏周期上感测心脏信号，并产生已知心脏周期的模板。 未知的心脏信号在未知的心脏周期上被感测。 通过使用四阶差分信号来识别模板对准点和未知心脏信号对准点。 模板和未知的心脏信号通过对准模板对准点和未知的心脏信号对准点在校准窗口上对准。 计算测量对准的模板和未知心脏信号之间的相似性的形态匹配度量。

公开(公告)号：US20140214104A1

公开(公告)日：2014-07-31

申请号：US14178711

申请日：2014-02-12

Applicant: Medtronic, Inc.

Inventor： Saul E Greenhut ,  Robert J Nehls ,  Walter H Olson ,  Xusheng Zhang ,  Wade M Demmer ,  Troy E Jackson ,  James D Reinke

IPC: A61N1/39 ,  A61N1/362 ,  A61N1/372

CPC classification number: A61N1/3962 ,  A61N1/056 ,  A61N1/3621 ,  A61N1/36585 ,  A61N1/37288 ,  A61N1/3756 ,  A61N1/3987

Abstract: Techniques and systems for monitoring cardiac arrhythmias and delivering electrical stimulation therapy using a subcutaneous implantable cardioverter defibrillator (SICD) and a leadless pacing device (LPD) are described. For example, the SICD may detect a tachyarrhythmia within a first electrical signal from a heart and determine, based on the tachyarrhythmia, to deliver anti-tachyarrhythmia shock therapy to the patient to treat the detected arrhythmia. The LPD may receive communication from the SICD requesting the LPD deliver anti-tachycardia pacing to the heart and determine, based on a second electrical signal from the heart sensed by the LPD, whether to deliver anti-tachycardia pacing (ATP) to the heart. In this manner, the SICD and LPD may communicate to coordinate ATP and/or cardioversion/defibrillation therapy. In another example, the LPD may be configured to deliver post-shock pacing after detecting delivery of anti-tachyarrhythmia shock therapy.

Abstract translation: 描述了使用皮下植入式心律转复除颤器（SICD）和无引线起搏装置（LPD）监测心律不齐和递送电刺激治疗的技术和系统。 例如，SICD可以检测来自心脏的第一电信号内的快速性心律失常，并且基于快速性心律失常确定将抗心律失常休克疗法递送给患者以治疗所检测到的心律失常。 LPD可以接收来自SICD的通信，请求LPD向心脏提供抗心动过速起搏，并且基于由LPD感测到的心脏的第二电信号确定是否将心动过速（ATP）提供给心脏。 以这种方式，SICD和LPD可以通信以协调ATP和/或心脏复律/除颤疗法。 在另一个示例中，LPD可以被配置为在检测到抗快速性心律失常性休克疗法的递送之后递送后冲击起搏。