公开(公告)号：US08543198B2

公开(公告)日：2013-09-24

申请号：US12768807

申请日：2010-04-28

申请人： Xusheng Zhang ,  Robert W. Stadler ,  Jeffrey M. Gillberg

发明人： Xusheng Zhang ,  Robert W. Stadler ,  Jeffrey M. Gillberg

IPC分类号： A61B5/04

CPC分类号： A61B5/0464 ,  A61B5/0245 ,  A61B5/7203 ,  A61N1/3622 ,  A61N1/3962

摘要： A medical device and associated method for discriminating cardiac events includes determining whether a first match score is within a first match zone having a first correlation with a non-treatable cardiac event, a second match zone having a second correlation with the non-treatable cardiac event less than the first correlation with the non-treatable event, a third match zone having a first correlation with a treatable cardiac event, and a fourth match zone having a second correlation with the treatable cardiac event greater than the first correlation with the treatable cardiac event. A determination is made as to whether a second match score and a third match score are within the first match zone, the second match zone, the third match zone and the fourth match zone to generate a first adjusting factor, and cardiac event evidence is accumulated in response to the first adjusting factor for discriminating cardiac events.

摘要翻译： 用于鉴别心脏事件的医疗装置和相关联的方法包括确定第一匹配得分是否在与不可治疗心脏事件具有第一相关性的第一匹配区域内，与不可治疗心脏事件具有第二相关性的第二匹配区域 小于与不可治疗事件的第一相关性，具有与可治疗心脏事件的第一相关性的第三匹配区，以及与可治疗心脏事件具有大于与可治疗心脏事件的第一相关性的第二相关性的第四匹配区 。 确定第二匹配分数和第三匹配分数是否在第一匹配区域，第二匹配区域，第三匹配区域和第四匹配区域内，以产生第一调整因子，并且累积心脏事件证据 响应于用于区分心脏事件的第一调整因子。

公开(公告)号：US08435185B2

公开(公告)日：2013-05-07

申请号：US11380842

申请日：2006-04-28

申请人： Raja N. Ghanem ,  Robert W. Stadler ,  Xusheng Zhang

发明人： Raja N. Ghanem ,  Robert W. Stadler ,  Xusheng Zhang

IPC分类号： A61B5/0402 ,  A61B5/04

CPC分类号： A61N1/3987 ,  A61B5/04011 ,  A61B5/0422 ,  A61B5/0456 ,  A61B5/046 ,  A61B5/0464 ,  A61B5/0468 ,  A61B5/4836 ,  A61B5/686 ,  A61B5/7203 ,  A61B5/7221 ,  A61B5/7239 ,  A61N1/05 ,  A61N1/3621 ,  A61N1/3925 ,  A61N1/3956 ,  Y10S128/901 ,  Y10S128/902

摘要： A method of detecting a cardiac event in a medical device that includes sensing cardiac signals from a plurality of electrodes forming a first sensing vector and a second sensing vector, determining whether a signal energy content metric of the sensed cardiac signals is within predetermined limits, determining whether a noise to signal ratio of the sensed cardiac signals is less than a signal to noise threshold, determining whether the sensed cardiac signals are associated with muscle noise, and determining whether a mean frequency corresponding to the sensed cardiac signals is less than a mean frequency threshold.

摘要翻译： 一种检测医疗装置中的心脏事件的方法，包括：感测来自形成第一感测向量和第二感测向量的多个电极的心脏信号，确定感测到的心脏信号的信号能量内容度量是否在预定限度内，确定 感测到的心脏信号的噪声信号比是否小于信号噪声阈值，确定感测的心脏信号是否与肌肉噪声相关联，以及确定对应于感测的心脏信号的平均频率是否小于平均频率 阈。

公开(公告)号：US20130060298A1

公开(公告)日：2013-03-07

申请号：US13600282

申请日：2012-08-31

申请人： Vincent E. Splett ,  Robert W. Stadler ,  Nathan A. Grenz

发明人： Vincent E. Splett ,  Robert W. Stadler ,  Nathan A. Grenz

IPC分类号： A61N1/37

CPC分类号： A61N1/36585 ,  A61N1/3611 ,  A61N1/371

摘要： A medical device system and associated method for controlling a cardiac rhythm management therapy detect extracardiac stimulation. Cardiac pacing pulses are delivered, and a cardiac electrical signal comprising myocardial depolarization and repolarization signals is acquired. A processor is configured to, responsive to the cardiac electrical signal, detect extracardiac capture due to the cardiac pacing pulse.

摘要翻译： 用于控制心律管理疗法的医疗装置系统和相关方法检测心外刺激。 发送心脏起搏脉冲，并且获取包括心肌去极化和复极信号的心电信号。 处理器被配置为响应于心脏电信号，检测由于心脏起搏脉冲引起的心外捕获。

公开(公告)号：US20130053916A1

公开(公告)日：2013-02-28

申请号：US13598784

申请日：2012-08-30

申请人： Aleksandre T. Sambelashvili ,  Robert W. Stadler

发明人： Aleksandre T. Sambelashvili ,  Robert W. Stadler

IPC分类号： A61N1/37

CPC分类号： A61N1/3627 ,  A61B5/04525 ,  A61B5/7264 ,  A61N1/362 ,  A61N1/3684 ,  A61N1/3686

摘要： A medical device and associated method classify candidate pacing electrode sites for delivering pacing pulses to a patient's heart. A first morphology template is established and stored in memory of the device. A processor is configured to determine a cardiac signal morphology in response to delivering pacing pulses at a candidate pacing site in a first heart chamber. The processor compares the determined cardiac signal morphology to the first morphology template. The pacing site in the first heart chamber is classified in response to the comparing of the determined cardiac signal morphology and the first morphology template.

摘要翻译： 医疗装置和相关联的方法对候选起搏电极位置进行分类，以将起搏脉冲输送到患者的心脏。 建立第一形态学模板并存储在设备的存储器中。 处理器被配置为响应于在第一心室中的候选起搏部位处输送起搏脉冲来确定心脏信号形态。 处理器将确定的心脏信号形态与第一形态学模板进行比较。 响应于确定的心脏信号形态与第一形态学模板的比较，将第一心室中的起搏部位分类。

公开(公告)号：US08271073B2

公开(公告)日：2012-09-18

申请号：US12768835

申请日：2010-04-28

申请人： Xusheng Zhang ,  Robert W. Stadler ,  Jeffrey M. Gillberg

发明人： Xusheng Zhang ,  Robert W. Stadler ,  Jeffrey M. Gillberg

IPC分类号： A61B5/0464

CPC分类号： A61B5/0464 ,  A61B5/04525 ,  A61B5/686 ,  A61B5/6869 ,  A61B5/7203 ,  A61N1/3621 ,  A61N1/3624 ,  A61N1/3962

摘要： A medical device and associated method for discriminating cardiac events includes determining whether a first match score is within a first match zone having a first correlation with a non-treatable cardiac event, a second match zone having a second correlation with the non-treatable cardiac event less than the first correlation, a third match zone having a first correlation with a treatable cardiac event, and a fourth match zone having a second correlation with the treatable cardiac event greater than the first correlation with the treatable cardiac event. In response to the first match score being within one of the first and second match zones, a determination is made whether consecutive match scores are within the first match zone and whether a break in the treatable cardiac event has occurred. Cardiac evidence is accumulated in response to determining whether a break has occurred and utilized to discriminate cardiac events.

摘要翻译： 用于鉴别心脏事件的医疗装置和相关联的方法包括确定第一匹配得分是否在与不可治疗心脏事件具有第一相关性的第一匹配区域内，与不可治疗心脏事件具有第二相关性的第二匹配区域 小于第一相关性，具有与可治疗心脏事件的第一相关性的第三匹配区，以及与可治疗心脏事件具有大于与可治疗心脏事件的第一相关性的第二相关性的第四匹配区。 响应于第一匹配分数在第一和第二匹配区域之一内，确定连续匹配分数是否在第一匹配区域内，以及是否发生了可治疗心脏事件中断。 响应于确定是否发生休息并利用心脏事件来积累心脏证据。

公开(公告)号：US08170654B1

公开(公告)日：2012-05-01

申请号：US12903325

申请日：2010-10-13

申请人： Xusheng Zhang ,  Robert W. Stadler ,  Jeffrey M. Gillberg

发明人： Xusheng Zhang ,  Robert W. Stadler ,  Jeffrey M. Gillberg

IPC分类号： A61B5/046 ,  A61B5/0464

CPC分类号： A61B5/7267 ,  A61B5/0422 ,  A61B5/046 ,  A61B5/0464 ,  A61B5/686 ,  A61B5/7239 ,  A61N1/3624 ,  A61N1/3962

摘要： A system and method for use in a medical device for discriminating cardiac events establishes population-based thresholds corresponding to cardiac signal morphology metrics for discriminating between a first cardiac event and a second cardiac event. A population-based threshold criterion for discriminating cardiac events is established. The population-based threshold criterion is applied to a cardiac signal segment and the segment is classified if the criterion is satisfied. A patient-specific threshold is established in response to the sensed cardiac signal segment not being classified after applying the population-based threshold criterion. The sensed signal segment is classified in response to the patient-specific threshold comparison.

摘要翻译： 用于辨别心脏事件的医疗装置中的系统和方法建立了对应于心脏信号形态度量的基于群体的阈值，用于区分第一心脏事件和第二心脏事件。 建立了基于人群的阈值判别标准，用于辨别心脏事件。 基于人群的阈值标准被应用于心脏信号段，并且如果满足标准，则对该段进行分类。 响应于在应用基于群体的阈值标准之后未被分类的感测到的心脏信号段建立患者特异性阈值。 感测的信号段根据患者特异性阈值比较进行分类。

公开(公告)号：US20120029373A1

公开(公告)日：2012-02-02

申请号：US12846224

申请日：2010-07-29

申请人： Robert W. Stadler ,  Tim Dirk Jan Jongen ,  Richard PM Houben

发明人： Robert W. Stadler ,  Tim Dirk Jan Jongen ,  Richard PM Houben

IPC分类号： A61B5/0456

CPC分类号： A61N1/37 ,  A61B5/0456

摘要： In general, this disclosure is directed to signal processing based methods to reject undersensing in a signal indicative of cardiac activity, e.g., ECG. The undersensing may be due to very small signal amplitudes or due to a sudden increase in single peak amplitude resulting in an increased sensing threshold. The undersensing may result in falsely detecting a cardiac event, e.g., asystole or bradycardia. The techniques of this disclosure monitor the behavior of the signal to determine when a detected asystole is false.

摘要翻译： 通常，本公开涉及基于信号处理的方法来拒绝指示心脏活动的信号（例如ECG）中的不足感。 欠感应可能是由于非常小的信号幅度或由于单峰幅度的突然增加导致增加的感测阈值。 不足之处可能导致错误检测心脏事件，例如心搏停止或心动过缓。 本公开的技术监测信号的行为以确定检测到的心脏停搏是否为假。

公开(公告)号：US20110301491A1

公开(公告)日：2011-12-08

申请号：US13177912

申请日：2011-07-07

申请人： Robert W. Stadler ,  Li Wang

发明人： Robert W. Stadler ,  Li Wang

IPC分类号： A61B5/053

CPC分类号： A61B5/0538 ,  A61B5/0537 ,  A61B5/4875 ,  A61B5/686 ,  A61B5/7275 ,  A61N1/362 ,  A61N1/3627 ,  A61N1/36521 ,  G06F12/0862 ,  G06F12/0877

摘要： A method and apparatus for detection of changes in impedance a patient that includes generating measured impedances, generating an adaptive baseline trend of the measured impedances corresponding to a first time period, generating a short term trend of the measured impedances corresponding to a second time period less than the first time period, determining changes in relative position of the short term trend and the baseline trend, the determined changes in relative position corresponding to determining intersecting of the baseline trend by the short term trend, determining differences between the baseline trend and calculated period average impedances, and accumulating, in response to determining no intersecting of the baseline trend by the short term trend, the determined differences between the baseline trend and the calculated period average impedances.

摘要翻译： 一种用于检测患者阻抗变化的方法和装置，包括产生测量的阻抗，产生对应于第一时间段的所测量的阻抗的自适应基线趋势，产生对应于第二时间段的所测量的阻抗的短期趋势 确定短期趋势相对位置的变化和基准趋势，确定相对位置的变化对应于基线趋势与短期趋势的相交，确定基线趋势与计算周期之间的差异 平均阻力和累积，以确定基准趋势与短期趋势的相交，确定基线趋势与计算的周期平均阻抗之间的差异。

公开(公告)号：US20110270334A1

公开(公告)日：2011-11-03

申请号：US13080820

申请日：2011-04-06

申请人： Robert W. Stadler ,  Carissa Lynn Bellardine Black

发明人： Robert W. Stadler ,  Carissa Lynn Bellardine Black

IPC分类号： A61N1/365 ,  A61N1/39

CPC分类号： A61B5/04525 ,  A61B5/02438 ,  A61B5/0464 ,  A61B5/686 ,  A61B5/7203 ,  A61N1/3622 ,  A61N1/3962

摘要： A method and apparatus for monitoring a patient's heart rate sense first cardiac events in a heart chamber using a first cardiac electrode pair and sense second cardiac events in the heart chamber using a second cardiac electrode pair. The method includes estimating a first heart rate using the first cardiac events, comparing the first heart rate to a heart rate threshold and estimating a second heart rate using the second cardiac events in response to the first heart rate exceeding the heart rate threshold, determining whether the second cardiac events are unreliable, and setting the second heart rate equal to the first heart rate in response to the second cardiac events being unreliable.

摘要翻译： 用于监测患者心率的方法和装置使用第一心脏电极对感测心室中的第一心脏事件，并使用第二心电极对感测心室中的第二心脏事件。 该方法包括使用第一心脏事件估计第一心率，将第一心率与心率阈值进行比较，并且响应于超过心率阈值的第一心率估计使用第二心脏事件的第二心率，确定是否 第二心脏事件是不可靠的，并且响应于第二心脏事件不可靠而将第二心率设定为等于第一心率。

公开(公告)号：US07986994B2

公开(公告)日：2011-07-26

申请号：US10727008

申请日：2003-12-03

申请人： Robert W. Stadler ,  Li Wang

发明人： Robert W. Stadler ,  Li Wang

IPC分类号： A61N1/365

CPC分类号： A61B5/0538 ,  A61B5/0537 ,  A61B5/4875 ,  A61B5/686 ,  A61B5/7275 ,  A61N1/362 ,  A61N1/3627 ,  A61N1/36521 ,  G06F12/0862 ,  G06F12/0877

摘要： A method and apparatus for detection of changes in impedance a patient that includes generating measured impedances, generating an adaptive baseline trend of the measured impedances corresponding to a first time period, generating a short term trend of the measured impedances corresponding to a second time period less than the first time period, and generating a metric of impedance change between the adaptive baseline trend and one of a most recent measured impedance and the short term trend of the measured impedances.

摘要翻译： 一种用于检测患者阻抗变化的方法和装置，包括产生测量的阻抗，产生对应于第一时间段的所测量的阻抗的自适应基线趋势，产生对应于第二时间段的所测量的阻抗的短期趋势 并且产生自适应基线趋势与最近测量的阻抗之一和所测量的阻抗的短期趋势之间的阻抗变化的度量。