公开(公告)号：US06449509B1

公开(公告)日：2002-09-10

申请号：US09651623

申请日：2000-08-30

申请人： Euljoon Park ,  Gene A. Bornzin ,  Joseph J. Florio ,  Said Mortazavi

发明人： Euljoon Park ,  Gene A. Bornzin ,  Joseph J. Florio ,  Said Mortazavi

IPC分类号： A61N1365

CPC分类号： A61N1/36521

摘要： An implantable cardiac device that is adapted to periodically measure a body parameter, such as transthoracic impedance, at time periods selected so that the body parameter is primarily indicative of the respiration of the patient. In this way, a ventilation parameter, such as minute ventilation, can be reconstructed from the signals without requiring filtering of the sampled signals. In one embodiment, the implantable cardiac device measures transthoracic impedance during each quiescent period of the heart and thereby obtains a plurality of transthoracic impedance data points which are then used to reconstruct a ventilation signal. As the transthoracic impedance data points are obtained during the quiescent period, the contribution of the heart to the resulting transthoracic impedance measurement can be ignored and the resulting measurements are indicative of the action of the heart. In another embodiment, the implantable cardiac device obtains transthoracic impedance signals during the zero crossings of the measured impedance signal. As the transthoracic signal is measured during the zero crossing of the measured impedance signal, the heart component of the signal is filtered out.

摘要翻译： 一种可植入心脏装置，其适于在所选择的时间周期周期性地测量身体参数，例如经胸阻抗，使得身体参数主要指示患者的呼吸。 以这种方式，可以从信号重建诸如分钟通气的通气参数，而不需要对采样信号进行滤波。 在一个实施例中，可植入心脏装置在心脏的每个静止期间测量经胸阻抗，从而获得多个经胸阻抗数据点，然后将其用于重建通气信号。 由于在静止期间获得经胸阻抗数据点，所以可以忽略心脏对所得经胸阻抗测量的贡献，并且所得到的测量值表示心脏的作用。 在另一个实施例中，可植入心脏装置在测量的阻抗信号的过零点期间获得经胸阻抗信号。 由于在测量的阻抗信号的过零点期间测量经胸廓信号，所以信号的心脏分量被滤除。

公开(公告)号：US09107585B1

公开(公告)日：2015-08-18

申请号：US11684664

申请日：2007-03-12

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

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

IPC分类号： A61N1/18 ,  A61B5/02 ,  A61B5/053 ,  A61N1/37 ,  A61B5/029 ,  A61B5/08 ,  A61B5/00

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：US08626278B2

公开(公告)日：2014-01-07

申请号：US12901296

申请日：2010-10-08

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

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

IPC分类号： A61B5/0464 ,  A61B5/053

CPC分类号： A61B5/046 ,  A61B5/0006 ,  A61B5/0031 ,  A61B5/02028 ,  A61B5/0205 ,  A61B5/029 ,  A61B5/0402 ,  A61B5/0422 ,  A61B5/0468 ,  A61B5/0538 ,  A61B5/0816 ,  A61B5/1116 ,  A61B5/1118 ,  A61B5/686 ,  A61B5/6869 ,  A61N1/3624 ,  A61N1/36521 ,  A61N1/36592

摘要： A medical device is provided that comprises a lead assembly. The lead assembly includes at least one intra-cardiac (IC) electrode, an extra-cardiac (EC) electrode and a subcutaneous remote-cardiac (RC) electrode. The IC electrode is configured to be located within the heart. The EC electrode is configured to be positioned proximate to at least one of a superior vena cava (SVC) and a left ventricle (LV) of a heart. The RC electrode is configured to be located remote from the heart. An extra-cardiac impedance (ECI) module is configured to measure extra-cardiac impedance along an ECI vector between the EC and RC electrodes to obtain ECI measurements. An arrhythmia monitoring module is configured to declare a potential atrial arrhythmia to be an atrial arrhythmia based on the hemodynamic performance determined from the ECI measurements. The hemodynamic performance assessment module is further enabled to compare a current ECI pattern with a prior baseline ECI waveform.

摘要翻译： 提供了包括引线组件的医疗装置。 引线组件包括至少一个心脏内（IC）电极，心外（EC）电极和皮下远心电（RC）电极）。 IC电极被配置为位于心脏内。 EC电极配置成靠近心脏的上腔静脉（SVC）和左心室（LV）中的至少一个定位。 RC电极被配置为远离心脏。 心脏外阻抗（ECI）模块被配置为测量EC和RC电极之间的ECI向量的心外阻抗，以获得ECI测量值。 心律失常监测模块被配置为基于从ECI测量确定的血液动力学性能来将潜在心房心律失常宣告为房性心律失常。 血液动力学性能评估模块还能够将当前ECI模式与先前的基线ECI波形进行比较。

公开(公告)号：US20120089032A1

公开(公告)日：2012-04-12

申请号：US12901296

申请日：2010-10-08

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

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

IPC分类号： A61B5/042 ,  A61B5/0205

CPC分类号： A61B5/046 ,  A61B5/0006 ,  A61B5/0031 ,  A61B5/02028 ,  A61B5/0205 ,  A61B5/029 ,  A61B5/0402 ,  A61B5/0422 ,  A61B5/0468 ,  A61B5/0538 ,  A61B5/0816 ,  A61B5/1116 ,  A61B5/1118 ,  A61B5/686 ,  A61B5/6869 ,  A61N1/3624 ,  A61N1/36521 ,  A61N1/36592

摘要： A medical device is provided that comprises a lead assembly. The lead assembly includes at least one intra-cardiac (IC) electrode, an extra-cardiac (EC) electrode and a subcutaneous remote-cardiac (RC) electrode. The IC electrode is configured to be located within the heart. The EC electrode is configured to be positioned proximate to at least one of a superior vena cava (SVC) and a left ventricle (LV) of a heart. The RC electrode is configured to be located remote from the heart. An arrhythmia monitoring module is configured to analyze intra-cardiac electrogram (IEGM) signals from the at least one IC electrode to identify a potential atrial arrhythmia. An extra-cardiac impedance (ECI) module is configured to measure extra-cardiac impedance along an ECI vector between the EC and RC electrodes to obtain ECI measurements. The hemodynamic performance (HDP) assessment module is configured to determine a hemodynamic performance based on the ECI measurements. The arrhythmia monitoring module is configured to declare the potential atrial arrhythmia to be an atrial arrhythmia based on the hemodynamic performance determined from the ECI measurements. The medical device further provides the HDP assessment module that derives a current ECI waveform from current ECI measurements and compares the current ECI pattern with a prior ECI waveform that is derived from prior ECI measurements.

摘要翻译： 提供了包括引线组件的医疗装置。 引线组件包括至少一个心脏内（IC）电极，心外（EC）电极和皮下远心电（RC）电极）。 IC电极被配置为位于心脏内。 EC电极配置成靠近心脏的上腔静脉（SVC）和左心室（LV）中的至少一个定位。 RC电极被配置为远离心脏。 心律失常监测模块被配置为分析来自至少一个IC电极的心脏内电针（IEGM）信号以识别潜在的心房心律失常。 心脏外阻抗（ECI）模块被配置为测量EC和RC电极之间的ECI向量的心外阻抗，以获得ECI测量值。 血液动力学性能（HDP）评估模块被配置为基于ECI测量来确定血液动力学性能。 心律失常监测模块被配置为基于从ECI测量确定的血流动力学性能来将潜在心房心律失常宣告为心房心律失常。 医疗设备还提供HDP评估模块，其从当前ECI测量中导出当前ECI波形，并将当前ECI模式与从先前ECI测量得到的先前ECI波形进行比较。

公开(公告)号：US07945314B1

公开(公告)日：2011-05-17

申请号：US11432636

申请日：2006-05-10

申请人： Jeffery D. Snell ,  Jong Gill ,  Gene A. Bornzin ,  Peter Boileau ,  Euljoon Park

发明人： Jeffery D. Snell ,  Jong Gill ,  Gene A. Bornzin ,  Peter Boileau ,  Euljoon Park

IPC分类号： A61B5/04

CPC分类号： A61B5/0402 ,  A61B5/0006 ,  A61N1/3702 ,  A61N1/37235 ,  A61N1/37282

摘要： A surface electrocardiogram (EKG) is emulated using signals detected by internal leads of an implanted device. In one example, emulation is performed using a technique that concatenates portions of signals sensed using different electrodes, such as by combining far-field ventricular signals sensed in the atria with far-field atrial signals sensed in the ventricles. In another example, emulation is performed using a technique that selectively amplifies or attenuates portions of a single signal, such as by attenuating near-field portions of an atrial unipolar signal relative to far-field portions of the same signal. The surface EKG emulation may be performed by the implanted device itself or by an external programmer based on cardiac signals transmitted thereto. A transtelephonic monitoring network is also described, wherein the emulated surface EKG (or raw data used to emulate the EKG) is relayed from an implanted device to a remote monitor, typically installed in a physician's office.

摘要翻译： 使用由植入装置的内部引线检测的信号来模拟表面心电图（EKG）。 在一个示例中，使用将使用不同电极感测的信号的部分连接的技术来执行仿真，例如通过将在心房中感测到的远场心室信号与在心室中感测到的远场心房信号组合。 在另一示例中，使用选择性地放大或衰减单个信号的部分的技术来执行仿真，例如通过衰减相对于相同信号的远场部分的心房单极信号的近场部分。 表面EKG仿真可以由植入装置本身或外部编程器基于发送到其上的心脏信号执行。 还描述了一种跨耳监测网络，其中仿真表面EKG（或用于模拟EKG的原始数据）从植入装置中继到通常安装在医师办公室中的远程监视器。

公开(公告)号：US07925349B1

公开(公告)日：2011-04-12

申请号：US11684681

申请日：2007-03-12

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

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

IPC分类号： A61N1/37

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：US07899522B1

公开(公告)日：2011-03-01

申请号：US11549569

申请日：2006-10-13

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

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

IPC分类号： A61B5/04

CPC分类号： A61B5/0452 ,  A61B5/0472 ,  A61N1/3627 ,  A61N1/36521 ,  A61N1/36585 ,  A61N1/37258 ,  A61N1/37282

摘要： Techniques are provided for evaluating heart failure within a patient. In one example, the implantable device detects a decrease, if any, in selected morphological parameters derived from the intracardiac electrogram (IEGM) that are indicative of possible heart failure, such as paced depolarization integrals (PDI) or peak-to-peak amplitudes of QRS-complexes. The device also detects a decrease, if any, in transthoracic impedance, which is also indicative of possible heart failure. Acute heart failure is indicated if there is a decrease in the morphological IEGM parameters but no significant decrease in transthoracic impedance. Chronic heart failure is indicated if there is a decrease in transthoracic impedance but no significant decrease in the morphological IEGM parameters. If both transthoracic impedance and the morphological IEGM parameters are found to be decreasing significantly, the device issues a warning of severe heart failure.

摘要翻译： 提供了用于评估患者心脏衰竭的技术。 在一个示例中，可植入装置检测出来自指示可能的心力衰竭的心内电描记图（IEGM）的选定形态学参数中的减少（如果有的话），例如节奏去极化积分（PDI）或峰 - 峰幅度 QRS复合物。 该器件还检测经胸阻抗的减少（如果有的话），这也表示可能的心力衰竭。 如果形态学IEGM参数有降低但经胸阻抗无显着降低，则表示急性心力衰竭。 如果经胸阻抗降低但形态学IEGM参数无明显降低，则表示慢性心力衰竭。 如果发现经胸阻抗和形态学IEGM参数均明显下降，则该装置发出严重心力衰竭的警告。

公开(公告)号：US07725181B1

公开(公告)日：2010-05-25

申请号：US11291310

申请日：2005-11-30

申请人： Gene A. Bornzin ,  Euljoon Park

发明人： Gene A. Bornzin ,  Euljoon Park

IPC分类号： A61N1/00

CPC分类号： A61N1/368 ,  A61B5/113 ,  A61B5/4818 ,  A61N1/36514 ,  A61N1/3682

摘要： An implantable cardiac device minimizes apnea burden. In one implementation, the device administers a series of cardiac pacing trials using a different value for a pacing parameter in each trial and then measures an apnea burden corresponding to each trial in order to determine a value which reduces apnea burden when used for ongoing cardiac pacing. In one implementation the implantable cardiac device performs series of trials in cycles, during which a first series of trials determines a value for a first pacing parameter for reducing apnea burden while other pacing parameters are held constant. Subsequent series of trials subject the other pacing parameters, in turn, to their own series of pacing trials while holding the non-subjected pacing parameters constant. Through multiple cycles, the device optimizes each parameter in turn based on continually improving values for the other pacing parameters.

摘要翻译： 可植入的心脏装置使呼吸暂停负担最小化。 在一个实施方案中，该装置使用每个试验中的起搏参数使用不同的值进行一系列心脏起搏试验，然后测量与每次试验相对应的呼吸暂停负担，以便确定当用于持续心脏起搏时减少呼吸暂停负担的值 。 在一个实施方案中，可植入心脏装置以周期执行一系列试验，在此期间，第一系列试验确定第一起搏参数的值以减少呼吸暂停负担，而其他起搏参数保持恒定。 随后的一系列试验将其他起搏参数反过来归因于其自己的一系列起搏试验，同时保持不受起搏的起搏参数不变。 通过多个循环，设备会根据其他起搏参数的持续改进值轮流优化每个参数。

公开(公告)号：US07349732B1

公开(公告)日：2008-03-25

申请号：US10735944

申请日：2003-12-12

申请人： Jong Kil ,  Gene A. Bornzin ,  Peter Boileau ,  Euljoon Park

发明人： Jong Kil ,  Gene A. Bornzin ,  Peter Boileau ,  Euljoon Park

IPC分类号： A61B5/0402

CPC分类号： A61B5/042 ,  A61B5/04011

摘要： A surface electrocardiogram (EKG) is emulated using signals detected by the internal leads of an implanted device. In one example, the emulation is performed using a technique that concatenates portions of signals sensed using different electrodes, such as by combining far-field ventricular signals sensed in the atria with far-field atrial signals sensed in the ventricles or by combining near-field signals sensed in the atria with near-field signals sensed in the ventricles. In another example, the emulation is performed using a technique that selectively amplifies or attenuates portions of a single signal sensed using a single pair of electrodes, such as by attenuating near-field portions of an atrial unipolar signal relative to far-field portions of the same signal or by attenuating atrial portions of a cross-chamber signal relative to ventricular portions to the same signal. The surface EKG emulation may be performed by the implanted device itself or by an external programmer based on cardiac signals transmitted thereto.

公开(公告)号：US07286875B1

公开(公告)日：2007-10-23

申请号：US10838947

申请日：2004-05-03

申请人： Euljoon Park ,  Gene A. Bornzin ,  Robert G. Turcott

发明人： Euljoon Park ,  Gene A. Bornzin ,  Robert G. Turcott

IPC分类号： A61N1/00

CPC分类号： A61N1/3627 ,  A61N1/36521 ,  A61N1/36542 ,  A61N1/36564 ,  A61N1/36585

摘要： An implantable cardiac stimulation device is configured to measure selected ventricular contraction parameters and possibly apply stimulation therapy based on the ventricular contraction parameters. In accordance with one aspect, the ventricular contraction parameters include impedance values that correspond to the volume of fluid in the right ventricle and the left ventricle. In accordance with another aspect, the ventricular contraction parameters include motion values that correspond to heart sounds/motion in the right ventricle and the left ventricle. The ventricular contraction parameters can be used to form pseudo P-V loop from which treatment decisions can be made.