公开(公告)号：US09282907B2

公开(公告)日：2016-03-15

申请号：US13948568

申请日：2013-07-23

Applicant: Medtronic, Inc.

Inventor： Subham Ghosh

IPC: A61B5/04 ,  A61B5/00 ,  A61B5/044 ,  A61B5/0408 ,  A61B5/0472 ,  A61B5/0468 ,  A61B5/0402 ,  A61B5/0452

CPC classification number: A61B5/04012 ,  A61B5/0402 ,  A61B5/0408 ,  A61B5/044 ,  A61B5/0452 ,  A61B5/0468 ,  A61B5/0472 ,  A61B5/6823

Abstract: A medical device system performs a method determining presence of scar tissue. Torso-surface potential signals are received by a processor from multiple electrodes distributed on a torso of a patient. The processor extracts features of the potential signal from each electrode and stores values of the features in a non-transitory storage medium. The processor determines a scar indicator index for each of the electrodes from the stored features and identifies which ones of the electrodes have an affirmative scar indicator index. An overall scar burden index is determined as a proportion of the electrodes with an affirmative scar indicator index.

Abstract translation: 医疗装置系统执行确定瘢痕组织存在的方法。 躯体表面电位信号由处理器从分布在患者躯体上的多个电极接收。 处理器从每个电极提取潜在信号的特征，并将特征的值存储在非暂时的存储介质中。 处理器从存储的特征中确定每个电极的瘢痕指示器指数，并且识别哪些电极具有肯定的瘢痕指示器指数。 整个瘢痕负担指数被确定为具有肯定瘢痕指标指数的电极的比例。

公开(公告)号：US20160067498A1

公开(公告)日：2016-03-10

申请号：US14853640

申请日：2015-09-14

Applicant: Medtronic, Inc.

Inventor： Subham Ghosh

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

CPC classification number: A61N1/36507 ,  A61B5/04017 ,  A61B5/0402 ,  A61B5/04085 ,  A61B5/0452 ,  A61B5/1107 ,  A61B5/4836 ,  A61B2562/043 ,  A61B2562/046 ,  A61N1/3627 ,  A61N1/3684

Abstract: An exemplary computer-implemented method is disclosed for detection of onset of depolarization on far-field electrograms (EGMs) or electrocardiogram (ECG)-or ECG-like signals. The method includes determining a baseline rhythm using a plurality of body-surface electrodes. The baseline rhythm includes an atrial marker and a ventricular marker. A pre-specified window is defined as being between the atrial marker and the ventricular marker. A low pass filter is applied to a signal within the window. A rectified slope of the signal within the window is determined. A determination is made as to whether a time point (t1) is present such that the rectified slope exceeds 10% of a maximum value of the rectified slope. A point of onset of a depolarization complex in the signal is determined. The point of onset occurs at a largest curvature in the signal within the window.

Abstract translation: 公开了用于检测远场电描记图（EGM）或心电图（ECG）或ECG样信号的去极化开始的示例性计算机实现的方法。 该方法包括使用多个体表电极确定基线节律。 基线节律包括心房标记和心室标志。 预先指定的窗口被定义为在心房标记和心室标记之间。 低通滤波器被应用于窗口内的信号。 确定窗口内的信号的整流斜率。 确定是否存在时间点（t1），使得整流斜率超过整流斜率的最大值的10％。 确定信号中去极化复合物的起始点。 起始点发生在窗口内信号的最大曲率。

公开(公告)号：US09265954B2

公开(公告)日：2016-02-23

申请号：US13952043

申请日：2013-07-26

Applicant: Medtronic, Inc.

Inventor： Subham Ghosh

IPC: A61N1/36 ,  A61N1/368 ,  A61N1/365 ,  A61N1/05 ,  A61N1/02 ,  A61N1/362 ,  A61B5/0452

CPC classification number: A61N1/3682 ,  A61B5/0452 ,  A61N1/025 ,  A61N1/05 ,  A61N1/3627 ,  A61N1/365

Abstract: A method and system of cardiac pacing is disclosed. A baseline rhythm is determined. The baseline rhythm includes a baseline atrial event and a baseline right ventricular RV event from an implanted cardiac lead or a leadless device, a pre-excitation interval determined from the baseline atrial event and the baseline RV event, and a plurality of activation times determined from a plurality of body-surface electrodes. A determination is made as to whether a time interval measured from an atrial event to a RV event is disparate from another time interval measured from the atrial event to an earliest RV activation time of the plurality of activation times. A correction factor is applied to the pre-excitation interval to obtain a corrected pre-excitation interval in response to determining the RV event is disparate from the earliest RV activation time. The processor is configured to signal the pulse generator to deliver electrical stimuli to a left ventricle (LV) using the corrected pre-excitation interval before RV sensing time.

Abstract translation: 公开了一种心脏起搏方法和系统。 确定基线节奏。 基线节奏包括来自植入心脏引线或无引线装置的基线心房事件和基线右心室RV事件，从基线心房事件和基线RV事件确定的预激励间隔，以及从基线心房事件确定的多个激活时间 多个体表电极。 确定从心房事件到RV事件测量的时间间隔是否从从心房事件测量的另一个时间间隔到多个激活时间的最早的RV激活时间是不同的。 响应于确定RV事件与最早的RV激活时间不同，将校正因子应用于预激励间隔以获得校正的预激励间隔。 处理器被配置为用信号通知脉冲发生器，以在RV感测时间之前使用校正的预激励间隔将电刺激递送到左心室（LV）。

公开(公告)号：US20150032173A1

公开(公告)日：2015-01-29

申请号：US13952061

申请日：2013-07-26

Applicant: Medtronic, Inc.

Inventor： Subham Ghosh

IPC: A61N1/368 ,  A61N1/365

CPC classification number: A61N1/3682 ,  A61B5/042 ,  A61B5/0468 ,  A61B5/1102 ,  A61N1/025 ,  A61N1/05 ,  A61N1/3627 ,  A61N1/365 ,  A61N1/36592

Abstract: A method and system of cardiac pacing is disclosed. A baseline rhythm is determined. The baseline rhythm includes a baseline atrial event and a baseline right ventricular RV event from an implanted cardiac lead or a leadless device, a pre-excitation interval determined from the baseline atrial event and the baseline RV event, and a plurality of activation times determined from a plurality of body-surface electrodes. A determination is made as to whether a time interval measured from an atrial event to a RV event is disparate from another time interval measured from the atrial event to an earliest RV activation time of the plurality of activation times. A correction factor is applied to the pre-excitation interval to obtain a corrected pre-excitation interval in response to determining the RV event is disparate from the earliest RV activation time. The processor is configured to signal the pulse generator to deliver electrical stimuli to a left ventricle (LV) using the corrected pre-excitation interval before RV sensing time.

Abstract translation: 公开了一种心脏起搏方法和系统。 确定基线节奏。 基线节奏包括来自植入心脏引线或无引线装置的基线心房事件和基线右心室RV事件，从基线心房事件和基线RV事件确定的预激励间隔，以及从基线心房事件确定的多个激活时间 多个体表电极。 确定从心房事件到RV事件测量的时间间隔是否从从心房事件测量的另一个时间间隔到多个激活时间的最早的RV激活时间是不同的。 响应于确定RV事件与最早的RV激活时间不同，将校正因子应用于预激励间隔以获得校正的预激励间隔。 处理器被配置为用信号通知脉冲发生器，以在RV感测时间之前使用校正的预激励间隔将电刺激递送到左心室（LV）。

公开(公告)号：US20140277247A1

公开(公告)日：2014-09-18

申请号：US14216100

申请日：2014-03-17

Applicant: Medtronic, Inc.

Inventor： Robert W. Stadler ,  Subham Ghosh

IPC: A61N1/37

CPC classification number: A61N1/371 ,  A61B5/046 ,  A61N1/3622 ,  A61N1/3624 ,  A61N1/3684 ,  A61N1/3716

Abstract: The present disclosure relates to cardiac evoked response detection and, more particularly, reducing polarization effects in order to detect an evoked response following delivery of a stimulation pulse. An implantable medical device (IMD) is configured to deliver a ventricular pacing pulse. A signal is sensed in response to the ventricular pacing stimulus. A window is placed over the sensed signal to obtain a set of data from the signal after a paced event. The set of data extracted from the sensed signal comprises a maximum amplitude, a maximum time associated with the maximum amplitude, a minimum amplitude, and a minimum time associated with the minimum amplitude. Responsive to processing the extracted data, the window is delayed to avoid polarization effects. A determination is then made as to whether the ventricular pacing stimulus is capturing the paced ventricle in response to determining whether the maximum time is greater than the minimum time.

Abstract translation: 本公开涉及心脏诱发反应检测，并且更具体地涉及减少极化效应，以便在递送刺激脉冲之后检测诱发反应。 可植入医疗装置（IMD）被配置为递送心室起搏脉冲。 响应于心室起搏刺激感测信号。 在感测到的信号上放置一个窗口，以在起搏事件之后从信号中获得一组数据。 从感测到的信号提取的数据集合包括最大幅度，与最大幅度相关联的最大时间，最小幅度和与最小幅度相关联的最小时间。 响应于处理提取的数据，窗口被延迟以避免极化效应。 然后响应于确定最大时间是否大于最小时间，确定心室起搏刺激是否捕获起搏心室。

公开(公告)号：US20140277245A1

公开(公告)日：2014-09-18

申请号：US14211884

申请日：2014-03-14

Applicant: Medtronic, Inc.

Inventor： Richard M.T. Lu ,  Subham Ghosh ,  Robert W. Stadler

IPC: A61N1/37

CPC classification number: A61N1/371 ,  A61B5/046 ,  A61N1/3622 ,  A61N1/3624 ,  A61N1/3684 ,  A61N1/3716

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 whether a patient is experiencing atrial fibrillation (AF). If the patient is experiencing AF, the efficacy of CRT is determined. A signal is sensed in response to a ventricular pacing stimulus. Through signal processing, a number of features are parsed from the signal and a determination is made as to whether the ventricular pacing stimulus evoked a response from the ventricle.

公开(公告)号：US20140163633A1

公开(公告)日：2014-06-12

申请号：US13707391

申请日：2012-12-06

Applicant: MEDTRONIC, INC.

Inventor： Subham Ghosh ,  Robert W. Stadler

IPC: A61N1/37

CPC classification number: A61N1/371 ,  A61B5/0452 ,  A61B5/4836 ,  A61B5/686 ,  A61N1/3627 ,  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.

公开(公告)号：US20140163632A1

公开(公告)日：2014-06-12

申请号：US13707366

申请日：2012-12-06

Applicant: MEDTRONIC, INC.

Inventor： Subham Ghosh ,  Robert W. Stadler

IPC: A61N1/37

CPC classification number: A61N1/371

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.

公开(公告)号：US20140114372A1

公开(公告)日：2014-04-24

申请号：US13717896

申请日：2012-12-18

Applicant: Medtronic, Inc.

Inventor： Subham Ghosh ,  Jeffrey M. Gillberg ,  Aleksandre T. Sambelashvili

IPC: A61N1/37

CPC classification number: A61N1/371 ,  A61B5/04525 ,  A61B5/686 ,  A61B5/7246 ,  A61B5/7264 ,  A61N1/37 ,  A61N1/3712

Abstract: Methods and/or devices may be configured to track effectiveness of pacing therapy by monitoring two or more electrical vectors of the patient's heart during pacing therapy and analyzing at least one feature of a morphological waveform within each of the two or more electrical vectors.

Abstract translation: 方法和/或设备可以被配置为通过在起搏治疗期间监测患者心脏的两个或更多个电向量并且分析两个或更多个电矢量中的每个中的形态波形的至少一个特征来跟踪起搏治疗的有效性。

公开(公告)号：US20140005740A1

公开(公告)日：2014-01-02

申请号：US13886884

申请日：2013-05-03

Applicant: Medtronic, Inc.

Inventor： Subham Ghosh ,  Robert W Stadler

IPC: 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。