公开(公告)号：US08750994B2

公开(公告)日：2014-06-10

申请号：US13562039

申请日：2012-07-30

申请人： Subham Ghosh ,  Jeffrey M. Gillberg

发明人： Subham Ghosh ,  Jeffrey M. Gillberg

IPC分类号： A61N1/36

CPC分类号： A61N1/3956 ,  A61B5/04012 ,  A61B5/046 ,  A61B5/0464 ,  A61B5/686 ,  A61N1/3621 ,  G06K9/0055

摘要： Techniques for morphologic discrimination between beats of a tachyarrhythmia episode are described for selecting delivery of appropriate therapy. An exemplary method comprises nonordered binning of digitized amplitude values of signals associated with cardiac depolarizations. Monomorphic VT is discriminated from polymorphic VT without signal alignment. One exemplary method involves sensing electrical signals associated with depolarizations of a patient's heart during a tachyarrhythmia episode. The sensed electrical signals are converted to digital values and stored. The stored digital values are normalized and binned. At most, 5 pairs of beats or depolarizations are compared for morphologic similarity by determining the similarity between the binned values associated with each pair. The result of the comparison is used to select and deliver therapy to the patient.

摘要翻译： 描述了用于选择适当治疗的递送的快速性心律失常发作的心跳形态鉴别技术。 示例性方法包括与心脏去极化相关联的信号的数字化振幅值的无序并置。 单态VT与多态VT鉴别，无信号对齐。 一种示例性方法包括在快速性心律失常发作期间感测与患者心脏的去极化相关联的电信号。 感测到的电信号被转换成数字值并存储。 存储的数字值被归一化并分箱。 通过确定与每对相关联的合并值之间的相似度，最多比较5对节拍或去极化的形态相似性。 比较结果用于选择并向患者提供治疗。

公开(公告)号：US08577455B2

公开(公告)日：2013-11-05

申请号：US11037123

申请日：2005-01-18

申请人： Raul D. Mitrani ,  Peter P. Tarjan ,  Jeffrey M. Gillberg

发明人： Raul D. Mitrani ,  Peter P. Tarjan ,  Jeffrey M. Gillberg

IPC分类号： A61N1/362

CPC分类号： A61N1/3987 ,  A61B5/0408 ,  A61N1/05 ,  A61N1/3622 ,  A61N1/3702 ,  A61N1/3756 ,  A61N1/3925 ,  A61N1/3956

摘要： A method and device for detecting arrhythmias in a patient that includes electrodes positioned subcutaneously within the patient, a microprocessor, coupled to the electrodes, determining one of a sequence of the sensing of cardiac signals by the electrodes and a duration between the sensing of cardiac signals by the electrodes, and control circuitry delivering a therapy in response to one of the determined sequence and the determined duration.

摘要翻译： 一种用于检测患者心律失常的方法和装置，其包括皮下置于患者体内的电极，耦合到所述电极的微处理器，确定由所述电极感测心脏信号的序列之一以及感测心脏信号之间的持续时间 通过电极和控制电路响应于所确定的序列之一和所确定的持续时间递送治疗。

公开(公告)号：US08565865B2

公开(公告)日：2013-10-22

申请号：US12178850

申请日：2008-07-24

申请人： Paul A. Belk ,  Jian Cao ,  Jeffrey M. Gillberg ,  Charles D. Swerdlow

发明人： Paul A. Belk ,  Jian Cao ,  Jeffrey M. Gillberg ,  Charles D. Swerdlow

IPC分类号： A61N1/39

CPC分类号： A61N1/3987 ,  A61B5/0452 ,  A61N1/3962

摘要： Methods for determination of timing for electrical shocks to the heart to determine shock strength necessary to defibrillate a fibrillating heart. The timing corresponds the window of most vulnerability in the heart, which occurs during the T-wave of a heartbeat. Using a derivatized T-wave representation, the timing of most vulnerability is determined by a center of the area method, peak amplitude method, width method, or other similar methods. Devices are similarly disclosed embodying the methods of the present disclosure.

摘要翻译： 确定心脏电击时机的方法，以确定除颤原纤维心脏所需的休克强度。 时间对应于在心脏的T波期间发生的心脏中最脆弱的窗口。 使用衍生的T波表示，大多数漏洞的时间由区域方法的中心，峰值振幅法，宽度法或其他类似方法确定。 类似地公开了实现本公开的方法的装置。

公开(公告)号：US20120232606A1

公开(公告)日：2012-09-13

申请号：US13357659

申请日：2012-01-25

申请人： Yong-Fu Xiao ,  Jeffrey M. Gillberg ,  Paul J. DeGroot ,  Eduardo N. Warman ,  Scott J. Brabec ,  John L. Sommer ,  Jon F. Urban ,  Lepeng Zeng

发明人： Yong-Fu Xiao ,  Jeffrey M. Gillberg ,  Paul J. DeGroot ,  Eduardo N. Warman ,  Scott J. Brabec ,  John L. Sommer ,  Jon F. Urban ,  Lepeng Zeng

IPC分类号： A61N1/365

CPC分类号： A61N1/365 ,  A61N1/3622 ,  A61N1/36585

摘要： An apparatus and method to discriminate cardiac events by sensing atrial and ventricular depolarizations having associated refractory periods thereafter. A fast ventricular rate is detected in response to the sensed ventricular depolarizations. Responsive to detecting the fast ventricular rate, at least one stimulus pulse is delivered to atrial tissue within the associated refractory period of the ventricle but outside of an associated refractory period of the stimulated atrial tissue. A ventricular response to the atrial tissue stimulus pulse is determined, and the cardiac event is discriminated based on the ventricular response to the atrial tissue stimulus pulse.

公开(公告)号：US08046067B2

公开(公告)日：2011-10-25

申请号：US12897485

申请日：2010-10-04

申请人： Todd J. Sheldon ,  Jeffrey M. Gillberg

发明人： Todd J. Sheldon ,  Jeffrey M. Gillberg

IPC分类号： A61N1/362

CPC分类号： A61N1/3622 ,  A61B5/0468

摘要： AV synchronous, dual chamber pacing systems are disclosed having improved sensing of ectopic ventricular depolarizations or PVCs coincidentally occurring at or shortly following delivery of an A-PACE pulse. A first ventricular sense amplifier that is blanked during and following delivery of an A-PACE pulse is coupled to active and indifferent ventricular pace/sense electrodes defining a ventricular sense vector for sensing natural ventricular depolarizations and declaring a V-EVENT. A far field PVC sense amplifier coupled to a far field PVC sense electrode pair defining a PVC sense vector detects such PVCs while the ventricular sense amplifier is blanked. A PVC declared during the ventricular blanking period by the far field PVC sense amplifier is employed to deliver a VSP pulse upon time-out of a VSP delay, if the VSP function is provided and programmed ON, and/or to halt time-out of an AV delay.

摘要翻译： 公开了AV同步双室起搏系统，其具有改善的异位心室去极化感测或偶然发生在A-PACE脉冲输送或不久之后的PVC。 在A-PACE脉冲输送期间和随后的A-PACE脉冲输送期间被消隐的第一个心室感应放大器与定义用于感测自然心室去极化并宣布V-EVENT的心室感觉矢量的活动和无关心室速度/感觉电极耦合。 耦合到定义PVC感测矢量的远场PVC感测电极对的远场PVC读出放大器检测这种PVC，同时将心室感知放大器消隐。 如果VSP功能被提供和编程为ON，则使用在远场PVC读出放大器的心室消隐期间声明的PVC，以在VSP延迟超时时传送VSP脉冲，和/或停止超时 AV延迟。

公开(公告)号：US07640054B2

公开(公告)日：2009-12-29

申请号：US11420521

申请日：2006-05-26

申请人： Lev A. Koyrakh ,  Eugene Davydov ,  Jeffrey M. Gillberg ,  Jian Cao

发明人： Lev A. Koyrakh ,  Eugene Davydov ,  Jeffrey M. Gillberg ,  Jian Cao

IPC分类号： A61B5/0468 ,  A61B5/0472

CPC分类号： A61B5/04525

摘要： A method of generating a template in an implantable medical device for implantation within a patient, and a processor readable medium for performing the method, that includes generating a template from collected events corresponding to the patient, delaying the generation of the template for a first predetermined time period in response to the template not being generated within a predetermined number of collected events, determining whether the template is valid, and monitoring the template to determine whether the template is an accurate representation of the patient.

公开(公告)号：US07496403B2

公开(公告)日：2009-02-24

申请号：US11217050

申请日：2005-08-31

申请人： Jian Cao ,  Jeffrey M. Gillberg

发明人： Jian Cao ,  Jeffrey M. Gillberg

IPC分类号： A61N1/00

CPC分类号： A61N1/37247 ,  A61N1/371

摘要： In an apparatus and a method for use in setting a sensing parameter of an implantable medical device (IMD) of a patient, cardiac data corresponding to a cardiac episode experienced by the patient is obtained from a sensing electrode associated with the IMD. At the time the cardiac data is obtained, the IMD is operated at a first setting of the sensing parameter. Based upon this cardiac data, a simulation is performed of cardiac event identification if the IMD were operated at a different setting of the sensing parameter. The simulated cardiac event identification performance of the IMD is then reported.

摘要翻译： 在用于设置患者的可植入医疗装置（IMD）的感测参数的装置和方法中，从与IMD相关联的感测电极获得与患者经历的心脏发作相对应的心脏数据。 在获得心脏数据时，在感测参数的第一设定下操作IMD。 基于该心脏数据，如果IMD在感测参数的不同设置下操作，则进行心脏事件识别的模拟。 然后报告IMD的模拟心脏事件识别性能。

公开(公告)号：US07142916B2

公开(公告)日：2006-11-28

申请号：US10692990

申请日：2003-10-24

申请人： D. Curtis Deno ,  Vincent E. Splett ,  Jeffrey M. Gillberg ,  Glenn C. Zillmer ,  Ruth N. Klepfer ,  Karen J. Kleckner

发明人： D. Curtis Deno ,  Vincent E. Splett ,  Jeffrey M. Gillberg ,  Glenn C. Zillmer ,  Ruth N. Klepfer ,  Karen J. Kleckner

IPC分类号： A61N1/36

CPC分类号： A61N1/365 ,  A61N1/3627

摘要： The present invention relates to the secure delivery of an extra-systolic stimulation (ESS) therapy to treat cardiac dysfunction that employs atrial and/or ventricular extra-systoles via pacing-like stimulation of the heart. These extra-systoles must be timed correctly to achieve beneficial effects on myocardial mechanics (benefit) while maintaining an extremely low level of risk of arrhythmia induction and excellent ICD-like arrhythmia sensing and detection (security). Further experience with ESS has led to improved implementation methods that depend on better blanking, ESS stimulation timing (of an “extra-systolic interval” or ESI), and ESS therapy delivery options and guidance. These methods may be employed individually or in combinations in an external or implantable ESS therapy delivery device.

摘要翻译： 本发明涉及一种收缩期刺激（ESS）疗法的安全递送，以治疗心脏功能障碍，其通过心脏起搏样刺激使用心房和/或心室外的心脏。 这些额外的收缩期必须正确定时，以获得对心肌力学（益处）的有益影响，同时保持心律失常诱导和优异的ICD样心律失常感知和检测（安全性）的极低水平的风险。 ESS的进一步经验导致改进的实施方法取决于更好的消隐，ESS刺激时间（“收缩期间期”或ESI）和ESS治疗递送选项和指导。 这些方法可以在外部或可植入的ESS治疗递送装置中单独使用或组合使用。

公开(公告)号：US5523759A

公开(公告)日：1996-06-04

申请号：US105670

申请日：1993-08-16

申请人： Jeffrey M. Gillberg ,  Gregory H. Piesinger ,  Mitchell S. Pockrandt

发明人： Jeffrey M. Gillberg ,  Gregory H. Piesinger ,  Mitchell S. Pockrandt

IPC分类号： G01S13/95

CPC分类号： G01S13/953

摘要： An airborne doppler radar wind shear detection system has a volumetric scanning pattern for providing atmospheric measurement data for individual resolution cells that are formed into a 3-D grid of atmospheric data samples. Volumetric feature extraction modules identify and group resolution cells having particular features into air masses of interest. A spatial feature association and filtering module combines the air masses of interest into a 3-D representation of atmospheric conditions and filters out ground clutter. A contextual matching and temporal tracking module compares the 3-D representation to known wind shear models and compares successive 3-D representations to one another to aid in identifying hazardous wind shear conditions in the aircraft flight path.

摘要翻译： 空中多普勒雷达风切变检测系统具有体积扫描模式，用于为形成大气数据样本的3-D网格的各个分辨率单元提供大气测量数据。 体积特征提取模块将具有特定特征的分辨率单元识别并分组到感兴趣的空气质量体中。 空间特征关联和滤波模块将感兴趣的空气质量组合成大气条件的3-D表示并滤除地面杂波。 上下文匹配和时间跟踪模块将3-D表示与已知风切变模型进行比较，并将连续的3-D表示相互比较，以帮助识别飞行器飞行路径中的危险风切变条件。

公开(公告)号：US08594775B2

公开(公告)日：2013-11-26

申请号：US13104794

申请日：2011-05-10

申请人： Subham Ghosh ,  Jeffrey M. Gillberg

发明人： Subham Ghosh ,  Jeffrey M. Gillberg

IPC分类号： A61B5/04 ,  A61N1/00

CPC分类号： A61B5/686 ,  A61B5/04012 ,  A61B5/0452 ,  A61N1/3621

摘要： A method includes retrieving electrogram (EGM) data for N cardiac cycles from a memory of an implantable medical device. N is an integer greater than 1. The method further include categorizing each of the N cardiac cycles into one of a plurality of categories based on a morphology of the N cardiac cycles and performing comparisons between pairs of the N cardiac cycles. Each of the comparisons between two cardiac cycles includes detecting a mismatch between the two cardiac cycles when the two cardiac cycles are in different categories, and detecting a match between the two cardiac cycles when the two cardiac cycles are in the same category. Additionally, the method includes classifying the rhythm of the N cardiac cycles based on a number of detected matches and detected mismatches.

摘要翻译： 一种方法包括从可植入医疗装置的存储器检索N个心动周期的电描记图（EGM）数据。 N是大于1的整数。该方法还包括基于N个心动周期的形态将N个心动周期中的每一个分类为多个类别中的一个，并且执行N个心动周期对之间的比较。 两个心动周期之间的每个比较包括当两个心动周期处于不同类别时检测两个心动周期之间的不匹配，以及当两个心动周期处于相同类别时检测两个心动周期之间的匹配。 另外，该方法包括基于检测到的匹配次数和检测到的错配来对N个心动周期的节奏进行分类。