公开(公告)号：US08473054B2

公开(公告)日：2013-06-25

申请号：US12474157

申请日：2009-05-28

申请人： Ajit Pillai ,  Cecilia Qin Xi

发明人： Ajit Pillai ,  Cecilia Qin Xi

IPC分类号： A61N1/05 ,  A61B5/053

CPC分类号： A61B5/0538 ,  A61N1/3627 ,  A61N1/36521 ,  A61N1/3702

摘要： Techniques are provided for use by implantable medical devices such as cardiac resynchronization therapy (CRT) devices for detecting pulmonary edema based on transthoracic impedance sensed using cardiac pacing/sensing leads, wherein detection can be performed while lead maturation occurs. Briefly, the implantable device determines whether the leads are within an initial post-implant interval following implant during which lead maturation generally occurs. The device then detects pulmonary edema or related medical conditions within the patient based on transthoracic impedance using a set of detection parameters adjusted for use during the post-implant interval. Thus, rather than “blanking” impedance data during lead maturation, the device instead detects and processes impedance during this period to identify possible episodes of pulmonary edema so that appropriate measures can be undertaken, such as delivery of warnings or titration of appropriate medications.

摘要翻译： 技术被提供用于可植入的医疗装置，例如心脏再同步治疗（CRT）装置，用于基于使用心脏起搏/感测引线检测到的经胸廓阻抗来检测肺水肿，其中可以在发生铅成熟的同时进行检测。 简而言之，可植入装置确定引线是否在植入之后的初始植入后间隔内，在此期间通常发生铅成熟。 该装置然后使用调整为在植入后间隔期间使用的一组检测参数，基于经胸阻抗检测患者内的肺水肿或相关的医疗状况。 因此，在铅成熟过程中，不是“阻塞”阻抗数据，而是在此期间检测并处理阻抗，以识别肺水肿的可能发作，以便进行适当的措施，例如传送警告或滴定合适的药物。

公开(公告)号：US20090287103A1

公开(公告)日：2009-11-19

申请号：US12120499

申请日：2008-05-14

申请人： Ajit Pillai

发明人： Ajit Pillai

IPC分类号： A61B5/04 ,  A61N1/00

CPC分类号： A61B5/0245 ,  A61B5/0422 ,  A61B5/0468 ,  A61N1/36542 ,  A61N1/36585 ,  A61N1/37 ,  A61N1/37247

摘要： Patient activity and heart rate (HR) are monitored. For each of a plurality of time periods, periods of patient exercise and/or patient activity, if any, are detected based on the monitored patient activity and HR and an activity threshold. A cumulative duration of exercise and/or a cumulative duration of activity is/are determined for each time period, and the peak exercise HR for each period of patient exercise is detected. Information is stored, including duration information indicative of the cumulative duration of exercise and/or the cumulative duration of activity for each time period, and peak exercise information associated with the period of patient exercise during which the highest peak exercise HR occurred for each time period. The stored duration information, or information indicative thereof, are transferred from an implantable system to a non-implanted system so that a graphical representation of such information can be displayed and observed to evaluate exercise compliance and/or heart failure condition.

摘要翻译： 监测患者活动和心率（HR）。 对于多个时间段中的每一个，基于所监测的患者活动和HR和活动阈值来检测患者运动和/或患者活动的周期（如果有的话）。 每个时间段确定运动的累积持续时间和/或累积活动持续时间，并且检测每个患者运动时段的高峰运动HR。 存储信息，包括指示每个时间段的累积运动持续时间和/或累积活动持续时间的持续时间信息，以及与每个时间段发生最高峰值运动HR的患者运动期间相关联的峰值运动信息 。 存储的持续时间信息或指示其的信息从可植入系统转移到非植入系统，使得可以显示和观察此类信息的图形表示以评估运动顺应性和/或心力衰竭状况。

公开(公告)号：US08600497B1

公开(公告)日：2013-12-03

申请号：US11558088

申请日：2006-11-09

申请人： Weiqun Yang ,  Malin Ohlander ,  Louis Wong ,  Nils Holmstrom ,  Cem Shaquer ,  Euljoon Park ,  Dorin Panescu ,  Shahrooz Shahparnia ,  Andre Walker ,  Ajit Pillai ,  Mihir Naware

发明人： Weiqun Yang ,  Malin Ohlander ,  Louis Wong ,  Nils Holmstrom ,  Cem Shaquer ,  Euljoon Park ,  Dorin Panescu ,  Shahrooz Shahparnia ,  Andre Walker ,  Ajit Pillai ,  Mihir Naware

IPC分类号： A61B5/05 ,  A61N1/00

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 device monitors and treats heart failure, pulmonary edema, and hemodynamic conditions and in some cases applies therapy. In one implementation, the implantable device applies a high-frequency multi-phasic pulse waveform over multiple-vectors through tissue. The waveform has a duration less than the charging time constant of electrode-electrolyte interfaces in vivo to reduce intrusiveness while increasing sensitivity and specificity for trending parameters. The waveform can be multiplexed over multiple vectors and the results cross-correlated or subjected to probabilistic analysis or thresholding schemata to stage heart failure or pulmonary edema. In one implementation, a fractionation morphology of a sensed impedance waveform is used to trend intracardiac pressure to stage heart failure and to regulate cardiac resynchronization therapy. The waveform also provides unintrusive electrode integrity checks and 3-D impedancegrams.

摘要翻译： 植入式装置监测和治疗心力衰竭，肺水肿和血液动力学状况，并且在某些情况下应用治疗。 在一个实施方案中，可植入装置通过组织在多个向量上施加高频多相脉冲波形。 该波形的持续时间小于体内电极 - 电解质界面的充电时间常数，以降低侵入性，同时增加趋势参数的灵敏度和特异性。 波形可以在多个载体上进行复用，并且结果相互关联或进行概率分析或阈值模式以分步心脏衰竭或肺水肿。 在一个实施方案中，使用感测阻抗波形的分级形态来趋向心脏内压力来分级心力衰竭并调节心脏再同步治疗。 该波形还提供非侵入式电极完整性检查和3-D阻抗图。

公开(公告)号：US20100305641A1

公开(公告)日：2010-12-02

申请号：US12474157

申请日：2009-05-28

申请人： Ajit Pillai ,  Cecilia Qin Xi

发明人： Ajit Pillai ,  Cecilia Qin Xi

IPC分类号： A61N1/365

CPC分类号： A61B5/0538 ,  A61N1/3627 ,  A61N1/36521 ,  A61N1/3702

摘要： Techniques are provided for use by implantable medical devices such as cardiac resynchronization therapy (CRT) devices for detecting pulmonary edema based on transthoracic impedance sensed using cardiac pacing/sensing leads, wherein detection can be performed while lead maturation occurs. Briefly, the implantable device determines whether the leads are within an initial post-implant interval following implant during which lead maturation generally occurs. The device then detects pulmonary edema or related medical conditions within the patient based on transthoracic impedance using a set of detection parameters adjusted for use during the post-implant interval. Thus, rather than “blanking” impedance data during lead maturation, the device instead detects and processes impedance during this period to identify possible episodes of pulmonary edema so that appropriate measures can be undertaken, such as delivery of warnings or titration of appropriate medications.

摘要翻译： 技术被提供用于可植入的医疗装置，例如心脏再同步治疗（CRT）装置，用于基于使用心脏起搏/感测引线检测到的经胸廓阻抗来检测肺水肿，其中可以在发生铅成熟的同时进行检测。 简而言之，可植入装置确定引线是否在植入之后的初始植入后间隔内，在此期间通常发生铅成熟。 该装置然后使用调整为在植入后间隔期间使用的一组检测参数，基于经胸阻抗检测患者内的肺水肿或相关的医疗状况。 因此，在铅成熟过程中，不是“阻塞”阻抗数据，而是在此期间检测并处理阻抗，以识别肺水肿的可能发作，以便进行适当的措施，例如传送警告或滴定合适的药物。

公开(公告)号：US07676264B1

公开(公告)日：2010-03-09

申请号：US11734850

申请日：2007-04-13

申请人： Ajit Pillai ,  Mihir Naware ,  Dorin Panescu

发明人： Ajit Pillai ,  Mihir Naware ,  Dorin Panescu

IPC分类号： A61N1/00

CPC分类号： A61N1/3627 ,  A61B5/0452 ,  A61B5/7239 ,  A61N1/365

摘要： Techniques are provided for detecting and evaluating ventricular dyssynchrony based on morphological features of the T-wave and for controlling therapy in response thereto. For example, the number of peaks in the T-wave, the area under the peaks, the number of points of inflection, and the slope of the T-wave can be used to detect ventricular dyssynchrony and evaluate its severity. As ventricular dyssynchrony often arises due to heart failure, the degree of dyssynchrony may also be used as a proxy for tracking the progression of heart failure. Pacing therapy is automatically and adaptively adjusted based on the degree of ventricular dyssynchrony so as to reduce the dyssynchrony and thereby improve cardiac function.

摘要翻译： 提供了基于T波的形态学特征和用于控制对其的治疗来检测和评价心室不同步的技术。 例如，可以使用T波中的峰数，峰下的面积，拐点的数量和T波的斜率来检测心室不同步并评估其严重程度。 由于心脏衰竭经常出现心室不同步，不同步程度也可用作跟踪心力衰竭进展的代理。 基于心室不同步程度自动调整起搏治疗，减少不同步，从而改善心脏功能。