公开(公告)号：US20140046690A1

公开(公告)日：2014-02-13

申请号：US13570884

申请日：2012-08-09

申请人： Bruce D. Gunderson ,  Kevin T. Ousdigian ,  Amisha S. Patel

发明人： Bruce D. Gunderson ,  Kevin T. Ousdigian ,  Amisha S. Patel

IPC分类号： G06Q50/24

CPC分类号： G16H40/63 ,  G06F19/3418 ,  G06F19/3481 ,  G16H15/00

摘要： Techniques, systems, and devices, for generating a patient management report based on clinician input and patient data are described. For example, one or more processors may be configured to receive a clinician input selecting at least one reporting characteristic for each of a plurality of diagnostic metrics and organize the diagnostic metrics based on the selected reporting characteristic. In addition, the one or more processors may be configured to receive patient data for at least one patient, determine a value for at least a subset of the diagnostic metrics based on the patient data, and generate a patient management report comprising the diagnostic metrics having a value that exceeds a respective threshold. The diagnostic metrics may be ordered in the patient management report based on the organization.

摘要翻译： 描述了用于基于临床医生输入和患者数据生成患者管理报告的技术，系统和设备。 例如，一个或多个处理器可以被配置为接收为多个诊断度量中的每一个选择至少一个报告特征的临床医生输入，并且基于所选择的报告特征来组织诊断度量。 此外，一个或多个处理器可以被配置为接收至少一个患者的患者数据，基于患者数据确定诊断度量的至少一个子集的值，并且生成患者管理报告，其包括具有 超过相应阈值的值。 可以根据组织在患者管理报告中订购诊断指标。

公开(公告)号：US20130289428A1

公开(公告)日：2013-10-31

申请号：US13456828

申请日：2012-04-26

申请人： Amisha S. Patel ,  Bruce D. Gunderson ,  Mark L. Brown

发明人： Amisha S. Patel ,  Bruce D. Gunderson ,  Mark L. Brown

IPC分类号： A61B5/0456 ,  A61B5/02

CPC分类号： A61B5/686 ,  A61B5/0452 ,  A61B5/7221 ,  A61B5/7282 ,  A61N1/368 ,  A61N1/37247 ,  A61N1/37264 ,  A61N1/37282

摘要： A medical device system senses cardiac signals and generates and stores sensing data including sensed cardiac events. A processor receiving the sensing data is configured to detect undersensed and oversensed events. The processor generates an episode display comprising event identifying codes in response to the received sensing data and produces an adjusted episode display in response to an event being identified as an undersensed event or an oversensed event.

摘要翻译： 医疗设备系统感测心脏信号，并产生并存储包括感测的心脏事件的感测数据。 接收感测数据的处理器被配置为检测不足和超级的事件。 所述处理器响应于所接收的感测数据而生成包括事件识别码的剧集显示，并响应于被识别为超大事件或超大事件的事件而产生经调整的剧集显示。

公开(公告)号：US20130079654A1

公开(公告)日：2013-03-28

申请号：US13245585

申请日：2011-09-26

申请人： Amisha S. Patel ,  Bruce D. Gunderson ,  Mark L. Brown

发明人： Amisha S. Patel ,  Bruce D. Gunderson ,  Mark L. Brown

IPC分类号： G06F19/00 ,  A61B5/046 ,  A61B5/0464

CPC分类号： A61B5/04 ,  A61B5/046 ,  A61B5/0464 ,  A61N1/3702

摘要： The present disclosure is directed to the classification of cardiac episodes using an algorithm. In various examples, an episode classification algorithm evaluates electrogram signal data from a near-field channel and a far-field channel. The episode classification algorithm classifies the cardiac episode based on the evaluation of the electrogram signal data for at least one of the near-field and far-field channels. In some examples, a cardiac episode being classified may be an episode that resulted in treatment being provided by an implantable medical device. Possible classifications of the cardiac episode may include, for example, unknown, inappropriate, appropriate, supraventricular tachycardia, ventricular tachycardia, ventricular fibrillation or ventricular over-sensing.

摘要翻译： 本公开涉及使用算法对心脏发作的分类。 在各种示例中，事件分类算法从近场信道和远场信道评估电描记图信号数据。 情节分类算法基于对近场和远场信道中的至少一个的电描记图信号数据的评估来分类心脏发作。 在一些实例中，分类的心脏发作可能是导致由可植入医疗装置提供的治疗的发作。 心脏事件的可能分类可能包括例如未知的，不适当的，适当的，室上性心动过速，室性心动过速，心室颤动或心室过度感测。

公开(公告)号：US20100030575A1

公开(公告)日：2010-02-04

申请号：US12181429

申请日：2008-07-29

申请人： Amisha S. Patel ,  Luc Roland Mongeon ,  Susan Heilman Kilbane ,  James E. Willenbring ,  Christopher John Gennaro

发明人： Amisha S. Patel ,  Luc Roland Mongeon ,  Susan Heilman Kilbane ,  James E. Willenbring ,  Christopher John Gennaro

IPC分类号： G06Q50/00 ,  G06Q10/00

CPC分类号： G06F19/3418 ,  G06F19/00 ,  G06Q50/22 ,  G06Q50/24

摘要： Embodiments of the present invention provide a system in which a medical device selects less than all of its stored information and provides the selected subset of information to a data mart for storage, processing, and/or communication to one or more interested parties. In many embodiments, customers, patients, or even components of the medical device or of the remote patient management system can access selected medical device information (e.g., customers can access medical device information tailored to the care they are providing to one or more patients). In many embodiments, customers can receive such medical device information according to a schedule that best suits their care (or whenever they desire such information, irrespective of a schedule). In many embodiments, providing less than full transmissions to the data mart reduces the strain on medical device batteries.

摘要翻译： 本发明的实施例提供一种系统，其中医疗设备选择少于其所有存储的信息，并将所选择的信息子集提供给数据集市以用于存储，处理和/或与一个或多个有关方面的通信。 在许多实施例中，医疗设备或远程患者管理系统的客户，患者或甚至组件可以访问所选择的医疗设备信息（例如，客户可以访问为他们提供给一个或多个患者的护理而定制的医疗设备信息） 。 在许多实施例中，客户可以根据最适合其照顾的时间表（或每当他们希望这样的信息，而不管时间表）接收这样的医疗设备信息。 在许多实施例中，向数据集市提供少于完整的传输减少了医疗设备电池的压力。

公开(公告)号：US07567835B2

公开(公告)日：2009-07-28

申请号：US11108472

申请日：2005-04-18

申请人： Bruce D. Gunderson ,  Amisha S. Patel ,  Chad A. Bounds ,  Mark L. Brown

发明人： Bruce D. Gunderson ,  Amisha S. Patel ,  Chad A. Bounds ,  Mark L. Brown

IPC分类号： A61B5/04

CPC分类号： A61B5/0456 ,  A61B5/0464 ,  A61B5/7217 ,  A61B5/7239 ,  A61B5/7264 ,  A61N1/3622 ,  A61N1/3702 ,  A61N1/3704

摘要： A method for identifying and classifying various types of oversensing in implantable medical devices (IMDs), such as implantable cardioverter defibrillators (ICDs), to assist a physician in choosing corrective action to reduce the likelihood of oversensing and inappropriate therapy delivery. Far-field electrogram (EGM) signals are analyzed to detect the occurrence of R-waves, and the result is compared to the number and pattern of R-waves sensed by the IMD and indicated on the marker channel. A marker channel with more sensed R-waves than indicated by analysis of the far-field EGM indicates the presence of oversensing, including double-counting of R-waves, T-wave oversensing, lead malfunction or failure, poor lead connections, noise associated with electromagnetic interference, non-cardiac myopotentials, etc. Identification of the type of oversensing may be determined by analysis of the number and pattern of marker channel sensed R-waves with respect to the timing of the R-waves detected from the far-field EGM.

摘要翻译： 用于识别和分类可植入医疗装置（IMD）中的各种类型的过度感染的方法，例如可植入的心律转复除颤器（ICD），以协助医师选择矫正动作以减少过度和不适当的治疗递送的可能性。 分析远场电描记图（EGM）信号以检测R波的发生，并将结果与​​由IMD感测并在标记通道上指示的R波的数量和模式进行比较。 具有比通过远场EGM分析指示的更多的感测R波的标记通道表示存在过敏，包括R波的双重计数，T波超检测，导线故障或故障，导线连接不良，噪声相关 具有电磁干扰，非心脏近视等。过敏类型的识别可以通过对从远场检测到的R波的定时的标记信道感测R波的数量和模式的分析来确定 股东特别大会

公开(公告)号：US08886296B2

公开(公告)日：2014-11-11

申请号：US13274010

申请日：2011-10-14

申请人： Amisha S. Patel

发明人： Amisha S. Patel

IPC分类号： A61B5/04 ,  G06F19/00 ,  A61B5/00 ,  A61B5/0452 ,  A61B5/0464 ,  A61N1/37

CPC分类号： G06F19/3443 ,  A61B5/04525 ,  A61B5/0464 ,  A61B5/7264 ,  A61N1/3702 ,  G06F19/00 ,  G06F19/3418 ,  G16H50/20 ,  G16H50/70

摘要： The present disclosure is directed to the classification of cardiac episodes using an algorithm. In various examples, an episode classification algorithm evaluates electrogram signal data to determine whether T-wave oversensing has occurred. The T-wave oversensing analysis may include, for example, identifying beat runs within the cardiac episode whether the beats within the run have at least one characteristic that alternates beat to be or clustering beats within the cardiac episode based on beat to beat interval length. The T-wave oversensing determination may be based on probabilistic analysis in some examples.

摘要翻译： 本公开涉及使用算法对心脏发作的分类。 在各种示例中，情节分类算法评估电描记图信号数据，以确定是否发生了T波超检测。 T波超检测分析可以包括例如在心脏发作中识别搏动运动，无论运行中的搏动是否具有基于搏动到搏动间隔长度在心脏发作中交替搏动或聚焦搏动的至少一个特征。 在一些示例中，T波超检测可以基于概率分析。

公开(公告)号：US08744560B2

公开(公告)日：2014-06-03

申请号：US13250676

申请日：2011-09-30

申请人： Bruce D. Gunderson ,  Karen J. Kleckner ,  Kevin T. Ousdigian ,  Amisha S. Patel ,  Julian Sanchez

发明人： Bruce D. Gunderson ,  Karen J. Kleckner ,  Kevin T. Ousdigian ,  Amisha S. Patel ,  Julian Sanchez

IPC分类号： A61B5/0456

CPC分类号： A61N1/37247 ,  A61B5/0031 ,  A61B5/044 ,  A61B5/0452 ,  A61B5/0464 ,  A61B5/0468 ,  A61B5/076 ,  A61B5/7217 ,  A61B5/7264

摘要： The present disclosure is directed to generating and displaying an electrogram (EGM) summary for use by physicians or other clinicians. An implantable medical device (IMD) transmits EGM signal data for a number of cardiac episodes to an external computing device. The external computing device selects a subset of the cardiac episodes for which information or images are displayed to the user. In various examples, cardiac episodes may be selected for display based at least in part on a retrospective analysis classification of the cardiac episode.

摘要翻译： 本公开涉及生成和显示用于医生或其他临床医师使用的电描记图（EGM）摘要。 可植入医疗装置（IMD）向多个心脏发作的EGM信号数据发送到外部计算装置。 外部计算设备选择向用户显示信息或图像的心脏发作的子集。 在各种示例中，可以至少部分地基于心脏发作的回顾性分析分类来选择心脏发作来进行显示。

公开(公告)号：US08644931B2

公开(公告)日：2014-02-04

申请号：US12180304

申请日：2008-07-25

申请人： Robert W. Stadler ,  Bruce D. Gunderson ,  Amisha S. Patel

发明人： Robert W. Stadler ,  Bruce D. Gunderson ,  Amisha S. Patel

IPC分类号： A61N1/00

CPC分类号： A61N1/36521 ,  A61N1/3706 ,  A61N2001/083

摘要： In general, the disclosure relates to techniques for calculating mean impedance values and impedance variability values to detect a possible condition with a lead or device-lead pathway or connection. In one example, a device may be configured to determine an impedance value for an electrical path based on a plurality of measured impedance values for the electrical path, wherein the electrical path comprises a plurality of electrodes, and to determine an impedance variability value based on at least one of the plurality of measured impedance values. The device may be further configured to determine a threshold value based on the determined impedance value and the impedance variability value, compare a newly measured impedance value for the electrical path to the threshold value, and indicate a possible condition of the electrical path based on the comparison.

摘要翻译： 通常，本公开涉及用于计算平均阻抗值和阻抗变异性值以用于检测具有引线或器件引导路径或连接的可能状况的技术。 在一个示例中，设备可以被配置为基于用于电路径的多个测量的阻抗值来确定电路径的阻抗值，其中电路径包括多个电极，并且基于以下方式确定阻抗变异性值： 所述多个测量的阻抗值中的至少一个。 该装置还可以被配置为基于所确定的阻抗值和阻抗变异性值来确定阈值，将新测量的电通路的阻抗值与阈值进行比较，并且基于该路径指示电路径的可能状态 比较。

公开(公告)号：US20130096449A1

公开(公告)日：2013-04-18

申请号：US13273962

申请日：2011-10-14

申请人： Amisha S. Patel ,  Jian Cao ,  Karen J. Kleckner

发明人： Amisha S. Patel ,  Jian Cao ,  Karen J. Kleckner

IPC分类号： A61B5/0468 ,  A61N1/37 ,  A61B5/046 ,  A61B5/0464

CPC分类号： A61B5/046 ,  A61B5/0031 ,  A61B5/0464 ,  A61B5/0468 ,  A61N1/37 ,  A61N1/3962

摘要： The present disclosure is directed to the classification of cardiac episodes using an algorithm. In various examples, an episode classification algorithm evaluates electrogram signal data using a probabilistic ventricular oversensing algorithm. The algorithm may look at a plurality of factors weighing for and against a determination of ventricular oversensing. In some examples, the algorithm may also determine whether the cardiac episode includes atrial sensing issues.

摘要翻译： 本公开涉及使用算法对心脏发作的分类。 在各种示例中，发作分类算法使用概率性心室过敏算法来评估电描记图信号数据。 该算法可以考虑多个因素来衡量和抵抗心室过敏的确定。 在一些示例中，算法还可以确定心脏发作是否包括心房感知问题。

公开(公告)号：US20130096445A1

公开(公告)日：2013-04-18

申请号：US13274010

申请日：2011-10-14

申请人： Amisha S. Patel

发明人： Amisha S. Patel

IPC分类号： A61B5/0452

CPC分类号： G06F19/3443 ,  A61B5/04525 ,  A61B5/0464 ,  A61B5/7264 ,  A61N1/3702 ,  G06F19/00 ,  G06F19/3418 ,  G16H50/20 ,  G16H50/70

摘要： The present disclosure is directed to the classification of cardiac episodes using an algorithm. In various examples, an episode classification algorithm evaluates electrogram signal data to determine whether T-wave oversensing has occurred. The T-wave oversensing analysis may include, for example, identifying beat runs within the cardiac episode whether the beats within the run have at least one characteristic that alternates beat to be or clustering beats within the cardiac episode based on beat to beat interval length. The T-wave oversensing determination may be based on probabilistic analysis in some examples.

摘要翻译： 本公开涉及使用算法对心脏发作的分类。 在各种示例中，情节分类算法评估电描记图信号数据，以确定是否发生了T波超检测。 T波超检测分析可以包括例如在心脏发作中识别搏动运动，无论运行中的搏动是否具有基于搏动到搏动间隔长度在心脏发作中交替搏动或聚焦搏动的至少一个特征。 在一些示例中，T波超检测可以基于概率分析。