公开(公告)号：US08712519B1

公开(公告)日：2014-04-29

申请号：US11558194

申请日：2006-11-09

申请人： Dorin Panescu ,  Weiqun Yang ,  Louis Wong ,  Nils Holmstrom ,  Andre Walker

发明人： Dorin Panescu ,  Weiqun Yang ,  Louis Wong ,  Nils Holmstrom ,  Andre Walker

IPC分类号： A61N1/365

CPC分类号： A61N1/36521 ,  A61N1/3627 ,  A61N1/3684

摘要： Techniques are provided for controlling therapy provided by the implantable cardiac stimulation device based on cardiogenic impedance. A cardiogenic impedance signal (or intracardiac impedance signal) is an impedance signal representative of the beating of the heart of the patient in which the device is implanted. The cardiogenic impedance signal is sensed along a sensing vector passing through at least a portion of the heart so that the sensed impedance is affected by the mechanical beating of the heart along that sensing vector. Pacing therapy is automatically and adaptively adjusted based on the cardiogenic impedance signal. For example, pacing timing parameters such as the atrioventricular delay and the inter-ventricular delay may be adjusted. Preferably, the adjustments are adaptive, i.e. the adjustments are performed in a closed-loop so as to adapt the adjustments to changes in the cardiogenic impedance signal so as to optimize therapy. In one particular example, the adjustments are performed so as to reduce a degree of fractionation within a cardiogenic impedance waveform.

摘要翻译： 提供技术用于基于心源性阻抗来控制由可植入心脏刺激装置提供的治疗。 心源性阻抗信号（或心内阻抗信号）是表示装置植入的患者的心跳的阻抗信号。 沿着通过心脏的至少一部分的感测矢量感测心源性阻抗信号，使得感测到的阻抗受到沿着该感测向量的心脏的机械跳动的影响。 基于心源阻抗信号自动调整起搏治疗。 例如，可以调整起搏定时参数，例如房室延迟和心室间延迟。 优选地，调整是自适应的，即，在闭环中进行调整，以使调整适应于心源阻抗信号的变化，以便优化治疗。 在一个具体示例中，执行调整以便降低心源阻抗波形内的分级程度。

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：US08306623B2

公开(公告)日：2012-11-06

申请号：US13149507

申请日：2011-05-31

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

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

IPC分类号： A61N1/18

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：US07945326B1

公开(公告)日：2011-05-17

申请号：US11684677

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

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：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：US08200330B2

公开(公告)日：2012-06-12

申请号：US12781716

申请日：2010-05-17

申请人： Mark Kroll ,  Gabriel A. Mouchawar ,  J. Christopher Moulder ,  Andre Walker

发明人： Mark Kroll ,  Gabriel A. Mouchawar ,  J. Christopher Moulder ,  Andre Walker

IPC分类号： A61N1/39

CPC分类号： A61N1/3931 ,  A61N1/3621 ,  A61N2001/083

摘要： An implanted cardioverter defibrillator (ICD) delivers an electrical therapy signal to the heart of a patient. When ventricular fibrillation or another condition of the heart requiring high voltage therapy is sensed, the therapy signal is delivered to the heart. When a partial short-circuit or other low impedance condition occurs, an over-current protection circuit will stop delivery of a shocking pulse. The ICD will then reduce the voltage of the shocking pulse and try again to deliver electrical therapy. This process is repeated until a voltage level is found that is able to deliver the electrical therapy without causing an over-voltage condition. Alternate lead configurations may also be tried in an attempt to find a signal path that is not affected by the low impedance or short-circuit condition.

摘要翻译： 植入式心律转复除颤器（ICD）向患者的心脏递送电疗治疗信号。 当心室纤维性颤动或需要高压治疗的心脏的另一种情况被感测时，治疗信号传递到心脏。 当发生部分短路或其他低阻抗情况时，过电流保护电路将停止输送震动脉冲。 然后，ICD将降低冲击脉冲的电压，然后再次进行电疗治疗。 重复该过程，直到发现能够递送电疗而不引起过电压状况的电压电平。 也可以尝试替代引线配置来尝试找到不受低阻抗或短路条件影响的信号路径。

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：US20100228307A1

公开(公告)日：2010-09-09

申请号：US12781716

申请日：2010-05-17

申请人： Mark W. Kroll ,  Gabriel A. Mouchawar ,  J. Christopher Moulder ,  Andre Walker

发明人： Mark W. Kroll ,  Gabriel A. Mouchawar ,  J. Christopher Moulder ,  Andre Walker

IPC分类号： A61N1/39

CPC分类号： A61N1/3931 ,  A61N1/3621 ,  A61N2001/083

摘要： An implanted cardioverter defibrillator (ICD) delivers an electrical therapy signal to the heart of a patient. When ventricular fibrillation or another condition of the heart requiring high voltage therapy is sensed, the therapy signal is delivered to the heart. When a partial short-circuit or other low impedance condition occurs, an over-current protection circuit will stop delivery of a shocking pulse. The ICD will then reduce the voltage of the shocking pulse and try again to deliver electrical therapy. This process is repeated until a voltage level is found that is able to deliver the electrical therapy without causing an over-voltage condition. Alternate lead configurations may also be tried in an attempt to find a signal path that is not affected by the low impedance or short-circuit condition.

摘要翻译： 植入式心律转复除颤器（ICD）向患者的心脏递送电疗治疗信号。 当心室纤维性颤动或需要高压治疗的心脏的另一种情况被感测时，治疗信号传递到心脏。 当发生部分短路或其他低阻抗情况时，过电流保护电路将停止输送震动脉冲。 然后，ICD将降低冲击脉冲的电压，然后再次进行电疗治疗。 重复该过程，直到发现能够递送电疗而不引起过电压状况的电压电平。 也可以尝试替代引线配置来尝试找到不受低阻抗或短路条件影响的信号路径。

公开(公告)号：US07747320B1

公开(公告)日：2010-06-29

申请号：US11433541

申请日：2006-05-12

申请人： Mark W. Kroll ,  Gabriel A. Mouchawar ,  J. Christopher Moulder ,  Andre Walker

发明人： Mark W. Kroll ,  Gabriel A. Mouchawar ,  J. Christopher Moulder ,  Andre Walker

IPC分类号： A61N1/00

CPC分类号： A61N1/3931 ,  A61N1/3621 ,  A61N2001/083

摘要： An implanted cardioverter defibrillator (ICD) delivers an electrical therapy signal to the heart of a patient. When ventricular fibrillation or another condition of the heart requiring high voltage therapy is sensed, the therapy signal is delivered to the heart. When a partial short-circuit or other low impedance condition occurs, an over-current protection circuit will stop delivery of a shocking pulse. The ICD will then reduce the voltage of the shocking pulse and try again to deliver electrical therapy. This process is repeated until a voltage level is found that is able to deliver the electrical therapy without causing an over-voltage condition. Alternate lead configurations may also be tried in an attempt to find a signal path that is not affected by the low impedance or short-circuit condition.

摘要翻译： 植入式心律转复除颤器（ICD）向患者的心脏递送电疗治疗信号。 当心室纤维性颤动或需要高压治疗的心脏的另一种情况被感测时，治疗信号传递到心脏。 当发生部分短路或其他低阻抗情况时，过电流保护电路将停止输送震动脉冲。 然后，ICD将降低冲击脉冲的电压，然后再次进行电疗治疗。 重复该过程，直到发现能够递送电疗而不引起过电压状况的电压电平。 也可以尝试替代引线配置来尝试找到不受低阻抗或短路条件影响的信号路径。

公开(公告)号：US06636083B1

公开(公告)日：2003-10-21

申请号：US09970630

申请日：2001-10-03

申请人： Louis Wong ,  Shohan Hossain ,  Andre Walker

发明人： Louis Wong ,  Shohan Hossain ,  Andre Walker

IPC分类号： H03K500

CPC分类号： G11C27/026 ,  H03F1/02 ,  H03F3/005 ,  H03F2200/331

摘要： An active feedback loop is provided in a switched-capacitor circuit to automatically cancel both junction and sub-Vth channel leakage. Low power consumption that is crucial for implantable medical devices is achieved. The circuit technique largely minimizes the effective leakage current when the switch is turned off. This circuit technique of the invention can be used in many different circuit applications.

摘要翻译： 在开关电容电路中提供有源反馈回路，以自动消除结和子Vth通道泄漏。 实现了对植入式医疗设备至关重要的低功耗。 当开关断开时，电路技术大大减少了有效的漏电流。 本发明的该电路技术可用于许多不同的电路应用中。