公开(公告)号：US08965490B2

公开(公告)日：2015-02-24

申请号：US13829650

申请日：2013-03-14

申请人： Kichang Lee ,  Brian J. Wenzel ,  Jin Jiang ,  Stephen P. Hanlon

发明人： Kichang Lee ,  Brian J. Wenzel ,  Jin Jiang ,  Stephen P. Hanlon

IPC分类号： A61B5/0452 ,  A61B8/08 ,  A61B5/06 ,  A61B5/04 ,  A61B5/0456 ,  A61B8/12

CPC分类号： A61B34/20 ,  A61B5/026 ,  A61B5/04012 ,  A61B5/0456 ,  A61B5/061 ,  A61B5/065 ,  A61B8/06 ,  A61B8/0841 ,  A61B8/12 ,  A61B8/488 ,  A61B2034/2063

摘要： Described herein are systems, devices and methods to increase the accuracy of intravascular catheter placement, and to improve electrocardiogram (ECG), intravascular electrogram, and ultrasound Doppler signal processing to detect the Superior Vena Cava (SVC) area. Embodiments of the invention are intended to place an intravascular catheter within the lower ⅓ of SVC to the junction of the SVC and the right atrium (RA)—called the cavoatrial junction (CAJ). In particular, the improved accuracy of CAJ location detection during an intravascular catheter placement can be provided by optimization of ECG parameters and ultrasound Doppler signal using Neuro-Fuzzy logic and/or other processing techniques.

摘要翻译： 本文描述了提高血管内导管放置准确度以及改善心电图（ECG），血管内电描记图和超声多普勒信号处理以检测上腔静脉（SVC）区域的系统，装置和方法。 本发明的实施例旨在将SVC的下1/3中的血管内导管置于SVC和右心房（RA）的接合处，使呼吸腔连接处（CAJ）。 特别地，可以通过使用神经 - 模糊逻辑和/或其他处理技术优化ECG参数和超声多普勒信号来提供血管内导管放置期间CAJ位置检测的改进的准确度。

公开(公告)号：US08380303B2

公开(公告)日：2013-02-19

申请号：US13035793

申请日：2011-02-25

申请人： Stuart Rosenberg ,  Cecilia Q. Xi ,  Yelena Nabutovsky ,  Brian J. Wenzel ,  Jong Gill ,  William Hsu

发明人： Stuart Rosenberg ,  Cecilia Q. Xi ,  Yelena Nabutovsky ,  Brian J. Wenzel ,  Jong Gill ,  William Hsu

IPC分类号： A61N1/00

CPC分类号： A61B5/0538 ,  A61B5/686 ,  A61N1/36507 ,  A61N1/36521 ,  A61N1/36592 ,  A61N1/3684

摘要： Techniques are provided for use with implantable medical devices for addressing encapsulation effects, particularly in the detection of cardiac decompensation events such as heart failure (HF) or cardiogenic pulmonary edema (PE.) In one example, during an acute interval following device implant, cardiac decompensation is detected using heart rate variability (HRV), ventricular evoked response (ER) or various other non-impedance-based parameters that are insensitive to component encapsulation effects. During the subsequent chronic interval, decompensation is detected using intracardiac or transthoracic impedance signals. In another example, the degree of maturation of encapsulation of implanted components is assessed using impedance frequency-response measurements or based on the frequency bandwidth of heart sounds or other physiological signals. In this manner, impedance-based HF/PE detection systems can be activated as soon as component encapsulation has matured, without necessarily waiting until completion of a preset post-implant maturation interval, often set to forty-five days or more.

摘要翻译： 提供技术用于可植入医疗装置，用于解决封装效应，特别是在心脏代偿失调事件如心力衰竭（HF）或心源性肺水肿（PE）的检测中。在一个实例中，在装置植入后的急性期间，心脏 使用心率变异性（HRV），心室诱发反应（ER）或对组件封装效应不敏感的各种其他基于非阻抗的参数来检测代偿失调。 在随后的慢性间隔期间，使用心内或经胸阻抗信号检测代偿失调。 在另一示例中，使用阻抗频率响应测量值或基于心脏声音或其他生理信号的频率带宽来评估植入部件的封装的成熟程度。 以这种方式，一旦组件封装已经成熟，就可以激活基于阻抗的HF / PE检测系统，而不必等待直到完成植入后成熟间隔的预设，通常设置为四十五天或更长时间。

公开(公告)号：US07047078B2

公开(公告)日：2006-05-16

申请号：US10662055

申请日：2003-09-12

申请人： Joseph W. Boggs, II ,  Brian J. Wenzel ,  Kenneth J. Gustafson ,  Warren M. Grill

发明人： Joseph W. Boggs, II ,  Brian J. Wenzel ,  Kenneth J. Gustafson ,  Warren M. Grill

IPC分类号： A61N1/36

CPC分类号： A61N1/36196 ,  A61N1/36007 ,  A61N1/37247

摘要： Systems and methods control physiological functions of the urinary tract using at least one electrode sized and configured to be located on, in, or near a targeted component of the pudendal nerve. The systems and methods apply an electrical signal to the electrode at a selected frequency to stimulate the targeted component. The selected frequency is a first frequency or range of frequencies for achieving a first physiologic response (e.g., controlling urinary continence) and a second frequency or range of frequencies, different than the first frequency, for achieving a second physiologic response different than the first physiologic response (e.g., controlling micturition).

摘要翻译： 系统和方法使用至少一个电极来控制泌尿道的生理功能，所述至少一个电极的尺寸和构型设置成位于阴部神经的目标成分中，附近或其附近。 系统和方法以选定的频率将电信号施加到电极以刺激目标成分。 所选择的频率是用于实现与第一生理学不同的第一生理反应（例如，控制尿路）和频率不同于第一频率的第二频率或频率范围的第一频率或频率范围 反应（例如控制排尿）。

公开(公告)号：US06675029B2

公开(公告)日：2004-01-06

申请号：US10183660

申请日：2002-06-25

申请人： Stephen L. Monfre ,  Timothy L. Ruchti ,  Thomas B. Blank ,  Brian J. Wenzel

发明人： Stephen L. Monfre ,  Timothy L. Ruchti ,  Thomas B. Blank ,  Brian J. Wenzel

IPC分类号： A61B500

CPC分类号： A61B5/444 ,  A61B5/0062 ,  A61B5/0075 ,  A61B5/1075 ,  A61B5/14532 ,  A61B5/1455 ,  A61B5/7264 ,  G01N21/3554 ,  G01N21/359 ,  G01N21/4785 ,  G01N21/49 ,  G01N2201/129

摘要： An apparatus and method for non-destructively estimating a tissue property, such as hydration, of a living subject utilizes in vivo spectral measurements made by irradiating skin tissue with near infrared (NIR) light. The apparatus includes a spectroscopic instrument in conjunction with a subject interface. The resulting spectra are passed to an analyzer for further processing, which includes detecting and eliminating invalid spectral measurements, and preprocessing to increase the signal-to-noise ratio. Finally, an estimation model developed from an exemplary set of measurements is applied to predict the tissue hydration for the sample. The method of tissue hydration measurement provides additional information about primary sources of systematic tissue variability, namely, the water content of the epidermal layer of skin and the penetration depth of the incident light. Tissue hydration measurement is therefore suitable for further spectral analysis and quantification of biological and chemical compounds, such as analytes.

摘要翻译： 用于非破坏性地估计活体受试者的组织性质（例如水合）的装置和方法利用通过用近红外（NIR）光照射皮肤组织进行的体内光谱测量。 该装置包括结合主体界面的光谱仪器。 所得到的光谱被传递到分析器以用于进一步处理，其包括检测和消除无效光谱测量以及预处理以增加信噪比。 最后，应用从示例性测量集合开发的估计模型来预测样品的组织水合。 组织水合测量的方法提供关于系统组织变异性的主要来源的附加信息，即皮肤表皮层的水含量和入射光的穿透深度。 因此，组织水合测量适用于生物和化学化合物（如分析物）的进一步光谱分析和定量。

公开(公告)号：US06668181B2

公开(公告)日：2003-12-23

申请号：US10161197

申请日：2002-05-31

申请人： Brian J. Wenzel ,  Stephen L. Monfre ,  Timothy L. Ruchti ,  Ken Meissner ,  Frank Grochocki ,  Thomas Blank ,  Jessica Rennert

发明人： Brian J. Wenzel ,  Stephen L. Monfre ,  Timothy L. Ruchti ,  Ken Meissner ,  Frank Grochocki ,  Thomas Blank ,  Jessica Rennert

IPC分类号： A61B500

CPC分类号： A61B5/441 ,  A61B5/0075 ,  A61B5/1075 ,  A61B5/14532 ,  A61B5/1455 ,  A61B5/1495 ,  A61B5/7264 ,  A61B2560/0223 ,  A61B2560/0233 ,  G01N21/274 ,  G01N21/359 ,  G01N21/4785 ,  G01N21/49

摘要： An apparatus and method for non-invasively quantifying the hydration of the stratum corneum of a living subject utilizes in vivo spectral measurements made by irradiating skin tissue with near infrared (NIR) light. The apparatus includes a spectroscopic instrument in conjunction with a subject interface. The resulting NIR absorption spectra are passed to an analyzer for further processing, which includes detecting and eliminating invalid spectral measurements, and preprocessing to increase the signal-to-noise ratio. Finally, a calibration model developed from an exemplary set of measurements is applied to predict the SC hydration for the sample. The method of SC hydration measurement provides additional information about primary sources of systematic tissue variability, namely, the water content of the epidermal layer of skin and the penetration depth of the incident light. The stratum corneum hydration measurement is therefore suitable for further spectral analysis and the quantification of biological and chemical compounds, such as blood analytes.

公开(公告)号：US08295918B2

公开(公告)日：2012-10-23

申请号：US13035773

申请日：2011-02-25

申请人： Stuart Rosenberg ,  Cecilia Q. Xi ,  Yelena Nabutovsky ,  Brian J. Wenzel ,  Jong Gill ,  William Hsu

发明人： Stuart Rosenberg ,  Cecilia Q. Xi ,  Yelena Nabutovsky ,  Brian J. Wenzel ,  Jong Gill ,  William Hsu

IPC分类号： A61B5/04

CPC分类号： A61N1/3627 ,  A61N1/3702 ,  A61N1/372

摘要： Techniques are provided for use with implantable medical devices for addressing encapsulation effects, particularly in the detection of cardiac decompensation events such as heart failure (HF) or cardiogenic pulmonary edema (PE.) In one example, during an acute interval following device implant, cardiac decompensation is detected using heart rate variability (HRV), ventricular evoked response (ER) or various other non-impedance-based parameters that are insensitive to component encapsulation effects. During the subsequent chronic interval, decompensation is detected using intracardiac or transthoracic impedance signals. In another example, the degree of maturation of encapsulation of implanted components is assessed using impedance frequency-response measurements or based on the frequency bandwidth of heart sounds or other physiological signals. In this manner, impedance-based HF/PE detection systems can be activated as soon as component encapsulation has matured, without necessarily waiting until completion of a preset post-implant maturation interval, often set to forty-five days or more.

摘要翻译： 提供技术用于可植入医疗装置，用于解决封装效应，特别是在心脏代偿失调事件如心力衰竭（HF）或心源性肺水肿（PE）的检测中。在一个实例中，在装置植入后的急性期间，心脏 使用心率变异性（HRV），心室诱发反应（ER）或对组件封装效应不敏感的各种其他基于非阻抗的参数来检测代偿失调。 在随后的慢性间隔期间，使用心内或经胸阻抗信号检测代偿失调。 在另一示例中，使用阻抗频率响应测量值或基于心脏声音或其他生理信号的频率带宽来评估植入部件的封装的成熟程度。 以这种方式，一旦组件封装已经成熟，就可以激活基于阻抗的HF / PE检测系统，而不必等待直到完成植入后成熟间隔的预设，通常设置为四十五天或更长时间。

公开(公告)号：US08649865B2

公开(公告)日：2014-02-11

申请号：US12964625

申请日：2010-12-09

申请人： Gene A. Bornzin ,  Wenbo Hou ,  Edward Karst ,  Brian J. Wenzel ,  Timothy A Fayram

发明人： Gene A. Bornzin ,  Wenbo Hou ,  Edward Karst ,  Brian J. Wenzel ,  Timothy A Fayram

IPC分类号： A61N1/00

CPC分类号： A61N1/36585 ,  A61B5/02416 ,  A61B5/726 ,  A61N1/3627 ,  A61N1/36564 ,  A61N1/3684 ,  A61N1/3686

摘要： Time delays between a feature of a signal indicative of electrical activity of a patient's heart and a feature of a plethysmograph signal indicative of changes in arterial blood volume are used to arrange the operation of an implantable device, such as a pacemaker. Shorter time delays between the feature of the signal indicative of electrical activity of a patient's heart and the feature of the plethysmograph signal indicative of changes in arterial blood volume are indicative of larger cardiac stroke volumes. The time delay can be used to select a pacing site or combination of pacing sites and/or to select a pacing interval set.

摘要翻译： 使用指示患者心脏的电活动的信号的特征与指示动脉血容量变化的体积描记信号的特征之间的时间延迟来布置诸如起搏器的可植入装置的操作。 指示患者心脏的电活动的信号的特征与指示动脉血容量变化的体积描记器信号的特征之间的更短的时间延迟指示较大的心脏搏动量。 时间延迟可用于选择起搏站点或起搏站点的组合和/或选择起搏间隔集。

公开(公告)号：US08092386B1

公开(公告)日：2012-01-10

申请号：US11615591

申请日：2006-12-22

申请人： Brian J. Wenzel ,  Taraneh Ghaffari Farazi

发明人： Brian J. Wenzel ,  Taraneh Ghaffari Farazi

IPC分类号： A61B5/00

CPC分类号： A61B5/14532 ,  A61B5/0031 ,  A61B5/01 ,  A61B5/02055 ,  A61B5/021 ,  A61B5/024 ,  A61B5/14551 ,  A61B5/1459 ,  A61B5/4839 ,  A61M5/14276 ,  A61N1/36557

摘要： In an implantable medical device for monitoring blood-glucose concentration in the blood, metabolic oxygen consumption is derived by measuring physiological metrics related to mixed venous oxygen concentration. Blood-glucose concentration is determined using correlations of blood-glucose concentration with measures of metabolic oxygen consumption including oxymetric, temperature, and electrocardiographic data. Additional physiological sensor measurements may be used to enhance the accuracy of the analysis of blood-glucose concentration. By using a combination of oxymetric and other physiological metrics, blood-glucose concentration can be reliably calculated over a wide range. The device compares the blood-glucose concentration with upper and lower acceptable bounds and generates appropriate warning signals if the concentration falls outside the bounds. The device may also control a therapeutic device to maintain blood-glucose concentration within an acceptable range. A calibration technique determines patient-specific parameters for use in the calculation of blood-glucose concentration.

摘要翻译： 在用于监测血液中血糖浓度的可植入医疗装置中，通过测量与混合静脉血浓度相关的生理指标，可得出代谢氧消耗。 使用血糖浓度与代谢氧消耗量的相关性（包括氧测量，温度和心电图数据）来确定血糖浓度。 可以使用额外的生理传感器测量来提高血糖浓度分析的准确性。 通过使用氧化度和其他生理指标的组合，可以在宽范围内可靠地计算血糖浓度。 该装置将血糖浓度与上限和下限可接受的范围进行比较，如果浓度超出界限，则产生适当的警告信号。 该装置还可以控制治疗装置以将血糖浓度维持在可接受的范围内。 校准技术确定用于计算血糖浓度的患者特异性参数。

公开(公告)号：US20110144711A1

公开(公告)日：2011-06-16

申请号：US12964625

申请日：2010-12-09

申请人： Gene A. Bornzin ,  Wenbo Hou ,  Edward Karst ,  Brian J. Wenzel ,  Timothy A. Fayram

发明人： Gene A. Bornzin ,  Wenbo Hou ,  Edward Karst ,  Brian J. Wenzel ,  Timothy A. Fayram

IPC分类号： A61N1/36

CPC分类号： A61N1/36585 ,  A61B5/02416 ,  A61B5/726 ,  A61N1/3627 ,  A61N1/36564 ,  A61N1/3684 ,  A61N1/3686

摘要： Time delays between a feature of a signal indicative of electrical activity of a patient's heart and a feature of a plethysmograph signal indicative of changes in arterial blood volume are used to arrange the operation of an implantable device, such as a pacemaker. Shorter time delays between the feature of the signal indicative of electrical activity of a patient's heart and the feature of the plethysmograph signal indicative of changes in arterial blood volume are indicative of larger cardiac stroke volumes. The time delay can be used to select a pacing site or combination of pacing sites and/or to select a pacing interval set.

摘要翻译： 使用指示患者心脏的电活动的信号的特征与指示动脉血容量变化的体积描记信号的特征之间的时间延迟来布置诸如起搏器的可植入装置的操作。 指示患者心脏的电活动的信号的特征与指示动脉血容量变化的体积描记器信号的特征之间的更短的时间延迟指示较大的心脏搏动量。 时间延迟可用于选择起搏站点或起搏站点的组合和/或选择起搏间隔集。

公开(公告)号：US20090326603A1

公开(公告)日：2009-12-31

申请号：US12490611

申请日：2009-06-24

申请人： Joseph W. BOGGS, II ,  Brian J. Wenzel ,  Kenneth J. Gustafson ,  Warren M. Grill

发明人： Joseph W. BOGGS, II ,  Brian J. Wenzel ,  Kenneth J. Gustafson ,  Warren M. Grill

IPC分类号： A61N1/36

CPC分类号： A61N1/36196 ,  A61N1/36007 ,  A61N1/37247

摘要： Apparatus to control physiological functions, including urinary track physiological functions are described. The apparatus includes an electrode(s) configured to be placed on or in a targeted component of a pudendal nerve and to stimulate the targeted pudendal nerve pudendal. The targeted component of the pudendal nerve includes a pudendal nerve urethral afferent, and afferent nerve fibers in the deep perineal nerve. The apparatus includes a controller coupled to the electrode to apply an electrical signal having an amplitude and a selected frequency chosen to stimulate the targeted component. The controller operates in a first mode to apply a first frequency without substantially changing the amplitude for achieving a first physiologic response and the controller operates in a second mode to apply a second frequency, different than the first frequency, for achieving a second physiologic response different than the first physiologic response.

摘要翻译： 描述了用于控制生理功能的装置，包括尿道生理功能。 该装置包括构造成放置在阴部神经的目标部件上或其中的电极，并刺激目标阴部神经阴部。 阴部神经的目标成分包括阴部神经尿道传入和深会阴神经中的传入神经纤维。 该装置包括耦合到电极的控制器，以施加具有选择的振幅和选定频率的电信号，以刺激目标成分。 控制器以第一模式操作以施加第一频率而基本上不改变振幅以实现第一生理响应，并且控制器以第二模式操作以施加与第一频率不同的第二频率，以实现不同于第二频率的第二生理响应 比第一次生理反应。