公开(公告)号：US08843197B2

公开(公告)日：2014-09-23

申请号：US13049774

申请日：2011-03-16

申请人： Stuart Rosenberg ,  Cecilia Qin Xi ,  Jong Gill ,  Brian Jeffrey Wenzel ,  Yelena Nabutovsky ,  William Hsu

发明人： Stuart Rosenberg ,  Cecilia Qin Xi ,  Jong Gill ,  Brian Jeffrey Wenzel ,  Yelena Nabutovsky ,  William Hsu

IPC分类号： A61N1/365 ,  A61B5/02 ,  A61B5/042 ,  A61N1/362

CPC分类号： A61N1/36585 ,  A61B5/02028 ,  A61B5/042 ,  A61N1/3627 ,  A61N1/36507 ,  A61N1/36521 ,  A61N1/36564 ,  A61N1/36578

摘要： A method for trending heart failure measures cardiogenic impedance (CI) and obtains signals representing estimates for or direct measurements of at least one of cardiac volume and pressure of the heart when the CI measurements were obtained. The method identifies correction factors based on the signals and applies the correction factors to the contractility estimates. A system for trending heart failure includes a contractility module to determine contractility estimates from CI measurements taken along at least a first vector through a heart, and a collection module to receive signals representing estimates for or direct measurements of at least one of cardiac volume and pressure of the heart when the CI measurements were obtained. The system further includes a factor module to identify correction factors based on the signals and a correction module to apply the correction factors to the contractility estimates.

摘要翻译： 用于趋势性心力衰竭的方法测量心源性阻抗（CI）并且获得当获得CI测量时表示心脏体积和心脏压力中的至少一个的估计或直接测量的信号。 该方法基于信号识别校正因子，并将修正因子应用于收缩率估计。 用于趋向心力衰竭的系统包括收缩模块，用于根据通过心脏的至少第一载体进行的CI测量来确定收缩性估计，以及收集模块，用于接收代表心脏体积和压力中的至少一个的估计或直接测量的信号 的CI测量值。 该系统还包括一个因素模块，用于基于信号识别校正因子，以及一个校正模块，以将校正因子应用于收缩性估计。

公开(公告)号：US20140005739A1

公开(公告)日：2014-01-02

申请号：US13537757

申请日：2012-06-29

申请人： Cecilia Qin Xi ,  Lanitia Ness ,  Stuart Rosenberg

发明人： Cecilia Qin Xi ,  Lanitia Ness ,  Stuart Rosenberg

IPC分类号： A61N1/365

CPC分类号： A61N1/36592 ,  A61B5/0452 ,  A61B5/046 ,  A61B5/0468 ,  A61N1/36139 ,  A61N1/36142 ,  A61N1/36185 ,  A61N1/3621 ,  A61N1/36585

摘要： Methods and systems are provided to control a configuration of a neural stimulation (NS) system having an NS device coupled to an NS lead. The methods and systems change between configurations of the NS system and collect cardiac signals from a patient that are representative of cardiac rhythms experienced by the patient over a period of time and in connection with multiple NS configurations. The methods and systems derive, from the cardiac signals, characteristic values for at least one physiologic characteristic indicative of at least one of normal and abnormal cardiac rhythms in connection with the multiple NS configurations; and select, from the multiple NS configurations, an NS operating configuration to be used by the NS system based on the characteristic values.

摘要翻译： 提供了方法和系统来控制具有与NS引线相连的NS器件的神经刺激（NS）系统的配置。 所述方法和系统在NS系统的配置之间改变，并且收集来自患者的心脏信号，所述心脏信号代表患者经历一段时间并与多个NS配置相关的心脏节律。 所述方法和系统从心脏信号中导出与多个NS构型有关的指示正常和异常心律中的至少一个的至少一个生理特征的特征值; 并从多个NS配置中选择要由NS系统基于特征值使用的NS操作配置。

公开(公告)号：US08543206B2

公开(公告)日：2013-09-24

申请号：US12823870

申请日：2010-06-25

申请人： Mihir Naware ,  Cecilia Qin Xi

发明人： Mihir Naware ,  Cecilia Qin Xi

IPC分类号： A61N1/08

CPC分类号： A61B5/0538 ,  A61N1/37 ,  A61N2001/083

摘要： Testing lead conditions in an implantable medical device includes continuously sampling the impedance values of a lead associated with the implantable medical device. The sampling is conducted over a predetermined period of time. An impedance histogram is then generated using the sampled impedance values by separating each measured impedance value into a specific bin assigned to contain a particular range of impedance levels. The lead condition of the tested lead can then be determined based on one or more characteristics of the impedance histogram.

摘要翻译： 在可植入医疗装置中测试引导条件包括连续取样与可植入医疗装置相关的引线的阻抗值。 采样在预定的时间段内进行。 然后使用采样的阻抗值，通过将每个测量的阻抗值分成分配给包含特定阻抗水平范围的特定箱体来产生阻抗直方图。 然后可以基于阻抗直方图的一个或多个特性来确定测试引线的引导条件。

公开(公告)号：US20120239104A1

公开(公告)日：2012-09-20

申请号：US13049774

申请日：2011-03-16

申请人： Stuart Rosenberg ,  Cecilia Qin Xi ,  Jong Gill ,  Brian Jeffrey Wenzel ,  Yelena Nabutovsky ,  William Hsu

发明人： Stuart Rosenberg ,  Cecilia Qin Xi ,  Jong Gill ,  Brian Jeffrey Wenzel ,  Yelena Nabutovsky ,  William Hsu

IPC分类号： A61N1/365

CPC分类号： A61N1/36585 ,  A61B5/02028 ,  A61B5/042 ,  A61N1/3627 ,  A61N1/36507 ,  A61N1/36521 ,  A61N1/36564 ,  A61N1/36578

摘要： A method is provided for trending heart failure based on heart contractility information comprises measuring cardiogenic impedance (CI) measurements along at least a first vector through a heart over a period of time. The method determines contractility estimates from the CI measurements, the contractility estimates relating to contractility of the heart. The method further obtains physiologic and/or surrogate signals representing estimates for or direct measurements of at least one of cardiac volume and pressure of the heart when the CI measurements were obtained. The method identifies correction factors based on the physiologic and/or surrogate signals and applies the correction factors to the contractility estimates to produce contractility trend values over the period of time. A system is provided for trending heart failure based on heart contractility information which comprises inputs to receive cardiogenic impedance (CI) measurements taken along at least a first vector through a heart over a period of time. The system includes a contractility module to determine contractility estimates from the CI measurements, the contractility estimates relating to contractility of the heart and a collection module to receive physiologic and/or surrogate signals representing estimates for or direct measurements of at least one of cardiac volume and pressure of the heart when the CI measurements were obtained. A factor module is also provided to identify correction factors based on the physiologic and/or surrogate signals and a correction module to apply the correction factors to the contractility estimates to produce contractility trend values over the period of time.

摘要翻译： 提供了一种基于心脏收缩性信息来趋向于心力衰竭的方法，包括在一段时间内通过心脏沿着至少第一载体测量心源阻抗（CI）测量。 该方法确定CI测量的收缩性估计值，与心脏收缩性相关的收缩性估计值。 当获得CI测量时，该方法进一步获得表示心脏体积和心脏压力中的至少一个的估计值或直接测量值的生理和/或替代信号。 该方法基于生理和/或替代信号识别校正因子，并将修正因子应用于收缩性估计以产生一段时间内的收缩趋势值。 提供了一种用于基于心脏收缩性信息来趋向心力衰竭的系统，其包括用于在一段时间内通过心脏沿着至少第一载体进行的心源阻抗（CI）测量的输入。 该系统包括收缩性模块，用于根据CI测量值确定收缩性估计值，与心脏的收缩性相关的收缩性估计值以及收集模块以接收表示心脏体积和/或心脏容积中的至少一个的估计值或/或直接测量值的生理和/或替代信号， 获得CI测量时心脏的压力。 还提供了一个因素模块，用于根据生理和/或替代信号识别校正因子，以及校正模块，以将修正因子应用于收缩性估计，以产生一段时间内的收缩趋势值。

公开(公告)号：US08249707B2

公开(公告)日：2012-08-21

申请号：US12120471

申请日：2008-05-14

申请人： Yelena Nabutovsky ,  Rafael Donnay ,  Cecilia Qin Xi

发明人： Yelena Nabutovsky ,  Rafael Donnay ,  Cecilia Qin Xi

IPC分类号： A61N1/37

CPC分类号： A61N1/3622 ,  A61N1/3624

摘要： A non-implanted system receives, from an implantable cardiac device implanted within a patient, data corresponding to detected potential episodes of tachycardia. A representation of the data corresponding to the detected potential episodes of tachycardia is displayed to a user, and the user that observes the displayed representation of the data is allowed to enter a user diagnosis for each of the detected potential episodes of tachycardia. The non-implanted system simulates how the implantable cardiac device can use its discriminators to produce device diagnoses, based on the data for the detected potential episodes of tachycardia, including how adjustments to the discriminators affect how the device diagnoses match the user diagnoses. Thereafter, the non-implanted system can reprogram the implantable cardiac device to increase a likelihood that future device diagnoses produced by the implantable cardiac device would more closely match future user diagnoses produced by the user.

摘要翻译： 非植入系统从植入在患者体内的可植入心脏装置接收对应于检测到的心动过速潜在发作的数据。 与检测到的心动过速潜在发作相对应的数据的表示被显示给用户，并且观察所显示的数据表示的用户被允许针对每个检测到的心动过速的潜在发作进入用户诊断。 非植入系统模拟植入式心脏装置如何使用其鉴别器来产生装置诊断，基于检测到的心动过速的潜在发作的数据，包括如何对辨识器的调整影响装置诊断如何匹配用户诊断。 此后，非植入系统可重新编程可植入的心脏装置以增加由可植入心脏装置产生的未来设备诊断将更紧密地匹配用户产生的未来用户诊断的可能性。

公开(公告)号：US20100312131A1

公开(公告)日：2010-12-09

申请号：US12481434

申请日：2009-06-09

申请人： Mihir Naware ,  Cecilia Qin Xi

发明人： Mihir Naware ,  Cecilia Qin Xi

IPC分类号： A61B5/046

CPC分类号： A61B5/0402 ,  A61B5/0422 ,  A61B5/046 ,  A61B5/412 ,  A61B5/7203 ,  A61B5/721

摘要： Methods and systems of noise detection and response for use when monitoring for arrhythmias are described herein. At least two electrodes are used to obtain a signal indicative of cardiac electrical activity. The signal is bandpass filtered to obtain a filtered signal. Ventricular depolarizations are monitored for based on comparisons of the filtered signal to a first threshold. Arrhythmias are monitored for based on ventricular depolarization detections that occur as a result of monitoring for ventricular depolarizations. During one or more noise detection windows, noise is monitored for and a likelihood that monitoring for arrhythmias is adversely affected by noise is determined based on results thereof. Whether and/or how the monitoring for arrhythmias is performed is modified when it is determined that monitoring for arrhythmias is likely adversely affected by noise.

摘要翻译： 本文描述了监测心律失常时使用的噪声检测和响应的方法和系统。 使用至少两个电极来获得指示心脏电活动的信号。 信号被带通滤波以获得滤波信号。 基于滤波信号与第一阈值的比较来监测心室去极化。 基于心室去极化检测的结果，监测心律失常。 在一个或多个噪声检测窗口期间，监视噪声并且基于其结果来确定对由心律失常进行监测的不利影响的可能性。 当确定对心律失常的监测可能受到噪声的不利影响时，是否和/或如何进行心律失常的监测被修改。

公开(公告)号：US20100160800A1

公开(公告)日：2010-06-24

申请号：US12340370

申请日：2008-12-19

申请人： Cecilia Qin Xi

发明人： Cecilia Qin Xi

IPC分类号： A61B5/02

CPC分类号： A61B5/0215 ,  A61N1/3622 ,  A61N1/3627 ,  A61N1/36585 ,  A61N1/3702 ,  A61N1/37282

摘要： A method of monitoring myocardial stability includes determining a window length representing an acceptable time period between potential start times associated with at least two physiologic indices and monitoring multiple physiologic indices representative of myocardial stability. Predetermined variations in each of the physiologic indices denote the potential start times and potential end times for candidate events that are indicative of myocardial instability. The method further includes identifying the potential start times associated with at least two of the physiologic indices and declaring at least one of the candidate events to be an actual event of myocardial instability based on the window length and a time period between the potential start times identified by the identifying operation.

摘要翻译： 监测心肌稳定性的方法包括确定窗口长度，其表示与至少两个生理指标相关的潜在开始时间之间的可接受时间段，并监测代表心肌稳定性的多个生理指标。 每个生理指标中的预定变化表示指示心肌不稳定性的候选事件的潜在开始时间和潜在结束时间。 该方法还包括识别与至少两个生理指标相关联的潜在开始时间，并且基于窗口长度和所识别的潜在开始时间之间的时间段，将候选事件中的至少一个宣告为心肌不稳定性的实际事件 通过识别操作。

公开(公告)号：US09119965B2

公开(公告)日：2015-09-01

申请号：US13442749

申请日：2012-04-09

申请人： Cecilia Qin Xi ,  Stuart Rosenberg

发明人： Cecilia Qin Xi ,  Stuart Rosenberg

IPC分类号： A61N1/36 ,  A61N1/39 ,  A61N1/368

CPC分类号： A61N1/36114 ,  A61N1/36139 ,  A61N1/3684 ,  A61N1/3962

摘要： Techniques are provided for controlling spinal cord stimulation (SCS) or other forms of neurostimulation. In one example, SCS treatment is delivered to a patient and nerve impulse firing signals are sensed along the spinal cord following the SCS treatment. The nerve impulse signals are analyzed to determine whether the signals are associated with effective SCS and then the delivery of additional SCS is controlled to improve SCS efficacy. For example, the nerve impulse signals can be analyzed to determine whether the signals are consistent with a positive patient mood associated with pain mitigation and, if not, SCS control parameters are adjusted to improve the efficacy of the SCS in reducing pain. In other examples, heart rate variability (HRV) is also used to control SCS. Still further, adjustments may be made to SCS control parameters to improve antiarrhythmic or sympatholytic effects associated with SCS. Techniques employing baseline/target calibration procedures are also described.

摘要翻译： 提供了用于控制脊髓刺激（SCS）或其他形式的神经刺激的技术。 在一个示例中，SCS治疗被递送给患者，并且在SCS治疗之后沿着脊髓感测神经脉冲激发信号。 分析神经脉冲信号以确定信号是否与有效的SCS相关联，然后控制附加SCS的递送以提高SCS功效。 例如，可以分析神经脉冲信号以确定信号是否与与疼痛缓解相关的阳性患者情绪一致，并且如果不是，则调整SCS控制参数以提高SCS在减轻疼痛中的功效。 在其他实例中，心率变异性（HRV）也用于控制SCS。 此外，可以调整SCS控制参数以改善与SCS相关的抗心律失常或交感神经效应。 还描述了使用基线/目标校准程序的技术。

公开(公告)号：US20130268016A1

公开(公告)日：2013-10-10

申请号：US13442749

申请日：2012-04-09

申请人： Cecilia Qin Xi ,  Stuart Rosenberg

发明人： Cecilia Qin Xi ,  Stuart Rosenberg

IPC分类号： A61N1/36 ,  A61N1/365

CPC分类号： A61N1/36114 ,  A61N1/36139 ,  A61N1/3684 ,  A61N1/3962

摘要： Techniques are provided for controlling spinal cord stimulation (SCS) or other forms of neurostimulation. In one example, SCS treatment is delivered to a patient and nerve impulse firing signals are sensed along the spinal cord following the SCS treatment. The nerve impulse signals are analyzed to determine whether the signals are associated with effective SCS and then the delivery of additional SCS is controlled to improve SCS efficacy. For example, the nerve impulse signals can be analyzed to determine whether the signals are consistent with a positive patient mood associated with pain mitigation and, if not, SCS control parameters are adjusted to improve the efficacy of the SCS in reducing pain. In other examples, heart rate variability (HPV) is also used to control SCS. Still further, adjustments may be made to SCS control parameters to improve antiarrhythmic or sympatholytic effects associated with SCS. Techniques employing baseline/target calibration procedures are also described.

摘要翻译： 提供了用于控制脊髓刺激（SCS）或其他形式的神经刺激的技术。 在一个示例中，SCS治疗被递送给患者，并且在SCS治疗之后沿着脊髓感测神经脉冲激发信号。 分析神经脉冲信号以确定信号是否与有效的SCS相关联，然后控制附加SCS的递送以提高SCS功效。 例如，可以分析神经脉冲信号以确定信号是否与与疼痛缓解相关的阳性患者情绪一致，并且如果不是，则调整SCS控制参数以提高SCS在减轻疼痛中的功效。 在其他实例中，心率变异性（HPV）也用于控制SCS。 此外，可以调整SCS控制参数以改善与SCS相关的抗心律失常或交感神经效应。 还描述了使用基线/目标校准程序的技术。

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。