公开(公告)号：US07623914B1

公开(公告)日：2009-11-24

申请号：US11104240

申请日：2005-04-11

申请人： Dean Andersen ,  Cem Shaquer

发明人： Dean Andersen ,  Cem Shaquer

IPC分类号： A61N1/00

CPC分类号： A61N1/372 ,  A61B2560/0209 ,  A61N1/025 ,  A61N1/3622 ,  A61N1/37276 ,  A61N1/3962 ,  G06F1/3203 ,  G06F19/00 ,  G06F19/3418 ,  G16H40/63

摘要： An implantable medical device (IMD) is provided. The IMD comprises a sense circuit, a main processing unit coupled to the sense circuit, a memory unit coupled to the main processing unit, and a reconfigurable processor unit coupled to the memory unit and the main processing unit. The reconfigurable processor unit is adapted to receive data, perform a processing function on the data, and return processed data to the memory unit. The memory unit is adapted to store the processed data. The main processing unit is adapted to execute programmed instructions and selectively reconfigure the processing function of the reconfigurable processor unit in response to one of the programmed instructions. Such a configuration can be used to implement a method of efficiently processing data in an IMD.

摘要翻译： 提供可植入医疗器械（IMD）。 IMD包括感测电路，耦合到感测电路的主处理单元，耦合到主处理单元的存储单元和耦合到存储器单元和主处理单元的可重配置处理器单元。 可重配置处理器单元适于接收数据，对数据执行处理功能，并将处理后的数据返回到存储单元。 存储器单元适于存储经处理的数据。 主处理单元适于执行编程指令，并且响应于编程指令中的一个选择性地重新配置可重配置处理器单元的处理功能。 这样的配置可以用于实现在IMD中有效处理数据的方法。

公开(公告)号：US20090264783A1

公开(公告)日：2009-10-22

申请号：US12106043

申请日：2008-04-18

申请人： Cecilia Qin Xi ,  Cem Shaquer

发明人： Cecilia Qin Xi ,  Cem Shaquer

IPC分类号： A61B5/0456

CPC分类号： A61B5/046

摘要： Methods and systems described herein are especially useful wherein monitoring for atrial fibrillation (AF) is based on RR interval variability as measured from an electrocardiogram (ECG) signal. An activity threshold, which can be patient specific, is obtained. Patient activity is monitored. Based on the monitored patient activity and the activity threshold, there is a determination of when it is likely that AF monitoring based on RR interval variability is adversely affected by patient activity. When it has been determined that it is likely that AF monitoring based on RR interval variability is adversely affected by patient activity, whether and/or how AF monitoring is performed is modified.

摘要翻译： 本文所述的方法和系统特别有用，其中监测心房颤动（AF）是基于从心电图（ECG）信号测量的RR间期变异性。 获得可以是患者特异性的活动阈值。 监测患者活动。 根据监测的患者活动和活动阈值，确定何时可能基于RR间期差异的AF监测受到患者活动的不利影响。 当确定可能基于RR间期变异性的AF监测受到患者活动的不利影响时，是否修改和/或如何进行AF监视。

公开(公告)号：US09161817B2

公开(公告)日：2015-10-20

申请号：US12751843

申请日：2010-03-31

申请人： Eric S. Olson ,  John A. Hauck ,  Nicholas A. Patronik ,  Mark B. Kirschenman ,  Cem Shaquer ,  Yusof Ganji

发明人： Eric S. Olson ,  John A. Hauck ,  Nicholas A. Patronik ,  Mark B. Kirschenman ,  Cem Shaquer ,  Yusof Ganji

IPC分类号： A61B19/00 ,  A61B17/00 ,  A61M25/01

CPC分类号： A61M25/0147 ,  A61B5/042 ,  A61B34/20 ,  A61B34/25 ,  A61B34/30 ,  A61B34/37 ,  A61B34/71 ,  A61B34/76 ,  A61B34/77 ,  A61B2017/00026 ,  A61B2017/00477 ,  A61B2034/107 ,  A61B2034/301 ,  A61B2034/305 ,  A61B2034/741 ,  A61B2034/742 ,  A61B2090/064 ,  A61B2090/372 ,  A61M2205/33 ,  A61M2205/505 ,  A61M2210/125

摘要： A robotic system for manipulating a catheter with a plurality of steering wires longitudinally situated within a length of the catheter includes a user interface configured to display a view of an anatomical model and to receive one or more user inputs; a catheter manipulator assembly configured to linearly actuate one or more control members of a catheter; and a robotic controller configured to provide a view of an anatomical model to the user interface; accept one or more user inputs from the user interface; register the one or more user inputs to a coordinate system associated with the anatomical model; compute one or more actuator commands from the one or more registered inputs; and cause the catheter manipulator assembly to linearly actuate one or more control members of a catheter in accordance with the computed actuator commands.

摘要翻译： 用于操纵具有纵向位于导管的长度内的多个操纵导管的导管的机器人系统包括被配置为显示解剖模型视图并且接收一个或多个用户输入的用户界面; 导管操纵器组件，其构造成线性地致动导管的一个或多个控制构件; 以及机器人控制器，被配置为向所述用户界面提供解剖模型的视图; 从用户界面接受一个或多个用户输入; 将一个或多个用户输入注册到与解剖模型相关联的坐标系统; 从所述一个或多个注册输入计算一个或多个致动器命令; 并且使得导管操纵器组件根据所计算的致动器命令直线地致动导管的一个或多个控制构件。

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：US20110028848A1

公开(公告)日：2011-02-03

申请号：US12533307

申请日：2009-07-31

申请人： Cem Shaquer ,  John W. Sliwa ,  Zhenyi Ma ,  Jeremy D. Dando

发明人： Cem Shaquer ,  John W. Sliwa ,  Zhenyi Ma ,  Jeremy D. Dando

IPC分类号： A61B8/14

CPC分类号： A61B8/12 ,  A61B6/503 ,  A61B6/541 ,  A61B8/0883 ,  A61B8/4245 ,  A61B8/445 ,  A61B8/543 ,  A61B18/1492 ,  A61B2017/00106 ,  A61B2018/00357 ,  A61B2018/00577 ,  A61B2034/2051 ,  A61N7/022

摘要： A device for measuring a spatial location of a tissue surface, such as the interface between different types of tissues or between tissue and body fluids, generally includes an elongate catheter body having a distal end portion, a plurality of localization elements carried by the distal end portion, and at least one pulse-echo acoustic element carried by the distal end portion. The localization elements allow the catheter to be localized (e.g., position and/or orientation) within a localization field, while the acoustic element allows for the detection of tissue surfaces where incoming acoustic energy will reflect towards the acoustic element. A suitable controller can determine the location of the detected tissue surface from the localization of the distal end portion of the catheter body. Tissue thicknesses can be derived from the detected locations of multiple (e.g., near and far) tissue surfaces. Maps and models of tissue thickness can also be generated.

摘要翻译： 用于测量组织表面（例如不同类型的组织之间或组织与体液之间的界面）的空间位置的装置通常包括具有远端部分的细长导管主体，多个定位元件由远端 以及至少一个由远端部分携带的脉冲 - 回声声学元件。 定位元件允许导管在定位区域内定位（例如，位置和/或取向），而声学元件允许检测组织表面，其中传入的声能将朝向声学元件反射。 合适的控制器可以根据导管主体的远端部分的定位来确定检测到的组织表面的位置。 组织厚度可以从多个（例如，近和远）组织表面的检测位置导出。 还可以生成组织厚度的图和模型。

公开(公告)号：US20090270939A1

公开(公告)日：2009-10-29

申请号：US12207388

申请日：2008-09-09

申请人： Cem Shaquer ,  Jong Gill ,  Fujian Qu

发明人： Cem Shaquer ,  Jong Gill ,  Fujian Qu

IPC分类号： A61N1/362

CPC分类号： A61B5/046

摘要： Detection of atrial fibrillation involves detecting a plurality of ventricular events and obtaining a series of probabilities of AF, each corresponding to a probability of AF for a different beat window having a plurality of ventricular events. AF onset is detected when one or each of a plurality of consecutive AF probabilities satisfies an AF trigger threshold. AF termination is detected when one or each of a plurality of consecutive AF probabilities does not satisfy the AF trigger threshold. Upon detection of AF onset, ventricular events are processed to detect for a sudden onset of irregularity of the ventricular events. AF onset is confirmed when sudden onset is detected and overturned when sudden onset is not detected.

摘要翻译： 心房颤动的检测涉及检测多个心室事件并获得一系列AF概率，每个概率对应于具有多个心室事件的不同节拍窗口的AF概率。 当多个连续AF概率中的一个或每个满足AF触发阈值时，检测AF起始。 当多个连续AF概率中的一个或每个不满足AF触发阈值时，检测到AF终止。 在检测到AF发作时，处理心室事件以检测心室事件突然发作不规则。 当发现突然发作并且突然发现未被检测到翻转时，确定AF发作。

公开(公告)号：US09320448B2

公开(公告)日：2016-04-26

申请号：US12106043

申请日：2008-04-18

申请人： Cecilia Qin Xi ,  Cem Shaquer

发明人： Cecilia Qin Xi ,  Cem Shaquer

IPC分类号： A61B5/0456 ,  A61B5/046

CPC分类号： A61B5/046

摘要： Methods and systems described herein are especially useful wherein monitoring for atrial fibrillation (AF) is based on RR interval variability as measured from an electrocardiogram (ECG) signal. An activity threshold, which can be patient specific, is obtained. Patient activity is monitored. Based on the monitored patient activity and the activity threshold, there is a determination of when it is likely that AF monitoring based on RR interval variability is adversely affected by patient activity. When it has been determined that it is likely that AF monitoring based on RR interval variability is adversely affected by patient activity, whether and/or how AF monitoring is performed is modified.

摘要翻译： 本文所述的方法和系统特别有用，其中监测心房颤动（AF）是基于从心电图（ECG）信号测量的RR间期变异性。 获得可以是患者特异性的活动阈值。 监测患者活动。 根据监测的患者活动和活动阈值，确定何时可能基于RR间期差异的AF监测受到患者活动的不利影响。 当确定可能基于RR间期变异性的AF监测受到患者活动的不利影响时，是否修改和/或如何进行AF监视。

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：US20110152957A1

公开(公告)日：2011-06-23

申请号：US12643867

申请日：2009-12-21

申请人： Cem Shaquer

发明人： Cem Shaquer

IPC分类号： A61N1/365 ,  A61B5/046 ,  A61N1/39

CPC分类号： A61B5/046 ,  A61B5/686 ,  A61N1/3962 ,  G06K9/00536 ,  G06K9/6284

摘要： Techniques are provided for detecting atrial fibrillation (AF) based on variations in ventricular intervals detected by a pacemaker, implantable cardioverter-defibrillator (ICD) or implantable cardiac monitor (ICM). In one example, ventricular beats are detected and intervals between the ventricular beats are measured, such as RR intervals. Irregular ventricular beats are identified, including ectopic beats, bigeminal beats, and the like. The degree of variability within the ventricular intervals is then determined while excluding any intervals associated with irregular beats. AF is then detected based on the degree of variability. That is, AF is detected based on variability occurring within ventricular intervals after ectopic beats and other irregular beats have been eliminated, thus mitigating detection problems that might arise if the variability were instead calculated based on all ventricular beat intervals. Techniques are also described herein for distinguishing AF from sinus tachycardia, which can also cause a high degree of variability in RR intervals.

摘要翻译： 提供了用于基于由起搏器，可植入心律转复除颤器（ICD）或可植入心脏监测器（ICM）检测到的心室间隔变化来检测心房颤动（AF）的技术。 在一个实例中，检测心室搏动并测量心室搏动之间的间隔，例如RR间期。 确定不规则的心室搏动，包括异位搏动，小腿搏动等。 然后确定心室间隔内的变异程度，同时排除与不规则节拍相关的任何间隔。 然后根据变异程度检测AF。 也就是说，基于在异位搏动和其他不规则节拍已被消除之后的心室间隔内发生的变异性来检测AF，从而减轻如果基于所有心室搏动间隔而改变可变性而可能出现的检测问题。 本文还描述了区分AF与窦性心动过速的技术，这也可能导致RR间期的高度变异性。

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。