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公开(公告)号：US08744597B2
公开(公告)日：2014-06-03
申请号：US11810967
申请日：2007-06-07
申请人： Gary W. King , Kevin K. Tidemand , Wilbert A. Wesselink , Gabriela C. Miyazawa , Jordan J. Greenberg
发明人： Gary W. King , Kevin K. Tidemand , Wilbert A. Wesselink , Gabriela C. Miyazawa , Jordan J. Greenberg
IPC分类号： A61N1/05
CPC分类号： A61N1/37247 , A61N1/0529 , A61N1/0534 , A61N1/0553 , A61N1/36185 , G06F19/00 , G06F19/3481 , G16H40/63
摘要： Techniques for selecting electrode combinations for stimulation therapy include delivering stimulation via each of at least two electrode combination classes during a therapy evaluation period. A first one of the classes comprises one or more electrode combinations that include electrodes within one or two columns of an implantable array of electrodes. The array may include at least three electrode columns. A second one of the classes comprises one or more electrode combinations that include electrodes within at least three electrode columns of the implantable array of electrodes. A preferred one of the electrode combination classes for a patient, and/or a number of leads to implant within the patient, may by selected based on feedback collected from the patient during the therapy evaluation period.
摘要翻译： 用于选择用于刺激治疗的电极组合的技术包括在治疗评价期间通过至少两个电极组合类别中的每一个递送刺激。 这些类别中的第一个包括一个或多个电极组合，其包括在可植入的电极阵列的一列或两列内的电极。 阵列可以包括至少三个电极柱。 第二类包括一个或多个电极组合，其包括在可植入电极阵列的至少三个电极列内的电极。 可以通过基于在治疗评估期间从患者收集的反馈来选择用于患者的电极组合类别中的优选的一个，和/或患者内的植入物的数量。
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2.发明授权公开(公告)号：US08538523B2
公开(公告)日：2013-09-17
申请号：US13616300
申请日：2012-09-14
申请人： John L. Sommer , David Wayne Bourn , Mark T. Marshall , Michael D. Eggen , Gabriela C. Miyazawa
发明人： John L. Sommer , David Wayne Bourn , Mark T. Marshall , Michael D. Eggen , Gabriela C. Miyazawa
IPC分类号： A61N1/365
CPC分类号： A61N1/36514 , A61N1/056 , A61N1/36114 , A61N1/36185 , A61N1/3684 , A61N1/3686 , A61N2001/0585
摘要： A medical system comprises a plurality of electrodes; at least one sensor configured to output at least one signal based on at least one physiological parameter of a patient; and a processor. The processor is configured to control delivery of stimulation to the patient using a plurality of electrode configurations. Each of the electrode configurations comprises at least one of the plurality of electrodes. For each of the electrode configurations, the processor is configured to determine a first response of target tissue to the stimulation based on the signals, and a second response of non-target tissue to the stimulation based on the signals. The processor is also configured to select at least one of the electrode configurations for delivery of stimulation to the patient based on the first and second responses for the electrode configurations. As examples, the target tissue may be a left ventricle or vagus nerve.
摘要翻译： 医疗系统包括多个电极; 至少一个传感器被配置为基于患者的至少一个生理参数输出至少一个信号; 和处理器。 处理器被配置为使用多个电极配置来控制对患者的刺激递送。 每个电极配置包括多个电极中的至少一个。 对于每个电极配置，处理器被配置为基于信号来确定目标组织对刺激的第一响应，以及基于该信号来确定非目标组织对刺激的第二响应。 处理器还被配置为基于电极配置的第一和第二响应来选择用于将刺激递送到患者的电极配置中的至少一个。 作为示例，靶组织可以是左心室或迷走神经。
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公开(公告)号：US20090192556A1
公开(公告)日：2009-07-30
申请号：US12238105
申请日：2008-09-25
CPC分类号： A61B5/4812 , A61B5/0031 , A61B5/01 , A61B5/02055 , A61B5/024 , A61B5/04014 , A61B5/04015 , A61B5/0402 , A61B5/0478 , A61B5/048 , A61B5/1116 , A61B5/1118 , A61B5/4082 , A61B5/4839 , A61M5/1723 , A61M21/02 , A61M2005/1726 , A61M2021/0072 , A61M2205/3523 , A61M2205/3553 , A61M2205/3584 , A61M2205/3592 , A61M2205/50 , A61M2205/52 , A61M2230/005 , A61M2230/04 , A61M2230/08 , A61M2230/10 , A61M2230/205 , A61M2230/30 , A61M2230/42 , A61M2230/50 , A61M2230/60 , A61M2230/63 , A61M2230/65 , A61N1/36078 , A61N1/36139 , G06F19/3481 , G16H40/63
摘要： Therapy delivery to a patient may be controlled based on a determined sleep stage of the patient. In examples, the sleep stage may be determined based on a frequency characteristic of a biosignal indicative of brain activity of the patient. A frequency characteristic may include, for example, a power level within one or more frequency bands of the biosignal, a ratio of the power level in two or more frequency bands, or a pattern in the power level of one or more frequency bands over time. A therapy program may be selected or modified based on the sleep stage determination. Therapy may be delivered during the sleep stage according to the selected or modified therapy program. In some examples, therapy delivery may be controlled after making separate determinations of a sleep stage based on the biosignal and another physiological parameter, and confirming that the sleep stage determinations are consistent.
摘要翻译： 可以基于患者的确定的睡眠阶段来控制对患者的治疗递送。 在实施例中，睡眠阶段可以基于指示患者的大脑活动的生物信号的频率特性来确定。 频率特性可以包括例如生物信号的一个或多个频带内的功率电平，两个或更多个频带中的功率电平的比率，或者一个或多个频带的功率电平中的模式随时间的变化 。 可以基于睡眠阶段确定来选择或修改治疗程序。 根据所选择或修改的治疗方案，治疗可以在睡眠阶段期间递送。 在一些实例中，可以在基于生物信号和另一生理参数进行睡眠阶段的单独测定以及确认睡眠阶段确定是一致的之后控制治疗递送。
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公开(公告)号：US20090054936A1
公开(公告)日：2009-02-26
申请号：US12195287
申请日：2008-08-20
CPC分类号： A61N1/056 , A61N1/05 , A61N1/0534 , A61N1/0551 , A61N2001/0585
摘要： This disclosure describes implantable medical leads that include a lead body and an electrode. A width of the electrode as measured along a longitudinal direction of the lead varies about the perimeter of the lead. The uneven width of the electrode may bias a stimulation field in a particular direction, e.g., a radial or transverse direction relative to the longitudinal axis of the lead. Electrodes with an uneven width may be useful for controlling the direction of propagation of the stimulation field in order to, for example, avoid phrenic nerve stimulation during LV pacing or neck muscle stimulation during vagal neurostimulation.
摘要翻译： 本公开描述了包括引线体和电极的可植入医疗引线。 沿着铅的纵向测量的电极的宽度围绕导线的周边变化。 电极的不均匀宽度可以相对于引线的纵向轴线在特定方向（例如，径向或横向）偏置刺激场。 具有不均匀宽度的电极可用于控制刺激场的传播方向，以便例如在迷走神经刺激期间在LV起搏或颈部肌肉刺激期间避免膈神经刺激。
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公开(公告)号：US20080046036A1
公开(公告)日：2008-02-21
申请号：US11810943
申请日：2007-06-07
IPC分类号： A61N1/32
CPC分类号： A61N1/37247 , A61N1/0529 , A61N1/0534 , A61N1/0553 , A61N1/36185 , G06F19/00 , G06F19/3481 , G16H40/63
摘要： Techniques for selecting electrode combinations for stimulation therapy include delivering stimulation via each of at least five combination groups. A first group of electrode combinations is characterized by the presence of a caudal anode. A second group of electrode combinations is characterized by the presence of a rostral anode. A third group of electrode combinations is characterized by the presence of a single anode above and a single anode below the cathode(s) of the combination. A fourth group of electrode combinations is characterized by the presence of multiple anodes above and below the cathode(s) of the combination. A fifth group of electrode combinations is characterized by the presence of transverse anodes. A sixth group of electrode combination is characterized by at least one off-center cathode. One or more preferred electrode combinations groups, and/or a number of leads to implant within the patient, may by selected based on patient feedback.
摘要翻译： 用于选择用于刺激治疗的电极组合的技术包括通过至少五个组合组中的每一个递送刺激。 第一组电极组合的特征在于尾部阳极的存在。 第二组电极组合的特征在于存在罗氏阳极。 第三组电极组合的特征在于在组合的阴极下方存在单个阳极和单个阳极。 第四组电极组合的特征在于在组合的阴极上方和下方存在多个阳极。 第五组电极组合的特征在于存在横向阳极。 第六组电极组合的特征在于至少一个偏心阴极。 可以通过基于患者反馈来选择一个或多个优选的电极组合组和/或在患者体内植入的多个引线。
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公开(公告)号：US20070225674A1
公开(公告)日：2007-09-27
申请号：US11565268
申请日：2006-11-30
申请人： Gregory F. Molnar , Gabriela C. Miyazawa , Keith A. Miesel , Jonathan C. Werder , David L. Carlson , Jonathon E. Giftakis
发明人： Gregory F. Molnar , Gabriela C. Miyazawa , Keith A. Miesel , Jonathan C. Werder , David L. Carlson , Jonathon E. Giftakis
CPC分类号： A61N1/36067 , A61B5/048 , A61B5/4082 , A61N1/36003
摘要： A method, apparatus, and system for treating patients suffering from movement disorders having the ability to determine one or more biomarkers indicative of a disease state. In some embodiments, the biomarker may be used as a closed-loop feedback signal to control the delivery of therapy (such as electrical stimulation or drug therapy), and which may also be used as an indication of therapy effectiveness. One embodiment uses electrodes placed in the brain to measure EEG or local field potential (LFP) signals, from which the one or more biomarkers may be determined.
摘要翻译： 用于治疗患有运动障碍的患者的方法，装置和系统，其具有确定指示疾病状态的一种或多种生物标志物的能力。 在一些实施方案中，生物标志物可以用作闭环反馈信号以控制治疗的递送（例如电刺激或药物治疗），并且其也可以用作治疗有效性的指示。 一个实施例使用放置在脑中的电极来测量EEG或局部场电位（LFP）信号，从该信号可以确定一个或多个生物标志物。
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公开(公告)号：US08190251B2
公开(公告)日：2012-05-29
申请号：US11565268
申请日：2006-11-30
申请人： Gregory F. Molnar , Gabriela C. Miyazawa , Keith A. Miesel , Jonathan C. Werder , David L. Carlson , Jonathon E. Giftakis
发明人： Gregory F. Molnar , Gabriela C. Miyazawa , Keith A. Miesel , Jonathan C. Werder , David L. Carlson , Jonathon E. Giftakis
IPC分类号： A61B5/04
CPC分类号： A61N1/36067 , A61B5/048 , A61B5/4082 , A61N1/36003
摘要： A method, apparatus, and system for treating patients suffering from movement disorders having the ability to determine one or more biomarkers indicative of a disease state. In some embodiments, the biomarker may be used as a closed-loop feedback signal to control the delivery of therapy (such as electrical stimulation or drug therapy), and which may also be used as an indication of therapy effectiveness. One embodiment uses electrodes placed in the brain to measure EEG or local field potential (LFP) signals, from which the one or more biomarkers may be determined.
摘要翻译： 用于治疗患有运动障碍的患者的方法，装置和系统，其具有确定指示疾病状态的一种或多种生物标志物的能力。 在一些实施方案中，生物标志物可以用作闭环反馈信号以控制治疗的递送（例如电刺激或药物治疗），并且其也可以用作治疗有效性的指示。 一个实施例使用放置在脑中的电极来测量EEG或局部场电位（LFP）信号，从该信号可以确定一个或多个生物标志物。
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公开(公告)号：US20090112281A1
公开(公告)日：2009-04-30
申请号：US12133999
申请日：2008-06-05
IPC分类号： A61N1/08
CPC分类号： A61N1/36071 , A61B5/048 , A61B5/7257
摘要： The invention is directed to techniques and systems in which external brain monitoring is used to facilitate implantation and configuration of an implantable medical device. The techniques may create an open loop or closed loop system in which brain signals quantify the efficacy of electrical logical stimulation (or drug therapy via an implantable drug pump) at locations outside of the brain. The techniques may be used to improve placement of leads and electrodes during an implantation procedure, and/or to select or adjust stimulation parameters either during the implantation procedure or possibly following implantation of an implantable medical device. The described techniques have applications for the alleviation of pain, but may find other applications where EEG signals can quantify the efficacy of treatment via an implantable medical device.
摘要翻译： 本发明涉及使用外部脑部监测来促进可植入医疗装置的植入和构造的技术和系统。 这些技术可以产生开环或闭环系统，其中脑信号定量在脑外部位置的电逻辑刺激（或通过可植入药物泵的药物治疗）的功效。 这些技术可以用于在植入过程期间改善引线和电极的放置，和/或在植入过程期间或可能在植入可植入医疗器械之后选择或调整刺激参数。 所描述的技术具有减轻疼痛的应用，但是可以找到其他应用，其中EEG信号可以通过可植入医疗装置量化治疗的功效。
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公开(公告)号：US08666506B2
公开(公告)日：2014-03-04
申请号：US11810941
申请日：2007-06-07
申请人： Gary W. King , Steven M. Goetz , Kevin K. Tidemand , Wilbert A. Wesselink , Gabriela C. Miyazawa , Jordan J. Greenberg
发明人： Gary W. King , Steven M. Goetz , Kevin K. Tidemand , Wilbert A. Wesselink , Gabriela C. Miyazawa , Jordan J. Greenberg
IPC分类号： A61N1/05
CPC分类号： A61N1/37247 , A61N1/0529 , A61N1/0534 , A61N1/0553 , A61N1/36185 , G06F19/00 , G06F19/3481 , G16H40/63
摘要： Techniques for selecting electrode combinations for stimulation therapy are described. The techniques include selecting one or more electrode combinations based on information associating a plurality of electrode combinations with at least one value of a therapy metric. The therapy metric comprises a quantifiable result of delivery of stimulation, and may be generated computer modeling of delivery of stimulation via the electrode combinations. In one embodiment, a clinician may deliver stimulation via a baseline electrode combination, receive patient feedback to the baseline electrode combination, select a therapy metric based on the patient feedback, and select additional electrode combinations based on the selected therapy metric and the information associating the electrode combinations with therapy metric values. In another embodiment, the clinician may select a therapy metric prior to providing a test stimulation and select additional electrode combinations based on the selected therapy metric and the information associating electrode combinations with metric values.
摘要翻译： 描述了用于选择用于刺激治疗的电极组合的技术。 所述技术包括基于将多个电极组合与治疗度量的至少一个值相关联的信息来选择一个或多个电极组合。 治疗指标包括刺激递送的可量化结果，并且可以产生经由电极组合递送刺激的计算机建模。 在一个实施例中，临床医生可以经由基线电极组合递送刺激，将患者反馈接收到基线电极组合，基于患者反馈选择治疗度量，并且基于所选择的治疗度量选择附加电极组合，并且将关于 电极组合与治疗度量值。 在另一个实施例中，临床医生可以在提供测试刺激之前选择治疗度量，并且基于所选择的治疗度量和将电极组合与度量值相关联的信息来选择附加电极组合。
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公开(公告)号：US08295943B2
公开(公告)日：2012-10-23
申请号：US12195287
申请日：2008-08-20
IPC分类号： A61N1/05
CPC分类号： A61N1/056 , A61N1/05 , A61N1/0534 , A61N1/0551 , A61N2001/0585
摘要： This disclosure describes implantable medical leads that include a lead body and an electrode. A width of the electrode as measured along a longitudinal direction of the lead varies about the perimeter of the lead. The uneven width of the electrode may bias a stimulation field in a particular direction, e.g., a radial or transverse direction relative to the longitudinal axis of the lead. Electrodes with an uneven width may be useful for controlling the direction of propagation of the stimulation field in order to, for example, avoid phrenic nerve stimulation during LV pacing or neck muscle stimulation during vagal neurostimulation.
摘要翻译： 本公开描述了包括引线体和电极的可植入医疗引线。 沿着铅的纵向测量的电极的宽度围绕导线的周边变化。 电极的不均匀宽度可以相对于引线的纵向轴线在特定方向（例如，径向或横向）偏置刺激场。 具有不均匀宽度的电极可用于控制刺激场的传播方向，以便例如在迷走神经刺激期间在LV起搏或颈部肌肉刺激期间避免膈神经刺激。
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