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公开(公告)号：US09055917B2
公开(公告)日：2015-06-16
申请号：US11208416
申请日：2005-08-19
申请人： Brian Mann , James S. Whiting , Neal L. Eigler
发明人： Brian Mann , James S. Whiting , Neal L. Eigler
CPC分类号： A61N1/36564 , A61B5/021 , A61B5/02108 , A61B5/0215 , A61B5/4839 , A61B5/6882 , A61B2560/0209 , A61N1/3627 , A61N1/37247 , G06F19/00 , G06F19/3418 , G06F19/3456 , G06F19/3481 , G16H40/63
摘要： A method of treating cardiovascular disease in a medical patient is provided. The method includes the steps of generating a sensor signal indicative of a fluid pressure within the left atrium of the patient's heart, and delivering an electrical stimulus to a location in the heart. The electrical stimulus is delivered based at least in part on the sensor signal. The method also includes the steps of generating a processor output indicative of a treatment to a signaling device. The processor output is based at least in part on the sensor signal. At least two treatment signals are provided to the medical patient. The treatment signals are distinguishable from one another by the patient, and are indicative of a therapeutic treatment. The treatment signals are based at least in part on the processor output.
摘要翻译： 提供了一种在医疗患者中治疗心血管疾病的方法。 该方法包括以下步骤：产生指示患者心脏的左心房内的流体压力的传感器信号，以及将电刺激递送到心脏中的位置。 至少部分地基于传感器信号传送电刺激。 该方法还包括以下步骤：产生指示对信号装置的处理的处理器输出。 处理器输出至少部分地基于传感器信号。 向医疗病人提供至少两个治疗信号。 治疗信号可由患者彼此区分，并且指示治疗性治疗。 治疗信号至少部分地基于处理器输出。
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公开(公告)号：US08480594B2
公开(公告)日：2013-07-09
申请号：US11542386
申请日：2006-10-03
申请人： Neal L. Eigler , James S. Whiting
发明人： Neal L. Eigler , James S. Whiting
IPC分类号： A61B5/02
CPC分类号： A61B5/0215 , A61B5/4839 , A61B5/6882 , A61B2560/0209 , A61N1/3627 , A61N1/36564 , G06F19/00
摘要： The invention provides improved apparatus and methods for treating congestive heart failure in a medical patient. The apparatus includes a pressure transducer permanently implantable within the left atrium of the patient's heart and operable to generate electrical signals indicative of fluid pressures within the patient's left atrium. The pressure transducer is connected to a flexible electrical lead, which is connected in turn to electrical circuitry, which in the preferred embodiment includes digital circuitry for processing electrical signals. The electrical circuitry processes the electrical signals from the pressure transducer and, based at least in part on those signals, generates a signal that indicates a desired therapeutic treatment for treating the patient's condition. That signal is then communicated to the patient via a patient signaling device, following which the patient administers to him or herself the prescribed therapeutic treatment indicated by the signal.
摘要翻译： 本发明提供用于治疗医疗患者的充血性心力衰竭的改进的装置和方法。 该装置包括可永久植入患者心脏的左心房内的压力换能器，并可操作以产生指示患者左心房内的流体压力的电信号。 压力传感器连接到柔性电引线，其依次连接到电路，其在优选实施例中包括用于处理电信号的数字电路。 电路处理来自压力传感器的电信号，并且至少部分地基于这些信号产生指示用于治疗患者状况的期望治疗治疗的信号。 然后，该信号经由患者信号装置传送给患者，随后患者向他或她自己施加由信号指示的规定的治疗治疗。
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公开(公告)号：US08142363B1
公开(公告)日：2012-03-27
申请号：US11776225
申请日：2007-07-11
申请人： Neal L. Eigler , James S. Whiting , Brian M. Mann , Werner Hafelfinger , Xiangqun Chen , Phong D. Doan
发明人： Neal L. Eigler , James S. Whiting , Brian M. Mann , Werner Hafelfinger , Xiangqun Chen , Phong D. Doan
CPC分类号： A61B5/042 , A61B5/0215 , A61B5/0468 , A61B5/686 , A61B5/6882 , A61B5/6885 , A61B2562/0247 , A61N1/056 , A61N1/36564
摘要： Embodiments include a cardiac rhythm management system having a lead that includes an omni-directional pressure sensor that is configured to resist tissue in-growth and provide reliable and consistent pressure readings from within a patient's vasculature. Embodiments of the cardiac rhythm management lead may also include a variety of pacing and shocking electrodes.
摘要翻译： 实施例包括具有引线的心律管理系统，其包括全向压力传感器，其被配置为抵抗组织生长并且提供来自患者脉管系统内的可靠且一致的压力读数。 心律管理引线的实施例还可以包括各种起搏和震动电极。
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4.发明申请公开(公告)号：US20120046528A1
公开(公告)日：2012-02-23
申请号：US12857914
申请日：2010-08-17
申请人： Neal L. Eigler , James S. Whiting , Brian M. Mann
发明人： Neal L. Eigler , James S. Whiting , Brian M. Mann
CPC分类号： A61B5/0538 , A61B5/021
摘要： A system for detecting and treating congestive heart failure includes an implantable module, such as a pacemaker, and a patient advisory module. The system is configured to measure thoracic impedance and to provide the patient with instructions in order to improve the accuracy of the thoracic impedance measurement as well as treating symptoms of congestive heart failure.
摘要翻译： 用于检测和治疗充血性心力衰竭的系统包括诸如起搏器的可植入模块和患者咨询模块。 该系统被配置为测量胸部阻抗并向患者提供指令，以便提高胸部阻抗测量的准确性以及治疗充血性心力衰竭的症状。
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5.发明授权System and method for estimating cardiac pressure using parameters derived from impedance signals detected by an implantable medical device 有权使用由可植入医疗装置检测的阻抗信号导出的参数来估计心脏压力的系统和方法公开(公告)号：US07794404B1
公开(公告)日：2010-09-14
申请号：US11559235
申请日：2006-11-13
IPC分类号： A61B5/02
CPC分类号： A61B5/053 , A61B5/021 , A61B5/6846
摘要： Techniques are provided for estimating left atrial pressure (LAP) or other cardiac pressure parameters based on various parameters derived from impedance signals. In particular, effective LAP is estimated based on one or more of: electrical conductance values, cardiogenic pulse amplitudes, circadian rhythm pulse amplitudes, or signal morphology fractionation values, each derived from the impedance signals detected by the implantable device. Predetermined conversion factors stored within the device are used to convert the various parameters derived from the electrical impedance signal into LAP values or other appropriate cardiac pressure values. The conversion factors may be, for example, slope and baseline values derived during an initial calibration procedure performed by an external system, such as an external programmer. In some examples, the slope and baseline values may be periodically re-calibrated by the implantable device itself.
摘要翻译： 提供了基于从阻抗信号导出的各种参数来估计左心房压力（LAP）或其他心脏压力参数的技术。 特别地，基于以下中的一个或多个估计有效的LAP：电导值，心源性脉搏幅度，昼夜节奏脉搏幅度或信号形态分级值，每个来自由可植入装置检测的阻抗信号。 存储在装置内的预定转换因子用于将从电阻抗信号导出的各种参数转换为LAP值或其他适当的心脏压力值。 转换因子可以是例如由外部系统（诸如外部编程器）执行的初始校准过程期间导出的斜率和基线值。 在一些示例中，可以通过可植入装置本身周期性地重新校准斜率和基线值。
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公开(公告)号：US07483743B2
公开(公告)日：2009-01-27
申请号：US10698031
申请日：2003-10-29
申请人： Brian Mann , James S. Whiting , Neal L. Eigler
发明人： Brian Mann , James S. Whiting , Neal L. Eigler
IPC分类号： A61N1/362
CPC分类号： A61N1/36564 , A61B5/021 , A61B5/02108 , A61B5/0215 , A61B5/4839 , A61B5/6882 , A61B2560/0209 , A61N1/3627 , A61N1/37247 , G06F19/00 , G06F19/3418 , G06F19/3456 , G06F19/3481 , G16H40/63
摘要： An apparatus for treating cardiovascular disease in a medical patient includes one or more sensors, an implantable housing, at least one implantable lead, a signal processor, and a signaling device. The sensor is operable to generate a sensor signal indicative of fluid pressure within the left atrium of the heart. The implantable housing includes a cardiac rhythm management apparatus, such as a pacemaker or a defibrillator. The cardiac rhythm management apparatus includes an electrode, which is operable to deliver an electrical stimulus to a location in the heart. The electrical stimulus is delivered based at least in part on the sensor signal. The lead is coupled to the implantable housing, and to the electrode. The signal processor is operable to generate a processor output indicative of a treatment, and is based at least in part on the sensor signal.
摘要翻译： 用于治疗医疗患者心血管疾病的装置包括一个或多个传感器，可植入壳体，至少一个可植入引线，信号处理器和信号装置。 传感器可操作以产生指示心脏左心房内的流体压力的传感器信号。 可植入的壳体包括诸如起搏器或除颤器的心律管理装置。 心律管理装置包括电极，其可操作以将电刺激递送到心脏中的位置。 至少部分地基于传感器信号传送电刺激。 引线耦合到可植入的壳体和电极。 信号处理器可操作以产生指示治疗的处理器输出，并且至少部分地基于传感器信号。
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7.发明申请SYSTEM AND METHOD FOR CALIBRATING CARDIAC PRESSURE MEASUREMENTS DERIVED FROM SIGNALS DETECTED BY AN IMPLANTABLE MEDICAL DEVICE 有权用于校准由可植入医疗器械检测的信号衍生的心脏压力测量的系统和方法公开(公告)号：US20080262361A1
公开(公告)日：2008-10-23
申请号：US12109304
申请日：2008-04-24
IPC分类号： A61B5/0215
CPC分类号： A61B5/053 , A61B5/0215 , A61B5/6846
摘要： Various techniques are provided for calibrating and estimating left atrial pressure (LAP) using an implantable medical device, based on impedance, admittance or conductance parameters measured within a patient. In one example, default conversion factors are exploited for converting the measured parameters to estimates of LAP. The default conversion factors are derived from populations of patients. In another example, a correlation between individual conversion factors is exploited to allow for more efficient calibration. In yet another example, differences in thoracic fluid states are exploited during calibration. In still yet another example, a multiple stage calibration procedure is described, wherein both invasive and noninvasive calibration techniques are exploited. In a still further example, a therapy control procedure is provided, which exploits day time and night time impedance/admittance measurements.
摘要翻译： 提供了各种技术，用于基于在患者体内测量的阻抗，导纳或电导参数，使用可植入医疗装置校准和估计左心房压力（LAP）。 在一个示例中，利用默认转换因子将测量参数转换为LAP估计。 默认的转换因子来源于患者群体。 在另一个示例中，利用各个转换因子之间的相关性来允许更有效的校准。 在另一个例子中，在校准过程中利用了胸部流体状态的差异。 在另一个示例中，描述了多阶段校准过程，其中利用侵入性和非侵入性校准技术。 在另一个实例中，提供了一种治疗控制程序，其利用白天的时间和夜间阻抗/导纳测量。
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8.发明授权
公开(公告)号：US6157036A
公开(公告)日：2000-12-05
申请号：US205661
申请日：1998-12-02
CPC分类号： G21G1/0005 , G21G2001/0094
摘要： A system and method for eluting one or more radioisotope processing elements, such as generators and/or concentration and purification components, with a gas over eluent delivery mechanism is disclosed. The system is adapted to an elution/concentration system using two such mechanisms, one for an initial elution of one or more generators, and a second for "re-elution" of concentrated and purified radioisotope contained in a concentration subsystem. The operation of such a dual mechanism system may also be completely or partially automated. The invention also discloses a concentration subsystem containing all single-use components needed for concentration and/or purification, as a single use, self sealed, cartridge that can safely store waste eluate for safe and simple disposal.
摘要翻译： 公开了一种用于在洗脱液输送机构上用气体洗脱一种或多种放射性同位素处理元件（例如发生器和/或浓缩和净化组分）的系统和方法。 该系统适用于使用两个这样的机制的洗脱/浓缩系统，一个用于一个或多个发生器的初始洗脱，另一个用于浓缩子系统中所含的浓缩和纯化的放射性同位素的“再洗脱”。 这种双机制系统的操作也可以完全或部分地自动化。 本发明还公开了一种浓缩子系统，其包含用于浓缩和/或纯化所需的所有一次性成分，作为单次使用，自密封的，可安全地储存废弃洗脱液以便安全和简单处理的药筒。
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公开(公告)号：US5457728A
公开(公告)日：1995-10-10
申请号：US771015
申请日：1991-09-30
申请人： James S. Whiting , Neal L. Eigler
发明人： James S. Whiting , Neal L. Eigler
CPC分类号： A61B6/481 , A61B6/504 , G06T7/004 , G06T7/20 , G06T7/2033 , H04N5/3205 , H04N5/325 , H05G1/60 , G06T2207/30101
摘要： A method of displaying details of a coronary artery lesion in a cineangiogram, by adjusting each frame of the cineangiogram so that the lesion is continually displayed at a fixed location on a display. The remaining cardiac anatomy appears to move, in background, past a stationary arterial segment, thus making the displayed arterial segment easier to identify and to examine by medical personnel. Cineangiographic image frames are digitized and processed by a processor and the image frames are digitally shifted to place the arterial segment in substantially the same viewing location in each frame. Sequential image frames may be presented to the viewer as a stereoscopic pair, to produce pseudostereopsis. The arterial segment appears to the viewer in foreground, as if it was floating in front of the remaining cardiac anatomy. Image frames may be further processed to aid examination by medical personnel. The processor may make quantitative measurements of the cineangiogram and may display results of those measurements to aid review of the cineangiogram. Frames may be averaged to reduce quantum noise and to blur any structure noise; frames may be compared with prior cineangiograms to increase clarity or contrast. Coordinate adjustments for a cineangiogram may help guide therapeutic procedures, or may help enhance other imaging procedures such as fluoroscopy.
摘要翻译： 通过调整每一帧电影照相图，使病变在显示器上的固定位置不断显示，显示电影照相中的冠状动脉病变的细节的方法。 剩余的心脏解剖似乎在背景中移动通过静止的动脉段，从而使得显示的动脉段更容易识别和由医务人员进行检查。 血管造影图像帧由处理器数字化和处理，并且图像帧被数字移位以将动脉段在每个帧中基本上相同的观察位置。 顺序图像帧可以作为立体对呈现给观看者，以产生伪造图。 动脉段在前景中出现在观察者身上，好像它悬浮在剩下的心脏解剖结构的前面。 可以进一步处理图像帧以帮助医务人员进行检查。 处理器可以对电影图像进行定量测量，并且可以显示那些测量结果以帮助检查电影照相。 可以对帧进行平均以减少量子噪声并模糊任何结构噪声; 可以将帧与先前的电影显像进行比较以增加清晰度或对比度。 电影照相机的坐标调整可能有助于指导治疗过程，或可能有助于增强其他成像过程，如荧光透视。
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公开(公告)号：US20110054405A1
公开(公告)日：2011-03-03
申请号：US12552199
申请日：2009-09-01
IPC分类号： A61B17/34
CPC分类号： A61B17/3462 , A61B17/3439 , A61M39/0613
摘要： A hemostasis valve is disclosed herein. The hemostasis valve may include an inner bushing, a rotation sleeve, an elastomeric sleeve, and a biasing element. The rotation sleeve may extend about the inner bushing and be rotationally displaceable relative to the inner bushing. The elastomeric sleeve may include a first end operably coupled to the inner bushing, a second end operably coupled to the rotation sleeve, and an iris valve portion. Rotation of the rotation sleeve relative to the inner bushing may cause the iris valve to transition from an open state to a closed state. The biasing element may act between the rotation sleeve and inner bushing to bias the iris valve towards at least one of a closed state or an open state.
摘要翻译： 本文公开了一种止血阀。 止血阀可以包括内衬套，旋转套筒，弹性体套筒和偏置元件。 旋转套筒可以围绕内衬套延伸并且可相对于内衬套旋转移位。 弹性体套筒可以包括可操作地联接到内衬套的第一端，可操作地联接到旋转套筒的第二端和可变光阀部分。 旋转套筒相对于内衬套的旋转可能导致虹膜阀从打开状态转换到关闭状态。 偏置元件可以在旋转套筒和内衬套之间作用，以将虹膜阀朝向关闭状态或打开状态中的至少一个偏压。
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