公开(公告)号：US07272433B2

公开(公告)日：2007-09-18

申请号：US10136785

申请日：2002-04-30

申请人： Kenneth M. Riff ,  Gregory J. Linden ,  James E. Willenbring

发明人： Kenneth M. Riff ,  Gregory J. Linden ,  James E. Willenbring

IPC分类号： A61B5/02 ,  A61N1/18

CPC分类号： A61N1/37235 ,  A61B5/0031 ,  A61B2560/0271 ,  A61M5/14216 ,  A61M5/14244 ,  A61M5/14248 ,  A61M5/1723 ,  A61M37/0092 ,  A61M2005/14208 ,  A61M2005/14268 ,  A61M2205/3523 ,  A61N1/08 ,  A61N1/30 ,  A61N1/3702 ,  A61N1/37217 ,  A61N1/37258 ,  A61N1/37288 ,  G06F19/00 ,  G06F19/3456 ,  G06F19/3481 ,  G16H40/63

摘要： An external physiologic or implanted device monitor/controller (“monitor”) designed to be attached to the body, as for example, to the skin of the patient. The monitor is designed to detect the therapeutic outputs actually produced by the implanted medical device. Having knowledge of the operation of the implanted medical device, the monitor may then deduce, or decode, the physiologic conditions and/or devices conditions sensed by the implanted medical device. The monitor is then able to perform an action appropriate to the sensed condition and the specific implementation.

摘要翻译： 外部生理或植入的设备监视器/控制器（“监视器”）被设计成附接到身体，例如，附接到患者的皮肤。 该监视器设计用于检测由植入式医疗设备实际产生的治疗输出。 了解植入式医疗装置的操作后，监视器可以推断或解码由植入的医疗装置感测到的生理条件和/或装置状况。 监视器然后能够执行适合于感测状况和具体实现的动作。

公开(公告)号：US06529771B1

公开(公告)日：2003-03-04

申请号：US09723004

申请日：2000-11-27

申请人： Robert S. Kieval ,  Kenneth M. Riff

发明人： Robert S. Kieval ,  Kenneth M. Riff

IPC分类号： A61B50402

CPC分类号： A61B5/024 ,  A61B5/222 ,  A61N1/3627 ,  A61N1/36514 ,  A61N1/3702 ,  G06F19/00

摘要： An implantable medical device determines activity levels and Heart Rate and from a combination of these produces a value for a heart rate activity coefficient (HRAC). This value has significant diagnostic and patient tracking value. Methods and apparatus for determining this HRAC value are described. This enables physician review of patient cardiac status. Additional physiologic data can be recorded along with the HRAC data if desired, and this too, as well as the HRAC data alone, may be reported out from the implanted device to a medical communications system for alarm purposes, titrating drugs/therapies or other monitoring tasks. Further, substitutes for heart rate measurements and activity measurements are described which can be used to augment or substitute for heart rate measurements and activity measurements. These substitutes should represent cardiovascular or cardiac responsiveness to substitute for heart rate in the HRAC signal; and should represent cardiac demand to substitute for activity in the HRAC signal.

摘要翻译： 可植入医疗设备确定活动水平和心率，并且从这些组合产生心率活动系数（HRAC）的值。 该值具有重要的诊断和患者跟踪价值。 描述用于确定该HRAC值的方法和装置。 这使得医师可以检查患者的心脏状态。 如果需要，还可以连同HRAC数据一起记录额外的生理数据，并且这也可以将HRAC数据单独从植入装置报告给用于报警的医疗通信系统，滴定药物/治疗或其他监测 任务。 此外，描述了可用于增加或代替心率测量和活动测量的心率测量和活动测量的替代。 这些替代物应代表心血管或心脏反应性来代替HRAC信号中的心率; 并应代表心脏需求来替代HRAC信号中的活动。

公开(公告)号：US5351696A

公开(公告)日：1994-10-04

申请号：US52359

申请日：1993-04-23

申请人： Kenneth M. Riff ,  Ray S. McDonald ,  Michael J. German

发明人： Kenneth M. Riff ,  Ray S. McDonald ,  Michael J. German

IPC分类号： A61N1/37 ,  A61N1/39 ,  A61B5/0452

CPC分类号： A61N1/371 ,  A61N1/3962

摘要： A method and apparatus for morphologic analysis of an electrical signal, implementable in an implantable device such as a pacemaker, cardioverter, defibrillator or the like. The morphologic analysis uses a phase plane representation of the signal, where the signal and its first derivative are plotted along orthogonal axes. A magnitude signal corresponding to the magnitude component of the trajectory of the phase plane representation is generated and applied to a comparator. The comparator produces an activation signal when the magnitude signal exceeds a predetermined threshold. In response to the activation signal, a quadrant detector selectively applies the magnitude signal to one of four integrators, the selection of one integrator over the others being based at all times upon which quadrant of the phase plane the trajectory is in. When the magnitude decreases below a predetermined threshold, the activation signal is deasserted, whereupon the respective outputs from the four integrators may be interpreted as reflecting of the trajectory of the phase plane representation of the signal. In operation, a particular cardiac event to be detected is induced in a patient, and the resultant phase plane signals are examined to determine particular aspects of the phase plane signals which can be used as an indication that the particular event has occurred. The apparatus is then conditioned to recognize such aspects in subsequent phase plane signals, in order to provide an indication when such aspects are again present in the signals.

摘要翻译： 一种用于电信号形态学分析的方法和装置，可实现在诸如起搏器，心律转复器，除颤器等的可植入装置中。 形态分析使用信号的相平面表示，其中信号及其一阶导数沿正交轴绘制。 产生对应于相平面表示的轨迹的幅度分量的幅度信号并将其应用于比较器。 当幅度信号超过预定阈值时，比较器产生激活信号。 为了响应于激活信号，象限检测器选择性地将幅度信号施加到四个积分器中的一个，一个积分器的选择在所有时间上基于轨迹所在的相平面的哪个象限。当幅度减小时 低于预定阈值时，激活信号被解除无效，因此来自四个积分器的相应输出可以被解释为反映信号的相位平面表示的轨迹。 在操作中，在患者中诱发要检测的特定心脏事件，并检查所得的相平面信号以确定可用作特定事件已发生的指示的相平面信号的特定方面。 然后将装置调节为在随后的相平面信号中识别这些方面，以便当这些方面再次存在于信号中时提供指示。

公开(公告)号：US08961505B2

公开(公告)日：2015-02-24

申请号：US13337877

申请日：2011-12-27

申请人： Kenneth M. Riff

发明人： Kenneth M. Riff

IPC分类号： A61B18/04

CPC分类号： A61N1/3925 ,  A61B5/0402 ,  A61B5/686 ,  A61B5/7217 ,  A61B5/725 ,  A61B18/16 ,  A61B2018/00595 ,  A61B2018/00601 ,  A61N1/3605 ,  A61N1/362 ,  A61N1/3718

摘要： A device includes a plurality of electrodes and a detection module. The plurality of electrodes are configured to acquire an electrical signal in a patient. The detection module is configured to determine whether the acquired electrical signal includes signal content in each of N different frequency bands and detect operation of an electrosurgical device on the patient based on how many of the N different frequency bands include signal content. N is an integer that is greater than 1.

摘要翻译： 一种装置包括多个电极和检测模块。 多个电极被配置为获取患者中的电信号。 所述检测模块被配置为基于所述N个不同频带中的多个所述信号内容来确定所获取的电信号是否包括在N个不同频带中的每一个中的信号内容，并且检测所述患者的电外科设备的操作。 N是大于1的整数。

公开(公告)号：US20120109238A1

公开(公告)日：2012-05-03

申请号：US12915863

申请日：2010-10-29

申请人： Amisha S. Patel ,  Luc R. Mongeon ,  Kenneth M. Riff

发明人： Amisha S. Patel ,  Luc R. Mongeon ,  Kenneth M. Riff

IPC分类号： A61N1/08 ,  A61N1/362 ,  A61N1/39

CPC分类号： A61N1/37252 ,  A61N1/37288 ,  G16H40/63

摘要： A system includes a data retrieval module and a determination module. The data retrieval module receives a command from a user, the command indicating a first implantable medical device (IMD) and a second IMD. The data retrieval module also retrieves a first set of data from the first IMD in response to the command and retrieves a second set of data from a datastore. The second set of data includes data retrieved from the first IMD and stored in the datastore prior to receiving the command. The determination module determines a third set of data based on the first and second sets of data and transfers the third set of data to the second IMD.

摘要翻译： 系统包括数据检索模块和确定模块。 数据检索模块从用户接收命令，指示第一可植入医疗装置（IMD）和第二IMD。 数据检索模块还响应于命令从第一IMD检索第一组数据，并从数据存储区检索第二组数据。 第二组数据包括在接收命令之前从第一IMD检索并存储在数据存储中的数据。 确定模块基于第一和第二组数据确定第三组数据，并将第三组数据传送到第二IMD。

公开(公告)号：US5312453A

公开(公告)日：1994-05-17

申请号：US880877

申请日：1992-05-11

申请人： Michael B. Shelton ,  William J. Combs ,  Tommy D. Bennett ,  Michael R. Tollinger ,  Kenneth M. Riff

发明人： Michael B. Shelton ,  William J. Combs ,  Tommy D. Bennett ,  Michael R. Tollinger ,  Kenneth M. Riff

IPC分类号： A61N1/365 ,  A61N1/372 ,  A61N1/00

CPC分类号： A61N1/36514

摘要： A rate-responsive cardiac pacemaker in which deceleration of the pacing rate is modulated according to recent patient activity or "work". Based on signals provided from an activity sensor in the pacemaker, the pacemaker maintains and periodically recomputes a work value corresponding to the amount of patient activity detected over time. In response to a decrease in or cessation of detected patient activity, the pacemaker reduces the pacing rate, first at a more rapid deceleration rate, then at a lower deceleration rate, and then once again at a more rapid deceleration rate. The length of time during which the pacing rate is reduced at the lower deceleration rate is modulated according to the work value maintained by the pacemaker. The work-modulated pacing rate deceleration occurs only if certain achievement criteria are met, the achievement criteria being specified in terms of the amount of time the pacemaker's target pacing rate exceeds a predetermines rest value, and the difference between the target rate and the rest rate.

摘要翻译： 根据最近的患者活动或“工作”调节起搏速度的减速的速率响应心脏起搏器。 基于由起搏器中的活动传感器提供的信号，起搏器维持并周期性地重新计算与随时间检测的患者活动量相对应的工作值。 响应于检测到的患者活动的减少或停止，起搏器降低起搏速率，首先以更快的减速率，然后以较低的减速率，然后再次以更快的减速率。 以较低的减速率降低起搏速度的时间长短根据起搏器保持的工作值进行调制。 工作调节的起搏速度减速仅在满足某些成就标准的情况下发生，成就标准是根据起搏器的目标起搏速度超过预定值的时间量指定的，目标速率与休息率之间的差异 。

公开(公告)号：US20130165918A1

公开(公告)日：2013-06-27

申请号：US13337877

申请日：2011-12-27

申请人： Kenneth M. Riff

发明人： Kenneth M. Riff

IPC分类号： A61B18/16

CPC分类号： A61N1/3925 ,  A61B5/0402 ,  A61B5/686 ,  A61B5/7217 ,  A61B5/725 ,  A61B18/16 ,  A61B2018/00595 ,  A61B2018/00601 ,  A61N1/3605 ,  A61N1/362 ,  A61N1/3718

摘要： A device includes a plurality of electrodes and a detection module. The plurality of electrodes are configured to acquire an electrical signal in a patient. The detection module is configured to determine whether the acquired electrical signal includes signal content in each of N different frequency bands and detect operation of an electrosurgical device on the patient based on how many of the N different frequency bands include signal content. N is an integer that is greater than 1.

摘要翻译： 一种装置包括多个电极和检测模块。 多个电极被配置为获取患者中的电信号。 所述检测模块被配置为基于所述N个不同频带中的多个所述信号内容来确定所获取的电信号是否包括在N个不同频带中的每一个中的信号内容，并且检测所述患者的电外科设备的操作。 N是大于1的整数。

公开(公告)号：US06190324B1

公开(公告)日：2001-02-20

申请号：US09301206

申请日：1999-04-28

申请人： Robert S. Kieval ,  Kenneth M. Riff

发明人： Robert S. Kieval ,  Kenneth M. Riff

IPC分类号： A61B504

CPC分类号： A61B5/024 ,  A61B5/222 ,  A61N1/3627 ,  A61N1/36514 ,  A61N1/3702 ,  G06F19/00

摘要： An implantable medical device determines activity levels and Heart Rate and from a combination of these produces a value for a heart rate activity coefficient (HRAC). This value has significant diagnostic and patient tracking value. Methods and apparatus for determining this HRAC value are described. This enables physician review of patient cardiac status. Additional physiologic data can be recorded along with the HRAC data if desired, and this too, as well as the HRAC data alone, may be reported out from the implanted device to a medical communications system for alarm purposes, titrating drugs/therapies or other monitoring tasks. Further, substitutes for heart rate measurements and activity measurements are described which can be used to augment or substitute for heart rate measurements and activity measurements. These substitutes should represent cardiovascular or cardiac responsiveness to substitute for heart rate in the HRAC signal; and should represent cardiac demand to substitute for activity in the HRAC signal.

摘要翻译： 可植入医疗设备确定活动水平和心率，并且从这些组合产生心率活动系数（HRAC）的值。 该值具有重要的诊断和患者跟踪价值。 描述用于确定该HRAC值的方法和装置。 这使得医师可以检查患者的心脏状态。 如果需要，还可以连同HRAC数据一起记录额外的生理数据，并且这也可以将HRAC数据单独从植入装置报告给用于报警的医疗通信系统，滴定药物/治疗或其他监测 任务。 此外，描述了可用于增加或代替心率测量和活动测量的心率测量和活动测量的替代。 这些替代物应代表心血管或心脏反应性来代替HRAC信号中的心率; 并应代表心脏需求来替代HRAC信号中的活动。

公开(公告)号：US5876353A

公开(公告)日：1999-03-02

申请号：US792204

申请日：1997-01-31

申请人： Kenneth M. Riff

发明人： Kenneth M. Riff

IPC分类号： A61B5/053 ,  A61B5/08 ,  A61N1/362 ,  A61N1/37 ,  A61N1/06

CPC分类号： A61B5/4878 ,  A61B5/0535 ,  A61B5/0537 ,  A61B5/0809 ,  A61N1/3702 ,  A61N1/3627

摘要： An impedance monitor for discerning edema through evaluation of respiratory rate. Preferred embodiment includes edema monitor and trigger to initiate diagnostic reporting or corrective action when activated. Recording of Long Term Average and Short Term Average values for secondary edema measure based on DC signal level are described as are methods and apparatus for removing unwanted recurring noise.

公开(公告)号：US5441525A

公开(公告)日：1995-08-15

申请号：US246903

申请日：1994-05-20

申请人： Michael B. Shelton ,  Kenneth M. Riff ,  Michael F. Hess

发明人： Michael B. Shelton ,  Kenneth M. Riff ,  Michael F. Hess

IPC分类号： A61N1/365 ,  A61N1/36

CPC分类号： A61N1/36514 ,  A61N1/365

摘要： A rate-responsive cardiac pacemaker implements a novel scheme which detects incipient vasovagal syncope (or other episodes caused by a vasodepressive or cardioinhibitory disorder) when a) the heart rate drops below a programmable minimum size, and b) the rate after said drop is below a programmable maximum drop ending rate. The pacemaker implements a stability and intervention procedure upon the detection of an episode, in which it ignores transient drops in rate, and paces at a predetermined high rate if the drops are stable. The pacemaker then gradually reduces the pacing rate over a predetermined time to the pre-episodic level. A sleep disable feature disables the vasovagal syncope detection and therapy features during the patient's sleeping hours to reduce or eliminate false positive responses.

摘要翻译： 速率响应心脏起搏器实施一种新颖的方案，其检测初期的血管迷走性晕厥（或由血管抑郁或心脏抑制障碍引起的其他发作），当a）心率下降到可编程的最小尺寸以下时，b）所述下降之后的速率低于 可编程的最大下降结束率。 起搏器在检测到发作时实现稳定性和干预程序，其中它忽略了速率的瞬时下降，并且如果液滴是稳定的，起搏器以预定的高速度步进。 然后，起搏器逐渐将起搏速度在预定时间内降低到事件发生前的水平。 睡眠禁用功能在患者睡眠时间内禁用血管迷走性晕厥检测和治疗功能，以减少或消除假阳性反应。