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    Method of vagal stimulation to treat patients suffering from congestive heart failure
    1.
    发明授权
    Method of vagal stimulation to treat patients suffering from congestive heart failure 有权
    迷走神经刺激治疗充血性心力衰竭患者的方法

    公开(公告)号：US08457743B2

    公开(公告)日：2013-06-04

    申请号：US12807706

    申请日：2010-09-11

    申请人： Maik Gollasch ,  Eckhard Alt

    发明人： Maik Gollasch ,  Eckhard Alt

    IPC分类号： A61N1/378

    CPC分类号： A61N1/36139 ,  A61B5/0031 ,  A61B5/04012 ,  A61B5/0537 ,  A61B5/0809 ,  A61B2562/0219 ,  A61N1/36114 ,  A61N1/3627 ,  A61N1/36521

    摘要： An improved method is presented for evaluating the physiological status of a patient diagnosed with congestive heart failure and treating the patient accordingly to alleviate the congestive heart failure. As part of the method, the thoracic or cardiac impedance and ventilation of the particular patient are derived solely from an input consisting of cardiac signals (EKG) generated by electrical energy of the patient's heart as the heart is undergoing its cardiac cycle with a dynamic impedance obtained by subjecting the EKG to alternately high and low input impedances. The derived thoracic impedance and ventilation are used to control the pattern and rate at which stimulating electrical pulses are applied to the patient's vagus nerve by an implanted stimulator, in a manner to deliver therapy to the patient's heart by adjusting the heart rate to a prescribed target rate for alleviating the congestive heart failure. A change in state of the patient from one of rest to one of physical exercise and vice versa detected from the derived impedance and ventilation is accommodated by modifying the vagal stimulation therapy to adjust the patient's heart rate to a new target rate accordingly, while continuing to deliver the therapy for alleviating the congestive heart failure. A closed loop system is preferably employed for the control and adjustment functions.

    摘要翻译： 提出了一种改进的方法来评估诊断为充血性心力衰竭的患者的生理状态，并相应地治疗患者以缓解充血性心力衰竭。 作为该方法的一部分，特定患者的胸部或心脏阻抗和通气仅来自由心脏正在经历其心动周期的动态阻抗所产生的由心脏信号（EKG）产生的心脏信号（EKG）的输入 通过使EKG交替地输入高阻抗和低输入阻抗来获得。 导出的胸部阻抗和通气用于通过植入的刺激器来控制刺激电脉冲施加到患者的迷走神经的模式和速率，以通过将心率调节到规定的目标来向患者的心脏递送治疗的方式 减轻充血性心力衰竭的发生率。 通过改变迷走神经刺激疗法来适应患者从休息状态到体育运动之间的变化，反之亦然，从而可以通过改变迷走神经刺激疗法来相应地将患者的心率调整到新的目标速率，同时继续 提供缓解充血性心力衰竭的疗法。 闭环系统优选用于控制和调节功能。

    Method of detecting sleep apnea and treatment thereof
    2.
    发明申请
    Method of detecting sleep apnea and treatment thereof 有权
    检测睡眠呼吸暂停的方法及其治疗

    公开(公告)号：US20110190642A1

    公开(公告)日：2011-08-04

    申请号：US12931152

    申请日：2011-01-25

    申请人： Eckhard Alt ,  Maik Gollasch

    发明人： Eckhard Alt ,  Maik Gollasch

    IPC分类号： A61B5/0205 ,  A61N1/36

    CPC分类号： A61B5/0402 ,  A61B5/04012 ,  A61B5/4818 ,  A61N1/3601 ,  A61N1/3611 ,  A61N1/36128

    摘要： A method is presented for evaluating whether an episode of sleep apnea is occurring in a patient suffering from chronic sleep apnea disorder, for delivery of appropriate therapy. The method, performed by an implantable device, includes sensing the patient's EKG signal and using electrical energy generated by the heart to power subsequent signal processing. This signal is applied as the sole input to a differential signal processing circuit for passage through both a high impedance path and a substantially lower impedance path and amplification of the difference in magnitude between the resulting two signals, to determine changes in the patient's thoracic impedance. Based on such changes, the presence or absence of patient ventilation is detected, to enable an assessment of whether an episode of sleep apnea is occurring. An actual episode of sleep apnea is deemed to have occurred if lack of ventilation exceeds a predetermined interval of time between otherwise regular respiratory cycles. If sleep apnea is indicated, the appropriate therapy is delivered by the device to induce ventilation and halt the apnea episode.

    摘要翻译： 提出了一种用于评估患有慢性睡眠呼吸暂停障碍的患者是否发生睡眠呼吸暂停发作的方法，用于递送适当的治疗。 由可植入装置执行的该方法包括感测患者的EKG信号并使用心脏产生的电能来为随后的信号处理提供电力。 将该信号作为唯一的输入施加到差分信号处理电路，以通过高阻抗路径和基本上较低的阻抗路径，并且在所得到的两个信号之间放大幅度差，以确定患者胸部阻抗的变化。 基于这种变化，检测到患者通气的存在或不存在，以便能够评估是否发生睡眠呼吸暂停发作。 睡眠呼吸暂停的实际发作被认为是在通气量不足超过预定间隔时间之间而发生的。 如果指示出睡眠呼吸暂停，则该装置将传递适当的治疗以诱导通气并停止呼吸暂停发作。

    Detecting and treatment of sleep apnea
    5.
    发明申请
    Detecting and treatment of sleep apnea 有权
    检测和治疗睡眠呼吸暂停

    公开(公告)号：US20130197376A1

    公开(公告)日：2013-08-01

    申请号：US13694927

    申请日：2013-01-19

    申请人： Eckhard Alt ,  Maik Gollasch

    发明人： Eckhard Alt ,  Maik Gollasch

    IPC分类号： A61B5/00 ,  A61B5/0205

    CPC分类号： A61B5/4818 ,  A61B5/0205 ,  A61B5/04012 ,  A61B5/0402 ,  A61B5/053 ,  A61B5/4836 ,  A61N1/3601 ,  A61N1/3611 ,  A61N1/36128

    摘要： A device is presented for evaluating whether an episode of sleep apnea is occurring in a patient suffering from chronic sleep apnea disorder, for delivery of appropriate therapy. The device includes circuitry adapted to respond to a cardiac signal generated by the heart. Switching circuitry diverts passage of the heart signal through both a high impedance path and a substantially lower impedance path, and a differential amplifier processes the resulting signal pairs to ascertain the difference in magnitude between the two signals of each pair. An analyzer thereof determines changes in the patient's ventilation, from which inordinately reduced patient ventilation is detected to assess possible occurrence of an episode of sleep apnea. If the analyzer denotes change of ventilation between otherwise regular respiratory cycles, an actual episode of sleep apnea is indicated. A stimulus generator responds to such indication to generate an appropriate electrical therapy for delivery to a preselected location in the patient's body to induce ventilation so as to terminate the apnea episode.

    摘要翻译： 提供了一种用于评估患有慢性睡眠呼吸暂停障碍的患者是否发生睡眠呼吸暂停发作的装置，用于递送适当的治疗。 该装置包括适于响应由心脏产生的心脏信号的电路。 开关电路通过高阻抗路径和基本上较低的阻抗路径转移心脏信号的通过，并且差分放大器处理结果信号对以确定每对信号之间的幅度差异。 其分析仪确定患者通气中的变化，从该位置检测到病人通气不当地减少以评估睡眠呼吸暂停发作的可能发生。 如果分析仪表示在正常呼吸周期之间通气的变化，则表明睡眠呼吸暂停的实际发作。 刺激发生器响应于这种指示以产生适当的电疗法以递送到患者体内的预选位置以诱导通气，以终止呼吸暂停发作。

    Method of vagal stimulation to treat patients suffering from congestive heart failure
    6.
    发明申请
    Method of vagal stimulation to treat patients suffering from congestive heart failure 有权
    迷走神经刺激治疗充血性心力衰竭患者的方法

    公开(公告)号：US20110087304A1

    公开(公告)日：2011-04-14

    申请号：US12807706

    申请日：2010-09-10

    申请人： Maik Gollasch

    发明人： Maik Gollasch

    IPC分类号： A61N1/365 ,  A61N1/36

    CPC分类号： A61N1/36139 ,  A61B5/0031 ,  A61B5/04012 ,  A61B5/0537 ,  A61B5/0809 ,  A61B2562/0219 ,  A61N1/36114 ,  A61N1/3627 ,  A61N1/36521

    摘要： An improved method is presented for evaluating the physiological status of a patient diagnosed with congestive heart failure and treating the patient accordingly to alleviate the congestive heart failure. As part of the method, the thoracic or cardiac impedance and ventilation of the particular patient are derived solely from an input consisting of cardiac signals (EKG) generated by electrical energy of the patient's heart as the heart is undergoing its cardiac cycle with a dynamic impedance obtained by subjecting the EKG to alternately high and low input impedances. The derived thoracic impedance and ventilation are used to control the pattern and rate at which stimulating electrical pulses are applied to the patient's vagus nerve by an implanted stimulator, in a manner to deliver therapy to the patient's heart by adjusting the heart rate to a prescribed target rate for alleviating the congestive heart failure. A change in state of the patient from one of rest to one of physical exercise and vice versa detected from the derived impedance and ventilation is accommodated by modifying the vagal stimulation therapy to adjust the patient's heart rate to a new target rate accordingly, while continuing to deliver the therapy for alleviating the congestive heart failure. A closed loop system is preferably employed for the control and adjustment functions.

    摘要翻译： 提出了一种改进的方法来评估诊断为充血性心力衰竭的患者的生理状态，并相应地治疗患者以缓解充血性心力衰竭。 作为该方法的一部分，特定患者的胸部或心脏阻抗和通气仅来自由心脏正在经历其心动周期的动态阻抗所产生的由心脏信号（EKG）产生的心脏信号（EKG）的输入 通过使EKG交替地输入高阻抗和低输入阻抗来获得。 导出的胸部阻抗和通气用于通过植入的刺激器来控制刺激电脉冲施加到患者的迷走神经的模式和速率，以通过将心率调节到规定的目标来向患者的心脏递送治疗的方式 减轻充血性心力衰竭的发生率。 通过改变迷走神经刺激疗法来适应患者从休息状态到体育运动之间的变化，反之亦然，从而可以通过改变迷走神经刺激疗法来相应地将患者的心率调整到新的目标速率，同时继续 提供缓解充血性心力衰竭的疗法。 闭环系统优选用于控制和调节功能。

    Detecting and treatment of sleep apnea
    7.
    发明授权
    Detecting and treatment of sleep apnea 有权
    检测和治疗睡眠呼吸暂停

    公开(公告)号：US08781587B2

    公开(公告)日：2014-07-15

    申请号：US13694927

    申请日：2013-01-19

    申请人： Eckhard Alt ,  Maik Gollasch

    发明人： Eckhard Alt ,  Maik Gollasch

    IPC分类号： A61N1/378

    CPC分类号： A61B5/4818 ,  A61B5/0205 ,  A61B5/04012 ,  A61B5/0402 ,  A61B5/053 ,  A61B5/4836 ,  A61N1/3601 ,  A61N1/3611 ,  A61N1/36128

    摘要： A device is presented for evaluating whether an episode of sleep apnea is occurring in a patient suffering from chronic sleep apnea disorder, for delivery of appropriate therapy. The device includes circuitry adapted to respond to a cardiac signal generated by the heart. Switching circuitry diverts passage of the heart signal through both a high impedance path and a substantially lower impedance path, and a differential amplifier processes the resulting signal pairs to ascertain the difference in magnitude between the two signals of each pair. An analyzer thereof determines changes in the patient's ventilation, from which inordinately reduced patient ventilation is detected to assess possible occurrence of an episode of sleep apnea. If the analyzer denotes change of ventilation between otherwise regular respiratory cycles, an actual episode of sleep apnea is indicated. A stimulus generator responds to such indication to generate an appropriate electrical therapy for delivery to a preselected location in the patient's body to induce ventilation so as to terminate the apnea episode.

    摘要翻译： 提供了一种用于评估患有慢性睡眠呼吸暂停障碍的患者是否发生睡眠呼吸暂停发作的装置，用于递送适当的治疗。 该装置包括适于响应由心脏产生的心脏信号的电路。 开关电路通过高阻抗路径和基本上较低的阻抗路径转移心脏信号的通过，并且差分放大器处理结果信号对以确定每对信号之间的幅度差异。 其分析仪确定患者通气中的变化，从该位置检测到病人通气不当地减少以评估睡眠呼吸暂停发作的可能发生。 如果分析仪表示在正常呼吸周期之间通气的变化，则表明睡眠呼吸暂停的实际发作。 刺激发生器响应于这种指示以产生适当的电疗法以递送到患者体内的预选位置以诱导通气，以终止呼吸暂停发作。

    Method of detecting sleep apnea and treatment thereof
    9.
    发明授权
    Method of detecting sleep apnea and treatment thereof 有权
    检测睡眠呼吸暂停的方法及其治疗

    公开(公告)号：US08359097B2

    公开(公告)日：2013-01-22

    申请号：US12931152

    申请日：2011-01-25

    申请人： Eckhard Alt ,  Maik Gollasch

    发明人： Eckhard Alt ,  Maik Gollasch

    IPC分类号： A61N1/365

    CPC分类号： A61B5/0402 ,  A61B5/04012 ,  A61B5/4818 ,  A61N1/3601 ,  A61N1/3611 ,  A61N1/36128

    摘要： A method is presented for evaluating whether an episode of sleep apnea is occurring in a patient suffering from chronic sleep apnea disorder, for delivery of appropriate therapy. The method, performed by an implantable device, includes sensing the patient's EKG signal and using electrical energy generated by the heart to power subsequent signal processing. This signal is applied as the sole input to a differential signal processing circuit for passage through both a high impedance path and a substantially lower impedance path and amplification of the difference in magnitude between the resulting two signals, to determine changes in the patient's thoracic impedance. Based on such changes, the presence or absence of patient ventilation is detected, to enable an assessment of whether an episode of sleep apnea is occurring. An actual episode of sleep apnea is deemed to have occurred if lack of ventilation exceeds a predetermined interval of time between otherwise regular respiratory cycles. If sleep apnea is indicated, the appropriate therapy is delivered by the device to induce ventilation and halt the apnea episode.

    摘要翻译： 提出了一种用于评估患有慢性睡眠呼吸暂停障碍的患者是否发生睡眠呼吸暂停发作的方法，用于递送适当的治疗。 由可植入装置执行的该方法包括感测患者的EKG信号并使用心脏产生的电能来为随后的信号处理提供电力。 将该信号作为唯一的输入施加到差分信号处理电路，以通过高阻抗路径和基本上较低的阻抗路径，并且在所得到的两个信号之间放大幅度差，以确定患者胸部阻抗的变化。 基于这种变化，检测到患者通气的存在或不存在，以便能够评估是否发生睡眠呼吸暂停发作。 睡眠呼吸暂停的实际发作被认为是在通气量不足超过预定间隔时间之间而发生的。 如果指示出睡眠呼吸暂停，则该装置将传递适当的治疗以诱导通气并停止呼吸暂停发作。