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    METHODS AND SYSTEMS TO MONITOR AND IDENTIFY TRANSIENT ISCHEMIA
    2.
    发明申请
    METHODS AND SYSTEMS TO MONITOR AND IDENTIFY TRANSIENT ISCHEMIA 有权
    监测和识别过渡期ISCHEMIA的方法和系统

    公开(公告)号：US20120046564A1

    公开(公告)日：2012-02-23

    申请号：US12861573

    申请日：2010-08-23

    申请人： Steve Koh ,  Michael Yang ,  Ryan Rooke ,  Stuart Rosenberg ,  Wenbo Hou

    发明人： Steve Koh ,  Michael Yang ,  Ryan Rooke ,  Stuart Rosenberg ,  Wenbo Hou

    IPC分类号： A61B5/0402

    CPC分类号： A61B5/0422 ,  A61B5/686 ,  A61B5/7282 ,  A61B2576/023 ,  A61N1/365 ,  A61N1/3702

    摘要： A system and method are provided for monitoring ischemic development. The system and method identify a non-physiologic event and obtain cardiac signals along multiple sensing vectors, wherein at least a portion of the sensing vectors extend to or from electrodes located proximate to the left ventricle. The system and method monitor a segment of interest in the cardiac signals obtained along the multiple sensing vectors to identify deviations in the segment of interest from a baseline. The system and method record at least one of timing or segment shift information associated with the deviations in the segments of interest; and identify at least one of size, direction of development or rate of progression of an ischemia region based on the at least one of timing or segment shift information.

    摘要翻译： 提供了一种用于监测缺血发育的系统和方法。 系统和方法识别非生理事件并且沿着多个感测向量获得心脏信号，其中至少一部分感测向量延伸到位于靠近左心室的电极。 系统和方法监测沿着多个感测向量获得的心脏信号中的感兴趣区段，以识别感兴趣区段中的偏离基线。 系统和方法记录与感兴趣的部分中的偏差相关联的定时或分段移位信息中的至少一个; 并且基于定时或段位移信息中的至少一个来识别缺血区域的大小，发育方向或进展速度中的至少一个。

    Systems and methods for exploiting near-field impedance and admittance for use with implantable medical devices
    4.
    发明授权
    Systems and methods for exploiting near-field impedance and admittance for use with implantable medical devices 有权
    用于利用可植入医疗设备使用近场阻抗和导纳的系统和方法

    公开(公告)号：US08812093B2

    公开(公告)日：2014-08-19

    申请号：US13007424

    申请日：2011-01-14

    申请人： Dan E. Gutfinger ,  Fujian Qu ,  Alex Soriano ,  Ryan Rooke ,  Yelena Nabutovsky ,  Riddhi Shah

    发明人： Dan E. Gutfinger ,  Fujian Qu ,  Alex Soriano ,  Ryan Rooke ,  Yelena Nabutovsky ,  Riddhi Shah

    IPC分类号： A61B5/053 ,  A61B5/04 ,  A61B5/0452 ,  A61N1/365

    CPC分类号： A61B5/04011 ,  A61B5/02 ,  A61B5/0452 ,  A61B5/053 ,  A61B5/0538 ,  A61B5/686 ,  A61N1/36521

    摘要： Various techniques are provided for use with an implantable medical device for exploiting near-field impedance/admittance. Examples include techniques for assessing heart chamber disequilibrium, detecting chamber volumes and pressures, calibrating near-field-based left atrial pressure (LAP) estimation procedures and for assessing the recovery from injury at the electrode-tissue interface. In one particular example, the implantable device assesses the degree of concordance between the left ventricle (LV) and the right ventricle (RV) by quantifying a degree of scatter between LV and RV near-field admittance values. An increase in RV admittance is indicative of RV failure, an increase in LV admittance is indicative of LV failure, and an increase in both LV and RV admittance is indicative of biventricular failure.

    摘要翻译： 提供了与用于开发近场阻抗/导纳的可植入医疗装置一起使用的各种技术。 实例包括评估心脏室不平衡，检测腔室体积和压力，校准基于近场的左心房压力（LAP）估计程序和评估电极组织界面处损伤恢复的技术。 在一个特定示例中，可植入装置通过量化LV和RV近场导纳值之间的散射程度来评估左心室（LV）和右心室（RV）之间的一致程度。 RV导纳的增加表示RV失败，LV导纳的增加表示LV失败，LV和RV导纳的增加表明双心室衰竭。

    SYSTEMS AND METHODS FOR USE BY IMPLANTABLE MEDICAL DEVICES FOR DETECTING AND DISCRIMINATING STROKE AND CARDIAC ISCHEMIA USING ELECTROCARDIAC SIGNALS
    5.
    发明申请
    SYSTEMS AND METHODS FOR USE BY IMPLANTABLE MEDICAL DEVICES FOR DETECTING AND DISCRIMINATING STROKE AND CARDIAC ISCHEMIA USING ELECTROCARDIAC SIGNALS 有权
    用于通过电刺激信号检测和鉴别卒中和心脏病的植入式医疗设备使用的系统和方法

    公开(公告)号：US20130041274A1

    公开(公告)日：2013-02-14

    申请号：US13207307

    申请日：2011-08-10

    申请人： Jong Gill ,  Rupinder Bharmi ,  Edward Karst ,  Ryan Rooke ,  Riddhi Shah ,  Fujian Qu ,  Gene A. Bornzin ,  Taraneh Ghaffari Farazi ,  Euljoon Park

    发明人： Jong Gill ,  Rupinder Bharmi ,  Edward Karst ,  Ryan Rooke ,  Riddhi Shah ,  Fujian Qu ,  Gene A. Bornzin ,  Taraneh Ghaffari Farazi ,  Euljoon Park

    IPC分类号： A61B5/0468

    CPC分类号： A61B5/0468 ,  A61B5/0031 ,  A61B5/0205 ,  A61B5/02158 ,  A61B5/02405 ,  A61B5/0295 ,  A61B5/0422 ,  A61B5/4839 ,  A61N1/3702

    摘要： Techniques are provided for detecting and distinguishing stroke and cardiac ischemia based on electrocardiac signals. In one example, the device senses atrial and ventricular signals within the patient along a set of unipolar sensing vectors and identifies certain morphological features within the signals such as PR intervals, ST intervals, QT intervals, T-waves, etc. The device detects changes, if any, within the morphological features such as significant shifts in ST interval elevation or an inversion in T-wave shape, which are indicative of stroke or cardiac ischemia. By selectively comparing changes detected along different unipolar sensing vectors, the device distinguishes or discriminates stroke from cardiac ischemia within the patient. The discrimination may be corroborated using various physiological and hemodynamic parameters. In some examples, the device further identifies the location of the ischemia within the heart. In still other examples, the device detects cardiac ischemia occurring during stroke.

    摘要翻译： 提供了用于基于心电信号检测和区分中风和心脏缺血的技术。 在一个示例中，该装置沿着一组单极感测向量感测患者内的心房和心室信号，并且识别信号内的某些形态特征，例如PR间隔，ST间隔，QT间隔，T波等。该装置检测变化 （如果有的话）在形态学特征之中，例如ST间期升高的显着变化或T波形的反转，其指示中风或心脏缺血。 通过选择性地比较沿着不同的单极性感测向量检测的变化，该装置区分或区分患者体内的心脏缺血的中风。 可以使用各种生理和血液动力学参数来确认辨别。 在一些实例中，该装置还识别心脏内局部缺血的位置。 在另外的例子中，该装置检测在中风期间发生的心脏缺血。

    SYSTEMS AND METHODS FOR CORROBORATING IMPEDANCE-BASED LEFT ATRIAL PRESSURE (LAP) ESTIMATES FOR USE BY AN IMPLANTABLE MEDICAL DEVICE
    6.
    发明申请
    SYSTEMS AND METHODS FOR CORROBORATING IMPEDANCE-BASED LEFT ATRIAL PRESSURE (LAP) ESTIMATES FOR USE BY AN IMPLANTABLE MEDICAL DEVICE 审中-公开
    用于植入基于阻力的左心室压（LAP）评估用于可植入医疗装置的系统和方法

    公开(公告)号：US20120184859A1

    公开(公告)日：2012-07-19

    申请号：US13007364

    申请日：2011-01-14

    申请人： Riddhi Shah ,  Fujian Qu ,  Yelena Nabutovsky ,  Dan E. Gutfinger ,  Ryan Rooke ,  Alex Soriano

    发明人： Riddhi Shah ,  Fujian Qu ,  Yelena Nabutovsky ,  Dan E. Gutfinger ,  Ryan Rooke ,  Alex Soriano

    IPC分类号： A61B5/0215 ,  A61B5/021

    CPC分类号： A61B5/0538 ,  A61B5/0215

    摘要： Various techniques are provided for assessing the reliability of left atrial pressure (LAP) estimates made by an implantable medical device based on impedance values or related electrical values. In one example, various cardioelectric and cardiomechanical parameters are used to corroborate LAP estimation in circumstances where the LAP estimates deviate from an acceptable, satisfactory or otherwise healthy range. The cardioelectric parameters include, e.g.: ST elevation; heart rate (HR); heart rate variability (HRV); T-wave alternans (TWA); QRS waveform parameters; P-wave duration; evoked response (ER) parameters; and intrinsic PV/AV/VV conduction delays. The cardiomechanical parameters include, e.g.: heart rate turbulence (HRT); cardiogenic impedance signals; heart sounds; and non-LAP blood pressure measurements, such as aortic pressure measurements. The device compares the cardioelectric and cardiomechanical parameters against corresponding baseline values to determine whether variations in the parameters corroborate the LAP estimates. If not, the LAP estimates are selectively cancelled or suspended, or the overall procedure is re-calibrated.

    摘要翻译： 提供各种技术来评估由可植入医疗装置基于阻抗值或相关电气值进行的左心房压力（LAP）估计的可靠性。 在一个示例中，在LAP估计偏离可接受的，满意的或以其他方式健康的范围的情况下，使用各种心电和心力学参数来证实LAP估计。 心电参数包括：ST抬高; 心律（HR）; 心率变异性（HRV）; T波交替（TWA）; QRS波形参数; P波持续时间; 诱发反应（ER）参数; 和内在的PV / AV / VV传导延迟。 心脏力学参数包括例如：心率湍流（HRT）; 心源阻抗信号; 心声; 和非LAP血压测量，如主动脉压力测量。 该设备将心电参数和心机械参数与相应的基线值进行比较，以确定参数的变化是否证实了LAP估计值。 如果不是，则LAP估计被选择性地取消或暂停，或者整个程序被重新校准。

    SYSTEMS AND METHODS FOR EXPLOITING NEAR-FIELD IMPEDANCE AND ADMITTANCE FOR USE WITH IMPLANTABLE MEDICAL DEVICES
    7.
    发明申请
    SYSTEMS AND METHODS FOR EXPLOITING NEAR-FIELD IMPEDANCE AND ADMITTANCE FOR USE WITH IMPLANTABLE MEDICAL DEVICES 有权
    用于开发具有可移植医疗设备的近场阻抗和使用方法的系统和方法

    公开(公告)号：US20120035495A1

    公开(公告)日：2012-02-09

    申请号：US13007424

    申请日：2011-01-14

    申请人： Dan E. Gutfinger ,  Fujian Qu ,  Alex Soriano ,  Ryan Rooke ,  Yelena Nabutovsky ,  Riddhi Shah

    发明人： Dan E. Gutfinger ,  Fujian Qu ,  Alex Soriano ,  Ryan Rooke ,  Yelena Nabutovsky ,  Riddhi Shah

    IPC分类号： A61B5/053

    CPC分类号： A61B5/04011 ,  A61B5/02 ,  A61B5/0452 ,  A61B5/053 ,  A61B5/0538 ,  A61B5/686 ,  A61N1/36521

    摘要： Various techniques are provided for use with an implantable medical device for exploiting near-field impedance/admittance. Examples include techniques for assessing heart chamber disequilibrium, detecting chamber volumes and pressures, calibrating near-field-based left atrial pressure (LAP) estimation procedures and for assessing the recovery from injury at the electrode-tissue interface. In one particular example, the implantable device assesses the degree of concordance between the left ventricle (LV) and the right ventricle (RV) by quantifying a degree of scatter between LV and RV near-field admittance values. An increase in RV admittance is indicative of RV failure, an increase in LV admittance is indicative of LV failure, and an increase in both LV and RV admittance is indicative of biventricular failure.

    摘要翻译： 提供了与用于开发近场阻抗/导纳的可植入医疗装置一起使用的各种技术。 实例包括评估心脏室不平衡，检测腔室体积和压力，校准基于近场的左心房压力（LAP）估计程序和评估电极组织界面处损伤恢复的技术。 在一个特定示例中，可植入装置通过量化LV和RV近场导纳值之间的散射程度来评估左心室（LV）和右心室（RV）之间的一致程度。 RV导纳的增加表示RV失败，LV导纳的增加表示LV失败，LV和RV导纳的增加表明双心室衰竭。

    NEAR FIELD-BASED SYSTEMS AND METHODS FOR ASSESSING IMPEDANCE AND ADMITTANCE FOR USE WITH AN IMPLANTABLE MEDICAL DEVICE
    8.
    发明申请
    NEAR FIELD-BASED SYSTEMS AND METHODS FOR ASSESSING IMPEDANCE AND ADMITTANCE FOR USE WITH AN IMPLANTABLE MEDICAL DEVICE 有权
    基于现场的系统和方法，用于评估阻抗和使用植入式医疗设备的使用方法

    公开(公告)号：US20120035493A1

    公开(公告)日：2012-02-09

    申请号：US12853130

    申请日：2010-08-09

    申请人： Dan E. Gutfinger ,  Fujian Qu ,  Alex Soriano ,  Ryan Rooke ,  Yelena Nabutovsky ,  Riddhi Shah ,  Andreas Blomqvist

    发明人： Dan E. Gutfinger ,  Fujian Qu ,  Alex Soriano ,  Ryan Rooke ,  Yelena Nabutovsky ,  Riddhi Shah ,  Andreas Blomqvist

    IPC分类号： A61B5/053

    CPC分类号： A61B5/0538 ,  A61B5/02028 ,  A61B5/029 ,  A61B5/4878 ,  A61B5/686 ,  A61B7/00 ,  A61B2562/0219

    摘要： A new model is provided for understanding and exploiting impedance or admittance values measured by implantable medical devices, such as pacemakers or cardiac resynchronization devices (CRTs.) The device measures impedance along vectors extending through tissues of the patient between various pairs of electrodes. The device then converts the vector-based impedance measurements into near-field individual electrode-based impedance values. This is accomplished, in at least some examples, by converting the vector-based impedance measurements into a set of linear equations to be solved while ignoring far-field contributions to the impedance measurements. The device solves the linear equations to determine the near-field impedance values for the individual electrodes, which are representative of the impedance of tissues in the vicinity of the electrodes. The device then performs or controls various device functions based on the near-field values, such as analyzing selected near-field values to detect heart failure or pulmonary edema.

    摘要翻译： 提供了一种新型号，用于了解和利用可植入医疗设备（例如起搏器或心脏再同步装置（CRT））测量的阻抗或导纳值。该装置测量沿着延伸穿过患者组织的不同对电极之间的阻力。 然后，器件将基于矢量的阻抗测量值转换为近场单独的基于电极的阻抗值。 这在至少一些示例中是通过将基于矢量的阻抗测量值转换成待解决的一组线性方程而实现的，同时忽略对阻抗测量的远场贡献。 该装置解决了线性方程来确定各个电极的近场阻抗值，其代表电极附近的组织的阻抗。 然后，设备基于近场值执行或控制各种设备功能，例如分析所选的近场值以检测心脏衰竭或肺水肿。

    Near field-based systems and methods for assessing impedance and admittance for use with an implantable medical device
    9.
    发明授权
    Near field-based systems and methods for assessing impedance and admittance for use with an implantable medical device 有权
    用于评估用于可植入医疗设备的阻抗和导纳的近场系统和方法

    公开(公告)号：US08670820B2

    公开(公告)日：2014-03-11

    申请号：US12853130

    申请日：2010-08-09

    申请人： Dan E. Gutfinger ,  Fujian Qu ,  Alex Soriano ,  Ryan Rooke ,  Yelena Nabutovsky ,  Riddhi Shah ,  Andreas Blomqvist

    发明人： Dan E. Gutfinger ,  Fujian Qu ,  Alex Soriano ,  Ryan Rooke ,  Yelena Nabutovsky ,  Riddhi Shah ,  Andreas Blomqvist

    IPC分类号： A61B5/053

    CPC分类号： A61B5/0538 ,  A61B5/02028 ,  A61B5/029 ,  A61B5/4878 ,  A61B5/686 ,  A61B7/00 ,  A61B2562/0219

    摘要： A new model is provided for understanding and exploiting impedance or admittance values measured by implantable medical devices, such as pacemakers or cardiac resynchronization devices (CRTs.) The device measures impedance along vectors extending through tissues of the patient between various pairs of electrodes. The device then converts the vector-based impedance measurements into near-field individual electrode-based impedance values. This is accomplished, in at least some examples, by converting the vector-based impedance measurements into a set of linear equations to be solved while ignoring far-field contributions to the impedance measurements. The device solves the linear equations to determine the near-field impedance values for the individual electrodes, which are representative of the impedance of tissues in the vicinity of the electrodes. The device then performs or controls various device functions based on the near-field values, such as analyzing selected near-field values to detect heart failure or pulmonary edema.

    摘要翻译： 提供了一种新型号，用于了解和利用可植入医疗设备（例如起搏器或心脏再同步装置（CRT））测量的阻抗或导纳值。该装置测量沿着延伸穿过患者组织的不同对电极之间的阻力。 然后，器件将基于矢量的阻抗测量值转换为近场单独的基于电极的阻抗值。 这在至少一些示例中是通过将基于矢量的阻抗测量值转换成待解决的一组线性方程而实现的，同时忽略对阻抗测量的远场贡献。 该装置解决了线性方程来确定各个电极的近场阻抗值，其代表电极附近的组织的阻抗。 然后，设备基于近场值执行或控制各种设备功能，例如分析所选的近场值以检测心脏衰竭或肺水肿。

    Methods and systems to monitor and identify transient ischemia
    10.
    发明授权
    Methods and systems to monitor and identify transient ischemia 有权
    监测和鉴别短暂性脑缺血的方法和系统

    公开(公告)号：US08447389B2

    公开(公告)日：2013-05-21

    申请号：US12861573

    申请日：2010-08-23

    申请人： Steve Koh ,  Michael Yang ,  Ryan Rooke ,  Stuart Rosenberg ,  Wenbo Hou

    发明人： Steve Koh ,  Michael Yang ,  Ryan Rooke ,  Stuart Rosenberg ,  Wenbo Hou

    IPC分类号： A61B5/0452

    CPC分类号： A61B5/0422 ,  A61B5/686 ,  A61B5/7282 ,  A61B2576/023 ,  A61N1/365 ,  A61N1/3702

    摘要： A system and method are provided for monitoring ischemic development. The system and method identify a non-physiologic event and obtain cardiac signals along multiple sensing vectors, wherein at least a portion of the sensing vectors extend to or from electrodes located proximate to the left ventricle. The system and method monitor a segment of interest in the cardiac signals obtained along the multiple sensing vectors to identify deviations in the segment of interest from a baseline. The system and method record at least one of timing or segment shift information associated with the deviations in the segments of interest; and identify at least one of size, direction of development or rate of progression of an ischemia region based on the at least one of timing or segment shift information.

    摘要翻译： 提供了一种用于监测缺血发育的系统和方法。 系统和方法识别非生理事件并且沿着多个感测向量获得心脏信号，其中至少一部分感测向量延伸到位于靠近左心室的电极。 系统和方法监测沿着多个感测向量获得的心脏信号中的感兴趣区段，以识别感兴趣区段中的偏离基线。 系统和方法记录与感兴趣的部分中的偏差相关联的定时或分段移位信息中的至少一个; 并且基于定时或段位移信息中的至少一个来识别缺血区域的大小，发育方向或进展速度中的至少一个。