公开(公告)号：US08532762B2

公开(公告)日：2013-09-10

申请号：US11312279

申请日：2005-12-20

申请人： Shelley Cazares ,  Carlos Ricci ,  Dan Li ,  Yayun Lin ,  Yi Zhang ,  Jaeho Kim ,  Joseph Bocek

发明人： Shelley Cazares ,  Carlos Ricci ,  Dan Li ,  Yayun Lin ,  Yi Zhang ,  Jaeho Kim ,  Joseph Bocek

IPC分类号： A61N1/365

CPC分类号： A61N1/3622 ,  A61B5/04525 ,  A61B5/046 ,  A61B5/0464 ,  A61B5/0472 ,  A61B5/7264 ,  A61N1/3702 ,  A61N1/3962

摘要： Cardiac arrhythmias are classified based on the morphology of the arrhythmia episode beats. Templates are formed using morphological features of the cardiac beats of the episode. The arrhythmia episode is classified as a monomorphic tachyarrhythmia or polymorphic tachyarrhythmia based on the one or more templates. The arrhythmia episode may be classified based on a number templates formed from the arrhythmia episode. The templates are formed by determining a measure of similarity between morphological features of a cardiac beat to a template. The similarities can be determined based on a pairing rule that determines which beat morphologies are compared. Selection of therapy for treating the arrhythmia episode may depend on the historical success of a therapy at mitigating previous arrhythmias of the same type as the arrhythmia episode.

摘要翻译： 心律失常根据心律失常发作的形态进行分类。 使用情节心脏搏动的形态学特征形成模板。 基于一个或多个模板，心律失常发作被分类为单形性快速性心律失常或多态性快速性心律失常。 心律失常发作可以基于由心律失常发作形成的数字模板进行分类。 模板通过确定心跳的形态特征与模板之间的相似性的度量来形成。 可以基于确定哪些拍子形态进行比较的配对规则来确定相似度。 选择治疗心律失常发作的治疗可能取决于治疗在缓解与心律失常事件相同类型的以前心律失常方面的历史成功。

公开(公告)号：US20130138004A1

公开(公告)日：2013-05-30

申请号：US13483387

申请日：2012-05-30

申请人： Yanting Dong ,  Shijie Zhang ,  Deepa Mahajan ,  Chenguang Liu ,  Dan Li ,  Yayun Lin ,  Derek D. Bohn

发明人： Yanting Dong ,  Shijie Zhang ,  Deepa Mahajan ,  Chenguang Liu ,  Dan Li ,  Yayun Lin ,  Derek D. Bohn

IPC分类号： A61B5/04 ,  A61N1/39

CPC分类号： A61B5/04012 ,  A61B5/0245 ,  A61B5/042 ,  A61B5/0452 ,  A61B5/7217 ,  A61N1/3704 ,  A61N1/3937

摘要： A system and method for performing independent, off-line evaluation of event sensing for collected electrograms, comprising: sensing an electrogram using an implantable medical device (IMD); determining locations of heart beats on at least one channel of the electrogram using a multi-pass process, resulting in a group of multi-pass beat locations; storing the electrogram and device-identified beat locations in a memory location; and retrieving the electrogram and device-identified beat locations from the memory location. The multi-pass process determines locations of heart beats on at least a first channel of the electrogram. The device-identified group of beat locations are then compared to the multi-pass group of beat locations identified using the multi-pass method. Based on the comparing step, oversensing of beats, undersensing of beats, or noise from the device can be detected.

摘要翻译： 一种用于对收集的电描记图执行事件感测的独立离线评估的系统和方法，包括：使用可植入医疗装置（IMD）感测电描记图; 使用多遍处理确定心电图的至少一个通道上的心跳位置，从而产生一组多通拍位置; 将电描记图和设备识别的节拍位置存储在存储器位置中; 以及从存储器位置检索电描记图和设备标识的拍摄位置。 多遍处理确定心电图的至少第一个通道的位置。 然后将设备识别的拍摄位置组与使用多遍方法识别的拍摄位置的多通道组进行比较。 基于比较步骤，可以检测节拍过度，节拍不足或来自装置的噪音。

公开(公告)号：US20110166613A1

公开(公告)日：2011-07-07

申请号：US13048582

申请日：2011-03-15

申请人： Dan Li ,  Yayun Lin

发明人： Dan Li ,  Yayun Lin

IPC分类号： A61N1/365 ,  A61N1/39

CPC分类号： A61N1/3622 ,  A61B5/04525 ,  A61B5/0464 ,  A61N1/36585 ,  A61N1/3962

摘要： Methods and systems for selecting tachyarrhythmia therapy based on the morphological organization level of the arrhythmia are described. Morphological organization levels of arrhythmias are associated with cardiac therapies. The morphological organization levels are related to cardiac signal morphologies of the arrhythmias. An arrhythmia episode is detected and the morphological organization level of the arrhythmia episode is determined. A cardiac therapy associated with the morphological organization level of the arrhythmia episode is delivered to treat the arrhythmia. For example, the morphological organization levels may be associated with the cardiac therapies based on one or more of retrospective database analysis, patient therapy tolerance, and physician input. The associations may be static or may be dynamically adjusted based on therapy efficacy.

摘要翻译： 描述了基于心律失常形态组织水平选择快速性心律失常治疗的方法和系统。 心律失常的形态学组织水平与心脏治疗有关。 形态组织水平与心律失常的心脏信号形态有关。 检测到心律失常发作，确定心律失常发作的形态组织水平。 与心律失常发作的形态组织水平相关的心脏治疗被递送以治疗心律失常。 例如，形态组织水平可以基于回顾性数据库分析，患者治疗耐受性和医师输入中的一种或多种与心脏疗法相关联。 协会可以是静态的，或者可以基于治疗功效来动态调整。

公开(公告)号：US07933651B2

公开(公告)日：2011-04-26

申请号：US10995704

申请日：2004-11-23

申请人： Shelley Marie Cazares ,  Yayun Lin ,  Alok S. Sathaye

发明人： Shelley Marie Cazares ,  Yayun Lin ,  Alok S. Sathaye

IPC分类号： A61B5/0452

CPC分类号： A61B5/042 ,  A61N1/3702 ,  A61N1/3925

摘要： Cardiac treatment methods and devices provide for templates representative of past tachyarrhythmia events, each template associated with a therapy. Methods involve providing a cardiac waveform representative of a patient's cardiac activity and identifying a portion that indicates an arrhythmic event. A cardiac template corresponding to the portion is generated, and a therapy is associated with the template useful for treating a subsequent arrhythmia. The waveform portion may be identified by a physician using a patient-external device to display the cardiac waveform. The template may be generated by a physician selecting the cardiac waveform, and determining if the therapy associated with the template was satisfactory and/or effective in treating the arrhythmia. Identification may involve matching the event to templates generated using cardiac waveforms other than the patient's cardiac waveforms. The template may be generated in a patient-internal or patient-external medical device such as a programmer, and/or an advanced patient management system.

摘要翻译： 心脏治疗方法和装置提供代表过去快速性心律失常事件的模板，每个模板与治疗相关联。 方法包括提供代表患者心脏活动的心脏波形并识别指示心律失常事件的部分。 产生对应于该部分的心脏模板，并且与可用于治疗随后的心律失常的模板相关联的治疗。 波形部分可以由医师使用患者外部设备来识别，以显示心脏波形。 模板可以由医师选择心脏波形产生，并且确定与模板相关联的治疗是否令人满意和/或有效地治疗心律失常。 识别可能涉及将事件与使用除患者心脏波形之外的心脏波形产生的模板进行匹配。 模板可以在诸如程序员和/或高级患者管理系统的患者内部或患者外部医疗设备中生成。

公开(公告)号：US20070142737A1

公开(公告)日：2007-06-21

申请号：US11312280

申请日：2005-12-20

申请人： Shelley Cazares ,  Jaeho Kim ,  Yayun Lin ,  Carlos Ricci

发明人： Shelley Cazares ,  Jaeho Kim ,  Yayun Lin ,  Carlos Ricci

IPC分类号： A61B5/04

CPC分类号： A61B5/0464 ,  A61B5/04525 ,  A61B5/7264

摘要： Cardiac systems and methods provide for discriminating between supraventricular tachyarrhythmia and ventricular tachyarrhythmia based on a determination that the patient's supraventricular rhythm exhibits rate dependency. One approach involves determining if a patient's supraventricular rhythm exhibits rate dependent morphology. If the patient's supraventricular rhythm is determined to exhibit rate dependent morphology, an implantable device classifies a detected tachyarrhythmia episode based on one or more templates selected from a plurality of rate-indexed templates stored in the device. Determining if the supraventricular rhythm exhibits rate dependent morphology may also include determining one or more rates at which the rate dependent morphology occurs.

摘要翻译： 心脏系统和方法基于确定患者的室上节律表现出速率依赖性，确定了室上性快速性心律失常与室性快速性心律失常之间的区别。 一种方法涉及确定患者的室上节律是否表现出速率依赖性形态。 如果确定患者的室上节律表现出与速率相关的形态，则可植入装置基于从存储在装置中的多个速率索引模板中选择的一个或多个模板来分类检测到的快速性心律失常发作。 确定室性心律显示出速率依赖性形态还可以包括确定发生速率依赖形态的一个或多个速率。

公开(公告)号：US09008760B2

公开(公告)日：2015-04-14

申请号：US13483394

申请日：2012-05-30

申请人： Yanting Dong ,  Shijie Zhang ,  Deepa Mahajan ,  Chenguang Liu ,  Dan Li ,  Yayun Lin ,  Derek D. Bohn

发明人： Yanting Dong ,  Shijie Zhang ,  Deepa Mahajan ,  Chenguang Liu ,  Dan Li ,  Yayun Lin ,  Derek D. Bohn

IPC分类号： A61B5/04 ,  A61B5/0452 ,  A61B5/00 ,  A61B5/0245 ,  A61B5/042 ,  A61N1/37

CPC分类号： A61B5/0452 ,  A61B5/0245 ,  A61B5/042 ,  A61B5/7217 ,  A61N1/3704

摘要： A system and method for performing off-line analysis of cardiac electrogram data, comprising: retrieving an electrogram from a memory location; identifying a first-channel group of candidate beats from at least a first channel of the electrogram; and identifying a second-channel group of candidate beats from at least a second channel of an electrogram. For each first-channel beat candidate near a second-channel beat candidate, the amplitude of the first-channel beat candidate is compared with the amplitude of a previous beat and the amplitude of a next beat on the first electrogram channel, and first-channel beat candidates that are outside of a first pre-determined range from either the previous or next beat are removed. Then first-channel beat candidates that are outside of a second pre-determined range from either the previous or next beat candidate are removed.

摘要翻译： 一种用于执行心电图数据的离线分析的系统和方法，包括：从存储器位置检索电描记图; 从所述电描记图的至少第一通道识别候选节拍的第一通道组; 以及从电描记图的至少第二通道识别候选节拍的第二通道组。 对于靠近第二声道拍子候选的每个第一声道拍子候选，将第一声道拍子候选的幅度与先前拍子的幅度和第一电摄影通道上的下一拍子的幅度进行比较，并且将第一声道 从前一个或下一个节拍中跳出超出第一个预定范围之外的候选人被删除。 然后，除去来自前一个或下一个节拍候选的第二预定范围之外的第一声道拍子候选。

公开(公告)号：US08831714B2

公开(公告)日：2014-09-09

申请号：US11744952

申请日：2007-05-07

申请人： Yayun Lin ,  Shelley M. Cazares ,  Donald L. Hopper

发明人： Yayun Lin ,  Shelley M. Cazares ,  Donald L. Hopper

IPC分类号： A61B5/04

CPC分类号： A61N1/3702 ,  A61B5/02028 ,  A61B5/02405 ,  A61B5/0464 ,  A61N1/3627 ,  A61N1/36592

摘要： An indication of an actual or potential heart failure condition is computed. One example includes monitoring a first heart rate preceding a first onset of a first sinus tachyarrhythmia episode. Upon detecting the first sinus tachyarrhythmia episode, the indication is automatically provided using information about the first heart rate and how quickly the first onset occurs.

摘要翻译： 计算出实际或潜在的心力衰竭状况的指示。 一个例子包括监测在第一次窦性心律失常发作的第一次发作之前的第一心率。 在检测到第一窦性心律失常发作时，使用关于第一心率的信息以及第一次发作发生的速度自动提供指示。

公开(公告)号：US20130138005A1

公开(公告)日：2013-05-30

申请号：US13483394

申请日：2012-05-30

申请人： Yanting Dong ,  Shijie Zhang ,  Deepa Mahajan ,  Chenguang Liu ,  Dan Li ,  Yayun Lin ,  Derek D. Bohn

发明人： Yanting Dong ,  Shijie Zhang ,  Deepa Mahajan ,  Chenguang Liu ,  Dan Li ,  Yayun Lin ,  Derek D. Bohn

IPC分类号： A61B5/0452

CPC分类号： A61B5/0452 ,  A61B5/0245 ,  A61B5/042 ,  A61B5/7217 ,  A61N1/3704

摘要： A system and method for performing off-line analysis of cardiac electrogram data, comprising: retrieving an electrogram from a memory location; identifying a first-channel group of candidate beats from at least a first channel of the electrogram; and identifying a second-channel group of candidate beats from at least a second channel of an electrogram. For each first-channel beat candidate near a second-channel beat candidate, the amplitude of the first-channel beat candidate is compared with the amplitude of a previous beat and the amplitude of a next beat on the first electrogram channel, and first-channel beat candidates that are outside of a first pre-determined range from either the previous or next beat are removed. Then first-channel beat candidates that are outside of a second pre-determined range from either the previous or next beat candidate are removed.

摘要翻译： 一种用于执行心电图数据的离线分析的系统和方法，包括：从存储器位置检索电描记图; 从所述电描记图的至少第一通道识别候选节拍的第一通道组; 以及从电描记图的至少第二通道识别候选节拍的第二通道组。 对于靠近第二声道拍子候选的每个第一声道拍子候选，将第一声道拍子候选的幅度与先前拍子的幅度和第一电摄影频道上的下一拍子的幅度进行比较，并且将第一声道 从前一个或下一个节拍中跳出超出第一个预定范围之外的候选人被删除。 然后，除去来自前一个或下一个节拍候选的第二预定范围之外的第一声道拍子候选。

公开(公告)号：US20100249863A1

公开(公告)日：2010-09-30

申请号：US12813073

申请日：2010-06-10

申请人： Gerrard M. Carlson ,  Yayun Lin

发明人： Gerrard M. Carlson ,  Yayun Lin

IPC分类号： A61N1/365 ,  A61B5/02

CPC分类号： A61N1/3962 ,  A61B5/02028 ,  A61B5/024 ,  A61B5/02405 ,  A61B7/04 ,  A61N1/3621 ,  A61N1/3627 ,  A61N1/36514 ,  A61N1/36578 ,  A61N1/37247 ,  A61N1/37282

摘要： A method comprises detecting at least one episode of ventricular tachyarrhythmia in a subject using an implantable medical device (IMD), sensing at least one heart sound signal for the subject using the IMD, the heart sound signal associated with mechanical vibration of a heart of the subject; initiating, in response to and during the detected episode of tachyarrhythmia, a measurement of hemodynamic stability of the ventricular tachyarrhythmia from the heart sound signal, and deeming whether the ventricular tachyarrhythmia is stable according to the measurement of hemodynamic stability. The measurement of hemodynamic stability is determined using linear prediction.

摘要翻译： 一种方法包括使用可植入医疗装置（IMD）检测受试者中的至少一次心室快速性心律失常，使用IMD感测对象的至少一个心音信号，与心脏的心脏的机械振动相关的心音信号 学科; 响应于和在检测到的快速性心律失常发作期间，从心脏声音信号测量心室快速性心律失常的血液动力学稳定性，并且根据血液动力学稳定性的测量来确定心室性心律失常是否稳定。 使用线性预测确定血液动力学稳定性的测量。

公开(公告)号：US20070135722A1

公开(公告)日：2007-06-14

申请号：US11625432

申请日：2007-01-22

申请人： Yayun Lin

发明人： Yayun Lin

IPC分类号： A61B5/04

CPC分类号： A61B5/7221 ,  A61B5/0452 ,  A61B5/046 ,  A61B5/7264 ,  A61N1/3704 ,  A61N1/3718

摘要： Detecting or validating signals such as cardiac beats can be performed in the presence of myopotential or other noise. An amplitude peak, which can be a candidate for a detected beat, can be used in a normalized or other weighted average, along with a preceding and subsequent sample. The weighted average is compared to a noise threshold. Based on the result, the amplitude peak is either deemed an actual beat (e.g., depolarization or repolarization), or noise. The described systems, devices, and methods can improve the accuracy of detecting an actual beat in the presence of noise, during normal sinus rhythm or during an arrhythmia such as ventricular fibrillation. This, in turn, improves the accuracy with which therapy is delivered or withheld by an implantable device.

摘要翻译： 检测或验证心脏搏动等信号可以在有电位或其他噪声的情况下进行。 可以作为检测到的拍子的候选者的振幅峰值可以与归一化或其他加权平均值一起使用，以及前一个和后续的采样。 将加权平均值与噪声阈值进行比较。 基于该结果，振幅峰值被认为是实际的搏动（例如去极化或复极化）或噪声。 所描述的系统，装置和方法可以提高在正常窦性心律期间或在诸如心室颤动的心律失常期间在噪声存在下检测实际搏动的准确性。 这反过来又提高了可植入装置输送或保留治疗的准确性。