公开(公告)号：US20080009909A1

公开(公告)日：2008-01-10

申请号：US11478286

申请日：2006-06-29

申请人： Alok S. Sathaye ,  Aaron R. McCabe ,  Yinghong Yu

发明人： Alok S. Sathaye ,  Aaron R. McCabe ,  Yinghong Yu

IPC分类号： A61N1/00

CPC分类号： A61B5/0452 ,  A61N1/36585 ,  A61N1/368 ,  A61N1/3682 ,  A61N1/3684

摘要： Systems and methods for determining pacing timing intervals based on the temporal relationship between the timing of local and non-local cardiac signal features are described. A device includes a plurality of implantable electrodes electrically coupled to the heart and configured to sense local and non-local cardiac signals. Sense circuitry coupled to first and second electrode pairs senses a local cardiac signal via a first electrode pair and a non-local cardiac signal via a second electrode pair. Detection circuitry is used to detect a feature of the local signal associated with activation of a heart chamber and to detect a feature of the non-local signal associated with activation of the heart chamber. A control processor times delivery of one or more pacing pulses based on a temporal relationship between timing of the local signal feature and timing of the non-local signal feature.

摘要翻译： 描述了基于局部和非局部心脏信号特征的定时之间的时间关系来确定起搏定时间隔的系统和方法。 一种装置包括电耦合到心脏并被配置为感测局部和非局部心脏信号的多个可植入电极。 耦合到第一和第二电极对的感测电路经由第二电极对经由第一电极对和非局部心脏信号感测局部心脏信号。 检测电路用于检测与心室的激活相关联的局部信号的特征，并且检测与心室的激活相关的非局部信号的特征。 控制处理器基于本地信号特征的定时和非本地信号特征的定时之间的时间关系来递送一个或多个起搏脉冲的递送。

公开(公告)号：US08527048B2

公开(公告)日：2013-09-03

申请号：US11478286

申请日：2006-06-29

申请人： Alok S. Sathaye ,  Aaron R. McCabe ,  Yinghong Yu

发明人： Alok S. Sathaye ,  Aaron R. McCabe ,  Yinghong Yu

IPC分类号： A61N1/365

CPC分类号： A61B5/0452 ,  A61N1/36585 ,  A61N1/368 ,  A61N1/3682 ,  A61N1/3684

摘要： Systems and methods for determining pacing timing intervals based on the temporal relationship between the timing of local and non-local cardiac signal features are described. A device includes a plurality of implantable electrodes electrically coupled to the heart and configured to sense local and non-local cardiac signals. Sense circuitry coupled to first and second electrode pairs senses a local cardiac signal via a first electrode pair and a non-local cardiac signal via a second electrode pair. Detection circuitry is used to detect a feature of the local signal associated with activation of a heart chamber and to detect a feature of the non-local signal associated with activation of the heart chamber. A control processor times delivery of one or more pacing pulses based on a temporal relationship between timing of the local signal feature and timing of the non-local signal feature.

摘要翻译： 描述了基于局部和非局部心脏信号特征的定时之间的时间关系来确定起搏定时间隔的系统和方法。 一种装置包括电耦合到心脏并被配置为感测局部和非局部心脏信号的多个可植入电极。 耦合到第一和第二电极对的感测电路经由第二电极对经由第一电极对和非局部心脏信号感测局部心脏信号。 检测电路用于检测与心室的激活相关联的局部信号的特征，并且检测与心室的激活相关的非局部信号的特征。 控制处理器基于本地信号特征的定时和非本地信号特征的定时之间的时间关系来递送一个或多个起搏脉冲的递送。

公开(公告)号：US20080004665A1

公开(公告)日：2008-01-03

申请号：US11478428

申请日：2006-06-29

申请人： Aaron R. McCabe ,  Alok S. Sathaye ,  Yinghong Yu

发明人： Aaron R. McCabe ,  Alok S. Sathaye ,  Yinghong Yu

IPC分类号： A61N1/00

CPC分类号： A61N1/3627 ,  A61N1/3682

摘要： An atrioventricular delay (AVD) for cardiac pacing therapy is determined based, at least in part, on one or more cardiac activation signals sensed using body-implantable electrodes providing non-local sensing. A conduction delay is estimated using a non-local cardiac activation signal and the AVD is determined based on the conduction delay. Estimating the conduction delay may involve measuring a P-wave width or measuring a QRS complex width of the non-local signal. If multiple signals are sensed, the conduction delay may be estimated from a selected signal or may be estimated by forming a representative signal such as through averaging or other methods. The AVD may be determined as a function of the estimated conduction delay.

摘要翻译： 至少部分地基于使用提供非局部感测的体内植入电极感测到的一种或多种心脏激活信号来确定用于心脏起搏治疗的房室延迟（AVD）。 使用非局部心脏激活信号估计导通延迟，并且基于导通延迟来确定AVD。 估计传导延迟可能涉及测量P波宽度或测量非本地信号的QRS复数宽度。 如果感测到多个信号，则可以从所选择的信号估计导通延迟，或者可以通过形成诸如通过平均或其它方法的代表性信号来估计导通延迟。 AVD可以被确定为估计的传导延迟的函数。

公开(公告)号：US20110137192A1

公开(公告)日：2011-06-09

申请号：US13027608

申请日：2011-02-15

申请人： Yi Zhang ,  Carlos Alberto Ricci ,  Jeffrey E. Stahmann ,  Aaron R. McCabe ,  Scott A. Meyer ,  Yinghong Yu

发明人： Yi Zhang ,  Carlos Alberto Ricci ,  Jeffrey E. Stahmann ,  Aaron R. McCabe ,  Scott A. Meyer ,  Yinghong Yu

IPC分类号： A61B5/0402

CPC分类号： A61B5/04011 ,  A61B5/7203

摘要： Cardiac monitoring and/or stimulation methods and systems provide for monitoring, diagnosing, defibrillation and pacing therapies, or a combination of these capabilities, including cardiac systems incorporating or cooperating with neuro-stimulating devices, drug pumps, or other therapies. Embodiments of the present invention relate generally to implantable medical devices employing automated cardiac activation sequence monitoring and/or tracking for arrhythmia discrimination. Embodiments of the invention are directed to devices and methods involving sensing a plurality of composite cardiac signals using a plurality of implantable electrodes. A source separation is performed using the sensed plurality of composite cardiac signals and the separation produces one or more cardiac signal vectors associated with one or more cardiac activation sequences that is indicative of ischemia. A change of the one or more cardiac signal vectors is detected using the one or more cardiac signal vectors. Cardiac arrhythmias are discriminated using the one or more cardiac signal vectors.

摘要翻译： 心脏监测和/或刺激方法和系统提供监测，诊断，除颤和起搏治疗，或这些功能的组合，包括结合或与神经刺激装置，药物泵或其他疗法组合的心脏系统。 本发明的实施方案一般涉及使用自动心脏激活序列监测和/或跟踪用于心律失常鉴别的可植入医疗装置。 本发明的实施例涉及使用多个可植入电极感测多个复合心脏信号的装置和方法。 使用感测的多个复合心脏信号进行源分离，并且分离产生与指示缺血的一个或多个心脏激活序列相关联的一个或多个心脏信号载体。 使用一个或多个心脏信号矢量检测一个或多个心脏信号矢量的改变。 使用一个或多个心脏信号载体来区分心律失常。

公开(公告)号：US20100298729A1

公开(公告)日：2010-11-25

申请号：US12847657

申请日：2010-07-30

申请人： Yi Zhang ,  Scott A. Meyer ,  Jeffrey E. Stahmann ,  Carlos Alberto Ricci ,  Marina Brockway ,  Aaron R. McCabe ,  Yinghong Yu ,  Donald L. Hopper

发明人： Yi Zhang ,  Scott A. Meyer ,  Jeffrey E. Stahmann ,  Carlos Alberto Ricci ,  Marina Brockway ,  Aaron R. McCabe ,  Yinghong Yu ,  Donald L. Hopper

IPC分类号： A61B5/0452

CPC分类号： A61N1/3702 ,  A61B5/0452 ,  A61B5/7203

摘要： Cardiac monitoring and/or stimulation methods and systems that provide one or more of monitoring, diagnosing, defibrillation, and pacing. Cardiac signal separation is employed to detect, monitor, track and/or trend ischemia using cardiac activation sequence information. Ischemia detection may involve sensing composite cardiac signals using implantable electrodes, and performing a signal separation that produces one or more cardiac activation signal vectors associated with one or more cardiac activation sequences. A change in the signal vector may be detected using subsequent separations. The change may be an elevation or depression of the ST segment of a cardiac cycle or other change indicative of myocardial ischemia, myocardial infarction, or other pathological change. The change may be used to predict, quantify, and/or qualify an event such as an arrhythmia, a myocardial infarction, or other pathologic change. Information associated with the vectors may be stored and used to track the vectors.

摘要翻译： 提供一种或多种监测，诊断，除颤和起搏的心脏监测和/或刺激方法和系统。 使用心脏信号分离来使用心脏激活序列信息来检测，监测，跟踪和/或趋势性缺血。 缺血检测可以涉及使用可植入电极感测复合心脏信号，并且执行产生与一个或多个心脏激活序列相关联的一个或多个心脏激活信号载体的信号分离。 可以使用后续分离来检测信号矢量的变化。 该变化可以是心​​脏周期的ST段的升高或抑制或指示心肌缺血，心肌梗死或其他病理变化的其它变化。 该变化可用于预测，量化和/或限定诸如心律失常，心肌梗死或其它病理变化的事件。 与矢量相关联的信息可以被存储并用于跟踪矢量。

公开(公告)号：US07797036B2

公开(公告)日：2010-09-14

申请号：US11079744

申请日：2005-03-14

申请人： Yi Zhang ,  Scott A. Meyer ,  Jeffrey E. Stahmann ,  Carlos Alberto Ricci ,  Marina Brockway ,  Aaron R. McCabe ,  Yinghong Yu ,  Donald I. Hopper

发明人： Yi Zhang ,  Scott A. Meyer ,  Jeffrey E. Stahmann ,  Carlos Alberto Ricci ,  Marina Brockway ,  Aaron R. McCabe ,  Yinghong Yu ,  Donald I. Hopper

IPC分类号： A61B5/04

CPC分类号： A61N1/3702 ,  A61B5/0452 ,  A61B5/7203

摘要： Cardiac monitoring and/or stimulation methods and systems that provide one or more of monitoring, diagnosing, defibrillation, and pacing. Cardiac signal separation is employed to detect, monitor, track and/or trend ischemia using cardiac activation sequence information. Ischemia detection may involve sensing composite cardiac signals using implantable electrodes, and performing a signal separation that produces one or more cardiac activation signal vectors associated with one or more cardiac activation sequences. A change in the signal vector may be detected using subsequent separations. The change may be an elevation or depression of the ST segment of a cardiac cycle or other change indicative of myocardial ischemia, myocardial infarction, or other pathological change. The change may be used to predict, quantify, and/or qualify an event such as an arrhythmia, a myocardial infarction, or other pathologic change. Information associated with the vectors may be stored and used to track the vectors.

摘要翻译： 提供一种或多种监测，诊断，除颤和起搏的心脏监测和/或刺激方法和系统。 使用心脏信号分离来使用心脏激活序列信息来检测，监测，跟踪和/或趋势性缺血。 缺血检测可以涉及使用可植入电极感测复合心脏信号，并且执行产生与一个或多个心脏激活序列相关联的一个或多个心脏激活信号载体的信号分离。 可以使用后续分离来检测信号矢量的变化。 该变化可以是心​​脏周期的ST段的升高或抑制或指示心肌缺血，心肌梗死或其他病理变化的其它变化。 该变化可用于预测，量化和/或限定诸如心律失常，心肌梗死或其它病理变化的事件。 与矢量相关联的信息可以被存储并用于跟踪矢量。

公开(公告)号：US08626276B2

公开(公告)日：2014-01-07

申请号：US12847657

申请日：2010-07-30

申请人： Yi Zhang ,  Scott A. Meyer ,  Jeffrey E. Stahmann ,  Carlos Alberto Ricci ,  Marina Brockway ,  Aaron R. McCabe ,  Yinghong Yu ,  Donald L. Hopper

发明人： Yi Zhang ,  Scott A. Meyer ,  Jeffrey E. Stahmann ,  Carlos Alberto Ricci ,  Marina Brockway ,  Aaron R. McCabe ,  Yinghong Yu ,  Donald L. Hopper

IPC分类号： A61B5/04

CPC分类号： A61N1/3702 ,  A61B5/0452 ,  A61B5/7203

摘要： Cardiac monitoring and/or stimulation methods and systems that provide one or more of monitoring, diagnosing, defibrillation, and pacing. Cardiac signal separation is employed to detect, monitor, track and/or trend ischemia using cardiac activation sequence information. Ischemia detection may involve sensing composite cardiac signals using implantable electrodes, and performing a signal separation that produces one or more cardiac activation signal vectors associated with one or more cardiac activation sequences. A change in the signal vector may be detected using subsequent separations. The change may be an elevation or depression of the ST segment of a cardiac cycle or other change indicative of myocardial ischemia, myocardial infarction, or other pathological change. The change may be used to predict, quantify, and/or qualify an event such as an arrhythmia, a myocardial infarction, or other pathologic change. Information associated with the vectors may be stored and used to track the vectors.

摘要翻译： 提供一种或多种监测，诊断，除颤和起搏的心脏监测和/或刺激方法和系统。 使用心脏信号分离来使用心脏激活序列信息来检测，监测，跟踪和/或趋势性缺血。 缺血检测可以涉及使用可植入电极感测复合心脏信号，并且执行产生与一个或多个心脏激活序列相关联的一个或多个心脏激活信号载体的信号分离。 可以使用后续分离来检测信号矢量的变化。 该变化可以是心​​脏周期的ST段的升高或抑制或指示心肌缺血，心肌梗死或其他病理变化的其它变化。 该变化可用于预测，量化和/或限定诸如心律失常，心肌梗死或其它病理变化的事件。 与矢量相关联的信息可以被存储并用于跟踪矢量。

公开(公告)号：US20130190636A1

公开(公告)日：2013-07-25

申请号：US13552996

申请日：2012-07-19

申请人： Shibaji Shome ,  Pramodsingh Hirasingh Thakur ,  Yinghong Yu ,  Keith L. Herrmann ,  Aaron R. McCabe ,  Jiang Ding

发明人： Shibaji Shome ,  Pramodsingh Hirasingh Thakur ,  Yinghong Yu ,  Keith L. Herrmann ,  Aaron R. McCabe ,  Jiang Ding

IPC分类号： A61B5/0456 ,  A61B5/04

CPC分类号： A61B5/0456 ,  A61B5/04012 ,  A61N1/3684 ,  A61N1/3686 ,  A61N1/3702 ,  A61N1/37247 ,  A61N1/3918

摘要： A system comprises a cardiac signal sensing and a processing circuit. The cardiac signal sensing circuit senses a first cardiac signal segment that includes a QRS complex and a second cardiac signal segment that includes a fiducial indicative of local ventricular activation. The processor circuit includes a site activation timer circuit configured to determine a time duration between a fiducial of the QRS complex of the first cardiac signal segment and the fiducial of the second cardiac signal segment. The processor circuit is configured to generate, using the determined time duration, an indication of optimality of placement of one or more electrodes for delivering therapy and provide the indication to at least one of a user or process.

摘要翻译： 一种系统包括心脏信号感测和处理电路。 心脏信号感测电路感测包括QRS复合物的第一心脏信号片段和包括指示局部心室激活的基准的第二心脏信号片段。 处理器电路包括站点激活定时器电路，其被配置为确定第一心脏信号段的QRS复合体的基准点与第二心脏信号段的基准点之间的持续时间。 处理器电路被配置为使用所确定的持续时间来生成用于递送治疗的一个或多个电极的放置的最佳化的指示，并向至少一个用户或过程提供指示。

公开(公告)号：US07917196B2

公开(公告)日：2011-03-29

申请号：US11125020

申请日：2005-05-09

申请人： Yi Zhang ,  Carlos Alberto Ricci ,  Jeffrey E. Stahmann ,  Aaron R. McCabe ,  Scott A. Meyer ,  Yinghong Yu

发明人： Yi Zhang ,  Carlos Alberto Ricci ,  Jeffrey E. Stahmann ,  Aaron R. McCabe ,  Scott A. Meyer ,  Yinghong Yu

IPC分类号： A61B5/0464

CPC分类号： A61B5/04011 ,  A61B5/7203

摘要： Cardiac monitoring and/or stimulation methods and systems provide for monitoring, diagnosing, defibrillation and pacing therapies, or a combination of these capabilities, including cardiac systems incorporating or cooperating with neuro-stimulating devices, drug pumps, or other therapies. Embodiments relate generally to implantable medical devices employing automated cardiac activation sequence monitoring and/or tracking for arrhythmia discrimination. Embodiments are directed to devices and methods involving sensing a plurality of composite cardiac signals using a plurality of implantable electrodes. A source separation is performed using the sensed plurality of composite cardiac signals and the separation produces one or more cardiac signal vectors associated with one or more cardiac activation sequences that is indicative of ischemia. A change of the one or more cardiac signal vectors is detected using the one or more cardiac signal vectors. Cardiac arrhythmias are discriminated using the one or more cardiac signal vectors.

摘要翻译： 心脏监测和/或刺激方法和系统提供监测，诊断，除颤和起搏治疗，或这些能力的组合，包括结合或与神经刺激装置，药物泵或其他疗法组合的心脏系统。 实施例一般涉及使用自动心脏激活序列监测和/或跟踪用于心律失常鉴别的可植入医疗装置。 实施例涉及使用多个可植入电极感测多个复合心脏信号的装置和方法。 使用感测的多个复合心脏信号进行源分离，并且分离产生与指示缺血的一个或多个心脏激活序列相关联的一个或多个心脏信号载体。 使用一个或多个心脏信号矢量检测一个或多个心脏信号矢量的改变。 使用一个或多个心脏信号载体来区分心律失常。

公开(公告)号：US07457664B2

公开(公告)日：2008-11-25

申请号：US11125068

申请日：2005-05-09

申请人： Yi Zhang ,  Yinghong Yu ,  Aaron R. McCabe ,  Jiang Ding ,  Jeffrey E. Stahmann ,  Carlos Alberto Ricci ,  Scott A. Meyer

发明人： Yi Zhang ,  Yinghong Yu ,  Aaron R. McCabe ,  Jiang Ding ,  Jeffrey E. Stahmann ,  Carlos Alberto Ricci ,  Scott A. Meyer

IPC分类号： A61N1/365

CPC分类号： A61N1/3712 ,  A61N1/3627 ,  A61N1/365 ,  G06F19/00

摘要： Cardiac monitoring and/or stimulation methods and systems that provide one or more of monitoring, diagnosing, defibrillation, and pacing. Cardiac signal separation is employed to detect, monitor, track, and/or trend closed-loop cardiac resynchronization therapy using cardiac activation sequence information. Devices and methods involve sensing a plurality of composite cardiac signals using a plurality of electrodes, the electrodes configured for implantation in a patient. A source separation is performed using the sensed plurality of composite cardiac signals, producing one or more cardiac signal vectors associated with all or a portion of one or more cardiac activation sequences. A cardiac resynchronization therapy is adjusted using one or both of the one or more cardiac signal vectors and the signals associated with the one or more cardiac signal vectors. In further embodiments, the cardiac resynchronization therapy may be initiated, terminated, or one or more parameters of the resynchronization therapy may be altered.

摘要翻译： 提供一种或多种监测，诊断，除颤和起搏的心脏监测和/或刺激方法和系统。 心脏信号分离用于使用心脏激活序列信息来检测，监测，跟踪和/或趋向闭环心脏再同步治疗。 设备和方法包括使用多个电极感测多个复合心脏信号，所述电极被配置用于植入患者体内。 使用所感测的多个复合心脏信号进行源分离，产生与一个或多个心脏激活序列的全部或一部分相关联的一个或多个心脏信号载体。 使用一个或多个心脏信号向量和与一个或多个心脏信号载体相关联的信号中的一个或两个来调整心脏再同步治疗。 在另外的实施方案中，心脏再同步治疗可以被启动，终止，或者可以改变再同步治疗的一个或多个参数。