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    Local and non-local sensing for cardiac pacing
    1.
    发明申请
    Local and non-local sensing for cardiac pacing 有权
    心脏起搏的局部和非局部感觉

    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。

    Local and non-local sensing for cardiac pacing
    2.
    发明授权
    Local and non-local sensing for cardiac pacing 有权
    心脏起搏的局部和非局部感觉

    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。

    Determination of cardiac pacing parameters based on non-localized sensing
    3.
    发明申请
    Determination of cardiac pacing parameters based on non-localized sensing 审中-公开
    基于非局部感知的心脏起搏参数的确定

    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。

    Automatic electrode integrity management systems and methods
    4.
    发明授权
    Automatic electrode integrity management systems and methods 有权
    自动电极完整性管理系统和方法

    公开(公告)号：US08442635B2

    公开(公告)日：2013-05-14

    申请号：US13031762

    申请日：2011-02-22

    申请人： Derek D. Bohn ,  M. Jason Brooke ,  Rajesh K. Gandhi ,  Alok S. Sathaye ,  Aaron R. McCabe

    发明人： Derek D. Bohn ,  M. Jason Brooke ,  Rajesh K. Gandhi ,  Alok S. Sathaye ,  Aaron R. McCabe

    IPC分类号： A61N1/08

    CPC分类号： A61N1/37282 ,  A61N1/368 ,  A61N1/3684 ,  A61N1/3706 ,  A61N2001/083

    摘要： This document discusses, among other things, systems and methods for automatic electrode integrity management. Interelectrode impedance is measured for various electrode combinations of an implantable cardiac function management device. The impedance data is processed, such as at an external remote server, to determine whether an electrode is failing or has failed, to select an alternate electrode configuration, to alert a physician or patient, to predict a time-to-failure such as by using population data, or to reprogram electrode configuration or other device parameters of the implantable cardiac function management device.

    摘要翻译： 本文件还讨论了自动电极完整性管理的系统和方法。 测量可植入心脏功能管理装置的各种电极组合的电极内阻抗。 处理阻抗数据，例如在外部远程服务器处，以确定电极是否发生故障或失败，选择备用电极配置，以警告医师或患者预测失效时间，例如通过 使用种群数据，或重新编程可植入心脏功能管理装置的电极配置或其他装置参数。

    Cardiac activation sequence monitoring for ischemia detection
    8.
    发明授权
    Cardiac activation sequence monitoring for ischemia detection 失效
    心脏激活序列监测缺血检测

    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。

    OPTIMIZATION OF LV AND RV LEAD PLACEMENT BASED ON ELECTRICAL DELAYS
    9.
    发明申请
    OPTIMIZATION OF LV AND RV LEAD PLACEMENT BASED ON ELECTRICAL DELAYS 有权
    基于电延迟优化LV和RV导线放置

    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。

    Arrhythmia discrimination using electrocardiograms sensed from multiple implanted electrodes
    10.
    发明授权
    Arrhythmia discrimination using electrocardiograms sensed from multiple implanted electrodes 有权
    使用从多个植入电极感测的心电图的心律失常辨别

    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。