公开(公告)号：US20090076560A1

公开(公告)日：2009-03-19

申请号：US11885326

申请日：2005-03-02

申请人： Anders Bjorling ,  Nils Holmstrom

发明人： Anders Bjorling ,  Nils Holmstrom

IPC分类号： A61N1/37

CPC分类号： A61N1/3712 ,  A61N1/368 ,  A61N1/3684

摘要： In a biventricular heart stimulator and a method for controlling such a biventricular heart stimulator, successive stimulation pulses are delivered to the ventricles of a heart such that stimulation pulses in a single heartbeat cycle are respectively first delivered to the first ventricle and then to the second ventricle. Capture or loss of capture in response to stimulation pulses delivered to one ventricle is detected. As a result of a detected loss of capture, preventative measures are taken for preventing loss of capture in the other ventricle.

摘要翻译： 在双心室心脏刺激器和用于控制这种双心室心脏刺激器的方法中，连续的刺激脉冲被递送到心脏的心室，使得单个心跳周期中的刺激脉冲分别首先被传送到第一脑室，然后被传送到第二脑室 。 检测到响应于输送到一个脑室的刺激脉冲的捕获或丢失。 由于检测到的捕获损失，采取预防措施来防止在另一脑室中的捕获损失。

公开(公告)号：US20050004607A1

公开(公告)日：2005-01-06

申请号：US10864064

申请日：2004-06-09

申请人： Anders Bjorling ,  Sven-Erik Hedberg ,  Nils Holmstrom

发明人： Anders Bjorling ,  Sven-Erik Hedberg ,  Nils Holmstrom

IPC分类号： A61N1/362 ,  A61N1/368 ,  A61N1/37

CPC分类号： A61N1/37 ,  A61N1/3627 ,  A61N1/3684 ,  Y10S128/901

摘要： In an implantable heart stimulating device, system and method, a control circuit has first and second circuits for sensing and pacing. The first circuit can be connected to a first electrode member suited to be positioned in or at a first ventricle of the heart. The second circuit can be connected to a second electrode member suited to be positioned in or at a second ventricle of the heart. The control circuit is able to detect whether signals sensed by the second circuit are likely to be far field signals. The control circuit performs this detection by at least determining whether, during a predetermined time (length, more signals are sensed by the second circuit than by the first circuit.

摘要翻译： 在可植入心脏刺激装置，系统和方法中，控制电路具有用于感测和起搏的第一和第二电路。 第一电路可以连接到适于定位在心脏的第一心室中或第一心室处的第一电极构件。 第二电路可以连接到适于定位在心脏的第二心室中或第二心室处的第二电极构件。 控制电路能够检测由第二电路感测的信号是否可能是远场信号。 控制电路通过至少确定在预定时间（长度，由第二电路感测到的信号多于第一电路的信号）来执行该检测。

公开(公告)号：US20120184866A1

公开(公告)日：2012-07-19

申请号：US13498568

申请日：2009-09-29

申请人： Nils Holmstrom ,  Anders Bjorling

发明人： Nils Holmstrom ,  Anders Bjorling

IPC分类号： A61B5/0408

CPC分类号： A61N1/36521 ,  A61B5/053 ,  A61B5/686 ,  A61N1/3627 ,  A61N1/3702 ,  A61N1/3956

摘要： The present invention generally relates to an implantable medical device and method for detecting and monitoring cardiac status of a patient using simultaneous multisite measurements of the intracardiac impedance and in particular to ischemia detection using the simultaneous multisite measurements. The device comprises an impedance measuring unit being connectable to a plurality of electrode configurations including a current generating device adapted to generate a current and apply the current between two electrodes of a current injecting electrode configuration of the electrode configurations and a voltage sensing device including a plurality of voltage sensing circuits arranged in parallel. Each voltage sensing circuit being connectable to a specific voltage sensing electrode configuration of the electrode configurations and being arranged to sense a voltage over the voltage sensing electrode configuration resulting from the applied current, wherein the voltage sensing circuits are capable of sensing the resulting voltages simultaneously. The device further comprises an impedance calculating module adapted to calculate a plurality of impedance values, each impedance value being based on the applied current and a resulting voltage.

摘要翻译： 本发明总体上涉及一种可植入医疗装置和方法，用于使用同时进行心脏内阻抗的多站点测量来检测和监测患者的心脏状态，特别是使用同时多站点测量的缺血检测。 该装置包括阻抗测量单元，其可连接到多个电极配置，包括适于产生电流的电流产生装置，并施加电极配置的电流注入电极配置的两个电极之间的电流;以及电压感测装置，包括多个 的电压感测电路并联布置。 每个电压感测电路可连接到电极配置的特定电压感测电极配置，并且布置成感测由所施加的电流产生的电压感测电极配置上的电压，其中电压感测电路能够同时感测所得到的电压。 该装置还包括适于计算多个阻抗值的阻抗计算模块，每个阻抗值基于所施加的电流和所得到的电压。

公开(公告)号：US07546161B1

公开(公告)日：2009-06-09

申请号：US11330316

申请日：2006-01-11

申请人： Anders Bjorling ,  Xiaoyi Min ,  Richard Williamson ,  Karin Jarverud ,  Nils Holmstrom

发明人： Anders Bjorling ,  Xiaoyi Min ,  Richard Williamson ,  Karin Jarverud ,  Nils Holmstrom

IPC分类号： A61N1/368

CPC分类号： A61N1/3712 ,  A61B5/0452 ,  A61N1/3684

摘要： An exemplary method includes delivering biventricular pacing therapy using one or more timing parameters, detecting loss of capture, deciding if fusion exists without adjusting the one or more timing parameters and, based on the deciding, calling for fusion avoidance or calling for a capture threshold search. Various other exemplary methods, devices, systems, etc., are also disclosed.

摘要翻译： 一种示例性方法包括使用一个或多个定时参数提供双心室起搏治疗，检测捕获的丢失，确定融合是否存在而不调整一个或多个定时参数，以及基于决定呼叫融合避免或调用捕获阈值搜索 。 还公开了各种其它示例性方法，装置，系统等。

公开(公告)号：US20090030470A1

公开(公告)日：2009-01-29

申请号：US12160849

申请日：2006-01-26

申请人： Nils Holmstrom ,  Anders Bjorling

发明人： Nils Holmstrom ,  Anders Bjorling

IPC分类号： A61N1/368

CPC分类号： A61N1/371 ,  A61N1/3684

摘要： An implantable heart stimulating device has a left ventricular coronary sinus electrode lead provided with a tip electrode, a right ventricular electrode lead provided with a ring electrode, and a pulse generator connected to the leads that applies stimulation pulses between the tip electrode and the ring electrode, with the tip electrode serving as the anode. A monitoring unit monitors for and detects anodal capture at the right ventricular ring electrode subsequent to a stimulation. If anodal capture is detected, either a threshold search is performed by varying the pulse width and/or pulse amplitude of stimulation pulses in order to identify stimulation pulse characteristics that avoid anodal capture at the ring electrode, or at least one further electrode is activated to function as an indifferent electrode together with the ring electrode, also in order to avoid anodal capture at the ring electrode.

摘要翻译： 可植入心脏刺激装置具有设置有尖端电极的左心室冠状窦电极引线，设置有环形电极的右心室电极引线和连接到引线的脉冲发生器，其在尖端电极和环形电极之间施加刺激脉冲 ，尖端电极用作阳极。 监测单元在刺激之后监测和检测右心室环电极处的阳极捕获。 如果检测到阳极捕获，则通过改变刺激脉冲的脉冲宽度和/或脉冲幅度来执行阈值搜索，以便识别避免在环形电极处的阳极捕获的刺激脉冲特性，或者至少一个另外的电极被激活 与环形电极一起作为无关电极，也是为了避免在环形电极处的阳极捕获。

公开(公告)号：US20080281373A1

公开(公告)日：2008-11-13

申请号：US11793478

申请日：2004-12-17

申请人： Anders Bjorling ,  Nils Holmstrom

发明人： Anders Bjorling ,  Nils Holmstrom

IPC分类号： A61N1/362 ,  A61N1/37

CPC分类号： A61N1/3712

摘要： In an implantable heart stimulator and a method for operation thereof, stimulation pulses are delivered to a heart. The amplitude of the delivered stimulation pulses can be selectively set. For setting the amplitude, threshold searches are performed at selected time intervals. Each threshold search determines a threshold value required for achieving capture. The amplitudes of the respective stimulation pulses are set to a value that exceeds the determined threshold value by a safety margin. The safety margin is selected as a function of the selected time intervals.

摘要翻译： 在可植入心脏刺激器及其操作方法中，将刺激脉冲输送到心脏。 输送的刺激脉冲的幅度可以选择性地设定。 为了设置幅度，以选定的时间间隔执行阈值搜索。 每个阈值搜索确定实现捕获所需的阈值。 相应的刺激脉冲的振幅被设置为超过所确定的阈值的安全裕度的值。 根据所选择的时间间隔选择安全裕度。

公开(公告)号：US20090149908A1

公开(公告)日：2009-06-11

申请号：US12090157

申请日：2005-10-31

申请人： Anders Bjorling ,  Nils Holmstrom ,  Karin Jarverud

发明人： Anders Bjorling ,  Nils Holmstrom ,  Karin Jarverud

IPC分类号： A61N1/37 ,  A61N1/368

CPC分类号： A61N1/3627 ,  A61N1/368 ,  A61N1/3684 ,  A61N1/3712

摘要： In an implantable biventricular heart stimulating device, and a biventricular heart stimulating method, wherein operation takes place normally with a time VV between a pacing pulse delivered, or inhibited, by a first ventricular pacing circuit and a pacing pulse delivered, or inhibited, by a second ventricular pacing circuit, and wherein a time VVcts is determined that is to be used instead of VV during a capture threshold search.

摘要翻译： 在可植入的双心室心脏刺激装置和双心室心脏刺激方法中，其中手术通常由第一心室起搏电路递送或抑制的起搏脉冲与通过一个或多个第一心室起搏电路递送或抑制的起搏脉冲之间的时间VV进行 第二心室起搏电路，并且其中在捕获阈值搜索期间确定要用于代替VV的时间VVcts。

公开(公告)号：US20080091239A1

公开(公告)日：2008-04-17

申请号：US11582211

申请日：2006-10-16

申请人： Anna-Karin Johansson ,  Kenth Nilsson ,  Cecilia Tuvstedt ,  Kjell Noren ,  Anders Bjorling ,  Andreas Blomqvist ,  Berit Larsson ,  Sven-Erik Hedberg ,  Karin Jarverud ,  Nils Holmstrom

发明人： Anna-Karin Johansson ,  Kenth Nilsson ,  Cecilia Tuvstedt ,  Kjell Noren ,  Anders Bjorling ,  Andreas Blomqvist ,  Berit Larsson ,  Sven-Erik Hedberg ,  Karin Jarverud ,  Nils Holmstrom

IPC分类号： A61N1/36 ,  A61N1/362 ,  A61N1/39

CPC分类号： A61N1/36514 ,  A61N1/3956

摘要： In a cardiac assist device and method, a microphone is placed in contact with the epicardium of the heart of a patient, and heart and lung sounds are simultaneously detected at the placement location of the microphone. The heart and lung sounds are automatically analyzed to set an appropriate cardiac therapy for the patient.

摘要翻译： 在心脏辅助装置和方法中，将麦克风放置成与患者心脏的心外膜接触，并且在麦克风的放置位置同时检测心脏和肺部的声音。 自动分析心脏和肺部声音，为患者设定适当的心脏治疗。

公开(公告)号：US20060235325A1

公开(公告)日：2006-10-19

申请号：US10524196

申请日：2003-06-23

申请人： Nils Holmstrom ,  Martin Obel ,  Anna Norlin ,  Kenneth Dahlberg ,  Anders Bjorling ,  Sven Kalling ,  Karin Ljungstrom ,  Kjell Noren

发明人： Nils Holmstrom ,  Martin Obel ,  Anna Norlin ,  Kenneth Dahlberg ,  Anders Bjorling ,  Sven Kalling ,  Karin Ljungstrom ,  Kjell Noren

IPC分类号： A61B5/05 ,  A61B5/02

CPC分类号： A61B5/0538 ,  A61B5/053 ,  A61N1/3627

摘要： A congestive heart failure monitor has an impedance measuring unit that measures the impedance between at least two electrodes implanted in a patient, to use a detected change of the measured impedance as an indication of a change in the left atrium volume. Any analyzing unit analyzes the measured impedance and detects insipient congestive heart failure dependent on a quotient of a maximum value of the measured impedance and a minimum value of the measured impedance during a cardiac cycle.

摘要翻译： 充血性心力衰竭监测器具有阻抗测量单元，其测量植入患者中的至少两个电极之间的阻抗，以使用检测到的测量阻抗的变化作为左心房体积变化的指示。 任何分析单元分析所测量的阻抗，并根据所测量的阻抗的最大值和心动周期内所测量的阻抗的最小值来检测不利的充血性心力衰竭。

公开(公告)号：US08600497B1

公开(公告)日：2013-12-03

申请号：US11558088

申请日：2006-11-09

申请人： Weiqun Yang ,  Malin Ohlander ,  Louis Wong ,  Nils Holmstrom ,  Cem Shaquer ,  Euljoon Park ,  Dorin Panescu ,  Shahrooz Shahparnia ,  Andre Walker ,  Ajit Pillai ,  Mihir Naware

发明人： Weiqun Yang ,  Malin Ohlander ,  Louis Wong ,  Nils Holmstrom ,  Cem Shaquer ,  Euljoon Park ,  Dorin Panescu ,  Shahrooz Shahparnia ,  Andre Walker ,  Ajit Pillai ,  Mihir Naware

IPC分类号： A61B5/05 ,  A61N1/00

CPC分类号： A61B5/02028 ,  A61B5/0031 ,  A61B5/029 ,  A61B5/0538 ,  A61B5/08 ,  A61B5/4878 ,  A61N1/3627 ,  A61N1/36521 ,  A61N1/3702

摘要： An implantable device monitors and treats heart failure, pulmonary edema, and hemodynamic conditions and in some cases applies therapy. In one implementation, the implantable device applies a high-frequency multi-phasic pulse waveform over multiple-vectors through tissue. The waveform has a duration less than the charging time constant of electrode-electrolyte interfaces in vivo to reduce intrusiveness while increasing sensitivity and specificity for trending parameters. The waveform can be multiplexed over multiple vectors and the results cross-correlated or subjected to probabilistic analysis or thresholding schemata to stage heart failure or pulmonary edema. In one implementation, a fractionation morphology of a sensed impedance waveform is used to trend intracardiac pressure to stage heart failure and to regulate cardiac resynchronization therapy. The waveform also provides unintrusive electrode integrity checks and 3-D impedancegrams.

摘要翻译： 植入式装置监测和治疗心力衰竭，肺水肿和血液动力学状况，并且在某些情况下应用治疗。 在一个实施方案中，可植入装置通过组织在多个向量上施加高频多相脉冲波形。 该波形的持续时间小于体内电极 - 电解质界面的充电时间常数，以降低侵入性，同时增加趋势参数的灵敏度和特异性。 波形可以在多个载体上进行复用，并且结果相互关联或进行概率分析或阈值模式以分步心脏衰竭或肺水肿。 在一个实施方案中，使用感测阻抗波形的分级形态来趋向心脏内压力来分级心力衰竭并调节心脏再同步治疗。 该波形还提供非侵入式电极完整性检查和3-D阻抗图。