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    Method and apparatus for controlling cardiac therapy based on electromechanical timing
    1.
    发明申请
    Method and apparatus for controlling cardiac therapy based on electromechanical timing 有权
    基于机电定时控制心脏治疗的方法和装置

    公开(公告)号：US20060293714A1

    公开(公告)日：2006-12-28

    申请号：US11168024

    申请日：2005-06-28

    申请人： Rodney Salo ,  Joseph Pastore ,  Andrew Kramer ,  Jeffrey Stahmann ,  Jesse Hartley

    发明人： Rodney Salo ,  Joseph Pastore ,  Andrew Kramer ,  Jeffrey Stahmann ,  Jesse Hartley

    IPC分类号： A61N1/36

    CPC分类号： A61N1/3627 ,  A61M5/14276 ,  A61N1/36521 ,  A61N1/36585 ,  A61N1/3756

    摘要： Devices and methods for therapy control based on electromechanical timing involve detecting electrical activation of a patient's heart, and detecting mechanical cardiac activity resulting from the electrical activation. A timing relationship is determined between the electrical activation and the mechanical activity. A therapy is controlled based on the timing relationship. The therapy may improve intraventricular dyssynchrony of the patient's heart, or treat at least one of diastolic and systolic dysfunction and/or dyssynchrony of the patient's heart, for example. Electrical activation may be detected by sensing delivery of an electrical stimulation pulse to the heart or sensing intrinsic depolarization of the patient's heart. Mechanical activity may be detected by sensing heart sounds, a change in one or more of left ventricular impedance, ventricular pressure, right ventricular pressure, left atrial pressure, right atrial pressure, systemic arterial pressure and pulmonary artery pressure.

    摘要翻译： 基于机电定时的治疗控制的装置和方法涉及检测患者心脏的电激活，以及检测由电激活引起的机械心脏活动。 在电激活和机械活动之间确定时序关系。 基于时间关系控制治疗。 该治疗可以改善患者心脏的心室内不同步，或治疗患者心脏的舒张期和收缩功能障碍和/或不同步中的至少一种。 可以通过感测向心脏传递电刺激脉冲或感测患者心脏的固有去极化来检测电激活。 可以通过感测心脏声音，左心室阻抗，心室压力，右心室压力，左心房压力，右心房压力，全身动脉压力和肺动脉压力中的一个或多个的变化来检测机械活动。

    Therapy control based on the rate of change of intracardiac impedance
    5.
    发明申请
    Therapy control based on the rate of change of intracardiac impedance 有权
    基于心内阻抗变化率的治疗控制

    公开(公告)号：US20070005114A1

    公开(公告)日：2007-01-04

    申请号：US11169339

    申请日：2005-06-29

    申请人： Rodney Salo ,  Joseph Pastore ,  Jeffrey Stahmann ,  Jesse Hartley

    发明人： Rodney Salo ,  Joseph Pastore ,  Jeffrey Stahmann ,  Jesse Hartley

    IPC分类号： A61N1/00

    CPC分类号： A61N1/36521 ,  A61N1/30

    摘要： A system comprising a medical device that includes an impedance measurement circuit adapted to be coupled to implantable electrodes to obtain an intracardiac impedance signal between electrodes, a therapy circuit operable to deliver a therapy to a subject, and a controller circuit coupled to the impedance measurement circuit and the therapy circuit. The controller circuit determines a time rate of change of the intracardiac impedance signal and adjusts at least one parameter related to therapy in a manner that alters the rate of change.

    摘要翻译： 一种包括医疗装置的系统，该医疗装置包括阻抗测量电路，该阻抗测量电路适于耦合到可植入电极以获得电极之间的心内阻抗信号，可操作以将治疗递送给受试者的治疗电路，以及耦合到所述阻抗测量电路 和治疗电路。 控制器电路确定心内阻抗信号的时间变化率，并且以改变变化率的方式调节与治疗相关的至少一个参数。

    METHOD AND APPARATUS FOR TREATING IRREGULAR VENTRICULAR CONTRACTIONS SUCH AS DURING ATRIAL ARRHYTHMIA
    6.
    发明申请
    METHOD AND APPARATUS FOR TREATING IRREGULAR VENTRICULAR CONTRACTIONS SUCH AS DURING ATRIAL ARRHYTHMIA 有权
    方法和装置，用于治疗非正常血管造影，如阿司匹林

    公开(公告)号：US20070016258A1

    公开(公告)日：2007-01-18

    申请号：US11423516

    申请日：2006-06-12

    申请人： David Krig ,  Jesse Hartley ,  Wyatt Stahl ,  Jeffrey Stahmann

    发明人： David Krig ,  Jesse Hartley ,  Wyatt Stahl ,  Jeffrey Stahmann

    IPC分类号： A61N1/00

    CPC分类号： A61N1/3956 ,  A61N1/3622 ,  A61N1/395

    摘要： A cardiac rhythm management system is capable of treating irregular ventricular heart contractions, such as during atrial tachyarrhythmias such as atrial fibrillation. A first indicated pacing interval is computed based at least partially on a most recent V-V interval duration between ventricular beats and a previous value of the first indicated pacing interval. Pacing therapy is provided based on either the first indicated pacing interval or also based on a second indicated pacing interval, such as a sensor-indicated pacing interval. A weighted averager such as an infinite impulse response (IIR) filter adjusts the first indicated pacing interval for sensed beats and differently adjusts the first indicated pacing interval for paced beats. The system regularizes ventricular rhythms by pacing the ventricle, but inhibits pacing when the ventricular rhythms are stable.

    摘要翻译： 心律管理系统能够治疗不规则的心室心脏收缩，例如在房性快速性心律失常如心房颤动期间。 至少部分地基于心室搏动之间的最新V-V间期持续时间和第一个起搏间隔的先前值来计算第一个起搏间隔。 基于第一个起搏间隔或基于第二个起搏间隔（例如传感器指示的起搏间隔）来提供起搏疗法。 诸如无限脉冲响应（IIR）滤波器的加权平均器调节感测节拍的第一个起搏间隔，并且针对起搏节奏不同地调节第一个起搏间隔。 系统通过起搏心室使心室节律正常化，但是当心室节律稳定时，可抑制起搏。

    Detection of pleural effusion using transthoracic impedance
    7.
    发明申请
    Detection of pleural effusion using transthoracic impedance 有权
    使用经胸阻塞检测胸腔积液

    公开(公告)号：US20060264776A1

    公开(公告)日：2006-11-23

    申请号：US11132109

    申请日：2005-05-18

    申请人： Jeffrey Stahmann ,  John Hatlestad ,  Jesse Hartley ,  Richard Fogoros

    发明人： Jeffrey Stahmann ,  John Hatlestad ,  Jesse Hartley ,  Richard Fogoros

    IPC分类号： A61B5/05

    CPC分类号： A61B5/0205 ,  A61B5/0031 ,  A61B5/0535 ,  A61B5/1116 ,  A61B5/4869 ,  A61N1/36521 ,  A61N1/36535

    摘要： This patent document discusses systems, devices, and methods for increasing a sensitivity or specificity of thoracic fluid detection in a subject and differentiating between pleural effusion and pulmonary edema. In one example, a thoracic impedance measurement circuit senses a thoracic impedance signal. In another example, a processor receives the thoracic impedance signal and determines whether such thoracic impedance signal is “significant.” A significant thoracic impedance signal indicates the presence of thoracic fluid and may be recognized by comparing the thoracic impedance signal (or variation thereof) to a thoracic impedance threshold. When a significant thoracic impedance signal is recognized, the processor is adapted to detect one or both of: a pleural effusion indication and a pulmonary edema indication using one or a combination of: physiologic information, patient symptom information, and posture information. In another example, the thoracic impedance threshold is adjusted using such physiologic, patient symptom, or posture information.

    摘要翻译： 该专利文献讨论了用于增加受试者胸部液体检测的敏感性或特异性并区分胸腔积液和肺水肿的系统，装置和方法。 在一个示例中，胸部阻抗测量电路感测胸部阻抗信号。 在另一示例中，处理器接收胸部阻抗信号并确定这种胸部阻抗信号是否“显着”。 显着的胸部阻抗信号表示胸腔液的存在，并且可以通过将胸部阻抗信号（或其变化）与胸部阻抗阈值进行比较来识别。 当识别出显着的胸部阻抗信号时，处理器适合于使用生理信息，患者症状信息和姿势信息中的一个或组合来检测胸腔积液指示和肺水肿指示之一或两者。 在另一个例子中，使用这种生理，患者症状或姿势信息来调整胸阻抗阈值。

    Subcutaneous cardiac rhythm management with disordered breathing detection and treatment
    8.
    发明申请
    Subcutaneous cardiac rhythm management with disordered breathing detection and treatment 审中-公开
    皮下心律管理与无序呼吸检测和治疗

    公开(公告)号：US20050107838A1

    公开(公告)日：2005-05-19

    申请号：US10920549

    申请日：2004-08-17

    申请人： Eric Lovett ,  Jeffrey Stahmann ,  Kent Lee ,  Quan Ni ,  Jesse Hartley

    发明人： Eric Lovett ,  Jeffrey Stahmann ,  Kent Lee ,  Quan Ni ,  Jesse Hartley

    IPC分类号： A61B5/0205 ,  A61B5/08 ,  A61N1/36 ,  A61N1/365 ,  A61N1/39

    CPC分类号： A61B5/4818 ,  A61B5/02055 ,  A61B5/0809 ,  A61B5/4815 ,  A61B2562/0219 ,  A61N1/3601 ,  A61N1/36585 ,  A61N1/3956

    摘要： A lead system, coupled to an implantable device, is configured for subcutaneous, non-intrathoracic placement relative to a patient's heart. Cardiac activity detection circuitry is coupled to the lead system and configured to detect cardiac rhythms. Disordered breathing detection circuitry is coupled to the lead system and configured to detect disordered breathing. One or both of cardiac therapy circuitry and disordered breathing therapy circuitry may be coupled to the lead system and configured to delivery therapies to treat disordered breathing. Such therapies include cardiac pacing, diaphragmatic pacing, and hypoglossal nerve stimulation therapies. A patient-external respiratory device, such as a positive airway pressure device, may be configured to deliver a disordered breathing therapy. One or more of a patient-internal drug delivery device, a patient-external drug delivery device, or a gas therapy device may be employed to treat disordered breathing.

    摘要翻译： 耦合到可植入装置的引导系统被配置为相对于患者的心脏进行皮下，非胸内放置。 心脏活动检测电路耦合到引导系统并被配置成检测心律。 无序呼吸检测电路耦合到引导系统，并配置为检测无序呼吸。 心脏治疗电路和无序呼吸治疗电路中的一个或两者可以耦合到引导系统并且被配置为递送疗法以治疗无序呼吸。 这些疗法包括心脏起搏，膈肌起搏和舌下神经刺激疗法。 患者外部呼吸装置，例如气道正压通道装置，可配置成输送无序呼吸治疗。 可以使用患者内部药物递送装置，患者外部药物递送装置或气体治疗装置中的一种或多种来治疗无序呼吸。