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    Near field-based systems and methods for assessing impedance and admittance for use with an implantable medical device
    1.
    发明授权
    Near field-based systems and methods for assessing impedance and admittance for use with an implantable medical device 有权
    用于评估用于可植入医疗设备的阻抗和导纳的近场系统和方法

    公开(公告)号：US08670820B2

    公开(公告)日：2014-03-11

    申请号：US12853130

    申请日：2010-08-09

    申请人： Dan E. Gutfinger ,  Fujian Qu ,  Alex Soriano ,  Ryan Rooke ,  Yelena Nabutovsky ,  Riddhi Shah ,  Andreas Blomqvist

    发明人： Dan E. Gutfinger ,  Fujian Qu ,  Alex Soriano ,  Ryan Rooke ,  Yelena Nabutovsky ,  Riddhi Shah ,  Andreas Blomqvist

    IPC分类号： A61B5/053

    CPC分类号： A61B5/0538 ,  A61B5/02028 ,  A61B5/029 ,  A61B5/4878 ,  A61B5/686 ,  A61B7/00 ,  A61B2562/0219

    摘要： A new model is provided for understanding and exploiting impedance or admittance values measured by implantable medical devices, such as pacemakers or cardiac resynchronization devices (CRTs.) The device measures impedance along vectors extending through tissues of the patient between various pairs of electrodes. The device then converts the vector-based impedance measurements into near-field individual electrode-based impedance values. This is accomplished, in at least some examples, by converting the vector-based impedance measurements into a set of linear equations to be solved while ignoring far-field contributions to the impedance measurements. The device solves the linear equations to determine the near-field impedance values for the individual electrodes, which are representative of the impedance of tissues in the vicinity of the electrodes. The device then performs or controls various device functions based on the near-field values, such as analyzing selected near-field values to detect heart failure or pulmonary edema.

    摘要翻译： 提供了一种新型号，用于了解和利用可植入医疗设备（例如起搏器或心脏再同步装置（CRT））测量的阻抗或导纳值。该装置测量沿着延伸穿过患者组织的不同对电极之间的阻力。 然后，器件将基于矢量的阻抗测量值转换为近场单独的基于电极的阻抗值。 这在至少一些示例中是通过将基于矢量的阻抗测量值转换成待解决的一组线性方程而实现的，同时忽略对阻抗测量的远场贡献。 该装置解决了线性方程来确定各个电极的近场阻抗值，其代表电极附近的组织的阻抗。 然后，设备基于近场值执行或控制各种设备功能，例如分析所选的近场值以检测心脏衰竭或肺水肿。

    Systems and methods for estimating left atrial pressure (LAP) in patients with acute mitral valve regurgitation for use by an implantable medical device
    2.
    发明授权
    Systems and methods for estimating left atrial pressure (LAP) in patients with acute mitral valve regurgitation for use by an implantable medical device 有权
    用于估计急性二尖瓣反流患者的左心房压力（LAP）的系统和方法，用于可植入医疗器械

    公开(公告)号：US08135468B2

    公开(公告)日：2012-03-13

    申请号：US12853157

    申请日：2010-08-09

    申请人： Dan E. Gutfinger ,  Fujian Qu ,  Alex Soriano ,  Ryan Rooke ,  Yelena Nabutovsky ,  Riddhi Shah

    发明人： Dan E. Gutfinger ,  Fujian Qu ,  Alex Soriano ,  Ryan Rooke ,  Yelena Nabutovsky ,  Riddhi Shah

    IPC分类号： A61N1/00

    CPC分类号： A61N1/36585 ,  A61B5/0215 ,  A61B5/02158 ,  A61N1/36521 ,  A61N1/36564 ,  A61N1/36578 ,  A61N1/37235 ,  A61N1/37258 ,  A61N1/3962

    摘要： Various techniques are provided for use with an implantable medical device for estimating cardiac pressure within a patient based on admittance (or related electrical values such as impedance or conductance) that takes into account the presence of acute MR within the patient. Briefly, the device detects an indication of acute MR, if occurring within the patient. The device also applies electrical fields to tissues of the patient and measures electrical parameters influenced by the electrical field, such as admittance, impedance or conductance. The device then estimates cardiac pressure within the patient based on the measured electrical parameter and the indication of acute MR. In one example, different linear correlation functions are used to convert admittance values to left atrial pressure (LAP) values depending upon the presence or absence of acute MR within the patient.

    摘要翻译： 提供了与植入式医疗装置一起使用的各种技术，其基于考虑到患者内急性MR的存在的导纳（或相关的电气值，例如阻抗或电导）来估计患者内的心脏压力。 简而言之，如果在患者体内发生，则该装置检测到急性MR的指示。 该装置还对患者的组织施加电场并测量受电场影响的电参数，例如导纳，阻抗或电导。 然后，该装置基于测量的电参数和急性MR的指示来估计患者内的心脏压力。 在一个示例中，不同的线性相关函数用于根据患者内存在或不存在急性MR将导纳值转换为左心房压（LAP）值。

    SYSTEMS AND METHODS FOR ESTIMATING LEFT ATRIAL PRESSURE (LAP) IN PATIENTS WITH ACUTE MITRAL VALVE REGURGITATION FOR USE BY AN IMPLANTABLE MEDICAL DEVICE
    3.
    发明申请
    SYSTEMS AND METHODS FOR ESTIMATING LEFT ATRIAL PRESSURE (LAP) IN PATIENTS WITH ACUTE MITRAL VALVE REGURGITATION FOR USE BY AN IMPLANTABLE MEDICAL DEVICE 有权
    用于通过可植入医疗器械使用急性麻药阀注射患者的左心室压力（LAP）的系统和方法

    公开(公告)号：US20120035681A1

    公开(公告)日：2012-02-09

    申请号：US12853157

    申请日：2010-08-09

    申请人： Dan E. Gutfinger ,  Fujian Qu ,  Alex Soriano ,  Ryan Rooke ,  Yelena Nabutovsky ,  Riddhi Shah

    发明人： Dan E. Gutfinger ,  Fujian Qu ,  Alex Soriano ,  Ryan Rooke ,  Yelena Nabutovsky ,  Riddhi Shah

    IPC分类号： A61N1/36

    CPC分类号： A61N1/36585 ,  A61B5/0215 ,  A61B5/02158 ,  A61N1/36521 ,  A61N1/36564 ,  A61N1/36578 ,  A61N1/37235 ,  A61N1/37258 ,  A61N1/3962

    摘要： Various techniques are provided for use with an implantable medical device for estimating cardiac pressure within a patient based on admittance (or related electrical values such as impedance or conductance) that takes into account the presence of acute MR within the patient. Briefly, the device detects an indication of acute MR, if occurring within the patient. The device also applies electrical fields to tissues of the patient and measures electrical parameters influenced by the electrical field, such as admittance, impedance or conductance. The device then estimates cardiac pressure within the patient based on the measured electrical parameter and the indication of acute MR. In one example, different linear correlation functions are used to convert admittance values to left atrial pressure (LAP) values depending upon the presence or absence of acute MR within the patient.

    摘要翻译： 提供了与植入式医疗装置一起使用的各种技术，其基于考虑到患者内急性MR的存在的导纳（或相关的电气值，例如阻抗或电导）来估计患者内的心脏压力。 简而言之，如果在患者体内发生，则该装置检测到急性MR的指示。 该装置还对患者的组织施加电场并测量受电场影响的电参数，例如导纳，阻抗或电导。 然后，该装置基于测量的电参数和急性MR的指示来估计患者内的心脏压力。 在一个示例中，不同的线性相关函数用于根据患者内存在或不存在急性MR将导纳值转换为左心房压（LAP）值。

    Systems and methods for exploiting near-field impedance and admittance for use with implantable medical devices
    4.
    发明授权
    Systems and methods for exploiting near-field impedance and admittance for use with implantable medical devices 有权
    用于利用可植入医疗设备使用近场阻抗和导纳的系统和方法

    公开(公告)号：US08812093B2

    公开(公告)日：2014-08-19

    申请号：US13007424

    申请日：2011-01-14

    申请人： Dan E. Gutfinger ,  Fujian Qu ,  Alex Soriano ,  Ryan Rooke ,  Yelena Nabutovsky ,  Riddhi Shah

    发明人： Dan E. Gutfinger ,  Fujian Qu ,  Alex Soriano ,  Ryan Rooke ,  Yelena Nabutovsky ,  Riddhi Shah

    IPC分类号： A61B5/053 ,  A61B5/04 ,  A61B5/0452 ,  A61N1/365

    CPC分类号： A61B5/04011 ,  A61B5/02 ,  A61B5/0452 ,  A61B5/053 ,  A61B5/0538 ,  A61B5/686 ,  A61N1/36521

    摘要： Various techniques are provided for use with an implantable medical device for exploiting near-field impedance/admittance. Examples include techniques for assessing heart chamber disequilibrium, detecting chamber volumes and pressures, calibrating near-field-based left atrial pressure (LAP) estimation procedures and for assessing the recovery from injury at the electrode-tissue interface. In one particular example, the implantable device assesses the degree of concordance between the left ventricle (LV) and the right ventricle (RV) by quantifying a degree of scatter between LV and RV near-field admittance values. An increase in RV admittance is indicative of RV failure, an increase in LV admittance is indicative of LV failure, and an increase in both LV and RV admittance is indicative of biventricular failure.

    摘要翻译： 提供了与用于开发近场阻抗/导纳的可植入医疗装置一起使用的各种技术。 实例包括评估心脏室不平衡，检测腔室体积和压力，校准基于近场的左心房压力（LAP）估计程序和评估电极组织界面处损伤恢复的技术。 在一个特定示例中，可植入装置通过量化LV和RV近场导纳值之间的散射程度来评估左心室（LV）和右心室（RV）之间的一致程度。 RV导纳的增加表示RV失败，LV导纳的增加表示LV失败，LV和RV导纳的增加表明双心室衰竭。

    SYSTEMS AND METHODS FOR CORROBORATING IMPEDANCE-BASED LEFT ATRIAL PRESSURE (LAP) ESTIMATES FOR USE BY AN IMPLANTABLE MEDICAL DEVICE
    5.
    发明申请
    SYSTEMS AND METHODS FOR CORROBORATING IMPEDANCE-BASED LEFT ATRIAL PRESSURE (LAP) ESTIMATES FOR USE BY AN IMPLANTABLE MEDICAL DEVICE 审中-公开
    用于植入基于阻力的左心室压（LAP）评估用于可植入医疗装置的系统和方法

    公开(公告)号：US20120184859A1

    公开(公告)日：2012-07-19

    申请号：US13007364

    申请日：2011-01-14

    申请人： Riddhi Shah ,  Fujian Qu ,  Yelena Nabutovsky ,  Dan E. Gutfinger ,  Ryan Rooke ,  Alex Soriano

    发明人： Riddhi Shah ,  Fujian Qu ,  Yelena Nabutovsky ,  Dan E. Gutfinger ,  Ryan Rooke ,  Alex Soriano

    IPC分类号： A61B5/0215 ,  A61B5/021

    CPC分类号： A61B5/0538 ,  A61B5/0215

    摘要： Various techniques are provided for assessing the reliability of left atrial pressure (LAP) estimates made by an implantable medical device based on impedance values or related electrical values. In one example, various cardioelectric and cardiomechanical parameters are used to corroborate LAP estimation in circumstances where the LAP estimates deviate from an acceptable, satisfactory or otherwise healthy range. The cardioelectric parameters include, e.g.: ST elevation; heart rate (HR); heart rate variability (HRV); T-wave alternans (TWA); QRS waveform parameters; P-wave duration; evoked response (ER) parameters; and intrinsic PV/AV/VV conduction delays. The cardiomechanical parameters include, e.g.: heart rate turbulence (HRT); cardiogenic impedance signals; heart sounds; and non-LAP blood pressure measurements, such as aortic pressure measurements. The device compares the cardioelectric and cardiomechanical parameters against corresponding baseline values to determine whether variations in the parameters corroborate the LAP estimates. If not, the LAP estimates are selectively cancelled or suspended, or the overall procedure is re-calibrated.

    摘要翻译： 提供各种技术来评估由可植入医疗装置基于阻抗值或相关电气值进行的左心房压力（LAP）估计的可靠性。 在一个示例中，在LAP估计偏离可接受的，满意的或以其他方式健康的范围的情况下，使用各种心电和心力学参数来证实LAP估计。 心电参数包括：ST抬高; 心律（HR）; 心率变异性（HRV）; T波交替（TWA）; QRS波形参数; P波持续时间; 诱发反应（ER）参数; 和内在的PV / AV / VV传导延迟。 心脏力学参数包括例如：心率湍流（HRT）; 心源阻抗信号; 心声; 和非LAP血压测量，如主动脉压力测量。 该设备将心电参数和心机械参数与相应的基线值进行比较，以确定参数的变化是否证实了LAP估计值。 如果不是，则LAP估计被选择性地取消或暂停，或者整个程序被重新校准。

    SYSTEMS AND METHODS FOR EXPLOITING NEAR-FIELD IMPEDANCE AND ADMITTANCE FOR USE WITH IMPLANTABLE MEDICAL DEVICES
    6.
    发明申请
    SYSTEMS AND METHODS FOR EXPLOITING NEAR-FIELD IMPEDANCE AND ADMITTANCE FOR USE WITH IMPLANTABLE MEDICAL DEVICES 有权
    用于开发具有可移植医疗设备的近场阻抗和使用方法的系统和方法

    公开(公告)号：US20120035495A1

    公开(公告)日：2012-02-09

    申请号：US13007424

    申请日：2011-01-14

    申请人： Dan E. Gutfinger ,  Fujian Qu ,  Alex Soriano ,  Ryan Rooke ,  Yelena Nabutovsky ,  Riddhi Shah

    发明人： Dan E. Gutfinger ,  Fujian Qu ,  Alex Soriano ,  Ryan Rooke ,  Yelena Nabutovsky ,  Riddhi Shah

    IPC分类号： A61B5/053

    CPC分类号： A61B5/04011 ,  A61B5/02 ,  A61B5/0452 ,  A61B5/053 ,  A61B5/0538 ,  A61B5/686 ,  A61N1/36521

    摘要： Various techniques are provided for use with an implantable medical device for exploiting near-field impedance/admittance. Examples include techniques for assessing heart chamber disequilibrium, detecting chamber volumes and pressures, calibrating near-field-based left atrial pressure (LAP) estimation procedures and for assessing the recovery from injury at the electrode-tissue interface. In one particular example, the implantable device assesses the degree of concordance between the left ventricle (LV) and the right ventricle (RV) by quantifying a degree of scatter between LV and RV near-field admittance values. An increase in RV admittance is indicative of RV failure, an increase in LV admittance is indicative of LV failure, and an increase in both LV and RV admittance is indicative of biventricular failure.

    摘要翻译： 提供了与用于开发近场阻抗/导纳的可植入医疗装置一起使用的各种技术。 实例包括评估心脏室不平衡，检测腔室体积和压力，校准基于近场的左心房压力（LAP）估计程序和评估电极组织界面处损伤恢复的技术。 在一个特定示例中，可植入装置通过量化LV和RV近场导纳值之间的散射程度来评估左心室（LV）和右心室（RV）之间的一致程度。 RV导纳的增加表示RV失败，LV导纳的增加表示LV失败，LV和RV导纳的增加表明双心室衰竭。

    NEAR FIELD-BASED SYSTEMS AND METHODS FOR ASSESSING IMPEDANCE AND ADMITTANCE FOR USE WITH AN IMPLANTABLE MEDICAL DEVICE
    7.
    发明申请
    NEAR FIELD-BASED SYSTEMS AND METHODS FOR ASSESSING IMPEDANCE AND ADMITTANCE FOR USE WITH AN IMPLANTABLE MEDICAL DEVICE 有权
    基于现场的系统和方法，用于评估阻抗和使用植入式医疗设备的使用方法

    公开(公告)号：US20120035493A1

    公开(公告)日：2012-02-09

    申请号：US12853130

    申请日：2010-08-09

    申请人： Dan E. Gutfinger ,  Fujian Qu ,  Alex Soriano ,  Ryan Rooke ,  Yelena Nabutovsky ,  Riddhi Shah ,  Andreas Blomqvist

    发明人： Dan E. Gutfinger ,  Fujian Qu ,  Alex Soriano ,  Ryan Rooke ,  Yelena Nabutovsky ,  Riddhi Shah ,  Andreas Blomqvist

    IPC分类号： A61B5/053

    CPC分类号： A61B5/0538 ,  A61B5/02028 ,  A61B5/029 ,  A61B5/4878 ,  A61B5/686 ,  A61B7/00 ,  A61B2562/0219

    摘要： A new model is provided for understanding and exploiting impedance or admittance values measured by implantable medical devices, such as pacemakers or cardiac resynchronization devices (CRTs.) The device measures impedance along vectors extending through tissues of the patient between various pairs of electrodes. The device then converts the vector-based impedance measurements into near-field individual electrode-based impedance values. This is accomplished, in at least some examples, by converting the vector-based impedance measurements into a set of linear equations to be solved while ignoring far-field contributions to the impedance measurements. The device solves the linear equations to determine the near-field impedance values for the individual electrodes, which are representative of the impedance of tissues in the vicinity of the electrodes. The device then performs or controls various device functions based on the near-field values, such as analyzing selected near-field values to detect heart failure or pulmonary edema.

    摘要翻译： 提供了一种新型号，用于了解和利用可植入医疗设备（例如起搏器或心脏再同步装置（CRT））测量的阻抗或导纳值。该装置测量沿着延伸穿过患者组织的不同对电极之间的阻力。 然后，器件将基于矢量的阻抗测量值转换为近场单独的基于电极的阻抗值。 这在至少一些示例中是通过将基于矢量的阻抗测量值转换成待解决的一组线性方程而实现的，同时忽略对阻抗测量的远场贡献。 该装置解决了线性方程来确定各个电极的近场阻抗值，其代表电极附近的组织的阻抗。 然后，设备基于近场值执行或控制各种设备功能，例如分析所选的近场值以检测心脏衰竭或肺水肿。

    Methods and Systems that Use Implanted Posture Sensor to Monitor Pulmonary Edema
    10.
    发明申请
    Methods and Systems that Use Implanted Posture Sensor to Monitor Pulmonary Edema 有权
    使用植入姿势传感器监测肺水肿的方法和系统

    公开(公告)号：US20110125049A1

    公开(公告)日：2011-05-26

    申请号：US12649647

    申请日：2009-12-30

    申请人： Yelena Nabutovsky ,  Fujian Qu ,  Steve Koh ,  Dan E. Gutfinger ,  Alex Soriano

    发明人： Yelena Nabutovsky ,  Fujian Qu ,  Steve Koh ,  Dan E. Gutfinger ,  Alex Soriano

    IPC分类号： A61B5/05

    CPC分类号： A61B5/053 ,  A61B5/021 ,  A61B5/1116 ,  A61B5/4878 ,  A61B5/686 ,  A61B5/7275 ,  A61N1/3627 ,  A61N1/36521 ,  A61N1/36564 ,  A61N1/36585 ,  A61N1/3684 ,  A61N1/3702 ,  A61N1/37258 ,  A61N1/3962

    摘要： In specific embodiments, a method to monitor pulmonary edema of a patient, comprises (a) detecting, using an implanted posture sensor, when a posture of the patient changes from a first predetermined posture to a second predetermined posture, (b) determining an amount of time it takes an impedance signal to achieve a steady state after the posture of the patient changes from the first predetermined posture to the second predetermined posture, where the impedance signal is obtained using implanted electrodes and is indicative of left atrial pressure and/or intra-thoracic fluid volume of the patient, and (c) monitoring the pulmonary edema of the patient based on the determined amount of time it takes the impedance signal to achieve the steady state after the posture of the patient changes from the first predetermined posture to the second pre-determined posture.

    摘要翻译： 在具体实施例中，一种监测患者肺水肿的方法包括：（a）使用植入式姿势传感器时，当患者的姿势从第一预定姿势变化到第二预定姿势时，（b）确定量 的时间，在患者的姿势从第一预定姿势变化到第二预定姿势之后，阻抗信号获得稳定状态，其中使用植入电极获得阻抗信号，并且指示左心房压力和/或内部 - （c）基于在患者的姿势从第一预定姿势改变到第二预定姿势之后所确定的阻抗信号达到稳定状态的所确定的时间量来监测患者的肺水肿 第二预定姿势。