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    Implantable lead functional status monitor and method
    3.
    发明授权
    Implantable lead functional status monitor and method 有权
    可植入式铅功能状态监测和方法

    公开(公告)号：US06317633B1

    公开(公告)日：2001-11-13

    申请号：US09487562

    申请日：2000-01-19

    申请人： David J. Jorgenson ,  Ross O. Starkson ,  Rick D. McVenes ,  Charles D. Trautmann ,  John D. Wahlstrand ,  Bradley C. Peck

    发明人： David J. Jorgenson ,  Ross O. Starkson ,  Rick D. McVenes ,  Charles D. Trautmann ,  John D. Wahlstrand ,  Bradley C. Peck

    IPC分类号： A61N137

    CPC分类号： A61N1/08 ,  A61N1/3706

    摘要： An implantable medical device (IMD) coupled with leads extending to body tissue providing storage of lead related data, monitoring of lead functional status, and indication of lead integrity to the clinician. A lead status monitor (LSM) processes lead related data in a system self test mode and provides a lead status report that identifies and declares conductor/connector issues, insulation issues, and electrode/tissue interface issues indicative of suspected lead related condition mechanisms for each lead employed in the IMD. The LSM operates employing a set of LSM rules that process measured lead impedance values and loss of capture (LOC) values. In a pacing system, particular LSM rules are defined that process periodically determined, pacing pulse characteristic at LOC and bipolar and unipolar lead impedance values that are measured periodically. The lead impedance values are compared to upper and lower limits or trip points of a normal impedance range. Simultaneously, significant changes in lead impedance are detected, and the unipolar impedance value is compared to the bipolar lead impedance value of each lead. Counts of deviations in lead impedances satisfying each LSM rule are maintained. Certain of the lead related condition mechanisms are declared if a count of lead impedance deviations meets a programmed threshold number of such lead impedance deviations within a further programmed number of sequential impedance measurements. Preferably, the pacing pulse strength or voltage at LOC (characterized as LOC_RHEOBASE herein) is periodically determined and compared to a reference LOC_RHEOBASE.

    摘要翻译： 与可延伸到身体组织的引线耦合的可植入医疗装置（IMD），提供铅相关数据的存储，铅功能状态的监测以及针对临床医生的铅完整性的指示。 引导状态监视器（LSM）在系统自检模式下处理引导相关数据，并提供一个引导状态报告，用于识别和声明导体/连接器问题，绝缘问题和电极/组织界面问题，指示每个 主管在IMD工作。 LSM使用一组LSM规则来处理测量的导线阻抗值和捕获损失（LOC）值。 在起搏系统中，定义了特定的LSM规则，其在LOC处理周期性确定的起搏脉冲特性，并定期测量双极和单极性引线阻抗值。 将引线阻抗值与正常阻抗范围的上限和下限或跳变点进行比较。 同时，检测到引线阻​​抗的显着变化，并将单极性阻抗值与每个引线的双极引线阻抗值进行比较。 保持满足每个LSM规则的引线阻抗偏差的计数。 如果引导阻抗偏差的计数在另外编程的连续阻抗测量数量中达到这样的引线阻抗偏差的编程阈值数，则声明某些引线相关条件机制。 优选地，周期性地确定LOC（此处表征为LOC_RHEOBASE）的起搏脉冲强度或电压，并将其与参考LOC_RHEOBASE进行比较。

    Implantable lead functional status monitor and method
    4.
    发明授权
    Implantable lead functional status monitor and method 有权
    可植入式铅功能状态监测和方法

    公开(公告)号：US06721600B2

    公开(公告)日：2004-04-13

    申请号：US10039667

    申请日：2001-12-31

    申请人： David J. Jorgenson ,  Ross O. Starkson ,  Rick D. McVenes ,  Charles D. Trautmann ,  John D. Wahlstrand ,  Bradley C. Peck

    发明人： David J. Jorgenson ,  Ross O. Starkson ,  Rick D. McVenes ,  Charles D. Trautmann ,  John D. Wahlstrand ,  Bradley C. Peck

    IPC分类号： A61N118

    CPC分类号： A61N1/3925 ,  A61N1/3706 ,  A61N2001/083

    摘要： A system for monitoring trends in lead impedance includes collecting data from various sources in an implantable medical device system. Lead impedance, non-physiologic sensed events percentage of time in mode switch, results of capture management operation, sensed events, adversion pace counts, refractory sense counts and similar data are used to determine the status of a lead. A set of weighted sum rules are implemented by a software system to process the data and provide displayable information to health care professionals via a programmer. The lead monitoring system includes a patient alert system for patients to seek help in the event a serious lead condition is identified.

    摘要翻译： 用于监测引线阻抗趋势的系统包括在可植入医疗器械系统中收集来自各种来源的数据。 引线阻抗，非生理感测事件模式切换时间的百分比，捕获管理操作的结果，感测事件，反转步伐计数，难度感知计数和类似数据用于确定引线的状态。 一组加权和规则由软件系统实现，以处理数据，并通过程序员向医疗保健专业人员提供可显示的信息。 牵头监测系统包括一个病人警报系统，用于在发现严重的领先条件的情况下为病人寻求帮助。

    Determining intercardiac impedance
    6.
    发明授权
    Determining intercardiac impedance 有权
    确定心脏阻力

    公开(公告)号：US08478402B2

    公开(公告)日：2013-07-02

    申请号：US12263346

    申请日：2008-10-31

    申请人： John D. Wahlstrand ,  Timothy J. Denison ,  Wesley A. Santa

    发明人： John D. Wahlstrand ,  Timothy J. Denison ,  Wesley A. Santa

    IPC分类号： A61N1/00

    CPC分类号： A61B5/053 ,  A61B5/026 ,  A61B5/0538 ,  A61B5/6846 ,  A61B5/7217 ,  A61N1/36521

    摘要： A system and method for determining complex intercardiac impedance to detect various cardiac functions are disclosed involving a signal generator means for providing an adjustable direct current signal, a modulator for modulating the adjustable direct current signal to produce a modulated signal, at least one electrode for propagating the modulated signal across a myocardium, at least one sensor for detecting an outputted modulated signal from the myocardium, and at least one circuit to reduce the influence of process noise (aggressors) in the outputted modulated signal. The at least one circuit comprises an amplifier, a demodulator, and an integrator. The amplitude and phase of the final outputted modulated signal indicate the complex impedance of the myocardium. Changes in the complex impedance patterns of the myocardium provide indication of reduced oxygen and blood flow to the myocardium. The apparatus can be employed in implantable devices, including cardiac pacemakers and implantable cardioverter defibrillators.

    摘要翻译： 公开了一种用于确定复杂心脏阻抗以检测各种心脏功能的系统和方法，其涉及用于提供可调节直流电流信号的信号发生器装置，用于调制可调直流电信号以产生调制信号的调制器，用于传播的至少一个电极 跨越心肌的调制信号，用于检测来自心肌的输出的调制信号的至少一个传感器，以及至少一个电路，以减少输出的调制信号中的过程噪声（侵略者）的影响。 所述至少一个电路包括放大器，解调器和积分器。 最终输出的调制信号的振幅和相位表示心肌的复阻抗。 心肌复合阻抗模式的变化提供氧气和血液流向心肌的指示。 该装置可用于可植入装置，包括心脏起搏器和可植入的心律转复除颤器。

    Apparatus and method to discriminate between telemetry downlink signals and noise in an implanted device
    8.
    发明授权
    Apparatus and method to discriminate between telemetry downlink signals and noise in an implanted device 有权
    用于区分遥测下行链路信号和植入设备中的噪声的装置和方法

    公开(公告)号：US06788973B2

    公开(公告)日：2004-09-07

    申请号：US10117550

    申请日：2002-04-02

    申请人： Timothy J. Davis ,  Robert M. Ecker ,  James D. Reinke ,  John D. Wahlstrand

    发明人： Timothy J. Davis ,  Robert M. Ecker ,  James D. Reinke ,  John D. Wahlstrand

    IPC分类号： A61N137

    CPC分类号： A61N1/37211 ,  A61N1/3718 ,  A61N1/37223 ,  A61N1/37276

    摘要： An implanted medical device (IMD) conserves power by discriminating received radio frequency (RF) signals between noise and data based on frequency. Data is processed while noise is attenuated. The IMD operates in a first, relatively low, power mode while not receiving the RF signals, in a second, higher, power mode responsive to receiving RF signals, and operates in still higher power mode when the RF signals' average frequency over a selected period is within a predetermined range. A receiver circuit receives RF signals and discriminates a data signal from noise based on average frequency of the RF signals over selected time periods. The receiver circuit operates in a power-conserving mode unless it receives RF signals, or otherwise operates in a relatively higher-power mode. The receiver transfers signals to a telemetry circuit that operates in a power-conserving mode until it receives a valid data signal to operate in higher power mode.

    摘要翻译： 植入式医疗设备（IMD）通过基于频率鉴别噪声和数据之间的接收射频（RF）信号来节省功率。 在噪声衰减时处理数据。 IMD在第一个相对较低的功率模式下工作，而不响应于接收RF信号而在第二较高功率模式中接收RF信号，并且当RF信号在所选择的频率上的平均频率 期间在预定范围内。 接收机电路接收RF信号，并根据选定时间段内的RF信号的平均频率，将数据信号与噪声区分开。 接收器电路在功率节省模式下工作，除非它接收RF信号，否则以较高功率模式工作。 接收机将信号传送到工作在省电模式的遥测电路，直到接收到有效的数据信号以在较高功率模式下工作。