公开(公告)号：US08204592B1

公开(公告)日：2012-06-19

申请号：US11949532

申请日：2007-12-03

申请人： Eliot L. Ostrow ,  Jay Snell ,  Xiaoyi Min

发明人： Eliot L. Ostrow ,  Jay Snell ,  Xiaoyi Min

IPC分类号： A61N1/36

CPC分类号： A61B5/0464 ,  A61B5/686 ,  A61N1/36585 ,  A61N1/37258 ,  G06F19/00 ,  G06F19/3418 ,  G06F19/3468 ,  G06F19/3481

摘要： Techniques are described for generating diagnostic information to aid in determining whether cardiac ischemia within a patient is clinically actionable. In one example, a pacemaker or implantable cardioverter/defibrillator (ICD) detects information pertaining to arrhythmia precursors and to episodes of sustained arrhythmias, as well as information pertaining to episodes of cardiac ischemia. The implanted device then correlates the arrhythmia precursors and the sustained arrhythmias with the episodes of cardiac ischemia so as to generate diagnostics permitting a physician reviewing the diagnostics to determine whether the ischemia is clinically actionable. In some implementations, the diagnostics are instead generated by an external system based on raw data provided by the implanted device. In some implementations, the device itself determines whether the ischemia is clinically actionable and automatically controls therapy or generates warning signals accordingly.

摘要翻译： 描述了用于产生诊断信息以帮助确定患者心脏缺血是否具有临床可行性的技术。 在一个示例中，起搏器或植入式心律转复除颤器（ICD）检测与心律失常前体有关的信息和持续性心律不齐的发作以及与心脏缺血发作有关的信息。 然后植入的装置将心律失常前体和持续性心律失常与心脏缺血发作相关联，以便产生诊断，允许医师检查诊断以确定缺血是否具有临床可操作性。 在一些实施方式中，诊断代替地由外部系统基于植入设备提供的原始数据生成。 在一些实施方案中，装置本身确定缺血是否具有临床作用并且自动控制治疗或相应地产生警告信号。

公开(公告)号：US08670825B2

公开(公告)日：2014-03-11

申请号：US13563311

申请日：2012-07-31

申请人： Xiaoyi Min ,  Eliot L. Ostrow

发明人： Xiaoyi Min ,  Eliot L. Ostrow

IPC分类号： A61N1/00

CPC分类号： A61N1/3621 ,  A61B5/04012 ,  A61B5/046 ,  A61B5/0464 ,  A61B5/4836 ,  A61N1/395 ,  A61N1/3962

摘要： Methods and systems are provided for discriminating heart arrhythmias. The methods and systems include identifying an arrhythmia, recording a predetermined number of beats during the arrhythmia as a base arrhythmia (BA) beats; delivering anti-tachy pacing (ATP) therapy to at least one chamber of the heart. After delivering the ATP therapy, the methods and system record at least one return beat representing cardiac activity following the ATP therapy, determines whether the return beat originated in a reference chamber of the heart, compares a morphology of the return beat to a morphology of the BA beat; and declares a VT or SVT based on the comparing operation.

摘要翻译： 提供方法和系统用于区分心律失常。 方法和系统包括鉴定心律失常，在心律失常期间记录预定数量的搏动作为基础心律失常（BA）; 向心脏至少一个室提供抗速度起搏（ATP）治疗。 在ATP疗法交付之后，方法和系统记录在ATP治疗后代表心脏活动的至少一个返回搏动，确定起搏于心脏的参考室的返回搏动是否将返回搏动的形态与 BA打败 并根据比较操作声明VT或SVT。

公开(公告)号：US20080091114A1

公开(公告)日：2008-04-17

申请号：US11618266

申请日：2006-12-29

申请人： Xiaoyi Min ,  Paul A. Levine ,  Eliot L. Ostrow

发明人： Xiaoyi Min ,  Paul A. Levine ,  Eliot L. Ostrow

IPC分类号： A61B5/02

CPC分类号： A61B5/0537 ,  A61B5/08 ,  A61B5/4869 ,  A61N1/36521 ,  A61N1/36535 ,  A61N1/36542 ,  A61N1/36585

摘要： Exemplary techniques for correlating thoracic impedance values with physiological status are described. One technique involves an implantable medical device (IMD) that includes means for correlating thoracic impedance values with a patient's physiological status and means for interpreting the correlated thoracic impedance values utilizing a patient-based threshold to detect a heart failure condition.

摘要翻译： 描述了将胸廓阻抗值与生理状态相关联的示例性技术。 一种技术涉及可植入医疗装置（IMD），其包括用于使胸部阻抗值与患者的生理状态相关联的装置，以及利用基于患者的阈值来解释相关的胸部阻抗值以检测心力衰竭状况的装置。

公开(公告)号：US20140039332A1

公开(公告)日：2014-02-06

申请号：US13563311

申请日：2012-07-31

申请人： Xiaoyi Min ,  Eliot L. Ostrow

发明人： Xiaoyi Min ,  Eliot L. Ostrow

IPC分类号： A61B5/0452

CPC分类号： A61N1/3621 ,  A61B5/04012 ,  A61B5/046 ,  A61B5/0464 ,  A61B5/4836 ,  A61N1/395 ,  A61N1/3962

摘要： Methods and systems are provided for discriminating heart arrhythmias. The methods and systems include identifying an arrhythmia, recording a predetermined number of beats during the arrhythmia as a base arrhythmia (BA) beats; delivering anti-tachy pacing (ATP) therapy to at least one chamber of the heart. After delivering the ATP therapy, the methods and system record at least one return beat representing cardiac activity following the ATP therapy, determines whether the return beat originated in a reference chamber of the heart, compares a morphology of the return beat to a morphology of the BA beat; and declares a VT or SVT based on the comparing operation.

摘要翻译： 提供方法和系统用于区分心律失常。 方法和系统包括鉴定心律失常，在心律失常期间记录预定数量的搏动作为基础心律失常（BA）; 向心脏至少一个室提供抗速度起搏（ATP）治疗。 在ATP疗法交付之后，方法和系统记录在ATP治疗后代表心脏活动的至少一个返回搏动，确定起搏于心脏的参考室的返回搏动是否将返回搏动的形态与 BA打败 并根据比较操作声明VT或SVT。

公开(公告)号：US20110319953A1

公开(公告)日：2011-12-29

申请号：US13108740

申请日：2011-05-16

申请人： Derrick W. Reed ,  Rohan A. More ,  Heidi Hellman ,  Eliot L. Ostrow ,  Paul A. Levine

发明人： Derrick W. Reed ,  Rohan A. More ,  Heidi Hellman ,  Eliot L. Ostrow ,  Paul A. Levine

IPC分类号： A61N1/365

CPC分类号： A61N1/3684 ,  A61N1/3624 ,  A61N1/3688

摘要： Systems and methods are provided for use by implantable medical devices equipped to deliver multi-site left ventricular (MSLV) pacing. Sequential MSLV is associated with a relatively long post-ventricular atrial blanking (PVAB) period that might limit the detection of pathologic rapid organized atrial tachycardias (OAT). In one example, sequential MSLV cardiac resynchronization therapy (CRT) pacing is delivered within a tracking mode. A possible atrial tachycardia is detected based on the atrial rate exceeding an atrial tachycardia assessment rate (ATAR) threshold. The device then switches to either single-site LV pacing or simultaneous MSLV pacing, thereby effectively shortening the PVAB to detect additional atrial events that might otherwise be obscured, and thereby permitting the device to more reliably distinguish OATs (such as atrial flutter) from sinus tachycardia. The device may also employ an automatic mode switch (AMS) threshold set higher than the ATAR threshold for use in switching from tracking modes to nontracking modes.

摘要翻译： 系统和方法被提供用于装备用于递送多部位左心室（MSLV）起搏的可植入医疗装置的使用。 顺序MSLV与相对较长的心房后心房消融（PVAB）相关，可能限制了病理性快速组织性房性心动过速（OAT）的检测。 在一个示例中，顺序MSLV心脏再同步治疗（CRT）起搏在跟踪模式中被递送。 基于心房速率超过心房心动过速评估率（ATAR）阈值，可以检测到心房心动过速。 然后，该装置切换到单点LV起搏或同步MSLV起搏，从而有效地缩短PVAB以检测可能被模糊的另外的心房事件，从而允许装置更可靠地将OAT（例如心房扑动）与窦 心动过速 设备还可以采用高于ATAR阈值的自动模式切换（AMS）阈值，用于从跟踪模式切换到非跟踪模式。

公开(公告)号：US08260408B2

公开(公告)日：2012-09-04

申请号：US12492055

申请日：2009-06-25

申请人： Eliot L. Ostrow

发明人： Eliot L. Ostrow

IPC分类号： A61B5/0452 ,  A61B5/0464

CPC分类号： A61B5/0452 ,  A61B5/0031 ,  A61B5/0464 ,  A61B5/0816 ,  A61B5/1118 ,  A61N1/36542

摘要： Post-exercise arrhythmias are detected by an implantable medical device. In some aspects, post-exercise arrhythmia may be prognostic of a worsening cardiovascular condition. Thus, the detection of post-exercise arrhythmia may be used as an indicator for adjusting the therapy prescribed for a patient. In some aspects post-exercise arrhythmia are detected if a patient is exercising at a level that equals or exceeds a threshold exercise level. In some aspects, therapy for a patient is modified if the detected post-exercise arrhythmia exceeds a threshold arrhythmia level. In some aspects therapy for a patient is modified if ischemia is detected in conjunction with post-exercise arrhythmia.

摘要翻译： 运动后心律失常由可植入医疗装置检测。 在一些方面，运动后心律失常可能是心血管疾病恶化的预后。 因此，运动后心律失常的检测可以用作调整为患者规定的治疗的指标。 在某些方面，如果患者在等于或超过阈值运动水平的水平上锻炼，则检测到运动后心律失常。 在一些方面，如果检测到的运动后心律失常超过阈值心律失常水平，则修改患者的治疗。 在一些方面，如果与运动后心律失常联合检测到缺血，则修改患者的治疗。

公开(公告)号：US20100217141A1

公开(公告)日：2010-08-26

申请号：US12770598

申请日：2010-04-29

申请人： Eliot L. Ostrow

发明人： Eliot L. Ostrow

IPC分类号： A61B5/0402

CPC分类号： A61B5/02007 ,  A61B5/0452 ,  A61B5/6846 ,  G06F19/00 ,  G16H15/00

摘要： Systems and methods for determining whether there is a correlation between arrhythmias and myocardial ischemic episodes are provided. An implantable system (e.g., a monitor, pacemaker or ICD) is used to monitor for arrhythmias and to monitor for myocardial ischemic episodes. When such events are detected by the implantable system, the implantable system stores (e.g., in its memory) data indicative of the detected arrhythmias and data indicative of the detected myocardial, ischemic episodes. Then, for each detected arrhythmia, a determination is made based on the data, whether there was a myocardial ischemic episode detected within a specified temporal proximity of (e.g., within a specified amount of time of) the arrhythmia. Where a myocardial ischemic episode occurred within the specified temporal proximity of an arrhythmia, data for the two events can be linked. Additionally, when a log of arrhythmias is displayed, for each arrhythmia there is an indication of whether a myocardial ischemic episode was detected within the specified temporal proximity of the arrhythmia. This abstract is not intended to be a complete description of, or limit the scope of, the invention.

摘要翻译： 提供了确定心律失常与心肌缺血事件之间是否存在相关性的系统和方法。 可植入系统（例如，监护仪，起搏器或ICD）用于监测心律失常并监测心肌缺血发作。 当可植入系统检测到这种事件时，可植入系统存储（例如，在其存储器中）指示检测到的心律失常的数据和指示检测到的心肌缺血发作的数据。 然后，对于每个检测到的心律失常，基于数据确定是否在指定的时间接近（例如，在指定的时间内）心律失常之前检测到心肌缺血发作。 在心律失常的指定时间附近发生心肌缺血发作的地方，两个事件的数据可以相关联。 另外，当显示心律失常的对数时，对于每个心律失常，存在在心律失常的指定的临时接近程度内是否检测到心肌缺血发作的指示。 本摘要不是对本发明的完整描述或限制本发明的范围。

公开(公告)号：US20100152806A1

公开(公告)日：2010-06-17

申请号：US12332768

申请日：2008-12-11

申请人： Paul A. Levine ,  Eliot L. Ostrow

发明人： Paul A. Levine ,  Eliot L. Ostrow

IPC分类号： A61N1/00

CPC分类号： A61N1/37 ,  A61N1/3688 ,  A61N1/3718 ,  A61N1/37211

摘要： When a medical procedure is performed on a patient in whom an implantable medical device is implanted, the medical procedure may have undesired effects on the medical device, such as triggering a response that initiates therapy by the device that is unnecessary and potentially dangerous to the patient. Systems and methods may facilitate performing of such medical procedures on such patients by temporarily reprogramming the medical device, monitoring for one or more detectable characteristics associated with the medical procedure to be performed, and restoring normal programming of the device based on detection and/or lack of detection of the detectable characteristic(s).

摘要翻译： 当对植入了可植入医疗装置的患者执行医疗程序时，医疗程序可能对医疗装置具有不期望的影响，例如触发由该装置引起对患者不必要和潜在危险的治疗的响应 。 系统和方法可以通过临时重新编程医疗装置，监测与要执行的医疗程序相关联的一个或多个可检测特性，以及基于检测和/或缺乏恢复装置的正常编程来促进对这些患者的这种医疗程序的执行 检测可检测特性。

公开(公告)号：US07706867B1

公开(公告)日：2010-04-27

申请号：US11198781

申请日：2005-08-04

申请人： Eliot L. Ostrow

发明人： Eliot L. Ostrow

IPC分类号： A61B5/04

CPC分类号： A61B5/02007 ,  A61B5/0452 ,  A61B5/6846 ,  G06F19/00 ,  G16H15/00

摘要： Systems and methods for determining whether there is a correlation between arrhythmias and myocardial ischemic episodes are provided. An implantable system (e.g., a monitor, pacemaker or ICD) is used to monitor for arrhythmias and to monitor for myocardial ischemic episodes. When such events are detected by the implantable system, the implantable system stores (e.g., in its memory) data indicative of the detected arrhythmias and data indicative of the detected myocardial ischemic episodes. Then, for each detected arrhythmia, a determination is made based on the data, whether there was a myocardial ischemic episode detected within a specified temporal proximity of (e.g., within a specified amount of time of) the arrhythmia. Where a myocardial ischemic episode occurred within the specified temporal proximity of an arrhythmia, data for the two events can be linked. Additionally, when a log of arrhythmias is displayed, for each arrhythmia there is an indication of whether a myocardial ischemic episode was detected within the specified temporal proximity of the arrhythmia. This abstract is not intended to be a complete description of, or limit the scope of, the invention.

摘要翻译： 提供了确定心律失常与心肌缺血事件之间是否存在相关性的系统和方法。 可植入系统（例如，监护仪，起搏器或ICD）用于监测心律失常并监测心肌缺血发作。 当可植入系统检测到这种事件时，可植入系统存储（例如，在其存储器中）指示检测到的心律失常的数据和指示检测到的心肌缺血发作的数据。 然后，对于每个检测到的心律失常，基于数据确定是否在指定的时间接近（例如，在指定的时间内）心律失常之前检测到心肌缺血发作。 在心律失常的指定时间附近发生心肌缺血发作的地方，两个事件的数据可以相关联。 另外，当显示心律失常的对数时，对于每个心律失常，存在在心律失常的指定的临时接近程度内是否检测到心肌缺血发作的指示。 本摘要不是对本发明的完整描述或限制本发明的范围。

公开(公告)号：US08433397B2

公开(公告)日：2013-04-30

申请号：US12770598

申请日：2010-04-29

申请人： Eliot L. Ostrow

发明人： Eliot L. Ostrow

IPC分类号： A61B5/04

CPC分类号： A61B5/02007 ,  A61B5/0452 ,  A61B5/6846 ,  G06F19/00 ,  G16H15/00

摘要： Systems and methods for determining whether there is a correlation between arrhythmias and myocardial ischemic episodes are provided. An implantable system (e.g., a monitor, pacemaker or ICD) is used to monitor for arrhythmias and to monitor for myocardial ischemic episodes. When such events are detected by the implantable system, the implantable system stores (e.g., in its memory) data indicative of the detected arrhythmias and data indicative of the detected myocardial, ischemic episodes. Then, for each detected arrhythmia, a determination is made based on the data, whether there was a myocardial ischemic episode detected within a specified temporal proximity of (e.g., within a specified amount of time of) the arrhythmia. Where a myocardial ischemic episode occurred within the specified temporal proximity of an arrhythmia, data for the two events can be linked. Additionally, when a log of arrhythmias is displayed, for each arrhythmia there is an indication of whether a myocardial ischemic episode was detected within the specified temporal proximity of the arrhythmia. This abstract is not intended to be a complete description of, or limit the scope of, the invention.

摘要翻译： 提供了确定心律失常与心肌缺血事件之间是否存在相关性的系统和方法。 可植入系统（例如，监护仪，起搏器或ICD）用于监测心律失常并监测心肌缺血发作。 当可植入系统检测到这种事件时，可植入系统存储（例如，在其存储器中）指示检测到的心律失常的数据和指示检测到的心肌缺血发作的数据。 然后，对于每个检测到的心律失常，基于数据确定是否在指定的时间接近（例如，在指定的时间内）心律失常之前检测到心肌缺血发作。 在心律失常的指定时间附近发生心肌缺血发作的地方，两个事件的数据可以相关联。 另外，当显示心律失常的对数时，对于每个心律失常，存在在心律失常的指定的临时接近程度内是否检测到心肌缺血发作的指示。 本摘要不是对本发明的完整描述或限制本发明的范围。