公开(公告)号：US07212861B1

公开(公告)日：2007-05-01

申请号：US10838939

申请日：2004-05-03

申请人： Euljoon Park ,  Gene A. Bornzin ,  Robert G. Turcott

发明人： Euljoon Park ,  Gene A. Bornzin ,  Robert G. Turcott

IPC分类号： A61N1/00

CPC分类号： A61N1/36585 ,  A61N1/3627

摘要： An implantable cardiac stimulation device is configured to measure selected ventricular contraction parameters and possibly apply stimulation therapy based on the ventricular contraction parameters. In accordance with one aspect, the ventricular contraction parameters include impedance values that correspond to the volume of fluid in the right ventricle and the left ventricle. In accordance with another aspect, the ventricular contraction parameters include motion values that correspond to heart sounds/motion in the right ventricle and the left ventricle. The ventricular contraction parameters can be used to form pseudo P-V loop from which treatment decisions can be made.

摘要翻译： 可植入心脏刺激装置被配置为测量所选择的心室收缩参数，并且可以基于心室收缩参数应用刺激治疗。 根据一个方面，心室收缩参数包括对应于右心室和左心室中的流体体积的阻抗值。 根据另一方面，心室收缩参数包括对应于右心室和左心室中的心音/运动的运动值。 心室收缩参数可用于形成伪P-V循环，从中可以进行治疗决定。

公开(公告)号：US07286875B1

公开(公告)日：2007-10-23

申请号：US10838947

申请日：2004-05-03

申请人： Euljoon Park ,  Gene A. Bornzin ,  Robert G. Turcott

发明人： Euljoon Park ,  Gene A. Bornzin ,  Robert G. Turcott

IPC分类号： A61N1/00

CPC分类号： A61N1/3627 ,  A61N1/36521 ,  A61N1/36542 ,  A61N1/36564 ,  A61N1/36585

摘要： An implantable cardiac stimulation device is configured to measure selected ventricular contraction parameters and possibly apply stimulation therapy based on the ventricular contraction parameters. In accordance with one aspect, the ventricular contraction parameters include impedance values that correspond to the volume of fluid in the right ventricle and the left ventricle. In accordance with another aspect, the ventricular contraction parameters include motion values that correspond to heart sounds/motion in the right ventricle and the left ventricle. The ventricular contraction parameters can be used to form pseudo P-V loop from which treatment decisions can be made.

公开(公告)号：US08731665B1

公开(公告)日：2014-05-20

申请号：US11923286

申请日：2007-10-24

申请人： Xiaoyi Min ,  Laleh Jalali ,  Steve Koh ,  Gene A. Bornzin ,  Euljoon Park

发明人： Xiaoyi Min ,  Laleh Jalali ,  Steve Koh ,  Gene A. Bornzin ,  Euljoon Park

IPC分类号： A61N1/00

CPC分类号： A61N1/365 ,  A61N1/36535

摘要： Systems and methods are provided for detecting the orientation and/or movement of a patient having an implantable cardiac stimulation device and evaluating whether a change in the patient's cardiac activity can be at least in part due to a change in the patient's orientation. In one particular embodiment, signals from an orientation sensor and/or a pressure sensor are evaluated to determine static positional orientation of the patient and determine based on the static orientation whether the patient's cardiac activity is abnormal.

摘要翻译： 提供了用于检测具有可植入心脏刺激装置的患者的取向和/或运动的系统和方法，并且评估患者的心脏活动的变化是否可以至少部分地由于患者取向的改变而变化。 在一个特定实施例中，评估来自定向传感器和/或压力传感器的信号以确定患者的静态位置取向，并且基于静态取向来确定患者的心脏活动是否异常。

公开(公告)号：US06937900B1

公开(公告)日：2005-08-30

申请号：US10205188

申请日：2002-07-24

申请人： Anne M. Pianca ,  Gene A. Bornzin ,  Euljoon Park ,  Alan B. Vogel ,  Joseph J. Florio ,  Lee Jay Mandell ,  Junyu Mai

发明人： Anne M. Pianca ,  Gene A. Bornzin ,  Euljoon Park ,  Alan B. Vogel ,  Joseph J. Florio ,  Lee Jay Mandell ,  Junyu Mai

IPC分类号： A61N1/365 ,  A61N1/372

CPC分类号： A61N1/36542

摘要： An implantable cardiac stimulation device which determines stimulation based upon the patient's body position and activity level while eliminating special implantation or calibration procedures. To eliminate such special implantation and calibration procedures, the stimulation device correlates the patient's body position using a multi-axis DC accelerometer or other sensor during times of high activity and determines a patient's standing position value. During other times, the stimulation device compares the signals from the accelerometer to the standing position value to determine the patient's current body position. Based upon the current body position and the activity level, the stimulation device determines the necessary stimulation to deliver to the patient.

摘要翻译： 一种可植入心脏刺激装置，其基于患者的身体位置和活动水平确定刺激，同时消​​除特殊植入或校准过程。 为了消除这种特殊的植入和校准过程，刺激装置在高活动时间期间使用多轴DC加速度计或其他传感器来关联患者的身体位置并且确定患者的站立位置值。 在其他时间，刺激装置将来自加速度计的信号与站立位置值进行比较，以确定患者的当前身体位置。 基于当前身体位置和活动水平，刺激装置确定必要的刺激以递送给患者。

公开(公告)号：US06741885B1

公开(公告)日：2004-05-25

申请号：US09908179

申请日：2001-07-17

申请人： Euljoon Park ,  Eric Falkenberg ,  Gene A. Bornzin ,  Junyu Mai

发明人： Euljoon Park ,  Eric Falkenberg ,  Gene A. Bornzin ,  Junyu Mai

IPC分类号： A61B504

CPC分类号： A61N1/3627 ,  A61N1/36514

摘要： An implantable cardiac device detects a progression or regression in heart disease such as congestive heart failure. An activity sensor and a respiration sensor generate raw signals indicative of the patient's activity level and respiration level. Degradation or improvement of the patient's activity and respiration over a predetermined time corresponds to an indication of the progression or regression of the heart disease. A processor coupled to the sensors is programmed to process the raw sensor signals over the predetermined time and stores the processed sensor signals in a memory having a data storage area. A telemetry circuit coupled to the memory is configured to transmit the stored sensor signals to an external monitor for subsequent display. The processor further controls pacing of the heart, adjusts pacing therapy responsive to the process signals, and process the raw respiration signals when the patient is in a number of different active states.

摘要翻译： 可植入的心脏装置检测心脏病的进展或消退，例如充血性心力衰竭。 活动传感器和呼吸传感器产生指示患者的活动水平和呼吸水平的原始信号。 在预定时间内降低或改善患者的活动和呼吸对应于心脏病的进展或消退的指征。 耦合到传感器的处理器被编程为在预定时间内处理原始传感器信号，并将经处理的传感器信号存储在具有数据存储区域的存储器中。 耦合到存储器的遥测电路被配置为将存储的传感器信号发送到外部监视器用于随后的显示。 处理器进一步控制心脏的起搏，响应于过程信号调整起搏治疗，并且当患者处于多个不同的活动状态时处理原始呼吸信号。

公开(公告)号：US06512953B2

公开(公告)日：2003-01-28

申请号：US09844189

申请日：2001-04-26

申请人： Joseph J. Florio ,  Euljoon Park ,  Kerry Bradley ,  Gene A. Bornzin

发明人： Joseph J. Florio ,  Euljoon Park ,  Kerry Bradley ,  Gene A. Bornzin

IPC分类号： A61N1365

CPC分类号： A61N1/3712 ,  A61N1/3627

摘要： A system and corresponding method are provided to reliably detect capture during multi-chamber stimulation, and to further monitor the progression of congestive heart failure. The system provides a method by which intracardiac electrogram (IEGM) characteristics representing single-chamber capture and bi-ventricular capture are stored in memory and displayed. The annotation of the displayed waveforms is such that events associated with loss of capture, single-chamber capture, and bi-ventricular capture are clearly marked for ready interpretation by the physician. In a first situation, a stimulation pulse is followed by a time delay window and a subsequent depolarization complex that represents intrinsic responses of the chambers that have not been captured. In a second situation, a stimulation pulse is followed almost immediately by an evoked response that represents capture of one chamber, and a subsequent depolarization complex that represents an intrinsic response of one chamber that has not been captured. In a third situation, a stimulation pulse is almost immediately followed by an evoked response that represents simultaneous capture of two chambers.

摘要翻译： 提供了一种系统和相应的方法来可靠地检测多室刺激期间的捕获，并进一步监测充血性心力衰竭的进展。 该系统提供了一种表示单室捕获和双心室捕获的心内电图（IEGM）特征存储在存储器中并显示的方法。 显示的波形的注释使得与丢失捕获，单室捕获和双心室捕获相关联的事件被清楚地标记以供医师准备解释。 在第一种情况下，刺激脉冲之后是时间延迟窗口和随后的去极化复合体，其表示未被捕获的室的内在响应。 在第二种情况下，刺激脉冲几乎立即被跟随表示一个腔室的捕获的诱发反应，以及后续的去极化复合体，其表示一个未被捕获的腔室的固有响应。 在第三种情况下，刺激脉冲几乎紧随其后，表示同时捕获两个腔室的诱发反应。

公开(公告)号：US5991661A

公开(公告)日：1999-11-23

申请号：US954326

申请日：1997-10-17

申请人： Euljoon Park ,  Gene A. Bornzin ,  Joseph J. Florio ,  Kerry Bradley

发明人： Euljoon Park ,  Gene A. Bornzin ,  Joseph J. Florio ,  Kerry Bradley

IPC分类号： A61N1/365

CPC分类号： A61N1/36542

摘要： An implantable cardiac stimulation device, such as a pacemaker or an implantable cardioverter-defibrillator, that includes an accelerometer-based activity sensor that processes one or more signals from the activity sensor to obtain parameters that are indicative of the heartbeat of the patient. The implantable cardiac stimulation device determines when the patient is at rest and the activity sensor provides a signal that corresponds to the acceleration of the sensor due to the heartbeat of the patient. This acceleration signal is integrated over time once to provide a contractility parameter, which is indicative of the contractility of the heart and is integrated over time twice to provide a displacement parameter, which is indicative of the displacement of the heart wall during the heartbeat. This displacement parameter is thereby indicative of the volume of blood pumped by the heart. A microprocessor uses either the contractility parameter, the displacement parameter or both to modify the delivery of therapeutic stimulation pulses to the heart.

摘要翻译： 可植入心脏刺激装置，例如起搏器或植入式心律转复除颤器，其包括基于加速度计的活动传感器，其处理来自活动传感器的一个或多个信号以获得指示患者心跳的参数。 可植入心脏刺激装置确定患者何时休息，并且活动传感器提供对应于由于患者心跳引起的传感器的加速度的信号。 该加速度信号随着时间一度被积分以提供收缩性参数，其表示心脏的收缩性并且随时间积分两次以提供位移参数，其指示在心跳期间心脏壁的位移。 因此，该位移参数指示由心脏泵送的血液的体积。 微处理器使用收缩性参数，位移参数或两者来修改对心脏的治疗刺激脉冲的递送。

公开(公告)号：US08989852B2

公开(公告)日：2015-03-24

申请号：US13207307

申请日：2011-08-10

申请人： Jong Gill ,  Rupinder Bharmi ,  Edward Karst ,  Ryan Rooke ,  Riddhi Shah ,  Fujian Qu ,  Gene A. Bornzin ,  Taraneh G. Farazi ,  Euljoon Park

发明人： Jong Gill ,  Rupinder Bharmi ,  Edward Karst ,  Ryan Rooke ,  Riddhi Shah ,  Fujian Qu ,  Gene A. Bornzin ,  Taraneh G. Farazi ,  Euljoon Park

IPC分类号： A61B5/0452 ,  A61B5/0468 ,  A61B5/00 ,  A61B5/0205 ,  A61B5/0215 ,  A61B5/042 ,  A61N1/37 ,  A61B5/024 ,  A61B5/0295

CPC分类号： A61B5/0468 ,  A61B5/0031 ,  A61B5/0205 ,  A61B5/02158 ,  A61B5/02405 ,  A61B5/0295 ,  A61B5/0422 ,  A61B5/4839 ,  A61N1/3702

摘要： Techniques are provided for detecting and distinguishing stroke and cardiac ischemia based on electrocardiac signals. In one example, the device senses atrial and ventricular signals within the patient along a set of unipolar sensing vectors and identifies certain morphological features within the signals such as PR intervals, ST intervals, QT intervals, T-waves, etc. The device detects changes, if any, within the morphological features such as significant shifts in ST interval elevation or an inversion in T-wave shape, which are indicative of stroke or cardiac ischemia. By selectively comparing changes detected along different unipolar sensing vectors, the device distinguishes or discriminates stroke from cardiac ischemia within the patient. The discrimination may be corroborated using various physiological and hemodynamic parameters. In some examples, the device further identifies the location of the ischemia within the heart. In still other examples, the device detects cardiac ischemia occurring during stroke.

摘要翻译： 提供了用于基于心电信号检测和区分中风和心脏缺血的技术。 在一个示例中，该装置沿着一组单极感测向量感测患者内的心房和心室信号，并且识别信号内的某些形态特征，例如PR间隔，ST间隔，QT间隔，T波等。该装置检测变化 （如果有的话）在形态学特征之中，例如ST间隔升高的显着变化或T波形的反转，其指示中风或心脏缺血。 通过选择性地比较沿着不同的单极性感测向量检测的变化，该装置区分或区分患者体内的心脏缺血的中风。 可以使用各种生理和血液动力学参数来确认辨别。 在一些实例中，该装置还识别心脏内局部缺血的位置。 在另外的例子中，该装置检测在中风期间发生的心脏缺血。

公开(公告)号：US20130041274A1

公开(公告)日：2013-02-14

申请号：US13207307

申请日：2011-08-10

申请人： Jong Gill ,  Rupinder Bharmi ,  Edward Karst ,  Ryan Rooke ,  Riddhi Shah ,  Fujian Qu ,  Gene A. Bornzin ,  Taraneh Ghaffari Farazi ,  Euljoon Park

发明人： Jong Gill ,  Rupinder Bharmi ,  Edward Karst ,  Ryan Rooke ,  Riddhi Shah ,  Fujian Qu ,  Gene A. Bornzin ,  Taraneh Ghaffari Farazi ,  Euljoon Park

IPC分类号： A61B5/0468

CPC分类号： A61B5/0468 ,  A61B5/0031 ,  A61B5/0205 ,  A61B5/02158 ,  A61B5/02405 ,  A61B5/0295 ,  A61B5/0422 ,  A61B5/4839 ,  A61N1/3702

摘要： Techniques are provided for detecting and distinguishing stroke and cardiac ischemia based on electrocardiac signals. In one example, the device senses atrial and ventricular signals within the patient along a set of unipolar sensing vectors and identifies certain morphological features within the signals such as PR intervals, ST intervals, QT intervals, T-waves, etc. The device detects changes, if any, within the morphological features such as significant shifts in ST interval elevation or an inversion in T-wave shape, which are indicative of stroke or cardiac ischemia. By selectively comparing changes detected along different unipolar sensing vectors, the device distinguishes or discriminates stroke from cardiac ischemia within the patient. The discrimination may be corroborated using various physiological and hemodynamic parameters. In some examples, the device further identifies the location of the ischemia within the heart. In still other examples, the device detects cardiac ischemia occurring during stroke.

摘要翻译： 提供了用于基于心电信号检测和区分中风和心脏缺血的技术。 在一个示例中，该装置沿着一组单极感测向量感测患者内的心房和心室信号，并且识别信号内的某些形态特征，例如PR间隔，ST间隔，QT间隔，T波等。该装置检测变化 （如果有的话）在形态学特征之中，例如ST间期升高的显着变化或T波形的反转，其指示中风或心脏缺血。 通过选择性地比较沿着不同的单极性感测向量检测的变化，该装置区分或区分患者体内的心脏缺血的中风。 可以使用各种生理和血液动力学参数来确认辨别。 在一些实例中，该装置还识别心脏内局部缺血的位置。 在另外的例子中，该装置检测在中风期间发生的心脏缺血。

公开(公告)号：US08032212B2

公开(公告)日：2011-10-04

申请号：US12210848

申请日：2008-09-15

申请人： Gene A. Bornzin ,  Steve Koh ,  Euljoon Park

发明人： Gene A. Bornzin ,  Steve Koh ,  Euljoon Park

IPC分类号： A61B5/02 ,  A61B5/08 ,  A61B5/05 ,  A61N1/00

CPC分类号： A61N1/36521 ,  A61B5/0537 ,  A61B5/4869

摘要： Techniques are provided for monitoring thoracic fluid levels based on thoracic impedance (ZT) and cardiogenic impedance (ZC). In one example, the implantable device tracks the maximum time rate of change in cardiogenic impedance (i.e. max(dZC/dt)) to detect trends toward hypervolemic or hypovolemic states within the patient based on changes in heart contractility. The detection of these trends in combination with trends in thoracic impedance allows for a determination of whether the thoracic cavity of the patient is generally “too wet” or “too dry,” and thus allows for the titration of diuretics to avoid such extremes. In particular, a decrease in thoracic impedance (ZT) in combination with a decrease in max (dZC/dt) is indicative of the thorax being “too wet” (i.e. a fluid overload). Conversely, an increase in thoracic impedance (ZT) in combination with a decrease in max (dZC/dt) is indicative of the thorax being “too dry” (i.e. a fluid underload).

摘要翻译： 提供了基于胸部阻抗（ZT）和心源阻抗（ZC）监测胸水水平的技术。 在一个示例中，可植入装置跟踪心源性阻抗的最大时间变化率（即max（dZC / dt）），以基于心脏收缩力的变化来检测患者内的高血容量或低血容量状态的趋势。 这些趋势的检测结合胸部阻抗趋势可以确定患者的胸腔通常是否“太湿”或“太干”，从而允许滴定利尿剂以避免这种极端。 特别地，胸部阻抗（ZT）的降低与最大值（dZC / dt）的降低相结合表明胸部“太湿”（即流体过载）。 相反，胸部阻抗（ZT）的增加与最大（dZC / dt）的降低相结合，表明胸部“太干”（即，流体欠载）。