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：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）。

公开(公告)号：US20100069778A1

公开(公告)日：2010-03-18

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： A61B5/053

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的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）。

公开(公告)号：US07149579B1

公开(公告)日：2006-12-12

申请号：US10329233

申请日：2002-12-23

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

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

IPC分类号： A61N1/00

CPC分类号： A61N1/3925 ,  A61N1/36535 ,  A61N1/36542

摘要： Time-varying spatial signals are detected by accelerometers mounted within the patient. The signals, representative of the actual 3-D trajectory of the patient, are compared with information representative of expected trajectories retrieved from memory to identify a current patient posture, which may be either a dynamic posture such as walking or running or a change in posture such as rising from a seated position to a standing position. In this manner, a change in posture of the patient is identified based upon a full 3-D trajectory, rather than merely the orientation of the patient at the beginning and the end of the change in posture. In an example described herein, the implantable device stores information representative of expected 3-D trajectories in the form of pre-calculated comparison matrices derived from orthonormal kernels employing Laguerre functions or Lagrange functions. A technique is also described for use by an external programmer for pre-calculating comparison matrices so as to reduce the processing burden within the implanted device during posture detection.

摘要翻译： 时变空间信号由安装在患者体内的加速度计检测。 将代表患者的实际3-D轨迹的信号与表示从存储器检索到的预期轨迹的信息进行比较，以识别当前患者姿势，其可以是动态姿势，例如步行或跑步或姿势变化 例如从就座位置升高到站立位置。 以这种方式，基于完整的3-D轨迹来识别患者姿势的变化，而不仅仅是患者在姿势改变的开始和结束时的取向。 在本文所描述的示例中，可植入装置以使用拉格朗日函数或拉格朗日函数的从正常内核导出的预先计算的比较矩阵的形式存储表示预期3-D轨迹的信息。 还描述了一种用于外部编程器用于预计算比较矩阵的技术，以便在姿势检测期间减少植入装置内的处理负担。

公开(公告)号：US06928324B2

公开(公告)日：2005-08-09

申请号：US10077048

申请日：2002-02-14

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

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

IPC分类号： A61N1/36 ,  A61N1/365

CPC分类号： A61N1/36585 ,  A61N1/3601 ,  A61N1/36542 ,  A61N1/36557

摘要： An implantable cardiac stimulation device comprises a metabolic demand sensor, an activity sensor, and one or more pulse generators. The metabolic demand sensor and activity sensor can sense metabolic demand and physical activity parameters, respectively. The pulse generators can generate cardiac pacing pulses with timing based on a comparison of the metabolic demand and physical activity parameters. The timed cardiac pacing pulses can prevent a sleep apnea condition.

摘要翻译： 可植入心脏刺激装置包括代谢需求传感器，活动传感器和一个或多个脉冲发生器。 代谢需求传感器和活动传感器可以分别感测代谢需求和身体活动参数。 基于代谢需求和身体活动参数的比较，脉冲发生器可以产生具有定时的心脏起搏脉冲。 定时的心脏起搏脉冲可以防止睡眠呼吸暂停状态。

公开(公告)号：US07548785B2

公开(公告)日：2009-06-16

申请号：US10866422

申请日：2004-06-10

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

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

IPC分类号： A61N1/362

CPC分类号： A61N1/3627 ,  A61B5/0245 ,  A61B5/4035

摘要： An exemplary method includes selecting a cross-correlation frequency having an associated cross-correlation period, detecting and binning a heart rate in a heart rate bin, detecting and binning an activity state in an activity state bin, repeating the detecting and binning a heart rate and the detecting and binning an activity state during a cross-correlation period, and summing the products a bin count of the heart rate bins and a bin count of the activity state bins to provide a cross-correlation index for the cross-correlation period. Other exemplary algorithms, methods, devices, systems, etc., are also disclosed.

摘要翻译： 一种示例性方法包括选择具有相关联的相关周期的互相关频率，检测和归纳心率仓中的心率，检测和归纳活动状态仓中的活动状态，重复检测和归纳心率 以及在互相关时段期间检测和归纳活动状态，并且将乘积与心率仓的仓计数和活动状态仓的箱数相加，以提供互相关周期的互相关指数。 还公开了其它示例性算法，方法，设备，系统等。

公开(公告)号：US07212862B2

公开(公告)日：2007-05-01

申请号：US10247137

申请日：2002-09-18

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

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

IPC分类号： A61N1/365

CPC分类号： A61N1/36585 ,  A61N1/3601 ,  A61N1/36542 ,  A61N1/36557

摘要： An implantable cardiac stimulation device comprises a physiologic sensor and one or more pulse generators. The physiologic sensor is capable of sensing a physiologic parameter. The pulse generators can generate cardiac pacing pulses with a timing based on the physiologic parameter. The timed cardiac pacing pulses can prevent a sleep apnea condition. In one example, a cardiac stimulation device has a physiologic sensor and can be configured to pace a patient's heart according to a rest mode of operation. The cardiac stimulation device uses measurements from the physiologic sensor to prevent and treat sleep apnea using a revised rest mode of operation. The revised rest mode operates under a presumption that sleep apnea is primary to a reduced heart rate, rather than secondary, so that pacing at a rate higher than the natural cardiac rate during sleep will prevent sleep apnea.

摘要翻译： 植入式心脏刺激装置包括生理传感器和一个或多个脉冲发生器。 生理传感器能感测生理参数。 脉冲发生器可以产生基于生理参数的定时的心脏起搏脉冲。 定时的心脏起搏脉冲可以防止睡眠呼吸暂停状态。 在一个示例中，心脏刺激装置具有生理传感器，并且可以被配置为根据休息的操作模式来对患者的心脏进行加速。 心脏刺激装置使用来自生理传感器的测量来使用修改的休息模式来预防和治疗睡眠呼吸暂停。 修改后的休息模式的作用是假设睡眠呼吸暂停是降低心率而不是继发性睡眠呼吸暂停的原因，因此在睡眠期间以高于自然心率的速率起搏将防止睡眠呼吸暂停。

公开(公告)号：US07149584B1

公开(公告)日：2006-12-12

申请号：US10328642

申请日：2002-12-23

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

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

IPC分类号： A61N1/00

CPC分类号： A61N1/37252 ,  A61N1/36535 ,  A61N1/36542 ,  A61N1/37235

摘要： Time-varying spatial signals are detected by accelerometers mounted within the patient. The signals, representative of the actual 3-D trajectory of the patient, are compared with information representative of expected trajectories retrieved from memory to identify a current patient posture, which may be either a dynamic posture such as walking or running or a change in posture such as rising from a seated position to a standing position. In this manner, a change in posture of the patient is identified based upon a full 3-D trajectory, rather than merely the orientation of the patient at the beginning and the end of the change in posture. In an example described herein, the implantable device stores information representative of expected 3-D trajectories in the form of pre-calculated comparison matrices derived from orthonormal kernels employing Laguerre functions or Lagrange functions. A technique is also described for use by an external programmer for pre-calculating comparison matrices so as to reduce the processing burden within the implanted device during posture detection.

公开(公告)号：US06999817B2

公开(公告)日：2006-02-14

申请号：US10077660

申请日：2002-02-14

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

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

IPC分类号： A61N1/36

CPC分类号： A61N1/365 ,  A61N1/36557

摘要： An implantable cardiac stimulation device comprises a physiologic sensor and one or more pulse generators. The physiologic sensor is capable of sensing a physiologic parameter. The pulse generators can generate cardiac pacing pulses with a timing based on the physiologic parameter. The timed cardiac pacing pulses can prevent a sleep apnea condition. In one example, a cardiac stimulation device has a physiologic sensor and can be configured to pace a patient's heart according to a rest mode of operation. The cardiac stimulation device uses measurements from the physiologic sensor to prevent and treat sleep apnea using a revised rest mode of operation. The revised rest mode operates under a presumption that sleep apnea is primary to a reduced heart rate, rather than secondary, so that pacing at a rate higher than the natural cardiac rate during sleep will prevent sleep apnea.

公开(公告)号：US08626278B2

公开(公告)日：2014-01-07

申请号：US12901296

申请日：2010-10-08

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

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

IPC分类号： A61B5/0464 ,  A61B5/053

CPC分类号： A61B5/046 ,  A61B5/0006 ,  A61B5/0031 ,  A61B5/02028 ,  A61B5/0205 ,  A61B5/029 ,  A61B5/0402 ,  A61B5/0422 ,  A61B5/0468 ,  A61B5/0538 ,  A61B5/0816 ,  A61B5/1116 ,  A61B5/1118 ,  A61B5/686 ,  A61B5/6869 ,  A61N1/3624 ,  A61N1/36521 ,  A61N1/36592

摘要： A medical device is provided that comprises a lead assembly. The lead assembly includes at least one intra-cardiac (IC) electrode, an extra-cardiac (EC) electrode and a subcutaneous remote-cardiac (RC) electrode. The IC electrode is configured to be located within the heart. The EC electrode is configured to be positioned proximate to at least one of a superior vena cava (SVC) and a left ventricle (LV) of a heart. The RC electrode is configured to be located remote from the heart. An extra-cardiac impedance (ECI) module is configured to measure extra-cardiac impedance along an ECI vector between the EC and RC electrodes to obtain ECI measurements. An arrhythmia monitoring module is configured to declare a potential atrial arrhythmia to be an atrial arrhythmia based on the hemodynamic performance determined from the ECI measurements. The hemodynamic performance assessment module is further enabled to compare a current ECI pattern with a prior baseline ECI waveform.

摘要翻译： 提供了包括引线组件的医疗装置。 引线组件包括至少一个心脏内（IC）电极，心外（EC）电极和皮下远心电（RC）电极）。 IC电极被配置为位于心脏内。 EC电极配置成靠近心脏的上腔静脉（SVC）和左心室（LV）中的至少一个定位。 RC电极被配置为远离心脏。 心脏外阻抗（ECI）模块被配置为测量EC和RC电极之间的ECI向量的心外阻抗，以获得ECI测量值。 心律失常监测模块被配置为基于从ECI测量确定的血液动力学性能来将潜在心房心律失常宣告为房性心律失常。 血液动力学性能评估模块还能够将当前ECI模式与先前的基线ECI波形进行比较。