公开(公告)号：US08649865B2

公开(公告)日：2014-02-11

申请号：US12964625

申请日：2010-12-09

申请人： Gene A. Bornzin ,  Wenbo Hou ,  Edward Karst ,  Brian J. Wenzel ,  Timothy A Fayram

发明人： Gene A. Bornzin ,  Wenbo Hou ,  Edward Karst ,  Brian J. Wenzel ,  Timothy A Fayram

IPC分类号： A61N1/00

CPC分类号： A61N1/36585 ,  A61B5/02416 ,  A61B5/726 ,  A61N1/3627 ,  A61N1/36564 ,  A61N1/3684 ,  A61N1/3686

摘要： Time delays between a feature of a signal indicative of electrical activity of a patient's heart and a feature of a plethysmograph signal indicative of changes in arterial blood volume are used to arrange the operation of an implantable device, such as a pacemaker. Shorter time delays between the feature of the signal indicative of electrical activity of a patient's heart and the feature of the plethysmograph signal indicative of changes in arterial blood volume are indicative of larger cardiac stroke volumes. The time delay can be used to select a pacing site or combination of pacing sites and/or to select a pacing interval set.

摘要翻译： 使用指示患者心脏的电活动的信号的特征与指示动脉血容量变化的体积描记信号的特征之间的时间延迟来布置诸如起搏器的可植入装置的操作。 指示患者心脏的电活动的信号的特征与指示动脉血容量变化的体积描记器信号的特征之间的更短的时间延迟指示较大的心脏搏动量。 时间延迟可用于选择起搏站点或起搏站点的组合和/或选择起搏间隔集。

公开(公告)号：US20110144711A1

公开(公告)日：2011-06-16

申请号：US12964625

申请日：2010-12-09

申请人： Gene A. Bornzin ,  Wenbo Hou ,  Edward Karst ,  Brian J. Wenzel ,  Timothy A. Fayram

发明人： Gene A. Bornzin ,  Wenbo Hou ,  Edward Karst ,  Brian J. Wenzel ,  Timothy A. Fayram

IPC分类号： A61N1/36

CPC分类号： A61N1/36585 ,  A61B5/02416 ,  A61B5/726 ,  A61N1/3627 ,  A61N1/36564 ,  A61N1/3684 ,  A61N1/3686

摘要： Time delays between a feature of a signal indicative of electrical activity of a patient's heart and a feature of a plethysmograph signal indicative of changes in arterial blood volume are used to arrange the operation of an implantable device, such as a pacemaker. Shorter time delays between the feature of the signal indicative of electrical activity of a patient's heart and the feature of the plethysmograph signal indicative of changes in arterial blood volume are indicative of larger cardiac stroke volumes. The time delay can be used to select a pacing site or combination of pacing sites and/or to select a pacing interval set.

摘要翻译： 使用指示患者心脏的电活动的信号的特征与指示动脉血容量变化的体积描记信号的特征之间的时间延迟来布置诸如起搏器的可植入装置的操作。 指示患者心脏的电活动的信号的特征与指示动脉血容量变化的体积描记器信号的特征之间的更短的时间延迟指示较大的心脏搏动量。 时间延迟可用于选择起搏站点或起搏站点的组合和/或选择起搏间隔集。

公开(公告)号：US20110009754A1

公开(公告)日：2011-01-13

申请号：US12637489

申请日：2009-12-14

申请人： Brian Jeffrey Wenzel ,  Allen J. Keel ,  Edward Karst ,  Wenbo Hou ,  Taraneh Ghaffari Farazi ,  Gene A. Bornzin

发明人： Brian Jeffrey Wenzel ,  Allen J. Keel ,  Edward Karst ,  Wenbo Hou ,  Taraneh Ghaffari Farazi ,  Gene A. Bornzin

IPC分类号： A61B5/0215

CPC分类号： A61N1/36585 ,  A61B5/02125 ,  A61B5/0215 ,  A61B5/0295 ,  A61B5/0535 ,  A61B5/1459 ,  A61B5/7239 ,  A61N1/08 ,  B82Y10/00 ,  B82Y40/00 ,  G03F7/0002

摘要： Provided herein are implantable systems, and methods for use therewith, for monitoring a patient's arterial blood pressure. Electrode(s) implanting within and/or on the patient's heart are used to obtain a cardiogenic impedance (CI) signal indicative of cardiac contractile activity. Additionally, a signal (e.g., PPG or IPG signal) indicative of changes in arterial blood volume remote from the patient's heart is obtained using a sensor or electrodes that are implanted remote from the patient's heart. One or more metrics indicative of pulse arrival time (PAT) are determined, where each metric can be determined by determining a time from one of the detected features of the CI signal to one of the detected features of the signal indicative of changes in arterial blood volume. Based on at least one of the metric(s) indicative of PAT, arterial blood pressure is estimated, which can include determining values indicative of systolic blood pressure, diastolic blood pressure, pulse pressure and/or mean arterial blood pressure, and/or changes in such values.

摘要翻译： 本文提供了可植入系统及其使用的方法，用于监测患者的动脉血压。 使用植入在患者心脏内和/或患者心脏上的电极来获得指示心脏收缩活动的心源阻抗（CI）信号。 此外，使用远离患者心脏植入的传感器或电极获得指示远离患者心脏的动脉血容量变化的信号（例如，PPG或IPG信号）。 确定指示脉冲到达时间（PAT）的一个或多个度量，其中可以通过确定从CI信号的检测到的特征之一到检测到的指示动脉血液变化的特征之一的时间来确定每个度量 卷。 基于指示PAT的指标中的至少一个，估计动脉血压，其可以包括确定指示收缩压，舒张压，脉压和/或平均动脉血压的值，和/或变化 在这样的价值观。

公开(公告)号：US20130165965A1

公开(公告)日：2013-06-27

申请号：US13333793

申请日：2011-12-21

申请人： Mark Carlson ,  Gene A. Bornzin ,  Timothy A. Fayram

发明人： Mark Carlson ,  Gene A. Bornzin ,  Timothy A. Fayram

IPC分类号： A61B17/03

CPC分类号： A61B17/12122 ,  A61B17/12172 ,  A61B2017/00022 ,  A61B2017/00221 ,  A61B2017/00867 ,  A61B2090/064

摘要： Disclosed herein is a pressure sensing left atrial occluding implantable medical device. The implantable medical device includes a cardiac plug and a micro electro-mechanical system (“MEMS”). The cardiac plug includes an expandable lobe and an expandable disc proximal the lobe. The expandable lobe is configured to expand into an anchoring arrangement within the left atrial appendage. The expandable lobe is configured to expand into an occluding arrangement with the left atrial appendage. The MEMS is coupled to the cardiac plug proximal of the disc. The MEMS is configured to sense surrounding fluid pressure.

摘要翻译： 本文公开了一种压力感测左心房闭塞可植入医疗装置。 可植入医疗装置包括心脏塞和微机电系统（“MEMS”）。 心脏塞子包括可伸缩瓣膜和靠近瓣膜的可扩张椎间盘。 可扩张瓣构造成在左心耳内扩张成锚定布置。 可扩张瓣配置成扩张成具有左心耳的闭塞装置。 MEMS耦合到盘的近端的心脏插塞。 MEMS构造成感测周围的流体压力。

公开(公告)号：US20130325083A1

公开(公告)日：2013-12-05

申请号：US13485404

申请日：2012-05-31

申请人： Rupinder Bharmi ,  Taraneh Ghaffari Farazi ,  Ryan Rooke ,  Stuart Rosenberg ,  Kritika Gupta ,  Riddhi Shah ,  Gene A. Bornzin ,  Wenbo Hou ,  Laurence S. Sloman

发明人： Rupinder Bharmi ,  Taraneh Ghaffari Farazi ,  Ryan Rooke ,  Stuart Rosenberg ,  Kritika Gupta ,  Riddhi Shah ,  Gene A. Bornzin ,  Wenbo Hou ,  Laurence S. Sloman

IPC分类号： A61N1/36

CPC分类号： A61N1/36071 ,  A61B5/029 ,  A61B5/042 ,  A61B5/0538 ,  A61B5/1116 ,  A61B5/4836 ,  A61B5/686 ,  A61B5/7239 ,  A61N1/36139 ,  A61N1/36146 ,  A61N1/36185

摘要： Techniques are provided for controlling neurostimulation such as spinal cord stimulation (SCS) using a cardiac rhythm management device (CRMD). In various examples described herein, neurostimulation is delivered to a patient while regional cardiac performance of the heart of the patient is assessed by the CRMD. The delivery of further neurostimulation is adjusted or controlled based, at least in part, on the regional cardiac performance, preferably to enhance positive effects on the heart due to the neurostimulation or to mitigate any negative effects. Regional cardiac performance is assessed based on parameters derived from cardiogenic impedance signals detected along various vectors through the heart.

摘要翻译： 提供了使用心律管理装置（CRMD）来控制神经刺激如脊髓刺激（SCS）的技术。 在本文描述的各种示例中，神经刺激被递送给患者，同时通过CRMD来评估患者心脏的区域心脏性能。 至少部分地基于区域心脏性能来调整或控制进一步神经刺激的递送，优选地由于神经刺激而增强对心脏的积极作用或减轻任何负面影响。 基于通过心脏沿着各种载体检测到的心源性阻抗信号的参数来评估区域心脏性能。

公开(公告)号：US08706239B2

公开(公告)日：2014-04-22

申请号：US13485404

申请日：2012-05-31

申请人： Rupinder Bharmi ,  Taraneh Ghaffari Farazi ,  Ryan Rooke ,  Stuart Rosenberg ,  Kritika Gupta ,  Riddhi Shah ,  Gene A. Bornzin ,  Wenbo Hou ,  Laurence S. Sloman

发明人： Rupinder Bharmi ,  Taraneh Ghaffari Farazi ,  Ryan Rooke ,  Stuart Rosenberg ,  Kritika Gupta ,  Riddhi Shah ,  Gene A. Bornzin ,  Wenbo Hou ,  Laurence S. Sloman

IPC分类号： A61N1/00

CPC分类号： A61N1/36071 ,  A61B5/029 ,  A61B5/042 ,  A61B5/0538 ,  A61B5/1116 ,  A61B5/4836 ,  A61B5/686 ,  A61B5/7239 ,  A61N1/36139 ,  A61N1/36146 ,  A61N1/36185

摘要： Techniques are provided for controlling neurostimulation such as spinal cord stimulation (SCS) using a cardiac rhythm management device (CRMD). In various examples described herein, neurostimulation is delivered to a patient while regional cardiac performance of the heart of the patient is assessed by the CRMD. The delivery of further neurostimulation is adjusted or controlled based, at least in part, on the regional cardiac performance, preferably to enhance positive effects on the heart due to the neurostimulation or to mitigate any negative effects. Regional cardiac performance is assessed based on parameters derived from cardiogenic impedance signals detected along various vectors through the heart.

摘要翻译： 提供了使用心律管理装置（CRMD）来控制神经刺激如脊髓刺激（SCS）的技术。 在本文描述的各种示例中，神经刺激被递送给患者，同时通过CRMD来评估患者心脏的区域心脏性能。 至少部分地基于区域心脏性能来调整或控制进一步神经刺激的递送，优选地由于神经刺激而增强对心脏的积极作用或减轻任何负面影响。 基于通过心脏沿着各种载体检测到的心源性阻抗信号的参数来评估区域心脏性能。

公开(公告)号：US08634912B2

公开(公告)日：2014-01-21

申请号：US13352136

申请日：2012-01-17

申请人： Gene A. Bornzin ,  Gabriel A. Mouchawar ,  Xiaoyi Min ,  John W. Poore ,  Edward Karst ,  Richard Samade ,  Zoltan Somogyi ,  Didier Theret

发明人： Gene A. Bornzin ,  Gabriel A. Mouchawar ,  Xiaoyi Min ,  John W. Poore ,  Edward Karst ,  Richard Samade ,  Zoltan Somogyi ,  Didier Theret

IPC分类号： A61N1/362

CPC分类号： A61N1/056 ,  A61N1/057 ,  A61N1/0573 ,  A61N1/3622 ,  A61N1/368 ,  A61N1/3684 ,  A61N1/3688 ,  A61N1/3756

摘要： A leadless intra-cardiac medical device includes a housing that is configured to be implanted entirely within a single local chamber of the heart. A first electrode is provided on the housing at a first position such that when the housing is implanted in the local chamber, the first electrode engages the local wall tissue at a local activation site within the conduction network of the local chamber. An intra-cardiac extension is coupled to the housing and configured to extend from the local chamber into an adjacent chamber of the heart. A stabilization arm of the intra-cardiac extension engages the adjacent chamber. A second electrode on the intra-cardiac extension engages distal wall tissue at a distal activation site within the conduction network of the adjacent chamber.

摘要翻译： 无引线心脏内心脏医疗设备包括被配置为完全植入心脏的单个局部腔室内的壳体。 第一电极在第一位置处设置在壳体上，使得当壳体被植入局部腔室时，第一电极在局部腔室的传导网络内的局部激活位置接合局部壁组织。 心脏内延伸部分耦合到壳体并且构造成从局部腔室延伸到心脏的相邻室中。 心脏内延伸部的稳定臂与相邻的腔室相接合。 心脏延伸部分上的第二个电极与相邻腔室的传导网络内的远端活化位点处的远端壁组织接合。

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：US20130325081A1

公开(公告)日：2013-12-05

申请号：US13485513

申请日：2012-05-31

申请人： Edward Karst ,  Richard Samade ,  Gene A. Bornzin ,  John W. Poore ,  Zoltan Somogyi ,  Didier Theret

发明人： Edward Karst ,  Richard Samade ,  Gene A. Bornzin ,  John W. Poore ,  Zoltan Somogyi ,  Didier Theret

IPC分类号： A61N1/365

CPC分类号： A61N1/368 ,  A61B5/0422 ,  A61B5/0452 ,  A61B5/0464 ,  A61B5/1107 ,  A61B5/6869 ,  A61B5/6882 ,  A61B2560/0468 ,  A61N1/36507 ,  A61N1/36514 ,  A61N1/36578 ,  A61N1/36592 ,  A61N1/37205 ,  A61N1/3756

摘要： A leadless intra-cardiac medical device senses cardiac activity from multiple chambers and applies cardiac stimulation to at least one cardiac chamber and/or generates a cardiac diagnostic indication. The leadless device may be implanted in a local cardiac chamber (e.g., the right ventricle) and detect near-field signals from that chamber as well as far-field signals from an adjacent chamber (e.g., the right atrium).

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。