公开(公告)号：US20060047319A1

公开(公告)日：2006-03-02

申请号：US10928586

申请日：2004-08-27

申请人： Ken Bruhns ,  Xiaoyi Min ,  Paul Levine ,  Euljoon Park

发明人： Ken Bruhns ,  Xiaoyi Min ,  Paul Levine ,  Euljoon Park

IPC分类号： A61N1/362

CPC分类号： A61N1/3627 ,  A61N1/3682

摘要： Techniques are provided for estimating optimal atrioventricular delay values for use in pacing the ventricles. Both the intrinsic inter-atrial conduction delay and the intrinsic atrioventricular conduction delay are determined for the patient and then the preferred atrioventricular pacing delay is derived therefrom. By taking into account intrinsic inter-atrial delay along with intrinsic atrioventricular delay, it is believed that a more reliable estimate of the true optimal atrioventricular delay values for the patient can be achieved than with techniques that only take into account intrinsic atrioventricular delay values. In one example, the technique uses intracardiac electrogram (IEGM) signals and surface electrocardiogram (EKG) signals and hence can be performed by an external programmer without requiring Doppler echocardiography or other cardiac performance monitoring techniques. In another example, wherein the implanted device is equipped with a coronary sinus lead, the technique uses only IEGM signals and hence can be performed by the device itself.

摘要翻译： 提供了用于估计用于起搏心室的最佳房室延迟值的技术。 对于患者确定内在的心房传导延迟和内在的房室传导延迟，然后从其导出优选的房室起搏延迟。 通过考虑内在的心房延迟以及内在房室延迟，相信可以实现比仅考虑固有房室延迟值的技术更可靠的估计患者的真正最佳房室延迟值。 在一个示例中，该技术使用心内电描记图（IEGM）信号和表面心电图（EKG）信号，因此可以由外部编程器执行，而不需要多普勒超声心动图或其他心脏监测技术。 在另一示例中，其中植入的装置配备有冠状窦引线，该技术仅使用IEGM信号，因此可以由装置本身执行。

公开(公告)号：US07248925B2

公开(公告)日：2007-07-24

申请号：US10928586

申请日：2004-08-27

申请人： Ken Bruhns ,  Xiaoyi Min ,  Paul A. Levine ,  Euljoon Park

发明人： Ken Bruhns ,  Xiaoyi Min ,  Paul A. Levine ,  Euljoon Park

IPC分类号： A61N1/36

CPC分类号： A61N1/3627 ,  A61N1/3682

摘要： A system and method for estimating optimal atrioventricular delay values for use in pacing the ventricles. Both the intrinsic inter-atrial conduction delay and the intrinsic atrioventricular conduction delay are determined for the patient and then the preferred atrioventricular pacing delay is derived therefrom. By taking into account intrinsic inter-atrial delay along with intrinsic atrioventricular delay, a more reliable estimate of the true optimal atrioventricular delay values for the patient can be achieved than with techniques that only take into account intrinsic atrioventricular delay values. In one example, the technique uses intracardiac electrogram (IEGM) signals and surface electrocardiogram (EKG) signals and hence can be performed by an external programmer without requiring Doppler echocardiography or other cardiac performance monitoring techniques. In another example, wherein the implanted device is equipped with a coronary sinus lead, the technique uses only IEGM signals and hence can be performed by the device itself.

摘要翻译： 用于估计用于起搏心室的最佳房室延迟值的系统和方法。 对于患者确定内在的心房传导延迟和内在的房室传导延迟，然后从其导出优选的房室起搏延迟。 通过考虑内在的心房延迟以及内在的房室延迟，可以实现比仅考虑内在房室延迟值的技术更可靠的估计患者的真正最佳房室延迟值。 在一个示例中，该技术使用心内电描记图（IEGM）信号和表面心电图（EKG）信号，因此可以由外部编程器执行，而不需要多普勒超声心动图或其他心脏监测技术。 在另一示例中，其中植入的装置配备有冠状窦引线，该技术仅使用IEGM信号，因此可以由装置本身执行。

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：US08175707B1

公开(公告)日：2012-05-08

申请号：US11951928

申请日：2007-12-06

申请人： Connie Wright ,  Xiaoyi Min ,  Euljoon Park ,  Scott Simon

发明人： Connie Wright ,  Xiaoyi Min ,  Euljoon Park ,  Scott Simon

IPC分类号： A61N1/365

CPC分类号： A61N1/3627 ,  A61N1/36521 ,  A61N1/36542 ,  A61N1/3682 ,  A61N1/3684

摘要： An exemplary method includes delivering a cardiac resynchronization therapy using an atrio-ventricular delay and an interventricular delay, monitoring patient activity, optimizing the atrio-ventricular delay and the interventricular delay for a plurality of patient activity states to generate a plurality of optimal atrio-ventricular delays and a plurality of optimal interventricular delays, storing the optimal atrio-ventricular delays and the optimal interventricular delays in association with corresponding patient activity states, detecting a change in patient activity, adjusting an atrial pacing rate in response to the detected change in patient activity based at least in part on a heart failure status and setting the atrio-ventricular delay and the interventricular delay, in response to the detected change in patient activity, using a stored optimal atrio-ventricular delay that corresponds to the patient activity and a stored optimal interventricular delay that corresponds to the patient activity. Other exemplary technologies are also disclosed.

摘要翻译： 示例性方法包括使用心室延迟和心室间延迟来递送心脏再同步治疗，监测患者活动，优化多个患者活动状态的心房延迟和室间延迟以产生多个最佳心房室 延迟和多个最佳心室间延迟，存储与相应的患者活动状态相关联的最佳心室延迟和最佳心室延迟，检测患者活动的变化，响应于检测到的患者活动变化来调整心房起搏速率 至少部分地基于心力衰竭状态，并且响应于检测到的患者活动的变化来设置心室延迟和室间延迟，使用存储的对应于患者活动的最佳心室延迟和存储的最佳 室间延迟对应于pa 活跃。 还公开了其它示例性技术。

公开(公告)号：US07430447B2

公开(公告)日：2008-09-30

申请号：US11149058

申请日：2005-06-06

申请人： Xiaoyi Min ,  Euljoon Park ,  Malin Öhlander

发明人： Xiaoyi Min ,  Euljoon Park ,  Malin Öhlander

IPC分类号： A61N1/00

CPC分类号： A61B5/0535 ,  A61B5/0402 ,  A61B5/0816 ,  A61B5/1116 ,  A61B5/686 ,  A61N1/3601 ,  A61N1/365 ,  A61N1/36521 ,  A61N1/371

摘要： An exemplary method includes acquiring impedance values over one or more respiratory cycles, determining an impedance span based on the impedance values and, based at least in part on the impedance span, determining cardiac condition or respiratory condition. Another exemplary method includes acquiring IEGMs over one or more respiratory cycles, determining evoked response measure values based on the IEGMs, determining an evoked response span based on the evoked response measure values and, based at least in part on the evoked response span, determining cardiac condition or respiratory condition. Other exemplary methods, devices, systems, etc., are also disclosed.

摘要翻译： 示例性方法包括：通过一个或多个呼吸周期获取阻抗值，基于阻抗值确定阻抗跨度，并且至少部分地基于阻抗跨度，确定心脏状况或呼吸状况。 另一示例性方法包括通过一个或多个呼吸周期获取IEGM，基于IEGM确定诱发的应答测量值，基于诱发的响应测量值确定诱发的应答跨度，并且至少部分地基于诱发的响应跨度，确定心脏 病情或呼吸状况。 还公开了其它示例性方法，装置，系统等。

公开(公告)号：US20050216067A1

公开(公告)日：2005-09-29

申请号：US11014276

申请日：2004-12-15

申请人： Xiaoyi Min ,  Gene Bornzin ,  Euljoon Park

发明人： Xiaoyi Min ,  Gene Bornzin ,  Euljoon Park

IPC分类号： A61N1/362 ,  A61N1/365 ,  A61N1/37

CPC分类号： A61N1/36521 ,  A61B5/0538 ,  A61N1/3627 ,  A61N1/371

摘要： Techniques are provided for predicting the onset of a heart condition within a patient based on impedance measurements. Briefly, overloads in fluid levels in the thorax and in ventricular myocardial mass within the patient are detected based on impedance signals sensed using implanted electrodes. The onset of certain heart conditions is then predicted based on the overloads. For example, pulmonary edema arising due to diastolic heart failure is predicted based on the detection of on-going overloads in both fluid levels and ventricular mass. Ventricular hypertrophy is detected based on an on-going ventricular mass overload without a sustained fluid overload. Various other heart conditions may also be predicted based on specific combinations of recent or on-going overloads. Evoked response is exploited to corroborate the predictions. Appropriate warning signals are generated and preemptive therapy is initiated.

摘要翻译： 提供了基于阻抗测量来预测患者心脏病状发作的技术。 简单地说，基于使用植入电极感测到的阻抗信号来检测患者胸部液位水平和心室心肌质量的过载。 然后基于过载来预测某些心脏状况的发作。 例如，由于舒张性心力衰竭引起的肺水肿基于检测流体水平和心室质量中的持续过载而被预测。 基于正在进行的心室质量超载而无持续的流体超载检测出心室肥大。 还可以基于最近或正在进行的过载的特定组合来预测各种其他心脏状况。 被诱发的反应被利用来证实预测。 产生适当的警告信号并开始抢先治疗。

公开(公告)号：US20080306567A1

公开(公告)日：2008-12-11

申请号：US11759756

申请日：2007-06-07

申请人： Euljoon Park ,  Xiaoyi Min

发明人： Euljoon Park ,  Xiaoyi Min

IPC分类号： A61N1/362

CPC分类号： A61N1/3686 ,  A61N1/36185 ,  A61N1/3627 ,  A61N1/3684

摘要： A method is disclosed that includes selecting an electrode configuration from a plurality of electrode configurations associated with electrodes of an implantable lead, sensing activity of the right ventricle and the left ventricle, determining an interval between sensed activity of the right ventricle and sensed activity of the left ventricle and determining whether the selected electrode configuration is suitable based at least in part on the interval. In one embodiment, an implantable device performs such a method to improve patient response to the CRT therapy, for example, by selecting a different electrode configuration if the current configuration is not suitable. Other exemplary methods, devices, systems, etc., are also disclosed.

摘要翻译： 公开了一种方法，其包括从与可植入引线的电极相关联的多个电极配置中选择电极配置，感测右心室和左心室的活动，确定感测到的右心室的活动与感测的右心室的活动之间的间隔 并且至少部分地基于间隔来确定所选择的电极配置是否合适。 在一个实施例中，可植入装置执行这种方法以改善患者对CRT治疗的反应，例如，如果当前配置不合适，则通过选择不同的电极配置。 还公开了其它示例性方法，装置，系统等。

公开(公告)号：US08301246B2

公开(公告)日：2012-10-30

申请号：US11759756

申请日：2007-06-07

申请人： Euljoon Park ,  Xiaoyi Min

发明人： Euljoon Park ,  Xiaoyi Min

IPC分类号： A61N1/368

CPC分类号： A61N1/3686 ,  A61N1/36185 ,  A61N1/3627 ,  A61N1/3684

摘要： A method is disclosed that includes selecting an electrode configuration from a plurality of electrode configurations associated with electrodes of an implantable lead, sensing activity of the right ventricle and the left ventricle, determining an interval between sensed activity of the right ventricle and sensed activity of the left ventricle and determining whether the selected electrode configuration is suitable based at least in part on the interval. In one embodiment, an implantable device performs such a method to improve patient response to the CRT therapy, for example, by selecting a different electrode configuration if the current configuration is not suitable. Other exemplary methods, devices, systems, etc., are also disclosed.

摘要翻译： 公开了一种方法，其包括从与可植入引线的电极相关联的多个电极配置中选择电极配置，感测右心室和左心室的活动，确定感测到的右心室的活动与感测的右心室的活动之间的间隔 并且至少部分地基于间隔来确定所选择的电极配置是否合适。 在一个实施例中，可植入装置执行这种方法以改善患者对CRT治疗的反应，例如，如果当前配置不合适，则通过选择不同的电极配置。 还公开了其它示例性方法，装置，系统等。

公开(公告)号：US20060276848A1

公开(公告)日：2006-12-07

申请号：US11149058

申请日：2005-06-06

申请人： Xiaoyi Min ,  Euljoon Park ,  Malin Ohlander

发明人： Xiaoyi Min ,  Euljoon Park ,  Malin Ohlander

IPC分类号： A61N1/365

CPC分类号： A61B5/0535 ,  A61B5/0402 ,  A61B5/0816 ,  A61B5/1116 ,  A61B5/686 ,  A61N1/3601 ,  A61N1/365 ,  A61N1/36521 ,  A61N1/371

摘要： An exemplary method includes acquiring impedance values over one or more respiratory cycles, determining an impedance span based on the impedance values and, based at least in part on the impedance span, determining cardiac condition or respiratory condition. Another exemplary method includes acquiring IEGMs over one or more respiratory cycles, determining evoked response measure values based on the IEGMs, determining an evoked response span based on the evoked response measure values and, based at least in part on the evoked response span, determining cardiac condition or respiratory condition. Other exemplary methods, devices, systems, etc., are also disclosed.

摘要翻译： 示例性方法包括：通过一个或多个呼吸周期获取阻抗值，基于阻抗值确定阻抗跨度，并且至少部分地基于阻抗跨度，确定心脏状况或呼吸状况。 另一示例性方法包括通过一个或多个呼吸周期获取IEGM，基于IEGM确定诱发的应答测量值，基于诱发的响应测量值确定诱发的应答跨度，并且至少部分地基于诱发的响应跨度，确定心脏 病情或呼吸状况。 还公开了其它示例性方法，装置，系统等。

公开(公告)号：US07139609B1

公开(公告)日：2006-11-21

申请号：US10346809

申请日：2003-01-17

申请人： Xiaoyi Min ,  Paul A. Levine ,  Euljoon Park

发明人： Xiaoyi Min ,  Paul A. Levine ,  Euljoon Park

IPC分类号： A61B5/02 ,  A61N1/365

CPC分类号： A61N1/36585 ,  A61B5/02 ,  A61B5/04004 ,  A61B5/0402 ,  A61B5/7239 ,  A61B7/04 ,  A61N1/3627

摘要： Techniques are provided for performing internal measurement of heart sounds to estimate patient cardiac function in terms of stroke volume, cardiac output, or a maximum rate of change of aortic pressure with time (max dP/dt). Control parameters of the medical device are then automatically adjusted so as to optimize overall cardiac function or to provide for ventricular resynchronization therapy. In one example, heart sound signals are derived from acceleration signals received from an accelerometer. The heart sound signals are analyzed to identify S1 and S2 heart sounds as well as ejection period and isovolumic interval (ISOV). Proxies for max dP/dt, stroke volume and cardiac output are then derived from the S1 and S2 heart sounds, the ejection period and the ISOV. Alternative techniques, not requiring detection of ISOV, are employed for use if the patient has heart value regurgitation.

摘要翻译： 提供技术用于进行心脏声音的内部测量，以根据中风量，心输出量或主动脉压随时间的最大变化率（最大dP / dt）来估计患者心脏功能。 然后自动调节医疗装置的控制参数，以便优化整体心脏功能或提供心室再同步治疗。 在一个示例中，从加速度计接收的加速度信号导出心音信号。 分析心音信号以识别S1和S2心音，以及射血期和等容间隔（ISOV）。 然后从S1和S2心脏声音，射血期和ISOV导出最大dP / dt，搏出量和心输出量的代理。 如果患者有心脏反流，则采用不需要检测ISOV的替代技术。