公开(公告)号：US20080015653A1

公开(公告)日：2008-01-17

申请号：US11780405

申请日：2007-07-19

申请人： Krzysztof Siejko ,  Gerrard Carlson ,  William Lincoln ,  Qingsheng Zhu

发明人： Krzysztof Siejko ,  Gerrard Carlson ,  William Lincoln ,  Qingsheng Zhu

IPC分类号： A61N1/365

CPC分类号： A61N1/368 ,  A61N1/3627 ,  A61N1/36514 ,  A61N1/36542 ,  A61N1/36578 ,  A61N1/3682 ,  A61N1/3702

摘要： A cardiac rhythm management system provides a phonocardiographic image indicative of a heart's mechanical events related to hemodynamic performance. The phonocardiographic image includes a stack of acoustic sensor signal segments representing multiple cardiac cycles. Each acoustic sensor signal segment includes heart sounds indicative of the heart's mechanical events and representations of the heart's electrical events. The stack of acoustic sensor signal segments are aligned by a selected type of the heart's mechanical or electrical events and are grouped by a cardiac timing parameter for presentation.

摘要翻译： 心律管理系统提供指示与血液动力学性能相关的心脏的机械事件的心音图像。 心音图像包括表示多个心动周期的一组声传感器信号段。 每个声学传感器信号段包括指示心脏的机械事件和心脏电气事件的表示的心脏声音。 声学传感器信号段的堆叠通过所选择的心脏的机械或电气事件的类型对准，并且通过心脏定时参数分组以进行呈现。

公开(公告)号：US20060270939A1

公开(公告)日：2006-11-30

申请号：US11135985

申请日：2005-05-24

申请人： Ramesh Wariar ,  Krzysztof Siejko ,  Gerrard Carlson ,  Jeffrey Stahmann

发明人： Ramesh Wariar ,  Krzysztof Siejko ,  Gerrard Carlson ,  Jeffrey Stahmann

IPC分类号： A61B5/02

CPC分类号： A61B7/00 ,  A61N1/08

摘要： A system to monitor heart sounds, such as to detect a worsening condition of heart failure decompensation. The system comprises a medical device that includes an implantable multi-axis heart sound sensor, operable to produce, for each of at least two nonparallel axes, an electrical signal representative of at least one heart sound, the heart sound associated with mechanical activity of a patient's heart. The device further includes a controller circuit coupled to the heart sound sensor. The controller circuit measures components of the heart sound that respectively correspond to each of the axes.

摘要翻译： 监测心脏声音的系统，例如检测心力衰竭代偿失调的恶化情况。 该系统包括医疗装置，其包括可植入的多轴心音传感器，可操作以针对至少两个不平行的轴中的每一个产生代表至少一个心脏声音的电信号，所述心脏声音与 病人的心。 该装置还包括耦合到心脏声音传感器的控制器电路。 控制器电路测量分别对应于每个轴的心音的分量。

公开(公告)号：US20070078491A1

公开(公告)日：2007-04-05

申请号：US11465878

申请日：2006-08-21

申请人： Krzysztof Siejko ,  Laura Green ,  Gerrard Carlson

发明人： Krzysztof Siejko ,  Laura Green ,  Gerrard Carlson

IPC分类号： A61N1/00

CPC分类号： A61B7/006 ,  A61B5/02028 ,  A61B5/024 ,  A61B5/02438 ,  A61B5/4836 ,  A61B5/6847 ,  A61B5/7275 ,  A61B7/04 ,  A61B2562/0204 ,  A61B2562/0219 ,  A61N1/36514 ,  A61N1/37 ,  A61N1/3987

摘要： A cardiac rhythm management system provides for the trending of a third heart sound (S3) index. The S3 index is a ratio, or an estimate of the ratio, of the number of S3 beats to the number of all heart beats, where the S3 beats are each a heart beat during which an occurrence of S3 is detected. An implantable sensor such as an accelerometer or a microphone senses an acoustic signal indicative heart sounds including S3. An S3 detector detects occurrences of S3 from the acoustic signal. A heart sound processing system trends the S3 index on a periodic basis to allow continuous monitoring of the S3 activity level, which is indicative of conditions related to heart failure.

摘要翻译： 心律管理系统提供第三心音（S3）指数的趋势。 S3指数是S3跳动次数与所有心跳次数的比率或比率的估计，其中S3跳动各自是检测到S3的发生的心跳。 诸如加速度计或麦克风的可植入传感器感测到包括S3的指示心音的声信号。 S3检测器从声信号检测出S3的发生。 心脏声音处理系统周期性地推动S3指数，以允许连续监测S3活动水平，这表明与心力衰竭有关的病症。

公开(公告)号：US20050149136A1

公开(公告)日：2005-07-07

申请号：US10746874

申请日：2003-12-24

申请人： Krzysztof Siejko ,  Laura Green ,  Gerrard Carlson

发明人： Krzysztof Siejko ,  Laura Green ,  Gerrard Carlson

IPC分类号： A61B7/04 ,  A61N1/365 ,  A61N1/37

CPC分类号： A61B7/006 ,  A61B5/02028 ,  A61B5/024 ,  A61B5/02438 ,  A61B5/4836 ,  A61B5/6847 ,  A61B5/7275 ,  A61B7/04 ,  A61B2562/0204 ,  A61B2562/0219 ,  A61N1/36514 ,  A61N1/37 ,  A61N1/3987

摘要： A cardiac rhythm management system provides for the trending of a third heart sound (S3) index. The S3 index is a ratio, or an estimate of the ratio, of the number of S3 beats to the number of all heart beats, where the S3 beats are each a heart beat during which an occurrence of S3 is detected. An implantable sensor such as an accelerometer or a microphone senses an acoustic signal indicative heart sounds including S3. An S3 detector detects occurrences of S3 from the acoustic signal. A heart sound processing system trends the S3 index on a periodic basis to allow continuous monitoring of the S3 activity level, which is indicative of conditions related to heart failure.

摘要翻译： 心律管理系统提供第三心音（S3）指数的趋势。 S3指数是S3跳动次数与所有心跳次数的比率或比率的估计，其中S3跳动各自是检测到S3的发生的心跳。 诸如加速度计或麦克风的可植入传感器感测到包括S3的指示心音的声信号。 S3检测器从声信号检测出S3的发生。 心脏声音处理系统周期性地推动S3指数，以允许连续监测S3活动水平，这表明与心力衰竭有关的病症。

公开(公告)号：US20070027400A1

公开(公告)日：2007-02-01

申请号：US11189462

申请日：2005-07-26

申请人： Gerrard Carlson ,  Ramesh Wariar ,  Krzysztof Siejko

发明人： Gerrard Carlson ,  Ramesh Wariar ,  Krzysztof Siejko

IPC分类号： A61B5/02

CPC分类号： A61N1/36585 ,  A61B5/021 ,  A61B5/0452 ,  A61B7/04 ,  A61M5/1723 ,  A61N1/37

摘要： A system and method for managing preload reserve and tracking the inotropic state of a patient's heart. The S1 heart sound is measured as a proxy for direct measurement of stroke volume. The S3 heart sound may be measured as a proxy for direct measurement of preload level. The S1-S3 pair yield a point on a Frank Starling type of curve, and reveal information regarding the patient's ventricular operating point and inotropic state. As an alternative, or in addition to, measurement of the S3 heart sound, the S4 heart sound may be measured or a direct pressure measurement may be made for the sake of determining the patient's preload level. The aforementioned measurements may be made by a cardiac rhythm management device, such as a pacemaker or implantable defibrillator.

摘要翻译： 一种用于管理预负荷储备并跟踪患者心脏的变力状态的系统和方法。 测量S1心音作为直接测量行程体积的代理。 可以将S3心音测量为用于直接测量预载水平的代理。 S1-S3对在Frank Starling曲线上产生一个点，并显示关于患者的心室手术点和变力状态的信息。 作为S3心音的测量或除了测量S3心音之外，也可以测量S4心音，或者为了确定患者的预压水平可以进行直接的压力测量。 上述测量可以由诸如起搏器或可植入除颤器的心律管理装置进行。

公开(公告)号：US20060276849A1

公开(公告)日：2006-12-07

申请号：US11142851

申请日：2005-06-01

申请人： Gerrard Carlson ,  Krzysztof Siejko ,  Ramesh Wariar ,  Marina Brockway

发明人： Gerrard Carlson ,  Krzysztof Siejko ,  Ramesh Wariar ,  Marina Brockway

IPC分类号： A61N1/00

CPC分类号： A61B5/021 ,  A61N1/36564 ,  A61N1/36578 ,  A61N1/375

摘要： An implantable device and method for monitoring S1 heart sounds with a remotely located accelerometer. The device includes a transducer that converts heart sounds into an electrical signal. A control circuit is coupled to the transducer. The control circuit is configured to receive the electrical signal, identify an S1 heart sound, and to convert the S1 heart sound into electrical information. The control circuit also generates morphological data from the electrical information. The morphological data relates to a hemodynamic metric, such as left ventricular contractility. A housing may enclose the control circuit. The housing defines a volume coextensive with an outer surface of the housing. The transducer is in or on the volume defined by the housing.

公开(公告)号：US20050148896A1

公开(公告)日：2005-07-07

申请号：US10746853

申请日：2003-12-24

申请人： Krzysztof Siejko ,  Gerrard Carlson

发明人： Krzysztof Siejko ,  Gerrard Carlson

IPC分类号： A61B7/04 ,  A61B5/02

CPC分类号： A61B7/04

摘要： A cardiac rhythm management system includes a heart sound detector providing for detection of the third heart sounds (S3). An implantable sensor such as an accelerometer or a microphone senses an acoustic signal indicative heart sounds including the second heart sounds (S2) and S3. The heart sound detector detects occurrences of S2 and starts S3 detection windows each after a predetermined delay after a detected occurrence of S2. The occurrences of S3 are then detected from the acoustic signal within the S3 detection windows.

摘要翻译： 心律管理系统包括用于检测第三心音的心音检测器（S 3）。 诸如加速度计或麦克风的可植入传感器感测到指示包括第二心音（S 2）和S 3的心音的声信号。 心音检测器检测到S 2的发生，并且在检测到的S 2发生之后，在预定延迟之后开始S 3检测窗口。 然后从S 3检测窗口内的声信号检测出S 3的出现。

公开(公告)号：US20060293604A1

公开(公告)日：2006-12-28

申请号：US11168614

申请日：2005-06-28

申请人： Gerrard Carlson ,  Bruce Kenknight ,  Qingsheng Zhu

发明人： Gerrard Carlson ,  Bruce Kenknight ,  Qingsheng Zhu

IPC分类号： A61B5/04

CPC分类号： A61B5/0452 ,  A61B5/0205 ,  A61B5/4809 ,  A61B5/4812 ,  A61M16/024 ,  A61M2230/04 ,  A61M2230/10 ,  A61M2230/63 ,  A61M2230/65 ,  A61N1/3622 ,  A61N1/365

摘要： Systems and methods for evaluating a patient condition using autonomic balance information involve providing an implantable cardiac device that acquires a cardiac waveform from a patient. One or more characteristics associated with autonomic balance of the patient are detected and used to evaluate a patient condition, such as sleep onset, sleep stage, cardiac vulnerability over a predetermined duration, and sleep disordered breathing. Patient activity levels may be sensed and used to evaluate the patient's condition, such as for determining a level of systemic stress. Characteristics associated with the autonomic balance include calculating an LF/HF ratio waveform and/or determining one or more morphological features of the LF/HF ratio waveform. Coordination with a patient-external device may facilitate transmission of information about one or more of the cardiac waveform, the one or more characteristics associated with the autonomic balance, and a marked cardiac waveform.

摘要翻译： 使用自主平衡信息评估患者状况的系统和方法涉及提供从患者获取心脏波形的可植入心脏装置。 检测与患者的自主平衡相关联的一个或多个特征，并用于评估患者状况，例如睡眠发作，睡眠阶段，预定持续时间内的心脏易感性和睡眠呼吸障碍。 可以感测患者活动水平并用于评估患者的状况，例如用于确定全身应激水平。 与自主平衡相关的特征包括计算LF / HF比率波形和/或确定LF / HF比波形的一个或多个形态特征。 与患者外部设备的协调可以促进关于心脏波形中的一个或多个的信息的传输，与自主平衡相关联的一个或多个特征以及标记的心脏波形。

公开(公告)号：US20060009812A1

公开(公告)日：2006-01-12

申请号：US11225712

申请日：2005-09-13

申请人： Douglas Daum ,  Geng Zhang ,  Qingsheng Zhu ,  Gerrard Carlson ,  Julio Spinelli

发明人： Douglas Daum ,  Geng Zhang ,  Qingsheng Zhu ,  Gerrard Carlson ,  Julio Spinelli

IPC分类号： A61N1/37

CPC分类号： A61N1/365

摘要： A maximum pacing rate limiter for use in adaptive rate pacing in conjunction with a cardiac rhythm management system for a heart. The maximum pacing rate limiter may function to measure an interval, termed the ERT interval, between a paced ventricular evoked response and a T-wave. The maximum pacing rate limiter may further function to maintain the ERT interval at less than a certain percentage of the total cardiac cycle. In one disclosed embodiment, a maximum pacing rate limiter calculates an ERT rate based on the detected paced ventricular evoked response and the T-wave, and the pacing rate limiter module further communicates the minimum of the ERT rate and an adaptive-rate sensor indicated rate to a pacemaker.

摘要翻译： 与心脏心律管理系统结合使用的适应性起搏速度的最大起搏速率限制器。 最大起搏速率限制器可以用于测量在起搏心室诱发反应和T波之间的称为ERT间期的间隔。 最大起搏速率限制器可进一步起作用以将ERT间期维持在小于总心律周期的一定百分比。 在一个公开的实施例中，最大起搏速率限制器基于检测到的起搏心室诱发反应和T波计算ERT率，并且起搏速率限制器模块进一步传达最小ERT率和自适应速率传感器指示率 到起搏器。

公开(公告)号：US20050010257A1

公开(公告)日：2005-01-13

申请号：US10618261

申请日：2003-07-11

申请人： William Lincoln ,  Gerrard Carlson

发明人： William Lincoln ,  Gerrard Carlson

IPC分类号： A61B5/0452 ,  A61B5/0464 ,  A61N1/362 ,  A61B5/0402

CPC分类号： A61B5/0464 ,  A61B5/04525 ,  A61N1/362

摘要： A cardiac rhythm management system measures a time interval between a first fiducial marker indicative of a ventricular depolarization (e.g., a Q-wave, an R-wave, etc.) and a second fiducial marker indicative of a subsequent mitral valve closure (MVC) occurring during the same cardiac cycle. Such time intervals are used for detecting atrioventricular (AV) dissociation. The AV dissociation may, in turn, be used for discriminating between a supraventricular tachyarrhythmia (SVT) and a ventricular tachyarrhythmia (VT) or for any other diagnostic or therapeutic purpose. The AV dissociation and/or SVT/VT discrimination information may be communicated from an implantable cardiac rhythm management device to an external interface and/or used to determine the nature of therapy delivered to the subject. In a further example, amplitudes indicative of the MVCs are also used for determining whether AV dissociation exists.

摘要翻译： 心律管理系统测量指示心室去极化（例如，Q波，R波等）的第一基准标记与指示随后的二尖瓣关闭（MVC）的第二基准标记之间的时间间隔， 发生在同一心脏周期。 这样的时间间隔用于检测房室（AV）解离。 AV解离反过来可用于区分室上性快速性心律失常（SVT）和室性快速性心律失常（VT）或任何其他诊断或治疗目的。 AV解离和/或SVT / VT鉴别信息可以从可植入心律管理装置传递到外部界面和/或用于确定递送给对象的治疗的性质。 在另一示例中，指示MVC的幅度也用于确定AV解离是否存在。