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    System and method for distinguishing among cardiac ischemia, hypoglycemia and hyperglycemia using an implantable medical device
    3.
    发明授权
    System and method for distinguishing among cardiac ischemia, hypoglycemia and hyperglycemia using an implantable medical device 有权
    使用可植入医疗器械区分心脏缺血，低血糖和高血糖的系统和方法

    公开(公告)号：US08180441B2

    公开(公告)日：2012-05-15

    申请号：US12360822

    申请日：2009-01-27

    申请人： Jong Gill ,  Peter Boileau ,  Rupinder Bharmi ,  Xiaoyi Min ,  Joseph J. Florio ,  Michael E. Benser ,  Gene A. Bornzin

    发明人： Jong Gill ,  Peter Boileau ,  Rupinder Bharmi ,  Xiaoyi Min ,  Joseph J. Florio ,  Michael E. Benser ,  Gene A. Bornzin

    IPC分类号： A61B5/0468

    CPC分类号： A61N1/3962 ,  A61B5/0452 ,  A61B5/0468 ,  A61B5/14532 ,  A61N1/3621 ,  A61N1/3627 ,  A61N1/36557 ,  A61N1/3925

    摘要： Techniques are described for detecting ischemia, hypoglycemia or hyperglycemia based on intracardiac electrogram (IEGM) signals. Ischemia is detected based on a shortening of the interval between the QRS complex and the end of a T-wave (QTmax), alone or in combination with a change in ST segment elevation. Alternatively, ischemia is detected based on a change in ST segment elevation combined with minimal change in the interval between the QRS complex and the end of the T-wave (QTend). Hypoglycemia is detected based on a change in ST segment elevation along with a lengthening of either QTmax or QTend. Hyperglycemia is detected based on a change in ST segment elevation along with minimal change in QTmax and in QTend. By exploiting QTmax and QTend in combination with ST segment elevation, changes in ST segment elevation caused by hypo/hyperglycemia can be properly distinguished from changes caused by ischemia.

    摘要翻译： 描述了基于心内电描记图（IEGM）信号检测缺血，低血糖或高血糖的技术。 基于QRS复合体与T波结束（QTmax）之间的间隔的缩短单独或与ST段抬高的变化相结合来检测局部缺血。 或者，基于ST段抬高的变化结合QRS复合体与T波结束（QTend）之间的间隔的最小变化来检测局部缺血。 基于ST段抬高的变化以及QTmax或QTend的延长来检测低血糖。 基于ST段抬高的变化以及QTmax和QTend中的最小变化来检测高血糖。 通过利用QTmax和QTend与ST段抬高相结合，可以将由低/高血糖引起的ST段抬高的变化与缺血引起的变化进行适当区分。

    Systems and methods for distinguishing cardiac ischemia from systemic influences on IEGM morphology using an implantable medical device
    4.
    发明授权
    Systems and methods for distinguishing cardiac ischemia from systemic influences on IEGM morphology using an implantable medical device 有权
    使用可植入医疗器械区分心脏缺血与对IEGM形态的全身影响的系统和方法

    公开(公告)号：US08265739B1

    公开(公告)日：2012-09-11

    申请号：US12016166

    申请日：2008-01-17

    申请人： Peter Boileau ,  Xiaoyi Min ,  Jong Gill ,  Rupinder Bharmi ,  Joseph J. Florio ,  Michael E. Benser ,  Gene A. Bornzin

    发明人： Peter Boileau ,  Xiaoyi Min ,  Jong Gill ,  Rupinder Bharmi ,  Joseph J. Florio ,  Michael E. Benser ,  Gene A. Bornzin

    IPC分类号： A61B5/0402 ,  A61B5/0428 ,  A61B5/0452

    CPC分类号： A61B5/0452 ,  A61B5/0428 ,  A61B5/0468 ,  A61B5/0472 ,  A61B5/14532 ,  A61B5/7282

    摘要： Techniques are provided for use in a pacemaker or implantable cardioverter/defibrillator (ICD) for distinguishing cardiac ischemia from other conditions affecting the morphology of electrical cardiac signals sensed within a patient, such as hypoglycemia, hyperglycemia or other systemic conditions. In one example, the device detects changes in morphological features of cardiac signals indicative of possible cardiac ischemia within the patient, such as changes in ST segment elevation within an intracardiac electrogram (IEGM). The device determines whether the changes in the morphological features are the result of spatially localized changes within a portion of the heart and then distinguishes cardiac ischemia from other conditions affecting the morphology of electrical cardiac signals based on that determination. In another example, the device exploits the interval between the peak of a T-wave (Tmax) and the end of the T-wave (Tend). A significant increase in the Tend−Tmax interval is indicative of ischemia rather than a systemic condition.

    摘要翻译： 提供了用于起搏器或植入式心律转复除颤器（ICD）的技术，用于区分心脏缺血与影响患者体内感测的电心电信号形态的其他状况，如低血糖，高血糖或其他系统性疾病。 在一个示例中，该装置检测指示患者可能的心脏缺血的心脏信号的形态学特征的变化，例如心内电描记图（IEGM）内ST段抬高的变化。 该装置确定形态特征的变化是否是心脏部分内的空间局部变化的结果，然后基于该确定将心脏缺血与影响电心电信号形态的其它状况区分开。 在另一个例子中，器件利用了T波峰值（Tmax）和T波（Tend）结束之间的间隔。 Tend-Tmax间期的显着增加指示缺血而不是全身状况。

    SYSTEM AND METHOD FOR DISTINGUISHING AMONG CARDIAC ISCHEMIA, HYPOGLYCEMIA AND HYPERGLYCEMIA USING AN IMPLANTABLE MEDICAL DEVICE
    5.
    发明申请
    SYSTEM AND METHOD FOR DISTINGUISHING AMONG CARDIAC ISCHEMIA, HYPOGLYCEMIA AND HYPERGLYCEMIA USING AN IMPLANTABLE MEDICAL DEVICE 审中-公开
    使用可植入医疗器械评估心脏病，高血压和高血压的系统和方法

    公开(公告)号：US20120197149A1

    公开(公告)日：2012-08-02

    申请号：US13444733

    申请日：2012-04-11

    申请人： Jong Gill ,  Peter Boileau ,  Rupinder Bharmi ,  Xiaoyi Min ,  Joseph J. Florio ,  Michael E. Benser ,  Gene A. Bornzin

    发明人： Jong Gill ,  Peter Boileau ,  Rupinder Bharmi ,  Xiaoyi Min ,  Joseph J. Florio ,  Michael E. Benser ,  Gene A. Bornzin

    IPC分类号： A61B5/0468 ,  A61B5/0452

    CPC分类号： A61N1/3962 ,  A61B5/0452 ,  A61B5/0468 ,  A61B5/14532 ,  A61N1/3621 ,  A61N1/3627 ,  A61N1/36557 ,  A61N1/3925

    摘要： Techniques are described for detecting ischemia, hypoglycemia or hyperglycemia based on intracardiac electrogram (IEGM) signals. Ischemia is detected based on a shortening of the interval between the QRS complex and the end of a T-wave (QTmax), alone or in combination with a change in ST segment elevation. Alternatively, ischemia is detected based on a change in ST segment elevation combined with minimal change in the interval between the QRS complex and the end of the T-wave (QTend). Hypoglycemia is detected based on a change in ST segment elevation along with a lengthening of either QTmax or QTend. Hyperglycemia is detected based on a change in ST segment elevation along with minimal change in QTmax and in QTend. By exploiting QTmax and QTend in combination with ST segment elevation, changes in ST segment elevation caused by hypo/hyperglycemia can be properly distinguished from changes caused by ischemia.

    摘要翻译： 描述了基于心内电描记图（IEGM）信号检测缺血，低血糖或高血糖的技术。 基于QRS复合体与T波结束（QTmax）之间的间隔的缩短单独或与ST段抬高的变化相结合来检测局部缺血。 或者，基于ST段抬高的变化结合QRS复合体与T波结束（QTend）之间的间隔的最小变化来检测局部缺血。 基于ST段抬高的变化以及QTmax或QTend的延长来检测低血糖。 基于ST段抬高的变化以及QTmax和QTend中的最小变化来检测高血糖。 通过利用QTmax和QTend与ST段抬高相结合，可以将由低/高血糖引起的ST段抬高的变化与缺血引起的变化进行适当区分。

    System and Method for Distinguishing Among Cardiac Ischemia, Hypoglycemia and Hyperglycemia Using an Implantable Medical Device
    6.
    发明申请
    System and Method for Distinguishing Among Cardiac Ischemia, Hypoglycemia and Hyperglycemia Using an Implantable Medical Device 有权
    使用植入式医疗器械区分心脏缺血，低血糖和高血糖的系统和方法

    公开(公告)号：US20090177104A1

    公开(公告)日：2009-07-09

    申请号：US12360822

    申请日：2009-01-27

    申请人： Jong Gill ,  Peter Boileau ,  Rupinder Bharmi ,  Xiaoyi Min ,  Joseph J. Florio ,  Michael E. Benser ,  Gene A. Bornzin

    发明人： Jong Gill ,  Peter Boileau ,  Rupinder Bharmi ,  Xiaoyi Min ,  Joseph J. Florio ,  Michael E. Benser ,  Gene A. Bornzin

    IPC分类号： A61B5/0472

    CPC分类号： A61N1/3962 ,  A61B5/0452 ,  A61B5/0468 ,  A61B5/14532 ,  A61N1/3621 ,  A61N1/3627 ,  A61N1/36557 ,  A61N1/3925

    摘要： Techniques are described for detecting ischemia, hypoglycemia or hyperglycemia based on intracardiac electrogram (IEGM) signals. Ischemia is detected based on a shortening of the interval between the QRS complex and the end of a T-wave (QTmax), alone or in combination with a change in ST segment elevation. Alternatively, ischemia is detected based on a change in ST segment elevation combined with minimal change in the interval between the QRS complex and the end of the T-wave (QTend). Hypoglycemia is detected based on a change in ST segment elevation along with a lengthening of either QTmax or QTend. Hyperglycemia is detected based on a change in ST segment elevation along with minimal change in QTmax and in QTend. By exploiting QTmax and QTend in combination with ST segment elevation, changes in ST segment elevation caused by hypo/hyperglycemia can be properly distinguished from changes caused by ischemia.

    摘要翻译： 描述了基于心内电描记图（IEGM）信号检测缺血，低血糖或高血糖的技术。 基于QRS复合体与T波结束（QTmax）之间的间隔的缩短单独或与ST段抬高的变化相结合来检测局部缺血。 或者，基于ST段抬高的变化结合QRS复合体与T波结束（QTend）之间的间隔的最小变化来检测局部缺血。 基于ST段抬高的变化以及QTmax或QTend的延长来检测低血糖。 基于ST段抬高的变化以及QTmax和QTend中的最小变化来检测高血糖。 通过利用QTmax和QTend与ST段抬高相结合，可以将由低/高血糖引起的ST段抬高的变化与缺血引起的变化进行适当区分。

    System and method for distinguishing among cardiac ischemia, hypoglycemia and hyperglycemia using an implantable medical device
    7.
    发明授权
    System and method for distinguishing among cardiac ischemia, hypoglycemia and hyperglycemia using an implantable medical device 有权
    使用可植入医疗器械区分心脏缺血，低血糖和高血糖的系统和方法

    公开(公告)号：US07502644B2

    公开(公告)日：2009-03-10

    申请号：US11043612

    申请日：2005-01-25

    申请人： Jong Gill ,  Peter Boileau ,  Rupinder Bharmi ,  Xiaoyi Min ,  Joseph J. Florio ,  Michael Benser ,  Gene A. Bornzin

    发明人： Jong Gill ,  Peter Boileau ,  Rupinder Bharmi ,  Xiaoyi Min ,  Joseph J. Florio ,  Michael Benser ,  Gene A. Bornzin

    IPC分类号： A61B5/0468

    CPC分类号： A61N1/3962 ,  A61B5/0452 ,  A61B5/0468 ,  A61B5/14532 ,  A61N1/3621 ,  A61N1/3627 ,  A61N1/36557 ,  A61N1/3925

    摘要： Techniques are described for detecting ischemia, hypoglycemia or hyperglycemia based on intracardiac electrogram (IEGM) signals. Ischemia is detected based on a shortening of the interval between the QRS complex and the end of a T-wave (QTmax), alone or in combination with a change in ST segment elevation. Alternatively, ischemia is detected based on a change in ST segment elevation combined with minimal change in the interval between the QRS complex and the end of the T-wave (QTend). Hypoglycemia is detected based on a change in ST segment elevation along with a lengthening of either QTmax or QTend. Hyperglycemia is detected based on a change in ST segment elevation along with minimal change in QTmax and in QTend. By exploiting QTmax and QTend in combination with ST segment elevation, changes in ST segment elevation caused by hypo/hyperglycemia can be properly distinguished from changes caused by ischemia.

    摘要翻译： 描述了基于心内电描记图（IEGM）信号检测缺血，低血糖或高血糖的技术。 基于QRS复合体与T波结束（QTmax）之间的间隔的缩短单独或与ST段抬高的变化相结合来检测局部缺血。 或者，基于ST段抬高的变化结合QRS复合体与T波结束（QTend）之间的间隔的最小变化来检测局部缺血。 基于ST段抬高的变化以及QTmax或QTend的延长来检测低血糖。 基于ST段抬高的变化以及QTmax和QTend中的最小变化来检测高血糖。 通过利用QTmax和QTend与ST段抬高相结合，可以将由低/高血糖引起的ST段抬高的变化与缺血引起的变化进行适当区分。

    System and method for distinguishing among cardiac ischemia, hypoglycemia and hyperglycemia using an implantable medical device
    8.
    发明授权
    System and method for distinguishing among cardiac ischemia, hypoglycemia and hyperglycemia using an implantable medical device 有权
    使用可植入医疗器械区分心脏缺血，低血糖和高血糖的系统和方法

    公开(公告)号：US07297114B2

    公开(公告)日：2007-11-20

    申请号：US11043804

    申请日：2005-01-25

    申请人： Jong Gill ,  Peter Boileau ,  Rupinder Bharmi ,  Xiaoyi Min ,  Joseph J. Florio ,  Michael Benser ,  Gene A. Bornzin

    发明人： Jong Gill ,  Peter Boileau ,  Rupinder Bharmi ,  Xiaoyi Min ,  Joseph J. Florio ,  Michael Benser ,  Gene A. Bornzin

    IPC分类号： A61B5/0452

    CPC分类号： A61N1/3962 ,  A61B5/0452 ,  A61B5/0468 ,  A61B5/14532 ,  A61N1/3621 ,  A61N1/3627 ,  A61N1/36557 ,  A61N1/3925

    摘要： Techniques are described for detecting ischemia, hypoglycemia or hyperglycemia based on intracardiac electrogram (IEGM) signals. Ischemia is detected based on a shortening of the interval between the QRS complex and the end of a T-wave (QTmax), alone or in combination with a change in ST segment elevation. Alternatively, ischemia is detected based on a change in ST segment elevation combined with minimal change in the interval between the QRS complex and the end of the T-wave (QTend). Hypoglycemia is detected based on a change in ST segment elevation along with a lengthening of either QTmax or QTend. Hyperglycemia is detected based on a change in ST segment elevation along with minimal change in QTmax and in QTend. By exploiting QTmax and QTend in combination with ST segment elevation, changes in ST segment elevation caused by hypo/hyperglycemia can be properly distinguished from changes caused by ischemia.

    摘要翻译： 描述了基于心内电描记图（IEGM）信号检测缺血，低血糖或高血糖的技术。 基于QRS复合体与T波结束（QTmax）之间的间隔的缩短单独或与ST段抬高的变化相结合来检测局部缺血。 或者，基于ST段抬高的变化结合QRS复合体与T波结束（QTend）之间的间隔的最小变化来检测局部缺血。 基于ST段抬高的变化以及QTmax或QTend的延长来检测低血糖。 基于ST段抬高的变化以及QTmax和QTend中的最小变化来检测高血糖。 通过利用QTmax和QTend与ST段抬高相结合，可以将由低/高血糖引起的ST段抬高的变化与缺血引起的变化进行适当区分。

    Detecting ischemia using an implantable cardiac device based on morphology of cardiac pressure signal
    10.
    发明授权
    Detecting ischemia using an implantable cardiac device based on morphology of cardiac pressure signal 有权
    基于心脏压力信号的形态，使用可植入心脏装置检测缺血

    公开(公告)号：US07648464B1

    公开(公告)日：2010-01-19

    申请号：US11458617

    申请日：2006-07-19

    申请人： Jong Gill ,  Peter Boileau ,  Gene A. Bornzin ,  Joseph J. Florio ,  Xiaoyi Min

    发明人： Jong Gill ,  Peter Boileau ,  Gene A. Bornzin ,  Joseph J. Florio ,  Xiaoyi Min

    IPC分类号： A61B5/021

    CPC分类号： A61B5/0215 ,  A61B5/0031 ,  A61B5/042 ,  A61B5/7239 ,  A61N1/36564

    摘要： Methods and systems are presented for using an ICD to detect myocardial ischemia. In one embodiment, a method includes sensing a signal indicative of cardiac pressure, measuring a height of the sensed signal at a peak amplitude of the sensed signal, and measuring a duration of the sensed signal. The method further includes indicating an ischemia based on a comparison of a ratio of the height to the duration with a predetermined value. In another embodiment, a method includes sensing a signal indicative of cardiac pressure, determining a derivative signal that is a first derivative of the sensed signal, measuring a maximum positive value of the derivative signal, and measuring a maximum negative value of the derivative signal. The method further includes indicating an ischemia based on a comparison of a ratio of the maximum positive value to the maximum negative value with a predetermined value.

    摘要翻译： 提出了使用ICD检测心肌缺血的方法和系统。 在一个实施例中，一种方法包括感测指示心脏压力的信号，以感测信号的峰值幅度测量感测信号的高度，以及测量感测信号的持续时间。 该方法还包括基于将高度与持续时间的比率与预定值的比较来指示缺血。 在另一个实施例中，一种方法包括感测指示心脏压力的信号，确定作为感测信号的一阶导数的导数信号，测量导数信号的最大正值，以及测量导数信号的最大负值。 该方法还包括基于将最大正值与最大负值的比率与预定值进行比较来指示缺血。