公开(公告)号：US20050251215A1

公开(公告)日：2005-11-10

申请号：US11061315

申请日：2005-02-18

申请人： Richard Dujmovic ,  Phil Foshee ,  Richard Fogoros ,  Joseph Smith ,  Douglas Daum ,  Weimin Sun

发明人： Richard Dujmovic ,  Phil Foshee ,  Richard Fogoros ,  Joseph Smith ,  Douglas Daum ,  Weimin Sun

IPC分类号： A61N1/39

CPC分类号： A61N1/3937 ,  A61N1/3943

摘要： A cardiac rhythm management device predicts defibrillation thresholds without any need to apply defibrillation shocks or subjecting the patient to fibrillation. Intravascular defibrillation electrodes are implanted in a heart. By applying a small test energy, an electric field near one of the defibrillation electrodes is determined by measuring a voltage at a sensing electrode offset from the defibrillation electrode by a known distance. A desired minimum value of electric field at the heart periphery is established. A distance between a defibrillation electrodes and the heart periphery is measured, either fluoroscopically or by measuring a voltage at an electrode at or near the heart periphery. Using the measured electric field and the measured distance to the periphery of the heart, the defibrillation energy needed to obtain the desired electric field at the heart periphery is estimated. In an example, the device also includes a defibrillation shock circuit and a stimulation circuit.

摘要翻译： 心律管理装置预测除颤阈值，而不需要施加除颤电击或使患者起颤。 血管内除颤电极植入心脏。 通过施加小的测试能量，通过测量从除颤电极偏移已知距离的感测电极处的电压来确定除颤电极之一附近的电场。 建立心脏周围电场的期望最小值。 测量除颤电极和心脏周边之间的距离，通过荧光透视或通过测量心脏周围处或附近的电极处的电压。 使用测量的电场和到心脏外围的测量距离，估计在心脏周边获得所需电场所需的除颤能量。 在一个示例中，该装置还包括除颤电击电路和刺激电路。

公开(公告)号：US20060036288A1

公开(公告)日：2006-02-16

申请号：US10921777

申请日：2004-08-18

申请人： Joseph Bocek ,  Richard Dujmovic ,  Phil Foshee ,  Harley White ,  Jaeho Kim ,  Anthony Harrington ,  Richard Sanders ,  Douglas Daum ,  Paul De Coriolis ,  Joseph Smith ,  Richard Fogoros

发明人： Joseph Bocek ,  Richard Dujmovic ,  Phil Foshee ,  Harley White ,  Jaeho Kim ,  Anthony Harrington ,  Richard Sanders ,  Douglas Daum ,  Paul De Coriolis ,  Joseph Smith ,  Richard Fogoros

IPC分类号： A61N1/39

CPC分类号： A61N1/3956 ,  A61N1/3962

摘要： This document discusses, among other things, a combination pacer/defibrillator that is tailored for bradycardia patients. In one example, its shock-delivery specificity exceeds its sensitivity to shockable ventricular tachyarrhythmias. In another example, its specificity exceeds 95%, or 99%, or even 99.5%. Sensitivity is programmed to a high desired sensitivity value, but only if it can be done without decreasing the specificity below the desired specificity threshold value. This can be conceptualized as “avoiding at all costs” delivering false shocks, even at the expense of failing to deliver a shock to a treatable ventricular tachyarrhythmia. Specificity enhancements include, among other things, inhibiting shock delivery when the patient is breathing or not supine, using multiple channels or a high rate VT/VF detection threshold. The present pacer/defibrillator device could potentially save the lives of bradyarrhythmia patients who are not presently clinically indicated for a defibrillator/pacer, but who have an increased risk of sudden cardiac death due to one or more risk factors.

摘要翻译： 本文件还讨论了针对心动过缓患者定制的组合起搏器/除颤器。 在一个例子中，其冲击传递特异性超过其对可震荡室性快速性心律失常的敏感性。 在另一个实例中，其特异性超过95％，或99％，甚至99.5％。 灵敏度被编程为高期望的灵敏度值，但是只有在不降低低于所需特异性阈值的特异性的情况下才能进行。 这可以被概念化为“不惜一切代价”，提供虚假的冲击，即使以不能对可治疗的室性快速性心律失常发生冲击为代价。 特异性增强包括，当患者呼吸或不仰卧时，使用多个通道或高速率的VT / VF检测阈值来抑制冲击输送。 本发明的起搏器/除颤器装置可能潜在地节省目前临床指示用于除颤器/止痛器但是由于一个或多个危险因素引起的心脏猝死风险增加的缓慢心律失常患者的生命。

公开(公告)号：US08036744B2

公开(公告)日：2011-10-11

申请号：US12631944

申请日：2009-12-07

申请人： Richard Milon Dujmovic, Jr. ,  Phil Foshee ,  Richard Fogoros ,  Joseph M. Smith ,  Douglas R. Daum ,  Weimin Sun

发明人： Richard Milon Dujmovic, Jr. ,  Phil Foshee ,  Richard Fogoros ,  Joseph M. Smith ,  Douglas R. Daum ,  Weimin Sun

IPC分类号： A61N1/08 ,  A61N1/39 ,  A61N1/365

CPC分类号： A61N1/3937 ,  A61N1/3943

摘要： A cardiac rhythm management device predicts defibrillation thresholds without any need to apply defibrillation shocks or subjecting the patient to fibrillation. Intravascular defibrillation electrodes are implanted in a heart. By applying a small test energy, an electric field near one of the defibrillation electrodes is determined by measuring a voltage at a sensing electrode offset from the defibrillation electrode by a known distance. A desired minimum value of electric field at the heart periphery is established. A distance between a defibrillation electrodes and the heart periphery is measured, either fluoroscopically or by measuring a voltage at an electrode at or near the heart periphery. Using the measured electric field and the measured distance to the periphery of the heart, the defibrillation energy needed to obtain the desired electric field at the heart periphery is estimated. In an example, the device also includes a defibrillation shock circuit and a stimulation circuit.

摘要翻译： 心律管理装置预测除颤阈值，而不需要施加除颤电击或使患者起颤。 血管内除颤电极植入心脏。 通过施加小的测试能量，通过测量从除颤电极偏移已知距离的感测电极处的电压来确定除颤电极之一附近的电场。 建立心脏周围电场的期望最小值。 测量除颤电极和心脏周边之间的距离，通过荧光透视或通过测量心脏周围处或附近的电极处的电压。 使用测量的电场和到心脏外围的测量距离，估计在心脏周边获得所需电场所需的除颤能量。 在一个示例中，该装置还包括除颤电击电路和刺激电路。

公开(公告)号：US07643877B2

公开(公告)日：2010-01-05

申请号：US11061315

申请日：2005-02-18

申请人： Richard Milon Dujmovic, Jr. ,  Phil Foshee ,  Richard Fogoros ,  Joseph M. Smith ,  Douglas R. Daum ,  Weimin Sun

发明人： Richard Milon Dujmovic, Jr. ,  Phil Foshee ,  Richard Fogoros ,  Joseph M. Smith ,  Douglas R. Daum ,  Weimin Sun

IPC分类号： A61N1/08 ,  A61N1/39 ,  A61N1/365

CPC分类号： A61N1/3937 ,  A61N1/3943

摘要： A cardiac rhythm management device predicts defibrillation thresholds without any need to apply defibrillation shocks or subjecting the patient to fibrillation. Intravascular defibrillation electrodes are implanted in a heart. By applying a small test energy, an electric field near one of the defibrillation electrodes is determined by measuring a voltage at a sensing electrode offset from the defibrillation electrode by a known distance. A desired minimum value of electric field at the heart periphery is established. A distance between a defibrillation electrodes and the heart periphery is measured, either fluoroscopically or by measuring a voltage at an electrode at or near the heart periphery. Using the measured electric field and the measured distance to the periphery of the heart, the defibrillation energy needed to obtain the desired electric field at the heart periphery is estimated. In an example, the device also includes a defibrillation shock circuit and a stimulation circuit.

摘要翻译： 心律管理装置预测除颤阈值，而不需要施加除颤电击或使患者起颤。 血管内除颤电极植入心脏。 通过施加小的测试能量，通过测量从除颤电极偏移已知距离的感测电极处的电压来确定除颤电极之一附近的电场。 建立心脏周围电场的期望最小值。 测量除颤电极和心脏周边之间的距离，通过荧光透视或通过测量心脏周围处或附近的电极处的电压。 使用测量的电场和到心脏外围的测量距离，估计在心脏周边获得所需电场所需的除颤能量。 在一个示例中，该装置还包括除颤电击电路和刺激电路。

公开(公告)号：US20100087884A1

公开(公告)日：2010-04-08

申请号：US12631944

申请日：2009-12-07

申请人： Richard Milon Dujmovic, JR. ,  Phil Foshee ,  Richard Fogoros ,  Joseph M. Smith ,  Douglas R. Daum ,  Weimin Sun

发明人： Richard Milon Dujmovic, JR. ,  Phil Foshee ,  Richard Fogoros ,  Joseph M. Smith ,  Douglas R. Daum ,  Weimin Sun

IPC分类号： A61N1/39

CPC分类号： A61N1/3937 ,  A61N1/3943

摘要： A cardiac rhythm management device predicts defibrillation thresholds without any need to apply defibrillation shocks or subjecting the patient to fibrillation. Intravascular defibrillation electrodes are implanted in a heart. By applying a small test energy, an electric field near one of the defibrillation electrodes is determined by measuring a voltage at a sensing electrode offset from the defibrillation electrode by a known distance. A desired minimum value of electric field at the heart periphery is established. A distance between a defibrillation electrodes and the heart periphery is measured, either fluoroscopically or by measuring a voltage at an electrode at or near the heart periphery. Using the measured electric field and the measured distance to the periphery of the heart, the defibrillation energy needed to obtain the desired electric field at the heart periphery is estimated. In an example, the device also includes a defibrillation shock circuit and a stimulation circuit.

摘要翻译： 心律管理装置预测除颤阈值，而不需要施加除颤电击或使患者起颤。 血管内除颤电极植入心脏。 通过施加小的测试能量，通过测量从除颤电极偏移已知距离的感测电极处的电压来确定除颤电极之一附近的电场。 建立心脏周围电场的期望最小值。 测量除颤电极和心脏周边之间的距离，通过荧光透视或通过测量心脏周围处或附近的电极处的电压。 使用测量的电场和到心脏外围的测量距离，估计在心脏周边获得所需电场所需的除颤能量。 在一个示例中，该装置还包括除颤电击电路和刺激电路。

公开(公告)号：US07386344B2

公开(公告)日：2008-06-10

申请号：US10921777

申请日：2004-08-18

申请人： Joseph M. Bocek ,  Richard Milon Dujmovic, Jr. ,  Phil Foshee ,  Harley White ,  Jaeho Kim ,  Anthony Harrington ,  Richard S. Sanders ,  Douglas R. Daum ,  Paul De Coriolis ,  Joseph Smith ,  Richard Fogoros

发明人： Joseph M. Bocek ,  Richard Milon Dujmovic, Jr. ,  Phil Foshee ,  Harley White ,  Jaeho Kim ,  Anthony Harrington ,  Richard S. Sanders ,  Douglas R. Daum ,  Paul De Coriolis ,  Joseph Smith ,  Richard Fogoros

IPC分类号： A61N1/39

CPC分类号： A61N1/3956 ,  A61N1/3962

摘要： A combination pacer/defibrillator is tailored for bradycardia patients. In one example, its shock-delivery specificity exceeds its sensitivity to shockable ventricular tachyarrhythmias. In another example, its specificity exceeds 95%, or 99%, or even 99.5%. Sensitivity is programmed to a high desired sensitivity value, but only if it can be done without decreasing the specificity below the desired specificity threshold value. This can be conceptualized as “avoiding at all costs” delivering false shocks, even at the expense of failing to deliver a shock to a treatable ventricular tachyarrhythmia. Specificity enhancements include, among other things, inhibiting shock delivery when the patient is breathing or not supine, using multiple channels or a high rate VT/VF detection threshold. The present pacer/defibrillator device could potentially save the lives of bradyarrhythmia patients who are not presently clinically indicated for a defibrillator/pacer, but who have an increased risk of sudden cardiac death due to one or more risk factors.

摘要翻译： 组合起搏器/除颤器是为心动过缓患者量身打造的。 在一个例子中，其冲击传递特异性超过其对可震荡室性快速性心律失常的敏感性。 在另一个实例中，其特异性超过95％，或99％，甚至99.5％。 灵敏度被编程为高期望的灵敏度值，但是只有在不降低低于所需特异性阈值的特异性的情况下才能进行。 这可以被概念化为“不惜一切代价”，提供虚假的冲击，即使以不能对可治疗的室性快速性心律失常发生冲击为代价。 特异性增强包括，当患者呼吸或不仰卧时，使用多个通道或高速率的VT / VF检测阈值来抑制冲击输送。 本发明的起搏器/除颤器装置可能潜在地节省目前临床指示用于除颤器/止痛器但是由于一个或多个危险因素引起的心脏猝死风险增加的缓慢心律失常患者的生命。

公开(公告)号：US20080243201A1

公开(公告)日：2008-10-02

申请号：US12135709

申请日：2008-06-09

申请人： Joseph M. Bocek ,  Richard M. Dujmovic ,  Phil Foshee ,  Harley White ,  Jaeho Kim ,  Anthony Harrington ,  Richard S. Sanders ,  Douglas R. Daum ,  Paul De Coriolis ,  Joseph Smith ,  Richard Fogoros

发明人： Joseph M. Bocek ,  Richard M. Dujmovic ,  Phil Foshee ,  Harley White ,  Jaeho Kim ,  Anthony Harrington ,  Richard S. Sanders ,  Douglas R. Daum ,  Paul De Coriolis ,  Joseph Smith ,  Richard Fogoros

IPC分类号： A61N1/39 ,  A61N1/362

CPC分类号： A61N1/3956 ,  A61N1/3962

摘要： A combination pacer/defibrillator is tailored for bradycardia patients. In one example, its shock-delivery specificity exceeds its sensitivity to shockable ventricular tachyarrhythmias. In another example, its specificity exceeds 95%, or 99%, or even 99.5%. Sensitivity is programmed to a high desired sensitivity value, but only if it can be done without decreasing the specificity below the desired specificity threshold value. This can be conceptualized as “avoiding at all costs” delivering false shocks, even at the expense of failing to deliver a shock to a treatable ventricular tachyarrhythmia. Specificity enhancements include, among other things, inhibiting shock delivery when the patient is breathing or not supine, using multiple channels or a high rate VT/VF detection threshold. The present pacer/defibrillator device could potentially save the lives of bradyarrhythmia patients who are not presently clinically indicated for a defibrillator/pacer, but who have an increased risk of sudden cardiac death due to one or more risk factors.

摘要翻译： 组合起搏器/除颤器是为心动过缓患者量身打造的。 在一个例子中，其冲击传递特异性超过其对可震荡室性快速性心律失常的敏感性。 在另一个实例中，其特异性超过95％，或99％，甚至99.5％。 灵敏度被编程为高期望的灵敏度值，但是只有在不降低低于所需特异性阈值的特异性的情况下才能进行。 这可以被概念化为“不惜一切代价”，提供虚假的冲击，即使以不能对可治疗的室性快速性心律失常发生冲击为代价。 特异性增强包括，当患者呼吸或不仰卧时，使用多个通道或高速率的VT / VF检测阈值来抑制冲击输送。 本发明的起搏器/除颤器装置可能潜在地节省目前临床指示用于除颤器/止痛器但是由于一个或多个危险因素引起的心脏猝死风险增加的缓慢心律失常患者的生命。

公开(公告)号：US20120004565A1

公开(公告)日：2012-01-05

申请号：US13231152

申请日：2011-09-13

申请人： Yi Zhang ,  Richard Fogoros ,  Carlos Haro ,  Yousufali Dalal ,  Marina V. Brockway ,  Krzysztof Z. Siejko

发明人： Yi Zhang ,  Richard Fogoros ,  Carlos Haro ,  Yousufali Dalal ,  Marina V. Brockway ,  Krzysztof Z. Siejko

IPC分类号： A61B5/02 ,  A61B5/0205

CPC分类号： A61N1/3627 ,  A61B5/0031 ,  A61B5/024 ,  A61B5/0452 ,  A61B5/0456 ,  A61B7/04 ,  A61N1/36578 ,  A61N1/395

摘要： A system comprising an implantable medical device (IMD) includes an implantable heart sound sensor to produce an electrical signal representative of at least one heart sound. The heart sound is associated with mechanical activity of a patient's heart. Additionally, the IMD includes a heart sound sensor interface circuit coupled to the heart sound sensor to produce a heart sound signal, and a signal analyzer circuit coupled to the heart sound sensor interface circuit. The signal analyzer circuit measures a baseline heart sound signal, and deems that an ischemic event has occurred using, among other things, a measured subsequent change in the heart sound signal from the established baseline heart sound signal.

摘要翻译： 包括可植入医疗装置（IMD）的系统包括可植入心音传感器，以产生代表至少一个心音的电信号。 心脏声音与患者心脏的机械活动有关。 另外，IMD包括耦合到心脏声音传感器以产生心脏声音信号的心脏声音传感器接口电路，以及耦合到心脏声音传感器接口电路的信号分析器电路。 信号分析器电路测量基线心音信号，并且认为已经发生了缺血事件，其中使用来自已建立的基线心音信号的心音信号的测量后续变化。

公开(公告)号：US08041426B2

公开(公告)日：2011-10-18

申请号：US12565344

申请日：2009-09-23

申请人： Richard Fogoros ,  Jiang Ding ,  Yinghong Yu

发明人： Richard Fogoros ,  Jiang Ding ,  Yinghong Yu

IPC分类号： A61N1/365

CPC分类号： A61N1/3627 ,  A61N1/36564 ,  A61N1/3682 ,  A61N1/3684

摘要： A method and system for calculating an atrio-ventricular delay interval based upon an inter-atrial delay exhibited by a patient's heart. The aforementioned atrio-ventricular delay interval may optimize the stroke volume exhibited by a patient's heart. The aforementioned atrio-ventricular delay interval may be blended with another atrio-ventricular delay interval that may optimize another performance characteristic, such as left ventricular contractility. Such blending may include finding an arithmetic mean, geometric mean, or weighted mean of two or more proposed atrio-ventricular delay intervals.

摘要翻译： 一种用于根据患者心脏表现的心房间延迟来计算心房延迟间隔的方法和系统。 上述的心室延迟间隔可以优化患者心脏展示的搏动量。 上述房室延迟间隔可以与可以优化另一性能特征（例如左心室收缩力）的另一心房延迟间隔混合。 这种混合可以包括找到两个或更多个提出的心房延迟间隔的算术平均值，几何平均值或加权平均值。

公开(公告)号：US20080177156A1

公开(公告)日：2008-07-24

申请号：US11624974

申请日：2007-01-19

申请人： Yi Zhang ,  Krzysztof Z. Siejko ,  Richard Fogoros ,  Abhilash Patangay

发明人： Yi Zhang ,  Krzysztof Z. Siejko ,  Richard Fogoros ,  Abhilash Patangay

IPC分类号： A61B5/0205 ,  A61B5/0215

CPC分类号： A61B5/0215 ,  A61B5/02028 ,  A61B5/0205 ,  A61B5/145

摘要： This document discusses, among other things, a system and method for sensing a pulmonary artery pressure (“PAP”) signal of a pulmonary artery (“PA”) and computing an indication of a reduction of blood supply to at least a portion of a heart using information from the PAP signal. The reduction of blood supply to at least a portion of the heart can be detected using a PAP signal characteristic or measurement, using a change in the PAP, using an interval between multiple PAP signal features, using a mitral valve performance, or using information from the PAP and information from a different physiological signal, including a cardiac signal, a heart sound signal, right ventricular pressure signal, a left ventricular pressure signal, a blood pressure signal, and an oxygen saturation signal.

摘要翻译： 本文件尤其涉及用于感测肺动脉（“PA”）的肺动脉压（“PAP”）信号的系统和方法，并且计算将血液供应减少到至少一部分 心脏使用来自PAP信号的信息。 使用PAP信号特征或测量可以使用PAP信号特征或多个PAP信号特征之间的间隔，使用二尖瓣性能来使用PAP信号特征或测量来检测对心脏的至少一部分的血液供应，或使用来自 PAP和来自不同生理信号的信息，包括心脏信号，心音信号，右心室压力信号，左心室压力信号，血压信号和氧饱和度信号。