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：US06859664B2

公开(公告)日：2005-02-22

申请号：US10744991

申请日：2003-12-23

申请人： Douglas R. Daum ,  Weimin Sun

发明人： 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 predetermined minimum value of electric field at the periphery of the heart is established. A distance between one of the defibrillation electrodes and the heart periphery is measured, either fluoroscopically or by measuring a voltage at an electrode located 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. This estimation is based on an elliptical model of the electric field distribution around the dipole foci formed by the defibrillation electrodes, or other suitable electric field model.

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的预定最小值。 测量除颤电极中的一个与心脏外围之间的距离，通过荧光检查或通过测量位于心脏周边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。 该估计基于由除颤电极形成的偶极灶周围的电场分布的椭圆模型或其它合适的电场模型。

公开(公告)号：US06751502B2

公开(公告)日：2004-06-15

申请号：US09808419

申请日：2001-03-14

申请人： Douglas R. Daum ,  Weimin Sun

发明人： Douglas R. Daum ,  Weimin Sun

IPC分类号： A61N139

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 predetermined minimum value of electric field at the periphery of the heart is established. A distance between one of the defibrillation electrodes and the heart periphery is measured, either fluoroscopically or by measuring a voltage at an electrode located 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. This estimation is based on an elliptical model of the electric field distribution around the dipole foci formed by the defibrillation electrodes, or other suitable electric field model.

公开(公告)号：US08915741B2

公开(公告)日：2014-12-23

申请号：US13215592

申请日：2011-08-23

申请人： John D. Hatlestad ,  Quan Ni ,  Jeffrey E. Stahmann ,  Jesse Hartley ,  Qingsheng Zhu ,  Bruce H. KenKnight ,  Douglas R. Daum ,  Kent Lee

发明人： John D. Hatlestad ,  Quan Ni ,  Jeffrey E. Stahmann ,  Jesse Hartley ,  Qingsheng Zhu ,  Bruce H. KenKnight ,  Douglas R. Daum ,  Kent Lee

IPC分类号： G09B23/28 ,  A61B5/0205 ,  A61B5/00 ,  A61B5/0488 ,  A61B5/11 ,  A61B5/0476 ,  A61N1/362 ,  A61B5/08 ,  A61B5/0496

CPC分类号： A61B5/4815 ,  A61B5/0031 ,  A61B5/0205 ,  A61B5/0476 ,  A61B5/0488 ,  A61B5/0496 ,  A61B5/0809 ,  A61B5/11 ,  A61B5/4528 ,  A61B5/4818 ,  A61N1/3621 ,  G06F19/00

摘要： A sleep quality assessment approach involves collecting data based on detected physiological or non-physiological patient conditions. At least one of detecting patient conditions and collecting data is performed using an implantable device. Sleep quality may be evaluated using the collected data by an implantable or patient-external sleep quality processor. One approach to sleep quality evaluation involves computing one or more summary metrics based on occurrences of movement disorders or breathing disorders during sleep.

摘要翻译： 睡眠质量评估方法包括基于检测到的生理或非生理性患者状况收集数据。 使用可植入装置执行检测患者状况和收集数据中的至少一个。 可以使用可植入或患者外部的睡眠质量处理器收集的数据来评估睡眠质量。 睡眠质量评估的一种方法包括基于睡眠期间的运动障碍或呼吸障碍的发生来计算一个或多个总结度量。

公开(公告)号：US08535222B2

公开(公告)日：2013-09-17

申请号：US11717561

申请日：2007-03-13

申请人： Quan Ni ,  Zoe Hajenga ,  Douglas R. Daum ,  Jeff E. Stahmann ,  John D. Hatlestad ,  Kent Lee

发明人： Quan Ni ,  Zoe Hajenga ,  Douglas R. Daum ,  Jeff E. Stahmann ,  John D. Hatlestad ,  Kent Lee

IPC分类号： A61B5/00

CPC分类号： A61B5/4815 ,  A61B5/0031 ,  A61B5/0205 ,  A61B5/021 ,  A61B5/085 ,  A61B5/1116 ,  A61B5/4809 ,  A61B5/686 ,  A61B5/7271 ,  A61B5/7282 ,  A61N1/362 ,  A61N1/365 ,  A61N1/36542 ,  G16H40/63 ,  G16H50/20

摘要： Devices and methods for sleep detection involve the use of an adjustable threshold for detecting sleep onset and termination. A method for detecting sleep includes adjusting a sleep threshold associated with a first sleep-related signal using a second sleep-related signal. The first sleep-related signal is compared to the adjusted threshold and sleep is detected based on the comparison. The sleep-related signals may be derived from implantable or external sensors. Additional sleep-related signals may be used to confirm the sleep condition. A sleep detector device implementing a sleep detection method may be a component of an implantable pulse generator such as a pacemaker or defibrillator.

公开(公告)号：US20130046195A1

公开(公告)日：2013-02-21

申请号：US13657224

申请日：2012-10-22

申请人： Aaron R. McCabe ,  Avram Scheiner ,  Geng Zhang ,  Quan Ni ,  Douglas R. Daum ,  Yi Zhang

发明人： Aaron R. McCabe ,  Avram Scheiner ,  Geng Zhang ,  Quan Ni ,  Douglas R. Daum ,  Yi Zhang

IPC分类号： A61B5/0408

CPC分类号： A61B5/0402 ,  A61N1/365 ,  A61N1/3756

摘要： An implantable medical device such as an implantable pacemaker or implantable cardioverter/defibrillator includes a programmable sensing circuit providing for sensing of a signal approximating a surface electrocardiogram (ECG) through implanted electrodes. With various electrode configurations, signals approximating various standard surface ECG signals are acquired without the need for attaching electrodes with cables onto the skin. The various electrode configurations include, but are not limited to, various combinations of intracardiac pacing electrodes, portions of the implantable medical device contacting tissue, and electrodes incorporated onto the surface of the implantable medical device.

摘要翻译： 诸如可植入起搏器或植入式心律转复/除颤器的可植入医疗装置包括可编程感测电路，用于通过植入电极感测接近表面心电图（ECG）的信号。 通过各种电极配置，获取近似各种标准表面ECG信号的信号，而不需要将电极与电缆连接在皮肤上。 各种电极配置包括但不限于心脏内起搏电极，可植入医疗器械接触组织的部分和结合到可植入医疗装置的表面上的电极的各种组合。