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1.发明申请PHYSIOLOGICAL CONDITION DETERMINATION BASED ON PRESSURE WAVE PRODUCED BY AN IMPLANTABLE MEDICAL DEVICE HOUSING 审中-公开基于由可植入医疗器械住房产生的压力波的生理条件确定公开(公告)号：US20130310706A1
公开(公告)日：2013-11-21
申请号：US13982159
申请日：2012-01-24
申请人： Richard T. Stone , Xuan Wei
发明人： Richard T. Stone , Xuan Wei
摘要： A physiological state of a patient is detected by at least producing and detecting pressure waves with a free wall of an implantable medical device (IMD) housing. An actuator element may contact the free wall, e.g., a portion of the IMD housing, and cause movement of the free wall that produces a pressure wave within the fluid and tissue of the patient. A detector element contacting the free wall may in turn detect reflected pressure waves received by the free wall. An acoustic module within the IMD may then determine a physiological condition of the patient, e.g., a bladder fullness state, based on the time delay between the transmitted and reflected pressure waves. In some examples in which the IMD also delivers stimulation therapy to the patient, e.g., incontinence therapy, the IMD may also automatically adjust stimulation therapy based on the determined physiological condition.
摘要翻译： 通过至少用可植入医疗装置（IMD）壳体的自由壁产生和检测压力波来检测患者的生理状态。 致动器元件可以接触自由壁，例如IMD壳体的一部分，并引起在患者的流体和组织内产生压力波的游离壁的移动。 接触自由壁的检测器元件又可以检测由游离壁接收的反射压力波。 IMD内的声学模块然后可以基于发射和反射的压力波之间的时间延迟来确定患者的生理状况，例如膀胱充盈状态。 在其中IMD还向患者提供刺激疗法（例如，失禁治疗）的一些实例中，IMD还可以基于所确定的生理状况自动调整刺激疗法。
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公开(公告)号：US20090105785A1
公开(公告)日：2009-04-23
申请号：US12238025
申请日：2008-09-25
IPC分类号： A61N1/02 , A61B5/00 , A61B5/0476 , G08B21/00 , A61M31/00 , A61B5/0488
CPC分类号： A61N1/36542 , A61N1/36132 , A61N1/36135 , A61N1/37 , G06F19/00 , G06F19/3481
摘要： A therapy program is selected based on a patient state, where the patient state comprises at least one of a movement state, sleep state or speech state. In this way, therapy delivery is tailored to the patient state, which may include specific patient symptoms. The therapy program is selected from a plurality of stored therapy programs that comprise therapy programs associated with a respective one at least two of the movement, sleep, and speech states. Techniques for determining a patient state include receiving volitional patient input or detecting biosignals generated within the patient's brain. The biosignals are nonsymptomatic and may be incidental to the movement, sleep, and speech states or generated in response to volitional patient input.
摘要翻译： 基于患者状态选择治疗程序，其中患者状态包括运动状态，睡眠状态或语音状态中的至少一个。 以这种方式，治疗递送是针对患者状态而定制的，其可以包括特定的患者症状。 治疗程序选自包括与运动，睡眠和言语状态中的至少两个相关的治疗程序的多个存储的治疗程序。 用于确定患者状态的技术包括接收患者输入或检测患者大脑内生成的生物信号。 生物信号是无症状的，可能与运动，睡眠和言语状态有关，或者是响应于患者输入的意图产生的。
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公开(公告)号：US08290596B2
公开(公告)日：2012-10-16
申请号：US12238025
申请日：2008-09-25
IPC分类号： A61N1/36
CPC分类号： A61N1/36542 , A61N1/36132 , A61N1/36135 , A61N1/37 , G06F19/00 , G06F19/3481
摘要： A therapy program is selected based on a patient state, where the patient state comprises at least one of a movement state, sleep state or speech state. In this way, therapy delivery is tailored to the patient state, which may include specific patient symptoms. The therapy program is selected from a plurality of stored therapy programs that comprise therapy programs associated with a respective one at least two of the movement, sleep, and speech states. Techniques for determining a patient state include receiving volitional patient input or detecting biosignals generated within the patient's brain. The biosignals are nonsymptomatic and may be incidental to the movement, sleep, and speech states or generated in response to volitional patient input.
摘要翻译： 基于患者状态选择治疗程序，其中患者状态包括运动状态，睡眠状态或语音状态中的至少一个。 以这种方式，治疗递送是针对患者状态而定制的，其可以包括特定的患者症状。 治疗程序选自包括与运动，睡眠和言语状态中的至少两个相关的治疗程序的多个存储的治疗程序。 用于确定患者状态的技术包括接收患者输入或检测患者大脑内生成的生物信号。 生物信号是无症状的，可能与运动，睡眠和言语状态有关，或者是响应于患者输入的意图产生的。
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公开(公告)号：US20090264789A1
公开(公告)日：2009-10-22
申请号：US12431167
申请日：2009-04-28
申请人： Gregory F. Molnar , Richard T. Stone , Xuan Wei
发明人： Gregory F. Molnar , Richard T. Stone , Xuan Wei
IPC分类号： A61B5/0476 , A61M31/00 , A61N1/08 , A61B5/11 , G10L15/00
CPC分类号： A61N1/36135 , A61N1/36542 , A61N1/36585 , A61N1/37
摘要： A set of therapy parameter values is selected based on a patient state, where the patient state comprises a speech state or a mixed patient state including the speech state and at least one of a movement state or a sleep state. In this way, therapy delivery is tailored to the patient state, which may include one or more patient symptoms specific to the patient state. In some examples, a medical device determines whether the patient is in the speech state or a mixed patient state including the speech state based on a signal generated by a voice activity sensor. The voice activity sensor detects the use of the patient's voice, and may include a microphone, a vibration detector or an accelerometer.
摘要翻译： 基于患者状态选择一组治疗参数值，其中患者状态包括语音状态或包括语音状态和运动状态或睡眠状态中的至少一个的混合患者状态。 以这种方式，治疗递送适合于患者状态，其可以包括对患者状态特异的一个或多个患者症状。 在一些示例中，医疗设备基于由语音活动传感器生成的信号来确定患者是处于语音状态还是包括语音状态的混合患者状态。 语音活动传感器检测患者声音的使用，并且可以包括麦克风，振动检测器或加速度计。
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公开(公告)号：US10722169B2
公开(公告)日：2020-07-28
申请号：US13982159
申请日：2012-01-24
申请人： Richard T. Stone , Xuan Wei
发明人： Richard T. Stone , Xuan Wei
摘要： A physiological state of a patient is detected by at least producing and detecting pressure waves with a free wall of an implantable medical device (IMD) housing. An actuator element may contact the free wall, e.g., a portion of the IMD housing, and cause movement of the free wall that produces a pressure wave within the fluid and tissue of the patient. A detector element contacting the free wall may in turn detect reflected pressure waves received by the free wall. An acoustic module within the IMD may then determine a physiological condition of the patient, e.g., a bladder fullness state, based on the time delay between the transmitted and reflected pressure waves. In some examples in which the IMD also delivers stimulation therapy to the patient, e.g., incontinence therapy, the IMD may also automatically adjust stimulation therapy based on the determined physiological condition.
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公开(公告)号：US09216286B2
公开(公告)日：2015-12-22
申请号：US13265098
申请日：2010-04-28
CPC分类号： A61N1/08 , A61B90/39 , A61B2090/3966 , A61N1/05 , A61N1/0551 , A61N1/086 , A61N1/3718 , A61N1/3752 , A61N2001/058 , A61N2001/0582 , A61N2001/086 , Y10T29/49016 , Y10T29/49117 , Y10T29/4921 , Y10T29/49227 , Y10T29/49826
摘要： Implantable medical leads include a shield that is guarded at a termination by having a first portion and second portion of the shield, where the first portion is between a termination of the shield at the second portion and an inner insulation layer surrounding the filars. The first portion may reduce the coupling of RF energy from the termination of the shield at the second portion to the filars. The first and second portions may be part of a continuous shield, where the first and second portions are separated by an inversion of the shield. The first and second portions may instead be separate pieces. The first portion may be noninverted residing between the termination at the second portion and inner layers, or the first portion may be inverted to create first and second sub-portions. The shield termination at the second portion is between the first and second sub-portions.
摘要翻译： 可植入医疗引线包括通过具有屏蔽件的第一部分和第二部分在端子处被保护的屏蔽件，其中第一部分位于第二部分处的屏蔽件的终端和围绕线圈的内部绝缘层之间。 第一部分可以减少RF能量从第二部分处的屏蔽端接到丝状体的耦合。 第一和第二部分可以是连续屏蔽的一部分，其中第一和第二部分被屏蔽的反转分开。 第一和第二部分可以是分开的部分。 第一部分可以位于第二部分的终端和内层之间，或者第一部分可以被倒置以产生第一和第二子部分。 第二部分处的屏蔽终端位于第一和第二子部分之间。
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7.发明授权公开(公告)号：US08588914B2
公开(公告)日：2013-11-19
申请号：US11450127
申请日：2006-06-09
IPC分类号： A61N1/375
CPC分类号： A61N1/375 , A61N1/0504 , A61N1/0531 , A61N1/0534 , A61N1/0553 , A61N1/36071 , A61N1/3756
摘要： An implantable medical device (IMD) with a housing and electrodes on at least two surfaces of the housing is described. The surfaces may be, for example, opposed, substantially parallel surfaces, e.g., top and bottom surfaces. Location of electrodes on multiple surfaces of the housing may allow the IMD to deliver stimulation to a variety of tissues and with a variety of current field configurations. For example, the IMD may deliver peripheral nerve field stimulation (PNFS) to one or more tissue areas via electrodes selected from one or both of the surfaces to, for example, reduce the sensation of pain in a tissue area proximate to an implantation site of the IMD without targeting a specific nerve. The IMD may be implanted between or within intra-dermal, deep dermal, or subcutaneous layers of the tissue of the patient to deliver PNFS to any one or more of these layers.
摘要翻译： 描述了在壳体的至少两个表面上具有壳体和电极的可植入医疗装置（IMD）。 表面可以是例如相对的基本上平行的表面，例如顶部和底部表面。 电极在壳体的多个表面上的位置可以允许IMD将刺激递送到各种组织以及各种当前的现场配置。 例如，IMD可以通过选自一个或两个表面的电极将外周神经区域刺激（PNFS）递送到一个或多个组织区域，以例如减少接近植入部位的组织区域中的疼痛感觉 IMD没有针对特定的神经。 IMD可以植入在患者组织的真皮内，深层皮肤或皮下层之间或内，以将PNFS递送到这些层中的任何一个或多个层。
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8.发明授权Electrical and activation field models for programming a stimulation lead with complex electrode array geometry 有权用于通过复杂电极阵列几何编程刺激引线的电和激活场模型公开(公告)号：US08452415B2
公开(公告)日：2013-05-28
申请号：US11591187
申请日：2006-10-31
IPC分类号： A61N1/08
CPC分类号： A61N1/0529 , A61N1/0531 , A61N1/0534 , A61N1/0553 , A61N1/36071 , A61N1/36082 , A61N1/36185 , A61N1/37247
摘要： The disclosure is directed to programming implantable stimulators to deliver stimulation energy via one or more implantable leads having complex electrode array geometries. A programmer is configured to generate an electrical field model from selected stimulation parameters and patient anatomy data. The electrical field model indicates how the electrical field propagation would occur in the patient during therapy. In addition, the programmer may be configured to generate an activation field model from the electrical field model and a neuron model. The activation field indicates which neurons within the electrical field will be activated during the therapy. Either of these field models may be presented to the user via a user interface that also displays a representation of the lead implanted within the patient. The user interface may allow the user to adjust the stimulation therapy by manipulating displayed field or activation model representations.
摘要翻译： 本公开涉及编程可植入刺激器以通过具有复杂电极阵列几何形状的一个或多个可植入引线输送刺激能量。 编程器被配置为从所选择的刺激参数和患者解剖数据生成电场模型。 电场模型指示治疗期间患者的电场传播如何发生。 此外，程序员可以被配置为从电场模型和神经元模型生成激活场模型。 激活区域指示在治疗期间电场内的哪些神经元将被激活。 这些现场模型中的任一个可以经由还显示植入患者体内的引线的表示的用户界面呈现给用户。 用户界面可以允许用户通过操纵显示的场或激活模型表示来调整刺激疗法。
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公开(公告)号：US20120316619A1
公开(公告)日：2012-12-13
申请号：US13592918
申请日：2012-08-23
IPC分类号： A61N1/36
CPC分类号： A61N1/0534 , A61N1/36071 , A61N1/36157 , A61N1/36185 , A61N1/37247
摘要： The disclosure is directed to programming implantable stimulators to deliver stimulation energy via one or more implantable leads having complex electrode array geometries. The disclosure also contemplates guided programming to select electrode combinations and parameter values to support efficacy. The techniques may be applied to a programming interface associated with a clinician programmer, a patient programmer, or both. A user interface permits a user to view electrodes from different perspectives relative to the lead. For example, the user interface provides a side view of a lead and a cross-sectional view of the lead. The user interface may include an axial control medium to select and/or view electrodes at different axial positions along the length of a lead, and a rotational control medium to select and/or view electrodes at different angular positions around a circumference of the lead.
摘要翻译： 本公开涉及编程可植入刺激器以通过具有复杂电极阵列几何形状的一个或多个可植入引线输送刺激能量。 本公开还考虑了引导编程以选择电极组合和参数值以支持功效。 这些技术可以应用于与临床医生程序员，患者程序员或两者相关联的编程接口。 用户界面允许用户从相对于铅的不同角度来观察电极。 例如，用户界面提供引线的侧视图和引线的横截面图。 用户界面可以包括轴向控制介质，用于选择和/或查看沿引线长度的不同轴向位置处的电极;以及旋转控制介质，用于选择和/或查看围绕引线圆周的不同角位置处的电极。
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公开(公告)号：US20120035696A1
公开(公告)日：2012-02-09
申请号：US13264179
申请日：2010-04-27
申请人： Michael J. Kern , James M. Olsen , Michael R. Klardie , Richard T. Stone , Chad Q. Cai , Spencer M. Bondhus , Mark J. Conroy , Timothy R. Abraham , Brian T. Stolz
发明人： Michael J. Kern , James M. Olsen , Michael R. Klardie , Richard T. Stone , Chad Q. Cai , Spencer M. Bondhus , Mark J. Conroy , Timothy R. Abraham , Brian T. Stolz
CPC分类号： A61N1/08 , A61B90/39 , A61B2090/3966 , A61N1/05 , A61N1/0551 , A61N1/086 , A61N1/3718 , A61N1/3752 , A61N2001/058 , A61N2001/0582 , A61N2001/086 , Y10T29/49016 , Y10T29/49117 , Y10T29/4921 , Y10T29/49227 , Y10T29/49826
摘要： A shield located within an implantable medical lead may be terminated in various ways. The shield may be terminated by butt, scarf, lap, or other joints between insulation layers surrounding the lead and an insulation extension. For lap joints, a portion of an outer insulation layer may be removed and a replacement outer insulation layer is positioned in place of the removed outer insulation layer, where the replacement layer extends beyond an inner insulation layer and the shield. The replacement layer may also lap onto a portion of the insulation extension. Barbs may be located between the replacement layer and the inner insulation layer or the insulation extension. The shield wires have ends at the termination point that may be folded over individually or may be capped with a ring located within one of the insulation layers of the jacket.
摘要翻译： 位于可植入医疗引线内的护罩可以以各种方式终止。 护罩可以通过对接，围巾，搭接或围绕导线的绝缘层与绝缘延伸部分之间的其他接头来终止。 对于搭接接头，可以去除外部绝缘层的一部分，并且替换外部绝缘层被定位成代替去除的外部绝缘层，其中替换层延伸超出内部绝缘层和屏蔽。 替换层也可以搭接在绝缘延伸部分的一部分上。 倒钩可以位于替换层和内绝缘层之间或绝缘延伸部分之间。 屏蔽线在终止点处具有可以单独折叠的端部，或者可以用位于护套的绝缘层之一内的环来封盖。
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