公开(公告)号：US20120109235A1

公开(公告)日：2012-05-03

申请号：US12913400

申请日：2010-10-27

申请人： Todd J. Sheldon ,  Bruce D. Gunderson

发明人： Todd J. Sheldon ,  Bruce D. Gunderson

IPC分类号： A61N1/37 ,  A61N1/39

CPC分类号： A61N1/371 ,  A61N1/3706 ,  A61N1/3712 ,  A61N1/3962 ,  A61N2001/083

摘要： Various techniques for detecting cardiac capture in response to a detected lead related condition are described. One example method described includes delivering a pacing therapy to a heart of a patient, periodically determining whether the pacing therapy captures the heart of the patient, detecting a lead related condition, and, in response to the detected lead related condition, increasing a frequency of determining whether the pacing therapy captures the heart.

摘要翻译： 描述了响应于检测到的铅相关状况来检测心脏捕获的各种技术。 所描述的一个示例性方法包括将起搏治疗递送到患者的心脏，周期性地确定起搏疗法是否捕获患者的心脏，检测引线相关状况，并且响应于检测到的引线相关状况，增加频率 确定起搏治疗是否捕获心脏。

公开(公告)号：US08744560B2

公开(公告)日：2014-06-03

申请号：US13250676

申请日：2011-09-30

申请人： Bruce D. Gunderson ,  Karen J. Kleckner ,  Kevin T. Ousdigian ,  Amisha S. Patel ,  Julian Sanchez

发明人： Bruce D. Gunderson ,  Karen J. Kleckner ,  Kevin T. Ousdigian ,  Amisha S. Patel ,  Julian Sanchez

IPC分类号： A61B5/0456

CPC分类号： A61N1/37247 ,  A61B5/0031 ,  A61B5/044 ,  A61B5/0452 ,  A61B5/0464 ,  A61B5/0468 ,  A61B5/076 ,  A61B5/7217 ,  A61B5/7264

摘要： The present disclosure is directed to generating and displaying an electrogram (EGM) summary for use by physicians or other clinicians. An implantable medical device (IMD) transmits EGM signal data for a number of cardiac episodes to an external computing device. The external computing device selects a subset of the cardiac episodes for which information or images are displayed to the user. In various examples, cardiac episodes may be selected for display based at least in part on a retrospective analysis classification of the cardiac episode.

摘要翻译： 本公开涉及生成和显示用于医生或其他临床医师使用的电描记图（EGM）摘要。 可植入医疗装置（IMD）向多个心脏发作的EGM信号数据发送到外部计算装置。 外部计算设备选择向用户显示信息或图像的心脏发作的子集。 在各种示例中，可以至少部分地基于心脏发作的回顾性分析分类来选择心脏发作来进行显示。

公开(公告)号：US08660643B2

公开(公告)日：2014-02-25

申请号：US13569354

申请日：2012-08-08

申请人： Bruce D. Gunderson

发明人： Bruce D. Gunderson

IPC分类号： A61N1/365

CPC分类号： A61B5/0422 ,  A61B5/0031 ,  A61B5/0424 ,  A61B5/0452 ,  A61B5/0464 ,  A61B2560/0276 ,  A61N1/3702 ,  A61N2001/083

摘要： Techniques for determining whether a lead related condition exists based on analysis of a cardiac electrical signal associated with a non-sustained tachyarrhythmia (NST) are described. In some examples, the techniques include determining the duration of intervals between consecutive cardiac events, e.g., R-R intervals, during an NST. The techniques may further include determining one or more metrics based on the durations of the intervals during the NST. Examples of metrics include an average, a minimum, a maximum, a range, a median, a mode, or a mean. A lead related condition is identified based on the values of the one or more metrics, e.g., by comparison to respective thresholds. In some examples, an alert is provided or a therapy modification is suggested if a lead related condition is identified.

摘要翻译： 描述了基于与非持续性快速性心律失常（NST）相关的心脏电信号的分析来确定是否存在与铅相关的病症的技术。 在一些示例中，技术包括在NST期间确定连续心脏事件之间的间隔的持续时间，例如R-R间隔。 所述技术还可以包括基于在NST期间间隔的持续时间确定一个或多个度量。 度量的示例包括平均值，最小值，最大值，范围，中值，模式或平均值。 基于一个或多个度量的值，例如通过与相应的阈值进行比较来识别引线相关条件。 在一些示例中，如果识别出铅相关病症，则提供警报或建议进行治疗修改。

公开(公告)号：US08644931B2

公开(公告)日：2014-02-04

申请号：US12180304

申请日：2008-07-25

申请人： Robert W. Stadler ,  Bruce D. Gunderson ,  Amisha S. Patel

发明人： Robert W. Stadler ,  Bruce D. Gunderson ,  Amisha S. Patel

IPC分类号： A61N1/00

CPC分类号： A61N1/36521 ,  A61N1/3706 ,  A61N2001/083

摘要： In general, the disclosure relates to techniques for calculating mean impedance values and impedance variability values to detect a possible condition with a lead or device-lead pathway or connection. In one example, a device may be configured to determine an impedance value for an electrical path based on a plurality of measured impedance values for the electrical path, wherein the electrical path comprises a plurality of electrodes, and to determine an impedance variability value based on at least one of the plurality of measured impedance values. The device may be further configured to determine a threshold value based on the determined impedance value and the impedance variability value, compare a newly measured impedance value for the electrical path to the threshold value, and indicate a possible condition of the electrical path based on the comparison.

摘要翻译： 通常，本公开涉及用于计算平均阻抗值和阻抗变异性值以用于检测具有引线或器件引导路径或连接的可能状况的技术。 在一个示例中，设备可以被配置为基于用于电路径的多个测量的阻抗值来确定电路径的阻抗值，其中电路径包括多个电极，并且基于以下方式确定阻抗变异性值： 所述多个测量的阻抗值中的至少一个。 该装置还可以被配置为基于所确定的阻抗值和阻抗变异性值来确定阈值，将新测量的电通路的阻抗值与阈值进行比较，并且基于该路径指示电路径的可能状态 比较。

公开(公告)号：US08386024B2

公开(公告)日：2013-02-26

申请号：US12476733

申请日：2009-06-02

申请人： Bruce D. Gunderson ,  Amisha S. Patel ,  Chad A. Bounds ,  Mark L. Brown

发明人： Bruce D. Gunderson ,  Amisha S. Patel ,  Chad A. Bounds ,  Mark L. Brown

IPC分类号： A61B5/0456

CPC分类号： A61B5/0456 ,  A61B5/0464 ,  A61B5/7217 ,  A61B5/7239 ,  A61B5/7264 ,  A61N1/3622 ,  A61N1/3702 ,  A61N1/3704

摘要： A method for identifying and classifying various types of oversensing in implantable medical devices (IMDs), such as implantable cardioverter defibrillators (ICDs), to assist a physician in choosing corrective action to reduce the likelihood of oversensing and inappropriate therapy delivery. Far-field electrogram (EGM) signals are analyzed to detect the occurrence of R-waves, and the result is compared to the number and pattern of R-waves sensed by the IMD and indicated on the marker channel. A marker channel with more sensed R-waves than indicated by analysis of the far-field EGM indicates the presence of oversensing, including double-counting of R-waves, T-wave oversensing, lead malfunction or failure, poor lead connections, noise associated with electromagnetic interference, non-cardiac myopotentials, etc. Identification of the type of oversensing may be determined by analysis of the number and pattern of marker channel sensed R-waves with respect to the timing of the R-waves detected from the far-field EGM.

公开(公告)号：US20120109240A1

公开(公告)日：2012-05-03

申请号：US12915877

申请日：2010-10-29

申请人： Xiaohong Zhou ,  Robert Stadler ,  Bruce D. Gunderson ,  Walter H. Olson

发明人： Xiaohong Zhou ,  Robert Stadler ,  Bruce D. Gunderson ,  Walter H. Olson

IPC分类号： A61N1/39 ,  A61N1/365

CPC分类号： A61N1/3706 ,  A61B5/046 ,  A61B5/0464 ,  A61B5/4836 ,  A61N1/3621

摘要： Methods and/or devices for initiating an automatic adjustment of arrhythmia detection parameters (e.g., upon delivery of cardiac therapy after detection of VT/VF).

摘要翻译： 用于启动心律失常检测参数的自动调整的方法和/或装置（例如，在检测到VT / VF之后递送心脏治疗）。

公开(公告)号：US20110098766A1

公开(公告)日：2011-04-28

申请号：US12606899

申请日：2009-10-27

申请人： Bruce D. Gunderson

发明人： Bruce D. Gunderson

IPC分类号： A61N1/365

CPC分类号： A61B5/0422 ,  A61B5/0031 ,  A61B5/0424 ,  A61B5/0452 ,  A61B5/0464 ,  A61B2560/0276 ,  A61N1/3702 ,  A61N2001/083

摘要： Techniques for determining whether a lead related condition exists based on analysis of a cardiac electrical signal associated with a non-sustained tachyarrhythmia (NST) are described. In some examples, the techniques include determining the duration of intervals between consecutive cardiac events, e.g., R-R intervals, during an NST. The techniques may further include determining one or more metrics based on the durations of the intervals during the NST. Examples of metrics include an average, a minimum, a maximum, a range, a median, a mode, or a mean. A lead related condition is identified based on the values of the one or more metrics, e.g., by comparison to respective thresholds. In some examples, an alert is provided or a therapy modification is suggested if a lead related condition is identified.

摘要翻译： 描述了基于与非持续性快速性心律失常（NST）相关的心脏电信号的分析来确定是否存在与铅相关的病症的技术。 在一些示例中，技术包括在NST期间确定连续心脏事件之间的间隔的持续时间，例如R-R间隔。 所述技术还可以包括基于在NST期间间隔的持续时间确定一个或多个度量。 度量的示例包括平均值，最小值，最大值，范围，中值，模式或平均值。 基于一个或多个度量的值，例如通过与相应的阈值进行比较来识别引线相关条件。 在一些示例中，如果识别出铅相关病症，则提供警报或建议进行治疗修改。

公开(公告)号：US20100106209A1

公开(公告)日：2010-04-29

申请号：US12260560

申请日：2008-10-29

申请人： Bruce D. Gunderson ,  Donald James Ruzin

发明人： Bruce D. Gunderson ,  Donald James Ruzin

IPC分类号： A61N1/368

CPC分类号： A61N1/3704 ,  A61N1/3622

摘要： In general, the disclosure is directed to techniques for identification and remediation of oversensed cardiac events using far-field electrograms (FFEGMs). Identification of oversensed cardiac events can be used in an ICD to prevent ventricular fibrillation (VF) detection, and thereby avoid delivery of an unnecessary defibrillation shock. Alternatively, or additionally, identification of oversensed cardiac events can be used in an ICD to support delivery of bradycardia pacing during an oversensing condition. In some cases, bradycardia pacing delivered in response to detection of oversensed cardiac events may include pacing pulses from multiple vectors to provide redundancy in the event the oversensing may be due to a lead-related condition.

摘要翻译： 一般来说，本公开涉及使用远场电描记图（FFEGM）识别和补救超级心脏事件的技术。 识别超重心脏事件可用于ICD以防止心室颤动（VF）检测，从而避免不必要的除颤休克的传递。 或者或另外，过度心脏事件的识别可用于ICD以支持在过度状态期间心动过缓起搏的传送。 在一些情况下，响应于超大心脏事件的检测而发送的心动过缓起搏可以包括来自多个向量的起搏脉冲，以在超引线可能由于引线相关状况而提供冗余。

公开(公告)号：US20090299201A1

公开(公告)日：2009-12-03

申请号：US12180314

申请日：2008-07-25

申请人： Bruce D. Gunderson

发明人： Bruce D. Gunderson

IPC分类号： A61B5/02

CPC分类号： A61N1/37247 ,  A61N1/3621 ,  A61N1/3704 ,  A61N1/3925 ,  A61N2001/083

摘要： In general, the disclosure relates to techniques for providing a combination of stored diagnostic information, including impedance trend data, into one displayable report that may be used to diagnose a possible condition with an implantable medical electrode lead. One example device includes a processor that is configured to obtain impedance trend data for an electrical path, the electrical path comprising a plurality of electrodes, and to obtain additional diagnostic data that is associated with the electrical path, the additional diagnostic data being distinct from the impedance trend data. The device is further configured to combine both the impedance trend data and the additional diagnostic data into a displayable report that indicates whether there is a possible condition with the electrical path. The additional diagnostic data may include non-sustained episode data, sensing integrity data, pacing threshold, and/or electrogram data (such as P-wave amplitude and/or R-wave amplitude data).

摘要翻译： 通常，本公开涉及将存储的诊断信息（包括阻抗趋势数据）的组合提供到可用于使用可植入医疗电极引线诊断可能状况的可显示报告中的技术。 一个示例性设备包括被配置为获得用于电路径的阻抗趋势数据的处理器，该电路径包括多个电极，并且获得与电路径相关联的附加诊断数据，附加诊断数据不同于 阻抗趋势数据。 该装置还被配置为将阻抗趋势数据和附加诊断数据两者组合成可显示报告，该报告指示电路是否存在可能的状况。 附加诊断数据可以包括非持续发作数据，感测完整性数据，起搏阈值和/或电描记图数据（例如P波幅度和/或R波振幅数据）。

公开(公告)号：US07539540B2

公开(公告)日：2009-05-26

申请号：US11536364

申请日：2006-09-28

申请人： Bruce D. Gunderson ,  Troy E. Jackson

发明人： Bruce D. Gunderson ,  Troy E. Jackson

IPC分类号： A61N1/362

CPC分类号： A61B5/0402 ,  A61B2560/0276 ,  A61N1/37 ,  A61N1/3718

摘要： A troubleshooting method can identify potential sources of noise emanating from an implanted portion of a medical system. The method, which may be carried out by the system, for example, according to pre-programmed instructions, includes a step of collecting at least one EGM sample from a sensing pair of electrodes, and an EGM sample from each of a plurality of recording pairs of electrodes. The sensing pair may be formed by first and second electrodes of an implanted lead, and the plurality of recording pairs include pairs formed by each of the lead electrodes and an electrode of an implanted device. Following collection, the EGM samples from the recording pairs may be analyzed for the presence or absence of noise and, then, potential noise sources may be determined.

摘要翻译： 故障排除方法可以识别从医疗系统的植入部分发出的噪声的潜在来源。 可以由系统执行的方法，例如根据预先编程的指令，包括从感测对电极收集至少一个EGM样本的步骤，以及来自多个记录中的每一个的EGM样本 电极对。 感测对可以由植入引线的第一和第二电极形成，并且多个记录对包括由每个引线电极和植入装置的电极形成的对。 收集后，可以分析来自记录对的EGM样本的噪声的存在或不存在，然后可以确定潜在的噪声源。