公开(公告)号：US07457664B2

公开(公告)日：2008-11-25

申请号：US11125068

申请日：2005-05-09

申请人： Yi Zhang ,  Yinghong Yu ,  Aaron R. McCabe ,  Jiang Ding ,  Jeffrey E. Stahmann ,  Carlos Alberto Ricci ,  Scott A. Meyer

发明人： Yi Zhang ,  Yinghong Yu ,  Aaron R. McCabe ,  Jiang Ding ,  Jeffrey E. Stahmann ,  Carlos Alberto Ricci ,  Scott A. Meyer

IPC分类号： A61N1/365

CPC分类号： A61N1/3712 ,  A61N1/3627 ,  A61N1/365 ,  G06F19/00

摘要： Cardiac monitoring and/or stimulation methods and systems that provide one or more of monitoring, diagnosing, defibrillation, and pacing. Cardiac signal separation is employed to detect, monitor, track, and/or trend closed-loop cardiac resynchronization therapy using cardiac activation sequence information. Devices and methods involve sensing a plurality of composite cardiac signals using a plurality of electrodes, the electrodes configured for implantation in a patient. A source separation is performed using the sensed plurality of composite cardiac signals, producing one or more cardiac signal vectors associated with all or a portion of one or more cardiac activation sequences. A cardiac resynchronization therapy is adjusted using one or both of the one or more cardiac signal vectors and the signals associated with the one or more cardiac signal vectors. In further embodiments, the cardiac resynchronization therapy may be initiated, terminated, or one or more parameters of the resynchronization therapy may be altered.

摘要翻译： 提供一种或多种监测，诊断，除颤和起搏的心脏监测和/或刺激方法和系统。 心脏信号分离用于使用心脏激活序列信息来检测，监测，跟踪和/或趋向闭环心脏再同步治疗。 设备和方法包括使用多个电极感测多个复合心脏信号，所述电极被配置用于植入患者体内。 使用所感测的多个复合心脏信号进行源分离，产生与一个或多个心脏激活序列的全部或一部分相关联的一个或多个心脏信号载体。 使用一个或多个心脏信号向量和与一个或多个心脏信号载体相关联的信号中的一个或两个来调整心脏再同步治疗。 在另外的实施方案中，心脏再同步治疗可以被启动，终止，或者可以改变再同步治疗的一个或多个参数。

公开(公告)号：US20090198301A1

公开(公告)日：2009-08-06

申请号：US12409348

申请日：2009-03-23

申请人： Yi Zhang ,  Jiang Ding ,  Aaron R. McCabe ,  Scott A. Meyer

发明人： Yi Zhang ,  Jiang Ding ,  Aaron R. McCabe ,  Scott A. Meyer

IPC分类号： A61N1/37

CPC分类号： A61N1/3712 ,  A61N1/365

摘要： Cardiac monitoring and/or stimulation methods and systems that provide one or more of monitoring, diagnosing, defibrillation, and pacing. Cardiac signal separation is employed for automatic capture verification using cardiac activation sequence information. Devices and methods sense composite cardiac signals using implantable electrodes. A source separation is performed using the composite signals. One or more signal vectors are produced that are associated with all or a portion of one or more cardiac activation sequences based on the source separation. A cardiac response to the pacing pulses is classified using characteristics associated with cardiac signal vectors and the signals associated with the vectors. Further embodiments may involve classifying the cardiac response as capture or non-capture, fusion or intrinsic cardiac activity. The characteristics may include an angle or an angle change of the cardiac signal vectors, such as a predetermined range of angles of the one or more cardiac signal vectors.

摘要翻译： 提供一种或多种监测，诊断，除颤和起搏的心脏监测和/或刺激方法和系统。 心脏信号分离被用于使用心脏激活序列信息的自动捕获验证。 装置和方法使用可植入电极感测复合心脏信号。 使用复合信号进行源分离。 产生与基于源分离的一个或多个心脏激活序列的全部或一部分相关联的一个或多个信号载体。 使用与心脏信号矢量相关联的特征和与矢量相关联的信号来分类对起搏脉冲的心脏反应。 进一步的实施方案可以包括将心脏反应分类为捕获或非捕获，融合或内在心脏活动。 特征可以包括心脏信号矢量的角度或角度变化，例如一个或多个心脏信号矢量的预定角度范围。

公开(公告)号：US20090076557A1

公开(公告)日：2009-03-19

申请号：US12276070

申请日：2008-11-21

申请人： Yi Zhang ,  Yinghong Yu ,  Aaron R. McCabe ,  Jiang Ding ,  Jeffrey E. Stahmann ,  Carlos Alberto Ricci ,  Scott A. Meyer

发明人： Yi Zhang ,  Yinghong Yu ,  Aaron R. McCabe ,  Jiang Ding ,  Jeffrey E. Stahmann ,  Carlos Alberto Ricci ,  Scott A. Meyer

IPC分类号： A61N1/39 ,  A61N1/368

CPC分类号： A61N1/3712 ,  A61N1/3627 ,  A61N1/365 ,  G06F19/00

摘要： Cardiac monitoring and/or stimulation methods and systems that provide one or more of monitoring, diagnosing, defibrillation, and pacing. Cardiac signal separation is employed to detect, monitor, track and/or trend closed-loop cardiac resynchronization therapy using cardiac activation sequence information. Devices and methods involve sensing a plurality of composite cardiac signals using a plurality of electrodes, the electrodes configured for implantation in a patient. A source separation is performed using the sensed plurality of composite cardiac signals, producing one or more cardiac signal vectors associated with all or a portion of one or more cardiac activation sequences. A cardiac resynchronization therapy is adjusted using one or both of the one or more cardiac signal vectors and the signals associated with the one or more cardiac signal vectors. In further embodiments, the cardiac resynchronization therapy may be initiated, terminated, or one or more parameters of the resynchronization therapy may be altered.

摘要翻译： 提供一种或多种监测，诊断，除颤和起搏的心脏监测和/或刺激方法和系统。 心脏信号分离用于使用心脏激活序列信息来检测，监测，跟踪和/或趋势闭环心脏再同步治疗。 设备和方法包括使用多个电极感测多个复合心脏信号，所述电极被配置用于植入患者体内。 使用所感测的多个复合心脏信号进行源分离，产生与一个或多个心脏激活序列的全部或一部分相关联的一个或多个心脏信号载体。 使用一个或多个心脏信号向量和与一个或多个心脏信号载体相关联的信号中的一个或两个来调整心脏再同步治疗。 在另外的实施方案中，心脏再同步治疗可以被启动，终止，或者可以改变再同步治疗的一个或多个参数。

公开(公告)号：US07509170B2

公开(公告)日：2009-03-24

申请号：US11124972

申请日：2005-05-09

申请人： Yi Zhang ,  Jiang Ding ,  Aaron R. McCabe ,  Scott A. Meyer

发明人： Yi Zhang ,  Jiang Ding ,  Aaron R. McCabe ,  Scott A. Meyer

IPC分类号： A61N1/08 ,  A61N1/37 ,  A61B5/0452

CPC分类号： A61N1/3712 ,  A61N1/365

摘要： Cardiac monitoring and/or stimulation methods and systems that provide one or more of monitoring, diagnosing, defibrillation, and pacing. Cardiac signal separation is employed for automatic capture verification using cardiac activation sequence information. Devices and methods sense composite cardiac signals using implantable electrodes. A source separation is performed using the composite signals. One or more signal vectors are produced that are associated with all or a portion of one or more cardiac activation sequences based on the source separation. A cardiac response to the pacing pulses is classified using characteristics associated with cardiac signal vectors and the signals associated with the vectors. Further embodiments may involve classifying the cardiac response as capture or non-capture, fusion or intrinsic cardiac activity. The characteristics may include an angle or an angle change of the cardiac signal vectors, such as a predetermined range of angles of the one or more cardiac signal vectors.

摘要翻译： 提供一种或多种监测，诊断，除颤和起搏的心脏监测和/或刺激方法和系统。 心脏信号分离被用于使用心脏激活序列信息的自动捕获验证。 装置和方法使用可植入电极感测复合心脏信号。 使用复合信号进行源分离。 产生与基于源分离的一个或多个心脏激活序列的全部或一部分相关联的一个或多个信号载体。 使用与心脏信号矢量相关联的特征和与矢量相关联的信号来分类对起搏脉冲的心脏反应。 进一步的实施方案可以包括将心脏反应分类为捕获或非捕获，融合或内在心脏活动。 特征可以包括心脏信号矢量的角度或角度变化，例如一个或多个心脏信号矢量的预定角度范围。

公开(公告)号：US08626276B2

公开(公告)日：2014-01-07

申请号：US12847657

申请日：2010-07-30

申请人： Yi Zhang ,  Scott A. Meyer ,  Jeffrey E. Stahmann ,  Carlos Alberto Ricci ,  Marina Brockway ,  Aaron R. McCabe ,  Yinghong Yu ,  Donald L. Hopper

发明人： Yi Zhang ,  Scott A. Meyer ,  Jeffrey E. Stahmann ,  Carlos Alberto Ricci ,  Marina Brockway ,  Aaron R. McCabe ,  Yinghong Yu ,  Donald L. Hopper

IPC分类号： A61B5/04

CPC分类号： A61N1/3702 ,  A61B5/0452 ,  A61B5/7203

摘要： Cardiac monitoring and/or stimulation methods and systems that provide one or more of monitoring, diagnosing, defibrillation, and pacing. Cardiac signal separation is employed to detect, monitor, track and/or trend ischemia using cardiac activation sequence information. Ischemia detection may involve sensing composite cardiac signals using implantable electrodes, and performing a signal separation that produces one or more cardiac activation signal vectors associated with one or more cardiac activation sequences. A change in the signal vector may be detected using subsequent separations. The change may be an elevation or depression of the ST segment of a cardiac cycle or other change indicative of myocardial ischemia, myocardial infarction, or other pathological change. The change may be used to predict, quantify, and/or qualify an event such as an arrhythmia, a myocardial infarction, or other pathologic change. Information associated with the vectors may be stored and used to track the vectors.

摘要翻译： 提供一种或多种监测，诊断，除颤和起搏的心脏监测和/或刺激方法和系统。 使用心脏信号分离来使用心脏激活序列信息来检测，监测，跟踪和/或趋势性缺血。 缺血检测可以涉及使用可植入电极感测复合心脏信号，并且执行产生与一个或多个心脏激活序列相关联的一个或多个心脏激活信号载体的信号分离。 可以使用后续分离来检测信号矢量的变化。 该变化可以是心​​脏周期的ST段的升高或抑制或指示心肌缺血，心肌梗死或其他病理变化的其它变化。 该变化可用于预测，量化和/或限定诸如心律失常，心肌梗死或其它病理变化的事件。 与矢量相关联的信息可以被存储并用于跟踪矢量。

公开(公告)号：US07917196B2

公开(公告)日：2011-03-29

申请号：US11125020

申请日：2005-05-09

申请人： Yi Zhang ,  Carlos Alberto Ricci ,  Jeffrey E. Stahmann ,  Aaron R. McCabe ,  Scott A. Meyer ,  Yinghong Yu

发明人： Yi Zhang ,  Carlos Alberto Ricci ,  Jeffrey E. Stahmann ,  Aaron R. McCabe ,  Scott A. Meyer ,  Yinghong Yu

IPC分类号： A61B5/0464

CPC分类号： A61B5/04011 ,  A61B5/7203

摘要： Cardiac monitoring and/or stimulation methods and systems provide for monitoring, diagnosing, defibrillation and pacing therapies, or a combination of these capabilities, including cardiac systems incorporating or cooperating with neuro-stimulating devices, drug pumps, or other therapies. Embodiments relate generally to implantable medical devices employing automated cardiac activation sequence monitoring and/or tracking for arrhythmia discrimination. Embodiments are directed to devices and methods involving sensing a plurality of composite cardiac signals using a plurality of implantable electrodes. A source separation is performed using the sensed plurality of composite cardiac signals and the separation produces one or more cardiac signal vectors associated with one or more cardiac activation sequences that is indicative of ischemia. A change of the one or more cardiac signal vectors is detected using the one or more cardiac signal vectors. Cardiac arrhythmias are discriminated using the one or more cardiac signal vectors.

摘要翻译： 心脏监测和/或刺激方法和系统提供监测，诊断，除颤和起搏治疗，或这些能力的组合，包括结合或与神经刺激装置，药物泵或其他疗法组合的心脏系统。 实施例一般涉及使用自动心脏激活序列监测和/或跟踪用于心律失常鉴别的可植入医疗装置。 实施例涉及使用多个可植入电极感测多个复合心脏信号的装置和方法。 使用感测的多个复合心脏信号进行源分离，并且分离产生与指示缺血的一个或多个心脏激活序列相关联的一个或多个心脏信号载体。 使用一个或多个心脏信号矢量检测一个或多个心脏信号矢量的改变。 使用一个或多个心脏信号载体来区分心律失常。

公开(公告)号：US20110137192A1

公开(公告)日：2011-06-09

申请号：US13027608

申请日：2011-02-15

申请人： Yi Zhang ,  Carlos Alberto Ricci ,  Jeffrey E. Stahmann ,  Aaron R. McCabe ,  Scott A. Meyer ,  Yinghong Yu

发明人： Yi Zhang ,  Carlos Alberto Ricci ,  Jeffrey E. Stahmann ,  Aaron R. McCabe ,  Scott A. Meyer ,  Yinghong Yu

IPC分类号： A61B5/0402

CPC分类号： A61B5/04011 ,  A61B5/7203

摘要： Cardiac monitoring and/or stimulation methods and systems provide for monitoring, diagnosing, defibrillation and pacing therapies, or a combination of these capabilities, including cardiac systems incorporating or cooperating with neuro-stimulating devices, drug pumps, or other therapies. Embodiments of the present invention relate generally to implantable medical devices employing automated cardiac activation sequence monitoring and/or tracking for arrhythmia discrimination. Embodiments of the invention are directed to devices and methods involving sensing a plurality of composite cardiac signals using a plurality of implantable electrodes. A source separation is performed using the sensed plurality of composite cardiac signals and the separation produces one or more cardiac signal vectors associated with one or more cardiac activation sequences that is indicative of ischemia. A change of the one or more cardiac signal vectors is detected using the one or more cardiac signal vectors. Cardiac arrhythmias are discriminated using the one or more cardiac signal vectors.

摘要翻译： 心脏监测和/或刺激方法和系统提供监测，诊断，除颤和起搏治疗，或这些功能的组合，包括结合或与神经刺激装置，药物泵或其他疗法组合的心脏系统。 本发明的实施方案一般涉及使用自动心脏激活序列监测和/或跟踪用于心律失常鉴别的可植入医疗装置。 本发明的实施例涉及使用多个可植入电极感测多个复合心脏信号的装置和方法。 使用感测的多个复合心脏信号进行源分离，并且分离产生与指示缺血的一个或多个心脏激活序列相关联的一个或多个心脏信号载体。 使用一个或多个心脏信号矢量检测一个或多个心脏信号矢量的改变。 使用一个或多个心脏信号载体来区分心律失常。

公开(公告)号：US20100298729A1

公开(公告)日：2010-11-25

申请号：US12847657

申请日：2010-07-30

申请人： Yi Zhang ,  Scott A. Meyer ,  Jeffrey E. Stahmann ,  Carlos Alberto Ricci ,  Marina Brockway ,  Aaron R. McCabe ,  Yinghong Yu ,  Donald L. Hopper

发明人： Yi Zhang ,  Scott A. Meyer ,  Jeffrey E. Stahmann ,  Carlos Alberto Ricci ,  Marina Brockway ,  Aaron R. McCabe ,  Yinghong Yu ,  Donald L. Hopper

IPC分类号： A61B5/0452

CPC分类号： A61N1/3702 ,  A61B5/0452 ,  A61B5/7203

摘要： Cardiac monitoring and/or stimulation methods and systems that provide one or more of monitoring, diagnosing, defibrillation, and pacing. Cardiac signal separation is employed to detect, monitor, track and/or trend ischemia using cardiac activation sequence information. Ischemia detection may involve sensing composite cardiac signals using implantable electrodes, and performing a signal separation that produces one or more cardiac activation signal vectors associated with one or more cardiac activation sequences. A change in the signal vector may be detected using subsequent separations. The change may be an elevation or depression of the ST segment of a cardiac cycle or other change indicative of myocardial ischemia, myocardial infarction, or other pathological change. The change may be used to predict, quantify, and/or qualify an event such as an arrhythmia, a myocardial infarction, or other pathologic change. Information associated with the vectors may be stored and used to track the vectors.

摘要翻译： 提供一种或多种监测，诊断，除颤和起搏的心脏监测和/或刺激方法和系统。 使用心脏信号分离来使用心脏激活序列信息来检测，监测，跟踪和/或趋势性缺血。 缺血检测可以涉及使用可植入电极感测复合心脏信号，并且执行产生与一个或多个心脏激活序列相关联的一个或多个心脏激活信号载体的信号分离。 可以使用后续分离来检测信号矢量的变化。 该变化可以是心​​脏周期的ST段的升高或抑制或指示心肌缺血，心肌梗死或其他病理变化的其它变化。 该变化可用于预测，量化和/或限定诸如心律失常，心肌梗死或其它病理变化的事件。 与矢量相关联的信息可以被存储并用于跟踪矢量。

公开(公告)号：US07797036B2

公开(公告)日：2010-09-14

申请号：US11079744

申请日：2005-03-14

申请人： Yi Zhang ,  Scott A. Meyer ,  Jeffrey E. Stahmann ,  Carlos Alberto Ricci ,  Marina Brockway ,  Aaron R. McCabe ,  Yinghong Yu ,  Donald I. Hopper

发明人： Yi Zhang ,  Scott A. Meyer ,  Jeffrey E. Stahmann ,  Carlos Alberto Ricci ,  Marina Brockway ,  Aaron R. McCabe ,  Yinghong Yu ,  Donald I. Hopper

IPC分类号： A61B5/04

CPC分类号： A61N1/3702 ,  A61B5/0452 ,  A61B5/7203

摘要： Cardiac monitoring and/or stimulation methods and systems that provide one or more of monitoring, diagnosing, defibrillation, and pacing. Cardiac signal separation is employed to detect, monitor, track and/or trend ischemia using cardiac activation sequence information. Ischemia detection may involve sensing composite cardiac signals using implantable electrodes, and performing a signal separation that produces one or more cardiac activation signal vectors associated with one or more cardiac activation sequences. A change in the signal vector may be detected using subsequent separations. The change may be an elevation or depression of the ST segment of a cardiac cycle or other change indicative of myocardial ischemia, myocardial infarction, or other pathological change. The change may be used to predict, quantify, and/or qualify an event such as an arrhythmia, a myocardial infarction, or other pathologic change. Information associated with the vectors may be stored and used to track the vectors.

摘要翻译： 提供一种或多种监测，诊断，除颤和起搏的心脏监测和/或刺激方法和系统。 使用心脏信号分离来使用心脏激活序列信息来检测，监测，跟踪和/或趋势性缺血。 缺血检测可以涉及使用可植入电极感测复合心脏信号，并且执行产生与一个或多个心脏激活序列相关联的一个或多个心脏激活信号载体的信号分离。 可以使用后续分离来检测信号矢量的变化。 该变化可以是心​​脏周期的ST段的升高或抑制或指示心肌缺血，心肌梗死或其他病理变化的其它变化。 该变化可用于预测，量化和/或限定诸如心律失常，心肌梗死或其它病理变化的事件。 与矢量相关联的信息可以被存储并用于跟踪矢量。

公开(公告)号：US20110245890A1

公开(公告)日：2011-10-06

申请号：US13071680

申请日：2011-03-25

申请人： Amy Jean Brisben ,  Shibaji Shome ,  Kenneth N. Hayes ,  Yanting Dong ,  Aaron R. McCabe ,  Scott A. Meyer ,  Kevin John Stalsberg

发明人： Amy Jean Brisben ,  Shibaji Shome ,  Kenneth N. Hayes ,  Yanting Dong ,  Aaron R. McCabe ,  Scott A. Meyer ,  Kevin John Stalsberg

IPC分类号： A61N1/08 ,  A61N1/362

CPC分类号： A61N1/36585 ,  A61N1/3712

摘要： An apparatus comprises a cardiac signal sensing circuit, a pacing therapy circuit, and a controller circuit. The controller circuit includes a safety margin calculation circuit. The controller circuit initiates delivery of pacing stimulation energy to the heart using a first energy level, changes the energy level by at least one of: a) increasing the energy from the first energy level until detecting that the pacing stimulation energy induces stable capture, or b) reducing the energy from the first energy level until detecting that the stimulation energy fails to induce capture, and continues changing the stimulation energy level until confirming stable capture or the failure of capture. The safety margin calculation circuit calculates a safety margin of pacing stimulation energy using at least one of a determined stability of a parameter associated with evoked response and a determined range of energy levels corresponding to stable capture or intermittent failure of capture.

摘要翻译： 一种装置包括心脏信号感测电路，起搏治疗电路和控制器电路。 控制器电路包括安全裕度计算电路。 控制器电路使用第一能级开始向心脏传送起搏刺激能量，通过以下至少一种来改变能量水平：a）从第一能量级增加能量直到检测到起搏刺激能量引起稳定的捕获，或 b）减少来自第一能级的能量，直到检测到刺激能量不能诱导捕获，并且继续改变刺激能量水平，直到确认捕获稳定或捕获失败为止。 安全裕度计算电路使用与诱发反应相关联的参数的确定的稳定性以及与捕获的稳定捕获或间歇性故障相对应的能量水平的确定范围中的至少一个来计算起搏刺激能量的安全裕度。