公开(公告)号：US08527064B2

公开(公告)日：2013-09-03

申请号：US12327601

申请日：2008-12-03

申请人： Yunlong Zhang ,  Haresh G. Sachanandani ,  Dan Li ,  Bin Mi

发明人： Yunlong Zhang ,  Haresh G. Sachanandani ,  Dan Li ,  Bin Mi

IPC分类号： A61N1/36

CPC分类号： A61N1/0587 ,  A61B5/4035 ,  A61B5/6862 ,  A61B5/6876 ,  A61N1/057 ,  A61N1/36114 ,  A61N1/36117 ,  A61N1/3627 ,  A61N1/37211 ,  A61N1/37288

摘要： Various implantable medical device embodiments stimulate an autonomic neural target from within a pulmonary artery, and comprise at least one electrode, a power supply, a neural stimulator connected to the power supply, and an anchor structure. The neural stimulator is configured to generate a neural stimulation signal for delivery to the neural stimulation target through the at least one electrode. The anchor structure is configured to chronically and securely implant the neural stimulator, the power supply and the at least one electrode within the pulmonary artery. The anchor structure, the neural stimulator, the power supply and the at least one electrode are configured to be implanted through a pulmonary valve into the pulmonary artery. In various embodiments, the neural stimulator is configured to be operational to implement a neural stimulation protocol when chronically implanted within the pulmonary artery without a wired connection through the pulmonary valve.

摘要翻译： 各种可植入医疗装置实施例从肺动脉内刺激自主神经靶标，并且包括至少一个电极，电源，连接到电源的神经刺激器和锚结构。 神经刺激器被配置为产生神经刺激信号，以通过至少一个电极传递到神经刺激靶。 锚结构被配置为长期且牢固地植入神经刺激器，电源和至少一个电极在肺动脉内。 锚结构，神经刺激器，电源和至少一个电极构造成通过肺动脉瓣植入肺动脉。 在各种实施例中，神经刺激器被配置为在长期植入肺动脉内而不通过肺动脉瓣的有线连接的情况下实施神经刺激方案。

公开(公告)号：US20090228078A1

公开(公告)日：2009-09-10

申请号：US12327601

申请日：2008-12-03

申请人： Yunlong Zhang ,  Haresh G. Sachanandani ,  Dan Li ,  Bin Mi

发明人： Yunlong Zhang ,  Haresh G. Sachanandani ,  Dan Li ,  Bin Mi

IPC分类号： A61N1/36

CPC分类号： A61N1/0587 ,  A61B5/4035 ,  A61B5/6862 ,  A61B5/6876 ,  A61N1/057 ,  A61N1/36114 ,  A61N1/36117 ,  A61N1/3627 ,  A61N1/37211 ,  A61N1/37288

摘要： Various implantable medical device embodiments stimulate an autonomic neural target from within a pulmonary artery, and comprise at least one electrode, a power supply, a neural stimulator connected to the power supply, and an anchor structure. The neural stimulator is configured to generate a neural stimulation signal for delivery to the neural stimulation target through the at least one electrode. The anchor structure is configured to chronically and securely implant the neural stimulator, the power supply and the at least one electrode within the pulmonary artery. The anchor structure, the neural stimulator, the power supply and the at least one electrode are configured to be implanted through a pulmonary valve into the pulmonary artery. In various embodiments, the neural stimulator is configured to be operational to implement a neural stimulation protocol when chronically implanted within the pulmonary artery without a wired connection through the pulmonary valve.

摘要翻译： 各种可植入医疗装置实施例从肺动脉内刺激自主神经靶标，并且包括至少一个电极，电源，连接到电源的神经刺激器和锚结构。 神经刺激器被配置为产生神经刺激信号，以通过至少一个电极传递到神经刺激靶。 锚结构被配置为长期且牢固地植入神经刺激器，电源和至少一个电极在肺动脉内。 锚结构，神经刺激器，电源和至少一个电极构造成通过肺动脉瓣植入肺动脉。 在各种实施例中，神经刺激器被配置为在长期植入肺动脉内而不通过肺动脉瓣的有线连接的情况下实施神经刺激方案。

公开(公告)号：US20100056931A1

公开(公告)日：2010-03-04

申请号：US12543227

申请日：2009-08-18

申请人： Leah Soffer ,  Haresh G. Sachanandani ,  Bin Mi ,  Yunlong Zhang

发明人： Leah Soffer ,  Haresh G. Sachanandani ,  Bin Mi ,  Yunlong Zhang

IPC分类号： A61B5/0215 ,  A61B5/029

CPC分类号： A61B5/029 ,  A61B5/0002 ,  A61B5/02028 ,  A61B5/02116 ,  A61B5/0215

摘要： A system and method sense a pressure signal in a pulmonary artery and compute a stroke volume and cardiac output. A pressure signal is received from an implantable pressure sensor disposed in a pulmonary artery. The pressure signal includes a systolic period and a diastolic period for determining a heart rate (HR) and a heart cycle. An iteratively-updating model can relate pressure signal and HR to a stroke volume (SV) and a cardiac output (CO). The model extracts a mean pulse pressure (MPP) from the PAP signal and receives a patient-specific vascular resistance model parameter and a patient-specific arterial compliance model parameter. CO can be calculated using the HR, the PAP signal, and the model. The vascular resistance model parameter and the arterial compliance model parameter are iteratively updated using the output of the model.

摘要翻译： 系统和方法检测肺动脉中的压力信号并计算出行程体积和心输出量。 从设置在肺动脉中的可植入压力传感器接收压力信号。 压力信号包括用于确定心率（HR）和心脏周期的收缩期和舒张期。 迭代更新模型可以将压力信号和HR相关联到行程体积（SV）和心输出量（CO）。 该模型从PAP信号中提取平均脉压（MPP），并接收患者特异性血管阻力模型参数和患者特异性动脉顺应性模型参数。 CO可以使用HR，PAP信号和模型来计算。 使用模型的输出迭代地更新血管阻力模型参数和动脉顺应性模型参数。

公开(公告)号：US20090149719A1

公开(公告)日：2009-06-11

申请号：US12257296

申请日：2008-10-23

申请人： Ramesh Wariar ,  Yunlong Zhang ,  Haresh G. Sachanandani

发明人： Ramesh Wariar ,  Yunlong Zhang ,  Haresh G. Sachanandani

IPC分类号： A61B5/00

CPC分类号： A61B5/0002 ,  A61B5/022 ,  A61B5/0402 ,  A61B5/0476 ,  A61B5/0531 ,  A61B5/091 ,  A61B5/7275 ,  A61B5/7475 ,  G06F19/3418 ,  G16H10/20

摘要： A system and method for integrating qualitative assessment into remote patient management through a visual analog scale is provided. A query is associated to a physiological condition. A visual analog scale includes a linear gradient and, at each end, descriptors for a range of subjective and continuous responses to the query. Assessment data for a patient is obtained. A medical device of the patient is interrogated and stored data is received. The query is displayed with the visual analog scale. An answer to the query includes a point selected between the ends of and along the linear gradient. A distance of the point from one end of the linear gradient is determined. The distance is quantified as a fixed value in proportion to the distance. A risk to the patient is assessed. The stored data and the fixed value are analyzed against the physiological condition to represent patient wellness.

摘要翻译： 提供了一种通过视觉模拟量表将定性评估整合到远程患者管理中的系统和方法。 查询与生理条件相关联。 视觉模拟量表包括线性梯度，并且在每一端都有一系列对查询的主观和连续响应的描述符。 获得患者的评估数据。 询问患者的医疗装置并接收存储的数据。 查询以视觉模拟量表显示。 查询的答案包括在线性渐变的两端之间选择的点。 确定从线性梯度的一端的点的距离。 距离被量化为与距离成比例的固定值。 评估患者的风险。 根据生理条件分析存储的数据和固定值以表示患者健康。

公开(公告)号：US08417325B2

公开(公告)日：2013-04-09

申请号：US12249817

申请日：2008-10-10

申请人： Haresh G. Sachanandani ,  Yunlong Zhang

发明人： Haresh G. Sachanandani ,  Yunlong Zhang

IPC分类号： A61B5/04

CPC分类号： A61B5/7275 ,  A61B5/0002 ,  A61B5/02 ,  A61B5/02028 ,  A61B5/0205 ,  A61B5/021 ,  A61B5/02405 ,  A61B5/02455 ,  A61B5/029 ,  A61B5/0408 ,  A61B5/042 ,  A61B5/0538 ,  A61B5/08 ,  A61B5/0816 ,  A61B5/087 ,  A61B5/1118 ,  A61B5/145 ,  A61B5/14532 ,  A61B5/686 ,  A61B5/7264 ,  A61B5/7282 ,  A61B7/02 ,  A61B7/04 ,  A61N1/3627 ,  A61N1/3704 ,  A61N1/3956 ,  G06F19/00

摘要： This document discusses, among other things, a system comprising a sensor signal processor configured to receive a plurality of electrical sensor signals produced by a plurality of sensors and at least one sensor signal produced by an implantable sensor, a memory that includes information indicating a co-morbidity of a subject, a sensor signal selection circuit that selects a sensor signal to monitor from among the plurality of sensor signals, according to an indicated co-morbidity, a threshold adjustment circuit that adjusts a detection threshold of the selected sensor signal according to the indicated co-morbidity, and a decision circuit that applies the adjusted detection threshold to the selected sensor signal to determine whether an event associated with worsening heart failure (HF) occurred in the subject and outputs an indication of whether the event associated with worsening HF occurred to a user or process.

公开(公告)号：US20090099426A1

公开(公告)日：2009-04-16

申请号：US12249817

申请日：2008-10-10

申请人： Haresh G. Sachanandani ,  Yunlong Zhang

发明人： Haresh G. Sachanandani ,  Yunlong Zhang

IPC分类号： A61B5/02

CPC分类号： A61B5/7275 ,  A61B5/0002 ,  A61B5/02 ,  A61B5/02028 ,  A61B5/0205 ,  A61B5/021 ,  A61B5/02405 ,  A61B5/02455 ,  A61B5/029 ,  A61B5/0408 ,  A61B5/042 ,  A61B5/0538 ,  A61B5/08 ,  A61B5/0816 ,  A61B5/087 ,  A61B5/1118 ,  A61B5/145 ,  A61B5/14532 ,  A61B5/686 ,  A61B5/7264 ,  A61B5/7282 ,  A61B7/02 ,  A61B7/04 ,  A61N1/3627 ,  A61N1/3704 ,  A61N1/3956 ,  G06F19/00

摘要： This document discusses, among other things, a system comprising a sensor signal processor configured to receive a plurality of electrical sensor signals produced by a plurality of sensors and at least one sensor signal produced by an implantable sensor, a memory that includes information indicating a co-morbidity of a subject, a sensor signal selection circuit that selects a sensor signal to monitor from among the plurality of sensor signals, according to an indicated co-morbidity, a threshold adjustment circuit that adjusts a detection threshold of the selected sensor signal according to the indicated co-morbidity, and a decision circuit that applies the adjusted detection threshold to the selected sensor signal to determine whether an event associated with worsening heart failure (HF) occurred in the subject and outputs an indication of whether the event associated with worsening HF occurred to a user or process.

摘要翻译： 该文件尤其涉及一种包括传感器信号处理器的系统，该传感器信号处理器被配置为接收由多个传感器产生的多个电传感器信号和由可植入传感器产生的至少一个传感器信号，存储器包括指示co 根据所指示的并发症，从所述多个传感器信号中选择要监视的传感器信号的传感器信号选择电路，根据所述传感器信号选择电路调整所选择的传感器信号的检测阈值的阈值调整电路， 指示的并发症，以及决定电路，其将所调整的检测阈值应用于所选择的传感器信号，以确定与受试者中是否发生与恶化的心力衰竭（HF）有关的事件，并且输出与恶化HF相关的事件的指示 发生在用户或进程。

公开(公告)号：US20090234211A1

公开(公告)日：2009-09-17

申请号：US12402224

申请日：2009-03-11

申请人： Dan Li ,  Haresh G. Sachanandani ,  Michael John Kane ,  Yi Zhang

发明人： Dan Li ,  Haresh G. Sachanandani ,  Michael John Kane ,  Yi Zhang

IPC分类号： A61B5/1468 ,  A61B5/04

CPC分类号： A61B5/0402 ,  A61B5/0468 ,  A61B5/14532 ,  A61B5/14546 ,  A61B5/1459 ,  A61N1/3627 ,  A61N1/36585

摘要： Embodiments of the invention are related to devices and methods for myocardial ischemia detection, amongst other things. In an embodiment, the invention includes an implantable medical device including control circuitry, an electrical field sensor in communication with the control circuitry, the electrical field sensor configured to generate a signal corresponding to cardiac electrical fields. The implantable medical device can also include a chemical sensor in communication with the control circuitry, the chemical sensor configured to generate a signal corresponding to the concentration of a physiological analyte that affects cardiac electrical field waveform morphology. The control circuitry can be configured to monitor for the presence of myocardial ischemia by evaluating both the signal generated by the electrical field sensor and the signal generated by the chemical sensor. Other embodiments are also included herein.

摘要翻译： 本发明的实施方案涉及用于心肌缺血检测的装置和方法等。 在一个实施例中，本发明包括可植入医疗装置，其包括控制电路，与控制电路通信的电场传感器，电场传感器被配置为产生对应于心​​脏电场的信号。 可植入医疗装置还可以包括与控制电路通信的化学传感器，化学传感器被配置为产生对应于影响心电场波形形态的生理分析物的浓度的信号。 控制电路可以被配置为通过评估由电场传感器产生的信号和由化学传感器产生的信号来监测是否存在心肌缺血。 本文还包括其它实施例。

公开(公告)号：US20090043355A1

公开(公告)日：2009-02-12

申请号：US11835812

申请日：2007-08-08

申请人： Shelley M. Cazares ,  Haresh G. Sachanandani ,  Benjamin Ettori ,  Dan Li ,  Yanting Dong

发明人： Shelley M. Cazares ,  Haresh G. Sachanandani ,  Benjamin Ettori ,  Dan Li ,  Yanting Dong

IPC分类号： A61N1/02

CPC分类号： A61N1/37282 ,  A61B5/0031 ,  A61N1/3627 ,  A61N1/36585 ,  G06F19/00 ,  G06F19/3418 ,  G16H40/63

摘要： A system evaluates the performance of an implantable medical device, such as by using a remote external server and a user interface and stored historical physiological data of a population of congestive heart failure (CHF) patients. A processor is coupled to a patient data storage device to apply multiple algorithm variations against the same implantable physiological data from the patient to produce corresponding resulting CHF indicators. The user interface includes a display that is configured to display to a user information allowing comparison between the resulting CHF indicators from the multiple algorithm variations. The display also includes a population data selector to permit the user to select physiological data from a population that includes a different set of one or more patients or physiological data collected over a period of time from the patient. This permits optimization of an algorithm parameter or selection of a best performing algorithm.

摘要翻译： 系统评估可植入医疗装置的性能，例如通过使用远程外部服务器和用户界面以及存储充血性心力衰竭（CHF）患者群体的历史生理数据。 处理器耦合到患者数据存储装置，以对来自患者的相同的可植入生理数据应用多个算法变化，以产生相应的所得CHF指示符。 用户界面包括被配置为向用户显示信息的显示器，允许根据多个算法变化比较所得到的CHF指示符。 显示器还包括种群数据选择器，以允许用户从包括不同组的一个或多个患者或在患者的一段时间内收集的生理数据的群体中选择生理数据。 这允许优化算法参数或选择最佳执行算法。

公开(公告)号：US08864677B2

公开(公告)日：2014-10-21

申请号：US12402224

申请日：2009-03-11

申请人： Dan Li ,  Haresh G. Sachanandani ,  Michael John Kane ,  Yi Zhang

发明人： Dan Li ,  Haresh G. Sachanandani ,  Michael John Kane ,  Yi Zhang

IPC分类号： A61B5/02 ,  A61B5/04 ,  A61B5/145 ,  A61N1/362 ,  A61B5/0468 ,  A61N1/365 ,  A61B5/1459 ,  A61B5/0402

CPC分类号： A61B5/0402 ,  A61B5/0468 ,  A61B5/14532 ,  A61B5/14546 ,  A61B5/1459 ,  A61N1/3627 ,  A61N1/36585

摘要： Embodiments of the invention are related to devices and methods for myocardial ischemia detection, amongst other things. In an embodiment, the invention includes an implantable medical device including control circuitry, an electrical field sensor in communication with the control circuitry, the electrical field sensor configured to generate a signal corresponding to cardiac electrical fields. The implantable medical device can also include a chemical sensor in communication with the control circuitry, the chemical sensor configured to generate a signal corresponding to the concentration of a physiological analyte that affects cardiac electrical field waveform morphology. The control circuitry can be configured to monitor for the presence of myocardial ischemia by evaluating both the signal generated by the electrical field sensor and the signal generated by the chemical sensor. Other embodiments are also included herein.

摘要翻译： 本发明的实施方案涉及用于心肌缺血检测的装置和方法等。 在一个实施例中，本发明包括可植入医疗装置，其包括控制电路，与控制电路通信的电场传感器，电场传感器被配置为产生对应于心​​脏电场的信号。 可植入医疗装置还可以包括与控制电路通信的化学传感器，化学传感器被配置为产生对应于影响心电场波形形态的生理分析物的浓度的信号。 控制电路可以被配置为通过评估由电场传感器产生的信号和由化学传感器产生的信号来监测是否存在心肌缺血。 本文还包括其它实施例。

公开(公告)号：US08036735B2

公开(公告)日：2011-10-11

申请号：US11835812

申请日：2007-08-08

申请人： Shelley M. Cazares ,  Haresh G. Sachanandani ,  Benjamin Ettori ,  Dan Li ,  Yanting Dong

发明人： Shelley M. Cazares ,  Haresh G. Sachanandani ,  Benjamin Ettori ,  Dan Li ,  Yanting Dong

IPC分类号： A61B5/044 ,  A61B5/0452

CPC分类号： A61N1/37282 ,  A61B5/0031 ,  A61N1/3627 ,  A61N1/36585 ,  G06F19/00 ,  G06F19/3418 ,  G16H40/63

摘要： A system evaluates the performance of an implantable medical device, such as by using a remote external server and a user interface and stored historical physiological data of a population of congestive heart failure (CHF) patients. A processor is coupled to a patient data storage device to apply multiple algorithm variations against the same implantable physiological data from the patient to produce corresponding resulting CHF indicators. The user interface includes a display that is configured to display to a user information allowing comparison between the resulting CHF indicators from the multiple algorithm variations. The display also includes a population data selector to permit the user to select physiological data from a population that includes a different set of one or more patients or physiological data collected over a period of time from the patient. This permits optimization of an algorithm parameter or selection of a best performing algorithm.

摘要翻译： 系统评估可植入医疗装置的性能，例如通过使用远程外部服务器和用户界面以及存储充血性心力衰竭（CHF）患者群体的历史生理数据。 处理器耦合到患者数据存储装置，以对来自患者的相同的可植入生理数据应用多个算法变化，以产生相应的所得CHF指示符。 用户界面包括被配置为向用户显示信息的显示器，允许根据多个算法变化比较所得到的CHF指示符。 显示器还包括种群数据选择器，以允许用户从包括不同组的一个或多个患者或在患者的一段时间内收集的生理数据的群体中选择生理数据。 这允许优化算法参数或选择最佳执行算法。