公开(公告)号：WO2010051406A1

公开(公告)日：2010-05-06

申请号：PCT/US2009/062683

申请日：2009-10-30

申请人： MEDTRONIC, INC. ,  BURNES, John, E. ,  KRAUSE, Paul, G. ,  DONOFRIO, William, T. ,  ARNE, Gerald, P. ,  PEICHEL, David, J. ,  ZHOU, Xiaohong ,  REINKE, James, D.

发明人： BURNES, John, E. ,  KRAUSE, Paul, G. ,  DONOFRIO, William, T. ,  ARNE, Gerald, P. ,  PEICHEL, David, J. ,  ZHOU, Xiaohong ,  REINKE, James, D.

IPC分类号： A61N1/36 ,  A61N1/365 ,  A61N1/39 ,  A61N1/362 ,  A61N1/372 ,  A61B5/0452 ,  A61B5/046 ,  A61B5/0464 ,  A61N1/08

CPC分类号： A61N1/36114 ,  A61B5/0424 ,  A61B5/0452 ,  A61B5/046 ,  A61B5/0464 ,  A61B5/7217 ,  A61B2560/0271 ,  A61N1/36185 ,  A61N1/3622 ,  A61N1/365 ,  A61N1/3686 ,  A61N1/37247 ,  A61N1/37288 ,  A61N1/3962 ,  A61N2001/083

摘要： Electrical crosstalk between two implantable medical devices or two different therapy modules of a common implantable medical device may be evaluated, and, in some examples, mitigated. In some examples, one of the implantable medical devices or therapy modules delivers electrical stimulation to a nonmyocardial tissue site or a nonvascular cardiac tissue site, and the other implantable medical device or therapy module delivers cardiac rhythm management therapy to a heart of the patient.

公开(公告)号：WO2010014063A1

公开(公告)日：2010-02-04

申请号：PCT/US2008/009244

申请日：2008-07-31

申请人： MEDTRONIC, INC. ,  ZHANG, Xusheng ,  GHANEM, Raja ,  STADLER, Robert, W.

发明人： ZHANG, Xusheng ,  GHANEM, Raja ,  STADLER, Robert, W.

IPC分类号： A61B5/0464

CPC分类号： A61B5/0464 ,  A61B5/0006 ,  A61B5/7203 ,  A61B5/7239 ,  A61N1/365

摘要： Techniques for determining whether artifacts are present in a cardiac electrogram are described. According to one example, a medical device senses a cardiac electrogram via electrodes. The medical device determines a derivative, e.g., a second order derivative, the electrogram. The medical device detects beats within the derivative, e.g., by comparing a rectified version of the derivative to one or more thresholds determined based on a maximum of the rectified derivative. The medical device determines whether the beats are periodic, and determines whether artifacts are present in the cardiac electrogram based on the determination of whether the beats are periodic. The medical device may further determine whether tachyarrhythmia is present and/or whether the cardiac rhythm of the patient is treatable based on the determination of whether the beats are periodic. For example, the medical device may determine that an electrogram is not treatable when the beats are periodic.

摘要翻译： 描述了用于确定伪像是否存在于心电图中的技术。 根据一个示例，医疗装置通过电极感测心电图。 医疗设备确定导数，例如二阶导数，电描记图。 医疗设备检测导数内的跳动，例如通过将导数的整流版本与基于校正导数的最大值确定的一个或多个阈值进行比较。 医疗器械确定节拍是否是周期性的，并且基于确定节拍是否是周期性的确定来确定心脏电图中是否存在人造物。 医疗装置可以基于是否是周期性的确定来进一步确定是否存在快速性心律失常和/或患者的心律是否可治疗。 例如，当节拍是周期性的时，医疗装置可以确定电描记图是不可治疗的。

公开(公告)号：WO2009149075A1

公开(公告)日：2009-12-10

申请号：PCT/US2009/045959

申请日：2009-06-02

申请人： MEDTRONIC, INC. ,  CHOW, Theodore

发明人： CHOW, Theodore

IPC分类号： A61B5/0464 ,  A61N1/362 ,  A61N1/365

CPC分类号： A61B5/0464 ,  A61B5/0006 ,  A61B5/02405 ,  A61B5/7264 ,  A61N1/365 ,  A61N1/36585 ,  A61N1/36592

摘要： This disclosure describes various techniques for discriminating supraventricular tachycardia (SVT) from ventricular tachycardia (VT). As one example, a method includes detecting a tachycardia rhythm, identifying a rate of change in heart rate corresponding to the tachycardia rhythm, identifying a rate of change in heart rate variability corresponding to the tachycardia rhythm, and classifying the tachycardia rhythm as at least one of supraventricular tachycardia or ventricular tachycardia based on the rate of change in heart rate and rate of change in heart rate variability.

摘要翻译： 本公开描述了用于区分室上性心动过速（SVT）与室性心动过速（VT）的各种技术。 作为一个示例，一种方法包括检测心动过速节律，识别与心动过速节律相对应的心率变化率，确定与心动过速节律相对应的心率变异率的变化率，以及将心动过速节律分类为至少一个 基于心率变化率和心率变异率变化率的室上性心动过速或室性心动过速。

公开(公告)号：WO2009149070A1

公开(公告)日：2009-12-10

申请号：PCT/US2009/045952

申请日：2009-06-02

申请人： MEDTRONIC, INC. ,  CHOW, Theodore

发明人： CHOW, Theodore

IPC分类号： A61B5/0464 ,  A61N1/365

CPC分类号： A61N1/36592 ,  A61B5/0464 ,  A61N1/3627 ,  A61N1/37252

摘要： In some examples, this disclosure describes techniques for assessing hemodynamic intolerance of ventricular pacing. A method comprises sensing a parameter indicative of autonomic tone during a first period in which a medical device delivers ventricular pacing to a patient, sensing the parameter indicative of autonomic tone during a second period in which the medical device does not deliver ventricular pacing to the patient, and assessing a level of change in autonomic tone in the patient induced by ventricular pacing based on values of the sensed parameter during the first and second periods.

摘要翻译： 在一些实例中，本公开描述了用于评估心室起搏的血流动力学不耐受的技术。 一种方法包括在医疗装置向患者提供心室起搏的第一时段期间感测指示自主神经调节的参数，在医疗装置不向患者输送心室起搏的第二时段期间感测指示自主神经调节的参数 并且基于在第一和第二周期期间感测的参数的值来评估由心室起搏引起的患者的自主神经紧张度的变化水平。

公开(公告)号：WO2009124187A1

公开(公告)日：2009-10-08

申请号：PCT/US2009/039298

申请日：2009-04-02

申请人： DRAEGER MEDICAL SYSTEMS, INC. ,  GHODRATI, Alireza

发明人： GHODRATI, Alireza

IPC分类号： A61B5/046 ,  A61B5/0468 ,  A61B5/0464 ,  A61B5/024

CPC分类号： A61B5/024 ,  A61B5/02405 ,  A61B5/0464 ,  A61N1/362 ,  A61N1/39

摘要： A system is provided which processes cardiac condition data representative of heart electrical signals to identify a cardiac condition. An acquisition processor is conditioned for acquiring data representing a sequence of successive pulses of a type of electrical heart waveform of a patient. A computation processor is electrically coupled to the acquisition processor and is conditioned for calculating a pulse interval irregularity measure based on a sum of time interval differences occurring between pairs of successive pulses of the sequence of successive pulses and excluding time interval differences exceeding a predetermined maximum threshold from the sum. The computation processor is further conditioned to compare a calculated pulse interval irregularity measure with a predetermined irregularity measure threshold. An output processor is electrically coupled to the computation processor and conditioned for generating data representing an alarm message in response to the calculated pulse interval irregularity measure exceeding the predetermined threshold.

摘要翻译： 提供了一种系统，其处理表示心脏电信号的心脏状况数据以识别心脏状况。 条件是获取处理器用于获取表示患者的电心脏心脏波形类型的连续脉冲序列的数据。 计算处理器电耦合到采集处理器，并被调节用于基于在连续脉冲序列的连续脉冲对之间出现的时间间隔差的和来计算脉冲间隔不规则度量，并且排除超过预定最大阈值的时间间隔差 从总和。 计算处理器进一步调节为将计算的脉冲间隔不规则度量与预定的不规则度量阈值进行比较。 输出处理器电耦合到计算处理器，并被调节为响应于计算出的超过预定阈值的脉冲间隔不规则度量产生表示报警消息的数据。

公开(公告)号：WO2009114548A1

公开(公告)日：2009-09-17

申请号：PCT/US2009/036690

申请日：2009-03-10

申请人： CORVENTIS, INC. ,  LIBBUS, Imad ,  MANICKA, Yatheendhar, D. ,  AMURTHUR, Badri ,  MAZAR, Scott, T.

发明人： LIBBUS, Imad ,  MAZAR, Scott, T.

IPC分类号： A61B5/02

CPC分类号： A61B5/7275 ,  A61B5/0006 ,  A61B5/0022 ,  A61B5/0031 ,  A61B5/0205 ,  A61B5/02055 ,  A61B5/04085 ,  A61B5/046 ,  A61B5/0464 ,  A61B5/053 ,  A61B5/6833 ,  A61B5/7246 ,  A61B7/04 ,  A61B2560/0412 ,  G06F19/00

摘要： Systems and methods of detecting an impending cardiac decompensation of a patient measure an electrocardiogram signal of the patient. An incidence of cardiac arrhythmias is determined from the electrocardiogram signal. A risk of impending decompensation is determined in response to the incidence of cardiac arrhythmias. In many embodiments, the impending decompensation can be detected early enough to avoid, or at least delay, the impending decompensation, such that patient trauma and/or expensive ICU care can be avoided. Although embodiments make specific reference to monitoring electrocardiogram and other physiological signals with an adherent patch, the system methods and devices are applicable to many applications in which physiological monitoring is used, for example wireless physiological monitoring with implanted sensors for extended periods.

摘要翻译： 检测患者即将到来的心脏代偿失调的系统和方法测量患者的心电图信号。 由心电图信号确定心律失常的发生率。 随着心律失常的发生，确定即将失代偿的风险。 在许多实施方案中，可以提前检测即将发生的代偿失调，以避免或至少延迟即将发生的代偿失调，使得可以避免患者创伤和/或昂贵的ICU护理。 尽管实施例特别参考了使用粘附贴片监测心电图和其他生理信号，但是系统方法和装置可应用于其中使用生理监测的许多应用，例如用植入式传感器进行长时间的无线生理监测。

公开(公告)号：WO2009060374A2

公开(公告)日：2009-05-14

申请号：PCT/IB2008/054565

申请日：2008-11-03

申请人： KONINKLIJKE PHILIPS ELECTRONICS, N.V. ,  RUSSELL, James, K.

发明人： RUSSELL, James, K.

IPC分类号： A61B5/0452 ,  A61N1/39

CPC分类号： A61B5/7221 ,  A61B5/0464 ,  A61N1/046 ,  A61N1/0476 ,  A61N1/0492 ,  A61N1/3925

摘要： A system and method for positioning an electrode for eardiotherapy of atiial arrhythmia are described Signals from patient electrical actiuty for a plurality of electrode locations on a patiem arc analyzed Ao elcctiode can be iepositioned io different locations on the patient to obtain signals from patient electrical actn ity theτefτom Λ human perceptible output indicative of the quality of the signals for the plmalitv of locations is genetated and a final electiode location on {he patient for placement of the electrode for cardiotherapy h identified based on the human perceptible output

摘要翻译： 描述了用于定位用于心律失常心律治疗的电极的系统和方法，描述了患者电活动对患者电弧分析中多个电极位置的患者电活动的信号可以将患者的不同位置上的io电极定位到患者的电活动中获得信号 theteftom？ 人类可感知的输出指示位置信号质量的信号被遗传，并且基于人类可感知的输出识别用于放置用于心脏治疗的电极的患者的最终电位置

公开(公告)号：WO2006052838A3

公开(公告)日：2009-04-16

申请号：PCT/US2005040187

申请日：2005-11-04

申请人： WASHINGTON UNIVERSITY OF ST LO ,  EFIMOV IGOR R ,  KRINSKI VALENTIN I ,  NIKOLSKI VLADIMIR P

发明人： EFIMOV IGOR R ,  KRINSKI VALENTIN I ,  NIKOLSKI VLADIMIR P

IPC分类号： A61N1/00

CPC分类号： A61N1/3987 ,  A61B5/0402 ,  A61B5/0464 ,  A61B5/7239 ,  A61N1/3627 ,  A61N1/39 ,  A61N1/3906 ,  A61N1/3925 ,  A61N1/3962

摘要： A method for extinguishing a cardiac arrhythmia utilizes destructive interference of the passing of the reentry wave tip of an anatomical reentry through a depolarized region created by a relatively low voltage electric field in such a way as to effectively unpin the anatomical reentry. Preferably, the relatively low voltage electric field is defined by at least one unpinning shock(s) that are lower than an expected lower limit of vulnerability as established, for example, by a defibrillation threshold test. By understanding the physics of the electric field distribution between cardiac cells, the method permits the delivery of an electric field sufficient to unpin the core of the anatomical reentry, whether the precise or estimated location of the reentry is known or unknown and without the risk of inducting ventricular fibrillation. A number of embodiments for performing the method are disclosed.

摘要翻译： 用于扑灭心律失常的方法利用解剖复位的折回波尖通过由相对低电压电场产生的去极化区域的破坏性干扰，以有效地解除解剖学折返。 优选地，相对低电压的电场通过至少一个比例如通过除颤阈值测试所建立的低于预期的脆弱性下限的绝对冲击来定义。 通过理解心脏细胞之间的电场分布的物理学，该方法允许输送足够的电场以解开再解剖核心的核心，无论确切的或估计的再入位置是已知的还是未知的，并且没有风险 诱导室颤。 公开了用于执行该方法的多个实施例。

公开(公告)号：WO2009045852A1

公开(公告)日：2009-04-09

申请号：PCT/US2008/077708

申请日：2008-09-25

申请人： UNIVERSITY OF MARYLAND, BALTIMORE ,  SABA, Magdi M. ,  SHOROFSKY, Stephen R.

发明人： SABA, Magdi M. ,  SHOROFSKY, Stephen R.

IPC分类号： A61B5/0464 ,  A61B5/04

CPC分类号： A61B5/0464 ,  A61B5/04011

摘要： Techniques include determining a first vector of temporal changes in electrical data measured at multiple electrical sensors positioned at corresponding locations on a surface of a living body due to a natural electrical pulse. A different vector of temporal changes in electrical data measured at the same electrical sensors is determined due to each stimulated signal of multiple stimulated signals within the living body. Stimulated position data is received, which indicates a different corresponding position within the living body where each of the stimulated signals originates. The site of origin of the natural electrical pulse is determined based on the first vector and the multiple different vectors and the stimulated position data. Among other applications, these techniques allow the rapid, automatic determination of the site of origin of ventricular tachycardia arrhythmia (VT).

摘要翻译： 技术包括确定由于自然电脉冲而在位于生物体表面上的相应位置处的多个电传感器处测量的电数据的时间变化的第一矢量。 由于在活体内的多个受激信号的每个受激信号，确定在相同的电传感器处测量的电数据的时间变化的不同矢量。 受刺激的位置数据被接收，其表示生物体内每个受激信号起源的不同对应位置。 基于第一矢量和多个不同矢量以及受刺激的位置数据确定自然电脉冲的原点。 在其他应用中，这些技术允许快速，自动确定室性心动过速心律失常（VT）的起源部位。

公开(公告)号：WO2008146029A2

公开(公告)日：2008-12-04

申请号：PCT/GB2008/001895

申请日：2008-06-02

申请人： KING'S COLLEGE LONDON ,  CURTIS, Michael, J. ,  SHATTOCK, Michael, Jonathan ,  FARKAS, Andras

发明人： CURTIS, Michael, J. ,  SHATTOCK, Michael, Jonathan ,  FARKAS, Andras

IPC分类号： A61N1/00

CPC分类号： A61B5/0402 ,  A61B5/0464

摘要： The invention provides a method of producing a model of cardiac arrhythmias, by applying agents stimulating both the sympathetic and the parasympathetic receptors, or downstream autonomic signalling pathways, in an isolated heart. The resulting model may be used for screening agents for their propensity to cause and to treat cardiac arrhythmias.

摘要翻译： 本发明提供了通过在分离的心脏中施用刺激交感神经和副交感神经受体或下游自主信号传导途径的试剂来产生心律失常模型的方法。 所得到的模型可用于筛选试剂引起和治疗心律失常的倾向。