公开(公告)号：WO2012057662A1

公开(公告)日：2012-05-03

申请号：PCT/SE2010/051165

申请日：2010-10-27

Applicant: ST. JUDE MEDICAL AB ,  BLOMQVIST, Andreas

Inventor： BLOMQVIST, Andreas

IPC: A61N1/365 ,  A61N1/362 ,  A61N1/368

CPC classification number: A61N1/36585 ,  A61N1/3627 ,  A61N1/3684

Abstract: An implantable medical device, IMD, (100) conducts CRT settings searches at multiple CRT settings search periods during an optimization time period by testing different candidate CRT settings and selecting the optimal CRT setting based on output signals of a hemodynamic sensor (240). The respective optimal CRT settings determined during the optimization time period are employed in order to predict at least one future optimal CRT setting that can be used by the IMD (100) following the end of the optimization time period. The IMD (100) then generates and applies pacing pulses to a subject's (5) heart (10) according to a CRT setting of the at least one future optimal CRT setting. The embodiments therefore enable efficient cardiac resynchronization therapy without any sensor readings after the end of the optimization time period and can therefore provide cardiac resynchronization therapy even if the hemodynamic sensor (240) becomes inoperable.

Abstract translation: 可植入医疗装置IMD（100）通过测试不同的候选CRT设置并且基于血流动力学传感器（240）的输出信号选择最佳CRT设置，在优化时间段期间在多个CRT设置搜索周期进行CRT设置搜索。 采用在优化时间周期期间确定的各个最佳CRT设置，以便在优化时间段结束之后预测可由IMD（100）使用的至少一个未来最佳CRT设置。 IMD（100）然后根据至少一个未来最佳CRT设置的CRT设置产生和应用起搏脉冲到对象的（5）心脏（10）。 因此，实施例能够在优化时间段结束之后进行有效的心脏再同步治疗，而无需任何传感器读数，并且因此即使血液动力学传感器（240）变得不可操作也可以提供心脏再同步治疗。

公开(公告)号：WO2010131998A1

公开(公告)日：2010-11-18

申请号：PCT/SE2009/000244

申请日：2009-05-13

Applicant: ST. JUDE MEDICAL AB ,  BLOMQVIST, Andreas

Inventor： BLOMQVIST, Andreas

IPC: A61B5/053 ,  A61N1/368

CPC classification number: A61B5/1102 ,  A61B5/053 ,  A61B5/0538 ,  A61B5/6869 ,  A61N1/3627 ,  A61N1/36521 ,  A61N1/3684

Abstract: The present invention generally relates to implantable medical devices, such as bi-ventricular pacemakers, and, in particular, to techniques for such devices for detecting and monitoring mechanical dyssynchronicity of the heart. A dyssynchronicity measure indicating a degree of mechanical dyssynchronicity of a heart of a patient is calculated. A first intracardiac impedance set is measured using electrodes placed such that the first intracardiac impedance set substantially reflects a mechanical activity of the left side of the heart and a second intracardiac impedance set is measure using electrodes placed such that the second intracardiac impedance set substantially reflects a mechanical activity of the right side of the heart. The measure of a dyssynchronicity is calculated based on a resulting parameter set from a comparison between at least a subset of the first and the second impedance sets, respectively, the subsets containing information of the mechanical systole, wherein a reduced dyssynchronicity measure corresponds to an improved synchronicity between the right side and the left side of heart.

Abstract translation: 本发明一般涉及诸如双心室起搏器的可植入医疗装置，特别涉及用于检测和监测心脏的机械不同步性的这种装置的技术。 计算表示患者心脏的机械不同步度的不同步性度量。 使用放置使得第一心内阻抗设定基本上反映心脏左侧的机械活动的电极来测量第一心内阻抗集，并且使用放置的第二心内阻抗设定的电极来测量第二心内阻抗集， 心脏右侧的机械活动。 基于从第一和第二阻抗组的至少一个子集之间的比较的结果参数集计算包含机械收缩信息的子集，其中减少的不同步度测量对应于改进的 心脏右侧和左侧的同步性。

公开(公告)号：WO2008118041A1

公开(公告)日：2008-10-02

申请号：PCT/SE2007/000288

申请日：2007-03-23

Applicant: ST. JUDE MEDICAL AB ,  HOLMSTRÖM, Nils ,  ÖHLANDER, Malin ,  NOREN, Kjell ,  BLOMQVIST, Andreas ,  LJUNGSTRÖM, Karin

Inventor： HOLMSTRÖM, Nils ,  ÖHLANDER, Malin ,  NOREN, Kjell ,  BLOMQVIST, Andreas ,  LJUNGSTRÖM, Karin

IPC: A61N1/365 ,  A61N1/37

CPC classification number: A61N1/36521 ,  A61B5/0215 ,  A61B5/02405 ,  A61B5/053 ,  A61B5/4035 ,  A61B5/4836 ,  A61B5/7257 ,  A61N1/36564 ,  A61N1/36578 ,  A61N1/36592 ,  A61N1/3702

Abstract: An implantable cardiac device comprises a heart stimulator (10, 12) for electricly stimulating the heart of a patient, detecting means (2, 4) for measuring a physiologic parameter which is affected by the status of a cardiovascular disease associated with sympathetic activation, signal processing means (6) for determining at least one of a low frequency, LF, and a very low frequency, VLF, Mayer wave component in the measured parameter, and an analysor for analyzing the determined Mayer wave component in relation to a predetermined reference value to determine the status of the cardiovascular disease. The detecting means comprise measuring means (2) arranged to measure, as said physiologic parameter, a mechanical change in at least one of the four chambers of the heart. In a corresponding method for monitoring the status of a cardiovascular disease associated with sympathetic activation of a patient having an implantable electric heart stimulator (10, 12) a physiologic parameter affected by the cardiac disease is measured. At least one of a low frequency, LF, and a very low frequency, VLF, Mayer wave component in the parameter is determined, and the wave component is analysed in relation to a predetermined reference value to determine the status of the cardiovascular disease. A mechanical change in at least one of the four chambers of the heart is measured as the physiologic parameter.

Abstract translation: 可植入心脏装置包括用于电刺激患者心脏的心脏刺激器（10,12），用于测量受到与交感神经激活相关的心血管疾病状态影响的生理参数的检测装置（2,4），信号 用于确定所测量的参数中的低频，低频和极低频，伏尔伏特梅耶波分量中的至少一个的处理装置（6），以及用于相对于预定参考值分析所确定的梅尔波分量的分析器 以确定心血管疾病的状况。 检测装置包括测量装置（2），其被布置成根据所述生理参数测量心脏的四个腔室中的至少一个中的机械变化。 在用于监测与具有可植入电心脏刺激器（10,12）的患者的交感神经激活相关的心血管疾病的状态的相应方法中，测量受心脏病影响的生理参数。 确定参数中的低频，低频和极低频VLF，梅耶波分量中的至少一个，并且相对于预定参考值分析波分量以确定心血管疾病的状态。 测量心脏四个腔室中的至少一个的机械变化作为生理参数。

公开(公告)号：WO2007081248A1

公开(公告)日：2007-07-19

申请号：PCT/SE2006/000063

申请日：2006-01-16

Applicant: ST. JUDE MEDICAL AB ,  BLOMQVIST, Andreas ,  BJÖRLING, Anders

Inventor： BLOMQVIST, Andreas ,  BJÖRLING, Anders

IPC: A61N1/37

CPC classification number: A61N1/371

Abstract: The invention concerns an implantable heart stimulating device (10) including a con- trol circuit (14) comprising a first ventricular pacing circuit (37) adapted to enable pac ing of a ventricle (IV) and a first ventricular sensing circuit (35), adapted to communicate with one or more sensing electrodes or sensors (31, 32, 33). The control circuit (14) is arranged to be able to detect an evoked response to delivered pacing pulses by sensing within a first time window (ERl) that follows after a delivered pacing pulse. The control circuit (14) is arranged to be able to detect said evoked response with at least a first and a second evoked response detection method. The invention also concerns a method of operating an implantable heart stimulating device.

Abstract translation: 本发明涉及可植入心脏刺激装置（10），其包括控制电路（14），该控制电路包括适于使得能够平衡心室（IV）和第一心室感测电路（35）的第一心室起搏电路（37） 适于与一个或多个感测电极或传感器（31,32,33）通信。 控制电路（14）被布置成能够通过在传送的起搏脉冲之后的第一时间窗（ER1）中感测来检测对发出的起搏脉冲的诱发响应。 控制电路（14）被布置成能够利用至少第一和第二诱发响应检测方法来检测所述诱发响应。 本发明还涉及一种操作可植入心脏刺激装置的方法。

公开(公告)号：WO2012175105A1

公开(公告)日：2012-12-27

申请号：PCT/EP2011/060200

申请日：2011-06-20

Applicant: ST. JUDE MEDICAL AB ,  BLOMQVIST, Andreas ,  NORÈN, Kjell

Inventor： BLOMQVIST, Andreas ,  NORÈN, Kjell

IPC: A61N1/365 ,  A61B5/0215

CPC classification number: A61B5/02028 ,  A61B5/0215 ,  A61B5/04012 ,  A61B5/0422 ,  A61B5/0472 ,  A61B5/7239 ,  A61N1/36514 ,  A61N1/36564

Abstract: Cardiac valve events are monitored by recording a left atrial pressure (LAP) representing signal using an implantable pressure sensor (50). The LAP signal is processed in order to generate a derivative LAP signal representative of the first time derivative of the LAP signal. The opening of the aortic valve of the heart is then identified to coincide in time with a minimum in the derivative LAP signal following ventricular depolarization in a cardiac cycle.

Abstract translation: 通过使用可植入压力传感器（50）记录表示信号的左心房压力（LAP）来监测心脏瓣膜事件。 处理LAP信号以产生代表LAP信号的第一时间导数的导数LAP信号。 然后心脏的主动脉瓣的开口被确定为在心脏周期中心室去极化后的衍生LAP信号中的时间上的最小值。

公开(公告)号：WO2012072104A1

公开(公告)日：2012-06-07

申请号：PCT/EP2010/068472

申请日：2010-11-30

Applicant: ST. JUDE MEDICAL AB ,  BLOMQVIST, Andreas ,  PERSSON, Torbjörn ,  HILL, Rolf

Inventor： BLOMQVIST, Andreas ,  PERSSON, Torbjörn ,  HILL, Rolf

IPC: A61N1/365 ,  A61N1/362

CPC classification number: A61N1/365 ,  A61N1/3627 ,  A61N1/36585 ,  A61N1/3682 ,  A61N1/3684

Abstract: The present invention relates generally to methods for implantable medical devices and more particularly to methods for optimizing stimulation of a heart of a patient. The method comprises: determining recommended pacing settings including recommended AV delays and/or recommended W delays based on IEGM data. Further, at least one hemodynamical parameter is determined based on measured at least one hemodynamical signal. Reference pacing settings are determined including reference AV delays and/or reference W delays based on said hemodynamical parameters. An AV delay correction value and a W delay correction value are calculated as a difference between recommended AV and/or VV delays and reference AV and/or W delays, respectively. The correction values are used for updating recommended AV and/or VV delays, respectively.

Abstract translation: 本发明一般涉及可植入医疗装置的方法，更具体地涉及用于优化患者心脏的刺激的方法。 该方法包括：基于IEGM数据确定推荐的起搏设置，包括推荐的AV延迟和/或推荐的W延迟。 此外，基于测量的至少一个血液动力学信号来确定至少一个血液动力学参数。 基于所述血流动力学参数确定参考起搏设置，包括参考AV延迟和/或参考W延迟。 AV延迟校正值和W延迟校正值分别被计算为推荐的AV和/或VV延迟与参考AV和/或W延迟之间的差。 校正值分别用于更新推荐的AV和/或VV延迟。

公开(公告)号：WO2010062224A1

公开(公告)日：2010-06-03

申请号：PCT/SE2008/000671

申请日：2008-11-28

Applicant: ST. JUDE MEDICAL AB ,  JÄRVERUD, Karin ,  BLOMQVIST, Andreas

Inventor： JÄRVERUD, Karin ,  BLOMQVIST, Andreas

IPC: A61N1/37

CPC classification number: A61B5/0422 ,  A61B5/02028 ,  A61B5/04012 ,  A61B5/042 ,  A61B5/0432 ,  A61B5/076 ,  A61B5/4836 ,  A61B5/686 ,  A61B2562/0214 ,  A61B2562/227 ,  A61N1/3627 ,  A61N1/36521 ,  A61N1/368 ,  A61N1/3682 ,  A61N1/3684 ,  A61N1/3702

Abstract: An implantable medical device (100) comprises an impedance processor (130) for determining atrial impedance data reflective of the cardiogenic impedance of an atrium (12, 14) of a heart (10) during diastole and/or systole of heart cycle. Ventricular impedance data reflective of the cardiogenic impedance of a ventricle (16, 18) during diastole and/or systole is also determined. The determined impedance data is processed by a representation processor (140) for estimating a diastolic and/ or a systolic atrial impedance representation and a diastolic and/ or a systolic ventricular impedance representation. A condition processor (150) determines the presence of any heart valve malfunction, such as valve regurgitation and/or stenosis, of at least one heart valve (11, 13, 15, 17) based on the estimated atrial and ventricular impedance representations.

Abstract translation: 可植入医疗装置（100）包括阻抗处理器（130），用于在心脏周期的舒张和/或收缩期间确定反映心脏（10）的心房（12,14）的心源阻抗的心房阻抗数据。 还确定了在舒张期和/或收缩过程中反映心室（16,18）的心源阻抗的心室阻抗数据。 确定的阻抗数据由表示处理器（140）处理，用于估计舒张期和/或收缩期心房阻抗表示以及舒张期和/或收缩期心室阻抗表示。 条件处理器（150）基于估计的心房和心室阻抗表示来确定至少一个心脏瓣膜（11,13,15,17）的任何心脏瓣膜故障（例如瓣膜反流和/或狭窄）的存在。

公开(公告)号：WO2009134170A1

公开(公告)日：2009-11-05

申请号：PCT/SE2008/000298

申请日：2008-04-29

Applicant: ST. JUDE MEDICAL AB ,  BLOMQVIST, Andreas

Inventor： BLOMQVIST, Andreas

IPC: A61N1/37 ,  A61B5/02

CPC classification number: A61N1/3702 ,  A61B5/0031 ,  A61B5/0452 ,  A61B5/053 ,  A61B5/0538 ,  A61B5/7239 ,  A61B5/7275 ,  A61N1/36521 ,  G06F19/00

Abstract: An implantable medical device (100) comprises an event detector (110) for detecting a predefined cardiac event during a heart cycle of a subject (1). A reference time is assigned to this detected cardiac event. A detector (130) detects the onset of ventricular Filling of the subject's heart (10) during the heart cycle. The relative time of the detected filling onset is determined based on the assigned time reference. Increased risk of heart failure of the subject (1) is determined by the device (100) based on the determined relative time for the filling onset. Generally, a reduction in the relative time as determined at different time points indicates an increased heart failure risk or presence of a heart failure condition.

Abstract translation: 可植入医疗装置（100）包括用于在受试者（1）的心脏周期期间检测预定心脏事件的事件检测器（110）。 参考时间被分配给该检测到的心脏事件。 检测器（130）在心脏周期期间检测受试者的心脏（10）的心室填充的发作。 根据分配的时间参考确定检测到的填充开始的相对时间。 基于确定的填充开始的相对时间，由装置（100）确定对象（1）的心力衰竭的增加的风险。 通常，在不同时间点确定的相对时间的减少表明心力衰竭风险增加或心力衰竭状况的存在。

公开(公告)号：WO2009002238A1

公开(公告)日：2008-12-31

申请号：PCT/SE2007/000632

申请日：2007-06-27

Applicant: ST. JUDE MEDICAL AB ,  BLOMQVIST, Andreas ,  BROOME, Michael

Inventor： BLOMQVIST, Andreas ,  BROOME, Michael

IPC: A61N1/362 ,  A61B5/053

CPC classification number: A61N1/3702 ,  A61B5/02405 ,  A61B5/053 ,  A61B5/076 ,  A61B5/4812 ,  A61B5/7275 ,  A61N1/36521 ,  A61N1/36585 ,  A61N1/37282 ,  G06F19/00

Abstract: In a method and a device a REM sleep detector is provide to enable better trending and prediction of monitored conditions or diseases. REM sleep data is separated from other data whereby stable and uniform conditions for data collection are achieved. The REM sleep detector can advantageously be provided inside an implantable medical device.

Abstract translation: 在一种方法和装置中，提供REM睡眠检测器以使得能够更好地趋向并预测所监视的病症或疾病。 REM睡眠数据与其他数据分离，从而实现数据收集的稳定和统一的条件。 REM睡眠检测器可以有利地设置在可植入医疗装置的内部。

公开(公告)号：WO2008130291A1

公开(公告)日：2008-10-30

申请号：PCT/SE2007/000396

申请日：2007-04-24

Applicant: ST. JUDE MEDICAL AB ,  HEDBERG, Sven-Erik ,  BLOMQVIST, Andreas ,  JÄRVERUD, Karin ,  LJUNGSTRÖM, Karin ,  LINDKVIST, Leif ,  LÖNN, Urban

Inventor： HEDBERG, Sven-Erik ,  BLOMQVIST, Andreas ,  JÄRVERUD, Karin ,  LJUNGSTRÖM, Karin ,  LINDKVIST, Leif ,  LÖNN, Urban

IPC: A61N1/05 ,  A61N1/365

CPC classification number: A61N1/05 ,  A61B5/0084 ,  A61B5/0086 ,  A61B5/08 ,  A61B5/1116 ,  A61B5/1118 ,  A61B5/4878 ,  A61B5/7207 ,  A61N1/025 ,  A61N1/056 ,  A61N1/362

Abstract: The present invention generally relates implantable medical systems and, in particular, to systems, devices and methods for detecting incipient edema. The medical system comprises an implantable medical lead including an optical sensor comprising a light source and a light detector. The medical system further comprises an edema detection circuit being adapted to: activate the light source to emit light, wherein said light is directed into lung tissue of a patient; obtain a light intensity value corresponding to an intensity of light received by the light detector; and evaluate the light intensity value to detect a consistency with incipient edema.

Abstract translation: 本发明通常涉及可植入医疗系统，特别是涉及用于检测初期水肿的系统，装置和方法。 医疗系统包括可植入医疗引线，其包括包括光源和光检测器的光学传感器。 医疗系统还包括水肿检测电路，其适于：激活光源以发光，其中所述光被引导到患者的肺组织中; 获得与由光检测器接收的光的强度对应的光强度值; 并评估光强值以检测与初期水肿的一致性。