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91. 发明授权

US08626278B2 Method and system for discriminating and monitoring atrial arrhythmia based on cardiogenic impedance 有权
标题翻译：基于心源阻抗鉴别和监测心房心律失常的方法和系统
公开(公告)号：US08626278B2
公开(公告)日：2014-01-07
申请号：US12901296
申请日：2010-10-08
申请人： Euljoon Park , Steve Koh , Gene A. Bornzin
发明人： Euljoon Park , Steve Koh , Gene A. Bornzin
IPC分类号： A61B5/0464 , A61B5/053
CPC分类号： A61B5/046 , A61B5/0006 , A61B5/0031 , A61B5/02028 , A61B5/0205 , A61B5/029 , A61B5/0402 , A61B5/0422 , A61B5/0468 , A61B5/0538 , A61B5/0816 , A61B5/1116 , A61B5/1118 , A61B5/686 , A61B5/6869 , A61N1/3624 , A61N1/36521 , A61N1/36592
摘要： A medical device is provided that comprises a lead assembly. The lead assembly includes at least one intra-cardiac (IC) electrode, an extra-cardiac (EC) electrode and a subcutaneous remote-cardiac (RC) electrode. The IC electrode is configured to be located within the heart. The EC electrode is configured to be positioned proximate to at least one of a superior vena cava (SVC) and a left ventricle (LV) of a heart. The RC electrode is configured to be located remote from the heart. An extra-cardiac impedance (ECI) module is configured to measure extra-cardiac impedance along an ECI vector between the EC and RC electrodes to obtain ECI measurements. An arrhythmia monitoring module is configured to declare a potential atrial arrhythmia to be an atrial arrhythmia based on the hemodynamic performance determined from the ECI measurements. The hemodynamic performance assessment module is further enabled to compare a current ECI pattern with a prior baseline ECI waveform.
摘要翻译：提供了包括引线组件的医疗装置。引线组件包括至少一个心脏内（IC）电极，心外（EC）电极和皮下远心电（RC）电极）。 IC电极被配置为位于心脏内。 EC电极配置成靠近心脏的上腔静脉（SVC）和左心室（LV）中的至少一个定位。 RC电极被配置为远离心脏。心脏外阻抗（ECI）模块被配置为测量EC和RC电极之间的ECI向量的心外阻抗，以获得ECI测量值。心律失常监测模块被配置为基于从ECI测量确定的血液动力学性能来将潜在心房心律失常宣告为房性心律失常。血液动力学性能评估模块还能够将当前ECI模式与先前的基线ECI波形进行比较。

92. 发明授权

US08412327B2 Cardiac resynchronization therapy optimization using vector measurements obtained from realtime electrode position tracking 有权
标题翻译：使用从实时电极位置跟踪获得的矢量测量的心脏再同步治疗优化
公开(公告)号：US08412327B2
公开(公告)日：2013-04-02
申请号：US12621397
申请日：2009-11-18
申请人： Wenbo Hou , Stuart Rosenberg , Kyungmoo Ryu , Allen Keel , Steve Koh , Thao Thu Nguyen , Kjell Noren , Michael Yang
发明人： Wenbo Hou , Stuart Rosenberg , Kyungmoo Ryu , Allen Keel , Steve Koh , Thao Thu Nguyen , Kjell Noren , Michael Yang
IPC分类号： A61N1/365
CPC分类号： A61N1/3627 , A61B5/0205 , A61B5/04011 , A61B5/0424 , A61B5/053 , A61B5/0538 , A61B5/063 , A61N1/3684 , A61N1/3686
摘要： An exemplary method includes selecting a first pair of electrodes to define a first vector and selecting a second pair of electrodes to define a second vector; acquiring position information during one or more cardiac cycles for the first and second pairs of electrodes wherein the acquiring comprises using each of the electrodes for measuring one or more electrical potentials in an electrical localization field established in the patient; and determining a dyssynchrony index by applying a cross-covariance technique to the position information for the first and the second vectors. Another method includes determining a phase shift based on the acquired position information for the first and the second vectors; and determining an interventricular delay based at least in part on the phase shift.
摘要翻译：一种示例性方法包括选择第一对电极以限定第一矢量并选择第二对电极以限定第二矢量; 在所述第一和第二对电极的一个或多个心动周期期间获取位置信息，其中所述获取包括使用每个所述电极来测量在所述患者中建立的电定位区域中的一个或多个电位; 以及通过将交叉协方差技术应用于所述第一和第二向量的位置信息来确定不同步索引。另一种方法包括基于所获取的第一和第二矢量的位置信息来确定相移; 以及至少部分地基于所述相移来确定心室间延迟。

93. 发明申请

US20130053913A1 Method and System to Adjust Pacing Parameters Based on Systolic Interval Heart Sounds 审中-公开
标题翻译：基于收缩期间心脏声音调整起搏参数的方法和系统
公开(公告)号：US20130053913A1
公开(公告)日：2013-02-28
申请号：US13223117
申请日：2011-08-31
申请人： Steve Koh , Gene A. Bornzin , Jeffery D. Snell
发明人： Steve Koh , Gene A. Bornzin , Jeffery D. Snell
IPC分类号： A61N1/368
CPC分类号： A61N1/368 , A61B7/00 , A61B7/04 , A61N1/36585
摘要： A method is provided to determine pacing parameters for an implantable medical device (IMD) and collects heart sounds during the cardiac cycles. The method comprises changing a value for a pacing parameter between the cardiac cycles and analyzing a characteristic of interest from the heart sounds. The method comprises setting a desired value for the pacing parameter based on the characteristic of interest from the heart sounds. The system comprises inputs configured to be coupled to at least one lead having electrodes to sense intrinsic events and to deliver pacing pulses over cardiac cycles. The system has a sensor for collecting heart sounds during cardiac cycles and controller to control delivery of pacing pulses based on pacing parameters. The controller changes a value for at least one of the pacing parameters between the cardiac cycles and provides an analysis module to analyze a characteristic of interest from the heart sounds.
摘要翻译：提供了一种用于确定可植入医疗装置（IMD）的起搏参数并在心脏周期期间收集心脏声音的方法。该方法包括在心脏周期之间改变起搏参数的值并且从心脏声音分析感兴趣的特征。该方法包括基于来自心音的感兴趣的特征来设置起搏参数的期望值。该系统包括被配置为耦合到具有电极以感测固有事件并且在心动周期上传送起搏脉冲的至少一个引线的输入。该系统具有用于在心动周期期间收集心脏声音的传感器和控制器，以根据起搏参数控制起搏脉冲的传递。控制器改变心脏周期之间的至少一个起搏参数的值，并提供分析模块来分析来自心脏声音的兴趣特征。

94. 发明授权

US08343059B1 Identifying left atrial pressure elevation by means of a respiratory component 有权
标题翻译：通过呼吸成分识别左心房压力升高
公开(公告)号：US08343059B1
公开(公告)日：2013-01-01
申请号：US11678401
申请日：2007-02-23
申请人： Steve Koh
发明人： Steve Koh
IPC分类号： A61B5/02 , A61B5/08
CPC分类号： A61B5/686 , A61B5/0205 , A61B5/0215
摘要： A signal indicative of left atrial pressure in the heart of a patient is analyzed to identify a signal component that is related to the respiration of the patient. An indication relating to the left atrial pressure may be generated based on the presence, absence, or magnitude of the respiratory component. In some embodiments the indication may be used to indicate high left atrial pressure. In some embodiments the indication may be used to indicate heart failure. In some embodiments the indication may be used in conjunction with verifying the operation of a left atrial pressure sensor. In the event of high left atrial pressure or an incorrect pressure reading an appropriate warning may be generated. In the event of an incorrect pressure reading the left atrial pressure sensor may be recalibrated.
摘要翻译：分析指示患者心脏中的左心房压力的信号以识别与患者的呼吸相关的信号分量。可以基于呼吸成分的存在，不存在或大小产生与左心房压力有关的指示。在一些实施例中，该指示可用于指示高的左心房压力。在一些实施例中，该指示可用于指示心力衰竭。在一些实施例中，指示可以与验证左心房压力传感器的操作结合使用。在左心房压力高或压力读数不正确的情况下，可能会产生适当的警告。在压力读数不正确的情况下，可以重新校准左心房压力传感器。

95. 发明授权

US08326422B2 Implantable systems and methods for monitoring BNP levels, HF and MI 有权
标题翻译：用于监测BNP水平，HF和MI的植入式系统和方法
公开(公告)号：US08326422B2
公开(公告)日：2012-12-04
申请号：US12341074
申请日：2008-12-22
申请人： Allen Keel , Steve Koh , Taraneh Ghaffari Farazi
发明人： Allen Keel , Steve Koh , Taraneh Ghaffari Farazi
IPC分类号： A61N1/00
CPC分类号： A61N1/3627 , A61B5/024 , A61B5/0452 , A61B5/0464 , A61B5/053 , A61B5/145 , A61N1/36557 , A61N1/36585 , A61N1/37258
摘要： Methods for monitoring a patient's level of B-type natriuretic peptide (BNP), and implantable cardiac systems capable of performing such methods, are provided. A ventricle is paced for a period of time to provoke a ventricular evoked response, and a ventricular intracardiac electrogram (IEGM) indicative of the ventricular evoked response is obtained. Based on the ventricular IEGM, there is a determination of at least one ventricular evoked response metric (e.g., ventricular evoked response peak-to-peak amplitude, ventricular evoked response area and/or ventricular evoked response maximum slope), and the patient's level of BNP is monitored based on determined ventricular evoked response metric(s). Based on the monitored level's of BNP, the patients heart failure (HF) condition and/or risks and/or occurrences of certain events (e.g., an acute HF exacerbation and/or an acute myocardial infarction) can be monitored.
摘要翻译：提供了用于监测患者B型利钠肽（BNP）水平的方法，以及能够执行这些方法的可植入心脏系统。心室起搏一段时间以引发心室诱发反应，并获得指示心室诱发反应的心室心内电图（IEGM）。基于心室IEGM，确定至少一个心室诱发反应度量（例如，心室诱发反应峰 - 峰幅度，心室诱发反应面积和/或心室诱发反应最大斜率）和患者的水平基于确定的心室诱发反应度量监测BNP。基于监测的BNP水平，可以监测患者的心力衰竭（HF）状况和/或某些事件的风险和/或发生（例如急性HF急性发作和/或急性心肌梗塞）。

96. 发明授权

US08323205B2 System and method for identifying a potential cause of pulmonary edema 有权
标题翻译：识别肺水肿的潜在原因的系统和方法
公开(公告)号：US08323205B2
公开(公告)日：2012-12-04
申请号：US12368916
申请日：2009-02-10
申请人： Euljoon Park , Steve Koh
发明人： Euljoon Park , Steve Koh
IPC分类号： A61B5/0205
CPC分类号： A61B5/0537 , A61B5/4878 , A61N1/36521
摘要： A method of identifying a potential cause of pulmonary edema is provided. The method includes obtaining one or more impedance vectors between predetermined combinations of the electrodes positioned proximate the heart. At least one of the impedance vectors is representative of a thoracic fluid level. The method also includes applying a stimulation pulse to the heart and sensing cardiac signals of the heart that are representative of an electrophysiological response to the stimulation pulse. The method further includes monitoring the cardiac signals and at least one of the impedance vectors with respect to time to identify the potential cause of pulmonary edema.
摘要翻译：提供了鉴定肺水肿潜在原因的方法。该方法包括在定位在心脏附近的电极的预定组合之间获得一个或多个阻抗矢量。阻抗向量中的至少一个代表胸水液位。该方法还包括向心脏施加刺激脉冲并感测代表对刺激脉冲的电生理响应的心脏心脏信号。该方法还包括相对于时间监测心脏信号和阻抗向量中的至少一个以识别肺水肿的潜在原因。

97. 发明申请

US20120172867A1 SYSTEM AND METHOD FOR TREATING ARRHYTHMIAS IN THE HEART USING INFORMATION OBTAINED FROM HEART WALL MOTION 审中-公开
标题翻译：使用从心脏运动中获得的信息来治疗心脏中的脑膜炎的系统和方法
公开(公告)号：US20120172867A1
公开(公告)日：2012-07-05
申请号：US12980586
申请日：2010-12-29
申请人： Kyungmoo Ryu , Thao T. Ngo , Euljoon Park , Stuart Rosenberg , Allen Keel , Wenbo Hou , Steve Koh , Kjell Noren , Michael Yang
发明人： Kyungmoo Ryu , Thao T. Ngo , Euljoon Park , Stuart Rosenberg , Allen Keel , Wenbo Hou , Steve Koh , Kjell Noren , Michael Yang
IPC分类号： A61B18/14
CPC分类号： A61B18/1206 , A61B5/1107 , A61B8/488 , A61B18/082 , A61B18/1492 , A61B18/20 , A61B34/20 , A61B2018/00351 , A61B2018/00375 , A61B2018/00577 , A61B2018/00642 , A61B2018/00666 , A61B2018/00702 , A61B2018/00726 , A61B2018/00744 , A61B2018/00863 , A61B2018/0088 , A61B2018/00892 , A61B2018/0212 , A61B2034/2051 , A61B2034/2059 , A61B2218/002 , A61N7/022
摘要： A system and method for treating an arrhythmia in a heart are provided. The system includes an electronic control unit configured to monitor movement of one or more position sensor over a period of time. The position sensors may, for example, comprise electrodes or coils configured to generate induced voltages and currents in the presence of electromagnetic fields. The positions sensors are in contact with portions of heart tissue and changes in position are representative of motion of that tissue. The electronic control unit is further configured to generate an indicator, responsive to the movements of the sensors over the period of time, of a characteristic of the heart affected by delivery of ablation energy to heart tissue. In this manner, the effectiveness and safety of cardiac tissue ablation for treatment of the arrhythmia can be assessed and a post-ablation therapy regimen determined.
摘要翻译：提供了用于治疗心脏心律失常的系统和方法。该系统包括电子控制单元，其构造成在一段时间内监测一个或多个位置传感器的移动。位置传感器可以例如包括配置成在存在电磁场的情况下产生感应电压和电流的电极或线圈。位置传感器与心脏组织的部分接触并且位置变化代表该组织的运动。电子控制单元还被配置为响应于传感器在一段时间内的移动，产生受到将消融能量递送到心脏组织的心脏特征的指示器。以这种方式，可以评估心脏组织消融治疗心律失常的有效性和安全性，并确定消融后治疗方案。

98. 发明申请

US20120089032A1 METHOD AND SYSTEM FOR DISCRIMINATING AND MONITORING ATRIAL ARRHYTHMIA BASED ON CARDIOGENIC IMPEDANCE 有权
标题翻译：基于心脏阻力的ATRIAL ARRHYTHMIA的辨别和监测方法与系统
公开(公告)号：US20120089032A1
公开(公告)日：2012-04-12
申请号：US12901296
申请日：2010-10-08
申请人： Euljoon Park , Steve Koh , Gene A. Bornzin
发明人： Euljoon Park , Steve Koh , Gene A. Bornzin
IPC分类号： A61B5/042 , A61B5/0205
CPC分类号： A61B5/046 , A61B5/0006 , A61B5/0031 , A61B5/02028 , A61B5/0205 , A61B5/029 , A61B5/0402 , A61B5/0422 , A61B5/0468 , A61B5/0538 , A61B5/0816 , A61B5/1116 , A61B5/1118 , A61B5/686 , A61B5/6869 , A61N1/3624 , A61N1/36521 , A61N1/36592
摘要： A medical device is provided that comprises a lead assembly. The lead assembly includes at least one intra-cardiac (IC) electrode, an extra-cardiac (EC) electrode and a subcutaneous remote-cardiac (RC) electrode. The IC electrode is configured to be located within the heart. The EC electrode is configured to be positioned proximate to at least one of a superior vena cava (SVC) and a left ventricle (LV) of a heart. The RC electrode is configured to be located remote from the heart. An arrhythmia monitoring module is configured to analyze intra-cardiac electrogram (IEGM) signals from the at least one IC electrode to identify a potential atrial arrhythmia. An extra-cardiac impedance (ECI) module is configured to measure extra-cardiac impedance along an ECI vector between the EC and RC electrodes to obtain ECI measurements. The hemodynamic performance (HDP) assessment module is configured to determine a hemodynamic performance based on the ECI measurements. The arrhythmia monitoring module is configured to declare the potential atrial arrhythmia to be an atrial arrhythmia based on the hemodynamic performance determined from the ECI measurements. The medical device further provides the HDP assessment module that derives a current ECI waveform from current ECI measurements and compares the current ECI pattern with a prior ECI waveform that is derived from prior ECI measurements.
摘要翻译：提供了包括引线组件的医疗装置。引线组件包括至少一个心脏内（IC）电极，心外（EC）电极和皮下远心电（RC）电极）。 IC电极被配置为位于心脏内。 EC电极配置成靠近心脏的上腔静脉（SVC）和左心室（LV）中的至少一个定位。 RC电极被配置为远离心脏。心律失常监测模块被配置为分析来自至少一个IC电极的心脏内电针（IEGM）信号以识别潜在的心房心律失常。心脏外阻抗（ECI）模块被配置为测量EC和RC电极之间的ECI向量的心外阻抗，以获得ECI测量值。血液动力学性能（HDP）评估模块被配置为基于ECI测量来确定血液动力学性能。心律失常监测模块被配置为基于从ECI测量确定的血流动力学性能来将潜在心房心律失常宣告为心房心律失常。医疗设备还提供HDP评估模块，其从当前ECI测量中导出当前ECI波形，并将当前ECI模式与从先前ECI测量得到的先前ECI波形进行比较。

99. 发明申请

US20110184274A1 ELECTRODE CONFIGURATIONS FOR LEADS OR CATHETERS TO ENHANCE LOCALIZATION USING A LOCALIZATION SYSTEM 有权
标题翻译：用于使用本地化系统增强本地化的导线或导线的电极配置
公开(公告)号：US20110184274A1
公开(公告)日：2011-07-28
申请号：US12695815
申请日：2010-01-28
申请人： Stuart Rosenberg , Thao Thu Nguyen , Kyungmoo Ryu , Kjell Noren , Allen Keel , Wenbo Hou , Steve Koh , Michael Yang
发明人： Stuart Rosenberg , Thao Thu Nguyen , Kyungmoo Ryu , Kjell Noren , Allen Keel , Wenbo Hou , Steve Koh , Michael Yang
IPC分类号： A61B5/05 , A61N1/05
CPC分类号： A61B5/0538 , A61B5/0536 , A61B2562/0209 , A61N1/05 , A61N1/056
摘要： An exemplary method includes positioning a lead in a patient where the lead has a longitudinal axis that extends from a proximal end to a distal end and where the lead includes an electrode with an electrical center offset from the longitudinal axis of the lead body; measuring electrical potential in a three-dimensional potential field using the electrode; and based on the measuring and the offset of the electrical center, determining lead roll about the longitudinal axis of the lead body where lead roll may be used for correction of field heterogeneity, placement or navigation of the lead or physiological monitoring (e.g., cardiac function, respiration, etc.). Various other methods, devices, systems, etc., are also disclosed.
摘要翻译：一种示例性方法包括将引线定位在患者体内，其中引线具有从近端延伸到远端的纵向轴线，并且其中引线包括具有偏离引线主体的纵向轴线的电中心的电极; 使用所述电极测量三维势场中的电位; 并且基于电气中心的测量和偏移，确定围绕引线主体的纵轴的引导辊，其中引导辊可用于校正磁场异质性，引线的放置或导航或生理监测（例如，心脏功能，呼吸等）。还公开了各种其它方法，装置，系统等。

100. 发明申请

US20110125049A1 Methods and Systems that Use Implanted Posture Sensor to Monitor Pulmonary Edema 有权
标题翻译：使用植入姿势传感器监测肺水肿的方法和系统
公开(公告)号：US20110125049A1
公开(公告)日：2011-05-26
申请号：US12649647
申请日：2009-12-30
申请人： Yelena Nabutovsky , Fujian Qu , Steve Koh , Dan E. Gutfinger , Alex Soriano
发明人： Yelena Nabutovsky , Fujian Qu , Steve Koh , Dan E. Gutfinger , Alex Soriano
IPC分类号： A61B5/05
CPC分类号： A61B5/053 , A61B5/021 , A61B5/1116 , A61B5/4878 , A61B5/686 , A61B5/7275 , A61N1/3627 , A61N1/36521 , A61N1/36564 , A61N1/36585 , A61N1/3684 , A61N1/3702 , A61N1/37258 , A61N1/3962
摘要： In specific embodiments, a method to monitor pulmonary edema of a patient, comprises (a) detecting, using an implanted posture sensor, when a posture of the patient changes from a first predetermined posture to a second predetermined posture, (b) determining an amount of time it takes an impedance signal to achieve a steady state after the posture of the patient changes from the first predetermined posture to the second predetermined posture, where the impedance signal is obtained using implanted electrodes and is indicative of left atrial pressure and/or intra-thoracic fluid volume of the patient, and (c) monitoring the pulmonary edema of the patient based on the determined amount of time it takes the impedance signal to achieve the steady state after the posture of the patient changes from the first predetermined posture to the second pre-determined posture.
摘要翻译：在具体实施例中，一种监测患者肺水肿的方法包括：（a）使用植入式姿势传感器时，当患者的姿势从第一预定姿势变化到第二预定姿势时，（b）确定量的时间，在患者的姿势从第一预定姿势变化到第二预定姿势之后，阻抗信号获得稳定状态，其中使用植入电极获得阻抗信号，并且指示左心房压力和/或内部 - （c）基于在患者的姿势从第一预定姿势改变到第二预定姿势之后所确定的阻抗信号达到稳定状态的所确定的时间量来监测患者的肺水肿第二预定姿势。

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