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11. 发明授权

US08211032B2 Cardiomechanical assessment for cardiac resynchronization therapy 有权
标题翻译：心脏再同步治疗的心脏力学评估
公开(公告)号：US08211032B2
公开(公告)日：2012-07-03
申请号：US13191253
申请日：2011-07-26
申请人： Stuart O. Schecter , Kjell Noren
发明人： Stuart O. Schecter , Kjell Noren
IPC分类号： A61B5/0452
CPC分类号： A61N1/36514 , A61N1/36578
摘要： A first lead provides therapeutic stimulation to the heart and includes a first mechanical sensor that measures physical contraction and relaxation of the heart. A controller induces delivery of therapeutic stimulation via the first lead. The controller receives signals from the first mechanical sensor indicative of the contraction and relaxation; develops a template signal that corresponds to the contraction and relaxation; and uses the template signal to modify the delivery of therapeutic stimulations. In another arrangement, a second lead, with a second mechanical sensor also provides signals to the controller indicative of contraction and relaxation. The first mechanical sensor is adapted to be positioned at the interventricular septal region of the heart, and the second mechanical sensor is adapted to be positioned in the lateral region of the left ventricle. The controller processes the signals from the first mechanical sensor and the second mechanical sensor to develop a dysynchrony index.
摘要翻译：第一个引线提供对心脏的治疗刺激，并且包括测量心脏的身体收缩和松弛的第一机械传感器。控制器通过第一引线诱导治疗性刺激。控制器从第一机械传感器接收指示收缩和松弛的信号; 开发对应于收缩和放松的模板信号; 并使用模板信号修改治疗刺激的递送。在另一种布置中，具有第二机械传感器的第二引线还向控制器提供指示收缩和松弛的信号。第一机械传感器适于定位在心脏的室间隔区域，并且第二机械传感器适于定位在左心室的侧向区域中。控制器处理来自第一机械传感器和第二机械传感器的信号以产生异步指数。

12. 发明授权

US07970473B2 Systems and methods for detection of VT and VF from remote sensing electrodes 有权
标题翻译：从遥感电极检测VT和VF的系统和方法
公开(公告)号：US07970473B2
公开(公告)日：2011-06-28
申请号：US12244607
申请日：2008-10-02
申请人： Yelena Nabutovsky , Taraneh Ghaffari Farazi , Anders Bjorling , Kjell Noren , Gene A. Bornzin
发明人： Yelena Nabutovsky , Taraneh Ghaffari Farazi , Anders Bjorling , Kjell Noren , Gene A. Bornzin
IPC分类号： A61N1/00
CPC分类号： A61B5/046 , A61B5/04011 , A61B5/0464 , A61N1/3702 , A61N1/3956
摘要： Methods and systems are provided for performing ventricular arrhythmia monitoring using at least two sensing channels that are each associated with different sensing vectors, for example by different pairs of extracardiac remote sensing electrodes. Myopotential associated with each of the sensing channels in monitored, and a ventricular arrhythmia monitoring mode is selected based thereon (e.g., based on determined myopotential levels). Ventricular arrhythmia monitoring is then performed using the selected monitoring mode.
摘要翻译：提供的方法和系统用于使用至少两个感测通道进行心室心律失常监测，每个感测通道各自与不同的感测向量相关联，例如通过不同的心外感测电极对。与监测的每个感测通道相关联的神经电位和基于（例如，基于确定的电位电平）来选择心室心律失常监测模式。然后使用所选择的监测模式进行室性心律失常监测。

13. 发明申请

US20100249864A1 METHOD AND APPARATUS FOR DETERMINING VARIATION OVER TIME OF A MEDICAL PARAMETER OF A HUMAN BEING 有权
标题翻译：用于确定人类医疗参数时间变化的方法和装置
公开(公告)号：US20100249864A1
公开(公告)日：2010-09-30
申请号：US12438397
申请日：2006-08-28
申请人： Karin Järverud , Kjell Noren
发明人： Karin Järverud , Kjell Noren
IPC分类号： A61N1/362 , A61B5/103
CPC分类号： A61B5/0205 , A61B5/0031 , A61B5/02028 , A61B5/0215 , A61B5/1116 , A61B5/686 , A61B5/7239 , A61N1/36564 , A61N1/3702
摘要： An apparatus for determining variation over time of a medical parameter of a human being obtained from a sensed signal has a sensor implantable in the human being for sensing the signal. A comparator compares at least one characteristic property, derived from the sensed signal obtained for at least one predetermined first level of activity of the human being, with corresponding reference property of a sensed reference signal, obtained for a predetermined reference level of activity of the human being, for determining a relation between the characteristic property of the sensed signal and the reference property. A trend determining unit determines trends in the medical parameter by analyzing the relation between the characteristic property of the sensed signal obtained at different times and the reference property. A corresponding method also function an implant for heart failure diagnostics also function as described. A sensor is then arranged to pick up dynamic mechanical information from the heart of the human being and generate a corresponding signal. A heart stimulator includes such an implant and a control unit arranged to control stimulation of the heart depending on determined trends in the medical parameter.
摘要翻译：用于确定从感测信号获得的人的医学参数随时间变化的装置具有可植入人体的用于感测信号的传感器。比较器比较从针对人的至少一个预定的第一活动水平获得的感测信号导出的至少一个特征属性与针对人的预定参考活动水平获得的感测参考信号的相应参考特性用于确定感测信号的特性与参考属性之间的关系。趋势确定单元通过分析在不同时间获得的感测信号的特性与参考属性之间的关系来确定医疗参数的趋势。相应的方法也可以用于心力衰竭诊断的植入物也起到所述的作用。然后设置传感器以从人的心脏拾取动态机械信息并产生相应的信号。心脏刺激器包括这样的植入物和控制单元，其被布置成根据医学参数中确定的趋势来控制心脏的刺激。

14. 发明申请

US20080294213A1 Implantable Medical Device with Therapy Control 有权
标题翻译：具有治疗控制的植入式医疗器械
公开(公告)号：US20080294213A1
公开(公告)日：2008-11-27
申请号：US12094534
申请日：2005-11-30
申请人： Nils Holmstrom , Kjell Noren
发明人： Nils Holmstrom , Kjell Noren
IPC分类号： A61N1/365
CPC分类号： A61N1/36514 , A61B7/04 , A61N1/3627 , A61N1/36578 , A61N1/3684
摘要： A method for operating an implantable medical device to obtain substantially synchronized closure of the mitral and tricuspid valves based on sensed heart sounds includes sensing an acoustic energy; producing signals indicative of heart sounds of the heart of the patient over predetermined periods of a cardiac cycle during successive cardiac cycles; calculating a pulse width of such a signal; and iteratively controlling a delivery of the ventricular pacing pulses based on calculated pulse widths of successive heart sound signals to identify an RV interval or VV interval that causes a substantially synchronized closure of the mitral and tricuspid valve. A medical device for optimizing an RV interval or VV interval based on sensed heart sounds implements such a method and a computer readable medium encoded with instructions causes a computer to perform such a method.
摘要翻译：用于操作可植入医疗装置以基于感测到的心脏声音获得二尖瓣和三尖瓣的基本上同步闭合的方法包括感测声能; 在连续心脏周期期间产生指示心脏周期的预定周期的患者心脏的心脏声音的信号; 计算这种信号的脉冲宽度; 并且基于计算的连续心脏声音信号的脉冲宽度迭代地控制心室起搏脉冲的递送，以识别导致二尖瓣和三尖瓣的基本上同步闭合的RV间隔或VV间隔。基于感测到的心脏声音优化RV间隔或VV间隔的医疗装置实现了这样的方法，并且用指令编码的计算机可读介质使得计算机执行这种方法。

15. 发明申请

US20060235325A1 Congestive heart failure monitor 审中-公开
标题翻译：充血性心力衰竭监测仪
公开(公告)号：US20060235325A1
公开(公告)日：2006-10-19
申请号：US10524196
申请日：2003-06-23
申请人： Nils Holmstrom , Martin Obel , Anna Norlin , Kenneth Dahlberg , Anders Bjorling , Sven Kalling , Karin Ljungstrom , Kjell Noren
发明人： Nils Holmstrom , Martin Obel , Anna Norlin , Kenneth Dahlberg , Anders Bjorling , Sven Kalling , Karin Ljungstrom , Kjell Noren
IPC分类号： A61B5/05 , A61B5/02
CPC分类号： A61B5/0538 , A61B5/053 , A61N1/3627
摘要： A congestive heart failure monitor has an impedance measuring unit that measures the impedance between at least two electrodes implanted in a patient, to use a detected change of the measured impedance as an indication of a change in the left atrium volume. Any analyzing unit analyzes the measured impedance and detects insipient congestive heart failure dependent on a quotient of a maximum value of the measured impedance and a minimum value of the measured impedance during a cardiac cycle.
摘要翻译：充血性心力衰竭监测器具有阻抗测量单元，其测量植入患者中的至少两个电极之间的阻抗，以使用检测到的测量阻抗的变化作为左心房体积变化的指示。任何分析单元分析所测量的阻抗，并根据所测量的阻抗的最大值和心动周期内所测量的阻抗的最小值来检测不利的充血性心力衰竭。

16. 发明申请

US20050107836A1 Medical device 失效
标题翻译：医疗装置
公开(公告)号：US20050107836A1
公开(公告)日：2005-05-19
申请号：US10505013
申请日：2003-02-27
申请人： Kjell Noren
发明人： Kjell Noren
IPC分类号： A61B5/0452 , A61B5/046 , A61B5/0464 , A61N1/362 , A61B5/04
CPC分类号： A61N1/3622 , A61B5/0452 , A61B5/046 , A61B5/0464 , A61B5/7257
摘要： In a device and a method for determining a cardiac condition from a detected cardiac signal, an input signal is formed from the detected cardiac signal and supplied to an analysis unit. The analysis unit forms an analysis signal from the input signal, having a real part substantially corresponding to the input signal and an imaginary part that is a predetermined transformation of the input signal. A calculation unit operates on the analysis signal to calculated at least two heart-related parameters therefrom. The heart-related parameters are supplied to a processing unit that combines the heart-related parameters in a predetermined manner for identifying a cardiac condition.
摘要翻译：在根据检测到的心脏信号确定心脏状况的装置和方法中，根据检测到的心脏信号形成输入信号并提供给分析单元。分析单元从输入信号形成分析信号，其具有基本对应于输入信号的实部和作为输入信号的预定变换的虚部。计算单元对分析信号进行操作以从其计算至少两个心脏相关参数。将心脏相关参数提供给处理单元，该处理单元以预定方式组合心脏相关参数以识别心脏状况。

17. 发明授权

US6134472A Heart stimulation device 有权
标题翻译：心脏刺激装置
公开(公告)号：US6134472A
公开(公告)日：2000-10-17
申请号：US269347
申请日：1999-11-26
申请人： Hans Strandberg , Johan Lidman , Kjell Noren
发明人： Hans Strandberg , Johan Lidman , Kjell Noren
IPC分类号： A61N1/362 , A61N1/365
CPC分类号： A61N1/36521 , A61N1/3627
摘要： In the determination of an optimal rate for the delivery of stimulation pulses to a heart, the stroke volume (SV) of a heart ventricle is measured as a function of heart rate (HR), e.g. by determination of impedance in individual heart cycles whose duration is varied from the duration corresponding to the prevailing rate or the basic rate regarded as optimal for stimulation. The optimal rate should lie at the knee of this function. A corresponding knee is also found in the curve for cardiac output (CO). This rate is determined by calculation of an auxiliary function, e.g. HF=HR.times.CO, which displays a peak at the heart rate at which the knee is located, and the heart rate is determined which yields this maximum. The heart rate determined in this manner is subsequently employed as a basic rate.
摘要翻译： PCT No.PCT / SE97 / 01590 Sec。 371日期1999年11月26日 102（e）1999年11月26日PCT PCT 1997年9月22日PCT公布。公开号WO98 / 14240 日期1998年4月9日在确定将心脏刺激脉冲递送到最佳速率时，测量心室的搏动体积（SV）作为心率（HR）的函数，例如心率。通过确定其持续时间从对应于当前速率或被认为是刺激最佳的基本速率的持续时间变化的各个心脏周期中的阻抗的确定。最佳速率应该在这个功能的膝盖上。在心输出量（CO）曲线中也发现了相应的膝盖。该速率通过辅助功能的计算来确定，例如， HF = HRxCO，其以膝盖所处的心率显示峰值，并且确定产生该最大值的心率。以这种方式确定的心率随后用作基本速率。

18. 发明授权

US5632267A Heart defibrillator and defibrillation method wherein defibrillation is achieved by high-frequency, low-energy pulses 失效
标题翻译：心脏除颤器和除颤方法，其中通过高频，低能量脉冲实现除颤
公开(公告)号：US5632267A
公开(公告)日：1997-05-27
申请号：US521039
申请日：1995-08-29
申请人： Kurt Hognelid , Kjell Noren
发明人： Kurt Hognelid , Kjell Noren
IPC分类号： A61N1/05 , A61N1/362 , A61N1/38 , A61N1/39
CPC分类号： A61N1/3956 , A61N1/3621 , A61N1/385
摘要： An implantable heart defibrillator contains a pulse generator controlled by a control unit for emitting a number of heart stimulation pulses at a rate of several Hertz or more. The control unit causes the pulse generator to emit heart stimulation pulses with an energy content of the same, or somewhat greater, magnitude than conventional pacemaker pulses for a period of time long enough for the entire heart to become refractory.
摘要翻译：可植入心脏除颤器包含由控制单元控制的脉冲发生器，用于以几赫兹或更高的速率发射多个心脏刺激脉冲。控制单元使得脉冲发生器发出心脏刺激脉冲，该心脏刺激脉冲的能量含量与常规心脏起搏器脉冲相同或稍大一些，足够长的时间足以使整个心脏变得难治性。

19. 发明授权

US08532774B1 Detection and reduction of phrenic nerve stimulation 有权
标题翻译：检测和减少膈神经刺激
公开(公告)号：US08532774B1
公开(公告)日：2013-09-10
申请号：US13545794
申请日：2012-07-10
申请人： Sven-Erik Hedberg , Tomas Svensson , Kjell Noren , Stuart Rosenberg , Kyungmoo Ryu , Edward Karst
发明人： Sven-Erik Hedberg , Tomas Svensson , Kjell Noren , Stuart Rosenberg , Kyungmoo Ryu , Edward Karst
IPC分类号： A61N1/37
CPC分类号： A61N1/36521 , A61B5/042 , A61B5/0538 , A61N1/3686 , A61N1/3702
摘要： The present invention provides methods for detecting phrenic nerve stimulation. A pacing module is instructed to deliver pacing pulses having a predetermined pulse amplitude and/or width within the refractory period of the left ventricle. The pacing pulses are repeatedly delivered during a number of cardiac cycles and wherein the pacing pulses are delivered at different delays relative to an onset of the refractory period of the left ventricle in different cardiac cycles. Impedance signals are measured in time windows synchronized with the delivery of pacing pulses in the refractory period of the left ventricle using at least one electrode configuration. At least one impedance signal is gathered from each time window, aggregated impedance signals are created using the impedance signals from the different time windows, and the aggregated impedance signals are analyzed to detect PNS.
摘要翻译：本发明提供了检测膈神经刺激的方法。指示起搏模块在左心室的不应期内输送具有预定脉搏幅度和/或宽度的起搏脉冲。起搏脉冲在多个心动周期期间重复递送，并且其中起搏脉冲相对于在不同心脏周期中的左心室的不应期的开始以不同的延迟递送。使用至少一个电极配置，在与左心室的不应期中的起搏脉冲的递送同步的时间窗口中测量阻抗信号。从每个时间窗口收集至少一个阻抗信号，使用来自不同时间窗口的阻抗信号创建聚合阻抗信号，并分析聚合阻抗信号以检测PNS。

20. 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。

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