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21. 发明申请

US20110004111A1 ISCHEMIA DETECTION USING INTRA-CARDIAC SIGNALS 有权
标题翻译： ISCHEMIA检测使用内部信号
公开(公告)号：US20110004111A1
公开(公告)日：2011-01-06
申请号：US12846387
申请日：2010-07-29
申请人： Jong Gill , Peter Boileau , Gene A. Bornzin , Joseph J. Florio , Mohssen Fard
发明人： Jong Gill , Peter Boileau , Gene A. Bornzin , Joseph J. Florio , Mohssen Fard
IPC分类号： A61B5/0452
CPC分类号： A61B5/0452 , A61B5/7203 , A61B5/7264 , Y10S128/92
摘要： An implanted cardiac rhythm management device is disclosed that is operative to detect myocardial ischemia. This is done by evaluating electrogram features to detect an electrocardiographic change; specifically, changes in electrogram segment during the early part of an ST segment. The early part of the ST segment is chosen to avoid the T-wave.
摘要翻译：公开了可用于检测心肌缺血的植入式心律管理装置。这通过评估电描记图特征来检测心电图变化来完成; 具体来说，在ST段的早期部分的电描绘片段的变化。选择ST段的早期部分以避免T波。

22. 发明申请

US20090177105A1 System and Method for Distinguishing Among Cardiac Ischemia, Hypoglycemia and Hyperglycemia Using an Implantable Medical Device 有权
公开(公告)号：US20090177105A1
公开(公告)日：2009-07-09
申请号：US12360826
申请日：2009-01-27
申请人： Jong Gill , Peter Boileau , Rupinder Bharmi , Xiaoyi Min , Joseph J. Florio , Michael E. Benser , Gene A. Bornzin
发明人： Jong Gill , Peter Boileau , Rupinder Bharmi , Xiaoyi Min , Joseph J. Florio , Michael E. Benser , Gene A. Bornzin
IPC分类号： A61B5/04
CPC分类号： A61N1/3962 , A61B5/0452 , A61B5/0468 , A61B5/14532 , A61N1/3621 , A61N1/3627 , A61N1/36557 , A61N1/3925
摘要： Techniques are described for detecting ischemia, hypoglycemia or hyperglycemia based on intracardiac electrogram (IEGM) signals. Ischemia is detected based on a shortening of the interval between the QRS complex and the end of a T-wave (QTmax), alone or in combination with a change in ST segment elevation. Alternatively, ischemia is detected based on a change in ST segment elevation combined with minimal change in the interval between the QRS complex and the end of the T-wave (QTend). Hypoglycemia is detected based on a change in ST segment elevation along with a lengthening of either QTmax or QTend. Hyperglycemia is detected based on a change in ST segment elevation along with minimal change in QTmax and in QTend. By exploiting QTmax and QTend in combination with ST segment elevation, changes in ST segment elevation caused by hypo/hyperglycemia can be properly distinguished from changes caused by ischemia.

23. 发明申请

US20090018595A1 SYSTEMS AND METHODS FOR EMPLOYING MULTIPLE FILTERS TO DETECT T-WAVE OVERSENSING AND TO IMPROVE TACHYARRHYTHMIA DETECTION WITHIN AN IMPLANTABLE MEDICAL DEVICE 有权
标题翻译：使用多个过滤器检测T波波纹的系统和方法以及改进在可植入医疗设备中的TACHYARRHYTHMIA检测
公开(公告)号：US20090018595A1
公开(公告)日：2009-01-15
申请号：US11776266
申请日：2007-07-11
申请人： Rupinder Bharmi , Jeffery D. Snell , Gene A. Bornzin , Joseph J. Florio , Peter Boileau
发明人： Rupinder Bharmi , Jeffery D. Snell , Gene A. Bornzin , Joseph J. Florio , Peter Boileau
IPC分类号： A61N1/365
CPC分类号： A61B5/0464 , A61B5/04014 , A61B5/0456 , A61N1/3622 , A61N1/3925 , A61N1/3962
摘要： Techniques are described for detecting tachyarrhythmia and also for preventing T-wave oversensing using a narrowband bradycardia filter in combination with a narrowband tachycardia filter. In some embodiments, a separate wideband filter is also exploited. In one illustrative example, ventricular tachycardia (VT) is detected by: detecting a preliminary indication of VT using signals filtered by the bradycardia filter and, in response, confirming the detection of VT using signals filtered by the tachycardia filter. That is, the bradycardia filter, traditionally used only to detect bradycardia, is additionally used to provide a preliminary indication of VT. The tachycardia filter is then activated to confirm the detection of VT before therapy is delivered. In this manner, the tachycardia filter need not run continuously, but is instead activated only when there is some indication of possible VT, and hence power is saved. Numerous other exemplary techniques are set forth herein for arrhythmia detection and for T-wave oversensing detection.
摘要翻译：描述了用于检测快速性心律失常的技术，并且还使用窄带心动过缓过滤器与窄带心动过速过滤器结合来预防T波过度感觉的技术。在一些实施例中，还利用单独的宽带滤波器。在一个说明性示例中，通过以下方式来检测室性心动过速（VT）：使用由心动过缓过滤器过滤的信号检测VT的初步指示，并且作为响应，使用由心动过速过滤器过滤的信号确认VT的检测。也就是说，传统上仅用于检测心动过缓的心动过缓过滤器另外用于提供VT的初步指示。然后激活心动过速过滤器以确认在治疗之前VT的检测。以这种方式，心动过速过滤器不需要连续运行，而是仅当存在可能的VT的一些指示时激活，因此节省功率。本文中阐述了许多其它示例性技术用于心律失常检测和T波超检测。

24. 发明授权

US07289848B1 Implantable cardiac stimulation device, system and method which provides an electrogram signal having the appearance of a surface electrocardiogram 有权
标题翻译：可植入的心脏刺激装置，系统和方法，其提供具有表面心电图的外观的电描记图信号
公开(公告)号：US07289848B1
公开(公告)日：2007-10-30
申请号：US10723027
申请日：2003-11-25
申请人： Gene A. Bornzin , Joseph J. Florio , Kerry Bradley
发明人： Gene A. Bornzin , Joseph J. Florio , Kerry Bradley
IPC分类号： A61N1/362 , A61B5/402
CPC分类号： A61N1/3702 , A61N1/368
摘要： An implantable cardiac stimulation system and method provides an external display of a heart activity signal sensed internally by an implantable cardiac stimulation device which has the appearance of a surface EKG. The heart activity signal is sensed by the implanted device and is processed by the device or the external display to have frequency characteristics resembling that of a surface EKG. The heart activity signal to be displayed takes the form of an intracardiac electrogram signal with a low frequency roll-on of no greater than 0.4 Hz and a high frequency cutoff of no less than 20 Hz. This provides a heart activity signal for display which has the appearance and most attributes of a surface EKG.
摘要翻译：可植入心脏刺激系统和方法提供外部显示心脏活动信号，该心脏活动信号由具有表面EKG外观的可植入心脏刺激装置内部感测。心脏活动信号由植入装置感测，并被装置或外部显示器处理以具有类似于表面EKG的频率特性。要显示的心脏活动信号采取心内电图信号的形式，具有不大于0.4Hz的低频滚动和不小于20Hz的高频截止。这提供了用于显示的心脏活动信号，其具有表面EKG的外观和大多数属性。

25. 发明授权

US07233827B1 Implantable cardiac stimulation device with automatic evoked response sensing electrode configuration selection and method 有权
标题翻译：可植入心脏刺激装置具有自动诱发响应感应电极配置选择和方法
公开(公告)号：US07233827B1
公开(公告)日：2007-06-19
申请号：US10865124
申请日：2004-06-09
申请人： Gene A. Bornzin , Joseph J. Florio , Laurence S. Sloman , Brian M. Mann , Jason A. Sholder
发明人： Gene A. Bornzin , Joseph J. Florio , Laurence S. Sloman , Brian M. Mann , Jason A. Sholder
IPC分类号： A61N1/365
CPC分类号： A61N1/3686 , A61N1/36185 , A61N1/371
摘要： An implantable cardiac stimulation device applies pacing stimulation pulses to a heart and senses evoked responses to the pacing stimulation pulses. A pulse generator applies the stimulation pacing pulses to the heart in accordance with a pacing configuration. A sensor control selects an evoked response sensing electrode configuration from among a plurality of evoked response sensing electrode configurations in response to the pacing configuration. A sensor is then programmed to sense the evoked responses with the selected evoked response sensing electrode configuration. In accordance with a preferred embodiment, signal-to-noise ratios obtained with the various electrode configurations are used to select a best electrode configuration for sensing evoked responses.
摘要翻译：可植入心脏刺激装置将起搏刺激脉冲应用于心脏并感测对起搏刺激脉冲的诱发反应。脉冲发生器根据起搏配置将刺激起搏脉冲施加到心脏。传感器控制器响应于起搏配置从多个诱发响应感测电极配置中选择诱发响应感测电极配置。然后将传感器编程为用所选择的诱发响应感测电极配置感测诱发的反应。根据优选实施例，使用用各种电极配置获得的信噪比用于选择用于感测诱发响应的最佳电极配置。

26. 发明授权

US06915164B2 Automatic capture using independent channels in bi-chamber stimulation 有权
标题翻译：在双室刺激中使用独立通道自动捕获
公开(公告)号：US06915164B2
公开(公告)日：2005-07-05
申请号：US10124164
申请日：2002-04-16
申请人： Kerry Bradley , Joseph J. Florio , Gene A. Bornzin , Euljoon Park
发明人： Kerry Bradley , Joseph J. Florio , Gene A. Bornzin , Euljoon Park
IPC分类号： A61N1/368 , A61N1/37
CPC分类号： A61N1/371 , A61N1/3684
摘要： A cardiac stimulation device and method deliver independent stimulation pulses to right and left cardiac chambers, based on the capture thresholds of each chamber, and confirm capture in each chamber. A threshold test is performed in one chamber while stimulating the opposite chamber at increased pulse energy and adjusted interchamber delay.
摘要翻译：基于每个室的捕获阈值，心脏刺激装置和方法将独立的刺激脉冲输送到左心室和左心室，并确认每个腔室中的捕获。在一个腔室中执行阈值测试，同时以增加的脉冲能量和调节的车间延迟刺激相反的腔室。

27. 发明授权

US06904317B2 Method and apparatus for dynamically adjusting overdrive pacing parameters 失效
标题翻译：动态调整超速起搏参数的方法和装置
公开(公告)号：US06904317B2
公开(公告)日：2005-06-07
申请号：US10043472
申请日：2002-01-09
申请人： Joseph J. Florio , Gene A. Bornzin , Peter Boileau , Eric Falkenberg , Janice Barstad
发明人： Joseph J. Florio , Gene A. Bornzin , Peter Boileau , Eric Falkenberg , Janice Barstad
IPC分类号： A61N1/362 , A61N1/36
CPC分类号： A61N1/3621
摘要： Dynamic overdrive pacing adjustment techniques are described for use in implantable cardiac stimulation devices. In a first technique, an overdrive pacing unit of a microcontroller of the implantable device operates to optimize various control parameters that affect overdrive pacing so as to achieve a desired degree of overdrive pacing for the particular patient in which the stimulation device is implanted. Parameters to be optimized include the number of overdrive beats paced once overdrive pacing is trigged, the overdrive pacing response function, the recovery rate, and various base rates. The control parameters are adjusted in a hierarchical order of priority until the desired degree of overdrive pacing is achieved. Adjustment of the number of overdrive beats, the recovery rate, and various base rates is iteratively performed by using incremental numerical adjustments. Adjustment of the overdrive pacing response function may be performed by selecting among a set of fixed predetermined linear response functions. In a second technique, the overdrive pacing unit operates to optimize the shape of a single non-linear dynamic overdrive pacing response function so as to achieve the desired degree of overdrive pacing for the patient. The second technique may either be employed alone or in combination with the first, hierarchical optimization technique.
摘要翻译：动态超速起搏调节技术被描述用于可植入心脏刺激装置。在第一技术中，可植入装置的微控制器的过驱动起搏单元操作以优化影响过驱动起搏的各种控制参数，以便为其中植入刺激装置的特定患者达到期望程度的过速起搏。要优化的参数包括一旦超速起搏起搏起搏，超速起搏响应功能，恢复速率和各种基准速率起搏的过载跳动次数。控制参数以优先级的等级顺序进行调整，直到达到期望的过速起搏程度。通过使用增量数值调整迭代地执行过载跳动次数的调整，恢复率和各种基本速率。可以通过在一组固定的预定线性响应函数中进行选择来执行过速起搏响应功能的调整。在第二种技术中，超速起搏单元操作以优化单个非线性动态超速起搏响应功能的形状，以便达到病人期望程度的超速起搏起搏。第二种技术可以单独使用，也可以与第一层级优化技术结合使用。

28. 发明授权

US06711438B1 Method and apparatus for blanking T-waves from combipolar atrial cardiac signals based on expected T-wave locations 有权
标题翻译：基于预期的T波位置从组合极心房心脏信号消隐T波的方法和装置
公开(公告)号：US06711438B1
公开(公告)日：2004-03-23
申请号：US10033410
申请日：2001-10-25
申请人： Kelly H. McClure , Joseph J. Florio , Gene A. Bornzin
发明人： Kelly H. McClure , Joseph J. Florio , Gene A. Bornzin
IPC分类号： A61N1362
CPC分类号： A61N1/368 , A61N1/3704
摘要： The stimulation device blanks T-waves from the atrial channel of an electrical cardiac signal by employing a T-wave blanking interval localized to the expected location and duration of the T-wave. To this end, the stimulation device determines the average interval between an R-wave and a T-wave in the patient in which the device is implanted and also determines the average duration of a T-wave within the patient. A T-wave blanking interval is initiated following the average R-T interval subsequent to detection of an R-wave and lasts for a period of time equal to the average T-wave duration. In this manner, highly localized T-wave blanking is achieved permitting P-waves or other atrial signals to be detected during remaining non-blanked portions of the atrial channel of the cardiac signal at least for the purposes of atrial rate detection. The relatively short T-wave blanking interval of the invention is particularly well suited for use in combipolar sensing systems. Method and apparatus implementations are described.
摘要翻译：刺激装置通过采用局限于T波的预期位置和持续时间的T波消隐间隔来消除来自心电信号心房通道的T波。为此，刺激装置确定在其中植入装置的患者中的R波和T波之间的平均间隔，并且还确定患者内的T波的平均持续时间。在检测到R波之后的平均R-T间隔之后开始T波消隐间隔，并且持续一段时间等于平均T波持续时间。以这种方式，实现高度局部化的T波消隐，允许在心脏信号的心房通道的剩余非消隐部分期间检测P波或其他心房信号，至少用于心房率检测。本发明的相对较短的T波消隐间隔特别适用于组合极检测系统。描述了方法和装置实现。

29. 发明授权

US06636766B2 System and method for preventing sudden heart rate drop using implantable cardiac pacing device 有权
公开(公告)号：US06636766B2
公开(公告)日：2003-10-21
申请号：US09849723
申请日：2001-05-03
申请人： Gene A. Bornzin , Junyu Mai , Euljoon Park , Joseph J. Florio
发明人： Gene A. Bornzin , Junyu Mai , Euljoon Park , Joseph J. Florio
IPC分类号： A61N1365
CPC分类号： A61N1/362
摘要： A rate smoothing technique is applied by the pacing device to sensed and paced heart signals so as to prevent a sharp drop in heart rate, particularly for use within patients prone to vasovagal syncope. The rate smoothing technique is applied by the pacing device during the calculation of an escape interval employed by the device in determining whether to pace the heart. The rate smoothing technique has the effect of adjusting the escape interval to ensure the heart is paced for a period of time subsequent to a sharp drop in the natural heart rate of the patient permitting the heart rate to decrease gradually rather than suddenly. The rate smoothing technique however does not interfere with a sharp increase in heart rate as may be required during sudden physical exertion. System and method examples are described herein.

30. 发明授权

US06606517B1 Methods and apparatus for preventing atrial arrhythmias by overdrive pacing and prolonging atrial refractoriness using an implantable cardiac stimulation device 有权
$Methods and apparatus for preventing atrial arrhythmias by overdrive pacing and prolonging atrial refractoriness using an implantable cardiac stimulation device$
标题翻译：使用可植入心脏刺激装置通过过度起搏预防房性心律失常和延长心房不应性的方法和装置
公开(公告)号：US06606517B1
公开(公告)日：2003-08-12
申请号：US09548293
申请日：2000-04-12
申请人： Euljoon Park , Gene A. Bornzin , Joseph J. Florio , John W. Poore , Laurence S. Sloman , Peter Boileau , Douglas T. Kurschinski
发明人： Euljoon Park , Gene A. Bornzin , Joseph J. Florio , John W. Poore , Laurence S. Sloman , Peter Boileau , Douglas T. Kurschinski
IPC分类号： A61N1362
CPC分类号： A61N1/3622
摘要： A method and apparatus for reducing the incidence of atrial arrhythmias by using an overdrive algorithm to determine the application of overdrive stimulation pulses to a patient's heart, e.g., in the atria. In a first aspect of the invention, the apparatus first determines an overdrive pacing rate and then applies pairs of temporally spaced (staggered) pacing pulses, i.e., primary and secondary pacing pulses, at the determined overdrive pacing rate. In a further aspect of the invention, the pairs of pacing pulses are applied at the overdrive pacing rate to multiple spatially spaced electrodes, i.e., electrodes distributed among multiple sites in a patient's heart, e.g., in the atria. In accordance with a first preferred embodiment, the electrodes may be distributed within a single atrium, e.g., the right atrium, of the patient's heart. Alternatively, a first electrode may be placed in the right atrium and a second electrode may be placed in the coronary sinus or the left atrium or multiple electrodes may be placed proximate to the left atrium. Furthermore, the invention relates to techniques for controlling overdrive pacing to multiple sites in a patient's heart so as to achieve and maintain a target degree of pacing and thus suppress tachycardias.
摘要翻译：一种用于通过使用过驱动算法来确定过度驱动刺激脉冲施加到患者心脏（例如在心房）中来减少心房心律失常发生率的方法和装置。在本发明的第一方面中，装置首先确定过驱动起搏速率，然后以确定的超速起搏速率施加时间间隔（交错）的起搏脉冲，即初级和次级起搏脉冲。在本发明的另一方面，以超速起搏速率将多对起搏脉冲施加到多个空间间隔开的电极，即分布在患者心脏中的多个部位之间的电极，例如在心房中。根据第一优选实施例，电极可以分布在患者心脏的单个心房（例如右心房）内。或者，第一电极可以放置在右心房中，并且第二电极可以放置在冠状窦或左心房中，或者多个电极可以放置在靠近左心房的位置。此外，本发明涉及用于控制对患者心脏中的多个部位的超速起搏的技术，以便实现和维持目标起搏程度，从而抑制心动过速。

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