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21. 发明申请

US20110213261A1 SYSTEMS AND METHODS FOR USE WITH SUBCUTANEOUS IMPLANTABLE MEDICAL DEVICES FOR DETECTING ELECTRODE/TISSUE CONTACT PROBLEMS 审中-公开
标题翻译：用于检测电极/组织接触问题的可插入医疗器械的系统和方法
公开(公告)号：US20110213261A1
公开(公告)日：2011-09-01
申请号：US12714231
申请日：2010-02-26
申请人： Mihir Naware , Cecilia Qin Xi
发明人： Mihir Naware , Cecilia Qin Xi
IPC分类号： A61B5/0452
CPC分类号： A61B5/6886
摘要： Techniques are provided for detecting problems involving electrode/tissue contact with extracardiac electrodes of subcutaneous monitoring devices, such as atrial fibrillation (AF) monitors. Briefly, subcutaneous impedance signals are detected using extracardiac sensing electrodes of the subcutaneous device. Problems involving poor electrode/tissue contact are then detected within the subcutaneous impedance signals. Depending upon its programming, the device can then inhibit the recording of subcutaneous electrocardiogram (ECG) data during periods of poor contact. Additionally, the device can identify the particular contact problem based on the impedance signals. In one example, the device identifies one or more of: acute instability of impedance indicative of intermittent electrode/tissue contact; impedance signal saturation indicative of loss of electrode/tissue contact; and impedance signal dropout indicative of the presence of liquids surrounding the electrodes (such as blood or edema accumulation.) Techniques for programming various modes of operation of the subcutaneous device are also provided.
摘要翻译：提供技术用于检测涉及与皮下监测装置（例如心房颤动（AF））监测器的心脏电极接触的电极/组织的问题。简而言之，使用皮下装置的心外感测电极检测皮下阻抗信号。然后在皮下阻抗信号中检测到涉及电极/组织接触不良的问题。根据其编程，器件可以在不良接触期间抑制皮下心电图（ECG）数据的记录。另外，设备可以基于阻抗信号来识别特定的接触问题。在一个示例中，该装置识别以下中的一个或多个：表示间歇性电极/组织接触的阻抗的急性不稳定性; 指示电极/组织接触丧失的阻抗信号饱和度; 以及指示电极周围的液体的存在的阻抗信号丢失（例如血液或水肿积聚）。还提供了用于编程皮下装置的各种操作模式的技术。

22. 发明授权

US07676264B1 Systems and methods for use by an implantable medical device for evaluating ventricular dyssynchrony based on T-wave morphology 有权
标题翻译：基于T波形态的可植入医疗装置用于评估心室不同步的系统和方法
公开(公告)号：US07676264B1
公开(公告)日：2010-03-09
申请号：US11734850
申请日：2007-04-13
申请人： Ajit Pillai , Mihir Naware , Dorin Panescu
发明人： Ajit Pillai , Mihir Naware , Dorin Panescu
IPC分类号： A61N1/00
CPC分类号： A61N1/3627 , A61B5/0452 , A61B5/7239 , A61N1/365
摘要： Techniques are provided for detecting and evaluating ventricular dyssynchrony based on morphological features of the T-wave and for controlling therapy in response thereto. For example, the number of peaks in the T-wave, the area under the peaks, the number of points of inflection, and the slope of the T-wave can be used to detect ventricular dyssynchrony and evaluate its severity. As ventricular dyssynchrony often arises due to heart failure, the degree of dyssynchrony may also be used as a proxy for tracking the progression of heart failure. Pacing therapy is automatically and adaptively adjusted based on the degree of ventricular dyssynchrony so as to reduce the dyssynchrony and thereby improve cardiac function.
摘要翻译：提供了基于T波的形态学特征和用于控制对其的治疗来检测和评价心室不同步的技术。例如，可以使用T波中的峰数，峰下的面积，拐点的数量和T波的斜率来检测心室不同步并评估其严重程度。由于心脏衰竭经常出现心室不同步，不同步程度也可用作跟踪心力衰竭进展的代理。基于心室不同步程度自动调整起搏治疗，减少不同步，从而改善心脏功能。

23. 发明申请

US20090018597A1 System and Method for Estimating Cardiac Pressure Based on Cardiac Electrical Conduction Delays Using an Implantable Medical Device 有权
公开(公告)号：US20090018597A1
公开(公告)日：2009-01-15
申请号：US11779350
申请日：2007-07-18
申请人： Brian Jeffrey Wenzel , Dan E. Gutfinger , Mihir Naware , Xiaoyi Min , Jeffery Siou , Anders Bjorling , Dorin Panescu
发明人： Brian Jeffrey Wenzel , Dan E. Gutfinger , Mihir Naware , Xiaoyi Min , Jeffery Siou , Anders Bjorling , Dorin Panescu
IPC分类号： A61N1/36
CPC分类号： A61B5/02156 , A61B5/0215 , A61B5/72 , A61N1/365 , A61N1/36564 , A61N1/36578 , A61N1/3682 , A61N1/3684 , A61N1/37258
摘要： Techniques are provided for estimating left atrial pressure (LAP) or other cardiac performance parameters based on measured conduction delays. In particular, LAP is estimated based interventricular conduction delays. Predetermined conversion factors stored within the device are used to convert the various the conduction delays into LAP values or other appropriate cardiac performance parameters. The conversion factors may be, for example, slope and baseline values derived during an initial calibration procedure performed by an external system, such as an external programmer. In some examples, the slope and baseline values may be periodically re-calibrated by the implantable device itself. Techniques are also described for adaptively adjusting pacing parameters based on estimated LAP or other cardiac performance parameters. Still further, techniques are described for estimating conduction delays based on impedance or admittance values and for tracking heart failure therefrom.

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