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41. 发明申请

US20090299211A1 SYSTEM AND METHOD FOR ESTIMATING ELECTRICAL CONDUCTION DELAYS FROM IMMITTANCE VALUES MEASURED USING AN IMPLANTABLE MEDICAL DEVICE 有权
标题翻译：从使用可植入医疗器械的测量值估算电导率延迟的系统和方法
公开(公告)号：US20090299211A1
公开(公告)日：2009-12-03
申请号：US12127963
申请日：2008-05-28
申请人： Brian Jeffrey Wenzel , Dorin Panescu , Mihir Naware , Jeffery Siou
发明人： Brian Jeffrey Wenzel , Dorin Panescu , Mihir Naware , Jeffery Siou
IPC分类号： A61B5/053
CPC分类号： A61B5/0215 , A61B5/0002 , A61B5/002 , A61B5/053 , A61B5/4839 , A61B5/686 , A61B5/7278 , A61B5/7282 , A61B5/7405 , A61B5/742 , A61B5/746 , A61B2560/0223 , A61N1/36521
摘要： Techniques are provided for estimating electrical conduction delays with the heart of a patient based on measured immittance values. In one example, impedance or admittance values are measured within the heart of a patient by a pacemaker or other implantable medical device, then used by the device to estimate cardiac electrical conduction delays. A first set of predetermined conversion factors may be used to convert the measured immittance values into conduction delay values. In some examples, the device then uses the estimated conduction delay values to estimate LAP or other cardiac pressure values. A second set of predetermined conversion factors may be used to convert the estimated conduction delays into pressure values. Techniques are also described for adaptively adjusting pacing parameters based on estimated LAP.
摘要翻译：提供了用于基于测量的导纳值估计与患者心脏的导电延迟的技术。在一个示例中，阻抗或导纳值由起搏器或其他可植入医疗装置在患者的心脏内测量，然后由装置用于估计心脏导电延迟。可以使用第一组预定转换因子将测量的导纳值转换为导通延迟值。在一些示例中，器件然后使用估计的传导延迟值来估计LAP或其他心脏压力值。可以使用第二组预定转换因子将估计的传导延迟转换为压力值。还描述了基于估计的LAP自适应地调整起搏参数的技术。

42. 发明授权

US09002450B2 Systems and methods for assessing the sphericity and dimensional extent of heart chambers for use with an implantable medical device 有权
标题翻译：用于评估与可植入医疗装置一起使用的心室的球形度和尺寸范围的系统和方法
公开(公告)号：US09002450B2
公开(公告)日：2015-04-07
申请号：US12975085
申请日：2010-12-21
申请人： Stuart Rosenberg , Yelena Nabutovsky , Cecilia Qin Xi , Jong Gill , Kyungmoo Ryu , Brian Jeffrey Wenzel , William Hsu
发明人： Stuart Rosenberg , Yelena Nabutovsky , Cecilia Qin Xi , Jong Gill , Kyungmoo Ryu , Brian Jeffrey Wenzel , William Hsu
IPC分类号： A61N1/00 , A61N1/362 , A61N1/365 , A61N1/368 , A61N1/39
CPC分类号： A61N1/3627 , A61N1/36521 , A61N1/3684 , A61N1/3686 , A61N1/3962
摘要： Techniques are provided for use with an implantable medical device for assessing left ventricular (LV) sphericity and atrial dimensional extent based on impedance measurements for the purposes of detecting and tracking heart failure and related conditions such as volume overload or mitral regurgitation. In some examples described herein, various short-axis and long-axis impedance vectors are exploited that pass through portions of the LV for the purposes of assessing LV sphericity. In other examples, impedance measurements taken along a vector between a right atrial (RA) ring electrode and an LV electrode implanted near the atrioventricular (AV) groove are exploited to assess LA extent, biatrial extent or mitral annular diameter. The assessment techniques can be employed alone or in conjunction with other heart failure detection techniques, such as those based on left atrial pressure (LAP.)
摘要翻译：提供技术用于可植入医疗装置，用于基于阻抗测量来评估左心室（LV）球形度和心房尺寸范围，以便检测和跟踪心力衰竭和相关状况（例如体积过载或二尖瓣反流）。在本文描述的一些示例中，为了评估LV球形度的目的，利用穿过LV的部分的各种短轴和长轴阻抗矢量。在其他示例中，利用沿右心房（RA）环电极和植入在房室（AV）槽附近的LV电极之间的载体进行的阻抗测量来评估LA范围，生物学程度或二尖瓣环直径。评估技术可以单独使用或与其他心力衰竭检测技术结合使用，例如基于左心房压力（LAP）的那些。

43. 发明授权

US08517941B1 Implantable cardiac device and method for monitoring blood-glucose concentration 有权
标题翻译：植入式心脏装置及监测血糖浓度的方法
公开(公告)号：US08517941B1
公开(公告)日：2013-08-27
申请号：US11877004
申请日：2007-10-23
申请人： Brian Jeffrey Wenzel
发明人： Brian Jeffrey Wenzel
IPC分类号： A61B5/02
CPC分类号： A61B5/14503 , A61B5/0031 , A61B5/14532 , A61B5/14535 , A61B5/14552 , A61B5/1495 , A61M5/14276 , A61M2005/14208 , A61M2005/1726 , A61M2205/3507 , A61M2205/3523 , A61M2205/3561 , A61M2205/3584 , A61N1/3605 , A61N1/36557
摘要： An implantable medical device, implantable cardiac stimulation device, implantable defibrillator or pacemaker provides continuous monitoring of blood-glucose concentration in the blood of a patient. Blood-glucose concentration and blood-glucose concentration trends are calculated by measuring changes in the hematocrit of the patient. An external blood-glucose monitor may be used to provide blood-glucose calibration values to the implantable device to enhance accuracy of blood-glucose concentration values. The implantable device compares the blood-glucose concentration and/or concentration trends with acceptable limits and generates appropriate warning signals. The implantable device may optionally control one or more therapeutic devices to maintain blood-glucose concentration within an acceptable range. The enhanced control of blood-glucose concentration reduces the risk of arrhythmia and enhances the effectiveness of cardiac pacing and/or defibrillation.
摘要翻译：可植入医疗装置，可植入心脏刺激装置，可植入除颤器或起搏器提供对患者血液中血糖浓度的连续监测。通过测量患者的血细胞比容变化来计算血糖浓度和血糖浓度趋势。可以使用外部血糖监测器向可植入装置提供血糖校准值，以提高血糖浓度值的准确度。可植入装置将血糖浓度和/或浓度趋势与可接受的限度进行比较，并产生适当的警告信号。可植入装置可以可选地控制一个或多个治疗装置以将血糖浓度维持在可接受的范围内。增强的血糖浓度控制可降低心律失常的风险，并提高心脏起搏和/或除颤的有效性。

44. 发明申请

US20130137999A1 SYSTEM AND METHOD FOR ESTIMATING ELECTRICAL CONDUCTION DELAYS FROM IMMITTANCE VALUES MEASURED USING AN IMPLANTABLE MEDICAL DEVICE 审中-公开
公开(公告)号：US20130137999A1
公开(公告)日：2013-05-30
申请号：US13485512
申请日：2012-05-31
申请人： Brian Jeffrey Wenzel , Dorin Panescu , Mihir Naware , Jeffery Siou
发明人： Brian Jeffrey Wenzel , Dorin Panescu , Mihir Naware , Jeffery Siou
IPC分类号： A61B5/0215 , A61N1/365 , A61B5/00
CPC分类号： A61B5/0215 , A61B5/0002 , A61B5/002 , A61B5/053 , A61B5/4839 , A61B5/686 , A61B5/7278 , A61B5/7282 , A61B5/7405 , A61B5/742 , A61B5/746 , A61B2560/0223 , A61N1/36521
摘要： Techniques are provided for estimating electrical conduction delays with the heart of a patient based on measured immittance values. In one example, impedance or admittance values are measured within the heart of a patient by a pacemaker or other implantable medical device, then used by the device to estimate cardiac electrical conduction delays. A first set of predetermined conversion factors may be used to convert the measured immittance values into conduction delay values. In some examples, the device then uses the estimated conduction delay values to estimate LAP or other cardiac pressure values. A second set of predetermined conversion factors may be used to convert the estimated conduction delays into pressure values. Techniques are also described for adaptively adjusting pacing parameters based on estimated LAP.

45. 发明申请

US20120221066A1 Systems and Methods for Activating and Controlling Impedance-Based Detection Systems of Implantable Medical Devices 有权
标题翻译：用于激活和控制可植入医疗器械的基于阻抗的检测系统的系统和方法
公开(公告)号：US20120221066A1
公开(公告)日：2012-08-30
申请号：US13035773
申请日：2011-02-25
申请人： Stuart Rosenberg , Cecilia Qin Xi , Yelena Nabutovsky , Brian Jeffrey Wenzel , Jong Gill , William Hsu
发明人： Stuart Rosenberg , Cecilia Qin Xi , Yelena Nabutovsky , Brian Jeffrey Wenzel , Jong Gill , William Hsu
IPC分类号： A61N1/36
CPC分类号： A61N1/3627 , A61N1/3702 , A61N1/372
摘要： Techniques are provided for use with implantable medical devices for addressing encapsulation effects, particularly in the detection of cardiac decompensation events such as heart failure (HF) or cardiogenic pulmonary edema (PE.) In one example, during an acute interval following device implant, cardiac decompensation is detected using heart rate variability (HRV), ventricular evoked response (ER) or various other non-impedance-based parameters that are insensitive to component encapsulation effects. During the subsequent chronic interval, decompensation is detected using intracardiac or transthoracic impedance signals. In another example, the degree of maturation of encapsulation of implanted components is assessed using impedance frequency-response measurements or based on the frequency bandwidth of heart sounds or other physiological signals. In this manner, impedance-based HF/PE detection systems can be activated as soon as component encapsulation has matured, without necessarily waiting until completion of a preset post-implant maturation interval, often set to forty-five days or more.
摘要翻译：提供技术用于可植入医疗装置，用于解决封装效应，特别是在心脏代偿失调事件如心力衰竭（HF）或心源性肺水肿（PE）的检测中。在一个实例中，在装置植入后的急性期间，心脏使用心率变异性（HRV），心室诱发反应（ER）或对组件封装效应不敏感的各种其他基于非阻抗的参数来检测代偿失调。在随后的慢性间隔期间，使用心内或经胸阻抗信号检测代偿失调。在另一示例中，使用阻抗频率响应测量值或基于心脏声音或其他生理信号的频率带宽来评估植入部件的封装的成熟程度。以这种方式，一旦组件封装已经成熟，就可以激活基于阻抗的HF / PE检测系统，而不必等待直到完成植入后成熟间隔的预设，通常设置为四十五天或更长时间。

46. 发明申请

US20120190957A1 SYSTEM AND METHOD FOR MONITORING CARDIAC DISEASE 审中-公开
标题翻译：监测心脏病的系统和方法
公开(公告)号：US20120190957A1
公开(公告)日：2012-07-26
申请号：US13010535
申请日：2011-01-20
申请人： Jong Gill , Cecilia Qin Xi , Stuart Rosenberg , Yelena Nabutovsky , Brian Jeffrey Wenzel , William Hsu
发明人： Jong Gill , Cecilia Qin Xi , Stuart Rosenberg , Yelena Nabutovsky , Brian Jeffrey Wenzel , William Hsu
IPC分类号： A61B5/042 , A61B5/0408 , A61B5/0402
CPC分类号： A61B5/0452 , A61B5/4842 , A61N1/3627 , A61N1/36507
摘要： A method of monitoring progression of cardiac disease includes applying stimulus pulses to the heart and sensing electrophysiological responses of the heart at a plurality of different monitoring locations of the heart. The method also includes comparing a previously and subsequently sensed electrophysiological responses that are sensed near a first location of the monitoring locations and comparing previously and subsequently sensed electrophysiological responses that are sensed near a second location of the monitoring locations. The method further includes identifying a change in progression of cardiac disease of the heart based on a difference between the previously and subsequently sensed electrophysiological responses at the first location and based on a difference between the previously and subsequently sensed electrophysiological responses at the second location.
摘要翻译：监测心脏疾病进展的方法包括向心脏施加刺激脉冲并感测在心脏的多个不同监测位置的心脏的电生理反应。该方法还包括比较在监测位置的第一位置附近感测的先前和随后感测到的电生理反应，并比较先前和随后感测到的在监测位置的第二位置附近感测到的电生理反应。该方法还包括基于在第一位置处的先前感测和随后感测的电生理反应之间的差异，并且基于在第二位置处的先前感知和随后感测到的电生理反应之间的差异来识别心脏的心脏疾病进展的变化。

47. 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.

48. 发明授权

US08504153B2 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：US08504153B2
公开(公告)日：2013-08-06
申请号：US11779380
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： A61N1/365
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.

49. 发明申请

US20120165884A1 FLUID ACCUMULATION MONITORING DEVICES, SYSTEMS AND METHODS 审中-公开
标题翻译：流体累积监测装置，系统和方法
公开(公告)号：US20120165884A1
公开(公告)日：2012-06-28
申请号：US12975794
申请日：2010-12-22
申请人： Cecilia Qin Xi , Stuart Rosenberg , Jong Gill , Yelena Nabutovsky , William Hsu , Brian Jeffrey Wenzel
发明人： Cecilia Qin Xi , Stuart Rosenberg , Jong Gill , Yelena Nabutovsky , William Hsu , Brian Jeffrey Wenzel
IPC分类号： A61B5/053 , A61N1/39 , A61N1/362
CPC分类号： A61B5/0538 , A61B5/0537 , A61B5/4878 , A61B5/7239 , A61N1/3627 , A61N1/36521
摘要： Provided herein are implantable systems, and methods for use therewith, for monitoring a patient's fluid accumulation level. A thoracic impedance signal for the patient is obtained. Based on the thoracic impedance signal, a duration metric indicative of a duration of drop of the thoracic impedance signal, a magnitude metric indicative of a magnitude of drop of the thoracic impedance signal, and a rate metric indicative of a rate of drop of the thoracic impedance signal is determined. The patient's fluid accumulation level is monitored based on the duration metric, the magnitude metric and the rate metric.
摘要翻译：本文提供了可植入系统及其使用的方法，用于监测患者的血液积聚水平。获得患者的胸部阻抗信号。基于胸部阻抗信号，指示胸部阻抗信号下降持续时间的持续时间度量，指示胸部阻抗信号的下降幅度的幅度度量，以及指示胸部下降速率的速率度量确定阻抗信号。基于持续时间度量，幅度度量和速率度量来监测患者的血液积聚水平。

50. 发明申请

US20120158079A1 SYSTEMS AND METHODS FOR ASSESSING THE SPHERICITY AND DIMENSIONAL EXTENT OF HEART CHAMBERS FOR USE WITH AN IMPLANTABLE MEDICAL DEVICE 有权
标题翻译：用于评估使用可植入医疗设备的心脏瓣膜的空间和尺寸范围的系统和方法
公开(公告)号：US20120158079A1
公开(公告)日：2012-06-21
申请号：US12975085
申请日：2010-12-21
申请人： Stuart Rosenberg , Yelena Nabutovsky , Cecilia Qin Xi , Jong Gill , Kyungmoo Ryu , Brian Jeffrey Wenzel , William Hsu
发明人： Stuart Rosenberg , Yelena Nabutovsky , Cecilia Qin Xi , Jong Gill , Kyungmoo Ryu , Brian Jeffrey Wenzel , William Hsu
IPC分类号： A61N1/362
CPC分类号： A61N1/3627 , A61N1/36521 , A61N1/3684 , A61N1/3686 , A61N1/3962
摘要： Techniques are provided for use with an implantable medical device for assessing left ventricular (LV) sphericity and atrial dimensional extent based on impedance measurements for the purposes of detecting and tracking heart failure and related conditions such as volume overload or mitral regurgitation. In some examples described herein, various short-axis and long-axis impedance vectors are exploited that pass through portions of the LV for the purposes of assessing LV sphericity. In other examples, impedance measurements taken along a vector between a right atrial (RA) ring electrode and an LV electrode implanted near the atrioventricular (AV) groove are exploited to assess LA extent, biatrial extent or mitral annular diameter. The assessment techniques can be employed alone or in conjunction with other heart failure detection techniques, such as those based on left atrial pressure (LAP.)
摘要翻译：提供技术用于可植入医疗装置，用于基于阻抗测量来评估左心室（LV）球形度和心房尺寸范围，以便检测和跟踪心力衰竭和相关状况（例如体积过载或二尖瓣反流）。在本文描述的一些示例中，为了评估LV球形度的目的，利用穿过LV的部分的各种短轴和长轴阻抗矢量。在其他示例中，利用沿右心房（RA）环电极和植入在房室（AV）槽附近的LV电极之间的载体进行的阻抗测量来评估LA范围，生物学程度或二尖瓣环直径。评估技术可以单独使用或与其他心力衰竭检测技术结合使用，例如基于左心房压力（LAP）的那些。

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