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    • 41. 发明授权
    • System and method for monitoring diastolic function using an implantable medical device
    • 使用可植入医疗装置监测舒张功能的系统和方法
    • US08874213B2
    • 2014-10-28
    • US13601569
    • 2012-08-31
    • Allen KeelSteve KohTaraneh Ghaffari Farazi
    • Allen KeelSteve KohTaraneh Ghaffari Farazi
    • A61N1/362A61N1/37A61N1/368A61N1/365
    • A61N1/3702A61N1/3627A61N1/36507A61N1/368A61N1/3712
    • Diastolic function is monitored within a patient using a pacemaker or other implantable medical device. In one example, the implantable device uses morphological parameters derived from the T-wave evoked response waveform as proxies for ventricular relaxation rate and ventricular compliance. In particular, the magnitude of the peak of the T-wave evoked response is employed as a proxy for ventricular compliance. The maximum slew rate of the T-wave evoked response following its peak is employed as a proxy for ventricular relaxation. A metric is derived from these proxy values to represent diastolic function. The metric is tracked over time to evaluate changes in diastolic function. In other examples, specific values for ventricular compliance and ventricular relaxation are derived for the patient based on the T-wave evoked response parameters.
    • 使用起搏器或其他可植入医疗器械在患者体内监测舒张功能。 在一个示例中,可植入装置使用从T波诱发反应波形导出的形态参数作为心室松弛率和心室顺应性的代理。 特别地,T波诱发反应的峰值的大小被用作心室顺应性的代表。 其峰值后的T波诱发反应的最大压摆率被用作心室松弛的代用品。 来自这些代理值的度量来表示舒张功能。 随着时间的推移跟踪度量以评估舒张功能的变化。 在其他实例中,基于T波诱发反应参数为患者导出心室顺应性和心室松弛的具体值。
    • 44. 发明申请
    • SYSTEMS AND METHODS FOR ASSESSING HEART FAILURE AND CONTROLLING CARDIAC RESYNCHRONIZATION THERAPY USING HYBRID IMPEDANCE MEASUREMENT CONFIGURATIONS
    • 用于评估心脏衰竭和控制使用混合阻抗测量配置的心脏再生治疗的系统和方法
    • US20130053912A1
    • 2013-02-28
    • US13217554
    • 2011-08-25
    • Gene A. BornzinXiaoyi MinLaurence S. SlomanSteve Koh
    • Gene A. BornzinXiaoyi MinLaurence S. SlomanSteve Koh
    • A61N1/368
    • A61B5/053A61B5/0205A61B5/0538A61B5/686A61N1/36185A61N1/3627A61N1/3686
    • Techniques are provided for use with an implantable medical device for detecting and assessing heart failure and for controlling cardiac resynchronization therapy (CRT) based on impedance signals obtained using hybrid impedance configurations. The hybrid configurations exploit right atrial (RA)-based impedance measurement vectors and/or left ventricular (LV)-based impedance measurement vectors. In one example, current is injected between the device case and a ring electrode in the right ventricle (RV) or RA. RA-based impedance values are measured along vectors between the device case and an RA electrode. LV-based impedance values are measured along vectors between the device case and one or more electrodes of the LV. Heart failure and other cardiac conditions are detected and tracked using the measured impedance values. CRT delay parameters are also optimized based impedance. In this manner, multiple hybrid impedance measurement configurations are exploited whereby different vectors are used to inject current and measure impedance.
    • 提供技术用于可植入医疗装置,用于基于使用混合阻抗配置获得的阻抗信号来检测和评估心力衰竭并用于控制心脏再同步治疗(CRT)。 混合配置利用基于右心房(RA)的阻抗测量向量和/或左心室(LV))的阻抗测量向量。 在一个示例中,电流注入到装置壳体和右心室(RV)或RA中的环形电极之间。 基于RA的阻抗值是沿器件壳体和RA电极之间的矢量测量的。 基于LV的阻抗值在器件壳体和LV的一个或多个电极之间的矢量上测量。 使用测量的阻抗值检测和跟踪心力衰竭和其他心脏状况。 CRT延迟参数也是基于阻抗的优化。 以这种方式,利用多个混合阻抗测量配置,由此使用不同的矢量来注入电流并测量阻抗。
    • 46. 发明授权
    • Adaptive rate programming control in implantable medical devices using ventricular-arterial coupling surrogates
    • 使用心室 - 动脉耦合代理的可植入医疗装置中的自适应速率编程控制
    • US08249706B2
    • 2012-08-21
    • US12694098
    • 2010-01-26
    • Steve Koh
    • Steve Koh
    • A61N1/365
    • A61N1/36514
    • Selection of an appropriate rate programming control (RPC) setting in an implantable medical device (IMD), uses analysis of VA coupling surrogate conditions. The VA coupling surrogate conditions are derived from signals such as cardiogenic impedance, blood pressure, and the pulsatile components of PPG. By analyzing a waveform of the measured surrogate condition, the IMD estimates wall stiffness, through the slope of the waveform, and peripheral arterial pressure, through the reflection time between the main wave and reflection wave of the waveform. These values are plotted against each other on a VA coupling coordinate plane. Based on the location and orientation of the resulting VA coupling plot, the IMD selects an appropriate RPC setting.
    • 在可植入医疗设备(IMD)中选择适当的速率编程控制(RPC)设置,使用VA耦合替代条件的分析。 VA耦合替代条件来自诸如心源阻抗,血压和PPG脉冲成分的信号。 通过分析测量的替代条件的波形,IMD通过波形的波形和反射波之间的反射时间来估计壁面刚度,通过波形斜率和外周动脉压力。 这些值在VA耦合坐标平面上相互绘图。 根据所得的VA耦合图的位置和方向,IMD选择适当的RPC设置。