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41. 发明授权

US07769437B2 Method and apparatus for determining changes in heart failure status 有权
标题翻译：用于确定心力衰竭状态变化的方法和装置
公开(公告)号：US07769437B2
公开(公告)日：2010-08-03
申请号：US11299876
申请日：2005-12-12
申请人： Qingsheng Zhu , Julio C. Spinelli , Bruce H. KenKnight , Jay A. Warren
发明人： Qingsheng Zhu , Julio C. Spinelli , Bruce H. KenKnight , Jay A. Warren
IPC分类号： A61B5/04
CPC分类号： A61N1/3627 , A61N1/36585
摘要： A method for operating a cardiac rhythm management device in which a clinical state vector is computed as a combination of a plurality of parameters related to a patient's heart failure status and compared to a previously computed clinical state vector to determine a clinical trajectory indicative of changes in the patient's heart failure status. Such detected changes in status can be used both as a clinical tool to evaluate treatment and to automatically adjust the operation of the device.
摘要翻译：一种用于操作心律管理装置的方法，其中临床状态矢量被计算为与患者心力衰竭状态相关的多个参数的组合，并且与先前计算的临床状态向量进行比较，以确定指示变化的临床轨迹患者的心力衰竭状态。这种检测到的状态变化可以用作临床工具来评估治疗并自动调整装置的操作。

42. 发明申请

US20100152799A1 Implantable Defibrillator Systems and Methods with Mitigations for Saturation Avoidance and Accommodation 有权
标题翻译：植入式除颤器系统和缓解饱和度的住院方法
公开(公告)号：US20100152799A1
公开(公告)日：2010-06-17
申请号：US12636575
申请日：2009-12-11
申请人： Rick Sanghera , Venugopal Allavatam , Surekha Palreddy , Jay A. Warren
发明人： Rick Sanghera , Venugopal Allavatam , Surekha Palreddy , Jay A. Warren
IPC分类号： A61N1/39
CPC分类号： A61N1/3704 , A61N1/048 , A61N1/0504 , A61N1/0563 , A61N1/3702 , A61N1/3968 , A61N1/3987
摘要： Methods and implantable devices that address response to, or avoidance of, likely non-cardiac voltages including afterpotentials from external or internal stimulus. Some examples are directed toward methods of operation in implantable medical devices, the methods configured for identifying saturation of input circuitry and mitigating the effects of such saturation. Some examples are directed toward implantable cardiac stimulus or monitoring devices that include methods for identifying saturated conditions and mitigating the effects of such saturation.
摘要翻译：解决可能的非心脏电压（包括来自外部或内部刺激的后电位）的响应或避免的方法和可植入装置。一些示例涉及可植入医疗设备中的操作方法，该方法被配置用于识别输入电路的饱和度并减轻这种饱和的影响。一些示例涉及可植入心脏刺激或监测装置，其包括用于识别饱和状况和减轻这种饱和的影响的方法。

43. 发明申请

US20100076513A1 Multiple Electrode Vectors for Implantable Cardiac Treatment Devices 有权
标题翻译：用于可植入心脏治疗装置的多个电极载体
公开(公告)号：US20100076513A1
公开(公告)日：2010-03-25
申请号：US12627861
申请日：2009-11-30
申请人： Jay A. Warren , Gust H. Bardy
发明人： Jay A. Warren , Gust H. Bardy
IPC分类号： A61N1/365
CPC分类号： A61B5/0424 , A61B5/0402 , A61B5/042 , A61B5/04288 , A61B5/076 , A61B5/7207 , A61N1/3622 , A61N1/3925
摘要： The implantable cardiac treatment system of the present invention is capable of choosing the most appropriate electrode vector to sense within a particular patient. In certain embodiments, the implantable cardiac treatment system determines the most appropriate electrode vector for continuous sensing based on which electrode vector results in the greatest signal amplitude, or some other useful metric such as signal-to-noise ratio (SNR). The electrode vector possessing the highest quality as measured using the metric is then set as the default electrode vector for sensing. Additionally, in certain embodiments of the present invention, a next alternative electrode vector is selected based on being generally orthogonal to the default electrode vector. In yet other embodiments of the present invention, the next alternative electrode vector is selected based on possessing the next highest quality metric after the default electrode vector. In some embodiments, if analysis of the default vector is ambiguous, the next alternative electrode vector is analyzed to reduce ambiguity.
摘要翻译：本发明的可植入心脏治疗系统能够选择最合适的电极载体以在特定患者体内感测。在某些实施例中，可植入心脏治疗系统基于哪个电极向量导致最大的信号幅度或诸如信噪比（SNR）的一些其他有用的度量来确定用于连续感测的最合适的电极向量。使用度量测量的具有最高质量的电极矢量然后被设置为用于感测的默认电极矢量。另外，在本发明的某些实施例中，基于大致正交于默认电极向量来选择下一个备选电极矢量。在本发明的其它实施例中，基于在默认电极向量之后拥有下一个最高质量度量来选择下一个备选电极矢量。在一些实施例中，如果默认矢量的分析是不明确的，则分析下一个替代电极矢量以减少模糊度。

44. 发明授权

US07627367B2 Multiple electrode vectors for implantable cardiac treatment devices 有权
标题翻译：用于可植入心脏治疗装置的多个电极载体
公开(公告)号：US07627367B2
公开(公告)日：2009-12-01
申请号：US11120284
申请日：2005-05-02
申请人： Jay A. Warren , Gust H. Bardy
发明人： Jay A. Warren , Gust H. Bardy
IPC分类号： A61B5/046
CPC分类号： A61B5/0424 , A61B5/0402 , A61B5/042 , A61B5/04288 , A61B5/076 , A61B5/7207 , A61N1/3622 , A61N1/3925
摘要： The implantable cardiac treatment system of the present invention is capable of choosing the most appropriate electrode vector to sense within a particular patient. In certain embodiments, the implantable cardiac treatment system determines the most appropriate electrode vector for continuous sensing based on which electrode vector results in the greatest signal amplitude, or some other useful metric such as signal-to-noise ratio (SNR). The electrode vector possessing the highest quality as measured using the metric is then set as the default electrode vector for sensing. Additionally, in certain embodiments of the present invention, a next alternative electrode vector is selected based on being generally orthogonal to the default electrode vector. In yet other embodiments of the present invention, the next alternative electrode vector is selected based on possessing the next highest quality metric after the default electrode vector. In some embodiments, if analysis of the default vector is ambiguous, the next alternative electrode vector is analyzed to reduce ambiguity.
摘要翻译：本发明的可植入心脏治疗系统能够选择最合适的电极载体以在特定患者体内感测。在某些实施例中，可植入心脏治疗系统基于哪个电极向量导致最大的信号幅度或诸如信噪比（SNR）的一些其他有用的度量来确定用于连续感测的最合适的电极向量。使用度量测量的具有最高质量的电极矢量然后被设置为用于感测的默认电极矢量。另外，在本发明的某些实施例中，基于大致正交于默认电极向量来选择下一个备选电极矢量。在本发明的其它实施例中，基于在默认电极向量之后拥有下一个最高质量度量来选择下一个备选电极矢量。在一些实施例中，如果默认矢量的分析是不明确的，则分析下一个替代电极矢量以减少模糊度。

45. 发明授权

US07376458B2 Method for defining signal templates in implantable cardiac devices 有权
标题翻译：在可植入心脏装置中定义信号模板的方法
公开(公告)号：US07376458B2
公开(公告)日：2008-05-20
申请号：US10999853
申请日：2004-11-29
申请人： Surekha Palreddy , Jay A. Warren , Alan H. Ostroff
发明人： Surekha Palreddy , Jay A. Warren , Alan H. Ostroff
IPC分类号： A61B5/04
CPC分类号： A61B5/04525 , A61B5/0472
摘要： Template formation methods for use in implantable cardiac rhythm management devices. In an illustrative method, a signal is captured signal an implanted cardiac rhythm management device, and parameters for analysis of the captured signal are then defined. Then, in the example, additional signals can be captured and used to either verify or discard the captured signal defined parameters. The template formation methods provide for creating a robust template to compare with sensed cardiac complexes. Devices and systems configured to perform template formation and verification methods are also shown.
摘要翻译：用于植入式心律管理装置的模板形成方法。在说明性方法中，捕获信号以植入心律管理装置，然后定义用于分析捕捉信号的参数。然后，在该示例中，可以捕获附加信号并用于验证或丢弃所捕获的信号定义参数。模板形成方法提供了创建一个可靠的模板来与感觉到的心脏复合物进行比较。还显示了配置为执行模板形成和验证方法的设备和系统。

46. 发明授权

US07248921B2 Method and devices for performing cardiac waveform appraisal 有权
标题翻译：用于进行心脏波形鉴定的方法和装置
公开(公告)号：US07248921B2
公开(公告)日：2007-07-24
申请号：US10858598
申请日：2004-06-01
申请人： Surekha Palreddy , Jay A. Warren , James William Phillips
发明人： Surekha Palreddy , Jay A. Warren , James William Phillips
IPC分类号： A61N1/00
CPC分类号： A61N1/365 , A61B5/0031 , A61B5/0422 , A61B5/04525 , A61B5/7207 , A61B5/7239 , A61N1/3622 , A61N1/368
摘要： The present invention is directed toward a sensing architecture for use in cardiac rhythm management devices. The sensing architecture of the present invention provides a method and means for certifying detected events by the cardiac rhythm management device. Moreover, by exploiting the enhanced capability to accurately identifying only those sensed events that are desirable, and preventing the use of events marked as suspect, the sensing architecture of the present invention can better discriminate between rhythms appropriate for device therapy and those that are not.
摘要翻译：本发明涉及用于心律管理装置的感测架构。本发明的感测架构提供了一种用于通过心律管理装置认证检测到的事件的方法和装置。此外，通过利用增强的能力来精确地识别所希望的那些感测到的事件，并且防止使用标记为可疑的事件，本发明的感测体系结构可以更好地区分适合于设备治疗的节律和不适合于设备治疗的节律。

47. 发明授权

US07103409B2 Atrial and ventricular implantable cardioverter-defibrillator and lead system 有权
公开(公告)号：US07103409B2
公开(公告)日：2006-09-05
申请号：US10434612
申请日：2003-05-09
申请人： Jay A. Warren
发明人： Jay A. Warren
IPC分类号： A61N1/362
CPC分类号： A61N1/3622 , A61N1/3918 , A61N1/3925 , A61N1/3956
摘要： A cardiac rhythm management system, such as an implantable cardioverter-defibrillator (ICD), provides atrial anti-tachyarrhythmia therapy, such as a bipolar or unipolar electrical cardioversion countershock, or provides both atrial and ventricular anti-tachyarrhythmia therapy. The atrial and ventricular anti-tachyarrhythmia therapies have independent cardioversion-defibrillation energy levels and other parameters. The system provides an endocardial lead that is convenient to implant for providing the anti-tachyarrhythmia therapy. The endocardial lead includes a first supraventricular electrode disposed in the atrium and superior vena cava, and optionally includes a first ventricular electrode and ICD housing electrode.

48. 发明授权

US6119043A Atrial and ventricular cardiac lead having a mechanical bias 失效
标题翻译：心房和心室心脏铅具有机械偏置
公开(公告)号：US6119043A
公开(公告)日：2000-09-12
申请号：US129348
申请日：1998-08-05
申请人： William Hsu , Jay A. Warren , Gerrard M. Carlson
发明人： William Hsu , Jay A. Warren , Gerrard M. Carlson
IPC分类号： A61N1/362 , A61N1/00
CPC分类号： A61N1/3622
摘要： A method and system for discriminating atrial and ventricular signal components from a single heart lead, and for using this information for identifying an arrhythmia condition as being atrial or ventricular in origin. The invention is effective in identifying P waves occurring in complex signal which includes relatively stronger R waves or other ventricular artifacts which mask the P waves. The contribution of the R wave signal to the complex signal is obtained by filtering, time windowing and transfer function estimation, then the R wave estimate is subtracted from the combined signal to leave the P wave. The ratio of P waves to R waves, P--P and R--R intervals, and their ratios to one another and to fixed values can be estimated, and used in a comparison to discriminate between atrial and ventricular arrhythmia, to thereby enable appropriate treatment.
摘要翻译：用于区分来自单个心脏引线的心房和心室信号分量的方法和系统，以及用于将该信息用于将心律失常状态识别为心房或心室起源的方法和系统。本发明有效地识别出复杂信号中出现的P波，其中包含相对较强的R波或掩蔽P波的其他心室伪像。通过滤波，时间窗口和传递函数估计得到R波信号对复信号的贡献，然后将R波估计从组合信号中减去离开P波。可以估计P波与R波，P-P和R-R间隔的比率以及它们彼此之间的比值和固定值，并用于比较以区分心房和心室心律不齐，从而使得能够进行适当的治疗。

49. 发明授权

US6067471A Atrial and ventricular implantable cardioverter-defibrillator and lead system 有权
公开(公告)号：US6067471A
公开(公告)日：2000-05-23
申请号：US130087
申请日：1998-08-07
申请人： Jay A. Warren
发明人： Jay A. Warren
IPC分类号： A61N1/39
CPC分类号： A61N1/3622 , A61N1/3918 , A61N1/3925 , A61N1/3956
摘要： A cardiac rhythm management system, such as an implantable cardioverter-defibrillator (ICD), provides atrial anti-tachyarrhythmia therapy, such as a bipolar or unipolar electrical cardioversion countershock, or provides both atrial and ventricular anti-tachyarrhythmia therapy. The atrial and ventricular anti-tachyarrhythmia therapies have independent cardioversion-defibrillation energy levels and other parameters. The system provides an endocardial lead that is convenient to implant for providing the anti-tachyarrhythmia therapy. The endocardial lead includes a first supraventricular electrode disposed in the atrium and superior vena cava, and optionally includes a first ventricular electrode and ICD housing electrode.

50. 发明授权

US5776072A Discrimination of atrial and ventricular signals from a single cardiac lead 失效
公开(公告)号：US5776072A
公开(公告)日：1998-07-07
申请号：US579872
申请日：1995-12-28
申请人： William Hsu , Jay A. Warren , Gerrard M. Carlson
发明人： William Hsu , Jay A. Warren , Gerrard M. Carlson
IPC分类号： A61N1/362 , A61B5/046
CPC分类号： A61N1/3622
摘要： A method and system for discriminating atrial and ventricular signal components from a single heart lead, and for using this information for identifying an arrhythmia condition as being atrial or ventricular in origin. The invention is effective in identifying P waves occurring in complex signal which includes relatively stronger R waves or other ventricular artifacts which mask the P waves. The contribution of the R wave signal to the complex signal is obtained by filtering, time windowing and transfer function estimation, then the R wave estimate is subtracted from the combined signal to leave the P wave. The ratio of P waves to R waves, P--P and R--R intervals, and their ratios to one another and to fixed values can be estimated, and used in a comparison to discriminate between atrial and ventricular arrhythmia, to thereby enable appropriate treatment.

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