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61. 发明授权

US07650182B2 Dual sensing for brady-tachy pacemaker/ICD 失效
标题翻译：双重感觉用于快速起搏器/ ICD
公开(公告)号：US07650182B2
公开(公告)日：2010-01-19
申请号：US11177230
申请日：2005-07-08
申请人： Jaeho Kim , Joseph M. Bocek
发明人： Jaeho Kim , Joseph M. Bocek
IPC分类号： A61B5/0464
CPC分类号： A61N1/3622 , A61B5/04011 , A61B5/0464
摘要： A system detects events related to cardiac activity. The system comprises a primary cardiac signal sensing circuit, at least one secondary cardiac signal sensing circuit having a higher sensitivity than the primary sensing circuit, and a controller circuit coupled to the primary and secondary cardiac signal sensing circuits. The controller circuit determines a rate of depolarization using the primary sensing circuit and detects tachyarrhythmia using the rate. The controller circuit also detects tachyarrhythmia using the secondary sensing circuit and also deems the tachyarrhythmia valid if the controller circuit detects the tachyarrhythmia using both the primary and secondary sensing circuit.
摘要翻译：系统检测与心脏活动相关的事件。所述系统包括主要心脏信号感测电路，至少一个具有比初级感测电路更高灵敏度的次级心脏信号感测电路，以及耦合到主要和次要心脏信号感测电路的控制器电路。控制器电路使用主感测电路确定去极化率，并使用该速率检测快速性心律失常。控制器电路还使用次级感测电路检测快速性心律失常，并且如果控制器电路使用主感测电路和次感测电路检测到快速性心律失常，则认为快速性心律失常是有效的。

62. 发明申请

US20090216289A1 CARDIAC RHYTHM MANAGEMENT SYSTEMS AND METHODS USING MULTIPLE MORPHOLOGY TEMPLATES FOR DISCRIMINATING BETWEEN RHYTHMS 审中-公开
标题翻译： CARDIAC RHYTHM管理系统和使用多种形态模板分析RHYTHMS之间的方法
公开(公告)号：US20090216289A1
公开(公告)日：2009-08-27
申请号：US12431633
申请日：2009-04-28
申请人： Mark Schwartz , Joseph M. Bocek , Jaeho Kim
发明人： Mark Schwartz , Joseph M. Bocek , Jaeho Kim
IPC分类号： A61N1/365 , A61N1/39
CPC分类号： A61N1/3956 , A61B5/04525
摘要： This document describes systems, devices, and methods that use multiple morphology templates for discriminating between rhythms, such as supraventricular tachyarrhythmias (SVTs) and ventricular tachyarrhythmias (VTs), for delivering a countershock in response to a VT episode, but withholding delivery of such a countershock in response to an SVT episode. In certain examples, the particular morphology used for storing morphological features is selected at least in part using a sensor-indicated activity level of a subject, or a metabolic need of the subject.
摘要翻译：本文档描述了使用多种形态学模板来区分节律（例如室上性快速性心律失常（SVT））和室性快速性心律失常（VT）的系统，装置和方法，用于响应于VT发作而产生反冲突，但是不提供这种反应SVT情节。在某些实例中，用于存储形态特征的特定形态至少部分地使用受试者的传感器指示的活动水平或受试者的代谢需要。

63. 发明申请

US20090099616A1 METHOD AND APPARATUS FOR CONCURRENT ATRIO-VENTRICULAR ANTI-TACHYCARDIA PACING 有权
标题翻译：相关性ATRIO-VENTRICULAR ANTI-TACHYCARDIA PACING的方法和装置
公开(公告)号：US20090099616A1
公开(公告)日：2009-04-16
申请号：US12234840
申请日：2008-09-22
申请人： Dan Li , Jaeho Kim , Joseph M. Bocek
发明人： Dan Li , Jaeho Kim , Joseph M. Bocek
IPC分类号： A61N1/365
CPC分类号： A61N1/3621 , A61N1/368 , A61N1/3688
摘要： An implantable medical device delivers anti-tachyarrhythmia therapies including anti-tachycardia pacing (ATP). If a detected tachyarrhythmia is classified as a type suitable for treatment using ATP, the implantable medical device selects one of an atrial ATP (A-ATP) mode, a ventricular ATP (V-ATP) mode, and a concurrent atrio-ventricular ATP (concurrent AV-ATP) mode according to the characteristics of the detected tachyarrhythmia. The concurrent ATP mode is an ATP mode during which the atrial pacing pulses and the ventricular pacing pulses are delivered concurrently. In one embodiment, the concurrent AV-ATP mode includes a synchronized atrio-ventricular ATP (synchronized AV-ATP) mode during which atrial and ventricular pacing pulses are delivered synchronously and an independent atrio-ventricular ATP (independent AV-ATP) mode during which atrial and ventricular pacing pulses are delivered concurrently but timed independently.
摘要翻译：植入式医疗装置提供抗心律失常疗法，包括抗心动过速起搏（ATP）。如果检测到的快速性心律失常被分类为适合于使用ATP治疗的类型，则可植入医疗装置选择心房ATP（A-ATP）模式，心室ATP（V-ATP）模式和并发心室ATP 并发AV-ATP）模式根据检测到的快速性心律失常的特点。并发ATP模式是ATP模式，其中心房起搏脉冲和心室起搏脉冲同时传递。在一个实施方案中，并发的AV-ATP模式包括同步的心房ATP（同步的AV-ATP）模式，其中同步递送心房和心室起搏脉冲以及独立的心房ATP（独立的AV-ATP）模式，在此期间心房和心室起搏脉冲同时传递，但可以独立计时。

64. 发明申请

US20080288009A1 SELF-ADJUSTING ECG MORPHOLOGICAL FEATURE CORRELATION THRESHOLD 有权
标题翻译：自我调节心电图形态特征相关阈值
公开(公告)号：US20080288009A1
公开(公告)日：2008-11-20
申请号：US11749283
申请日：2007-05-16
申请人： Jaeho Kim , Joseph M. Bocek
发明人： Jaeho Kim , Joseph M. Bocek
IPC分类号： A61N1/362
CPC分类号： A61B5/0422 , A61N1/3622 , A61N1/3931 , A61N1/3962
摘要： An apparatus comprising an implantable cardiac signal sensing circuit configured for sensing an intrinsic cardiac signal, a memory to store a template of a morphology of normal atrial-ventricular conduction, and a controller that includes a tachyarrhythmia detection circuit and a correlation circuit. The tachyarrhythmia detection circuit is configured for detecting a rhythm with elevated ventricular rate using the sensed intrinsic cardiac signal. The correlation circuit is configured for iteratively calculating a correlation between the sensed intrinsic cardiac signal and the template, and comparing the calculated correlation to a variable correlation threshold to determine whether the detected rhythm correlates to the template. The apparatus also includes a therapy circuit configured for inhibiting a ventricular tachycardia therapy when the detected rhythm correlates to the template. Other apparatuses and methods are described.
摘要翻译：一种装置，包括被配置为感测本征心脏信号的可植入心脏信号感测电路，存储器以存储正常心室传导形态的模板，以及包括快速性心律失常检测电路和相关电路的控制器。快速心律失常检测电路被配置为使用感测到的本征心脏信号来检测具有升高的心室率的节律。相关电路被配置为迭代地计算所感测的本征心脏信号与模板之间的相关性，并将所计算的相关性与可变相关阈值进行比较，以确定检测到的节律是否与模板相关。该装置还包括治疗电路，其被配置为当检测到的节律与模板相关时抑制室性心动过速治疗。描述其他设备和方法。

65. 发明申请

US20080177340A1 POST-SHOCK RECOVERY MONITORING FOR TACHYARRHYTHMIA DISCRIMINATION 有权
标题翻译：用于TACHYARRHYTHMIA分辨率的震后恢复监测
公开(公告)号：US20080177340A1
公开(公告)日：2008-07-24
申请号：US12056684
申请日：2008-03-27
申请人： Jaeho Kim , Joseph M. Bocek , Eric G. Lovett
发明人： Jaeho Kim , Joseph M. Bocek , Eric G. Lovett
IPC分类号： A61N1/39 , A61N1/365
CPC分类号： A61B5/0464 , A61N1/3925 , A61N1/3962
摘要： A cardiac rhythm management device is configured to discriminate between ventricular and supraventricular tachycardias (referred to as SVT/VT discrimination) by utilizing a morphology criterion in which the morphology of electrogram waveforms during ventricular beats are analyzed to determine if the beats are normally conducted. After the delivery of a cardioversion/defibrillation shock, however, the intraventricular conduction system is left in a modified state which alters the subsequently generated electrogram signal. Use of the morphology criterion for SVT/VT discrimination is discontinued after delivery of such a shock and resumed after a predetermined minimum number of normally conducted ventricular beats has been detected.
摘要翻译：心律管理装置被配置为通过利用形态学标准来区分心室和室上性心动过速（称为SVT / VT鉴别），其中分析心室搏动时的电描记图波形的形态以确定节拍是否正常进行。然而，在输出心脏复律/除颤休克之后，心室内传导系统处于改变随后产生的电描记图信号的修改状态。在发生这种休克后，停止使用SVT / VT鉴别的形态学标准，并且在检测到预定的最小数量的正常进行的心室搏动之后恢复。

66. 发明申请

US20080140143A1 RATE ABERRANT BEAT SELECTION AND TEMPLATE FORMATION 有权
标题翻译： RATE ABERRANT BEAT选择和模式形成
公开(公告)号：US20080140143A1
公开(公告)日：2008-06-12
申请号：US11608411
申请日：2006-12-08
申请人： Benjamin Ettori , Joseph M. Bocek , Jaeho Kim
发明人： Benjamin Ettori , Joseph M. Bocek , Jaeho Kim
IPC分类号： A61N1/36
CPC分类号： A61B5/04525 , A61B5/0464
摘要： A cardiac rhythm management system can be used to detect episode beats associated with cardiac events in a subject's body. These events may be monitored and depolarization morphology information can be derived for candidate arrhythmic beats in an arrhythmia episode. An arrhythmic beat morphology template may be formed from selecting at least one of the candidate arrhythmic beats based upon user's labeling according to specific morphologies of one or more candidate episodes. Methods of use are also presented.
摘要翻译：可以使用心律管理系统来检测与受试者体内心脏事件相关的发作次数。可以监测这些事件，并且可以在心律失常发作中为候选心律失常节拍导出去极化形态信息。可以根据一个或多个候选事件的特定形态，基于用户的标签选择候选心律失常节拍中的至少一个来形成心律失常搏动形态模板。还介绍了使用方法。

67. 发明授权

US07386344B2 Pacer with combined defibrillator tailored for bradycardia patients 失效
标题翻译：步行者联合除颤器为心动过缓患者量身打造
公开(公告)号：US07386344B2
公开(公告)日：2008-06-10
申请号：US10921777
申请日：2004-08-18
申请人： Joseph M. Bocek , Richard Milon Dujmovic, Jr. , Phil Foshee , Harley White , Jaeho Kim , Anthony Harrington , Richard S. Sanders , Douglas R. Daum , Paul De Coriolis , Joseph Smith , Richard Fogoros
发明人： Joseph M. Bocek , Richard Milon Dujmovic, Jr. , Phil Foshee , Harley White , Jaeho Kim , Anthony Harrington , Richard S. Sanders , Douglas R. Daum , Paul De Coriolis , Joseph Smith , Richard Fogoros
IPC分类号： A61N1/39
CPC分类号： A61N1/3956 , A61N1/3962
摘要： A combination pacer/defibrillator is tailored for bradycardia patients. In one example, its shock-delivery specificity exceeds its sensitivity to shockable ventricular tachyarrhythmias. In another example, its specificity exceeds 95%, or 99%, or even 99.5%. Sensitivity is programmed to a high desired sensitivity value, but only if it can be done without decreasing the specificity below the desired specificity threshold value. This can be conceptualized as “avoiding at all costs” delivering false shocks, even at the expense of failing to deliver a shock to a treatable ventricular tachyarrhythmia. Specificity enhancements include, among other things, inhibiting shock delivery when the patient is breathing or not supine, using multiple channels or a high rate VT/VF detection threshold. The present pacer/defibrillator device could potentially save the lives of bradyarrhythmia patients who are not presently clinically indicated for a defibrillator/pacer, but who have an increased risk of sudden cardiac death due to one or more risk factors.
摘要翻译：组合起搏器/除颤器是为心动过缓患者量身打造的。在一个例子中，其冲击传递特异性超过其对可震荡室性快速性心律失常的敏感性。在另一个实例中，其特异性超过95％，或99％，甚至99.5％。灵敏度被编程为高期望的灵敏度值，但是只有在不降低低于所需特异性阈值的特异性的情况下才能进行。这可以被概念化为“不惜一切代价”，提供虚假的冲击，即使以不能对可治疗的室性快速性心律失常发生冲击为代价。特异性增强包括，当患者呼吸或不仰卧时，使用多个通道或高速率的VT / VF检测阈值来抑制冲击输送。本发明的起搏器/除颤器装置可能潜在地节省目前临床指示用于除颤器/止痛器但是由于一个或多个危险因素引起的心脏猝死风险增加的缓慢心律失常患者的生命。

68. 发明授权

US5522852A Selective cardiac activity analysis atrial fibrillation detection system and method and atrial defibrillator utilizing same 失效
标题翻译：选择性心脏活动分析心房颤动检测系统和方法和心房除颤器利用它
公开(公告)号：US5522852A
公开(公告)日：1996-06-04
申请号：US233251
申请日：1994-04-26
申请人： Harley White , Joseph M. Bocek
发明人： Harley White , Joseph M. Bocek
IPC分类号： A61N1/39
CPC分类号： A61N1/3956 , A61N1/395
摘要： An atrial defibrillator applies cardioverting electrical energy to the atria of a human heart in need of cardioversion. The defibrillator includes an electrode pair and a sense amplifier associated with the atria of the heart for sensing electrical activity of the heart during a plurality of cardiac cycles to provide a cardiac signal. A detector is responsive to the cardiac signal for detecting cardiac events. During each cardiac cycle of the plurality of cardiac cycles, a time for counting is established wherein each time for counting has a total duration less than the duration of its corresponding cardiac cycle. A counter counts the cardiac events detected by the detector during the time for counting of the plurality of cardiac cycles to provide a cardiac event count. A comparator compares the cardiac event count to a predetermined cardiac event count. If the cardiac event count is greater than the predetermined cardiac event count, the atria are deemed to be in fibrillation and a cardiovertor applies cardioverting electrical energy to the atria to cardiovert the detected atrial fibrillation.
摘要翻译：心房除颤器将心脏电复律应用于需要心脏复律的人心脏心房。除颤器包括电极对和与心脏心房相关联的感测放大器，用于在多个心动周期期间感测心脏的电活动以提供心脏信号。检测器响应于心脏信号以检测心脏事件。在多个心动周期的每个心动周期期间，建立用于计数的时间，其中每次计数的总持续时间小于其对应的心动周期的持续时间。计数器对在计数多个心动周期的时间期间由检测器检测到的心脏事件进行计数以提供心脏事件计数。比较器将心脏事件计数与预定的心脏事件计数进行比较。如果心脏事件计数大于预定心脏事件计数，则心房被认为是颤动，心脏转移器将心脏转移电能施加到心房以对所检测到的心房颤动进行心跳转移。

69. 发明授权

US5464432A Implantable atrial defibrillator having an intermittently activated fibrillation detector 失效
标题翻译：具有间歇激活的原纤颤检测器的可植入心房除颤器
公开(公告)号：US5464432A
公开(公告)日：1995-11-07
申请号：US232767
申请日：1994-04-25
申请人： Kenneth R. Infinger , Joseph M. Bocek
发明人： Kenneth R. Infinger , Joseph M. Bocek
IPC分类号： A61N1/39
CPC分类号： A61N1/3956 , A61N1/395
摘要： An implantable automatic atrial defibrillator powered by a depletable battery power source conserves battery power for extending the predicted life of the defibrillator by intermittently detecting for atrial fibrillation. The atrial defibrillator includes a real time clock which, at spaced apart predetermined times, causes heart activity data to be stored in a memory. Thereafter, a normally deactivated atrial fibrillation detector is activated for processing the stored data to detect for atrial fibrillation.
摘要翻译：由可消耗电池电源供电的植入式自动心房除颤器通过间歇检测心房颤动而节省电池电力，延长除颤器的预期寿命。心房除颤器包括实时时钟，其以间隔开的预定时间将心脏活动数据存储在存储器中。此后，激活正常失活的心房颤动检测器用于处理存储的数据以检测心房颤动。

70. 发明授权

US5251624A Pulse generator for use in an implantable atrial defibrillator 失效
标题翻译：用于可植入心房除颤器的脉冲发生器
公开(公告)号：US5251624A
公开(公告)日：1993-10-12
申请号：US902998
申请日：1992-06-22
申请人： Joseph M. Bocek , Kenneth R. Infinger , Darrell O. Wagner
发明人： Joseph M. Bocek , Kenneth R. Infinger , Darrell O. Wagner
IPC分类号： A61N1/39 , A61N1/36
CPC分类号： A61N1/3956 , A61N1/3906 , A61N1/3912 , A61N1/395
摘要： A pulse generator for use in implantable atrial defibrillator provides cardiovertinq electrical energy to the atria of a heart through at least one lead having a pair of electrodes associated with the atria of the heart. The pulse generator includes a depletable, low voltage, power source such as a battery. A charging circuit coupled to the battery includes a flyback transformer for converting the battery voltage to low duty cycle pulsating high voltage electrical energy to store the high voltage electrical energy in a storage capacitor coupled to the charging circuit. A crosspoint switch selectively couples the storage capacitor to the electrodes for applying a portion of the stored electrical energy to the atria of the heart for cardioverting the atria of the heart.

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