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61. 发明授权

US08162842B2 Detecting ischemia using an implantable cardiac device based on morphology of cardiac pressure signal 有权
标题翻译：基于心脏压力信号的形态，使用可植入心脏装置检测缺血
公开(公告)号：US08162842B2
公开(公告)日：2012-04-24
申请号：US12632689
申请日：2009-12-07
申请人： Jong Gill , Peter Boileau , Gene A. Bornzin , Joseph J. Florio , Xiaoyi Min
发明人： Jong Gill , Peter Boileau , Gene A. Bornzin , Joseph J. Florio , Xiaoyi Min
IPC分类号： A61B5/04
CPC分类号： A61B5/0215 , A61B5/0031 , A61B5/042 , A61B5/7239 , A61N1/36564
摘要： Methods and systems are presented for using an ICD to detect myocardial ischemia. One such method includes sensing via an implantable cardiac-rhythm-management device (ICRMD) a signal indicative of cardiac pressure; determining via a processor associated with the ICRMD, a derivative signal that is a first derivative of the sensed signal; measuring via the processor, a maximum positive value of the derivative signal; measuring via the processor, a maximum negative value of the derivative signal; and indicating via the processor, an ischemia based on a comparison of a ratio of the maximum positive value to the maximum negative value with a predetermined value.
摘要翻译：提出了使用ICD检测心肌缺血的方法和系统。一种这样的方法包括通过可植入心律管理装置（ICRMD）感测指示心脏压力的信号; 通过与ICRMD相关联的处理器确定作为感测信号的一阶导数的导数信号; 通过处理器测量导数信号的最大正值; 通过处理器测量导数信号的最大负值; 并且经由处理器指示基于将最大正值与最大负值的比率与预定值进行比较的缺血。

62. 发明授权

US07933643B1 System and method for displaying an emulated surface EKG using an external programming device 有权
标题翻译：使用外部编程设备显示仿真表面EKG的系统和方法
公开(公告)号：US07933643B1
公开(公告)日：2011-04-26
申请号：US11030380
申请日：2005-01-05
申请人： Jong Gill , George Walls , Gene A. Bornzin , Peter Boileau , Euljoon Park
发明人： Jong Gill , George Walls , Gene A. Bornzin , Peter Boileau , Euljoon Park
IPC分类号： A61B5/04
CPC分类号： A61B5/0402 , A61N1/3702 , A61N1/37235
摘要： A surface electrocardiogram (EKG) is emulated using signals detected by the internal leads of an implanted device. In one example, the emulation is performed using a technique that concatenates portions of signals sensed using different electrodes. In another example, the emulation is performed using a technique that selectively amplifies or attenuates portions of a single cardiac signal sensed using a single pair of electrodes. The surface EKG emulation may be performed by the implanted device itself or by an external device, such as a programmer, based on cardiac signals transmitted thereto. The external device then displays the emulated surface EKG along with an intracardiac electrogram (IEGM) and set of event markers. Alternatively, the external device displays an entire set of emulated EKGs that had been generated based on the same patient input data but using different emulation techniques. The emulated EKGs are displayed along with an actual surface EKG for the patient so that a physician may easily identify the optimal emulation technique for that patient.
摘要翻译：使用由植入装置的内部引线检测的信号来模拟表面心电图（EKG）。在一个示例中，使用连接使用不同电极感测的信号的部分的技术来执行仿真。在另一示例中，使用选择性地放大或衰减使用单对电极感测的单个心脏信号的部分的技术来执行仿真。表面EKG仿真可以由植入装置本身或外部设备（例如编程器）基于发送到其上的心脏信号来执行。然后，外部设备显示仿真表面EKG以及心内电描记图（IEGM）和一组事件标记。或者，外部设备显示已经基于相同的患者输入数据而使用不同的仿真技术生成的整套仿真EKG。仿真的EKG与患者的实际表面EKG一起显示，使得医生可以容易地识别该患者的最佳仿真技术。

63. 发明授权

US07769436B1 System and method for adaptively adjusting cardiac ischemia detection thresholds and other detection thresholds used by an implantable medical device 有权
标题翻译：用于自适应调节心脏缺血检测阈值和由可植入医疗装置使用的其它检测阈值的系统和方法
公开(公告)号：US07769436B1
公开(公告)日：2010-08-03
申请号：US11757796
申请日：2007-06-04
申请人： Peter Boileau , Jay Snell , Rupinder Bharmi , Laleh Jalali , Gene A. Bornzin
发明人： Peter Boileau , Jay Snell , Rupinder Bharmi , Laleh Jalali , Gene A. Bornzin
IPC分类号： A61B5/04 , A61B5/0402 , A61B5/0452
CPC分类号： A61B5/0452 , A61B5/0422 , A61B5/053 , A61N1/36585
摘要： Techniques are described for adaptively adjusting detection thresholds for use in detecting cardiac ischemia and other abnormal physiological conditions based on morphological parameters derived from intracardiac electrogram (IEGM) signals, impedance measurements, or other signals. In one example, where ST segment elevation is used to detect cardiac ischemia, default detection thresholds are determined in advance from an examination of variations in ST segment elevations occurring within a population of patients. Thereafter, an individual pacemaker or other implantable medical device uses the default thresholds during an initial learning period to detect ischemia within the patient in which the device is implanted. During the initial learning period, the pacemaker also collects data representative of the range of variation in ST segment elevations occurring within the patient. The pacemaker then adaptively adjusts the thresholds based on the range of variation so as to improve detection specificity within the patient.
摘要翻译：描述了基于从心脏电图（IEGM）信号，阻抗测量或其它信号得出的形态学参数自适应地调整检测阈值用于检测心脏缺血和其他异常生理状况的技术。在一个例子中，使用ST段抬高来检测心脏缺血，默认检测阈值是从对患者群体内发生的ST段抬高的变化的检查预先确定的。此后，单个起搏器或其它可植入医疗装置在初始学习期间使用默认阈值来检测装置植入的患者内的局部缺血。在初始学习期间，起搏器还收集代表病人ST段抬高范围变化的数据。起搏器然后根据变异范围自适应地调整阈值，以提高患者内的检测特异性。

64. 发明授权

US07756572B1 System and method for efficiently distinguishing among cardiac ischemia, hypoglycemia and hyperglycemia using an implantable medical device and an external system 有权
标题翻译：使用可植入医疗器械和外部系统有效区分心脏缺血，低血糖和高血糖的系统和方法
公开(公告)号：US07756572B1
公开(公告)日：2010-07-13
申请号：US11740175
申请日：2007-04-25
申请人： Mohssen Fard , Xiaoyi Min , Peter Boileau , Jong Gill , Bing Zhu , Jay Snell , Laleh Jalali , Josh Reiss , Gene Bornzin
发明人： Mohssen Fard , Xiaoyi Min , Peter Boileau , Jong Gill , Bing Zhu , Jay Snell , Laleh Jalali , Josh Reiss , Gene Bornzin
IPC分类号： A61B5/0468
CPC分类号： A61N1/36585 , A61B5/0452 , A61B5/0468 , A61B5/14532 , A61N1/36557
摘要： Techniques are described for efficiently detecting and distinguishing among cardiac ischemia, hypoglycemia or hyperglycemia based on intracardiac electrogram (IEGM) signals. In one example, a preliminary indication of an episode of cardiac ischemia is detected based on shifts in ST segment elevation within the IEGM. In response, the implanted device then records additional IEGM data for transmission to an external system. The external system analyzes the additional IEGM data to confirm the detection of cardiac ischemia using a more sophisticated analysis procedure exploiting additional detection parameters. In particular, the external system uses detection parameters capable of distinguishing hypoglycemia, hyperglycemia and hyperkalemia from cardiac ischemia, such as QTmax and QTend intervals. Alternatively, the more sophisticated analysis procedure may be performed by the device itself, if it is so equipped. Other examples described herein pertain instead to the detection of atrial fibrillation.
摘要翻译：描述了基于心脏电图（IEGM）信号来有效检测和区分心脏缺血，低血糖或高血糖的技术。在一个实例中，基于IEGM内的ST段抬高的移动来检测心脏缺血发作的初步指示。作为响应，植入的装置然后记录附加的IEGM数据以传输到外部系统。外部系统使用更复杂的分析程序利用额外的检测参数来分析额外的IEGM数据，以确认心脏缺血的检测。特别地，外部系统使用能够区分低血糖，高血糖和高血钾从心脏缺血的检测参数，例如QTmax和QTend间期。或者，如果装置如此装备，则可以由装置本身执行更复杂的分析程序。本文描述的其它实例代替心房颤动的检测。

65. 发明授权

US07632235B1 System and method for measuring cardiac output via thermal dilution using an implantable medical device with an external ultrasound power delivery system 有权
标题翻译：使用具有外部超声功率输送系统的可植入医疗装置通过热稀释测量心输出量的系统和方法
公开(公告)号：US07632235B1
公开(公告)日：2009-12-15
申请号：US11099888
申请日：2005-04-05
申请人： Annapurna Karicherla , Xiaoyi Min , Peter Boileau , Jong Gill , Gene A. Bornzin
发明人： Annapurna Karicherla , Xiaoyi Min , Peter Boileau , Jong Gill , Gene A. Bornzin
IPC分类号： A61B5/029 , A61B5/028 , A61B8/06
CPC分类号： A61B5/028 , A61B5/029 , A61B2560/0209 , A61B2560/0214 , A61N1/3627 , A61N1/3655
摘要： The implantable device is capable of performing thermal dilution analysis of the cardiac output of a patient using power delivered from an external source. By using power from an external source, the implantable device conserves its power resources for other purposes, such as for pacing or defibrillation therapy. In one example, an external programmer or bedside monitor provides power through a hand-held power delivery wand via electromagnetic induction, with the power routed from a subcutaneous coil to a heating element implanted in the right atrium, which heats blood as it passes through the right atrium. In another example, the heating element is formed of a material that generates heat in response to a beam of ultrasound provided by the wand. In either case, a downstream blood temperature profile is detected using a thermistor implanted in the pulmonary artery and cardiac output is then estimated by analyzing the temperature profile.
摘要翻译：可植入装置能够使用从外部源传递的功率来对患者的心输出量进行热稀释分析。通过使用来自外部来源的电力，可植入装置为其他目的节省其功率资源，例如用于起搏或除颤疗法。在一个示例中，外部编程器或床边监视器通过电磁感应通过手持式电力输送棒提供电力，电力从皮下线圈路由到植入右心房的加热元件，该加热元件在通过右心房。在另一个实例中，加热元件由响应于由魔杖提供的超声波束产生热量的材料形成。在任一情况下，使用植入肺动脉中的热敏电阻检测下游血液温度分布，然后通过分析温度分布来估计心输出量。

66. 发明申请

US20090177104A1 System and Method for Distinguishing Among Cardiac Ischemia, Hypoglycemia and Hyperglycemia Using an Implantable Medical Device 有权
标题翻译：使用植入式医疗器械区分心脏缺血，低血糖和高血糖的系统和方法
公开(公告)号：US20090177104A1
公开(公告)日：2009-07-09
申请号：US12360822
申请日：2009-01-27
申请人： Jong Gill , Peter Boileau , Rupinder Bharmi , Xiaoyi Min , Joseph J. Florio , Michael E. Benser , Gene A. Bornzin
发明人： Jong Gill , Peter Boileau , Rupinder Bharmi , Xiaoyi Min , Joseph J. Florio , Michael E. Benser , Gene A. Bornzin
IPC分类号： A61B5/0472
CPC分类号： A61N1/3962 , A61B5/0452 , A61B5/0468 , A61B5/14532 , A61N1/3621 , A61N1/3627 , A61N1/36557 , A61N1/3925
摘要： Techniques are described for detecting ischemia, hypoglycemia or hyperglycemia based on intracardiac electrogram (IEGM) signals. Ischemia is detected based on a shortening of the interval between the QRS complex and the end of a T-wave (QTmax), alone or in combination with a change in ST segment elevation. Alternatively, ischemia is detected based on a change in ST segment elevation combined with minimal change in the interval between the QRS complex and the end of the T-wave (QTend). Hypoglycemia is detected based on a change in ST segment elevation along with a lengthening of either QTmax or QTend. Hyperglycemia is detected based on a change in ST segment elevation along with minimal change in QTmax and in QTend. By exploiting QTmax and QTend in combination with ST segment elevation, changes in ST segment elevation caused by hypo/hyperglycemia can be properly distinguished from changes caused by ischemia.
摘要翻译：描述了基于心内电描记图（IEGM）信号检测缺血，低血糖或高血糖的技术。基于QRS复合体与T波结束（QTmax）之间的间隔的缩短单独或与ST段抬高的变化相结合来检测局部缺血。或者，基于ST段抬高的变化结合QRS复合体与T波结束（QTend）之间的间隔的最小变化来检测局部缺血。基于ST段抬高的变化以及QTmax或QTend的延长来检测低血糖。基于ST段抬高的变化以及QTmax和QTend中的最小变化来检测高血糖。通过利用QTmax和QTend与ST段抬高相结合，可以将由低/高血糖引起的ST段抬高的变化与缺血引起的变化进行适当区分。

67. 发明授权

US07502644B2 System and method for distinguishing among cardiac ischemia, hypoglycemia and hyperglycemia using an implantable medical device 有权
标题翻译：使用可植入医疗器械区分心脏缺血，低血糖和高血糖的系统和方法
公开(公告)号：US07502644B2
公开(公告)日：2009-03-10
申请号：US11043612
申请日：2005-01-25
申请人： Jong Gill , Peter Boileau , Rupinder Bharmi , Xiaoyi Min , Joseph J. Florio , Michael Benser , Gene A. Bornzin
发明人： Jong Gill , Peter Boileau , Rupinder Bharmi , Xiaoyi Min , Joseph J. Florio , Michael Benser , Gene A. Bornzin
IPC分类号： A61B5/0468
CPC分类号： A61N1/3962 , A61B5/0452 , A61B5/0468 , A61B5/14532 , A61N1/3621 , A61N1/3627 , A61N1/36557 , A61N1/3925
摘要： Techniques are described for detecting ischemia, hypoglycemia or hyperglycemia based on intracardiac electrogram (IEGM) signals. Ischemia is detected based on a shortening of the interval between the QRS complex and the end of a T-wave (QTmax), alone or in combination with a change in ST segment elevation. Alternatively, ischemia is detected based on a change in ST segment elevation combined with minimal change in the interval between the QRS complex and the end of the T-wave (QTend). Hypoglycemia is detected based on a change in ST segment elevation along with a lengthening of either QTmax or QTend. Hyperglycemia is detected based on a change in ST segment elevation along with minimal change in QTmax and in QTend. By exploiting QTmax and QTend in combination with ST segment elevation, changes in ST segment elevation caused by hypo/hyperglycemia can be properly distinguished from changes caused by ischemia.
摘要翻译：描述了基于心内电描记图（IEGM）信号检测缺血，低血糖或高血糖的技术。基于QRS复合体与T波结束（QTmax）之间的间隔的缩短单独或与ST段抬高的变化相结合来检测局部缺血。或者，基于ST段抬高的变化结合QRS复合体与T波结束（QTend）之间的间隔的最小变化来检测局部缺血。基于ST段抬高的变化以及QTmax或QTend的延长来检测低血糖。基于ST段抬高的变化以及QTmax和QTend中的最小变化来检测高血糖。通过利用QTmax和QTend与ST段抬高相结合，可以将由低/高血糖引起的ST段抬高的变化与缺血引起的变化进行适当区分。

68. 发明授权

US07297114B2 System and method for distinguishing among cardiac ischemia, hypoglycemia and hyperglycemia using an implantable medical device 有权
标题翻译：使用可植入医疗器械区分心脏缺血，低血糖和高血糖的系统和方法
公开(公告)号：US07297114B2
公开(公告)日：2007-11-20
申请号：US11043804
申请日：2005-01-25
申请人： Jong Gill , Peter Boileau , Rupinder Bharmi , Xiaoyi Min , Joseph J. Florio , Michael Benser , Gene A. Bornzin
发明人： Jong Gill , Peter Boileau , Rupinder Bharmi , Xiaoyi Min , Joseph J. Florio , Michael Benser , Gene A. Bornzin
IPC分类号： A61B5/0452
CPC分类号： A61N1/3962 , A61B5/0452 , A61B5/0468 , A61B5/14532 , A61N1/3621 , A61N1/3627 , A61N1/36557 , A61N1/3925
摘要： Techniques are described for detecting ischemia, hypoglycemia or hyperglycemia based on intracardiac electrogram (IEGM) signals. Ischemia is detected based on a shortening of the interval between the QRS complex and the end of a T-wave (QTmax), alone or in combination with a change in ST segment elevation. Alternatively, ischemia is detected based on a change in ST segment elevation combined with minimal change in the interval between the QRS complex and the end of the T-wave (QTend). Hypoglycemia is detected based on a change in ST segment elevation along with a lengthening of either QTmax or QTend. Hyperglycemia is detected based on a change in ST segment elevation along with minimal change in QTmax and in QTend. By exploiting QTmax and QTend in combination with ST segment elevation, changes in ST segment elevation caused by hypo/hyperglycemia can be properly distinguished from changes caused by ischemia.
摘要翻译：描述了基于心内电描记图（IEGM）信号检测缺血，低血糖或高血糖的技术。基于QRS复合体与T波结束（QTmax）之间的间隔的缩短单独或与ST段抬高的变化相结合来检测局部缺血。或者，基于ST段抬高的变化结合QRS复合体与T波结束（QTend）之间的间隔的最小变化来检测局部缺血。基于ST段抬高的变化以及QTmax或QTend的延长来检测低血糖。基于ST段抬高的变化以及QTmax和QTend中的最小变化来检测高血糖。通过利用QTmax和QTend与ST段抬高相结合，可以将由低/高血糖引起的ST段抬高的变化与缺血引起的变化进行适当区分。

69. 发明授权

US07272436B2 System and method for distinguishing among cardiac ischemia, hypoglycemia and hyperglycemia using an implantable medical device 有权
公开(公告)号：US07272436B2
公开(公告)日：2007-09-18
申请号：US11043780
申请日：2005-01-25
申请人： Jong Gill , Peter Boileau , Rupinder Bharmi , Xiaoyi Min , Joseph J. Florio , Michael Benser , Gene A. Bornzin
发明人： Jong Gill , Peter Boileau , Rupinder Bharmi , Xiaoyi Min , Joseph J. Florio , Michael Benser , Gene A. Bornzin
IPC分类号： A61B5/0452
CPC分类号： A61N1/3962 , A61B5/0452 , A61B5/0468 , A61B5/14532 , A61N1/3621 , A61N1/3627 , A61N1/36557 , A61N1/3925
摘要： Techniques are described for detecting ischemia, hypoglycemia or hyperglycemia based on intracardiac electrogram (IEGM) signals. Ischemia is detected based on a shortening of the interval between the QRS complex and the end of a T-wave (QTmax), alone or in combination with a change in ST segment elevation. Alternatively, ischemia is detected based on a change in ST segment elevation combined with minimal change in the interval between the QRS complex and the end of the T-wave (QTend). Hypoglycemia is detected based on a change in ST segment elevation along with a lengthening of either QTmax or QTend. Hyperglycemia is detected based on a change in ST segment elevation along with minimal change in QTmax and in QTend. By exploiting QTmax and QTend in combination with ST segment elevation, changes in ST segment elevation caused by hypo/hyperglycemia can be properly distinguished from changes caused by ischemia.

70. 发明授权

US07142911B2 Method and apparatus for monitoring drug effects on cardiac electrical signals using an implantable cardiac stimulation device 有权
标题翻译：使用可植入心脏刺激装置监测对心脏电信号的药物作用的方法和装置
公开(公告)号：US07142911B2
公开(公告)日：2006-11-28
申请号：US10608409
申请日：2003-06-26
申请人： Peter Boileau , Janice Barstad , Gene A. Bornzin , Kerry Bradley , Eric Falkenberg , Joseph J. Florio
发明人： Peter Boileau , Janice Barstad , Gene A. Bornzin , Kerry Bradley , Eric Falkenberg , Joseph J. Florio
IPC分类号： A61N1/365 , A61N1/362
CPC分类号： A61N1/3622 , A61B5/0031 , A61B5/04525 , A61B5/4839 , A61M5/14276 , A61M5/1723 , A61M2205/3523 , A61M2205/3553 , A61M2230/10 , G06F19/00 , G06F19/3456 , G06F19/3481 , G16H50/20 , Y10S514/821
摘要： An implantable cardiac stimulation device, such as a pacemaker or Implantable Cardioverter Defibrillator, is configured to automatically monitor the effects of antiarrhythmic drugs on cardiac electrical signals within a patient to verify the efficacy of the drugs taken. In one example, an analysis of patient cardiac electrical signals is performed by comparing the cardiac electrical signals with values representative of the effects of different classes of antiarrhythmic drugs. If the implantable device determines that the prescribed antiarrhythmic drugs have not been effective, a warning signal is generated. The warning signal is conveyed directly to the patient via a bedside monitor and to the patient's physician via remote connection to an external programmer device so that both are notified of the drug efficacy problems. Additionally, the implantable device may be configured to automatically adjust pacing and defibrillation control parameters in an attempt to compensate for any lack of efficacy in the drugs. For example, the aggressiveness of overdrive pacing may be increased. Alternatively, a drug pump is controlled to adjust the dosage of antiarrhythmic drugs if an initial dosage is found to be ineffective.
摘要翻译：可植入心脏刺激装置，例如起搏器或植入式心律转复除颤器，被配置为自动监测抗心律失常药物对患者内心脏电信号的影响，以验证所用药物的功效。在一个示例中，通过将心脏电信号与代表不同类别的抗心律失常药物的作用的值进行比较来进行对患者心电信号的分析。如果植入装置确定规定的抗心律不齐药物没有效果，则产生警告信号。警告信号通过床边监护仪直接传送给患者，并通过与外部编程器设备的远程连接向病人的医生传送，以便两者被通知药物功效问题。另外，可植入装置可被配置为自动调节起搏和除颤控制参数，以试图补偿药物中的任何功效缺乏。例如，可能会增加超速起搏的积极性。或者，如果发现初始剂量无效，则控制药物泵以调节抗心律失常药物的剂量。

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