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71. 发明授权

US08478403B2 Implantable systems and methods for use therewith for monitoring and modifying arterial blood pressure without requiring an intravascular pressure transducer 有权
标题翻译：可植入的系统和方法，用于监测和改变动脉血压，而不需要血管内压力传感器
公开(公告)号：US08478403B2
公开(公告)日：2013-07-02
申请号：US13033484
申请日：2011-02-23
申请人： Brian Jeffrey Wenzel , Michael E. Benser , Taraneh Ghaffari Farazi , Timothy A. Fayram , Edward Karst , Allen Keel , Wenbo Hou , Jong Gill
发明人： Brian Jeffrey Wenzel , Michael E. Benser , Taraneh Ghaffari Farazi , Timothy A. Fayram , Edward Karst , Allen Keel , Wenbo Hou , Jong Gill
IPC分类号： A61N1/00
CPC分类号： A61N1/36564 , A61B5/0031 , A61B5/02125 , A61B5/02158 , A61B5/02416 , A61B5/042 , A61B5/0452 , A61N1/36507 , A61N1/36585
摘要： Embodiments of the present invention are directed to implantable systems, and methods for use therewith, that monitor and modify a patient's arterial blood pressure without requiring an intravascular pressure transducer. In accordance with an embodiment, for each of a plurality of periods of time, there is a determination one or more metrics indicative of pulse arrival time (PAT), each of which are indicative of how long it takes for the left ventricle to generate a pressure pulsation that travels from the patient's aorta to a location remote from the patient's aorta. Based on the one or more metrics indicative of PAT, the patient's arterial blood pressure is estimated. Changes in the arterial blood pressure are monitored over time. Additionally, the patient's arterial blood pressure can be modified by initiating and/or adjusting pacing and/or other therapy based on the estimates of the patient's arterial blood pressure and/or monitored changes therein.
摘要翻译：本发明的实施例涉及可植入系统及其使用的方法，其不需要血管内压力传感器来监测和修改患者的动脉血压。根据实施例，对于多个时间段中的每一个，存在确定指示脉搏到达时间（PAT）的一个或多个度量，每个指标指示左心室产生多长时间从患者主动脉行进到远离患者主动脉的位置的压力脉动。基于指示PAT的一个或多个指标，估计患者的动脉血压。随着时间的推移监测动脉血压的变化。此外，可以通过基于患者的动脉血压的估计和/或其中监测的变化来启动和/或调整起搏和/或其他治疗来改变患者的动脉血压。

72. 发明申请

US20120065528A1 PRE-EJECTION INTERVAL (PEI) MONITORING DEVICES, SYSTEMS AND METHODS 有权
标题翻译：预引导间隔（PEI）监控设备，系统和方法
公开(公告)号：US20120065528A1
公开(公告)日：2012-03-15
申请号：US12882084
申请日：2010-09-14
申请人： Jong Gill , Brian Jeffrey Wenzel , Allen Keel , Wenbo Hou , Edward Karst , Taraneh G. Farazi
发明人： Jong Gill , Brian Jeffrey Wenzel , Allen Keel , Wenbo Hou , Edward Karst , Taraneh G. Farazi
IPC分类号： A61B5/042
CPC分类号： A61B5/0456 , A61B5/02028 , A61B5/0295 , A61B5/0422 , A61B5/686 , A61B5/7239 , A61N1/3684
摘要： Provided herein are implantable systems, and methods for use therewith, for monitoring a patient's pre-ejection interval (PEI). A signal indicative of cardiac electrical activity and a signal indicative of changes in arterial blood volume are obtained. One or more predetermined features of the signal indicative of cardiac electrical activity and the signal indicative of changes in arterial blood volume are detected. The patient's PEI is determined by determining an interval between the predetermined feature of the signal indicative of cardiac electrical activity and the predetermined feature of the signal indicative of changes in arterial blood volume.
摘要翻译：本文提供了可植入系统及其使用的方法，用于监测患者的预喷射间隔（PEI）。获得指示心脏电活动的信号和指示动脉血容量变化的信号。检测到指示心脏电活动的信号的一个或多个预定特征以及指示动脉血容量变化的信号。通过确定指示心脏电活动的信号的预定特征与指示动脉血容量变化的信号的预定特征之间的间隔来确定患者的PEI。

73. 发明申请

US20120065527A1 Methods and Systems for Monitoring Aterial Stiffness 审中-公开
标题翻译：监测动静刚度的方法和系统
公开(公告)号：US20120065527A1
公开(公告)日：2012-03-15
申请号：US12882099
申请日：2010-09-14
申请人： Jong Gill , Brian Jeffrey Wenzel , Allen Keel , Wenbo Hou , Edward Karst , Taraneh G. Farazi
发明人： Jong Gill , Brian Jeffrey Wenzel , Allen Keel , Wenbo Hou , Edward Karst , Taraneh G. Farazi
IPC分类号： A61B5/0295
CPC分类号： A61B5/02007 , A61B5/0295 , A61B5/686
摘要： Implanted systems and methods for monitoring a patient's arterial stiffness are provided. An implanted sensor is used to produce a signal indicative of changes in arterial blood volume for a plurality of beats of the patient's heart. A pulse duration metric is determined for each of a plurality of pulses of the signal, wherein each pulse of the signal corresponds to a beat of the patient's heart. Arterial stiffness is monitored based on the determined pulse duration metric for the plurality of pulses of the signal. This can include monitoring arterial stiffness based on a dispersion of the pulse duration metric and/or an average of the pulse duration metric.
摘要翻译：提供了用于监测患者动脉硬度的植入系统和方法。植入的传感器用于产生指示患者心脏的多个节拍的动脉血容量变化的信号。为信号的多个脉冲中的每一个确定脉冲持续时间度量，其中信号的每个脉冲对应于患者心脏的搏动。基于确定的信号的多个脉冲的脉冲持续时间度量监测动脉硬度。这可以包括基于脉冲持续时间度量的偏差和/或脉冲持续时间度量的平均值监视动脉硬度。

74. 发明授权

US07908004B1 Considering cardiac ischemia in electrode selection 有权
标题翻译：考虑到电极选择中的心脏缺血
公开(公告)号：US07908004B1
公开(公告)日：2011-03-15
申请号：US11847878
申请日：2007-08-30
申请人： Jong Gill , Kyungmoo Ryu
发明人： Jong Gill , Kyungmoo Ryu
IPC分类号： A61N1/00
CPC分类号： A61N1/368 , A61B5/04525 , A61N1/3686
摘要： Exemplary systems, devices, and methods for considering cardiac ischemia in electrode selection are described. One method determines whether an electrode of a multiple-electrode lead is proximate a region of cardiac ischemia or infarct. The method also paces through a different electrode of the multiple-electrode lead in an instance where the electrode is determined to be proximate the region.
摘要翻译：描述了用于考虑电极选择中心脏缺血的示例性系统，装置和方法。一种方法确定多电极引线的电极是否接近心脏缺血或梗死的区域。在确定电极靠近该区域的情况下，该方法还穿过多电极引线的不同电极。

75. 发明授权

US07437192B2 System and method for detecting heart failure and pulmonary edema based on ventricular end-diastolic pressure using an implantable medical device 有权
标题翻译：基于使用可植入医疗装置的心室舒张末期压力来检测心力衰竭和肺水肿的系统和方法
公开(公告)号：US07437192B2
公开(公告)日：2008-10-14
申请号：US11100008
申请日：2005-04-05
申请人： Jong Gill , Xiaoyi Min
发明人： Jong Gill , Xiaoyi Min
IPC分类号： A61N1/365
CPC分类号： A61N1/36564 , A61N1/3627 , A61N1/36521
摘要： Techniques are provided for detecting left ventricular end diastolic pressure (LV EDP) using a pressure sensor implanted within the heart of a patient and for detecting and evaluating heart failure and pulmonary edema based on LV EDP. Briefly, the peak of the R-wave of an intracardiac electrogram (IEGM) is used to trigger the measurement of a pressure value within the left ventricle. This pressure value is deemed to be representative of LV EDP. In this manner, LV EDP is easily detected merely by measuring pressure at one point within the heartbeat—thereby eliminating any need to track ventricular pressure throughout the heartbeat. Techniques for detecting and evaluating heart failure and pulmonary edema based on the R-wave triggered LV EDP measurements are also set forth herein.
摘要翻译：提供了使用植入患者心脏内的压力传感器来检测左心室舒张压（LV EDP）的技术，并且用于基于LV EDP检测和评估心脏衰竭和肺水肿。简而言之，使用心内电描记图（IEGM）的R波的峰值来触发左心室内的压力值的测量。该压力值被认为是LV EDP的代表。以这种方式，仅通过测量心跳内的一点的压力来容易地检测LV EDP，从而消除了跟踪整个心跳期间的心室压力的任何需要。本文还介绍了基于R波触发的LV EDP测量来检测和评估心脏衰竭和肺水肿的技术。

76. 发明申请

US20080086177A1 System and Related Methods for Monitoring Cardiac Disease Using Pacing Latency Measurements 审中-公开
标题翻译：使用起搏延迟测量监测心脏疾病的系统和相关方法
公开(公告)号：US20080086177A1
公开(公告)日：2008-04-10
申请号：US11539824
申请日：2006-10-09
申请人： Xiaoyi Min , Paul A. Levine , Jong Gill
发明人： Xiaoyi Min , Paul A. Levine , Jong Gill
IPC分类号： A61N1/365
CPC分类号： A61N1/37 , A61B5/0452 , A61B5/0809 , A61B5/091 , A61B5/11 , A61N1/3621 , A61N1/3627
摘要： A system and related methods for monitoring cardiac disease. The system includes an implantable medical device having a microcontroller that is configured to measure a pacing latency value for a region of a heart, compare the measured pacing latency value to a previously measured pacing latency value for the region of the heart, and determine a change in an amount of cardiac disease in the region of the heart based on the comparison of the measured pacing latency values.
摘要翻译：用于监测心脏病的系统和相关方法。该系统包括具有微控制器的可植入医疗装置，微控制器被配置为测量心脏区域的起搏延迟值，将测量的起搏延迟值与心脏区域的先前测量的起搏延迟值进行比较，并确定改变基于测量的起搏延迟值的比较，在心脏区域中的心脏病的量。

77. 发明申请

US20070038138A1 Detection of renal failure by cardiac implantable medical device 有权
标题翻译：通过心脏植入式医疗器械检测肾功能衰竭
公开(公告)号：US20070038138A1
公开(公告)日：2007-02-15
申请号：US11202534
申请日：2005-08-11
申请人： Jong Gill , Gene Bornzin
发明人： Jong Gill , Gene Bornzin
IPC分类号： A61B5/04
CPC分类号： A61B5/0452 , A61B5/201 , A61N1/3702
摘要： Morphological features within electrical cardiac signals are tracked and changes in features are monitored to detect renal failure. The morphological feature may be an interval between corresponding polarization events such as the interval between QRS-complexes and peaks of corresponding T-waves (QTmax interval); the interval between QRS-complexes and ends of corresponding T-waves (QTend interval); or the interval between P-waves and corresponding QRS-complexes (PR interval). The feature may also be the elevation of a cardiac signal segment between corresponding polarization events, such as QRS-complexes and corresponding T-waves (ST segment); a duration of a polarization event, such as a QRS-complex (QRS width); or an amplitude of a polarization event, such as a T-wave (T-wave amplitude). The change in the feature may comprise a decrease in QTmax intervals, a decrease in QTend intervals, a deviation in ST segment elevation, an increase in QRS width, an increase in PR interval or a deviation in T-wave amplitude.
摘要翻译：跟踪电心电信号中的形态学特征，监测特征变化以检测肾功能衰竭。形态特征可以是相应的极化事件之间的间隔，例如QRS-复合物之间的间隔和对应的T波的峰值（QTmax间隔）; QRS复合体与相应T波结束之间的间隔（QTend间隔）; 或P波与相应的QRS复合体之间的间隔（PR间隔）。该特征还可以是对应的极化事件之间的心脏信号段的升高，例如QRS复合物和相应的T波（ST段）; 极化事件的持续时间，例如QRS复合（QRS宽度）; 或极化事件的振幅，例如T波（T波振幅）。特征的变化可以包括QTmax间隔的减小，QTend间隔的减小，ST段抬高的偏差，QRS宽度的增加，PR间期的增加或T波幅度的偏差。

78. 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。

79. 发明申请

US20130158619A1 MULTI-VENTRICULAR SITE TIMING OPTIMIZATION USING CARDIOGENIC IMPEDANCE 审中-公开
标题翻译：多中心站点时序优化使用心脏阻力
公开(公告)号：US20130158619A1
公开(公告)日：2013-06-20
申请号：US13329091
申请日：2011-12-16
申请人： Kwangdeok Lee , Jong Gill , Kyungmoo Ryu
发明人： Kwangdeok Lee , Jong Gill , Kyungmoo Ryu
IPC分类号： A61N1/365
CPC分类号： A61N1/3684 , A61B5/0538 , A61B5/686 , A61B5/6869 , A61N1/36521 , A61N1/3682
摘要： A method of calculating a timing delay for an implantable medical device based on cardiogenic impedance estimates cardiogenic impedance from a signal between a first electrode and a second electrode positioned in at least one chamber of a heart. The method also determines the timing delay based on the estimated cardiogenic impedance.
摘要翻译：基于心源阻抗计算可植入医疗装置的定时延迟的方法根据位于心脏的至少一个腔室中的第一电极和第二电极之间的信号估计心源阻抗。该方法还基于估计的心源阻抗确定定时延迟。

80. 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。

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