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71. 发明申请

US20130041274A1 SYSTEMS AND METHODS FOR USE BY IMPLANTABLE MEDICAL DEVICES FOR DETECTING AND DISCRIMINATING STROKE AND CARDIAC ISCHEMIA USING ELECTROCARDIAC SIGNALS 有权
标题翻译：用于通过电刺激信号检测和鉴别卒中和心脏病的植入式医疗设备使用的系统和方法
公开(公告)号：US20130041274A1
公开(公告)日：2013-02-14
申请号：US13207307
申请日：2011-08-10
申请人： Jong Gill , Rupinder Bharmi , Edward Karst , Ryan Rooke , Riddhi Shah , Fujian Qu , Gene A. Bornzin , Taraneh Ghaffari Farazi , Euljoon Park
发明人： Jong Gill , Rupinder Bharmi , Edward Karst , Ryan Rooke , Riddhi Shah , Fujian Qu , Gene A. Bornzin , Taraneh Ghaffari Farazi , Euljoon Park
IPC分类号： A61B5/0468
CPC分类号： A61B5/0468 , A61B5/0031 , A61B5/0205 , A61B5/02158 , A61B5/02405 , A61B5/0295 , A61B5/0422 , A61B5/4839 , A61N1/3702
摘要： Techniques are provided for detecting and distinguishing stroke and cardiac ischemia based on electrocardiac signals. In one example, the device senses atrial and ventricular signals within the patient along a set of unipolar sensing vectors and identifies certain morphological features within the signals such as PR intervals, ST intervals, QT intervals, T-waves, etc. The device detects changes, if any, within the morphological features such as significant shifts in ST interval elevation or an inversion in T-wave shape, which are indicative of stroke or cardiac ischemia. By selectively comparing changes detected along different unipolar sensing vectors, the device distinguishes or discriminates stroke from cardiac ischemia within the patient. The discrimination may be corroborated using various physiological and hemodynamic parameters. In some examples, the device further identifies the location of the ischemia within the heart. In still other examples, the device detects cardiac ischemia occurring during stroke.
摘要翻译：提供了用于基于心电信号检测和区分中风和心脏缺血的技术。在一个示例中，该装置沿着一组单极感测向量感测患者内的心房和心室信号，并且识别信号内的某些形态特征，例如PR间隔，ST间隔，QT间隔，T波等。该装置检测变化（如果有的话）在形态学特征之中，例如ST间期升高的显着变化或T波形的反转，其指示中风或心脏缺血。通过选择性地比较沿着不同的单极性感测向量检测的变化，该装置区分或区分患者体内的心脏缺血的中风。可以使用各种生理和血液动力学参数来确认辨别。在一些实例中，该装置还识别心脏内局部缺血的位置。在另外的例子中，该装置检测在中风期间发生的心脏缺血。

72. 发明授权

US08265739B1 Systems and methods for distinguishing cardiac ischemia from systemic influences on IEGM morphology 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与对IEGM形态的全身影响的系统和方法
公开(公告)号：US08265739B1
公开(公告)日：2012-09-11
申请号：US12016166
申请日：2008-01-17
申请人： Peter Boileau , Xiaoyi Min , Jong Gill , Rupinder Bharmi , Joseph J. Florio , Michael E. Benser , Gene A. Bornzin
发明人： Peter Boileau , Xiaoyi Min , Jong Gill , Rupinder Bharmi , Joseph J. Florio , Michael E. Benser , Gene A. Bornzin
IPC分类号： A61B5/0402 , A61B5/0428 , A61B5/0452
CPC分类号： A61B5/0452 , A61B5/0428 , A61B5/0468 , A61B5/0472 , A61B5/14532 , A61B5/7282
摘要： Techniques are provided for use in a pacemaker or implantable cardioverter/defibrillator (ICD) for distinguishing cardiac ischemia from other conditions affecting the morphology of electrical cardiac signals sensed within a patient, such as hypoglycemia, hyperglycemia or other systemic conditions. In one example, the device detects changes in morphological features of cardiac signals indicative of possible cardiac ischemia within the patient, such as changes in ST segment elevation within an intracardiac electrogram (IEGM). The device determines whether the changes in the morphological features are the result of spatially localized changes within a portion of the heart and then distinguishes cardiac ischemia from other conditions affecting the morphology of electrical cardiac signals based on that determination. In another example, the device exploits the interval between the peak of a T-wave (Tmax) and the end of the T-wave (Tend). A significant increase in the Tend−Tmax interval is indicative of ischemia rather than a systemic condition.
摘要翻译：提供了用于起搏器或植入式心律转复除颤器（ICD）的技术，用于区分心脏缺血与影响患者体内感测的电心电信号形态的其他状况，如低血糖，高血糖或其他系统性疾病。在一个示例中，该装置检测指示患者可能的心脏缺血的心脏信号的形态学特征的变化，例如心内电描记图（IEGM）内ST段抬高的变化。该装置确定形态特征的变化是否是心脏部分内的空间局部变化的结果，然后基于该确定将心脏缺血与影响电心电信号形态的其它状况区分开。在另一个例子中，器件利用了T波峰值（Tmax）和T波（Tend）结束之间的间隔。 Tend-Tmax间期的显着增加指示缺血而不是全身状况。

73. 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。

74. 发明申请

US20120197149A1 SYSTEM AND METHOD FOR DISTINGUISHING AMONG CARDIAC ISCHEMIA, HYPOGLYCEMIA AND HYPERGLYCEMIA USING AN IMPLANTABLE MEDICAL DEVICE 审中-公开
标题翻译：使用可植入医疗器械评估心脏病，高血压和高血压的系统和方法
公开(公告)号：US20120197149A1
公开(公告)日：2012-08-02
申请号：US13444733
申请日：2012-04-11
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： A61B5/0468 , 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。

75. 发明申请

US20120190957A1 SYSTEM AND METHOD FOR MONITORING CARDIAC DISEASE 审中-公开
标题翻译：监测心脏病的系统和方法
公开(公告)号：US20120190957A1
公开(公告)日：2012-07-26
申请号：US13010535
申请日：2011-01-20
申请人： Jong Gill , Cecilia Qin Xi , Stuart Rosenberg , Yelena Nabutovsky , Brian Jeffrey Wenzel , William Hsu
发明人： Jong Gill , Cecilia Qin Xi , Stuart Rosenberg , Yelena Nabutovsky , Brian Jeffrey Wenzel , William Hsu
IPC分类号： A61B5/042 , A61B5/0408 , A61B5/0402
CPC分类号： A61B5/0452 , A61B5/4842 , A61N1/3627 , A61N1/36507
摘要： A method of monitoring progression of cardiac disease includes applying stimulus pulses to the heart and sensing electrophysiological responses of the heart at a plurality of different monitoring locations of the heart. The method also includes comparing a previously and subsequently sensed electrophysiological responses that are sensed near a first location of the monitoring locations and comparing previously and subsequently sensed electrophysiological responses that are sensed near a second location of the monitoring locations. The method further includes identifying a change in progression of cardiac disease of the heart based on a difference between the previously and subsequently sensed electrophysiological responses at the first location and based on a difference between the previously and subsequently sensed electrophysiological responses at the second location.
摘要翻译：监测心脏疾病进展的方法包括向心脏施加刺激脉冲并感测在心脏的多个不同监测位置的心脏的电生理反应。该方法还包括比较在监测位置的第一位置附近感测的先前和随后感测到的电生理反应，并比较先前和随后感测到的在监测位置的第二位置附近感测到的电生理反应。该方法还包括基于在第一位置处的先前感测和随后感测的电生理反应之间的差异，并且基于在第二位置处的先前感知和随后感测到的电生理反应之间的差异来识别心脏的心脏疾病进展的变化。

76. 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。

77. 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。

78. 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。

79. 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。

80. 发明申请

US20090270939A1 DEVICE AND METHOD FOR DETECTING ATRIAL FIBRILLATION 有权
标题翻译：用于检测椎间孔纤维化的装置和方法
公开(公告)号：US20090270939A1
公开(公告)日：2009-10-29
申请号：US12207388
申请日：2008-09-09
申请人： Cem Shaquer , Jong Gill , Fujian Qu
发明人： Cem Shaquer , Jong Gill , Fujian Qu
IPC分类号： A61N1/362
CPC分类号： A61B5/046
摘要： Detection of atrial fibrillation involves detecting a plurality of ventricular events and obtaining a series of probabilities of AF, each corresponding to a probability of AF for a different beat window having a plurality of ventricular events. AF onset is detected when one or each of a plurality of consecutive AF probabilities satisfies an AF trigger threshold. AF termination is detected when one or each of a plurality of consecutive AF probabilities does not satisfy the AF trigger threshold. Upon detection of AF onset, ventricular events are processed to detect for a sudden onset of irregularity of the ventricular events. AF onset is confirmed when sudden onset is detected and overturned when sudden onset is not detected.
摘要翻译：心房颤动的检测涉及检测多个心室事件并获得一系列AF概率，每个概率对应于具有多个心室事件的不同节拍窗口的AF概率。当多个连续AF概率中的一个或每个满足AF触发阈值时，检测AF起始。当多个连续AF概率中的一个或每个不满足AF触发阈值时，检测到AF终止。在检测到AF发作时，处理心室事件以检测心室事件突然发作不规则。当发现突然发作并且突然发现未被检测到翻转时，确定AF发作。

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