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71. 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。

72. 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。

73. 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。

74. 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。

75. 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.

76. 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。

77. 发明授权

US07085603B1 System and method for automatically verifying capture during multi-chamber stimulation 有权
公开(公告)号：US07085603B1
公开(公告)日：2006-08-01
申请号：US10353104
申请日：2003-01-27
申请人： Joseph J. Florio , Euljoon Park , Kerry Bradley , Gene A. Bornzin
发明人： Joseph J. Florio , Euljoon Park , Kerry Bradley , Gene A. Bornzin
IPC分类号： A61N1/365
CPC分类号： A61N1/3712 , A61N1/3627
摘要： A system and corresponding method are provided to reliably detect capture during multi-chamber stimulation, and to further monitor the progression of congestive heart failure. The system provides a method by which intracardiac electrogram (IEGM) characteristics representing single-chamber capture and bi-ventricular capture are stored in memory and displayed. The annotation of the displayed waveforms is such that events associated with loss of capture, single-chamber capture, and bi-ventricular capture are clearly marked for ready interpretation by the physician. In a first situation, a stimulation pulse is followed by a time delay window and a subsequent depolarization complex that represents intrinsic responses of the chambers that have not been captured. In a second situation, a stimulation pulse is followed almost immediately by an evoked response that represents capture of one chamber, and a subsequent depolarization complex that represents an intrinsic response of one chamber that has not been captured. In a third situation, a stimulation pulse is almost immediately followed by an evoked response that represents simultaneous capture of two chambers.

78. 发明授权

US06988007B1 Single pass telescoping cardiac lead for the left heart 失效
标题翻译：单通伸缩心脏线为左心
公开(公告)号：US06988007B1
公开(公告)日：2006-01-17
申请号：US10218353
申请日：2002-08-13
申请人： Kevin L. Morgan , Gene A. Bornzin , Joseph J. Florio , John R. Helland
发明人： Kevin L. Morgan , Gene A. Bornzin , Joseph J. Florio , John R. Helland
IPC分类号： A61N1/05
CPC分类号： A61N1/056 , A61N1/057 , A61N2001/0585
摘要： An implantable single-pass cardiac stimulation lead provides for placement of electrodes into electrical contact with two chambers of a patient's heart. The lead includes an inner lead body having at least one electrode at its distal end and an outer lead body having at least one electrode at its distal end. The outer lead body has an internal lumen that slidingly receives the inner lead body. The inner lead body is extendable from the outer lead body at a point proximal to the distal end of the outer lead body. The sliding of the inner lead body relative to the outer lead body enables the inner lead body distal electrode to have a varying distance from the outer lead body distal electrode and enables the inner lead body to extend into the coronary sinus region of the heart to place the inner lead body electrode into electrical contact with the left ventricle.
摘要翻译：可植入的单程心脏刺激引线提供将电极放置在与患者心脏的两个腔室电接触的位置。引线包括在其远端具有至少一个电极的内引线体和在其远端具有至少一个电极的外引线体。外引线体具有滑动地接收内引线体的内腔。内引线体可以在外引线体的远离外引线体的远端的位置处延伸。内引线体相对于外引线体的滑动能够使内引线体远端电极与外引线体远端电极间距离变化，能够使内引线体延伸到心脏的冠状窦区域内部引线体电极与左心室电接触。

79. 发明授权

US06968232B2 Method and apparatus for using a rest mode indicator to automatically adjust control parameters of an implantable cardiac stimulation device 失效
标题翻译：用于使用静止模式指示器自动调节可植入心脏刺激装置的控制参数的方法和装置
公开(公告)号：US06968232B2
公开(公告)日：2005-11-22
申请号：US10093225
申请日：2002-03-06
申请人： Joseph J. Florio , Gene A. Bornzin , Peter Boileau , Eric Falkenberg , Janice Barstad
发明人： Joseph J. Florio , Gene A. Bornzin , Peter Boileau , Eric Falkenberg , Janice Barstad
IPC分类号： A61N1/362 , A61N1/368 , A61N1/18
CPC分类号： A61N1/3622 , A61N1/3682
摘要： An implantable cardiac stimulation device is described wherein a controller of the cardiac stimulation device controls selected functions of the device based on whether the patient is at rest and further based on whether the patient is prone to vagally-mediated arrhythmias. Functions of the device that may be controlled include, for example, a pacing base rate, an AV/PV delay, and a refractory period as well as overdrive pacing parameters and diagnostic data gathering parameters. In one example, if the patient is not prone to vagally-mediated arrhythmias, the base rate is lowered while the patient is at rest. Also, overdrive pacing parameters are set to be less aggressive. As such, the operation of the cardiac stimulation device is controlled to make it easier for the patient to rest while also reducing power consumption. However, if the patient is prone to vagally-mediated arrhythmias, the base rate is not lowered while the patient is at rest. Overdrive pacing parameters are instead set to be more aggressive, rather than less aggressive. In this manner, the cardiac stimulation device attempts to compensate for any increased risk of arrhythmia that may occur while the patient, who is prone to vagally-mediated arrhythmias, is at rest. Numerous other parameters may be adjusted dependent upon whether the patient is at rest or dependent upon whether the patient is prone to vagally-mediated arrhythmias.
摘要翻译：描述了可植入心脏刺激装置，其中心脏刺激装置的控制器基于患者是否处于静止状态并且还基于患者是否易于经历迷走神经介导的心律失常来控制装置的选定功能。可以被控制的设备的功能包括例如起搏基准速率，AV / PV延迟和不应期，以及过速起搏参数和诊断数据采集参数。在一个示例中，如果患者不易于经历迷走神经介导的心律失常，则在患者静止时基础速率降低。此外，过度起搏参数设置为较不积极。因此，控制心脏刺激装置的操作以使患者更容易休息，同时也降低功率消耗。然而，如果患者容易出现迷走神经介导的心律失常，则在患者休息时基础速率不降低。相反，超速起搏参数设置为更具侵略性，而不是较不积极。以这种方式，心脏刺激装置试图补偿在容易发生迷走神经介导的心律失常的患者处于静止状态时可能出现的任何增加的心律失常风险。可以根据患者是否休息或依赖于患者是否易于经历迷走神经介导的心律失常而调整许多其他参数。

80. 发明授权

US06904321B1 System and method of identifying fusion for dual-chamber automatic capture stimulation device 有权
标题翻译：识别双室自动捕获刺激装置融合的系统和方法
公开(公告)号：US06904321B1
公开(公告)日：2005-06-07
申请号：US10208169
申请日：2002-07-29
申请人： Gene A. Bornzin , Joseph J. Florio , Laurence S. Sloman
发明人： Gene A. Bornzin , Joseph J. Florio , Laurence S. Sloman
IPC分类号： A61N1/37 , A61N1/36
CPC分类号： A61N1/3712
摘要： A multi-chamber stimulation device and associated method reliably and automatically distinguish fusion from loss of capture during ventricular stimulation. The stimulation device provides immediate and accurate fusion detection when a loss of capture is suspected in the ventricles without delivering back-up stimulation pulses. To achieve this objective, the far-field signal present in the atrial channel is examined for evidence of a far-field R-wave whenever the ventricular channel detects a loss of capture. If a far-field R-wave is present, fusion is confirmed, and a far-field R-wave is absent, loss of capture is confirmed. Additionally, the stimulation device inhibits unnecessary back-up stimulation and threshold tests when fusion occurs, and provides appropriate adjustment of stimulation parameters based on confirmed fusion detection such that fusion re-occurrence is minimized.
摘要翻译：多室刺激装置和相关方法可靠和自动地将融合与心室刺激期间的捕获损失区分开来。刺激装置提供即时和准确的融合检测，当脑袋怀疑丢失而不输送备用刺激脉冲时。为了达到这个目的，每当心室通道检测到捕获的丢失时，都会检查存在于心房通道中的远场信号以获得远场R波的证据。如果存在远场R波，则确认融合，并且不存在远场R波，确认捕获损失。此外，当融合发生时，刺激装置抑制不必要的后备刺激和阈值测试，并且基于确认的融合检测提供刺激参数的适当调整，使得融合再现最小化。

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