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81. 发明申请

US20130226078A1 MONITORING OF CHRONOBIOLOGICAL RHYTHMS FOR DISEASE AND DRUG MANAGEMENT USING ONE OR MORE IMPLANTABLE DEVICE 审中-公开
标题翻译：使用一个或多个可植入装置监测疾病和药物管理的血液生殖系统
公开(公告)号：US20130226078A1
公开(公告)日：2013-08-29
申请号：US13845398
申请日：2013-03-18
申请人： Yi Zhang , John D. Hatlestad , Gerrard M. Carlson , Yousufali Dalal , Marina V. Brockway , Kent Lee , Richard O. Kuenzler , Carlos Haro , Krzysztof Z. Siejko , Abhilash Patangay
发明人： Yi Zhang , John D. Hatlestad , Gerrard M. Carlson , Yousufali Dalal , Marina V. Brockway , Kent Lee , Richard O. Kuenzler , Carlos Haro , Krzysztof Z. Siejko , Abhilash Patangay
IPC分类号： A61M5/172 , A61N1/36
CPC分类号： A61M5/1723 , A61B5/02055 , A61B5/0215 , A61B5/024 , A61B5/02405 , A61B5/053 , A61B5/0816 , A61B5/1116 , A61B5/686 , A61B5/7275 , A61N1/36114 , A61N1/36135 , A61N1/3621 , A61N1/365 , A61N1/36585 , G16H20/10 , G16H20/40 , G16H50/20 , G16H50/30
摘要： The health state of a subject is automatically evaluated or predicted using at least one implantable device. In varying examples, the health state is determined by sensing or receiving information about at least one physiological process having a circadian rhythm whose presence, absence, or baseline change is associated with impending disease, and comparing such rhythm to baseline circadian rhythm prediction criteria. Other chronobiological rhythms beside circadian may also be used. The baseline prediction criteria may be derived using one or more past physiological process observation of the subject or population of subjects in a non-disease health state. The prediction processing may be performed by the at least one implantable device or by an external device in communication with the implantable device. Systems and methods for invoking a therapy in response to the health state, such as to prevent or minimize the consequences of predicted impending heart failure, are also discussed.
摘要翻译：使用至少一个可植入装置自动评价或预测受试者的健康状况。在不同的实施例中，通过感测或接收关于至少一个具有昼夜节律的生理过程的信息来确定健康状况，所述生理过程的存在，不存在或基线变化与即将发生的疾病相关联，并将该节律与基线昼夜节律预测标准进行比较。也可以使用昼夜节律以外的其他时间生理节律。可以使用在非疾病健康状态下的受试者或受试者群体的一个或多个过去的生理过程观察来导出基线预测标准。预测处理可以由至少一个可植入装置或与可植入装置通信的外部装置执行。还讨论了响应于健康状态调用疗法的系统和方法，例如预防或最小化预期的即将到来的心力衰竭的后果。

82. 发明授权

US08364263B2 System and method for systolic interval analysis 有权
公开(公告)号：US08364263B2
公开(公告)日：2013-01-29
申请号：US11553179
申请日：2006-10-26
申请人： Abhilash Patangay , Krzysztof Z. Siejko , Gerrard M. Carlson , Loell Boyce Moon
发明人： Abhilash Patangay , Krzysztof Z. Siejko , Gerrard M. Carlson , Loell Boyce Moon
IPC分类号： A61N1/00
CPC分类号： A61B5/0265 , A61B5/0031 , A61B5/029 , A61B5/042 , A61B5/0456 , A61B5/053 , A61B5/0538 , A61B5/4836 , A61B5/686 , A61B5/7239 , A61B5/7282 , A61B7/00 , A61B7/04 , A61N1/36521 , A61N1/36571 , A61N1/36578 , A61N1/36585
摘要： A system and method provide for systolic interval analysis. In an example, an implantable device measures a cardiac impedance signal. A transformation of the cardiac impedance interval is generated. The device also measures a heart sound signal. A time interval between a point on the transformed signal of the cardiac impedance signal and a point on the heart sound signal is calculated.

83. 发明授权

US08229557B2 Estimating acute response to cardiac resynchronization therapy 有权
标题翻译：估计对心脏再同步治疗的急性反应
公开(公告)号：US08229557B2
公开(公告)日：2012-07-24
申请号：US11729453
申请日：2007-03-29
申请人： Abhilash Patangay , Krzysztof Siejko , Mohan Krishnan , Gerrard M. Carlson
发明人： Abhilash Patangay , Krzysztof Siejko , Mohan Krishnan , Gerrard M. Carlson
IPC分类号： A61N1/365
CPC分类号： A61N1/3627 , A61B5/0031 , A61B5/02028 , A61B5/0215 , A61B5/029 , A61B5/0422 , A61B5/0535 , A61B5/0538 , A61B5/1102 , A61B5/7267 , A61B7/00 , A61N1/3684 , A61N1/3704
摘要： Systolic timing intervals are measured in response to delivering pacing energy to a pacing site of a patient's heart. An estimate of a patient's acute response to cardiac resynchronization therapy (CRT) for the pacing site is determined using the measured systolic timing intervals. The estimate is compared to a threshold. The threshold preferably distinguishes between acute responsiveness and non-responsiveness to CRT for a patient population. An indication of acute responsiveness to CRT for the pacing site may be produced in response to the comparison.
摘要翻译：响应于将起搏能量递送到患者心脏的起搏部位来测量收缩时间间隔。使用测量的收缩时间间隔来确定对于起搏部位的患者对心脏再同步治疗（CRT）的急性反应的估计。将估计值与阈值进行比较。该阈值优选地区分对于患者群体的急性反应性和对CRT的无反应性。响应于比较可以产生针对起搏部位对CRT的急性反应性的指示。

84. 发明授权

US08162844B2 Managing preload reserve by tracking the ventricular operating point with heart sounds 有权
标题翻译：通过用心脏声音跟踪心室手术点来管理预负荷储备
公开(公告)号：US08162844B2
公开(公告)日：2012-04-24
申请号：US12547207
申请日：2009-08-25
申请人： Gerrard M. Carlson , Ramesh Wariar , Krzysztof Z. Siejko
发明人： Gerrard M. Carlson , Ramesh Wariar , Krzysztof Z. Siejko
IPC分类号： A61B5/021 , A61B5/0225
CPC分类号： A61N1/36585 , A61B5/021 , A61B5/0452 , A61B7/04 , A61M5/1723 , A61N1/37
摘要： A system and method for managing preload reserve and tracking the inotropic state of a patient's heart. The S1 heart sound is measured as a proxy for direct measurement of stroke volume. The S3 heart sound may be measured as a proxy for direct measurement of preload level. The S1-S3 pair yield a point on a Frank Starling type of curve, and reveal information regarding the patient's ventricular operating point and inotropic state. As an alternative, or in addition to, measurement of the S3 heart sound, the S4 heart sound may be measured or a direct pressure measurement may be made for the sake of determining the patient's preload level. The aforementioned measurements may be made by a cardiac rhythm management device, such as a pacemaker or implantable defibrillator.
摘要翻译：一种用于管理预负荷储备并跟踪患者心脏的变力状态的系统和方法。测量S1心音作为直接测量行程体积的代理。可以将S3心音测量为用于直接测量预载水平的代理。 S1-S3对在Frank Starling曲线上产生一个点，并显示关于患者的心室手术点和变力状态的信息。作为S3心音的测量或除了测量S3心音之外，也可以测量S4心音，或者为了确定患者的预压水平可以进行直接的压力测量。上述测量可以由诸如起搏器或可植入除颤器的心律管理装置进行。

85. 发明申请

US20110263988A1 SENSING RATE OF CHANGE OF PRESSURE IN THE LEFT VENTRICLE WITH AN IMPLANTED DEVICE 有权
标题翻译：在具有嵌入式装置的左心室中的压力变化率的感测率
公开(公告)号：US20110263988A1
公开(公告)日：2011-10-27
申请号：US13178945
申请日：2011-07-08
申请人： Gerrard M. Carlson , Krzysztof Z. Siejko , Ramesh Wariar , Marina Brockway
发明人： Gerrard M. Carlson , Krzysztof Z. Siejko , Ramesh Wariar , Marina Brockway
IPC分类号： A61B5/0205 , A61N1/365 , A61M5/168 , A61B5/02
CPC分类号： A61B5/021 , A61N1/36564 , A61N1/36578 , A61N1/375
摘要： An implantable device and method for monitoring S1 heart sounds with a remotely located accelerometer. The device includes a transducer that converts heart sounds into an electrical signal. A control circuit is coupled to the transducer. The control circuit is configured to receive the electrical signal, identify an S1 heart sound, and to convert the S1 heart sound into electrical information. The control circuit also generates morphological data from the electrical information. The morphological data relates to a hemodynamic metric, such as left ventricular contractility. A housing may enclose the control circuit. The housing defines a volume coextensive with an outer surface of the housing. The transducer is in or on the volume defined by the housing.
摘要翻译：一种用远程位置加速度计监测S1心音的可植入装置和方法。该装置包括将心音转换为电信号的换能器。控制电路耦合到换能器。控制电路被配置为接收电信号，识别S1心音，并将S1心音转换为电信息。控制电路还从电信息生成形态数据。形态学数据涉及血流动力学指标，如左心室收缩力。壳体可以包围控制电路。壳体限定与壳体的外表面共同延伸的体积。传感器位于由外壳限定的体积中。

86. 发明授权

US08025624B2 System and method for assessing cardiac performance through cardiac vibration monitoring 有权
标题翻译：通过心脏振动监测评估心脏性能的系统和方法
公开(公告)号：US08025624B2
公开(公告)日：2011-09-27
申请号：US11367852
申请日：2006-03-03
申请人： Ramesh Wariar , Gerrard M. Carlson
发明人： Ramesh Wariar , Gerrard M. Carlson
IPC分类号： A61B5/02
CPC分类号： A61B7/04 , A61B5/021 , A61B7/00
摘要： A system and method for assessing cardiac performance through cardiac vibration monitoring is described. Cardiac vibration measures are directly collected through an implantable medical device. Cardiac events including at least one first heart sound reflected by the cardiac vibration measures are identified. The first heart sound is correlated to cardiac dimensional measures relative to performance of an intrathoracic pressure maneuver. The cardiac dimensional measures are grouped into at least one measures set corresponding to a temporal phase of the intrathoracic pressure maneuver. The at least one cardiac dimensional measures set is evaluated against a cardiac dimensional trend for the corresponding intrathoracic pressure maneuver temporal phase to represent cardiac performance.
摘要翻译：描述了通过心脏振动监测来评估心脏性能的系统和方法。通过植入式医疗设备直接收集心脏振动。识别心脏事件，包括由心脏振动测量反射的至少一个第一心音。第一个心音与胸腔内压力作用的心脏尺寸相关。心脏尺寸测量被分组为对应于胸内压力操纵的时间相位的至少一个测量组。针对相应的胸内压力机动时间阶段的心脏尺寸趋势来评估至少一个心脏尺寸测量集合以表示心脏性能。

87. 发明授权

US07938781B2 Hemodynamic stability assessment based on heart sounds 有权
标题翻译：基于心音的血流动力学稳定性评估
公开(公告)号：US07938781B2
公开(公告)日：2011-05-10
申请号：US12813073
申请日：2010-06-10
申请人： Gerrard M. Carlson , Yayun Lin
发明人： Gerrard M. Carlson , Yayun Lin
IPC分类号： A61B5/02
CPC分类号： A61N1/3962 , A61B5/02028 , A61B5/024 , A61B5/02405 , A61B7/04 , A61N1/3621 , A61N1/3627 , A61N1/36514 , A61N1/36578 , A61N1/37247 , A61N1/37282
摘要： A method comprises detecting at least one episode of ventricular tachyarrhythmia in a subject using an implantable medical device (IMD), sensing at least one heart sound signal for the subject using the IMD, the heart sound signal associated with mechanical vibration of a heart of the subject; initiating, in response to and during the detected episode of tachyarrhythmia, a measurement of hemodynamic stability of the ventricular tachyarrhythmia from the heart sound signal, and deeming whether the ventricular tachyarrhythmia is stable according to the measurement of hemodynamic stability. The measurement of hemodynamic stability is determined using linear prediction.
摘要翻译：一种方法包括使用可植入医疗装置（IMD）检测受试者中的至少一次心室快速性心律失常，使用IMD感测对象的至少一个心音信号，与心脏的心脏的机械振动相关的心音信号学科; 响应于和在检测到的快速性心律失常发作期间，从心脏声音信号测量心室快速性心律失常的血液动力学稳定性，并且根据血液动力学稳定性的测量来确定心室性心律失常是否稳定。使用线性预测确定血液动力学稳定性的测量。

88. 发明授权

US07930019B2 Method and apparatus for phonocardiographic image acquisition and presentation 有权
标题翻译：用于心律图像获取和呈现的方法和装置
公开(公告)号：US07930019B2
公开(公告)日：2011-04-19
申请号：US11780405
申请日：2007-07-19
申请人： Krzysztof Z. Siejko , Gerrard M. Carlson , William C. Lincoln , Qingsheng Zhu
发明人： Krzysztof Z. Siejko , Gerrard M. Carlson , William C. Lincoln , Qingsheng Zhu
IPC分类号： A61B5/04
CPC分类号： A61N1/368 , A61N1/3627 , A61N1/36514 , A61N1/36542 , A61N1/36578 , A61N1/3682 , A61N1/3702
摘要： A cardiac rhythm management system provides a phonocardiographic image indicative of a heart's mechanical events related to hemodynamic performance. The phonocardiographic image includes a stack of acoustic sensor signal segments representing multiple cardiac cycles. Each acoustic sensor signal segment includes heart sounds indicative of the heart's mechanical events and representations of the heart's electrical events. The stack of acoustic sensor signal segments are aligned by a selected type of the heart's mechanical or electrical events and are grouped by a cardiac timing parameter for presentation.
摘要翻译：心律管理系统提供指示与血液动力学性能相关的心脏的机械事件的心音图像。心音图像包括表示多个心动周期的一组声传感器信号段。每个声学传感器信号段包括指示心脏的机械事件和心脏电气事件的表示的心脏声音。声学传感器信号段的堆叠通过所选择的心脏的机械或电气事件的类型对准，并且通过心脏定时参数分组以进行呈现。

89. 发明申请

US20100280564A1 MONITORING OF CHRONOBIOLOGICAL RHYTHMS FOR DISEASE AND DRUG MANAGEMENT USING ONE OR MORE IMPLANTABLE DEVICE 有权
标题翻译：使用一个或多个可植入装置监测疾病和药物管理的血液生殖系统
公开(公告)号：US20100280564A1
公开(公告)日：2010-11-04
申请号：US12836441
申请日：2010-07-14
申请人： Yi Zhang , John D. Hatlestad , Gerrard M. Carlson , Yousufali Dalal , Marina V. Brockway , Kent Lee , Richard O. Kuenzler , Carlos Haro , Krzysztof Z. Siejko , Abhilash Patangay
发明人： Yi Zhang , John D. Hatlestad , Gerrard M. Carlson , Yousufali Dalal , Marina V. Brockway , Kent Lee , Richard O. Kuenzler , Carlos Haro , Krzysztof Z. Siejko , Abhilash Patangay
IPC分类号： A61N1/02 , A61B5/00
CPC分类号： A61M5/1723 , A61B5/02055 , A61B5/0215 , A61B5/024 , A61B5/02405 , A61B5/053 , A61B5/0816 , A61B5/1116 , A61B5/686 , A61B5/7275 , A61N1/36114 , A61N1/36135 , A61N1/3621 , A61N1/365 , A61N1/36585 , G06F19/00
摘要： The health state of a subject is automatically evaluated or predicted using at least one implantable device. In varying examples, the health state is determined by sensing or receiving information about at least one physiological process having a circadian rhythm whose presence, absence, or baseline change is associated with impending disease, and comparing such rhythm to baseline circadian rhythm prediction criteria. Other chronobiological rhythms beside circadian may also be used. The baseline prediction criteria may be derived using one or more past physiological process observation of the subject or population of subjects in a non-disease health state. The prediction processing may be performed by the at least one implantable device or by an external device in communication with the implantable device. Systems and methods for invoking a therapy in response to the health state, such as to prevent or minimize the consequences of predicted impending heart failure, are also discussed.
摘要翻译：使用至少一个可植入装置自动评价或预测受试者的健康状况。在不同的实施例中，通过感测或接收关于至少一个具有昼夜节律的生理过程的信息来确定健康状况，所述生理过程的存在，不存在或基线变化与即将发生的疾病相关联，并将该节律与基线昼夜节律预测标准进行比较。也可以使用昼夜节律以外的其他时间生理节律。可以使用在非疾病健康状态下的受试者或受试者群体的一个或多个过去的生理过程观察来导出基线预测标准。预测处理可以由至少一个可植入装置或与可植入装置通信的外部装置执行。还讨论了响应于健康状态调用疗法的系统和方法，例如预防或最小化预期的即将到来的心力衰竭的后果。

90. 发明授权

US07780606B2 Hemodynamic stability assessment based on heart sounds 有权
标题翻译：基于心音的血流动力学稳定性评估
公开(公告)号：US07780606B2
公开(公告)日：2010-08-24
申请号：US11277773
申请日：2006-03-29
申请人： Gerrard M. Carlson , Yayun Lin
发明人： Gerrard M. Carlson , Yayun Lin
IPC分类号： A61B5/02
CPC分类号： A61N1/3962 , A61B5/02028 , A61B5/024 , A61B5/02405 , A61B7/04 , A61N1/3621 , A61N1/3627 , A61N1/36514 , A61N1/36578 , A61N1/37247 , A61N1/37282
摘要： A system comprising an implantable medical device (IMD). The IMD includes an implantable sensor operable to produce an electrical signal representative of mechanical activity of a heart of a subject and a controller circuit coupled to the sensor. The IMD also includes a heart sound sensor interface circuit to produce a heart sound signal, a tachyarrhythmia detector, and a controller circuit. The controller circuit includes a hemodynamic stability assessment module configured to determine that at least one episode of ventricular tachyarrhythmia is detected in a subject and obtain a measurement of hemodynamic stability of the ventricular tachyarrhythmia from the heart sound signal.
摘要翻译：一种包括可植入医疗装置（IMD）的系统。 IMD包括可植入传感器，其可操作以产生代表受试者心脏的机械活动的电信号和耦合到传感器的控制器电路。 IMD还包括产生心脏声音信号的心脏声音传感器接口电路，快速心律失常检测器和控制器电路。控制器电路包括血液动力学稳定性评估模块，其被配置为确定在受试者中检测到至少一次心室快速性心律失常发作，并且从心脏声音信号获得心室快速性心律失常的血液动力学稳定性的测量。

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