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1. 发明授权

US09037240B2 Electrode lead integrity reports 有权
标题翻译：电极铅完整性报告
公开(公告)号：US09037240B2
公开(公告)日：2015-05-19
申请号：US12180314
申请日：2008-07-25
申请人： Bruce D. Gunderson
发明人： Bruce D. Gunderson
IPC分类号： A61N1/36 , A61N1/372 , A61N1/362 , A61N1/37 , A61N1/39 , A61N1/08
CPC分类号： A61N1/37247 , A61N1/3621 , A61N1/3704 , A61N1/3925 , A61N2001/083
摘要： In general, the disclosure relates to techniques for providing a combination of stored diagnostic information, including impedance trend data, into one displayable report that may be used to diagnose a possible condition with an implantable medical electrode lead. One example device includes a processor that is configured to obtain impedance trend data for an electrical path, the electrical path comprising a plurality of electrodes, and to obtain additional diagnostic data that is associated with the electrical path, the additional diagnostic data being distinct from the impedance trend data. The device is further configured to combine both the impedance trend data and the additional diagnostic data into a displayable report that indicates whether there is a possible condition with the electrical path. The additional diagnostic data may include non-sustained episode data, sensing integrity data, pacing threshold, and/or electrogram data (such as P-wave amplitude and/or R-wave amplitude data).
摘要翻译：通常，本公开涉及将存储的诊断信息（包括阻抗趋势数据）的组合提供到可用于使用可植入医疗电极引线诊断可能状况的可显示报告中的技术。一个示例性设备包括被配置为获得用于电路径的阻抗趋势数据的处理器，该电路径包括多个电极，并且获得与电路径相关联的附加诊断数据，附加诊断数据不同于阻抗趋势数据。该装置还被配置为将阻抗趋势数据和附加诊断数据两者组合成可显示报告，该报告指示电路是否存在可能的状况。附加诊断数据可以包括非持续发作数据，感测完整性数据，起搏阈值和/或电描记图数据（例如P波幅度和/或R波振幅数据）。

2. 发明授权

US08798750B2 Identifying a lead related condition based on detecting noise subsequent to signal delivery 有权
标题翻译：基于在信号传递之后检测噪声识别引线相关条件
公开(公告)号：US08798750B2
公开(公告)日：2014-08-05
申请号：US12719650
申请日：2010-03-08
申请人： Bruce D. Gunderson , Kevin A. Wanasek , Charles D. Swerdlow
发明人： Bruce D. Gunderson , Kevin A. Wanasek , Charles D. Swerdlow
IPC分类号： A61N1/08 , A61B5/0424 , A61N1/37 , A61B5/00
CPC分类号： A61N1/08 , A61B5/0424 , A61B5/7203 , A61B5/7217 , A61N1/3702 , A61N1/3706 , A61N1/371 , A61N1/37247 , A61N2001/083
摘要： In general, the disclosure describes techniques for detecting lead related conditions, such as lead fractures or other lead integrity issues. As described herein, delivering an electrical signal through selected electrodes may result in, reveal, or amplify noise if a lead related condition is present. A processor may detect electrical noise indicative of the lead related condition subsequent to the delivery of the electrical signal, and identify a lead related condition in response to detecting the noise.
摘要翻译：通常，本公开描述了用于检测铅相关条件的技术，例如铅断裂或其他引线完整性问题。如本文所述，如果存在铅相关条件，则通过所选择的电极传送电信号可导致，显示或放大噪声。处理器可以检测指示在传送电信号之后引线相关状况的电噪声，并且响应于检测到噪声来识别引线相关条件。

3. 发明申请

US20140046690A1 MANAGEMENT AND DISTRIBUTION OF PATIENT INFORMATION 审中-公开
标题翻译：患者信息管理与分配
公开(公告)号：US20140046690A1
公开(公告)日：2014-02-13
申请号：US13570884
申请日：2012-08-09
申请人： Bruce D. Gunderson , Kevin T. Ousdigian , Amisha S. Patel
发明人： Bruce D. Gunderson , Kevin T. Ousdigian , Amisha S. Patel
IPC分类号： G06Q50/24
CPC分类号： G16H40/63 , G06F19/3418 , G06F19/3481 , G16H15/00
摘要： Techniques, systems, and devices, for generating a patient management report based on clinician input and patient data are described. For example, one or more processors may be configured to receive a clinician input selecting at least one reporting characteristic for each of a plurality of diagnostic metrics and organize the diagnostic metrics based on the selected reporting characteristic. In addition, the one or more processors may be configured to receive patient data for at least one patient, determine a value for at least a subset of the diagnostic metrics based on the patient data, and generate a patient management report comprising the diagnostic metrics having a value that exceeds a respective threshold. The diagnostic metrics may be ordered in the patient management report based on the organization.
摘要翻译：描述了用于基于临床医生输入和患者数据生成患者管理报告的技术，系统和设备。例如，一个或多个处理器可以被配置为接收为多个诊断度量中的每一个选择至少一个报告特征的临床医生输入，并且基于所选择的报告特征来组织诊断度量。此外，一个或多个处理器可以被配置为接收至少一个患者的患者数据，基于患者数据确定诊断度量的至少一个子集的值，并且生成患者管理报告，其包括具有超过相应阈值的值。可以根据组织在患者管理报告中订购诊断指标。

4. 发明申请

US20130289428A1 METHOD AND APPARATUS FOR DISPLAY OF CARDIAC SIGNAL EPISODES WITH OVER- OR UNDER-SENSING 有权
标题翻译：用于显示具有超感或感知信号的心脏信号的方法和装置
公开(公告)号：US20130289428A1
公开(公告)日：2013-10-31
申请号：US13456828
申请日：2012-04-26
申请人： Amisha S. Patel , Bruce D. Gunderson , Mark L. Brown
发明人： Amisha S. Patel , Bruce D. Gunderson , Mark L. Brown
IPC分类号： A61B5/0456 , A61B5/02
CPC分类号： A61B5/686 , A61B5/0452 , A61B5/7221 , A61B5/7282 , A61N1/368 , A61N1/37247 , A61N1/37264 , A61N1/37282
摘要： A medical device system senses cardiac signals and generates and stores sensing data including sensed cardiac events. A processor receiving the sensing data is configured to detect undersensed and oversensed events. The processor generates an episode display comprising event identifying codes in response to the received sensing data and produces an adjusted episode display in response to an event being identified as an undersensed event or an oversensed event.
摘要翻译：医疗设备系统感测心脏信号，并产生并存储包括感测的心脏事件的感测数据。接收感测数据的处理器被配置为检测不足和超级的事件。所述处理器响应于所接收的感测数据而生成包括事件识别码的剧集显示，并响应于被识别为超大事件或超大事件的事件而产生经调整的剧集显示。

5. 发明申请

US20130079654A1 EPISODE CLASSIFIER ALGORITHM 有权
标题翻译： EPISODE分类器算法
公开(公告)号：US20130079654A1
公开(公告)日：2013-03-28
申请号：US13245585
申请日：2011-09-26
申请人： Amisha S. Patel , Bruce D. Gunderson , Mark L. Brown
发明人： Amisha S. Patel , Bruce D. Gunderson , Mark L. Brown
IPC分类号： G06F19/00 , A61B5/046 , A61B5/0464
CPC分类号： A61B5/04 , A61B5/046 , A61B5/0464 , A61N1/3702
摘要： The present disclosure is directed to the classification of cardiac episodes using an algorithm. In various examples, an episode classification algorithm evaluates electrogram signal data from a near-field channel and a far-field channel. The episode classification algorithm classifies the cardiac episode based on the evaluation of the electrogram signal data for at least one of the near-field and far-field channels. In some examples, a cardiac episode being classified may be an episode that resulted in treatment being provided by an implantable medical device. Possible classifications of the cardiac episode may include, for example, unknown, inappropriate, appropriate, supraventricular tachycardia, ventricular tachycardia, ventricular fibrillation or ventricular over-sensing.
摘要翻译：本公开涉及使用算法对心脏发作的分类。在各种示例中，事件分类算法从近场信道和远场信道评估电描记图信号数据。情节分类算法基于对近场和远场信道中的至少一个的电描记图信号数据的评估来分类心脏发作。在一些实例中，分类的心脏发作可能是导致由可植入医疗装置提供的治疗的发作。心脏事件的可能分类可能包括例如未知的，不适当的，适当的，室上性心动过速，室性心动过速，心室颤动或心室过度感测。

6. 发明授权

US08200322B2 Electrogram storage for suspected non-physiological episodes 有权
标题翻译：怀疑非生理发作的电图存储
公开(公告)号：US08200322B2
公开(公告)日：2012-06-12
申请号：US12182687
申请日：2008-07-30
申请人： Kevin T. Ousdigian , Catherine R. Condie , Karen J. Kleckner , Bruce D. Gunderson
发明人： Kevin T. Ousdigian , Catherine R. Condie , Karen J. Kleckner , Bruce D. Gunderson
IPC分类号： A61B5/0468
CPC分类号： A61N1/3702 , A61B5/042 , A61B5/046 , A61B5/0464 , A61B5/053 , A61B5/0538 , A61B5/7264 , A61B2560/0276 , A61N1/3704 , A61N2001/083
摘要： Techniques for storing electrograms (EGMS) that are associated with sensed episodes or events that may be non-physiological and, instead, associated with a sensing integrity condition are described. In some examples, a device or system identifies suspected non-physiological NSTs, and stores an EGM for the suspected non-physiological NSTs within an episode log. In some examples, a device or system determines whether to store an EGM for a suspected non-physiological episode or event based on whether an impedance integrity criterion has been satisfied. For example, a device or system may store an EGM for a detected short interval if the impedance integrity criterion has been met. In some examples, a device or system determines whether to buffer EGM data based on whether an impedance integrity criterion or other sensing integrity criterion has been met.
摘要翻译：描述了用于存储与可能是非生理感知的事件相关联的电摄影（EGMS）的技术，并且相反地与感测完整性条件相关联的技术。在一些示例中，设备或系统识别疑似非生理NST，并且在发作日志中存储用于可疑非生理NST的EGM。在一些示例中，设备或系统基于是否已经满足阻抗完整性标准来确定是否存储用于可疑非生理事件或事件的EGM。例如，如果已经满足了阻抗完整性标准，则设备或系统可以存储用于检测到的短间隔的EGM。在一些示例中，设备或系统基于是否已经满足阻抗完整性标准或其他感测完整性标准来确定是否缓冲EGM数据。

7. 发明申请

US20120109235A1 CAPTURE DETECTION IN RESPONSE TO LEAD RELATED CONDITIONS 审中-公开
标题翻译：对领导相关条件的响应能力的检测
公开(公告)号：US20120109235A1
公开(公告)日：2012-05-03
申请号：US12913400
申请日：2010-10-27
申请人： Todd J. Sheldon , Bruce D. Gunderson
发明人： Todd J. Sheldon , Bruce D. Gunderson
IPC分类号： A61N1/37 , A61N1/39
CPC分类号： A61N1/371 , A61N1/3706 , A61N1/3712 , A61N1/3962 , A61N2001/083
摘要： Various techniques for detecting cardiac capture in response to a detected lead related condition are described. One example method described includes delivering a pacing therapy to a heart of a patient, periodically determining whether the pacing therapy captures the heart of the patient, detecting a lead related condition, and, in response to the detected lead related condition, increasing a frequency of determining whether the pacing therapy captures the heart.
摘要翻译：描述了响应于检测到的铅相关状况来检测心脏捕获的各种技术。所描述的一个示例性方法包括将起搏治疗递送到患者的心脏，周期性地确定起搏疗法是否捕获患者的心脏，检测引线相关状况，并且响应于检测到的引线相关状况，增加频率确定起搏治疗是否捕获心脏。

8. 发明申请

US20110112417A1 METHOD AND APPARATUS FOR POST-PROCESSING OF EPISODES DETECTED BY A MEDICAL DEVICE 审中-公开
标题翻译：用于后处理由医疗装置检测的EPISOD的方法和装置
公开(公告)号：US20110112417A1
公开(公告)日：2011-05-12
申请号：US12906821
申请日：2010-10-18
申请人： Bruce D. Gunderson , Mark L. Brown , Amisha Somabhai Patel
发明人： Bruce D. Gunderson , Mark L. Brown , Amisha Somabhai Patel
IPC分类号： A61B5/0452
CPC分类号： A61B5/0452 , A61B5/0006 , A61B5/0031 , A61B5/04525 , A61B2560/0271 , A61N1/368 , A61N1/3702 , A61N1/3706 , A61N1/37211 , A61N1/3925 , A61N1/3962 , G06F19/3418
摘要： A method and system for determining undersensing during post-processing of sensing data generated by a medical device that includes transmitting a plurality of stored sensing data generated by the medical device to an access device, the stored sensing data including sensed atrial events and sensed ventricular events. The access device determines, in response to the transmitted data, instances where the medical device identified a cardiac event being detected in response to the sensing data, and determines whether one of a predetermined number of undersensing criteria have been met in response to the transmitted data.
摘要翻译：一种用于在由医疗设备产生的感测数据的后处理期间确定不足感的方法和系统，包括将由医疗设备生成的多个存储的感测数据发送到接入设备，所存储的感测数据包括感测到的心房事件和感测到的心室事件。接入装置响应于所发送的数据确定医疗装置响应于感测数据识别出正在检测的心脏事件并且确定响应于所发送的数据是否已经满足预定数量的不足的标准中的一个。

9. 发明申请

US20110054558A1 IDENTIFYING A LEAD RELATED CONDITION BASED ON DETECTING NOISE SUBSEQUENT TO SIGNAL DELIVERY 有权
标题翻译：基于检测噪声的信号传递识别领先相关条件
公开(公告)号：US20110054558A1
公开(公告)日：2011-03-03
申请号：US12719650
申请日：2010-03-08
申请人： Bruce D. Gunderson , Kevin A. Wanasek , Charles D. Swerdlow
发明人： Bruce D. Gunderson , Kevin A. Wanasek , Charles D. Swerdlow
IPC分类号： A61N1/08
CPC分类号： A61N1/08 , A61B5/0424 , A61B5/7203 , A61B5/7217 , A61N1/3702 , A61N1/3706 , A61N1/371 , A61N1/37247 , A61N2001/083
摘要： In general, the disclosure describes techniques for detecting lead related conditions, such as lead fractures or other lead integrity issues. As described herein, delivering an electrical signal through selected electrodes may result in, reveal, or amplify noise if a lead related condition is present. A processor may detect electrical noise indicative of the lead related condition subsequent to the delivery of the electrical signal, and identify a lead related condition in response to detecting the noise.
摘要翻译：通常，本公开描述了用于检测铅相关条件的技术，例如铅断裂或其他引线完整性问题。如本文所述，如果存在铅相关条件，则通过所选择的电极传送电信号可导致，显示或放大噪声。处理器可以检测指示在传送电信号之后引线相关状况的电噪声，并且响应于检测到噪声来识别引线相关条件。

10. 发明授权

US07783354B2 Method and apparatus for identifying cardiac and non-cardiac oversensing using intracardiac electrograms 有权
标题翻译：使用心内电描记图识别心脏和非心脏过敏的方法和装置
公开(公告)号：US07783354B2
公开(公告)日：2010-08-24
申请号：US10418857
申请日：2003-04-18
申请人： Bruce D. Gunderson
发明人： Bruce D. Gunderson
IPC分类号： A61N1/00
CPC分类号： A61B5/0452 , A61B5/04525 , A61B5/0456 , A61B5/0464 , A61B5/7203 , A61N1/3622 , A61N1/3702 , A61N1/3925
摘要： A method and apparatus for automatically identifying various types of cardiac and non-cardiac oversensing and automatically performing a corrective action to reduce the likelihood of oversensing is provided. EGM data, including time intervals between sensed and paced events and signal morphologies, are analyzed for patterns indicative of various types of oversensing, including oversensing of far-field R-waves, R-waves, T-waves, or noise associated with electromagnetic interference, non-cardiac myopotentials, a lead fracture, or a poor lead connection. Identification of oversensing and its suspected cause are reported so that corrective action may be taken. The corrective action may include, for example, adjusting sensing parameters such as blanking periods, decay constants, decay delays, threshold values, sensitivity values, electrode configurations and the like.
摘要翻译：提供了一种用于自动识别各种类型的心脏和非心脏过度感觉并自动执行校正动作以减少过度感觉的可能性的方法和装置。分析EGM数据，包括感测和起搏事件与信号形态之间的时间间隔，用于指示各种类型的过度感应的模式，包括远场R波，R波，T波或与电磁干扰相关的噪声的过度干扰，非心脏神经障碍，铅断裂或不良引线连接。报告过敏的识别及其疑似原因，以便采取纠正措施。校正动作可以包括例如调整感测参数，例如消隐周期，衰减常数，衰减延迟，阈值，灵敏度值，电极配置等。

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