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1. 发明授权

US09433793B2 System and method for accurately detecting cardiac events using multi-threshold processing 有权
标题翻译：使用多阈值处理准确检测心脏事件的系统和方法
公开(公告)号：US09433793B2
公开(公告)日：2016-09-06
申请号：US12264131
申请日：2008-11-03
申请人： Rupinder Bharmi , Jeffery D. Snell
发明人： Rupinder Bharmi , Jeffery D. Snell
IPC分类号： A61B5/04 , A61N1/37 , A61B5/0452 , A61B5/0456
CPC分类号： A61N1/3704 , A61B5/04012 , A61B5/04525 , A61B5/0456
摘要： A system and method provide precise detection of the time of occurrence of a cardiac event of a heart. The method comprises the steps of sensing electrical activity of the heart to generate an electrogram of the heart and applying the electrogram to an event detector having a plurality of spaced apart thresholds. The thresholds are selected such that the electrogram has an amplitude for crossing at least one of the thresholds. The method further comprises determining a characteristic identifying feature of the electrogram at each threshold crossing of the electrogram, comparing the determined characteristic identifying features to an electrogram template, and identifying the time of occurrence of the cardiac event based upon the comparison.
摘要翻译：系统和方法提供对心脏心脏事件发生时间的精确检测。该方法包括以下步骤：感测心脏的电活动以产生心脏的电描记图，并将电描记图应用于具有多个间隔开的阈值的事件检测器。选择阈值使得电描记图具有用于与至少一个阈值交叉的幅度。该方法还包括在电描记图的每个阈值交叉处确定电描记图的特征识别特征，将所确定的特征识别特征与电描记图模板进行比较，以及基于该比较来识别心脏事件的发生时间。

2. 发明授权

US09415226B1 Method and apparatus with anodal capture monitoring 有权
标题翻译：具有阳极捕获监测的方法和装置
公开(公告)号：US09415226B1
公开(公告)日：2016-08-16
申请号：US11961720
申请日：2007-12-20
申请人： Jeffery D. Snell , Gene A. Bornzin , Laurence S. Sloman , Jong Gill
发明人： Jeffery D. Snell , Gene A. Bornzin , Laurence S. Sloman , Jong Gill
IPC分类号： A61N1/00 , A61N1/362
CPC分类号： A61N1/3622 , A61N1/3684 , A61N1/3686 , A61N1/3712
摘要： During cross-chamber pacing, where anodal capture may not be desirable, pulses are applied between a cathode electrode in a first chamber and an anode electrode in a second chamber. A capture detector detects for capture of the second chamber by the pacing pulses. If capture of the second chamber persists, another electrode is selected as the anodal electrode. During single-chamber pacing, where anodal capture may be desirable, pulses are applied between a cathode electrode and an anode electrode associated with the same chamber. A capture detector detects for capture at both electrodes. If anodal capture is not detected, the energy of the pacing pulse is increased, until anodal capture is detected.
摘要翻译：在跨室起搏期间，可能不需要阳极捕获，脉冲施加在第一室中的阴极和第二室中的阳极之间。捕获检测器通过起搏脉冲检测第二腔室的捕获。如果第二室的捕获持续，则选择另一电极作为阳极电极。在可以期望阳极捕获的单室起搏期间，在与相同的室相关联的阴极和阳极之间施加脉冲。捕获检测器检测两个电极的捕获。如果没有检测到阳极捕获，则起搏脉冲的能量增加，直到检测到阳极捕获。

3. 发明授权

US08265756B1 System and method for adjusting automatic sensitivity control parameters based on intracardiac electrogram signals 有权
标题翻译：基于心脏电图信号调整自动灵敏度控制参数的系统和方法
公开(公告)号：US08265756B1
公开(公告)日：2012-09-11
申请号：US11608154
申请日：2006-12-07
申请人： Jeffery D. Snell , Rupinder Bharmi
发明人： Jeffery D. Snell , Rupinder Bharmi
IPC分类号： A61N1/06
CPC分类号： A61N1/36507
摘要： Systems and methods are provided for use by an implantable medical device capable of automatically adjusting the sensitivity with which electrical cardiac signals are sensed within a patient, i.e. a device equipped with Automatic Sensitivity Control (ASC.) In a first example, ASC parameters are automatically adjusted by the device itself based on parameters derived from both R-waves and T-waves and further based on a detected noise floor. In a second example, a profile representative of the shape of cardiac signals is generated by the device. ASC parameters are then adjusted based on the profile. In various embodiments, histograms are used to determine sizes and shapes of the R-waves and T-waves via statistical prevalence techniques. The histograms are also employed to derive the aforementioned profile.
摘要翻译：系统和方法被提供用于能够自动调节在患者体内感测到电心电信号的灵敏度的可植入医疗装置，即配备有自动灵敏度控制（ASC）的装置。在第一示例中，ASC参数是自动的由设备本身根据从R波和T波两个导出的参数进一步调整，并进一步基于检测到的本底噪声。在第二示例中，通过该装置产生代表心脏信号形状的轮廓。然后根据配置文件调整ASC参数。在各种实施例中，使用直方图通过统计学流行技术来确定R波和T波的大小和形状。直方图也用于推导上述轮廓。

4. 发明授权

US08260404B1 Systems and methods for employing multiple filters to detect T-wave oversensing and to improve tachyarrhythmia detection within an implantable medical device 有权
标题翻译：使用多个滤波器来检测T波过度感知并改善可植入医疗装置内的快速性心律失常检测的系统和方法
公开(公告)号：US08260404B1
公开(公告)日：2012-09-04
申请号：US11776275
申请日：2007-07-11
申请人： Rupinder Bharmi , Jeffery D. Snell , Gene A. Bornzin , Joseph J. Florio , Peter Boileau
发明人： Rupinder Bharmi , Jeffery D. Snell , Gene A. Bornzin , Joseph J. Florio , Peter Boileau
IPC分类号： A61B5/0452 , A61B5/0456
CPC分类号： A61B5/0456 , A61B5/0464 , A61B5/725 , A61N1/3702 , A61N1/395
摘要： Techniques for detecting tachyarrhythmia and also for preventing T-wave oversensing use signals filtered by a narrowband bradycardia filter in combination with signals filtered by a narrowband tachycardia filter. A separate wideband filter may also be used.
摘要翻译：用于检测快速性心律失常并且还用于预防T波超检的技术使用由窄带心动过缓过滤器滤波的信号与由窄带心动过速过滤器过滤的信号组合。也可以使用单独的宽带滤波器。

5. 发明授权

US08175708B1 System and method for adjusting automatic sensitivity control parameters based on intracardiac electrogram signals 有权
公开(公告)号：US08175708B1
公开(公告)日：2012-05-08
申请号：US11608168
申请日：2006-12-07
申请人： Jeffery D. Snell , Rupinder Bharmi
发明人： Jeffery D. Snell , Rupinder Bharmi
IPC分类号： A61N1/37
CPC分类号： A61N1/365 , A61N1/3702 , A61N1/3706
摘要： Systems and methods are provided for use by an implantable medical device capable of automatically adjusting the sensitivity with which electrical cardiac signals are sensed within a patient, i.e. a device equipped with Automatic Sensitivity Control (ASC.) In a first example, ASC parameters are automatically adjusted by the device itself based on parameters derived from both R-waves and T-waves and further based on a detected noise floor. In a second example, a profile representative of the shape of cardiac signals is generated by the device. ASC parameters are then adjusted based on the profile. In various embodiments, histograms are used to determine sizes and shapes of the R-waves and T-waves via statistical prevalence techniques. The histograms are also employed to derive the aforementioned profile.

6. 发明授权

US08150529B2 Medical devices and systems having separate power sources for enabling different telemetry systems 有权
标题翻译：具有用于实现不同遥测系统的独立电源的医疗设备和系统
公开(公告)号：US08150529B2
公开(公告)日：2012-04-03
申请号：US12104301
申请日：2008-04-16
申请人： Jeffery D. Snell , Gene A. Bornzin
发明人： Jeffery D. Snell , Gene A. Bornzin
IPC分类号： A61N1/08
CPC分类号： A61N1/378 , A61N1/025 , A61N1/37217 , Y10S128/904
摘要： An implantable medical device includes a first, short-range telemetry circuit; a second, long-range telemetry circuit; a first power system that powers the first telemetry circuit; and a second power system that powers the second telemetry circuit. The second power system includes an internal charging system and a rechargeable battery coupled to the internal charging system. The internal charging system may be configured for electromagnetic-inductive or RF-transmission coupling with an external charging system. A controller monitors the energy level of the rechargeable battery and provides an signal indicative of the level.
摘要翻译：可植入医疗装置包括第一短距离遥测电路; 第二个远程遥测电路; 为第一遥测电路供电的第一电力系统; 以及为第二遥测电路供电的第二电力系统。第二电力系统包括内部充电系统和连接到内部充电系统的可再充电电池。内部充电系统可以被配置为与外部充电系统进行电磁感应或RF传输耦合。控制器监视可再充电电池的能量级并提供指示电平的信号。

7. 发明授权

US08121688B2 Method and system for automatically switching between modes of an implantable medical device 有权
标题翻译：用于在可植入医疗装置的模式之间自动切换的方法和系统
公开(公告)号：US08121688B2
公开(公告)日：2012-02-21
申请号：US12483995
申请日：2009-06-12
申请人： Laurence S. Sloman , Jeffery D. Snell
发明人： Laurence S. Sloman , Jeffery D. Snell
IPC分类号： A61N1/37
CPC分类号： A61N1/3712
摘要： An implantable medical device includes a lead, a pulse generator, an autocapture module, an autothreshold module, a fusion detection module, and a control module. The lead includes electrodes configured to be positioned within a heart. At least one of the electrodes is capable of sensing cardiac signals. The pulse generator delivers a stimulus pulse through at least one of the electrodes. The autocapture module senses an evoked response of the heart after delivery of the stimulus pulse when operating in an autocapture mode. The autothreshold module performs a threshold search when operating in an autothreshold mode. The fusion detection module identifies fusion-based behavior in the heart. The control module automatically switches between the autothreshold and autocapture modes based on a presence of the fusion-based behavior.
摘要翻译：可植入医疗装置包括引线，脉冲发生器，自动俘获模块，自动阈值模块，融合检测模块和控制模块。引线包括配置成定位在心脏内的电极。电极中的至少一个能够感测心脏信号。脉冲发生器通过至少一个电极传送刺激脉冲。自动捕获模块在以自动捕获模式操作时感测到在递送刺激脉冲之后心脏的诱发反应。自动阈值模块在自动阈值模式下运行时执行阈值搜索。融合检测模块识别心脏中基于融合的行为。基于基于融合的行为的存在，控制模块在自动阈值和自动捕捉模式之间自动切换。

8. 发明申请

US20110125206A1 SINGLE CHAMBER IMPLANTABLE MEDICAL DEVICE FOR CONFIRMING ARRHYTHMIA THROUGH RETROSPECTIVE CARDIAC SIGNALS 审中-公开
标题翻译：通过回顾性心脏病信号确认ARRHYTHMIA的单室可植入医疗器械
公开(公告)号：US20110125206A1
公开(公告)日：2011-05-26
申请号：US12625416
申请日：2009-11-24
申请人： Gene A. Bornzin , Jong Gill , Jeffery D. Snell
发明人： Gene A. Bornzin , Jong Gill , Jeffery D. Snell
IPC分类号： A61N1/39 , A61B5/0452 , A61B5/046
CPC分类号： A61N1/36507 , A61B5/0031 , A61B5/0422 , A61B5/0452 , A61N1/3956
摘要： An implantable medical device is provided that comprises a housing, sensors configured to be located to proximate a heart, and a sensing module to sense cardiac signals originating from the heart over a channel defined by the sensors. The cardiac signals include intrinsic R-wave events and associated intrinsic confirmation events when the heart exhibits normal sinus rhythm. The device further includes memory to store the cardiac signals sensed over a channel, and a detection module. The detection module identifies an R-wave event within the cardiac signals. The detection module captures, in the memory, a segment of the cardiac signals that precedes the R-wave event as a retrospective segment. The detection module determines whether the retrospective segment includes an intrinsic confirmation event that is associated with and occurs before the R-wave event. The detection module declares an arrhythmia based at least in part on the determination of whether the retrospective segment includes the intrinsic confirmation event is absent from the retrospective segment.
摘要翻译：提供了一种植入式医疗装置，其包括壳体，被配置为邻近心脏定位的传感器，以及感测模块，用于感测通过由传感器限定的通道的来自心脏的心脏信号。当心脏呈现正常窦性心律时，心脏信号包括固有的R波事件和相关的固有确认事件。该装置还包括用于存储通过信道感测的心脏信号的存储器和检测模块。检测模块识别心脏信号内的R波事件。检测模块在存储器中捕获在作为回顾段的R波事件之前的心脏信号的一部分。检测模块确定回溯段是否包括与R波事件相关联并发生的固有确认事件。检测模块至少部分地基于回顾段中是否包含内在确认事件的确定来声明心律失常。

9. 发明授权

US07706865B1 Apparatus and method for cardiac rhythm detection 有权
标题翻译：心律检测装置及方法
公开(公告)号：US07706865B1
公开(公告)日：2010-04-27
申请号：US11626754
申请日：2007-01-24
申请人： Jeffery D. Snell
发明人： Jeffery D. Snell
IPC分类号： A61B5/04
CPC分类号： A61N1/3622 , A61B5/0452 , A61B5/7203 , A61B5/7289 , A61N1/36507 , A61N1/3704
摘要： Cardiac pacing may be controlled through retrospective detection of events that are sensed during a given period of time. In some embodiments a detection decision is made substantially prior to the end of an escape interval. In some embodiments the mode of detection may be changed near the end of the period of time. In some embodiments the period of time is extended when an event is detected near the end of the period of time.
摘要翻译：可以通过回顾性检测在给定时间段内感测到的事件来控制心脏起搏。在一些实施例中，基本上在逃逸间隔结束之前进行检测决定。在一些实施例中，可以在时间段结束时改变检测模式。在一些实施例中，当在该时间段的结束附近检测到事件时，该时间段被延长。

10. 发明授权

US07529588B1 Method and apparatus to backup, update and share data among implantable cardiac stimulation device programmers 有权
标题翻译：在可植入的心脏刺激装置程序员之间备份，更新和共享数据的方法和装置
公开(公告)号：US07529588B1
公开(公告)日：2009-05-05
申请号：US11208053
申请日：2005-08-18
申请人： Jeffery D. Snell
发明人： Jeffery D. Snell
IPC分类号： A61N1/08
CPC分类号： A61N1/37264 , A61N1/37282
摘要： A system is provided for backing up and synchronizing data stored within a set of programmers used for programming implantable cardiac stimulation devices such as pacemakers or implantable cardioverter defibrillators (ICDs). The data from the programmers that is backed up and synchronized includes programmer software, set up and configuration data, programming parameters, patient personal data, implantable device diagnostic data, and patient diagnostic data received from implanted devices. The implanted devices are classified into one or more groups and the programmer backup system merges and synchronizes data received from all programmers within a particular group. In other words, the backup system operates to ensure that each programmer within a particular group shares the same set up and configuration data, programmer software, patient contact data, and device diagnostic information. Programmers within different groups may have different data stored therein, particularly different set up and configuration data, patient data and the like. The merging and synchronization of data may depend upon the particular type of data. For example, all devices connected to the backup system may be synchronized to have the same programmer software, whereas only programmers within a particular group may be synchronized to have the same set up and configuration data, patient data, and the like.
摘要翻译：提供了用于备份和同步存储在用于编程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（ICD））的一组程序员中的数据的系统。备份和同步的程序员的数据包括程序员软件，设置和配置数据，编程参数，患者个人数据，可植入设备诊断数据以及从植入设备接收的患者诊断数据。植入的设备分为一个或多个组，并且编程器备份系统合并并同步来自特定组内的所有程序员的数据。换句话说，备份系统操作以确保特定组中的每个程序员共享相同的设置和配置数据，程序员软件，患者联系人数据和设备诊断信息。不同组内的程序员可能存储不同的数据，特别是不同的设置和配置数据，患者数据等。数据的合并和同步可能取决于具体的数据类型。例如，连接到备份系统的所有设备可以被同步以具有相同的编程器软件，而只有特定组内的编程器可以被同步以具有相同的设置和配置数据，患者数据等。

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