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1. 发明授权

US07454250B1 System and method for applying therapy during hyperpnea phase of periodic breathing using an implantable medical device 有权
标题翻译：使用可植入医疗器械在周期性呼吸的呼吸过度期使用治疗的系统和方法
公开(公告)号：US07454250B1
公开(公告)日：2008-11-18
申请号：US11192779
申请日：2005-07-29
申请人： Anders Bjorling , Euljoon Park , Michael Benser
发明人： Anders Bjorling , Euljoon Park , Michael Benser
IPC分类号： A61N1/36
CPC分类号： A61N1/3601
摘要： Techniques are provided for treating periodic breathing, such as Cheyne-Stokes Respiration, using an implantable medical system. In one technique, diaphragmatic stimulation is delivered during a hyperpnea phase of periodic breathing via electrical stimulation of the phrenic nerves. Diaphragmatic stimulation is synchronized with intrinsic inspiration so as to increase the amplitude of diaphragmatic contraction during inspiration. This tends to decrease intrathoracic pressure leading to occlusion of the respiratory airway. Occlusion reduces actual ventilation during hyperpnea, thus reducing the cyclic blood chemistry imbalance that sustains periodic breathing so as to either mitigate periodic breathing or eliminate it completely. In another technique, respiration is instead inhibited during the hyperpnea phase of periodic breathing by blocking phrenic nerve signals to the extent necessary to reduce ventilation to terminate periodic breathing or at least mitigate its severity. Techniques are also described for controlling the type of therapy applied in response to periodic breathing.
摘要翻译：提供了使用植入式医疗系统治疗周期性呼吸的技术，例如Cheyne-Stokes呼吸。在一种技术中，通过膈神经的电刺激，在定期呼吸的呼吸过度期间传送膈肌刺激。膈肌刺激与固有吸气同步，以增加吸气期间膈肌收缩的幅度。这往往会降低导致呼吸道气道闭塞的胸腔内压力。闭塞减少呼吸过程中的实际通气，从而减少持续周期性呼吸的循环血液化学不平衡，以减轻周期性呼吸或完全消除呼吸。在另一种技术中，通过阻止膈神经信号到减少通气以终止周期性呼吸或至少减轻其严重程度所必需的程度，在呼吸的呼吸过度期间，呼吸反而被抑制。还描述了用于控制响应于周期性呼吸所应用的治疗类型的技术。

2. 发明授权

US07596410B1 Tiered antitachycardia pacing and pre-pulsing therapy 有权
标题翻译：分层抗心动过速起搏和预脉冲治疗
公开(公告)号：US07596410B1
公开(公告)日：2009-09-29
申请号：US11413772
申请日：2006-04-28
申请人： Mark W. Kroll , Michael Benser , Euljoon Park
发明人： Mark W. Kroll , Michael Benser , Euljoon Park
IPC分类号： A61N1/368
CPC分类号： A61N1/3962 , A61N1/0563 , A61N1/36071 , A61N1/3622
摘要： An implantable system applies tiered antitachycardia pacing (ATP) that may be combined with pre-pulsing therapy in order to reduce pain. In one implementation, an exemplary system applies a progression of increasingly potent pacing vectors, progressing in an initial tier from small electrodes inside the heart to later tiers that increasingly use a large electrode surface outside the heart. In the latter tiers, a pre-pulse may be added prior to each ATP pulse to reduce the sensation of pain.
摘要翻译：植入式系统应用分层抗心动过速起搏（ATP），可与预脉冲治疗相结合，以减轻疼痛。在一个实施方案中，示例性系统应用越来越有效的起搏向量的进展，在初始层级内从心脏内的小电极进行到越来越多地使用心脏外的大电极表面的后续层级。在后一级，可以在每个ATP脉冲之前加入预脉冲以减少疼痛的感觉。

3. 发明授权

US07371220B1 System and method for real-time apnea/hypopnea detection using an implantable medical system 有权
标题翻译：使用植入式医疗系统实时呼吸暂停/呼吸不足检测的系统和方法
公开(公告)号：US07371220B1
公开(公告)日：2008-05-13
申请号：US10883857
申请日：2004-06-30
申请人： Steve Koh , Euljoon Park , Michael Benser
发明人： Steve Koh , Euljoon Park , Michael Benser
IPC分类号： A61B5/08
CPC分类号： A61B5/0809 , A61B5/4519 , A61B5/4818 , A61B5/7239
摘要： Techniques are provided for detecting the onset of an episode of apnea/hypopnea substantially in real-time. A moving threshold is generated based on recent respiration cycles and differences are accumulated between amplitudes of new respiration cycles and the moving threshold. Apnea/hypopnea is then detected based upon a comparison of the accumulated differences against a fixed threshold. The technique exploits the fact that many episodes of hypopnea begin with a sharp drop in respiration and many episodes of apnea are preceded by a sharp drop in respiration. By accumulating differences between new respiration amplitudes and a short term moving average, any sharp drop in respiration is thereby promptly detected. In many cases, by the time the amplitudes of individual respiration cycles drop to levels directly indicative of apnea/hypopnea, the episode of apnea/hypopnea will have already been detected based upon the sudden sharp drop in respiration amplitude and therapy will have already been initiated.
摘要翻译：提供了用于基本上实时检测呼吸暂停/呼吸不足发作的技术。基于最近的呼吸循环产生移动阈值，并且在新呼吸循环的振幅和移动阈值之间累积差异。然后基于累积差异与固定阈值的比较来检测呼吸暂停/呼吸不足。该技术利用了许多次呼吸不畅的情况，呼吸急剧下降，许多呼吸暂停发作前呼吸急剧下降。通过累积新的呼吸振幅和短期移动平均值之间的差异，因此迅速检测到呼吸中的任何急剧下降。在许多情况下，当个别呼吸周期的振幅下降到直接指示呼吸暂停/呼吸不全的水平时，呼吸暂停/呼吸不足的发作将基于呼吸振幅的突然急剧下降而被检测到，并且已经开始治疗。

4. 发明授权

US07245971B2 System and method for applying therapy during hyperpnea phase of periodic breathing using an implantable medical device 有权
标题翻译：使用可植入医疗器械在周期性呼吸的呼吸过度期使用治疗的系统和方法
公开(公告)号：US07245971B2
公开(公告)日：2007-07-17
申请号：US10829719
申请日：2004-04-21
申请人： Euljoon Park , Michael Benser
发明人： Euljoon Park , Michael Benser
IPC分类号： A61N1/36
CPC分类号： A61N1/3601
摘要： Techniques are provided for treating periodic breathing, such as Cheyne-Stokes Respiration, using an implantable medical system. In one technique, diaphragmatic stimulation is delivered during a hyperpnea phase of periodic breathing via electrical stimulation of the phrenic nerves. Diaphragmatic stimulation is synchronized with intrinsic inspiration so as to increase the amplitude of diaphragmatic contraction during inspiration. This tends to decrease intrathoracic pressure leading to occlusion of the respiratory airway. Occlusion reduces actual ventilation during hyperpnea, thus reducing the cyclic blood chemistry imbalance that sustains periodic breathing so as to either mitigate periodic breathing or eliminate it completely. In another technique, respiration is instead inhibited during the hyperpnea phase of periodic breathing by blocking phrenic nerve signals to the extent necessary to reduce ventilation to terminate periodic breathing or at least mitigate its severity. Techniques are also described for controlling the type of therapy applied in response to periodic breathing.
摘要翻译：提供了使用植入式医疗系统治疗周期性呼吸的技术，例如Cheyne-Stokes呼吸。在一种技术中，通过膈神经的电刺激，在定期呼吸的呼吸过度期间传送膈肌刺激。膈肌刺激与固有吸气同步，以增加吸气期间膈肌收缩的幅度。这往往会降低导致呼吸道气道闭塞的胸腔内压力。闭塞减少呼吸过程中的实际通气，从而减少持续周期性呼吸的循环血液化学不平衡，以减轻周期性呼吸或完全消除呼吸。在另一种技术中，通过阻止膈神经信号到减少通气以终止周期性呼吸或至少减轻其严重程度所必需的程度，在呼吸的呼吸过度期间，呼吸反而被抑制。还描述了用于控制响应于周期性呼吸所应用的治疗类型的技术。

5. 发明授权

US07751887B1 Tiered antitachycardia pacing and pre-pulsing therapy 有权
标题翻译：分层抗心动过速起搏和预脉冲治疗
公开(公告)号：US07751887B1
公开(公告)日：2010-07-06
申请号：US11413773
申请日：2006-04-28
申请人： Mark W. Kroll , Michael Benser , Euljoon Park
发明人： Mark W. Kroll , Michael Benser , Euljoon Park
IPC分类号： A61N1/368
CPC分类号： A61N1/3622 , A61N1/368 , A61N1/3684 , A61N1/3962 , A61N2001/0585
摘要： An implantable system applies tiered antitachycardia pacing (ATP) that may be combined with pre-pulsing therapy in order to reduce pain. In one implementation, an exemplary system applies a progression of increasingly potent pacing vectors, progressing in an initial tier from small electrodes inside the heart to later tiers that increasingly use a large electrode surface outside the heart. In the latter tiers, a pre-pulse may be added prior to each ATP pulse to reduce the sensation of pain.
摘要翻译：植入式系统应用分层抗心动过速起搏（ATP），可与预脉冲治疗相结合，以减轻疼痛。在一个实施方案中，示例性系统应用越来越有效的起搏向量的进展，在初始层级内从心脏内的小电极进行到越来越多地使用心脏外的大电极表面的后续层级。在后一级，可以在每个ATP脉冲之前加入预脉冲以减少疼痛的感觉。

6. 发明授权

US07082331B1 System and method for applying therapy during hyperpnea phase of periodic breathing using an implantable medical device 失效
标题翻译：使用可植入医疗器械在周期性呼吸的呼吸过度期使用治疗的系统和方法
公开(公告)号：US07082331B1
公开(公告)日：2006-07-25
申请号：US10830357
申请日：2004-04-21
申请人： Euljoon Park , Michael Benser
发明人： Euljoon Park , Michael Benser
IPC分类号： A61N1/00
CPC分类号： A61N1/3601
摘要： Techniques are provided for treating periodic breathing, such as Cheyne-Stokes Respiration, using an implantable medical system. In one technique, diaphragmatic stimulation is delivered during a hyperpnea phase of periodic breathing via electrical stimulation of the phrenic nerves. Diaphragmatic stimulation is synchronized with intrinsic inspiration so as to increase the amplitude of diaphragmatic contraction during inspiration. This tends to decrease intrathoracic pressure leading to occlusion of the respiratory airway. Occlusion reduces actual ventilation during hyperpnea, thus reducing the cyclic blood chemistry imbalance that sustains periodic breathing so as to either mitigate periodic breathing or eliminate it completely. In another technique, respiration is instead inhibited during the hyperpnea phase of periodic breathing by blocking phrenic nerve signals to the extent necessary to reduce ventilation to terminate periodic breathing or at least mitigate its severity. Techniques are also described for controlling the type of therapy applied in response to periodic breathing.
摘要翻译：提供了使用植入式医疗系统治疗周期性呼吸的技术，例如Cheyne-Stokes呼吸。在一种技术中，通过膈神经的电刺激，在定期呼吸的呼吸过度期间传送膈肌刺激。膈肌刺激与固有吸气同步，以增加吸气期间膈肌收缩的幅度。这往往会降低导致呼吸道气道闭塞的胸腔内压力。闭塞减少呼吸过程中的实际通气，从而减少持续周期性呼吸的循环血液化学不平衡，以减轻周期性呼吸或完全消除呼吸。在另一种技术中，通过阻止膈神经信号到减少通气以终止周期性呼吸或至少减轻其严重程度所必需的程度，在呼吸的呼吸过度期间，呼吸反而被抑制。还描述了用于控制响应于周期性呼吸所应用的治疗类型的技术。

7. 发明申请

US20050240240A1 System and method for applying therapy during hyperpnea phase of periodic breathing using an implantable medical device 有权
标题翻译：使用可植入医疗器械在周期性呼吸的呼吸过度期使用治疗的系统和方法
公开(公告)号：US20050240240A1
公开(公告)日：2005-10-27
申请号：US10829719
申请日：2004-04-21
申请人： Euljoon Park , Michael Benser
发明人： Euljoon Park , Michael Benser
IPC分类号： A61N1/36 , A61N1/18
CPC分类号： A61N1/3601
摘要： Techniques are provided for treating periodic breathing, such as Cheyne-Stokes Respiration, using an implantable medical system. In one technique, diaphragmatic stimulation is delivered during a hyperpnea phase of periodic breathing via electrical stimulation of the phrenic nerves. Diaphragmatic stimulation is synchronized with intrinsic inspiration so as to increase the amplitude of diaphragmatic contraction during inspiration. This tends to decrease intrathoracic pressure leading to occlusion of the respiratory airway. Occlusion reduces actual ventilation during hyperpnea, thus reducing the cyclic blood chemistry imbalance that sustains periodic breathing so as to either mitigate periodic breathing or eliminate it completely. In another technique, respiration is instead inhibited during the hyperpnea phase of periodic breathing by blocking phrenic nerve signals to the extent necessary to reduce ventilation to terminate periodic breathing or at least mitigate its severity. Techniques are also described for controlling the type of therapy applied in response to periodic breathing.
摘要翻译：提供了使用植入式医疗系统治疗周期性呼吸的技术，例如Cheyne-Stokes呼吸。在一种技术中，通过膈神经的电刺激，在定期呼吸的呼吸过度期间传送膈肌刺激。膈肌刺激与固有吸气同步，以增加吸气期间膈肌收缩的幅度。这往往会降低导致呼吸道气道闭塞的胸腔内压力。闭塞减少呼吸过程中的实际通气，从而减少持续周期性呼吸的循环血液化学不平衡，以减轻周期性呼吸或完全消除呼吸。在另一种技术中，通过阻止膈神经信号到减少通气以终止周期性呼吸或至少减轻其严重程度所必需的程度，在呼吸的呼吸过度期间，呼吸反而被抑制。还描述了用于控制响应于周期性呼吸所应用的治疗类型的技术。

8. 发明授权

US07650189B1 Techniques to maintain or alter upper airway patency 有权
标题翻译：维持或改变上呼吸道通畅的技术
公开(公告)号：US07650189B1
公开(公告)日：2010-01-19
申请号：US11446179
申请日：2006-06-02
申请人： Euljoon Park , Michael Benser
发明人： Euljoon Park , Michael Benser
IPC分类号： A61N1/00
CPC分类号： A61N1/3601 , A61N1/36521 , A61N1/36585
摘要： An exemplary method includes calling for delivery of energy to one or more electrodes positionable proximate to an autonomic pathway to alter tone of the geniglossus muscle. Such a method may maintain or alter upper airway patency and, in turn, prevent or alleviate obstructive apnea. Other exemplary methods, devices, systems, etc., are also disclosed.
摘要翻译：一个示例性的方法包括要求将能量递送到靠近自主路径定位的一个或多个电极以改变颏舌肌的音调。这种方法可以维持或改变上呼吸道通畅，从而防止或减轻阻塞性呼吸暂停。还公开了其它示例性方法，装置，系统等。

9. 发明授权

US07171270B1 Implantable cardiac device to promote intrinsic rhythm to alleviate orthostatic hypotension 有权
标题翻译：植入性心脏器械促进内在节律，减轻直立性低血压
公开(公告)号：US07171270B1
公开(公告)日：2007-01-30
申请号：US10748486
申请日：2003-12-29
申请人： Euljoon Park , Michael Benser , Ruth Lyons
发明人： Euljoon Park , Michael Benser , Ruth Lyons
IPC分类号： A61N1/00
CPC分类号： A61N1/36514 , A61N1/36535 , A61N1/36542 , A61N1/36564
摘要： An implantable cardiac device is programmed to promote intrinsic rhythm of a patient's heart to alleviate orthostatic hypotension. In one implementation, the cardiac device is set in a reduced rate mode while the patient is in a less upright position, such as when resting in a supine position. If the patient is in intrinsic rhythm when transitioning to a more upright position, the cardiac device disables administration of any increased pacing rate for a programmed duration. In this manner, the patient will experience a more natural variation in heart rate during transition from the less upright posture to the more upright posture (e.g., from supine to sitting or standing). On the other hand, if the patient is being paced during the transition, the cardiac device administers an increased base rate or triggers an orthostatic response algorithm.
摘要翻译：可植入心脏装置被编程以促进患者心脏的内在节律以减轻直立性低血压。在一个实施方案中，当患者处于较不直立的位置时，例如在仰卧位置休息时，将心脏装置设置为降低速率模式。如果患者在过渡到更直立的位置时处于内在节律，则心脏设备会禁止在编程持续时间内施加任何增加的起搏速率。以这种方式，患者将在从较不直立的姿势到更直立的姿势（例如，从仰卧到坐或站立）的过渡期间经历更加自然的心率变化。另一方面，如果在转换期间患者正在起搏，则心脏装置管理增加的基本速率或触发立体响应算法。

10. 发明申请

US20060167519A1 System and method for distinguishing among cardiac ischemia, hypoglycemia and hyperglycemia using an implantable medical device 有权
公开(公告)号：US20060167519A1
公开(公告)日：2006-07-27
申请号：US11043804
申请日：2005-01-25
申请人： Jong Gill , Peter Boileau , Rupinder Bharmi , Xiaoyi Min , Joseph Florio , Michael Benser , Gene Bornzin
发明人： Jong Gill , Peter Boileau , Rupinder Bharmi , Xiaoyi Min , Joseph Florio , Michael Benser , Gene Bornzin
IPC分类号： A61N1/365
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.

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