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1. 发明授权

US07047083B2 Method and apparatus for identifying lead-related conditions using lead impedance measurements 有权
标题翻译：使用引线阻抗测量来识别引线相关条件的方法和装置
公开(公告)号：US07047083B2
公开(公告)日：2006-05-16
申请号：US10260676
申请日：2002-09-30
申请人： Bruce D. Gunderson , Amisha S. Patel , Chad A. Bounds , Edwin G. Duffin
发明人： Bruce D. Gunderson , Amisha S. Patel , Chad A. Bounds , Edwin G. Duffin
IPC分类号： A61N1/05
CPC分类号： A61N1/3925 , A61B5/0424 , A61N2001/083
摘要： A method and apparatus for automatically detecting and diagnosing lead-related conditions is provided. Specifically, relatively short-term and relatively long-term impedance parameters are determined for detecting an impedance trend indicative of a lead-related condition such as an open circuit, which may be due to a conductor fracture or poor connection to an associated implantable medical device, or a short circuit due to an insulation breach. Monitoring of multiple lead impedance parameters is performed to diagnose a lead-related condition based on a number of diagnostic criteria. Supplementary analysis of multiple lead impedance parameter trends may be performed to identify lead-specific conditions, such as metal ion oxidation induced insulation degradation. A lead-related condition diagnosis and supporting data are stored in memory for uplinking to an external device for review by a clinician. A recommended corrective action and/or a patient notification signal for a lead-related condition may optionally be provided.
摘要翻译：提供了一种用于自动检测和诊断铅相关条件的方法和装置。具体地，确定相对短期和相对长期的阻抗参数，用于检测指示诸如开路的引线相关状况的阻抗趋势，其可能是由于导体断裂或与相关联的可植入医疗装置的不良连接，或由于绝缘破坏引起的短路。执行多个引线阻抗参数的监测，以根据多个诊断标准来诊断引线相关状况。可以进行多个引线阻抗参数趋势的补充分析，以识别铅特异性条件，例如金属离子氧化诱导的绝缘降解。引导相关状况诊断和支持数据存储在存储器中用于上行链接到外部设备以供临床医生审查。可以可选地提供用于引线相关状况的推荐的纠正措施和/或患者通知信号。

2. 发明授权

US07567835B2 Method and apparatus for identifying oversensing using far-field intracardiac electrograms and marker channels 有权
标题翻译：使用远场心内电描记图和标记通道识别过敏的方法和装置
公开(公告)号：US07567835B2
公开(公告)日：2009-07-28
申请号：US11108472
申请日：2005-04-18
申请人： Bruce D. Gunderson , Amisha S. Patel , Chad A. Bounds , Mark L. Brown
发明人： Bruce D. Gunderson , Amisha S. Patel , Chad A. Bounds , Mark L. Brown
IPC分类号： A61B5/04
CPC分类号： A61B5/0456 , A61B5/0464 , A61B5/7217 , A61B5/7239 , A61B5/7264 , A61N1/3622 , A61N1/3702 , A61N1/3704
摘要： A method for identifying and classifying various types of oversensing in implantable medical devices (IMDs), such as implantable cardioverter defibrillators (ICDs), to assist a physician in choosing corrective action to reduce the likelihood of oversensing and inappropriate therapy delivery. Far-field electrogram (EGM) signals are analyzed to detect the occurrence of R-waves, and the result is compared to the number and pattern of R-waves sensed by the IMD and indicated on the marker channel. A marker channel with more sensed R-waves than indicated by analysis of the far-field EGM indicates the presence of oversensing, including double-counting of R-waves, T-wave oversensing, lead malfunction or failure, poor lead connections, noise associated with electromagnetic interference, non-cardiac myopotentials, etc. Identification of the type of oversensing may be determined by analysis of the number and pattern of marker channel sensed R-waves with respect to the timing of the R-waves detected from the far-field EGM.
摘要翻译：用于识别和分类可植入医疗装置（IMD）中的各种类型的过度感染的方法，例如可植入的心律转复除颤器（ICD），以协助医师选择矫正动作以减少过度和不适当的治疗递送的可能性。分析远场电描记图（EGM）信号以检测R波的发生，并将结果与由IMD感测并在标记通道上指示的R波的数量和模式进行比较。具有比通过远场EGM分析指示的更多的感测R波的标记通道表示存在过敏，包括R波的双重计数，T波超检测，导线故障或故障，导线连接不良，噪声相关具有电磁干扰，非心脏近视等。过敏类型的识别可以通过对从远场检测到的R波的定时的标记信道感测R波的数量和模式的分析来确定股东特别大会

3. 发明授权

US08942795B2 Implantable medical device with real time T-wave oversensing detection 有权
标题翻译：具有实时T波超检测的植入式医疗器械
公开(公告)号：US08942795B2
公开(公告)日：2015-01-27
申请号：US11096851
申请日：2005-03-31
申请人： Bruce D. Gunderson , Amisha S. Patel , Chad A. Bounds
发明人： Bruce D. Gunderson , Amisha S. Patel , Chad A. Bounds
IPC分类号： A61B5/0452 , A61N1/362 , A61B5/0464 , A61N1/37 , A61N1/39
CPC分类号： A61N1/3621 , A61B5/04525 , A61B5/0464 , A61N1/3702 , A61N1/3925
摘要： An implantable cardioverter defibrillator (ICD) senses ventricular depolarizations (R-waves) in an electrogram signal to detect a ventricular tachycardia or fibrillation episodes. The EGM signal is also monitored in real time for characteristics that uniquely identify instances of T-wave oversensing. The ICD determines whether detection of a tachycardia or fibrillation episode is appropriate based upon counts of each of the unique characteristics evidencing T-wave oversensing.
摘要翻译：植入式心脏复律除颤器（ICD）感测电描记信号中的心室去极化（R波），以检测室性心动过速或纤维性颤动发作。还可以实时监控EGM信号，以获得唯一识别T波过度传感的特性。 ICD确定是否根据证明T波过度感染的每个独特特征的计数来检测心动过速或颤动发作是否合适。

4. 发明授权

US07283863B2 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：US07283863B2
公开(公告)日：2007-10-16
申请号：US10135080
申请日：2002-04-29
申请人： Bruce D. Gunderson , Amisha S. Patel , Chad A. Bounds
发明人： Bruce D. Gunderson , Amisha S. Patel , Chad A. Bounds
IPC分类号： A61B5/04
CPC分类号： A61B5/0452 , A61B5/0456 , A61N1/3622 , A61N1/3925
摘要： A method and apparatus for automatically identifying various types of cardiac and non-cardiac 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.
摘要翻译：提供一种用于自动识别各种类型的心脏和非心脏过度感觉的方法和装置。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。

5. 发明授权

US07289851B2 Method and apparatus for identifying lead-related conditions using impedance trends and oversensing criteria 有权
标题翻译：使用阻抗趋势和过度标准来识别引线相关条件的方法和装置
公开(公告)号：US07289851B2
公开(公告)日：2007-10-30
申请号：US10818098
申请日：2004-04-05
申请人： Bruce D. Gunderson , Amisha S. Patel , Chad A. Bounds , Li Wang
发明人： Bruce D. Gunderson , Amisha S. Patel , Chad A. Bounds , Li Wang
IPC分类号： A61N1/08
CPC分类号： A61N1/3706 , A61N2001/083
摘要： A method and apparatus for detecting a lead-related condition that includes determining whether a first oversensing criteria is satisfied, determining whether a second oversensing criteria is satisfied, determining whether an impedance criteria has been satisfied, and generating an alert in response to more than one of the first oversensing criteria, the second over sensing criteria and the impedance criteria being satisfied.
摘要翻译：一种用于检测引线相关状况的方法和装置，包括确定是否满足第一过度标准，确定是否满足第二过度标准，确定是否已经满足阻抗标准，以及响应于多于一个产生警报的第一超检标准，第二过度感测标准和阻抗标准得到满足。

6. 发明授权

US08386024B2 Method and apparatus for identifying oversensing using far-field intracardiac electrograms and marker channels 有权
公开(公告)号：US08386024B2
公开(公告)日：2013-02-26
申请号：US12476733
申请日：2009-06-02
申请人： Bruce D. Gunderson , Amisha S. Patel , Chad A. Bounds , Mark L. Brown
发明人： Bruce D. Gunderson , Amisha S. Patel , Chad A. Bounds , Mark L. Brown
IPC分类号： A61B5/0456
CPC分类号： A61B5/0456 , A61B5/0464 , A61B5/7217 , A61B5/7239 , A61B5/7264 , A61N1/3622 , A61N1/3702 , A61N1/3704
摘要： A method for identifying and classifying various types of oversensing in implantable medical devices (IMDs), such as implantable cardioverter defibrillators (ICDs), to assist a physician in choosing corrective action to reduce the likelihood of oversensing and inappropriate therapy delivery. Far-field electrogram (EGM) signals are analyzed to detect the occurrence of R-waves, and the result is compared to the number and pattern of R-waves sensed by the IMD and indicated on the marker channel. A marker channel with more sensed R-waves than indicated by analysis of the far-field EGM indicates the presence of oversensing, including double-counting of R-waves, T-wave oversensing, lead malfunction or failure, poor lead connections, noise associated with electromagnetic interference, non-cardiac myopotentials, etc. Identification of the type of oversensing may be determined by analysis of the number and pattern of marker channel sensed R-waves with respect to the timing of the R-waves detected from the far-field EGM.

7. 发明申请

US20130103106A1 METHODS, APPARATUS AND SYSTEMS TO ADAPT PROGRAMMING FOR A MEDICAL ELECTRICAL LEAD 审中-公开
标题翻译：方法，适用于医疗电源适配器编程的设备和系统
公开(公告)号：US20130103106A1
公开(公告)日：2013-04-25
申请号：US13276473
申请日：2011-10-19
申请人： Elizabeth A. Schotzko , Chad A. Bounds
发明人： Elizabeth A. Schotzko , Chad A. Bounds
IPC分类号： A61N1/05 , A61N1/08
CPC分类号： A61N1/3686 , A61N1/056 , A61N1/36053 , A61N1/371
摘要： The disclosure is directed towards medical electrical leads having a plurality of electrodes, each of which may be selectable either individually or as a set in combination with one or more other electrodes. The selected one or more electrodes may be performed through the exemplary selection criteria and selection mechanism described herein to define an active stimulation field or sensing vector. For example, the criteria may comprise defining a predetermined ratio and selecting the electrodes to define an anode and cathode with a ratio of a surface area of the anode to a surface area of the cathode being equal to or greater than the predetermined ratio. The medical electrical lead may be adapted for continued therapy by selecting one or more different electrode(s) to define an alternate anode and/or cathode that maintains the criteria.
摘要翻译：本公开涉及具有多个电极的医疗电引线，每个电极可以单独地或与一个或多个其它电极组合地设置。所选择的一个或多个电极可以通过本文所述的示例性选择标准和选择机制来执行，以定义有源刺激场或感测矢量。例如，标准可以包括限定预定比例，并且选择电极来限定阳极和阴极，阳极的表面积与阴极的表面积之比等于或大于预定比率。可以通过选择一个或多个不同的电极来限定维持标准的替代阳极和/或阴极来适应医疗电引线的持续治疗。

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