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    • 1. 发明申请
    • MEDICAL DEVICE WITH MULTIPLE SENSOR FUSION
    • 具有多个传感器融合的医疗装置
    • WO2014158986A1
    • 2014-10-02
    • PCT/US2014/021287
    • 2014-03-06
    • CARDIAC PACEMAKERS, INC.
    • AN, QiMASKARA, BarunTHAKUR, Pramodsingh HirasinghTHOMPSON, Julie
    • A61N1/05A61N1/36A61N1/365A61N1/368A61N1/37
    • A61N1/36585A61N1/056A61N1/36139A61N1/3625A61N1/3627A61N1/365A61N1/36514A61N1/368A61N1/3682A61N1/3684A61N1/3704
    • Devices and methods for improving device therapy such as cardiac resynchronization therapy (CRT) by determining a desired value for a device parameter are described. An ambulatory medical device can receive one or more physiologic signals and generate multiple signal metrics from the physiologic signals. The ambulatory medical device can determine a desired value for a device parameter, such as a timing parameter used for controlling the delivery of CRT pacing to various heart chambers, using information fusion of signal metrics that are selected based on one or more of a signal metric sensitivity to perturbations to the device parameter in response to a stimulation, a signal metric variability in response to a stimulation, or a covariability between two or more signal metrics in response to a stimulation. The ambulatory medical device can program a stimulation using the desired device parameter value, and deliver the programmed stimulation to one or more target sites to achieve desired therapeutic effects.
    • 描述了通过确定器件参数的期望值来改善诸如心脏再同步治疗(CRT)的装置疗法的装置和方法。 移动医疗设备可以接收一个或多个生理信号并从生理信号产生多个信号度量。 移动医疗设备可以使用基于信号度量的信号融合来确定设备参数的期望值,例如用于控制向各种心脏腔室输送CRT起搏的定时参数,所述信号度量基于信号度量 响应于刺激对装置参数的扰动的灵敏度,响应于刺激的信号度量可变性或响应于刺激的两个或更多个信号度量之间的协方差。 移动医疗设备可以使用期望的设备参数值对刺激进行编程,并将编程的刺激递送到一个或多个目标位点以实现期望的治疗效果。
    • 2. 发明申请
    • SYSTEMS AND METHODS FOR TACHYARRHYTHMIA DISCRIMINATION
    • TACHYARRHYTHMIA歧视的系统和方法
    • WO2008150363A1
    • 2008-12-11
    • PCT/US2008/006393
    • 2008-05-19
    • CARDIAC PACEMAKERS, INC.THOMPSON, Julie
    • THOMPSON, Julie
    • A61B5/046A61B5/0464A61N1/362A61N1/39
    • A61B5/0464A61B5/7264A61N1/3622A61N1/3702A61N1/3925A61N1/3962
    • Systems, devices, and methods detect or classify tachyarrhythmias or make a therapy decision. A tachyarrhythmia can be classified using a rhythm discrimination parameter having a value. In certain examples, the value of the rhythm discrimination parameter can be adjusted using a relationship between a detected atrial rate and a detected ventricular rate, or the value can be adjusted using information about at least one of the atrial rate or the ventricular rate in addition to using the relationship between the atrial rate and the ventricular rate. These techniques can improve the specificity of arrhythmia detection or classification, allow anti-tachyarrhythmia therapy to be better tailored to the particular tachyarrhythmia, or provide more automatic operation making it easier for a physician to use an implantable device.
    • 系统,装置和方法检测或分类快速性心律失常或作出治疗决定。 可以使用具有值的节律辨别参数来分类快速性心律失常。 在某些示例中,可以使用检测到的心房率和检测到的心室率之间的关系来调整节律辨别参数的值,或者可以使用关于至少一个心房率或心室率的信息来调整该值 使用心房率与心室率之间的关系。 这些技术可以改善心律失常检测或分类的特异性,允许抗特发性心律失常治疗更适合于特定的快速性心律失常,或提供更自动的操作,使得医生更容易使用可植入装置。
    • 5. 发明申请
    • TACHYARRHYTHMIA DISCRIMINATION OR THERAPY DECISIONS
    • TACHYARRHYTHMIA歧视或治疗决定
    • WO2006020198A2
    • 2006-02-23
    • PCT/US2005/025397
    • 2005-07-18
    • CARDIAC PACEMAKERS, INC.SMITH, ValerieDUJMOVIC, Richard, Milon, Jr.THOMPSON, Julie
    • SMITH, ValerieDUJMOVIC, Richard, Milon, Jr.THOMPSON, Julie
    • A61N1/362
    • A61B5/7264A61B5/0464A61N1/3622A61N1/3962
    • This document discusses, among other things, systems, devices, and methods for detecting or classifying tachyarrhythmias or making a therapy decision. In one example, a rate-dependent threshold is used for comparing atrial and ventricular rates for classifying a tachyarrhythmia as a ventricular tachyarrhythmia (VT) or a supraventricular tachyarrhythmia (SVT). In another example, the classification uses an atrial rate cutoff value, a ventricular rate cutoff value, or both. In another example, a tachyarrhythmia detection is tested over a time window with a duration that is automatically adjusted as a substantially continuously monotonically decreasing function of duration vs. rate. These techniques improve the specificity of arrhythmia detection or classification, allow anti-tachyarrhythmia therapy to be better tailored to the particular tachyarrhythmia, or provide more automatic operation making it easier for a physician to use an implantable device.
    • 本文件还讨论了用于检测或分类快速性心律失常或作出治疗决定的系统,设备和方法。 在一个示例中,速率依赖阈值用于比较心房和心室率,用于将快速性心律失常分类为室性快速性心律失常(VT)或室上性快速性心律失常(SVT)。 在另一个例子中,分类使用心房率截止值,心室率截止值或两者。 在另一个示例中,在时间窗口上测试快速心律失常检测,其持续时间被自动调整为持续时间与速率的基本上连续单调递减的功能。 这些技术改进了心律失常检测或分类的特异性,允许抗特发性心律失常治疗更适合特定的快速性心律失常,或提供更自动的操作,使得医生更容易使用可植入装置。
    • 6. 发明申请
    • HEART FAILURE MANAGEMENT TO AVOID REHOSPITALIZATION
    • 心脏失败管理以避免复发
    • WO2014158800A1
    • 2014-10-02
    • PCT/US2014/020232
    • 2014-03-04
    • CARDIAC PACEMAKERS, INC.
    • THAKUR, Pramodsingh HirasinghAN, QiMASKARA, BarunTHOMPSON, Julie
    • A61B5/00A61B5/0205
    • A61B5/7275A61B5/02A61B5/0205A61B5/091A61B5/4848A61B5/686A61B5/7282A61B5/746A61B7/04A61N1/36114A61N1/36139A61N1/3627A61N1/36585A61N1/3682G06F19/00
    • Systems and methods are described for subject rehospitalization management. In an example, multiple physiologic signals can be obtained from a subject using multiple sensors. In response to a hospitalization event, pre-hospitalization characteristics of the multiple physiologic signals can be identified. Post-hospitalization characteristics of the multiple physiologic signals can be identified, including characteristics that differ from their corresponding pre-hospitalization characteristics. Later subsequent physiologic signals can be further monitored after the hospitalization event, such as using the same multiple sensors, and subsequent physiologic signal characteristics can be identified. In an example, a heart failure diagnostic indication can be determined using information about the pre-hospitalization characteristics, the post-hospitalization characteristics, and the subsequent characteristics. Information about relative changes in signal characteristics from multiple sensors can be used to identify particular subject physiologic signals to monitor during subsequent periods.
    • 系统和方法被描述为主体再住院管理。 在一个例子中,可以使用多个传感器从受试者获得多个生理信号。 针对住院治疗事件,可以确定多发生生理信号的住院前特征。 可以确定多种生理信号的住院后特征,包括与其相应的住院前特征不同的特征。 后来的生理信号可以在住院事件之后进一步监测,例如使用相同的多个传感器,并且可以识别随后的生理信号特征。 在一个示例中,可以使用关于住院前特征,住院后特征和随后特征的信息来确定心力衰竭诊断指示。 可以使用关于来自多个传感器的信号特性的相对变化的信息来识别特定的受试者生理信号以在随后的时间段内监测。