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1. 发明申请

US20120165884A1 FLUID ACCUMULATION MONITORING DEVICES, SYSTEMS AND METHODS 审中-公开
标题翻译：流体累积监测装置，系统和方法
公开(公告)号：US20120165884A1
公开(公告)日：2012-06-28
申请号：US12975794
申请日：2010-12-22
申请人： Cecilia Qin Xi , Stuart Rosenberg , Jong Gill , Yelena Nabutovsky , William Hsu , Brian Jeffrey Wenzel
发明人： Cecilia Qin Xi , Stuart Rosenberg , Jong Gill , Yelena Nabutovsky , William Hsu , Brian Jeffrey Wenzel
IPC分类号： A61B5/053 , A61N1/39 , A61N1/362
CPC分类号： A61B5/0538 , A61B5/0537 , A61B5/4878 , A61B5/7239 , A61N1/3627 , A61N1/36521
摘要： Provided herein are implantable systems, and methods for use therewith, for monitoring a patient's fluid accumulation level. A thoracic impedance signal for the patient is obtained. Based on the thoracic impedance signal, a duration metric indicative of a duration of drop of the thoracic impedance signal, a magnitude metric indicative of a magnitude of drop of the thoracic impedance signal, and a rate metric indicative of a rate of drop of the thoracic impedance signal is determined. The patient's fluid accumulation level is monitored based on the duration metric, the magnitude metric and the rate metric.
摘要翻译：本文提供了可植入系统及其使用的方法，用于监测患者的血液积聚水平。获得患者的胸部阻抗信号。基于胸部阻抗信号，指示胸部阻抗信号下降持续时间的持续时间度量，指示胸部阻抗信号的下降幅度的幅度度量，以及指示胸部下降速率的速率度量确定阻抗信号。基于持续时间度量，幅度度量和速率度量来监测患者的血液积聚水平。

2. 发明申请

US20120158079A1 SYSTEMS AND METHODS FOR ASSESSING THE SPHERICITY AND DIMENSIONAL EXTENT OF HEART CHAMBERS FOR USE WITH AN IMPLANTABLE MEDICAL DEVICE 有权
标题翻译：用于评估使用可植入医疗设备的心脏瓣膜的空间和尺寸范围的系统和方法
公开(公告)号：US20120158079A1
公开(公告)日：2012-06-21
申请号：US12975085
申请日：2010-12-21
申请人： Stuart Rosenberg , Yelena Nabutovsky , Cecilia Qin Xi , Jong Gill , Kyungmoo Ryu , Brian Jeffrey Wenzel , William Hsu
发明人： Stuart Rosenberg , Yelena Nabutovsky , Cecilia Qin Xi , Jong Gill , Kyungmoo Ryu , Brian Jeffrey Wenzel , William Hsu
IPC分类号： A61N1/362
CPC分类号： A61N1/3627 , A61N1/36521 , A61N1/3684 , A61N1/3686 , A61N1/3962
摘要： Techniques are provided for use with an implantable medical device for assessing left ventricular (LV) sphericity and atrial dimensional extent based on impedance measurements for the purposes of detecting and tracking heart failure and related conditions such as volume overload or mitral regurgitation. In some examples described herein, various short-axis and long-axis impedance vectors are exploited that pass through portions of the LV for the purposes of assessing LV sphericity. In other examples, impedance measurements taken along a vector between a right atrial (RA) ring electrode and an LV electrode implanted near the atrioventricular (AV) groove are exploited to assess LA extent, biatrial extent or mitral annular diameter. The assessment techniques can be employed alone or in conjunction with other heart failure detection techniques, such as those based on left atrial pressure (LAP.)
摘要翻译：提供技术用于可植入医疗装置，用于基于阻抗测量来评估左心室（LV）球形度和心房尺寸范围，以便检测和跟踪心力衰竭和相关状况（例如体积过载或二尖瓣反流）。在本文描述的一些示例中，为了评估LV球形度的目的，利用穿过LV的部分的各种短轴和长轴阻抗矢量。在其他示例中，利用沿右心房（RA）环电极和植入在房室（AV）槽附近的LV电极之间的载体进行的阻抗测量来评估LA范围，生物学程度或二尖瓣环直径。评估技术可以单独使用或与其他心力衰竭检测技术结合使用，例如基于左心房压力（LAP）的那些。

3. 发明授权

US08843197B2 Method and system to correct contractility based on non-heart failure factors 有权
标题翻译：基于非心力衰竭因子校正收缩性的方法和系统
公开(公告)号：US08843197B2
公开(公告)日：2014-09-23
申请号：US13049774
申请日：2011-03-16
申请人： Stuart Rosenberg , Cecilia Qin Xi , Jong Gill , Brian Jeffrey Wenzel , Yelena Nabutovsky , William Hsu
发明人： Stuart Rosenberg , Cecilia Qin Xi , Jong Gill , Brian Jeffrey Wenzel , Yelena Nabutovsky , William Hsu
IPC分类号： A61N1/365 , A61B5/02 , A61B5/042 , A61N1/362
CPC分类号： A61N1/36585 , A61B5/02028 , A61B5/042 , A61N1/3627 , A61N1/36507 , A61N1/36521 , A61N1/36564 , A61N1/36578
摘要： A method for trending heart failure measures cardiogenic impedance (CI) and obtains signals representing estimates for or direct measurements of at least one of cardiac volume and pressure of the heart when the CI measurements were obtained. The method identifies correction factors based on the signals and applies the correction factors to the contractility estimates. A system for trending heart failure includes a contractility module to determine contractility estimates from CI measurements taken along at least a first vector through a heart, and a collection module to receive signals representing estimates for or direct measurements of at least one of cardiac volume and pressure of the heart when the CI measurements were obtained. The system further includes a factor module to identify correction factors based on the signals and a correction module to apply the correction factors to the contractility estimates.
摘要翻译：用于趋势性心力衰竭的方法测量心源性阻抗（CI）并且获得当获得CI测量时表示心脏体积和心脏压力中的至少一个的估计或直接测量的信号。该方法基于信号识别校正因子，并将修正因子应用于收缩率估计。用于趋向心力衰竭的系统包括收缩模块，用于根据通过心脏的至少第一载体进行的CI测量来确定收缩性估计，以及收集模块，用于接收代表心脏体积和压力中的至少一个的估计或直接测量的信号的CI测量值。该系统还包括一个因素模块，用于基于信号识别校正因子，以及一个校正模块，以将校正因子应用于收缩性估计。

4. 发明申请

US20120239104A1 METHOD AND SYSTEM TO CORRECT CONTRACTILITY BASED ON NON-HEART FAILURE FACTORS 有权
标题翻译：基于非心脏衰竭因子校正合并的方法和系统
公开(公告)号：US20120239104A1
公开(公告)日：2012-09-20
申请号：US13049774
申请日：2011-03-16
申请人： Stuart Rosenberg , Cecilia Qin Xi , Jong Gill , Brian Jeffrey Wenzel , Yelena Nabutovsky , William Hsu
发明人： Stuart Rosenberg , Cecilia Qin Xi , Jong Gill , Brian Jeffrey Wenzel , Yelena Nabutovsky , William Hsu
IPC分类号： A61N1/365
CPC分类号： A61N1/36585 , A61B5/02028 , A61B5/042 , A61N1/3627 , A61N1/36507 , A61N1/36521 , A61N1/36564 , A61N1/36578
摘要： A method is provided for trending heart failure based on heart contractility information comprises measuring cardiogenic impedance (CI) measurements along at least a first vector through a heart over a period of time. The method determines contractility estimates from the CI measurements, the contractility estimates relating to contractility of the heart. The method further obtains physiologic and/or surrogate signals representing estimates for or direct measurements of at least one of cardiac volume and pressure of the heart when the CI measurements were obtained. The method identifies correction factors based on the physiologic and/or surrogate signals and applies the correction factors to the contractility estimates to produce contractility trend values over the period of time. A system is provided for trending heart failure based on heart contractility information which comprises inputs to receive cardiogenic impedance (CI) measurements taken along at least a first vector through a heart over a period of time. The system includes a contractility module to determine contractility estimates from the CI measurements, the contractility estimates relating to contractility of the heart and a collection module to receive physiologic and/or surrogate signals representing estimates for or direct measurements of at least one of cardiac volume and pressure of the heart when the CI measurements were obtained. A factor module is also provided to identify correction factors based on the physiologic and/or surrogate signals and a correction module to apply the correction factors to the contractility estimates to produce contractility trend values over the period of time.
摘要翻译：提供了一种基于心脏收缩性信息来趋向于心力衰竭的方法，包括在一段时间内通过心脏沿着至少第一载体测量心源阻抗（CI）测量。该方法确定CI测量的收缩性估计值，与心脏收缩性相关的收缩性估计值。当获得CI测量时，该方法进一步获得表示心脏体积和心脏压力中的至少一个的估计值或直接测量值的生理和/或替代信号。该方法基于生理和/或替代信号识别校正因子，并将修正因子应用于收缩性估计以产生一段时间内的收缩趋势值。提供了一种用于基于心脏收缩性信息来趋向心力衰竭的系统，其包括用于在一段时间内通过心脏沿着至少第一载体进行的心源阻抗（CI）测量的输入。该系统包括收缩性模块，用于根据CI测量值确定收缩性估计值，与心脏的收缩性相关的收缩性估计值以及收集模块以接收表示心脏体积和/或心脏容积中的至少一个的估计值或/或直接测量值的生理和/或替代信号，获得CI测量时心脏的压力。还提供了一个因素模块，用于根据生理和/或替代信号识别校正因子，以及校正模块，以将修正因子应用于收缩性估计，以产生一段时间内的收缩趋势值。

5. 发明申请

US20120221069A1 Systems and Methods for Activating and Controlling Impedance-Based Detection Systems of Implantable Medical Devices 有权
公开(公告)号：US20120221069A1
公开(公告)日：2012-08-30
申请号：US13035793
申请日：2011-02-25
申请人： Stuart Rosenberg , Cecilia Qin Xi , Yelena Nabutovsky , Brian Jeffrey Wenzel , Jong Gill , William Hsu
发明人： Stuart Rosenberg , Cecilia Qin Xi , Yelena Nabutovsky , Brian Jeffrey Wenzel , Jong Gill , William Hsu
IPC分类号： A61N1/365
CPC分类号： A61B5/0538 , A61B5/686 , A61N1/36507 , A61N1/36521 , A61N1/36592 , A61N1/3684
摘要： Techniques are provided for use with implantable medical devices for addressing encapsulation effects, particularly in the detection of cardiac decompensation events such as heart failure (HF) or cardiogenic pulmonary edema (PE.) In one example, during an acute interval following device implant, cardiac decompensation is detected using heart rate variability (HRV), ventricular evoked response (ER) or various other non-impedance-based parameters that are insensitive to component encapsulation effects. During the subsequent chronic interval, decompensation is detected using intracardiac or transthoracic impedance signals. In another example, the degree of maturation of encapsulation of implanted components is assessed using impedance frequency-response measurements or based on the frequency bandwidth of heart sounds or other physiological signals. In this manner, impedance-based HF/PE detection systems can be activated as soon as component encapsulation has matured, without necessarily waiting until completion of a preset post-implant maturation interval, often set to forty-five days or more.

6. 发明授权

US09002450B2 Systems and methods for assessing the sphericity and dimensional extent of heart chambers for use with an implantable medical device 有权
标题翻译：用于评估与可植入医疗装置一起使用的心室的球形度和尺寸范围的系统和方法
公开(公告)号：US09002450B2
公开(公告)日：2015-04-07
申请号：US12975085
申请日：2010-12-21
申请人： Stuart Rosenberg , Yelena Nabutovsky , Cecilia Qin Xi , Jong Gill , Kyungmoo Ryu , Brian Jeffrey Wenzel , William Hsu
发明人： Stuart Rosenberg , Yelena Nabutovsky , Cecilia Qin Xi , Jong Gill , Kyungmoo Ryu , Brian Jeffrey Wenzel , William Hsu
IPC分类号： A61N1/00 , A61N1/362 , A61N1/365 , A61N1/368 , A61N1/39
CPC分类号： A61N1/3627 , A61N1/36521 , A61N1/3684 , A61N1/3686 , A61N1/3962
摘要： Techniques are provided for use with an implantable medical device for assessing left ventricular (LV) sphericity and atrial dimensional extent based on impedance measurements for the purposes of detecting and tracking heart failure and related conditions such as volume overload or mitral regurgitation. In some examples described herein, various short-axis and long-axis impedance vectors are exploited that pass through portions of the LV for the purposes of assessing LV sphericity. In other examples, impedance measurements taken along a vector between a right atrial (RA) ring electrode and an LV electrode implanted near the atrioventricular (AV) groove are exploited to assess LA extent, biatrial extent or mitral annular diameter. The assessment techniques can be employed alone or in conjunction with other heart failure detection techniques, such as those based on left atrial pressure (LAP.)
摘要翻译：提供技术用于可植入医疗装置，用于基于阻抗测量来评估左心室（LV）球形度和心房尺寸范围，以便检测和跟踪心力衰竭和相关状况（例如体积过载或二尖瓣反流）。在本文描述的一些示例中，为了评估LV球形度的目的，利用穿过LV的部分的各种短轴和长轴阻抗矢量。在其他示例中，利用沿右心房（RA）环电极和植入在房室（AV）槽附近的LV电极之间的载体进行的阻抗测量来评估LA范围，生物学程度或二尖瓣环直径。评估技术可以单独使用或与其他心力衰竭检测技术结合使用，例如基于左心房压力（LAP）的那些。

7. 发明申请

US20120221066A1 Systems and Methods for Activating and Controlling Impedance-Based Detection Systems of Implantable Medical Devices 有权
标题翻译：用于激活和控制可植入医疗器械的基于阻抗的检测系统的系统和方法
公开(公告)号：US20120221066A1
公开(公告)日：2012-08-30
申请号：US13035773
申请日：2011-02-25
申请人： Stuart Rosenberg , Cecilia Qin Xi , Yelena Nabutovsky , Brian Jeffrey Wenzel , Jong Gill , William Hsu
发明人： Stuart Rosenberg , Cecilia Qin Xi , Yelena Nabutovsky , Brian Jeffrey Wenzel , Jong Gill , William Hsu
IPC分类号： A61N1/36
CPC分类号： A61N1/3627 , A61N1/3702 , A61N1/372
摘要： Techniques are provided for use with implantable medical devices for addressing encapsulation effects, particularly in the detection of cardiac decompensation events such as heart failure (HF) or cardiogenic pulmonary edema (PE.) In one example, during an acute interval following device implant, cardiac decompensation is detected using heart rate variability (HRV), ventricular evoked response (ER) or various other non-impedance-based parameters that are insensitive to component encapsulation effects. During the subsequent chronic interval, decompensation is detected using intracardiac or transthoracic impedance signals. In another example, the degree of maturation of encapsulation of implanted components is assessed using impedance frequency-response measurements or based on the frequency bandwidth of heart sounds or other physiological signals. In this manner, impedance-based HF/PE detection systems can be activated as soon as component encapsulation has matured, without necessarily waiting until completion of a preset post-implant maturation interval, often set to forty-five days or more.
摘要翻译：提供技术用于可植入医疗装置，用于解决封装效应，特别是在心脏代偿失调事件如心力衰竭（HF）或心源性肺水肿（PE）的检测中。在一个实例中，在装置植入后的急性期间，心脏使用心率变异性（HRV），心室诱发反应（ER）或对组件封装效应不敏感的各种其他基于非阻抗的参数来检测代偿失调。在随后的慢性间隔期间，使用心内或经胸阻抗信号检测代偿失调。在另一示例中，使用阻抗频率响应测量值或基于心脏声音或其他生理信号的频率带宽来评估植入部件的封装的成熟程度。以这种方式，一旦组件封装已经成熟，就可以激活基于阻抗的HF / PE检测系统，而不必等待直到完成植入后成熟间隔的预设，通常设置为四十五天或更长时间。

8. 发明申请

US20120190957A1 SYSTEM AND METHOD FOR MONITORING CARDIAC DISEASE 审中-公开
标题翻译：监测心脏病的系统和方法
公开(公告)号：US20120190957A1
公开(公告)日：2012-07-26
申请号：US13010535
申请日：2011-01-20
申请人： Jong Gill , Cecilia Qin Xi , Stuart Rosenberg , Yelena Nabutovsky , Brian Jeffrey Wenzel , William Hsu
发明人： Jong Gill , Cecilia Qin Xi , Stuart Rosenberg , Yelena Nabutovsky , Brian Jeffrey Wenzel , William Hsu
IPC分类号： A61B5/042 , A61B5/0408 , A61B5/0402
CPC分类号： A61B5/0452 , A61B5/4842 , A61N1/3627 , A61N1/36507
摘要： A method of monitoring progression of cardiac disease includes applying stimulus pulses to the heart and sensing electrophysiological responses of the heart at a plurality of different monitoring locations of the heart. The method also includes comparing a previously and subsequently sensed electrophysiological responses that are sensed near a first location of the monitoring locations and comparing previously and subsequently sensed electrophysiological responses that are sensed near a second location of the monitoring locations. The method further includes identifying a change in progression of cardiac disease of the heart based on a difference between the previously and subsequently sensed electrophysiological responses at the first location and based on a difference between the previously and subsequently sensed electrophysiological responses at the second location.
摘要翻译：监测心脏疾病进展的方法包括向心脏施加刺激脉冲并感测在心脏的多个不同监测位置的心脏的电生理反应。该方法还包括比较在监测位置的第一位置附近感测的先前和随后感测到的电生理反应，并比较先前和随后感测到的在监测位置的第二位置附近感测到的电生理反应。该方法还包括基于在第一位置处的先前感测和随后感测的电生理反应之间的差异，并且基于在第二位置处的先前感知和随后感测到的电生理反应之间的差异来识别心脏的心脏疾病进展的变化。

9. 发明授权

US08295918B2 Systems and methods for activating and controlling impedance-based detection systems of implantable medical devices 有权
标题翻译：用于激活和控制可植入医疗设备的基于阻抗的检测系统的系统和方法
公开(公告)号：US08295918B2
公开(公告)日：2012-10-23
申请号：US13035773
申请日：2011-02-25
申请人： Stuart Rosenberg , Cecilia Q. Xi , Yelena Nabutovsky , Brian J. Wenzel , Jong Gill , William Hsu
发明人： Stuart Rosenberg , Cecilia Q. Xi , Yelena Nabutovsky , Brian J. Wenzel , Jong Gill , William Hsu
IPC分类号： A61B5/04
CPC分类号： A61N1/3627 , A61N1/3702 , A61N1/372
摘要： Techniques are provided for use with implantable medical devices for addressing encapsulation effects, particularly in the detection of cardiac decompensation events such as heart failure (HF) or cardiogenic pulmonary edema (PE.) In one example, during an acute interval following device implant, cardiac decompensation is detected using heart rate variability (HRV), ventricular evoked response (ER) or various other non-impedance-based parameters that are insensitive to component encapsulation effects. During the subsequent chronic interval, decompensation is detected using intracardiac or transthoracic impedance signals. In another example, the degree of maturation of encapsulation of implanted components is assessed using impedance frequency-response measurements or based on the frequency bandwidth of heart sounds or other physiological signals. In this manner, impedance-based HF/PE detection systems can be activated as soon as component encapsulation has matured, without necessarily waiting until completion of a preset post-implant maturation interval, often set to forty-five days or more.
摘要翻译：提供技术用于可植入医疗装置，用于解决封装效应，特别是在心脏代偿失调事件如心力衰竭（HF）或心源性肺水肿（PE）的检测中。在一个实例中，在装置植入后的急性期间，心脏使用心率变异性（HRV），心室诱发反应（ER）或对组件封装效应不敏感的各种其他基于非阻抗的参数来检测代偿失调。在随后的慢性间隔期间，使用心内或经胸阻抗信号检测代偿失调。在另一示例中，使用阻抗频率响应测量值或基于心脏声音或其他生理信号的频率带宽来评估植入部件的封装的成熟程度。以这种方式，一旦组件封装已经成熟，就可以激活基于阻抗的HF / PE检测系统，而不必等待直到完成植入后成熟间隔的预设，通常设置为四十五天或更长时间。

10. 发明授权

US08380303B2 Systems and methods for activating and controlling impedance-based detection systems of implantable medical devices 有权
标题翻译：用于激活和控制可植入医疗设备的基于阻抗的检测系统的系统和方法
公开(公告)号：US08380303B2
公开(公告)日：2013-02-19
申请号：US13035793
申请日：2011-02-25
申请人： Stuart Rosenberg , Cecilia Q. Xi , Yelena Nabutovsky , Brian J. Wenzel , Jong Gill , William Hsu
发明人： Stuart Rosenberg , Cecilia Q. Xi , Yelena Nabutovsky , Brian J. Wenzel , Jong Gill , William Hsu
IPC分类号： A61N1/00
CPC分类号： A61B5/0538 , A61B5/686 , A61N1/36507 , A61N1/36521 , A61N1/36592 , A61N1/3684
摘要： Techniques are provided for use with implantable medical devices for addressing encapsulation effects, particularly in the detection of cardiac decompensation events such as heart failure (HF) or cardiogenic pulmonary edema (PE.) In one example, during an acute interval following device implant, cardiac decompensation is detected using heart rate variability (HRV), ventricular evoked response (ER) or various other non-impedance-based parameters that are insensitive to component encapsulation effects. During the subsequent chronic interval, decompensation is detected using intracardiac or transthoracic impedance signals. In another example, the degree of maturation of encapsulation of implanted components is assessed using impedance frequency-response measurements or based on the frequency bandwidth of heart sounds or other physiological signals. In this manner, impedance-based HF/PE detection systems can be activated as soon as component encapsulation has matured, without necessarily waiting until completion of a preset post-implant maturation interval, often set to forty-five days or more.
摘要翻译：提供技术用于可植入医疗装置，用于解决封装效应，特别是在心脏代偿失调事件如心力衰竭（HF）或心源性肺水肿（PE）的检测中。在一个实例中，在装置植入后的急性期间，心脏使用心率变异性（HRV），心室诱发反应（ER）或对组件封装效应不敏感的各种其他基于非阻抗的参数来检测代偿失调。在随后的慢性间隔期间，使用心内或经胸阻抗信号检测代偿失调。在另一示例中，使用阻抗频率响应测量值或基于心脏声音或其他生理信号的频率带宽来评估植入部件的封装的成熟程度。以这种方式，一旦组件封装已经成熟，就可以激活基于阻抗的HF / PE检测系统，而不必等待直到完成植入后成熟间隔的预设，通常设置为四十五天或更长时间。

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