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1. 发明授权

US08649865B2 Method and system for hemodynamic optimization using plethysmography 有权
标题翻译：使用体积描记法进行血液动力学优化的方法和系统
公开(公告)号：US08649865B2
公开(公告)日：2014-02-11
申请号：US12964625
申请日：2010-12-09
申请人： Gene A. Bornzin , Wenbo Hou , Edward Karst , Brian J. Wenzel , Timothy A Fayram
发明人： Gene A. Bornzin , Wenbo Hou , Edward Karst , Brian J. Wenzel , Timothy A Fayram
IPC分类号： A61N1/00
CPC分类号： A61N1/36585 , A61B5/02416 , A61B5/726 , A61N1/3627 , A61N1/36564 , A61N1/3684 , A61N1/3686
摘要： Time delays between a feature of a signal indicative of electrical activity of a patient's heart and a feature of a plethysmograph signal indicative of changes in arterial blood volume are used to arrange the operation of an implantable device, such as a pacemaker. Shorter time delays between the feature of the signal indicative of electrical activity of a patient's heart and the feature of the plethysmograph signal indicative of changes in arterial blood volume are indicative of larger cardiac stroke volumes. The time delay can be used to select a pacing site or combination of pacing sites and/or to select a pacing interval set.
摘要翻译：使用指示患者心脏的电活动的信号的特征与指示动脉血容量变化的体积描记信号的特征之间的时间延迟来布置诸如起搏器的可植入装置的操作。指示患者心脏的电活动的信号的特征与指示动脉血容量变化的体积描记器信号的特征之间的更短的时间延迟指示较大的心脏搏动量。时间延迟可用于选择起搏站点或起搏站点的组合和/或选择起搏间隔集。

2. 发明申请

US20110144711A1 Method and System for Hemodynamic Optimization Using Plethysmography 有权
标题翻译：使用体积描记术进行血流动力学优化的方法和系统
公开(公告)号：US20110144711A1
公开(公告)日：2011-06-16
申请号：US12964625
申请日：2010-12-09
申请人： Gene A. Bornzin , Wenbo Hou , Edward Karst , Brian J. Wenzel , Timothy A. Fayram
发明人： Gene A. Bornzin , Wenbo Hou , Edward Karst , Brian J. Wenzel , Timothy A. Fayram
IPC分类号： A61N1/36
CPC分类号： A61N1/36585 , A61B5/02416 , A61B5/726 , A61N1/3627 , A61N1/36564 , A61N1/3684 , A61N1/3686
摘要： Time delays between a feature of a signal indicative of electrical activity of a patient's heart and a feature of a plethysmograph signal indicative of changes in arterial blood volume are used to arrange the operation of an implantable device, such as a pacemaker. Shorter time delays between the feature of the signal indicative of electrical activity of a patient's heart and the feature of the plethysmograph signal indicative of changes in arterial blood volume are indicative of larger cardiac stroke volumes. The time delay can be used to select a pacing site or combination of pacing sites and/or to select a pacing interval set.
摘要翻译：使用指示患者心脏的电活动的信号的特征与指示动脉血容量变化的体积描记信号的特征之间的时间延迟来布置诸如起搏器的可植入装置的操作。指示患者心脏的电活动的信号的特征与指示动脉血容量变化的体积描记器信号的特征之间的更短的时间延迟指示较大的心脏搏动量。时间延迟可用于选择起搏站点或起搏站点的组合和/或选择起搏间隔集。

3. 发明申请

US20110009755A1 ARTERIAL BLOOD PRESSURE MONITORING DEVICES, SYSTEMS AND METHODS FOR USE WHILE PACING 有权
标题翻译：动脉血压监测装置，系统和使用方法
公开(公告)号：US20110009755A1
公开(公告)日：2011-01-13
申请号：US12637574
申请日：2009-12-14
申请人： Brian Jeffrey Wenzel , Timothy A. Fayram , Allen J. Keel , Edward Karst , Wenbo Hou , Taraneh Ghaffari Farazi
发明人： Brian Jeffrey Wenzel , Timothy A. Fayram , Allen J. Keel , Edward Karst , Wenbo Hou , Taraneh Ghaffari Farazi
IPC分类号： A61B5/0215
CPC分类号： A61N1/36585 , A61B5/02125 , A61B5/0215 , A61B5/0295 , A61B5/0535 , A61B5/1459 , A61B5/7239 , A61N1/08 , B82Y10/00 , B82Y40/00 , G03F7/0002
摘要： Provided herein are implantable systems, and methods for use therewith, for monitoring a patient's arterial blood pressure while a patient's heart is being paced. A signal (e.g., PPG or IPG signal) indicative of changes in arterial blood volume remote from the patient's heart is obtained using a sensor or electrodes that are implanted remote from the patient's heart. One or more metrics indicative of pulse arrival time (PAT) are determined, where each metric can be determined by determining a time from a paced cardiac event to one or more predetermined features of the signal indicative of changes in arterial blood volume. Based on at the metric(s) indicative of PAT, arterial blood pressure is estimated, which can include determining values indicative of systolic blood pressure, diastolic blood pressure, pulse pressure and/or mean arterial blood pressure, and/or changes in such values.
摘要翻译：本文提供了可植入系统及其使用的方法，用于在患者的心脏起搏时监测患者的动脉血压。使用远离患者心脏植入的传感器或电极获得指示远离患者心脏的动脉血容量变化的信号（例如，PPG或IPG信号）。确定指示脉冲到达时间（PAT）的一个或多个度量，其中可以通过确定从起搏心脏事件到指示动脉血容量变化的信号的一个或多个预定特征的时间来确定每个度量。基于指示PAT的度量，估计动脉血压，其可以包括确定指示收缩压，舒张压，脉压和/或平均动脉血压的值，和/或这些值的变化。

4. 发明申请

US20110009754A1 ARTERIAL BLOOD PRESSURE MONITORING DEVICES, SYSTEMS AND METHODS USING CARDIOGENIC IMPEDANCE SIGNAL 审中-公开
标题翻译：动脉血压监测装置，系统和使用心脏阻力信号的方法
公开(公告)号：US20110009754A1
公开(公告)日：2011-01-13
申请号：US12637489
申请日：2009-12-14
申请人： Brian Jeffrey Wenzel , Allen J. Keel , Edward Karst , Wenbo Hou , Taraneh Ghaffari Farazi , Gene A. Bornzin
发明人： Brian Jeffrey Wenzel , Allen J. Keel , Edward Karst , Wenbo Hou , Taraneh Ghaffari Farazi , Gene A. Bornzin
IPC分类号： A61B5/0215
CPC分类号： A61N1/36585 , A61B5/02125 , A61B5/0215 , A61B5/0295 , A61B5/0535 , A61B5/1459 , A61B5/7239 , A61N1/08 , B82Y10/00 , B82Y40/00 , G03F7/0002
摘要： Provided herein are implantable systems, and methods for use therewith, for monitoring a patient's arterial blood pressure. Electrode(s) implanting within and/or on the patient's heart are used to obtain a cardiogenic impedance (CI) signal indicative of cardiac contractile activity. Additionally, a signal (e.g., PPG or IPG signal) indicative of changes in arterial blood volume remote from the patient's heart is obtained using a sensor or electrodes that are implanted remote from the patient's heart. One or more metrics indicative of pulse arrival time (PAT) are determined, where each metric can be determined by determining a time from one of the detected features of the CI signal to one of the detected features of the signal indicative of changes in arterial blood volume. Based on at least one of the metric(s) indicative of PAT, arterial blood pressure is estimated, which can include determining values indicative of systolic blood pressure, diastolic blood pressure, pulse pressure and/or mean arterial blood pressure, and/or changes in such values.
摘要翻译：本文提供了可植入系统及其使用的方法，用于监测患者的动脉血压。使用植入在患者心脏内和/或患者心脏上的电极来获得指示心脏收缩活动的心源阻抗（CI）信号。此外，使用远离患者心脏植入的传感器或电极获得指示远离患者心脏的动脉血容量变化的信号（例如，PPG或IPG信号）。确定指示脉冲到达时间（PAT）的一个或多个度量，其中可以通过确定从CI信号的检测到的特征之一到检测到的指示动脉血液变化的特征之一的时间来确定每个度量卷。基于指示PAT的指标中的至少一个，估计动脉血压，其可以包括确定指示收缩压，舒张压，脉压和/或平均动脉血压的值，和/或变化在这样的价值观。

5. 发明授权

US09687656B2 Arterial blood pressure monitoring devices, systems and methods for use while pacing 有权
公开(公告)号：US09687656B2
公开(公告)日：2017-06-27
申请号：US12637574
申请日：2009-12-14
申请人： Brian Jeffrey Wenzel , Timothy A. Fayram , Allen J. Keel , Edward Karst , Wenbo Hou , Taraneh Ghaffari Farazi
发明人： Brian Jeffrey Wenzel , Timothy A. Fayram , Allen J. Keel , Edward Karst , Wenbo Hou , Taraneh Ghaffari Farazi
IPC分类号： A61B5/02 , A61N1/365 , A61B5/0215 , A61B5/0295 , A61B5/1459 , A61N1/08 , G03F7/00 , B82Y10/00 , B82Y40/00 , A61B5/021 , A61B5/053 , A61B5/00
CPC分类号： A61N1/36585 , A61B5/02125 , A61B5/0215 , A61B5/0295 , A61B5/0535 , A61B5/1459 , A61B5/7239 , A61N1/08 , B82Y10/00 , B82Y40/00 , G03F7/0002
摘要： Provided herein are implantable systems, and methods for use therewith, for monitoring a patient's arterial blood pressure while a patient's heart is being paced. A signal (e.g., PPG or IPG signal) indicative of changes in arterial blood volume remote from the patient's heart is obtained using a sensor or electrodes that are implanted remote from the patient's heart. One or more metrics indicative of pulse arrival time (PAT) are determined, where each metric can be determined by determining a time from a paced cardiac event to one or more predetermined features of the signal indicative of changes in arterial blood volume. Based on at the metric(s) indicative of PAT, arterial blood pressure is estimated, which can include determining values indicative of systolic blood pressure, diastolic blood pressure, pulse pressure and/or mean arterial blood pressure, and/or changes in such values.

6. 发明授权

US08162841B2 Standalone systemic arterial blood pressure monitoring device 有权
标题翻译：独立的全身动脉血压监测装置
公开(公告)号：US08162841B2
公开(公告)日：2012-04-24
申请号：US12474276
申请日：2009-05-29
申请人： Allen J. Keel , Brian Jeffrey Wenzel , Edward Karst , Wenbo Hou , Taraneh Ghaffari Farazi , Timothy A. Fayram , Eric S. Fain , Paul A. Levine
发明人： Allen J. Keel , Brian Jeffrey Wenzel , Edward Karst , Wenbo Hou , Taraneh Ghaffari Farazi , Timothy A. Fayram , Eric S. Fain , Paul A. Levine
IPC分类号： A61B5/02
CPC分类号： A61B5/02158 , A61B5/02125 , A61B5/0295 , A61B5/0452 , A61B5/1459 , A61B2562/0219 , A61N1/36557 , A61N1/36564 , A61N1/36585 , G06F19/00
摘要： Certain embodiments of the present invention are related to an implantable monitoring device to monitor a patient's arterial blood pressure, where the device is configured to be implanted subcutaneously. The device includes subcutaneous (SubQ) electrodes and a plethysmography sensor. Additionally, the device includes an arterial blood pressure monitor configured to determine at least one value indicative of the patient's arterial blood pressure based on at least one detected predetermined feature of a SubQ ECG and at least one detected predetermined feature of a plethysmography signal. Alternative embodiments of the present invention are directed to a non-implantable monitoring device to monitor a patient's arterial blood pressure based on features of a surface ECG and a plethysmography signal obtained from a non-implanted sensor.
摘要翻译：本发明的某些实施例涉及一种用于监测患者的动脉血压的可植入监测装置，其中该装置被配置为被皮下植入。该装置包括皮下（SubQ）电极和体积描记传感器。另外，该装置包括动脉血压监测器，其被配置为基于至少一个检测到的SubQ ECG的预定特征和至少一个检测到的体积描记信号的预定特征来确定指示患者的动脉血压的至少一个值。本发明的替代实施例涉及一种非植入式监测装置，用于基于从非植入传感器获得的表面ECG和体积描记信号的特征来监测患者的动脉血压。

7. 发明申请

US20110040345A1 ELECTROMECHANICAL DELAY (EMD) MONITORING DEVICES, SYSTEMS AND METHODS 有权
标题翻译：电子延迟（EMD）监测装置，系统和方法
公开(公告)号：US20110040345A1
公开(公告)日：2011-02-17
申请号：US12637596
申请日：2009-12-14
申请人： Brian Jeffrey Wenzel , Timothy A. Fayram , Allen J. Keel , Edward Karst , Wenbo Hou , Taraneh Ghaffari Farazi
发明人： Brian Jeffrey Wenzel , Timothy A. Fayram , Allen J. Keel , Edward Karst , Wenbo Hou , Taraneh Ghaffari Farazi
IPC分类号： A61N1/365
CPC分类号： A61N1/36585 , A61B5/02125 , A61B5/0215 , A61B5/0295 , A61B5/0535 , A61B5/1459 , A61B5/7239 , A61N1/08 , B82Y10/00 , B82Y40/00 , G03F7/0002
摘要： Provided herein are implantable systems, and methods for use therewith, for monitoring a patient's electromechanical delay (EMD). Paced cardiac events are caused by delivering sufficient pacing stimulation to cause capture to the patient's heart. A cardiogenic impedance (CI) signal, indicative of cardiac contractile activity in response to the pacing stimulation being delivered, is obtained. One or more predetermined features of the CI signal are detected, and a value indicative of the patient's EMD is determined by determining a time between a delivered pacing stimulation and at least one of the detected one or more features of the CI signal.
摘要翻译：本文提供了可植入系统及其使用的方法，用于监测患者的机电延迟（EMD）。节奏心脏事件是通过提供足够的起搏刺激来引起对患者心脏的捕获而引起的。获得指示响应于起搏刺激被递送的心脏收缩活动的心源阻抗（CI）信号。检测CI信号的一个或多个预定特征，并且通过确定发出的起搏刺激与检测到的CI信号的一个或多个特征中的至少一个之间的时间来确定指示患者的EMD的值。

8. 发明授权

US08321017B2 Electromechanical delay (EMD) monitoring devices, systems and methods 有权
标题翻译：机电延迟（EMD）监测装置，系统和方法
公开(公告)号：US08321017B2
公开(公告)日：2012-11-27
申请号：US12637596
申请日：2009-12-14
申请人： Brian Jeffrey Wenzel , Timothy A. Fayram , Allen J. Keel , Edward Karst , Wenbo Hou , Taraneh Ghaffari Farazi
发明人： Brian Jeffrey Wenzel , Timothy A. Fayram , Allen J. Keel , Edward Karst , Wenbo Hou , Taraneh Ghaffari Farazi
IPC分类号： A61N1/368
CPC分类号： A61N1/36585 , A61B5/02125 , A61B5/0215 , A61B5/0295 , A61B5/0535 , A61B5/1459 , A61B5/7239 , A61N1/08 , B82Y10/00 , B82Y40/00 , G03F7/0002
摘要： Implantable systems, and methods for use therewith, enable the monitoring of a patient's electromechanical delay (EMD) and arterial blood pressure. Paced cardiac events are caused by delivering sufficient pacing stimulation to cause capture. A cardiogenic impedance (CI) signal, indicative of cardiac contractile activity in response to the pacing stimulation being delivered, is obtained. One or more predetermined features of the CI signal are detected, and a value indicative of the patient's EMD is determined by determining a time between a delivered pacing stimulation and at least one of the detected one or more features of the CI signal. The value indicative of EMD can be used to more accurately determine metrics indicative of pulse arrival time (PAT), which can be used to estimate arterial blood pressure.
摘要翻译：可植入系统及其使用的方法能够监测患者的机电延迟（EMD）和动脉血压。节奏心脏事件是由提供足够的起搏刺激引起的捕获引起的。获得指示响应于起搏刺激被递送的心脏收缩活动的心源阻抗（CI）信号。检测CI信号的一个或多个预定特征，并且通过确定发出的起搏刺激与检测到的CI信号的一个或多个特征中的至少一个之间的时间来确定指示患者的EMD的值。可以使用指示EMD的值来更精确地确定指示脉冲到达时间（PAT）的度量，其可用于估计动脉血压。

9. 发明申请

US20120215275A1 IMPLANTABLE SYSTEMS AND METHODS FOR USE THEREWITH FOR MONITORING AND MODIFYING ARTERIAL BLOOD PRESSURE WITHOUT REQUIRING AN INTRAVASCULAR PRESSURE TRANSDUCER 有权
标题翻译：不需要输血管压力传感器的可植入式系统和方法，用于监测和修改血管内血压
公开(公告)号：US20120215275A1
公开(公告)日：2012-08-23
申请号：US13033484
申请日：2011-02-23
申请人： Brian Jeffrey Wenzel , Michael E. Benser , Taraneh Ghaffari Farazi , Timothy A. Fayram , Edward Karst , Allen Keel , Wenbo Hou , Jong Gill
发明人： Brian Jeffrey Wenzel , Michael E. Benser , Taraneh Ghaffari Farazi , Timothy A. Fayram , Edward Karst , Allen Keel , Wenbo Hou , Jong Gill
IPC分类号： A61N1/365
CPC分类号： A61N1/36564 , A61B5/0031 , A61B5/02125 , A61B5/02158 , A61B5/02416 , A61B5/042 , A61B5/0452 , A61N1/36507 , A61N1/36585
摘要： Embodiments of the present invention are directed to implantable systems, and methods for use therewith, that monitor and modify a patient's arterial blood pressure without requiring an intravascular pressure transducer. In accordance with an embodiment, for each of a plurality of periods of time, there is a determination one or more metrics indicative of pulse arrival time (PAT), each of which are indicative of how long it takes for the left ventricle to generate a pressure pulsation that travels from the patient's aorta to a location remote from the patient's aorta. Based on the one or more metrics indicative of PAT, the patient's arterial blood pressure is estimated. Changes in the arterial blood pressure are monitored over time. Additionally, the patient's arterial blood pressure can be modified by initiating and/or adjusting pacing and/or other therapy based on the estimates of the patient's arterial blood pressure and/or monitored changes therein.
摘要翻译：本发明的实施例涉及可植入系统及其使用的方法，其不需要血管内压力传感器来监测和修改患者的动脉血压。根据实施例，对于多个时间段中的每一个，存在确定指示脉搏到达时间（PAT）的一个或多个指标，每个指标指示左心室产生多长时间从患者主动脉行进到远离患者主动脉的位置的压力脉动。基于指示PAT的一个或多个指标，估计患者的动脉血压。随着时间的推移监测动脉血压的变化。此外，可以通过基于患者的动脉血压的估计和/或其中监测的变化来启动和/或调整起搏和/或其他治疗来改变患者的动脉血压。

10. 发明申请

US20120215117A1 SYSTEMS AND METHODS FOR ESTIMATING CENTRAL ARTERIAL BLOOD PRESSURE OF A PATIENT 审中-公开
标题翻译：用于估计患者中枢性血压的系统和方法
公开(公告)号：US20120215117A1
公开(公告)日：2012-08-23
申请号：US13033465
申请日：2011-02-23
申请人： Edward Karst , Brian Jeffrey Wenzel , Timothy A. Fayram , Allen Keel , Wenbo Hou , Taraneh Ghaffari Farazi , Jong Gill
发明人： Edward Karst , Brian Jeffrey Wenzel , Timothy A. Fayram , Allen Keel , Wenbo Hou , Taraneh Ghaffari Farazi , Jong Gill
IPC分类号： A61B5/0215
CPC分类号： A61N1/36585 , A61B5/02125 , A61B5/02154 , A61B5/0452 , A61N1/36564 , A61N1/3962 , A61N1/3987
摘要： In specific embodiments, a method for estimating a patient's central arterial blood pressure (CBP) for use with an implantable system, comprises (a) using an implanted sensor at a first site to obtain a first signal indicative of changes in arterial blood volume at the first site, the first site being along one or more peripheral arterial structures of the patient, (b) using an implanted sensor at a second site to obtain a second signal indicative of changes in arterial blood volume at the second site, the second site being a distance from the first site downstream along an arterial path of the peripheral arterial structure of the patient, and (c) using implanted electrodes to obtain a signal indicative of electrical activity of the patient's heart. The method further comprises (d) determining a time t1 from a predetermined feature of the signal indicative of electrical activity to a predetermined feature of one of the first and second signals, the time t1 being a first pulse arrival time (PAT1) indicative of how long it takes a pulse wave to travel from the patient's aorta to one of the first and second sites, (e) determining a time t2 from a predetermined feature of the signal indicative of electrical activity to a predetermined feature of the other of the first and second signals, the time t2 being a second pulse arrival time (PAT2) indicative of how long it takes a pulse wave to travel from the patient's aorta to the other of the first and second sites, and (f) estimating the patient's central arterial blood pressure (CBP) based on the first pulse arrival time (PAT1) and the second pulse arrival time (PAT2).
摘要翻译：在具体实施例中，用于估计与可植入系统一起使用的患者中心动脉血压（CBP）的方法包括：（a）在第一部位使用植入的传感器以获得指示第一位置处的动脉血容量变化的第一信号第一部位，沿着患者的一个或多个外周动脉结构，（b）在第二部位使用植入的传感器获得指示第二部位的动脉血容量变化的第二信号，第二部位为距患者的外周动脉结构的动脉途径下游的第一部位的距离，以及（c）使用植入电极获得表示患者心脏的电活动的信号。该方法还包括（d）从指示电活动的信号的预定特征到第一和第二信号中的一个的预定特征来确定时间t1，时间t1是表示第一和第二信号的第一脉冲到达时间（PAT1）长时间，脉搏波从患者主动脉行进到第一和第二部位之一，（e）从指示电活动的信号的预定特征到第一和第二部分另一个的预定特征确定时间t2，以及第二信号，时间t2是第二脉冲到达时间（PAT2），其指示脉搏波从患者主动脉行进到第一和第二部位另一个所需的时间，以及（f）估计患者的中心动脉血基于第一脉冲到达时间（PAT1）和第二脉冲到达时间（PAT2）的压力（CBP）。

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