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1. 发明授权

US09415226B1 Method and apparatus with anodal capture monitoring 有权
标题翻译：具有阳极捕获监测的方法和装置
公开(公告)号：US09415226B1
公开(公告)日：2016-08-16
申请号：US11961720
申请日：2007-12-20
申请人： Jeffery D. Snell , Gene A. Bornzin , Laurence S. Sloman , Jong Gill
发明人： Jeffery D. Snell , Gene A. Bornzin , Laurence S. Sloman , Jong Gill
IPC分类号： A61N1/00 , A61N1/362
CPC分类号： A61N1/3622 , A61N1/3684 , A61N1/3686 , A61N1/3712
摘要： During cross-chamber pacing, where anodal capture may not be desirable, pulses are applied between a cathode electrode in a first chamber and an anode electrode in a second chamber. A capture detector detects for capture of the second chamber by the pacing pulses. If capture of the second chamber persists, another electrode is selected as the anodal electrode. During single-chamber pacing, where anodal capture may be desirable, pulses are applied between a cathode electrode and an anode electrode associated with the same chamber. A capture detector detects for capture at both electrodes. If anodal capture is not detected, the energy of the pacing pulse is increased, until anodal capture is detected.
摘要翻译：在跨室起搏期间，可能不需要阳极捕获，脉冲施加在第一室中的阴极和第二室中的阳极之间。捕获检测器通过起搏脉冲检测第二腔室的捕获。如果第二室的捕获持续，则选择另一电极作为阳极电极。在可以期望阳极捕获的单室起搏期间，在与相同的室相关联的阴极和阳极之间施加脉冲。捕获检测器检测两个电极的捕获。如果没有检测到阳极捕获，则起搏脉冲的能量增加，直到检测到阳极捕获。

2. 发明申请

US20110125206A1 SINGLE CHAMBER IMPLANTABLE MEDICAL DEVICE FOR CONFIRMING ARRHYTHMIA THROUGH RETROSPECTIVE CARDIAC SIGNALS 审中-公开
标题翻译：通过回顾性心脏病信号确认ARRHYTHMIA的单室可植入医疗器械
公开(公告)号：US20110125206A1
公开(公告)日：2011-05-26
申请号：US12625416
申请日：2009-11-24
申请人： Gene A. Bornzin , Jong Gill , Jeffery D. Snell
发明人： Gene A. Bornzin , Jong Gill , Jeffery D. Snell
IPC分类号： A61N1/39 , A61B5/0452 , A61B5/046
CPC分类号： A61N1/36507 , A61B5/0031 , A61B5/0422 , A61B5/0452 , A61N1/3956
摘要： An implantable medical device is provided that comprises a housing, sensors configured to be located to proximate a heart, and a sensing module to sense cardiac signals originating from the heart over a channel defined by the sensors. The cardiac signals include intrinsic R-wave events and associated intrinsic confirmation events when the heart exhibits normal sinus rhythm. The device further includes memory to store the cardiac signals sensed over a channel, and a detection module. The detection module identifies an R-wave event within the cardiac signals. The detection module captures, in the memory, a segment of the cardiac signals that precedes the R-wave event as a retrospective segment. The detection module determines whether the retrospective segment includes an intrinsic confirmation event that is associated with and occurs before the R-wave event. The detection module declares an arrhythmia based at least in part on the determination of whether the retrospective segment includes the intrinsic confirmation event is absent from the retrospective segment.
摘要翻译：提供了一种植入式医疗装置，其包括壳体，被配置为邻近心脏定位的传感器，以及感测模块，用于感测通过由传感器限定的通道的来自心脏的心脏信号。当心脏呈现正常窦性心律时，心脏信号包括固有的R波事件和相关的固有确认事件。该装置还包括用于存储通过信道感测的心脏信号的存储器和检测模块。检测模块识别心脏信号内的R波事件。检测模块在存储器中捕获在作为回顾段的R波事件之前的心脏信号的一部分。检测模块确定回溯段是否包括与R波事件相关联并发生的固有确认事件。检测模块至少部分地基于回顾段中是否包含内在确认事件的确定来声明心律失常。

3. 发明授权

US07945314B1 System and method for emulating a surface EKG for use with transtelephonic monitoring of an implantable medical device 有权
标题翻译：用于模拟表面EKG的系统和方法，用于可植入医疗装置的经耳监测
公开(公告)号：US07945314B1
公开(公告)日：2011-05-17
申请号：US11432636
申请日：2006-05-10
申请人： Jeffery D. Snell , Jong Gill , Gene A. Bornzin , Peter Boileau , Euljoon Park
发明人： Jeffery D. Snell , Jong Gill , Gene A. Bornzin , Peter Boileau , Euljoon Park
IPC分类号： A61B5/04
CPC分类号： A61B5/0402 , A61B5/0006 , A61N1/3702 , A61N1/37235 , A61N1/37282
摘要： A surface electrocardiogram (EKG) is emulated using signals detected by internal leads of an implanted device. In one example, emulation is performed using a technique that concatenates portions of signals sensed using different electrodes, such as by combining far-field ventricular signals sensed in the atria with far-field atrial signals sensed in the ventricles. In another example, emulation is performed using a technique that selectively amplifies or attenuates portions of a single signal, such as by attenuating near-field portions of an atrial unipolar signal relative to far-field portions of the same signal. The surface EKG emulation may be performed by the implanted device itself or by an external programmer based on cardiac signals transmitted thereto. A transtelephonic monitoring network is also described, wherein the emulated surface EKG (or raw data used to emulate the EKG) is relayed from an implanted device to a remote monitor, typically installed in a physician's office.
摘要翻译：使用由植入装置的内部引线检测的信号来模拟表面心电图（EKG）。在一个示例中，使用将使用不同电极感测的信号的部分连接的技术来执行仿真，例如通过将在心房中感测到的远场心室信号与在心室中感测到的远场心房信号组合。在另一示例中，使用选择性地放大或衰减单个信号的部分的技术来执行仿真，例如通过衰减相对于相同信号的远场部分的心房单极信号的近场部分。表面EKG仿真可以由植入装置本身或外部编程器基于发送到其上的心脏信号执行。还描述了一种跨耳监测网络，其中仿真表面EKG（或用于模拟EKG的原始数据）从植入装置中继到通常安装在医师办公室中的远程监视器。

4. 发明授权

US08090435B2 System and method for distinguishing among cardiac ischemia, hypoglycemia and hyperglycemia using an implantable medical device 有权
公开(公告)号：US08090435B2
公开(公告)日：2012-01-03
申请号：US12360826
申请日：2009-01-27
申请人： Jong Gill , Peter Boileau , Rupinder Bharmi , Xiaoyi Min , Joseph J. Florio , Michael E. Benser , Gene A. Bornzin
发明人： Jong Gill , Peter Boileau , Rupinder Bharmi , Xiaoyi Min , Joseph J. Florio , Michael E. Benser , Gene A. Bornzin
IPC分类号： A61B5/0402
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.

5. 发明授权

US07917214B1 Methods and systems for identifying a preferred pacing configuration for a multi-electrode implantable cardiac electrotherapy device 有权
标题翻译：用于识别多电极可植入心脏电疗装置的优选起搏配置的方法和系统
公开(公告)号：US07917214B1
公开(公告)日：2011-03-29
申请号：US11851240
申请日：2007-09-06
申请人： Jong Gill , Annapurna Karicherla , Kyungmoo Ryu , Gene A. Bornzin
发明人： Jong Gill , Annapurna Karicherla , Kyungmoo Ryu , Gene A. Bornzin
IPC分类号： A61N1/362
CPC分类号： A61N1/372 , A61N1/3686
摘要： Methods and systems of identifying an electrode or combination of electrodes of a multi-electrode device for pacing include selecting a first electrode or electrode combination as a first candidate; delivering a pacing pulse through the first candidate and determining a measurement based on sensed cardiac electrical activity resulting from the first candidate pacing; selecting a second candidate; delivering a pacing pulse through the second candidate and determining a measurement based on sensed cardiac electrical activity resulting from the second candidate pacing; comparing the measurement for the first and second candidates; and identifying the first or second candidate for pacing based on the comparison. The measurement may be one or more of activation time ΔTact, activation recovery interval (ARI), a fractioned electrogram width, and a standard deviation of a fractioned electrogram feature.
摘要翻译：识别用于起搏的多电极装置的电极或电极组合的方法和系统包括选择第一电极或电极组合作为第一候选; 通过所述第一候选者发送起搏脉冲，并且基于由所述第一候选起搏产生的感测的心脏电活动来确定测量; 选择第二候选人; 通过所述第二候选者递送起搏脉冲，并且基于由所述第二候选起搏产生的感测到的心脏电活动来确定测量; 比较第一和第二候选人的测量; 以及基于所述比较来识别用于起搏的第一或第二候选者。测量可以是一个或多个激活时间＆Dgr; Tact，激活恢复间隔（ARI），分数的电描记图宽度和分数的电描记图特征的标准偏差。

6. 发明申请

US20110004111A1 ISCHEMIA DETECTION USING INTRA-CARDIAC SIGNALS 有权
标题翻译： ISCHEMIA检测使用内部信号
公开(公告)号：US20110004111A1
公开(公告)日：2011-01-06
申请号：US12846387
申请日：2010-07-29
申请人： Jong Gill , Peter Boileau , Gene A. Bornzin , Joseph J. Florio , Mohssen Fard
发明人： Jong Gill , Peter Boileau , Gene A. Bornzin , Joseph J. Florio , Mohssen Fard
IPC分类号： A61B5/0452
CPC分类号： A61B5/0452 , A61B5/7203 , A61B5/7264 , Y10S128/92
摘要： An implanted cardiac rhythm management device is disclosed that is operative to detect myocardial ischemia. This is done by evaluating electrogram features to detect an electrocardiographic change; specifically, changes in electrogram segment during the early part of an ST segment. The early part of the ST segment is chosen to avoid the T-wave.
摘要翻译：公开了可用于检测心肌缺血的植入式心律管理装置。这通过评估电描记图特征来检测心电图变化来完成; 具体来说，在ST段的早期部分的电描绘片段的变化。选择ST段的早期部分以避免T波。

7. 发明申请

US20090177105A1 System and Method for Distinguishing Among Cardiac Ischemia, Hypoglycemia and Hyperglycemia Using an Implantable Medical Device 有权
公开(公告)号：US20090177105A1
公开(公告)日：2009-07-09
申请号：US12360826
申请日：2009-01-27
申请人： Jong Gill , Peter Boileau , Rupinder Bharmi , Xiaoyi Min , Joseph J. Florio , Michael E. Benser , Gene A. Bornzin
发明人： Jong Gill , Peter Boileau , Rupinder Bharmi , Xiaoyi Min , Joseph J. Florio , Michael E. Benser , Gene A. Bornzin
IPC分类号： A61B5/04
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.

8. 发明申请

US20130204312A1 SYSTEMS AND METHODS FOR CONTROLLING PACING INDUCED DYSSYNCHRONY TO REDUCE ISCHEMIC INJURY USING AN IMPLANTABLE MEDICAL DEVICE 审中-公开
标题翻译：使用可植入医疗装置来控制皮肤诱导性神经元以减少异常损伤的系统和方法
公开(公告)号：US20130204312A1
公开(公告)日：2013-08-08
申请号：US13365061
申请日：2012-02-02
申请人： Jong Gill , Kwangdeok Lee , Kyungmoo Ryu , Gene A. Bornzin
发明人： Jong Gill , Kwangdeok Lee , Kyungmoo Ryu , Gene A. Bornzin
IPC分类号： A61N1/365
CPC分类号： A61N1/3627 , A61N1/36557 , A61N1/3682 , A61N1/3684 , A61N1/3686
摘要： Techniques are provided for use by an implantable medical device for optimizing the amount of ventricular dyssynchrony induced within a patient during protective pacing. In one example, the device analyzes intracardiac electrogram signals to detect an ischemic event within the heart. The device then delivers pacing stimulus in accordance with adjustable pacing parameters to induce ventricular dyssynchrony within the heart and adjusts the pacing parameters within a range of permissible values to achieve a preferred degree of ventricular dyssynchrony within the patient, so long as there is no significant reduction in left ventricular pumping functionality. Preferably, the pacing parameters are adjusted to maximize or otherwise optimize the degree of dyssynchrony induced within the patient. If a significant reduction in LV pumping functionality is detected, the dyssynchrony-inducing pacing is preferably suspended to avoid any deterioration in the condition of the heart. Techniques for detecting early onset of ischemia are also disclosed.
摘要翻译：技术被提供用于由可植入医疗装置用于在保护性起搏期间优化患者内引起的心室不同步的量。在一个实例中，该装置分析心内电描记信号以检测心脏内的缺血事件。然后，该装置根据可调整的起搏参数提供起搏刺激，以诱导心脏内的心室不同步，并在允许值的范围内调整起搏参数，以在患者体内达到优选的心室不同步程度，只要没有显着的减少在左心室泵功能。优选地，起搏参数被调整以最大化或以其他方式优化患者内诱发的不同步程度。如果检测到LV泵送功能的显着降低，则优选暂停不同步的起搏，以避免心脏状况的任何恶化。还公开了用于检测早期发作缺血的技术。

9. 发明授权

US08449472B2 Neurostimulation and neurosensing techniques to optimize atrial anti-tachycardia pacing for prevention of atrial tachyarrhythmias 有权
标题翻译：神经刺激和神经感应技术优化房性心动过速起搏预防房性快速性心律失常
公开(公告)号：US08449472B2
公开(公告)日：2013-05-28
申请号：US12891429
申请日：2010-09-27
申请人： Kyungmoo Ryu , Jong Gill , Taraneh Ghaffari Farazi , Gene A. Bornzin
发明人： Kyungmoo Ryu , Jong Gill , Taraneh Ghaffari Farazi , Gene A. Bornzin
IPC分类号： A61B5/02 , A61N1/00
CPC分类号： A61N1/3621 , A61N1/36114 , A61N1/3624
摘要： Implantable systems and method for use therewith are provided that take advantage of various neuromodulation and neurosensing techniques for either preventing atrial fibrillation (AF) or terminating AF. Specific embodiments are for use with an implantable device that includes one or more atrial electrode for sensing atrial fibrillation (AF) and/or delivering Atrial Anti-Tachycardia Pacing (AATP) and one or more electrode for monitoring and/or stimulating atrial vagal fat pads.
摘要翻译：提供了可植入系统及其使用的方法，其利用各种神经调节和神经感应技术来预防心房颤动（AF）或终止AF。具体实施方案用于可植入装置，其包括一个或多个心房电极，用于感测心房颤动（AF）和/或递送心房抗心动过速起搏（AATP）和用于监测和/或刺激心房迷走神经脂肪垫的一个或多个电极。

10. 发明申请

US20100121395A1 System and Method for Setting Atrioventricular Pacing Delays Based on Far-Field Atrial Signals 有权
标题翻译：基于远场心房信号设置房室起搏延迟的系统和方法
公开(公告)号：US20100121395A1
公开(公告)日：2010-05-13
申请号：US12267483
申请日：2008-11-07
申请人： Jong Gill , Gene A. Bornzin
发明人： Jong Gill , Gene A. Bornzin
IPC分类号： A61N1/368
CPC分类号： A61N1/368 , A61B5/0452 , A61N1/3704
摘要： An intrinsic inter-atrial conduction delay is determined by a pacemaker or implantable cardioverter-defibrillator based, at least in part, on far-field atrial events sensed using ventricular pacing/sensing leads. An atrioventricular pacing delay is then set based on the inter-atrial conduction delay. By detecting atrial events using ventricular leads, rather than using atrial leads, a more useful measurement of the intrinsic inter-atrial conduction delay can be obtained. In this regard, since atrial electrodes detect atrial activity locally around the electrodes, a near-field atrial event sensed using an atrial electrode might not properly represent the actual timing of the atrial event across both the right and left atria. Far-field atrial events sensed using ventricular leads thus allow for a more useful measurement of inter-atrial conduction delays for use in setting atrioventricular pacing delays. The delivery of individual V-pulses to the heart of the patient may be timed relative to the ends of individual far-field atrial events.
摘要翻译：至少部分地基于使用心室起搏/感测引线感测的远场心房事件，起搏器或植入式心律转复除颤器确定内在的心房间传导延迟。然后基于心房间传导延迟来设置房室起搏延迟。通过使用心室导联检测心房事件，而不是使用心房线，可以获得更有用的内在心房传导延迟的测量。在这方面，由于心房电极在电极周围局部地检测心房活动，使用心房电极感测到的近场心房事件可能不能正确地表示在右心房和左心房两侧的心房事件的实际时间。使用心室引线检测的远场心房事件因此允许更有用的测量心房间传导延迟，用于设置房室起搏延迟。单个V脉冲到患者心脏的传送可以相对于单个远场心房事件的结束而定时。

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