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1. 发明授权

US08180439B2 Ischemia detection using intra-cardiac signals 有权
标题翻译：使用心脏内信号的缺血检测
公开(公告)号：US08180439B2
公开(公告)日：2012-05-15
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，电描绘片段的变化。选择ST段的早期部分以避免T波。

2. 发明授权

US07460900B1 Method and apparatus for detecting ischemia using changes in QRS morphology 有权
标题翻译：使用QRS形态变化检测缺血的方法和装置
公开(公告)号：US07460900B1
公开(公告)日：2008-12-02
申请号：US11227856
申请日：2005-09-14
申请人： Jong Gill , Peter Boileau , Gene A. Bornzin
发明人： Jong Gill , Peter Boileau , Gene A. Bornzin
IPC分类号： A61B5/04
CPC分类号： A61B5/04525 , A61B5/024 , A61N1/3627 , A61N1/36507
摘要： A method for operating an implantable medical device includes determining the difference of the absolute value of the voltage of a test QRS complex and the voltage of a baseline QRS template at a plurality of corresponding sample points and detecting ischemia if the sum of the differences at the plurality of sample points is greater than an ischemia detection threshold.
摘要翻译：一种用于操作可植入医疗装置的方法包括确定测试QRS复合物的电压的绝对值与基准QRS模板在多个对应采样点的电压之间的差异，并检测缺血，如果在多个采样点大于缺血检测阈值。

3. 发明授权

US07648464B1 Detecting ischemia using an implantable cardiac device based on morphology of cardiac pressure signal 有权
标题翻译：基于心脏压力信号的形态，使用可植入心脏装置检测缺血
公开(公告)号：US07648464B1
公开(公告)日：2010-01-19
申请号：US11458617
申请日：2006-07-19
申请人： Jong Gill , Peter Boileau , Gene A. Bornzin , Joseph J. Florio , Xiaoyi Min
发明人： Jong Gill , Peter Boileau , Gene A. Bornzin , Joseph J. Florio , Xiaoyi Min
IPC分类号： A61B5/021
CPC分类号： A61B5/0215 , A61B5/0031 , A61B5/042 , A61B5/7239 , A61N1/36564
摘要： Methods and systems are presented for using an ICD to detect myocardial ischemia. In one embodiment, a method includes sensing a signal indicative of cardiac pressure, measuring a height of the sensed signal at a peak amplitude of the sensed signal, and measuring a duration of the sensed signal. The method further includes indicating an ischemia based on a comparison of a ratio of the height to the duration with a predetermined value. In another embodiment, a method includes sensing a signal indicative of cardiac pressure, determining a derivative signal that is a first derivative of the sensed signal, measuring a maximum positive value of the derivative signal, and measuring a maximum negative value of the derivative signal. The method further includes indicating an ischemia based on a comparison of a ratio of the maximum positive value to the maximum negative value with a predetermined value.
摘要翻译：提出了使用ICD检测心肌缺血的方法和系统。在一个实施例中，一种方法包括感测指示心脏压力的信号，以感测信号的峰值幅度测量感测信号的高度，以及测量感测信号的持续时间。该方法还包括基于将高度与持续时间的比率与预定值的比较来指示缺血。在另一个实施例中，一种方法包括感测指示心脏压力的信号，确定作为感测信号的一阶导数的导数信号，测量导数信号的最大正值，以及测量导数信号的最大负值。该方法还包括基于将最大正值与最大负值的比率与预定值进行比较来指示缺血。

4. 发明授权

US07613508B2 Implantable cardiac stimulation device, system and method which provides an electrogram signal facilitating measurement of slow-changing electrogram features 有权
标题翻译：可植入的心脏刺激装置，系统和方法，其提供便于测量慢变化电描记图特征的电描记图信号
公开(公告)号：US07613508B2
公开(公告)日：2009-11-03
申请号：US11871873
申请日：2007-10-12
申请人： Peter Boileau , Gene A. Bornzin , Jong Gill
发明人： Peter Boileau , Gene A. Bornzin , Jong Gill
IPC分类号： A61B5/042
CPC分类号： A61N1/3702 , A61B5/04018 , A61B5/042 , A61B5/0452 , A61N1/368
摘要： An implantable cardiac system including an implantable cardiac stimulation device provides a heart activity signal of a heart facilitating measurement of slowly changing electrogram features. The system comprises at least one implantable electrode arrangement that senses cardiac electrical activity and provides an intracardiac electrogram signal, a first high pass filter that filters the electrogram and an equalizer that filters the filtered electrogram signal. The equalizer has a transfer function that is non-decreasing for frequencies up to a lower frequency breakpoint that is less than the upper frequency breakpoint, decreasing for frequencies between the lower frequency breakpoint and the upper frequency breakpoint, and generally flat for frequencies above the upper frequency breakpoint through a bandpass region of interest.
摘要翻译：包括可植入心脏刺激装置的可植入心脏系统提供心脏的心脏活动信号，便于测量缓慢变化的电描绘图特征。该系统包括感测心脏电活动并提供心内电描记图信号的至少一个可植入电极装置，对电描记图进行滤波的第一高通滤波器和对经滤波的电描记图信号进行滤波的均衡器。均衡器具有对于低于较高频率断点的频率的频率不降低的传递函数，对于较低频率断点和较高频率断点之间的频率而言降低，并且对于高于上限频率的频率，通常平坦频率断点通过感兴趣的带通区域。

5. 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.

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. 发明授权

US08180441B2 System and method for distinguishing among cardiac ischemia, hypoglycemia and hyperglycemia using an implantable medical device 有权
标题翻译：使用可植入医疗器械区分心脏缺血，低血糖和高血糖的系统和方法
公开(公告)号：US08180441B2
公开(公告)日：2012-05-15
申请号：US12360822
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： A61B5/0468
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.
摘要翻译：描述了基于心内电描记图（IEGM）信号检测缺血，低血糖或高血糖的技术。基于QRS复合体与T波结束（QTmax）之间的间隔的缩短单独或与ST段抬高的变化相结合来检测局部缺血。或者，基于ST段抬高的变化结合QRS复合体与T波结束（QTend）之间的间隔的最小变化来检测局部缺血。基于ST段抬高的变化以及QTmax或QTend的延长来检测低血糖。基于ST段抬高的变化以及QTmax和QTend中的最小变化来检测高血糖。通过利用QTmax和QTend与ST段抬高相结合，可以将由低/高血糖引起的ST段抬高的变化与缺血引起的变化进行适当区分。

9. 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。

10. 发明授权

US07813791B1 Systems and methods for employing an FFT to distinguish R-waves from T-waves using an implantable medical device 有权
标题翻译：使用FFT使用可植入医疗装置区分R波和T波的系统和方法
公开(公告)号：US07813791B1
公开(公告)日：2010-10-12
申请号：US11841350
申请日：2007-08-20
申请人： Jong Gill , Peter Boileau , Gene A. Bornzin
发明人： Jong Gill , Peter Boileau , Gene A. Bornzin
IPC分类号： A61B5/0456
CPC分类号： A61B5/0452 , A61B5/0464 , A61B5/7257 , A61N1/3621
摘要： A Fast Fourier Transform (FFT) converts time-varying event waveforms into the frequency domain waveforms to thereby decompose the events into their spectral components, which are analyzed to distinguish R-waves from T-waves. In some embodiments, the FFT is only activated if a ventricular tachyarrhythmia is already indicated. For example, an initial ventricular rate may be derived from a ventricular IEGM based on all events detected therein. The initial ventricular rate is compared against one or more thresholds representative of ventricular tachycardia (VT) and/or ventricular fibrillation (VF) to determine if VT/VF is indicated. If so, the FFT is activated to distinguish R-waves from T-waves and, in particular, to detect and eliminate T-wave oversensing. Then, the ventricular rate is re-determined based only on the rate of true R-waves. Therapy is delivered if VT/VF is still detected.
摘要翻译：快速傅里叶变换（FFT）将时变事件波形转换成频域波形，从而将事件分解为其频谱分量，分析其以区分R波和T波。在一些实施例中，仅当已经指示心室快速性心律失常时才激活FFT。例如，可以基于其中检测到的所有事件从心室IEGM导出初始心室率。将初始心室率与代表室性心动过速（VT）和/或心室颤动（VF）的一个或多个阈值进行比较，以确定是否指示VT / VF。如果是这样，则FFT被激活以区分R波和T波，特别是检测和消除T波超检测。然后，仅根据真正的R波的速率重新确定心室率。如果仍然检测到VT / VF，则进行治疗。

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