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    • 1. 发明申请
    • ISCHEMIA DETECTION AND CLASSIFICATION
    • ISCHEMIA检测和分类
    • WO2012057852A1
    • 2012-05-03
    • PCT/US2011/033811
    • 2011-04-25
    • MEDTRONIC, INC.SONG, ZhendongSTADLER, Robert, W.
    • SONG, ZhendongSTADLER, Robert, W.
    • A61B5/0452A61B5/0245
    • A61B5/0452A61B5/0245A61B5/1118
    • Techniques for detecting ischemia and classifying a type of ischemia are described. Electrograms of cardiac activity may be generated using implanted or external electrodes, e.g., electrodes carried on vascular leads within the heart and a housing electrode. In some examples, ischemia is detected and classified as benign or malignant based on whether a change an electrogram metric is detected, or first detected, in an endocardial electrogram or a non-endocardial electrogram. The relative timing of the change in the electrogram metric and a change in heart rate or patient activity may also be considered. In some examples, the system may create a stress test for detecting ischemia by instructing the patient to exercise or increasing the cardiac pacing rate.
    • 描述了用于检测缺血和分类一种缺血的技术。 可以使用植入或外部电极(例如,在心脏内的血管引线上承载的电极和外壳电极)产生心脏活动的电描记图。 在一些实例中,基于在心内膜电图或非心内膜电图中是否检测到或者首先检测到电描记图量度,检测到缺血并将其分类为良性或恶性。 也可以考虑电描记图度量的变化和心率或患者活动变化的相对时间。 在一些实例中,系统可以通过指示患者运动或增加心脏起搏速率来产生用于检测缺血的压力测试。
    • 4. 发明申请
    • PERIODIC BEAT DETECTION TO DETECT ARTIFACTS IN A CARDIAC ELECTROGRAM
    • 在心脏电泳中检测人体的周期性BEAT检测
    • WO2010014063A1
    • 2010-02-04
    • PCT/US2008/009244
    • 2008-07-31
    • MEDTRONIC, INC.ZHANG, XushengGHANEM, RajaSTADLER, Robert, W.
    • ZHANG, XushengGHANEM, RajaSTADLER, Robert, W.
    • A61B5/0464
    • A61B5/0464A61B5/0006A61B5/7203A61B5/7239A61N1/365
    • Techniques for determining whether artifacts are present in a cardiac electrogram are described. According to one example, a medical device senses a cardiac electrogram via electrodes. The medical device determines a derivative, e.g., a second order derivative, the electrogram. The medical device detects beats within the derivative, e.g., by comparing a rectified version of the derivative to one or more thresholds determined based on a maximum of the rectified derivative. The medical device determines whether the beats are periodic, and determines whether artifacts are present in the cardiac electrogram based on the determination of whether the beats are periodic. The medical device may further determine whether tachyarrhythmia is present and/or whether the cardiac rhythm of the patient is treatable based on the determination of whether the beats are periodic. For example, the medical device may determine that an electrogram is not treatable when the beats are periodic.
    • 描述了用于确定伪像是否存在于心电图中的技术。 根据一个示例,医疗装置通过电极感测心电图。 医疗设备确定导数,例如二阶导数,电描记图。 医疗设备检测导数内的跳动,例如通过将导数的整流版本与基于校正导数的最大值确定的一个或多个阈值进行比较。 医疗器械确定节拍是否是周期性的,并且基于确定节拍是否是周期性的确定来确定心脏电图中是否存在人造物。 医疗装置可以基于是否是周期性的确定来进一步确定是否存在快速性心律失常和/或患者的心律是否可治疗。 例如,当节拍是周期性的时,医疗装置可以确定电描记图是不可治疗的。
    • 7. 发明申请
    • DETECTION OF TACHYARRHYTHMIA TERMINATION
    • 检测TACHYARRHYTHMIA终止
    • WO2004075983A1
    • 2004-09-10
    • PCT/US2004/004805
    • 2004-02-19
    • MEDTRONIC, INC.STADLER, Robert, W.ERICKSEN, James, H.WARMAN, Eduardo, N.HOLBROOK, Reece, W.
    • STADLER, Robert, W.ERICKSEN, James, H.WARMAN, Eduardo, N.HOLBROOK, Reece, W.
    • A61N1/362
    • A61N1/3622
    • Determining termination of an identified tachyarrhythmia episode may involve analysis of a relative decrease in tachyarrhythmia rate, a normalization of electrogram morphology criteria, or both. An implanted medical device may obtain a tachyarrhythmia rate and a morphology of a cardiac waveform. The device may compare the tachyarrhythmia rate to a threshold tachyarrhythmia rate and the morphology to a template morphology, and classify the heart beat as indicating termination of the tachyarrhythmia episode when the tachyarrhythmia rate is less than the threshold tachyarrhythmia rate, the morphology categorizes as normal, or both. For arrhythmias with no therapy delivered, observation of arrhythmia behavior at the point of termination may lead to improved classification. In addition, observation of a relative decrease in tachyarrhythmia rate immediately after therapy application can lead to application of slower but more specific criteria for redetection. Also, delivery of cardioversion shocks can be aborted upon tachyarrhythmia termination.
    • 确定确定的快速性心律失常发作的终止可能涉及快速心律失常率相对降低的分析,电描记图形态学标准的归一化或两者。 植入式医疗装置可以获得心律失常速率和心脏波形的形态。 该装置可以将快速性心律失常率与阈值快速性心律失常率和形态学比较为模板形态,并且当心律失常发生率低于阈值心动过速率时,将心跳分类为指示快速性心律失常发作的终止,形态分类为正常, 或两者。 对于没有治疗的心律失常,在终止时观察心律失常行为可能导致分类改善。 另外,在治疗应用后立即观察到快速性心律失常率的相对降低可导致应用较慢但更具体的重新检测标准。 此外,快速性心律失常终止可以中止心脏复律冲击的输送。
    • 9. 发明申请
    • IMPEDANCE VARIABILITY ANALYSIS TO IDENTIFY LEAD-RELATED CONDITIONS
    • 阻碍可变性分析来识别与铅相关的条件
    • WO2009148425A1
    • 2009-12-10
    • PCT/US2008/009027
    • 2008-07-25
    • MEDTRONIC, INC.STADLER, Robert, W.GUNDERSON, Bruce, D.PATEL, Amisha, S.
    • STADLER, Robert, W.GUNDERSON, Bruce, D.PATEL, Amisha, S.
    • A61N1/362
    • A61N1/36521A61N1/3706A61N2001/083
    • In general, the disclosure relates to techniques for calculating mean impedance values and impedance variability values to detect a possible condition with a lead or device-lead pathway or connection. In one example, a system may be configured to determine an impedance value for an electrical path based on a plurality of measured impedance values for the electrical path, wherein the electrical path comprises a plurality of electrodes, and to determine an impedance variability value based on at least one of the plurality of measured impedance values. The system may be further configured to determine a threshold value based on the determined impedance value and the impedance variability value, compare a newly measured impedance value for the electrical path to the threshold value, and indicate a possible condition of the electrical path based on the comparison.
    • 通常,本公开涉及用于计算平均阻抗值和阻抗变异性值以用于检测具有引线或器件引导路径或连接的可能状况的技术。 在一个示例中,系统可以被配置为基于用于电路径的多个测量的阻抗值来确定电路径的阻抗值,其中电路径包括多个电极,并且基于以下方式确定阻抗变异性值: 所述多个测量的阻抗值中的至少一个。 该系统还可以被配置为基于所确定的阻抗值和阻抗变异性值来确定阈值,将新测量的电通路的阻抗值与阈值进行比较,并且基于该路径指示电路径的可能状态 比较。