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1. 发明授权

US09144685B2 Using focal myocardial stimulation to distinguish supraventricular tachycardia from ventricular tachycardia 有权
标题翻译：使用局灶性心肌刺激来区分室上性心动过速与室性心动过速
公开(公告)号：US09144685B2
公开(公告)日：2015-09-29
申请号：US13357646
申请日：2012-01-25
申请人： Yong-Fu Xiao , Jeffrey M. Gillberg , Paul J. DeGroot , Eduardo N. Warman , Scott J. Brabec , John L. Sommer , Jon F. Urban , Lepeng Zeng
发明人： Yong-Fu Xiao , Jeffrey M. Gillberg , Paul J. DeGroot , Eduardo N. Warman , Scott J. Brabec , John L. Sommer , Jon F. Urban , Lepeng Zeng
IPC分类号： A61N1/00 , A61N1/365 , A61N1/362
CPC分类号： A61N1/365 , A61N1/3622 , A61N1/36585
摘要： An apparatus and method to discriminate cardiac events by sensing atrial and ventricular depolarizations having associated refractory periods thereafter. A fast ventricular rate is detected in response to the sensed ventricular depolarizations. Responsive to detecting the fast ventricular rate, at least one stimulus pulse is delivered to atrial tissue within the associated refractory period of the ventricle but outside of an associated refractory period of the stimulated atrial tissue. A ventricular response to the atrial tissue stimulus pulse is determined, and the cardiac event is discriminated based on the ventricular response to the atrial tissue stimulus pulse.
摘要翻译：通过感应心房和心室去极化来区分心脏事件的装置和方法，其后具有相关联的不良期。响应于感测到的心室去极化，检测到快速心室率。响应于检测快速心室率，至少一个刺激脉冲被输送到心室的相关不应期内但在受刺激的心房组织的相关不应期内之外的心房组织。确定对心房组织刺激脉冲的心室反应，并且基于对心房组织刺激脉冲的心室响应来区分心脏事件。

2. 发明授权

US08876727B2 Phrenic nerve stimulation detection using heart sounds 有权
标题翻译：使用心脏声音进行膈神经刺激检测
公开(公告)号：US08876727B2
公开(公告)日：2014-11-04
申请号：US13474041
申请日：2012-05-17
申请人： Xusheng Zhang , Jeffrey M. Gillberg , Thomas J. Mullen , Paul J. DeGroot
发明人： Xusheng Zhang , Jeffrey M. Gillberg , Thomas J. Mullen , Paul J. DeGroot
IPC分类号： A61B5/04 , A61B5/08 , A61N1/36 , A61B7/04 , A61B5/00 , A61B7/00 , A61B5/0205 , A61N1/365 , A61B5/024
CPC分类号： A61N1/3611 , A61B5/0031 , A61B5/0205 , A61B5/024 , A61B5/0826 , A61B5/4029 , A61B5/7217 , A61B7/005 , A61B7/006 , A61B7/04 , A61N1/36114 , A61N1/36135 , A61N1/36535 , A61N1/36578
摘要： A method and system of detecting phrenic nerve stimulation in a patient that includes detecting an activation event, obtaining a heart sound signal of a patient from an implanted heart sound sensor, determining that an electrical stimulation has been applied to the patient, in response to detecting the activation event, monitoring a portion of the heart sound signal, the portion defined by a predetermined window after the application of the electrical stimulation, and determining whether phrenic nerve stimulation occurred based on the portion of the heart sound signal.
摘要翻译：一种检测患者膈神经刺激的方法和系统，包括检测激活事件，响应于检测，从植入的心音传感器获得患者的心音信号，确定电刺激已经施加到患者激活事件，监测心音信号的一部分，在施加电刺激之后由预定窗口定义的部分，以及基于心音信号的部分来确定是否发生膈神经刺激。

3. 发明授权

US08170663B2 Method and apparatus to control delivery of high-voltage and anti-tachy pacing therapy in an implantable medical device 有权
标题翻译：用于控制可植入医疗装置中的高电压和抗速度起搏治疗递送的方法和装置
公开(公告)号：US08170663B2
公开(公告)日：2012-05-01
申请号：US11687282
申请日：2007-03-16
申请人： Paul J. DeGroot , Kevin T. Ousdigian , Vasant Padmanabhan , Paul Krause , Vinod Sharma
发明人： Paul J. DeGroot , Kevin T. Ousdigian , Vasant Padmanabhan , Paul Krause , Vinod Sharma
IPC分类号： A61N1/362 , A61N1/39
CPC分类号： A61N1/3622 , A61N1/3688 , A61N1/3925 , A61N1/3956 , A61N1/3962 , A61N1/3987
摘要： A system and method for delivering both anti-tachy pacing (ATP) therapy and high-voltage shock therapy in response to detection of abnormal cardiac rhythms is disclosed. The system controls the time between delivering ATP therapy and the charging of high-voltage capacitors in preparation for shock delivery based on a predetermined set of criteria. In one embodiment, the inventive system operates in an ATP During Capacitor Charging (ATP-DCC) mode wherein all, or substantially all, of the ATP therapy is delivered during charging of the high-voltage capacitors. Based on evaluation of the predetermined set of criteria, the system may switch to an additional ATP Before Capacitor Charging (ATP-BCC) mode, wherein substantially all of the ATP therapy is delivered prior to charging of the high-voltage capacitor. According to one aspect of the invention, the predetermined set of criteria is based, at least in part, on the effectiveness of previously-delivered ATP therapy.
摘要翻译：公开了一种用于响应于异常心律的检测而提供抗起搏起搏（ATP）治疗和高压休克疗法的系统和方法。该系统基于预定的一组标准来控制ATP治疗与高压电容器的充电之间的时间，以准备冲击输送。在一个实施例中，本发明的系统在ATP电容器充电（ATP-DCC）模式下工作，其中在高压电容器充电期间全部或基本上全部ATP治疗被递送。基于对预定标准集合的评估，系统可以切换到在电容器充电（ATP-BCC）模式之外的另外的ATP，其中在高压电容器充电之前基本上全部ATP治疗被递送。根据本发明的一个方面，预定的一组标准至少部分地基于先前传递的ATP治疗的有效性。

4. 发明授权

US5836975A Method and apparatus for diagnosis and treatment of arrhythmias 失效
公开(公告)号：US5836975A
公开(公告)日：1998-11-17
申请号：US816822
申请日：1997-06-05
申请人： Paul J. DeGroot
发明人： Paul J. DeGroot
IPC分类号： A61N1/05 , A61N1/362 , A61N1/372 , A61N1/39
CPC分类号： A61N1/3962 , A61N1/056 , A61N1/3622 , A61N1/37258 , A61N1/3925 , A61N1/3987
摘要： An implantable anti-arrhythmia device such as a defibrillator or anti-tachycardia pacemaker with an associated patient activator. In response to the patient activation signal, the implanted device notifies the activator whether an atrial rhythm requiring treatment is present and whether a therapy is available for delivery in response to the patient's request. After the patient is notified that a therapy is pending, the implanted device charges its output capacitors and thereafter determines whether opportunities for prompt synchronization are present with a desired frequency, over a preceding series of depolarizations. If both conditions are met, the likelihood that a defibrillation or cardioversion pulse can be delivered quickly following a patient initiated retrigger signal is high, and the device notifies the patient's activator that it will await receipt of a patient retrigger signal, as a prerequisite for a delivery of the cardioversion or defibrillation pulse. The patient retrigger signal may take the form of a second downlink from the activator to the implanted device, or may take the form of a defined patient action, detected by the implanted device. For example, the implanted device may be provided with an impedance sensor of the sort typically employed in rate responsive implantable pacemakers to measure respiration rate and minute volume. This sensor may be used to detect the action of the patient holding his or her breath, in preparation to receiving the shock. In this embodiment, the patient's own action of bracing to receive the shock may be used as the mechanism for triggering delivery of the shock. An alternative patient trigger might be accomplished by providing the implanted device with a piezoelectric crystal, located on an interior surface of the pacemaker housing, of the sort typically employed to sense physical activity in the rate responsive cardiac pacemakers. This sensor may be employed in the context of the present invention to detect the patient tapping on an implanted device, as a signal to trigger delivery of therapy.

5. 发明授权

US08374686B2 Continuous monitoring of risk burden for sudden cardiac death risk stratification 有权
标题翻译：持续监测心源性猝死危险分层的风险负担
公开(公告)号：US08374686B2
公开(公告)日：2013-02-12
申请号：US12793526
申请日：2010-06-03
申请人： Raja N. Ghanem , Paul J. DeGroot
发明人： Raja N. Ghanem , Paul J. DeGroot
IPC分类号： A61B5/04
CPC分类号： A61B5/0452 , A61B5/02405 , A61B5/7275 , G06F19/00
摘要： System and method for assessing a likelihood of a patient to experience a cardiac arrhythmia. A biological sensor is configured to sense biological parameters of the patient. A processor is coupled to the biological sensor and is configured to determine the likelihood of the patient experiencing a cardiac arrhythmia based, at least in part, on a combination of the biological parameters, the combination dynamically weighting each of the plurality of biological parameters based on another one of the plurality of biological parameters.
摘要翻译：用于评估患者经历心律失常的可能性的系统和方法。生物传感器被配置为感测患者的生物学参数。处理器耦合到生物传感器并且被配置为至少部分地基于生物参数的组合来确定患者经历心律失常的可能性，所述组合基于动态加权多个生物参数中的每一个，基于多个生物参数中的另一个。

6. 发明申请

US20120296388A1 PHRENIC NERVE STIMULATION DETECTION USING HEART SOUNDS 有权
标题翻译：使用心脏声波的神经根神经刺激检测
公开(公告)号：US20120296388A1
公开(公告)日：2012-11-22
申请号：US13474041
申请日：2012-05-17
申请人： Xusheng Zhang , Jeffrey M. Gillberg , Thomas J. Mullen , Paul J. DeGroot
发明人： Xusheng Zhang , Jeffrey M. Gillberg , Thomas J. Mullen , Paul J. DeGroot
IPC分类号： A61N1/37 , A61N1/365
CPC分类号： A61N1/3611 , A61B5/0031 , A61B5/0205 , A61B5/024 , A61B5/0826 , A61B5/4029 , A61B5/7217 , A61B7/005 , A61B7/006 , A61B7/04 , A61N1/36114 , A61N1/36135 , A61N1/36535 , A61N1/36578
摘要： A method and system of detecting phrenic nerve stimulation in a patient that includes detecting an activation event, obtaining a heart sound signal of a patient from an implanted heart sound sensor, determining that an electrical stimulation has been applied to the patient, in response to detecting the activation event, monitoring a portion of the heart sound signal, the portion defined by a predetermined window after the application of the electrical stimulation, and determining whether phrenic nerve stimulation occurred based on the portion of the heart sound signal.
摘要翻译：一种检测患者膈神经刺激的方法和系统，包括检测激活事件，响应于检测，从植入的心音传感器获得患者的心音信号，确定电刺激已经施加到患者激活事件，监测心音信号的一部分，在施加电刺激之后由预定窗口定义的部分，以及基于心音信号的部分来确定是否发生膈神经刺激。

7. 发明申请

US20120232605A1 USING FOCAL MYOCARDIAL STIMULATION TO DISTINGUISH SUPRAVENTRICULAR TACHYCARDIA FROM VENTRICULAR TACHYCARDIA 有权
标题翻译：使用焦虑性心肌梗塞对来自心脏TACHYCARDIA的非致病性TACHYCARDIA
公开(公告)号：US20120232605A1
公开(公告)日：2012-09-13
申请号：US13357646
申请日：2012-01-25
申请人： Yong-Fu Xiao , Jeffrey M. Gillberg , Paul J. DeGroot , Eduardo N. Warman , Scott J. Brabec , John L. Sommer , Jon F. Urban , Lepeng Zeng
发明人： Yong-Fu Xiao , Jeffrey M. Gillberg , Paul J. DeGroot , Eduardo N. Warman , Scott J. Brabec , John L. Sommer , Jon F. Urban , Lepeng Zeng
IPC分类号： A61N1/365
CPC分类号： A61N1/365 , A61N1/3622 , A61N1/36585
摘要： An apparatus and method to discriminate cardiac events by sensing atrial and ventricular depolarizations having associated refractory periods thereafter. A fast ventricular rate is detected in response to the sensed ventricular depolarizations. Responsive to detecting the fast ventricular rate, at least one stimulus pulse is delivered to atrial tissue within the associated refractory period of the ventricle but outside of an associated refractory period of the stimulated atrial tissue. A ventricular response to the atrial tissue stimulus pulse is determined, and the cardiac event is discriminated based on the ventricular response to the atrial tissue stimulus pulse.
摘要翻译：通过感应心房和心室去极化来区分心脏事件的装置和方法，其后具有相关联的不良期。响应于感测到的心室去极化，检测到快速心室率。响应于检测快速心室率，至少一个刺激脉冲被输送到心室的相关不应期内但在受刺激的心房组织的相关不应期内之外的心房组织。确定对心房组织刺激脉冲的心室反应，并且基于对心房组织刺激脉冲的心室响应来区分心脏事件。

8. 发明授权

US07010344B2 Method and apparatus for delaying a ventricular tachycardia therapy 有权
公开(公告)号：US07010344B2
公开(公告)日：2006-03-07
申请号：US10134352
申请日：2002-04-26
申请人： John E. Burnes , Paul J. DeGroot
发明人： John E. Burnes , Paul J. DeGroot
IPC分类号： A61N1/39
CPC分类号： A61N1/3621 , A61N1/3962
摘要： A device and method to detect slow ventricular tachycardia, deliver anti-tachycardia pacing therapies, and delay a scheduled shock therapy if the ventricular tachycardia is not terminated or accelerated. Preferably, a shock therapy is delayed after verifying hemodynamic stability based on a hemodynamic sensor. After a shock is delayed, the device operates in a high alert mode for redetecting an accelerated tachycardia. Anti-tachycardia pacing therapies are repeated during the shock delay. A number of conditions can trigger delivery of the delayed shock therapy including a specified period of elapsed time; determination that the patient is likely to be asleep; detection of myocardial ischemia; detection of compromised hemodynamics, or detection of a substantially prone position or sudden change in position. A delayed shock therapy may be triggered by the patient and repeated delivery of painful shock therapies in patients that are not seriously compromised by a recurring, slow ventricular tachycardia is avoided.

9. 发明授权

US06718204B2 Method and apparatus to control delivery of high-voltage and anti-tachy pacing therapy in an implantable medical device 有权
标题翻译：用于控制可植入医疗装置中的高电压和抗速度起搏治疗递送的方法和装置
公开(公告)号：US06718204B2
公开(公告)日：2004-04-06
申请号：US09918224
申请日：2001-07-30
申请人： Paul J. DeGroot , Kevin T. Ousdigian , Vasant Padmanabhan , Paul Krause , Vinod Sharma
发明人： Paul J. DeGroot , Kevin T. Ousdigian , Vasant Padmanabhan , Paul Krause , Vinod Sharma
IPC分类号： A61N108
CPC分类号： A61N1/3622 , A61N1/3688 , A61N1/3925 , A61N1/3956 , A61N1/3962 , A61N1/3987
摘要： A system and method for delivering both anti-tachy pacing (ATP) therapy and high-voltage shock therapy in response to detection of abnormal cardiac rhythms is disclosed. The system controls the time between delivering ATP therapy and the charging of high-voltage capacitors in preparation for shock delivery based on a predetermined set of criteria. In one embodiment, the inventive system operates in an ATP During Capacitor Charging (ATP-DCC) mode wherein all, or substantially all, of the ATP therapy is delivered during charging of the high-voltage capacitors. Based on evaluation of the predetermined set of criteria, the system may switch to an additional ATP Before Capacitor Charging (ATP-BCC) mode, wherein substantially all of the ATP therapy is delivered prior to charging of the high-voltage capacitor. According to one aspect of the invention, the predetermined set of criteria is based, at least in part, on the effectiveness of previously-delivered ATP therapy.
摘要翻译：公开了一种用于响应于异常心律的检测而提供抗起搏起搏（ATP）治疗和高压休克疗法的系统和方法。该系统基于预定的一组标准来控制ATP治疗与高压电容器的充电之间的时间，以准备冲击输送。在一个实施例中，本发明的系统在ATP电容器充电（ATP-DCC）模式下工作，其中在高压电容器充电期间全部或基本上全部ATP治疗被递送。基于对预定标准集合的评估，系统可以切换到在电容器充电（ATP-BCC）模式之外的另外的ATP，其中在高压电容器充电之前基本上全部ATP治疗被递送。根据本发明的一个方面，预定的一组标准至少部分地基于先前传递的ATP治疗的有效性。

10. 发明申请

US20130237872A1 HEART SOUND SENSING TO REDUCE INAPPROPRIATE TACHYARRHYTHMIA THERAPY 审中-公开
标题翻译：心脏感觉减少不明显的TACHYARRHYTHMIA治疗
公开(公告)号：US20130237872A1
公开(公告)日：2013-09-12
申请号：US13457959
申请日：2012-04-27
申请人： Xusheng Zhang , Teresa A. Whitman , Paul J. DeGroot , Mark L. Brown , Jeffrey M. Gillberg
发明人： Xusheng Zhang , Teresa A. Whitman , Paul J. DeGroot , Mark L. Brown , Jeffrey M. Gillberg
IPC分类号： A61N1/365 , A61B7/00 , A61B5/0402
CPC分类号： A61B5/7221 , A61B5/0456 , A61B5/046 , A61B5/0464 , A61B5/686 , A61B5/6869 , A61B5/7264 , A61B5/7285 , A61B7/00 , A61N1/3621 , A61N1/36514
摘要： Techniques for reducing inappropriate tachyarrhythmia therapy and associated medical device systems are described. In some examples a processor is enabled to receive a cardiac electrical signal representative of electrical activity of a heart of a patient and provide an indication of cardiac electrical signal reliability. A heart sound analyzing module is enabled to receive the indication of cardiac electrical signal reliability and a heart sound signal representing sounds generated by the heart of the patient and generated by a heart sound sensor. The heart sound analyzing module selectively determines an ensemble averaged heart sound signal or detects a plurality of heart sounds from the heart sound signal in response to the indication of cardiac electrical signal reliability.
摘要翻译：描述了用于减少不适当的快速性心律失常治疗和相关的医疗装置系统的技术。在一些示例中，处理器能够接收表示患者心脏的电活动的心脏电信号，并提供心脏电信号可靠性的指示。心音分析模块能够接收心电信号可靠性的指示，以及表示由心脏声音传感器产生的由患者的心脏产生的声音的心音信号。心脏声音分析模块响应于心脏电信号可靠性的指示，选择性地确定整体平均心音信号或从心音信号检测多个心音。

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