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1. 发明申请

US20160361026A1 METHOD AND APPARATUS FOR MONITORING TISUE FLUID CONTENT FOR USE IN AN IMPLANTABLE CARDIAC DEVICE 审中-公开
标题翻译：用于监测组织流体含量的方法和装置，用于可植入的心脏装置
公开(公告)号：US20160361026A1
公开(公告)日：2016-12-15
申请号：US13391376
申请日：2011-03-29
申请人： Shantanu Sarkar , Douglas A. Hettrick , Amul Y. Desai , Randolph M. Biallas , Holly S. Vitense , Jodi L. Redemske
发明人： Shantanu Sarkar , Douglas A. Hettrick , Amul Y. Desai , Randolph M. Biallas , Holly S. Vitense , Jodi L. Redemske
IPC分类号： A61B5/00 , A61B5/0245 , G06F19/00 , A61N1/365 , A61N1/362 , A61B5/024 , A61B5/053
CPC分类号： A61N1/36585 , A61B5/02405 , A61B5/0245 , A61B5/0452 , A61B5/0537 , A61B5/0538 , A61B5/4848 , A61B5/686 , A61B5/7264 , A61B5/7275 , A61B5/742 , A61M5/14276 , A61M5/1723 , A61M2230/30 , A61M2230/65 , A61N1/3627 , A61N1/3629 , A61N1/36521 , A61N1/36564 , A61N1/36592 , A61N1/3956 , G16H50/20 , G16H50/30
摘要： Techniques for using multiple physiological parameters to provide an early warning for worsening heart failure are described. A system is provided that monitors a multiple diagnostic parameters indicative of worsening heart failure. The parameters preferably include are least one parameter acquired from an implanted device, such as intrathoracic impedance. The system device derives an index of the likelihood of worsening heart failure based upon the parameters using a Bayesian approach and displays the resultant index for review by a physician.
摘要翻译：描述了使用多种生理参数为恶化心力衰竭提供早期预警的技术。提供了一种系统，其监测指示恶化的心力衰竭的多个诊断参数。参数优选地包括从植入装置获取的至少一个参数，例如胸内阻抗。系统装置根据使用贝叶斯方法的参数得出心力衰竭恶化的可能性的指标，并显示由医生审查的结果索引。

2. 发明申请

US20120253207A1 HEART FAILURE MONITORING 审中-公开
标题翻译：心力衰竭监测
公开(公告)号：US20120253207A1
公开(公告)日：2012-10-04
申请号：US13436408
申请日：2012-03-30
申请人： Shantanu Sarkar , Jodi L. Redemske , Eduardo N. Warman , Douglas A. Hettrick , Kevin T. Ousdigian
发明人： Shantanu Sarkar , Jodi L. Redemske , Eduardo N. Warman , Douglas A. Hettrick , Kevin T. Ousdigian
IPC分类号： A61B5/0205
CPC分类号： A61B5/0006 , A61B5/0004 , A61B5/7275 , G06F19/3418 , G16H40/40 , G16H50/30
摘要： Techniques for transmitting diagnostic information stored in an implantable medical device (IMD) based on patient hospitalization are described. For example, the IMD may transmit higher resolution diagnostic information to a clinician and/or an external device during a hospitalization period to aid the clinician in evaluating heart failure treatment and when discharge is proper. This higher resolution diagnostic information may include one or more patient metrics automatically generated and transmitted by the IMD at least once every two hours. During a post-hospitalization period, the IMD may transmit lower resolution diagnostic information to a clinician that indicates a risk level of re-hospitalization. The lower resolution diagnostic information may include the risk level and/or patient metrics once a day, for example. In this manner, the IMD transmitted diagnostic information may be tailored to the specific heart failure monitoring needed by the patient.
摘要翻译：描述了基于患者住院时间传送存储在可植入医疗装置（IMD）中的诊断信息的技术。例如，IMD可以在住院期间向临床医师和/或外部设备传送更高分辨率的诊断信息，以帮助临床医师评价心力衰竭治疗以及放电是否合适。该更高分辨率的诊断信息可以包括由IMD自动生成和发送的至少每两小时一次的一个或多个患者度量。在住院后期间，IMD可以向临床医生传递较低分辨率的诊断信息，指示重新住院的风险水平。例如，较低分辨率诊断信息可以包括一天一次的风险水平和/或患者度量。以这种方式，IMD传输的诊断信息可以针对患者所需的特定心力衰竭监测。

3. 发明申请

US20120303085A1 METHODS AND APAPRATUS FOR MANUALLY SUSPENDING INTRATHORACIC IMPEDANCE FLUID STATUS MEASUREMENTS 审中-公开
标题翻译：用于手动停止静脉内阻滞流体状态测量的方法和APAPRATUS
公开(公告)号：US20120303085A1
公开(公告)日：2012-11-29
申请号：US13570858
申请日：2012-08-09
申请人： Holly S. Vitense , Li Wang , Denise Dirnberger , Melissa M. Rhodes , Douglas A. Hettrick , Shantanu Sarkar
发明人： Holly S. Vitense , Li Wang , Denise Dirnberger , Melissa M. Rhodes , Douglas A. Hettrick , Shantanu Sarkar
IPC分类号： A61N1/365
CPC分类号： A61N1/37258 , A61B5/0031 , A61B5/0215 , A61B5/053 , A61N1/37247 , G16H40/63
摘要： The capability to suspend a patient alert relating to a monitored physiologic parameters addresses a need to selectively shut off a patient-alert signal or signals during the time a patient is being treated for an excursion in the parameter. Of course, in general a signal call attention to a patient's a potentially deleterious status or condition for which they should seek medical attention. Once a chronically-implanted monitoring device has detected or provided information about the parameter relative to a desired value, trend, or range and a clinician has been notified and intervened the alert signal is temporarily disabled for a predetermined period. That is, once the notification occurs and alert has served its purpose, the alert mechanism is selectively deactivated while the patient ostensibly begins to gradually correct the monitored physiologic parameter under a caregiver's direction and control. After which time, the alert will reactivate.
摘要翻译：暂停与所监测的生理参数相关的患者警报的能力解决了在患者被治疗参数期间偏移的时间期间选择性地切断病人警报信号或信号的需要。当然，一般来说，一个信号会引起对患者的一个潜在的有害的状态或状况的关注，他们应该寻求医疗护理。一旦长期植入的监测装置已经相对于期望值，趋势或范围已经检测或提供了关于参数的信息，并且已通知临床医生并且中介了警报信号暂时禁用预定时间段。也就是说，一旦通知发生并且警报已经达到其目的，则警告机制被选择性地去激活，同时患者表面上开始逐渐校正受照顾者的方向和控制下的监测的生理参数。之后，警报将重新启动。

4. 发明授权

US10542887B2 Heart failure monitoring 有权
公开(公告)号：US10542887B2
公开(公告)日：2020-01-28
申请号：US13436408
申请日：2012-03-30
申请人： Shantanu Sarkar , Jodi L. Redemske , Eduardo N. Warman , Douglas A. Hettrick , Kevin T. Ousdigian
发明人： Shantanu Sarkar , Jodi L. Redemske , Eduardo N. Warman , Douglas A. Hettrick , Kevin T. Ousdigian
IPC分类号： A61B5/02 , A61B5/00
摘要： Techniques for transmitting diagnostic information stored in an implantable medical device (IMD) based on patient hospitalization are described. For example, the IMD may transmit higher resolution diagnostic information to a clinician and/or an external device during a hospitalization period to aid the clinician in evaluating heart failure treatment and when discharge is proper. This higher resolution diagnostic information may include one or more patient metrics automatically generated and transmitted by the IMD at least once every two hours. During a post-hospitalization period, the IMD may transmit lower resolution diagnostic information to a clinician that indicates a risk level of re-hospitalization. The lower resolution diagnostic information may include the risk level and/or patient metrics once a day, for example. In this manner, the IMD transmitted diagnostic information may be tailored to the specific heart failure monitoring needed by the patient.

5. 发明申请

US20080103530A1 Methods and Apparatus for Manually Suspending Intrathoracic Impedance Fluid Status Measurements 有权
标题翻译：手动悬挂胸膜内阻抗液体状态测量的方法和装置
公开(公告)号：US20080103530A1
公开(公告)日：2008-05-01
申请号：US11554825
申请日：2006-10-31
申请人： Holly S. Vitense , Li Wang , Denise Dirnberger , Melissa M. Rhodes , Douglas A. Hettrick , Shantanu Sarkar
发明人： Holly S. Vitense , Li Wang , Denise Dirnberger , Melissa M. Rhodes , Douglas A. Hettrick , Shantanu Sarkar
IPC分类号： A61N1/00
CPC分类号： A61N1/37258 , A61B5/0031 , A61B5/0215 , A61B5/053 , A61N1/37247 , G16H40/63
摘要： The capability to suspend a patient alert relating to a monitored physiologic parameters addresses a need to selectively shut off a patient-alert signal or signals during the time a patient is being treated for an excursion in the parameter. Of course, in general a signal call attention to a patient's a potentially deleterious status or condition for which they should seek medical attention. Once a chronically-implanted monitoring device has detected or provided information about the parameter relative to a desired value, trend, or range and a clinician has been notified and intervened the alert signal is temporarily disabled for a predetermined period. That is, once the notification occurs and alert has served its purpose, the alert mechanism is selectively deactivated while the patient ostensibly begins to gradually correct the monitored physiologic parameter under a caregiver's direction and control. After which time, the alert will reactivate.
摘要翻译：暂停与所监测的生理参数相关的患者警报的能力解决了在患者被治疗参数期间偏移的时间期间选择性地切断病人警报信号或信号的需要。当然，一般来说，一个信号会引起对患者的一个潜在的有害的状态或状况的关注，他们应该寻求医疗护理。一旦长期植入的监测装置已经相对于期望值，趋势或范围已经检测或提供了关于参数的信息，并且已通知临床医生并且中介了警报信号暂时禁用预定时间段。也就是说，一旦通知发生并且警报已经达到其目的，则警告机制被选择性地去激活，同时患者表面上开始逐渐校正受照顾者的方向和控制下的监测的生理参数。之后，警报将重新启动。

6. 发明授权

US08948868B2 Methods and apparatus for manually suspending intrathoracic impedance fluid status measurements 有权
标题翻译：手动暂停胸腔内阻抗流体状态测量的方法和装置
公开(公告)号：US08948868B2
公开(公告)日：2015-02-03
申请号：US11554825
申请日：2006-10-31
申请人： Holly S. Vitense , Li Wang , Denise Dirnberger , Melissa M. Rhodes , Douglas A. Hettrick , Shantanu Sarkar
发明人： Holly S. Vitense , Li Wang , Denise Dirnberger , Melissa M. Rhodes , Douglas A. Hettrick , Shantanu Sarkar
IPC分类号： A61N1/00 , A61N1/372 , A61B5/00 , A61B5/0215 , A61B5/053
CPC分类号： A61N1/37258 , A61B5/0031 , A61B5/0215 , A61B5/053 , A61N1/37247 , G16H40/63
摘要： The capability to suspend a patient alert relating to a monitored physiologic parameters addresses a need to selectively shut off a patient-alert signal or signals during the time a patient is being treated for an excursion in the parameter. Of course, in general a signal call attention to a patient's a potentially deleterious status or condition for which they should seek medical attention. Once a chronically-implanted monitoring device has detected or provided information about the parameter relative to a desired value, trend, or range and a clinician has been notified and intervened the alert signal is temporarily disabled for a predetermined period. That is, once the notification occurs and alert has served its purpose, the alert mechanism is selectively deactivated while the patient ostensibly begins to gradually correct the monitored physiologic parameter under a caregiver's direction and control. After which time, the alert will reactivate.
摘要翻译：暂停与所监测的生理参数相关的患者警报的能力解决了在患者被治疗参数期间偏移的时间期间选择性地切断病人警报信号或信号的需要。当然，一般来说，一个信号会引起对患者的一个潜在的有害的状态或状况的关注，他们应该寻求医疗护理。一旦长期植入的监测装置已经相对于期望值，趋势或范围已经检测或提供了关于参数的信息，并且已通知临床医生并且中介了警报信号暂时禁用预定时间段。也就是说，一旦通知发生并且警报已经达到其目的，则警告机制被选择性地去激活，同时患者表面上开始逐渐校正受照顾者的方向和控制下的监测的生理参数。之后，警报将重新启动。

7. 发明申请

US20120109245A1 CARDIAC THERAPY BASED UPON IMPEDANCE SIGNALS 有权
标题翻译：基于阻抗信号的心脏病治疗
公开(公告)号：US20120109245A1
公开(公告)日：2012-05-03
申请号：US12916012
申请日：2010-10-29
申请人： Douglas A. Hettrick , Todd M. Zielinski , Eduardo Warman , Shantanu Sarkar
发明人： Douglas A. Hettrick , Todd M. Zielinski , Eduardo Warman , Shantanu Sarkar
IPC分类号： A61N1/365
CPC分类号： A61N1/36521 , A61B5/0452 , A61B5/0535 , A61B5/7239 , A61N1/3627 , A61N1/3682 , A61N1/3684 , A61N1/3987
摘要： Methods and/or devices are disclosed herein for monitoring cardiac impedance signal and delivering therapy to a patient's heart based upon the monitored cardiac impedance.
摘要翻译：本文公开了用于监测心脏阻抗信号并基于所监测的心脏阻抗将治疗递送到患者心脏的方法和/或装置。

8. 发明授权

US08435186B2 Quantifying autonomic tone with thoracic impedance 有权
标题翻译：量化自主神经与胸阻抗
公开(公告)号：US08435186B2
公开(公告)日：2013-05-07
申请号：US12696753
申请日：2010-01-29
申请人： Douglas A. Hettrick , Donald J. Hefner , Shantanu Sarkar , Todd M. Zielinski
发明人： Douglas A. Hettrick , Donald J. Hefner , Shantanu Sarkar , Todd M. Zielinski
IPC分类号： A61B5/00
CPC分类号： A61N1/36521 , A61B5/0031 , A61B5/0215 , A61B5/02405 , A61B5/053 , A61B5/08 , A61B5/11 , A61B5/1116 , A61B5/4035 , A61N1/36535 , A61N1/37247 , A61N1/37258
摘要： The disclosure describes techniques for quantifying the autonomic nervous system (ANS) health of a patient with thoracic impedance measurements. Thoracic impedance may be measured utilizing cardiac electrodes and an implantable medical device housing or other electrodes located on or within the patient. Since greater variability in thoracic impedance may indicate better health of the ANS, monitoring impedance changes in a patient may be used to quantify autonomic tone of the ANS, and ultimately, overall patient health. In some examples, thoracic impedance may be measured in response to a change in patient posture for acute monitoring or at predetermined times over several days, weeks, or months for more chronic monitoring of the patient. An implantable medical device may independently analyze the impedance measurements and transmit an alert to the patient or clinician when impedance changes indicate a change in patient health.
摘要翻译：本公开描述了用于量化具有胸部阻抗测量的患者的自主神经系统（ANS）健康的技术。可以使用心电极和位于患者内部或内部的可植入医疗装置外壳或其它电极来测量胸腔阻抗。由于胸部阻抗变化较大可能表明ANS的健康状况良好，所以监测患者的阻抗变化可用于量化ANS的自主音调，并最终对整体患者的健康状况进行量化。在一些示例中，可以响应于用于急性监测的患者姿势的变化或在几天，几周或几个月的预定时间来测量胸部阻抗以进行更长期的患者监测。当阻抗变化表示患者健康状况发生变化时，植入式医疗设备可以独立地分析阻抗测量结果并向患者或临床医生发送警报。

9. 发明申请

US20100113962A1 SYSTEM AND METHOD TO LOCALIZE CHANGES IN INTRATHORACIC FLUID CONTENT USING MEASURED IMPEDANCE IN AN IMPLANTABLE DEVICE 有权
标题翻译：使用可植入装置中的测量阻抗来定位变化的流体内容物的系统和方法
公开(公告)号：US20100113962A1
公开(公告)日：2010-05-06
申请号：US12261131
申请日：2008-10-30
申请人： Douglas A. Hettrick , Shantanu Sarkar , Todd M. Zielinksi , Kevin P. Knox
发明人： Douglas A. Hettrick , Shantanu Sarkar , Todd M. Zielinksi , Kevin P. Knox
IPC分类号： A61B5/053
CPC分类号： A61B5/0536 , A61B5/0537 , A61B5/0538 , A61B5/4878
摘要： An implantable medical device and associated methods monitor thoracic fluid status and discriminate thoracic fluid conditions. Intrathoracic impedance is measured along multiple intrathoracic measurement vectors using implanted electrodes. A map of thoracic conductivity is computed using the measured intrathoracic impedances. A thoracic fluid condition is detected in response to the computed map.
摘要翻译：可植入医疗器械和相关方法监测胸腔液状态并辨别胸腔液体状况。使用植入电极沿多个胸腔内测量载体测量胸内阻抗。使用测量的胸腔内阻抗计算胸导电图。根据计算的图检测胸部液体状况。

10. 发明申请

US20100030087A1 ESTIMATING CARDIOVASCULAR PRESSURE AND VOLUME USING IMPEDANCE MEASUREMENTS 有权
标题翻译：使用阻力测量估算心血管压力和体积
公开(公告)号：US20100030087A1
公开(公告)日：2010-02-04
申请号：US12263065
申请日：2008-10-31
申请人： Douglas A. Hettrick , Yong K. Cho , Mattias Rouw , Shantanu Sarkar , Todd M. Zielinski
发明人： Douglas A. Hettrick , Yong K. Cho , Mattias Rouw , Shantanu Sarkar , Todd M. Zielinski
IPC分类号： A61B5/0215 , A61B5/053
CPC分类号： A61N1/36521 , A61B5/021 , A61B5/0215 , A61B5/02158 , A61B5/053 , A61B5/0535 , A61B5/0538 , A61B5/7239 , A61N1/36564
摘要： Techniques for estimating a cardiac chamber or vascular pressure based upon impedance are described. A device or system may measure an impedance between at least two electrodes implanted within or proximate to a cardiovascular system. The device or system may estimate a pressure of an element of the cardiovascular system based on a relationship between impedance and volume of the element, and based on a empirical relationship between the volume and the pressure. The device or system may also estimate the dimension of the element based on the impedance-volume relationship, or other characteristics based on the impedance. Because the impedance measurements may be obtained, in some examples, by using electrodes and leads implanted within the cardiovascular system and coupled to an implantable medical device, a practical estimation of a cardiovascular pressure can be obtained on a chronic basis without requiring the use other invasive sensors, such as micronanometer transducers.
摘要翻译：描述了基于阻抗估计心室或血管压力的技术。装置或系统可以测量植入在心血管系统内或其附近的至少两个电极之间的阻抗。装置或系统可以基于元件的阻抗和体积之间的关系，并且基于体积和压力之间的经验关系来估计心血管系统的元件的压力。装置或系统还可以基于阻抗 - 体积关系或基于阻抗的其它特性来估计元件的尺寸。由于可以获得阻抗测量值，在一些示例中，通过使用植入心血管系统内并连接到可植入医疗装置的电极和引线，可以长期获得心血管压力的实际估计，而不需要使用其它侵入性传感器，如微量计传感器。

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