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1. 发明授权

US07371220B1 System and method for real-time apnea/hypopnea detection using an implantable medical system 有权
标题翻译：使用植入式医疗系统实时呼吸暂停/呼吸不足检测的系统和方法
公开(公告)号：US07371220B1
公开(公告)日：2008-05-13
申请号：US10883857
申请日：2004-06-30
申请人： Steve Koh , Euljoon Park , Michael Benser
发明人： Steve Koh , Euljoon Park , Michael Benser
IPC分类号： A61B5/08
CPC分类号： A61B5/0809 , A61B5/4519 , A61B5/4818 , A61B5/7239
摘要： Techniques are provided for detecting the onset of an episode of apnea/hypopnea substantially in real-time. A moving threshold is generated based on recent respiration cycles and differences are accumulated between amplitudes of new respiration cycles and the moving threshold. Apnea/hypopnea is then detected based upon a comparison of the accumulated differences against a fixed threshold. The technique exploits the fact that many episodes of hypopnea begin with a sharp drop in respiration and many episodes of apnea are preceded by a sharp drop in respiration. By accumulating differences between new respiration amplitudes and a short term moving average, any sharp drop in respiration is thereby promptly detected. In many cases, by the time the amplitudes of individual respiration cycles drop to levels directly indicative of apnea/hypopnea, the episode of apnea/hypopnea will have already been detected based upon the sudden sharp drop in respiration amplitude and therapy will have already been initiated.
摘要翻译：提供了用于基本上实时检测呼吸暂停/呼吸不足发作的技术。基于最近的呼吸循环产生移动阈值，并且在新呼吸循环的振幅和移动阈值之间累积差异。然后基于累积差异与固定阈值的比较来检测呼吸暂停/呼吸不足。该技术利用了许多次呼吸不畅的情况，呼吸急剧下降，许多呼吸暂停发作前呼吸急剧下降。通过累积新的呼吸振幅和短期移动平均值之间的差异，因此迅速检测到呼吸中的任何急剧下降。在许多情况下，当个别呼吸周期的振幅下降到直接指示呼吸暂停/呼吸不全的水平时，呼吸暂停/呼吸不足的发作将基于呼吸振幅的突然急剧下降而被检测到，并且已经开始治疗。

2. 发明申请

US20060058852A1 Multi-variable feedback control of stimulation for inspiratory facilitation 审中-公开
标题翻译：吸气辅助刺激的多变量反馈控制
公开(公告)号：US20060058852A1
公开(公告)日：2006-03-16
申请号：US10938114
申请日：2004-09-10
申请人： Steve Koh , Michael Benser
发明人： Steve Koh , Michael Benser
IPC分类号： A61N1/08
CPC分类号： A61N1/3601
摘要： An exemplary method includes delivering stimulation according to one or more stimulation parameters to cause contraction of the diaphragm, monitoring chest activity related to respiration and, in response to the monitoring, adjusting one or more of the one or more stimulation parameters during contraction of the diaphragm and continuing the delivering. Various other exemplary methods, devices, systems, etc., are also disclosed.
摘要翻译：示例性方法包括根据一个或多个刺激参数递送刺激以引起隔膜的收缩，监测与呼吸相关的胸部活动，并且响应于该监测，在隔膜收缩期间调整一个或多个刺激参数中的一个或多个并继续交付。还公开了各种其它示例性方法，装置，系统等。

3. 发明申请

US20070156199A1 MULTI-VARIABLE FEEDBACK CONTROL OF STIMULATION FOR INSPIRATORY FACILITATION 失效
标题翻译：多变量反馈控制刺激感染器具
公开(公告)号：US20070156199A1
公开(公告)日：2007-07-05
申请号：US11624106
申请日：2007-01-17
申请人： Steve Koh , Michael Benser
发明人： Steve Koh , Michael Benser
IPC分类号： A61N1/36
CPC分类号： A61N1/3601
摘要： An exemplary method includes delivering stimulation according to one or more stimulation parameters to cause contraction of the diaphragm, monitoring chest activity related to respiration and, in response to the monitoring, adjusting one or more of the one or more stimulation parameters during contraction of the diaphragm and continuing the delivering. Various other exemplary methods, devices, systems, etc., are also disclosed.
摘要翻译：示例性方法包括根据一个或多个刺激参数递送刺激以引起隔膜的收缩，监测与呼吸相关的胸部活动，并且响应于该监测，在隔膜收缩期间调整一个或多个刺激参数中的一个或多个并继续交付。还公开了各种其它示例性方法，装置，系统等。

4. 发明授权

US08478388B2 Cardiac coordinate system for motion analysis 有权
标题翻译：用于运动分析的心脏坐标系
公开(公告)号：US08478388B2
公开(公告)日：2013-07-02
申请号：US12755359
申请日：2010-04-06
申请人： Thao Thu Nguyen , Kjell Norén , Allen Keel , Kyungmoo Ryu , Stuart Rosenberg , Wenbo Hou , Steve Koh , Michael Yang
发明人： Thao Thu Nguyen , Kjell Norén , Allen Keel , Kyungmoo Ryu , Stuart Rosenberg , Wenbo Hou , Steve Koh , Michael Yang
IPC分类号： A61N1/00 , A61B5/04
CPC分类号： A61B5/042 , A61B5/7203 , A61N1/3627 , A61N1/36521 , A61N1/36535 , A61N1/36542 , A61N1/36578 , A61N1/3684 , A61N1/37258 , A61N1/37264
摘要： An exemplary method includes accessing cardiac information acquired via a catheter located at various positions in a venous network of a heart of a patient wherein the cardiac information comprises position information with respect to time for one or more electrodes of the catheter; performing a principal component analysis on at least some of the position information; and selecting at least one component of the principal component analysis to represent an axis of a cardiac coordinate system. Various other methods, devices, systems, etc., are also disclosed.
摘要翻译：示例性方法包括访问经由位于患者心脏的静脉网络中的各个位置的导管获取的心脏信息，其中所述心脏信息包括相对于导管的一个或多个电极的时间的位置信息; 对至少一些所述位置信息进行主成分分析; 以及选择所述主成分分析的至少一个分量来表示心脏坐标系的轴。还公开了各种其它方法，装置，系统等。

5. 发明申请

US20130035736A1 SYSTEMS AND METHODS FOR CONTROLLING PAIRED PACING BASED ON PATIENT ACTIVITY FOR USE WITH AN IMPLANTABLE MEDICAL DEVICE 审中-公开
标题翻译：基于患者活动控制成对的PAC的系统和方法与可植入的医疗设备一起使用
公开(公告)号：US20130035736A1
公开(公告)日：2013-02-07
申请号：US13196763
申请日：2011-08-02
申请人： Steve Koh
发明人： Steve Koh
IPC分类号： A61N1/368
CPC分类号： A61N1/3627 , A61N1/3624 , A61N1/36571 , A61N1/3962
摘要： Techniques are provided for use with implantable medical devices equipped to deliver paired postextrasystolic potentiation (PESP) pacing to control the paired pacing rate based on changes in patient activity. In one example, the current activity level of the patient is detected during paired pacing using an accelerometer. The cardiac output level needed to maintain the current activity level of the patient is determined with reference to pre-stored lookup tables relating activity levels with corresponding minimum necessary cardiac output levels for the particular patient. The minimum paired pacing rate sufficient to achieve the cardiac output level is then determined based, e.g., on stroke volume derived from cardiogenic impedance signals. Paired pacing is then delivered at the minimum paired pacing rate sufficient to achieve the needed cardiac output, thereby assuring that the paired pacing rate is sufficient to meet the current physiological demands of the patient without consuming too much oxygen.
摘要翻译：提供技术用于与植入式医疗装置配合以递送成对的后收缩期增强（PESP）起搏以基于患者活动的变化来控制配对的起搏速率。在一个示例中，使用加速度计在配对起搏期间检测患者的当前活动水平。参考预先存储的查找表来确定维持患者的当前活动水平所需的心输出量水平，其将活动水平与特定患者的相应的最小必要心输出量水平相关联。然后基于例如来自心源阻抗信号的搏动体积确定足以实现心输出量的最小配对起搏速率。然后以足以实现所需心输出量的最小配对起搏速率递送配对起搏，从而确保配对的起搏速率足以满足患者的当前生理需求而不消耗太多的氧气。

6. 发明申请

US20120330371A1 SYSTEM AND METHOD FOR MONITORING DIASTOLIC FUNCTION USING AN IMPLANTABLE MEDICAL DEVICE 有权
标题翻译：使用可植入医疗装置监测脱脂功能的系统和方法
公开(公告)号：US20120330371A1
公开(公告)日：2012-12-27
申请号：US13601569
申请日：2012-08-31
申请人： Allen Keel , Steve Koh , Taraneh Ghaffari Farazi
发明人： Allen Keel , Steve Koh , Taraneh Ghaffari Farazi
IPC分类号： A61N1/365
CPC分类号： A61N1/3702 , A61N1/3627 , A61N1/36507 , A61N1/368 , A61N1/3712
摘要： Diastolic function is monitored within a patient using a pacemaker or other implantable medical device. In one example, the implantable device uses morphological parameters derived from the T-wave evoked response waveform as proxies for ventricular relaxation rate and ventricular compliance. In particular, the magnitude of the peak of the T-wave evoked response is employed as a proxy for ventricular compliance. The maximum slew rate of the T-wave evoked response following its peak is employed as a proxy for ventricular relaxation. A metric is derived from these proxy values to represent diastolic function. The metric is tracked over time to evaluate changes in diastolic function. In other examples, specific values for ventricular compliance and ventricular relaxation are derived for the patient based on the T-wave evoked response parameters.
摘要翻译：使用起搏器或其他可植入医疗器械在患者体内监测舒张功能。在一个示例中，可植入装置使用从T波诱发反应波形导出的形态参数作为心室松弛率和心室顺应性的代理。特别地，T波诱发反应的峰值的大小被用作心室顺应性的代表。其峰值后的T波诱发反应的最大压摆率被用作心室松弛的代用品。来自这些代理值的度量来表示舒张功能。随着时间的推移跟踪度量以评估舒张功能的变化。在其他实例中，基于T波诱发反应参数为患者导出心室顺应性和心室松弛的具体值。

7. 发明授权

US08032212B2 System and method for monitoring thoracic fluid levels based on impedance using an implantable medical device 失效
标题翻译：使用可植入医疗装置基于阻抗监测胸水液位的系统和方法
公开(公告)号：US08032212B2
公开(公告)日：2011-10-04
申请号：US12210848
申请日：2008-09-15
申请人： Gene A. Bornzin , Steve Koh , Euljoon Park
发明人： Gene A. Bornzin , Steve Koh , Euljoon Park
IPC分类号： A61B5/02 , A61B5/08 , A61B5/05 , A61N1/00
CPC分类号： A61N1/36521 , A61B5/0537 , A61B5/4869
摘要： Techniques are provided for monitoring thoracic fluid levels based on thoracic impedance (ZT) and cardiogenic impedance (ZC). In one example, the implantable device tracks the maximum time rate of change in cardiogenic impedance (i.e. max(dZC/dt)) to detect trends toward hypervolemic or hypovolemic states within the patient based on changes in heart contractility. The detection of these trends in combination with trends in thoracic impedance allows for a determination of whether the thoracic cavity of the patient is generally “too wet” or “too dry,” and thus allows for the titration of diuretics to avoid such extremes. In particular, a decrease in thoracic impedance (ZT) in combination with a decrease in max (dZC/dt) is indicative of the thorax being “too wet” (i.e. a fluid overload). Conversely, an increase in thoracic impedance (ZT) in combination with a decrease in max (dZC/dt) is indicative of the thorax being “too dry” (i.e. a fluid underload).
摘要翻译：提供了基于胸部阻抗（ZT）和心源阻抗（ZC）监测胸水水平的技术。在一个示例中，可植入装置跟踪心源性阻抗的最大时间变化率（即max（dZC / dt）），以基于心脏收缩力的变化来检测患者内的高血容量或低血容量状态的趋势。这些趋势的检测结合胸部阻抗趋势可以确定患者的胸腔通常是否“太湿”或“太干”，从而允许滴定利尿剂以避免这种极端。特别地，胸部阻抗（ZT）的降低与最大值（dZC / dt）的降低相结合表明胸部“太湿”（即流体过载）。相反，胸部阻抗（ZT）的增加与最大（dZC / dt）的降低相结合，表明胸部“太干”（即，流体欠载）。

8. 发明申请

US20110230771A1 HEART FAILURE STATUS MONITORING 审中-公开
标题翻译：心脏故障状态监测
公开(公告)号：US20110230771A1
公开(公告)日：2011-09-22
申请号：US12728064
申请日：2010-03-19
申请人： Steve Koh , Euljoon Park
发明人： Steve Koh , Euljoon Park
IPC分类号： A61B5/02 , A61B5/01
CPC分类号： A61B5/01 , A61B5/0215 , A61B5/1118 , A61B5/4806 , A61B5/6869 , A61N1/3937 , A61N1/3956
摘要： Left atrial pressure and temperature of a patient are monitored to identify a normal wake state, a normal sleep state, and any deviation from those normal states (e.g., an alarm state). In the event an alarm state is identified, a determination is made as to whether to generate an indication of heart failure exacerbation based on a heart failure score. In addition, congestion and perfusion in a patient may be monitored over time to provide a two-dimensional indication of a trend relating to the heart failure status of the patient.
摘要翻译：监测患者的左心房压力和温度以识别正常的唤醒状态，正常睡眠状态以及与那些正常状态（例如，报警状态）的任何偏差。在识别到报警状态的情况下，确定是否基于心力衰竭得分产生心力衰竭恶化的指示。此外，可以随时间监测患者的充血和灌注以提供与患者的心力衰竭状态相关的趋势的二维指示。

9. 发明申请

US20110213260A1 CRT LEAD PLACEMENT BASED ON OPTIMAL BRANCH SELECTION AND OPTIMAL SITE SELECTION 审中-公开
标题翻译：基于最佳分支选择和最佳选址的CRT铅排
公开(公告)号：US20110213260A1
公开(公告)日：2011-09-01
申请号：US12713417
申请日：2010-02-26
申请人： Allen Keel , Kyungmoo Ryu , Stuart Rosenberg , Wenbo Hou , Thao Thu Nguyen , Steve Koh , Kjell Norén , Michael Yang
发明人： Allen Keel , Kyungmoo Ryu , Stuart Rosenberg , Wenbo Hou , Thao Thu Nguyen , Steve Koh , Kjell Norén , Michael Yang
IPC分类号： A61B5/0402
CPC分类号： A61B5/04085 , A61B5/686 , A61B5/6869 , A61B5/7271 , A61N1/3627 , A61N1/3702
摘要： An exemplary method includes accessing cardiac information acquired via a catheter located at various positions in a coronary sinus of a patient where the cardiac information includes electrical information and mechanical information; calculating scores based on the cardiac information where each of the scores corresponds to the coronary sinus or a tributary of the coronary sinus; and based on the scores, selecting a tributary of the coronary sinus as an optimal candidate for placement of a left ventricular lead. Accordingly, the selected tributary may be relied on during an implant procedure for the left ventricular lead. Various other methods, devices, systems, etc., are also disclosed.
摘要翻译：一种示例性方法包括访问位于患者冠状窦内的各种位置处的导管获得的心脏信息，其中心脏信息包括电信息和机械信息; 基于心脏信息计算得分，其中每个评分对应于冠状窦或冠状窦的支流; 并且基于分数，选择冠状窦的支流作为放置左心室铅的最佳候选者。因此，在用于左心室引线的植入过程期间可以依赖所选择的支流。还公开了各种其它方法，装置，系统等。

10. 发明申请

US20110054559A1 PACING, SENSING AND OTHER PARAMETER MAPS BASED ON LOCALIZATION SYSTEM DATA 有权
标题翻译：基于本地化系统数据的PACING，感觉和其他参数
公开(公告)号：US20110054559A1
公开(公告)日：2011-03-03
申请号：US12553413
申请日：2009-09-03
申请人： Stuart Rosenberg , Kyungmoo Ryu , Allen Keel , Wenbo Hou , Thao Thu Nguyen , Steve Koh , Kjell Noren , Michael Yang
发明人： Stuart Rosenberg , Kyungmoo Ryu , Allen Keel , Wenbo Hou , Thao Thu Nguyen , Steve Koh , Kjell Noren , Michael Yang
IPC分类号： A61N1/08 , A61N1/362
CPC分类号： A61N1/3627 , A61N1/36521 , A61N1/36585 , A61N1/368 , A61N1/3684
摘要： An exemplary method generates a map of a pacing parameter, a sensing parameter or one or more other parameters based in part on location information acquired using a localization system configured to locate electrodes in vivo (i.e., within a patient's body). Various examples map capture thresholds, qualification criteria for algorithms, undesirable conditions and sensing capabilities. Various other methods, devices, systems, etc., are also disclosed.
摘要翻译：一种示例性方法基于部分地基于使用配置成在体内（即，在患者体内）定位电极的定位系统获取的位置信息来生成起搏参数，感测参数或一个或多个其它参数的图。各种示例映射捕获阈值，算法的资格标准，不良条件和感测能力。还公开了各种其它方法，装置，系统等。

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