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1. 发明申请

US20140371833A1 IMPLANTABLE ELECTRODE LOCATION SELECTION 审中-公开
公开(公告)号：US20140371833A1
公开(公告)日：2014-12-18
申请号：US13916377
申请日：2013-06-12
申请人： Subham Ghosh , Manfred Justen , Eric Schilling
发明人： Subham Ghosh , Manfred Justen , Eric Schilling
IPC分类号： A61N1/05 , A61B19/00
CPC分类号： A61B5/0044 , A61B5/0037 , A61B5/04012 , A61B5/0452 , A61B5/489 , A61B6/12 , A61B6/504 , A61B6/547 , A61N1/0484 , A61N1/056 , A61N1/372
摘要： Systems, methods, and interfaces are described herein for assisting in noninvasive location selection for an implantable electrode for use in cardiac therapy. Mechanical motion information and surrogate electrical activation times may be used to identify one or more candidate site regions.

2. 发明授权

US09510763B2 Assessing intra-cardiac activation patterns and electrical dyssynchrony 有权
标题翻译：评估心脏内激活模式和电气不同步
公开(公告)号：US09510763B2
公开(公告)日：2016-12-06
申请号：US13462404
申请日：2012-05-02
申请人： Subham Ghosh , Jeffrey M. Gillberg , Robert W. Stadler
发明人： Subham Ghosh , Jeffrey M. Gillberg , Robert W. Stadler
IPC分类号： A61B5/04 , A61B5/0452 , A61B5/05 , A61B5/02 , A61B5/0402 , A61B5/0408 , A61N1/04 , A61N1/362 , A61N1/368 , A61B5/00
CPC分类号： A61B5/04012 , A61B5/02 , A61B5/0402 , A61B5/04085 , A61B5/044 , A61B5/0452 , A61B5/05 , A61B5/742 , A61N1/0476 , A61N1/0484 , A61N1/3627 , A61N1/3682 , A61N1/3684
摘要： Techniques for evaluating cardiac electrical dyssynchrony are described. In some examples, an activation time is determined for each of a plurality of torso-surface potential signals. The dispersion or sequence of these activation times may be analyzed or presented to provide variety of indications of the electrical dyssynchrony of the heart of the patient. In some examples, the locations of the electrodes of the set of electrodes, and thus the locations at which the torso-surface potential signals were sensed, may be projected on the surface of a model torso that includes a model heart. The inverse problem of electrocardiography may be solved to determine electrical activation times for regions of the model heart based on the torso-surface potential signals sensed from the patient.
摘要翻译：描述了评估心脏电气不同步的技术。在一些示例中，为多个躯干表面电位信号中的每一个确定激活时间。可以分析或呈现这些激活时间的分散或序列以提供患者心脏的电不同步的各种指征。在一些示例中，电极组的电极的位置以及因此感测躯干表面电位信号的位置可以投影在包括模型心脏的模型躯干的表面上。可以基于从患者感测到的躯干表面电位信号来解决心电图的逆问题，以确定模型心脏区域的电激活时间。

3. 发明申请

US20150032014A1 DETERMINING ONSETS AND OFFSETS OF CARDIAC DEPOLARIZATION AND REPOLARIZATION WAVES 有权
标题翻译：确定心脏分离和再分化波的偏差和偏差
公开(公告)号：US20150032014A1
公开(公告)日：2015-01-29
申请号：US13952076
申请日：2013-07-26
申请人： Subham Ghosh
发明人： Subham Ghosh
IPC分类号： A61N1/365 , A61B5/0402 , A61B5/00 , A61B5/0245
CPC分类号： A61N1/36507 , A61B5/04017 , A61B5/0402 , A61B5/04085 , A61B5/0452 , A61B5/1107 , A61B5/4836 , A61B2562/043 , A61B2562/046 , A61N1/3627 , A61N1/3684
摘要： An exemplary computer-implemented method is disclosed for detection of onset of depolarization on far-field electrograms (EGMs) or electrocardiogram (ECG)- or ECG-like signals. The method includes determining a baseline rhythm using a plurality of body-surface electrodes. The baseline rhythm includes an atrial marker and a ventricular marker. A pre-specified window is defined as being between the atrial marker and the ventricular marker. A low pass filter is applied to a signal within the window. A rectified slope of the signal within the window is determined. A determination is made as to whether a time point (t1) is present such that the rectified slope exceeds 10% of a maximum value of the rectified slope. A point of onset of a depolarization complex in the signal is determined. The point of onset occurs at a largest curvature in the signal within the window.
摘要翻译：公开了用于检测远场电描记图（EGM）或心电图（ECG）或ECG样信号的去极化开始的示例性计算机实现的方法。该方法包括使用多个体表电极确定基线节律。基线节律包括心房标记和心室标志。预先指定的窗口被定义为在心房标记和心室标记之间。低通滤波器被应用于窗口内的信号。确定窗口内的信号的整流斜率。确定是否存在时间点（t1），使得整流斜率超过整流斜率的最大值的10％。确定信号中去极化复合物的起始点。起始点发生在窗口内信号的最大曲率。

4. 发明授权

US08750994B2 Morphology-based discrimination algorithm based on relative amplitude differences and correlation of imprints of energy distribution 有权
标题翻译：基于形态学的辨别算法，基于相对幅度差异和能量分布印记的相关性
公开(公告)号：US08750994B2
公开(公告)日：2014-06-10
申请号：US13562039
申请日：2012-07-30
申请人： Subham Ghosh , Jeffrey M. Gillberg
发明人： Subham Ghosh , Jeffrey M. Gillberg
IPC分类号： A61N1/36
CPC分类号： A61N1/3956 , A61B5/04012 , A61B5/046 , A61B5/0464 , A61B5/686 , A61N1/3621 , G06K9/0055
摘要： Techniques for morphologic discrimination between beats of a tachyarrhythmia episode are described for selecting delivery of appropriate therapy. An exemplary method comprises nonordered binning of digitized amplitude values of signals associated with cardiac depolarizations. Monomorphic VT is discriminated from polymorphic VT without signal alignment. One exemplary method involves sensing electrical signals associated with depolarizations of a patient's heart during a tachyarrhythmia episode. The sensed electrical signals are converted to digital values and stored. The stored digital values are normalized and binned. At most, 5 pairs of beats or depolarizations are compared for morphologic similarity by determining the similarity between the binned values associated with each pair. The result of the comparison is used to select and deliver therapy to the patient.
摘要翻译：描述了用于选择适当治疗的递送的快速性心律失常发作的心跳形态鉴别技术。示例性方法包括与心脏去极化相关联的信号的数字化振幅值的无序并置。单态VT与多态VT鉴别，无信号对齐。一种示例性方法包括在快速性心律失常发作期间感测与患者心脏的去极化相关联的电信号。感测到的电信号被转换成数字值并存储。存储的数字值被归一化并分箱。通过确定与每对相关联的合并值之间的相似度，最多比较5对节拍或去极化的形态相似性。比较结果用于选择并向患者提供治疗。

5. 发明授权

US08768459B2 Morphology-based precursor to template matching comparison 有权
标题翻译：基于形态学的前体模板匹配比较
公开(公告)号：US08768459B2
公开(公告)日：2014-07-01
申请号：US13561967
申请日：2012-07-30
申请人： Subham Ghosh , Jeffrey M. Gillberg
发明人： Subham Ghosh , Jeffrey M. Gillberg
IPC分类号： A61N1/00
CPC分类号： A61N1/3702 , A61N1/3621 , A61N1/3925 , A61N1/3962
摘要： One or more embodiments of the present disclosure relates to a method and/or system for classifying and/or treating heart rhythms. The present disclosure involves sensing electrical signals associated with depolarizations of a patient's heart. The sensed electrical signals are converted to digital values and storing the digital values. Normalizing solely a maximum and a minimum value of the stored digital values associated with a depolarization of the patient's heart without normalizing other stored digital values of the depolarization is another aspect of the present disclosure. The maximum and minimum values associated with the depolarization are compared to maximum and minimum values associated with a template derived from signals indicative of a heart depolarization of known type. A determination is made as to whether a match exists between the maximum and minimum values associated with the depolarization to the maximum and minimum values associated with a template.
摘要翻译：本公开的一个或多个实施方案涉及用于分类和/或治疗心律的方法和/或系统。本公开涉及感测与患者心脏的去极化相关联的电信号。感测的电信号被转换成数字值并存储数字值。仅对与患者心脏去极化相关联的存储数字值的最大值和最小值进行归一化，而不对其他存储的去极化数字值进行归一化，这是本发明的另一方面。将与去极化相关联的最大值和最小值与与从指示已知类型的心脏去极化的信号衍生的模板相关联的最大值和最小值进行比较。确定在与去极化相关联的最大值和最小值与与模板相关联的最大值和最小值之间是否存在匹配。

6. 发明申请

US20130218227A1 CRITERIA FOR OPTIMAL ELECTRICAL RESYNCHRONIZATION DERIVED FROM MULTIPOLAR LEADS OR MULTIPLE ELECTRODES DURING BIVENTRICULAR PACING 有权
公开(公告)号：US20130218227A1
公开(公告)日：2013-08-22
申请号：US13464279
申请日：2012-05-04
申请人： Subham Ghosh , Robert W. Stadler
发明人： Subham Ghosh , Robert W. Stadler
IPC分类号： A61N1/37
CPC分类号： A61N1/3686 , A61N1/3622 , A61N1/3627 , A61N1/368 , A61N1/3684 , A61N1/371
摘要： Generally, the disclosure is directed one or more methods or systems of cardiac pacing employing a right ventricular electrode and a plurality of left ventricular electrodes. Pacing using the right ventricular electrode and a first one of the left ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes. Pacing using the right ventricular electrode and a second one of the ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes. Employing sums of the measured activation times to select one of the left ventricular electrodes for delivery of subsequent pacing pulses.

7. 发明授权

US08768465B2 Criteria for optimal electrical resynchronization derived from multipolar leads or multiple electrodes during biventricular pacing 有权
公开(公告)号：US08768465B2
公开(公告)日：2014-07-01
申请号：US13464255
申请日：2012-05-04
申请人： Subham Ghosh , Robert W. Stadler
发明人： Subham Ghosh , Robert W. Stadler
IPC分类号： A61N1/05 , A61N1/362
CPC分类号： A61N1/3686 , A61N1/3622 , A61N1/3627 , A61N1/368 , A61N1/3684 , A61N1/371
摘要： Generally, the disclosure is directed one or more methods or systems of cardiac pacing employing a right ventricular electrode and a plurality of left ventricular electrodes. Pacing using the right ventricular electrode and a first one of the left ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes. Pacing using the right ventricular electrode and a second one of the ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes. Employing sums of the measured activation times to select one of the left ventricular electrodes for delivery of subsequent pacing pulses.

8. 发明申请

US20130030481A1 MORPHOLOGY-BASED DISCRIMINATION ALGORITHM BASED ON RELATIVE AMPLITUDE DIFFERENCES AND CORRELATION OF IMPRINTS OF ENERGY DISTRIBUTION 有权
标题翻译：基于相对振幅差异的基于形态学的辨别算法和能量分布的相关性
公开(公告)号：US20130030481A1
公开(公告)日：2013-01-31
申请号：US13562039
申请日：2012-07-30
申请人： Subham Ghosh , Jeffrey M. Gillberg
发明人： Subham Ghosh , Jeffrey M. Gillberg
IPC分类号： A61N1/365
CPC分类号： A61N1/3956 , A61B5/04012 , A61B5/046 , A61B5/0464 , A61B5/686 , A61N1/3621 , G06K9/0055
摘要： Techniques for morphologic discrimination between beats of a tachyarrhythmia episode are described for selecting delivery of appropriate therapy. An exemplary method comprises nonordered binning of digitized amplitude values of signals associated with cardiac depolarizations. Monomorphic VT is discriminated from polymorphic VT without signal alignment. One exemplary method involves sensing electrical signals associated with depolarizations of a patient's heart during a tachyarrhythmia episode. The sensed electrical signals are converted to digital values and stored. The stored digital values are normalized and binned. At most, 5 pairs of beats or depolarizations are compared for morphologic similarity by determining the similarity between the binned values associated with each pair. The result of the comparison is used to select and deliver therapy to the patient.
摘要翻译：描述了用于选择适当治疗的递送的快速性心律失常发作的心跳形态鉴别技术。示例性方法包括与心脏去极化相关联的信号的数字化振幅值的无序并置。单态VT与多态VT鉴别，无信号对齐。一种示例性方法包括在快速性心律失常发作期间感测与患者心脏的去极化相关联的电信号。感测到的电信号被转换成数字值并存储。存储的数字值被归一化并分箱。通过确定与每对相关联的合并值之间的相似度，最多比较5对节拍或去极化的形态相似性。比较结果用于选择并向患者提供治疗。

9. 发明授权

US08972228B2 Assessing intra-cardiac activation patterns 有权
标题翻译：评估心脏内激活模式
公开(公告)号：US08972228B2
公开(公告)日：2015-03-03
申请号：US13462480
申请日：2012-05-02
申请人： Subham Ghosh , Jeffrey M. Gillberg , Robert W. Stadler
发明人： Subham Ghosh , Jeffrey M. Gillberg , Robert W. Stadler
IPC分类号： G06G7/48 , A61B5/0408 , A61B5/0452 , A61B5/05 , A61B5/02 , A61B5/0402 , A61N1/04 , A61N1/362 , A61N1/368
CPC分类号： A61B5/04012 , A61B5/02 , A61B5/0402 , A61B5/04085 , A61B5/044 , A61B5/0452 , A61B5/05 , A61B5/742 , A61N1/0476 , A61N1/0484 , A61N1/3627 , A61N1/3682 , A61N1/3684
摘要： Techniques for evaluating cardiac electrical dyssynchrony are described. In some examples, an activation time is determined for each of a plurality of torso-surface potential signals. The dispersion or sequence of these activation times may be analyzed or presented to provide variety of indications of the electrical dyssynchrony of the heart of the patient. In some examples, the locations of the electrodes of the set of electrodes, and thus the locations at which the torso-surface potential signals were sensed, may be projected on the surface of a model torso that includes a model heart. The inverse problem of electrocardiography may be solved to determine electrical activation times for regions of the model heart based on the torso-surface potential signals sensed from the patient.
摘要翻译：描述了评估心脏电气不同步的技术。在一些示例中，为多个躯干表面电位信号中的每一个确定激活时间。可以分析或呈现这些激活时间的分散或序列以提供患者心脏的电不同步的各种指征。在一些示例中，电极组的电极的位置以及因此感测躯干表面电位信号的位置可以投影在包括模型心脏的模型躯干的表面上。可以基于从患者感测到的躯干表面电位信号来解决心电图的逆问题，以确定模型心脏区域的电激活时间。

10. 发明授权

US08682436B2 Detection of target vein for CRT therapy 有权
标题翻译： CRT治疗目标静脉检测
公开(公告)号：US08682436B2
公开(公告)日：2014-03-25
申请号：US13336113
申请日：2011-12-23
申请人： Subham Ghosh , Jeffrey M. Gillberg , Nathan A. Grenz
发明人： Subham Ghosh , Jeffrey M. Gillberg , Nathan A. Grenz
IPC分类号： A61N1/00
CPC分类号： A61N1/3627 , A61N1/3684 , A61N1/3702
摘要： A method for selecting a target vein for left ventricular lead placement for cardiac resynchronization therapy includes determining electrical dispersion for the first coronary vein by calculating the difference between (i) activation time at a location of the vein that has the latest activation time of a plurality of locations in the vein and (ii) activation time at a location that has the earliest activation time of the plurality of locations. The method may further include (ii) determining whether the magnitude of the electrical dispersion for the vein meets or exceeds a predetermined threshold selecting the vein if the vein meets or exceeds the predetermined threshold; or (ii) selecting, among several veins, the vein that has the highest electrical dispersion.
摘要翻译：用于选择用于心脏再同步治疗的左心室引导放置的目标静脉的方法包括通过计算（i）静脉位置处的激活时间之间的差异来确定第一冠状静脉的电离散，所述差异具有多个静脉中的位置和（ii）在多个位置具有最早激活时间的位置处的激活时间。该方法还可以包括（ii）确定静脉的电色差的大小是否满足或超过预定阈值，如果静脉达到或超过预定阈值则选择静脉; 或（ii）在几条静脉中选择具有最高电色差的静脉。

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