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1. 发明授权

US08527051B1 Detection and reduction of phrenic nerve stimulation 有权
标题翻译：检测和减少膈神经刺激
公开(公告)号：US08527051B1
公开(公告)日：2013-09-03
申请号：US13545776
申请日：2012-07-10
申请人： Sven-Erik Hedberg , Tomas Svensson , Kjell Noren , Stuart Rosenberg , Kyungmoo Ryu , Edward Karst
发明人： Sven-Erik Hedberg , Tomas Svensson , Kjell Noren , Stuart Rosenberg , Kyungmoo Ryu , Edward Karst
IPC分类号： A61N1/37
CPC分类号： A61N1/36521 , A61N1/3702
摘要： The present invention provides implantable medical devices for detecting phrenic nerve stimulation. A pacing module is configured to deliver pacing pulses having a predetermined pulse amplitude and/or width within the refractory period of the left ventricle. The pacing pulses are repeatedly delivered during a number of cardiac cycles, and the pacing pulses are delivered at different delays relative to an onset of the refractory period of the left ventricle in different cardiac cycles. An impedance measurement module is configured to measure impedance signals in time windows synchronized with the delivery of pacing pulses in the refractory period of the left ventricle. A phrenic nerve stimulation, PNS, detection module is configured to gather at least one impedance signal from each time window, create aggregated impedance signals using the impedance signals from the different time windows, and analyze the aggregated impedance signals to detect PNS.
摘要翻译：本发明提供了用于检测膈神经刺激的可植入医疗装置。起搏模块被配置为在左心室的不应期内输送具有预定脉冲幅度和/或宽度的起搏脉冲。起搏脉冲在多个心动周期期间重复递送，起搏脉冲相对于不同心脏周期中左心室的不应期的开始以不同的延迟递送。阻抗测量模块被配置为测量与在左心室的不应期中递送起搏脉冲同步的时间窗内的阻抗信号。膈神经刺激，PNS检测模块配置为从每个时间窗口收集至少一个阻抗信号，使用来自不同时间窗口的阻抗信号创建聚合阻抗信号，并分析聚合阻抗信号以检测PNS。

2. 发明授权

US08532774B1 Detection and reduction of phrenic nerve stimulation 有权
标题翻译：检测和减少膈神经刺激
公开(公告)号：US08532774B1
公开(公告)日：2013-09-10
申请号：US13545794
申请日：2012-07-10
申请人： Sven-Erik Hedberg , Tomas Svensson , Kjell Noren , Stuart Rosenberg , Kyungmoo Ryu , Edward Karst
发明人： Sven-Erik Hedberg , Tomas Svensson , Kjell Noren , Stuart Rosenberg , Kyungmoo Ryu , Edward Karst
IPC分类号： A61N1/37
CPC分类号： A61N1/36521 , A61B5/042 , A61B5/0538 , A61N1/3686 , A61N1/3702
摘要： The present invention provides methods for detecting phrenic nerve stimulation. A pacing module is instructed to deliver pacing pulses having a predetermined pulse amplitude and/or width within the refractory period of the left ventricle. The pacing pulses are repeatedly delivered during a number of cardiac cycles and wherein the pacing pulses are delivered at different delays relative to an onset of the refractory period of the left ventricle in different cardiac cycles. Impedance signals are measured in time windows synchronized with the delivery of pacing pulses in the refractory period of the left ventricle using at least one electrode configuration. At least one impedance signal is gathered from each time window, aggregated impedance signals are created using the impedance signals from the different time windows, and the aggregated impedance signals are analyzed to detect PNS.
摘要翻译：本发明提供了检测膈神经刺激的方法。指示起搏模块在左心室的不应期内输送具有预定脉搏幅度和/或宽度的起搏脉冲。起搏脉冲在多个心动周期期间重复递送，并且其中起搏脉冲相对于在不同心脏周期中的左心室的不应期的开始以不同的延迟递送。使用至少一个电极配置，在与左心室的不应期中的起搏脉冲的递送同步的时间窗口中测量阻抗信号。从每个时间窗口收集至少一个阻抗信号，使用来自不同时间窗口的阻抗信号创建聚合阻抗信号，并分析聚合阻抗信号以检测PNS。

3. 发明授权

US08798765B2 Determination of cardiac resynchronization therapy settings 有权
标题翻译：心脏再同步治疗设置的测定
公开(公告)号：US08798765B2
公开(公告)日：2014-08-05
申请号：US13471167
申请日：2012-05-14
申请人： Kjell Noren , Anders Bjorling , Tomas Svensson , Sven-Erik Hedberg , Allen Keel , Stuart Rosenberg , Kyungmoo Ryu
发明人： Kjell Noren , Anders Bjorling , Tomas Svensson , Sven-Erik Hedberg , Allen Keel , Stuart Rosenberg , Kyungmoo Ryu
IPC分类号： A61N1/365 , A61N1/372 , A61N1/368
CPC分类号： A61N1/36507 , A61N1/3682 , A61N1/3684 , A61N1/37252
摘要： CRT settings for an implantable medical device are determined by applying pacing pulses to heart chambers of a scheme of different combinations of interchamber delays. A respective width parameter value representing an R or P wave width is determined for each such delay combination based on an ECG representing signal and the width parameter values are employed to estimate a parametric model defining the width parameter as a function of interchamber delays. Candidate interchamber delays that minimize the width parameter are determined from the parametric model and employed to determine optimal CRT settings. The technique provides an efficient way of finding optimal CRT settings when multiple pacing sites are available in a heart chamber.
摘要翻译：用于可植入医疗装置的CRT设置通过将不同组合的车间延迟的方案应用于心室来进行起搏脉冲来确定。基于ECG表示信号为每个这样的延迟组合确定表示R或P波宽的相应宽度参数值，并且使用宽度参数值来估计定义作为间歇延迟的函数的宽度参数的参数模型。从参数模型中确定最小化宽度参数的候选车间延迟，并用于确定最佳CRT设置。该技术提供了一种在心室中可用多个起搏部位时可以找到最佳CRT设置的有效方式。

4. 发明申请

US20120310296A1 DETERMINATION OF CARDIAC RESYNCHRONIZATION THERAPY SETTINGS 有权
标题翻译：心脏康复治疗方法的确定
公开(公告)号：US20120310296A1
公开(公告)日：2012-12-06
申请号：US13471167
申请日：2012-05-14
申请人： Kjell Noren , Anders Bjorling , Tomas Svensson , Sven-Erik Hedberg , Allen Keel , Stuart Rosenberg , Kyungmoo Ryu
发明人： Kjell Noren , Anders Bjorling , Tomas Svensson , Sven-Erik Hedberg , Allen Keel , Stuart Rosenberg , Kyungmoo Ryu
IPC分类号： A61N1/365
CPC分类号： A61N1/36507 , A61N1/3682 , A61N1/3684 , A61N1/37252
摘要： CRT settings for an implantable medical device are determined by applying pacing pulses to heart chambers of a scheme of different combinations of interchamber delays. A respective width parameter value representing an R or P wave width is determined for each such delay combination based on an ECG representing signal and the width parameter values are employed to estimate a parametric model defining the width parameter as a function of interchamber delays. Candidate interchamber delays that minimize the width parameter are determined from the parametric model and employed to determine optimal CRT settings. The technique provides an efficient way of finding optimal CRT settings when multiple pacing sites are available in a heart chamber.
摘要翻译：用于可植入医疗装置的CRT设置通过将不同组合的车间延迟的方案应用于心室来进行起搏脉冲来确定。基于ECG表示信号为每个这样的延迟组合确定表示R或P波宽的相应宽度参数值，并且使用宽度参数值来估计定义作为间歇延迟的函数的宽度参数的参数模型。从参数模型中确定最小化宽度参数的候选车间延迟，并用于确定最佳CRT设置。该技术提供了一种在心室中可用多个起搏部位时可以找到最佳CRT设置的有效方式。

5. 发明授权

US5417715A Rate responsive heart stimulation 失效
标题翻译：速率响应心脏刺激
公开(公告)号：US5417715A
公开(公告)日：1995-05-23
申请号：US132815
申请日：1993-10-07
申请人： Kjell Noren , Sven-Erik Hedberg , Pia Hagel , Kurt Hoegnelid
发明人： Kjell Noren , Sven-Erik Hedberg , Pia Hagel , Kurt Hoegnelid
IPC分类号： A61N1/365 , A61N1/368
CPC分类号： A61N1/368 , A61N1/36521
摘要： A rate-responsive heart stimulator with a variable stimulation interval contains a measurement device which generates a measurement signal corresponding to the volume of blood in a heart during the blood-filling phase (diastole) and a comparator which compares the measurement signal with a defined threshold value corresponding to a defined degree of blood filling. The comparator generates a control signal when the measurement signal reaches the threshold value, the control signal representing the time elapsing since the last stimulation pulse, and controlling the heart stimulator's stimulation interval.
摘要翻译：具有可变刺激间隔的速率响应心脏刺激器包含测量装置，该测量装置在血液灌注阶段（舒张期）期间产生对应于心脏中的血液体积的测量信号，以及将测量信号与限定阈值进行比较的比较器值对应于确定的血液灌注程度。当测量信号达到阈值时，比较器产生控制信号，控制信号表示自上次刺激脉冲以来经过的时间，并且控制心脏刺激器的刺激间隔。

6. 发明授权

US06915162B2 Implantable medical device for measuring ventricular pressure 有权
标题翻译：用于测量心室压力的可植入医疗器械
公开(公告)号：US06915162B2
公开(公告)日：2005-07-05
申请号：US10002496
申请日：2001-11-15
申请人： Kjell Noren , Charlotte Kjellmann , Kenth Nilsson , Sven-Erik Hedberg
发明人： Kjell Noren , Charlotte Kjellmann , Kenth Nilsson , Sven-Erik Hedberg
IPC分类号： A61B5/0215 , A61N1/365 , A61B5/04
CPC分类号： A61N1/36564 , A61B5/0215 , A61B5/7239
摘要： An implantable medical device has a pressure sensing arrangement to measure right ventricular pressure of a heart including a pressure sensor adapted to be positioned in the right ventricle of the heart, to measure the pressure and to generate a pressure signal in response to the measured pressure. The pressure sensing arrangement also has a pressure signal processor and a timing unit. The processor determines from the pressure signal, using diastolic timing signals from the timing unit based on the pressure signal identifying the diastolic phase, a diastolic pressure signal representing the ventricular pressure only during the diastolic phase of the heart cycle.
摘要翻译：可植入医疗装置具有用于测量心脏的右心室压力的压力感测装置，包括适于定位在心脏右心室的压力传感器，以测量压力并响应于测量的压力产生压力信号。压力感测装置还具有压力信号处理器和定时单元。处理器根据压力信号，基于识别舒张期的压力信号使用来自定时单元的舒张定时信号，仅在心脏周期舒张期期间表示心室压力的舒张压信号。

7. 发明授权

US6078835A Pacemaker wherein emission of stimulation pulses is controlled dependent on stretching of the ventricular wall 失效
标题翻译：其中刺激脉冲的发射取决于心室壁的拉伸来控制起搏器
公开(公告)号：US6078835A
公开(公告)日：2000-06-20
申请号：US242278
申请日：1998-02-12
申请人： Sven-Erik Hedberg , Karin Jarverud , Kjell Noren , Staffan Bowald
发明人： Sven-Erik Hedberg , Karin Jarverud , Kjell Noren , Staffan Bowald
IPC分类号： A61N1/365
CPC分类号： A61N1/36564
摘要： A pacemaker has control circuits contained in an enclosure and a lead containing an electrical conductor connected to an electrode for delivering electrical stimulation pulses to a heart. The stretching of a wall in the ventricle, corresponding to adequate filling of the ventricle in the heart, is determined in order to identify a time of emitting the stimulation pulses. This stretching is measured indirectly by measurement of pressure in the ventricle using a pressure sensor disposed near the lead in the ventricle. The signal from the sensor is supplied via the lead to circuitry in the enclosure, wherein the signal is amplified and is supplied to an edge detector, which detects an increasing or positive edge of the signal. The edge detector compares the incoming signal with a threshold value, and when the pressure indicated by the signal increases so as to exceed the threshold value, the edge detector supplies a signal to the control circuit which, in turn, triggers the emission of a stimulation pulse from a pulse generator, with or without a delay. The aforementioned stretching can also be measured using a strain gauge or a distance sensor attached to the ventricle wall.
摘要翻译： PCT No.PCT / SE97 / 01239 Sec。 371日期1999年2月12日 102（e）1999年2月12日PCT PCT 1997年7月4日PCT公布。公开号WO98 / 06454 日期1998年2月19日起搏器具有包含在外壳中的控制电路和包含连接到电极的电导体的引线，用于将电刺激脉冲传递到心脏。为了确定发射刺激脉冲的时间，确定对应于心脏中心室充分填充的心室中的壁的拉伸。使用设置在心室中的引线附近的压力传感器通过测量心室中的压力来间接测量该拉伸。来自传感器的信号通过导线提供给外壳中的电路，其中信号被放大并被提供给检测信号的增加或上升沿的边缘检测器。边缘检测器将输入信号与阈值进行比较，并且当信号指示的压力增加以超过阈值时，边缘检测器向控制电路提供信号，该信号又触发了刺激的发射来自脉冲发生器的脉冲，有或没有延迟。上述拉伸也可以使用附着于心室壁的应变计或距离传感器来测量。

8. 发明申请

US20080091239A1 Cardiac assist device and method using epicardially placed microphone 审中-公开
标题翻译：使用心外膜放置麦克风的心脏辅助装置和方法
公开(公告)号：US20080091239A1
公开(公告)日：2008-04-17
申请号：US11582211
申请日：2006-10-16
申请人： Anna-Karin Johansson , Kenth Nilsson , Cecilia Tuvstedt , Kjell Noren , Anders Bjorling , Andreas Blomqvist , Berit Larsson , Sven-Erik Hedberg , Karin Jarverud , Nils Holmstrom
发明人： Anna-Karin Johansson , Kenth Nilsson , Cecilia Tuvstedt , Kjell Noren , Anders Bjorling , Andreas Blomqvist , Berit Larsson , Sven-Erik Hedberg , Karin Jarverud , Nils Holmstrom
IPC分类号： A61N1/36 , A61N1/362 , A61N1/39
CPC分类号： A61N1/36514 , A61N1/3956
摘要： In a cardiac assist device and method, a microphone is placed in contact with the epicardium of the heart of a patient, and heart and lung sounds are simultaneously detected at the placement location of the microphone. The heart and lung sounds are automatically analyzed to set an appropriate cardiac therapy for the patient.
摘要翻译：在心脏辅助装置和方法中，将麦克风放置成与患者心脏的心外膜接触，并且在麦克风的放置位置同时检测心脏和肺部的声音。自动分析心脏和肺部声音，为患者设定适当的心脏治疗。

9. 发明申请

US20110319769A1 ISCHEMIC STATUS MONITORING 审中-公开
标题翻译： ISCHEMIC状态监测
公开(公告)号：US20110319769A1
公开(公告)日：2011-12-29
申请号：US13255460
申请日：2009-03-13
申请人： Sven-Erik Hedberg , Tomas Svensson , Michael Broomé , Karin Järverud , Stefan Hjelm
发明人： Sven-Erik Hedberg , Tomas Svensson , Michael Broomé , Karin Järverud , Stefan Hjelm
IPC分类号： A61N1/365 , A61B5/026
CPC分类号： A61B5/0452 , A61B5/026 , A61B5/053 , A61B5/1116 , A61B5/1118 , A61B5/4836 , A61B5/6846 , A61B5/7405 , A61B5/7455 , A61N1/3702
摘要： An ischemia monitoring system has detectors for detecting the onset of an ischemic event of a tissue in subject, the end of the ischemic event and the end of a following recovery from the ischemic event, respectively. A time processor determines the duration of the ischemic event and the recovery period based on the detected onset and end times. A status processor co-processes the two determined time durations for the purpose of monitoring the ischemic status of the subject and detecting any deterioration in ischemic status for the latest ischemic event as compared to previous ischemic events that have occurred in the subject's tissue.
摘要翻译：缺血监测系统具有检测器，用于分别检测受试者组织的缺血事件的发作，缺血事件的结束以及从缺血事件中恢复的结束。时间处理器基于检测到的开始和结束时间来确定缺血事件的持续时间和恢复期。状态处理器协调处理两个确定的持续时间以便监测受试者的缺血状态并且检测与在受试者组织中发生的先前缺血事件相比，最新缺血事件的缺血状态的任何恶化。

10. 发明授权

US09162066B2 Method and system for stimulating a heart 有权
标题翻译：刺激心脏的方法和系统
公开(公告)号：US09162066B2
公开(公告)日：2015-10-20
申请号：US13508968
申请日：2011-05-31
申请人： Sven-Erik Hedberg , Nils Holmstrom , Karin Jarverud
发明人： Sven-Erik Hedberg , Nils Holmstrom , Karin Jarverud
IPC分类号： A61N1/368 , A61N1/362
CPC分类号： A61N1/368 , A61N1/3622 , A61N1/3682 , A61N1/3684
摘要： A first ventricle is stimulated at a stimulation site, a point of time for arrival at the AV node for at least one depolarization wave resulting from the stimulation is estimated and a first activation time interval substantially corresponding to the time interval required for at least one depolarization wave to travel from the stimulation site in the first ventricle to the AV node is computed. A similar process is used to compute a second activation time interval for the other ventricle. Based on these activation time intervals and a difference between the intervals, a pacing therapy can be determined.
摘要翻译：在刺激部位刺激第一脑室，估计从刺激产生的至少一个去极化波到达AV节点的时间点，并且基本对应于至少一个去极化所需的时间间隔的第一激活时间间隔计算从第一脑室的刺激部位到AV节点的波。使用类似的过程来计算另一个心室的第二激活时间间隔。基于这些激活时间间隔和间隔之间的差异，可以确定起搏治疗。

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