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1. 发明授权

US07181268B2 Ischemia detection 失效
标题翻译：缺血检测
公开(公告)号：US07181268B2
公开(公告)日：2007-02-20
申请号：US10304112
申请日：2002-11-25
申请人： Todd J. Sheldon , Lee Stylos , Shannon D. Nelson , Robert W. Stadler
发明人： Todd J. Sheldon , Lee Stylos , Shannon D. Nelson , Robert W. Stadler
IPC分类号： A61B5/0402
CPC分类号： A61N1/368 , A61N1/3627 , A61N1/36585
摘要： Techniques for detection and treatment of myocardial ischemia are described that monitor both the electrical and dynamic mechanical activity of the heart to detect and verify the occurrence of myocardial ischemia in a more reliable manner. The occurrence of myocardial ischemia can be detected by monitoring changes in an electrical signal such as an ECG or EGM, and changes in dynamic mechanical activity of the heart that are sensed by an accelerometer sensor. The heart acceleration signal can be obtained from an single- or multiple-axis accelerometer and/or a pressure sensor deployed within or near the heart. The techniques correlate contractility changes detected by an accelerometer or pressure sensor with changes in the ST electrogram segment detected by the electrodes to increase the reliability of ischemia detection.
摘要翻译：描述了用于检测和治疗心肌缺血的技术，其监测心脏的电和动态机械活性以更可靠的方式检测和验证心肌缺血的发生。可以通过监测诸如ECG或EGM的电信号的变化以及由加速度计传感器感测到的心脏的动态机械活动的变化来检测心肌缺血的发生。心脏加速度信号可以从部署在心脏内部或附近的单轴或多轴加速度计和/或压力传感器获得。该技术将由加速度计或压力传感器检测到的收缩性变化与由电极检测到的ST电描绘部分的变化相关联，以增加缺血检测的可靠性。

2. 发明授权

US06937899B2 Ischemia detection 有权
标题翻译：缺血检测
公开(公告)号：US06937899B2
公开(公告)日：2005-08-30
申请号：US09945179
申请日：2001-08-30
申请人： Todd J. Sheldon , Lee Stylos , Shannon D. Nelson , Robert W. Stadler
发明人： Todd J. Sheldon , Lee Stylos , Shannon D. Nelson , Robert W. Stadler
IPC分类号： A61B5/04 , A61B5/0452 , A61B5/11 , A61N1/365 , A61N1/368 , A61N1/362
CPC分类号： A61B5/4839 , A61B5/04011 , A61B5/0452 , A61B5/1107 , A61B5/6869 , A61B5/7203 , A61B2562/028 , A61B2562/222 , A61N1/36542 , A61N1/368
摘要： Techniques for detection and treatment of myocardial ischemia are described that monitor both the electrical and dynamic mechanical activity of the heart to detect and verify the occurrence of myocardial ischemia in a more reliable manner. The occurrence of myocardial ischemia can be detected by monitoring changes in an electrical signal such as an ECG or EGM, and changes in dynamic mechanical activity of the heart. Dynamic mechanical activity can be represented, for example, by a heart acceleration signal or pressure signal. The electrical signal can be obtained from a set of implanted or external electrodes. The heart acceleration signal can be obtained from an accelerometer or pressure sensor deployed within or near the heart. The techniques correlate contractility changes detected by an accelerometer or pressure sensor with changes in the ST electrogram segment detected by the electrodes to increase the reliability of ischemia detection.
摘要翻译：描述了用于检测和治疗心肌缺血的技术，其监测心脏的电和动态机械活性以更可靠的方式检测和验证心肌缺血的发生。可以通过监测诸如ECG或EGM的电信号的变化以及心脏的动态机械活动的变化来检测心肌缺血的发生。动态机械活动可以例如通过心脏加速度信号或压力信号来表示。电信号可以从一组植入电极或外部电极获得。可以从部署在心脏内部或附近的加速度计或压力传感器获得心脏加速度信号。该技术将由加速度计或压力传感器检测到的收缩性变化与由电极检测到的ST电描绘部分的变化相关联，以增加缺血检测的可靠性。

3. 发明授权

US07996084B2 Implantable medical device with automatic ischemia threshold determination 有权
标题翻译：具有自动缺血阈值测定的植入式医疗器械
公开(公告)号：US07996084B2
公开(公告)日：2011-08-09
申请号：US11379290
申请日：2006-04-19
申请人： Lee Stylos , Todd J. Sheldon , Steven N. Lu , William J. Combs , Robert J. Nehls
发明人： Lee Stylos , Todd J. Sheldon , Steven N. Lu , William J. Combs , Robert J. Nehls
IPC分类号： A61N1/08
CPC分类号： A61N1/3702 , A61N1/36514 , A61N1/36542 , A61N1/36557 , A61N1/37252
摘要： An implantable medical device (IMD) performs periodic testing of a patient to determine ischemia threshold information. At selected times while the patient is at rest, the IMD increases the pacing rate over time until it receives feedback either from the patient or from an ischemia sensor. The IMD determines the threshold based upon the pacing rate at the time when the feedback was received. The threshold information can be used to adjust the upper pacing rate that can be used during rate adaptive pacing, to determine the effects of drug therapy, and to provide a general indication of the state of coronary artery disease in the patient. The periodic increase of pacing rate to the ischemic zone also provides a preconditioning of the myocardium to allow the patient greater exercise benefit without angina.
摘要翻译：可植入医疗装置（IMD）执行患者的周期性测试以确定缺血阈值信息。在患者静止时的选定时间，IMD随着时间的推移增加起搏速率，直到其从患者或缺血传感器接收到反馈。 IMD根据接收到反馈时的起搏速率来确定阈值。阈值信息可以用于调整速率自适应起搏期间可以使用的上起搏速率，以确定药物治疗的效果，并提供患者冠状动脉疾病状态的一般指示。对缺血区的起搏速率的周期性增加也提供心肌的预处理，以允许患者在没有心绞痛的情况下更大的运动益处。

4. 发明授权

US07848808B2 System and method for delivery of cardiac pacing in a medical device in response to ischemia 有权
标题翻译：用于在医疗装置中递送心脏起搏以应对局部缺血的系统和方法
公开(公告)号：US07848808B2
公开(公告)日：2010-12-07
申请号：US11364828
申请日：2006-02-28
申请人： Todd J. Sheldon , William J. Combs , Lee Stylos , Steven N. Lu , Robert J. Nehls
发明人： Todd J. Sheldon , William J. Combs , Lee Stylos , Steven N. Lu , Robert J. Nehls
IPC分类号： A61N1/365
CPC分类号： A61N1/37 , A61N1/3627
摘要： An implantable medical device system and method in which the implantable device is adapted to operate in a minimum ventricular pacing mode. The device delivers cardiac pacing pulses in a first pacing mode during a normal mode of operation and upon detecting myocardial ischemia alters the first pacing mode in response to the myocardial ischemia detection.
摘要翻译：一种植入式医疗装置系统和方法，其中所述可植入装置适于以最小心室起搏模式操作。该装置在正常操作模式期间以第一起搏模式递送心脏起搏脉冲，并且在检测心肌缺血时，响应于心肌缺血检测改变第一起搏模式。

5. 发明授权

US6128526A Method for ischemia detection and apparatus for using same 有权
标题翻译：缺血检测方法及其使用方法
公开(公告)号：US6128526A
公开(公告)日：2000-10-03
申请号：US280286
申请日：1999-03-29
申请人： Robert Stadler , Shannon Nelson , Lee Stylos , Todd J. Sheldon
发明人： Robert Stadler , Shannon Nelson , Lee Stylos , Todd J. Sheldon
IPC分类号： A61B5/0452 , A61B5/0472 , A61N1/37 , A61N1/39 , A61B5/0402
CPC分类号： A61N1/3956 , A61B5/0452 , A61B5/0472 , A61B5/7203 , A61N1/3702
摘要： In determining whether a patient has ischemia or other conditions discernible in the variation occurring in the ST portion of the electrocardiogram signal, we filter out bad ST change parameters that are not changing at a rate representative of human ischemia ST change parameter rates of change. This can be used for driving therapy systems to alleviate cardiac ischemia. This filtering can be enhanced by using multiple cardiac electrical vectors for the electrogram signal vectors, and using a determination of Axis shift to modify filter parameters and the expected ranges of precursors to the ST change parameter (an ST change variable) to eliminate bad cardiac cycles, that is cardiac cycle information that may be misleading.
摘要翻译：在确定心电图信号的ST部分发生的变化中患者是否存在缺血或其他状况时，我们滤除不以代表人类缺血ST变化参数变化率的速率变化的不良ST变化参数。这可以用于驱动治疗系统以减轻心脏缺血。可以通过使用多个心电向量作为电描记图信号向量来增强该滤波，并且使用轴移动的确定来修改滤波器参数和ST变化参数（ST变化变量）的前体预期范围，以消除不良心脏周期，那可能是误导的心脏周期信息。

6. 发明授权

US6115628A Method and apparatus for filtering electrocardiogram (ECG) signals to remove bad cycle information and for use of physiologic signals determined from said filtered ECG signals 有权
标题翻译：用于过滤心电图（ECG）信号以去除不良循环信息并使用从所述滤波的ECG信号确定的生理信号的方法和装置
公开(公告)号：US6115628A
公开(公告)日：2000-09-05
申请号：US280595
申请日：1999-03-29
申请人： Robert Stadler , Shannon Nelson , Lee Stylos , Todd J. Sheldon
发明人： Robert Stadler , Shannon Nelson , Lee Stylos , Todd J. Sheldon
IPC分类号： A61B5/0452
CPC分类号： A61B5/0452 , A61B5/7203 , A61B5/7239
摘要： In using electrogram signals to determine physiologic conditions like ischemia, the bad cardiac cycle information due to noise, axis shifts in the cardiac electrical axis, and the like must be removed if the electrogram signal can be made to be a good indicator. If this is accomplished through the adaptive filtering techniques shown here, the signal can be used to drive a closed loop therapy system responsive to those physiologic conditions discernible from good cardiac cycle electrocardiogram signals.
摘要翻译：在使用电描记图信号来确定如缺血的生理条件时，如果电描记图信号可以作为良好的指示器，则必须去除由噪声引起的心脏心脏循环信息不良，心脏电轴轴移动等。如果这是通过这里显示的自适应滤波技术来实现的，则该信号可用于驱动闭环治疗系统，以响应于从良好的心动周期心电图信号中辨别出的生理条件。

7. 发明授权

US06882883B2 Implantable medical device (IMD) system configurable to subject a patient to a stress test and to detect myocardial ischemia within the patient 有权
标题翻译：可植入医疗装置（IMD）系统可配置为使患者进行压力测试并检测患者内的心肌缺血
公开(公告)号：US06882883B2
公开(公告)日：2005-04-19
申请号：US09945195
申请日：2001-08-31
申请人： Catherine R. Condie , Robert W. Stadler , Lee Stylos
发明人： Catherine R. Condie , Robert W. Stadler , Lee Stylos
IPC分类号： A61B5/0472 , A61N1/362 , A61N1/372
CPC分类号： A61B5/4884 , A61B5/0472 , A61N1/362
摘要： Various implantable medical devices (IMDs) are disclosed for implantation in a patient. The IMD includes pacing circuitry configured to selectively produce pacing pulses at a programmable pacing rate. In one embodiment, the IMD is configurable to subject a patient to a stress test. The IMD may be configurable to subject the patient to the stress test at the time specified by stored timing information, or in response to a signal (e.g., from a patient activator). Another embodiment of the implantable medical device (IMD) includes sensor circuitry, a memory for storing data, and a control unit. The sensor circuitry produces sensor data relating to cardiac condition. The control unit is configurable to store the sensor data in the memory until a trigger signal is received. Methods are described for performing a stress test in a patient with an IMD, and for subsequently reproducing cardiac operational states.
摘要翻译：公开了用于植入患者体内的各种植入式医疗装置（IMD）。 IMD包括起搏电路，其配置成以可编程起搏速率选择性地产生起搏脉冲。在一个实施例中，IMD可配置为使患者进行压力测试。 IMD可以被配置为使患者在由存储的定时信息指定的时间或者响应于信号（例如来自患者激活器）的时间对患者进行压力测试。可植入医疗装置（IMD）的另一实施例包括传感器电路，用于存储数据的存储器和控制单元。传感器电路产生有关心脏状况的传感器数据。控制单元可配置为将传感器数据存储在存储器中，直到接收到触发信号。描述了用于在具有IMD的患者中进行压力测试并且随后再现心脏操作状态的方法。

8. 发明申请

US20070203524A1 System and method for delivery of cardiac pacing in a medical device in response to ischemia 有权
标题翻译：用于在医疗装置中递送心脏起搏以应对局部缺血的系统和方法
公开(公告)号：US20070203524A1
公开(公告)日：2007-08-30
申请号：US11364828
申请日：2006-02-28
申请人： Todd Sheldon , William Combs , Lee Stylos , Steven Lu , Robert Nehls
发明人： Todd Sheldon , William Combs , Lee Stylos , Steven Lu , Robert Nehls
IPC分类号： A61N1/00
CPC分类号： A61N1/37 , A61N1/3627
摘要： An implantable medical device system and method in which the implantable device is adapted to operate in a minimum ventricular pacing mode. The device delivers cardiac pacing pulses in a first pacing mode during a normal mode of operation and upon detecting myocardial ischemia alters the first pacing mode in response to the myocardial ischemia detection.
摘要翻译：一种植入式医疗装置系统和方法，其中所述可植入装置适于以最小心室起搏模式操作。该装置在正常操作模式期间以第一起搏模式递送心脏起搏脉冲，并且在检测心肌缺血时，响应于心肌缺血检测改变第一起搏模式。

9. 发明申请

US20110004265A1 MEDICAL DEVICE PACKAGING SYSTEM 有权
标题翻译：医疗器械包装系统
公开(公告)号：US20110004265A1
公开(公告)日：2011-01-06
申请号：US12825798
申请日：2010-06-29
申请人： William K. Wenger , Paul G. Krause , William J. Plombon , Steven N. Lu , Sean B. McAdams , Brian B. Lee , Lee Stylos , Judy B. Salzer , G. Jordan Montgomery
发明人： William K. Wenger , Paul G. Krause , William J. Plombon , Steven N. Lu , Sean B. McAdams , Brian B. Lee , Lee Stylos , Judy B. Salzer , G. Jordan Montgomery
IPC分类号： A61N1/00
CPC分类号： A61N1/08 , A61B50/30 , A61B2050/0065 , A61N1/372 , A61N1/375 , A61N2001/37294
摘要： A system, comprising a sterilizable package; an implantable medical device placed inside the sterilizable package; and an electrical interface electrically coupled to the implantable medical device and extending from inside the sterilizable package to outside the sterilizable package. In various embodiments, the interface may include package contacts electrically coupled to electrode terminals on the implantable medical device, patient terminals and conductors extending between the package contacts and the patient terminals.
摘要翻译：一种包括可灭菌包装的系统; 可植入医疗器械放置在可灭菌包装内; 以及电接口，其电耦合到所述可植入医疗装置并且从所述可灭菌包装内部延伸到所述可灭菌包装之外。在各种实施例中，接口可以包括电耦合到可植入医疗装置上的电极端子的封装接点，在封装触点和患者端子之间延伸的患者端子和导体。

10. 发明授权

US06248080B1 Intracranial monitoring and therapy delivery control device, system and method 有权
标题翻译：颅内监测和治疗传递控制装置，系统和方法
公开(公告)号：US06248080B1
公开(公告)日：2001-06-19
申请号：US09299774
申请日：1999-04-26
申请人： Keith A. Miesel , Lee Stylos
发明人： Keith A. Miesel , Lee Stylos
IPC分类号： A61B503
CPC分类号： A61N1/36557 , A61B5/0031 , A61B5/0215 , A61B5/02154 , A61B5/031 , A61B5/076 , A61B5/14539 , A61B5/1459 , A61B5/6864 , A61N1/05 , A61N1/056 , A61N1/36585 , Y10S977/90
摘要： An implantable medical device having an hermetically sealed enclosure housing electrical and electronic circuitry and a battery for powering such circuitry is connected to an intracranial lead or pigtail which measures or senses intracranial physiologic signals such as intracranial fluid pressure and/or temperature. The implantable medical device is preferably implanted subcutaneously beneath a patient's skin and telemeters stored data or real-time-sensed data to an external device which may be configured to combine barometric pressure data with intracranial pressure data to derive intracranial gage pressure. The implantable medical device and its associated lead reduce the risk of intracranial infections.
摘要翻译：具有容纳电气和电子电路的气密密封的壳体和用于为这种电路供电的电池的可植入医疗装置连接到测量或感测颅内生理信号如颅内流体压力和/或温度的颅内引线或尾纤。优选将植入式医疗装置皮下植入患者皮肤下方，并将电能存储数据或实时检测数据传输到外部装置，外部装置可被配置为将大气压力数据与颅内压数据组合以导出颅内计量压力。可植入医疗器械及其相关的导线可降低颅内感染的风险。

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