专利快速检索-快速检索全球专利，免费商用专利数据库-IPRDB

1. 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。

2. 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。

3. 发明授权

US07991467B2 Remotely enabled pacemaker and implantable subcutaneous cardioverter/defibrillator system 有权
标题翻译：远程启动心脏起搏器和植入式皮下心律转复/除颤器系统
公开(公告)号：US07991467B2
公开(公告)日：2011-08-02
申请号：US11114474
申请日：2005-04-26
申请人： H. Toby Markowitz , Douglas A. Hettrick , William J. Combs , Todd J. Sheldon , David L. Thompson , Raja N. Ghanem , Kevin A. Wanasek
发明人： H. Toby Markowitz , Douglas A. Hettrick , William J. Combs , Todd J. Sheldon , David L. Thompson , Raja N. Ghanem , Kevin A. Wanasek
IPC分类号： A61B5/02 , A61N1/362
CPC分类号： A61N1/3962 , A61N1/025 , A61N1/37211 , A61N1/37229 , A61N1/37288
摘要： Subcutaneous Implantable cardioverter-defibrillators (SubQ ICDs) are disclosed that are entirely implantable subcutaneously with minimal surgical intrusion into the body of the patient and provide distributed cardioversion-defibrillation sense and stimulation electrodes for delivery of cardioversion-defibrillation shock and pacing therapies across the heart when necessary. The SubQ ICD is implemented with other implantable and external medical devices and communicates to provide drugs and therapy in a coordinated and synergistic manner.
摘要翻译：皮下植入式心脏复律除颤器（SubQ ICD）被公开，其完全可植入皮下，以最小的外科手术入侵患者体内，并提供分布式心脏复律除颤感和刺激电极，用于在整个心脏中递送心脏复律除颤休克和起搏疗法必要。 SubQ ICD与其他植入式和外部医疗设备一起实施，并以协调和协同的方式进行通信以提供药物和治疗。

4. 发明授权

US6044297A Posture and device orientation and calibration for implantable medical devices 有权
标题翻译：植入式医疗设备的姿势和设备定向和校准
公开(公告)号：US6044297A
公开(公告)日：2000-03-28
申请号：US160647
申请日：1998-09-25
申请人： Todd J. Sheldon , William J. Combs , Mark K. Erickson , Can Cinbis
发明人： Todd J. Sheldon , William J. Combs , Mark K. Erickson , Can Cinbis
IPC分类号： A61N1/365 , A61N1/362
CPC分类号： A61N1/36542 , A61N1/36535
摘要： A method of and apparatus for determining the physical posture of a patient's body, having a superior-inferior body axis, an anterior-posterior body axis and a lateral-medial body axis, in relation to earth's gravitational field. A medical device having first, second and, optionally, third accelerometers having sensitive axes mounted orthogonally within an implantable housing is adapted to be implanted with the sensitive axes nominally aligned with ideal X, Y and Z device axes correlated to patient body axes. Each accelerometer generates DC accelerometer signals having characteristic magnitudes and polarities on alignment of the sensitive axis with, against or normal to earth's gravitational field and DC accelerometer signals of varying magnitudes and polarities when not so aligned. The actual pitch and roll angles of the sensitive axes of the accelerometers in the implanted IMD with respect to the true gravitational axes are determined and the yaw angles are determined or estimated. Corrected DC accelerometer output signals are derived from the pitch, roll and yaw angles and are compared to a set of stored thresholds for each body posture to determine the actual body posture. Storage of these comparisons or the raw signals themselves can be used for histogram data to provide theraputic or research benefits also described.
摘要翻译：一种用于确定患者身体的物理姿势的方法和装置，其具有相对于地球重力场的上下身体轴线，前后身体轴线和侧向内侧身体轴线。具有第一，第二和第三加速度计的医疗设备具有正交安装在可植入的外壳内的敏感轴，适于植入与名义上与理想的与患者体轴相关的X，Y和Z装置轴对准的敏感轴。每个加速度计产生具有特征幅度和极性的特征幅度和极性的直流加速度计信号，当不对准时，敏感轴对准或反对或垂直于地球重力场和具有不同幅度和极性的直流加速度计信号。确定和估计在植入的IMD中相对于真重力轴的加速度计的敏感轴的实际俯仰角和倾斜角，并且确定或估计偏航角。校正的直流加速度计输出信号是从俯仰角，偏转角和偏航角度得出的，并且与每个身体姿势的一组存储的阈值进行比较，以确定实际的身体姿势。这些比较或原始信号本身的存储可用于直方图数据，以提供还描述的治疗或研究益处。

5. 发明授权

US07130679B2 Organ rejection monitoring 有权
标题翻译：器官排斥监测
公开(公告)号：US07130679B2
公开(公告)日：2006-10-31
申请号：US10299397
申请日：2002-11-20
申请人： Victor Parsonnet , William J. Combs
发明人： Victor Parsonnet , William J. Combs
IPC分类号： A61B5/05
CPC分类号： A61B5/413 , A61B5/0537
摘要： The invention is directed to techniques for monitoring organ rejection. An implanted device monitors the impedance of the transplanted organ. When the impedance measurements indicate that the organ is being rejected, the device provides early warning of rejection.
摘要翻译：本发明涉及用于监测器官排斥的技术。植入装置监测移植器官的阻抗。当阻抗测量表明器官被拒绝时，器件提供拒收的早期警告。

6. 发明授权

US06584352B2 Leadless fully automatic pacemaker follow-up 有权
公开(公告)号：US06584352B2
公开(公告)日：2003-06-24
申请号：US09749169
申请日：2000-12-27
申请人： William J. Combs , Gary Berg
发明人： William J. Combs , Gary Berg
IPC分类号： A61N1362
CPC分类号： A61N1/37252 , A61N1/3702 , A61N1/37288
摘要： A leadless fully automatic follow-up (LFAPF) device that is triggered into operation either locally or remotely is implemented extra-corporeally to access cardiac data such as ECGs stored in one or more implantable medical device (IMDs) implanted in one or more patients. A telemetry unit is used in the LFAPF to transmit and test stored data in the IMDs. The telemetry unit implements a series of adjustable commands depending on the desired level of detail of the follow-up. An alternate embodiment representing intra-corporeal use of an additional device includes cardiac data monitoring and cardioversion pulse synchronization in cooperation with another IMD such as a pacer.

7. 发明授权

US5902325A Method and apparatus for detecting cardiac capture 失效
标题翻译：用于检测心脏捕获的方法和装置
公开(公告)号：US5902325A
公开(公告)日：1999-05-11
申请号：US126469
申请日：1998-07-30
申请人： Catherine R. Condie , Daniel J. Baxter , William J. Combs , Daniel J. Greeninger , Karen J. Kleckner , H. Toby Markowitz , John C. Stroebel , John D. Wahlstrand
发明人： Catherine R. Condie , Daniel J. Baxter , William J. Combs , Daniel J. Greeninger , Karen J. Kleckner , H. Toby Markowitz , John C. Stroebel , John D. Wahlstrand
IPC分类号： A61N1/365 , A61N1/37
CPC分类号： A61N1/36521 , A61N1/3712 , A61N1/3714
摘要： A method and apparatus for automatic determination of a pacemaker patient's pacing stimulation threshold. Circuitry is provided in a pacemaker for obtaining a signal reflecting cardiac impedance, which is known to reliably reflect certain aspects of cardiac function. Circuitry is also provided for monitoring the cardiac impedance waveform during a predetermined capture detect window following delivery of stimulating pulses. One or more values are derived which characterize the morphology of the impedance waveform during the capture detect window associated with each stimulation pulse delivered. These values are compared to predetermined control values in order to assess whether a stimulation pulse has achieved cardiac capture. The assessment of whether cardiac capture has been achieved is also based partly upon the conventional sensing of atrial and/or ventricular cardiac signals occurring during the capture detect window. In one embodiment of the invention, the control values against which impedance waveform characterization values are compared are obtained by delivering a series of stimulation pulses having sufficient energy to ensure that capture is achieved, and by monitoring the impedance waveform during delivery of these pulses.
摘要翻译：一种用于自动确定起搏器患者起搏刺激阈值的方法和装置。在起搏器中提供电路以获得反映心脏阻抗的信号，这已知可靠地反映心脏功能的某些方面。还提供电路用于在传送刺激脉冲之后的预定捕获检测窗口期间监测心脏阻抗波形。导出一个或多个值，其表征在与递送的每个刺激脉冲相关联的捕获检测窗口期间阻抗波形的形态。将这些值与预定的控制值进行比较，以便评估刺激脉冲是否已经实现心脏捕获。是否已经实现心脏捕获的评估也部分地基于在捕获检测窗口期间发生的心房和/或心室心脏信号的常规感测。在本发明的一个实施例中，通过递送具有足够能量的一系列刺激脉冲来确定阻抗波形表征值被比较的控制值，以确保实现捕获，并且通过在传送这些脉冲期间监视阻抗波形来获得。

8. 发明授权

US5782888A Method of selecting an operating mode for an implantable medical device 失效
标题翻译：选择可植入医疗装置的操作模式的方法
公开(公告)号：US5782888A
公开(公告)日：1998-07-21
申请号：US823006
申请日：1997-03-21
申请人： Weimin Sun , Eric J. Panken , William J. Combs
发明人： Weimin Sun , Eric J. Panken , William J. Combs
IPC分类号： A61B5/042 , A61B5/0464 , A61N1/37
CPC分类号： A61B5/726 , A61B5/0422 , A61B5/0464 , A61B5/7203 , A61B5/7267 , A61B5/7225
摘要： This is a method and apparatus for the automated discrimination of cardiac events of interest, including P-waves, R-waves, T-waves and specific arrhythmic sequences, in EGM signals for data storage in an implantable monitor or to control operations of an implantable cardiac stimulator through the use of Hidden Markov Modeling techniques and a reduced set of observations.
摘要翻译：这是用于自动辨别感兴趣的心脏事件（包括P波，R波，T波和特定心律失常序列）的方法和装置，用于在可植入监测器中进行数据存储的EGM信号中，或用于控制可植入的心脏刺激器通过使用隐马尔可夫建模技术和一组减少的观察结果。

9. 发明授权

US5755739A Adaptive and morphological system for discriminating P-waves and R-waves inside the human body 失效
标题翻译：用于辨别人体内P波和R波的自适应和形态系统
公开(公告)号：US5755739A
公开(公告)日：1998-05-26
申请号：US759902
申请日：1996-12-04
申请人： Weimin Sun , Pamela A. Abshire , Eric J. Panken , William J. Combs
发明人： Weimin Sun , Pamela A. Abshire , Eric J. Panken , William J. Combs
IPC分类号： A61B5/0452 , A61N1/368 , A61N1/37 , A61N1/362 , A61B5/0464
CPC分类号： A61N1/3704 , A61B5/04525 , A61N1/368
摘要： The present invention is a method and apparatus for processing a sensed atrial electrogram in conjunction with a sensed ventricular electrogram. The present invention permits accurate discrimination of atrial P-waves from far field ventricular events such as far field R-waves and avoids oversensing such far field ventricular events as atrial sense events and undersensing atrial events occurring within a fusion beat masked by a far field ventricular event in the atrial electrogram. Atrial channel trigger signals are generated in response to sensed P-waves and far field R-waves in the atrial electrogram, and ventricular trigger signals are generated in response to sensed R-waves in the ventricular electrogram. In response to each ventricular channel trigger signal, the sensed atrial electrogram signal is adaptively filtered for an adaptive filter time window only to remove the far field R-wave signal from the sensed atrial electrogram signal while avoiding adaptive filtering of the sensed atrial electrogram signal at other times. In response to each atrial channel trigger signal, the adaptively filtered, sensed atrial electrogram signal is subjected to morphological analysis in respect of a morphological model of a P-wave only during a morphology time window. In this manner, P-waves in the sensed atrial electrogram signal are detected and far field R-waves in the sensed atrial electrogram signal are not mistakenly detected as P-waves, while morphological analysis of the sensed atrial electrogram at other times is avoided.
摘要翻译：本发明是一种结合感测的心室电描记图处理感测的心房电描记图的方法和装置。本发明允许从远场心室事件（例如远场R波）中准确地辨别心房P波，并避免过度监测诸如心房感觉事件的远场心室事件以及在由远场心室掩蔽的融合搏动内发生的低度心房事件心房电图中的事件。响应于心房电描记图中的感测到的P波和远场R波产生心房通道触发信号，并且响应于心室电图中的感测到的R波而产生心室触发信号。响应于每个心室通道触发信号，感测的心房电描记信号被自适应滤波以用于自适应滤波器时间窗口，仅从感测的心房电描记图信号中去除远场R波信号，同时避免对感测的心房电描记图信号的自适应滤波其他时候。响应于每个心房通道触发信号，仅在形态学时间窗口期间，自适应滤波感应的心房电描记信号就P波的形态学模型进行形态学分析。以这种方式，检测到感测的心房电描记信号中的P波，并且将感测到的心房电描记信号中的远场R波未被错误地检测为P波，同时避免了其他时间的感测的心房电描记图的形态学分析。

10. 发明授权

US5562711A Method and apparatus for rate-responsive cardiac pacing 失效
标题翻译：速率响应心脏起搏方法和装置
公开(公告)号：US5562711A
公开(公告)日：1996-10-08
申请号：US346813
申请日：1994-11-30
申请人： Charles G. Yerich , William J. Combs , Karen J. Kleckner , Eric J. Panken , Richard S. Schallhorn , John D. Wahlstrand
发明人： Charles G. Yerich , William J. Combs , Karen J. Kleckner , Eric J. Panken , Richard S. Schallhorn , John D. Wahlstrand
IPC分类号： A61N1/365
CPC分类号： A61N1/36585
摘要： A body-implantable rate-responsive cardiac pacemaker is provided with circuitry for sensing a plurality of physiologic parameters known to be indicative of a patient's metabolic demand for increased cardiac output. In one embodiment, a rate-responsive pacemaker is provided with an activity sensor for detecting the patient's level of physical activity, and is further provided with an impedance sensing circuit for detecting the patient's level of minute ventilation by monitoring cardiac impedance. A rate-response transfer function, implemented by the pacemaker's control circuitry, periodically computes a rate-responsive pacing rate as a function of the outputs from both physiologic sensing circuits. The pacemaker's pacing rate is variable within a rate range defined by predetermined (programmable) upper and lower limits. In the preferred embodiment, the influence of activity sensing and minute ventilation parameters varies in accordance with the current pacing rate. In particular, the influence of activity sensing in rate determination in accordance with the rate-response function is greater than that of minute ventilation, for slower pacing rates, while the influence of minute ventilation sensing dominates over that of activity sensing for higher pacing rates. Rate response operation of the disclosed system is recorded in the form of histogram data stored over a predetermined history time. The relative influence of the activity sensing and minute ventilation sensing on rate determination is periodically scaled or balanced based upon comparison of the histogram data with predetermined desired response data.
摘要翻译：身体植入式速率响应心脏起搏器被提供有用于感测已知指示患者对增加的心输出量的代谢需求的多个生理参数的电路。在一个实施例中，速率响应起搏器设置有用于检测患者的身体活动水平的活动传感器，并且还设置有阻抗感测电路，用于通过监测心脏阻抗来检测患者的分钟通气水平。由起搏器的控制电路实现的速率响应传递函数周期性地计算速率响应起搏速率作为来自生理感测电路的输出的函数。起搏器的起搏速率在由预定（可编程）上限和下限限定的速率范围内是可变的。在优选实施例中，活动感测和分钟通气参数的影响根据当前起搏速率而变化。特别是，根据速率响应函数的速率测定中的活动检测的影响大于分钟通气量，对于较慢的起搏速率，而微动通气检测的影响比活动检测的影响高于起搏率。以预定历史时间存储的直方图数据的形式记录所公开的系统的速率响应操作。基于直方图数据与预定的期望响应数据的比较，活动感测和分钟通气感测对速率确定的相对影响被周期地缩放或平衡。

你已经成功收藏专利！

检索式保存成功!

IPRDB

热门服务

关于我们

友情链接

联系方式