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1. 发明申请

US20090275854A1 SYSTEM AND METHOD OF MONITORING PHYSIOLOGIC PARAMETERS BASED ON COMPLEX IMPEDANCE WAVEFORM MORPHOLOGY 审中-公开
标题翻译：基于复杂阻抗波形形态监测生理参数的系统和方法
公开(公告)号：US20090275854A1
公开(公告)日：2009-11-05
申请号：US12112655
申请日：2008-04-30
申请人： Todd M. Zielinski , Douglas A. Hettrick , Eduardo N. Warman
发明人： Todd M. Zielinski , Douglas A. Hettrick , Eduardo N. Warman
IPC分类号： A61B5/053
CPC分类号： A61B5/053 , A61B5/029 , A61B5/0538 , A61N1/36521
摘要： Changes in physiologic parameters may be detected in a patient by measuring the impedance of a tissue segment located in a selected electrode vector field, storing baseline impedance information based on the measured impedance, detecting changes in impedance characteristics from the baseline impedance information, and providing alerts for changes in the physiologic parameters based on the detected changes in impedance characteristics. In some situations, detecting the changes in impedance characteristics involves detecting changes in morphology of an impedance waveform, such as a cardiac component of an impedance waveform, a respiratory component of an impedance waveform, and the phase angle of the complex impedance.
摘要翻译：可以通过测量位于所选择的电极向量场中的组织段的阻抗，基于所测量的阻抗存储基线阻抗信息，从基线阻抗信息检测阻抗特性的变化，并提供警报来检测患者生理参数的变化基于检测到的阻抗特性变化对生理参数进行变化。在某些情况下，检测阻抗特性的变化涉及检测阻抗波形的形态变化，例如阻抗波形的心脏分量，阻抗波形的呼吸成分和复阻抗的相位角。

2. 发明授权

US08938292B2 Estimating cardiovascular pressure and volume using impedance measurements 有权
标题翻译：使用阻抗测量估算心血管压力和体积
公开(公告)号：US08938292B2
公开(公告)日：2015-01-20
申请号：US12263065
申请日：2008-10-31
申请人： Douglas A. Hettrick , Yong K. Cho , Mattias Rouw , Shantanu Sarkar , Todd M. Zielinski
发明人： Douglas A. Hettrick , Yong K. Cho , Mattias Rouw , Shantanu Sarkar , Todd M. Zielinski
IPC分类号： A61B5/05 , A61N1/365 , A61B5/0215 , A61B5/053 , A61B5/021 , A61B5/00
CPC分类号： A61N1/36521 , A61B5/021 , A61B5/0215 , A61B5/02158 , A61B5/053 , A61B5/0535 , A61B5/0538 , A61B5/7239 , A61N1/36564
摘要： Techniques for estimating a cardiac chamber or vascular pressure based upon impedance are described. A device or system may measure an impedance between at least two electrodes implanted within or proximate to a cardiovascular system. The device or system may estimate a pressure of an element of the cardiovascular system based on a relationship between impedance and volume of the element, and based on a empirical relationship between the volume and the pressure. The device or system may also estimate the dimension of the element based on the impedance-volume relationship, or other characteristics based on the impedance. Because the impedance measurements may be obtained, in some examples, by using electrodes and leads implanted within the cardiovascular system and coupled to an implantable medical device, a practical estimation of a cardiovascular pressure can be obtained on a chronic basis without requiring the use other invasive sensors, such as micronanometer transducers.
摘要翻译：描述了基于阻抗估计心室或血管压力的技术。装置或系统可以测量植入在心血管系统内或其附近的至少两个电极之间的阻抗。装置或系统可以基于元件的阻抗和体积之间的关系，并且基于体积和压力之间的经验关系来估计心血管系统的元件的压力。装置或系统还可以基于阻抗 - 体积关系或基于阻抗的其它特性来估计元件的尺寸。由于可以获得阻抗测量值，在一些示例中，通过使用植入心血管系统内并连接到可植入医疗装置的电极和引线，可以长期获得心血管压力的实际估计，而不需要使用其它侵入性传感器，如微量计传感器。

3. 发明授权

US08744565B2 Multi-frequency impedance monitoring system 有权
标题翻译：多频阻抗监测系统
公开(公告)号：US08744565B2
公开(公告)日：2014-06-03
申请号：US12112765
申请日：2008-04-30
申请人： Todd M. Zielinski , Douglas A. Hettrick , Shantanu Sarkar
发明人： Todd M. Zielinski , Douglas A. Hettrick , Shantanu Sarkar
IPC分类号： A61B5/00
CPC分类号： A61B5/0809 , A61B5/053 , A61B5/0538 , A61B5/4869 , A61B5/686 , A61B5/7257 , A61N1/36521
摘要： A system and method is provided to measure intrathoracic complex impedance and to identify and indicate disease conditions based on the impedance measurements. Multiple impedance vectors may betaken into account, and an optimal vector may be selected to provide the most useful impedance measurement for the identification and indication of disease conditions.
摘要翻译：提供了一种系统和方法来测量胸腔内复合阻抗，并根据阻抗测量来识别和指示疾病状况。可以考虑多个阻抗向量，并且可以选择最佳向量以提供用于疾病状况的识别和指示的最有用的阻抗测量。

4. 发明授权

US08241222B2 Monitoring hemodynamic status based on intracardiac or vascular impedance 有权
标题翻译：基于心内或血管阻抗监测血液动力学状态
公开(公告)号：US08241222B2
公开(公告)日：2012-08-14
申请号：US12262941
申请日：2008-10-31
申请人： Todd M. Zielinski , Douglas A. Hettrick , Mattias Rouw
发明人： Todd M. Zielinski , Douglas A. Hettrick , Mattias Rouw
IPC分类号： A61B5/02
CPC分类号： A61N1/36521 , A61B5/021 , A61B5/0215 , A61B5/02158 , A61B5/053 , A61B5/0535 , A61B5/0538 , A61B5/7239 , A61N1/36564
摘要： This disclosure relates to monitoring intracardiac or vascular impedance to determine a change in hemodynamic status by detecting changes in an impedance parameter over cardiac cycles. An example method includes measuring a plurality of impedance values of a path within a patient over time, wherein the path includes at least one blood vessel or cardiac chamber of the patient, and wherein the impedance values vary as a function of blood pressure within the at least one vessel or chamber, determining a plurality of values of an impedance parameter over time based on the measured impedance values, wherein each of the impedance parameter values is determined based on a respective sub-plurality of the impedance values, comparing at least one of the impedance parameter values to at least one prior impedance parameter value, and identifying a change in a cardiovascular parameter related to the blood pressure based on the comparison.
摘要翻译：本公开涉及监测心脏内或血管阻抗，以通过检测心动周期上的阻抗参数的变化来确定血液动力学状态的变化。一个示例性方法包括测量患者随着时间的路径的多个阻抗值，其中所述路径包括患者的至少一个血管或心室，并且其中阻抗值随着at 至少一个容器或室，基于所测量的阻抗值确定随时间的多个阻抗参数值，其中每个所述阻抗参数值是基于所述阻抗值的相应次级多个来确定的，阻抗参数值至少一个先前的阻抗参数值，并且基于该比较来识别与血压相关的心血管参数的变化。

5. 发明申请

US20110190654A1 QUANTIFYING AUTONOMIC TONE WITH THORACIC IMPEDANCE 有权
标题翻译：定量自动音调与THORACIC阻抗
公开(公告)号：US20110190654A1
公开(公告)日：2011-08-04
申请号：US12696753
申请日：2010-01-29
申请人： Douglas A. Hettrick , Donald J. Hefner , Shantanu Sarkar , Todd M. Zielinski
发明人： Douglas A. Hettrick , Donald J. Hefner , Shantanu Sarkar , Todd M. Zielinski
IPC分类号： A61B5/053
CPC分类号： A61N1/36521 , A61B5/0031 , A61B5/0215 , A61B5/02405 , A61B5/053 , A61B5/08 , A61B5/11 , A61B5/1116 , A61B5/4035 , A61N1/36535 , A61N1/37247 , A61N1/37258
摘要： The disclosure describes techniques for quantifying the autonomic nervous system (ANS) health of a patient with thoracic impedance measurements. Thoracic impedance may be measured utilizing cardiac electrodes and an implantable medical device housing or other electrodes located on or within the patient. Since greater variability in thoracic impedance may indicate better health of the ANS, monitoring impedance changes in a patient may be used to quantify autonomic tone of the ANS, and ultimately, overall patient health. In some examples, thoracic impedance may be measured in response to a change in patient posture for acute monitoring or at predetermined times over several days, weeks, or months for more chronic monitoring of the patient. An implantable medical device may independently analyze the impedance measurements and transmit an alert to the patient or clinician when impedance changes indicate a change in patient health.
摘要翻译：本公开描述了用于量化具有胸部阻抗测量的患者的自主神经系统（ANS）健康的技术。可以使用心电极和位于患者内部或内部的可植入医疗装置外壳或其它电极来测量胸腔阻抗。由于胸部阻抗变化较大可能表明ANS的健康状况良好，所以监测患者的阻抗变化可用于量化ANS的自主音调，并最终对整体患者的健康状况进行量化。在一些示例中，可以响应于用于急性监测的患者姿势的变化或在几天，几周或几个月的预定时间来测量胸部阻抗以进行更长期的患者监测。当阻抗变化表示患者健康状况发生变化时，植入式医疗设备可以独立地分析阻抗测量结果并向患者或临床医生发送警报。

6. 发明授权

US08435186B2 Quantifying autonomic tone with thoracic impedance 有权
标题翻译：量化自主神经与胸阻抗
公开(公告)号：US08435186B2
公开(公告)日：2013-05-07
申请号：US12696753
申请日：2010-01-29
申请人： Douglas A. Hettrick , Donald J. Hefner , Shantanu Sarkar , Todd M. Zielinski
发明人： Douglas A. Hettrick , Donald J. Hefner , Shantanu Sarkar , Todd M. Zielinski
IPC分类号： A61B5/00
CPC分类号： A61N1/36521 , A61B5/0031 , A61B5/0215 , A61B5/02405 , A61B5/053 , A61B5/08 , A61B5/11 , A61B5/1116 , A61B5/4035 , A61N1/36535 , A61N1/37247 , A61N1/37258
摘要： The disclosure describes techniques for quantifying the autonomic nervous system (ANS) health of a patient with thoracic impedance measurements. Thoracic impedance may be measured utilizing cardiac electrodes and an implantable medical device housing or other electrodes located on or within the patient. Since greater variability in thoracic impedance may indicate better health of the ANS, monitoring impedance changes in a patient may be used to quantify autonomic tone of the ANS, and ultimately, overall patient health. In some examples, thoracic impedance may be measured in response to a change in patient posture for acute monitoring or at predetermined times over several days, weeks, or months for more chronic monitoring of the patient. An implantable medical device may independently analyze the impedance measurements and transmit an alert to the patient or clinician when impedance changes indicate a change in patient health.
摘要翻译：本公开描述了用于量化具有胸部阻抗测量的患者的自主神经系统（ANS）健康的技术。可以使用心电极和位于患者内部或内部的可植入医疗装置外壳或其它电极来测量胸腔阻抗。由于胸部阻抗变化较大可能表明ANS的健康状况良好，所以监测患者的阻抗变化可用于量化ANS的自主音调，并最终对整体患者的健康状况进行量化。在一些示例中，可以响应于用于急性监测的患者姿势的变化或在几天，几周或几个月的预定时间来测量胸部阻抗以进行更长期的患者监测。当阻抗变化表示患者健康状况发生变化时，植入式医疗设备可以独立地分析阻抗测量结果并向患者或临床医生发送警报。

7. 发明申请

US20100030087A1 ESTIMATING CARDIOVASCULAR PRESSURE AND VOLUME USING IMPEDANCE MEASUREMENTS 有权
标题翻译：使用阻力测量估算心血管压力和体积
公开(公告)号：US20100030087A1
公开(公告)日：2010-02-04
申请号：US12263065
申请日：2008-10-31
申请人： Douglas A. Hettrick , Yong K. Cho , Mattias Rouw , Shantanu Sarkar , Todd M. Zielinski
发明人： Douglas A. Hettrick , Yong K. Cho , Mattias Rouw , Shantanu Sarkar , Todd M. Zielinski
IPC分类号： A61B5/0215 , A61B5/053
CPC分类号： A61N1/36521 , A61B5/021 , A61B5/0215 , A61B5/02158 , A61B5/053 , A61B5/0535 , A61B5/0538 , A61B5/7239 , A61N1/36564
摘要： Techniques for estimating a cardiac chamber or vascular pressure based upon impedance are described. A device or system may measure an impedance between at least two electrodes implanted within or proximate to a cardiovascular system. The device or system may estimate a pressure of an element of the cardiovascular system based on a relationship between impedance and volume of the element, and based on a empirical relationship between the volume and the pressure. The device or system may also estimate the dimension of the element based on the impedance-volume relationship, or other characteristics based on the impedance. Because the impedance measurements may be obtained, in some examples, by using electrodes and leads implanted within the cardiovascular system and coupled to an implantable medical device, a practical estimation of a cardiovascular pressure can be obtained on a chronic basis without requiring the use other invasive sensors, such as micronanometer transducers.
摘要翻译：描述了基于阻抗估计心室或血管压力的技术。装置或系统可以测量植入在心血管系统内或其附近的至少两个电极之间的阻抗。装置或系统可以基于元件的阻抗和体积之间的关系，并且基于体积和压力之间的经验关系来估计心血管系统的元件的压力。装置或系统还可以基于阻抗 - 体积关系或基于阻抗的其它特性来估计元件的尺寸。由于可以获得阻抗测量值，在一些示例中，通过使用植入心血管系统内并连接到可植入医疗装置的电极和引线，可以长期获得心血管压力的实际估计，而不需要使用其它侵入性传感器，如微量计传感器。

8. 发明申请

US20090270934A1 Pressure and Impedance Based Discrimination of Hemodynamic Stability 有权
公开(公告)号：US20090270934A1
公开(公告)日：2009-10-29
申请号：US12108818
申请日：2008-04-24
申请人： Douglas A. Hettrick , Kevin P. Vincent , Shantanu Sarkar , Yong Kyun Cho , Todd M. Zielinski
发明人： Douglas A. Hettrick , Kevin P. Vincent , Shantanu Sarkar , Yong Kyun Cho , Todd M. Zielinski
IPC分类号： A61N1/39
CPC分类号： A61N1/36585 , A61B5/0215 , A61B5/0402 , A61B5/053 , A61N1/36521 , A61N1/36564
摘要： An implantable cardioverter defibrillator evaluates the hemodynamic stability of an arrhythmia to determine whether or not to defibrillate. The device obtains cardiac pressure and cardiac impedance data and evaluates a phase relationship between these parameters. Hemodynamically stable rhythms will result in an out of phase relationship.

9. 发明申请

US20090270933A1 Pressure and Impedance Based Discrimination of Hemodynamic Stability 有权
标题翻译：基于压力和阻抗的血液动力学稳定性鉴别
公开(公告)号：US20090270933A1
公开(公告)日：2009-10-29
申请号：US12108785
申请日：2008-04-24
申请人： Douglas A. Hettrick , Kevin P. Vincent , Shantanu Sarkar , Yong-yo K.Y. Cho , Todd M. Zielinski
发明人： Douglas A. Hettrick , Kevin P. Vincent , Shantanu Sarkar , Yong-yo K.Y. Cho , Todd M. Zielinski
IPC分类号： A61N1/39
CPC分类号： A61N1/36585 , A61B5/0535 , A61B5/0538 , A61B5/7264 , A61N1/00 , A61N1/36521 , A61N1/36564 , A61N1/3962
摘要： An implantable cardioverter defibrillator evaluates the hemodynamic stability of an arrhythmia to determine whether or not to defibrillate. The device obtains cardiac pressure and cardiac impedance data and evaluates a phase relationship between these parameters. Hemodynamically stable rhythms will result in an out of phase relationship.
摘要翻译：植入式心律转复除颤器评估心律失常的血液动力学稳定性，以确定是否除颤。该装置获得心脏压力和心脏阻抗数据，并评估这些参数之间的相位关系。血液动力学稳定的节律将导致异相关系。

10. 发明授权

US07181283B2 System and method for controlling implantable medical device parameters in response to atrial pressure attributes 有权
标题翻译：用于根据心房压力属性控制植入式医疗装置参数的系统和方法
公开(公告)号：US07181283B2
公开(公告)日：2007-02-20
申请号：US11097408
申请日：2005-03-31
申请人： Douglas A. Hettrick , Todd M. Zielinski , Amber L Jaeger , Nicole M. Campbell
发明人： Douglas A. Hettrick , Todd M. Zielinski , Amber L Jaeger , Nicole M. Campbell
IPC分类号： A61N1/365 , A61B5/021
CPC分类号： A61N1/36564
摘要： In an implantable medical device a real-time left atrial pressure (“LAP”) signal obtained from a patient's heart is used as a feedback control mechanism to adjust one or more device parameters. In one example the device identifies specific characteristics and attributes of the LAP signal that correlate to hemodynamic performance, and adjusts the device parameters to optimize the LAP characteristics and attributes. In a dual-chamber pacing system, the controlled operating parameter may include the atrioventricular pacing delay, and LAP attribute suitable for controlling the atrioventricular pacing delay time intervals of v-wave, a-wave, and/or c-wave characteristics of the LAP signal.
摘要翻译：在可植入医疗装置中，使用从患者心脏获得的实时左心房压力（“LAP”）信号作为反馈控制机构来调节一个或多个装置参数。在一个示例中，设备识别与血液动力学性能相关的LAP信号的特定特征和属性，并且调整设备参数以优化LAP特征和属性。在双室起搏系统中，受控操作参数可以包括房室起搏延迟，并且LAP属性适用于控制LAP的v波，a波和/或c波特征的房室起搏延迟时间间隔信号。

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