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1. 发明申请

US20050148897A1 Implantable medical device with sleep disordered breathing monitoring 有权
标题翻译：可植入医疗器械，带有睡眠呼吸障碍监测
公开(公告)号：US20050148897A1
公开(公告)日：2005-07-07
申请号：US10746814
申请日：2003-12-24
申请人： Yong Cho , Eduardo Warman , Todd Sheldon
发明人： Yong Cho , Eduardo Warman , Todd Sheldon
IPC分类号： A61B5/00 , A61B5/0205 , A61B5/0215 , A61B5/022 , A61B5/0245 , A61B5/0456 , A61B5/0464 , A61B5/0476 , A61B5/08 , A61B5/083 , A61B5/087 , A61B5/11 , A61B5/113 , A61B7/00 , A61N1/36 , A61N1/365
CPC分类号： A61N1/3601 , A61B5/0031 , A61B5/01 , A61B5/0205 , A61B5/0215 , A61B5/022 , A61B5/0245 , A61B5/0456 , A61B5/0464 , A61B5/0476 , A61B5/0809 , A61B5/0816 , A61B5/0833 , A61B5/0836 , A61B5/087 , A61B5/0878 , A61B5/1116 , A61B5/1118 , A61B5/1135 , A61B5/4818 , A61B7/003 , A61N1/36521 , A61N1/36557
摘要： An implantable medical device (IMD) includes a sensor for monitoring parameters indicative of sleep disordered breathing. The IMD also includes a position sensor that indicates the relative position and/or activity level of the patient. The position sensor data is used in one or more ways in conjunction with the SDB sensing. The position data is used to confirm that such sensed data is likely indicative of SDB or to select the appropriate criteria for comparison.
摘要翻译：可植入医疗装置（IMD）包括用于监测指示睡眠呼吸紊乱的参数的传感器。 IMD还包括指示患者的相对位置和/或活动水平的位置传感器。位置传感器数据以一种或多种方式与SDB感测结合使用。位置数据用于确认这样的感测数据可能表示SDB或选择适当的比较标准。

2. 发明申请

US20050119711A1 Apparatus and method for monitoring for disordered breathing 有权
标题翻译：用于监测无序呼吸的装置和方法
公开(公告)号：US20050119711A1
公开(公告)日：2005-06-02
申请号：US10419404
申请日：2003-04-21
申请人： Yong Cho , Abed Lawabni , Todd Sheldon , H. Markowitz , Sameh Sowelam , Raylene Pitschneider
发明人： Yong Cho , Abed Lawabni , Todd Sheldon , H. Markowitz , Sameh Sowelam , Raylene Pitschneider
IPC分类号： A61B5/0205 , A61B5/08 , A61N1/18
CPC分类号： A61B5/4818 , A61B5/0205 , A61B5/0809 , A61B5/0816 , G06F19/00
摘要： The present invention relates to a device and method for monitoring for sleep disordered breathing or other types of disordered breathing such as Cheyne-Stokes breathing. More specifically, a device and method for detecting disordered breathing is provided that monitors a physiological parameter, which becomes cyclical due to apnea-hyperpnea (or arousal) alternation and provides the basis for the determination of a number of breathing disorder metrics.
摘要翻译：本发明涉及一种用于监测睡眠呼吸紊乱或其他类型无序呼吸（例如Cheyne-Stokes呼吸）的装置和方法。更具体地，提供了一种用于检测无序呼吸的装置和方法，其监测由于呼吸暂停呼吸（或唤醒）交替而变得周期性的生理参数，并且提供了确定多个呼吸障碍度量的基础。

3. 发明申请

US20050203579A1 Real-time optimization of right to left ventricular timing sequence in bi-ventircular pacing of heart failure patients 有权
标题翻译：心力衰竭患者双向心脏起搏的左心室正时序列的实时优化
公开(公告)号：US20050203579A1
公开(公告)日：2005-09-15
申请号：US10799260
申请日：2004-03-12
申请人： Sameh Sowelam , Todd Sheldon , Yong Cho
发明人： Sameh Sowelam , Todd Sheldon , Yong Cho
IPC分类号： A61B5/103 , A61N1/362 , A61N1/365 , A61N1/368 , A61N1/18 , A61N1/20 , A61N1/22
CPC分类号： A61N1/368 , A61N1/3627 , A61N1/36521 , A61N1/3684
摘要： A system and automated method for assessing ventricular synchrony in ambulatory patients is provided including at least one mechanical sensor (e.g., accelerometer, tensiometric sensor, force transducer, and the like) operatively coupled to a first myocardial location in order to measure a wall motion signal of a first chamber, and a second mechanical sensor operatively coupled to a second myocardial location in order to measure a wall motion signal of a second chamber. The wall motion signals are processed in order to identify the time at which a fiducial (e.g., an inflection point, a threshold crossing, a maximum amplitude, etc.) occurs for each respective signal. The temporal separation between the fiducial points on each respective signal is measured as a metric of ventricular synchrony and can be optionally utilized to adjust pacing therapy timing to improve synchrony.
摘要翻译：提供了一种用于评估移动患者的心室同步的系统和自动化方法，其包括至少一个可操作地耦合到第一心肌位置的机械传感器（例如，加速度计，张力传感器，力换能器等），以便测量壁运动信号以及可操作地耦合到第二心肌位置的第二机械传感器，以便测量第二腔室的壁运动信号。对墙壁运动信号进行处理，以便识别针对每个相应信号发生基准（例如，拐点，阈值交叉，最大振幅等）的时间。每个相应信号上的基准点之间的时间间隔被测量为心室同步的度量，并且可以可选地用于调整起搏治疗定时以改善同步。

4. 发明申请

US20070167843A1 METHOD AND APPARATUS FOR DETECTING RESPIRATORY DISTURBANCES 有权
标题翻译：用于检测呼吸障碍的方法和装置
公开(公告)号：US20070167843A1
公开(公告)日：2007-07-19
申请号：US11565092
申请日：2006-11-30
申请人： Yong Cho , Steven Lu , Luc Mongeon , Scott Davie , Todd Sheldon , Mark Erickson , H. Markowitz
发明人： Yong Cho , Steven Lu , Luc Mongeon , Scott Davie , Todd Sheldon , Mark Erickson , H. Markowitz
IPC分类号： A61B5/02 , A61B5/08
CPC分类号： A61B5/0809 , A61B5/0205 , A61B5/0215 , A61B5/0402 , A61B5/1459 , A61B5/4818 , G06F19/00
摘要： A system and method for monitoring respiration including sensing a signal that varies with respiration, deriving a respiration parameter, applying criteria for detecting a respiration disturbance and determining one or more respiratory disturbance metrics. The system preferably includes an implantable sensor with an associated implantable medical device such that chronic respiration monitoring is possible. The implantable medical device may execute methods for detecting and measuring respiratory disturbances or may store data to be transferred to an external device for detecting and measuring respiratory disturbances. Respiratory disturbance detection may trigger a responsive action such as physiological data storage, a change in therapy delivery, or a clinician warning. Assessment of cardiac function may be made based on metrics of respiratory disturbances or a measure of circulatory delay time following detection of a respiratory disturbance.
摘要翻译：一种用于监测呼吸的系统和方法，包括感测随呼吸变化的信号，导出呼吸参数，应用用于检测呼吸障碍的标准和确定一个或多个呼吸障碍度量。该系统优选地包括具有相关联的可植入医疗装置的可植入传感器，使得可以进行慢性呼吸监测。可植入医疗装置可以执行用于检测和测量呼吸障碍的方法，或者可以将要传送到外部设备的数据存储以检测和测量呼吸障碍。呼吸道干扰检测可能会触发响应动作，如生理数据存储，治疗传递的变化或临床医生的警告。心脏功能的评估可以基于呼吸紊乱的度量或检测到呼吸障碍之后的循环延迟时间的量度进行。

5. 发明申请

US20070250127A1 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：US20070250127A1
公开(公告)日：2007-10-25
申请号：US11379290
申请日：2006-04-19
申请人： Lee Stylos , Todd Sheldon , Steven Lu , William Combs , Robert Nehls
发明人： Lee Stylos , Todd Sheldon , Steven Lu , William Combs , Robert Nehls
IPC分类号： A61N1/365
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了心肌的预调节，以允许患者在没有心绞痛的情况下更大的运动益处。

6. 发明申请

US20060149328A1 LV threshold measurement and capture management 有权
标题翻译： LV阈值测量和捕获管理
公开(公告)号：US20060149328A1
公开(公告)日：2006-07-06
申请号：US11311984
申请日：2005-12-20
申请人： Purvee Parikh , John Stroebel , Todd Sheldon , Karen Kleckner
发明人： Purvee Parikh , John Stroebel , Todd Sheldon , Karen Kleckner
IPC分类号： A61N1/365
CPC分类号： A61N1/3627 , A61N1/3684 , A61N1/371
摘要： The invention provides methods and apparatus for determining in a non-tracking pacing mode (e.g., DDI/R, VVI/R) whether a ventricular pacing stimulus is capturing a paced ventricle, including some or all of the following aspects. For example, increasing a ventricular pacing rate a nominal amount to an overdrive pacing rate higher than a most recent heart rate and evaluating a conduction interval from a first pacing ventricle to a second sensing ventricle and then continuing to monitor the underlying rate to ensure that a threshold testing pacing rate will not exceed a predetermined minimum interval and providing pacing stimulation to the first ventricle and sensing the second ventricle to determine whether the pacing stimulation to the first ventricle was one of sub-threshold and supra-threshold. The methods and apparatus are especially useful in conjunction with ensuring actual delivery of a ventricular pacing regime (e.g., cardiac resynchronization therapy or “CRT”).
摘要翻译：本发明提供了用于在非跟踪起搏模式（例如，DDI / R，VVI / R）中确定心室起搏刺激是否捕获节奏心室的方法和装置，包括以下方面中的一些或全部。例如，将心室起搏速率提高到高于最近心率的超速起搏速率的标称值，并评估从第一起搏心室到第二感测心室的传导间隔，然后继续监测潜在速率，以确保阈值测试起搏速率不会超过预定的最小间隔，并且向第一脑室提供起搏刺激并且感测第二脑室以确定对第一脑室的起搏刺激是否是子阈值和超阈值之一。所述方法和装置与确保心室起搏方案（例如，心脏再同步治疗或“CRT”）的实际递送相结合特别有用。

7. 发明申请

US20050027320A1 Method of optimizing cardiac resynchronization therapy using sensor signals of septal wall motion 有权
标题翻译：使用间隔壁运动的传感器信号优化心脏再同步治疗的方法
公开(公告)号：US20050027320A1
公开(公告)日：2005-02-03
申请号：US10631551
申请日：2003-07-30
申请人： Robert Nehls , Todd Sheldon
发明人： Robert Nehls , Todd Sheldon
IPC分类号： A61N1/362 , A61N1/365 , A61N1/368
CPC分类号： A61N1/3627 , A61N1/36542 , A61N1/3682 , A61N1/3684
摘要： The present invention relates to monitoring septal wall motion of the atrial and/or ventricular chambers of a heart for optimizing cardiac pacing intervals based on signals derived from said wall motion. At least one lead of medical device is equipped with a motion sensor adapted to couple to septal tissue. The device receives and may post-process (e.g., suitably filter, rectify and/or integrate) motion signals to determine acceleration, velocity or displacement. During pacing interval optimization the wall motion is measured for many pacing intervals and the pacing interval setting(s) that produce minimal wall motion are implemented for therapy delivery. In addition, the present invention provides methods for periodically determining whether to cease or resume delivery of a bi-ventricular pacing therapy to a patient that may have experienced beneficial reverse remodeling of the heart.
摘要翻译：本发明涉及基于从所述壁运动得到的信号来监测心脏的心房和/或室室的间隔壁运动以优化心脏起搏间隔。医疗装置的至少一个引线配备有适于耦合到间隔组织的运动传感器。设备接收并且可以后处理（例如，适当地过滤，整流和/或整合）运动信号以确定加速度，速度或位移。在起搏间期优化过程中，测量了许多起搏间隔的壁运动，并且实施了产生最小壁运动的起搏间隔设置用于治疗递送。此外，本发明提供了周期性地确定是否停止或恢复对可能经历有益的逆转重建的患者的双心室起搏疗法的递送的方法。

8. 发明申请

US20060161207A1 Method of continuous capture verification in cardiac resynchronization devices 有权
公开(公告)号：US20060161207A1
公开(公告)日：2006-07-20
申请号：US11312102
申请日：2005-12-20
申请人： James Busacker , Todd Sheldon
发明人： James Busacker , Todd Sheldon
IPC分类号： A61N1/36
CPC分类号： A61N1/3627 , A61N1/3684 , A61N1/371
摘要： In bi-ventricular pacing devices (including CRT devices) analysis of myocardial electrogram signals in one ventricle (e.g., a left ventricle, or “LV”) can be used to infer capture or loss-of-capture (LOC) of an earlier stimulus pulse in the same ventricle, on a continuous (every pacing cycle), triggered, aperiodic and/or periodic basis. Rather than using an evoked-response principle as has been the basis of capture detection in prior art and other systems, a principle employed via the present invention uses evidence of inter-ventricular conduction (i.e., from the opposite chamber) and/or atrio-ventricular conduction as evidence of LOC, since a non-capturing pacing stimulus provided to a first chamber will allow the myocardial tissue of the first chamber to remain non-refractory and thus inter-ventricular and atrio-ventricular wavefront propagation and conduction can commence and be detected thereby revealing whether LOC has occurred.

9. 发明申请

US20100198295A1 PERFORMING EXTENDED CAPTURE DETECTION TEST AFTER DETECTING INADEQUATE CAPTURE 审中-公开
标题翻译：在检测到不正确的捕获后执行扩展捕获检测测试
公开(公告)号：US20100198295A1
公开(公告)日：2010-08-05
申请号：US12362905
申请日：2009-01-30
申请人： Todd Sheldon , Lynn A. Davenport
发明人： Todd Sheldon , Lynn A. Davenport
IPC分类号： A61N1/37
CPC分类号： A61N1/371
摘要： Techniques are described for performing an extended capture detection test after detecting inadequate capture during a first capture detection test. An example system includes an implantable medical device that delivers pacing pulses to a patient, that periodically performs a first capture detection test to detect capture or loss of capture of the pacing pulses, and that detects inadequate capture during the first capture detection test, wherein in response to detecting the inadequate capture, the implantable medical device performs a second capture detection test that is longer than the first test. The system also includes a programmer device that programs the implantable medical device and that retrieves data from the implantable medical device corresponding to the second capture detection test. The example system may conserve battery power and prevent loss of current by performing the extended capture detection test only after detection of inadequate capture during the first test.
摘要翻译：描述了在第一捕获检测测试中检测到不充分捕获之后进行扩展捕获检测测试的技术。示例性系统包括向患者传送起搏脉冲的可植入医疗装置，其周期性地执行第一捕获检测测试以检测起搏脉冲的捕获或丢失，并且在第一捕获检测测试期间检测不充分的捕获，其中响应于检测到不充分的捕获，可植入医疗装置执行比第一测试更长的第二捕获检测测试。该系统还包括编程器设备，其对可植入医疗设备进行编程，并从与第二捕获检测测试相对应的可植入医疗设备中检索数据。该示例系统可以仅在第一次测试中检测到不充分的捕获之后执行扩展捕获检测测试来节省电池电力并防止电流损失。

10. 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。

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