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91. 发明授权

US07203541B2 Real-time optimization of right to left ventricular timing sequence in bi-ventricular pacing of heart failure patients 有权
标题翻译：心力衰竭患者双心室起搏右心室时间序列的实时优化
公开(公告)号：US07203541B2
公开(公告)日：2007-04-10
申请号：US10799260
申请日：2004-03-12
申请人： Sameh Sowelam , Todd J. Sheldon , Yong K. Cho
发明人： Sameh Sowelam , Todd J. Sheldon , Yong K. Cho
IPC分类号： A61N1/368 , A61N1/365
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。

92. 发明授权

US07092759B2 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：US07092759B2
公开(公告)日：2006-08-15
申请号：US10631551
申请日：2003-07-30
申请人： Robert J. Nehls , Todd J. Sheldon
发明人： Robert J. Nehls , Todd J. Sheldon
IPC分类号： 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 the monitored 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 and/or displacement. During pacing interval optimization the wall motion is measured for those pacing intervals and the pacing interval setting(s) that produce minimal wall motion for chronic therapy delivery. In addition, 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：本发明涉及基于从监测的壁运动导出的信号来监测心脏的心房和/或心室的隔膜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。该装置接收并且可以后处理（例如，适当地过滤，整流和/或积分）运动信号以确定加速度，速度和/或位移。在起搏间期优化期间，针对这些起搏间隔和针对慢性治疗传递产生最小壁运动的起搏间隔设置测量壁运动。此外，定期确定是否停止或恢复双向心室起搏治疗对可能经历有益的逆转重建的病人的患者的方法。

93. 发明授权

US06964641B2 Implantable medical device with sleep disordered breathing monitoring 有权
公开(公告)号：US06964641B2
公开(公告)日：2005-11-15
申请号：US10746814
申请日：2003-12-24
申请人： Yong Kyun Cho , Eduardo N. Warman , Todd J. Sheldon
发明人： Yong Kyun Cho , Eduardo N. Warman , Todd J. 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.

94. 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。

95. 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。

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