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11. 发明授权

US08428698B2 Systems and methods for monitoring DP, IVRT, DiFT, diastolic function and/or HF 有权
标题翻译：用于监测DP，IVRT，DiFT，舒张功能和/或HF的系统和方法
公开(公告)号：US08428698B2
公开(公告)日：2013-04-23
申请号：US12474275
申请日：2009-05-29
申请人： Allen J. Keel , Brian Jeffrey Wenzel , Edward Karst , Wenbo Hou , Taraneh Ghaffari Farazi
发明人： Allen J. Keel , Brian Jeffrey Wenzel , Edward Karst , Wenbo Hou , Taraneh Ghaffari Farazi
IPC分类号： A61B5/04 , A61N1/00
CPC分类号： A61B5/0402 , A61B5/02416 , A61B5/6846
摘要： Implantable systems, and methods for use therewith, are provided for monitoring a patient's diastolic function and/or heart failure (HF) condition. A signal indicative of changes in arterial blood volume and a signal indicative of electrical activity of the patient's heart are obtained. Beginnings of diastolic periods can be detected based on a feature of the signal indicative of changes in arterial blood volume. Ends of the diastolic periods can be detected based on a feature of the signal indicative of electrical activity of the patient's heart, or on the signal indicative of changes in arterial blood volume. Diastolic periods (DPs), isovolumic relaxation times (IVRTs) and/or diastolic filling times (DiFTs) can be estimated based on the detected beginnings of the diastolic periods and detected ends of the diastolic periods. The patient's diastolic function and/or HF condition (and/or changes therein) can be monitored based on the estimates of DP, IVRT and/or DiFT.
摘要翻译：提供了可植入系统及其使用方法，用于监测患者的舒张功能和/或心力衰竭（HF）状况。获得指示动脉血容量变化的信号和表示患者心脏的电活动的信号。可以基于指示动脉血容量变化的信号的特征来检测舒张期的开始。可以基于指示患者心脏的电活动的信号的特征或指示动脉血容量变化的信号来检测舒张期的结束。舒张期（DPs），等容舒张时间（IVRT）和/或舒张期充盈时间（DiFT）可以基于检测到的舒张期的开始和舒张期的检测结束来估计。可以基于DP，IVRT和/或DiFT的估计来监测患者的舒张功能和/或HF状态（和/或其中的变化）。

12. 发明申请

US20130030315A1 DEVICES, SYSTEMS AND METHODS TO MONITOR AND TREAT HEART FAILURE (HF) 有权
标题翻译：监测和治疗心脏衰竭（HF）的装置，系统和方法
公开(公告)号：US20130030315A1
公开(公告)日：2013-01-31
申请号：US13194700
申请日：2011-07-29
申请人： Allen J. Keel , Kyungmoo Ryu , Stuart Rosenburg
发明人： Allen J. Keel , Kyungmoo Ryu , Stuart Rosenburg
IPC分类号： A61N1/368 , A61B5/0452
CPC分类号： A61B5/0422 , A61B5/0452 , A61B5/0456 , A61B5/0464 , A61N1/3627 , A61N1/3684 , A61N1/3686
摘要： Described herein are implantable systems and devices, and methods for use therewith, that can be used to monitor and treat heart failure (HF). Such implantable systems preferably includes a lead having at least two electrodes implantable in a patient's left ventricular (LV) chamber. A plurality of different sensing vectors are used to obtain a plurality of IEGMs each of which is indicative of an evoked response at a corresponding different region of the LV chamber. For each of the IEGMs, there is a determination of one or more evoked response metrics indicative of a localized cardiac function at the corresponding region of the LV chamber. The evoke response metrics can be, e.g., paced depolarization integral (PDI) and/or maximum upward slope of an R-wave, but are not limited thereto. The patient's HF condition is monitored based on the localized cardiac function at the plurality of different regions of the LV chamber as determined based on the one or more evoked response metrics determined for each of the IEGMs.
摘要翻译：本文描述了可用于监测和治疗心力衰竭（HF）的可植入系统和装置及其使用的方法。这种可植入系统优选地包括具有可植入患者左心室（LV）腔室中的至少两个电极的引线。使用多个不同的感测向量来获得多个IEGM，每个IEGM指示LV室的相应不同区域处的诱发反应。对于每个IEGM，存在一个或多个诱发响应度量的确定，所述诱发响应度量指示LV室的相应区域处的局部心脏功能。唤醒响应度量可以是例如R波的步调去极化积分（PDI）和/或最大上升斜率，但不限于此。基于根据为每个IEGM确定的一个或多个诱发响应度量确定的，基于LV室的多个不同区域处的局部心脏功能来监测患者的HF状况。

13. 发明申请

US20120271371A1 CAPTURE VERIFICATION AND PACING ADJUSTMENTS FOR USE WITH MULTISITE LEFT VENTRICULAR PACING 有权
标题翻译：采用多层左侧透水板进行捕获和剥离调整
公开(公告)号：US20120271371A1
公开(公告)日：2012-10-25
申请号：US13091830
申请日：2011-04-21
申请人： Allen J. Keel , Kyungmoo Ryu , Stuart Rosenberg
发明人： Allen J. Keel , Kyungmoo Ryu , Stuart Rosenberg
IPC分类号： A61N1/37 , A61N1/362
CPC分类号： A61N1/3712 , A61N1/3684 , A61N1/3686
摘要： Various embodiments of the present invention are directed to, or are for use with, an implantable system including a lead having multiple electrodes implantable in a patient's left ventricular (LV) chamber. In accordance with an embodiment, the patients LV chamber is paced at first and second sites within the LV chamber using a programmed LV1-LV2 delay, wherein the LV1-LV2 delay is a programmed delay between when first and second pacing pulses are to be delivered respectively at the first and second sites within the LV chamber. Evoked responses to the first and second pacing pulses are monitored for, and one or more LV pacing parameter is/are adjusted and/or one or more backup pulse is/are delivered based on results of the monitoring.
摘要翻译：本发明的各种实施例涉及或可用于包括具有可植入患者左心室（LV）室中的多个电极的引线的可植入系统。根据实施例，患者LV腔室使用编程的LV1-LV2延迟在LV室内的第一和第二位置处起搏，其中LV1-LV2延迟是在第一和第二起搏脉冲要被传送之间的编程延迟分别在LV室内的第一和第二位置。基于监测结果监测对第一和第二起搏脉冲的诱发响应，并且调整一个或多个LV起搏参数和/或一个或多个备用脉冲。

14. 发明授权

US09002453B2 Devices, systems and methods to perform arrhythmia discrimination based on R-R interval stability corresponding to a plurality of ventricular regions 有权
标题翻译：基于对应于多个心室区域的R-R间期稳定性执行心律失常鉴别的装置，系统和方法
公开(公告)号：US09002453B2
公开(公告)日：2015-04-07
申请号：US13194732
申请日：2011-07-29
申请人： Allen J. Keel , Kyungmoo Ryu , Stuart Rosenberg
发明人： Allen J. Keel , Kyungmoo Ryu , Stuart Rosenberg
IPC分类号： A61N1/00 , A61B5/04 , A61B5/042 , A61B5/0452 , A61B5/0464 , A61N1/362 , A61N1/368 , A61B5/0456
CPC分类号： A61B5/0422 , A61B5/0452 , A61B5/0456 , A61B5/0464 , A61N1/3627 , A61N1/3684 , A61N1/3686
摘要： Described herein are implantable systems and devices, and methods for use therewith, that can be used to perform arrhythmia discrimination. A plurality of different sensing vectors are used to obtain a plurality of different IEGMs, each of which is indicative of cardiac electrical activity at a different ventricular region. The plurality of different IEGMs can include, e.g., an IEGM indicative of cardiac electrical activity at a first region of the patient's left ventricular (LV) chamber and an IEGM indicative of cardiac electrical activity at a second region of the patient's LV chamber. Additionally, the plurality of different IEGMs can further include an IEGM indicative of cardiac electrical activity at a region of a patient's right ventricular (RV) chamber. For each of the IEGMs, there is a determination of a corresponding localized R-R interval stability metric indicative of the R-R interval stability at the corresponding ventricular region. This can include, e.g., determining, for each of the IEGMs, a plurality of R-R intervals corresponding to a plurality of consecutive cardiac cycles of the IEGM. For each IEGM, a measure of variation (e.g., standard deviation, range or variance, but not limited thereto) can then be determined for the plurality of R-R intervals to thereby determine the localized R-R interval stability metric for the IEGM. Arrhythmia discrimination is then performed using the plurality of determined localized R-R interval stability metrics.
摘要翻译：本文描述了可用于执行心律失常鉴别的可植入系统和装置及其使用方法。使用多个不同的感测向量来获得多个不同的IEGM，每个IEGM指示在不同心室区域处的心脏电活动。多个不同的IEGM可以包括例如指示患者左心室（LV）室的第一区域处的心脏电活动的IEGM和指示患者LV室的第二区域处的心脏电活动的IEGM。另外，多个不同的IEGM还可以包括指示患者右心室（RV）室的区域处的心脏电活动的IEGM。对于每个IEGM，存在确定相应的局部R-R间期稳定性度量，其指示相应心室区域处的R-R间期稳定性。这可以包括例如为每个IEGM确定对应于IEGM的多个连续心脏周期的多个R-R间隔。对于每个IEGM，然后可以为多个R-R间隔确定变化量（例如，标准偏差，范围或方差，但不限于此），从而确定IEGM的局部R-R间隔稳定性度量。然后使用多个确定的局部R-R间期稳定性度量进行心律失常鉴别。

15. 发明申请

US20130030312A1 DEVICES, SYSTEMS AND METHODS TO PERFORM ARRHYTHMIA DISCRIMINATION BASED ON R-R INTERVAL STABILITY CORRESPONDING TO A PLURALITY OF VENTRICULAR REGIONS 有权
标题翻译：基于R-R间隔稳定性相对于多个地区的ARRHYTHMIA辨别的设备，系统和方法
公开(公告)号：US20130030312A1
公开(公告)日：2013-01-31
申请号：US13194732
申请日：2011-07-29
申请人： Allen J. Keel , Kyungmoo Ryu , Stuart Rosenberg
发明人： Allen J. Keel , Kyungmoo Ryu , Stuart Rosenberg
IPC分类号： A61B5/046 , A61N1/365 , A61N1/39 , A61B5/0456
CPC分类号： A61B5/0422 , A61B5/0452 , A61B5/0456 , A61B5/0464 , A61N1/3627 , A61N1/3684 , A61N1/3686
摘要： Described herein are implantable systems and devices, and methods for use therewith, that can be used to perform arrhythmia discrimination. A plurality of different sensing vectors are used to obtain a plurality of different IEGMs, each of which is indicative of cardiac electrical activity at a different ventricular region. The plurality of different IEGMs can include, e.g., an IEGM indicative of cardiac electrical activity at a first region of the patient's left ventricular (LV) chamber and an IEGM indicative of cardiac electrical activity at a second region of the patient's LV chamber. Additionally, the plurality of different IEGMs can further include an IEGM indicative of cardiac electrical activity at a region of a patient's right ventricular (RV) chamber. For each of the IEGMs, there is a determination of a corresponding localized R-R interval stability metric indicative of the R-R interval stability at the corresponding ventricular region. This can include, e.g., determining, for each of the IEGMs, a plurality of R-R intervals corresponding to a plurality of consecutive cardiac cycles of the IEGM. For each IEGM, a measure of variation (e.g., standard deviation, range or variance, but not limited thereto) can then be determined for the plurality of R-R intervals to thereby determine the localized R-R interval stability metric for the IEGM. Arrhythmia discrimination is then performed using the plurality of determined localized R-R interval stability metrics.
摘要翻译：本文描述了可用于执行心律失常鉴别的可植入系统和装置及其使用方法。使用多个不同的感测向量来获得多个不同的IEGM，每个IEGM指示在不同心室区域处的心脏电活动。多个不同的IEGM可以包括例如指示患者左心室（LV）室的第一区域处的心脏电活动的IEGM和指示患者LV室的第二区域处的心脏电活动的IEGM。另外，多个不同的IEGM还可以包括指示患者右心室（RV）室的区域处的心脏电活动的IEGM。对于每个IEGM，存在确定相应的局部R-R间期稳定性度量，其指示相应心室区域处的R-R间期稳定性。这可以包括例如为每个IEGM确定对应于IEGM的多个连续心脏周期的多个R-R间隔。对于每个IEGM，然后可以为多个R-R间隔确定变化量（例如，标准偏差，范围或方差，但不限于此），从而确定IEGM的局部R-R间隔稳定性度量。然后使用多个确定的局部R-R间期稳定性度量进行心律失常鉴别。

16. 发明申请

US20130030487A1 DEVICES, SYSTEMS AND METHODS TO INCREASE COMPLIANCE WITH A PREDETERMINED VENTRICULAR ELECTRICAL ACTIVATION PATTERN 审中-公开
标题翻译：设备，系统和方法，以增加符合预定的静脉电活动模式
公开(公告)号：US20130030487A1
公开(公告)日：2013-01-31
申请号：US13194716
申请日：2011-07-29
申请人： Allen J. Keel , Kyungmoo Ryu , Stuart Rosenberg
发明人： Allen J. Keel , Kyungmoo Ryu , Stuart Rosenberg
IPC分类号： A61N1/368
CPC分类号： A61N1/3925 , A61N1/3622 , A61N1/3624 , A61N1/3627 , A61N1/3684 , A61N1/371 , A61N1/395 , A61N1/3962
摘要： Described herein are implantable systems and devices, and methods for use therewith, that can be used to increase compliance with a predetermined preferred ventricular electrical activation pattern. Such implantable systems preferably includes a first lead having at least one electrode implantable in a right ventricular (RV) chamber, and a second lead having at least two electrodes implantable in a left ventricular (LV) chamber. A plurality of different sensing vectors are used to obtain a plurality of IEGMs that collectively enable electrical activations to be detected in at least the RV chamber and at at least two separate regions of the LV chamber. The IEGMs can be obtained while the patient's LV chamber is not being paced, or during bi-ventricular (BiV) pacing that includes pacing at only a single site within the LV chamber. An actual ventricular electrical activation pattern is determined based on the plurality of IEGMs. Additionally, there is a determination of whether the actual ventricular electrical activation pattern matches the predetermined preferred ventricular electrical activation pattern. If the actual ventricular electrical activation pattern does not match the predetermined preferred ventricular electrical activation pattern, then multisite LV (MSLV) pacing is delivered to achieve the predetermined preferred ventricular electrical activation pattern.
摘要翻译：这里描述的是可植入的系统和装置以及与其一起使用的方法，其可用于增加对预定的优选心室电活动模式的依从性。这种可植入系统优选地包括具有可植入右心室（RV）室中的至少一个电极的第一引线和具有可植入在左心室（LV））腔中的至少两个电极的第二引线。使用多个不同的感测向量来获得多个IEGM，其共同地使得能够在至少RV室中和在LV室的至少两个分开的区域处检测电激活。当患者的LV室未起搏时，或者在双室（BiV）起搏期间可以获得IEGM，其中仅包括在LV室内的单个部位起搏。基于多个IEGM确定实际的心室电激活模式。此外，确定实际心室电活动模式是否与预定的优选心室电激活模式匹配。如果实际的心室电激活模式与预定的优选心室电激活模式不匹配，则输送多部位LV（MSLV）起搏以实现预定的优选心室电活动模式。

17. 发明申请

US20130006317A1 DEVICES, SYSTEMS AND METHODS TO ANALYZE EVOKED RESPONSES TO PRE-PACING PULSES TO PREDICT IMMINENT VT/VF, ESTIMATE ISCHEMIC BURDEN AND/OR CHARACTERIZE ELECTRICAL SUBSTRATES 审中-公开
标题翻译：用于分析预处理脉冲以预测VT / VF，估计电阻率和/或表征电气基板的反应器的装置，系统和方法
公开(公告)号：US20130006317A1
公开(公告)日：2013-01-03
申请号：US13174307
申请日：2011-06-30
申请人： Allen J. Keel , Kyungmoo Ryu , Stuart Rosenberg , Kiell Norén
发明人： Allen J. Keel , Kyungmoo Ryu , Stuart Rosenberg , Kiell Norén
IPC分类号： A61N1/368 , A61N1/39 , A61N1/362
CPC分类号： A61B5/046 , A61B5/0464 , A61B5/4836 , A61B5/7257 , A61B5/7275 , A61B2562/0219 , A61N1/3622 , A61N1/3684 , A61N1/3962 , G16H20/40 , G16H50/20 , G16H50/70
摘要： Described herein are implantable systems, and methods for use therewith, to predict whether ventricular tachycardia (VT) or ventricular fibrillation (VF) is imminent, estimate ischemic burden and/or characterize an electrical substrate of the LV chamber. For each of a plurality of cardiac cycles, a pacing vector comprising a first set of electrodes is used to deliver a pre-pacing pulse at a site within the LV chamber (wherein the pre-pacing pulse is delivered prior to an intrinsic activation of the LV chamber), and a sensing vector comprising a second set of electrodes is used to detect an evoked response to the pre-pacing pulse. The detected evoked responses to the pre-pacing pulses are analyzed, and results of the analysis are used predict whether VT or VF is imminent, estimate ischemic burden and/or characterize an electrical substrate of the LV chamber.
摘要翻译：本文描述的是可植入系统及其使用的方法来预测室性心动过速（VT）或心室颤动（VF）是否即将到来，估计LV室的电气基底的缺血负荷和/或表征。对于多个心动周期中的每一个，包括第一组电极的起搏矢量被用于在LV室内的部位处递送预起搏脉冲（其中，预激动脉冲在内部激活前 LV室），并且使用包括第二组电极的感测矢量来检测对所述预起搏脉冲的诱发响应。分析检测到的对起搏脉冲的诱发反应，并且使用分析结果来预测VT或VF是否即将到来，估计LV室的电气底物的缺血负荷和/或表征。

18. 发明授权

US09554717B2 Devices, systems and methods to monitor and treat heart failure (HF) 有权
标题翻译：监测和治疗心力衰竭（HF）的装置，系统和方法
公开(公告)号：US09554717B2
公开(公告)日：2017-01-31
申请号：US13194700
申请日：2011-07-29
申请人： Allen J. Keel , Kyungmoo Ryu , Stuart Rosenberg
发明人： Allen J. Keel , Kyungmoo Ryu , Stuart Rosenberg
IPC分类号： A61B5/0456 , A61B5/0452 , A61B5/042 , A61B5/0464 , A61N1/362 , A61N1/368
CPC分类号： A61B5/0422 , A61B5/0452 , A61B5/0456 , A61B5/0464 , A61N1/3627 , A61N1/3684 , A61N1/3686
摘要： Described herein are implantable systems and devices, and methods for use therewith, that can be used to monitor and treat heart failure (HF). Such implantable systems preferably includes a lead having at least two electrodes implantable in a patient's left ventricular (LV) chamber. A plurality of different sensing vectors are used to obtain a plurality of IEGMs each of which is indicative of an evoked response at a corresponding different region of the LV chamber. For each of the IEGMs, there is a determination of one or more evoked response metrics indicative of a localized cardiac function at the corresponding region of the LV chamber. The evoke response metrics can be, e.g., paced depolarization integral (PDI) and/or maximum upward slope of an R-wave, but are not limited thereto. The patient's HF condition is monitored based on the localized cardiac function at the plurality of different regions of the LV chamber as determined based on the one or more evoked response metrics determined for each of the IEGMs.
摘要翻译：本文描述了可用于监测和治疗心力衰竭（HF）的可植入系统和装置及其使用的方法。这种可植入系统优选地包括具有可植入患者左心室（LV）腔室中的至少两个电极的引线。使用多个不同的感测向量来获得多个IEGM，每个IEGM指示LV室的相应不同区域处的诱发反应。对于每个IEGM，存在一个或多个诱发响应度量的确定，所述诱发响应度量指示LV室的相应区域处的局部心脏功能。唤醒响应度量可以是例如R波的步调去极化积分（PDI）和/或最大上升斜率，但不限于此。基于根据为每个IEGM确定的一个或多个诱发响应度量确定的，基于LV室的多个不同区域处的局部心脏功能来监测患者的HF状况。

19. 发明授权

US08798731B2 Devices, systems and methods to perform arrhythmia discrimination based on the atrial and ventricular activation times 有权
标题翻译：基于心房和心室激活时间进行心律失常鉴别的装置，系统和方法
公开(公告)号：US08798731B2
公开(公告)日：2014-08-05
申请号：US13194747
申请日：2011-07-29
申请人： Allen J. Keel , Kyungmoo Ryu , Stuart Rosenberg
发明人： Allen J. Keel , Kyungmoo Ryu , Stuart Rosenberg
IPC分类号： A61B5/04 , A61N1/362 , A61N1/368 , A61B5/0452 , A61B5/0464 , A61B5/042 , A61B5/0456
CPC分类号： A61N1/3962 , A61B5/0422 , A61B5/0452 , A61B5/0456 , A61B5/0464 , A61N1/3627 , A61N1/3684 , A61N1/3686
摘要： Described herein are implantable systems and devices, and methods for use therewith, that can be used to perform arrhythmia discrimination based on activation times. A plurality of different sensing vectors are used to obtain a plurality of IEGMs that collectively enable electrical activations to be detected in the left atrial (LA) chamber, the right atrial (RA) chamber, and at least one ventricular chamber of a patient's heart. For each of a plurality of cardiac cycles, there is a determination, based on the plurality of obtained IEGMs, of an LA activation time, an RA activation time, and a ventricular activation time. Arrhythmia discrimination is then performed based on the determined activation times.
摘要翻译：本文描述的是可植入的系统和装置及其使用的方法，其可用于基于活化时间执行心律失常鉴别。使用多个不同的感测向量来获得多个IEGM，其共同地使得能够在左心房（LA）腔室，右心房（RA）腔室和患者心脏的至少一个心室中检测电激活。对于多个心动周期中的每一个，基于多个获得的IEGM，确定LA激活时间，RA激活时间和心室激活时间。然后基于确定的活化时间进行心律失常鉴别。

20. 发明授权

US08509890B2 Capture verification and pacing adjustments for use with multisite left ventricular pacing 有权
标题翻译：捕获验证和起搏调整，用于多站点左心室起搏
公开(公告)号：US08509890B2
公开(公告)日：2013-08-13
申请号：US13091830
申请日：2011-04-21
申请人： Allen J. Keel , Kyungmoo Ryu , Stuart Rosenberg
发明人： Allen J. Keel , Kyungmoo Ryu , Stuart Rosenberg
IPC分类号： A61N1/362
CPC分类号： A61N1/3712 , A61N1/3684 , A61N1/3686
摘要： Various embodiments of the present invention are directed to, or are for use with, an implantable system including a lead having multiple electrodes implantable in a patient's left ventricular (LV) chamber. In accordance with an embodiment, the patients LV chamber is paced at first and second sites within the LV chamber using a programmed LV1-LV2 delay, wherein the LV1-LV2 delay is a programmed delay between when first and second pacing pulses are to be delivered respectively at the first and second sites within the LV chamber. Evoked responses to the first and second pacing pulses are monitored for, and one or more LV pacing parameter is/are adjusted and/or one or more backup pulse is/are delivered based on results of the monitoring.
摘要翻译：本发明的各种实施例涉及或可用于包括具有可植入患者左心室（LV）室中的多个电极的引线的可植入系统。根据实施例，患者LV腔室使用编程的LV1-LV2延迟在LV室内的第一和第二位置处起搏，其中LV1-LV2延迟是在第一和第二起搏脉冲要被传送之间的编程延迟分别在LV室内的第一和第二位置。基于监测结果监测对第一和第二起搏脉冲的诱发响应，并且调整一个或多个LV起搏参数和/或一个或多个备用脉冲。

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