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11. 发明授权

US06748261B1 Implantable cardiac stimulation device for and method of monitoring progression or regression of heart disease by monitoring interchamber conduction delays 有权
标题翻译：通过监测车间传导延迟，可植入心脏刺激装置和监测心脏病进展或消退的方法
公开(公告)号：US06748261B1
公开(公告)日：2004-06-08
申请号：US09675462
申请日：2000-09-28
申请人： Mark W. Kroll , Joseph J. Florio , Gene A. Bornzin , Euljoon Park , Kerry A. Bradley
发明人： Mark W. Kroll , Joseph J. Florio , Gene A. Bornzin , Euljoon Park , Kerry A. Bradley
IPC分类号： A61B504
CPC分类号： A61N1/3627 , A61B5/0031 , A61B5/0456 , A61B5/046 , A61N1/3684
摘要： A system and method, for use in an implantable cardiac stimulation device, monitors progression or regression in heart disease such as congestive heart failure. The system includes a sensing circuit that derives an electrogram signal indicative of the electrical activity of the patient's heart. A processor processes the electrogram signal to determine interchamber conduction delays which are then stored in memory. The stored interchamber conduction delays may be later retrieved by way of a telemetry circuit. Relative changes in the interchamber conduction delays, over time, are indicative of progression or regression in the heart disease. The relative changes in the interchamber conduction delays may be further used to automatically adjust pacing parameters of the implantable cardiac stimulation device.
摘要翻译：用于可植入心脏刺激装置的系统和方法监测心脏疾病如充血性心力衰竭的进展或消退。该系统包括感测电路，其导出指示患者心脏的电活动的电描绘信号。处理器处理电描记图信号以确定然后存储在存储器中的车间传导延迟。存储的车间传导延迟可以稍后通过遥测电路检索。随着时间的推移，间歇传导延迟的相对变化表明心脏病发展或消退。室间传导延迟的相对变化可以进一步用于自动调整可植入心脏刺激装置的起搏参数。

12. 发明授权

US06449509B1 Implantable stimulation device having synchronous sampling for a respiration sensor 有权
标题翻译：具有用于呼吸传感器的同步采样的可植入刺激装置
公开(公告)号：US06449509B1
公开(公告)日：2002-09-10
申请号：US09651623
申请日：2000-08-30
申请人： Euljoon Park , Gene A. Bornzin , Joseph J. Florio , Said Mortazavi
发明人： Euljoon Park , Gene A. Bornzin , Joseph J. Florio , Said Mortazavi
IPC分类号： A61N1365
CPC分类号： A61N1/36521
摘要： An implantable cardiac device that is adapted to periodically measure a body parameter, such as transthoracic impedance, at time periods selected so that the body parameter is primarily indicative of the respiration of the patient. In this way, a ventilation parameter, such as minute ventilation, can be reconstructed from the signals without requiring filtering of the sampled signals. In one embodiment, the implantable cardiac device measures transthoracic impedance during each quiescent period of the heart and thereby obtains a plurality of transthoracic impedance data points which are then used to reconstruct a ventilation signal. As the transthoracic impedance data points are obtained during the quiescent period, the contribution of the heart to the resulting transthoracic impedance measurement can be ignored and the resulting measurements are indicative of the action of the heart. In another embodiment, the implantable cardiac device obtains transthoracic impedance signals during the zero crossings of the measured impedance signal. As the transthoracic signal is measured during the zero crossing of the measured impedance signal, the heart component of the signal is filtered out.
摘要翻译：一种可植入心脏装置，其适于在所选择的时间周期周期性地测量身体参数，例如经胸阻抗，使得身体参数主要指示患者的呼吸。以这种方式，可以从信号重建诸如分钟通气的通气参数，而不需要对采样信号进行滤波。在一个实施例中，可植入心脏装置在心脏的每个静止期间测量经胸阻抗，从而获得多个经胸阻抗数据点，然后将其用于重建通气信号。由于在静止期间获得经胸阻抗数据点，所以可以忽略心脏对所得经胸阻抗测量的贡献，并且所得到的测量值表示心脏的作用。在另一个实施例中，可植入心脏装置在测量的阻抗信号的过零点期间获得经胸阻抗信号。由于在测量的阻抗信号的过零点期间测量经胸廓信号，所以信号的心脏分量被滤除。

13. 发明授权

US06636766B2 System and method for preventing sudden heart rate drop using implantable cardiac pacing device 有权
公开(公告)号：US06636766B2
公开(公告)日：2003-10-21
申请号：US09849723
申请日：2001-05-03
申请人： Gene A. Bornzin , Junyu Mai , Euljoon Park , Joseph J. Florio
发明人： Gene A. Bornzin , Junyu Mai , Euljoon Park , Joseph J. Florio
IPC分类号： A61N1365
CPC分类号： A61N1/362
摘要： A rate smoothing technique is applied by the pacing device to sensed and paced heart signals so as to prevent a sharp drop in heart rate, particularly for use within patients prone to vasovagal syncope. The rate smoothing technique is applied by the pacing device during the calculation of an escape interval employed by the device in determining whether to pace the heart. The rate smoothing technique has the effect of adjusting the escape interval to ensure the heart is paced for a period of time subsequent to a sharp drop in the natural heart rate of the patient permitting the heart rate to decrease gradually rather than suddenly. The rate smoothing technique however does not interfere with a sharp increase in heart rate as may be required during sudden physical exertion. System and method examples are described herein.

14. 发明授权

US06606517B1 Methods and apparatus for preventing atrial arrhythmias by overdrive pacing and prolonging atrial refractoriness using an implantable cardiac stimulation device 有权
$Methods and apparatus for preventing atrial arrhythmias by overdrive pacing and prolonging atrial refractoriness using an implantable cardiac stimulation device$
标题翻译：使用可植入心脏刺激装置通过过度起搏预防房性心律失常和延长心房不应性的方法和装置
公开(公告)号：US06606517B1
公开(公告)日：2003-08-12
申请号：US09548293
申请日：2000-04-12
申请人： Euljoon Park , Gene A. Bornzin , Joseph J. Florio , John W. Poore , Laurence S. Sloman , Peter Boileau , Douglas T. Kurschinski
发明人： Euljoon Park , Gene A. Bornzin , Joseph J. Florio , John W. Poore , Laurence S. Sloman , Peter Boileau , Douglas T. Kurschinski
IPC分类号： A61N1362
CPC分类号： A61N1/3622
摘要： A method and apparatus for reducing the incidence of atrial arrhythmias by using an overdrive algorithm to determine the application of overdrive stimulation pulses to a patient's heart, e.g., in the atria. In a first aspect of the invention, the apparatus first determines an overdrive pacing rate and then applies pairs of temporally spaced (staggered) pacing pulses, i.e., primary and secondary pacing pulses, at the determined overdrive pacing rate. In a further aspect of the invention, the pairs of pacing pulses are applied at the overdrive pacing rate to multiple spatially spaced electrodes, i.e., electrodes distributed among multiple sites in a patient's heart, e.g., in the atria. In accordance with a first preferred embodiment, the electrodes may be distributed within a single atrium, e.g., the right atrium, of the patient's heart. Alternatively, a first electrode may be placed in the right atrium and a second electrode may be placed in the coronary sinus or the left atrium or multiple electrodes may be placed proximate to the left atrium. Furthermore, the invention relates to techniques for controlling overdrive pacing to multiple sites in a patient's heart so as to achieve and maintain a target degree of pacing and thus suppress tachycardias.
摘要翻译：一种用于通过使用过驱动算法来确定过度驱动刺激脉冲施加到患者心脏（例如在心房）中来减少心房心律失常发生率的方法和装置。在本发明的第一方面中，装置首先确定过驱动起搏速率，然后以确定的超速起搏速率施加时间间隔（交错）的起搏脉冲，即初级和次级起搏脉冲。在本发明的另一方面，以超速起搏速率将多对起搏脉冲施加到多个空间间隔开的电极，即分布在患者心脏中的多个部位之间的电极，例如在心房中。根据第一优选实施例，电极可以分布在患者心脏的单个心房（例如右心房）内。或者，第一电极可以放置在右心房中，并且第二电极可以放置在冠状窦或左心房中，或者多个电极可以放置在靠近左心房的位置。此外，本发明涉及用于控制对患者心脏中的多个部位的超速起搏的技术，以便实现和维持目标起搏程度，从而抑制心动过速。

15. 发明授权

US06510342B1 Methods and apparatus for preventing atrial arrhythmias by overdrive pacing multiple heart tissue sites using an implantable cardiac stimulation device 有权
标题翻译：使用可植入心脏刺激装置通过超速起搏多个心脏组织部位预防房性心律失常的方法和装置
公开(公告)号：US06510342B1
公开(公告)日：2003-01-21
申请号：US09548116
申请日：2000-04-12
申请人： Euljoon Park , Gene A. Bornzin , Joseph J. Florio , John W. Poore , Douglas T. Kurschinski
发明人： Euljoon Park , Gene A. Bornzin , Joseph J. Florio , John W. Poore , Douglas T. Kurschinski
IPC分类号： A61N1368
CPC分类号： A61N1/3622 , A61N1/3684
摘要： Techniques are described for pacing multiple sites in a patient's heart using overdrive pacing the heart using a pacemaker including techniques where the overdrive pacing rate only increases when at least two intrinsic beats are detected within a determined search period. In one specific technique, an increase in the pacing rate occurs only if two P-waves are detected within X cardiac cycles. In another specific technique, the overdrive pacing rate is increased only if at least two P-waves are detected within a block of N cardiac cycles. In both techniques, the overdrive pacing rate is decreased if no increase has occurred in the last Z cardiac cycles. By increasing the overdrive pacing rate only in response to detection of at least two P-waves within a determined number of cardiac cycles, an excessively high overdrive pacing rate is avoided. Other techniques are described for adaptively adjusting overdrive pacing parameters so as to achieve a determined target degree of pacing of, for example, 95% paced beats. By adaptively adjusting overdrive parameters to maintain a target degree of pacing, the average overdrive pacing rate is minimized while still maintaining a high number of paced beats, thereby reducing the risk of a tachyarrhythmia occurring within the patient.
摘要翻译：描述了用于使用起搏器使用超速起搏心脏起搏心脏多个部位的技术，其包括其中在确定的搜索周期内检测到至少两个固有节拍时，超速起搏速率仅增加的技术。在一种特定技术中，只有在X个心动周期内检测到两个P波时，起搏速率才会增加。在另一个具体技术中，只有在N个心动周期的块内检测到至少两个P波时，才能增加超速起搏速率。在两种技术中，如果在最后Z个心动周期中没有发生增加，则超速起搏速率将降低。通过仅在确定的心跳周期内响应于至少两个P波的检测来增加超速起搏速率，避免了过高的超速起搏速率。描述了用于自适应地调节过驱动起搏参数的其它技术，以便实现例如95％起搏节拍的确定的目标起搏程度。通过自适应地调整过驱动参数以保持目标起搏程度，平均超速起搏速度最小化，同时仍然保持大量的起搏节奏，从而降低患者内出现快速性心律失常的风险。

16. 发明授权

US06275733B1 Dual sensor rate response pacemaker 有权
标题翻译：双传感器速率反应起搏器
公开(公告)号：US06275733B1
公开(公告)日：2001-08-14
申请号：US09334861
申请日：1999-06-16
申请人： Euljoon Park , Gene A. Bornzin , Joseph J. Florio , Saul E. Greenhut
发明人： Euljoon Park , Gene A. Bornzin , Joseph J. Florio , Saul E. Greenhut
IPC分类号： A61N1365
CPC分类号： A61N1/36585
摘要： A pacing system which determines a dual indicated rate (DIR) corresponding to a desired pacing rate of the heart of the patient by selecting the maximum between an activity indicated rate (AIR) and a metabolic indicated rate (MIR). The activity indicated rate is a pacing rate that is determined based upon a well-known acceleration-based sensor. The metabolic indicated rate is a desired pacing rate of the heart as determined based upon a well-known metabolic sensor, such as a minute ventilation sensor. Determining the dual indicated rate by selecting between the two rates provided by these two sensors results in the advantageous use of the activity indicated rate during periods of low-level and brisk activity and the use of the metabolic indicated rate during periods of high exertion.
摘要翻译：一种起搏系统，其通过选择活动指示速率（AIR）和代谢指示速率（MIR）之间的最大值来确定对应于患者心脏的期望起搏速率的双指示速率（DIR）。活动指示率是基于众所周知的基于加速度的传感器确定的起搏速率。代谢指示速率是基于众所周知的代谢传感器（例如分钟通气传感器）确定的心脏的期望起搏速率。通过在这两个传感器提供的两个速率之间进行选择来确定双指示率导致在低水平和轻快活动期间有利地使用活动指示速率，并且在高消耗期间使用代谢指示速率。

17. 发明授权

US6044294A Methods and apparatus for measuring impedance in the body 失效
标题翻译：测量体内阻抗的方法和装置
公开(公告)号：US6044294A
公开(公告)日：2000-03-28
申请号：US766636
申请日：1996-12-13
申请人： Said Mortazavi , Euljoon Park , Gene A. Bornzin , Joseph J. Florio , Jason A. Sholder , Robert R. Weyant
发明人： Said Mortazavi , Euljoon Park , Gene A. Bornzin , Joseph J. Florio , Jason A. Sholder , Robert R. Weyant
IPC分类号： A61N1/365 , A61B5/05
CPC分类号： A61N1/36521
摘要： Methods and apparatus are provided for measuring the impedance of a patient's body. Pulse generating circuitry within a rate-responsive pacemaker is used to generate an impedance measurement signal that is applied to the body of the patient with conventional pacemaker leads. The impedance measurement signal contains a series of multiphasic impedance measurement waveforms, which have no net DC value and zero value after second integration. The impedance measurement signal allows the impedance of the body to be measured without interfering with external cardiac monitoring equipment such as electrocardiogram machines.
摘要翻译：提供了用于测量患者身体阻抗的方法和装置。速率响应起搏器内的脉冲发生电路用于产生用常规起搏器引线施加到患者身体的阻抗测量信号。阻抗测量信号包含一系列多相阻抗测量波形，其在第二次积分后不具有净DC值和零值。阻抗测量信号允许测量身体的阻抗，而不会干扰外部心脏监测设备，如心电图仪。

18. 发明授权

US06466821B1 AC/DC multi-axis accelerometer for determining patient activity and body position 失效
标题翻译：用于确定患者活动和身体位置的AC / DC多轴加速度计
公开(公告)号：US06466821B1
公开(公告)日：2002-10-15
申请号：US09457451
申请日：1999-12-08
申请人： Anne M. Pianca , Gene A. Bornzin , Euljoon Park , Joseph J. Florio , Alan B. Vogel , Lee Jay Mandell , Junyu Mai
发明人： Anne M. Pianca , Gene A. Bornzin , Euljoon Park , Joseph J. Florio , Alan B. Vogel , Lee Jay Mandell , Junyu Mai
IPC分类号： A61N1362
CPC分类号： A61N1/36542
摘要： An implantable cardiac stimulation device which determines stimulation based upon the patient's body position and activity level while eliminating special implantation or calibration procedures. To eliminate such special implantation and calibration procedures, the stimulation device correlates the patient's body position using a multi-axis DC accelerometer or other sensor during times of high activity and determines a patient's standing position value. During other times, the stimulation device compares the signals from the accelerometer to the standing position value to determine the patient's current body position. Based upon the current body position and the activity level, the stimulation device determines the necessary stimulation to deliver to the patient.
摘要翻译：一种可植入心脏刺激装置，其基于患者的身体位置和活动水平确定刺激，同时消除特殊植入或校准过程。为了消除这种特殊的植入和校准过程，刺激装置在高活动时间期间使用多轴DC加速度计或其他传感器来关联患者的身体位置并且确定患者的站立位置值。在其他时间，刺激装置将来自加速度计的信号与站立位置值进行比较，以确定患者的当前身体位置。基于当前身体位置和活动水平，刺激装置确定必要的刺激以递送给患者。

19. 发明授权

US06269264B1 Method for measuring impedance in the body 有权
标题翻译：测量身体阻抗的方法
公开(公告)号：US06269264B1
公开(公告)日：2001-07-31
申请号：US09325312
申请日：1999-06-03
申请人： Robert R. Weyant , Jason A. Sholder , Euljoon Park , Gene A. Bornzin , Joseph J. Florio , Said Mortazavi
发明人： Robert R. Weyant , Jason A. Sholder , Euljoon Park , Gene A. Bornzin , Joseph J. Florio , Said Mortazavi
IPC分类号： A61B505
CPC分类号： A61N1/36521
摘要： Methods and apparatus are provided for measuring the impedance of a patient's body. Pulse generating circuitry within a rate-responsive pacemaker is used to generate an impedance measurement signal that is applied to the body of the patient with conventional pacemaker leads. The impedance measurement signal contains a series of multiphasic impedance measurement waveforms, which have no net DC value and zero value after second integration. The impedance measurement signal allows the impedance of the body to be measured without interfering with external cardiac monitoring equipment such as electrocardiogram machines.
摘要翻译：提供了用于测量患者身体阻抗的方法和装置。速率响应起搏器内的脉冲发生电路用于产生用常规起搏器引线施加到患者身体的阻抗测量信号。阻抗测量信号包含一系列多相阻抗测量波形，其在第二次积分后不具有净DC值和零值。阻抗测量信号允许测量身体的阻抗，而不会干扰外部心脏监测设备，如心电图仪。

20. 发明授权

US08731665B1 Posture detection using pressure and other physiologic sensors 有权
标题翻译：使用压力和其他生理传感器的姿势检测
公开(公告)号：US08731665B1
公开(公告)日：2014-05-20
申请号：US11923286
申请日：2007-10-24
申请人： Xiaoyi Min , Laleh Jalali , Steve Koh , Gene A. Bornzin , Euljoon Park
发明人： Xiaoyi Min , Laleh Jalali , Steve Koh , Gene A. Bornzin , Euljoon Park
IPC分类号： A61N1/00
CPC分类号： A61N1/365 , A61N1/36535
摘要： Systems and methods are provided for detecting the orientation and/or movement of a patient having an implantable cardiac stimulation device and evaluating whether a change in the patient's cardiac activity can be at least in part due to a change in the patient's orientation. In one particular embodiment, signals from an orientation sensor and/or a pressure sensor are evaluated to determine static positional orientation of the patient and determine based on the static orientation whether the patient's cardiac activity is abnormal.
摘要翻译：提供了用于检测具有可植入心脏刺激装置的患者的取向和/或运动的系统和方法，并且评估患者的心脏活动的变化是否可以至少部分地由于患者取向的改变而变化。在一个特定实施例中，评估来自定向传感器和/或压力传感器的信号以确定患者的静态位置取向，并且基于静态取向来确定患者的心脏活动是否异常。

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