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11. 发明授权

US6058328A Implantable stimulation device having means for operating in a preemptive pacing mode to prevent tachyarrhythmias and method thereof 失效
标题翻译：可植入刺激装置具有用于以抢占式起搏模式操作以防止快速性心律失常的装置及其方法
公开(公告)号：US6058328A
公开(公告)日：2000-05-02
申请号：US788152
申请日：1997-01-24
申请人： Paul A. Levine , Jason A. Sholder , Gene A. Bornzin , Joseph J. Florio , Kenneth Valikai , Lisa P. Weinberg
发明人： Paul A. Levine , Jason A. Sholder , Gene A. Bornzin , Joseph J. Florio , Kenneth Valikai , Lisa P. Weinberg
IPC分类号： A61N1/362 , A61N1/365 , A61N1/39
CPC分类号： A61N1/3956 , A61N1/3622 , A61N1/36585 , A61N1/3688
摘要： Preemptive tachyarrhythmia pacing is provided in an implantable cardiac-stimulation device, such as an implantable pacemaker or defibrillator, by modifying the operation of the implantable device in a way that minimizes the likelihood of occurrence of a tachyarrhythmia. The behavior modification is achieved through the use of an appropriate preemptive tachyarrhythmia pacing control routine stored within the memory of the device. Depending upon the needs of the patient, preemptive tachyarrhythmia pacing is invoked continuously or on demand. If invoked on demand, Preemptive tachyarrhythmia pacing is triggered only upon the sensing of one or more conditions suggest that the onset of a tachyarrhythmia is imminent. When thus invoked, preemptive tachyarrhythmia pacing remains invoked only for as long as the onset-of-a-tachyarrhythmia-is-imminent conditions persist. Various preemptive tachyarrhythmia pacing control routines are contemplated, including those based on overdrive pacing, pacing with randomicity, and mode switching. Overdrive pacing, when used, is based on an automatically-determined diurnal rate, an automatic stepped increase over the average atrial rate, or a rate set by a cycle-to-cycle negative hysteresis. Conditions which suggest the imminency of the onset of a tachyarrhythmia include, but are not limited to, a sudden change in the patient's cardiac cycle from a previously-determined normal cardiac cycle.
摘要翻译：通过以最小化发生快速性心律失常的可能性的方式修改可植入装置的操作，在可植入心脏刺激装置（例如可植入起搏器或除颤器）中提供先发性快速性心律失调起搏。通过使用存储在设备的存储器内的适当的先发性快速性心律失常起搏控制程序来实现行为修改。根据患者的需要，可以连续或按需调用抢先式快速性心律失调起搏。如果按需调用，先发性快速性心律失常起搏仅在感觉到一种或多种情况时才触发，表明快速性心律失常的发作即将到来。当这样被援引时，只有在发生急性心律失常即将到来的情况持续存在的情况下，抢救性快速性心律失调起搏仍然被援引。预期各种先发性快速性心律失常起搏控制程序，包括基于超速起搏，起搏随机性和模式切换的那些。超速起搏在使用时，基于自动确定的昼夜速率，比平均心房率自动逐步增加，或由周期到周期的负滞后设定的速率。表明快速性心律失常发作即将发生的情况包括但不限于患者心动周期从先前确定的正常心动周期的突然变化。

12. 发明授权

US5991661A System and method for measuring cardiac activity 失效
标题翻译：用于测量心脏活动的系统和方法
公开(公告)号：US5991661A
公开(公告)日：1999-11-23
申请号：US954326
申请日：1997-10-17
申请人： Euljoon Park , Gene A. Bornzin , Joseph J. Florio , Kerry Bradley
发明人： Euljoon Park , Gene A. Bornzin , Joseph J. Florio , Kerry Bradley
IPC分类号： A61N1/365
CPC分类号： A61N1/36542
摘要： An implantable cardiac stimulation device, such as a pacemaker or an implantable cardioverter-defibrillator, that includes an accelerometer-based activity sensor that processes one or more signals from the activity sensor to obtain parameters that are indicative of the heartbeat of the patient. The implantable cardiac stimulation device determines when the patient is at rest and the activity sensor provides a signal that corresponds to the acceleration of the sensor due to the heartbeat of the patient. This acceleration signal is integrated over time once to provide a contractility parameter, which is indicative of the contractility of the heart and is integrated over time twice to provide a displacement parameter, which is indicative of the displacement of the heart wall during the heartbeat. This displacement parameter is thereby indicative of the volume of blood pumped by the heart. A microprocessor uses either the contractility parameter, the displacement parameter or both to modify the delivery of therapeutic stimulation pulses to the heart.
摘要翻译：可植入心脏刺激装置，例如起搏器或植入式心律转复除颤器，其包括基于加速度计的活动传感器，其处理来自活动传感器的一个或多个信号以获得指示患者心跳的参数。可植入心脏刺激装置确定患者何时休息，并且活动传感器提供对应于由于患者心跳引起的传感器的加速度的信号。该加速度信号随着时间一度被积分以提供收缩性参数，其表示心脏的收缩性并且随时间积分两次以提供位移参数，其指示在心跳期间心脏壁的位移。因此，该位移参数指示由心脏泵送的血液的体积。微处理器使用收缩性参数，位移参数或两者来修改对心脏的治疗刺激脉冲的递送。

13. 发明授权

US5549649A Programmable pacemaker including an atrial rate filter for deriving a filtered atrial rate used for switching pacing modes 失效
标题翻译：可编程起搏器，包括用于导出用于切换起搏模式的滤波心房率的心房速率滤波器
公开(公告)号：US5549649A
公开(公告)日：1996-08-27
申请号：US258014
申请日：1994-06-10
申请人： Joseph J. Florio , Gene A. Bornzin , Paul A. Levine , J. Jeffrey Barlow
发明人： Joseph J. Florio , Gene A. Bornzin , Paul A. Levine , J. Jeffrey Barlow
IPC分类号： A61N1/362 , A61N1/36
CPC分类号： A61N1/3622
摘要： An implantable dual-chamber pacemaker programmed to operate primarily in an atrial tracking mode is provided, where the pacemaker includes an atrial rate smoothing filter for producing a filtered atrial rate from an intrinsic atrial rate, and where the pacemaker automatically switches its mode of operation from the atrial tracking mode to a non-atrial tracking mode in the event the filtered atrial rate exceeds a prescribed upper rate limit. The pacemaker switches from a primary set of operational parameter settings for the primary mode, to an alternate set of operational parameters for the alternate mode when the mode is switched from the primary mode to the alternate mode. The pacemaker also includes the capability of recording and storing mode switching events and data pertaining to the mode switching events.
摘要翻译：提供了一种被编程为主要以心房跟踪模式操作的可植入双室心脏起搏器，其中起搏器包括心房速率平滑滤波器，用于从固有心房率产生经滤波的心房率，并且起搏器自动将其操作模式从在过滤心房率超过规定的上限速率的情况下，将心房跟踪模式转换为非心房跟踪模式。当模式从主模式切换到备用模式时，起搏器从主模式的主要操作参数设置切换到备用模式的备用操作参数集。起搏器还包括记录和存储模式切换事件和与模式切换事件有关的数据的能力。

14. 发明授权

US5514162A System and method for automatically determining the slope of a transfer function for a rate-responsive cardiac pacemaker 失效
标题翻译：用于自动确定速率响应心脏起搏器的传递函数的斜率的系统和方法
公开(公告)号：US5514162A
公开(公告)日：1996-05-07
申请号：US255194
申请日：1994-06-07
申请人： Gene A. Bornzin , Elia R. Arambula , Joseph J. Florio
发明人： Gene A. Bornzin , Elia R. Arambula , Joseph J. Florio
IPC分类号： A61N1/365 , A61N1/36
CPC分类号： A61N1/36542
摘要： A rate-responsive pacemaker measures a patient's level of activity and stores the results in an activity level histogram. The patient's average level of activity is maintained as a running average. Based on a prescribed base pacing rate, a prescribed maximum pacing rate, the average level of activity, and the measured levels of activity stored in the activity level histogram, the rate-responsive pacemaker automatically calculates the slope of the pacemaker transfer function. An activity deviation histogram is also maintained. Analysis of the activity deviation histogram allows the pacemaker to determine if the patient was usually inactive for an extended period of time, and to inhibit an automatic slope calculation under such conditions. If a patient desires to reach a prescribed target heart rate during exercise, the slope may be calculated using the target heart rate and a prescribed fraction of time each week that the patient devotes to exercise.
摘要翻译：速率敏感的起搏器测量患者的活动水平，并将结果存储在活动级直方图中。患者的平均活动水平维持在平均水平。根据规定的基准起搏速率，规定的最大起搏速率，平均活动水平和存储在活动水平直方图中的测量活动水平，速率响应起搏器自动计算起搏器传递函数的斜率。也保持活动偏差直方图。活动偏差直方图的分析允许起搏器确定患者是否通常长时间不活动，并且抑制在这种情况下的自动斜率计算。如果患者希望在运动期间达到规定的目标心率，则可以使用目标心率和患者每周锻炼的规定的时间段来计算斜率。

15. 发明授权

US08090435B2 System and method for distinguishing among cardiac ischemia, hypoglycemia and hyperglycemia using an implantable medical device 有权
公开(公告)号：US08090435B2
公开(公告)日：2012-01-03
申请号：US12360826
申请日：2009-01-27
申请人： Jong Gill , Peter Boileau , Rupinder Bharmi , Xiaoyi Min , Joseph J. Florio , Michael E. Benser , Gene A. Bornzin
发明人： Jong Gill , Peter Boileau , Rupinder Bharmi , Xiaoyi Min , Joseph J. Florio , Michael E. Benser , Gene A. Bornzin
IPC分类号： A61B5/0402
CPC分类号： A61N1/3962 , A61B5/0452 , A61B5/0468 , A61B5/14532 , A61N1/3621 , A61N1/3627 , A61N1/36557 , A61N1/3925
摘要： Techniques are described for detecting ischemia, hypoglycemia or hyperglycemia based on intracardiac electrogram (IEGM) signals. Ischemia is detected based on a shortening of the interval between the QRS complex and the end of a T-wave (QTmax), alone or in combination with a change in ST segment elevation. Alternatively, ischemia is detected based on a change in ST segment elevation combined with minimal change in the interval between the QRS complex and the end of the T-wave (QTend). Hypoglycemia is detected based on a change in ST segment elevation along with a lengthening of either QTmax or QTend. Hyperglycemia is detected based on a change in ST segment elevation along with minimal change in QTmax and in QTend. By exploiting QTmax and QTend in combination with ST segment elevation, changes in ST segment elevation caused by hypo/hyperglycemia can be properly distinguished from changes caused by ischemia.

16. 发明申请

US20110004111A1 ISCHEMIA DETECTION USING INTRA-CARDIAC SIGNALS 有权
标题翻译： ISCHEMIA检测使用内部信号
公开(公告)号：US20110004111A1
公开(公告)日：2011-01-06
申请号：US12846387
申请日：2010-07-29
申请人： Jong Gill , Peter Boileau , Gene A. Bornzin , Joseph J. Florio , Mohssen Fard
发明人： Jong Gill , Peter Boileau , Gene A. Bornzin , Joseph J. Florio , Mohssen Fard
IPC分类号： A61B5/0452
CPC分类号： A61B5/0452 , A61B5/7203 , A61B5/7264 , Y10S128/92
摘要： An implanted cardiac rhythm management device is disclosed that is operative to detect myocardial ischemia. This is done by evaluating electrogram features to detect an electrocardiographic change; specifically, changes in electrogram segment during the early part of an ST segment. The early part of the ST segment is chosen to avoid the T-wave.
摘要翻译：公开了可用于检测心肌缺血的植入式心律管理装置。这通过评估电描记图特征来检测心电图变化来完成; 具体来说，在ST段的早期部分的电描绘片段的变化。选择ST段的早期部分以避免T波。

17. 发明申请

US20090177105A1 System and Method for Distinguishing Among Cardiac Ischemia, Hypoglycemia and Hyperglycemia Using an Implantable Medical Device 有权
公开(公告)号：US20090177105A1
公开(公告)日：2009-07-09
申请号：US12360826
申请日：2009-01-27
申请人： Jong Gill , Peter Boileau , Rupinder Bharmi , Xiaoyi Min , Joseph J. Florio , Michael E. Benser , Gene A. Bornzin
发明人： Jong Gill , Peter Boileau , Rupinder Bharmi , Xiaoyi Min , Joseph J. Florio , Michael E. Benser , Gene A. Bornzin
IPC分类号： A61B5/04
CPC分类号： A61N1/3962 , A61B5/0452 , A61B5/0468 , A61B5/14532 , A61N1/3621 , A61N1/3627 , A61N1/36557 , A61N1/3925
摘要： Techniques are described for detecting ischemia, hypoglycemia or hyperglycemia based on intracardiac electrogram (IEGM) signals. Ischemia is detected based on a shortening of the interval between the QRS complex and the end of a T-wave (QTmax), alone or in combination with a change in ST segment elevation. Alternatively, ischemia is detected based on a change in ST segment elevation combined with minimal change in the interval between the QRS complex and the end of the T-wave (QTend). Hypoglycemia is detected based on a change in ST segment elevation along with a lengthening of either QTmax or QTend. Hyperglycemia is detected based on a change in ST segment elevation along with minimal change in QTmax and in QTend. By exploiting QTmax and QTend in combination with ST segment elevation, changes in ST segment elevation caused by hypo/hyperglycemia can be properly distinguished from changes caused by ischemia.

18. 发明申请

US20090018595A1 SYSTEMS AND METHODS FOR EMPLOYING MULTIPLE FILTERS TO DETECT T-WAVE OVERSENSING AND TO IMPROVE TACHYARRHYTHMIA DETECTION WITHIN AN IMPLANTABLE MEDICAL DEVICE 有权
标题翻译：使用多个过滤器检测T波波纹的系统和方法以及改进在可植入医疗设备中的TACHYARRHYTHMIA检测
公开(公告)号：US20090018595A1
公开(公告)日：2009-01-15
申请号：US11776266
申请日：2007-07-11
申请人： Rupinder Bharmi , Jeffery D. Snell , Gene A. Bornzin , Joseph J. Florio , Peter Boileau
发明人： Rupinder Bharmi , Jeffery D. Snell , Gene A. Bornzin , Joseph J. Florio , Peter Boileau
IPC分类号： A61N1/365
CPC分类号： A61B5/0464 , A61B5/04014 , A61B5/0456 , A61N1/3622 , A61N1/3925 , A61N1/3962
摘要： Techniques are described for detecting tachyarrhythmia and also for preventing T-wave oversensing using a narrowband bradycardia filter in combination with a narrowband tachycardia filter. In some embodiments, a separate wideband filter is also exploited. In one illustrative example, ventricular tachycardia (VT) is detected by: detecting a preliminary indication of VT using signals filtered by the bradycardia filter and, in response, confirming the detection of VT using signals filtered by the tachycardia filter. That is, the bradycardia filter, traditionally used only to detect bradycardia, is additionally used to provide a preliminary indication of VT. The tachycardia filter is then activated to confirm the detection of VT before therapy is delivered. In this manner, the tachycardia filter need not run continuously, but is instead activated only when there is some indication of possible VT, and hence power is saved. Numerous other exemplary techniques are set forth herein for arrhythmia detection and for T-wave oversensing detection.
摘要翻译：描述了用于检测快速性心律失常的技术，并且还使用窄带心动过缓过滤器与窄带心动过速过滤器结合来预防T波过度感觉的技术。在一些实施例中，还利用单独的宽带滤波器。在一个说明性示例中，通过以下方式来检测室性心动过速（VT）：使用由心动过缓过滤器过滤的信号检测VT的初步指示，并且作为响应，使用由心动过速过滤器过滤的信号确认VT的检测。也就是说，传统上仅用于检测心动过缓的心动过缓过滤器另外用于提供VT的初步指示。然后激活心动过速过滤器以确认在治疗之前VT的检测。以这种方式，心动过速过滤器不需要连续运行，而是仅当存在可能的VT的一些指示时激活，因此节省功率。本文中阐述了许多其它示例性技术用于心律失常检测和T波超检测。

19. 发明授权

US07289848B1 Implantable cardiac stimulation device, system and method which provides an electrogram signal having the appearance of a surface electrocardiogram 有权
标题翻译：可植入的心脏刺激装置，系统和方法，其提供具有表面心电图的外观的电描记图信号
公开(公告)号：US07289848B1
公开(公告)日：2007-10-30
申请号：US10723027
申请日：2003-11-25
申请人： Gene A. Bornzin , Joseph J. Florio , Kerry Bradley
发明人： Gene A. Bornzin , Joseph J. Florio , Kerry Bradley
IPC分类号： A61N1/362 , A61B5/402
CPC分类号： A61N1/3702 , A61N1/368
摘要： An implantable cardiac stimulation system and method provides an external display of a heart activity signal sensed internally by an implantable cardiac stimulation device which has the appearance of a surface EKG. The heart activity signal is sensed by the implanted device and is processed by the device or the external display to have frequency characteristics resembling that of a surface EKG. The heart activity signal to be displayed takes the form of an intracardiac electrogram signal with a low frequency roll-on of no greater than 0.4 Hz and a high frequency cutoff of no less than 20 Hz. This provides a heart activity signal for display which has the appearance and most attributes of a surface EKG.
摘要翻译：可植入心脏刺激系统和方法提供外部显示心脏活动信号，该心脏活动信号由具有表面EKG外观的可植入心脏刺激装置内部感测。心脏活动信号由植入装置感测，并被装置或外部显示器处理以具有类似于表面EKG的频率特性。要显示的心脏活动信号采取心内电图信号的形式，具有不大于0.4Hz的低频滚动和不小于20Hz的高频截止。这提供了用于显示的心脏活动信号，其具有表面EKG的外观和大多数属性。

20. 发明授权

US07233827B1 Implantable cardiac stimulation device with automatic evoked response sensing electrode configuration selection and method 有权
标题翻译：可植入心脏刺激装置具有自动诱发响应感应电极配置选择和方法
公开(公告)号：US07233827B1
公开(公告)日：2007-06-19
申请号：US10865124
申请日：2004-06-09
申请人： Gene A. Bornzin , Joseph J. Florio , Laurence S. Sloman , Brian M. Mann , Jason A. Sholder
发明人： Gene A. Bornzin , Joseph J. Florio , Laurence S. Sloman , Brian M. Mann , Jason A. Sholder
IPC分类号： A61N1/365
CPC分类号： A61N1/3686 , A61N1/36185 , A61N1/371
摘要： An implantable cardiac stimulation device applies pacing stimulation pulses to a heart and senses evoked responses to the pacing stimulation pulses. A pulse generator applies the stimulation pacing pulses to the heart in accordance with a pacing configuration. A sensor control selects an evoked response sensing electrode configuration from among a plurality of evoked response sensing electrode configurations in response to the pacing configuration. A sensor is then programmed to sense the evoked responses with the selected evoked response sensing electrode configuration. In accordance with a preferred embodiment, signal-to-noise ratios obtained with the various electrode configurations are used to select a best electrode configuration for sensing evoked responses.
摘要翻译：可植入心脏刺激装置将起搏刺激脉冲应用于心脏并感测对起搏刺激脉冲的诱发反应。脉冲发生器根据起搏配置将刺激起搏脉冲施加到心脏。传感器控制器响应于起搏配置从多个诱发响应感测电极配置中选择诱发响应感测电极配置。然后将传感器编程为用所选择的诱发响应感测电极配置感测诱发的反应。根据优选实施例，使用用各种电极配置获得的信噪比用于选择用于感测诱发响应的最佳电极配置。

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