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51. 发明授权

US5755739A Adaptive and morphological system for discriminating P-waves and R-waves inside the human body 失效
标题翻译：用于辨别人体内P波和R波的自适应和形态系统
公开(公告)号：US5755739A
公开(公告)日：1998-05-26
申请号：US759902
申请日：1996-12-04
申请人： Weimin Sun , Pamela A. Abshire , Eric J. Panken , William J. Combs
发明人： Weimin Sun , Pamela A. Abshire , Eric J. Panken , William J. Combs
IPC分类号： A61B5/0452 , A61N1/368 , A61N1/37 , A61N1/362 , A61B5/0464
CPC分类号： A61N1/3704 , A61B5/04525 , A61N1/368
摘要： The present invention is a method and apparatus for processing a sensed atrial electrogram in conjunction with a sensed ventricular electrogram. The present invention permits accurate discrimination of atrial P-waves from far field ventricular events such as far field R-waves and avoids oversensing such far field ventricular events as atrial sense events and undersensing atrial events occurring within a fusion beat masked by a far field ventricular event in the atrial electrogram. Atrial channel trigger signals are generated in response to sensed P-waves and far field R-waves in the atrial electrogram, and ventricular trigger signals are generated in response to sensed R-waves in the ventricular electrogram. In response to each ventricular channel trigger signal, the sensed atrial electrogram signal is adaptively filtered for an adaptive filter time window only to remove the far field R-wave signal from the sensed atrial electrogram signal while avoiding adaptive filtering of the sensed atrial electrogram signal at other times. In response to each atrial channel trigger signal, the adaptively filtered, sensed atrial electrogram signal is subjected to morphological analysis in respect of a morphological model of a P-wave only during a morphology time window. In this manner, P-waves in the sensed atrial electrogram signal are detected and far field R-waves in the sensed atrial electrogram signal are not mistakenly detected as P-waves, while morphological analysis of the sensed atrial electrogram at other times is avoided.
摘要翻译：本发明是一种结合感测的心室电描记图处理感测的心房电描记图的方法和装置。本发明允许从远场心室事件（例如远场R波）中准确地辨别心房P波，并避免过度监测诸如心房感觉事件的远场心室事件以及在由远场心室掩蔽的融合搏动内发生的低度心房事件心房电图中的事件。响应于心房电描记图中的感测到的P波和远场R波产生心房通道触发信号，并且响应于心室电图中的感测到的R波而产生心室触发信号。响应于每个心室通道触发信号，感测的心房电描记信号被自适应滤波以用于自适应滤波器时间窗口，仅从感测的心房电描记图信号中去除远场R波信号，同时避免对感测的心房电描记图信号的自适应滤波其他时候。响应于每个心房通道触发信号，仅在形态学时间窗口期间，自适应滤波感应的心房电描记信号就P波的形态学模型进行形态学分析。以这种方式，检测到感测的心房电描记信号中的P波，并且将感测到的心房电描记信号中的远场R波未被错误地检测为P波，同时避免了其他时间的感测的心房电描记图的形态学分析。

52. 发明授权

US5562711A Method and apparatus for rate-responsive cardiac pacing 失效
标题翻译：速率响应心脏起搏方法和装置
公开(公告)号：US5562711A
公开(公告)日：1996-10-08
申请号：US346813
申请日：1994-11-30
申请人： Charles G. Yerich , William J. Combs , Karen J. Kleckner , Eric J. Panken , Richard S. Schallhorn , John D. Wahlstrand
发明人： Charles G. Yerich , William J. Combs , Karen J. Kleckner , Eric J. Panken , Richard S. Schallhorn , John D. Wahlstrand
IPC分类号： A61N1/365
CPC分类号： A61N1/36585
摘要： A body-implantable rate-responsive cardiac pacemaker is provided with circuitry for sensing a plurality of physiologic parameters known to be indicative of a patient's metabolic demand for increased cardiac output. In one embodiment, a rate-responsive pacemaker is provided with an activity sensor for detecting the patient's level of physical activity, and is further provided with an impedance sensing circuit for detecting the patient's level of minute ventilation by monitoring cardiac impedance. A rate-response transfer function, implemented by the pacemaker's control circuitry, periodically computes a rate-responsive pacing rate as a function of the outputs from both physiologic sensing circuits. The pacemaker's pacing rate is variable within a rate range defined by predetermined (programmable) upper and lower limits. In the preferred embodiment, the influence of activity sensing and minute ventilation parameters varies in accordance with the current pacing rate. In particular, the influence of activity sensing in rate determination in accordance with the rate-response function is greater than that of minute ventilation, for slower pacing rates, while the influence of minute ventilation sensing dominates over that of activity sensing for higher pacing rates. Rate response operation of the disclosed system is recorded in the form of histogram data stored over a predetermined history time. The relative influence of the activity sensing and minute ventilation sensing on rate determination is periodically scaled or balanced based upon comparison of the histogram data with predetermined desired response data.
摘要翻译：身体植入式速率响应心脏起搏器被提供有用于感测已知指示患者对增加的心输出量的代谢需求的多个生理参数的电路。在一个实施例中，速率响应起搏器设置有用于检测患者的身体活动水平的活动传感器，并且还设置有阻抗感测电路，用于通过监测心脏阻抗来检测患者的分钟通气水平。由起搏器的控制电路实现的速率响应传递函数周期性地计算速率响应起搏速率作为来自生理感测电路的输出的函数。起搏器的起搏速率在由预定（可编程）上限和下限限定的速率范围内是可变的。在优选实施例中，活动感测和分钟通气参数的影响根据当前起搏速率而变化。特别是，根据速率响应函数的速率测定中的活动检测的影响大于分钟通气量，对于较慢的起搏速率，而微动通气检测的影响比活动检测的影响高于起搏率。以预定历史时间存储的直方图数据的形式记录所公开的系统的速率响应操作。基于直方图数据与预定的期望响应数据的比较，活动感测和分钟通气感测对速率确定的相对影响被周期地缩放或平衡。

53. 发明授权

US09327129B2 Blended posture state classification and therapy delivery 有权
标题翻译：混合姿势状态分类和治疗传递
公开(公告)号：US09327129B2
公开(公告)日：2016-05-03
申请号：US12433038
申请日：2009-04-30
申请人： Eric J. Panken
发明人： Eric J. Panken
IPC分类号： A61N1/00 , A61N1/365 , A61B5/11 , A61B5/00
CPC分类号： A61N1/36542 , A61B5/1116 , A61B5/1118 , A61B5/686 , A61B5/7264 , A61B2562/0219 , A61N1/36535 , G06F19/00
摘要： Techniques for classification of a posture state of a patient using multiple posture state definitions, and for delivering therapy according to the patient's classified posture state. Detected parameter values describing a patient's posture state are compared to posture state definitions. This comparison is used to determine similarity values describing how similar the patient's posture state is to each of the posture states described by the posture state definitions. Weighting factors may be determined from the similarity values and used to weight therapy parameter values that are associated with each of the posture state definitions. The resulting weighted therapy parameter values may be used to derive a blended therapy parameter value for use in delivering therapy to the patient. The patient's posture state may be expressed in terms of a blending of the multiple posture state definitions.
摘要翻译：用于使用多个姿势状态定义对患者的姿势状态进行分类的技术，以及根据患者分类的姿势状态进行治疗的技术。将描述患者姿势状态的检测参数值与姿势状态定义进行比较。该比较用于确定描述患者姿势状态与由姿势状态定义描述的每个姿势状态相似的相似性值。加权因子可以根据相似度值确定并用于与每个姿势状态定义相关联的加权治疗参数值。所得到的加权治疗参数值可用于导出用于向患者递送疗法的混合治疗参数值。患者的姿势状态可以用多姿势状态定义的混合来表示。

54. 发明授权

US09149210B2 Automated calibration of posture state classification for a medical device 有权
标题翻译：自动校准医疗器械的姿势状态分类
公开(公告)号：US09149210B2
公开(公告)日：2015-10-06
申请号：US12769391
申请日：2010-04-28
申请人： Rajeev M. Sahasrabudhe , Lynn Davenport , Jon P. Davis , Wende L. Dewing , Elizabeth A. Fehrmann , Steven Goetz , Shyam Gokaldas , Eric J. Panken
发明人： Rajeev M. Sahasrabudhe , Lynn Davenport , Jon P. Davis , Wende L. Dewing , Elizabeth A. Fehrmann , Steven Goetz , Shyam Gokaldas , Eric J. Panken
IPC分类号： A61B5/11 , A61B5/00 , A61N1/36 , A61B5/021 , A61B5/024 , A61B5/0476 , A61B5/0488 , A61B5/145 , A61N1/365 , A61N1/372 , G06F19/00
CPC分类号： A61B5/4839 , A61B5/021 , A61B5/024 , A61B5/0476 , A61B5/0488 , A61B5/1116 , A61B5/1118 , A61B5/14532 , A61B5/686 , A61B5/7264 , A61B5/7282 , A61B5/742 , A61B5/7475 , A61B2560/0223 , A61B2560/0475 , A61N1/36071 , A61N1/36535 , A61N1/37247 , G06F19/00 , G06F19/324 , G16H50/20
摘要： Techniques relate to operating a medical device by classifying a detected posture state of a patient. This classification may be performed by comparing the detected posture state to posture state definitions available within the system. Each definition may be described in terms of a parameter (e.g., vector) indicative of a direction in three-dimensional space. The posture state definitions may be calibrated by automatically estimating values for these parameters, thereby eliminating the need for the patient to assume each posture state during the calibration process to capture actual parameter values. According to another aspect, the estimated parameter values may be updated as the patient assumes various postures during a daily routine. For instance, estimated vectors initially used to calibrate the posture state definitions may be changed over time to more closely represent posture states the patient actually assumes, and to further adapt to changes in a patient's condition.
摘要翻译：技术涉及通过对检测到的患者的姿势状态进行分类来操作医疗装置。可以通过将检测到的姿势状态与系统内可用的姿势状态定义进行比较来执行该分类。可以根据指示三维空间中的方向的参数（例如，矢量）来描述每个定义。可以通过自动估计这些参数的值来校准姿势状态定义，从而消除了在校准过程期间患者承担每个姿势状态以捕获实际参数值的需要。根据另一方面，当患者在日常例行程序中呈现各种姿势时，可以更新所估计的参数值。例如，最初用于校准姿势状态定义的估计矢量可以随着时间而改变以更加紧密地表示患者实际假定的姿势状态，并进一步适应患者状况的变化。

55. 发明授权

US08958885B2 Posture state classification for a medical device 有权
标题翻译：医疗器械的姿态分类
公开(公告)号：US08958885B2
公开(公告)日：2015-02-17
申请号：US12433004
申请日：2009-04-30
申请人： Eric J. Panken , Dennis M. Skelton
发明人： Eric J. Panken , Dennis M. Skelton
IPC分类号： A61N1/00 , A61N1/365 , A61B5/11 , A61B5/00
CPC分类号： A61N1/36542 , A61B5/1116 , A61B5/1118 , A61B5/686 , A61B5/7264 , A61B2562/0219 , A61N1/36535 , G06F19/00
摘要： One embodiment relates to a medical device including a sensor to provide signals indicative of a detected posture state of a patient. A memory stores one or more defined vectors, each defined vector being associated with a tolerance describing a relationship with the defined vector. A processor determines a respective similarity between the detected vector and each of one or more of the defined vectors and classifies a posture state of the patient based on whether any similarity has a relationship to the respective defined vector that is described by the associated tolerance. In one embodiment, the similarity is determined without regard to a coordinate system of the patient. Another embodiment relates to determining the similarity based on at least one of an inner product, a length of the defined posture vector and a length of the detected vector.
摘要翻译：一个实施例涉及一种医疗设备，其包括用于提供指示患者的检测到的姿势状态的信号的传感器。存储器存储一个或多个定义的向量，每个定义的向量与描述与所定义的向量的关系的公差相关联。处理器确定检测到的矢量与所定义的一个或多个矢量中的每一个之间的各自的相似度，并且基于任何相似性是否与由相关联的容限描述的相应定义的矢量具有关系来对患者的姿势状态进行分类。在一个实施例中，不考虑患者的坐标系确定相似度。另一实施例涉及基于内积，所定义的姿态向量的长度和所检测的向量的长度中的至少一个来确定相似性。

56. 发明申请

US20130289652A1 ADJUSTMENT OF THERAPY BASED ON ACCELERATION 有权
标题翻译：基于加速度的治疗调整
公开(公告)号：US20130289652A1
公开(公告)日：2013-10-31
申请号：US13457104
申请日：2012-04-26
申请人： Dennis M. Skelton , Christopher Poletto , Eric J. Panken
发明人： Dennis M. Skelton , Christopher Poletto , Eric J. Panken
IPC分类号： A61N1/36
CPC分类号： A61N1/36535 , A61B5/01 , A61B5/021 , A61B5/024 , A61B5/0402 , A61B5/0476 , A61B5/0488 , A61B5/0816 , A61B5/1116 , A61B5/1118 , A61B2562/0219 , A61N1/36071 , A61N1/36139 , A61N1/36146 , A61N1/36153 , A61N1/36171 , A61N1/36175 , A61N1/36185 , A61N1/36542
摘要： A medical device provides stimulation therapy to a patient based on a set of therapy parameters. One or more therapy parameters may be automatically adjusted based on acceleration forces detected by a sensor, the acceleration forces being applied to the patient. In some examples, adjustments to one or more therapy parameter may be made based on an algorithm. The algorithm may be defined by acceleration and therapy parameter value pairs associated with opposite patient positions.
摘要翻译：医疗装置基于一组治疗参数向患者提供刺激疗法。可以基于由传感器检测到的加速力自动调整一个或多个治疗参数，加速力被施加到患者身上。在一些示例中，可以基于算法进行对一个或多个治疗参数的调整。可以通过与相对的患者位置相关联的加速度和治疗参数值对来定义算法。

57. 发明授权

US08388555B2 Posture state classification for a medical device 有权
标题翻译：医疗器械的姿态分类
公开(公告)号：US08388555B2
公开(公告)日：2013-03-05
申请号：US12769484
申请日：2010-04-28
申请人： Eric J. Panken , Amanda Gaudreau
发明人： Eric J. Panken , Amanda Gaudreau
IPC分类号： A61B5/00
CPC分类号： A61B5/4839 , A61B5/021 , A61B5/024 , A61B5/0476 , A61B5/0488 , A61B5/1116 , A61B5/1118 , A61B5/14532 , A61B5/686 , A61B5/7264 , A61B5/7282 , A61B5/742 , A61B5/7475 , A61B2560/0223 , A61B2560/0475 , A61N1/36071 , A61N1/36535 , A61N1/37247 , G06F19/00 , G06F19/324 , G16H50/20
摘要： Techniques relate to operating a medical device in response to a detected posture state of a patient. A trigger event such as a request to modify how therapy is being delivered to the patient may cause a determination to be made as to whether the patient's posture state is stable. If the posture state is stable, an association is created between the posture state and one or more therapy parameter values. Over time, a library of such associations is created that may reflect any posture state in three dimensional space, wherein a posture state comprises at least one of a posture and an activity component. The library of associations may be used to automatically control therapy delivery. Similar ones of the associations may automatically be grouped into posture state regions to facilitate more efficient classification of the patient's posture state to control therapy delivery.
摘要翻译：技术涉及响应于患者的检测到的姿势状态来操作医疗装置。诸如要求修改治疗如何递送给患者的触发事件可能导致确定患者的姿势状态是否稳定。如果姿势状态稳定，则在姿势状态和一个或多个治疗参数值之间产生关联。随着时间的推移，创建了可以反映三维空间中的任何姿势状态的这种关联的库，其中姿势状态包括姿势和活动组件中的至少一个。协会图书馆可用于自动控制治疗传递。相似的关联可以自动地被分组到姿势状态区域中，以便于更有效地分类患者的姿态以控制治疗递送。

58. 发明授权

US08317770B2 Systems and methods of identifying catheter malfunctions using pressure sensing 有权
标题翻译：使用压力感测识别导管故障的系统和方法
公开(公告)号：US08317770B2
公开(公告)日：2012-11-27
申请号：US11731355
申请日：2007-03-30
申请人： Keith A. Miesel , Eric J. Panken
发明人： Keith A. Miesel , Eric J. Panken
IPC分类号： A61M31/00 , A61M37/00
CPC分类号： A61M5/16859 , A61M5/14276 , A61M2205/14 , A61M2205/15
摘要： Methods and systems for determining whether a catheter malfunction is present in a catheter by analyzing changes in the pressure of fluids being pumped through the delivery lumen of the catheter. The pressure changes that may be monitored may include, e.g., the peak pressure within the catheter and/or the pressure decay profile. The catheter malfunctions that may be determined using the methods and systems of the invention may include, e.g., leaks, blockages, the presence of gas bubbles, etc.
摘要翻译：通过分析通过导管的输送腔泵送的流体的压力变化来确定导管故障是否存在于导管中的方法和系统。可以监测的压力变化可以包括例如导管内的峰值压力和/或压力衰减曲线。可以使用本发明的方法和系统确定的导管故障可以包括例如泄漏，堵塞，气泡的存在等

59. 发明申请

US20100010381A1 POSTURE STATE RESPONSIVE THERAPY DELIVERY USING DWELL TIMES 有权
标题翻译：使用DWELL时间的心理状态的治疗方法
公开(公告)号：US20100010381A1
公开(公告)日：2010-01-14
申请号：US12433017
申请日：2009-04-30
申请人： Dennis M. Skelton , Jon P. Davis , Eric J. Panken
发明人： Dennis M. Skelton , Jon P. Davis , Eric J. Panken
IPC分类号： A61B5/103
CPC分类号： A61N1/36542 , A61B5/1116 , A61B5/1118 , A61B5/686 , A61B5/7264 , A61B2562/0219 , A61N1/36535 , G06F19/00
摘要： Techniques related to classifying a posture state of a living body are disclosed. One aspect relates to sensing at least one signal indicative of a posture state of a living body. Posture state detection logic classifies the living body as being in a posture state based on the at least one signal, wherein this classification may take into account at least one of posture and activity state of the living body. The posture state detection logic further determines whether the living body is classified in the posture state for at least a predetermined period of time. Response logic is described that initiates a response as a result of the body being classified in the posture state only after the living body has maintained the classified posture state for at least the predetermined period of time. This response may involve a change in therapy, such as neurostimulation therapy, that is delivered to the living body.
摘要翻译：公开了对活体姿势状态进行分类的技术。一个方面涉及感测指示生物体的姿势状态的至少一个信号。姿势状态检测逻辑基于至少一个信号将生物体分为处于姿势状态，其中该分类可以考虑活体的姿势和活动状态中的至少一个。姿势状态检测逻辑进一步确定生物体是否至少在预定时间段内分类为姿势状态。描述了响应逻辑，其仅在生物体至少在预定时间段内保持分类姿势状态之后，作为身体被分类为姿势状态的结果而发起响应。这种反应可能涉及到递送到生物体的治疗方法，如神经刺激疗法。

60. 发明申请

US20090082829A1 Patient directed therapy control 有权
标题翻译：患者定向治疗控制
公开(公告)号：US20090082829A1
公开(公告)日：2009-03-26
申请号：US11974931
申请日：2007-10-16
申请人： Eric J. Panken , Timothy J. Denison , Gregory F. Molnar
发明人： Eric J. Panken , Timothy J. Denison , Gregory F. Molnar
IPC分类号： A61N1/00
CPC分类号： A61N1/36139 , A61B5/048 , A61B5/4082 , A61B5/7475 , A61M5/14276 , A61M5/1723 , A61M2210/0693 , A61N1/36014 , A61N1/36017 , A61N1/36021 , A61N1/36025 , A61N1/3605 , A61N1/3606 , A61N1/36071 , A61N1/36082 , A61N1/37252 , G06F3/015
摘要： A patient controls the delivery of therapy through volitional inputs that are detected by a biosignal within the brain. The volitional patient input may be directed towards performing a specific physical or mental activity, such as moving a muscle or performing a mathematical calculation. In one embodiment, a biosignal detection module monitors an electroencephalogram (EEG) signal from within the brain of the patient and determines whether the EEG signal includes the biosignal. In one embodiment, the biosignal detection module analyzes one or more frequency components of the EEG signal. In this manner, the patient may adjust therapy delivery by providing a volitional input that is detected by brain signals, wherein the volitional input may not require the interaction with another device, thereby eliminating the need for an external programmer to adjust therapy delivery. Example therapies include electrical stimulation, drug delivery, and delivery of sensory cues.
摘要翻译：患者通过由大脑内的生物信号检测到的输入量来控制治疗的传递。患者的输入可以指向执行特定的身体或精神活动，例如移动肌肉或执行数学计算。在一个实施例中，生物信号检测模块监测来自患者脑内的脑电图（EEG）信号，并确定EEG信号是否包括生物信号。在一个实施例中，生物信号检测模块分析EEG信号的一个或多个频率分量。以这种方式，患者可以通过提供由脑信号检测到的输入量来调节治疗递送，其中，该输入可能不需要与另一个装置的相互作用，从而消除了外部程序员调整治疗递送的需要。示例治疗包括电刺激，药物递送和感觉线索的递送。

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