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51. 发明授权

US08874213B2 System and method for monitoring diastolic function using an implantable medical device 有权
标题翻译：使用可植入医疗装置监测舒张功能的系统和方法
公开(公告)号：US08874213B2
公开(公告)日：2014-10-28
申请号：US13601569
申请日：2012-08-31
申请人： Allen Keel , Steve Koh , Taraneh Ghaffari Farazi
发明人： Allen Keel , Steve Koh , Taraneh Ghaffari Farazi
IPC分类号： A61N1/362 , A61N1/37 , A61N1/368 , A61N1/365
CPC分类号： A61N1/3702 , A61N1/3627 , A61N1/36507 , A61N1/368 , A61N1/3712
摘要： Diastolic function is monitored within a patient using a pacemaker or other implantable medical device. In one example, the implantable device uses morphological parameters derived from the T-wave evoked response waveform as proxies for ventricular relaxation rate and ventricular compliance. In particular, the magnitude of the peak of the T-wave evoked response is employed as a proxy for ventricular compliance. The maximum slew rate of the T-wave evoked response following its peak is employed as a proxy for ventricular relaxation. A metric is derived from these proxy values to represent diastolic function. The metric is tracked over time to evaluate changes in diastolic function. In other examples, specific values for ventricular compliance and ventricular relaxation are derived for the patient based on the T-wave evoked response parameters.
摘要翻译：使用起搏器或其他可植入医疗器械在患者体内监测舒张功能。在一个示例中，可植入装置使用从T波诱发反应波形导出的形态参数作为心室松弛率和心室顺应性的代理。特别地，T波诱发反应的峰值的大小被用作心室顺应性的代表。其峰值后的T波诱发反应的最大压摆率被用作心室松弛的代用品。来自这些代理值的度量来表示舒张功能。随着时间的推移跟踪度量以评估舒张功能的变化。在其他实例中，基于T波诱发反应参数为患者导出心室顺应性和心室松弛的具体值。

52. 发明授权

US08447389B2 Methods and systems to monitor and identify transient ischemia 有权
标题翻译：监测和鉴别短暂性脑缺血的方法和系统
公开(公告)号：US08447389B2
公开(公告)日：2013-05-21
申请号：US12861573
申请日：2010-08-23
申请人： Steve Koh , Michael Yang , Ryan Rooke , Stuart Rosenberg , Wenbo Hou
发明人： Steve Koh , Michael Yang , Ryan Rooke , Stuart Rosenberg , Wenbo Hou
IPC分类号： A61B5/0452
CPC分类号： A61B5/0422 , A61B5/686 , A61B5/7282 , A61B2576/023 , A61N1/365 , A61N1/3702
摘要： A system and method are provided for monitoring ischemic development. The system and method identify a non-physiologic event and obtain cardiac signals along multiple sensing vectors, wherein at least a portion of the sensing vectors extend to or from electrodes located proximate to the left ventricle. The system and method monitor a segment of interest in the cardiac signals obtained along the multiple sensing vectors to identify deviations in the segment of interest from a baseline. The system and method record at least one of timing or segment shift information associated with the deviations in the segments of interest; and identify at least one of size, direction of development or rate of progression of an ischemia region based on the at least one of timing or segment shift information.
摘要翻译：提供了一种用于监测缺血发育的系统和方法。系统和方法识别非生理事件并且沿着多个感测向量获得心脏信号，其中至少一部分感测向量延伸到位于靠近左心室的电极。系统和方法监测沿着多个感测向量获得的心脏信号中的感兴趣区段，以识别感兴趣区段中的偏离基线。系统和方法记录与感兴趣的部分中的偏差相关联的定时或分段移位信息中的至少一个; 并且基于定时或段位移信息中的至少一个来识别缺血区域的大小，发育方向或进展速度中的至少一个。

53. 发明授权

US08249706B2 Adaptive rate programming control in implantable medical devices using ventricular-arterial coupling surrogates 有权
标题翻译：使用心室 - 动脉耦合代理的可植入医疗装置中的自适应速率编程控制
公开(公告)号：US08249706B2
公开(公告)日：2012-08-21
申请号：US12694098
申请日：2010-01-26
申请人： Steve Koh
发明人： Steve Koh
IPC分类号： A61N1/365
CPC分类号： A61N1/36514
摘要： Selection of an appropriate rate programming control (RPC) setting in an implantable medical device (IMD), uses analysis of VA coupling surrogate conditions. The VA coupling surrogate conditions are derived from signals such as cardiogenic impedance, blood pressure, and the pulsatile components of PPG. By analyzing a waveform of the measured surrogate condition, the IMD estimates wall stiffness, through the slope of the waveform, and peripheral arterial pressure, through the reflection time between the main wave and reflection wave of the waveform. These values are plotted against each other on a VA coupling coordinate plane. Based on the location and orientation of the resulting VA coupling plot, the IMD selects an appropriate RPC setting.
摘要翻译：在可植入医疗设备（IMD）中选择适当的速率编程控制（RPC）设置，使用VA耦合替代条件的分析。 VA耦合替代条件来自诸如心源阻抗，血压和PPG脉冲成分的信号。通过分析测量的替代条件的波形，IMD通过波形的波形和反射波之间的反射时间来估计壁面刚度，通过波形斜率和外周动脉压力。这些值在VA耦合坐标平面上相互绘图。根据所得的VA耦合图的位置和方向，IMD选择适当的RPC设置。

54. 发明授权

US08192360B2 Implantable body fluid analyzer 有权
标题翻译：植入体液分析仪
公开(公告)号：US08192360B2
公开(公告)日：2012-06-05
申请号：US11861028
申请日：2007-09-25
申请人： Steve Koh , Jonathan T. Losk
发明人： Steve Koh , Jonathan T. Losk
IPC分类号： A61B5/00 , C12M1/00
CPC分类号： G01N21/6454 , A61B5/0031 , A61B5/0071 , A61B5/0075 , A61B5/0084 , A61B5/411 , A61B2562/028 , G01N21/05 , G01N21/6428 , G01N2021/0328 , G01N2021/0346 , G01N2021/058 , G01N2021/6482
摘要： An exemplary implantable microarray device includes an inlet for a body fluid, a plurality of individual reaction cell arrays where each reaction cell array includes a series of reaction cells configured to receive the body fluid, a sensor array to sense a reaction result for an individual reaction cell array where the reaction result corresponds to a reaction between the body fluid and at least one reagent in each of the reaction cells of the individual reaction cell array and a positioning mechanism to position an individual reaction cell array with respect to the sensor array. Various other exemplary technologies are also disclosed.
摘要翻译：示例性可植入微阵列装置包括用于体液的入口，多个单独的反应池阵列，其中每个反应池阵列包括一系列被配置为接纳体液的反应池，感测器阵列以感测各个反应的反应结果其中反应结果对应于体液和单个反应池阵列的每个反应池中的至少一个试剂之间的反应以及相对于传感器阵列定位单个反应池阵列的定位机构。还公开了各种其它示例性技术。

55. 发明授权

US08016812B2 Techniques for delivery of stem cell and related therapies to treat cardiac conditions 有权
标题翻译：用于输送干细胞和相关疗法以治疗心脏病症的技术
公开(公告)号：US08016812B2
公开(公告)日：2011-09-13
申请号：US12841944
申请日：2010-07-22
申请人： Steve Koh
发明人： Steve Koh
IPC分类号： A61M31/00
CPC分类号： A61N1/326 , A61M5/14276 , A61M5/1723 , A61M2210/125 , A61M2230/04 , A61N1/3621 , A61N1/371
摘要： An exemplary method includes acquiring cardiac electrical activity information, detecting a T wave and, based on the detecting, calling for delivery of matter to the heart where the matter may include one or more of stem cells, progenitor cells, nutrients and drugs. Another exemplary method includes calling for delivery of electrical energy to cells destined for implantation in the body or cells already implanted in the body. Such delivery may be timed according to cardiac electrical activity and/or delivered at an energy level below a capture threshold of neighboring tissue. Various other exemplary technologies are also disclosed.
摘要翻译：一种示例性方法包括获取心脏电活动信息，检测T波，并且基于检测要求将物质递送到心脏，其中物质可以包括干细胞，祖细胞，营养物和药物中的一种或多种。另一个示例性方法包括要求将电能递送到注入体内的细胞或已经植入体内的细胞中。这种递送可以根据心脏电活动定时和/或在低于相邻组织的捕获阈值的能量水平下递送。还公开了各种其它示例性技术。

56. 发明申请

US20110196440A1 ADAPTIVE DETERMINATION OF PATIENT SPECIFIC OPTIMAL AV DELAY DURING ELEVATED HEART RATES BASED ON CARDIAC OUTPUT MEASUREMENTS 有权
标题翻译：基于心脏输出测量的高能心率患者特异性最佳AV延迟的自适应确定
公开(公告)号：US20110196440A1
公开(公告)日：2011-08-11
申请号：US12701816
申请日：2010-02-08
申请人： Steve Koh
发明人： Steve Koh
IPC分类号： A61N1/365
CPC分类号： A61N1/36514 , A61B5/0215 , A61B5/028 , A61B5/029 , A61B5/0295 , A61B5/686 , A61N1/36564 , A61N1/36571 , A61N1/3682
摘要： Adaptively creating a table of optimal, patient-specific atrioventricular (AV) delays for a an implantable medical device (IMD) begins as the IMD detects the patient entering a target heart rates within a defined range of elevated heart rates. On detection, the device begins testing AV delays by pacing the heart at a number of different AV delays. The IMD selects the optimal AV delay based on a comparison of measurements of cardiac output obtained during each delay's test pacing period. The optimal AV delay corresponds to the one which resulted in the highest cardiac output. The device selects this optimal AV delay and stores it in an AV delay table on the device. The process continues as the device detects the patient entering the other target heart rates in order to complete the table.
摘要翻译：随着IMD检测到患者在确定的升高的心率范围内进入目标心率，自适应地创建用于可植入医疗装置（IMD）的最佳患者特异性房室（AV）延迟的表格。在检测时，设备通过在许多不同的AV延迟进行心脏起搏来开始测试AV延迟。 IMD基于每个延迟的测试起搏期间获得的心输出量测量值的比较来选择最佳的AV延迟。最佳AV延迟对应于导致心输出量最高的延迟。该设备选择此最佳AV延迟并将其存储在设备上的AV延迟表中。该过程继续，因为设备检测到患者进入其他目标心率以完成该表。

57. 发明申请

US20110184485A1 ADAPTIVE RATE PROGRAMMING CONTROL IN IMPLANTABLE MEDICAL DEVICES USING VENTRICULAR-ARTERIAL COUPLING SURROGATES 有权
标题翻译：使用静脉血管连接术的可移植医疗器械中的自适应速率编程控制
公开(公告)号：US20110184485A1
公开(公告)日：2011-07-28
申请号：US12694098
申请日：2010-01-26
申请人： Steve Koh
发明人： Steve Koh
IPC分类号： A61N1/365
CPC分类号： A61N1/36514
摘要： Selection of an appropriate rate programming control (RPC) setting in an implantable medical device (IMD), uses analysis of VA coupling surrogate conditions. The VA coupling surrogate conditions are derived from signals such as cardiogenic impedance, blood pressure, and the pulsatile components of PPG. By analyzing a waveform of the measured surrogate condition, the IMD estimates wall stiffness, through the slope of the waveform, and peripheral arterial pressure, through the reflection time between the main wave and reflection wave of the waveform. These values are plotted against each other on a VA coupling coordinate plane. Based on the location and orientation of the resulting VA coupling plot, the IMD selects an appropriate RPC setting.
摘要翻译：在可植入医疗设备（IMD）中选择适当的速率编程控制（RPC）设置，使用VA耦合替代条件的分析。 VA耦合替代条件来自诸如心源阻抗，血压和PPG脉冲成分的信号。通过分析测量的替代条件的波形，IMD通过波形的波形和反射波之间的反射时间来估计壁面刚度，通过波形斜率和外周动脉压力。这些值在VA耦合坐标平面上相互绘图。根据所得的VA耦合图的位置和方向，IMD选择适当的RPC设置。

58. 发明申请

US20110184304A1 IMPLANTABLE MEDICAL DEVICE WITH SLEEP APNEA DETECTION CONTROL AND METHOD 有权
标题翻译：具有睡眠APNEA检测控制和方法的可植入医疗装置
公开(公告)号：US20110184304A1
公开(公告)日：2011-07-28
申请号：US13080527
申请日：2011-04-05
申请人： Steve Koh
发明人： Steve Koh
IPC分类号： A61B5/08
CPC分类号： A61B5/4818 , A61B5/0809 , A61B5/0826 , A61B5/686 , A61N1/3601 , A61N1/362 , A61N1/3962
摘要： A method for use in an implantable medical device comprises the steps of monitoring respiration with an amplifier having a gain, generating a moving apneic threshold based on recent respiration cycles, accumulating differences between amplitudes of respiration cycles and the moving apnea detection threshold and comparing the accumulated differences against an apnea detection threshold to detect the onset of an episode of apnea. The method further comprises measuring respiration levels upon detecting the onset of apnea, confirming the episode of apnea based upon the respiration levels measured upon detecting the onset of apnea; and adjusting one of the gain of the amplifier and the apnea detection threshold so that the time from the detection of onset of apnea to the time of confirmation of the episode of apnea is within a predetermined time range following the detection of the onset of apnea.
摘要翻译：一种用于可植入医疗装置的方法包括以下步骤：利用具有增益的放大器监测呼吸，基于最近的呼吸循环产生移动呼吸暂停阈值，累积呼吸循环幅度与移动呼吸暂停检测阈值之间的差异，并比较累积与呼吸暂停检测阈值的差异，以检测呼吸暂停发作的发作。该方法还包括在检测呼吸暂停发作时测量呼吸水平，基于在检测呼吸暂停发作时测量的呼吸水平确认呼吸暂停发作; 并调整放大器的增益和呼吸暂停检测阈值之一，使得从检测呼吸暂停发作到呼吸暂停发作时间的时间在检测呼吸暂停发生之后在预定时间范围内。

59. 发明授权

US07894901B1 Apparatus and method for assessing cardiac therapy 有权
标题翻译：心脏治疗评估装置及方法
公开(公告)号：US07894901B1
公开(公告)日：2011-02-22
申请号：US11466074
申请日：2006-08-21
申请人： Steve Koh
发明人： Steve Koh
IPC分类号： A61N1/365
CPC分类号： A61N1/36585 , A61B5/0452 , A61N1/3627 , A61N1/36507 , A61N1/36542 , A61N1/3684
摘要： A patient's response to therapy such as CRT is assessed by cross correlation of a patient's evoked response and physical activity surrogates. Based on the cross correlation, a determination may be made as to whether or how much the therapy is helping the patient's physical activity. For example, the degree of cross correlation index between IEGM parameters and activity threshold parameters may be used to assess whether the patient's heart condition improves the patient's physical activity. The therapy may then be modified as necessary in the event the patient is not sufficiently responding to the therapy.
摘要翻译：患者对治疗如CRT的反应是通过患者的诱发反应和身体活动代理的互相关来评估的。基于互相关，可以确定治疗是否或多少帮助患者的身体活动。例如，可以使用IEGM参数和活动阈值参数之间的互相关指数的程度来评估患者的心脏状况是否改善患者的身体活动。然后可以在患者对治疗没有充分反应的情况下根据需要修改治疗。

60. 发明申请

US20110028801A1 CARDIOVASCULAR VESSEL ELASTICITY MONITORING 审中-公开
标题翻译：心血管血管弹性监测
公开(公告)号：US20110028801A1
公开(公告)日：2011-02-03
申请号：US12511484
申请日：2009-07-29
申请人： Steve Koh
发明人： Steve Koh
IPC分类号： A61B5/0205 , A61B5/02
CPC分类号： A61B5/02152 , A61B2562/0247
摘要： Elasticity of a cardiovascular vessel of a patient is monitored to provide an indication of whether the patient's health is changing. In some aspects the elasticity of a cardiovascular vessel is determined irrespective of the current blood pressure level of the patient at the time the elasticity is determined. For example, vessel elasticity may be determined based on a defined set of data that maps vessel elasticity with reflectance times for different blood pressure levels. In some implementations, this set of data corresponds to a set of iso-pressure lines.
摘要翻译：监测患者的心血管血管的弹性以提供患者的健康状况是否变化的指示。在一些方面，确定心血管血管的弹性，而不考虑在确定弹性时患者的当前血压水平。例如，容器弹性可以基于将血管弹性与不同血压水平的反射时间映射的定义的数据组确定。在一些实施方案中，该组数据对应于一组等压线。

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