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61. 发明授权

US08886319B2 MRI signal filtering for implantable medical device 有权
标题翻译：可植入医疗器械的MRI信号滤波
公开(公告)号：US08886319B2
公开(公告)日：2014-11-11
申请号：US12617532
申请日：2009-11-12
申请人： Jin Zhang , J. Christopher Moulder , George I. Isaac , Gabriel A. Mouchawar , Peter Boileau , Ingmar Viohl
发明人： Jin Zhang , J. Christopher Moulder , George I. Isaac , Gabriel A. Mouchawar , Peter Boileau , Ingmar Viohl
IPC分类号： A61N1/08 , G01R33/28 , A61N1/37 , A61N1/375 , A61N1/365 , G01R33/36
CPC分类号： G01R33/288 , A61N1/36521 , A61N1/3718 , A61N1/3754 , G01R33/3685
摘要： A filtering scheme for an implantable medical device mitigates potentially adverse effects that may be caused by MRI-induced signals. In some aspects filtering is provided to attenuate MRI-induced signals on an implanted cardiac lead that is coupled to an implanted device. In some aspects the filter may be configured to complement a capacitor circuit (e.g., a feedthrough capacitor) that reduces the amount of EMI that enters the implanted device via the cardiac lead. In some implementations the filter consists of a LC tank circuit and a series LC circuit, where the LC tank circuit is in series with the cardiac lead and a cardiac stimulation circuit and the series LC circuit is in a shunt configuration across the cardiac stimulation circuit.
摘要翻译：用于可植入医疗装置的过滤方案减轻了可能由MRI诱导的信号引起的潜在的不利影响。在一些方面，提供过滤以减少与植入装置耦合的植入心脏引线上的MRI诱导信号。在一些方面，滤波器可以被配置为补充通过心脏引线减少进入植入装置的EMI量的电容器电路（例如，馈通电容器）。在一些实施方式中，滤波器由LC谐振电路和串联LC电路组成，其中LC谐振电路与心脏引线和心脏刺激电路串联，并且串联LC电路处于穿过心脏刺激电路的分流配置。

62. 发明授权

US08725256B2 Implantable medical device voltage divider circuit for mitigating electromagnetic interference 有权
标题翻译：可植入医疗器械分压器电路，用于减轻电磁干扰
公开(公告)号：US08725256B2
公开(公告)日：2014-05-13
申请号：US12968563
申请日：2010-12-15
申请人： J. Christopher Moulder , Peter Boileau
发明人： J. Christopher Moulder , Peter Boileau
IPC分类号： A61N1/08 , A61N1/36
CPC分类号： A61N1/36125 , A61N1/36142 , A61N1/362 , A61N1/37 , A61N1/3718
摘要： An RF protection circuit mitigates potentially adverse effects that may otherwise result from electromagnetic interference (e.g., due to MRI scanning of a patient having an implanted medical device). The RF protection circuit may comprise a voltage divider that is deployed across a pair of cardiac electrodes that are coupled to internal circuitry of the implantable medical device. Each leg of the voltage divider may be referenced to a ground of the internal circuit, whereby the different legs are deployed in parallel across different circuits of the internal circuitry. In this way, when an EMI-induced (e.g., MRI-induced) signal appears across the cardiac electrodes, the voltages appearing across these circuits and the currents flowing through these circuits may be reduced. The RF protection circuit may be used in an implantable medical device that employs a relatively low capacitance feedthrough to reduce EMI-induced (e.g., MRI-induced) current flow in a cardiac lead.
摘要翻译： RF保护电路减轻了可能由电磁干扰引起的潜在不利影响（例如，由于具有植入的医疗装置的患者的MRI扫描）。 RF保护电路可以包括分压器，其分布在耦合到可植入医疗装置的内部电路的一对心脏电极上。分压器的每个支路可以参考内部电路的接地，由此不同的支路并联地布置在内部电路的不同电路上。以这种方式，当在心电极上出现EMI诱发（例如，MRI诱发的）信号时，可以减少跨越这些电路的电压和流过这些电路的电流。 RF保护电路可以用在可植入医疗装置中，其采用相对低电容的馈通以减少心脏导联中的EMI诱发（例如，MRI诱发的）电流。

63. 发明授权

US07437190B1 Cardiac stimulation device with adjustable blanking intervals 有权
标题翻译：具有可调消隐间隔的心脏刺激装置
公开(公告)号：US07437190B1
公开(公告)日：2008-10-14
申请号：US10792082
申请日：2004-03-02
申请人： Katie Hoberman , Peter Boileau
发明人： Katie Hoberman , Peter Boileau
IPC分类号： A61N1/362
CPC分类号： A61N1/3622 , A61N1/371
摘要： An implantable cardiac stimulating device employs different post-ventricular atrial refractory periods for different types of ventricular events, such as a sensed ventricular event and a paced ventricular event. A controller facilitates selection or adjustment by remote programming of two different post-ventricular atrial blanking intervals that are invoked depending upon the type of ventricular event. A set of discrete blanking interval values may be available for programming the different blanking intervals, and a search routine may be executed to systematically apply the different blanking interval values and determine a suitable value by determining whether far-field R-waves are detected after expiration of each applied blanking interval value.
摘要翻译：植入式心脏刺激装置对于不同类型的心室事件（例如感测到的心室事件和起搏心室事件）使用不同的心室后心房不应期。控制器通过远程编程来促进根据心室事件的类型被调用的两个不同的心室后空白间隔的选择或调整。一组离散消隐间隔值可用于编程不同的消隐间隔，并且可以执行搜索例程以系统地应用不同的消隐间隔值，并且通过确定在到期后是否检测到远场R波来确定适当的值每个应用的消隐间隔值。

64. 发明授权

US07809439B2 Spectrum-driven arrhythmia treatment method 有权
标题翻译：频谱驱动心律失常治疗方法
公开(公告)号：US07809439B2
公开(公告)日：2010-10-05
申请号：US12111036
申请日：2008-04-28
申请人： Mark W. Kroll , Peter Boileau
发明人： Mark W. Kroll , Peter Boileau
IPC分类号： A61N1/36
CPC分类号： A61N1/3622
摘要： A method and apparatus for treating an arrhythmia is provided. The method includes the steps of: (a) sensing at least one electrical signal from the patient's heart; (b) calculating a frequency spectrum of each electrical signal; (c) calculating a center frequency for each frequency spectrum; and (d) selecting an electro-therapy for delivery to the patient's heart based on the center frequency. The electro-therapy can be a pre-programmed anti-tachycardia pacing (ATP) therapy, a shock therapy, or no therapy at all. The method is performed through the use of an implantable cardioverter defibrillator (ICD). Also provided is a method of determining the optimal location to deliver the electro-therapy.
摘要翻译：提供了一种治疗心律失常的方法和装置。该方法包括以下步骤：（a）感测来自患者心脏的至少一个电信号; （b）计算每个电信号的频谱; （c）计算每个频谱的中心频率; 以及（d）根据中心频率选择电疗以传送到患者的心脏。电疗可以是预先编程的抗心动过速起搏（ATP）治疗，休克疗法，或根本没有治疗。该方法通过使用植入式心律转复除颤器（ICD）进行。还提供了确定递送电疗的最佳位置的方法。

65. 发明授权

US07610086B1 System and method for detecting cardiac ischemia in real-time using a pattern classifier implemented within an implanted medical device 有权
标题翻译：使用在植入式医疗装置内实现的模式分类器来实时检测心脏缺血的系统和方法
公开(公告)号：US07610086B1
公开(公告)日：2009-10-27
申请号：US11394724
申请日：2006-03-31
申请人： Chunlei Ke , Jong Gill , Peter Boileau
发明人： Chunlei Ke , Jong Gill , Peter Boileau
IPC分类号： A61B5/04
CPC分类号： A61B5/0452 , A61B5/04525 , A61B5/7267
摘要： Pattern classification techniques are provided for use with an implantable medical device for detecting cardiac ischemia substantially in real-time. Values representative of morphological features of electrical cardiac signals are detected by the implantable medical device. Then, a determination is made as to whether the patient is subject to an on-going episode of cardiac ischemia by applying the values to a pattern classifier configured to identify patterns representative of cardiac ischemia. In one example, the determination is made substantially in real-time by the device itself based on the IEGM signals it detects. In other examples, the IEGM signals are relayed promptly to a bedside monitor or other external device, which analyzes the signals using the pattern classifier to detect ischemia. Therapy may be applied in response to cardiac ischemia. For example, if the implanted device is equipped with a drug pump, appropriate medications may be administered such as anti-thrombolytics.
摘要翻译：模式分类技术被提供用于基本上实时检测心脏缺血的可植入医疗装置。通过可植入医疗装置检测代表电心电信号的形态特征的值。然后，通过将值应用于配置成识别代表心脏缺血的模式的模式分类器来确定患者是否经历心脏缺血的持续发作。在一个示例中，基于其检测到的IEGM信号，设备本身基本上实时地进行确定。在其他示例中，IEGM信号被迅速地中继到床边监护仪或其他外部设备，其使用模式分类器分析信号以检测局部缺血。治疗可以应用于心脏缺血。例如，如果植入装置配备有药物泵，则可以施用适当的药物，例如抗血栓溶解剂。

66. 发明申请

US20080200961A1 SPECTRUM-DRIVEN ARRHYTHMIA TREATMENT METHOD 有权
标题翻译：光谱驱动的ARRHYTHMIA治疗方法
公开(公告)号：US20080200961A1
公开(公告)日：2008-08-21
申请号：US12111036
申请日：2008-04-28
申请人： Mark W. Kroll , Peter Boileau
发明人： Mark W. Kroll , Peter Boileau
IPC分类号： A61N1/00
CPC分类号： A61N1/3622
摘要： A method and apparatus for treating an arrhythmia is provided. The method includes the steps of: (a) sensing at least one electrical signal from the patient's heart; (b) calculating a frequency spectrum of each electrical signal; (c) calculating a center frequency for each frequency spectrum; and (d) selecting an electro-therapy for delivery to the patient's heart based on the center frequency. The electro-therapy can be a pre-programmed anti-tachycardia pacing (ATP) therapy, a shock therapy, or no therapy at all. The method is performed through the use of an implantable cardioverter defibrillator (ICD). Also provided is a method of determining the optimal location to deliver the electro-therapy.
摘要翻译：提供了一种治疗心律失常的方法和装置。该方法包括以下步骤：（a）感测来自患者心脏的至少一个电信号; （b）计算每个电信号的频谱; （c）计算每个频谱的中心频率; 以及（d）根据中心频率选择电疗以传送到患者的心脏。电疗可以是预先编程的抗心动过速起搏（ATP）治疗，休克疗法，或根本没有治疗。该方法通过使用植入式心律转复除颤器（ICD）进行。还提供了确定递送电疗的最佳位置的方法。

67. 发明授权

US07139611B1 System and method for rejecting far-field signals using an implantable cardiac stimulation device 有权
标题翻译：使用可植入心脏刺激装置排除远场信号的系统和方法
公开(公告)号：US07139611B1
公开(公告)日：2006-11-21
申请号：US10430039
申请日：2003-05-05
申请人： Mark W. Kroll , Peter Boileau
发明人： Mark W. Kroll , Peter Boileau
IPC分类号： A61N1/05
CPC分类号： A61N1/368 , A61N1/056 , A61N2001/0585
摘要： A technique is provided for filtering far-field electrical cardiac signals from near-field signals. Atrial tip and ring signals are sensed using unipolar electrodes and any timing differences between corresponding events within the signals are detected. Then, far-field signals are filtered from the tip and ring signals based on the detected timing differences, such that substantially only near-field atrial signals remain. The technique exploits the fact that near-field atrial signals are sensed when a conduction wave passes by the atrial electrodes. In contrast, far-field signals from the ventricles propagate to the atrium at near the speed of light. Hence, any significant timing difference between corresponding events appearing in the atrial signals is indicative of a near-field event, whereas the lack of a significant timing difference is indicative of a far-field event. In one example, a sense amplifier is provided with a Boolean logic circuit to aid in time delay-based filtering.
摘要翻译：提供了用于从近场信号过滤远场电心脏信号的技术。使用单极电极感测心尖和环形信号，并检测信号内相应事件之间的任何定时差异。然后，基于检测到的定时差，从尖端和环形信号过滤远场信号，使得基本上只有近场心房信号保留。该技术利用了当导电波通过心房电极时感测近场心房信号的事实。相比之下，来自心室的远场信号在光速附近传播到心房。因此，出现在心房信号中的相应事件之间的任何显着的定时差异表示近场事件，而缺乏有效定时差异是指示远场事件。在一个示例中，读出放大器设置有布尔逻辑电路以辅助基于时间延迟的滤波。

68. 发明申请

US20060167519A1 System and method for distinguishing among cardiac ischemia, hypoglycemia and hyperglycemia using an implantable medical device 有权
公开(公告)号：US20060167519A1
公开(公告)日：2006-07-27
申请号：US11043804
申请日：2005-01-25
申请人： Jong Gill , Peter Boileau , Rupinder Bharmi , Xiaoyi Min , Joseph Florio , Michael Benser , Gene Bornzin
发明人： Jong Gill , Peter Boileau , Rupinder Bharmi , Xiaoyi Min , Joseph Florio , Michael Benser , Gene Bornzin
IPC分类号： A61N1/365
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.

69. 发明申请

US20060167518A1 System and method for distinguishing among cardiac ischemia, hypoglycemia and hyperglycemia using an implantable medical device 有权
公开(公告)号：US20060167518A1
公开(公告)日：2006-07-27
申请号：US11043780
申请日：2005-01-25
申请人： Jong Gill , Peter Boileau , Rupinder Bharmi , Xiaoyi Min , Joseph Florio , Michael Benser , Gene Bornzin
发明人： Jong Gill , Peter Boileau , Rupinder Bharmi , Xiaoyi Min , Joseph Florio , Michael Benser , Gene Bornzin
IPC分类号： A61N1/365
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.

70. 发明授权

US08340765B2 System and method for controlling ventricular pacing during AF based on underlying ventricular rates using an implantable medical device 有权
标题翻译：使用植入式医疗设备，根据潜在的心室率控制房颤期间心室起搏的系统和方法
公开(公告)号：US08340765B2
公开(公告)日：2012-12-25
申请号：US12410386
申请日：2009-03-24
申请人： Peter Boileau , Michael E. Benser
发明人： Peter Boileau , Michael E. Benser
IPC分类号： A61N1/36
CPC分类号： A61N1/3622 , A61N1/3702
摘要： Techniques are provided for controlling ventricular pacing during an episode of atrial fibrillation (AF) for use by a pacemaker, implantable cardioverter-defibrillator (ICD) or other implantable medical device. In one example, upon detection of AF, the underlying intrinsic ventricular rate of the patient is determined prior to delivering any ventricular pacing. Then, a ventricular pacing procedure—such as dynamic ventricular overdrive (DVO) pacing—is activated to reduce ventricular rate variability to mitigate the adverse effects of AF. The ventricular pacing procedure employed during AF is controlled based on a maximum ventricular rate set relative to the underlying intrinsic ventricular rate so as to keep an overall ventricular rate below the maximum rate.
摘要翻译：提供技术用于在心房颤动（AF）发作期间控制心室起搏，以供起搏器，可植入式心律转复除颤器（ICD）或其他可植入医疗装置使用。在一个实例中，在检测到AF后，在递送任何心室起搏之前确定患者的潜在内在心室率。然后，启动心室起搏手术，例如动态心室超速（DVO）起搏 - 以减少心室率变异性，以减轻AF的不良反应。在AF期间使用的心室起搏过程基于相对于潜在的内部心室率设定的最大心室率进行控制，以保持总体心率低于最大速率。

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