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61. 发明申请

US20120108987A1 IMPLANTABLE SYSTEMIC BLOOD PRESSURE MEASUREMENT SYSTEMS AND METHODS 审中-公开
标题翻译：可植入系统血压测量系统和方法
公开(公告)号：US20120108987A1
公开(公告)日：2012-05-03
申请号：US13342864
申请日：2012-01-03
申请人： Timothy A. Fayram , Eric S. Fain , Paul A. Levine , Anders Björling
发明人： Timothy A. Fayram , Eric S. Fain , Paul A. Levine , Anders Björling
IPC分类号： A61B5/0215
CPC分类号： A61B5/0215 , A61B5/02108 , A61B5/02116 , A61B5/02125 , A61B5/0285 , A61B5/0295 , A61B5/0452 , A61B5/6846 , A61B2562/0219 , A61N1/36564 , A61N1/36578 , A61N1/36585
摘要： Implantable systems, and methods for use therewith, for monitoring arterial blood pressure on a chronic basis are provided herein. A first signal indicative of electrical activity of a patient's heart, and a second signal indicative of mechanical activity of the patient's heart, are obtained using implanted electrodes and an implanted sensor. By measuring the times between various features of the first signal relative to features of the second signal, values indicative of systolic pressure and diastolic pressure can be determined. In specific embodiments, such features are used to determine a peak pulse arrival time (PPAT), which is used to determine the value indicative of systolic pressure. Additionally, a peak-to-peak amplitude at the maximum peak of the second signal, and the value indicative of systolic pressure, can be used to determine the value indicative of diastolic pressure.
摘要翻译：本文提供了可植入系统及其使用方法，用于长期监测动脉血压。使用植入电极和植入的传感器获得指示患者心脏的电活动的第一信号和指示患者心脏的机械活动的第二信号。通过测量第一信号的各个特征相对于第二信号的特征之间的时间，可以确定指示收缩压和舒张压的值。在具体实施例中，这些特征用于确定峰值脉冲到达时间（PPAT），其用于确定指示收缩压的值。此外，可以使用在第二信号的最大峰值处的峰 - 峰幅度和指示收缩压的值来确定指示舒张压的值。

62. 发明授权

US08162841B2 Standalone systemic arterial blood pressure monitoring device 有权
标题翻译：独立的全身动脉血压监测装置
公开(公告)号：US08162841B2
公开(公告)日：2012-04-24
申请号：US12474276
申请日：2009-05-29
申请人： Allen J. Keel , Brian Jeffrey Wenzel , Edward Karst , Wenbo Hou , Taraneh Ghaffari Farazi , Timothy A. Fayram , Eric S. Fain , Paul A. Levine
发明人： Allen J. Keel , Brian Jeffrey Wenzel , Edward Karst , Wenbo Hou , Taraneh Ghaffari Farazi , Timothy A. Fayram , Eric S. Fain , Paul A. Levine
IPC分类号： A61B5/02
CPC分类号： A61B5/02158 , A61B5/02125 , A61B5/0295 , A61B5/0452 , A61B5/1459 , A61B2562/0219 , A61N1/36557 , A61N1/36564 , A61N1/36585 , G06F19/00
摘要： Certain embodiments of the present invention are related to an implantable monitoring device to monitor a patient's arterial blood pressure, where the device is configured to be implanted subcutaneously. The device includes subcutaneous (SubQ) electrodes and a plethysmography sensor. Additionally, the device includes an arterial blood pressure monitor configured to determine at least one value indicative of the patient's arterial blood pressure based on at least one detected predetermined feature of a SubQ ECG and at least one detected predetermined feature of a plethysmography signal. Alternative embodiments of the present invention are directed to a non-implantable monitoring device to monitor a patient's arterial blood pressure based on features of a surface ECG and a plethysmography signal obtained from a non-implanted sensor.
摘要翻译：本发明的某些实施例涉及一种用于监测患者的动脉血压的可植入监测装置，其中该装置被配置为被皮下植入。该装置包括皮下（SubQ）电极和体积描记传感器。另外，该装置包括动脉血压监测器，其被配置为基于至少一个检测到的SubQ ECG的预定特征和至少一个检测到的体积描记信号的预定特征来确定指示患者的动脉血压的至少一个值。本发明的替代实施例涉及一种非植入式监测装置，用于基于从非植入传感器获得的表面ECG和体积描记信号的特征来监测患者的动脉血压。

63. 发明申请

US20110257700A1 REMOTE FOLLOW-UP AUTOMATICITY WITH INTELLIGENT DATA DOWNLOAD RESTRICTIONS 有权
标题翻译：远程自动化智能数据下载限制
公开(公告)号：US20110257700A1
公开(公告)日：2011-10-20
申请号：US13169928
申请日：2011-06-27
申请人： Paul A. Levine
发明人： Paul A. Levine
IPC分类号： A61N1/362
CPC分类号： A61N1/37211 , A61N1/37252 , A61N1/37282
摘要： An implanted device is equipped with a flag that indicates to a remote monitoring unit that an event such as a patient medical emergency or device failure has occurred. The remote monitoring unit is configured in some embodiments to maintain a low power communication link with the implanted device when they are within range. When the flag indicates an event has occurred, the remote monitoring unit quickly downloads sensed data collected by the implanted device and transfers it over a network so that it can be utilized by a medical practitioner. The remote monitoring unit is further configured in some embodiments to query the implanted device at regular intervals. The remote monitoring unit may read a subset of the data stored by the implanted device and, based on that data, determine whether to complete a full or partial download.
摘要翻译：植入装置配备有向远程监视单元指示发生诸如患者医疗紧急情况或装置故障的事件的标志。在一些实施例中，远程监视单元被配置为当植入设备在范围内时保持与植入设备的低功率通信链路。当标志指示事件已经发生时，远程监视单元快速地下载由植入的设备收集的感测数据，并通过网络传送，以便医疗人员可以使用它。在一些实施例中，进一步配置远程监视单元以规则的间隔查询植入的设备。远程监视单元可以读取植入设备存储的数据的子集，并且基于该数据确定是否完成全部或部分下载。

64. 发明授权

US08005546B1 Remote follow-up automaticity with intelligent data download restrictions 有权
标题翻译：远程后续自动化具有智能数据下载限制
公开(公告)号：US08005546B1
公开(公告)日：2011-08-23
申请号：US11838781
申请日：2007-08-14
申请人： Paul A. Levine
发明人： Paul A. Levine
IPC分类号： A61N1/37 , A61N1/08
CPC分类号： A61N1/37211 , A61N1/37252 , A61N1/37282
摘要： An implanted device is equipped with a flag that indicates to a remote monitoring unit that an event such as a patient medical emergency or device failure has occurred. The remote monitoring unit is configured in some embodiments to maintain a low power communication link with the implanted device when they are within range. When the flag indicates an event has occurred, the remote monitoring unit quickly downloads sensed data collected by the implanted device and transfers it over a network so that it can be utilized by a medical practitioner. The remote monitoring unit is further configured in some embodiments to query the implanted device at regular intervals. The remote monitoring unit may read a subset of the data stored by the implanted device and, based on that data, determine whether to complete a full or partial download.
摘要翻译：植入装置配备有向远程监视单元指示发生诸如患者医疗紧急情况或装置故障的事件的标志。在一些实施例中，远程监视单元被配置为当植入设备在范围内时保持与植入设备的低功率通信链路。当标志指示事件已经发生时，远程监视单元快速地下载由植入的设备收集的感测数据，并通过网络传送，以便医疗人员可以使用它。在一些实施例中，进一步配置远程监视单元以规则的间隔查询植入的设备。远程监视单元可以读取植入设备存储的数据的子集，并且基于该数据确定是否完成全部或部分下载。

65. 发明授权

US07574259B1 Capture threshold and lead condition analysis 有权
标题翻译：捕获阈值和引导条件分析
公开(公告)号：US07574259B1
公开(公告)日：2009-08-11
申请号：US10987731
申请日：2004-11-12
申请人： Xing Pei , Robert E. Smith , Paul A. Levine
发明人： Xing Pei , Robert E. Smith , Paul A. Levine
IPC分类号： A61N1/37
CPC分类号： A61N1/08 , A61N1/056 , A61N1/0563 , A61N1/368 , A61N1/3682 , A61N1/3702 , A61N1/371 , A61N1/3712 , A61N1/372 , A61N1/3962 , A61N2001/083
摘要： An exemplary method includes performing a capture threshold assessment using a bipolar electrode configuration, deciding if capture occurred for a maximum energy value of the capture threshold assessment and, if capture did not occur, then performing a lead impedance test for the lead associated with the bipolar electrode configuration. Such a test may aim to detect an insulation defect and/or a conductor defect. Other exemplary methods, devices, systems, etc., are also disclosed.
摘要翻译：示例性方法包括使用双极电极配置执行捕获阈值评估，确定捕获阈值评估的最大能量值是否发生捕获，并且如果没有发生捕获，则对与双极性相关联的引线执行引线阻抗测试电极配置。这种测试可能旨在检测绝缘缺陷和/或导体缺陷。还公开了其它示例性方法，装置，系统等。

66. 发明授权

US07551961B1 Cardiac stimulation device with selective atrial pacing on premature ventricular complex detection and method 有权
标题翻译：心脏刺激装置与早期心室复合物检测及方法的选择性心房起搏
公开(公告)号：US07551961B1
公开(公告)日：2009-06-23
申请号：US11401972
申请日：2006-04-10
申请人： Xing Pei , Paul A. Levine
发明人： Xing Pei , Paul A. Levine
IPC分类号： A61N1/39
CPC分类号： A61N1/3622 , A61N1/3702
摘要： An implantable cardiac stimulation device provides selective atrial pacing upon detection of a premature ventricular complex (PVC). The device comprises a premature ventricular complex detector that detects premature complexes of the heart, and a sensing circuit that senses atrial events. The device further comprises a P wave discriminator that identifies an atrial event sensed by the sensing circuit following detection of a premature ventricular complex as one of a retrograde P wave and a normal sinus P wave, and an atrial pulse generator that delivers an atrial pacing pulse responsive to the discriminator identifying an atrial event sensed by the sensing circuit following detection of a premature ventricular complex as a retrograde P wave.
摘要翻译：可植入心脏刺激装置在检测到早期心室复合物（PVC）时提供选择性心房起搏。该装置包括检测心脏过早复合物的早产性心室复合物检测器和感测心房事件的感测电路。该装置还包括P波鉴别器，其识别在检测到过早心室复合体之后由感测电路感测的心房事件，作为逆行P波和正常窦P波之一，以及心房脉搏发生器，其传送心房起搏脉冲响应鉴别器识别在检测到过早心室复合体之后由感测电路感测的心房事件作为逆行P波。

67. 发明申请

US20090082826A1 AUTOMATIC SIGNAL AMPLITUDE MEASUREMENT SYSTEM IN THE SETTING OF ABNORMAL RHYTHMS 有权
标题翻译：自动信号振幅测量系统在异常RHYTHMS的设置
公开(公告)号：US20090082826A1
公开(公告)日：2009-03-26
申请号：US12266441
申请日：2008-11-06
申请人： Paul A. Levine , Amdt Godau
发明人： Paul A. Levine , Amdt Godau
IPC分类号： A61N1/37
CPC分类号： A61N1/3706
摘要： A system for automatically evaluating the sensing and detection of physiological processes by an implantable medical device, such as an implantable cardiac stimulation device. The system includes an automatic testing algorithm which iteratively adjusts at least one of the threshold and gain settings of the device and evaluates the accuracy of the detection for refining the programming of the device. The algorithm can include sampling the physiological process beginning at a relatively low rate to avoid excessive burden on the processing and battery capacity available and progressively increasing the rate to obtain higher resolution data. The algorithm can also evaluate the observed physiological process for periodicity and can determine repetition of an irregular pattern, such as bigeminy, and use the determined pattern for predictive purposes to refine the programming of the device. The algorithm employs observation of a change in observed pattern as indicia for loss of proper detection.
摘要翻译：一种用于通过可植入医疗装置（例如可植入心脏刺激装置）自动评估生理过程的感测和检测的系统。该系统包括自动测试算法，其迭代地调整设备的阈值和增益设置中的至少一个，并评估用于精简设备编程的检测的准确性。该算法可以包括以相对较低的速率开始生理过程的采样，以避免对可用处理和电池容量的过度负担，并逐渐增加速率以获得更高分辨率的数据。该算法还可以评估观察到的生理过程的周期性，并且可以确定诸如bigeminy的不规则图案的重复，并且使用确定的图案进行预测目的来改进设备的编程。该算法使用观察模式的变化观察作为丢失适当检测的标记。

68. 发明申请

US20090062667A1 Implantable Systemic Blood Pressure Measurement Systems and Methods 有权
标题翻译：植入式系统血压测量系统和方法
公开(公告)号：US20090062667A1
公开(公告)日：2009-03-05
申请号：US11848586
申请日：2007-08-31
申请人： Timothy A. Fayram , Eric S. Fain , Paul A. Levine
发明人： Timothy A. Fayram , Eric S. Fain , Paul A. Levine
IPC分类号： A61B5/0215
CPC分类号： A61B5/0215 , A61B5/02108 , A61B5/02116 , A61B5/02125 , A61B5/0285 , A61B5/0295 , A61B5/0452 , A61B5/6846 , A61B2562/0219 , A61N1/36564 , A61N1/36578 , A61N1/36585
摘要： Implantable systems, and methods for use therewith, for monitoring arterial blood pressure on a chronic basis are provided herein. A first signal indicative of electrical activity of a patient's heart, and a second signal indicative of mechanical activity of the patient's heart, are obtained using implanted electrodes and an implanted sensor. By measuring the times between various features of the first signal relative to features of the second signal, values indicative of systolic pressure and diastolic pressure can be determined. In specific embodiments, such features are used to determine a peak pulse arrival time (PPAT), which is used to determine the value indicative of systolic pressure. Additionally, a peak-to-peak amplitude at the maximum peak of the second signal, and the value indicative of systolic pressure, can be used to determine the value indicative of diastolic pressure.
摘要翻译：本文提供了可植入系统及其使用方法，用于长期监测动脉血压。使用植入电极和植入的传感器获得指示患者心脏的电活动的第一信号和指示患者心脏的机械活动的第二信号。通过测量第一信号的各个特征相对于第二信号的特征之间的时间，可以确定指示收缩压和舒张压的值。在具体实施例中，这些特征用于确定峰值脉冲到达时间（PPAT），其用于确定指示收缩压的值。此外，可以使用在第二信号的最大峰值处的峰 - 峰幅度和指示收缩压的值来确定指示舒张压的值。

69. 发明授权

US07363081B1 System and method for providing preventive overdrive pacing and antitachycardia pacing using an implantable cardiac stimulation device 有权
标题翻译：使用可植入心脏刺激装置提供预防性超速起搏和抗心动过速起搏的系统和方法
公开(公告)号：US07363081B1
公开(公告)日：2008-04-22
申请号：US10657840
申请日：2003-09-08
申请人： Mark W. Kroll , Eric Falkenberg , Paul A. Levine
发明人： Mark W. Kroll , Eric Falkenberg , Paul A. Levine
IPC分类号： A61N1/362
CPC分类号： A61N1/3712 , A61N1/3624 , A61N1/3688 , A61N1/3714 , A61N1/395
摘要： Techniques for enabling both preventive overdrive pacing and antitachycardia pacing (ATP) within an implantable device are provided. The device gains the benefits of overdrive pacing for preventing the onset of a tachycardia and, if one nevertheless occurs, ATP is employed to terminate the tachycardia. In particular, a technique is provided for promptly detecting the onset of atrial tachycardia during preventive overdrive pacing based on loss of capture of atrial pacing pulses. A technique is also provided for using detection of loss of capture of atrial or ventricular pacing pulses to trigger automatic switching from overdrive pacing to ATP. A setup technique determines whether to enable the automatic switching from overdrive pacing to ATP within a particular patient. Also, techniques are provided for verifying loss of capture of atrial or ventricular backup pacing pulses and for detecting low amplitude ventricular fibrillation based on loss of capture of ventricular backup pacing pulses.
摘要翻译：提供了在植入式装置内实现预防性超速起搏和抗心动过速起搏（ATP）的技术。该装置获得超速起搏的好处，以防止心动过速的发作，并且如果仍然发生，则使用ATP来终止心动过速。特别地，提供了一种技术，用于基于心房起搏脉冲的捕获损失，在预防性超速起搏中及时检测心房心动过速的发生。还提供了一种技术，用于检测心房或心室起搏脉冲的捕获损失，以触发从过速起搏到ATP的自动切换。设置技术确定是否启用在特定患者内从过速起搏到ATP的自动切换。此外，提供了用于验证心房或心室起搏脉冲的捕获损失的技术，并且用于基于心室起搏脉冲的捕获损失来检测低振幅心室颤动。

70. 发明授权

US07146213B1 Method and apparatus for improving specificity of atrial tachycardia detection techniques in dual-unipolar or dual-bipolar implantable cardiac stimulation systems 有权
标题翻译：用于改善心房心动过速检测技术在双单极或双极双极植入式心脏刺激系统中的特异性的方法和装置
公开(公告)号：US07146213B1
公开(公告)日：2006-12-05
申请号：US10728459
申请日：2003-12-05
申请人： Paul A. Levine
发明人： Paul A. Levine
IPC分类号： A61N1/20
CPC分类号： A61N1/3622 , A61N1/365 , A61N1/3688 , A61N1/3925
摘要： Techniques are provided for allowing Automatic Mode Switching (AMS) to be exploited within dual unipolar systems employing Combipolar sensing. Relative refractory windows are opened within both the atrial and ventricular refractory periods for the purposes of determining the atrial rate using Combipolar sensing logic. In this manner, T-waves occurring during the relative refractory windows are excluded from the atrial rate calculation, whereas any P-waves occurring during the relative refractory windows are counted, thereby achieving a more accurate atrial rate calculation, particularly at high atrial rates, and thus permitting AMS to be enabled along with Combipolar sensing in the dual unipolar lead system. An alternative technique is provided for use in dual unipolar systems not initially set to a Combipolar Sensing mode, which also achieves more accurate atrial rate calculation at high atrial rates. Additional techniques are provided for use in dual bipolar systems. An improved Combipolar sensing logic is also provided.
摘要翻译：提供了技术，允许在采用组合极性检测的双重单极系统中利用自动模式切换（AMS）。在心房和心室不应期内开放相对耐火窗，以确定使用联合极检测逻辑的心房率。以这种方式，在相对耐火窗口期间发生的T波从心房率计算中排除，而在相对耐火窗口期间发生的任何P波被计数，从而实现更精确的心房率计算，特别是在高心房率，并因此允许AMS在双极性引线系统中与Combipolar感测一起使能。提供了一种替代技术，用于未初始设置为组合极检测模式的双重单极系统，其也可以在高心房率下实现更准确的心房率计算。另外提供了用于双极双极系统的技术。还提供了改进的组合极检测逻辑。

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