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71. 发明授权

US07062322B2 Rhythm-based transition to discriminatory arrhythmia classification 有权
公开(公告)号：US07062322B2
公开(公告)日：2006-06-13
申请号：US10023234
申请日：2001-12-18
申请人： Robert W. Stadler , Jeffrey M. Gillberg
发明人： Robert W. Stadler , Jeffrey M. Gillberg
IPC分类号： A61N1/365
CPC分类号： A61N1/3622 , A61N1/3956
摘要： In a medical device that monitors and/or treats ventricular arrhythmia, the invention provides for a “normal” processing mode of operation and a “guarded” processing mode of operation. The transition between the two modes is a function of cardiac rhythm. Benign rhythms are processed in the normal processing mode and non-benign rhythms are processed in the guarded processing mode. In normal processing mode, the device performs functions that are not computationally demanding, but in guarded processing mode, the device performs the computationally demanding operations that classify arrhythmias. If therapy is deemed necessary, the device may provide the therapy in guarded processing mode.

72. 发明授权

US06882883B2 Implantable medical device (IMD) system configurable to subject a patient to a stress test and to detect myocardial ischemia within the patient 有权
标题翻译：可植入医疗装置（IMD）系统可配置为使患者进行压力测试并检测患者内的心肌缺血
公开(公告)号：US06882883B2
公开(公告)日：2005-04-19
申请号：US09945195
申请日：2001-08-31
申请人： Catherine R. Condie , Robert W. Stadler , Lee Stylos
发明人： Catherine R. Condie , Robert W. Stadler , Lee Stylos
IPC分类号： A61B5/0472 , A61N1/362 , A61N1/372
CPC分类号： A61B5/4884 , A61B5/0472 , A61N1/362
摘要： Various implantable medical devices (IMDs) are disclosed for implantation in a patient. The IMD includes pacing circuitry configured to selectively produce pacing pulses at a programmable pacing rate. In one embodiment, the IMD is configurable to subject a patient to a stress test. The IMD may be configurable to subject the patient to the stress test at the time specified by stored timing information, or in response to a signal (e.g., from a patient activator). Another embodiment of the implantable medical device (IMD) includes sensor circuitry, a memory for storing data, and a control unit. The sensor circuitry produces sensor data relating to cardiac condition. The control unit is configurable to store the sensor data in the memory until a trigger signal is received. Methods are described for performing a stress test in a patient with an IMD, and for subsequently reproducing cardiac operational states.
摘要翻译：公开了用于植入患者体内的各种植入式医疗装置（IMD）。 IMD包括起搏电路，其配置成以可编程起搏速率选择性地产生起搏脉冲。在一个实施例中，IMD可配置为使患者进行压力测试。 IMD可以被配置为使患者在由存储的定时信息指定的时间或者响应于信号（例如来自患者激活器）的时间对患者进行压力测试。可植入医疗装置（IMD）的另一实施例包括传感器电路，用于存储数据的存储器和控制单元。传感器电路产生有关心脏状况的传感器数据。控制单元可配置为将传感器数据存储在存储器中，直到接收到触发信号。描述了用于在具有IMD的患者中进行压力测试并且随后再现心脏操作状态的方法。

73. 发明授权

US06795732B2 Implantable medical device employing sonomicrometer output signals for detection and measurement of cardiac mechanical function 有权
公开(公告)号：US06795732B2
公开(公告)日：2004-09-21
申请号：US10002338
申请日：2001-10-30
申请人： Robert W. Stadler , William J. Combs , David Lipson
发明人： Robert W. Stadler , William J. Combs , David Lipson
IPC分类号： A61N1365
CPC分类号： A61N1/36528 , A61B8/00 , A61N1/3627 , A61N1/36578
摘要： Implantable medical devices (IMDs) for detection and measurement of cardiac mechanical and electrical function employ a system and method for determining mechanical heart function and measuring mechanical heart performance of upper and lower and left and right heart chambers without intruding into a left heart chamber through use of a dimension sensor. The dimension sensor or sensors comprise at least a first sonomicrometer piezoelectric crystal mounted to a first lead body implanted into or in relation to one heart chamber that operates as an ultrasound transmitter when a drive signal is applied to it and at least one second sonomicrometer crystal mounted to a second lead body implanted into or in relation to a second heart chamber that operates as an ultrasound receiver.

74. 发明授权

US06567691B1 Method and apparatus diagnosis and treatment of arrhythias 有权
标题翻译：方法和仪器诊断和治疗心律失常
公开(公告)号：US06567691B1
公开(公告)日：2003-05-20
申请号：US09532478
申请日：2000-03-22
申请人： Robert W. Stadler
发明人： Robert W. Stadler
IPC分类号： A61B50468
CPC分类号： A61N1/3622
摘要： Adaptive rules for a more accurate sinus tachycardia detection mechanism for implantable device (IMD) and other devices. In an embodiment, the rule is incorporated into a prioritized, rule-based arrhythmia classification system in an IMD. If the rule is met, anti-tachyarrhythmia therapy is withheld even if a lower priority rule determines presence of a treatable tachyarrhythmia. The rule includes adaptive onset criterion, where an expected range of R—R is calculated based on a trimmed mean and a metric of R—R variability derived over a preceding series of R—R intervals. Pattern codes indicative of gradual rate changes and normal sinus rhythm will be within a grammar defined by a continuous recognition machine and will if they persist, result in the ST rule being met. All other codes inconsistent with sinus tachycardia will not adhere to the associatd grammar and will result in the ST rule not being met.
摘要翻译：用于更准确的用于可植入装置（IMD）和其他装置的窦性心动过速检测机制的自适应规则。在一个实施例中，该规则被并入IMD中的基于规则的基于心律失常的心律失常分类系统中。如果规则得到满足，即使较低优先权规则确定存在可治疗的快速性心律失常，也可以禁止抗快速性心律失常治疗。该规则包括自适应发起标准，其中基于在前一系列R-R间隔上导出的修整平均值和R-R可变性的度量来计算R-R的预期范围。指示渐进率变化和正常窦性心律的模式代码将在由连续识别机定义的语法内，并且如果它们持续存在，则导致满足ST规则。与窦性心动过速不一致的所有其他代码不会遵守相关语法，并且将导致ST规则不被满足。

75. 发明授权

US06324421B1 Axis shift analysis of electrocardiogram signal parameters especially applicable for multivector analysis by implantable medical devices, and use of same 有权
标题翻译：心电图信号参数的轴移位分析，特别适用于可植入医疗器械的多因素分析及其使用
公开(公告)号：US06324421B1
公开(公告)日：2001-11-27
申请号：US09280203
申请日：1999-03-29
申请人： Robert W. Stadler , Shannon Nelson
发明人： Robert W. Stadler , Shannon Nelson
IPC分类号： A61B504
CPC分类号： A61N1/37 , A61B5/04011 , A61B5/0452 , A61B5/7203 , Y10S128/901
摘要： We show how to determine whether there has been an axis shift in an electrocardiogram waveform and how to use this for filtering out bad electrocardiogram information and to modify an adaptive filter that can be used to adapt the filtering of such electrocardiogram information to make it available for determining physiologic conditions even after an axis shift.
摘要翻译：我们显示如何确定心电图波形中是否有轴移位，以及如何使用它来滤除不良心电图信息和修改自适应滤波器，该自适应滤波器可用于调整这种心电图信息的滤波，使其可用于即使在轴移动之后也确定生理条件。

76. 发明授权

US6115630A Determination of orientation of electrocardiogram signal in implantable medical devices 有权
标题翻译：确定可植入医疗器械中心电图信号的方向
公开(公告)号：US6115630A
公开(公告)日：2000-09-05
申请号：US280592
申请日：1999-03-29
申请人： Robert W. Stadler , Shannon Nelson
发明人： Robert W. Stadler , Shannon Nelson
IPC分类号： A61B5/04 , A61B5/0452 , A61N1/37
CPC分类号： A61B5/04011 , A61B5/0452 , A61B5/7217 , A61N1/3702
摘要： As particularly useful for implantable medical devices we teach a method and apparatus for orienting electrocardiogram input from electrodes of unknown vector orientation. This can be used for locating a fiducial point in the electrocardiogram signal by which other parameterization of measurements taken of the electrocardiogram signal can be made. It is of particular relevance in any cardio electrogram reading where the orientation of the electrogram signal is unknown, and knowledge of the orientation and a fiducial point can form the basis for useful analysis of electrogram signals for detection of physiologic conditions.
摘要翻译：对于可植入医疗装置来说特别有用，我们教导了一种用于定向来自未知向量方向的电极的心电图输入的方法和装置。这可用于定位心电图信号中的基准点，通过该心电图信号可以进行心电图信号测量的其他参数化。它在任何心电图读数中特别相关，其中电描记图信号的取向是未知的，并且取向和基准点的知识可以形成用于检测生理条件的电描记图信号的有用分析的基础。

77. 发明授权

US5495852A Method and apparatus for estimating diameter of an artery using B-mode ultrasonic images 失效
标题翻译：使用B模式超声图像估计动脉直径的方法和装置
公开(公告)号：US5495852A
公开(公告)日：1996-03-05
申请号：US379852
申请日：1995-01-27
申请人： Robert W. Stadler , W. Clem Karl , Robert S. Lees
发明人： Robert W. Stadler , W. Clem Karl , Robert S. Lees
IPC分类号： A61B5/107 , A61B8/08 , A61B8/00
CPC分类号： A61B8/0858 , A61B5/1076
摘要： An improved apparatus and method for measuring the diameter of an artery utilizes an ultrasonic imaging plane that is rotated slightly from the centerline of an artery to produce a "skew" image of the artery. The invention detects edge points on the image of near and far walls of the artery. It fits curves to the near and far end edge points and measures distances between the curves. Alternatively, it fits one curve to all the edge points and measures a parameter (such as minor diameter of an ellipse) of the curve. Finally, it estimates arterial diameter from the measurement.
摘要翻译：用于测量动脉直径的改进的装置和方法利用从动脉中心线稍微旋转的超声成像平面，以产生动脉的“歪斜”图像。本发明检测动脉近壁和远壁的图像上的边缘点。它适合曲线到近端和远端边缘点，并测量曲线之间的距离。或者，它适合于所有边缘点的一条曲线，并测量曲线的参数（如椭圆的小直径）。最后，从测量中估计动脉直径。

78. 发明授权

US09713701B2 Using multiple diagnostic parameters for predicting heart failure events 有权
公开(公告)号：US09713701B2
公开(公告)日：2017-07-25
申请号：US12184003
申请日：2008-07-31
申请人： Shantanu Sarkar , Douglas A. Hettrick , Robert W. Stadler
发明人： Shantanu Sarkar , Douglas A. Hettrick , Robert W. Stadler
IPC分类号： A61N1/365 , A61M37/00 , A61B5/046 , A61B5/0464 , A61B5/053 , A61B5/11
CPC分类号： A61B5/0422 , A61B5/0205 , A61B5/021 , A61B5/046 , A61B5/0464 , A61B5/0537 , A61B5/0538 , A61B5/08 , A61B5/1118 , A61B2562/0219 , A61M5/1723 , A61M37/00 , A61M2230/04 , A61M2230/42 , A61N1/36585
摘要： Techniques for using multiple physiological parameters to provide an early warning for worsening heart failure are described. A medical device monitors a primary diagnostic parameter that is indicative of worsening heart failure, such as intrathoracic impedance or pressure, and one or more secondary diagnostic parameters. The medical device detects worsening heart failure in the patient based on the primary diagnostic parameter when an index that is changed over time based on the primary diagnostic parameter value is outside a range of values, termed the threshold zone. When the index is within the threshold zone, the medical device detects worsening heart failure in the patient based on the one or more secondary diagnostic parameters. Upon detecting worsening heart failure, the medical device may, for example, provide an alert that enables the patient to seek medical attention before experiencing a heart failure event.

79. 发明授权

US09216295B2 Cardiac resynchronization therapy loss diagnostics 有权
标题翻译：心脏再同步治疗损失诊断
公开(公告)号：US09216295B2
公开(公告)日：2015-12-22
申请号：US13297104
申请日：2011-11-15
申请人： Sean R. Landman , Robert W. Stadler
发明人： Sean R. Landman , Robert W. Stadler
IPC分类号： A61N1/362 , A61N1/372 , A61N1/368
CPC分类号： A61N1/37282 , A61N1/3622 , A61N1/3627 , A61N1/3682 , A61N1/37235
摘要： In some examples, an IMD provides CRT data that indicates an amount of time that CRT was not delivered by the IMD, such as the % CRT. In some examples, a CRT loss diagnosis module apportions the amount of time that CRT was not delivered amongst predetermined reasons for loss of CRT based on the CRT data and sensed cardiac data from the IMD. An external computing device may present a representation of the apportionment to a user, e.g., a clinician. The external computing device may also analyze the apportionment, and recommend programming changes for the delivery of CRT by the IMD based on the analysis.
摘要翻译：在一些示例中，IMD提供CRT数据，其指示CRT未由IMD递送的时间量，例如％CRT。在一些示例中，CRT损失诊断模块基于CRT数据和来自IMD的感测的心脏数据来分配在CRT的丢失的预定原因之间没有输送CRT的时间量。外部计算设备可以向用户（例如临床医师）呈现分配的表示。外部计算设备还可以分析分析，并且基于分析推荐由IMD传送CRT的编程改变。

80. 发明授权

US08688200B2 Ischemia detection and classification 有权
标题翻译：缺血检测和分类
公开(公告)号：US08688200B2
公开(公告)日：2014-04-01
申请号：US12915925
申请日：2010-10-29
申请人： Zhendong Song , Robert W. Stadler
发明人： Zhendong Song , Robert W. Stadler
IPC分类号： A61B5/04
CPC分类号： A61B5/0452 , A61B5/0245 , A61B5/1118
摘要： Techniques for detecting ischemia and classifying a type of ischemia are described. Electrograms of cardiac activity may be generated using implanted or external electrodes, e.g., electrodes carried on vascular leads within the heart and a housing electrode. In some examples, ischemia is detected and classified as benign or malignant based on whether a change an electrogram metric is detected, or first detected, in an endocardial electrogram or a non-endocardial electrogram. The relative timing of the change in the electrogram metric and a change in heart rate or patient activity may also be considered. In some examples, the system may create a stress test for detecting ischemia by instructing the patient to exercise or increasing the cardiac pacing rate.
摘要翻译：描述了用于检测缺血和分类一种缺血的技术。可以使用植入或外部电极（例如，在心脏内的血管引线上承载的电极和外壳电极）产生心脏活动的电图。在一些实例中，基于在心内膜电图或非心内膜电图中是否检测到或者首先检测到电描记图度量，检测到缺血并将其分类为良性或恶性。也可以考虑电描记图度量的变化和心率或患者活动变化的相对时间。在一些实例中，系统可以通过指示患者运动或增加心脏起搏速率来产生用于检测缺血的压力测试。

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