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81. 发明授权

US5776072A Discrimination of atrial and ventricular signals from a single cardiac lead 失效
公开(公告)号：US5776072A
公开(公告)日：1998-07-07
申请号：US579872
申请日：1995-12-28
申请人： William Hsu , Jay A. Warren , Gerrard M. Carlson
发明人： William Hsu , Jay A. Warren , Gerrard M. Carlson
IPC分类号： A61N1/362 , A61B5/046
CPC分类号： A61N1/3622
摘要： A method and system for discriminating atrial and ventricular signal components from a single heart lead, and for using this information for identifying an arrhythmia condition as being atrial or ventricular in origin. The invention is effective in identifying P waves occurring in complex signal which includes relatively stronger R waves or other ventricular artifacts which mask the P waves. The contribution of the R wave signal to the complex signal is obtained by filtering, time windowing and transfer function estimation, then the R wave estimate is subtracted from the combined signal to leave the P wave. The ratio of P waves to R waves, P--P and R--R intervals, and their ratios to one another and to fixed values can be estimated, and used in a comparison to discriminate between atrial and ventricular arrhythmia, to thereby enable appropriate treatment.

82. 发明授权

US08888710B2 System and method for assessing cardiac performance through cardiac vibration monitoring 有权
标题翻译：通过心脏振动监测评估心脏性能的系统和方法
公开(公告)号：US08888710B2
公开(公告)日：2014-11-18
申请号：US13208722
申请日：2011-08-12
申请人： Ramesh Wariar , Gerrard M. Carlson
发明人： Ramesh Wariar , Gerrard M. Carlson
IPC分类号： A61B5/02 , A61B7/04
CPC分类号： A61B7/04 , A61B5/021 , A61B7/00
摘要： A system and method for assessing cardiac performance through cardiac vibration monitoring is described. Cardiac vibration measures are directly collected through an implantable medical device. Cardiac events including at least one first heart sound reflected by the cardiac vibration measures are identified. The first heart sound is correlated to cardiac dimensional measures relative to performance of an intrathoracic pressure maneuver. The cardiac dimensional measures are grouped into at least one measures set corresponding to a temporal phase of the intrathoracic pressure maneuver. The at least one cardiac dimensional measures set is evaluated against a cardiac dimensional trend for the corresponding intrathoracic pressure maneuver temporal phase to represent cardiac performance.
摘要翻译：描述了通过心脏振动监测来评估心脏性能的系统和方法。通过植入式医疗设备直接收集心脏振动。识别心脏事件，包括由心脏振动测量反射的至少一个第一心音。第一个心音与胸腔内压力作用的心脏尺寸相关。心脏尺寸测量被分组为对应于胸内压力操纵的时间相位的至少一个测量组。针对相应的胸内压力机动时间阶段的心脏尺寸趋势来评估至少一个心脏尺寸测量集合以表示心脏性能。

83. 发明授权

US08831724B2 Method and apparatus for using heart rate variability as a safety check in electrical therapies 有权
标题翻译：使用心率变异性作为电疗法安全检查的方法和装置
公开(公告)号：US08831724B2
公开(公告)日：2014-09-09
申请号：US12694124
申请日：2010-01-26
申请人： Joseph M. Pastore , Rodney W. Salo , Gerrard M. Carlson , Andrew P. Kramer , Jiang Ding , Yinghong Yu
发明人： Joseph M. Pastore , Rodney W. Salo , Gerrard M. Carlson , Andrew P. Kramer , Jiang Ding , Yinghong Yu
IPC分类号： A61N1/362 , A61N1/365
CPC分类号： A61N1/365 , A61N1/36592
摘要： A cardiac rhythm management system modulates the delivery of pacing and/or autonomic neurostimulation pulses based on heart rate variability (HRV). An HRV parameter being a measure of the HRV is produced to indicate a patient's cardiac condition, based on which the delivery of pacing and/or autonomic neurostimulation pulses is started, stopped, adjusted, or optimized. In one embodiment, the HRV parameter is used as a safety check to stop an electrical therapy when it is believed to be potentially harmful to continue the therapy.
摘要翻译：心律管理系统基于心率变异性（HRV）调节起搏和/或自主神经刺激脉冲的传递。产生作为HRV的量度的HRV参数以指示患者的心脏状况，基于该HRV参数开始，停止，调整或优化起搏和/或自主神经刺激脉冲的递送。在一个实施例中，当HRV参数被认为对继续治疗有潜在危害时，将HRV参数用作安全检查以停止电疗法。

84. 发明授权

US08768718B2 Between-patient comparisons for risk stratification of future heart failure decompensation 有权
标题翻译：患者对未来心力衰竭代偿失调风险分层的比较
公开(公告)号：US08768718B2
公开(公告)日：2014-07-01
申请号：US11616430
申请日：2006-12-27
申请人： Shelley Cazares , Jon Peterson , Haresh G. Sachanandani , Kevin J. Stalsberg , Robert J. Sweeney , Krzysztof Z. Siejko , Gerrard M. Carlson
发明人： Shelley Cazares , Jon Peterson , Haresh G. Sachanandani , Kevin J. Stalsberg , Robert J. Sweeney , Krzysztof Z. Siejko , Gerrard M. Carlson
IPC分类号： G06Q50/00 , A61B5/00
CPC分类号： G06Q50/22 , A61B5/0031 , A61N1/37282 , G06F19/00 , G16H50/20 , G16H50/30 , G16H50/50 , G16H50/70
摘要： This document discusses, among other things, systems and methods for using between-patient comparisons for risk stratification of future heart failure decompensation. A method comprises receiving patient data of a current patient, the patient data collected by a patient monitoring device; determining a reference group related to the patient; determining a reference group dataset selected from the reference group, wherein the dataset includes patient data that is of a similar type received from the patient monitoring device; generating a model of the reference group dataset; and automatically comparing the received physiological data to a model to derive an index for the patient.
摘要翻译：本文件除了其他内容之外还讨论了使用患者间比较以预测未来心力衰竭代偿失调的风险分层的系统和方法。一种方法包括接收当前患者的患者数据，由患者监测装置收集的患者数据; 确定与患者相关的参考组; 确定从所述参考组中选择的参考组数据集，其中所述数据集包括从所述患者监视装置接收到的类似类型的患者数据; 生成参考组数据集的模型; 并且将接收到的生理数据自动地与模型进行比较以导出患者的指标。

85. 发明授权

US08579828B2 Managing preload reserve by tracking the ventricular operating point with heart sounds 有权
公开(公告)号：US08579828B2
公开(公告)日：2013-11-12
申请号：US13447506
申请日：2012-04-16
申请人： Gerrard M. Carlson , Ramesh Wariar , Krzysztof Z. Siejko
发明人： Gerrard M. Carlson , Ramesh Wariar , Krzysztof Z. Siejko
IPC分类号： A61B5/021 , A61B5/0225
CPC分类号： A61N1/36585 , A61B5/021 , A61B5/0452 , A61B7/04 , A61M5/1723 , A61N1/37
摘要： A system and method for managing preload reserve and tracking the inotropic state of a patient's heart. The S1 heart sound is measured as a proxy for direct measurement of stroke volume. The S3 heart sound may be measured as a proxy for direct measurement of preload level. The S1-S3 pair yield a point on a Frank Starling type of curve, and reveal information regarding the patient's ventricular operating point and inotropic state. As an alternative, or in addition to, measurement of the S3 heart sound, the S4 heart sound may be measured or a direct pressure measurement may be made for the sake of determining the patient's preload level. The aforementioned measurements may be made by a cardiac rhythm management device, such as a pacemaker or implantable defibrillator.

86. 发明申请

US20130226078A1 MONITORING OF CHRONOBIOLOGICAL RHYTHMS FOR DISEASE AND DRUG MANAGEMENT USING ONE OR MORE IMPLANTABLE DEVICE 审中-公开
标题翻译：使用一个或多个可植入装置监测疾病和药物管理的血液生殖系统
公开(公告)号：US20130226078A1
公开(公告)日：2013-08-29
申请号：US13845398
申请日：2013-03-18
申请人： Yi Zhang , John D. Hatlestad , Gerrard M. Carlson , Yousufali Dalal , Marina V. Brockway , Kent Lee , Richard O. Kuenzler , Carlos Haro , Krzysztof Z. Siejko , Abhilash Patangay
发明人： Yi Zhang , John D. Hatlestad , Gerrard M. Carlson , Yousufali Dalal , Marina V. Brockway , Kent Lee , Richard O. Kuenzler , Carlos Haro , Krzysztof Z. Siejko , Abhilash Patangay
IPC分类号： A61M5/172 , A61N1/36
CPC分类号： A61M5/1723 , A61B5/02055 , A61B5/0215 , A61B5/024 , A61B5/02405 , A61B5/053 , A61B5/0816 , A61B5/1116 , A61B5/686 , A61B5/7275 , A61N1/36114 , A61N1/36135 , A61N1/3621 , A61N1/365 , A61N1/36585 , G16H20/10 , G16H20/40 , G16H50/20 , G16H50/30
摘要： The health state of a subject is automatically evaluated or predicted using at least one implantable device. In varying examples, the health state is determined by sensing or receiving information about at least one physiological process having a circadian rhythm whose presence, absence, or baseline change is associated with impending disease, and comparing such rhythm to baseline circadian rhythm prediction criteria. Other chronobiological rhythms beside circadian may also be used. The baseline prediction criteria may be derived using one or more past physiological process observation of the subject or population of subjects in a non-disease health state. The prediction processing may be performed by the at least one implantable device or by an external device in communication with the implantable device. Systems and methods for invoking a therapy in response to the health state, such as to prevent or minimize the consequences of predicted impending heart failure, are also discussed.
摘要翻译：使用至少一个可植入装置自动评价或预测受试者的健康状况。在不同的实施例中，通过感测或接收关于至少一个具有昼夜节律的生理过程的信息来确定健康状况，所述生理过程的存在，不存在或基线变化与即将发生的疾病相关联，并将该节律与基线昼夜节律预测标准进行比较。也可以使用昼夜节律以外的其他时间生理节律。可以使用在非疾病健康状态下的受试者或受试者群体的一个或多个过去的生理过程观察来导出基线预测标准。预测处理可以由至少一个可植入装置或与可植入装置通信的外部装置执行。还讨论了响应于健康状态调用疗法的系统和方法，例如预防或最小化预期的即将到来的心力衰竭的后果。

87. 发明授权

US08364263B2 System and method for systolic interval analysis 有权
公开(公告)号：US08364263B2
公开(公告)日：2013-01-29
申请号：US11553179
申请日：2006-10-26
申请人： Abhilash Patangay , Krzysztof Z. Siejko , Gerrard M. Carlson , Loell Boyce Moon
发明人： Abhilash Patangay , Krzysztof Z. Siejko , Gerrard M. Carlson , Loell Boyce Moon
IPC分类号： A61N1/00
CPC分类号： A61B5/0265 , A61B5/0031 , A61B5/029 , A61B5/042 , A61B5/0456 , A61B5/053 , A61B5/0538 , A61B5/4836 , A61B5/686 , A61B5/7239 , A61B5/7282 , A61B7/00 , A61B7/04 , A61N1/36521 , A61N1/36571 , A61N1/36578 , A61N1/36585
摘要： A system and method provide for systolic interval analysis. In an example, an implantable device measures a cardiac impedance signal. A transformation of the cardiac impedance interval is generated. The device also measures a heart sound signal. A time interval between a point on the transformed signal of the cardiac impedance signal and a point on the heart sound signal is calculated.

88. 发明授权

US08229557B2 Estimating acute response to cardiac resynchronization therapy 有权
标题翻译：估计对心脏再同步治疗的急性反应
公开(公告)号：US08229557B2
公开(公告)日：2012-07-24
申请号：US11729453
申请日：2007-03-29
申请人： Abhilash Patangay , Krzysztof Siejko , Mohan Krishnan , Gerrard M. Carlson
发明人： Abhilash Patangay , Krzysztof Siejko , Mohan Krishnan , Gerrard M. Carlson
IPC分类号： A61N1/365
CPC分类号： A61N1/3627 , A61B5/0031 , A61B5/02028 , A61B5/0215 , A61B5/029 , A61B5/0422 , A61B5/0535 , A61B5/0538 , A61B5/1102 , A61B5/7267 , A61B7/00 , A61N1/3684 , A61N1/3704
摘要： Systolic timing intervals are measured in response to delivering pacing energy to a pacing site of a patient's heart. An estimate of a patient's acute response to cardiac resynchronization therapy (CRT) for the pacing site is determined using the measured systolic timing intervals. The estimate is compared to a threshold. The threshold preferably distinguishes between acute responsiveness and non-responsiveness to CRT for a patient population. An indication of acute responsiveness to CRT for the pacing site may be produced in response to the comparison.
摘要翻译：响应于将起搏能量递送到患者心脏的起搏部位来测量收缩时间间隔。使用测量的收缩时间间隔来确定对于起搏部位的患者对心脏再同步治疗（CRT）的急性反应的估计。将估计值与阈值进行比较。该阈值优选地区分对于患者群体的急性反应性和对CRT的无反应性。响应于比较可以产生针对起搏部位对CRT的急性反应性的指示。

89. 发明授权

US08162844B2 Managing preload reserve by tracking the ventricular operating point with heart sounds 有权
标题翻译：通过用心脏声音跟踪心室手术点来管理预负荷储备
公开(公告)号：US08162844B2
公开(公告)日：2012-04-24
申请号：US12547207
申请日：2009-08-25
申请人： Gerrard M. Carlson , Ramesh Wariar , Krzysztof Z. Siejko
发明人： Gerrard M. Carlson , Ramesh Wariar , Krzysztof Z. Siejko
IPC分类号： A61B5/021 , A61B5/0225
CPC分类号： A61N1/36585 , A61B5/021 , A61B5/0452 , A61B7/04 , A61M5/1723 , A61N1/37
摘要： A system and method for managing preload reserve and tracking the inotropic state of a patient's heart. The S1 heart sound is measured as a proxy for direct measurement of stroke volume. The S3 heart sound may be measured as a proxy for direct measurement of preload level. The S1-S3 pair yield a point on a Frank Starling type of curve, and reveal information regarding the patient's ventricular operating point and inotropic state. As an alternative, or in addition to, measurement of the S3 heart sound, the S4 heart sound may be measured or a direct pressure measurement may be made for the sake of determining the patient's preload level. The aforementioned measurements may be made by a cardiac rhythm management device, such as a pacemaker or implantable defibrillator.
摘要翻译：一种用于管理预负荷储备并跟踪患者心脏的变力状态的系统和方法。测量S1心音作为直接测量行程体积的代理。可以将S3心音测量为用于直接测量预载水平的代理。 S1-S3对在Frank Starling曲线上产生一个点，并显示关于患者的心室手术点和变力状态的信息。作为S3心音的测量或除了测量S3心音之外，也可以测量S4心音，或者为了确定患者的预压水平可以进行直接的压力测量。上述测量可以由诸如起搏器或可植入除颤器的心律管理装置进行。

90. 发明授权

US08096954B2 Adaptive sampling of heart sounds 有权
标题翻译：心音的自适应采样
公开(公告)号：US08096954B2
公开(公告)日：2012-01-17
申请号：US11564637
申请日：2006-11-29
申请人： Jeffrey E. Stahmann , Krzysztof Z. Siejko , Carlos Haro , Abhilash Patangay , Gerrard M. Carlson , Andres Belalcazar
发明人： Jeffrey E. Stahmann , Krzysztof Z. Siejko , Carlos Haro , Abhilash Patangay , Gerrard M. Carlson , Andres Belalcazar
IPC分类号： A61B5/02
CPC分类号： A61N1/36514 , A61B5/0031 , A61B5/021 , A61B5/024 , A61B5/053 , A61B5/08 , A61B5/0816 , A61B5/1116 , A61B5/4806 , A61B5/686 , A61B5/7275 , A61B7/04 , A61N1/36578
摘要： A system and method to sense heart sounds with one or more implantable medical devices according to one or more parameters. The system alters one or more of the parameters as a function of one or more triggering events. The system then senses heart sounds with the one or more implantable medical devices according to at least the one or more altered parameters.
摘要翻译：根据一个或多个参数用一个或多个可植入医疗装置感测心脏声音的系统和方法。系统根据一个或多个触发事件改变一个或多个参数。该系统然后根据至少一个或多个改变的参数用一个或多个可植入医疗装置感测心脏声音。

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