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81. 发明申请

US20120029588A1 METHOD AND APPARATUS FOR CONTROL OF CARDIAC THERAPY USING NON-INVASIVE HEMODYNAMIC SENSOR 有权
标题翻译：使用非侵入式血液动力传感器控制心脏病治疗的方法和装置
公开(公告)号：US20120029588A1
公开(公告)日：2012-02-02
申请号：US13273108
申请日：2011-10-13
申请人： Andrew P. Kramer , Joseph M. Pastore , Jeffrey E. Stahmann , Rodney W. Salo , Jesse W. Hartley
发明人： Andrew P. Kramer , Joseph M. Pastore , Jeffrey E. Stahmann , Rodney W. Salo , Jesse W. Hartley
IPC分类号： A61N1/365
CPC分类号： A61N1/36557 , A61B5/6816 , A61B5/6826 , A61B5/6829 , A61B5/6838 , A61N1/36114 , A61N1/36564
摘要： A cardiac rhythm management (CRM) system includes a non-invasive hemodynamic sensing device and an implantable medical device to sense a hemodynamic signal and derive one or more cardiac performance parameters from the hemodynamic signal. The non-invasive hemodynamic sensing device includes at least a portion configured for external attachment to a body in which the implantable medical device is implanted. The one or more cardiac performance parameters are used for various diagnostic, monitoring, and therapy control purposes.
摘要翻译：心律管理（CRM）系统包括非侵入性血液动力学感测装置和可植入医疗装置，用于感测血液动力学信号并从血流动力学信号导出一个或多个心脏性能参数。非侵入式血流动力学检测装置包括至少一部分，其构造成用于外部附接到其中植入可植入医疗装置的主体。一个或多个心脏性能参数用于各种诊断，监测和治疗控制目的。

82. 发明授权

US08027719B2 Method and apparatus for delivering defibrillation shock therapy while reducing electrical dispersion due to ventricular conduction disorder 有权
标题翻译：用于递送除颤休克疗法同时减少由于心室传导障碍引起的电离散的方法和装置
公开(公告)号：US08027719B2
公开(公告)日：2011-09-27
申请号：US12051997
申请日：2008-03-20
申请人： Jeffrey E. Stahmann , Jesse W. Hartley , Steven D. Girouard
发明人： Jeffrey E. Stahmann , Jesse W. Hartley , Steven D. Girouard
IPC分类号： A61N1/00
CPC分类号： A61N1/3622 , A61N1/3627 , A61N1/3684 , A61N1/3962
摘要： A method and device for delivering defibrillation shock therapy in patients having an inter-ventricular conduction disorder is presented. Ventricular resynchronization therapy is employed to reduce the dispersion of ventricular depolarization which takes place due to the conduction disorder and reduces the safety margin of shocks delivered synchronously with ventricular beats. The method may be employed in the treatment of atrial or ventricular tachyarrhythmias.
摘要翻译：提出了一种用于在患有心室间传导障碍的患者中递送除颤休克疗法的方法和装置。采用心室再同步治疗来减少由于传导障碍引起的心室去极化的分散，降低与心室搏动同步传递的休克的安全余量。该方法可用于治疗心房或室性快速性心律失常。

83. 发明授权

US07979115B2 Detection of pleural effusion using transthoracic impedance 有权
标题翻译：使用经胸阻塞检测胸腔积液
公开(公告)号：US07979115B2
公开(公告)日：2011-07-12
申请号：US11972405
申请日：2008-01-10
申请人： Jeffrey E. Stahmann , John Hatlestad , Jesse W. Hartley , Richard Fogoros
发明人： Jeffrey E. Stahmann , John Hatlestad , Jesse W. Hartley , Richard Fogoros
IPC分类号： A61B5/05
CPC分类号： A61B5/0205 , A61B5/0031 , A61B5/0535 , A61B5/1116 , A61B5/4869 , A61N1/36521 , A61N1/36535
摘要： This patent document discusses systems, devices, and methods for increasing a sensitivity or specificity of thoracic fluid detection in a subject and differentiating between pleural effusion and pulmonary edema. In one example, a thoracic impedance measurement circuit senses a thoracic impedance signal. In another example, a processor receives the thoracic impedance signal and determines whether such thoracic impedance signal is “significant.” A significant thoracic impedance signal indicates the presence of thoracic fluid and may be recognized by comparing the thoracic impedance signal (or variation thereof) to a thoracic impedance threshold. When a significant thoracic impedance signal is recognized, the processor is adapted to detect one or both of: a pleural effusion indication and a pulmonary edema indication using one or a combination of: physiologic information, patient symptom information, and posture information. In another example, the thoracic impedance threshold is adjusted using such physiologic, patient symptom, or posture information.
摘要翻译：该专利文献讨论了用于增加受试者胸部液体检测的敏感性或特异性并区分胸腔积液和肺水肿的系统，装置和方法。在一个示例中，胸部阻抗测量电路感测胸部阻抗信号。在另一示例中，处理器接收胸部阻抗信号并确定这种胸部阻抗信号是否“显着”。显着的胸部阻抗信号表示胸腔存在，并且可以通过将胸部阻抗信号（或其变化）与胸阻抗阈值。当识别出显着的胸部阻抗信号时，处理器适合于使用生理信息，患者症状信息和姿势信息中的一个或组合来检测胸腔积液指示和肺水肿指示之一或两者。在另一个例子中，使用这种生理，患者症状或姿势信息来调整胸阻抗阈值。

84. 发明申请

US20110144526A1 ENHANCEMENTS TO THE DETECTION OF PULMONARY EDEMA WHEN USING TRANSTHORACIC IMPEDANCE 有权
标题翻译：使用潮热阻力时检测脉搏电流的增强
公开(公告)号：US20110144526A1
公开(公告)日：2011-06-16
申请号：US13033081
申请日：2011-02-23
申请人： Jeffrey E. Stahmann , John Hatlestad , Jesse W. Hartley
发明人： Jeffrey E. Stahmann , John Hatlestad , Jesse W. Hartley
IPC分类号： A61B5/053
CPC分类号： A61B5/0537 , A61B5/0002 , A61B5/0538 , A61B5/4869 , A61B5/4878
摘要： This patent document discusses, among other things, systems, devices, and methods for enhancing detection of pulmonary edema using, in addition to thoracic impedance, one or a combination of: physiologic information about a subject, at least one statistical parameter, a user-programmable detection level, at least one parameter associated with a previous pulmonary edema event, and patient symptom information about the subject. In one example, a (base) thoracic impedance threshold is modified to an adjusted thoracic impedance threshold. The adjusted thoracic impedance threshold provides an increased sensitivity of pulmonary edema detection as compared to the base thoracic impedance threshold. In another example, an alert is provided to a subject, a caregiver, or other user based on a pulmonary edema indication determined by the present systems, devices, and methods. In a further example, a therapy (provided to the subject) is adjusted or initiated in response to the pulmonary edema indication.
摘要翻译：该专利文献尤其涉及用于增强肺水肿检测的系统，装置和方法，除胸部阻抗之外，还包括以下之一或组合：关于受试者的生理信息，至少一个统计参数，可编程检测水平，与先前的肺水肿事件相关联的至少一个参数，以及关于受试者的患者症状信息。在一个示例中，（基底）胸部阻抗阈值被修改为经调整的胸部阻抗阈值。与基础胸廓阻抗阈值相比，经调整的胸廓阻抗阈值提供了肺水肿检测的灵敏度增加。在另一示例中，基于由本系统，设备和方法确定的肺水肿指示，向受检者，照顾者或其他用户提供警报。在另一个实例中，响应于肺水肿指示调整或启动治疗（提供给受试者）。

85. 发明授权

US07742813B2 Minimizing hemodynamic compromise during post-mi remodeling control pacing 有权
标题翻译：最小化血液动力学妥协在后重建控制起搏
公开(公告)号：US07742813B2
公开(公告)日：2010-06-22
申请号：US11276741
申请日：2006-03-13
申请人： Joseph M. Pastore , Rodney W. Salo , Jesse W. Hartley , Andrew P. Kramer , Jeffrey E. Stahmann
发明人： Joseph M. Pastore , Rodney W. Salo , Jesse W. Hartley , Andrew P. Kramer , Jeffrey E. Stahmann
IPC分类号： A61N1/368
CPC分类号： A61N1/3627 , A61N1/36521 , A61N1/3684
摘要： A method and device for delivering pre-excitation pacing to prevent or reduce cardiac remodeling following a myocardial infarction is described. The pre-excitation pacing is modulated in accordance with an assessment of cardiac function in order to balance the beneficial effects of stress reduction with hemodynamic compromise.
摘要翻译：描述了用于递送预激发起搏以预防或减少心肌梗塞后的心脏重塑的方法和装置。根据心脏功能的评估调节预激励起搏，以平衡应力减少与血液动力学妥协的有益效果。

86. 发明授权

US07120490B2 Cardiac rhythm management system with atrial shock timing optimization 失效
公开(公告)号：US07120490B2
公开(公告)日：2006-10-10
申请号：US10211414
申请日：2002-08-02
申请人： Victor T. Chen , Jay A. Warren , Gary T. Seim , David B. Krig , Jesse W. Hartley , Jeffrey E. Stahmann
发明人： Victor T. Chen , Jay A. Warren , Gary T. Seim , David B. Krig , Jesse W. Hartley , Jeffrey E. Stahmann
IPC分类号： A61N1/39
CPC分类号： A61N1/3962 , A61N1/3621 , A61N1/3627 , A61N1/3682 , A61N1/395 , A61N1/3987
摘要： A cardiac rhythm management system includes atrial shock timing optimization. Because an atrial tachyarrhythmia, such as atrial fibrillation typically causes significant variability in the ventricular heart rate, resulting in potentially proarrhythmic conditions. The system avoids delivering atrial cardioversion/defibrillation therapy during potentially proarrhythmic conditions because doing so could result in dangerous ventricular arrhythmias. Using Ventricular Rate Regularization (“VRR”) techniques, the system actively stabilizes the ventricular heart rate to obtain less potentially proarrhythmic conditions for delivering the atrial tachyarrhythmia therapy. The intrinsic ventricular heart rate is stabilized at a variable VRR-indicated rate, computed using an infinite impulse response (IIR) filter, and based on the underlying intrinsic ventricular heart rate. The system withholds delivery of atrial cardioversion/defibrillation therapy until the intervals between ventricular beats (“V—V intervals”) meet certain criteria that decrease the chance that the atrial cardioversion/defibrillation therapy will induce a ventricular arrhythmia.

87. 发明授权

US06353759B1 Cardiac rhythm management system promoting a trial pacing 有权
标题翻译：心律管理系统促进心房起搏
公开(公告)号：US06353759B1
公开(公告)日：2002-03-05
申请号：US09693402
申请日：2000-10-20
申请人： Jesse W. Hartley , Andrew P. Kramer , Jeffrey E. Stahmann , David B. Krig
发明人： Jesse W. Hartley , Andrew P. Kramer , Jeffrey E. Stahmann , David B. Krig
IPC分类号： A61N1362
CPC分类号： A61N1/3621 , A61N1/3627 , A61N1/3682 , A61N1/395 , A61N1/3962 , A61N1/3987
摘要： A cardiac rhythm management system includes an atrial pacing preference (APP) filter for promoting atrial pacing. The APP filter includes an infinite impulse response (IIR) or other filter that controls the timing of delivery of atrial pacing pulses. The atrial pacing pulses are delivered at an APP-indicated pacing rate that is typically at a small amount above the intrinsic atrial heart rate. For sensed beats, the APP indicated rate is increased until it becomes slightly faster than the intrinsic atrial heart rate. The APP-indicated pacing rate is then gradually decreased to search for the underlying intrinsic atrial heart rate. Then, after a sensed atrial beat, the APP filter again increases the pacing rate until it becomes faster than the intrinsic atrial rate by a small amount. As a result, most atrial heart beats are paced, rather than sensed. This decreases the likelihood of the occurrence of an atrial tachyarrhythima, such as atrial fibrillation. The decreased likelihood of atrial tachyarrhythmia, in turn, decreases the likelihood of inducing a ventricular arrhythmia, either as a result of the atrial tachyarrhythmia, or as the result of delivering a defibrillation shock to treat the atrial tachyarrhythmia.
摘要翻译：心律管理系统包括用于促进心房起搏的心房起搏偏好（APP）滤波器。 APP滤波器包括无限脉冲响应（IIR）或其他滤波器，其控制心房起搏脉冲的递送时间。心房起搏脉冲以APP指示的起搏速率递送，其通常在固有心房心率以上的小量起搏。对于检测到的心跳，APP指示的速率增加，直到其变得比内在的心房心率稍快。然后APP指示的起搏率逐渐降低，以寻找潜在的固有心房心率。然后，在感觉到的心房搏动之后，APP滤波器再次增加起搏速率，直到其变得比固有心房率小得多。因此，大多数心房心脏跳动起搏，而不是感觉到。这降低了房性快速性心律失常发生的可能性，例如房颤。房性心律失常的可能性降低反过来也降低了引起室性心律失常的可能性，由于房性快速性心律失常，或作为递送除颤休克以治疗房性快速性心律失常的结果。

88. 发明授权

US06351669B1 Cardiac rhythm management system promoting atrial pacing 有权
标题翻译：心律管理系统促进心房起搏
公开(公告)号：US06351669B1
公开(公告)日：2002-02-26
申请号：US09316682
申请日：1999-05-21
申请人： Jesse W. Hartley , Andrew P. Kramer , Jeffrey E. Stahmann , David B. Krig
发明人： Jesse W. Hartley , Andrew P. Kramer , Jeffrey E. Stahmann , David B. Krig
IPC分类号： A61N118
CPC分类号： A61N1/3621 , A61N1/3627 , A61N1/3682 , A61N1/395 , A61N1/3962 , A61N1/3987
摘要： A cardiac rhythm management system includes an atrial pacing preference (APP) filter for promoting atrial pacing. The APP filter includes an infinite impulse response (IIR) or other filter that controls the timing of delivery of atrial pacing pulses. The atrial pacing pulses are delivered at an APP-indicated pacing rate that is typically at a small amount above the intrinsic atrial heart rate. For sensed beats, the APP indicated rate is increased until it becomes slightly faster than the intrinsic atrial heart rate. The APP-indicated pacing rate is then gradually decreased to search for the underlying intrinsic atrial heart rate. Then, after a sensed atrial beat, the APP filter again increases the pacing rate until it becomes faster than the intrinsic atrial rate by a small amount. As a result, most atrial heart beats are paced, rather than sensed. This decreases the likelihood of the occurrence of an atrial tachyarrhythmia, such as atrial fibrillation. The decreased likelihood of atrial tachyarrhythmia, in turn, decreases the likelihood of inducing a ventricular arrhythmia, either as a result of the atrial tachyarrhythmia, or as the result of delivering a defibrillation shock to treat the atrial tachyarrhythmia.
摘要翻译：心律管理系统包括用于促进心房起搏的心房起搏偏好（APP）滤波器。 APP滤波器包括无限脉冲响应（IIR）或其他滤波器，其控制心房起搏脉冲的递送时间。心房起搏脉冲以APP指示的起搏速率递送，其通常在固有心房心率以上的小量起搏。对于检测到的心跳，APP指示的速率增加，直到其变得比内在的心房心率稍快。然后APP指示的起搏率逐渐降低，以寻找潜在的固有心房心率。然后，在感觉到的心房搏动之后，APP滤波器再次增加起搏速率，直到其变得比固有心房率小得多。因此，大多数心房心脏跳动起搏，而不是感觉到。这降低了房性心律失常发生的可能性，例如房颤。房性心律失常的可能性降低反过来也降低了引起室性心律失常的可能性，由于房性快速性心律失常，或作为递送除颤休克以治疗房性快速性心律失常的结果。

89. 发明授权

US5376106A Multi-sensor blending in a rate responsive cardiac pacemaker 失效
标题翻译：多速传感器混合在速率响应心脏起搏器中
公开(公告)号：US5376106A
公开(公告)日：1994-12-27
申请号：US136892
申请日：1993-10-18
申请人： Jeffrey E. Stahmann , Jesse W. Hartley
发明人： Jeffrey E. Stahmann , Jesse W. Hartley
IPC分类号： A61N1/365
CPC分类号： A61N1/36585
摘要： A multi-sensor blending circuit for use in a rate responsive cardiac pacemaker. The blending logic circuit blends delta pacing rate signals from two or more sensors which measure physical and physiological parameters of a patient. Programmable equations stored in the blending logic circuit determine which percentages or a ratio of the delta pacing rate sensor signals comprise a single delta pacing rate signal as a function of the delta pacing rate. This delta pacing rate signal is provided to the pacing control circuitry of a pacemaker. The blending ratios are dynamically determined based on the pacing rate established at the most recent cardiac cycle. The blending equations are comprised of several programmable variables, wherein the equations can be programmed by the external programmer in view of clinical data.
摘要翻译：用于速率响应心脏起搏器的多传感器混合电路。混合逻辑电路混合来自测量患者的物理和生理参数的两个或更多个传感器的三角波起搏速率信号。存储在混合逻辑电路中的可编程方程式确定哪个百分比或三角波起搏速率传感器信号的比例包括作为三角波起搏速率的函数的单个增量起搏速率信号。该三角波形起搏速率信号被提供给起搏器的起搏控制电路。基于最近心动周期建立的起搏速率动态地确定混合比。混合方程由几个可编程变量组成，其中可以根据临床数据由外部程序员编程方程式。

90. 发明授权

US08798747B2 Method and apparatus for control of cardiac therapy using non-invasive hemodynamic sensor 有权
标题翻译：使用非侵入性血液动力学传感器控制心脏治疗的方法和装置
公开(公告)号：US08798747B2
公开(公告)日：2014-08-05
申请号：US13273108
申请日：2011-10-13
申请人： Andrew P. Kramer , Joseph M. Pastore , Jeffrey E. Stahmann , Rodney W. Salo , Jesse W. Hartley
发明人： Andrew P. Kramer , Joseph M. Pastore , Jeffrey E. Stahmann , Rodney W. Salo , Jesse W. Hartley
IPC分类号： A61N1/00
CPC分类号： A61N1/36557 , A61B5/6816 , A61B5/6826 , A61B5/6829 , A61B5/6838 , A61N1/36114 , A61N1/36564
摘要： A cardiac rhythm management (CRM) system includes a non-invasive hemodynamic sensing device and an implantable medical device to sense a hemodynamic signal and derive one or more cardiac performance parameters from the hemodynamic signal. The non-invasive hemodynamic sensing device includes at least a portion configured for external attachment to a body in which the implantable medical device is implanted. The one or more cardiac performance parameters are used for various diagnostic, monitoring, and therapy control purposes.
摘要翻译：心律管理（CRM）系统包括非侵入性血液动力学感测装置和可植入医疗装置，用于感测血液动力学信号并从血流动力学信号导出一个或多个心脏性能参数。非侵入式血流动力学检测装置包括至少一部分，其构造成用于外部附接到其中植入可植入医疗装置的主体。一个或多个心脏性能参数用于各种诊断，监测和治疗控制目的。

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