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1. 发明授权

US08244355B2 Method and apparatus to provide diagnostic index and therapy regulated by subject's autonomic nervous system 有权
标题翻译：提供受试者自主神经系统调节的诊断指标和治疗的方法和装置
公开(公告)号：US08244355B2
公开(公告)日：2012-08-14
申请号：US10977073
申请日：2004-10-29
申请人： Tommy D. Bennett , Edwin G. Duffin , Barbro Kjellstrom
发明人： Tommy D. Bennett , Edwin G. Duffin , Barbro Kjellstrom
IPC分类号： A61N1/00
CPC分类号： A61B5/0205 , A61B5/4035 , A61B5/7239 , A61N1/36535 , A61N1/36578 , A61N1/36585 , A61N1/36592 , A61N1/3702
摘要： A system and method are provided for determining an index of autonomic nervous system (ANS) or sympathetic nervous system (SNS) activity for use in patient monitoring or therapy delivery control. An ANS or SNS index is calculated as a function of multiple monitored physiological variables that strongly correlate to changes in autonomic or sympathetic tone. These ANS-influenced variables are derived from selected hemodynamic and/or electrical signals and may include variables relating to any of: the maximum rate of pressure rise (dP/dtmax), the maximum rate of pressure decline (dP/dtmin), pulse pressure (PP), pre-ejection time interval (PEI) and/or systolic time interval (STI), heart rate (HR), heart rate variability (HRV), and baro-reflex gain. Changes in the ANS or SNS index may be used to automatically adjust a device delivered therapy.
摘要翻译：提供了一种用于确定用于患者监测或治疗递送控制的自主神经系统（ANS）或交感神经系统（SNS）活动指数的系统和方法。 ANS或SNS指数被计算为与自主神经或交感神经紧张度变化密切相关的多个被监测的生理变量的函数。这些受ANS影响的变量来源于选定的血液动力学和/或电信号，并且可以包括与以下任何相关的变量：压力升高的最大速率（dP / dtmax），压力下降的最大速率（dP / dtmin），脉压（PP），预喷射时间间隔（PEI）和/或收缩期间隔（STI），心率（HR），心率变异性（HRV）和压力反射增益。可以使用ANS或SNS指数的变化来自动调整设备传递的治疗。

2. 发明申请

US20070123786A1 Portable programmer for providing patient status information 有权
标题翻译：用于提供患者状态信息的便携式程序员
公开(公告)号：US20070123786A1
公开(公告)日：2007-05-31
申请号：US11291033
申请日：2005-11-30
申请人： Pierre Grandjean , Ilaria Vicini , Barbro Kjellstrom
发明人： Pierre Grandjean , Ilaria Vicini , Barbro Kjellstrom
IPC分类号： A61B5/04
CPC分类号： A61B5/0022 , A61B5/72 , A61N1/37235
摘要： A method and apparatus concerning the retrieval and storage of status information obtained from patients having implantable medical devices (IMDs). When patients are having episodes during which symptoms are experienced relating to their medical condition, the collection of the patient's status information can be helpful to the patient's physician for diagnostic purposes. Telemetered signals recorded by the IMD can be transmitted from the IMD to a programmer. Such programmer is portable and sized so as to be carried by the patient. As such, mechanisms added to such programmers for use in retrieving and storing patient status information can provide more convenience for patients.
摘要翻译：关于从具有可植入医疗装置（IMD）的患者获得的状态信息的检索和存储的方法和装置。当患者发生与其医疗状况有关的症状时，患者的状态信息的收集可能有助于患者的医师进行诊断。由IMD记录的遥测信号可以从IMD发送到编程器。这样的程序员是便携式的并且尺寸被设计成由病人携带。因此，添加到这样的程序员中用于检索和存储患者状态信息的机制可以为患者提供更多便利。

3. 发明申请

US20070073171A1 Methods for detecting and monitoring sleep disordered breathing using an implantable medical device 有权
标题翻译：使用可植入医疗装置检测和监测睡眠无序呼吸的方法
公开(公告)号：US20070073171A1
公开(公告)日：2007-03-29
申请号：US11237354
申请日：2005-09-28
申请人： Yong Cho , Tommy Bennett , Barbro Kjellstrom
发明人： Yong Cho , Tommy Bennett , Barbro Kjellstrom
IPC分类号： A61B5/02
CPC分类号： A61B5/042 , A61B5/0215 , A61B5/4818 , A61B5/7239
摘要： A method of identifying sleep disordered breathing (SDB) in a patient includes monitoring a hemodynamic pressure, deriving high, middle, and low values representative of the distribution of the hemodynamic pressure over a storage interval, measuring a ratio of a lower range to a full range of the hemodynamic pressure based on the derived high, middle, and low values, and using the ratio to determine whether the patient has experienced an SDB episode. Certain embodiments of the invention compare the ratio to a threshold value to identify the occurrence of an SDB episode, while other embodiments of the invention identify the occurrence of an SDB episode by monitoring for a simultaneous increase in both the ratio and the full range of the hemodynamic pressure. In certain other embodiments of the invention, activity level and/or duration criteria may be employed to confirm the occurrence of an SDB episode detected using the ratio.
摘要翻译：识别患者中睡眠呼吸障碍（SDB）的方法包括监测血液动力学压力，导出代表存储间隔内血流动力压力分布的高，中，低值，测量下限范围与满基于导出的高，中，低值的血流动力压力范围，并使用该比例来确定患者是否经历SDB发作。本发明的某些实施方案将比率与阈值进行比较以鉴定SDB发作的发生，而本发明的其它实施方案通过监测SDB发作的比例和全部范围的同时增加来识别SDB发作的发生血流动力学压力。在本发明的某些其他实施方案中，可以使用活动水平和/或持续时间标准来确认使用该比率检测到的SDB发作的发生。

4. 发明申请

US20060167516A1 System and method for monitoring a ventricular pressure index to predict worsening heart failure 有权
公开(公告)号：US20060167516A1
公开(公告)日：2006-07-27
申请号：US11045571
申请日：2005-01-27
申请人： Barbro Kjellstrom , Tommy Bennett
发明人： Barbro Kjellstrom , Tommy Bennett
IPC分类号： A61N1/36 , A61B5/02
CPC分类号： A61N1/36564
摘要： A medical device monitors a patient to predict worsening heart failure. An input circuit of the medical device receives a pressure signal representative of a pressure sensed within a ventricle of the patient's heart as a function of time. A processor derives from the pressure signal a ventricular pressure index for a ventricular contraction based upon pressures in the ventricle. The processor then provides an output based upon the ventricular pressure index.

5. 发明申请

US20060167361A1 Method and apparatus for continuous pulse contour cardiac output 审中-公开
公开(公告)号：US20060167361A1
公开(公告)日：2006-07-27
申请号：US11045573
申请日：2005-01-27
申请人： Tommy Bennett , Robert Taepke , Barbro Kjellstrom
发明人： Tommy Bennett , Robert Taepke , Barbro Kjellstrom
IPC分类号： A61B5/02
CPC分类号： A61B5/02028 , A61B5/021 , A61B5/02108 , A61B5/029 , A61B5/0456
摘要： A system and method are provided for sensing cardiac electrogram (EGM) signals and ventricular pressure signals and for using the sensed EGM and sensed pressure signals for estimating stroke volume (SV). A measure of cardiac output can be computed from the estimated SV and a heart rate determined from the EGM signals. The sensed ventricular pressure signal and the sensed EGM signal are used to derive landmark points such as an estimated pulmonary diastolic pressure, a mean pulmonary artery pressure, a peak right ventricular pressure (RVP), and various time intervals used in computing an area or a pulse contour integral. The pulse contour integral is used to estimate SV. The estimated pulmonary diastolic pressure, mean pulmonary artery pressure and CO computed from the estimated SV can be used to compute a pulmonary vascular resistance.

6. 发明申请

US20070179383A1 Methods of identifying and/or assessing cardiac arrhythmias using an implantable medical device 有权
标题翻译：使用可植入医疗装置识别和/或评估心律失常的方法
公开(公告)号：US20070179383A1
公开(公告)日：2007-08-02
申请号：US11342397
申请日：2006-01-30
申请人： Yong Cho , Tommy Bennett , Barbro Kjellstrom , Susan Vadnais
发明人： Yong Cho , Tommy Bennett , Barbro Kjellstrom , Susan Vadnais
IPC分类号： A61B5/02
CPC分类号： A61N1/056 , A61B5/0031 , A61B5/02028 , A61B5/0215 , A61B5/024 , A61B5/02405 , A61B5/042 , A61B5/046 , A61N1/3622 , A61N1/3627 , A61N1/37 , A61N1/3925 , G06F19/00 , G06F19/3418
摘要： Apparatus using one or more modes of statistical analysis with one or more monitored parameters of a patient's heart to identify and/or assess arrhythmias. Through use of the one or more modes of statistical analysis, a medical professional can be aided during evaluation of patient data for diagnosis of the patient. At least one of the monitored parameters may include one or more values used representatively for storage intervals of a selected length. As such, for each storage interval, a value may be determined for the one monitored parameter occurring at an upper percentile and a lower percentile. In addition, a median value may be determined for the one monitored parameter for each storage interval. Over a plurality of the storage intervals, these determined values can be used in one or more modes of statistical analysis to better identify and assess the arrhythmias.
摘要翻译：一种使用一种或多种统计分析模式的患者心脏的一个或多个监测参数来识别和/或评估心律失常的装置。通过使用一种或多种统计分析模式，可以在评估用于患者诊断的患者数据时辅助医学专业人员。所监视的参数中的至少一个可以包括代表性地用于所选长度的存储间隔的一个或多个值。因此，对于每个存储间隔，可以针对在上百分位数和下百分位数处发生的一个监视参数来确定值。此外，可以针对每个存储间隔的一个被监视的参数确定中值。在多个存储间隔中，这些确定的值可以用于一种或多种统计分析模式，以更好地识别和评估心律失常。

7. 发明申请

US20060094967A1 Method and apparatus to provide diagnostic index and therapy regulated by subject's autonomic nervous system 有权
标题翻译：提供受试者自主神经系统调节的诊断指标和治疗的方法和装置
公开(公告)号：US20060094967A1
公开(公告)日：2006-05-04
申请号：US10977073
申请日：2004-10-29
申请人： Tommy Bennett , Edwin Duffin , Robert Taepke , Barbro Kjellstrom
发明人： Tommy Bennett , Edwin Duffin , Robert Taepke , Barbro Kjellstrom
IPC分类号： A61B5/02
CPC分类号： A61B5/0205 , A61B5/4035 , A61B5/7239 , A61N1/36535 , A61N1/36578 , A61N1/36585 , A61N1/36592 , A61N1/3702
摘要： A system and method are provided for determining an index of autonomic nervous system (ANS) or sympathetic nervous system (SNS) activity for use in patient monitoring or therapy delivery control. An ANS or SNS index is calculated as a function of multiple monitored physiological variables that strongly correlate to changes in autonomic or sympathetic tone. These ANS-influenced variables are derived from selected hemodynamic and/or electrical signals and may include variables relating to any of: the maximum rate of pressure rise (dP/dtmax), the maximum rate of pressure decline (dP/dtmin), pulse pressure (PP), pre-ejection time interval (PEI) and/or systolic time interval (STI), heart rate (HR), heart rate variability (HRV), and baro-reflex gain. Changes in the ANS or SNS index may be used to automatically adjust a device delivered therapy.
摘要翻译：提供了一种用于确定用于患者监测或治疗递送控制的自主神经系统（ANS）或交感神经系统（SNS）活动指数的系统和方法。 ANS或SNS指数被计算为与自主神经或交感神经紧张度变化密切相关的多个被监测的生理变量的函数。这些受ANS影响的变量来自选定的血流动力学和/或电信号，并且可以包括与以下任何相关的变量：压力上升的最大速率（dP / dt最大值），最大压力下降速率（dP / dt分钟），脉压（PP），预喷射时间间隔（PEI）和/或收缩时间间隔（STI），心率（HR），心率变异性（HRV），以及压力反射增益。可以使用ANS或SNS指数的变化来自动调整设备传递的治疗。

8. 发明申请

US20060167514A1 System and method for monitoring myocardial performance using sensed ventricular pressures 有权
标题翻译：使用感测的心室压力监测心肌性能的系统和方法
公开(公告)号：US20060167514A1
公开(公告)日：2006-07-27
申请号：US11044645
申请日：2005-01-27
申请人： Barbro Kjellstrom , Kathryn Hilpisch , Edward Chinchoy
发明人： Barbro Kjellstrom , Kathryn Hilpisch , Edward Chinchoy
IPC分类号： A61B5/04 , A61N1/365
CPC分类号： A61B5/0205 , A61B5/0022 , A61B5/0245 , A61B5/0402 , A61B5/7239 , A61N1/3627 , A61N1/36564
摘要： A medical device chronically monitors cardiac function in a patient. An input circuit of the medical device receives a pressure signal representative of a pressure sensed within a ventricle of the patient's heart as a function of time. A processor derives from the pressure signal a myocardial performance index based upon pressures in the ventricle. The processor then provides an output based upon the myocardial performance index.
摘要翻译：医疗器械长期监测患者的心脏功能。医疗装置的输入电路作为时间的函数接收表示患者心脏的心室内感测到的压力的压力信号。处理器从压力信号得到基于心室压力的心肌性能指数。然后处理器基于心肌性能指数提供输出。

9. 发明申请

US20050234517A1 Apparatus and method for hemodynamic-based optimization of cardiac pacing 审中-公开
标题翻译：心脏起搏血液动力学优化的装置和方法
公开(公告)号：US20050234517A1
公开(公告)日：2005-10-20
申请号：US10629424
申请日：2003-07-29
申请人： Frieder Braunschweig , Barbro Kjellstrom
发明人： Frieder Braunschweig , Barbro Kjellstrom
IPC分类号： A61B5/0215 , A61N1/362 , A61N1/365 , A61N1/368 , A61N1/37 , A61N1/39 , A61N1/18 , A61B5/02 , A61N1/20 , A61N1/22 , A61N1/378
CPC分类号： A61N1/3627 , A61N1/368 , A61N1/3682
摘要： The present invention demonstrates that continuous hemodynamic monitoring can be used to identify the optimal AV-delay in a pacemaker-treated patient with end stage heart failure. The AV-delay determines the timing of late diastolic filling in relation to the onset of ventricular contraction and the duration of diastolic filling. An optimal tuning of the AV-delay improves left ventricular filling pressures in patients with a DDD-programmed pacemaker and is particularly important in the presence of a compromised left ventricular function. It has been discovered that using the lowest ePAD pressure, an indirect parameter of the left ventricular end-diastolic pressure, as an indicator for the optimal AV interval. Importantly, measurements of the ePAD revealed the same optimal AV-delay as echocardiographic assessment of left ventricular diastolic filling by standard echocardiographic methods. Importantly, the HR determined as optimal during the acute hemodynamic test did not turn out to be optimal during daily living activities.
摘要翻译：本发明表明，连续血液动力学监测可用于鉴定起搏器治疗的终末期心力衰竭患者的最佳AV延迟。 AV延迟决定了舒张末期充盈的时间与心室收缩发作和舒张期充盈的时间有关。 AV延迟的最佳调整改善DDD程序起搏器患者的左心室充盈压，并且在存在左心室功能受损时特别重要。已经发现，使用最低ePAD压力，左心室舒张末期压力的间接参数作为最佳AV间期的指标。重要的是，ePAD的测量显示与通过标准超声心动图方法的左心室舒张期充盈的超声心动图评估相同的最佳AV延迟。重要的是，在急性血液动力学测试期间确定为最佳的HR在日常生活活动中并不是最佳的。

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