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1. 发明申请

US20120184867A1 SYSTEMS AND METHODS FOR INCREASED SPECIFICITY IN DIAGNOSTICS 有权
标题翻译：诊断中提高特异性的系统和方法
公开(公告)号：US20120184867A1
公开(公告)日：2012-07-19
申请号：US13432923
申请日：2012-03-28
申请人： Taraneh Ghaffari Farazi , Rupinder Bharmi , Brian Jeffrey Wenzel
发明人： Taraneh Ghaffari Farazi , Rupinder Bharmi , Brian Jeffrey Wenzel
IPC分类号： A61B5/0452 , A61B5/0432
CPC分类号： A61B5/0452 , A61B5/4842 , A61B5/686 , A61N1/365
摘要： Specific embodiments provided herein relate to diagnosing, with improved specificity, occurrences of episodes relating to disorders that are known to affect T-wave morphology. One or more propensity metric is obtained, each of which is indicative of a patient's propensity for a specific disorder that is known to affect T-wave morphology. T-wave variability is monitored. Additionally, there is monitoring for a specific change in T-wave morphology that is known to be indicative of episodes relating to a disorder. When the specific change in T-wave morphology is detected, a diagnosis is determined for detecting the specific change in T-wave morphology, taking into account the propensity metric(s) and the T-wave variability.
摘要翻译：本文提供的具体实施方案涉及具有改善的特异性诊断与已知影响T波形态的病症相关的发作的发生。获得一个或多个倾向度量，每个倾向度量指示患者对已知影响T波形态的特定病症的倾向。监测T波变化。另外，监测T波形态的具体变化已知是指示与病症相关的发作。当检测到T波形态的具体变化时，考虑到倾向度量和T波变异性，确定检测T波形态的具体变化的诊断。

2. 发明申请

US20100298670A1 ELECTROLYTE MONITORING USING IMPLANTED CARDIAC RHYTHM MANAGEMENT DEVICE 审中-公开
标题翻译：使用植入式牙科管理装置进行电解质监测
公开(公告)号：US20100298670A1
公开(公告)日：2010-11-25
申请号：US12469564
申请日：2009-05-20
申请人： Rupinder Bharmi , Gene A. Bornzin
发明人： Rupinder Bharmi , Gene A. Bornzin
IPC分类号： A61B5/145
CPC分类号： A61B5/0452 , A61B5/0031 , A61B5/042 , A61B5/14546 , A61N1/36557 , A61N1/368 , A61N1/37211
摘要： A method for diagnosing an electrolyte level with a cardiac rhythm management device includes recording intra-cardiac electrograms from multiple sites. The method determines the electrolyte level based upon a comparative analysis of intra-cardiac electrograms recorded from at least two of the sites. The electrolyte level can be quantified based upon a general model, or a patient specific model.
摘要翻译：用心律管理装置诊断电解质水平的方法包括记录多个部位的心脏内电图。该方法基于从至少两个位点记录的心脏内电图的比较分析来确定电解质水平。可以基于一般模型或患者特异性模型量化电解质水平。

3. 发明申请

US20100057158A1 Neurostimulation Based On Glycemic Condition 审中-公开
标题翻译：基于血糖条件的神经刺激
公开(公告)号：US20100057158A1
公开(公告)日：2010-03-04
申请号：US12198791
申请日：2008-08-26
申请人： Rodolfo Rodriguez , Brian Jeffrey Wenzel , Fujian Qu , Rupinder Bharmi , Karin Jarverud , Taraneh Ghaffari Farazi
发明人： Rodolfo Rodriguez , Brian Jeffrey Wenzel , Fujian Qu , Rupinder Bharmi , Karin Jarverud , Taraneh Ghaffari Farazi
IPC分类号： A61N1/365 , A61N1/36
CPC分类号： A61N1/36114 , A61N1/365
摘要： A glycemic condition is indicated based on variance of a feature derived from cardiac electrogram data. Neurostimulation is then used to counteract a cardiac-related autonomic response to the glycemic condition. For example, stimulation of parasympathetic innervation may be used to counteract an autonomic sympathetic response that is associated with hypoglycemia or hyperglycemia. In addition, stimulation of sympathetic innervation may be used to counteract an autonomic parasympathetic response that is associated with hypoglycemia or hyperglycemia.
摘要翻译：根据心脏电图数据得出的特征的方差来指示血糖状况。然后使用神经刺激来抵消对血糖状况的心脏相关的自主反应。例如，可以使用副交感神经支配的刺激来抵消与低血糖或高血糖相关的自主交感神经反应。此外，交感神经支配的刺激可用于抵消与低血糖或高血糖相关的自主神经副交感神经反应。

4. 发明授权

US07435221B1 System and method for detecting abnormal respiration based on intracardiac electrogram signals using a pattern recognition device 有权
标题翻译：使用模式识别装置，基于心内电描记信号检测异常呼吸的系统和方法
公开(公告)号：US07435221B1
公开(公告)日：2008-10-14
申请号：US11558819
申请日：2006-11-10
申请人： Rupinder Bharmi , Philip de Chazal , Gene A. Bornzin , Michael E. Benser
发明人： Rupinder Bharmi , Philip de Chazal , Gene A. Bornzin , Michael E. Benser
IPC分类号： A61B5/08 , A61B5/02 , A61B5/04
CPC分类号： A61B5/0452 , A61B5/0031 , A61B5/02405 , A61B5/0472 , A61B5/08 , A61B5/0803 , A61B5/0816 , A61B5/11 , A61B5/145 , A61B5/411 , A61B5/4818 , A61B5/7267 , A61N1/3601 , A61N1/365 , A61N1/37
摘要： Techniques are provided for detecting abnormal respiration within a patient based upon intracardiac electrogram (IEGM) signals or other electrical cardiac signals. Briefly, abnormal respiration is detected using a pattern recognition trained to discriminate normal and abnormal respiration based on morphological parameters and interval-based parameters extracted from the IEGM signals. In addition, techniques are described for distinguishing among different cardiac rhythm types within the patient while using one or more pattern classifiers or other pattern recognition devices.
摘要翻译：提供了用于基于心内电描记图（IEGM）信号或其他电心脏信号来检测患者内异常呼吸的技术。简而言之，使用根据从IEGM信号提取的形态参数和基于间隔的参数来鉴别正常和异常呼吸的训练的模式识别来检测异常呼吸。此外，描述了用于在使用一个或多个模式分类器或其他模式识别装置的同时区分患者内的不同心律类型之类的技术。

5. 发明申请

US20060247685A1 System and method for detecting hypoglycemia based on a paced depolarization integral using an implantable medical device 有权
公开(公告)号：US20060247685A1
公开(公告)日：2006-11-02
申请号：US11117624
申请日：2005-04-27
申请人： Rupinder Bharmi
发明人： Rupinder Bharmi
IPC分类号： A61N1/36
CPC分类号： A61N1/3925 , A61B5/0031 , A61B5/0452 , A61B5/076 , A61B5/14532 , A61B5/7275 , A61M5/14276 , A61M2205/3523 , A61N1/36557 , A61N1/371
摘要： Techniques are provided for use with an implantable medical device such as a pacemaker or implantable cardioverter/defibrillator (ICD) for predicting and detecting hypoglycemia. In one example, the device tracks changes in a paced depolarization integral (PDI). A significant increase in PDI over a relatively short period of time indicates the onset of hypoglycemia (this can also be confirmed with QT changes). Upon detection of hypoglycemia, appropriate warning signals are generated to alert the patient. Certain therapies automatically provided by the implantable device may also be controlled in response to hypoglycemia. For example, if the patient is an insulin-dependent diabetic and the implantable device is equipped with an insulin pump capable of delivering insulin directly into the bloodstream, insulin delivery is automatically suspended until blood glucose levels return to acceptable levels. If the device is an ICD, it may be controlled to begin charging defibrillation capacitors upon detection of hypoglycemia so as to permit prompt delivery of a defibrillation shock, which may be needed if hypoglycemia triggers ventricular fibrillation. The detection techniques may be used in conjunction with other hypoglycemia detection techniques to improve detection specificity.

6. 发明授权

US08706239B2 Systems and methods for controlling neurostimulation based on regional cardiac performance for use by implantable medical devices 有权
标题翻译：基于区域心脏性能的控制神经刺激的系统和方法，用于可植入医疗器械
公开(公告)号：US08706239B2
公开(公告)日：2014-04-22
申请号：US13485404
申请日：2012-05-31
申请人： Rupinder Bharmi , Taraneh Ghaffari Farazi , Ryan Rooke , Stuart Rosenberg , Kritika Gupta , Riddhi Shah , Gene A. Bornzin , Wenbo Hou , Laurence S. Sloman
发明人： Rupinder Bharmi , Taraneh Ghaffari Farazi , Ryan Rooke , Stuart Rosenberg , Kritika Gupta , Riddhi Shah , Gene A. Bornzin , Wenbo Hou , Laurence S. Sloman
IPC分类号： A61N1/00
CPC分类号： A61N1/36071 , A61B5/029 , A61B5/042 , A61B5/0538 , A61B5/1116 , A61B5/4836 , A61B5/686 , A61B5/7239 , A61N1/36139 , A61N1/36146 , A61N1/36185
摘要： Techniques are provided for controlling neurostimulation such as spinal cord stimulation (SCS) using a cardiac rhythm management device (CRMD). In various examples described herein, neurostimulation is delivered to a patient while regional cardiac performance of the heart of the patient is assessed by the CRMD. The delivery of further neurostimulation is adjusted or controlled based, at least in part, on the regional cardiac performance, preferably to enhance positive effects on the heart due to the neurostimulation or to mitigate any negative effects. Regional cardiac performance is assessed based on parameters derived from cardiogenic impedance signals detected along various vectors through the heart.
摘要翻译：提供了使用心律管理装置（CRMD）来控制神经刺激如脊髓刺激（SCS）的技术。在本文描述的各种示例中，神经刺激被递送给患者，同时通过CRMD来评估患者心脏的区域心脏性能。至少部分地基于区域心脏性能来调整或控制进一步神经刺激的递送，优选地由于神经刺激而增强对心脏的积极作用或减轻任何负面影响。基于通过心脏沿着各种载体检测到的心源性阻抗信号的参数来评估区域心脏性能。

7. 发明授权

US08600490B1 Two-dimensional refractory period 有权
$Two-dimensional refractory period$
标题翻译：二维不应期
公开(公告)号：US08600490B1
公开(公告)日：2013-12-03
申请号：US11943825
申请日：2007-11-21
申请人： Rupinder Bharmi , Jeffery D. Snell
发明人： Rupinder Bharmi , Jeffery D. Snell
IPC分类号： A61B5/04
CPC分类号： A61B5/0452 , A61B5/0456 , A61B5/046 , A61B5/0464 , A61B5/0472 , A61N1/0563 , A61N1/365 , A61N1/368
摘要： A two-dimensional refractory period is defined in conjunction with the detection of cardiac events. Detection parameters associated with the two-dimensional refractory period may define a period of time during which a sensed cardiac signal is blanked or may define a period of time during which a given sensing threshold applies. The two-dimensional refractory period may be employed in atrial sensing to selectively blank far-field T-waves while enabling P-wave detection. The two-dimensional refractory period may be employed in ventricular sensing to selectively blank near-field T-waves while enabling detection of the QRS complex. The detection parameters associated with the two-dimensional refractory period may be adapted based on characteristics of previously detected cardiac signals.
摘要翻译：结合心脏事件的检测来定义二维不应期。与二维不应期相关联的检测参数可以定义感测心脏信号被消隐的时间段，或者可以限定适用给定感测阈值的时间段。二维不应期可用于心房感应，以选择性地空白远场T波，同时实现P波检测。二维不应期可用于心室感应以选择性地空白近场T波，同时能够检测QRS波群。可以基于先前检测的心脏信号的特征来适应与二维不应期相关的检测参数。

8. 发明授权

US08090435B2 System and method for distinguishing among cardiac ischemia, hypoglycemia and hyperglycemia using an implantable medical device 有权
公开(公告)号：US08090435B2
公开(公告)日：2012-01-03
申请号：US12360826
申请日：2009-01-27
申请人： Jong Gill , Peter Boileau , Rupinder Bharmi , Xiaoyi Min , Joseph J. Florio , Michael E. Benser , Gene A. Bornzin
发明人： Jong Gill , Peter Boileau , Rupinder Bharmi , Xiaoyi Min , Joseph J. Florio , Michael E. Benser , Gene A. Bornzin
IPC分类号： A61B5/0402
CPC分类号： A61N1/3962 , A61B5/0452 , A61B5/0468 , A61B5/14532 , A61N1/3621 , A61N1/3627 , A61N1/36557 , A61N1/3925
摘要： Techniques are described for detecting ischemia, hypoglycemia or hyperglycemia based on intracardiac electrogram (IEGM) signals. Ischemia is detected based on a shortening of the interval between the QRS complex and the end of a T-wave (QTmax), alone or in combination with a change in ST segment elevation. Alternatively, ischemia is detected based on a change in ST segment elevation combined with minimal change in the interval between the QRS complex and the end of the T-wave (QTend). Hypoglycemia is detected based on a change in ST segment elevation along with a lengthening of either QTmax or QTend. Hyperglycemia is detected based on a change in ST segment elevation along with minimal change in QTmax and in QTend. By exploiting QTmax and QTend in combination with ST segment elevation, changes in ST segment elevation caused by hypo/hyperglycemia can be properly distinguished from changes caused by ischemia.

9. 发明授权

US08019410B1 System and method for detecting hypoglycemia using an implantable medical device based on pre-symptomatic physiological responses 有权
标题翻译：基于预处理的生理反应，使用可植入医疗装置检测低血糖的系统和方法
公开(公告)号：US08019410B1
公开(公告)日：2011-09-13
申请号：US11843480
申请日：2007-08-22
申请人： Rupinder Bharmi , Gene A. Bornzin , Brian Jeffrey Wenzel
发明人： Rupinder Bharmi , Gene A. Bornzin , Brian Jeffrey Wenzel
IPC分类号： A61B5/0205 , A61B5/0452
CPC分类号： A61B5/0205 , A61B5/0472 , A61B5/721
摘要： An intracardiac electrogram (IEGM) or other suitable electrical cardiac signal is sensed. Values representative of a pre-symptomatic physiologic response to a hypoglycemic event are derived from the cardiac signal. Then, hypoglycemia is detected based on the values representative of the pre-symptomatic physiologic response. In one example, both temporal morphological parameters and spectral parameters affected by pre-symptomatic hypoglycemia are derived from the cardiac signal. Hypoglycemia is then detected based on a combination of the temporal and spectral parameters using, e.g., a linear discriminator. By detecting hypoglycemia based on parameters affected by pre-symptomatic hypoglycemia, suitable warnings can be generated and therapies initiated before the condition becomes symptomatic.
摘要翻译：感测到心内电描记图（IEGM）或其他合适的心电信号。代表低血糖事件的症状性生理反应的值代表心脏信号。然后，根据代表症状前生理反应的值检测低血糖。在一个实例中，由症状性低血糖影响的时间形态学参数和光谱参数均来自心脏信号。然后使用例如线性鉴别器基于时间和频谱参数的组合检测低血糖。通过根据受症状性低血糖影响的参数检测低血糖，可以产生合适的警告，并在症状发作前进行治疗。

10. 发明申请

US20100114228A1 SYSTEM AND METHOD FOR ACCURATELY DETECTING CARDIAC EVENTS USING RETROSPECTIVE CORRELATION 有权
标题翻译：使用回归相关性来精确检测心脏事件的系统和方法
公开(公告)号：US20100114228A1
公开(公告)日：2010-05-06
申请号：US12264147
申请日：2008-11-03
申请人： Rupinder Bharmi , Jeffery D. Snell
发明人： Rupinder Bharmi , Jeffery D. Snell
IPC分类号： A61N1/00
CPC分类号： A61N1/37 , A61B5/0002 , A61B5/04525 , A61N1/3622 , A61N1/3962
摘要： A system and method enables precise detection of the time of occurrence of a cardiac event of a heart. The method includes the steps of sensing electrical activity of the heart to generate an electrogram signal including the cardiac event, storing the electrogram signal, correlating the electrogram signal with an electrogram template, and identifying the time of occurrence of the cardiac event based upon the correlation.
摘要翻译：系统和方法可以精确检测心脏心脏事件发生的时间。该方法包括以下步骤：感测心脏的电活动以产生包括心脏事件的电描记图信号，存储电描记图信号，将电描记图信号与电描记图模板相关联，以及基于相关性来识别心脏事件的发生时间。

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