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1. 发明授权

US08983604B2 Closed-loop systems and methods for controlling neurostimulation based on far-field cardiac signals sensed by a spinal cord stimulation device 有权
标题翻译：基于由脊髓刺激装置感测到的远场心脏信号的闭环系统和用于控制神经刺激的方法
公开(公告)号：US08983604B2
公开(公告)日：2015-03-17
申请号：US13838305
申请日：2013-03-15
申请人： Allen Keel , Stuart Rosenberg , Rupinder Bharmi , Kyungmoo Ryu , Edward Karst , Fujian Qu , Xiaoyi Min , Yelena Nabutovsky
发明人： Allen Keel , Stuart Rosenberg , Rupinder Bharmi , Kyungmoo Ryu , Edward Karst , Fujian Qu , Xiaoyi Min , Yelena Nabutovsky
IPC分类号： A61N1/365 , A61N1/36
CPC分类号： A61N1/36114 , A61N1/36139
摘要： Techniques are provided for controlling spinal cord stimulation (SCS) or other forms of neurostimulation. Far-field cardiac electrical signals are sensed using a lead of the SCS device and neurostimulation is selectively delivering using a set of adjustable SCS control parameters. Parameters representative of cardiac rhythm are derived from the far-field cardiac electrical signals. The parameters representative of cardiac rhythm are correlated with SCS control parameters to thereby map neurostimulation control settings to cardiac rhythm parameters. The delivery of further neurostimulation is then controlled based on the mapping of neurostimulation control settings to cardiac rhythm parameters to, for example, address any cardiovascular disorders detected based on the far-field cardiac signals. In this manner, a closed loop control system is provided to automatically adjust SCS control parameters to respond to changes in cardiac rhythm such as changes associated with ischemia, arrhythmia or heart failure.
摘要翻译：提供了用于控制脊髓刺激（SCS）或其他形式的神经刺激的技术。使用SCS装置的引线感测远场心电信号，并且神经刺激使用一组可调节的SCS控制参数选择性地递送。代表心律的参数来源于远场心电信号。代表心律的参数与SCS控制参数相关，从而将神经刺激控制设置映射到心律参数。然后基于神经刺激控制设置对心律参数的映射来控制进一步的神经刺激的传递，以例如解决基于远场心脏信号检测的任何心血管疾病。以这种方式，提供闭环控制系统以自动调整SCS控制参数以响应心律的变化，例如与缺血，心律失常或心力衰竭相关的变化。

2. 发明申请

US20130035738A1 METHODS AND SYSTEMS FOR DETERMINING PACING PARAMETERS BASED ON REPOLARIZATION INDEX 审中-公开
标题翻译：基于复合指数确定PAC参数的方法和系统
公开(公告)号：US20130035738A1
公开(公告)日：2013-02-07
申请号：US13197665
申请日：2011-08-03
申请人： Edward Karst , Kyungmoo Ryu , Stuart Rosenberg , Allen Keel
发明人： Edward Karst , Kyungmoo Ryu , Stuart Rosenberg , Allen Keel
IPC分类号： A61N1/368
CPC分类号： A61N1/3684 , A61N1/36507
摘要： Methods and systems are provided for determining pacing parameters for an implantable medical device (IMD). The methods and systems provide electrodes in the right atrium (RA), right ventricle (RV) and left ventricle (LV). The methods and systems sense RV cardiac signals and LV cardiac signals at an RV electrode and an LV electrode, respectively, over multiple cardiac cycles, to collect global activation information. The methods and systems identify a T-wave in the LV cardiac signal. The methods and systems calculate a repolarization index based at least in part on a timing of the T-wave identified in the LV cardiac signal. The methods and systems set at least one pacing parameter based on the repolarization index, wherein the at least one pacing parameter that is set represents at least one of an AV delay, an inter-ventricular interval and an intra-ventricular interval. Optionally, the methods and systems may deliver an RV pacing stimulus at the RV electrode such that the LV cardiac signal sensed thereafter includes the RV pacing stimulus followed by a T-wave. The methods and systems determine a waveform metric such as at least one of a QT interval, T-wave duration, and T-wave amplitude, and utilize the waveform metric to determine as the repolarization index.
摘要翻译：提供了用于确定可植入医疗装置（IMD）的起搏参数的方法和系统。方法和系统在右心房（RA），右心室（RV）和左心室（LV）中提供电极。方法和系统分别在多个心动周期上检测RV电极和LV电极上的RV心脏信号和LV心脏信号，以收集全局激活信息。方法和系统识别LV心脏信号中的T波。所述方法和系统至少部分地基于在LV心脏信号中识别的T波的定时来计算复极化指数。方法和系统基于复极度指数设置至少一个起搏参数，其中设置的至少一个起搏参数表示AV延迟，心室间间隔和心室间间隔中的至少一个。任选地，方法和系统可以在RV电极处递送RV起搏刺激，使得之后感测的LV心脏信号包括后跟T波的RV起搏刺激。方法和系统确定诸如QT间期，T波持续时间和T波幅度中的至少一个的波形度量，并且利用波形度量来确定复极化指数。

3. 发明授权

US08798765B2 Determination of cardiac resynchronization therapy settings 有权
标题翻译：心脏再同步治疗设置的测定
公开(公告)号：US08798765B2
公开(公告)日：2014-08-05
申请号：US13471167
申请日：2012-05-14
申请人： Kjell Noren , Anders Bjorling , Tomas Svensson , Sven-Erik Hedberg , Allen Keel , Stuart Rosenberg , Kyungmoo Ryu
发明人： Kjell Noren , Anders Bjorling , Tomas Svensson , Sven-Erik Hedberg , Allen Keel , Stuart Rosenberg , Kyungmoo Ryu
IPC分类号： A61N1/365 , A61N1/372 , A61N1/368
CPC分类号： A61N1/36507 , A61N1/3682 , A61N1/3684 , A61N1/37252
摘要： CRT settings for an implantable medical device are determined by applying pacing pulses to heart chambers of a scheme of different combinations of interchamber delays. A respective width parameter value representing an R or P wave width is determined for each such delay combination based on an ECG representing signal and the width parameter values are employed to estimate a parametric model defining the width parameter as a function of interchamber delays. Candidate interchamber delays that minimize the width parameter are determined from the parametric model and employed to determine optimal CRT settings. The technique provides an efficient way of finding optimal CRT settings when multiple pacing sites are available in a heart chamber.
摘要翻译：用于可植入医疗装置的CRT设置通过将不同组合的车间延迟的方案应用于心室来进行起搏脉冲来确定。基于ECG表示信号为每个这样的延迟组合确定表示R或P波宽的相应宽度参数值，并且使用宽度参数值来估计定义作为间歇延迟的函数的宽度参数的参数模型。从参数模型中确定最小化宽度参数的候选车间延迟，并用于确定最佳CRT设置。该技术提供了一种在心室中可用多个起搏部位时可以找到最佳CRT设置的有效方式。

4. 发明申请

US20110098770A1 SYSTEMS AND METHODS FOR OPTIMIZING MULTI-SITE LEFT VENTRICULAR PACING BASED ON INTERELECTRODE CONDUCTION DELAYS 有权
标题翻译：基于电介质导通延迟优化多位置左心室的系统和方法
公开(公告)号：US20110098770A1
公开(公告)日：2011-04-28
申请号：US12607817
申请日：2009-10-28
申请人： Kyungmoo Ryu , Stuart Rosenberg , Allen Keel
发明人： Kyungmoo Ryu , Stuart Rosenberg , Allen Keel
IPC分类号： A61N1/368 , A61N1/365
CPC分类号： A61N1/3627 , A61N1/368 , A61N1/3684
摘要： Techniques are provided for use with an implantable cardiac stimulation device equipped for multi-site left ventricular (MSLV) pacing using a multi-pole LV lead. In one example, MSLV interelectrode conduction delays are determined among the electrodes of the multi-pole LV lead. MSLV interelectrode pacing delays are then set based on the MSLV interelectrode conduction delays for use in delivering MSLV pacing. To this end, various criteria are exploited for determining optimal values for the pacing delays based on the interelectrode conduction delays. MSLV pacing is then controlled using the specified MSLV interelectrode pacing delays. In some examples, the optimization procedure is performed by the implantable device itself. In other examples, the procedure is performed by an external programmer device. In such an embodiment, the external device determines optimal MSLV interelectrode pacing delays and then transmits programming commands to the implantable device to program the device to use the pacing delays.
摘要翻译：提供技术用于使用多极LV引线配备用于多位点左心室（MSLV）起搏的可植入心脏刺激装置。在一个示例中，在多极LV引线的电极之间确定MSLV电极间导电延迟。然后根据MSLV电极间传导延迟来设置MSLV电极间起搏延迟，以用于传递MSLV起搏。为此，利用各种标准来确定基于电极间传导延迟的起搏延迟的最佳值。然后使用指定的MSLV电极间起搏延迟来控制MSLV起搏。在一些示例中，优化过程由可植入装置本身执行。在其他示例中，该过程由外部编程器设备执行。在这样的实施例中，外部设备确定最佳MSLV电极间起搏延迟，然后将编程命令发送到可植入设备，以对设备进行编程以使用起搏延迟。

5. 发明授权

US09572620B2 System and method for treating arrhythmias in the heart using information obtained from heart wall motion 有权
标题翻译：使用从心脏壁运动获得的信息来治疗心脏心律失常的系统和方法
公开(公告)号：US09572620B2
公开(公告)日：2017-02-21
申请号：US12980586
申请日：2010-12-29
申请人： Kyungmoo Ryu , Thao T. Ngo , Euljoon Park , Stuart Rosenberg , Allen Keel , Wenbo Hou , Steve Koh , Kjell Noren , Michael Yang
发明人： Kyungmoo Ryu , Thao T. Ngo , Euljoon Park , Stuart Rosenberg , Allen Keel , Wenbo Hou , Steve Koh , Kjell Noren , Michael Yang
IPC分类号： A61B18/12 , A61B5/11 , A61B18/08 , A61B18/14 , A61B18/20 , A61B18/00 , A61B18/02 , A61N7/02
CPC分类号： A61B18/1206 , A61B5/1107 , A61B8/488 , A61B18/082 , A61B18/1492 , A61B18/20 , A61B34/20 , A61B2018/00351 , A61B2018/00375 , A61B2018/00577 , A61B2018/00642 , A61B2018/00666 , A61B2018/00702 , A61B2018/00726 , A61B2018/00744 , A61B2018/00863 , A61B2018/0088 , A61B2018/00892 , A61B2018/0212 , A61B2034/2051 , A61B2034/2059 , A61B2218/002 , A61N7/022
摘要： A system and method for treating an arrhythmia in a heart are provided. The system includes an electronic control unit configured to monitor movement of one or more position sensor over a period of time. The position sensors may, for example, comprise electrodes or coils configured to generate induced voltages and currents in the presence of electromagnetic fields. The positions sensors are in contact with portions of heart tissue and changes in position are representative of motion of that tissue. The electronic control unit is further configured to generate an indicator, responsive to the movements of the sensors over the period of time, of a characteristic of the heart affected by delivery of ablation energy to heart tissue. In this manner, the effectiveness and safety of cardiac tissue ablation for treatment of the arrhythmia can be assessed and a post-ablation therapy regimen determined.
摘要翻译：提供了用于治疗心脏心律失常的系统和方法。该系统包括电子控制单元，其构造成在一段时间内监测一个或多个位置传感器的移动。位置传感器可以例如包括配置成在存在电磁场的情况下产生感应电压和电流的电极或线圈。位置传感器与心脏组织的部分接触并且位置变化代表该组织的运动。电子控制单元还被配置为响应于传感器在一段时间内的移动，产生受到将消融能量递送到心脏组织的心脏特征的指示器。以这种方式，可以评估心脏组织消融治疗心律失常的有效性和安全性，并确定消融后治疗方案。

6. 发明授权

US09421381B2 Systems and methods for optimizing multi-site left ventricular pacing based on interelectrode conduction delays 有权
标题翻译：基于电极间导电延迟优化多位点左心室起搏的系统和方法
公开(公告)号：US09421381B2
公开(公告)日：2016-08-23
申请号：US12607817
申请日：2009-10-28
申请人： Kyungmoo Ryu , Stuart Rosenberg , Allen Keel
发明人： Kyungmoo Ryu , Stuart Rosenberg , Allen Keel
IPC分类号： A61N1/368 , A61N1/362
CPC分类号： A61N1/3627 , A61N1/368 , A61N1/3684
摘要： Techniques are provided for use with an implantable cardiac stimulation device equipped for multi-site left ventricular (MSLV) pacing using a multi-pole LV lead. In one example, MSLV interelectrode conduction delays are determined among the electrodes of the multi-pole LV lead. MSLV interelectrode pacing delays are then set based on the MSLV interelectrode conduction delays for use in delivering MSLV pacing. To this end, various criteria are exploited for determining optimal values for the pacing delays based on the interelectrode conduction delays. MSLV pacing is then controlled using the specified MSLV interelectrode pacing delays. In some examples, the optimization procedure is performed by the implantable device itself. In other examples, the procedure is performed by an external programmer device. In such an embodiment, the external device determines optimal MSLV interelectrode pacing delays and then transmits programming commands to the implantable device to program the device to use the pacing delays.
摘要翻译：提供技术用于使用多极LV引线配备用于多位点左心室（MSLV）起搏的可植入心脏刺激装置。在一个示例中，在多极LV引线的电极之间确定MSLV电极间导电延迟。然后根据MSLV电极间传导延迟来设置MSLV电极间起搏延迟，以用于传递MSLV起搏。为此，利用各种标准来确定基于电极间传导延迟的起搏延迟的最佳值。然后使用指定的MSLV电极间起搏延迟来控制MSLV起搏。在一些示例中，优化过程由可植入装置本身执行。在其他示例中，该过程由外部编程器设备执行。在这样的实施例中，外部设备确定最佳MSLV电极间起搏延迟，然后将编程命令发送到可植入设备，以对设备进行编程以使用起搏延迟。

7. 发明授权

US08903510B2 Electrode configurations for leads or catheters to enhance localization using a localization system 有权
标题翻译：导线或导管的电极配置，以增强使用定位系统的定位
公开(公告)号：US08903510B2
公开(公告)日：2014-12-02
申请号：US12695815
申请日：2010-01-28
申请人： Stuart Rosenberg , Thao Thu Nguyen , Kyungmoo Ryu , Kjell Noren , Allen Keel , Wenbo Hou , Steve Koh , Michael Yang
发明人： Stuart Rosenberg , Thao Thu Nguyen , Kyungmoo Ryu , Kjell Noren , Allen Keel , Wenbo Hou , Steve Koh , Michael Yang
IPC分类号： A61N1/00 , A61B5/053 , A61N1/05
CPC分类号： A61B5/0538 , A61B5/0536 , A61B2562/0209 , A61N1/05 , A61N1/056
摘要： An exemplary method includes positioning a lead in a patient where the lead has a longitudinal axis that extends from a proximal end to a distal end and where the lead includes an electrode with an electrical center offset from the longitudinal axis of the lead body; measuring electrical potential in a three-dimensional potential field using the electrode; and based on the measuring and the offset of the electrical center, determining lead roll about the longitudinal axis of the lead body where lead roll may be used for correction of field heterogeneity, placement or navigation of the lead or physiological monitoring (e.g., cardiac function, respiration, etc.). Various other methods, devices, systems, etc., are also disclosed.
摘要翻译：一种示例性方法包括将引线定位在患者体内，其中引线具有从近端延伸到远端的纵向轴线，并且其中引线包括具有偏离引线主体的纵向轴线的电中心的电极; 使用所述电极测量三维势场中的电位; 并且基于电气中心的测量和偏移，确定围绕引线主体的纵轴的引导辊，其中引导辊可用于校正磁场异质性，引线的放置或导航或生理监测（例如，心脏功能，呼吸等）。还公开了各种其它方法，装置，系统等。

8. 发明授权

US08326419B2 Therapy optimization via multi-dimensional mapping 有权
标题翻译：通过多维映射进行治疗优化
公开(公告)号：US08326419B2
公开(公告)日：2012-12-04
申请号：US12755366
申请日：2010-04-06
申请人： Stuart Rosenberg , Kyungmoo Ryu , Allen Keel , Wenbo Hou , Thao Thu Nguyen , Steve Koh , Kjell Noren , Michael Yang
发明人： Stuart Rosenberg , Kyungmoo Ryu , Allen Keel , Wenbo Hou , Thao Thu Nguyen , Steve Koh , Kjell Noren , Michael Yang
IPC分类号： A61N1/00 , A61B5/04
CPC分类号： A61B5/042 , A61B5/7203 , A61N1/3627 , A61N1/36521 , A61N1/36535 , A61N1/36542 , A61N1/36578 , A61N1/3684 , A61N1/37258 , A61N1/37264
摘要： An exemplary method includes accessing cardiac information acquired via a catheter located at various positions in a venous network of a heart of a patient where the cardiac information comprises position information, electrical information and mechanical information; mapping local electrical activation times to anatomic positions to generate an electrical activation time map; mapping local mechanical activation times to anatomic positions to generate a mechanical activation time map; generating an electromechanical delay map by subtracting local electrical activation times from corresponding local mechanical activation times; and rendering at least the electromechanical delay map to a display. Various other methods, devices, systems, etc., are also disclosed.
摘要翻译：一种示例性方法包括访问位于患者心脏的静脉网络中的各个位置处的导管获取的心脏信息，其中所述心脏信息包括位置信息，电信息和机械信息; 将局部电激活时间映射到解剖位置以产生电激活时间图; 将局部机械激活时间映射到解剖位置以产生机械激活时间图; 通过从相应的局部机械激活时间减去局部电激活时间来产生机电延迟图; 并将至少机电延迟图呈现给显示器。还公开了各种其它方法，装置，系统等。

9. 发明授权

US08209010B2 Systems and methods for optimizing multi-site cardiac pacing and sensing configurations for use with an implantable medical device 有权
标题翻译：用于优化与可植入医疗装置一起使用的多部位心脏起搏和感测配置的系统和方法
公开(公告)号：US08209010B2
公开(公告)日：2012-06-26
申请号：US12703069
申请日：2010-02-09
申请人： Kyungmoo Ryu , Stuart Rosenberg , Allen Keel , Taraneh Ghaffari Farazi , Xiaoyi Min
发明人： Kyungmoo Ryu , Stuart Rosenberg , Allen Keel , Taraneh Ghaffari Farazi , Xiaoyi Min
IPC分类号： A61N1/00
CPC分类号： A61N1/36514 , A61N1/3627 , A61N1/368 , A61N1/3708
摘要： Techniques are provided for use with an implantable cardiac stimulation device equipped for multi-site left ventricular (MSLV) pacing using a multi-pole LV lead. In one example, referred to herein as QuickStim, cardiac pacing configurations are optimized based on an assessment of hemodynamic benefit and device longevity. In another example, referred to herein as QuickSense, cardiac sensing configurations are optimized based on sensing profiles input by a clinician. Various virtual sensing channels are also described that provide for the multiplexing or gating of sensed signals. Anisotropic oversampling is also described.
摘要翻译：提供技术用于使用多极LV引线配备用于多位点左心室（MSLV）起搏的可植入心脏刺激装置。在一个例子中，本文称为QuickStim，基于对血液动力学益处和器械寿命的评估来优化心脏起搏配置。在另一个例子中，本文称为QuickSense，基于由临床医生输入的感测曲线来优化心脏感测配置。还描述了各种虚拟感测通道，其提供感测信号的复用或门控。还描述了各向异性过采样。

10. 发明授权

US08175693B2 Cardiac resynchronization therapy optimization using electromechanical delay from realtime electrode motion tracking 有权
标题翻译：使用实时电极运动跟踪的机电延迟的心脏再同步治疗优化
公开(公告)号：US08175693B2
公开(公告)日：2012-05-08
申请号：US13206395
申请日：2011-08-09
申请人： Stuart Rosenberg , Allen Keel , Kyungmoo Ryu , Wenbo Hou , Kjell Noren , Thao Ngo , Michael Yang
发明人： Stuart Rosenberg , Allen Keel , Kyungmoo Ryu , Wenbo Hou , Kjell Noren , Thao Ngo , Michael Yang
IPC分类号： A61B5/04
CPC分类号： A61N1/3627 , A61B5/0422 , A61B5/0452 , A61B5/1107 , A61B5/6876 , A61B2562/043 , A61N1/36514 , A61N1/36578 , A61N1/3684 , A61N1/37252
摘要： An exemplary method includes providing a mechanical activation time (MA time) for a myocardial location, the location defined at least in part by an electrode and the mechanical activation time determined at least in part by movement of the electrode; providing an electrical activation time (EA time) for the myocardial location; and determining an electromechanical delay (EMD) for the myocardial location based on the difference between the mechanical activation time (MA time) and the electrical activation time (EA time).
摘要翻译：示例性方法包括提供用于心肌位置的机械活化时间（MA时间），至少部分地由电极限定的位置和至少部分地通过电极的移动确定的机械活化时间; 为心肌位置提供电激活时间（EA时间）; 并且基于机械激活时间（MA时间）和电激活时间（EA时间）之间的差异来确定心肌位置的机电延迟（EMD）。

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