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1. 发明授权

US07613513B1 System and method for determining cardiac geometry 有权
标题翻译：用于确定心脏几何的系统和方法
公开(公告)号：US07613513B1
公开(公告)日：2009-11-03
申请号：US10612770
申请日：2003-07-01
申请人： James E. Brewer , Mark W. Kroll
发明人： James E. Brewer , Mark W. Kroll
IPC分类号： A61N1/362
CPC分类号： A61N1/3627 , A61B5/0452 , A61B5/0535 , A61B5/0816 , A61B5/1076 , A61B5/11 , A61B5/145 , A61N1/36507 , A61N1/36521
摘要： An exemplary method includes delivering an electrical signal to a first position in or adjacent to a cardiac chamber; sensing a potential generated by the delivered electrical signal at a second position; and determining a parameter based, at least in part, on the sensing wherein the parameter relates to cardiac geometry. Other exemplary methods, devices and/or systems are also disclosed.
摘要翻译：一种示例性方法包括将电信号传送到心室或其周围的第一位置; 感测在第二位置处由所传送的电信号产生的电位; 以及至少部分地基于所述感测确定参数，其中所述参数涉及心脏几何。还公开了其它示例性方法，装置和/或系统。

2. 发明授权

US07333854B1 Orthostatic cardiac output response pacer for heart failure patients and diabetic patients 有权
标题翻译：心力衰竭患者和糖尿病患者的正常心输出量反应发作
公开(公告)号：US07333854B1
公开(公告)日：2008-02-19
申请号：US11048251
申请日：2005-01-31
申请人： James E. Brewer , Mark W. Kroll
发明人： James E. Brewer , Mark W. Kroll
IPC分类号： A61N1/00
CPC分类号： A61N1/3627 , A61N1/36542
摘要： An exemplary method includes detecting a change in position, measuring cardiac output after the detecting a change in position and, based at least in part on the measuring cardiac output, deciding whether to increase a cardiac pacing rate. An exemplary method may rely on activity in lieu of or in addition to position to decide whether to increase a cardiac pacing rate. Various exemplary methods aim to compensate for orthostatic effects such as those associated with dysautonomia. Various other exemplary methods are disclosed along with various exemplary devices, systems, etc.
摘要翻译：示例性方法包括检测位置变化，在检测到位置变化之后测量心输出量，并且至少部分地基于测量心输出量来决定是否增加心脏起搏速率。示例性方法可以依赖于代替或除了位置之外的活动以决定是否增加心脏起搏速率。各种示例性方法旨在补偿诸如与自主神经病相关的直立效应。公开了各种其它示例性方法以及各种示例性装置，系统等

3. 发明授权

US07155277B1 Pathway management for CHF patients 有权
标题翻译： CHF患者的途径管理
公开(公告)号：US07155277B1
公开(公告)日：2006-12-26
申请号：US10370125
申请日：2003-02-18
申请人： James E. Brewer , Mark W. Kroll , Scott H. Simcoe
发明人： James E. Brewer , Mark W. Kroll , Scott H. Simcoe
IPC分类号： A61N1/00
CPC分类号： A61B5/0031 , A61N1/3625 , A61N1/3627 , G06F19/00 , G06F19/3418 , G06F19/3456 , G06F19/3481 , G16H10/60
摘要： An exemplary system and/or method allows for automated and/or semi-automated treatment of CHF, for example, via a pathway. Various exemplary systems and/or methods include a server and/or a client for creating, implementing and/or maintaining a CHF pathway. An exemplary client has a communication link with an implantable cardiac device for communicating one or more operational parameters to the implantable cardiac device and/or receiving information from the implantable cardiac device. Other exemplary systems and/or methods are also disclosed.
摘要翻译：示例性的系统和/或方法允许例如通过途径自动化和/或半自动化治疗CHF。各种示例性系统和/或方法包括用于创建，实施和/或维护CHF路径的服务器和/或客户端。示例性客户端具有与可植入心脏设备的通信链路，用于将一个或多个操作参数传送到可植入心脏设备和/或从可植入心脏设备接收信息。还公开了其它示例性系统和/或方法。

4. 发明授权

US07076300B1 Implantable cardiac stimulation device and method that discriminates between and treats atrial tachycardia and atrial fibrillation 失效
标题翻译：植入式心脏刺激装置和方法，其区分和治疗房性心动过速和心房颤动
公开(公告)号：US07076300B1
公开(公告)日：2006-07-11
申请号：US10746303
申请日：2003-12-24
申请人： Mark W. Kroll , James E. Brewer , Lisa M. Clem
发明人： Mark W. Kroll , James E. Brewer , Lisa M. Clem
IPC分类号： A61N1/18
CPC分类号： A61N1/3962 , A61N1/3622 , A61N1/3925 , A61N1/395
摘要： An implantable cardiac stimulation device discriminates and treats accelerated atrial arrhythmias of a patient's heart. The device includes a sensing circuit that senses cardiac activity of one of the patient's atria to provide an atrial activity signal, a detector that detects an accelerated atrial arrhythmia of the patient's heart, and a classifying circuit that measures relative correspondence between successive P waves of the atrial activity signal to classify the detected accelerated atrial arrhythmia as either atrial tachycardia or atrial fibrillation. A therapy circuit provides anti-tachycardia pacing therapy responsive to a classified atrial tachycardia and defibrillation therapy responsive to a classified atrial fibrillation.
摘要翻译：可植入心脏刺激装置辨别和治疗患者心脏加速的房性心律失常。该装置包括感测电路，其感测患者心房中的一个心脏的心脏活动以提供心房活动信号，检测器，其检测患者心脏的加速心房心律失常;以及分类电路，其测量相邻P波的相对对应关系心房活动信号将检测到的加速心房心律失常分为房性心动过速或心房颤动。治疗电路提供响应于分类的房性心动过速的反心动过速起搏治疗和对分类的心房颤动的除颤治疗。

5. 发明授权

US07020521B1 Methods and apparatus for detecting and/or monitoring heart failure 失效
标题翻译：用于检测和/或监测心力衰竭的方法和装置
公开(公告)号：US07020521B1
公开(公告)日：2006-03-28
申请号：US10291267
申请日：2002-11-08
申请人： James E. Brewer , Mark W. Kroll
发明人： James E. Brewer , Mark W. Kroll
IPC分类号： A61N1/365
CPC分类号： A61N1/3627 , A61N1/0551 , A61N1/36514
摘要： Methods and apparatuses are provided for assisting with the diagnosis, monitoring, and/or treatment of patients that are suffering from asymptomatic heart failure or may be susceptible to asymptomatic heart failure. The methods and apparatuses can be implemented with implantable devices. In certain implementations, a method is provided which includes sensing muscle sympathetic nerve activity using at least one nerve sensing electrode that is in electrical contact with a patient's efferent muscle-nerve structure, acquiring a muscle sympathetic nerve activity signal from the sensed nerve activity using a nerve activity sensing circuit operatively coupled to the nerve sensing electrode, and analyzing the nerve activity signal for changes in nerve burst activity indicative of the presence and/or severity of asymptomatic heart failure.
摘要翻译：提供了方法和装置，用于帮助诊断，监测和/或治疗患有无症状心力衰竭的患者或可能对无症状的心力衰竭易感。该方法和装置可以用可植入装置实现。在某些实施方式中，提供了一种方法，其包括使用与患者的传出肌肉 - 神经结构电接触的至少一个神经感测电极感测肌肉交感神经活动，使用感测到的神经活动从感测到的神经活动获得肌肉交感神经活动信号神经活动感测电路可操作地耦合到神经感测电极，并且分析神经活动信号以指示无症状心力衰竭的存在和/或严重性的神经突发活动的变化。

6. 发明授权

US06904314B1 Automatic defibrillation threshold tracking 失效
标题翻译：自动除颤阈值跟踪
公开(公告)号：US06904314B1
公开(公告)日：2005-06-07
申请号：US10119590
申请日：2002-04-09
申请人： James E. Brewer , Mark W. Kroll
发明人： James E. Brewer , Mark W. Kroll
IPC分类号： A61N1/39
CPC分类号： A61N1/3943
摘要： An implantable cardiac stimulating device employs an automatic defibrillation threshold tracking process that uses a measured pacing stimulation threshold to estimate the patient's defibrillation threshold on a dynamic, ongoing basis, using changes in the defibrillation threshold to re-calculate new defibrillation parameters (e.g., energy settings) on a periodic basis as a patient's heart changes over time. The defibrillation threshold estimation formula may involve a variety of variables, such as, for example, the patient's age and/or gender, and may include a selected safety margin. New defibrillation parameters are loaded into the appropriate locations of the device's memory, replacing the prior parameters, and are thereafter available for use by the device for defibrillation therapy. The defibrillation threshold tracking technique may be used in an external device, such as a programmer or external cardiac stimulation device.
摘要翻译：可植入心脏刺激装置采用自动除颤阈值跟踪过程，该过程使用测量的起搏刺激阈值在动态持续的基础上使用除颤阈值的变化来估计患者的除颤阈值，以重新计算新的除颤参数（例如能量设定）作为患者的心脏随着时间的推移而定期进行。除颤阈值估计公式可以涉及各种变量，例如患者的年龄和/或性别，并且可以包括所选择的安全裕度。新的除颤参数被加载到设备的存储器的适当位置，替换了先前的参数，然后可用于设备用于除颤疗法。除颤阈值跟踪技术可以用在诸如编程器或外部心脏刺激装置的外部装置中。

7. 发明授权

US07003348B1 Monitoring cardiac geometry for diagnostics and therapy 有权
标题翻译：监测诊断和治疗的心脏几何
公开(公告)号：US07003348B1
公开(公告)日：2006-02-21
申请号：US10612611
申请日：2003-07-01
申请人： James E. Brewer , Mark W. Kroll
发明人： James E. Brewer , Mark W. Kroll
IPC分类号： A61N1/18
CPC分类号： A61N1/3627 , A61N1/36542
摘要： An exemplary method includes determining, in vivo, position, displacement and/or spatial time derivatives of myocardial tissue. Such determinations are optionally made with respect to systolic and/or diastolic cycles. Further, position, displacement and/or spatial time derivatives may be used in cardiac diagnosis or therapy. Other exemplary methods, devices and/or systems are also disclosed.
摘要翻译：示例性方法包括确定心肌组织的体内，位置，位移和/或空间时间衍生物。任选地对收缩期和/或舒张期进行这种测定。此外，位置，位移和/或空间时间导数可用于心脏诊断或治疗。还公开了其它示例性方法，装置和/或系统。

8. 发明授权

US5913877A Implantable defibrillator system for generating a biphasic waveform with enhanced phase transition 失效
标题翻译：可植入除颤器系统，用于产生增强相变的双相波形
公开(公告)号：US5913877A
公开(公告)日：1999-06-22
申请号：US920653
申请日：1997-08-15
申请人： Mark W. Kroll , James E. Brewer , Brad D. Pedersen
发明人： Mark W. Kroll , James E. Brewer , Brad D. Pedersen
IPC分类号： A61N1/39
CPC分类号： A61N1/3956 , A61N1/3906 , A61N1/3912
摘要： A method and apparatus for generating biphasic waveforms uses an implantable cardioverter defibrillator (ICD) system having a phase transition enhancing capacitor system in addition to the capacitor system(s) which deliver the first and second phase of the biphasic countershock. Preferably, the ICD system has at least three capacitor systems and a capacitor switching network. The three capacitor systems include two primary capacitor systems and a third high voltage phase transition enhancing capacitor system having a time constant shorter than the time constant of the two primary capacitor systems. A first phase of the biphasic waveform preferably is produced by configuring the two primary capacitor systems to selectively discharge first in a parallel combination, and then in a series combination. The second phase of the biphasic waveform preferably is produced by reconfiguring the two primary capacitor systems to discharge in a parallel combination with reversed polarity. The phase transition enhancing capacitor system is selectively switched into the discharge of the biphasic waveform so as to effectively increase the voltage differential seen by the heart during the transition between the first and second phases of the biphasic waveform.
摘要翻译：用于产生双相波形的方法和装置除了提供双相反相的第一和第二相的电容器系统之外还使用具有相变增强电容器系统的可植入式心律转复除颤器（ICD）系统。优选地，ICD系统具有至少三个电容器系统和电容器切换网络。三个电容器系统包括两个初级电容器系统和具有比两个初级电容器系统的时间常数更短的时间常数的第三高电压相变增强电容器系统。双相波形的第一相优选地通过将两个主电容器系统配置为以并联组合首先选择性地放电，然后以串联组合来产生。双相波形的第二相优选地通过重新配置两个初级电容器系统以以相反极性的并联组合放电来产生。相变增强电容器系统选择性地切换到双相波形的放电，以便在双相波形的第一和第二相之间的转变期间有效地增加心脏看到的电压差。

9. 发明授权

US4947859A Bio-acoustic signal sensing device 失效
标题翻译：生物声学信号检测装置
公开(公告)号：US4947859A
公开(公告)日：1990-08-14
申请号：US301796
申请日：1989-01-25
申请人： James E. Brewer , Mark W. Kroll
发明人： James E. Brewer , Mark W. Kroll
IPC分类号： A61B7/04
CPC分类号： A61B7/04
摘要： This invention provides a sound sensor apparatus for reception of bio-acoustic signals from the body of a patient and for use with a medical diagnostic device. The apparatus comprises a unitary containment structure of a pliable, adhering material for conforming placement on the patient body surface. A sound sensing transducer is embedded in the containment structure to receive and convert bio-acoustic signals to electrical signals. A cable is communicatively linked to the sound sensing transducer for transmitting the electrical signals to the medical diagnostic device. The composition of the pliable containment structure material is a polymeric mixture substantially acoustically matched to the patient body. The sound sensing transducer is preferably a piezoelectric crystal transducer constructed of a composite material which comprises at least 65 percent by weight lead, at least 20 percent by weight zirconium, and at least 10 percent by weight titanium.
摘要翻译：本发明提供了一种用于从患者身体接收生物声学信号并与医疗诊断装置一起使用的声音传感器装置。该装置包括一个柔韧的粘合材料的整体容纳结构，用于将其放置在病人身体表面上。声传感器被嵌入在容纳结构中以接收和转换生物声学信号到电信号。电缆通信地链接到声音传感器，用于将电信号传送到医疗诊断装置。柔韧的容纳结构材料的组成是与患者体基本上声学匹配的聚合物混合物。声音传感器优选是由复合材料构成的压电晶体换能器，其包含至少65重量％的铅，至少20重量％的锆和至少10重量％的钛。

10. 发明授权

US08483822B1 Adaptive medium voltage therapy for cardiac arrhythmias 有权
标题翻译：心律失常的适应性中压治疗
公开(公告)号：US08483822B1
公开(公告)日：2013-07-09
申请号：US12830251
申请日：2010-07-02
申请人： Byron L. Gilman , Mark W. Kroll , James E. Brewer
发明人： Byron L. Gilman , Mark W. Kroll , James E. Brewer
IPC分类号： A61N1/00
CPC分类号： A61N1/3925 , A61N1/3605 , A61N1/362 , A61N1/3621 , A61N1/36564 , A61N1/39 , A61N1/3956 , A61N1/3968 , A61N1/3993
摘要： Aspects of the invention are directed to advanced monitoring and control of medium voltage therapy (MVT) in implantable and external devices. Apparatus and methods are disclosed that facilitate dynamic adjustment of MVT parameter values in response to new and changing circumstances such as the patient's condition before, during, and after administration of MVT. Administration of MVT is automatically and dynamically adjusted to achieve specific treatment or life-support objectives, such as prolongation of the body's ability to endure and respond to MVT, specifically addressing the type of arrhythmia or other pathologic state of the patient with targeted treatment, a tiered-intensity MVT treatment strategy, and supporting patients in non life-critical conditions where the heart may nevertheless benefit from a certain level of assistance.
摘要翻译：本发明的方面涉及可植入和外部设备中的中压治疗（MVT）的高级监视和控制。公开了用于响应于新的和变化的情况（例如在MVT管理之前，之中和之后的患者状况）MVT参数值的动态调整的装置和方法。自动动态地调整MVT的管理，以达到特定的治疗或生命维持目标，例如延长身体耐受和应对MVT的能力，具体针对靶向治疗患者的心律失常或其他病理状态，分层强度的MVT治疗策略，并支持非生命危险条件下的患者，心脏可能受益于一定程度的帮助。

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