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1. 发明授权

US06937902B2 Pacemaker with determination of the dependency of cardiac output on the AV-delay 有权
标题翻译：起搏器确定心输出量对AV延迟的依赖性
公开(公告)号：US06937902B2
公开(公告)日：2005-08-30
申请号：US10258645
申请日：2001-04-23
申请人： Johan Lidman , Nils Holmström , Kjell Norén
发明人： Johan Lidman , Nils Holmström , Kjell Norén
IPC分类号： A61N1/362 , A61N1/368 , A61N1/37 , A61N1/365
CPC分类号： A61N1/368 , A61N1/3627 , A61N1/3682 , A61N1/3702
摘要： A cardiac pacemaker has a pulse generator for delivering stimulation pulses to a patient's heart and a control unit for controlling the delivery of the stimulation pulses from the pulse generator. The control unit includes an altering unit for altering the AV-delay value from a predetermined first AV-delay value to a predetermined second AV-delay value, and back to the first AV-delay value. A sensor measures a parameter related to cardiac output of the patient, the sensor measuring this parameter in a time window within a time of operation with the first AV-delay value, and in a time window within the time of operation with said second AV-delay value, and in a time window within the time of operation after the return back to the first AV-delay value. A calculation unit calculates respective average values of the parameter during each of the time windows, and a determining unit determines from these average values which of the AV-delay values results in a higher cardiac output.
摘要翻译：心脏起搏器具有用于将刺激脉冲传送到患者心脏的脉冲发生器和用于控制来自脉冲发生器的刺激脉冲的传送的控制单元。控制单元包括改变单元，用于将AV延迟值从预定的第一AV延迟值改变到预定的第二AV延迟值，并且返回到第一AV延迟值。传感器测量与患者的心输出量相关的参数，所述传感器在具有第一AV延迟值的操作时间内的时间窗中测量该参数，并且在所述第二AV-延迟值的操作时间内的时间窗中，延迟值，并且在返回到第一AV延迟值之后的操作时间内的时间窗中。计算单元计算每个时间窗口期间的参数的各个平均值，并且确定单元从这些平均值确定哪个AV延迟值导致更高的心输出量。

2. 发明授权

US06754535B2 Method and apparatus for verifying evoked response in the atrium 有权
标题翻译：用于验证心房诱发反应的方法和装置
公开(公告)号：US06754535B2
公开(公告)日：2004-06-22
申请号：US09901324
申请日：2001-07-09
申请人： Kjell Norén , Nils Holmström
发明人： Kjell Norén , Nils Holmström
IPC分类号： A61N1362
CPC分类号： A61N1/371 , A61N1/36521
摘要： In a method and an apparatus for verifying the occurrence of an evoked response in the atrium, following emission of a stimulation pulse to the atrium, an impedance signal is measured in a time window following the emission of the stimulation pulse. The impedance signal is high pass filtered and a characteristic of the high pass filtered impedance signal, such as its amplitude or its morphology, is compared to a predetermined criterion in a comparison unit. The occurrence of an evoked response is verified if the characteristic equals or exceeds the predetermined criterion. The occurrence of an evoked response can therefore be monitored on a beat-to-beat or pulse-to-pulse basis.
摘要翻译：在用于验证心房诱发反应的发生的方法和装置中，在向心房发出刺激脉冲之后，在发出刺激脉冲之后的时间窗中测量阻抗信号。阻抗信号被高通滤波，并且比较单元中的高通滤波阻抗信号的特性，例如其幅度或其形态，与预定标准进行比较。如果特征等于或超过预定标准，则验证诱发响应的发生。因此，可以基于节拍或脉冲至脉冲来监视诱发响应的发生。

3. 发明申请

US20100121400A1 IMPLANTABLE CARDIAC DEVICE AND METHOD FOR MONITORING THE STATUS OF A CARDIOVASCULAR DISEASE 有权
标题翻译：可注射的心脏装置和监测心血管疾病状态的方法
公开(公告)号：US20100121400A1
公开(公告)日：2010-05-13
申请号：US12528653
申请日：2007-03-23
申请人： Nils Holmström , Malin Öhlander , Kjell Norén , Andreas Blomqvist , Karin Ljungström
发明人： Nils Holmström , Malin Öhlander , Kjell Norén , Andreas Blomqvist , Karin Ljungström
IPC分类号： A61N1/365
CPC分类号： A61N1/36521 , A61B5/0215 , A61B5/02405 , A61B5/053 , A61B5/4035 , A61B5/4836 , A61B5/7257 , A61N1/36564 , A61N1/36578 , A61N1/36592 , A61N1/3702
摘要： An implantable cardiac device has a heart stimulator for electrically stimulating the heart of a patient, detector that measures a physiologic parameter that is affected by the status of a cardiovascular disease associated with sympathetic activation, a signal processor that determines at least one of a low frequency, LF, and a very low frequency, VLF, Mayer wave component in the measured parameter, and analyzer that automatically analyzes the determined Mayer wave component in relation to a predetermined reference value to determine the status of the cardiovascular disease. The detector is a cardio-mechanical parameter detector that measures, as said physiologic parameter, a mechanical change in at least one of the four chambers of the heart. In a corresponding method for monitoring the status of a cardiovascular disease associated with sympathetic activation of a patient having an implantable electric heart stimulator a physiologic parameter affected by the cardiac disease is measured. At least one of a low frequency, LF, and a very low frequency, VLF, Mayer wave component in the parameter is determined, and the wave component is analyzed in relation to a predetermined reference value to determine the status of the cardiovascular disease. A mechanical change in at least one of the four chambers of the heart is measured as the physiologic parameter.
摘要翻译：可植入心脏装置具有用于电刺激患者心脏的心脏刺激器，所述心脏刺激器测量受到与交感神经激活相关的心血管疾病状态影响的生理参数的检测器，信号处理器确定低频 LF，以及在测量参数中的非常低频VLF，Mayer波分量，以及分析仪，其自动分析与预定参考值相关的确定的Mayer波分量，以确定心血管疾病的状态。检测器是心机械参数检测器，其作为所述生理参数测量心脏的四个腔室中的至少一个中的机械变化。在用于监测与具有可植入电心脏刺激器的患者的交感神经激活相关的心血管疾病的状态的相应方法中，测量受心脏病影响的生理参数。确定参数中的低频，低频和极低频VLF，迈耶波分量中的至少一个，并且相对于预定参考值分析波分量以确定心血管疾病的状态。心脏的四个腔室中的至少一个的机械变化被测量为生理参数。

4. 发明授权

US07569020B2 Method for extracting timing parameters using a cardio-mechanical sensor 有权
标题翻译：使用心机械传感器提取定时参数的方法
公开(公告)号：US07569020B2
公开(公告)日：2009-08-04
申请号：US11455518
申请日：2006-06-19
申请人： Kjell Norén , Nils Holmström
发明人： Kjell Norén , Nils Holmström
IPC分类号： A61B5/026
CPC分类号： A61B5/02416 , A61B5/0031 , A61B5/0452 , A61B5/083 , A61B5/1116 , A61B5/686 , A61B5/7239 , A61N1/36514 , A61N1/36578
摘要： In a method and apparatus for measuring the ejection fraction in a mammalian heart, the opening and closing of a heart valve is sensed with an implanted sensor, and a pre-ejection period is measured as a function of the sensed opening and closing of the heart valve. The ventricular ejection time also is measured, and the ejection fraction is determined as a function of the measured pre-ejection period and the ejection time.
摘要翻译：在用于测量哺乳动物心脏中的射血分数的方法和装置中，用植入的传感器感测心脏瓣膜的打开和关闭，并且根据检测到的心脏的开启和关闭来测量预喷射周期阀。也测量心室射血时间，并且将射血分数确定为所测量的预喷射时间和喷射时间的函数。

5. 发明申请

US20100113961A1 MEDICAL DEVICE FOR DETERMINING THE POSTURE OF PATIENT 有权
标题翻译：用于确定患者症状的医疗装置
公开(公告)号：US20100113961A1
公开(公告)日：2010-05-06
申请号：US11993254
申请日：2005-06-29
申请人： Malin Öhlander , Nils Holmström , Kjell Norén
发明人： Malin Öhlander , Nils Holmström , Kjell Norén
IPC分类号： A61B5/053
CPC分类号： G06F19/34 , A61B5/0031 , A61B5/01 , A61B5/029 , A61B5/053 , A61B5/0816 , A61B5/1116 , A61B5/4561 , A61B5/686
摘要： The present invention relates to a method for determining the posture of a patient. The method comprises the steps of: initiating (50, 52) a patient posture determining session by performing an electrical bio-impedance measurement session in at least one of a number of different electrode configurations in order to measure an impedance value for the at least one configuration; obtaining reference impedance values (54) stored in advance for the at least one configuration and for at least one potential posture of the patient; comparing (54) the measured impedance value for the at least one configuration with corresponding stored reference impedance values for at least one potential posture of the patient; and determining (56) the present posture of the patient by using results from the comparison between measured impedance values and the stored reference impedance values. Furthermore, the invention relates to a medical device for determining the posture of a patient and a computer readable medium comprising instructions for bringing a computer to perform the inventive method.
摘要翻译：本发明涉及一种用于确定患者姿势的方法。该方法包括以下步骤：通过在多个不同电极配置中的至少一个中执行电生物阻抗测量会话来启动（50,52）患者姿势确定会话，以便测量至少一个组态; 获得针对所述至少一个配置和所述患者的至少一个潜在姿势预先存储的参考阻抗值（54）; 将所述至少一个配置的测量阻抗值与所述患者的至少一个潜在姿势的对应存储的参考阻抗值进行比较（54）; 以及通过使用测量的阻抗值与所存储的参考阻抗值之间的比较的结果来确定（56）患者的当前姿势。此外，本发明涉及一种用于确定患者姿势的医疗装置和包括用于使计算机执行本发明的方法的指令的计算机可读介质。

6. 发明授权

US07164947B2 Heart stimulator with stimulation controlled by analysis of an average impedance morphology curve 失效
标题翻译：通过分析平均阻抗形态曲线控制刺激的心脏刺激器
公开(公告)号：US07164947B2
公开(公告)日：2007-01-16
申请号：US10619354
申请日：2003-07-14
申请人： Nils Holmström , Anders Björling , Kjell Norén , Karin Ljungström , Sven Kalling
发明人： Nils Holmström , Anders Björling , Kjell Norén , Karin Ljungström , Sven Kalling
IPC分类号： A61N1/365
CPC分类号： A61N1/36521 , A61N1/3627
摘要： A heart stimulator for electric stimulation of a patient's heart has an impedance measuring unit that measures the impedance between at least two measurement electrodes implanted in a patient such that volume changes of at least one of the chambers of the left heart result in changes in the measured impedance. An analyzer analyzes the measured impedance for the control of the stimulation of the heart. A calculation unit calculates an average impedance morphology curve during a time interval of several cardiac cycles. The analyzer analyzes the average impedance morphology curve for use for the control of the stimulation to optimize the patient hemodynamics.
摘要翻译：用于对患者心脏进行电刺激的心脏刺激器具有阻抗测量单元，其测量植入患者体内的至少两个测量电极之间的阻抗，使得左心脏的至少一个腔室的体积变化导致测量的变化阻抗。分析仪分析测量的阻抗以控制心脏的刺激。计算单元在几个心动周期的时间间隔内计算平均阻抗形态曲线。分析仪分析用于控制刺激的平均阻抗形态曲线，以优化患者的血液动力学。

7. 发明授权

US08790254B2 Medical device for determining the posture of patient 有权
标题翻译：用于确定患者姿势的医疗装置
公开(公告)号：US08790254B2
公开(公告)日：2014-07-29
申请号：US11993254
申请日：2005-06-29
申请人： Malin Öhlander , Nils Holmström , Kjell Norén
发明人： Malin Öhlander , Nils Holmström , Kjell Norén
IPC分类号： A61B5/00 , G06F19/00 , A61B5/053
CPC分类号： G06F19/34 , A61B5/0031 , A61B5/01 , A61B5/029 , A61B5/053 , A61B5/0816 , A61B5/1116 , A61B5/4561 , A61B5/686
摘要： In a method and a device for determining the posture of a patient, a bio-impedance measurement device, having a number of electrodes configured to interact with the patient in a number of different electrode configurations, is operated to initiate a patient posture determining session by measuring an impedance value of the patient with the electrodes in at least one configuration among the number of configurations. A reference impedance value from among a number of stored reference impedance values for the at least one configuration is selected. The number of stored reference impedance values are respectively associated with different postures of the patient, and the posture associated with the selected reference impedance value represents a candidate posture. The measured impedance value is compared with the selected reference impedance value, thereby obtaining a comparison result. Dependent on said comparison result, it is automatically determined whether the current posture of the patient conforms to the candidate posture.
摘要翻译：在用于确定患者姿势的方法和装置中，操作具有多个电极的生物阻抗测量装置，其被配置成以多个不同的电极配置与患者相互作用，以通过以下方式启动患者姿势确定会话：在配置数量中，至少一个配置中测量具有电极的患者的阻抗值。选择用于至少一个配置的多个存储的参考阻抗值中的参考阻抗值。存储的参考阻抗值的数量分别与患者的不同姿势相关联，并且与所选择的参考阻抗值相关联的姿势表示候选姿势。将测量的阻抗值与所选择的参考阻抗值进行比较，从而获得比较结果。根据所述比较结果，自动确定患者的当前姿势是否符合候选姿势。

8. 发明授权

US08308649B2 Implantable cardiac device and method for monitoring the status of a cardiovascular disease 有权
标题翻译：可植入的心脏装置和监测心血管疾病状态的方法
公开(公告)号：US08308649B2
公开(公告)日：2012-11-13
申请号：US12528653
申请日：2007-03-23
申请人： Nils Holmström , Malin Öhlander , Kjell Norén , Andreas Blomqvist , Karin Ljungström
发明人： Nils Holmström , Malin Öhlander , Kjell Norén , Andreas Blomqvist , Karin Ljungström
IPC分类号： A61B5/02
CPC分类号： A61N1/36521 , A61B5/0215 , A61B5/02405 , A61B5/053 , A61B5/4035 , A61B5/4836 , A61B5/7257 , A61N1/36564 , A61N1/36578 , A61N1/36592 , A61N1/3702
摘要： An implantable cardiac device has a heart stimulator for electrically stimulating the heart of a patient, detector that measures a physiologic parameter that is affected by the status of a cardiovascular disease associated with sympathetic activation, a signal processor that determines at least one of a low frequency, LF, and a very low frequency, VLF, Mayer wave component in the measured parameter, and analyzer that automatically analyzes the determined Mayer wave component in relation to a predetermined reference value to determine the status of the cardiovascular disease. The detector is a cardio-mechanical parameter detector that measures, as said physiologic parameter, a mechanical change in at least one of the four chambers of the heart. In a corresponding method for monitoring the status of a cardiovascular disease associated with sympathetic activation of a patient having an implantable electric heart stimulator a physiologic parameter affected by the cardiac disease is measured. At least one of a low frequency, LF, and a very low frequency, VLF, Mayer wave component in the parameter is determined, and the wave component is analyzed in relation to a predetermined reference value to determine the status of the cardiovascular disease. A mechanical change in at least one of the four chambers of the heart is measured as the physiologic parameter.
摘要翻译：可植入心脏装置具有用于电刺激患者心脏的心脏刺激器，所述心脏刺激器测量受到与交感神经激活相关的心血管疾病状态影响的生理参数的检测器，信号处理器确定低频 LF，以及在测量参数中的非常低频VLF，Mayer波分量，以及分析仪，其自动分析与预定参考值相关的确定的Mayer波分量，以确定心血管疾病的状态。检测器是心机械参数检测器，其作为所述生理参数测量心脏的四个腔室中的至少一个中的机械变化。在用于监测与具有可植入电心脏刺激器的患者的交感神经激活相关的心血管疾病的状态的相应方法中，测量受心脏病影响的生理参数。确定参数中的低频，低频和极低频VLF，迈耶波分量中的至少一个，并且相对于预定参考值分析波分量以确定心血管疾病的状态。心脏的四个腔室中的至少一个的机械变化被测量为生理参数。

9. 发明授权

US06985772B2 Cardiac pacemaker with automatic adaptation of pacing rate to cardiac output 失效
标题翻译：心脏起搏器具有自动适应起搏率的心输出量
公开(公告)号：US06985772B2
公开(公告)日：2006-01-10
申请号：US10267239
申请日：2002-10-09
申请人： Nils Holmström , Kjell Norén
发明人： Nils Holmström , Kjell Norén
IPC分类号： A61N1/368
CPC分类号： A61N1/3627 , A61N1/36557 , A61N1/3684
摘要： A pacemaker has a pulse generator for delivering stimulation pulses to a patient's heart, a sensor for measuring a parameter related to cardiac output, and a control unit for controlling the delivery of stimulation pulses from the pulse generator. The control unit includes an altering unit for altering at least one of the VV delay between consecutive stimulation pulses to the right and left ventricles and the AA delay between consecutive stimulation pulses to the right and left atria. The sensor measures the parameter in various time windows within a time of operation of predetermined VV- or AA-delay values. A determining unit includes a calculation unit for calculating an average value of the measured parameter during each of said time windows and the determining unit uses these average values to determine which one of the VV- and/or AA-delay values results in a higher cardiac output.
摘要翻译：起搏器具有用于向患者心脏输送刺激脉冲的脉冲发生器，用于测量与心输出量相关的参数的传感器，以及用于控制来自脉冲发生器的刺激脉冲传送的控制单元。控制单元包括改变单元，用于改变在右心房和左心室之间的连续刺激脉冲之间的VV延迟中的至少一个以及在右心房和左心房之间的连续刺激脉冲之间的AA延迟。传感器在预定的VV或AA延迟值的操作时间内测量各种时间窗内的参数。确定单元包括计算单元，用于在每个所述时间窗口期间计算测量参数的平均值，并且确定单元使用这些平均值来确定VV和/或AA延迟值中的哪一个导致更高的心脏输出。

10. 发明授权

US07979125B2 Implantable biventricular heart stimulating device and method for performing a capture threshold search 有权
标题翻译：可植入的双心室心脏刺激装置和执行捕获阈值搜索的方法
公开(公告)号：US07979125B2
公开(公告)日：2011-07-12
申请号：US12090157
申请日：2005-10-31
申请人： Anders Björling , Nils Holmström , Karin Järverud
发明人： Anders Björling , Nils Holmström , Karin Järverud
IPC分类号： A61N1/362
CPC分类号： A61N1/3627 , A61N1/368 , A61N1/3684 , A61N1/3712
摘要： In an implantable biventricular heart stimulating device, and a biventricular heart stimulating method, wherein operation takes place normally with a time VV between a pacing pulse delivered, or inhibited, by a first ventricular pacing circuit and a pacing pulse delivered, or inhibited, by a second ventricular pacing circuit, and wherein a time VVcts is determined that is to be used instead of VV during a capture threshold search.
摘要翻译：在可植入的双心室心脏刺激装置和双心室心脏刺激方法中，其中手术通常由第一心室起搏电路递送或抑制的起搏脉冲与通过一个或多个第一心室起搏电路递送或抑制的起搏脉冲之间的时间VV进行第二心室起搏电路，并且其中在捕获阈值搜索期间确定要用于代替VV的时间VVcts。

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