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1. 发明授权

US08133187B2 Implantable medical device with heart condition detection 有权
标题翻译：具有心脏状态检测的可植入医疗器械
公开(公告)号：US08133187B2
公开(公告)日：2012-03-13
申请号：US12095216
申请日：2005-12-16
申请人： Nils Holmström , Kjell Noren
发明人： Nils Holmström , Kjell Noren
IPC分类号： A61B5/0255
CPC分类号： A61B7/00 , A61B7/04 , A61N1/36514 , A61N1/36578
摘要： A method for detecting a condition of a heart of a patient using an implantable medical device, including the steps of sensing acoustic signals indicative of heart sounds of the heart of the patient; extracting signals corresponding to a first heart sound (S1) and a second heart sound (S2) from sensed signals; calculating an energy value corresponding to a signal corresponding to the first heart sound (S1) and an energy value corresponding to the second heart sound (S2); calculating a relation between the energy value corresponding to the first heart sound and the energy value corresponding to the second heart sound for successive cardiac cycles; and using at least one relation to detect the condition or a change of the condition. A medical device for determining the posture of a patient and a computer readable medium encoded with instructions are used to perform the inventive method.
摘要翻译：一种用于使用可植入医疗装置检测患者心脏状态的方法，包括以下步骤：感测指示患者心脏的心脏声音的声学信号; 从感测信号中提取对应于第一心音（S1）和第二心音（S2）的信号; 计算对应于对应于第一心音（S1）的信号的能量值和对应于第二心音（S2）的能量值; 计算对应于第一心音的能量值与对应于第二心音的能量值之间的关系，用于连续的心动周期; 并使用至少一个关系来检测条件或条件的变化。用于确定患者姿势的医疗装置和用指令编码的计算机可读介质用于执行本发明的方法。

2. 发明授权

US08682428B2 Implantable medical device with therapy control 有权
标题翻译：具有治疗控制的植入式医疗器械
公开(公告)号：US08682428B2
公开(公告)日：2014-03-25
申请号：US12094534
申请日：2005-11-30
申请人： Nils Holmström , Kjell Noren
发明人： Nils Holmström , Kjell Noren
IPC分类号： A61N1/00
CPC分类号： A61N1/36514 , A61B7/04 , A61N1/3627 , A61N1/36578 , A61N1/3684
摘要： A method for operating an implantable medical device to obtain substantially synchronized closure of the mitral and tricuspid valves based on sensed heart sounds includes sensing an acoustic energy; producing signals indicative of heart sounds of the heart of the patient over predetermined periods of a cardiac cycle during successive cardiac cycles; calculating a pulse width of such a signal; and iteratively controlling a delivery of the ventricular pacing pulses based on calculated pulse widths of successive heart sound signals to identify an RV interval or VV interval that causes a substantially synchronized closure of the mitral and tricuspid valve. A medical device for optimizing an RV interval or VV interval based on sensed heart sounds implements such a method and a computer readable medium encoded with instructions causes a computer to perform such a method.
摘要翻译：用于操作可植入医疗装置以基于感测到的心脏声音获得二尖瓣和三尖瓣的基本上同步闭合的方法包括感测声能; 在连续心脏周期期间产生指示心脏周期的预定周期的患者心脏的心脏声音的信号; 计算这种信号的脉冲宽度; 并且基于计算的连续心脏声音信号的脉冲宽度迭代地控制心室起搏脉冲的递送，以识别导致二尖瓣和三尖瓣的基本上同步闭合的RV间隔或VV间隔。基于感测到的心脏声音优化RV间隔或VV间隔的医疗装置实现了这样的方法，并且用指令编码的计算机可读介质使得计算机执行这种方法。

3. 发明授权

US08060201B2 Medical device 有权
标题翻译：医疗装置
公开(公告)号：US08060201B2
公开(公告)日：2011-11-15
申请号：US12095241
申请日：2005-12-16
申请人： Nils Holmström , Kjell Noren
发明人： Nils Holmström , Kjell Noren
IPC分类号： A61N1/00
CPC分类号： A61N1/36514 , A61N1/36578 , A61N1/368 , A61N1/3682
摘要： A method for operating an implantable medical device to control a stimulation therapy includes the steps of: sensing an acoustic energy; producing acoustic signals indicative of heart sounds of the heart of the patient over predetermined periods of a cardiac cycle during successive cardiac cycles; extracting a signal corresponding to a first heart sound (S1) from a measured acoustic signal; calculating an energy value corresponding to the extracted signal; storing the energy value corresponding to the first heart sound; and initiating an optimization procedure, the optimization procedure comprising the steps of: iteratively controlling a delivery of the pacing pulses based on successive energy values corresponding to successive first heart sound signals and determining an optimal PV interval or AV interval with respect to the energy values. A medical device and a computer readable medium to implement the method.
摘要翻译：用于操作可植入医疗装置以控制刺激疗法的方法包括以下步骤：感测声能; 在连续心脏周期期间产生指示心脏周期的预定周期的患者心脏心脏的声音信号; 从测量的声信号中提取与第一心音（S1）对应的信号; 计算与所提取的信号相对应的能量值; 存储对应于第一心音的能量值; 并且启动优化过程，所述优化过程包括以下步骤：基于对应于连续的第一心音信号的连续能量值迭代地控制所述起搏脉冲的递送，并且相对于所述能量值确定最佳PV间隔或AV间隔。一种用于实施该方法的医疗装置和计算机可读介质。

4. 发明授权

US08812109B2 Method and system for stimulating a heart of a patient 有权
标题翻译：刺激患者心脏的方法和系统
公开(公告)号：US08812109B2
公开(公告)日：2014-08-19
申请号：US13593334
申请日：2012-08-23
申请人： Andreas Blomqvist , Kjell Noren
发明人： Andreas Blomqvist , Kjell Noren
IPC分类号： A61N1/00
CPC分类号： A61N1/00 , A61N1/3627 , A61N1/36514 , A61N1/36564 , A61N1/3682 , A61N1/3684
摘要： In an implantable medical device and a method for stimulating a heart of a patient, at least one left atrial pressure (LAP) signal over a cardiac cycle is obtained. The A-wave is identified using the LAP signal and a maximum positive rate of change of the A-wave of the LAP signal is determined. The maximum positive rate of change of the A-wave corresponds to the rate which the pressure in the atrium raises as the atria contraction forces more blood into the ventricle during the very last stage of diastole. Further, AV and/or VV delay is adjusted in response to the maximum positive rate of change of the A-wave, wherein a reduction of the maximum positive rate of change of the A-wave indicates an AV and/or VV delay providing an enhanced hemodynamic performance.
摘要翻译：在可植入医疗装置和刺激患者心脏的方法中，获得心动周期上的至少一个左心房压力（LAP）信号。使用LAP信号识别A波，并确定LAP信号的A波的最大正比率。 A波的最大阳性变化率对应于心房收缩期间压力升高的速率，因为心房收缩在舒张期的最后阶段迫使更多的血液进入心室。此外，AV和/或VV延迟响应于A波的最大正的变化速率而被调整，其中A波的最大正的变化率的减小表示AV和/或VV延迟提供增强血液动力学性能。

5. 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。

6. 发明授权

US08211032B2 Cardiomechanical assessment for cardiac resynchronization therapy 有权
标题翻译：心脏再同步治疗的心脏力学评估
公开(公告)号：US08211032B2
公开(公告)日：2012-07-03
申请号：US13191253
申请日：2011-07-26
申请人： Stuart O. Schecter , Kjell Noren
发明人： Stuart O. Schecter , Kjell Noren
IPC分类号： A61B5/0452
CPC分类号： A61N1/36514 , A61N1/36578
摘要： A first lead provides therapeutic stimulation to the heart and includes a first mechanical sensor that measures physical contraction and relaxation of the heart. A controller induces delivery of therapeutic stimulation via the first lead. The controller receives signals from the first mechanical sensor indicative of the contraction and relaxation; develops a template signal that corresponds to the contraction and relaxation; and uses the template signal to modify the delivery of therapeutic stimulations. In another arrangement, a second lead, with a second mechanical sensor also provides signals to the controller indicative of contraction and relaxation. The first mechanical sensor is adapted to be positioned at the interventricular septal region of the heart, and the second mechanical sensor is adapted to be positioned in the lateral region of the left ventricle. The controller processes the signals from the first mechanical sensor and the second mechanical sensor to develop a dysynchrony index.
摘要翻译：第一个引线提供对心脏的治疗刺激，并且包括测量心脏的身体收缩和松弛的第一机械传感器。控制器通过第一引线诱导治疗性刺激。控制器从第一机械传感器接收指示收缩和松弛的信号; 开发对应于收缩和放松的模板信号; 并使用模板信号修改治疗刺激的递送。在另一种布置中，具有第二机械传感器的第二引线还向控制器提供指示收缩和松弛的信号。第一机械传感器适于定位在心脏的室间隔区域，并且第二机械传感器适于定位在左心室的侧向区域中。控制器处理来自第一机械传感器和第二机械传感器的信号以产生异步指数。

7. 发明申请

US20110245701A1 ARRHYTHMIA CLASSIFICATION 有权
标题翻译： ARRHYTHMIA分类
公开(公告)号：US20110245701A1
公开(公告)日：2011-10-06
申请号：US13076627
申请日：2011-03-31
申请人： Anders Bjorling , Malin Hollmark , Tomas Svensson , Stefan Hjelm , Kjell Noren , Karin Jarverud
发明人： Anders Bjorling , Malin Hollmark , Tomas Svensson , Stefan Hjelm , Kjell Noren , Karin Jarverud
IPC分类号： A61B5/0456 , A61N1/39
CPC分类号： A61B5/0456 , A61B5/0031 , A61B5/053 , A61B5/7264 , A61N1/3621 , A61N1/36521 , A61N1/3702 , A61N1/3925 , A61N1/3962
摘要： An implantable medical device, is designed to collect a signal representative of the electric activity of the heart and determine a cardiogenic impedance signal for at least a portion of the heart. An R-wave detector of the IMD detects the timing of an R-wave during a cardiac cycle based on the signal representative of the electric activity. A minimum detector detects the timing of a cardiogenic impedance minimum in the cardiogenic impedance signal and within a systolic time window of the cardiac cycle. A detected arrhythmia is then classified by the IMD based on the timing of the R-wave detected by the R-wave detector and the timing of the cardiogenic impedance minimum detected by the minimum detector.
摘要翻译：可植入医疗装置被设计成收集表示心脏的电活动的信号，并确定至少一部分心脏的心源性阻抗信号。基于代表电活动的信号，IMD的R波检测器在心动周期中检测R波的定时。最小检测器检测心源性阻抗信号中心源性阻抗最小值的定时，并在心动周期的收缩时间窗内检测。然后，基于由R波检测器检测到的R波的定时和由最小检测器检测的心源阻抗最小值的定时，通过IMD对检测到的心律失常进行分类。

8. 发明授权

US07970473B2 Systems and methods for detection of VT and VF from remote sensing electrodes 有权
标题翻译：从遥感电极检测VT和VF的系统和方法
公开(公告)号：US07970473B2
公开(公告)日：2011-06-28
申请号：US12244607
申请日：2008-10-02
申请人： Yelena Nabutovsky , Taraneh Ghaffari Farazi , Anders Bjorling , Kjell Noren , Gene A. Bornzin
发明人： Yelena Nabutovsky , Taraneh Ghaffari Farazi , Anders Bjorling , Kjell Noren , Gene A. Bornzin
IPC分类号： A61N1/00
CPC分类号： A61B5/046 , A61B5/04011 , A61B5/0464 , A61N1/3702 , A61N1/3956
摘要： Methods and systems are provided for performing ventricular arrhythmia monitoring using at least two sensing channels that are each associated with different sensing vectors, for example by different pairs of extracardiac remote sensing electrodes. Myopotential associated with each of the sensing channels in monitored, and a ventricular arrhythmia monitoring mode is selected based thereon (e.g., based on determined myopotential levels). Ventricular arrhythmia monitoring is then performed using the selected monitoring mode.
摘要翻译：提供的方法和系统用于使用至少两个感测通道进行心室心律失常监测，每个感测通道各自与不同的感测向量相关联，例如通过不同的心外感测电极对。与监测的每个感测通道相关联的神经电位和基于（例如，基于确定的电位电平）来选择心室心律失常监测模式。然后使用所选择的监测模式进行室性心律失常监测。

9. 发明申请

US20100249864A1 METHOD AND APPARATUS FOR DETERMINING VARIATION OVER TIME OF A MEDICAL PARAMETER OF A HUMAN BEING 有权
标题翻译：用于确定人类医疗参数时间变化的方法和装置
公开(公告)号：US20100249864A1
公开(公告)日：2010-09-30
申请号：US12438397
申请日：2006-08-28
申请人： Karin Järverud , Kjell Noren
发明人： Karin Järverud , Kjell Noren
IPC分类号： A61N1/362 , A61B5/103
CPC分类号： A61B5/0205 , A61B5/0031 , A61B5/02028 , A61B5/0215 , A61B5/1116 , A61B5/686 , A61B5/7239 , A61N1/36564 , A61N1/3702
摘要： An apparatus for determining variation over time of a medical parameter of a human being obtained from a sensed signal has a sensor implantable in the human being for sensing the signal. A comparator compares at least one characteristic property, derived from the sensed signal obtained for at least one predetermined first level of activity of the human being, with corresponding reference property of a sensed reference signal, obtained for a predetermined reference level of activity of the human being, for determining a relation between the characteristic property of the sensed signal and the reference property. A trend determining unit determines trends in the medical parameter by analyzing the relation between the characteristic property of the sensed signal obtained at different times and the reference property. A corresponding method also function an implant for heart failure diagnostics also function as described. A sensor is then arranged to pick up dynamic mechanical information from the heart of the human being and generate a corresponding signal. A heart stimulator includes such an implant and a control unit arranged to control stimulation of the heart depending on determined trends in the medical parameter.
摘要翻译：用于确定从感测信号获得的人的医学参数随时间变化的装置具有可植入人体的用于感测信号的传感器。比较器比较从针对人的至少一个预定的第一活动水平获得的感测信号导出的至少一个特征属性与针对人的预定参考活动水平获得的感测参考信号的相应参考特性用于确定感测信号的特性与参考属性之间的关系。趋势确定单元通过分析在不同时间获得的感测信号的特性与参考属性之间的关系来确定医疗参数的趋势。相应的方法也可以用于心力衰竭诊断的植入物也起到所述的作用。然后设置传感器以从人的心脏拾取动态机械信息并产生相应的信号。心脏刺激器包括这样的植入物和控制单元，其被布置成根据医学参数中确定的趋势来控制心脏的刺激。

10. 发明申请

US20080294213A1 Implantable Medical Device with Therapy Control 有权
标题翻译：具有治疗控制的植入式医疗器械
公开(公告)号：US20080294213A1
公开(公告)日：2008-11-27
申请号：US12094534
申请日：2005-11-30
申请人： Nils Holmstrom , Kjell Noren
发明人： Nils Holmstrom , Kjell Noren
IPC分类号： A61N1/365
CPC分类号： A61N1/36514 , A61B7/04 , A61N1/3627 , A61N1/36578 , A61N1/3684
摘要： A method for operating an implantable medical device to obtain substantially synchronized closure of the mitral and tricuspid valves based on sensed heart sounds includes sensing an acoustic energy; producing signals indicative of heart sounds of the heart of the patient over predetermined periods of a cardiac cycle during successive cardiac cycles; calculating a pulse width of such a signal; and iteratively controlling a delivery of the ventricular pacing pulses based on calculated pulse widths of successive heart sound signals to identify an RV interval or VV interval that causes a substantially synchronized closure of the mitral and tricuspid valve. A medical device for optimizing an RV interval or VV interval based on sensed heart sounds implements such a method and a computer readable medium encoded with instructions causes a computer to perform such a method.
摘要翻译：用于操作可植入医疗装置以基于感测到的心脏声音获得二尖瓣和三尖瓣的基本上同步闭合的方法包括感测声能; 在连续心脏周期期间产生指示心脏周期的预定周期的患者心脏的心脏声音的信号; 计算这种信号的脉冲宽度; 并且基于计算的连续心脏声音信号的脉冲宽度迭代地控制心室起搏脉冲的递送，以识别导致二尖瓣和三尖瓣的基本上同步闭合的RV间隔或VV间隔。基于感测到的心脏声音优化RV间隔或VV间隔的医疗装置实现了这样的方法，并且用指令编码的计算机可读介质使得计算机执行这种方法。

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