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    • 4. 发明申请
    • SYSTEMS AND METHODS FOR CONTROLLING PAIRED PACING BASED ON PATIENT ACTIVITY FOR USE WITH AN IMPLANTABLE MEDICAL DEVICE
    • 基于患者活动控制成对的PAC的系统和方法与可植入的医疗设备一起使用
    • US20130035736A1
    • 2013-02-07
    • US13196763
    • 2011-08-02
    • Steve Koh
    • Steve Koh
    • A61N1/368
    • A61N1/3627A61N1/3624A61N1/36571A61N1/3962
    • Techniques are provided for use with implantable medical devices equipped to deliver paired postextrasystolic potentiation (PESP) pacing to control the paired pacing rate based on changes in patient activity. In one example, the current activity level of the patient is detected during paired pacing using an accelerometer. The cardiac output level needed to maintain the current activity level of the patient is determined with reference to pre-stored lookup tables relating activity levels with corresponding minimum necessary cardiac output levels for the particular patient. The minimum paired pacing rate sufficient to achieve the cardiac output level is then determined based, e.g., on stroke volume derived from cardiogenic impedance signals. Paired pacing is then delivered at the minimum paired pacing rate sufficient to achieve the needed cardiac output, thereby assuring that the paired pacing rate is sufficient to meet the current physiological demands of the patient without consuming too much oxygen.
    • 提供技术用于与植入式医疗装置配合以递送成对的后收缩期增强(PESP)起搏以基于患者活动的变化来控制配对的起搏速率。 在一个示例中,使用加速度计在配对起搏期间检测患者的当前活动水平。 参考预先存储的查找表来确定维持患者的当前活动水平所需的心输出量水平,其将活动水平与特定患者的相应的最小必要心输出量水平相关联。 然后基于例如来自心源阻抗信号的搏动体积确定足以实现心输出量的最小配对起搏速率。 然后以足以实现所需心输出量的最小配对起搏速率递送配对起搏,从而确保配对的起搏速率足以满足患者的当前生理需求而不消耗太多的氧气。
    • 5. 发明申请
    • SYSTEM AND METHOD FOR MONITORING DIASTOLIC FUNCTION USING AN IMPLANTABLE MEDICAL DEVICE
    • 使用可植入医疗装置监测脱脂功能的系统和方法
    • US20120330371A1
    • 2012-12-27
    • US13601569
    • 2012-08-31
    • Allen KeelSteve KohTaraneh Ghaffari Farazi
    • Allen KeelSteve KohTaraneh Ghaffari Farazi
    • A61N1/365
    • A61N1/3702A61N1/3627A61N1/36507A61N1/368A61N1/3712
    • Diastolic function is monitored within a patient using a pacemaker or other implantable medical device. In one example, the implantable device uses morphological parameters derived from the T-wave evoked response waveform as proxies for ventricular relaxation rate and ventricular compliance. In particular, the magnitude of the peak of the T-wave evoked response is employed as a proxy for ventricular compliance. The maximum slew rate of the T-wave evoked response following its peak is employed as a proxy for ventricular relaxation. A metric is derived from these proxy values to represent diastolic function. The metric is tracked over time to evaluate changes in diastolic function. In other examples, specific values for ventricular compliance and ventricular relaxation are derived for the patient based on the T-wave evoked response parameters.
    • 使用起搏器或其他可植入医疗器械在患者体内监测舒张功能。 在一个示例中,可植入装置使用从T波诱发反应波形导出的形态参数作为心室松弛率和心室顺应性的代理。 特别地,T波诱发反应的峰值的大小被用作心室顺应性的代表。 其峰值后的T波诱发反应的最大压摆率被用作心室松弛的代用品。 来自这些代理值的度量来表示舒张功能。 随着时间的推移跟踪度量以评估舒张功能的变化。 在其他实例中,基于T波诱发反应参数为患者导出心室顺应性和心室松弛的具体值。
    • 6. 发明授权
    • System and method for monitoring thoracic fluid levels based on impedance using an implantable medical device
    • 使用可植入医疗装置基于阻抗监测胸水液位的系统和方法
    • US08032212B2
    • 2011-10-04
    • US12210848
    • 2008-09-15
    • Gene A. BornzinSteve KohEuljoon Park
    • Gene A. BornzinSteve KohEuljoon Park
    • A61B5/02A61B5/08A61B5/05A61N1/00
    • A61N1/36521A61B5/0537A61B5/4869
    • Techniques are provided for monitoring thoracic fluid levels based on thoracic impedance (ZT) and cardiogenic impedance (ZC). In one example, the implantable device tracks the maximum time rate of change in cardiogenic impedance (i.e. max(dZC/dt)) to detect trends toward hypervolemic or hypovolemic states within the patient based on changes in heart contractility. The detection of these trends in combination with trends in thoracic impedance allows for a determination of whether the thoracic cavity of the patient is generally “too wet” or “too dry,” and thus allows for the titration of diuretics to avoid such extremes. In particular, a decrease in thoracic impedance (ZT) in combination with a decrease in max (dZC/dt) is indicative of the thorax being “too wet” (i.e. a fluid overload). Conversely, an increase in thoracic impedance (ZT) in combination with a decrease in max (dZC/dt) is indicative of the thorax being “too dry” (i.e. a fluid underload).
    • 提供了基于胸部阻抗(ZT)和心源阻抗(ZC)监测胸水水平的技术。 在一个示例中,可植入装置跟踪心源性阻抗的最大时间变化率(即max(dZC / dt)),以基于心脏收缩力的变化来检测患者内的高血容量或低血容量状态的趋势。 这些趋势的检测结合胸部阻抗趋势可以确定患者的胸腔通常是否“太湿”或“太干”,从而允许滴定利尿剂以避免这种极端。 特别地,胸部阻抗(ZT)的降低与最大值(dZC / dt)的降低相结合表明胸部“太湿”(即流体过载)。 相反,胸部阻抗(ZT)的增加与最大(dZC / dt)的降低相结合,表明胸部“太干”(即,流体欠载)。
    • 10. 发明授权
    • Method and system for displaying patient activity data using Poincaré and intensity plot
    • 使用Poincaré和强度图显示患者活动数据的方法和系统
    • US07785256B1
    • 2010-08-31
    • US11329671
    • 2006-01-11
    • Steve Koh
    • Steve Koh
    • A61B5/00
    • A61B5/1118A61B5/0031A61B5/7445Y10S128/92
    • Methods and systems are presented for displaying patient activity data from implantable cardiac device (ICD). The method includes: sensing an activity level, storing the sensed activity level as a first coordinate of an activity data point, generating an average activity level from a predetermined number of sensed activity levels, storing the average activity level as a second coordinate of the activity data point, accumulating a number of times the activity data point having the first and second coordinates occurs, and storing the accumulated number of times. These steps are repeated for a predetermined period of time, and a plurality of activity data points each having an associated accumulated number of times is stored. The method further includes graphically displaying each of the plurality of activity data points with the associated accumulated number of times.
    • 呈现用于显示可植入心脏装置(ICD)的患者活动数据的方法和系统。 该方法包括:感测活动级别,将感测到的活动级别存储为活动数据点的第一坐标,从预定数量的感测活动级别生成平均活动级别,将平均活动级别存储为活动的第二坐标 数据点,累积具有第一和第二坐标的活动数据点的次数,并存储累积次数。 这些步骤重复预定的时间段,并且存储每个具有相关联的累积次数的多个活动数据点。 该方法还包括以相关联的累积次数图形地显示多个活动数据点中的每一个。