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1. 发明申请

US20100069768A1 USE OF CARDIOHEMIC VIBRATION FOR PACING THERAPIES 有权
标题翻译：用于治疗的心脏震颤的使用
公开(公告)号：US20100069768A1
公开(公告)日：2010-03-18
申请号：US12211760
申请日：2008-09-16
申请人： Xiaoyi Min , Gene A. Bornzin , Jay Snell , Josh Reiss
发明人： Xiaoyi Min , Gene A. Bornzin , Jay Snell , Josh Reiss
IPC分类号： A61B5/02
CPC分类号： A61N1/365 , A61B5/0215 , A61B5/026 , A61B7/023 , A61B8/08 , A61B2562/0219 , A61N1/3627 , A61N1/36578
摘要： An exemplary method includes receiving a signal from an intrathoracic vibration sensor, analyzing the signal for vibration associated with deceleration of blood flow into the left ventricle, based at least in part on the analyzing, deciding whether to call for adjustment to one or more parameters of a bi-ventricular pacing therapy. Other exemplary methods, devices, systems, etc., are also disclosed.
摘要翻译：一种示例性方法包括从胸腔内振动传感器接收信号，至少部分地基于分析来分析与进入左心室的血流减速相关的振动信号，决定是否要调整一个或多个参数双心室起搏治疗。还公开了其它示例性方法，装置，系统等。

2. 发明授权

US09717914B2 Use of cardiohemic vibration for pacing therapies 有权
公开(公告)号：US09717914B2
公开(公告)日：2017-08-01
申请号：US12211760
申请日：2008-09-16
申请人： Xiaoyi Min , Gene A. Bornzin , Jay Snell , Josh Reiss
发明人： Xiaoyi Min , Gene A. Bornzin , Jay Snell , Josh Reiss
IPC分类号： A61N1/36 , A61N1/365 , A61N1/362 , A61B5/0215 , A61B5/026 , A61B7/02 , A61B8/08
CPC分类号： A61N1/365 , A61B5/0215 , A61B5/026 , A61B7/023 , A61B8/08 , A61B2562/0219 , A61N1/3627 , A61N1/36578
摘要： An exemplary method includes receiving a signal from an intrathoracic vibration sensor, analyzing the signal for vibration associated with deceleration of blood flow into the left ventricle, based at least in part on the analyzing, deciding whether to call for adjustment to one or more parameters of a bi-ventricular pacing therapy. Other exemplary methods, devices, systems, etc., are also disclosed.

3. 发明授权

US07756572B1 System and method for efficiently distinguishing among cardiac ischemia, hypoglycemia and hyperglycemia using an implantable medical device and an external system 有权
标题翻译：使用可植入医疗器械和外部系统有效区分心脏缺血，低血糖和高血糖的系统和方法
公开(公告)号：US07756572B1
公开(公告)日：2010-07-13
申请号：US11740175
申请日：2007-04-25
申请人： Mohssen Fard , Xiaoyi Min , Peter Boileau , Jong Gill , Bing Zhu , Jay Snell , Laleh Jalali , Josh Reiss , Gene Bornzin
发明人： Mohssen Fard , Xiaoyi Min , Peter Boileau , Jong Gill , Bing Zhu , Jay Snell , Laleh Jalali , Josh Reiss , Gene Bornzin
IPC分类号： A61B5/0468
CPC分类号： A61N1/36585 , A61B5/0452 , A61B5/0468 , A61B5/14532 , A61N1/36557
摘要： Techniques are described for efficiently detecting and distinguishing among cardiac ischemia, hypoglycemia or hyperglycemia based on intracardiac electrogram (IEGM) signals. In one example, a preliminary indication of an episode of cardiac ischemia is detected based on shifts in ST segment elevation within the IEGM. In response, the implanted device then records additional IEGM data for transmission to an external system. The external system analyzes the additional IEGM data to confirm the detection of cardiac ischemia using a more sophisticated analysis procedure exploiting additional detection parameters. In particular, the external system uses detection parameters capable of distinguishing hypoglycemia, hyperglycemia and hyperkalemia from cardiac ischemia, such as QTmax and QTend intervals. Alternatively, the more sophisticated analysis procedure may be performed by the device itself, if it is so equipped. Other examples described herein pertain instead to the detection of atrial fibrillation.
摘要翻译：描述了基于心脏电图（IEGM）信号来有效检测和区分心脏缺血，低血糖或高血糖的技术。在一个实例中，基于IEGM内的ST段抬高的移动来检测心脏缺血发作的初步指示。作为响应，植入的装置然后记录附加的IEGM数据以传输到外部系统。外部系统使用更复杂的分析程序利用额外的检测参数来分析额外的IEGM数据，以确认心脏缺血的检测。特别地，外部系统使用能够区分低血糖，高血糖和高血钾从心脏缺血的检测参数，例如QTmax和QTend间期。或者，如果装置如此装备，则可以由装置本身执行更复杂的分析程序。本文描述的其它实例代替心房颤动的检测。

4. 发明授权

US07769436B1 System and method for adaptively adjusting cardiac ischemia detection thresholds and other detection thresholds used by an implantable medical device 有权
标题翻译：用于自适应调节心脏缺血检测阈值和由可植入医疗装置使用的其它检测阈值的系统和方法
公开(公告)号：US07769436B1
公开(公告)日：2010-08-03
申请号：US11757796
申请日：2007-06-04
申请人： Peter Boileau , Jay Snell , Rupinder Bharmi , Laleh Jalali , Gene A. Bornzin
发明人： Peter Boileau , Jay Snell , Rupinder Bharmi , Laleh Jalali , Gene A. Bornzin
IPC分类号： A61B5/04 , A61B5/0402 , A61B5/0452
CPC分类号： A61B5/0452 , A61B5/0422 , A61B5/053 , A61N1/36585
摘要： Techniques are described for adaptively adjusting detection thresholds for use in detecting cardiac ischemia and other abnormal physiological conditions based on morphological parameters derived from intracardiac electrogram (IEGM) signals, impedance measurements, or other signals. In one example, where ST segment elevation is used to detect cardiac ischemia, default detection thresholds are determined in advance from an examination of variations in ST segment elevations occurring within a population of patients. Thereafter, an individual pacemaker or other implantable medical device uses the default thresholds during an initial learning period to detect ischemia within the patient in which the device is implanted. During the initial learning period, the pacemaker also collects data representative of the range of variation in ST segment elevations occurring within the patient. The pacemaker then adaptively adjusts the thresholds based on the range of variation so as to improve detection specificity within the patient.
摘要翻译：描述了基于从心脏电图（IEGM）信号，阻抗测量或其它信号得出的形态学参数自适应地调整检测阈值用于检测心脏缺血和其他异常生理状况的技术。在一个例子中，使用ST段抬高来检测心脏缺血，默认检测阈值是从对患者群体内发生的ST段抬高的变化的检查预先确定的。此后，单个起搏器或其它可植入医疗装置在初始学习期间使用默认阈值来检测装置植入的患者内的局部缺血。在初始学习期间，起搏器还收集代表病人ST段抬高范围变化的数据。起搏器然后根据变异范围自适应地调整阈值，以提高患者内的检测特异性。

5. 发明授权

US08204592B1 System and method for generating and using cardiac ischemia diagnostics based on arrhythmia precursors and arrhythmia episodes 有权
标题翻译：基于心律失常前兆和心律失常事件产生和使用心脏缺血诊断的系统和方法
公开(公告)号：US08204592B1
公开(公告)日：2012-06-19
申请号：US11949532
申请日：2007-12-03
申请人： Eliot L. Ostrow , Jay Snell , Xiaoyi Min
发明人： Eliot L. Ostrow , Jay Snell , Xiaoyi Min
IPC分类号： A61N1/36
CPC分类号： A61B5/0464 , A61B5/686 , A61N1/36585 , A61N1/37258 , G06F19/00 , G06F19/3418 , G06F19/3468 , G06F19/3481
摘要： Techniques are described for generating diagnostic information to aid in determining whether cardiac ischemia within a patient is clinically actionable. In one example, a pacemaker or implantable cardioverter/defibrillator (ICD) detects information pertaining to arrhythmia precursors and to episodes of sustained arrhythmias, as well as information pertaining to episodes of cardiac ischemia. The implanted device then correlates the arrhythmia precursors and the sustained arrhythmias with the episodes of cardiac ischemia so as to generate diagnostics permitting a physician reviewing the diagnostics to determine whether the ischemia is clinically actionable. In some implementations, the diagnostics are instead generated by an external system based on raw data provided by the implanted device. In some implementations, the device itself determines whether the ischemia is clinically actionable and automatically controls therapy or generates warning signals accordingly.
摘要翻译：描述了用于产生诊断信息以帮助确定患者心脏缺血是否具有临床可行性的技术。在一个示例中，起搏器或植入式心律转复除颤器（ICD）检测与心律失常前体有关的信息和持续性心律不齐的发作以及与心脏缺血发作有关的信息。然后植入的装置将心律失常前体和持续性心律失常与心脏缺血发作相关联，以便产生诊断，允许医师检查诊断以确定缺血是否具有临床可操作性。在一些实施方式中，诊断代替地由外部系统基于植入设备提供的原始数据生成。在一些实施方案中，装置本身确定缺血是否具有临床作用并且自动控制治疗或相应地产生警告信号。

6. 发明申请

US20120157861A1 DEVICES AND METHOD FOR DETERMINING AND MONITORING A CARDIAC STATUS OF A PATIENT BY USING PLVDT OR PLVST PARAMETERS 有权
标题翻译：使用PLVDT或PLVST参数确定和监测患者的心脏状态的装置和方法
公开(公告)号：US20120157861A1
公开(公告)日：2012-06-21
申请号：US13392395
申请日：2009-08-27
申请人： Karin Jarverud , Anders Bjorling , Jay Snell
发明人： Karin Jarverud , Anders Bjorling , Jay Snell
IPC分类号： A61B5/0402 , A61B5/0215 , A61B5/02
CPC分类号： A61B5/1102 , A61B5/02 , A61B5/0215 , A61B5/02416 , A61B5/042 , A61B5/0452 , A61B5/1118 , A61B5/6846 , A61B5/7275 , A61B5/7278 , A61B7/023 , A61N1/3627
摘要： The present invention relates to an improved medical device and method for accurately and reliably determining a cardiac status of a patient. An implantable medical device, IMD, comprises a sensor arrangement adapted to sense signals related to mechanical activity of the heart and an activity level sensor arrangement adapted to sense an activity level of the patient. Further, the IMD calculates a percentage of left ventricular diastolic time (PLVDT) for a cardiac cycle corresponding to a relation between a diastolic time interval and a cardiac cycle time interval using the determined systolic and diastolic time intervals or a percentage of left ventricular systolic time (PLVST) for a cardiac cycle corresponding to a relation between a systolic interval time interval and a cardiac cycle time interval. A cardiac status is determined based on the calculated PLVDT (or PLVST) and on an activity level of the patient.
摘要翻译：本发明涉及用于准确且可靠地确定患者的心脏状态的改进的医疗装置和方法。可植入医疗装置IMD包括适于感测与心脏的机械活动相关的信号的传感器装置和适于感测患者的活动水平的活动度传感器装置。此外，IMD使用确定的收缩期和舒张时间间隔或左心室收缩期的百分比来计算对应于舒张时间间隔和心动周期时间间隔之间的关系的心脏周期的左心室舒张时间（PLVDT）的百分比（PLVST），其对应于收缩期间隔时间间隔和心搏周期时间间隔之间的关系。基于计算的PLVDT（或PLVST）和患者的活动水平来确定心脏状态。

7. 发明授权

US08521267B1 Methods and systems for trending ST segment changes over time 有权
标题翻译： ST段趋势变化的方法和系统随着时间的推移而变化
公开(公告)号：US08521267B1
公开(公告)日：2013-08-27
申请号：US11771660
申请日：2007-06-29
申请人： Laleh Jalali , Jay Snell , Elizabeth Bacon , Katie Hoberman , Bing Zhu
发明人： Laleh Jalali , Jay Snell , Elizabeth Bacon , Katie Hoberman , Bing Zhu
IPC分类号： A61B5/0472
CPC分类号： A61B5/0472 , A61B5/0022 , A61B5/0031 , A61N1/3622 , A61N1/3627 , A61N1/36507 , A61N1/36585 , G06F19/00 , G16H40/63
摘要： A method and system are provided for trending a coronary burden such as an ischemic burden or acute myocardial infarction (AMI) for a patient. Trending provides obtaining cardiac data over a period of time, identifying the onset and the termination of coronary episodes based on a ST segment variation within the cardiac data, recording coronary burden information, and presenting the coronary burden information to a user. The coronary burden information may include the number of coronary episodes occurring over a period of time, the time duration of the coronary episodes, and the maximum ST segment variations for the coronary episodes that occur over a period of time.
摘要翻译：提供了一种方法和系统，用于对患者的冠状动脉负荷如缺血负担或急性心肌梗塞（AMI）进行趋势。趋势提供在一段时间内获得心脏数据，基于心脏数据内的ST段变化识别冠状动脉发作的发作和终止，记录冠状动脉负荷信息，以及向使用者呈现冠状动脉负荷信息。冠状动脉负荷信息可以包括在一段时间内发生的冠状动脉发作次数，冠状动脉发作的持续时间以及在一段时间内发生的冠状动脉发作的最大ST段变化。

8. 发明授权

US08214033B2 Interferential cardiac preconditioning and depolarization 有权
标题翻译：干预心脏预处理和去极化
公开(公告)号：US08214033B2
公开(公告)日：2012-07-03
申请号：US12265579
申请日：2008-11-05
申请人： Jay Snell , Mary Elizabeth Bush
发明人： Jay Snell , Mary Elizabeth Bush
IPC分类号： A61N1/00
CPC分类号： A61N1/3925 , A61N1/3906 , A61N1/3918 , A61N1/3956
摘要： Exemplary systems, devices, and methods pertaining to cardiac related therapy and particularly to interferential cardiac preconditioning and depolarization are described. A cardiac arrhythmia is detected from electrogram data sensed from a patient's heart and a region of the heart affected by the cardiac arrhythmia is determined. The affected region is interferentially energized by multiple cycles of two concurrently delivered alternating currents which are offset in frequency.
摘要翻译：描述了与心脏相关治疗有关的示例性系统，装置和方法，特别是涉及干扰性心脏预处理和去极化。从患者心脏感测的电描记图数据中检测到心律失常，并确定受心律失常影响的心脏区域。受影响的区域通过两个同时传递的交流电流在频率上偏移的多个周期被周向地激励。

9. 发明申请

US20110245699A1 SYSTEMS AND METHODS RELATED TO ST SEGMENT MONITORING BY AN IMPLANTABLE MEDICAL DEVICE 有权
标题翻译：通过可植入医疗器械进行ST段监测的系统和方法
公开(公告)号：US20110245699A1
公开(公告)日：2011-10-06
申请号：US13049805
申请日：2011-03-16
申请人： Jay Snell , Bing Zhu , Katie Hoberman , Harish Krishnaswamy
发明人： Jay Snell , Bing Zhu , Katie Hoberman , Harish Krishnaswamy
IPC分类号： A61B5/0452
CPC分类号： A61B5/0452 , A61B5/7264
摘要： Cardiac activity is sensed over a plurality of heart beats defining a beat set. For each beat in the set, it is determined whether the beat is a non-classified beat (e.g., paced beat, a beat outside of a specified heart rate range or a PVC), or a classified beat. For each classified beat, it is determined whether the beat is a non-detect beat, a minor beat or a major beat. Counts of classified beats, non-classified beats, major beats, minor beats, and non-detect beats are maintained. The beat set is declared to be one of a non-classified set, a major set, a minor set or a non-detect set based on the relative counts of classified beats, non-classified beats, major beats, minor beats, and non-detect beats. Over a period of time, counts of beat-set types are maintained and entry into and exit from ST episodes are determined based on these beat-set counts.
摘要翻译：在定义拍子组的多个心跳上感测到心脏活动。对于集合中的每个节拍，确定节拍是否是非分类节拍（例如，节奏拍子，指定的心率范围或PVC之外的节拍）或分类节拍。对于每个分类的节拍，确定节拍是否是非检测节拍，小节奏或主要节拍。维持分类节拍，非分类节拍，主要节拍，次要节拍和非检测节拍的数量。基于分类节拍，非分类节拍，主要节拍，次要节拍和非节奏组合的相对计数，节拍组被宣布为非分类组，主要组，未成年组或未检测组之一检测节拍在一段时间内，基于这些节拍设置计算确定节拍类型的计数，并且进入和退出ST剧集。

10. 发明授权

US07930017B1 Method and system for trending variation in coronary burden across multiple heart rate ranges 有权
标题翻译：多个心率范围冠状动脉负荷变化趋势的方法和系统
公开(公告)号：US07930017B1
公开(公告)日：2011-04-19
申请号：US11753759
申请日：2007-05-25
申请人： Eric S. Fain , Jay Snell , Katie Hoberman , Laleh Jalali , Bing Zhu , Jeffery D. Snell
发明人： Eric S. Fain , Jay Snell , Katie Hoberman , Laleh Jalali , Bing Zhu , Jeffery D. Snell
IPC分类号： A61B5/04
CPC分类号： A61B5/0402 , A61B5/024 , A61B5/02405 , A61B5/6846
摘要： A method and system are provided for trending variation in coronary burden across multiple heart rate ranges. The method and system include obtaining cardiac signals having a segment of interest over a period of time where each cardiac signal has an associated heart rate that falls within at least one heart rate range. Segment variations of the segment of interest are determined and grouped based on the associated heart rates to produce distributions of segment variations that are associated with the heart rate ranges. Trending information is produced by automatically comparing the distributions of segment variations between different heart rate ranges.
摘要翻译：提供了一种方法和系统，用于跨越多个心率范围的冠状动脉负荷的趋势变化。所述方法和系统包括在一段时间内获得具有感兴趣区段的心脏信号，其中每个心脏信号具有落入至少一个心率范围内的相关心率。基于相关的心率来确定和分组感兴趣区段的区段变化，以产生与心率范围相关联的区段变化的分布。通过自动比较不同心率范围之间的段变化的分布来产生趋势信息。

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