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    • 1. 发明授权
    • System and method for monitoring cardiac function via cardiac sounds using an implantable cardiac stimulation device
    • 使用可植入心脏刺激装置通过心脏声音监测心脏功能的系统和方法
    • US07139609B1
    • 2006-11-21
    • US10346809
    • 2003-01-17
    • Xiaoyi MinPaul A. LevineEuljoon Park
    • Xiaoyi MinPaul A. LevineEuljoon Park
    • A61B5/02A61N1/365
    • A61N1/36585A61B5/02A61B5/04004A61B5/0402A61B5/7239A61B7/04A61N1/3627
    • Techniques are provided for performing internal measurement of heart sounds to estimate patient cardiac function in terms of stroke volume, cardiac output, or a maximum rate of change of aortic pressure with time (max dP/dt). Control parameters of the medical device are then automatically adjusted so as to optimize overall cardiac function or to provide for ventricular resynchronization therapy. In one example, heart sound signals are derived from acceleration signals received from an accelerometer. The heart sound signals are analyzed to identify S1 and S2 heart sounds as well as ejection period and isovolumic interval (ISOV). Proxies for max dP/dt, stroke volume and cardiac output are then derived from the S1 and S2 heart sounds, the ejection period and the ISOV. Alternative techniques, not requiring detection of ISOV, are employed for use if the patient has heart value regurgitation.
    • 提供技术用于进行心脏声音的内部测量,以根据中风量,心输出量或主动脉压随时间的最大变化率(最大dP / dt)来估计患者心脏功能。 然后自动调节医疗装置的控制参数,以便优化整体心脏功能或提供心室再同步治疗。 在一个示例中,从加速度计接收的加速度信号导出心音信号。 分析心音信号以识别S1和S2心音,以及射血期和等容间隔(ISOV)。 然后从S1和S2心脏声音,射血期和ISOV导出最大dP / dt,搏出量和心输出量的代理。 如果患者有心脏反流,则采用不需要检测ISOV的替代技术。
    • 2. 发明授权
    • System and method for determining optimal atrioventricular delay based on intrinsic conduction delays
    • 基于内在传导延迟确定最佳房室延迟的系统和方法
    • US07248925B2
    • 2007-07-24
    • US10928586
    • 2004-08-27
    • Ken BruhnsXiaoyi MinPaul A. LevineEuljoon Park
    • Ken BruhnsXiaoyi MinPaul A. LevineEuljoon Park
    • A61N1/36
    • A61N1/3627A61N1/3682
    • A system and method for estimating optimal atrioventricular delay values for use in pacing the ventricles. Both the intrinsic inter-atrial conduction delay and the intrinsic atrioventricular conduction delay are determined for the patient and then the preferred atrioventricular pacing delay is derived therefrom. By taking into account intrinsic inter-atrial delay along with intrinsic atrioventricular delay, a more reliable estimate of the true optimal atrioventricular delay values for the patient can be achieved than with techniques that only take into account intrinsic atrioventricular delay values. In one example, the technique uses intracardiac electrogram (IEGM) signals and surface electrocardiogram (EKG) signals and hence can be performed by an external programmer without requiring Doppler echocardiography or other cardiac performance monitoring techniques. In another example, wherein the implanted device is equipped with a coronary sinus lead, the technique uses only IEGM signals and hence can be performed by the device itself.
    • 用于估计用于起搏心室的最佳房室延迟值的系统和方法。 对于患者确定内在的心房传导延迟和内在的房室传导延迟,然后从其导出优选的房室起搏延迟。 通过考虑内在的心房延迟以及内在的房室延迟,可以实现比仅考虑内在房室延迟值的技术更可靠的估计患者的真正最佳房室延迟值。 在一个示例中,该技术使用心内电描记图(IEGM)信号和表面心电图(EKG)信号,因此可以由外部编程器执行,而不需要多普勒超声心动图或其他心脏监测技术。 在另一示例中,其中植入的装置配备有冠状窦引线,该技术仅使用IEGM信号,因此可以由装置本身执行。
    • 3. 发明授权
    • Method and system to graphically display programming parameters for multi-chamber devices
    • 用于图形显示多室设备的编程参数的方法和系统
    • US07333856B1
    • 2008-02-19
    • US10847709
    • 2004-05-17
    • Siew Bee ErQiuju HuangEuljoon ParkPaul A. Levine
    • Siew Bee ErQiuju HuangEuljoon ParkPaul A. Levine
    • A61N1/362
    • A61N1/37247
    • A method and system for programming an implantable therapeutic stimulation device sensing from and delivering therapeutic stimulations to multiple sites within a patient under a plurality of programmable parameters. The method includes automatically determining which parameters need to be programmed, graphically indicating specific parameters that need to be programmed in a spatial correspondence to the affected sites in the patient and/or displaying a waveform corresponding to expected physiological activity with the programming, and providing control inputs to program the specific parameters. The method can also include automatically evaluating the programmed parameters, and if errors exist in the programming, indicating the errors and awaiting corrective input, else programming the implantable device. The method can also include automatically determining a number of sensing and stimulation electrodes connected to the device.
    • 一种用于编程可植入治疗刺激装置的方法和系统,其在多个可编程参数下感测并向患者内的多个部位递送治疗刺激。 该方法包括自动确定哪些参数需要被编程,以图形方式指示需要编程的具体参数与病人的受影响部位的空间对应,和/或显示与编程有关的预期生理活动的波形,以及提供控制 输入来编程具体参数。 该方法还可以包括自动评估编程参数,并且如果编程中存在错误,指示错误并等待校正输入,则编程可植入设​​备。 该方法还可以包括自动确定连接到该装置的感测和刺激电极的数量。
    • 7. 发明授权
    • Systems and methods for use by an implantable medical device for controlling multi-site CRT pacing in the presence of atrial tachycardia
    • 用于在存在心房性心动过速时用于控制多部位CRT起搏的可植入医疗装置的系统和方法
    • US08447400B2
    • 2013-05-21
    • US12822983
    • 2010-06-24
    • Rohan A. MoreHeidi HellmanEliot L. OstrowPaul A. Levine
    • Rohan A. MoreHeidi HellmanEliot L. OstrowPaul A. Levine
    • A61N1/368
    • A61N1/368A61N1/3624A61N1/3684A61N1/3688
    • Systems and methods are provided for use by implantable medical devices equipped to deliver multi-site left ventricular (MSLV) pacing. MSLV is associated with a relatively long post-ventricular atrial blanking (PVAB) period that might limit the detection of pathologic rapid organized atrial tachycardias (OAT). In one example, MSLV cardiac resynchronization therapy (CRT) pacing is delivered within a tracking mode. A possible atrial tachycardia is detected based on the atrial rate exceeding an atrial tachycardia assessment rate (ATAR) threshold. The device then switches to single-site LV pacing, thereby effectively shortening the PVAB to detect additional atrial events that might otherwise be obscured, and thereby permitting the device to more reliably distinguish organized atrial tachycardias (such as atrial flutter) from sinus tachycardia. The device may also employ an automatic mode switch (AMS) threshold that is set higher than the ATAR threshold for use in switching from tracking modes to nontracking modes.
    • 系统和方法被提供用于装备用于递送多部位左心室(MSLV)起搏的可植入医疗装置的使用。 MSLV与相对较长的心室后空位(PVAB)相关,可能限制病理性快速组织性房性心动过速(OAT)的检测。 在一个示例中,MSLV心脏再同步治疗(CRT)起搏在跟踪模式内递送。 基于心房速率超过心房心动过速评估率(ATAR)阈值,可以检测到心房心动过速。 然后,该装置切换到单位置LV起搏,从而有效地缩短PVAB以检测可能被模糊的额外的心房事件,从而允许该装置更可靠地区分有组织的心房心动过速(例如心房扑动)和窦性心动过速。 设备还可以采用设置为高于ATAR阈值的自动模式切换(AMS)阈值,用于从跟踪模式切换到非跟踪模式。
    • 9. 发明申请
    • Systems and Methods for Use by an Implantable Medical Device for Controlling Multi-Site CRT Pacing in the Presence of Atrial Tachycardia
    • 可植入医疗器械使用的系统和方法用于控制心房心动过速的多站点CRT起搏
    • US20110319951A1
    • 2011-12-29
    • US12822983
    • 2010-06-24
    • Rohan A. MoreHeidi HellmanEliot L. OstrowPaul A. Levine
    • Rohan A. MoreHeidi HellmanEliot L. OstrowPaul A. Levine
    • A61N1/368
    • A61N1/368A61N1/3624A61N1/3684A61N1/3688
    • Systems and methods are provided for use by implantable medical devices equipped to deliver multi-site left ventricular (MSLV) pacing. MSLV is associated with a relatively long post-ventricular atrial blanking (PVAB) period that might limit the detection of pathologic rapid organized atrial tachycardias (OAT). In one example, MSLV cardiac resynchronization therapy (CRT) pacing is delivered within a tracking mode. A possible atrial tachycardia is detected based on the atrial rate exceeding an atrial tachycardia assessment rate (ATAR) threshold. The device then switches to single-site LV pacing, thereby effectively shortening the PVAB to detect additional atrial events that might otherwise be obscured, and thereby permitting the device to more reliably distinguish organized atrial tachycardias (such as atrial flutter) from sinus tachycardia. The device may also employ an automatic mode switch (AMS) threshold that is set higher than the ATAR threshold for use in switching from tracking modes to nontracking modes.
    • 系统和方法被提供用于装备用于递送多部位左心室(MSLV)起搏的可植入医疗装置的使用。 MSLV与相对较长的心室后空泡(PVAB)相关,可能限制病理性快速组织性房性心动过速(OAT)的检测。 在一个示例中,MSLV心脏再同步治疗(CRT)起搏在跟踪模式内递送。 基于心房速率超过心房心动过速评估率(ATAR)阈值,可以检测到心房心动过速。 然后,该装置切换到单位置LV起搏,从而有效地缩短PVAB以检测可能被模糊的额外的心房事件,从而允许该装置更可靠地区分有组织的心房心动过速(例如心房扑动)和窦性心动过速。 设备还可以采用设置为高于ATAR阈值的自动模式切换(AMS)阈值,用于从跟踪模式切换到非跟踪模式。
    • 10. 发明授权
    • Automatic signal amplitude measurement system in the setting of abnormal rhythms
    • 自动信号幅度测量系统在设定异常节奏
    • US08082036B2
    • 2011-12-20
    • US12266441
    • 2008-11-06
    • Paul A. LevineAmdt Godau
    • Paul A. LevineAmdt Godau
    • A61N1/37
    • A61N1/3706
    • A system for automatically evaluating the sensing and detection of physiological processes by an implantable medical device, such as an implantable cardiac stimulation device. The system includes an automatic testing algorithm which iteratively adjusts at least one of the threshold and gain settings of the device and evaluates the accuracy of the detection for refining the programming of the device. The algorithm can include sampling the physiological process beginning at a relatively low rate to avoid excessive burden on the processing and battery capacity available and progressively increasing the rate to obtain higher resolution data. The algorithm can also evaluate the observed physiological process for periodicity and can determine repetition of an irregular pattern, such as bigeminy, and use the determined pattern for predictive purposes to refine the programming of the device. The algorithm employs observation of a change in observed pattern as indicia for loss of proper detection.
    • 一种用于通过可植入医疗装置(例如可植入心脏刺激装置)自动评估生理过程的感测和检测的系统。 该系统包括自动测试算法,其迭代地调整设备的阈值和增益设置中的至少一个,并评估用于精简设备编程的检测的准确性。 该算法可以包括以相对较低的速率开始生理过程的采样,以避免对可用处理和电池容量的过度负担,并逐渐增加速率以获得更高分辨率的数据。 该算法还可以评估观察到的生理过程的周期性,并且可以确定诸如bigeminy的不规则图案的重复,并且使用确定的图案进行预测目的来改进设备的编程。 该算法使用观察模式的变化观察作为丢失适当检测的标记。