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11. 发明申请

WO2012015498A1 PREVENTION OF FALSE ASYSTOLE OR BRADYCARDIA DETECTION 审中-公开
标题翻译：防止异常或BRADYCARDIA检测
公开(公告)号：WO2012015498A1
公开(公告)日：2012-02-02
申请号：PCT/US2011/033560
申请日：2011-04-22
申请人： MEDTRONIC, INC. , STADLER, Robert, W. , JONGEN, Tim Dirk, Jan , HOUBEN, Richard, Pm
发明人： STADLER, Robert, W. , JONGEN, Tim Dirk, Jan , HOUBEN, Richard, Pm
IPC分类号： A61N1/37
CPC分类号： A61N1/37 , A61B5/0456
摘要： In general, this disclosure is directed to signal processing based methods to reject undersensing in a signal indicative of cardiac activity, e.g., ECG. The undersensing may be due to very small signal amplitudes or due to a sudden increase in single peak amplitude resulting in an increased sensing threshold. The undersensing may result in falsely detecting a cardiac event, e.g., asystole or bradycardia. The techniques of this disclosure monitor the behavior of the signal to determine when a detected asystole is false.
摘要翻译：通常，本公开涉及基于信号处理的方法来拒绝指示心脏活动的信号（例如ECG）中的不足感。欠感应可能是由于非常小的信号幅度或由于单峰幅度的突然增加导致增加的感测阈值。不足之处可能导致错误检测心脏事件，例如心搏停止或心动过缓。本公开的技术监测信号的行为以确定检测到的心搏停止是否为假。

12. 发明申请

WO2005055823A1 METHOD AND APPARATUS FOR DETECTING CHANGE IN PHYSIOLOGIC PARAMETERS 审中-公开
标题翻译：用于检测生理参数变化的方法和装置
公开(公告)号：WO2005055823A1
公开(公告)日：2005-06-23
申请号：PCT/US2004/040250
申请日：2004-12-01
申请人： MEDTRONIC, INC. , STADLER, Robert, W. , KLEKNER, Karen, J. , TAEPKE, Robert, T. II
发明人： STADLER, Robert, W. , KLEKNER, Karen, J. , TAEPKE, Robert, T. II
IPC分类号： A61B5/00
CPC分类号： A61B5/02055 , A61B5/0031 , A61B5/0215 , A61B5/024 , A61B5/145 , A61N1/37258 , A61N1/37282 , G06F19/00 , G06K9/00496
摘要： ABSTRACT A method and apparatus for detection of changes in physiologic parameters of a patient that includes generating measured physiologic parameters, generating an adaptive baseline trend of the measured physiologic parameters corresponding to a first time period, generating a short term trend of the measured physiologic parameters corresponding to a second time period less than the first time period, and generating a metric of physiologic parameter change between the adaptive baseline trend and one of a most recent measured physiologic parameter and the short term trend of the measured physiologic parameters.
摘要翻译：摘要一种用于检测患者生理参数变化的方法和装置，包括产生测量的生理参数，产生对应于第一时间段的测量生理参数的自适应基线趋势，产生相应的测量生理参数的短期趋势到第一时间段的第二时间段，并且产生自适应基线趋势与最近测量的生理参数和测量的生理参数的短期趋势之间的生理参数变化的度量。

13. 发明申请

WO2004075983A1 DETECTION OF TACHYARRHYTHMIA TERMINATION 审中-公开
标题翻译：检测TACHYARRHYTHMIA终止
公开(公告)号：WO2004075983A1
公开(公告)日：2004-09-10
申请号：PCT/US2004/004805
申请日：2004-02-19
申请人： MEDTRONIC, INC. , STADLER, Robert, W. , ERICKSEN, James, H. , WARMAN, Eduardo, N. , HOLBROOK, Reece, W.
发明人： STADLER, Robert, W. , ERICKSEN, James, H. , WARMAN, Eduardo, N. , HOLBROOK, Reece, W.
IPC分类号： A61N1/362
CPC分类号： A61N1/3622
摘要： Determining termination of an identified tachyarrhythmia episode may involve analysis of a relative decrease in tachyarrhythmia rate, a normalization of electrogram morphology criteria, or both. An implanted medical device may obtain a tachyarrhythmia rate and a morphology of a cardiac waveform. The device may compare the tachyarrhythmia rate to a threshold tachyarrhythmia rate and the morphology to a template morphology, and classify the heart beat as indicating termination of the tachyarrhythmia episode when the tachyarrhythmia rate is less than the threshold tachyarrhythmia rate, the morphology categorizes as normal, or both. For arrhythmias with no therapy delivered, observation of arrhythmia behavior at the point of termination may lead to improved classification. In addition, observation of a relative decrease in tachyarrhythmia rate immediately after therapy application can lead to application of slower but more specific criteria for redetection. Also, delivery of cardioversion shocks can be aborted upon tachyarrhythmia termination.
摘要翻译：确定确定的快速性心律失常发作的终止可能涉及快速心律失常率相对降低的分析，电描记图形态学标准的归一化或两者。植入式医疗装置可以获得心律失常速率和心脏波形的形态。该装置可以将快速性心律失常率与阈值快速性心律失常率和形态学比较为模板形态，并且当心律失常发生率低于阈值心动过速率时，将心跳分类为指示快速性心律失常发作的终止，形态分类为正常，或两者。对于没有治疗的心律失常，在终止时观察心律失常行为可能导致分类改善。另外，在治疗应用后立即观察到快速性心律失常率的相对降低可导致应用较慢但更具体的重新检测标准。此外，快速性心律失常终止可以中止心脏复律冲击的输送。

14. 发明申请

WO2009148425A1 IMPEDANCE VARIABILITY ANALYSIS TO IDENTIFY LEAD-RELATED CONDITIONS 审中-公开
标题翻译：阻碍可变性分析来识别与铅相关的条件
公开(公告)号：WO2009148425A1
公开(公告)日：2009-12-10
申请号：PCT/US2008/009027
申请日：2008-07-25
申请人： MEDTRONIC, INC. , STADLER, Robert, W. , GUNDERSON, Bruce, D. , PATEL, Amisha, S.
发明人： STADLER, Robert, W. , GUNDERSON, Bruce, D. , PATEL, Amisha, S.
IPC分类号： A61N1/362
CPC分类号： A61N1/36521 , A61N1/3706 , A61N2001/083
摘要： In general, the disclosure relates to techniques for calculating mean impedance values and impedance variability values to detect a possible condition with a lead or device-lead pathway or connection. In one example, a system may be configured to determine an impedance value for an electrical path based on a plurality of measured impedance values for the electrical path, wherein the electrical path comprises a plurality of electrodes, and to determine an impedance variability value based on at least one of the plurality of measured impedance values. The system may be further configured to determine a threshold value based on the determined impedance value and the impedance variability value, compare a newly measured impedance value for the electrical path to the threshold value, and indicate a possible condition of the electrical path based on the comparison.
摘要翻译：通常，本公开涉及用于计算平均阻抗值和阻抗变异性值以用于检测具有引线或器件引导路径或连接的可能状况的技术。在一个示例中，系统可以被配置为基于用于电路径的多个测量的阻抗值来确定电路径的阻抗值，其中电路径包括多个电极，并且基于以下方式确定阻抗变异性值：所述多个测量的阻抗值中的至少一个。该系统还可以被配置为基于所确定的阻抗值和阻抗变异性值来确定阈值，将新测量的电通路的阻抗值与阈值进行比较，并且基于该路径指示电路径的可能状态比较。

15. 发明申请

WO2012057852A1 ISCHEMIA DETECTION AND CLASSIFICATION 审中-公开
标题翻译： ISCHEMIA检测和分类
公开(公告)号：WO2012057852A1
公开(公告)日：2012-05-03
申请号：PCT/US2011/033811
申请日：2011-04-25
申请人： MEDTRONIC, INC. , SONG, Zhendong , STADLER, Robert, W.
发明人： SONG, Zhendong , STADLER, Robert, W.
IPC分类号： A61B5/0452 , A61B5/0245
CPC分类号： A61B5/0452 , A61B5/0245 , A61B5/1118
摘要： Techniques for detecting ischemia and classifying a type of ischemia are described. Electrograms of cardiac activity may be generated using implanted or external electrodes, e.g., electrodes carried on vascular leads within the heart and a housing electrode. In some examples, ischemia is detected and classified as benign or malignant based on whether a change an electrogram metric is detected, or first detected, in an endocardial electrogram or a non-endocardial electrogram. The relative timing of the change in the electrogram metric and a change in heart rate or patient activity may also be considered. In some examples, the system may create a stress test for detecting ischemia by instructing the patient to exercise or increasing the cardiac pacing rate.
摘要翻译：描述了用于检测缺血和分类一种缺血的技术。可以使用植入或外部电极（例如，在心脏内的血管引线上承载的电极和外壳电极）产生心脏活动的电描记图。在一些实例中，基于在心内膜电图或非心内膜电图中是否检测到或者首先检测到电描记图量度，检测到缺血并将其分类为良性或恶性。也可以考虑电描记图度量的变化和心率或患者活动变化的相对时间。在一些实例中，系统可以通过指示患者运动或增加心脏起搏速率来产生用于检测缺血的压力测试。

16. 发明申请

WO2010014066A1 USING MULTIPLE DIAGNOSTIC PARAMETERS FOR PREDICTING HEART FAILURE EVENTS 审中-公开
标题翻译：使用多种诊断参数预测心脏衰竭事件
公开(公告)号：WO2010014066A1
公开(公告)日：2010-02-04
申请号：PCT/US2008/009307
申请日：2008-07-31
申请人： MEDTRONIC, INC. , HETTRICK, Douglas, A. , STADLER, Robert, W. , SARKAR, Shantanu
发明人： HETTRICK, Douglas, A. , STADLER, Robert, W. , SARKAR, Shantanu
IPC分类号： A61B5/053 , A61B5/0215
CPC分类号： A61B5/053 , A61B5/0215 , A61B5/042 , A61B5/0538 , A61B5/6846
摘要： Techniques for using multiple physiological parameters to provide an early warning for worsening heart failure are described. A medical device monitors a primary diagnostic parameter that is indicative of worsening heart failure, such as intrathoracic impedance or pressure, and one or more secondary diagnostic parameters. The medical device detects worsening heart failure in the patient based on the primary diagnostic parameter when an index that is changed over time based on the primary diagnostic parameter value is outside a range of values, termed the threshold zone. When the index is within the threshold zone, the medical device detects worsening heart failure in the patient based on the one or more secondary diagnostic parameters. Upon detecting worsening heart failure, the medical device may, for example, provide an alert that enables the patient to seek medical attention before experiencing a heart failure event.
摘要翻译：描述了使用多种生理参数为恶化心力衰竭提供早期预警的技术。医疗设备监测指示心脏衰竭恶化的主要诊断参数，例如胸内阻抗或压力，以及一个或多个次要诊断参数。当基于主要诊断参数值随时间改变的索引在称为阈值区域的值的范围之外时，医疗装置基于主要诊断参数来检测患者的心脏衰竭的恶化。当索引在阈值区域内时，医疗装置基于一个或多个次要诊断参数来检测患者心脏衰竭的恶化。在检测到心脏衰竭恶化时，医疗装置可以例如提供使患者能够在经历心力衰竭事件之前寻求医疗护理的警报。

17. 发明申请

WO2011139483A1 METHOD OF DUAL EGM SENSING AND HEART RATE ESTIMATION IN IMPLANTED CARDIAC DEVICES 审中-公开
标题翻译：方法在双眼球感知和心率估计在植入心脏器械
公开(公告)号：WO2011139483A1
公开(公告)日：2011-11-10
申请号：PCT/US2011/031876
申请日：2011-04-11
申请人： MEDTRONIC, INC. , STADLER, Robert, W. , BLACK, Carrissa, Lynn, Bellardine
发明人： STADLER, Robert, W. , BLACK, Carrissa, Lynn, Bellardine
IPC分类号： A61N1/362 , A61B5/0464 , A61B5/0452
CPC分类号： A61B5/04525 , A61B5/02438 , A61B5/0464 , A61B5/686 , A61B5/7203 , A61N1/3622 , A61N1/3962
摘要： A method and apparatus for monitoring a patient's heart rate sense first cardiac events in a heart chamber using a first cardiac electrode pair and sense second cardiac events in the heart chamber using a second cardiac electrode pair. The method includes estimating a first heart rate using the first cardiac events, comparing the first heart rate to a heart rate threshold and estimating a second heart rate using the second cardiac events in response to the first heart rate exceeding the heart rate threshold, determining whether the second cardiac events are unreliable, and setting the second heart rate equal to the first heart rate in response to the second cardiac events being unreliable.
摘要翻译：用于监测患者心率的方法和装置使用第一心脏电极对感测心室中的第一心脏事件，并使用第二心电极对感测心室中的第二心脏事件。该方法包括使用第一心脏事件估计第一心率，将第一心率与心率阈值进行比较，并且响应于超过心率阈值的第一心率估计使用第二心脏事件的第二心率，确定是否第二心脏事件不可靠，并且响应于第二心脏事件不可靠而将第二心率设定为等于第一心率。

18. 发明申请

WO2010014070A1 DETECTING WORSENING HEART FAILURE BASED ON IMPEDANCE MEASUREMENTS 审中-公开
标题翻译：基于阻抗测量检测心脏衰竭的心脏衰竭
公开(公告)号：WO2010014070A1
公开(公告)日：2010-02-04
申请号：PCT/US2008/009336
申请日：2008-07-31
申请人： MEDTRONIC, INC. , HETTRICK, Douglas, A. , STADLER, Robert, W. , SARKAR, Shantanu
发明人： HETTRICK, Douglas, A. , STADLER, Robert, W. , SARKAR, Shantanu
IPC分类号： A61B5/053
CPC分类号： A61B5/053 , A61B5/746
摘要： Techniques for processing impedance data to provide an early warning for heart failure decompensation are described. An example device may be configured to measure intrathoracic impedance values, and increment an index when a determined impedance is less than a reference impedance. The incrementing may be based on the difference between the reference impedances and the determined impedance. In some examples, the amount of incrementing is reduced based on a variability of the impedances, or increased over time so long as the index remains above a threshold, e.g., zero. In some examples, the manner is which the reference impedances are determined changes over time to, for example, address rapid changes in impedance after device or system implantation. In some examples, the index is compared to a threshold to determine whether to provide an alert. In some examples, two thresholds are used to provide hysteresis.
摘要翻译：描述了用于处理阻抗数据以提供心力衰竭失代偿的早期警告的技术。示例性装置可以被配置为测量胸内阻抗值，并且当确定的阻抗小于参考阻抗时增加指数。增量可以基于参考阻抗和确定的阻抗之间的差异。在一些示例中，只要索引保持高于阈值（例如零），基于阻抗的可变性减小增量的量，或随时间增加。在一些示例中，确定参考阻抗的方式随时间而变化，例如，在器件或系统植入之后，阻抗的快速变化。在一些示例中，将索引与阈值进行比较，以确定是否提供警报。在一些示例中，使用两个阈值来提供滞后。

19. 发明申请

WO2005035052A1 METHOD AND APPARATUS FOR CONTROLLING EXTRA-SYSTOLIC STIMULATION (ESS) THERAPY USING ISCHEMIA DETECTION 审中-公开
标题翻译：用于控制异常刺激（ESS）治疗的方法和装置，使用ISCHEMIA检测
公开(公告)号：WO2005035052A1
公开(公告)日：2005-04-21
申请号：PCT/US2004/033274
申请日：2004-10-07
申请人： MEDTRONIC, INC. , WARKENTIN, Dwight, H. , STADLER, Robert, W. , ZILLMER, Glenn, C. , DENO, D. Curtis
发明人： WARKENTIN, Dwight, H. , STADLER, Robert, W. , ZILLMER, Glenn, C. , DENO, D. Curtis
IPC分类号： A61N1/362
CPC分类号： A61N1/3627
摘要： An implantable cardiac stimulation device capable of delivering ESS, monitoring for myocardial ischemia and responding to the detection of myocardial ischemia by modifying the delivery of ESS. Modification of ESS delivery may include disabling ESS, initiating ESS, and/or modifying ESS control parameters.
摘要翻译：一种植入式心脏刺激装置，能够传递ESS，监测心肌缺血，并通过修改ESS的传递来应对心肌缺血的检测。 ESS传送的修改可能包括禁用ESS，启动ESS和/或修改ESS控制参数。

20. 发明申请

WO2004050178A1 METHOD AND APPARATUS FOR DETECTING CHANGE IN INTRATHORACIC ELECTRICAL IMPEDANCE 审中-公开
标题翻译：用于检测血管电阻的变化的方法和装置
公开(公告)号：WO2004050178A1
公开(公告)日：2004-06-17
申请号：PCT/US2003/038440
申请日：2003-12-04
申请人： MEDTRONIC, INC.
发明人： STADLER, Robert, W. , WANG, Li
IPC分类号： A61N1/365
CPC分类号： A61B5/0538 , A61B5/0537 , A61B5/4875 , A61B5/686 , A61B5/7275 , A61N1/362 , A61N1/3627 , A61N1/36521 , G06F12/0862 , G06F12/0877
摘要： A method and apparatus for detection of changes in impedance a patient that includes generating measured impedances, generating an adaptive baseline trend of the measured impedances corresponding to a first time period, generating a short term trend of the measured impedances corresponding to a second time period less than the first time period, and generating a metric of impedance change between the adaptive baseline trend and one of a most recent measured impedance and the short term trend of the measured impedances.
摘要翻译：一种用于检测患者阻抗变化的方法和装置，包括产生测量的阻抗，产生对应于第一时间段的所测量的阻抗的自适应基线趋势，产生对应于第二时间段的所测量的阻抗的短期趋势并且产生自适应基线趋势与最近测量的阻抗之一和所测量的阻抗的短期趋势之间的阻抗变化的度量。

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