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1. 发明申请

WO2010056426A1 HEART FAILURE DECOMPENSATION DETERMINATION 审中-公开
标题翻译：心脏衰竭解决决定
公开(公告)号：WO2010056426A1
公开(公告)日：2010-05-20
申请号：PCT/US2009/059151
申请日：2009-10-01
申请人： MEDTRONIC, INC. , CHO, Yong, K. , SARKAR, Shantanu , HETTRICK, Douglas, A. , TAEPKE, Robert, T., II
发明人： CHO, Yong, K. , SARKAR, Shantanu , HETTRICK, Douglas, A. , TAEPKE, Robert, T., II , BENNETT, Thomas, D.
IPC分类号： A61B5/021 , A61B5/053
CPC分类号： A61B5/0452 , A61B5/0215 , A61B5/053 , A61B5/0538 , A61N1/3627 , A61N1/36521 , A61N1/36564
摘要： Heart failure decompensation is detected by sensing at least one physiological signal. Values of at least two different heart failure variables are derived using one or more physiological signals and a threshold for the first heart failure variable is adjusted in response to the value of the second heart failure variable. The value of the first heart failure variable is compared to first threshold for detecting a heart failure condition.
摘要翻译：通过感测至少一个生理信号来检测心力衰竭失代偿。使用一个或多个生理信号导出至少两个不同的心力衰竭变量的值，并且响应于第二心力衰竭变量的值调整第一心力衰竭变量的阈值。将第一心力衰竭变量的值与用于检测心力衰竭状况的第一阈值进行比较。

2. 发明申请

WO2010014931A1 ESTIMATING CARDIOVASCULAR PRESSURE AND VOLUME USING IMPEDANCE MEASUREMENTS 审中-公开
标题翻译：使用阻力测量估算心血管压力和体积
公开(公告)号：WO2010014931A1
公开(公告)日：2010-02-04
申请号：PCT/US2009/052450
申请日：2009-07-31
申请人： MEDTRONIC, INC. , HETTRICK, Douglas, A. , CHO, Yong, K. , ROUW, Mattias , SARKAR, Shantanu , ZIELINSKI, Todd, M.
发明人： HETTRICK, Douglas, A. , CHO, Yong, K. , ROUW, Mattias , SARKAR, Shantanu , ZIELINSKI, Todd, M.
IPC分类号： A61B5/0215 , A61B5/053 , A61N1/365
CPC分类号： A61N1/36521 , A61B5/021 , A61B5/0215 , A61B5/02158 , A61B5/053 , A61B5/0535 , A61B5/0538 , A61B5/7239 , A61N1/36564
摘要： Techniques for estimating a cardiac chamber or vascular pressure based upon impedance are described. A device or system may measure an impedance between at least two electrodes implanted within or proximate to a cardiovascular system. The device or system may estimate a pressure of an element of the cardiovascular system based on a relationship between impedance and volume of the element, and based on a empirical relationship between the volume and the pressure. The device or system may also estimate the dimension of the element based on the impedance-volume relationship, or other characteristics based on the impedance. Because the impedance measurements may be obtained, in some examples, by using electrodes and leads implanted within the cardiovascular system and coupled to an implantable medical device, a practical estimation of a cardiovascular pressure can be obtained on a chronic basis without requiring the use other invasive sensors, such as micronanometer transducers.
摘要翻译：描述了基于阻抗估计心室或血管压力的技术。装置或系统可以测量植入在心血管系统内或其附近的至少两个电极之间的阻抗。装置或系统可以基于元件的阻抗和体积之间的关系，并且基于体积和压力之间的经验关系来估计心血管系统的元件的压力。装置或系统还可以基于阻抗 - 体积关系或基于阻抗的其它特性来估计元件的尺寸。由于可以获得阻抗测量值，在一些示例中，通过使用植入心血管系统内并连接到可植入医疗装置的电极和引线，可以长期获得心血管压力的实际估计，而不需要使用其它侵入性传感器，如微量计传感器。

3. 发明申请

WO2009131768A1 PRESSURE AND IMPEDANCE BASED DISCRIMINATION OF HEMODYNAMIC STABILITY 审中-公开
标题翻译：基于压力和阻力的血液动力学稳定性的辨别
公开(公告)号：WO2009131768A1
公开(公告)日：2009-10-29
申请号：PCT/US2009/037109
申请日：2009-03-13
申请人： MEDTRONIC, INC. , HETTRICK, Douglas, A. , VINCENT, Kevin, P. , SARKAR, Shantanu , CHO, Yong, K. , ZIELINSKI, Todd, M.
发明人： HETTRICK, Douglas, A. , VINCENT, Kevin, P. , SARKAR, Shantanu , CHO, Yong, K. , ZIELINSKI, Todd, M.
IPC分类号： A61N1/362 , A61N1/365
CPC分类号： A61N1/36585 , A61B5/0535 , A61B5/0538 , A61B5/7264 , A61N1/00 , A61N1/36521 , A61N1/36564 , A61N1/3962
摘要： An implantable cardioverter defibrillator evaluates the hemodynamic stability of an arrhythmia to determine whether or not to defibrillate. The device obtains cardiac pressure and cardiac impedance data and evaluates a phase relationship between these parameters. Hemodynamically stable rhythms will result in an out of phase relationship.
摘要翻译：植入式心律转复除颤器评估心律失常的血液动力学稳定性，以确定是否除颤。该装置获得心脏压力和心脏阻抗数据，并评估这些参数之间的相位关系。血液动力学稳定的节律将导致异相关系。

4. 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。

5. 发明申请

WO2012057860A1 HEART FAILURE MONITORING AND NOTIFICATION 审中-公开
标题翻译：心脏失效监测和通报
公开(公告)号：WO2012057860A1
公开(公告)日：2012-05-03
申请号：PCT/US2011/033991
申请日：2011-04-26
申请人： MEDTRONIC, INC. , HETTRICK, Douglas, A. , SARKAR, Shantanu , OUSDIGIAN, Kevin, T.
发明人： HETTRICK, Douglas, A. , SARKAR, Shantanu , OUSDIGIAN, Kevin, T.
IPC分类号： G06F19/00
CPC分类号： A61B5/7275 , A61B5/0022 , A61B5/0031 , A61B5/0205 , A61B5/02405 , A61B5/046 , A61B5/0464 , A61B5/0538 , A61B5/1118 , A61B5/4875 , A61B5/686 , G06F19/00 , G06F19/3418 , G16H50/30
摘要： Techniques for generating a heart failure risk score with detected patient metrics are described. An implantable medical device (IMD) may collect and store patient data regarding therapy use statistics, thoracic impedance, heart rate, patient activity, and other patient metrics. Based on the number of patient metrics exceeding their respective metric thresholds, the IMD may automatically generate a risk score that indicates the likelihood that the patient will suffer from heart failure. The risk score may identify a patient as requiring immediate medical attention to reduce the risk of heart failure. The IMD may push an alert of the heart failure risk score to a clinician, and the clinician may review the patient metric data on an external device. In some examples, a clinician may prioritize patient treatment with a presented list ranking patients with the most severe heart failure risk scores.
摘要翻译：描述用于产生具有检测到的患者度量的心力衰竭风险评分的技术。可植入医疗设备（IMD）可以收集和存储关于治疗使用统计，胸部阻抗，心率，患者活动和其他患者度量的患者数据。基于超过其各自度量阈值的患者指标的数量，IMD可以自动产生指示患者将患有心力衰竭的可能性的风险评分。风险评分可能会确定患者需要立即就医以减少心力衰竭的风险。 IMD可以向临床医生推荐心力衰竭风险评分的警报，并且临床医生可以在外部设备上检查患者度量数据。在一些例子中，临床医生可以用列出的列表对患者治疗进行优先级排序，排除具有最严重心力衰竭风险评分的患者。

6. 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。

7. 发明申请

WO2012057867A1 CARDIAC THERAPY BASED UPON IMPEDANCE SIGNALS 审中-公开
标题翻译：基于阻抗信号的心脏病治疗
公开(公告)号：WO2012057867A1
公开(公告)日：2012-05-03
申请号：PCT/US2011/034486
申请日：2011-04-29
申请人： MEDTRONIC, INC. , HETTRICK, Douglas, A. , ZIELINSKI, Todd, M. , WARMAN, Eduardo , SARKAR, Shantanu
发明人： HETTRICK, Douglas, A. , ZIELINSKI, Todd, M. , WARMAN, Eduardo , SARKAR, Shantanu
IPC分类号： A61N1/365 , A61B5/053
CPC分类号： A61N1/36521 , A61B5/0452 , A61B5/0535 , A61B5/7239 , A61N1/3627 , A61N1/3682 , A61N1/3684 , A61N1/3987
摘要： Methods and/or devices are disclosed herein for monitoring cardiac impedance signal and delivering therapy to a patient's heart based upon the monitored cardiac impedance.
摘要翻译：本文公开了用于监测心脏阻抗信号并基于所监测的心脏阻抗将治疗递送到患者心脏的方法和/或装置。

8. 发明申请

WO2011093917A1 QUANTIFYING AUTONOMIC TONE WITH THORACIC IMPEDANCE 审中-公开
标题翻译：定量自动音调与THORACIC阻抗
公开(公告)号：WO2011093917A1
公开(公告)日：2011-08-04
申请号：PCT/US2010/033915
申请日：2010-05-06
申请人： MEDTRONIC, INC. , HETTRICK, Douglas, A. , HEFNER, Donald, J. , SARKAR, Shantanu , ZIELINSKI, Todd, M.
发明人： HETTRICK, Douglas, A. , HEFNER, Donald, J. , SARKAR, Shantanu , ZIELINSKI, Todd, M.
IPC分类号： A61N1/365 , A61B5/053
CPC分类号： A61N1/36521 , A61B5/0031 , A61B5/0215 , A61B5/02405 , A61B5/053 , A61B5/08 , A61B5/11 , A61B5/1116 , A61B5/4035 , A61N1/36535 , A61N1/37247 , A61N1/37258
摘要： The disclosure describes techniques for quantifying the autonomic nervous system (ANS) health of a patient with thoracic impedance measurements. Thoracic impedance may be measured utilizing cardiac electrodes and an implantable medical device housing or other electrodes located on or within the patient. Since greater variability in thoracic impedance may indicate better health of the ANS, monitoring impedance changes in a patient may be used to quantify autonomic tone of the ANS, and ultimately, overall patient health. In some examples, thoracic impedance may be measured in response to a change in patient posture for acute monitoring or at predetermined times over several days, weeks, or months for more chronic monitoring of the patient. An implantable medical device may independently analyze the impedance measurements and transmit an alert to the patient or clinician when impedance changes indicate a change in patient health.
摘要翻译：本公开描述了用于量化具有胸部阻抗测量的患者的自主神经系统（ANS）健康的技术。可以使用心电极和位于患者内部或内部的可植入医疗装置外壳或其它电极来测量胸腔阻抗。由于胸部阻抗变化较大可能表明ANS的健康状况良好，所以监测患者的阻抗变化可用于量化ANS的自主音调，并最终对整体患者的健康状况进行量化。在一些示例中，可以响应于用于急性监测的患者姿势的变化或在几天，几周或几个月的预定时间来测量胸部阻抗以进行更长期的患者监测。当阻抗变化表示患者健康状况发生变化时，植入式医疗设备可以独立地分析阻抗测量结果并向患者或临床医生发送警报。

9. 发明申请

WO2006104844A3 SYSTEM FOR CHARACTERIZING CHRONIC PHYSIOLOGICAL DATA 审中-公开
公开(公告)号：WO2006104844A3
公开(公告)日：2006-10-05
申请号：PCT/US2006/010589
申请日：2006-03-23
申请人： MEDTRONIC, INC. , ZIEGLER, Paul, D. , HETTRICK, Douglas, A. , SARKAR, Shantanu
发明人： ZIEGLER, Paul, D. , HETTRICK, Douglas, A. , SARKAR, Shantanu
IPC分类号： A61B5/00
摘要： An implantable medical device (IMD) senses physiological episodes and stores data associated with the physiological episodes in the IMD. The data is then processed based on a pattern of recurrence of the physiological episodes.

10. 发明申请

WO2009134581A1 MULTI-FREQUENCY IMPEDANCE MONITORING SYSTEM 审中-公开
标题翻译：多频阻抗监测系统
公开(公告)号：WO2009134581A1
公开(公告)日：2009-11-05
申请号：PCT/US2009/039314
申请日：2009-04-02
申请人： MEDTRONIC, INC. , ZIELINSKI, Todd, M. , HETTRICK, Douglas, A. , SARKAR, Shantanu
发明人： ZIELINSKI, Todd, M. , HETTRICK, Douglas, A. , SARKAR, Shantanu
IPC分类号： A61B5/05
CPC分类号： A61B5/0809 , A61B5/053 , A61B5/0538 , A61B5/4869 , A61B5/686 , A61B5/7257 , A61N1/36521
摘要： A system and method is provided to measure intrathoracic complex impedance and to identify and indicate disease conditions based on the impedance measurements. Multiple impedance vectors may be taken into account, and an optimal vector may be selected to provide the most useful impedance measurement for the identification and indication of disease conditions.
摘要翻译：提供了一种系统和方法来测量胸腔内复合阻抗，并根据阻抗测量来识别和指示疾病状况。可以考虑多个阻抗矢量，并且可以选择最佳矢量以提供用于疾病状况的识别和指示的最有用的阻抗测量。

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