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1. 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。

2. 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。

3. 发明申请

WO2012003291A2 SYSTEM AND METHOD FOR ESTABLISHING EPISODE PROFILES OF DETECTED TACHYCARDIA EPISODES 审中-公开
标题翻译：用于建立检测到的TACHYCARDIA EPISODE的EPISODE分布的系统和方法
公开(公告)号：WO2012003291A2
公开(公告)日：2012-01-05
申请号：PCT/US2011/042551
申请日：2011-06-30
申请人： MEDTRONIC, INC. , ZHANG, Xusheng , STADLER, Robert, W. , HETTRICK, Douglas, A.
发明人： ZHANG, Xusheng , STADLER, Robert, W. , HETTRICK, Douglas, A.
IPC分类号： A61N1/365 , A61B5/0452 , A61N1/39
CPC分类号： A61B5/0464 , A61N1/3621 , A61N1/3962
摘要： A medical device and associated method sense a cardiac signal and initiate an arrhythmia episode detection process in response to the cardiac signal by enabling an arrhythmia detection counter to be adjusted during the detection process. Data is accumulated relating to cardiac events during the detection process. An arrhythmia episode profile is established using the accumulated data. The accumulated data includes a pattern of the adjustment of the detection counter during the detection process
摘要翻译：医疗装置和相关联的方法感测心脏信号，并且通过使得能够在检测过程期间调节心律失常检测计数器来响应于心脏信号而引发心律失常发作检测过程。在检测过程中与心脏事件相关的数据被累积。使用累积数据建立心律失常发作概况。累积数据包括在检测处理期间检测计数器的调整的模式

4. 发明申请

WO2010014063A1 PERIODIC BEAT DETECTION TO DETECT ARTIFACTS IN A CARDIAC ELECTROGRAM 审中-公开
标题翻译：在心脏电泳中检测人体的周期性BEAT检测
公开(公告)号：WO2010014063A1
公开(公告)日：2010-02-04
申请号：PCT/US2008/009244
申请日：2008-07-31
申请人： MEDTRONIC, INC. , ZHANG, Xusheng , GHANEM, Raja , STADLER, Robert, W.
发明人： ZHANG, Xusheng , GHANEM, Raja , STADLER, Robert, W.
IPC分类号： A61B5/0464
CPC分类号： A61B5/0464 , A61B5/0006 , A61B5/7203 , A61B5/7239 , A61N1/365
摘要： Techniques for determining whether artifacts are present in a cardiac electrogram are described. According to one example, a medical device senses a cardiac electrogram via electrodes. The medical device determines a derivative, e.g., a second order derivative, the electrogram. The medical device detects beats within the derivative, e.g., by comparing a rectified version of the derivative to one or more thresholds determined based on a maximum of the rectified derivative. The medical device determines whether the beats are periodic, and determines whether artifacts are present in the cardiac electrogram based on the determination of whether the beats are periodic. The medical device may further determine whether tachyarrhythmia is present and/or whether the cardiac rhythm of the patient is treatable based on the determination of whether the beats are periodic. For example, the medical device may determine that an electrogram is not treatable when the beats are periodic.
摘要翻译：描述了用于确定伪像是否存在于心电图中的技术。根据一个示例，医疗装置通过电极感测心电图。医疗设备确定导数，例如二阶导数，电描记图。医疗设备检测导数内的跳动，例如通过将导数的整流版本与基于校正导数的最大值确定的一个或多个阈值进行比较。医疗器械确定节拍是否是周期性的，并且基于确定节拍是否是周期性的确定来确定心脏电图中是否存在人造物。医疗装置可以基于是否是周期性的确定来进一步确定是否存在快速性心律失常和/或患者的心律是否可治疗。例如，当节拍是周期性的时，医疗装置可以确定电描记图是不可治疗的。

5. 发明申请

WO2008137529A2 METHOD AND APPARATUS FOR DETECTING ARRHYTHMIAS IN A MEDICAL DEVICE 审中-公开
标题翻译：用于检测医疗设备中的心律失常的方法和设备
公开(公告)号：WO2008137529A2
公开(公告)日：2008-11-13
申请号：PCT/US2008/062193
申请日：2008-05-01
申请人： MEDTRONIC, INC. , GHANEM, Raja, N. , STADLER, Robert, W. , ZHANG, Xusheng , KLECKNER, Karin, J. , KRAUSE, Paul, G.
发明人： GHANEM, Raja, N. , STADLER, Robert, W. , ZHANG, Xusheng , KLECKNER, Karin, J. , KRAUSE, Paul, G.
IPC分类号： A61B5/0456 , A61B5/046 , A61B5/0464 , A61B5/0468 , A61B5/0472 , A61N1/362
CPC分类号： A61N1/3704 , A61B5/046 , A61B5/0464 , A61B5/7239 , A61N1/05 , A61N1/0563 , A61N1/3925
摘要： A method and apparatus for determining oversensing of cardiac signals that includes a housing containing electronic circuitry, an electrode coupled to the electronic circuitry to sense cardiac signals, and a processor, positioned within the housing, to determine an oversensing characteristic associated with the cardiac signals sensed over a predetermined sensing window, and to identify oversensing in response to the determined oversensing characteristic.
摘要翻译：一种用于确定心脏信号的过度感测的方法和设备，所述方法和设备包括：包含电子电路的外壳，耦合到电子电路以感测心脏信号的电极，以及位于外壳内的处理器，以确定过度感测特征与在预定感测窗口上感测的心脏信号相关联，并且响应于所确定的过度感测特征来识别过度感测。

6. 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。

7. 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。

8. 发明申请

WO2012051163A1 A SEQUENTIAL DISCRIMINATION APPROACH FOR DETECTING TREATABLE CARDIAC RHYTHMS 审中-公开
标题翻译：用于检测可治疗心脏病的顺序分析方法
公开(公告)号：WO2012051163A1
公开(公告)日：2012-04-19
申请号：PCT/US2011/055732
申请日：2011-10-11
申请人： MEDTRONIC, INC. , ZHANG, Xusheng , STADLER, Robert, W. , GILLBERG, Jeffrey M.
发明人： ZHANG, Xusheng , STADLER, Robert, W. , GILLBERG, Jeffrey M.
IPC分类号： A61B5/0464 , A61N1/39
CPC分类号： A61B5/7267 , A61B5/0422 , A61B5/046 , A61B5/0464 , A61B5/686 , A61B5/7239 , A61N1/3624 , A61N1/3962
摘要： A system and method for use in a medical device for discriminating cardiac events establishes population-based thresholds corresponding to cardiac signal morphology metrics for discriminating between a first cardiac event and a second cardiac event. A population-based threshold criterion for discriminating cardiac events is established. The population-based threshold criterion is applied to a cardiac signal segment and the segment is classified if the criterion is satisfied. A patient-specific threshold is established in response to the sensed cardiac signal segment not being classified after applying the population-based threshold criterion. The sensed signal segment is classified in response to the patient-specific threshold comparison.
摘要翻译：用于辨别心脏事件的医疗装置中的系统和方法建立了对应于心脏信号形态度量的基于群体的阈值，用于区分第一心脏事件和第二心脏事件。建立了基于人群的阈值判别标准，用于辨别心脏事件。基于人群的阈值标准被应用于心脏信号段，并且如果满足标准，则对该段进行分类。响应于在应用基于群体的阈值标准之后未被分类的感测到的心脏信号段建立患者特异性阈值。感测的信号段根据患者特异性阈值比较进行分类。

9. 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。

10. 发明申请

WO2007013911A2 METHOD AND APPARATUS FOR DETECTION AND MONITORING OF T-WAVE ALTERNANS 审中-公开
标题翻译：用于检测和监测T波形变换器的方法和装置
公开(公告)号：WO2007013911A2
公开(公告)日：2007-02-01
申请号：PCT/US2006/027995
申请日：2006-07-19
申请人： MEDTRONIC, INC. , ZHOU, Xiaohong , MULLEN, Thomas, J. , GILLBERG, Jeffrey, M. , STADLER, Robert, W.
发明人： ZHOU, Xiaohong , MULLEN, Thomas, J. , GILLBERG, Jeffrey, M. , STADLER, Robert, W.
IPC分类号： A61N1/00 , A61B5/00
CPC分类号： A61B5/0452 , A61B5/0422 , A61N1/365 , A61N1/3702 , A61N1/37258
摘要： A system and method are provided for assessing T-wave alternans (TWA) using cardiac EGM signals received from implanted electrodes. A T-wave signal parameter is measured from signals received by an automatic gain control sense amplifier. A TWA measurement is computed from a beat-by-beat comparison of T-wave parameter measurements or using frequency spectrum techniques. The TWA measurement magnitude and measurement conditions are used in detecting a clinically important TWA. TWA assessment further includes discriminating concordant and discordant TWA in a multi-vector TWA assessment, and determining the association of a TWA measurement with QRS alternans, mechanical alternans, and other physiological events. A prediction of a pathological cardiac event is made in response to a TWA assessment. A response to a cardiac event prediction is provided.
摘要翻译：提供了一种使用从植入电极接收的心脏EGM信号评估T波交替（TWA）的系统和方法。从由自动增益控制读出放大器接收的信号测量T波信号参数。通过T波参数测量或使用频谱技术的逐拍比较来计算TWA测量。 TWA测量值和测量条件用于检测临床重要的TWA。 TWA评估还包括在多向量TWA评估中区分一致和不一致的TWA，并确定TWA测量与QRS交替，机械交替和其他生理事件的关联。病理性心脏事件的预测是针对TWA评估做出的。提供对心脏事件预测的响应。

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