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    • 5. 发明申请
    • SYSTEMS AND METHODS FOR MONITORING EFFECTIVENESS OF CONGESTIVE HEART FAILURE THERAPY
    • 用于监测充血性心力衰竭疗法的有效性的系统和方法
    • WO2008094816A3
    • 2008-10-16
    • PCT/US2008051978
    • 2008-01-25
    • MEDTRONIC INCSOWELAM SAMEHMARKOWITZ H TOBY
    • SOWELAM SAMEHMARKOWITZ H TOBY
    • A61B5/042A61B5/0285
    • A61B5/6826A61B5/0285A61B5/042A61B5/053A61B5/08A61B5/14551A61B5/4818A61B5/6838
    • A method for monitoring a patient includes measuring a series of consecutive pulse transit times (PTT's) of the patient, and processing the resulting PTT signal to detect a presence or absence of central sleep apnea (CSA). The method further includes determining an effectiveness of congestive heart failure therapy, which is being provided to the patient, based on the detected presence or absence of CSA. A system incorporating the method includes an electrode of an implantable medical device, which is adapted to pick up the patient's ventricular depolarization signals, a sensor, which is adapted to pick up peripheral arterial pulse signals of the patient, and a signal processor, which is adapted to receive the two types of signals and to process the signals according to the method. The system may provide the therapy via cardiac resynchronization pacing and, upon detection of CSA, the system may adjust at least one pacing parameter.
    • 用于监测患者的方法包括测量患者的一系列连续脉搏传播时间(PTT),并且处理所得到的PTT信号以检测中枢性睡眠呼吸暂停(CSA)的存在或不存在。 该方法进一步包括基于检测到的CSA的存在或不存在来确定提供给患者的充血性心力衰竭治疗的有效性。 结合该方法的系统包括适于拾取患者的心室去极化信号的可植入医疗设备的电极,适于拾取患者的外周动脉脉搏信号的传感器,以及信号处理器,其为 适于接收两种类型的信号并根据该方法处理信号。 系统可以通过心脏再同步起搏来提供治疗,并且在检测到CSA时,系统可以调整至少一个起搏参数。
    • 6. 发明申请
    • CHRONICALLY-IMPLANTABLE ACTIVE FIXATION MEDICAL ELECTRICAL LEADS AND RELATED METHODS FOR NON-FLUOROSCOPIC IMPLANTATION
    • 慢性植入式有源固定型医用电线及相关方法非手术植入
    • WO2008108901A8
    • 2010-02-18
    • PCT/US2007089087
    • 2007-12-28
    • MEDTRONIC INCMARKOWITZ H TOBYGIESE CHADWALDHAUSER STEVEN
    • MARKOWITZ H TOBYGIESE CHADWALDHAUSER STEVEN
    • A61B5/053A61N1/05
    • A61N1/0573A61B2034/2053A61N1/3627
    • Bio-impedance may be used for navigation systems to chronically implant pacing and defibrillation leads in the heart using a non-fluoroscopic position sensing unit (PSU), such as a modified LocaLisa® system from Medtronic Inc., which allows for variable frequency sampling of the position of electrode of a catheter. The PSU injects small AC signals via surface electrodes in three orthogonal axes, each on a slightly different frequency (e.g., near 30 KHz). Indwelling electrodes electrically connected to the PSU resolves the magnitude of induced voltage for each of the three frequencies, thus measuring voltage for each of the three axes. Voltages are divided by induced current to yield impedance in each axis for each electrode. Impedance is proportional to position within the body. Such a system requires that a conductive material, such as a retractable helical tip-electrode, be exposed during implantation. Since the tip is retracted during implantation, this disclosure provides a modified distal portion employing at least one aperture (or 'window') for fluid exposure of the helix-electrode and a deployable internal sleeve for covering the aperture(s) when the helix-electrode is extended.
    • 生物阻抗可用于导航系统,以使用非荧光位置感测单元(PSU)长期地在心脏中植入起搏和除颤引线,例如来自Medtronic Inc.的经修改的LocaLisa系统,该系统允许对 导管电极的位置。 PSU通过三个正交轴中的表面电极注入小的AC信号,每个在稍微不同的频率(例如,接近30KHz)处。 电连接到PSU的留置电极解决三个频率中的每一个的感应电压的大小,从而测量三个轴中的每一个的电压。 电压被感应电流除以每个电极的每个轴线产生阻抗。 阻抗与体内的位置成比例。 这样的系统需要在植入期间露出诸如可伸缩螺旋尖端电极的导电材料。 由于尖端在植入期间缩回,所以本公开提供了一种修改的远端部分,其采用用于螺旋电极的流体暴露的至少一个孔口(或“窗口”)和可展开的内部套筒, 电极延长。
    • 8. 发明申请
    • METHOD AND DEVICE FOR DETECTING RESPIRATORY DISTURBANCES
    • 检测呼吸紊乱的方法和装置
    • WO2004062484A3
    • 2004-09-16
    • PCT/US2004000671
    • 2004-01-09
    • MEDTRONIC INC
    • CHO YOUNG KYUNLAWABNI ABED ESHELDON TODD JMARKOWITZ H TOBYSOWELAM SAMEHPITSCHNEIDER RAYLENE
    • A61B5/0205A61B5/08
    • A61B5/4818A61B5/0205A61B5/0809A61B5/0816
    • A system and method is disclosed for monitoring respiration including sensing a signal that varies with respiration, deriving a respiration parameter, applying criteria for detecting a respiration disturbance and determining one or more respiratory disturbance metrics. The system preferably includes an implantable sensor with an associated implantable medical device such that chronic respiration monitoring is possible. The implantable medical device may execute methods for detecting and measuring respiratory disturbances or may store data to be transferred to an external device for detecting and measuring respiratory disturbances. Respiratory disturbance detection may trigger a responsive action such as physiological data storage, a change in therapy, or a clinician warning. Assessment of cardiac function may be made on metrics of respiratory disturbances or a measure of circulatory delay time following detection of a respiratory disturbance.
    • 公开了一种用于监测呼吸的系统和方法,包括感测随呼吸变化的信号,导出呼吸参数,应用用于检测呼吸干扰的标准以及确定一个或多个呼吸干扰度量。 该系统优选地包括具有相关联的可植入医疗装置的可植入传感器,使得慢性呼吸监测是可能的。 可植入医疗设备可以执行用于检测和测量呼吸干扰的方法,或者可以存储要传送到外部设备以检测和测量呼吸干扰的数据。 呼吸紊乱检测可能会触发响应动作,如生理数据存储,治疗变化或临床医师警告。 心脏功能的评估可以根据呼吸紊乱度量或者在检测到呼吸紊乱之后的循环延迟时间量度来进行。
    • 9. 发明申请
    • REGULARIZATION OF VENTRICULAR RATE DURING ATRIAL TACHYARRHYTHMIA
    • 心律失常的心室速率的定量
    • WO0038782A9
    • 2002-04-11
    • PCT/US9930915
    • 1999-12-22
    • MEDTRONIC INC
    • IGEL DAVID AMARKOWITZ H TOBYBETZOLD ROBERT AKLECKNER KAREN JSCHROETTER JERAMY A
    • A61N1/362A61N1/368
    • A61N1/3622
    • A pacing system provided with a mode switching feature and ventricular rate regularization (VRR) function adapted to stabilize or regularize ventricular heart rate during chronic or paroxysmal atrial tachyarrhythmia. In a preferred embodiment, the pacing system nominally operates in an atrial synchronized pacing mode such as DDD or DDDR pacing mode. In response to detection of atrial rhythm characteristics consistent with an atrial tachyarrhythmia, e.g., atrial fibrillation, a mode switch into a non-atrial synchronized, ventricular rate regularization pacing mode, e.g. DDIR or VDIR pacing mode, is made. If the VRR function is programmed on, the ventricular pacing rate based upon a rate responsive sensor derived ventricular pacing rate modulated on a beat by beat basis by preceding intrinsic or paced ventricular events, the stability of the intrinsic ventricular heart rate, and any atrial pace events to regularize the ventricular pacing rate. The pacing system may also be permanently programmed to the DDIR pacing mode with the VRR feature functioning continuously. The pacing system may also be permanently programmed to the VVIR pacing mode with VRR function activated, but without consideration of atrial pace events.
    • 具有模式切换特征和心室率正常化(VRR)功能的起搏系统适于在慢性或阵发性房性快速性心律失常期间稳定或规范心室心率。 在优选实施例中,起搏系统名义地以心房同步起搏模式(例如DDD或DDDR起搏模式)操作。 响应于检测与房性快速性心律失常(例如心房颤动)一致的心房节律特征,模式切换到非心房同步的心室速率正则化起搏模式,例如心房颤动。 DDIR或VDIR起搏模式。 如果VRR功能被编程,则基于速率响应传感器导出的心室起搏速率的心室起搏速率通过先前的内在或节奏心室事件,内部心室心率的稳定性和任何心房起搏 事件来规范心室起搏率。 起搏系统也可以永久编程到DDIR起搏模式,VRR功能连续工作。 起搏系统也可以被永久编程到VVIR起搏模式,VRR功能被激活,但不考虑心房速度事件。