公开(公告)号：US20130325081A1

公开(公告)日：2013-12-05

申请号：US13485513

申请日：2012-05-31

申请人： Edward Karst ,  Richard Samade ,  Gene A. Bornzin ,  John W. Poore ,  Zoltan Somogyi ,  Didier Theret

发明人： Edward Karst ,  Richard Samade ,  Gene A. Bornzin ,  John W. Poore ,  Zoltan Somogyi ,  Didier Theret

IPC分类号： A61N1/365

CPC分类号： A61N1/368 ,  A61B5/0422 ,  A61B5/0452 ,  A61B5/0464 ,  A61B5/1107 ,  A61B5/6869 ,  A61B5/6882 ,  A61B2560/0468 ,  A61N1/36507 ,  A61N1/36514 ,  A61N1/36578 ,  A61N1/36592 ,  A61N1/37205 ,  A61N1/3756

摘要： A leadless intra-cardiac medical device senses cardiac activity from multiple chambers and applies cardiac stimulation to at least one cardiac chamber and/or generates a cardiac diagnostic indication. The leadless device may be implanted in a local cardiac chamber (e.g., the right ventricle) and detect near-field signals from that chamber as well as far-field signals from an adjacent chamber (e.g., the right atrium).

公开(公告)号：US20130041274A1

公开(公告)日：2013-02-14

申请号：US13207307

申请日：2011-08-10

申请人： Jong Gill ,  Rupinder Bharmi ,  Edward Karst ,  Ryan Rooke ,  Riddhi Shah ,  Fujian Qu ,  Gene A. Bornzin ,  Taraneh Ghaffari Farazi ,  Euljoon Park

发明人： Jong Gill ,  Rupinder Bharmi ,  Edward Karst ,  Ryan Rooke ,  Riddhi Shah ,  Fujian Qu ,  Gene A. Bornzin ,  Taraneh Ghaffari Farazi ,  Euljoon Park

IPC分类号： A61B5/0468

CPC分类号： A61B5/0468 ,  A61B5/0031 ,  A61B5/0205 ,  A61B5/02158 ,  A61B5/02405 ,  A61B5/0295 ,  A61B5/0422 ,  A61B5/4839 ,  A61N1/3702

摘要： Techniques are provided for detecting and distinguishing stroke and cardiac ischemia based on electrocardiac signals. In one example, the device senses atrial and ventricular signals within the patient along a set of unipolar sensing vectors and identifies certain morphological features within the signals such as PR intervals, ST intervals, QT intervals, T-waves, etc. The device detects changes, if any, within the morphological features such as significant shifts in ST interval elevation or an inversion in T-wave shape, which are indicative of stroke or cardiac ischemia. By selectively comparing changes detected along different unipolar sensing vectors, the device distinguishes or discriminates stroke from cardiac ischemia within the patient. The discrimination may be corroborated using various physiological and hemodynamic parameters. In some examples, the device further identifies the location of the ischemia within the heart. In still other examples, the device detects cardiac ischemia occurring during stroke.

摘要翻译： 提供了用于基于心电信号检测和区分中风和心脏缺血的技术。 在一个示例中，该装置沿着一组单极感测向量感测患者内的心房和心室信号，并且识别信号内的某些形态特征，例如PR间隔，ST间隔，QT间隔，T波等。该装置检测变化 （如果有的话）在形态学特征之中，例如ST间期升高的显着变化或T波形的反转，其指示中风或心脏缺血。 通过选择性地比较沿着不同的单极性感测向量检测的变化，该装置区分或区分患者体内的心脏缺血的中风。 可以使用各种生理和血液动力学参数来确认辨别。 在一些实例中，该装置还识别心脏内局部缺血的位置。 在另外的例子中，该装置检测在中风期间发生的心脏缺血。

公开(公告)号：US08175670B2

公开(公告)日：2012-05-08

申请号：US11521960

申请日：2006-09-15

申请人： Clark R. Baker, Jr. ,  Edward Karst ,  Carine Hoarau

发明人： Clark R. Baker, Jr. ,  Edward Karst ,  Carine Hoarau

IPC分类号： A61B5/1455 ,  A61B5/02

CPC分类号： A61B5/7207 ,  A61B5/02416 ,  A61B5/14551

摘要： A method and system for measuring a physiological parameter, comprising collecting a first absorbance at a first wavelength, chosen to be primarily absorbed by water; collecting a second absorbance at a second wavelength, chosen to be primarily absorbed by hemoglobin; and combining the first signal and the second signal to generate a combined plethysmograph signal which is proportionate lower in noise caused by motion-related interference.

摘要翻译： 一种用于测量生理参数的方法和系统，包括收集被选择为主要被水吸收的第一波长的第一吸光度; 收集第二波长的第二吸光度，其被选择为主要由血红蛋白吸收; 以及组合第一信号和第二信号以产生由运动相关干扰引起的噪声相对较低的组合体积描记器信号。

公开(公告)号：US20120035443A1

公开(公告)日：2012-02-09

申请号：US13267681

申请日：2011-10-06

申请人： Carine Hoarau ,  Clark R. Baker, JR. ,  Edward Karst

发明人： Carine Hoarau ,  Clark R. Baker, JR. ,  Edward Karst

IPC分类号： A61B5/1455 ,  B23P11/00

CPC分类号： A61B5/6886 ,  A61B5/14552 ,  A61B5/6826 ,  A61B5/6838 ,  A61B5/6844 ,  Y10T29/49826

摘要： A sensor for pulse oximetry or other applications utilizing spectrophotometry may be adapted to reduce motion artifacts by fixing the optical distance between an emitter and detector. A flexible sensor is provided with a stiffening member to hold the emitter and detector of the sensor in a relatively fixed position when applied to a patient. Further, an annular or partially annular sensor is adapted to hold an emitter and detector of the sensor in a relatively fixed position when applied to a patient. A clip-style sensor is provided with a spacer that controls the distance between the emitter and detector.

摘要翻译： 用于脉搏血氧饱和度测定的传感器或利用分光光度法的其它应用可适用于通过固定发射器和检测器之间的光学距离来减少运动伪影。 柔性传感器设置有加强构件，以在应用于患者时将传感器的发射器和检测器保持在相对固定的位置。 此外，环形或部分环形的传感器适于在施加到患者时将传感器的发射器和检测器保持在相对固定的位置。 夹式传感器设置有间隔器，该间隔件控制发射器和检测器之间的距离。

公开(公告)号：US20110009755A1

公开(公告)日：2011-01-13

申请号：US12637574

申请日：2009-12-14

申请人： Brian Jeffrey Wenzel ,  Timothy A. Fayram ,  Allen J. Keel ,  Edward Karst ,  Wenbo Hou ,  Taraneh Ghaffari Farazi

发明人： Brian Jeffrey Wenzel ,  Timothy A. Fayram ,  Allen J. Keel ,  Edward Karst ,  Wenbo Hou ,  Taraneh Ghaffari Farazi

IPC分类号： A61B5/0215

CPC分类号： A61N1/36585 ,  A61B5/02125 ,  A61B5/0215 ,  A61B5/0295 ,  A61B5/0535 ,  A61B5/1459 ,  A61B5/7239 ,  A61N1/08 ,  B82Y10/00 ,  B82Y40/00 ,  G03F7/0002

摘要： Provided herein are implantable systems, and methods for use therewith, for monitoring a patient's arterial blood pressure while a patient's heart is being paced. A signal (e.g., PPG or IPG signal) indicative of changes in arterial blood volume remote from the patient's heart is obtained using a sensor or electrodes that are implanted remote from the patient's heart. One or more metrics indicative of pulse arrival time (PAT) are determined, where each metric can be determined by determining a time from a paced cardiac event to one or more predetermined features of the signal indicative of changes in arterial blood volume. Based on at the metric(s) indicative of PAT, arterial blood pressure is estimated, which can include determining values indicative of systolic blood pressure, diastolic blood pressure, pulse pressure and/or mean arterial blood pressure, and/or changes in such values.

摘要翻译： 本文提供了可植入系统及其使用的方法，用于在患者的心脏起搏时监测患者的动脉血压。 使用远离患者心脏植入的传感器或电极获得指示远离患者心脏的动脉血容量变化的信号（例如，PPG或IPG信号）。 确定指示脉冲到达时间（PAT）的一个或多个度量，其中可以通过确定从起搏心脏事件到指示动脉血容量变化的信号的一个或多个预定特征的时间来确定每个度量。 基于指示PAT的度量，估计动脉血压，其可以包括确定指示收缩压，舒张压，脉压和/或平均动脉血压的值，和/或这些值的变化 。

公开(公告)号：US20110009754A1

公开(公告)日：2011-01-13

申请号：US12637489

申请日：2009-12-14

申请人： Brian Jeffrey Wenzel ,  Allen J. Keel ,  Edward Karst ,  Wenbo Hou ,  Taraneh Ghaffari Farazi ,  Gene A. Bornzin

发明人： Brian Jeffrey Wenzel ,  Allen J. Keel ,  Edward Karst ,  Wenbo Hou ,  Taraneh Ghaffari Farazi ,  Gene A. Bornzin

IPC分类号： A61B5/0215

CPC分类号： A61N1/36585 ,  A61B5/02125 ,  A61B5/0215 ,  A61B5/0295 ,  A61B5/0535 ,  A61B5/1459 ,  A61B5/7239 ,  A61N1/08 ,  B82Y10/00 ,  B82Y40/00 ,  G03F7/0002

摘要： Provided herein are implantable systems, and methods for use therewith, for monitoring a patient's arterial blood pressure. Electrode(s) implanting within and/or on the patient's heart are used to obtain a cardiogenic impedance (CI) signal indicative of cardiac contractile activity. Additionally, a signal (e.g., PPG or IPG signal) indicative of changes in arterial blood volume remote from the patient's heart is obtained using a sensor or electrodes that are implanted remote from the patient's heart. One or more metrics indicative of pulse arrival time (PAT) are determined, where each metric can be determined by determining a time from one of the detected features of the CI signal to one of the detected features of the signal indicative of changes in arterial blood volume. Based on at least one of the metric(s) indicative of PAT, arterial blood pressure is estimated, which can include determining values indicative of systolic blood pressure, diastolic blood pressure, pulse pressure and/or mean arterial blood pressure, and/or changes in such values.

摘要翻译： 本文提供了可植入系统及其使用的方法，用于监测患者的动脉血压。 使用植入在患者心脏内和/或患者心脏上的电极来获得指示心脏收缩活动的心源阻抗（CI）信号。 此外，使用远离患者心脏植入的传感器或电极获得指示远离患者心脏的动脉血容量变化的信号（例如，PPG或IPG信号）。 确定指示脉冲到达时间（PAT）的一个或多个度量，其中可以通过确定从CI信号的检测到的特征之一到检测到的指示动脉血液变化的特征之一的时间来确定每个度量 卷。 基于指示PAT的指标中的至少一个，估计动脉血压，其可以包括确定指示收缩压，舒张压，脉压和/或平均动脉血压的值，和/或变化 在这样的价值观。

公开(公告)号：US20100069761A1

公开(公告)日：2010-03-18

申请号：US12561960

申请日：2009-09-17

申请人： Edward Karst ,  Joseph Douglas Vandine ,  Charles E. Porges ,  Clark Raymond Baker, JR.

发明人： Edward Karst ,  Joseph Douglas Vandine ,  Charles E. Porges ,  Clark Raymond Baker, JR.

IPC分类号： A61B5/0205 ,  A61B5/021

CPC分类号： A61B5/0806 ,  A61B5/0205 ,  A61B5/029 ,  A61B5/14551 ,  A61B5/4035

摘要： The present disclosure relates, in some embodiments, to devices, systems, and/or methods for collecting, processing, and/or displaying stroke volume and/or cardiac output data. For example, a device for assessing changes in cardiac output and/or stroke volume of a subject receiving airway support may comprise a processor; an airway sensor in communication with the processor, wherein the airway sensor is configured and arranged to sense pressure in the subject's airway, lungs, and/or intrapleural space over time; a blood volume sensor in communication with the processor, wherein the blood volume sensor is configured and arranged to sense pulsatile volume of blood in a tissue of the subject over time; and a display configured and arranged to display a representative of an airway pressure, a pulsatile blood volume, a photoplethysmogram, a photoplethysmogram ratio, the determined cardiac output and/or stroke volume, or combinations thereof. A method of assessing changes in cardiac output or stroke volume of a subject receiving airway support from a breathing assistance system may comprise sensing pressure in the subject's airway as a function of time, sensing pulsatile volume of blood in a tissue of the subject as a function of time, producing a photoplethysmogram from the sensed pulsatile volume, determining the ratio of the amplitude of the photoplethysmogram during inhalation to the amplitude of the photoplethysmogram during exhalation, and determining the change in cardiac output or stroke volume of the subject using the determined ratio.

摘要翻译： 在一些实施例中，本公开涉及用于收集，处理和/或显示搏动体积和/或心输出量数据的装置，系统和/或方法。 例如，用于评估受试者接受气道支持的心输出量和/或卒中体积变化的装置可以包括处理器; 与所述处理器通信的气道传感器，其中所述气道传感器被配置和布置成随时间感测所述受试者的气道，肺和/或胸膜内空​​间中的压力; 与所述处理器通信的血容量传感器，其中所述血液体积传感器被配置和布置成在时间上感测所述受试者的组织中的血液的脉动体积; 以及显示器，被配置和布置成显示气道压力，搏动血液体积，光电积氧图，光电积氧图比例，所确定的心输出量和/或行程体积的代表，或其组合。 评估来自呼吸辅助系统的受试者接受呼吸道支持的受试者的心输出量或中风体积变化的方法可以包括感测受试者的气道中的压力作为时间的函数，感测作为一个功能的受试者的组织中的血液的脉动体积 的时间，从感测到的脉动体积产生光电积氧图，确定吸入期间的光电积氧图的振幅与呼气期间的光谱脉搏波幅度的比率，以及使用确定的比例确定受试者的心输出量或中风体积的变化。

公开(公告)号：US20140018818A1

公开(公告)日：2014-01-16

申请号：US13547791

申请日：2012-07-12

申请人： Zoltan Somogyi ,  Edward Karst ,  Gene A. Bornzin ,  John W. Poore ,  Richard Samade ,  Didier Theret

发明人： Zoltan Somogyi ,  Edward Karst ,  Gene A. Bornzin ,  John W. Poore ,  Richard Samade ,  Didier Theret

IPC分类号： A61N1/05

CPC分类号： A61N1/372 ,  A61B17/3468 ,  A61N1/37205

摘要： A system for implanting an implantable medical device (IMD) within a patient may include a main handle assembly having proximal and distal ends, a device-connection control handle connected to the proximal end of the main handle assembly, an introducer connected to the distal end of the main handle assembly, and a connection tool extending from the introducer. The connection tool may include a device-engaging member configured to change at least one of shape or orientation to selectively connect to and disconnect from the IMD. The device-connection control handle may be operatively connected to the device-engaging member and the device-connection control handle may be configured to manipulate the device-engaging member between connected and disconnected states by changing the at least one of the shape or orientation.

摘要翻译： 用于在患者体内植入可植入医疗装置（IMD）的系统可以包括具有近端和远端的主手柄组件，连接到主手柄组件的近端的装置连接控制手柄，连接到远端的导引器 的主把手组件，以及从导引器延伸的连接工具。 连接工具可以包括被配置为改变形状或取向中的至少一个以选择性地连接到IMD并与IMD断开连接的装置接合构件。 设备连接控制手柄可以可操作地连接到装置接合构件，并且装置连接控制手柄可以被配置成通过改变形状或取向中的至少一个来在连接状态和断开状态之间操纵装置接合构件。

公开(公告)号：US08532774B1

公开(公告)日：2013-09-10

申请号：US13545794

申请日：2012-07-10

申请人： Sven-Erik Hedberg ,  Tomas Svensson ,  Kjell Noren ,  Stuart Rosenberg ,  Kyungmoo Ryu ,  Edward Karst

发明人： Sven-Erik Hedberg ,  Tomas Svensson ,  Kjell Noren ,  Stuart Rosenberg ,  Kyungmoo Ryu ,  Edward Karst

IPC分类号： A61N1/37

CPC分类号： A61N1/36521 ,  A61B5/042 ,  A61B5/0538 ,  A61N1/3686 ,  A61N1/3702

摘要： The present invention provides methods for detecting phrenic nerve stimulation. A pacing module is instructed to deliver pacing pulses having a predetermined pulse amplitude and/or width within the refractory period of the left ventricle. The pacing pulses are repeatedly delivered during a number of cardiac cycles and wherein the pacing pulses are delivered at different delays relative to an onset of the refractory period of the left ventricle in different cardiac cycles. Impedance signals are measured in time windows synchronized with the delivery of pacing pulses in the refractory period of the left ventricle using at least one electrode configuration. At least one impedance signal is gathered from each time window, aggregated impedance signals are created using the impedance signals from the different time windows, and the aggregated impedance signals are analyzed to detect PNS.

摘要翻译： 本发明提供了检测膈神经刺激的方法。 指示起搏模块在左心室的不应期内输送具有预定脉搏幅度和/或宽度的起搏脉冲。 起搏脉冲在多个心动周期期间重复递送，并且其中起搏脉冲相对于在不同心脏周期中的左心室的不应期的开始以不同的延迟递送。 使用至少一个电极配置，在与左心室的不应期中的起搏脉冲的递送同步的时间窗口中测量阻抗信号。 从每个时间窗口收集至少一个阻抗信号，使用来自不同时间窗口的阻抗信号创建聚合阻抗信号，并分析聚合阻抗信号以检测PNS。

公开(公告)号：US20130066222A1

公开(公告)日：2013-03-14

申请号：US13230482

申请日：2011-09-12

申请人： Stuart Rosenberg ,  Tomas Svensson ,  Kjell Norén ,  Edward Karst ,  Kyungmoo Ryu

发明人： Stuart Rosenberg ,  Tomas Svensson ,  Kjell Norén ,  Edward Karst ,  Kyungmoo Ryu

IPC分类号： A61B5/0464 ,  A61N1/39 ,  A61B5/0452 ,  A61N1/365 ,  A61B5/0402 ,  A61B5/0456

CPC分类号： A61N1/3704 ,  A61B5/0464 ,  A61B5/0468 ,  A61B5/686 ,  A61N1/3627 ,  A61N1/3684

摘要： A device senses cardioelectrical signals using a right atrial (RA) lead, which might include far-field R-waves as well as near-field P-waves. The device concurrently senses events using a proximal electrode of an LV lead, which can sense both P-waves and R-waves as substantially near-field events. Suitable templates are then applied to the signals sensed via the proximal LV electrode to identify the origin of the signals (e.g. atrial vs. ventricular) so as to properly classify the corresponding events sensed in the RA as near-field or far-field events. In this manner, far-field oversensing is conveniently detected.

摘要翻译： 一种装置使用右心房（RA）导联感测心电信号，其可能包括远场R波以及近场P波。 该装置使用LV引线的近侧电极同时感测事件，其可以感测P波和R波作为基本近场事件。 然后将合适的模板施加到经由近端LV电极感测的信号以识别信号的来源（例如心房与心室），以便将在RA中感测到的相应事件适当地分类为近场或远场事件​​。 以这种方式，可以方便地检测远场超检测。