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公开(公告)号：US20130289641A1
公开(公告)日：2013-10-31
申请号：US13997620
申请日：2010-12-23
IPC分类号： A61N1/365
CPC分类号： A61N1/36571 , A61B5/02028 , A61B5/0215 , A61B5/028 , A61B5/029 , A61B5/0472 , A61B5/0538 , A61B5/1116 , A61B5/686 , A61B8/06 , A61B2562/0219 , A61N1/3627 , A61N1/36514 , A61N1/36521 , A61N1/36535 , A61N1/36564 , A61N1/36578 , A61N1/36585 , A61N1/3682
摘要： The present invention relates generally to methods and systems for optimizing stimulation of a heart of a patient. Hemodynamical index signals reflecting a mechanical functioning of a heart of a patient are recorded at different hemodynamical states. Corresponding hemodynamical reference signals at corresponding hemodynamical states are recorded. At least one hemodynamical index parameter is extracted from the recorded hemodynamical index signals. The at least one hemodynamical index parameter is a measure of the mechanical functioning of the heart and a hemodynamical index model is created, wherein the hemodynamical index model is based on the at least one hemodynamical index parameter and a comparison between output results from the hemodynamical index model and corresponding hemodynamical reference signals. From this hemodynamical index model, a hemodynamical index can be derived, which then can be used in determining patient customized cardiac pacing settings of the cardiac stimulator.
摘要翻译： 本发明一般涉及优化患者心脏的刺激的方法和系统。 在不同的血液动力学状态下记录反映患者心脏的机械功能的血液动力学指标信号。 记录相应血液动力学状态下的相应血液动力学参考信号。 从记录的血液动力学指标信号中提取至少一个血液动力学指标参数。 所述至少一个血液动力学指数参数是心脏的机械功能的度量，并且创建血液动力学指标模型，其中所述血液动力学指标模型基于所述至少一个血液动力学指数参数和来自所述血液动力学指标的输出结果之间的比较 模型和相应的血液动力学参考信号。 从该血液动力学指标模型可以得出血流动力学指标，然后可以用于确定心脏刺激器患者定制的心脏起搏设置。
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公开(公告)号：US20120239102A1
公开(公告)日：2012-09-20
申请号：US13510873
申请日：2009-12-08
申请人： Nils Holmstrom , John Gustafsson , Michael Broome
发明人： Nils Holmstrom , John Gustafsson , Michael Broome
CPC分类号： A61N1/368 , A61N1/3627 , A61N1/3684 , A61N2001/0585
摘要： An implantable medical device, IMD, (100) is connectable to at least one ventricular lead (210) having a ventricular basal electrode (214) and a ventricular apical electrode (212). The IMD (100) comprises a pulse generator (120) for generating pacing pulses applied to a heart (10) through the ventricular lead (210). The operation of this pulse generator (120) is controlled by a controller (130) that is configured to control the pulse generator to first deliver a pacing pulse to the ventricular basal electrode (214) to stimulate the basal portion of the ventricle (12, 14) before a pacing pulse is delivered to the apical portion of the ventricle (12, 14) by the ventricular apical electrode (212). This pulse sequence achieves a biologically more correct cardiac stimulation and a contraction pattern that reduces the risk for valvular regurgitation.
摘要翻译： 植入式医疗装置IMD（100）可连接到至少一个具有心室基底电极（214）和心室顶端电极（212）的心室引线（210）。 IMD（100）包括用于产生通过心室引线（210）施加到心脏（10）的起搏脉冲的脉冲发生器（120）。 该脉冲发生器（120）的操作由控制器（130）控制，控制器（130）被配置为控制脉冲发生器首先将起搏脉冲递送至心室基底电极（214）以刺激心室的基部（12， 14）在通过心室顶端电极（212）将起搏脉冲输送到心室（12,14）的顶端部分之前。 该脉冲序列实现了生物学更正确的心脏刺激和减少瓣膜反流风险的收缩模式。
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公开(公告)号：US20090118666A1
公开(公告)日：2009-05-07
申请号：US11363922
申请日：2006-02-28
CPC分类号： A61B5/053 , A61B5/14535 , A61N1/36521
摘要： In a method for detecting a change of a condition of a patient using an implantable medical device being connectable to the patient in at least one electrode configuration, at least one impedance measurement session is initiated to obtain at least one impedance value corresponding to an impedance of whole blood of the patient. At least one relative or absolute value of an amount of hematocrit in the blood of the patient is calculated using the at least one impedance value. A present hematocrit level is determined dependent on the at least one hematocrit value, with a change of the condition being derived from the present hematocrit level of the patient.
摘要翻译： 在用至少一个电极配置中使用可连接到患者的可植入医疗装置来检测患者病情变化的方法中，开始至少一个阻抗测量会话以获得至少一个阻抗值对应于 患者的全血。 使用至少一个阻抗值来计算患者血液中血细胞比容量的至少一个相对值或绝对值。 取决于至少一个血细胞比容值确定目前的血细胞比容水平，条件的变化来自患者的当前血细胞比容水平。
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公开(公告)号：US20080306565A1
公开(公告)日：2008-12-11
申请号：US12095212
申请日：2005-12-16
申请人： Nils Holmstrom , Kjell Noren
发明人： Nils Holmstrom , Kjell Noren
CPC分类号： A61B7/00 , A61B7/04 , A61N1/3627 , A61N1/36514
摘要： In an implantable medical device and a method and computer-readable medium for operating the medical device to detect a condition of a heart of a patient, activity level of a patient and acoustic energy in a patient are sensed, and acoustic signals are generated that are indicative of heart sounds of the patient over predetermined periods of a cardiac cycle during successive cardiac cycles. A signal corresponding to a first sound is extracted from the sensed acoustic signal of a cardiac cycle. A relation is calculated between a first signal corresponding to the first heart sound in a first activity range, and a second signal corresponding to the first heart sound in a second predetermined activity level range. The calculated relation is compared with at least one reference value to detect the condition or a change of the condition.
摘要翻译： 在可植入医疗装置和用于操作医疗装置以检测患者心脏状况的方法和计算机可读介质中，感测患者的活动水平和患者的声能，并且生成声信号 指示在连续心脏周期期间心脏周期的预定时间段的患者的心脏声音。 从感测到的心律周期的声信号中提取对应于第一声音的信号。 在与第一活动范围内的第一心音相对应的第一信号与对应于第二预定活动水平范围中的第一心音的第二信号之间计算关系。 将计算的关系与至少一个参考值进行比较以检测条件或状况的变化。
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公开(公告)号：US20080243025A1
公开(公告)日：2008-10-02
申请号：US11793849
申请日：2004-12-23
申请人： Nils Holmstrom , Malin Ohlander , Sven Kalling
发明人： Nils Holmstrom , Malin Ohlander , Sven Kalling
IPC分类号： A61B5/053
CPC分类号： A61B5/0535 , A61B5/0809 , A61N1/3627 , A61N1/3702
摘要： In a medical device and a method for operating the medical device, it is first determined whether a patient, at whom a medical measurement is to be made, satisfied specified criteria that will ensure comparability of the measurement results obtained from the patient. Only when the specified criteria had been satisfied is an electrical bio-impedance signal obtained from the patient. The cardiac component of the electrical bio-impedance signal is extracted, and is analyzed to identify a change in a medical condition of the patient.
摘要翻译： 在用于医疗装置的医疗装置和方法中，首先确定是否要进行医疗测量的患者满足将确保从患者获得的测量结果的可比性的指定标准。 只有当满足指定的标准是从患者获得的电生物阻抗信号。 提取电生物阻抗信号的心脏分量，并进行分析以识别患者的医疗状态的变化。
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6.发明申请Cardiac stimulating and detecting device, system and method for identifying far field signals 有权用于识别远场信号的心脏刺激和检测装置，系统和方法公开(公告)号：US20050004607A1
公开(公告)日：2005-01-06
申请号：US10864064
申请日：2004-06-09
CPC分类号： A61N1/37 , A61N1/3627 , A61N1/3684 , Y10S128/901
摘要： In an implantable heart stimulating device, system and method, a control circuit has first and second circuits for sensing and pacing. The first circuit can be connected to a first electrode member suited to be positioned in or at a first ventricle of the heart. The second circuit can be connected to a second electrode member suited to be positioned in or at a second ventricle of the heart. The control circuit is able to detect whether signals sensed by the second circuit are likely to be far field signals. The control circuit performs this detection by at least determining whether, during a predetermined time (length, more signals are sensed by the second circuit than by the first circuit.
摘要翻译： 在可植入心脏刺激装置，系统和方法中，控制电路具有用于感测和起搏的第一和第二电路。 第一电路可以连接到适于定位在心脏的第一心室中或第一心室处的第一电极构件。 第二电路可以连接到适于定位在心脏的第二心室中或第二心室处的第二电极构件。 控制电路能够检测由第二电路感测的信号是否可能是远场信号。 控制电路通过至少确定在预定时间（长度，由第二电路感测到的信号多于第一电路的信号）来执行该检测。
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7.发明授权Electrode lead and device for tissue stimulation and/or detection of tissue response 失效用于组织刺激和/或检测组织反应的电极引线和装置
公开(公告)号：US5935158A
公开(公告)日：1999-08-10
申请号：US915756
申请日：1997-08-21
申请人： Nils Holmstrom , Sven-Erik Hedberg , Kenth Nilsson
发明人： Nils Holmstrom , Sven-Erik Hedberg , Kenth Nilsson
CPC分类号： A61N1/0565
摘要： An implantable electrode for stimulating tissue has a piezoelectric electrode for electrically and mechanically stimulating tissue and for detecting electrical and mechanical evoked response of the stimulated tissue. An implantable lead and an implantable stimulation device employing such an electrode are described including diagnostic circuitry for making a diagnosis of the heart condition using such an electrode.
摘要翻译： 用于刺激组织的可植入电极具有用于电和机械刺激组织并用于检测受刺激组织的电和机械诱发反应的压电电极。 描述了使用这种电极的可植入引线和可植入刺激装置，其包括使用这种电极进行心脏病症诊断的诊断电路。
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公开(公告)号：US5846264A
公开(公告)日：1998-12-08
申请号：US625252
申请日：1996-04-01
申请人： Peter Andersson , Nils Holmstrom , Gunbritt Skog
发明人： Peter Andersson , Nils Holmstrom , Gunbritt Skog
CPC分类号： A61N1/3712
摘要： A back-up pulse generator for a pacemaker having a first energy storing component for storing energy to be delivered in a stimulation pulse and connectable to means for conducting the stimulation pulse to the heart, the back-up pulse generator including a back-up pulse energy storing component for emitting a back-up pulse after a failure to sense an evoked response from a preceding stimulation pulse. The back-up pulse energy storing component substantially permanently stores energy at a higher voltage than the energy stored in the first energy storing component.
摘要翻译： 一种用于起搏器的备用脉冲发生器，其具有第一能量存储部件，用于存储在刺激脉冲中被输送的能量并且可连接到用于向心脏传导刺激脉冲的装置，所述备用脉冲发生器包括备用脉冲 能量存储部件，用于在不能感测来自先前刺激脉冲的诱发响应之后发出备用脉冲。 备用脉冲能量存储部件基本上永久地将能量存储在比存储在第一能量存储部件中的能量更高的电压。
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公开(公告)号：US09162066B2
公开(公告)日：2015-10-20
申请号：US13508968
申请日：2011-05-31
CPC分类号： A61N1/368 , A61N1/3622 , A61N1/3682 , A61N1/3684
摘要： A first ventricle is stimulated at a stimulation site, a point of time for arrival at the AV node for at least one depolarization wave resulting from the stimulation is estimated and a first activation time interval substantially corresponding to the time interval required for at least one depolarization wave to travel from the stimulation site in the first ventricle to the AV node is computed. A similar process is used to compute a second activation time interval for the other ventricle. Based on these activation time intervals and a difference between the intervals, a pacing therapy can be determined.
摘要翻译： 在刺激部位刺激第一脑室，估计从刺激产生的至少一个去极化波到达AV节点的时间点，并且基本对应于至少一个去极化所需的时间间隔的第一激活时间间隔 计算从第一脑室的刺激部位到AV节点的波。 使用类似的过程来计算另一个心室的第二激活时间间隔。 基于这些激活时间间隔和间隔之间的差异，可以确定起搏治疗。
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公开(公告)号：US09138583B2
公开(公告)日：2015-09-22
申请号：US13596585
申请日：2012-08-28
申请人： Nils Holmstrom , Andreas Karlsson
发明人： Nils Holmstrom , Andreas Karlsson
CPC分类号： A61N1/36585 , A61N1/365 , A61N1/36514 , A61N1/3682 , A61N1/3704
摘要： Systems and methods for optimizing the stimulation of a heart of a patient are disclosed herein. The method comprises delivering pacing therapy to the patient according to a pacing therapy setting schedule, using specific pacing intervals via specific electrode configurations. Further, sinus rate values are recorded over at least one cardiac cycle at each pacing therapy setting and it is determined whether a sinus rate value satisfies predetermined measurement conditions, wherein sinus rate values are used for trending the sinus rate over time if the measurement conditions are satisfied. The accepted sinus rate values, i.e. values that satisfy the measurement conditions, are trended over time, wherein each trended sinus rate value is created based on recordings from at least one cardiac cycle. A preferred pacing therapy setting is determined to be the pacing therapy setting that provides a lowest sinus rate.
摘要翻译： 本文公开了用于优化患者心脏刺激的系统和方法。 该方法包括根据起搏治疗设置时间表，通过特定电极配置使用特定的起搏间隔向患者输送起搏治疗。 此外，在每个起搏治疗设置中，在至少一个心动周期上记录窦速率值，并且确定窦速率值是否满足预定的测量条件，其中如果测量条件是窦性速率值，则使用窦速率值来随着时间推移窦速率 满意。 接受的窦速率值，即满足测量条件的值随时间趋势，其中每个趋势窦速率值是基于至少一个心动周期的记录创建的。 优选的起搏治疗设置被确定为提供最低窦速率的起搏治疗设置。
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