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公开(公告)号：US11089958B2
公开(公告)日：2021-08-17
申请号：US16027670
申请日：2018-07-05
发明人： Amy Jean Brisben , Qi An , Pramodsingh Hirasingh Thakur , David J. Ternes , JoAnna Trapp Simpson , Viktoria A. Averina , Deepa Mahajan , Sunipa Saha , Krzysztof Z. Siejko
摘要： Systems and methods for managing machine-generated medical events detected from one or more patients are described herein. A medical event management system includes an event analyzer circuit to detect a medical event using physiological data from a patient-triggered episode acquired from a medical device. The event analyzer circuit determines a confidence score of the medical event detection, and generates an alignment indicator indicating a degree of concordance between the detected medical event and the information about the patient-triggered episode. The system assigns priority information to the patient-triggered episode using the generated alignment indicator and the confidence score of the detection. An output circuit can output the received physiological information to a user or a process according to the assigned priority information.
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公开(公告)号：US10849524B2
公开(公告)日：2020-12-01
申请号：US15889573
申请日：2018-02-06
IPC分类号： A61B5/04 , A61B5/0472 , A61B5/0452 , A61B5/0456 , A61B5/00 , A61B5/0468 , A61B5/046 , A61N1/362 , A61N1/39 , A61N1/05
摘要： Methods and devices adapted for cardiac signal analysis. A method or device has accessible to it more than one approach to cardiac cycle rate analysis and is adapted to monitor sensing signal quality. In response to an apparent reduction in signal quality or other trigger, the method or device checks whether an arrhythmia or an actual drop in signal quality is occurring prior to modifying sensing configurations or parameters.
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公开(公告)号：US08923966B2
公开(公告)日：2014-12-30
申请号：US14031459
申请日：2013-09-19
发明人： Amy Jean Brisben , Shibaji Shome , Kenneth N. Hayes , Yanting Dong , Aaron R. McCabe , Scott A. Meyer , Kevin John Stalsberg
CPC分类号： A61N1/36585 , A61N1/3712
摘要： An apparatus comprises a cardiac signal sensing circuit, a pacing therapy circuit, and a controller circuit. The controller circuit includes a safety margin calculation circuit. The controller circuit initiates delivery of pacing stimulation energy to the heart using a first energy level, changes the energy level by at least one of: a) increasing the energy from the first energy level until detecting that the pacing stimulation energy induces stable capture, or b) reducing the energy from the first energy level until detecting that the stimulation energy fails to induce capture, and continues changing the stimulation energy level until confirming stable capture or the failure of capture. The safety margin calculation circuit calculates a safety margin of pacing stimulation energy using at least one of a determined stability of a parameter associated with evoked response and a determined range of energy levels corresponding to stable capture or intermittent failure of capture.
摘要翻译： 一种装置包括心脏信号感测电路，起搏治疗电路和控制器电路。 控制器电路包括安全裕度计算电路。 控制器电路使用第一能级开始向心脏传送起搏刺激能量，通过以下至少一种来改变能量水平：a）从第一能量级增加能量直到检测到起搏刺激能量引起稳定的捕获，或 b）减少来自第一能级的能量，直到检测到刺激能量不能诱导捕获，并且继续改变刺激能量水平，直到确认捕获稳定或捕获失败为止。 安全裕度计算电路使用与诱发反应相关联的参数的确定的稳定性以及与捕获的稳定捕获或间歇性故障相对应的能量水平的确定范围中的至少一个来计算起搏刺激能量的安全裕度。
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公开(公告)号：US11052255B2
公开(公告)日：2021-07-06
申请号：US16256746
申请日：2019-01-24
发明人： Amy Jean Brisben , David J. Ternes , Allan Charles Shuros , Deepa Mahajan , David L. Perschbacher
摘要： Systems and methods for pacing cardiac conductive tissue are described. A medical system includes an electrostimulation circuit to generate His-bundle pacing (HBP) pulses. A sensing circuit senses a physiologic signal, and detect a local His-bundle activation discrete from a pacing artifact of the HBP pulse. A control circuit verifies capture status in response to the HBP pulses. Based on the capture status, the control circuit determines one or more pacing thresholds including a selective HBP threshold representing a threshold strength to capture only the His bundle but not the local myocardium, and a non-selective HBP threshold representing a threshold strength to capture both the His bundle and the local myocardium. The electrostimulation circuit may deliver HBP pulses based on the selective and non-selective HBP thresholds.
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公开(公告)号：US20190275329A1
公开(公告)日：2019-09-12
申请号：US16256746
申请日：2019-01-24
发明人： Amy Jean Brisben , David J. Ternes , Allan Charles Shuros , Deepa Mahajan , David L. Perschbacher
摘要： Systems and methods for pacing cardiac conductive tissue are described. A medical system includes an electrostimulation circuit to generate His-bundle pacing (HBP) pulses. A sensing circuit senses a physiologic signal, and detect a local His-bundle activation discrete from a pacing artifact of the HBP pulse. A control circuit verifies capture status in response to the HBP pulses. Based on the capture status, the control circuit determines one or more pacing thresholds including a selective HBP threshold representing a threshold strength to capture only the His bundle but not the local myocardium, and a non-selective HBP threshold representing a threshold strength to capture both the His bundle and the local myocardium. The electrostimulation circuit may deliver HBP pulses based on the selective and non-selective HBP thresholds.
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公开(公告)号：US20190216348A1
公开(公告)日：2019-07-18
申请号：US16297029
申请日：2019-03-08
发明人： Amy Jean Brisben , Venugopal Allavatam , Krzysztof Z. Siejko , Deepa Mahajan , Kevin G. Wika , Keith L. Herrmann , Stephen J. Hahn
IPC分类号： A61B5/04 , A61N1/39 , A61N1/05 , A61B5/042 , A61B5/00 , A61B5/0452 , A61N1/362 , A61B5/0402 , A61N1/04 , A61N1/365 , A61B5/0468 , A61B5/0456 , A61N1/37
CPC分类号： A61B5/04011 , A61B5/02416 , A61B5/0245 , A61B5/04012 , A61B5/04017 , A61B5/0402 , A61B5/04028 , A61B5/042 , A61B5/0422 , A61B5/0452 , A61B5/04525 , A61B5/0456 , A61B5/0468 , A61B5/0472 , A61B5/686 , A61B5/6869 , A61B5/72 , A61B5/7203 , A61B5/7221 , A61N1/046 , A61N1/05 , A61N1/0563 , A61N1/3622 , A61N1/3625 , A61N1/36514 , A61N1/3704 , A61N1/3925 , A61N1/3956 , A61N1/3987
摘要： New and alternative approaches to the monitoring of cardiac signal quality for external and/or implantable cardiac devices. In one example, signal quality is monitored continuously or in response to a triggering event or condition and, upon identification of a reduction in signal quality, a device may reconfigure its sensing state. In another example, one or more trends of signal quality are monitored by a device, either continuously or in response to a triggering event or condition, and sensing reconfiguration may be performed in response to identified trends and events. In yet another example, a device may use a looping data capture mode to track sensing data in multiple vectors while primarily relying on less than all sensing vectors to make decisions and, in response to a triggering event or condition, the looped data can be analyzed automatically, without waiting for additional data capture to reconfigure sensing upon identification of the triggering event or condition. In another example a device calculates a composite cardiac cycle by overlaying signal morphology for a number of cardiac cycles and analyzes the composite cardiac cycle to calculate signal quality metrics.
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公开(公告)号：US10321834B2
公开(公告)日：2019-06-18
申请号：US15297624
申请日：2016-10-19
发明人： Amy Jean Brisben , Venugopal Allavatam , Krzysztof Z. Siejko , Deepa Mahajan , Kevin G. Wika , Keith L. Herrmann , Stephen J. Hahn
IPC分类号： A61B5/04 , A61B5/042 , A61B5/00 , A61N1/39 , A61B5/0452 , A61N1/362 , A61B5/0402 , A61N1/04 , A61N1/05 , A61N1/365 , A61N1/37 , A61B5/0456 , A61B5/0468 , A61B5/024 , A61B5/0245 , A61B5/0472
摘要： Methods and devices for combining multiple signals from multiple sensing vectors for use in wearable or implantable cardiac devices. A preferred sensing configuration may be selected at a given point in time, for example under clinical conditions. Signal quality for the preferred sensing configuration is then monitored, and if the signal quality degrades under selected conditions, re-analysis may be performed to select a different sensing vector configuration for at least temporary use. If signal quality increases for the preferred sensing configuration, temporary use of the different sensing vector configuration may cease and reversion to the preferred sensing configuration takes place if certain conditions are met. The conditions for reversion may depend in part of a history of sensing signal quality for the preferred sensing configuration.
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公开(公告)号：US10299688B2
公开(公告)日：2019-05-28
申请号：US15297588
申请日：2016-10-19
发明人： Amy Jean Brisben , Venugopal Allavatam , Krzysztof Z. Siejko , Deepa Mahajan , Kevin G. Wika , Keith L. Herrmann , Stephen J. Hahn
IPC分类号： A61N1/365 , A61B5/04 , A61B5/042 , A61B5/00 , A61N1/39 , A61B5/0452 , A61N1/362 , A61B5/0402 , A61N1/04 , A61N1/05 , A61N1/37 , A61B5/0456 , A61B5/0468 , A61B5/024 , A61B5/0245 , A61B5/0472
摘要： Methods and devices for combining multiple signals from multiple sensing vectors for use in wearable or implantable cardiac devices. Signals from multiple vectors may be combined using weighting factors and/or by conversion to different coordinate systems than the original inputs, which may or may not be normalized to patient anatomy. Signals from multiple sensing vectors may be combined prior to or after several analytical steps or processes including before or after filtering, and before or after cardiac cycle detection. Cardiac cycle detection information may be combined across multiple sensing vectors before or after analysis of individual vectors for noise or overdetection. Cardiac cycle detection information may also be combined across multiple sensing vectors to identify noise and/or overdetection.
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公开(公告)号：US20180325466A1
公开(公告)日：2018-11-15
申请号：US15978963
申请日：2018-05-14
发明人： Qi An , Pramodsingh Hirasingh Thakur , Amy Jean Brisben , Jeffrey E. Stahmann , David J. Ternes
IPC分类号： A61B5/00 , A61B5/0205
CPC分类号： A61B5/7282 , A61B5/0031 , A61B5/0205 , A61B5/04012 , A61B5/0456 , A61B5/0472 , A61B5/14542 , A61B5/7264
摘要： Systems and methods for monitoring patient for syncope are discussed. A syncope monitor system can detect a precipitating event associated with a syncope onset, and acquire hemodynamic data in response to the detection of the precipitating event. A syncope analyzer circuit may generate temporal profiles of one or more hemodynamic parameters using the hemodynamic data. The syncope analyzer may use the temporal profiles to detect a syncopal event and to classify the syncopal event into one of a plurality of syncope categories. The detection and classification information may be output to a user or a process.
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公开(公告)号：US10123742B2
公开(公告)日：2018-11-13
申请号：US15362851
申请日：2016-11-29
发明人： Krzysztof Z. Siejko , Venugopal Allavatam , Amy Jean Brisben , Stephen J. Hahn , Keith L. Herrmann
IPC分类号： A61B5/00 , A61B5/0452 , A61B5/021 , A61B5/11 , A61N1/39 , A61N1/365 , A61B7/04 , A61B5/0205 , A61B5/04 , A61B5/1455 , A61B5/042 , A61B5/0245
摘要： In some examples, cardiac cycle detection may be used as an approach to cardiac activity tracking, with one or more second approaches to cardiac activity tracking also available for use. Additional rate measurement relying on different sources or analyses may require extra power consumption over the cycle detection methods. Therefore, new methods and devices are disclosed that selectively activate a second cardiac rate measurement. In some illustrative methods and devices, decisions are made as to whether and which previously collected data, if any, is to be discarded, replaced, or corrected upon activation of the second cardiac rate measurement. In some illustrative methods and devices, a cardiac cycle detection approach to cardiac activity tracking may be bypassed by a second cardiac rate measurement.
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