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    Cardiac arrhythmia detection system for an implantable stimulation device
    1.
    发明授权
    Cardiac arrhythmia detection system for an implantable stimulation device 失效
    用于植入式刺激装置的心律失常检测系统

    公开(公告)号：US5685315A

    公开(公告)日：1997-11-11

    申请号：US622905

    申请日：1996-03-29

    申请人： Kelly H. McClure ,  Gabriel Mouchawar ,  James D. Causey, III

    发明人： Kelly H. McClure ,  Gabriel Mouchawar ,  James D. Causey, III

    IPC分类号： A61N1/37 ,  A61B5/0456

    CPC分类号： A61N1/3702 ,  A61N1/3704

    摘要： A cardiac event and arrhythmia detection system and method detects arrhythmic cardiac activity or other information from an electrogram signal of a heart. The system senses the electrogram signal through an electrogram lead, preliminarily processes the signal, and converts it to a plurality of discrete digital signals, each of which represents the magnitude of the electrogram signal at a prescribed sample time. The discrete digital signals are applied to both a cardiac event detector which has a dynamic threshold which is programmably adjustable so that T-waves are not sensed and a morphology detector. The morphology detector detects selected changes in the morphology (shape) of the electrogram signal, wherein such changes automatically control the sensitivity (gain and/or threshold) used to detect cardiac events. The occurrence of a prescribed amount of change in the detected morphology over time indicates the occurrence of a prescribed arrhythmic cardiac condition.

    摘要翻译： 心脏事件和心律失常检测系统和方法从心脏的电描记图信号检测心律失常心脏活动或其他信息。 该系统通过电导线感测电描记图信号，预先处理信号，并将其转换为多个离散数字信号，每个离散数字信号表示规定采样时间的电描记信号的幅度。 离散数字信号被应用于心脏事件检测器，心脏事件检测器具有动态阈值，该动态阈值可编程调节，以便不检测T波和形态检测器。 形态检测器检测电描记图信号的形态（形状）中的选择的变化，其中这种变化自动控制用于检测心脏事件的灵敏度（增益和/或阈值）。 随着时间的推移，检测到的形态的规定量的变化的发生表明规定的心律失常心脏病的发生。

    Implantable cardiac device having event recording capability with compression
    2.
    发明授权
    Implantable cardiac device having event recording capability with compression 有权
    具有压缩事件记录能力的可植入心脏装置

    公开(公告)号：US6161043A

    公开(公告)日：2000-12-12

    申请号：US255140

    申请日：1999-02-22

    申请人： Kelly H. McClure ,  Gabriel Mouchawar ,  Timothy J. Starkweather ,  James D. Causey, III

    发明人： Kelly H. McClure ,  Gabriel Mouchawar ,  Timothy J. Starkweather ,  James D. Causey, III

    IPC分类号： A61B5/00 ,  A61N1/365 ,  A61N1/37 ,  A01B5/0452

    CPC分类号： A61B5/0006 ,  A61B5/7232 ,  A61N1/36542 ,  A61N1/3702

    摘要： An implantable cardiac device is disclosed having a converter that provides a digital electrocardiogram signal to a controller which is stored in memory or transmitted via the telemetry circuit in an improved compressed fashion. The improved compression scheme comprises sampling the electrogram signal, transmitting the starting value in an uncompressed format followed by a plurality of delta signals in a compressed format. The delta signals may be determined by subtracting successive signals or by subtracting a predicted value from the current value. In either case, the delta signal is then transmitted in a truncated number of bits, e.g., 2 or 4 bits. When the delta signal is too large to be represented in the compressed number of bits, the controller then provides an indicator signal followed by the delta signal in the uncompressed format. In addition, whenever successive delta signals are below a minimum threshold (e.g., zero), they may be compressed into a count.

    摘要翻译： 公开了一种可植入心脏装置，其具有向控制器提供数字心电图信号的转换器，该控制器存储在存储器中或者以经改进的压缩方式通过遥测电路传输。 改进的压缩方案包括对电描记图信号进行采样，以未压缩格式发送起始值，然后以压缩格式传送多个delta信号。 Δ信号可以通过减去连续信号或从当前值减去预测值来确定。 在任一种情况下，然后以截断的位数（例如2或4位）发送增量信号。 当增量信号太大而不能在压缩位数中表示时，控制器随后以未压缩格式提供指示符信号，后跟增量信号。 此外，每当连续的delta信号低于最小阈值（例如，零）时，它们可以被压缩成计数。

    Efficient generation of sensing signals in an implantable medical device such as a pacemaker or ICD
    4.
    发明授权
    Efficient generation of sensing signals in an implantable medical device such as a pacemaker or ICD 失效
    在诸如起搏器或ICD的可植入医疗装置中高效地产生感测信号

    公开(公告)号：US06275734B1

    公开(公告)日：2001-08-14

    申请号：US09223422

    申请日：1998-12-30

    申请人： Kelly H. McClure ,  Gabriel Mouchawar

    发明人： Kelly H. McClure ,  Gabriel Mouchawar

    IPC分类号： A61N137

    CPC分类号： A61N1/3704 ,  A61N1/3925

    摘要： An implantable cardiac device such as a pacemaker or an implantable cardioverter defibrillator (ICD) that stores a broad band electrogram signal in response to the detecting of a particular cardiac event. The system includes an external programmer which is capable of accessing the stored electrogram via a telemetry circuit so that the stored electrogram can be downloaded and reviewed on a display of the external programmer. The external programmer is also equipped with a digital filter emulator that is capable of emulating the filtering of the broad band electrogram signal that is being provided to the processor of the implanted cardiac device. The emulator therefore allows a treating physician to review an emulation of the waveform that the processor of the implanted cardiac device is seeing when the processor is initiating the delivery of therapeutic electrical stimulation to the heart.

    摘要翻译： 可植入心脏装置，例如起搏器或植入式心律转复除颤器（ICD），其响应于特定心脏事件的检测而存储宽带电描记图信号。 该系统包括外部编程器，其能够经由遥测电路访问存储的电描记图，以便可以在外部编程器的显示器上下载和检查所存储的电描记图。 外部编程器还配备有数字滤波器仿真器，其能够模拟正在提供给植入的心脏装置的处理器的宽带电描记信号的滤波。 因此，仿真器允许治疗医师检查当处理器开始向心脏递送治疗性电刺激时植入的心脏设备的处理器看到的波形的仿真。

    System and method for deriving hemodynamic signals from a cardiac wall motion sensor
    5.
    发明授权
    System and method for deriving hemodynamic signals from a cardiac wall motion sensor 失效
    用于从心脏壁运动传感器导出血液动力学信号的系统和方法

    公开(公告)号：US6009349A

    公开(公告)日：1999-12-28

    申请号：US942237

    申请日：1997-10-01

    申请人： Gabriel Mouchawar ,  Kelly H. McClure ,  Sheldon B. Moberg

    发明人： Gabriel Mouchawar ,  Kelly H. McClure ,  Sheldon B. Moberg

    IPC分类号： A61N1/365 ,  A61N1/39 ,  A61N5/00

    CPC分类号： A61N1/36542 ,  A61N1/3956

    摘要： A processing system and method are provided for deriving an improved hemodynamic indicator from cardiac wall acceleration signals. The cardiac wall acceleration signals are provided by a cardiac wall motion sensor that responds to cardiac mechanical activity. The cardiac wall acceleration signals are integrated over time to derive cardiac wall velocity signals, which are further integrated over time to derive cardiac wall displacement signals. The cardiac wall displacement signals correlate to known hemodynamic indicators, and are shown to be strongly suggestive of hemodynamic performance. An implantable cardiac stimulating device which uses cardiac wall displacement signals to detect and discriminate cardiac arrhythmias is also provided.

    摘要翻译： 提供了一种用于从心脏壁加速度信号导出改进的血液动力学指标的处理系统和方法。 心脏壁加速度信号由响应于心脏机械活动的心脏壁运动传感器提供。 随着时间的推移，心脏壁加速度信号被积分以导出心脏壁速度信号，其随时间进一步积分以导出心脏壁位移信号。 心脏壁位移信号与已知的血液动力学指标相关，并且显示出强烈地提示血流动力学性能。 还提供了使用心脏壁位移信号来检测和区分心律不齐的可植入心脏刺激装置。

    System and method for providing hemodynamically optimal pacing therapy
    6.
    发明授权
    System and method for providing hemodynamically optimal pacing therapy 失效
    用于提供血液动力学最佳起搏治疗的系统和方法

    公开(公告)号：US5549650A

    公开(公告)日：1996-08-27

    申请号：US259084

    申请日：1994-06-13

    申请人： Gene A. Bornzin ,  Kelly H. McClure ,  Gabriel Mouchawar ,  Sheldon B. Moberg

    发明人： Gene A. Bornzin ,  Kelly H. McClure ,  Gabriel Mouchawar ,  Sheldon B. Moberg

    IPC分类号： A61N1/365 ,  A61N1/368

    CPC分类号： A61N1/36542 ,  A61N1/3682

    摘要： A system and method for a pacemaker are provided, for using cardiac wall motion sensor signals to provide hemodynamically optimal pacing therapy to patient at rest, and for providing rate-responsive pacing therapy. The cardiac wall motion sensor signals are provided by an implantable lead that incorporates an accelerometer for measuring cardiac mechanical activity. The cardiac wall motion sensor signals are processed to derive cardiac wall velocity signals and cardiac wall displacement signals. The derived signals are further processed to derive physiologic parameters indicative of cardiac performance, including stroke volume, contractility, pre-ejection period, and ejection time. The physiological parameters, in turn, are used by the pacemaker to provide hemodynamically optimal pacing therapy at rest, and rate-responsive pacing therapy.

    摘要翻译： 提供了一种用于起搏器的系统和方法，用于使用心脏壁运动传感器信号为静息患者提供血液动力学最佳起搏治疗，并提供速率响应性起搏治疗。 心脏壁运动传感器信号由可植入引线提供，其包含用于测量心脏机械活动的加速度计。 处理心脏壁运动传感器信号以导出心脏壁速度信号和心脏壁位移信号。 导出的信号被进一步处理以得出指示心脏性能的生理参数，包括脑卒中体积，收缩性，预喷射期和排出时间。 生理参数又由起搏器用于提供血液动力学优化的静息起搏治疗和速率响应性起搏治疗。