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31. 发明申请

US20110257593A1 DEVICES AND METHODS FOR DETECTING CATHETER COMPLICATIONS 有权
标题翻译：用于检测导管连接的装置和方法
公开(公告)号：US20110257593A1
公开(公告)日：2011-10-20
申请号：US13169092
申请日：2011-06-27
申请人： Scott L. Kalpin , Lucien Bell Solefack , Keith A. Miesel
发明人： Scott L. Kalpin , Lucien Bell Solefack , Keith A. Miesel
IPC分类号： A61M25/00
CPC分类号： A61M5/14276 , A61M5/16854 , A61M5/16859 , A61M5/1723 , A61M27/006 , A61M2005/1726 , A61M2025/0003 , A61M2202/0464 , A61M2205/3331 , A61M2205/3344 , A61M2205/3355 , A61M2210/0693 , A61M2230/005 , A61M2230/04 , A61M2230/06 , A61M2230/40 , A61M2230/42 , A61M2230/63
摘要： A method for determining status of an implanted catheter includes acquiring raw pressure data from a pressure sensor of in an implantable infusion device. The pressure sensor is in communication with a lumen of the catheter operably coupled to the infusion device. The catheter has a delivery region, in communication with the lumen, intended to be positioned in a fluid-filled target location of a patient. The method further includes filtering the raw pressure data to remove the DC component, leaving the AC component within a relevant physiological frequency range; rectifying the AC component to produce a rectified pressure signal; calculating a mean magnitude of the rectified signal; and determining whether the mean magnitude is below a predetermined threshold. If the mean magnitude is below the threshold, the catheter is determined to be in a state other than a normal state.
摘要翻译：用于确定植入导管的状态的方法包括从可植入输注装置中的压力传感器获取原始压力数据。压力传感器与可操作地连接到输注装置的导管的内腔连通。导管具有与内腔连通的输送区域，用于定位在患者的流体填充的目标位置。该方法还包括过滤原始压力数据以去除DC分量，将AC分量留在相关的生理频率范围内; 整流交流分量以产生整流压力信号; 计算整流信号的平均幅度; 以及确定平均幅度是否低于预定阈值。如果平均值低于阈值，则确定导管处于正常状态以外的状态。

32. 发明申请

US20110208163A1 Pressure Sensing in Implantable Medical Devices 审中-公开
标题翻译：植入式医疗器械中的压力感应
公开(公告)号：US20110208163A1
公开(公告)日：2011-08-25
申请号：US13096590
申请日：2011-04-28
申请人： Keith A. Miesel
发明人： Keith A. Miesel
IPC分类号： A61M25/00
CPC分类号： A61M5/14276 , A61M5/16854 , A61M2205/3355 , A61M2205/3523
摘要： An implantable medical device for delivering a therapeutic substance to a delivery site in a patient. A reservoir holds a supply of the fluid therapeutic substance. A catheter has a proximal end, a delivery region and a lumen extending from the proximal end to the delivery region. The proximal end of the catheter is operatively coupled to the reservoir. The delivery region of the catheter is adapted to be placed proximate the delivery site in the patient. The therapeutic substance is adapted to be delivered through the lumen to the patient. A sensing device is operatively coupled with the lumen of the catheter being capable of detecting a pressure of the therapeutic substance in the lumen. A controller is operatively coupled to the sensing device, the controller being capable of taking an action in response to the pressure in the lumen.
摘要翻译：一种用于将治疗物质输送到患者的输送部位的可植入医疗装置。储存器容纳流体治疗物质的供应。导管具有近端，输送区域和从近端延伸到输送区域的内腔。导管的近端可操作地联接到储存器。导管的输送区域适于放置在患者体内的输送部位附近。治疗物质适于通过内腔输送给患者。感测装置与导管的内腔可操作地耦合，能够检测内腔中的治疗物质的压力。控制器可操作地耦合到感测装置，所述控制器能够响应于内腔中的压力而采取动作。

33. 发明授权

US07908013B2 Collecting activity information to evaluate therapy 有权
标题翻译：收集活动信息以评估治疗
公开(公告)号：US07908013B2
公开(公告)日：2011-03-15
申请号：US12017918
申请日：2008-01-22
申请人： Keith A. Miesel , Kenneth T. Heruth
发明人： Keith A. Miesel , Kenneth T. Heruth
IPC分类号： A61N1/37
CPC分类号： A61M5/1723 , A61B5/0031 , A61B5/02055 , A61B5/0476 , A61B5/0488 , A61B5/1118 , A61B5/1455 , A61B5/6814 , A61B5/6826 , A61B5/6831 , A61B5/6838 , A61B2562/0219 , A61M5/14276 , A61N1/36071 , A61N1/365 , A61N1/36521 , A61N1/36542 , A61N1/36557
摘要： A medical device delivers a therapy to a patient. The medical device may periodically determine an activity level of the patient, and associate each determined activity level with a current therapy parameter set. A value of at least one activity metric is determined for each of a plurality of therapy parameter sets based on the activity levels associated with that therapy parameter set. A list of the therapy parameter sets is presented to a user, such as a clinician, for evaluation of the relative efficacy of the therapy parameter sets. The list may be ordered according to the one or more activity metric values to aid in evaluation of the therapy parameter sets. Where values are determined for a plurality of activity metrics, the list may be ordered according to the one of the activity metrics selected by the user.
摘要翻译：医疗设备向患者传递治疗。医疗设备可以周期性地确定患者的活动水平，并将每个确定的活动水平与当前治疗参数组相关联。基于与该治疗参数组相关联的活动水平，为多个治疗参数组中的每一个确定至少一个活动度量的值。将治疗参数组的列表呈现给诸如临床医师的用户，用于评估治疗参数组的相对功效。该列表可以根据一个或多个活动度量值来排序以帮助评估治疗参数集。在确定多个活动度量的值的情况下，可以根据用户选择的活动度量中的一个排序列表。

34. 发明授权

US07853322B2 Closed-loop therapy adjustment 有权
标题翻译：闭环治疗调整
公开(公告)号：US07853322B2
公开(公告)日：2010-12-14
申请号：US11414625
申请日：2006-04-28
申请人： Duane Bourget , Keith A. Miesel
发明人： Duane Bourget , Keith A. Miesel
IPC分类号： A61N1/00
CPC分类号： A61N1/37247 , A61N1/36014 , A61N1/36071 , A61N1/37252
摘要： Techniques for detecting a value of a sensed patient parameter, and automatically delivering therapy to a patient according to therapy information previously associated with the detected value, are described. In exemplary embodiments, a medical device receives a therapy adjustment from the patient. In response to the adjustment, the medical device associates a sensed value of a patient parameter with therapy information determined based on the adjustment. Whenever the parameter value is subsequently detected, the medical device delivers therapy according to the associated therapy information. In this manner, the medical device may “learn” to automatically adjust therapy in the manner desired by the patient as the sensed parameter of the patient changes. Exemplary patient parameters that may be sensed for performance of the described techniques include posture, activity, heart rate, electromyography (EMG), an electroencephalogram (EEG), an electrocardiogram (ECG), temperature, respiration rate, and pH.
摘要翻译：描述了用于检测感测到的患者参数的值并根据先前与检测值相关联的治疗信息自动地向患者递送治疗的技术。在示例性实施例中，医疗设备从患者接收治疗调节。响应于调整，医疗设备将感测到的患者参数值与基于调整确定的治疗信息相关联。每当随后检测到参数值时，医疗装置根据相关联的治疗信息递送治疗。以这种方式，当患者的感测参数改变时，医疗设备可以“学习”以患者期望的方式自动调整治疗。可以感测用于执行所述技术的示例性患者参数包括姿势，活动，心率，肌电图（EMG），脑电图（EEG），心电图（ECG），温度，呼吸速率和pH。

35. 发明申请

US20100174155A1 COLLECTING SLEEP QUALITY INFORMATION VIA A MEDICAL DEVICE 有权
标题翻译：通过医疗器械收集睡眠质量信息
公开(公告)号：US20100174155A1
公开(公告)日：2010-07-08
申请号：US12723501
申请日：2010-03-12
申请人： Kenneth T. Heruth , Keith A. Miesel
发明人： Kenneth T. Heruth , Keith A. Miesel
IPC分类号： A61B5/00
CPC分类号： A61N1/36139 , A61B3/113 , A61B5/01 , A61B5/0402 , A61B5/0476 , A61B5/1116 , A61B5/1118 , A61B5/4815 , A61B5/6826 , A61B5/686 , A61M5/14276 , A61M5/1723 , A61N1/36071 , A61N1/36078 , A61N1/36135 , A61N1/36514 , A61N1/36521 , A61N1/36542 , A61N1/36557 , A61N1/3702 , A61N1/37247
摘要： At least one of a medical device, such as an implantable medical device, and a programming device determines values for one or more metrics that indicate the quality of a patient's sleep. Sleep efficiency, sleep latency, and time spent in deeper sleep states are example sleep quality metrics for which values may be determined. In some embodiments, determined sleep quality metric values are associated with a current therapy parameter set. In some embodiments, a programming device presents sleep quality information to a user based on determined sleep quality metric values. A clinician, for example, may use the sleep quality information presented by the programming device to evaluate the effectiveness of therapy delivered to the patient by the medical device, to adjust the therapy delivered by the medical device, or to prescribe a therapy not delivered by the medical device in order to improve the quality of the patient's sleep.
摘要翻译：诸如可植入医疗设备的医疗设备和编程设备中的至少一个确定了指示患者睡眠质量的一个或多个度量的值。睡眠效率，睡眠延迟和在更深的睡眠状态中花费的时间是可以确定值的示例性睡眠质量度量。在一些实施例中，确定的睡眠质量度量值与当前治疗参数组相关联。在一些实施例中，编程设备基于确定的睡眠质量度量值向用户呈现睡眠质量信息。例如，临床医生可以使用编程设备呈现的睡眠质量信息来评估由医疗设备递送给患者的治疗的有效性，以调整由医疗设备递送的治疗，或者开出不由医疗器械为了提高病人的睡眠质量。

36. 发明申请

US20090306740A1 CONTROLLING THERAPY BASED ON SLEEP QUALITY 有权
标题翻译：基于睡眠质量控制治疗
公开(公告)号：US20090306740A1
公开(公告)日：2009-12-10
申请号：US12544727
申请日：2009-08-20
申请人： Kenneth T. Heruth , Keith A. Miesel
发明人： Kenneth T. Heruth , Keith A. Miesel
IPC分类号： A61N1/34 , A61B5/00
CPC分类号： A61M5/14276 , A61B5/02 , A61B5/04 , A61B5/4815 , A61M5/1723 , A61M2230/06 , A61M2230/63 , A61N1/36071 , A61N1/365 , A61N1/36521 , A61N1/36542 , A61N1/36557
摘要： A medical device, such as an implantable medical device (IMD), determines values for one or more metrics that indicate the quality of a patient's sleep, and controls delivery of a therapy based on the sleep quality metric values. For example, the medical device may compare a sleep quality metric value with one or more threshold values, and adjust the therapy based on the comparison. In some embodiments, the medical device adjusts the intensity of therapy based on the comparison, e.g., increases the therapy intensity when the comparison indicates that the patient's sleep quality is poor. In some embodiments, the medical device automatically selects one of a plurality of therapy parameter set available for use in delivering therapy based on a comparison sleep quality metric values associated with respective therapy parameter sets within the plurality of available therapy parameter sets.
摘要翻译：诸如可植入医疗装置（IMD）的医疗设备确定指示患者睡眠质量的一个或多个指标的值，并且基于睡眠质量量度值控制治疗的递送。例如，医疗设备可以将睡眠质量度量值与一个或多个阈值进行比较，并且基于比较来调整治疗。在一些实施例中，医疗装置基于比较来调整治疗的强度，例如当比较表明患者的睡眠质量差时，增加治疗强度。在一些实施例中，医疗设备基于与多个可用治疗参数组内的各个治疗参数组相关联的比较睡眠质量量度值，自动选择可用于递送治疗的多个治疗参数集中的一个。

37. 发明授权

US07610093B2 Implantable optical pressure sensor for sensing urinary sphincter pressure 有权
标题翻译：植入式光学压力传感器，用于感测尿路括约肌压力
公开(公告)号：US07610093B2
公开(公告)日：2009-10-27
申请号：US11117064
申请日：2005-04-28
申请人： Martin T. Gerber , Keith A. Miesel , Steven J. Shumaker
发明人： Martin T. Gerber , Keith A. Miesel , Steven J. Shumaker
IPC分类号： A61N1/00
CPC分类号： A61B5/202 , A61B5/205 , A61N1/36007
摘要： The disclosure describes an optical fiber pressure sensor to measure sphincter pressure which may be incorporated into a therapeutic sphincter control system. The system senses sphincter pressure and sends the information to a stimulator that is capable of stimulation therapy to control sphincter contractility, thus reducing unwanted urinary incontinence. Measuring sphincter pressure is accomplished through the use of an optical fiber connected to flexible tube section placed through the sphincter, where properties of the emitted light are changed proportional to the pressure on the tube section. The light is returned to a light detector to measure light properties and create an electrical signal representative of the pressure on the tube section. The signal may then be sent by wireless telemetry to an implanted stimulator or external programmer.
摘要翻译：本公开描述了一种用于测量括约肌压力的光纤压力传感器，该压力传感器可并入治疗括约肌控制系统中。该系统感测括约肌压力，并将信息发送到能够刺激治疗的刺激器以控制括约肌收缩力，从而减少不必要的尿失禁。通过使用连接到通过括约肌放置的柔性管部分的光纤来实现测量括约肌压力，其中发射的光的性质与管部分上的压力成比例地变化。光返回到光检测器以测量光性质并产生代表管部分上的压力的电信号。然后可以通过无线遥测将信号发送到植入的刺激器或外部编程器。

38. 发明申请

US20090192450A1 BRANCHING CATHETER SYSTEMS WITH DIAGNOSTIC COMPONENTS 审中-公开
标题翻译：分支导管系统与诊断组件
公开(公告)号：US20090192450A1
公开(公告)日：2009-07-30
申请号：US12418335
申请日：2009-04-03
申请人： Keith A Miesel , Justin A. Blanco
发明人： Keith A Miesel , Justin A. Blanco
IPC分类号： A61M25/14 , A61M1/00
CPC分类号： A61M25/0021 , A61M5/14276 , A61M5/16813 , A61M25/00 , A61M25/0029 , A61M25/003 , A61M25/0043 , A61M25/0068 , A61M25/0071 , A61M25/0075 , A61M27/006 , A61M2025/0073 , A61M2039/1005 , A61M2205/15 , A61M2206/16
摘要： Branching catheter systems with diagnostic components for detecting and isolating fluid flow problems (e.g., leaks, occlusions, etc.) and methods for detecting and isolating fluid flow problems are disclosed. Among the fluid flow problems that may potentially be detected are leaks in the branching catheter systems (e.g., cuts, disconnected components, etc.). Another fluid flow problem that may be detected using the diagnostic systems of the present invention is the presence of occlusions or other blockages that prevent fluid flow within the catheter systems. In addition to identifying that a problem exists, the diagnostic components may preferably also be used to identify the location of the fluid flow problem as discussed herein. Connectors for use in the branching catheter systems are also disclosed. Among the diagnostic components that may be used in branching catheter systems of the present are valves to control fluid flow through the various sections of the branching catheter system, fluid flow detectors to detect flow through the one or more sections of the branching catheter system and a control system for operating the diagnostic components.
摘要翻译：公开了具有用于检测和分离流体流动问题（例如泄漏，闭塞等）的诊断部件的分支导管系统以及用于检测和分离流体流动问题的方法。在可能潜在检测的流体流动问题中，分支导管系统中的泄漏（例如，切割，断开的部件等）。可以使用本发明的诊断系统检测的另一个流体流动问题是存在妨碍导管系统内的流体流动的闭塞或其它阻塞物。除了确定存在问题之外，诊断部件还可以优选地用于识别本文所讨论的流体流动问题的位置。还公开了用于分支导管系统的连接器。在本发明的分支导管系统中可以使用的诊断部件中的阀是用于控制通过分支导管系统的各个部分的流体流动的流体流动检测器，用于检测通过分支导管系统的一个或多个部分的流动，以及用于操作诊断部件的控制系统。

39. 发明申请

US20090099627A1 THERAPY CONTROL BASED ON A PATIENT MOVEMENT STATE 有权
标题翻译：基于患者运动状态的治疗控制
公开(公告)号：US20090099627A1
公开(公告)日：2009-04-16
申请号：US12237799
申请日：2008-09-25
申请人： Gregory F. Molnar , Steven S. Gill , Keith A. Miesel , Mark S. Lent , Timothy J. Denison , Eric J. Panken , Carl D. Wahlstrand , Jonathan C. Werder
发明人： Gregory F. Molnar , Steven S. Gill , Keith A. Miesel , Mark S. Lent , Timothy J. Denison , Eric J. Panken , Carl D. Wahlstrand , Jonathan C. Werder
IPC分类号： A61N1/36 , A61B5/0476 , A61M37/00
CPC分类号： A61B5/04014 , A61B5/0006 , A61B5/4082 , A61B5/6814 , A61N1/36003 , A61N1/36014 , A61N1/36025 , A61N1/36067 , A61N1/36082
摘要： A movement state of a patient is detected based on brain signals, such as an electroencephalogram (EEG) signal. In some examples, a brain signal within a dorsal-lateral prefrontal cortex of a brain of the patient indicative of prospective movement of the patient may be sensed in order to detect the movement state. The movement state may include the brain state that indicates the patient is intending on initiating movement, initiating movement, attempting to initiate movement or is actually moving. In some examples, upon detecting the movement state, a movement disorder therapy is delivered to the patient. In some examples, the therapy delivery is deactivated upon detecting the patient is no longer in a movement state or that the patient has successfully initiated movement. In addition, in some examples, the movement state detected based on the brain signals may be confirmed based on a signal from a motion sensor.
摘要翻译：基于诸如脑电图（EEG）信号的脑信号检测患者的运动状态。在一些示例中，可以检测指示患者的预期运动的患者的脑的背侧前额叶皮层内的脑信号，以便检测运动状态。运动状态可以包括指示患者打算启动运动，启动运动，尝试启动运动或实际运动的脑状态。在一些示例中，在检测到运动状态时，将运动障碍治疗递送给患者。在一些示例中，在检测到患者不再处于运动状态或患者已经成功启动运动时，治疗递送被停用。此外，在一些示例中，可以基于来自运动传感器的信号来确认基于脑信号检测到的运动状态。

40. 发明申请

US20080243074A1 Catheter malfunction determinations using physiologic pressure 有权
标题翻译：使用生理压力的导管故障测定
公开(公告)号：US20080243074A1
公开(公告)日：2008-10-02
申请号：US11731356
申请日：2007-03-30
申请人： Keith A. Miesel , Robert J. Coffey
发明人： Keith A. Miesel , Robert J. Coffey
IPC分类号： A61M25/095
CPC分类号： A61M5/14276 , A61M5/16859 , A61M2005/1726 , A61M2202/0464
摘要： Methods and systems for determining whether an implanted catheter used to deliver fluids to a selected internal delivery site is malfunctioning. The malfunctions may include that the infusion section of the catheter is not located at or has migrated away from the selected internal delivery site, is leaking, is blocked, etc. The determination is made by analyzing the pressure modulation of fluid within the catheter and determining whether the pressure of the fluid in the catheter is modulated by physiologic pressure changes experienced at the selected internal delivery site. The physiologic pressure modulations at the selected internal delivery site may be caused by, e.g., cardiac activity, respiration, changes in patient's posture, etc.
摘要翻译：用于确定用于将流体输送到选择的内部递送部位的植入导管是否发生故障的方法和系统。故障可能包括导管的输液部分不位于或已经偏离所选择的内部输送部位，正在泄漏，被阻塞等。通过分析导管内的流体的压力调节并确定导管中液体的压力是否受选择的内部递送部位所经历的生理压力变化的调节。选择的内部递送部位的生理压力调节可以由例如心脏活动，呼吸，患者姿势变化等引起。

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