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1. 发明授权

US11357439B1 Advanced cardiovascular monitoring system with personalized st-segment thresholds 有权
公开(公告)号：US11357439B1
公开(公告)日：2022-06-14
申请号：US17304675
申请日：2021-06-24
申请人： ANGEL MEDICAL SYSTEMS, INC.
发明人： David R. Fischell , Michael Sasha John , David Keenan , Steve Johnson , Gregg Turi
IPC分类号： A61B5/00 , A61B5/358 , A61B5/366 , A61B5/36 , A61B5/283 , A61B5/352
摘要： A device for detecting acute coronary syndrome (ACS) events, arrythmias, heart rate abnormalities, medication problems such as non-compliance or ineffective amount or type of medication, and demand/supply related cardiac ischemia is disclosed. The device may have both implanted and external components and can communicate with other user devices such as smartphones and smartwatches for monitoring and alerting in response to detected medically relevant events or states of a patient. The processor is configured to provide event detection based upon various criteria including what is found to be statistically abnormal for a patient or what has been defined by a doctor to be abnormal. A patient's cardiovascular condition can be tracked over time using histogram, trend, and summary information related to heart rate and/or cardiac features such as those measured from the S-T segment of heartbeats. Heartbeats that are elevated but which are below what is defined as high, are used to provide medically relevant detections.

2. 发明授权

US09101278B2 RR interval based beat rejection for a cardiac monitor 有权
标题翻译：心脏监测器的基于RR间隔的搏动抑制
公开(公告)号：US09101278B2
公开(公告)日：2015-08-11
申请号：US13025476
申请日：2011-02-11
申请人： David R. Fischell , Tim A. Fischell , Jonathan Harwood , Robert E. Fischell
发明人： David R. Fischell , Tim A. Fischell , Jonathan Harwood , Robert E. Fischell
IPC分类号： A61B5/0452 , A61B5/0468 , A61B5/00
CPC分类号： A61B5/02455 , A61B5/0031 , A61B5/04012 , A61B5/0422 , A61B5/0452 , A61B5/0456 , A61B5/0468 , A61B5/0472 , A61B5/746 , A61B5/7465 , A61B2560/0209
摘要： Disclosed is a system for the detection of cardiac events (a guardian system) that includes an implanted device called a cardiosaver, a physician's programmer and an external alarm system. The system is designed to provide early detection of cardiac events such as acute myocardial infarction or exercise induced myocardial ischemia caused by an increased heart rate or exertion. The system can also alert the patient with a less urgent alarm if a heart arrhythmia is detected. Using one or more detection algorithms, the cardiosaver can detect a change in the patient's electrogram that is indicative of a cardiac event within five minutes after it occurs and then automatically warn the patient that the event is occurring. To provide this warning, the guardian system includes an internal alarm sub-system (internal alarm means) within the cardiosaver and/or an external alarm system (external alarm means). If the guardian system is put into a pacemaker, the algorithm can utilize a different analysis of the electrogram depending on whether or not the pacemaker is actually pacing the heart.
摘要翻译：公开了一种用于检测心脏事件（监护系统）的系统，其包括称为心脏切除器的植入装置，医师编程器和外部警报系统。该系统旨在提供心脏事件的早期检测，例如由心率增加或运动引起的急性心肌梗死或运动诱发的心肌缺血。如果检测到心律失常，该系统还可以警告患者不太紧急的警报。使用一个或多个检测算法，心脏扫描器可以检测患者的电描记图中的变化，其指示在发生后五分钟内的心脏事件，然后自动向患者发出事件发生。为了提供此警告，监护系统包括在心脏保护器内和/或外部报警系统（外部报警装置）内的内部报警子系统（内部报警装置）。如果将监护人系统放入心脏起搏器，该算法可以根据起搏器是否实际起搏心脏，对电图进行不同的分析。

3. 发明授权

US08965494B2 Means and method for the detection of cardiac events 有权
公开(公告)号：US08965494B2
公开(公告)日：2015-02-24
申请号：US14054982
申请日：2013-10-16
申请人： Angel Medical Systems, Inc.
发明人： David R. Fischell , Tim A. Fischell , Jonathan Harwood , Robert E. Fischell , Steven R. Johnson
IPC分类号： A61B5/00 , A61B5/0472 , A61B5/0452 , A61N1/37 , A61N1/372 , A61B5/0245 , A61B5/04 , A61B5/042 , A61B5/0432 , A61N1/375
CPC分类号： A61B5/0464 , A61B5/0006 , A61B5/0031 , A61B5/02455 , A61B5/04012 , A61B5/042 , A61B5/0432 , A61B5/0452 , A61B5/0456 , A61B5/046 , A61B5/0472 , A61B5/686 , A61B5/746 , A61B5/7465 , A61N1/3702 , A61N1/37258 , A61N1/3756 , G16H40/67
摘要： Disclosed is a system for the detection of cardiac events that includes an implanted device called a cardiosaver, a physician's programmer and an external alarm system. The system is designed to provide early detection of cardiac events such as acute myocardial infarction or exercise induced myocardial ischemia caused by an increased heart rate or exertion. The system can also alert the patient with a less urgent alarm if a heart arrhythmia is detected. Using different algorithms, the cardiosaver can detect a change in the patient's electrogram that is indicative of a cardiac event within five minutes after it occurs and then automatically warn the patient that the event is occurring. To provide this warning, the system includes an internal alarm sub-system (internal alarm means) within the cardiosaver and/or an external alarm system (external alarm means) which are activated after the ST segment of the electrogram exceeds a preset threshold.

4. 发明授权

US08903487B1 Pacemaker enabled ischemia detection with selective ischemia tests 有权
标题翻译：起搏器能够通过选择性缺血试验进行缺血检测
公开(公告)号：US08903487B1
公开(公告)日：2014-12-02
申请号：US12624521
申请日：2009-11-24
申请人： David R. Fischell , Michael Sasha John , Bruce Hopenfeld
发明人： David R. Fischell , Michael Sasha John , Bruce Hopenfeld
IPC分类号： A61N1/00 , A61N1/368
CPC分类号： A61N1/3702 , A61B5/0452 , A61B5/0472 , A61B5/4836 , A61B5/7282 , A61N1/025 , A61N1/362 , A61N1/368 , A61N1/3684
摘要： A device for detecting cardiac ischemia is disclosed. The device includes a processor that is configured to distinguish between two different heart beats types such as ventricularly paced beats and supraventricular beats. The processor collects separate reference data for a first one of the beat types indicative of the normal values of a cardiac feature. The processor performs an ischemia test to beats of the first type by first checking whether valid reference data exists for that beat type. If so, the ischemia test is based on this reference data. If no valid reference data exists for the first beat type, the processor applies an ischemia test that is not based on reference data for the first beat type.
摘要翻译：公开了一种用于检测心脏缺血的装置。该装置包括处理器，其被配置为区分两种不同的心跳类型，例如心室起搏节拍和室上搏动。处理器针对指示心脏特征的正常值的节拍类型中的第一个收集单独的参考数据。处理器通过首先检查是否存在针对该节拍类型的有效参考数据来执行第一类型的缺血测试。如果是这样，缺血试验基于该参考数据。如果第一节拍类型没有有效的参考数据，则处理器应用不基于第一节拍类型的参考数据的缺血测试。

5. 发明授权

US08781566B2 System and methods for sliding-scale cardiac event detection 有权
标题翻译：用于滑动式心脏事件检测的系统和方法
公开(公告)号：US08781566B2
公开(公告)日：2014-07-15
申请号：US12068776
申请日：2008-02-12
申请人： Michael Sasha John , David R. Fischell , Bruce Hopenfeld
发明人： Michael Sasha John , David R. Fischell , Bruce Hopenfeld
IPC分类号： A61B5/0402
CPC分类号： A61B5/0452 , A61B5/0031 , A61B5/024 , A61B5/7232
摘要： A system for the detection of cardiac events occurring in a human patient is disclosed to include at least two electrodes for obtaining an electrical signal from a patient's heart. At least two electrodes are included in the system for obtaining an electrical signal from a patient's heart. An electrical signal processor is electrically coupled to the electrodes for processing the electrical signal. The system determines the presence of a cardiovascular condition by applying a sliding scale rule to heart signal feature values. When the cardiovascular condition is ischemia, the ST segment may be analyzed. A sliding scale is applied to ST segment shifts such that when the magnitudes of ST segment shifts are relatively small, a larger number of beats is required to detect ischemia compared to the case when the magnitudes of ST shifts are large.
摘要翻译：公开了一种用于检测在人类患者中发生的心脏事件的系统，以包括用于从患者心脏获得电信号的至少两个电极。系统中包括至少两个电极，以从患者的心脏获得电信号。电信号处理器电耦合到电极以处理电信号。该系统通过将滑动比例规则应用于心脏信号特征值来确定心血管疾病的存在。当心血管疾病缺血时，ST段可能被分析。将滑动刻度应用于ST段移位，使得当ST段移位的幅度相对较小时，与ST移位量大的情况相比，需要较大数量的搏动来检测缺血。

6. 发明授权

US08655434B2 Physician's programmer with ST-segment histogram display capability 有权
标题翻译：具有ST段直方图显示能力的医师程序员
公开(公告)号：US08655434B2
公开(公告)日：2014-02-18
申请号：US13461100
申请日：2012-05-01
申请人： David R. Fischell , Robert E. Fischell , Jonathan Harwood , Steven R. Johnson
发明人： David R. Fischell , Robert E. Fischell , Jonathan Harwood , Steven R. Johnson
IPC分类号： A61B5/0452
CPC分类号： A61B5/0472 , A61B5/0006 , A61B5/0031 , A61B5/02405 , A61B5/02455 , A61B5/04012 , A61B5/042 , A61B5/0432 , A61B5/044 , A61B5/0452 , A61B5/413 , A61B5/686 , A61B5/746 , A61N1/025 , A61N1/37211 , A61N1/37247
摘要： A physician's programmer for an implantable device is disclosed. The programmer includes a receiver for receiving wireless transmission data from the implantable heart monitor. A processor is configured to extract from the wireless transmission data ST-deviation histogram data as a function of heart rate. The histogram data for a particular heart rate range is shown on a display in the form of a bar chart. The histogram data for a plurality of heart rate ranges is shown in the form of a chart with multiple line plots.
摘要翻译：公开了一种用于可植入装置的医师编程器。编程器包括用于从可植入心脏监视器接收无线传输数据的接收器。处理器被配置为从无线传输数据提取作为心率的函数的ST偏差直方图数据。特定心率范围的直方图数据以条形图的形式显示在显示器上。多个心率范围的直方图数据以具有多个线图的图表的形式示出。

7. 发明授权

US08630702B2 System for detection of different types of cardiac events 有权
标题翻译：用于检测不同类型心脏事件的系统
公开(公告)号：US08630702B2
公开(公告)日：2014-01-14
申请号：US11594806
申请日：2006-11-09
申请人： David R. Fischell , Tim A. Fischell , Jonathan Harwood , Robert E. Fischell , Steven R. Johnson , Bruce Hopenfeld , Michael Sasha John
发明人： David R. Fischell , Tim A. Fischell , Jonathan Harwood , Robert E. Fischell , Steven R. Johnson , Bruce Hopenfeld , Michael Sasha John
IPC分类号： A61B5/0452
CPC分类号： A61B5/0456 , A61B5/0006 , A61B5/0031 , A61B5/0452 , A61B5/046 , A61B5/0464 , A61B5/7465 , A61B2560/0209 , A61N1/3627 , A61N1/3702
摘要： A system for the detection of cardiac events occurring in a human patient is provided. At least two electrodes are included in the system for obtaining an electrical signal from a patient's heart. An electrical signal processor is electrically coupled to the electrodes for processing the electrical signal and a patient alarm means is further provided and electrically coupled to the electrical signal processor. The electrical signal is acquired in the form of electrogram segments, which are categorized according to heart rate, ST segment shift and type heart rhythm (normal or abnormal). Baseline electrogram segments are tracked over time.
摘要翻译：提供了一种用于检测在人类患者中发生的心脏事件的系统。系统中包括至少两个电极，以从患者的心脏获得电信号。电信号处理器电耦合到电极以处理电信号，并且还提供患者报警装置并电耦合到电信号处理器。电信号是以心律，ST段移位和心律（正常或异常）分为心电图段的形式获得的。基线电描绘片段随时间跟踪。

8. 发明授权

US08428704B2 Threshold adjustment schemes for acute ischemia detection 有权
公开(公告)号：US08428704B2
公开(公告)日：2013-04-23
申请号：US12914536
申请日：2010-10-28
申请人： Steven R. Johnson , Bruce Hopenfeld
发明人： Steven R. Johnson , Bruce Hopenfeld
IPC分类号： A61N1/00
CPC分类号： A61B5/0006 , A61B5/0031 , A61B5/0452 , A61B5/0468 , A61B2560/0204 , A61B2560/0219
摘要： A heart monitor is disclosed. The monitor computes ST segment deviations and stores the results in heart rate based histograms. Periodically, the monitor analyzes the histogram data to determine heart rate dependent acute ischemia detection thresholds. If the statistical distribution associated with a heart rate range is insufficient, the threshold for that heart rate range is set as a function of the threshold for a neighboring heart rate range. Thresholds are also increased for heart rate ranges associated with statistical distributions that are sufficient but that have a relatively small number of entries.

9. 发明授权

US08396542B2 Parameter value rejection for a cardiac monitor 有权
标题翻译：心脏监护仪的参数值拒绝
公开(公告)号：US08396542B2
公开(公告)日：2013-03-12
申请号：US12914548
申请日：2010-10-28
申请人： Steven R. Johnson , Bruce Hopenfeld
发明人： Steven R. Johnson , Bruce Hopenfeld
IPC分类号： A61B5/0452
CPC分类号： A61B5/02028 , A61B5/0006 , A61B5/0022 , A61B5/02405 , A61B5/04012 , A61B5/0452 , A61B5/686 , A61B5/7282 , A61B5/742 , A61B5/746 , A61B5/7465
摘要： A heart monitor is disclosed. The monitor computes ST segment deviations and stores the results in heart rate based histograms. Periodically, the monitor analyzes the histogram data to determine a median value of ST deviation. Subsequently, beats are excluded from the computation of the time series if their ST deviations both varies too far from the long term median value and varies too far from the then current time series value.
摘要翻译：公开了心脏监护仪。监视器计算ST段偏差，并将结果存储在基于心率的直方图中。周期性地，监视器分析直方图数据以确定ST偏差的中值。随后，如果它们的ST偏差都与长期中值变化太远，并且与当前时间序列值变得太远，则不计算时间序列的节拍。

10. 发明申请

US20120053476A1 ISCHEMIA DETECTION BASED ON COMBINATION OF PARAMETERS ASSOCIATED WITH DIFFERENT SENSORS 有权
标题翻译：基于与不同传感器相关的参数组合的ISCHEMIA检测
公开(公告)号：US20120053476A1
公开(公告)日：2012-03-01
申请号：US12945039
申请日：2010-11-12
申请人： BRUCE HOPENFELD
发明人： BRUCE HOPENFELD
IPC分类号： A61B5/0452
CPC分类号： A61B5/0006 , A61B5/0031 , A61B5/0468
摘要： An acute ischemia monitor is disclosed. The monitor, which includes an analog to digital convertor and a processor that performs beat detection, monitors the time course of a heart signal parameter, namely ST segment deviation, computed from an electrocardiogram. The device stores ST deviation statistics for multiple leads. For each lead, upper and lower ST deviation boundaries are computed. For each lead, current ST deviation values are compared with the statistical values to determine a metric indicative of the degree of abnormality of a current ST deviation value. The metric is equal to the difference between the current ST deviation value and the upper or lower boundary, normalized according to the dispersion of the ST deviation. Metrics from different leads are summed and compared to a threshold to determine whether the combined metric is indicative of a cardiac event.
摘要翻译：公开了一种急性缺血监测仪。包括模数转换器和执行拍频检测的处理器的监视器监视从心电图计算的心脏信号参数的时间过程，即ST段偏差。该设备存储多个引线的ST偏差统计信息。对于每个引线，计算上下ST偏差边界。对于每个引线，将当前ST偏差值与统计值进行比较，以确定表示当前ST偏差值的异常程度的度量。该度量等于当前ST偏差值与上边界或下边界之间的差值，根据ST偏差的偏差进行归一化。将来自不同引线的度量相加并与阈值进行比较，以确定组合度量是否表示心脏事件。

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