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1. 发明授权

US08202224B2 System and method for calibrating cardiac pressure measurements derived from signals detected by an implantable medical device 有权
标题翻译：用于校准由可植入医疗装置检测的信号导出的心脏压力测量的系统和方法
公开(公告)号：US08202224B2
公开(公告)日：2012-06-19
申请号：US12109304
申请日：2008-04-24
申请人： Dan E. Gutfinger , Neal L. Eigler , Dorin Panescu , James S. Whiting
发明人： Dan E. Gutfinger , Neal L. Eigler , Dorin Panescu , James S. Whiting
IPC分类号： A61B5/0205 , A61B5/021 , A61B5/02
CPC分类号： A61B5/053 , A61B5/0215 , A61B5/6846
摘要： Various techniques are provided for calibrating and estimating left atrial pressure (LAP) using an implantable medical device, based on impedance, admittance or conductance parameters measured within a patient. In one example, default conversion factors are exploited for converting the measured parameters to estimates of LAP. The default conversion factors are derived from populations of patients. In another example, a correlation between individual conversion factors is exploited to allow for more efficient calibration. In yet another example, differences in thoracic fluid states are exploited during calibration. In still yet another example, a multiple stage calibration procedure is described, wherein both invasive and noninvasive calibration techniques are exploited. In a still further example, a therapy control procedure is provided, which exploits day time and night time impedance/admittance measurements.
摘要翻译：提供了各种技术，用于基于在患者体内测量的阻抗，导纳或电导参数，使用可植入医疗装置校准和估计左心房压力（LAP）。在一个示例中，利用默认转换因子将测量参数转换为LAP估计。默认的转换因子来源于患者群体。在另一个示例中，利用各个转换因子之间的相关性来允许更有效的校准。在另一个例子中，在校准过程中利用了胸部流体状态的差异。在另一个示例中，描述了多阶段校准过程，其中利用侵入性和非侵入性校准技术。在另一个实例中，提供了一种治疗控制程序，其利用白天的时间和夜间阻抗/导纳测量。

2. 发明授权

US07794404B1 System and method for estimating cardiac pressure using parameters derived from impedance signals detected by an implantable medical device 有权
标题翻译：使用由可植入医疗装置检测的阻抗信号导出的参数来估计心脏压力的系统和方法
公开(公告)号：US07794404B1
公开(公告)日：2010-09-14
申请号：US11559235
申请日：2006-11-13
申请人： Dan E. Gutfinger , Neal L. Eigler , Dorin Panescu , James S. Whiting
发明人： Dan E. Gutfinger , Neal L. Eigler , Dorin Panescu , James S. Whiting
IPC分类号： A61B5/02
CPC分类号： A61B5/053 , A61B5/021 , A61B5/6846
摘要： Techniques are provided for estimating left atrial pressure (LAP) or other cardiac pressure parameters based on various parameters derived from impedance signals. In particular, effective LAP is estimated based on one or more of: electrical conductance values, cardiogenic pulse amplitudes, circadian rhythm pulse amplitudes, or signal morphology fractionation values, each derived from the impedance signals detected by the implantable device. Predetermined conversion factors stored within the device are used to convert the various parameters derived from the electrical impedance signal into LAP values or other appropriate cardiac pressure values. The conversion factors may be, for example, slope and baseline values derived during an initial calibration procedure performed by an external system, such as an external programmer. In some examples, the slope and baseline values may be periodically re-calibrated by the implantable device itself.
摘要翻译：提供了基于从阻抗信号导出的各种参数来估计左心房压力（LAP）或其他心脏压力参数的技术。特别地，基于以下中的一个或多个估计有效的LAP：电导值，心源性脉搏幅度，昼夜节奏脉搏幅度或信号形态分级值，每个来自由可植入装置检测的阻抗信号。存储在装置内的预定转换因子用于将从电阻抗信号导出的各种参数转换为LAP值或其他适当的心脏压力值。转换因子可以是例如由外部系统（诸如外部编程器）执行的初始校准过程期间导出的斜率和基线值。在一些示例中，可以通过可植入装置本身周期性地重新校准斜率和基线值。

3. 发明申请

US20080262361A1 SYSTEM AND METHOD FOR CALIBRATING CARDIAC PRESSURE MEASUREMENTS DERIVED FROM SIGNALS DETECTED BY AN IMPLANTABLE MEDICAL DEVICE 有权
标题翻译：用于校准由可植入医疗器械检测的信号衍生的心脏压力测量的系统和方法
公开(公告)号：US20080262361A1
公开(公告)日：2008-10-23
申请号：US12109304
申请日：2008-04-24
申请人： Dan E. Gutfinger , Neal L. Eigler , Dorin Panescu , James S. Whiting
发明人： Dan E. Gutfinger , Neal L. Eigler , Dorin Panescu , James S. Whiting
IPC分类号： A61B5/0215
CPC分类号： A61B5/053 , A61B5/0215 , A61B5/6846
摘要： Various techniques are provided for calibrating and estimating left atrial pressure (LAP) using an implantable medical device, based on impedance, admittance or conductance parameters measured within a patient. In one example, default conversion factors are exploited for converting the measured parameters to estimates of LAP. The default conversion factors are derived from populations of patients. In another example, a correlation between individual conversion factors is exploited to allow for more efficient calibration. In yet another example, differences in thoracic fluid states are exploited during calibration. In still yet another example, a multiple stage calibration procedure is described, wherein both invasive and noninvasive calibration techniques are exploited. In a still further example, a therapy control procedure is provided, which exploits day time and night time impedance/admittance measurements.
摘要翻译：提供了各种技术，用于基于在患者体内测量的阻抗，导纳或电导参数，使用可植入医疗装置校准和估计左心房压力（LAP）。在一个示例中，利用默认转换因子将测量参数转换为LAP估计。默认的转换因子来源于患者群体。在另一个示例中，利用各个转换因子之间的相关性来允许更有效的校准。在另一个例子中，在校准过程中利用了胸部流体状态的差异。在另一个示例中，描述了多阶段校准过程，其中利用侵入性和非侵入性校准技术。在另一个实例中，提供了一种治疗控制程序，其利用白天的时间和夜间阻抗/导纳测量。

4. 发明申请

US20110054405A1 HEMOSTASIS VALVE WITH IRIS SEAL 有权
标题翻译： HEMOSTASIS阀与IRIS密封
公开(公告)号：US20110054405A1
公开(公告)日：2011-03-03
申请号：US12552199
申请日：2009-09-01
申请人： James S. Whiting , Werner Hafelfinger , Neal L. Eigler , John L. Wardle
发明人： James S. Whiting , Werner Hafelfinger , Neal L. Eigler , John L. Wardle
IPC分类号： A61B17/34
CPC分类号： A61B17/3462 , A61B17/3439 , A61M39/0613
摘要： A hemostasis valve is disclosed herein. The hemostasis valve may include an inner bushing, a rotation sleeve, an elastomeric sleeve, and a biasing element. The rotation sleeve may extend about the inner bushing and be rotationally displaceable relative to the inner bushing. The elastomeric sleeve may include a first end operably coupled to the inner bushing, a second end operably coupled to the rotation sleeve, and an iris valve portion. Rotation of the rotation sleeve relative to the inner bushing may cause the iris valve to transition from an open state to a closed state. The biasing element may act between the rotation sleeve and inner bushing to bias the iris valve towards at least one of a closed state or an open state.
摘要翻译：本文公开了一种止血阀。止血阀可以包括内衬套，旋转套筒，弹性体套筒和偏置元件。旋转套筒可以围绕内衬套延伸并且可相对于内衬套旋转移位。弹性体套筒可以包括可操作地联接到内衬套的第一端，可操作地联接到旋转套筒的第二端和可变光阀部分。旋转套筒相对于内衬套的旋转可能导致虹膜阀从打开状态转换到关闭状态。偏置元件可以在旋转套筒和内衬套之间作用，以将虹膜阀朝向关闭状态或打开状态中的至少一个偏压。

5. 发明授权

US07717854B2 System for detecting, diagnosing, and treating cardiovascular disease 有权
标题翻译：心血管疾病检测，诊断和治疗系统
公开(公告)号：US07717854B2
公开(公告)日：2010-05-18
申请号：US11746593
申请日：2007-05-09
申请人： Brian Mann , James S. Whiting , Neal L. Eigler
发明人： Brian Mann , James S. Whiting , Neal L. Eigler
IPC分类号： A61B5/0215
CPC分类号： A61N1/36564 , A61B5/021 , A61B5/02108 , A61B5/0215 , A61B5/4839 , A61B5/6882 , A61B2560/0209 , A61N1/3627 , A61N1/37247 , G06F19/00 , G06F19/3418 , G06F19/3456 , G06F19/3481 , G16H40/63
摘要： A method of treating cardiovascular disease in a medical patient is provided. The method includes the steps of generating a sensor signal indicative of a fluid pressure within the left atrium of the patient's heart, and delivering an electrical stimulus to a location in the heart. The electrical stimulus is delivered based at least in part on the sensor signal. The method also includes the steps of generating a processor output indicative of a treatment to a signaling device. The processor output is based at least in part on the sensor signal. At least two treatment signals are provided to the medical patient. The treatment signals are distinguishable from one another by the patient, and are indicative of a therapeutic treatment. The treatment signals are based at least in part on the processor output.
摘要翻译：提供了一种在医疗患者中治疗心血管疾病的方法。该方法包括以下步骤：产生指示患者心脏的左心房内的流体压力的传感器信号，以及将电刺激递送到心脏中的位置。至少部分地基于传感器信号传送电刺激。该方法还包括以下步骤：产生指示对信号装置的处理的处理器输出。处理器输出至少部分地基于传感器信号。向医疗病人提供至少两个治疗信号。治疗信号可由患者彼此区分，并且指示治疗性治疗。治疗信号至少部分地基于处理器输出。

6. 发明授权

US07402899B1 Hermetically sealable silicon system and method of making same 有权
标题翻译：密封硅系统及其制作方法
公开(公告)号：US07402899B1
公开(公告)日：2008-07-22
申请号：US11622647
申请日：2007-01-12
申请人： James S. Whiting , Neal L. Eigler , Brian M. Mann , Werner Hafelfinger
发明人： James S. Whiting , Neal L. Eigler , Brian M. Mann , Werner Hafelfinger
IPC分类号： H01L21/30
CPC分类号： H01L23/10 , B81B7/0077 , H01L2924/0002 , H01L2924/01079 , H01L2924/09701 , H01L2924/00
摘要： A device and method for hermetically sealing a medical device is provided. In one aspect, a silicon device is coupled to a sensor, such as a pressure transducer, which benefits from having direct contact with its environment, which in many cases, is the human body. Thus, a method to hermetically seal the non-sensing portion of a silicon device while allowing the sensing portion (e.g. the pressure transducer) to have direct contact with the body is provided. In one aspect, a silicon chip, a gold preform and a metallic housing are each primed for sealing and are assembled. The assembly is then heated to react the gold preform to the silicon chip and to form a molten gold-silicon alloy in-situ to bind the metallic housing to the non-sensing portion of the silicon chip. In this way, the non-sensing portion of the silicon chip is hermetically sealed and protected from exposure, while still permitting exposure of the sensing portion to the environment.
摘要翻译：提供一种用于密封医疗装置的装置和方法。在一个方面，硅器件耦合到诸如压力传感器的传感器，其受益于与其环境的直接接触，其在许多情况下是人体。因此，提供了一种使允许感测部分（例如压力传感器）与身体直接接触的硅器件的非感测部分密封的方法。在一个方面，硅芯片，金预成型件和金属外壳各自用于密封并组装。然后将组件加热以使金预成型件与硅芯片反应，并原位形成熔融的金 - 硅合金，以将金属外壳固定到硅芯片的非感测部分。以这种方式，硅芯片的非感测部分被气密地密封并防止暴露，同时仍然允许感测部分暴露于环境中。

7. 发明授权

US09060696B2 Implantable pressure transducer system optimized to correct environmental factors 有权
标题翻译：植入式压力传感器系统优化，以纠正环境因素
公开(公告)号：US09060696B2
公开(公告)日：2015-06-23
申请号：US11116138
申请日：2005-04-27
申请人： Neal L. Eigler , Brian M. Mann , James S. Whiting , Werner Hafelfinger
发明人： Neal L. Eigler , Brian M. Mann , James S. Whiting , Werner Hafelfinger
IPC分类号： A61B5/0215 , A61M25/04 , A61M25/02
CPC分类号： A61B5/6882 , A61B5/0215 , A61B5/042 , A61B5/6869 , A61B8/12 , A61B17/3468 , A61M25/0108 , A61M25/04 , A61M31/002 , A61M2025/0233 , A61N1/362 , A61N2001/0578
摘要： This invention relates generally to systems and methods for optimizing the performance and minimizing complications related to implanted sensors, such as pressure sensors, for the purposes of detecting, diagnosing and treating cardiovascular disease in a medical patient. Systems and methods for anchoring implanted sensors to various body structures is also provided.
摘要翻译：本发明一般涉及用于优化性能并最小化与诸如压力传感器的植入传感器有关的并发症的系统和方法，以便在医疗患者中检测，诊断和治疗心血管疾病。还提供了用于将植入的传感器锚定到各种身体结构的系统和方法。

8. 发明授权

US08303511B2 Implantable pressure transducer system optimized for reduced thrombosis effect 有权
标题翻译：植入式压力传感器系统优化减少血栓形成的作用
公开(公告)号：US08303511B2
公开(公告)日：2012-11-06
申请号：US11111691
申请日：2005-04-21
申请人： Neal L. Eigler , Brian M. Mann , James S. Whiting , Werner Hafelfinger
发明人： Neal L. Eigler , Brian M. Mann , James S. Whiting , Werner Hafelfinger
IPC分类号： A61B5/02 , A61B5/00 , A61M31/00
CPC分类号： A61B5/6882 , A61B5/0215 , A61B5/042 , A61B5/6869 , A61B8/12 , A61B17/3468 , A61M25/0108 , A61M25/04 , A61M31/002 , A61M2025/0233 , A61N1/362 , A61N2001/0578
摘要： This invention relates generally to systems and methods for optimizing the performance and minimizing complications related to implanted sensors, such as pressure sensors, for the purposes of detecting, diagnosing and treating cardiovascular disease in a medical patient. Systems and methods for anchoring implanted sensors to various body structures are also provided.
摘要翻译：本发明一般涉及用于优化性能并最小化与诸如压力传感器的植入传感器有关的并发症的系统和方法，以便在医疗患者中检测，诊断和治疗心血管疾病。还提供了用于将植入的传感器锚定到各种身体结构的系统和方法。

9. 发明申请

US20120035590A1 SYSTEM AND METHOD FOR MANIPULATING INSERTION PATHWAYS FOR ACCESSING TARGET SITES 有权
标题翻译：用于操纵目标站点的插入路径的系统和方法
公开(公告)号：US20120035590A1
公开(公告)日：2012-02-09
申请号：US13248922
申请日：2011-09-29
申请人： James S. Whiting , Neal L. Eigler , Brian M. Mann , Werner Hafelfinger
发明人： James S. Whiting , Neal L. Eigler , Brian M. Mann , Werner Hafelfinger
IPC分类号： A61M25/09
CPC分类号： A61B17/3468 , A61B2017/00243 , A61M25/01 , A61M25/09 , A61M2025/0681 , A61N1/056
摘要： A method for accessing a target site in the body by transferring a guidewire from an initial insertion site on the body to a different insertion site on the body is provided. In one aspect, a method for transferring a medical device or component, such as a sensor lead, from an initial insertion site to another insertion site is also provided. A guidewire of sufficient length, pliancy and deformability to perform a transfer from one insertion site to another insertion site is provided. In one aspect, the guidewire comprises a removable core mandrel to increase rigidity, facilitate insertion and/or improve steerability. A kit or system, comprising introducers, guidewires and catheters for performing a guidewire or device transfer is also provided.
摘要翻译：提供了一种通过将导丝从身体上的初始插入位置传递到身体上的不同插入位置来访问身体中的目标部位的方法。一方面，还提供了用于将诸如传感器引线的医疗装置或部件从初始插入位置转移到另一插入位置的方法。提供了足够的长度，柔软度和变形性的导线，以执行从一个插入位点到另一个插入位点的转移。在一个方面，导丝包括可移除的芯心，以增加刚性，便于插入和/或提高可操纵性。还提供了一种套件或系统，其包括用于执行导丝或设备转移的导引器，导线和导管。

10. 发明授权

US08029470B2 Transmembrane access systems and methods 有权
标题翻译：跨膜进入系统和方法
公开(公告)号：US08029470B2
公开(公告)日：2011-10-04
申请号：US10956899
申请日：2004-09-30
申请人： James S. Whiting , Neal L. Eigler , John L. Wardle , Werner Hafelfinger , Brian Mann
发明人： James S. Whiting , Neal L. Eigler , John L. Wardle , Werner Hafelfinger , Brian Mann
IPC分类号： A61M5/178
CPC分类号： A61M25/0662 , A61M25/0041 , A61M2025/0681
摘要： Systems and methods for penetrating a tissue membrane to gain access to a target site are disclosed. In some examples, systems and methods for accessing the left atrium from the right atrium of a patient's heart are carried out by puncturing the intra-atrial septal wall. One embodiment provides a system for transseptal cardiac access that includes a stabilizer sheath having a side port, a shaped guiding catheter configured to exit the side port and a tissue penetration member disposed within and extendable from the distal end of the guide catheter. The tissue penetration member may be configured to penetrate tissue upon rotation and may be coupled to a distal portion of a torqueable shaft. In some embodiments, the stabilizer sheath and shaped guiding catheter may be moved relative to the patient's body structure and relative to each other so that a desired approach angle may be obtained for the tissue penetration member with respect to the target tissue.
摘要翻译：公开了渗透组织膜以获得进入目标部位的系统和方法。在一些实例中，通过穿刺房间隔壁来进行从患者心脏的右心房进入左心房的系统和方法。一个实施例提供了一种用于经心脏进入的系统，其包括具有侧端口的稳定器护套，被配置为离开侧端口的成形引导导管和设置在引导导管的远端内并且可从引导导管的远端延伸的组织穿透构件。组织穿透构件可以构造成在旋转时穿透组织并且可以联接到可扭转轴的远侧部分。在一些实施例中，稳定器护套和成形引导导管可以相对于患者的身体结构相对于彼此移动，使得组织穿透构件相对于目标组织可以获得期望的接近角。

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