JP2009505737A - 形態的秩序に基づく不整脈の自動多段階治療 - Google Patents
形態的秩序に基づく不整脈の自動多段階治療 Download PDFInfo
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- JP2009505737A JP2009505737A JP2008528096A JP2008528096A JP2009505737A JP 2009505737 A JP2009505737 A JP 2009505737A JP 2008528096 A JP2008528096 A JP 2008528096A JP 2008528096 A JP2008528096 A JP 2008528096A JP 2009505737 A JP2009505737 A JP 2009505737A
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/362—Heart stimulators
- A61N1/3621—Heart stimulators for treating or preventing abnormally high heart rate
- A61N1/3622—Heart stimulators for treating or preventing abnormally high heart rate comprising two or more electrodes co-operating with different heart regions
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
- A61B5/316—Modalities, i.e. specific diagnostic methods
- A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
- A61B5/346—Analysis of electrocardiograms
- A61B5/349—Detecting specific parameters of the electrocardiograph cycle
- A61B5/35—Detecting specific parameters of the electrocardiograph cycle by template matching
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
- A61B5/316—Modalities, i.e. specific diagnostic methods
- A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
- A61B5/346—Analysis of electrocardiograms
- A61B5/349—Detecting specific parameters of the electrocardiograph cycle
- A61B5/363—Detecting tachycardia or bradycardia
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/38—Applying electric currents by contact electrodes alternating or intermittent currents for producing shock effects
- A61N1/39—Heart defibrillators
- A61N1/3956—Implantable devices for applying electric shocks to the heart, e.g. for cardioversion
- A61N1/3962—Implantable devices for applying electric shocks to the heart, e.g. for cardioversion in combination with another heart therapy
- A61N1/39622—Pacing therapy
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/362—Heart stimulators
- A61N1/365—Heart stimulators controlled by a physiological parameter, e.g. heart potential
- A61N1/36585—Heart stimulators controlled by a physiological parameter, e.g. heart potential controlled by two or more physical parameters
Abstract
Description
Claims (32)
- 不整脈発作を検出するように構成される不整脈検出器と、
不整脈の形態的秩序レベルを心臓治療に関連付けて不整脈発作の形態的秩序レベルを判定する手段と、
前記不整脈発作の前記形態的秩序レベルに関連付けられる心臓治療を実施する手段と、
を含む、心調律管理装置。 - 前記形態的秩序レベルが複数の治療コンポーネントを含む多段階治療と関連付けられる、請求項1に記載の装置。
- 前記形態的秩序レベルの1つ以上が抗頻脈ペーシング治療および心臓ショック治療の一方または両方と関連付けられる、請求項1に記載の装置。
- 前記形態的秩序レベルが治療の探索時間と関連付けられ、前記治療の探索時間は前記心臓治療が実施される時間の長さを表す、請求項1に記載の装置。
- 前記不整脈発作の形態的秩序レベルは、前記不整脈発作の心電図信号の形態的規則性、前記心電図のエントロピー、および前記不整脈発作の血行動態の安定性の少なくとも1項目に基づいて判定される、請求項1に記載の装置。
- 前記不整脈発作の形態的秩序レベルは、前記形態的規則性、前記エントロピー、および前記血行動態の安定性の少なくとも2項目の組合せに基づいて判定される、請求項5に記載の装置。
- 前記不整脈発作の形態的秩序レベルは、前記不整脈発作の1つ以上の心拍信号の形態をテンプレートと比較することに基づいて判定される、請求項1に記載の装置。
- 前記不整脈発作の形態的秩序レベルは、前記不整脈発作の心拍信号の形態を、前記不整脈発作の別の心拍信号の形態と比較することによって判定される、請求項1に記載の装置。
- 前記不整脈発作の形態的秩序レベルは、前記不整脈発作の心拍数の不規則性に基づいて判定される、請求項1に記載の装置。
- 前記不整脈発作の形態的秩序レベルは、前記不整脈発作の心電図信号の形態的複雑性に基づいて判定される、請求項1に記載の装置。
- 前記不整脈発作の形態的秩序レベルは、前記不整脈発作の血行動態の安定性に基づいて判定される、請求項1に記載の装置。
- 前記不整脈発作の形態的秩序レベルは、形態的秩序の1つ以上の尺度にそれぞれ関連付けられる1つ以上の閾値を使って判定される、請求項1に記載の装置。
- 前記形態的秩序レベルは、遡及的データベース解析、患者治療の許容範囲、および医師の入力の1項目以上に基づいて前記心臓治療と関連付けられる、請求項1に記載の装置。
- 前記心臓治療の1つ以上のコンポーネントの実施に続いて、前記不整脈の再検出の検知手段をさらに含む、請求項1に記載の装置。
- 前記形態的秩序レベルは心臓治療に静的に関連付けられる、請求項1に記載の装置。
- 前記形態的秩序レベルは心臓治療に動的に関連付けられる、請求項1に記載の装置。
- 前記形態的秩序レベルは、病歴データ、患者治療の許容範囲、および医師の入力の1項目以上に基づいて前記心臓治療と関連付けられる、請求項1に記載の装置。
- 前記形態的秩序レベルは、前記心臓治療の効果に基づいて前記形態的秩序レベルと前記心臓治療との関連性を動的に変更することによって、前記心臓治療に関連付けられる、請求項1に記載の装置。
- 前記心臓治療と治療パラメータとに関連付けられる前記形態的秩序レベルの少なくとも1つは実施済みの前記心臓治療の効果に基づいて修正される、請求項1に記載の装置。
- 前記不整脈の形態的秩序レベルを心臓治療に関連付ける手段と、前記不整脈発作の形態的秩序レベルを判定する手段とが、植込み回路からなる、請求項1に記載の装置。
- 前記植込み回路は、前記不整脈発作の心電図信号の形態的規則性、前記心電図信号のエントロピー、前記不整脈発作の心拍数の規則性、および前記不整脈発作の血行動態の少なくとも1項目に基づいて、前記不整脈発作の形態的秩序レベルを判定するように構成される、請求項20に記載の装置。
- 前記植込み回路は、前記不整脈発作の1つ以上の心拍信号の形態をテンプレートと比較して前記不整脈発作の形態的秩序を判定するように構成される、請求項20に記載の装置。
- 前記植込み回路は、前記不整脈発作の1つの心拍信号の形態を前記不整脈発作の別の心拍信号の形態と比較して前記不整脈発作の形態的秩序を判定するように構成される、請求項20に記載の装置。
- 前記植込み回路は、血行動態センサをさらに含み、前記血行動態センサの出力に基づいて前記不整脈発作の形態的秩序を判定するように構成される、請求項20に記載の装置。
- 前記血行動態センサはインピーダンスセンサを含む、請求項24に記載の装置。
- 前記血行動態センサは圧力センサを含む、請求項24に記載の装置。
- 前記植込み回路は、遡及的データベース解析、患者治療の許容範囲、および医師の入力の1項目以上に基づいて前記形態的秩序レベルを前記心臓治療に関連付けるように構成される、請求項20に記載の装置。
- 前記植込み回路は、前記形態的秩序レベルを前記心臓治療に静的に関連付けるように構成される、請求項20に記載の装置。
- 前記植込み回路は、前記形態的秩序レベルを前記心臓治療に動的に関連付けるように構成される、請求項20に記載の装置。
- 前記植込み回路は、心臓治療の効果に基づいて、前記形態的秩序レベルと心臓治療の関連付けを修正するように構成される、請求項20に記載の装置。
- 前記植込み回路は、実施済みの前記心臓治療の効果を判定し、前記実施済みの心臓治療の効果に基づいて、前記心臓治療と治療パラメータに関連付けられる少なくとも1つの前記形態的秩序レベルを修正するように構成される、請求項20に記載の装置。
- 心臓治療のライブラリと、前記形態的秩序レベルと前記心臓治療の関連性のマッピングを記憶する、メモリをさらに含む、請求項20に記載の装置。
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US11/209,976 US7908001B2 (en) | 2005-08-23 | 2005-08-23 | Automatic multi-level therapy based on morphologic organization of an arrhythmia |
US11/209,976 | 2005-08-23 | ||
PCT/US2006/032872 WO2007024920A2 (en) | 2005-08-23 | 2006-08-23 | Automatic multi-level therapy based on morphologic organization of an arrhythmia |
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JP2009505737A true JP2009505737A (ja) | 2009-02-12 |
JP2009505737A5 JP2009505737A5 (ja) | 2009-10-08 |
JP5180828B2 JP5180828B2 (ja) | 2013-04-10 |
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US (2) | US7908001B2 (ja) |
EP (1) | EP1933939A2 (ja) |
JP (1) | JP5180828B2 (ja) |
WO (1) | WO2007024920A2 (ja) |
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JP2013528467A (ja) * | 2010-06-16 | 2013-07-11 | カーディアック ペースメイカーズ, インコーポレイテッド | 自動神経刺激滴定掃引 |
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JP2015100525A (ja) * | 2013-11-25 | 2015-06-04 | 株式会社カオテック研究所 | 診断データ生成装置および診断装置 |
JP2017504414A (ja) * | 2014-01-16 | 2017-02-09 | ノキア テクノロジーズ オサケユイチア | 医学的データのエントロピーの程度の検出の方法およびデバイス |
CN108778407A (zh) * | 2016-03-14 | 2018-11-09 | 马克斯-普朗克科学促进学会 | 用于将电脉冲施加给活的心肌组织的装置 |
JP7433233B2 (ja) | 2018-01-21 | 2024-02-19 | アクタス メディカル インク | 心臓伝導パターンを識別するためのシステム |
Also Published As
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EP1933939A2 (en) | 2008-06-25 |
US20110166613A1 (en) | 2011-07-07 |
WO2007024920A3 (en) | 2007-05-03 |
US20070049974A1 (en) | 2007-03-01 |
JP5180828B2 (ja) | 2013-04-10 |
WO2007024920A2 (en) | 2007-03-01 |
US7908001B2 (en) | 2011-03-15 |
US8583228B2 (en) | 2013-11-12 |
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