JP2017518846A - 検出されるペーシングパルスに応答した植え込み型医療装置(imd)の感知修正 - Google Patents
検出されるペーシングパルスに応答した植え込み型医療装置(imd)の感知修正 Download PDFInfo
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- A—HUMAN NECESSITIES
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- 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]
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- A—HUMAN NECESSITIES
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- A—HUMAN NECESSITIES
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- 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
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- A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
- A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
- A61B5/6847—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive mounted on an invasive device
- A61B5/686—Permanently implanted devices, e.g. pacemakers, other stimulators, biochips
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- A—HUMAN NECESSITIES
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- 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
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Abstract
Description
12 患者
14 皮下ICDシステム
16 リードレス心臓ペーシング装置
18 心臓
20 植え込み型心臓除細動器(ICD)
22 植え込み型心臓除細動リード
24 除細動電極
26、28 感知電極
30 制御モジュール
32 感知モジュール
34 療法モジュール
36 パワー源
38 通信モジュール
40 メモリ
42 アンテナ
50 前置フィルタ
52 前置増幅器
54 低域通過フィルタ
56 アナログデジタル変換器
58 デシメータ
60 ブランキングモジュール
62、62’ ペースパルス検出器
64 ブランキング制御モジュール、パルス除去制御モジュール
66 感知デジタルフィルタ
67 形態デジタルフィルタ
68 診断ECGデジタルフィルタ
70 ペーシング列
72 ペーシングパルス
74 スルーレート信号
76 スパイク
78 スルーレート閾値
90 フィルタ
91 微分(dV/dT)フィルタ
92 整流器
94 ペースアーチファクト検出器
96 ペーススパイク検出器
180 デシメータ
182 カスケード・インテグレータ・コーム(CIC)フィルタ
184 移動平均フィルタ
186 帯域通過フィルタ
188 微分(dV/dt)フィルタ
190A、190B、190C 閾値検出器
192A、192B ノイズ検出器
194 沈黙タイマー
Claims (10)
- 植え込み型医療装置において、
前記植え込み型医療装置へ連結されている1つ又はそれ以上の電極によって感知される電気信号を処理する複数の構成要素を含んでいる感知チャネルと、
第2の植え込み型医療装置によって送達されるペーシングパルスを、前記感知される電気信号の前記処理に基づいて検出するペースパルス検出器と、
ブランキングモジュールと、
前記ペースパルス検出器が前記ペーシングパルスを検出していることに応えて、前記ブランキングモジュールに前記感知チャネルの前記電気信号をブランキングさせて前記感知される電気信号から前記ペーシングパルスを除去するように構成されているブランキング制御モジュールと、
を備えている植え込み型医療装置。 - 前記ペースパルス検出器は、4ミリボルトより大きい又は4ミリボルトに等しい振幅及び少なくとも1ミリ秒のパルス幅を有しているペーシングパルスを検出する、請求項1に記載の装置。
- 前記ブランキングモジュールは前記感知される電気信号を前記ペーシングパルスより前の当該感知される電気信号の値に保持して前記感知される電気信号から前記ペーシングパルスを除去する、請求項1又は請求項2の何れか一項に記載の装置。
- 前記ブランキングモジュールは、前記感知される電気信号を、大凡20ミリ秒より短い又は大凡20ミリ秒に等しい間、前記値に保持する、請求項1から請求項3の何れか一項に記載の装置。
- 前記ブランキングモジュールは、前記ペーシングパルスが検出されると前記感知される電気信号のブランキングを始める、請求項1から請求項4の何れか一項に記載の装置。
- 前記植え込み型医療装置は、各々が異なった感知される電気信号を処理し各々がブランキングモジュールを含んでいる複数の感知チャネルを含んでおり、
前記ペースパルス検出器は、前記複数の感知チャネルの第1の感知チャネル上に前記ペーシングパルスを検出し、
前記ブランキング制御モジュールは、前記複数の感知チャネルの各々の前記ブランキングモジュールに当該複数の感知チャネルの各々での前記感知される電気信号をブランキングさせて各感知される電気信号上の前記ペーシングパルスを除去する、請求項1から請求項5の何れか一項に記載の装置。 - 前記装置は、前記植え込み型医療装置へ連結されている植え込み型電気リードであって患者の血管外場所にて電気信号を感知する前記1つ又はそれ以上の電極の少なくとも一部分を備えている植え込み型医用リードを更に備えており、前記患者の前記血管外場所は皮下場所又は胸骨下場所の一方である、請求項1から請求項6の何れか一項に記載の装置。
- 前記ブランキング制御モジュールは、前記感知される電気信号のブランキングが以前に閾値時間期間内に起こっていたかどうかを判定し、前記感知チャネルのブランキングが以前に前記閾値時間期間内に起こっていたらブランキングの開始を差し控える、請求項1から請求項7の何れか一項に記載の装置
- 検出されるペーシングパルスを除去するように血管外ICDの感知される電気信号を修正する方法において、
患者の血管外場所にて電気信号を感知する段階と、
前記血管外場所にて感知される前記電気信号を処理する段階と、
前記植え込み型電気リード上に感知される前記電気信号の前記処理に基づいて、第2の植え込み型医療装置からのペーシングパルスの送達を検出する段階と、
前記ペーシングパルスの前記検出に基づいて、前記感知される電気信号をブランキングして当該感知される電気信号から前記ペーシングパルスを除去する段階と、
を備えている方法。 - 患者の血管外場所にて電気信号を感知する1つ又はそれ以上の電極を含んでいる植え込み型医用リードと、
前記植え込み型医用リードへ連結されているICDと、
を備えている血管外植え込み型カーディオバータ−除細動器(ICD)システムにおいて、
前記ICDは、
ハウジング電極と、
複数の感知チャネルであって、それらの各々が、前記植え込み型医用リード上の前記1つ又はそれ以上の電極と前記ICDの前記ハウジング電極の組合せによって形成されているそれぞれの感知ベクトルを介して感知される電気信号を処理するように構成されている、複数の感知チャネルと、
前記複数の感知チャネルの第1の感知チャネル上に感知される前記電気信号を解析し、第2の植え込み型医療装置によって送達されるペーシングパルスを、前記解析に基づいて検出するペースパルス検出器と、
前記複数の感知チャネルの前記第1の感知チャネル内のブランキングモジュールと、
ペースパルス検出器が前記ペーシングパルスを検出していることに応えて、制御信号を前記ブランキングモジュールへ提供するように構成されているブランキング制御モジュールと、を備え、
前記ブランキングモジュールが、前記ブランキング制御モジュールからの前記制御信号に応答して、前記感知される電気信号を当該感知される電気信号の或る値に保持して、前記複数の感知チャネルの前記第の1感知チャネル上の前記感知される電気信号から前記ペーシングパルスを除去する、
血管外植え込み型カーディオバータ−除細動器(ICD)システム。
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US201461984233P | 2014-04-25 | 2014-04-25 | |
US61/984,233 | 2014-04-25 | ||
US14/686,947 US10448855B2 (en) | 2014-04-25 | 2015-04-15 | Implantable medical device (IMD) sensing modifications responsive to detected pacing pulses |
US14/686,947 | 2015-04-15 | ||
PCT/US2015/026094 WO2015164167A1 (en) | 2014-04-25 | 2015-04-16 | Implantable medical device (imd) sensing modifications responsive to detected pacing pulses |
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JP6533569B2 JP6533569B2 (ja) | 2019-06-19 |
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US (1) | US10448855B2 (ja) |
EP (1) | EP3134175B1 (ja) |
JP (1) | JP6533569B2 (ja) |
CN (1) | CN106231994B (ja) |
WO (1) | WO2015164167A1 (ja) |
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JPS63226338A (ja) * | 1987-02-26 | 1988-09-21 | ヒューレット・パッカード・カンパニー | Ecg波信号からペース・パルス信号を除去する方法とecg波信号からペース・パルス信号を除去する装置 |
JPH10165383A (ja) * | 1996-12-09 | 1998-06-23 | Nec Corp | 監視装置 |
WO2012011065A1 (en) * | 2010-07-21 | 2012-01-26 | Kyma Medical Technologies Ltd. | Implantable radio-frequency sensor |
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EP3134175B1 (en) | 2020-05-06 |
JP6533569B2 (ja) | 2019-06-19 |
CN106231994A (zh) | 2016-12-14 |
CN106231994B (zh) | 2019-11-12 |
WO2015164167A1 (en) | 2015-10-29 |
US20150305640A1 (en) | 2015-10-29 |
US10448855B2 (en) | 2019-10-22 |
EP3134175A1 (en) | 2017-03-01 |
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