JP4861323B2 - 埋込み可能なデバイスによる血圧測定のための技術 - Google Patents
埋込み可能なデバイスによる血圧測定のための技術 Download PDFInfo
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- A61B5/08—Detecting, measuring or recording devices for evaluating the respiratory organs
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
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- A61B5/11—Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb
- A61B5/1116—Determining posture transitions
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- A—HUMAN NECESSITIES
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- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/103—Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
- A61B5/11—Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb
- A61B5/1118—Determining activity level
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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
- A61B5/25—Bioelectric electrodes therefor
- A61B5/279—Bioelectric electrodes therefor specially adapted for particular uses
- A61B5/28—Bioelectric electrodes therefor specially adapted for particular uses for electrocardiography [ECG]
- A61B5/283—Invasive
- A61B5/287—Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
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Description
出願が参照によって本明細書に組み込まれる、2004年8月20日に提出された米国特許出願第10/922,816号に対する優先権の利益がここに請求される。
上記で説明したような血圧波形の収集は、血圧と心臓活動を測定するために必要な感知能力を有するいずれのタイプの心臓デバイス(たとえば、従来型のペース・メーカー、再同調ペース・メーカー、除細動器、組合せデバイスまたは心臓モニタ)で実施される。以下で説明されるのは、血圧測定やノイズ減少のために必要とされるデータを収集するようにプログラミングされた、埋込み可能な心臓律動管理デバイスである。
埋込み可能なデバイスが、上記で説明されたようなノイズ減少を有する血圧波形を収集するための技術を実装し、使用するいくつかの方式がある。たとえば、血圧波形が、デバイスによって収集され、タイム・スタンプまたは、検知された心臓活動と波形を位置合わせするためのその他の手段にとともに保管される。波形の平均化および/または特徴抽出などのその他の処理が、次に、埋込み可能なデバイス、または収集された波形がそれにダウンロードされる外部プログラマなどの外部デバイスによって行われる。同様に、心拍数、活動レベル、体位、温度などの他の感知データが、収集された圧力波形とともに保管され、次に上記で説明したように波形を計算するために埋込み可能なデバイスまたは外部デバイスによって使用されてもよい。心拍数、活動レベル、体位、温度などの他の感知データは、圧力波形が収集されるときにゲーティングするために埋込み可能なデバイスによって使用されてもよい、またはデータは、複数の収集された圧力波形のどちらがさらなる処理または解析のために選択できるかどうかを判定するために、データが示される外部デバイスまたは臨床医によって使用されてもよい。
AvgP=(1/N)ΣP(n)
ここで、各圧力波形P(n)の対応するK個のサンプルを合計することによって、n=1からNまでの合計が実行される。いかなる所望の数の平均波形AvgPも、今説明した方式で数値計算することができる。アルゴリズムは、スケジュールに従って周期的に、外部プログラマから命令を受信した際、または特定の事象または状態の検知の際などのいかなる所望の時間でも実行されてもよい。平均波形が次に、臨床医に対する図式的または数値的表示のために外部プログラマまたはその他の外部デバイスに送信される。
Claims (19)
- 患者体内への埋込みのためのハウジングと、
心臓内心電図信号を発生させるための1つまたは複数の感知チャネルと、
前記心電図信号から固有心臓活動を検知するためのコントローラと、
血圧波形を生成するために前記コントローラとインターフェースされた血管内圧力センサと
を備え、
前記コントローラが、経時的に取得された複数の血圧波形を収集するようにプログラミングされ、各波形が、心電図信号によって示されるような固有心臓活動の対応する発生に応じて位置合わせされ、前記コントローラが、平均圧力波形を計算するために、前記収集され、かつ位置合わせされた圧力波形を平均化するようにプログラミングされている、デバイス。 - 患者の体位を示す空間方向信号を発生させるために前記コントローラとインターフェースされた体位センサをさらに備え、
前記コントローラが、患者の体位の前記血圧波形への影響を補償するために前記空間方向信号に従って圧力波形を較正するようにプログラミングされている、請求項1に記載のデバイス。 - 患者の体位を示す空間方向信号を発生させるために前記コントローラとインターフェースされた体位センサをさらに備え、
前記コントローラが、前記患者が1つまたは複数の特定の体位にあることを前記空間方向信号が示すときにのみ、圧力波形を収集するようにプログラミングされている、請求項1に記載のデバイス。 - 患者の現在の体温を示す温度信号を発生させるために前記コントローラとインターフェースされた温度センサをさらに備え、
前記コントローラが、患者の体温の前記圧力センサへの影響を補償するために前記温度信号に従って圧力波形を較正するようにプログラミングされている、請求項1に記載のデバイス。 - 患者の現在の体温を示す温度信号を発生させるために前記コントローラとインターフェースされた温度センサをさらに備え、
患者の体温が特定の範囲内にあることを前記温度信号が示すときにのみ、前記コントローラが圧力波形を収集するようにプログラミングされている、請求項1に記載のデバイス。 - 患者の現在のエクサーション・レベルを示す信号を発生させるために前記コントローラとインターフェースされたエクサーション・レベル・センサをさらに備え、
前記コントローラが、圧力波形が収集されたとき、患者のエクサーション・レベルを示す対応する信号とともに前記圧力波形を収集するようにプログラミングされている、請求項1に記載のデバイス。 - 患者の現在のエクサーション・レベルを示す信号を発生させるために前記コントローラとインターフェースされたエクサーション・レベル・センサをさらに備え、
前記コントローラが、患者のエクサーション・レベルが特定の範囲内にあることを前記エクサーション・レベル信号が示しているときにのみ、圧力波形を収集するようにプログラミングされている、請求項1に記載のデバイス。 - 血流を示す信号を作成するために前記コントローラとインターフェースされた血管内フロー・センサをさらに備え、
前記コントローラが、流れ抵抗値を計算するために前記血流信号および圧力波形を使用するようにプログラミングされている、請求項1に記載のデバイス。 - 心臓のチャンバをペーシングするためのペーシング・チャネルをさらに備え、
前記コントローラが、経時的に取得された複数の血圧波形を収集しかつ平均化するようにプログラミングされ、各波形が、心電図信号によって示されるような固有心臓活動の対応する発生または前記ペーシング・チャネルを通したペーシングの対応する投与に応じて位置合わせされる、請求項1に記載のデバイス。 - 心臓内心電図信号を発生させ、かつ前記心電図信号から固有心臓活動を検知するための手段と、
血管内の位置から血圧波形を発生させるための手段と、
平均圧力波形を計算するために、経時的に取得された複数の血圧波形を平均化するための手段であって、前記複数の血圧波形の各々が、心電図信号によって示されるような固有心臓活動の対応する発生に応じて位置合わせされる、手段と
を含むシステム。 - 患者の体位を示す空間方向信号を発生させるための手段と、
前記空間方向信号が、前記患者が1つまたは複数の特定の体位にあることを示すときにのみ、平均化するために圧力波形を収集するための手段と
をさらに含む、請求項10に記載のシステム。 - 患者の現在の体温を示す温度信号を発生させるための手段と、
前記温度信号が、患者の体温が特定の範囲内にあることを示すときにのみ、平均化するために圧力波形を収集するための手段と
をさらに含む、請求項10に記載のシステム。 - 患者の現在のエクサーション・レベルを示す信号を発生させるための手段と、
前記エクサーション・レベル信号が、患者のエクサーション・レベルが特定の範囲内にあることを示しているときにのみ、平均化するために圧力波形を収集するための手段と
をさらに含む、請求項10に記載のシステム。 - 前記エクサーション・レベル信号発生手段が、活動レベル信号を作成する加速度計である、請求項13に記載のシステム。
- 収集されかつ位置合わせされた圧力波形を、埋込み可能なデバイスから外部デバイスへダウンロードするための手段をさらに含み、前記圧力波形の前記平均化が、前記外部デバイスによって行われる、請求項10に記載のシステム。
- 患者の体位を示す空間方向信号を発生させるための手段と、
患者の体位の前記血圧波形への影響を補償するために、前記空間方向信号に従って平均化の前に前記圧力波形を較正するための手段と
をさらに含む、請求項10に記載のシステム。 - 患者体内の血管内位置から血圧波形を発生させるための手段と、
患者の体位を示す空間方向信号を発生させるための手段と、
患者の体位の前記血圧波形への影響を補償するために、前記空間方向信号に従って圧力波形を較正するための手段と
を含むシステム。 - 患者体内の血管内位置から血圧波形を発生させるための手段と、
平均圧力波形を計算するために、経時的に取得された複数の血圧波形を平均化するための手段であって、前記複数の血圧波形の各々が、心電図信号によって示されるような固有心臓活動の対応する発生に応じて位置合わせされる、手段と、
患者の現在の体温を示す温度信号を発生させるための手段と、
患者の体温の前記圧力センサへの影響を補償するために、前記温度信号に従って圧力波形を較正するための手段と
を含むシステム。 - 患者体内への埋込みのためのハウジングと、
心音図信号を発生させるためのセンサと、
前記心音図信号から固有心臓活動を検知するためのコントローラと、
血圧波形を発生させるために前記コントローラとインターフェースされた血管内圧力センサと、
を備え、
前記コントローラが、経時的に取得された複数の血圧波形を収集するようにプログラミングされ、各波形が、心音図信号によって示されるような固有心臓活動の対応する発生に応じて位置合わせされ、前記コントローラが、平均圧力波形を計算するために、前記収集され、かつ位置合わせされた圧力波形を平均化するようにプログラミングされている、デバイス。
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Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US10/922,816 US7335161B2 (en) | 2004-08-20 | 2004-08-20 | Techniques for blood pressure measurement by implantable device |
US10/922,816 | 2004-08-20 | ||
PCT/US2005/029643 WO2006023786A2 (en) | 2004-08-20 | 2005-08-19 | Blood pressure measurement by implantable device |
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JP2008510523A JP2008510523A (ja) | 2008-04-10 |
JP4861323B2 true JP4861323B2 (ja) | 2012-01-25 |
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US (2) | US7335161B2 (ja) |
EP (1) | EP1819397B1 (ja) |
JP (1) | JP4861323B2 (ja) |
WO (1) | WO2006023786A2 (ja) |
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US7335161B2 (en) | 2008-02-26 |
WO2006023786A3 (en) | 2006-08-03 |
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WO2006023786A2 (en) | 2006-03-02 |
EP1819397A2 (en) | 2007-08-22 |
US20060041281A1 (en) | 2006-02-23 |
JP2008510523A (ja) | 2008-04-10 |
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