JP6527124B2 - 患者の治療を容易にするシステムおよび方法 - Google Patents
患者の治療を容易にするシステムおよび方法 Download PDFInfo
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- A61B5/316—Modalities, i.e. specific diagnostic methods
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- G16H20/00—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
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- 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
- A61N1/368—Heart stimulators controlled by a physiological parameter, e.g. heart potential comprising more than one electrode co-operating with different heart regions
- A61N1/3684—Heart stimulators controlled by a physiological parameter, e.g. heart potential comprising more than one electrode co-operating with different heart regions for stimulating the heart at multiple sites of the ventricle or the atrium
Description
本出願は、2011年7月5日に発明の名称「METHODS AND DEVICES FOR MEASURING AND OPTIMIZING VENTRICULAR SYNCHRONY IN CRT(CRTにおいて心室同期を測定し、最適化するための方法および装置)」でファイルされた米国仮特許出願第61/504,536号および2011年10月12日に発明の名称「METHOD AND SYSTEM TO DETERMINE A SENSING ZONE TO FACILITATE ELECTROCARDIOGRAPHIC MAPPING AND ELECTRODE ARRANGEMENT FOR ECM(ECM用に心電図マッピングと電極の配列とを容易にするための検知ゾーンを決定するための方法およびシステム)」でファイルされた米国仮特許出願第61/546,083号の優先権の利益を主張するものであり、それぞれの出願の内容全体を本明細書に援用する。
Claims (13)
- 患者の少なくとも1つの体内の解剖学的構造に対して適用される治療を行う治療実施装置を制御するために、少なくとも1つのパラメーターを制御システムが供給し、
前記治療の複数の反復のつど、複数のセンサーを介して取得される電気データを含む、前記患者から得られた電気データをプロセッサーがメモリーに格納し;
ここで、前記複数のセンサーは、前記患者の少なくとも一つの体内の解剖学的構造の少なくとも一つの所定の着目領域に決定論的に対応する、前記患者の体表面の少なくとも1つの所定のゾーンに取り付けられおり、
前記電気データを、前記少なくとも1つの体内の解剖学的構造のモデルの、対応する所定の着目領域とプロセッサーが相関させ、
前記適用される治療の前記複数の反復の間に取得された前記電気データを、前記電気データと前記少なくとも1つの体内の解剖学的構造のモデルの対応する所定の着目領域との相関に基づいて自動的にプロセッサーが分析して、前記適用される治療の反復のそれぞれで、前記患者の前記少なくとも1つの体内の解剖学的構造の少なくとも1つの機能の指標をプロセッサーが計算し、
前記患者の前記少なくとも1つの体内の解剖学的構造の前記少なくとも1つの機能の前記指標をプロセッサーがメモリーに格納し、
前記少なくとも1つの機能の前記指標に基づいて、前記治療を引き続いて反復する中で治療を行う治療実施装置を制御するために、前記少なくとも1つのパラメーターをプロセッサーが調節すること
を含む方法。 - 前記少なくとも1つの体内の解剖学的構造は、心臓に対応し、
前記少なくとも1つの所定の着目領域は、心臓のセグメントに対応する、請求項1に記載の方法。 - プロセッサーがディスプレイシステムで心臓の画像上のある領域に少なくとも1つの機能の指標を表示することをさらに含み、前記心臓の画像上のある領域が心臓セグメントに対応する、請求項2の方法。
- 前記モデルが、前記少なくとも1つの体内の解剖学的構造の一般的なモデルである、請求項1に記載の方法。
- プロセッサーが前記患者の前記少なくとも1つの体内の解剖学的構造に関連する寸法を計算し、
プロセッサーが前記患者の前記少なくとも1つの体内の解剖学的構造に関連する前記一般的なモデルを修正し、前記計算された寸法に基づいて、修正されたモデルを与えること
をさらに含む、請求項4に記載の方法。 - 前記プロセッサーが寸法を計算することは、
前記プロセッサーが前記患者の前記少なくとも1つの体内の解剖学的構造に関連する画像データを得て、
前記プロセッサーが前記画像データに基づいて、少なくとも2本の直交する軸における、前記患者の前記少なくとも1つの体内の解剖学的構造の最外端に関連する寸法を計算すること
をさらに含み、
前記寸法を計算することは、
前記プロセッサーが前記画像データに基づいて、前記患者の前記少なくとも1つの体内の解剖学的構造の最外端で複数の基準点を得て、
前記プロセッサーが対向する最外端における前記複数の基準点各々の間の寸法を計算すること
を含む、請求項5に記載の方法。 - 前記プロセッサーが寸法を計算することは、
前記プロセッサーが前記患者の前記少なくとも1つの体内の解剖学的構造に関連する画像データを得て、
前記プロセッサーが前記画像データに基づいて、少なくとも2本の直交する軸における、前記患者の前記少なくとも1つの体内の解剖学的構造の最外端に関連する寸法を計算すること
をさらに含み、
前記プロセッサーが一般的なモデルを修正することは、前記少なくとも2本の直交する軸で計算された前記寸法に基づいて、前記少なくとも2本の直交する軸の各々で、前記一般的なモデルに関連した寸法を前記プロセッサーが修正することを含む、請求項6に記載の方法。 - 前記治療は、心臓再同期療法(CRT)を含み、前記少なくとも1つのパラメーターがCRTのパラメーターを含み、
前記プロセッサーが電気データを自動的に分析することは、前記プロセッサーが前記複数の反復のそれぞれにおいて、前記患者の前記心臓の電気的刺激に関連する前記CRTのパラメーターのそれぞれの値に関連する前記電気データを自動的に分析して、前記患者の前記心臓に関連する同期の指標を計算することを含み、
前記プロセッサーが少なくとも1つのパラメーターを調節することは、前記プロセッサーが前記患者の前記心臓の前記同期に関連する前記電気データの前記分析をもとに、前記複数の反復のそれぞれで、CRTのパラメーターを調節することを含む、請求項2に記載の方法。 - 前記プロセッサーが電気データを自動的に分析することは、前記プロセッサーが前記電気データに基づいて、前記モデルに対応する前記心臓の膜上の電気信号を再構成することをさらに含み、
前記プロセッサーが電気信号を再構成することは、前記プロセッサーが画像診断技術から得られる前記患者の心臓に対する前記電気データおよび三次元幾何学形状データに基づいて、前記心臓の膜上の前記電気信号を再構成することをさらに含む、請求項2に記載の方法。 - 少なくとも1つの機能を計算するために用いられる電気データは、(i)前記所定のゾーンから得られた体表面電気信号、または(ii)前記所定のゾーンから得られた体表面電気信号に由来する、前記体内の解剖学的構造の少なくとも1つの所定の着目領域に対する再構成された電気信号、を含む、請求項1に記載の方法。
- 前記少なくとも一つの所定のゾーンは、複数の所定のゾーンを含み、前記複数のセンサーは、複数のセットのセンサーに対応し、
前記複数のセットのセンサーのそれぞれが、前記患者の前記少なくとも一つの体内の解剖学的構造の前記複数の所定の着目領域のそれぞれに決定論的に対応する、前記患者の体表面の複数の所定のゾーンのそれぞれに配置されている、請求項1に記載の方法。 - 前記患者の前記少なくとも一つの体内の解剖学的構造が、前記患者の心臓に対応し、
前記プロセッサーが電気データを自動的に分析することは、さらに、前記電気データに基づいて、前記心臓の前記少なくとも1つの所定の着目領域に対応する前記心臓の心膜上の電気信号を再構成するための逆解法を用いることを含む、請求項1に記載の方法。 - 前記患者の前記少なくとも一つの体内の解剖学的構造の実際の寸法に関連した画像データに基づいて、前記少なくとも一つの体内の解剖学的構造の修正されたモデルをプロセッサーが生成することをさらに含む、請求項1に記載の方法。
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Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US201161504536P | 2011-07-05 | 2011-07-05 | |
US61/504,536 | 2011-07-05 | ||
US201161546083P | 2011-10-12 | 2011-10-12 | |
US61/546,083 | 2011-10-12 |
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JP2014519303A Division JP2014523321A (ja) | 2011-07-05 | 2012-07-05 | 患者の治療を容易にするシステムおよび方法 |
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JP2016217516A Expired - Fee Related JP6527124B2 (ja) | 2011-07-05 | 2016-11-07 | 患者の治療を容易にするシステムおよび方法 |
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EP (1) | EP2729214B1 (ja) |
JP (2) | JP2014523321A (ja) |
CA (1) | CA2841381C (ja) |
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