WO2023026157A1 - Évaluation de risque en deux étapes pour prédire des épisodes cardiaques aigus imminents - Google Patents
Évaluation de risque en deux étapes pour prédire des épisodes cardiaques aigus imminents Download PDFInfo
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- WO2023026157A1 WO2023026157A1 PCT/IB2022/057804 IB2022057804W WO2023026157A1 WO 2023026157 A1 WO2023026157 A1 WO 2023026157A1 IB 2022057804 W IB2022057804 W IB 2022057804W WO 2023026157 A1 WO2023026157 A1 WO 2023026157A1
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Classifications
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- G—PHYSICS
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- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H50/00—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
- G16H50/30—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for calculating health indices; for individual health risk assessment
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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
- A61B5/361—Detecting fibrillation
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
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- 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
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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
- A61B5/68—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
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/3605—Implantable neurostimulators for stimulating central or peripheral nerve system
- A61N1/3606—Implantable neurostimulators for stimulating central or peripheral nerve system adapted for a particular treatment
- A61N1/36114—Cardiac control, e.g. by vagal stimulation
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- A—HUMAN NECESSITIES
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- 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
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61N1/365—Heart stimulators controlled by a physiological parameter, e.g. heart potential
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- 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
- A61N1/3987—Heart defibrillators characterised by the timing or triggering of the shock
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- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H20/00—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
- G16H20/30—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to physical therapies or activities, e.g. physiotherapy, acupressure or exercising
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- A61B5/4839—Diagnosis combined with treatment in closed-loop systems or methods combined with drug delivery
Abstract
Un système de dispositif médical détermine : des premières valeurs, associées à une première pluralité de paramètres de patient associés à un substrat arythmique, et/ou des déclencheurs physiologiques pour des événements cardiaques aigus selon un premier signal physiologique ou plusieurs signaux physiologiques générés pendant la période; et selon les premières valeurs associées à la première pluralité de paramètres de patient, s'il faut évaluer des altérations d'électrophysiologie (EP) cellulaire cardiaque et/ou des altérations mécaniques du patient. Le système peut, en réponse à la détermination permettant d'évaluer les altérations d'EP cellulaire cardiaque, déterminer : des secondes valeurs, associées à une seconde pluralité de paramètres de patient concernant l'EP cardiaque selon un second signal physiologique ou plusieurs signaux physiologiques générés pendant la période; et s'il faut générer une alerte indiquant qu'un événement cardiaque aigu du patient est prédit selon, au moins en partie, des secondes valeurs associées à la seconde pluralité de paramètres de patient.
Applications Claiming Priority (4)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US202163237747P | 2021-08-27 | 2021-08-27 | |
| US63/237,747 | 2021-08-27 | ||
| US17/813,393 US20230068131A1 (en) | 2021-08-27 | 2022-07-19 | Two stage risk assessment for predicting imminent acute cardiac episodes |
| US17/813,393 | 2022-07-19 |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| WO2023026157A1 true WO2023026157A1 (fr) | 2023-03-02 |
Family
ID=83193498
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| PCT/IB2022/057804 WO2023026157A1 (fr) | 2021-08-27 | 2022-08-19 | Évaluation de risque en deux étapes pour prédire des épisodes cardiaques aigus imminents |
Country Status (1)
| Country | Link |
|---|---|
| WO (1) | WO2023026157A1 (fr) |
Citations (11)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US5117824A (en) | 1990-11-14 | 1992-06-02 | Medtronic, Inc. | Apparatus for monitoring electrical physiologic signals |
| US5545186A (en) | 1995-03-30 | 1996-08-13 | Medtronic, Inc. | Prioritized rule based method and apparatus for diagnosis and treatment of arrhythmias |
| US5755736A (en) | 1996-05-14 | 1998-05-26 | Medtronic, Inc. | Prioritized rule based method and apparatus for diagnosis and treatment of arrhythmias |
| US20100114208A1 (en) * | 2008-10-31 | 2010-05-06 | Medtronic, Inc. | Implantable medical device crosstalk evaluation and mitigation |
| US8255046B2 (en) | 2008-07-31 | 2012-08-28 | Medtronic, Inc. | Detecting worsening heart failure based on impedance measurements |
| US8744572B1 (en) | 2013-01-31 | 2014-06-03 | Medronic, Inc. | Systems and methods for leadless pacing and shock therapy |
| US20140276928A1 (en) | 2013-03-15 | 2014-09-18 | Medtronic, Inc. | Subcutaneous delivery tool |
| US20170290550A1 (en) * | 2016-04-06 | 2017-10-12 | Cardiac Pacemakers, Inc. | Confidence of arrhythmia detection |
| US20190231207A1 (en) * | 2018-02-01 | 2019-08-01 | Cardiac Pacemakers, Inc. | Systems and methods for detecting and reporting arrhythmias |
| US20200069245A1 (en) * | 2016-06-13 | 2020-03-05 | Medtronic, Inc. | Multi-parameter prediction of acute cardiac episodes and attacks |
| US20200357519A1 (en) * | 2019-05-06 | 2020-11-12 | Medtronic, Inc. | Reduced power machine learning system for arrhythmia detection |
-
2022
- 2022-08-19 WO PCT/IB2022/057804 patent/WO2023026157A1/fr active Application Filing
Patent Citations (11)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US5117824A (en) | 1990-11-14 | 1992-06-02 | Medtronic, Inc. | Apparatus for monitoring electrical physiologic signals |
| US5545186A (en) | 1995-03-30 | 1996-08-13 | Medtronic, Inc. | Prioritized rule based method and apparatus for diagnosis and treatment of arrhythmias |
| US5755736A (en) | 1996-05-14 | 1998-05-26 | Medtronic, Inc. | Prioritized rule based method and apparatus for diagnosis and treatment of arrhythmias |
| US8255046B2 (en) | 2008-07-31 | 2012-08-28 | Medtronic, Inc. | Detecting worsening heart failure based on impedance measurements |
| US20100114208A1 (en) * | 2008-10-31 | 2010-05-06 | Medtronic, Inc. | Implantable medical device crosstalk evaluation and mitigation |
| US8744572B1 (en) | 2013-01-31 | 2014-06-03 | Medronic, Inc. | Systems and methods for leadless pacing and shock therapy |
| US20140276928A1 (en) | 2013-03-15 | 2014-09-18 | Medtronic, Inc. | Subcutaneous delivery tool |
| US20170290550A1 (en) * | 2016-04-06 | 2017-10-12 | Cardiac Pacemakers, Inc. | Confidence of arrhythmia detection |
| US20200069245A1 (en) * | 2016-06-13 | 2020-03-05 | Medtronic, Inc. | Multi-parameter prediction of acute cardiac episodes and attacks |
| US20190231207A1 (en) * | 2018-02-01 | 2019-08-01 | Cardiac Pacemakers, Inc. | Systems and methods for detecting and reporting arrhythmias |
| US20200357519A1 (en) * | 2019-05-06 | 2020-11-12 | Medtronic, Inc. | Reduced power machine learning system for arrhythmia detection |
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