公开(公告)号：EP1622681A1

公开(公告)日：2006-02-08

申请号：EP04760560.5

申请日：2004-04-19

申请人： MEDTRONIC, INC. ,  Burnes, John E.

发明人： MULLIGAN, Lawrence, J. ,  HILL, Michael, R. S.

IPC分类号： A61N1/362 ,  A61N1/365

CPC分类号： A61N1/36514 ,  A61N1/3627

摘要： Methods and devices for improving ventricular contractile status of a patient suitably exploit changes in ventricular pressure and/or dP/dtmax to provide and/or optimize a response to a patient. The ventricular pressure may be appropriately correlated to intracellular calcium regulation, which is indicative of contractile status. To assess ventricular contractile status, the device suitably observes a cardiac perturbation of the patient and measures force interval potentiation following the perturbation. The contractile potentiation can then be stored and/or quantified in the implantable medical device to determine the ventricular contractile status of the patient, and an appropriate response may be provided to the patient as a function of the ventricular contractile status. Examples of responses may include administration of drug or neuro therapies, modification of a pacing rate, or the like. Force interval potentiation may also be used to optimize or improve a parameter for a response provided by the implantable medical device.

公开(公告)号：EP1622681B1

公开(公告)日：2007-09-26

申请号：EP04760560.5

申请日：2004-04-19

申请人： MEDTRONIC, INC.

发明人： MULLIGAN, Lawrence, J. ,  HILL, Michael, R. S., c/o Bakken Research Center B.V. ,  BURNES, John, E.

IPC分类号： A61N1/362 ,  A61N1/365

CPC分类号： A61N1/36514 ,  A61N1/3627

摘要： Methods and devices for improving ventricular contractile status of a patient suitably exploit changes in ventricular pressure and/or dP/dtmax to provide and/or optimize a response to a patient. The ventricular pressure may be appropriately correlated to intracellular calcium regulation, which is indicative of contractile status. To assess ventricular contractile status, the device suitably observes a cardiac perturbation of the patient and measures force interval potentiation following the perturbation. The contractile potentiation can then be stored and/or quantified in the implantable medical device to determine the ventricular contractile status of the patient, and an appropriate response may be provided to the patient as a function of the ventricular contractile status. Examples of responses may include administration of drug or neuro therapies, modification of a pacing rate, or the like. Force interval potentiation may also be used to optimize or improve a parameter for a response provided by the implantable medical device.

公开(公告)号：EP1455896A2

公开(公告)日：2004-09-15

申请号：EP02802449.5

申请日：2002-10-11

申请人： Medtronic, Inc.

发明人： HILL, Michael, R.S. ,  MULLIGAN, Lawrence, J.

IPC分类号： A61N1/368

CPC分类号： A61N1/3627 ,  A61N1/36528 ,  A61N1/36564 ,  A61N1/3684

摘要： Implantable medical devices (IMDs) for monitoring signs of acute or chronic cardiac heart failure by measuring cardiac blood pressure and mechanical dimensions of the heart and providing multi-chamber pacing optimized as a function of measured blood pressure and dimensions are disclosed. The dimension sensor or sensors comprise at least a first sonomicrometer piezoelectric crystal mounted to a first lead body implanted into or in relation to one heart chamber that operates as an ultrasound transmitter when a drive signal is applied to it and at least one second sonomicrometer crystal mounted to a second lead body implanted into or in relation to a second heart chamber that operates as an ultrasound receiver. The sonomicrometer crystals are distributed about a heart chamber such that the distance between the separated ultrasound transmitter and receiver crystal pairs changes with contraction and relaxation of the heart chamber walls.

公开(公告)号：EP1347704B1

公开(公告)日：2007-12-19

申请号：EP01985621.0

申请日：2001-12-26

申请人： MEDTRONIC, INC.

发明人： DENO, D., Curtis ,  BENNETT, Tom, D. ,  MULLIGAN, Lawrence, J. ,  SHAW, Richard, J. ,  IGEL, David ,  HILL, Michael, R., S.

IPC分类号： A61B5/00

CPC分类号： A61N1/3627 ,  A61N1/36564

摘要： An implantable stimulator and monitor measures a group of heart failure parameters indicative of the state of heart failure employing EGM signals, measures of blood pressure including absolute pressure P, developed pressure (DP = systolic P diastolic P), and/or dP/dt, and measures of heart chamber volume (V) over one or more cardiac cycles. These parameters include: (1) relaxation or contraction time constant tau (t); (2) mechanical restitution (MR), ie., the mechanical response of a heart chamber to premature stimuli applied to the heart chamber; (3) recirculation fraction (RF), i.e., the rate of decay of PESP effects over a series of the heart cycles; and (4) end systolic elastance (EES), i.e., the ratios of end systolic blood pressure P to volume V. These heart failure parameters are determined periodically regardless of patient posture and activity level. The physician can determine whether a particular therapy is appropriate, prescribe the therapy for a period of time while again accumulating the stored patient data for a later review and assessment to determine whether the applied therapy is beneficial or not, thereby enabling periodic changes in therapy, if appropriate. Drug therapies and electrical stimulation therapies, including PESP stimulation, and pacing therapies including single chamber, dual chamber and multi-chamber (bi-atrial and/or bi-ventricular) pacing can be delivered. In patient's prone to malignant tachyarrhythmias, the assessment of heart failure state can be taken into account in setting parameters of detection or classification of tachyarrhythmias and the therapies that are delivered.

公开(公告)号：EP1667767A1

公开(公告)日：2006-06-14

申请号：EP04781603.8

申请日：2004-08-20

申请人： MEDTRONIC, INC.

发明人： HAMLEN, Robert, C. ,  DENO, D., Curtis ,  MULLIGAN, Lawrence, J.

IPC分类号： A61N1/362 ,  A61N1/39 ,  A61H31/00

CPC分类号： A61H31/005 ,  A61H31/006 ,  A61H2201/5007 ,  A61H2230/04 ,  A61M16/00 ,  A61N1/3621 ,  A61N1/39 ,  A61N1/3962

摘要： A method for resuscitating the heart during a sustained episode of ventricular fibrillation, fine ventricular fibrillation, or asystole is provided, which includes delivering circulatory support for an interval of time effective in alleviating myocardial hypoxia, and delivering a series of electrical pulses for evoking a series of myocardial depolarizations after the interval of circulatory support. The method may be implemented in conjunction with an external or implantable cardiac electrical stimulation device and associated electrodes capable of delivering a series of pacing-class or defibrillation class pulses. Circulatory support may be delivered manually, e.g., in the form of cardiopulmonary resuscitation (CPR), or mechanized, e.g., in the form of extracorporeal membrane oxygenation, activation of an implantable ventricular assist device, or automated CPR equipment and the like.

公开(公告)号：EP1624799A2

公开(公告)日：2006-02-15

申请号：EP04760611.6

申请日：2004-04-28

申请人： MEDTRONIC, INC.

发明人： MULLIGAN, Lawrence, J. ,  GEBHARDT, Ursula

IPC分类号： A61B5/04

CPC分类号： A61N1/3627

摘要： Methods and devices for improving ventricular contractile status of a patient suitably exploit changes in ventricular pressure and/or dP/dtmax to provide and/or optimize a response to a patient. The ventricular pressure may be appropriately correlated to intracellular calcium regulation, which is indicative of contractile status. To assess ventricular contractile status, the device (100) suitably observes a cardiac perturbation of the patient and measures force interval potentiation following the perturbation. The contractile potentiation can then be stored and/or quantified in the implantable medical device (100) to determine the ventricular contractile status of the patient, and an appropriate response may be provided to the patient as a function of the ventricular contractile status. Examples of responses may include administration of drug or neuro therapies, modification of a pacing rate, or the like. Force interval potentiation may also be used to optimize or improve a parameter for a response provided by the implantable medical device (100).

公开(公告)号：EP2217144A1

公开(公告)日：2010-08-18

申请号：EP08834893.3

申请日：2008-10-03

申请人： MEDTRONIC, INC.

发明人： KAISER, Daniel, R. ,  NEIDERT, Michael, R. ,  SKADSBERG, Nicholas, David ,  GARDESKI, Kenneth, C. ,  MULLIGAN, Lawrence, J. ,  KELLEY, James, F. ,  SHELTON, Michael, B. ,  FISCHER, Trent, Markham

IPC分类号： A61B5/11

CPC分类号： A61N1/368 ,  A61B5/042 ,  A61B5/062 ,  A61B5/1104 ,  A61B5/1107 ,  A61B5/686 ,  A61B5/6882 ,  A61B2562/0209 ,  A61N1/0573 ,  A61N1/3627 ,  A61N1/36578 ,  A61N1/3684 ,  A61N1/3686

摘要： A method for selecting a cardiac pacing site includes steps of: securing first and second electromagnetic receiver coils at first and second positions, respectively, along a heart wall; collecting a set of non-paced heart wall motion data from each of the coils secured at the corresponding positions; applying cardiac pacing stimulation at at least one first pacing site; collecting a first set of paced heart wall motion data from each of the secured coils; comparing the non-paced heart wall motion data to the first set of paced heart wall motion data; and determining, based on the comparing, whether to maintain pacing at the at least one first cardiac pacing site or to apply pacing stimulation at a second pacing site for collection of a second set of paced heart wall motion data. The at least one first pacing site may include a right ventricular site and a left ventricular site.

公开(公告)号：EP1663388B1

公开(公告)日：2010-04-14

申请号：EP04780585.8

申请日：2004-08-10

申请人： Medtronic, Inc.

发明人： DENO, Curtis, D. ,  EULER, David E. ,  MULLIGAN, Lawrence, J. ,  DUFFIN, Edwin, G. ,  IGEL, David, A.

IPC分类号： A61N1/362 ,  A61N1/365

CPC分类号： A61N1/36514 ,  A61N1/3627 ,  A61N1/36564 ,  A61N1/368

公开(公告)号：EP1599132A2

公开(公告)日：2005-11-30

申请号：EP04712354.2

申请日：2004-02-18

申请人： Medtronic Inc.

发明人： BENNETT, Tommy, D. ,  DUFFIN, Edwin, G. ,  MULLIGAN, Lawrence, J. ,  HAMLEN, Robert, C. ,  ABO-AUDA, Wael

IPC分类号： A61B5/02 ,  A61B5/04

CPC分类号： A61B5/02405 ,  A61B5/0031 ,  A61B5/0215 ,  A61B5/0245 ,  A61B5/0452

摘要： An implantable heart monitor (100) implanted in a patient's body having electrogram (EGM) sense electrodes (26) coupled with EGM sense circuitry (112) to generate sense events (S100) and a blood pressure measurement transducer (20) disposed in a heart chamber (10) and coupled with blood pressure measurement circuitry (112) operates to assess heart failure state (S144) as a function of mechanical pulsus alternans (MPA). MPA episodes are detected (S116), and MPA characteristics of the MPA episode are used alone or as a group as a diagnostic marker of HF state. The MPA episode data set can be stored in memory (124, 128) associated with a time and date stamp. The MPA characteristics of each MPA data set in a series of MPA data sets collected over time can be compared or plotted to determine if a trend indicative of change in HF state is discernible.

公开(公告)号：EP1347704A2

公开(公告)日：2003-10-01

申请号：EP01985621.0

申请日：2001-12-26

申请人： Medtronic, Inc.

发明人： DENO, D., Curtis ,  BENNETT, Tom, D. ,  MULLIGAN, Lawrence, J. ,  SHAW, Richard, J. ,  IGEL, David ,  HILL, Michael, R., S.

IPC分类号： A61B5/00

CPC分类号： A61N1/3627 ,  A61N1/36564

摘要： An implantable stimulator and monitor measures a group of heart failure parameters indicative of the state of heart failure employing EGM signals, measures of blood pressure including absolute pressure P, developed pressure (DP = systolic P diastolic P), and/or dP/dt, and measures of heart chamber volume (V) over one or more cardiac cycles. These parameters include: (1) relaxation or contraction time constant tau (t); (2) mechanical restitution (MR), ie., the mechanical response of a heart chamber to premature stimuli applied to the heart chamber; (3) recirculation fraction (RF), i.e., the rate of decay of PESP effects over a series of the heart cycles; and (4) end systolic elastance (EES), i.e., the ratios of end systolic blood pressure P to volume V. These heart failure parameters are determined periodically regardless of patient posture and activity level. The physician can determine whether a particular therapy is appropriate, prescribe the therapy for a period of time while again accumulating the stored patient data for a later review and assessment to determine whether the applied therapy is beneficial or not, thereby enabling periodic changes in therapy, if appropriate. Drug therapies and electrical stimulation therapies, including PESP stimulation, and pacing therapies including single chamber, dual chamber and multi-chamber (bi-atrial and/or bi-ventricular) pacing can be delivered. In patient's prone to malignant tachyarrhythmias, the assessment of heart failure state can be taken into account in setting parameters of detection or classification of tachyarrhythmias and the therapies that are delivered.