公开(公告)号：EP1429839A2

公开(公告)日：2004-06-23

申请号：EP02797838.6

申请日：2002-08-28

申请人： Medtronic, Inc.

发明人： DENO, Curtis, D. ,  HAVEL, William, J. ,  BENNETT, Tom, D. ,  STEIN, Paul, M. ,  EULER, David, E.

IPC分类号： A61N1/368 ,  A61N1/36 ,  A61N1/39

CPC分类号： A61N1/3956 ,  A61N1/36014 ,  A61N1/36114 ,  A61N1/3625 ,  A61N1/3627 ,  A61N1/36585 ,  A61N1/3706

摘要： The above-described methods and apparatus are believed to be of particular benefit for patients suffering heart failure including cardiac dysfunction, chronic HF, and the like and all variants as described herein and including those known to those of skill in the art to which the invention is directed. It will understood that the present invention offers the possibility of monitoring and therapy of a wide variety of acute and chronic cardiac dysfunctions. The current invention provides systems and methods for delivering therapy for cardiac hemodynamic dysfunction.

公开(公告)号：EP0862483A1

公开(公告)日：1998-09-09

申请号：EP96936854.0

申请日：1996-10-23

申请人： MEDTRONIC, INC.

发明人： KIEVAL, Robert, S. ,  BENNETT, Tom, D. ,  FITTS, Stephanie, Michele

IPC分类号： A61N1

CPC分类号： A61N1/36564 ,  A61N1/36114 ,  A61N1/36117 ,  A61N1/3627 ,  A61N1/36557

摘要： A system and method for stimulating a baroreflex arc based on levels of indicators from the body includes a pacemaker for bradycardia support pacing should the indicators show the need for support pacing. Other indicators and a process take advantage of an assumed relationship between peripheral vascular resistance and pulmonary resistance to determine the level of nerve stimulation required. This level is adjusted or optimized based on its interaction with heart activity and changes in the other indicators. These other indicators are readily available to the implanted device and allow for a process to make an estimate of pulmonary vascular resistance, from which SVR is also estimated. The value determined for SVR is the primary value used to determine the level of nerve stimulation absent indicators for the need to provide bradycardia pacing. The pacemaker can be rate responsive, as can the process for determining the level of nerve stimulation to be delivered. Several different lead configurations are described.

公开(公告)号：EP1341439B1

公开(公告)日：2004-10-20

申请号：EP01996019.4

申请日：2001-11-30

申请人： Medtronic, Inc.

发明人： MULLIGAN, Lawrence, J. ,  BENNETT, Tom, D.

IPC分类号： A61B5/02

CPC分类号： A61B5/0205 ,  A61B5/0006 ,  A61B5/0215

公开(公告)号：EP1341439A2

公开(公告)日：2003-09-10

申请号：EP01996019.4

申请日：2001-11-30

申请人： Medtronic, Inc.

发明人： MULLIGAN, Lawrence, J. ,  BENNETT, Tom, D.

IPC分类号： A61B5/02

CPC分类号： A61B5/0205 ,  A61B5/0006 ,  A61B5/0215

摘要： A system and method for determining mean pulmonary arterial pressure (MPAP) using a pressure sensor (16) located within a ventricle of a heart, and a signal indicative of cardiac electrical activity such as an electrocardiogram (EGM) signal. The pressure may be sensed within the right and/or left ventricle using an implanted pressure sensor (16). The sensed pressure may be used to determine the Ventricular Systolic Pressure (VSP) and an estimated Pulmonary Arterial diastolic pressure (ePAD). The VSP, ePAD, and time intervals associated with systole and diastole may then be used to obtain an MPAP that closely approximates mean pulmonary arterial measured using a sensor located in the pulmonary artery.

公开(公告)号：EP1345651B1

公开(公告)日：2006-03-29

申请号：EP01991449.8

申请日：2001-12-27

申请人： MEDTRONIC, INC.

发明人： DENO, D., Curtis ,  BENNETT, Tom, D. ,  IGEL, David ,  HILL, Michael, R., S.

IPC分类号： A61N1/365

CPC分类号： A61N1/36564 ,  G06F19/00

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 (&tgr;); (2) mechanical restitution (MR), i.e., 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 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. However, certain of the parameters are only measured or certain of the data are only stored when the patient heart rate is regular and within a normal sinus range between programmed lower and upper heart rates. The parameter data is associated with a date and time stamp and with other patient data, e.g., patient activity level, and the associated parameter data is stored in IMD memory for retrieval at a later date employing conventional telemetry systems. Incremental changes in the parameter data over time, taking any associated time of day and patient data into account, provide a measure of the degree of change in the heart failure state of the heart.

公开(公告)号：EP1345651A1

公开(公告)日：2003-09-24

申请号：EP01991449.8

申请日：2001-12-27

申请人： Medtronic, Inc.

发明人： DENO, D., Curtis ,  BENNETT, Tom, D. ,  IGEL, David ,  HILL, Michael, R., S.

IPC分类号： A61N1/365

CPC分类号： A61N1/36564 ,  G06F19/00

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 (&tgr;); (2) mechanical restitution (MR), i.e., 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 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. However, certain of the parameters are only measured or certain of the data are only stored when the patient heart rate is regular and within a normal sinus range between programmed lower and upper heart rates. The parameter data is associated with a date and time stamp and with other patient data, e.g., patient activity level, and the associated parameter data is stored in IMD memory for retrieval at a later date employing conventional telemetry systems. Incremental changes in the parameter data over time, taking any associated time of day and patient data into account, provide a measure of the degree of change in the heart failure state of the heart.

公开(公告)号：EP0573461B1

公开(公告)日：1994-08-31

申请号：EP92904719.9

申请日：1991-11-21

申请人： MEDTRONIC, INC.

发明人： ERICKSON, Mark, K. ,  BENNETT, Tom, D.

IPC分类号： A61N1/365 ,  A61N1/368

CPC分类号： A61N1/3962 ,  A61N1/3622 ,  A61N1/36557

摘要： A method and apparatus for discriminating between stable and unstable ventricular tachycardias based on a measurement of oxygen saturation. Reference values for average oxygen saturation level and of the pulsatile characteristic of the oxygen saturation level are taken while a patient is in a resting condition. Measurements of oxygen saturation are also taken in response to the detection of a high heart rate, and are compared to the reference measurements to discriminate between stable and unstable ventricular tachyarrhythmias. An unstable tachyarrhythmia is diagnosed if a tachycardia is diagnosed and the current oxygen saturation level is similar to the reference average oxygen saturation level or if the oxygen saturation as presently measured displays a decreased pulsatile characteristic as compared to the reference measurements. The discriminator is intended for use in conjunction with or as part of an automated cardioverter of the type capable of delivering differing therapies for termination of stable and unstable ventricular tachyarrhythmias, such as antitachycardia pacing, cardioversion and defibrillation.

公开(公告)号：EP0862483B1

公开(公告)日：2004-05-26

申请号：EP96936854.7

申请日：1996-10-23

申请人： MEDTRONIC, INC.

发明人： KIEVAL, Robert, S. ,  BENNETT, Tom, D. ,  FITTS, Stephanie, Michele

IPC分类号： A61N1/36 ,  A61N1/368 ,  A61N1/365

CPC分类号： A61N1/36564 ,  A61N1/36114 ,  A61N1/36117 ,  A61N1/3627 ,  A61N1/36557

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.

公开(公告)号：EP0592618A1

公开(公告)日：1994-04-20

申请号：EP93903498.0

申请日：1993-01-14

申请人： MEDTRONIC, INC.

发明人： BENNETT, Tom, D.

IPC分类号： A61N1

CPC分类号： A61N1/36542

摘要： Stimulateur cardiaque pouvant ajuster automatiquement à sa valeur optimale le réglage du seuil d'activité de son circuit de traitement de signal de détecteur d'activité. Selon un mode de réalisation, le stimulateur cardiaque maintient une moyenne glissante de la durée d'activité de valeur zéro et une totalisation cumulative de la durée d'activité de valeur zéro pendant une période prédéterminée. Le stimulateur cardiaque calcule périodiquement une différence temporelle entre la moyenne glissante de la durée d'activité de valeur zéro et la totalisation cumulative de cette même durée, et règle le seuil d'activité du circuit de traitement de signal de détecteur d'activité en fonction de ce calcul. Dans la mesure où l'ajustement du seuil d'activité est basé sur la moyenne à long-terme de la durée d'activité de valeur zéro, les effets de la variation de cycle en cycle de la durée d'activité de valeur zéro sont minimisés. Selon un autre mode de réalisation, le stimulateur cardiaque calcule une différence temporelle entre une valeur marginale préprogrammée et la totalisation cumulative de la durée d'activité de valeur zéro. Si la différence temporelle est inférieure à la marge prédéterminée, le seuil d'activité est augmenté. Si la différence temporelle est supérieure à la marge prédeterminée, le seuil d'activité est réduit.