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：EP2015838A1

公开(公告)日：2009-01-21

申请号：EP07760377.7

申请日：2007-04-10

申请人： Medtronic, Inc.

发明人： BURNES, John E. ,  EULER, David E.

IPC分类号： A61N1/362 ,  A61N1/365

CPC分类号： A61N1/3627 ,  A61N1/36514

摘要： Refractory period stimulation (RPS) disclosed herein includes apparatus and methods to enhance cardiac performance by delivering monophasic stimulation pulses during the refractory period. The disclosure describes several system level improvements to RPS that include one or more of the following: (i) Delivery of RPS therapy pulses at multiple sites in an automatically alternating way to avoid increasing demand at any one location for prolonged periods of time. (ii) Delivery of RPS therapy pulses at multiple sites to determine one or more optimal electrode configurations for chronic RPS therapy delivery. (iii) Use of separate electrode(s) for sensing ventricular activity to properly time and adjust the application of RPS thereby avoiding limitations associated with electrode polarization that occurs due to the amount of energy delivered during the RPS. (iv) Use of a relatively long active recharge pulse at the RPS stimulation electrodes to remove the undesirable effects of polarization.

摘要翻译： 本文公开的难治性期刺激（RPS）包括通过在不应期期间递送单相刺激脉冲来增强心脏表现的设备和方法。 本公开描述了对RPS的若干系统级改进，其包括以下中的一个或多个：（i）以自动交替的方式在多个地点提供RPS治疗脉冲，以避免在任何一个位置长时间增加需求。 （ii）在多个部位递送RPS治疗脉冲以确定用于慢性RPS治疗递送的一个或多个最佳电极配置。 （iii）使用单独的电极来感测心室活动以适当地计时和调整RPS的应用，从而避免由于在RPS期间输送的能量而发生的与电极极化相关的限制。 （iv）在RPS刺激电极处使用相对长的主动再充电脉冲以消除不希望的极化效应。

公开(公告)号：EP1663388A1

公开(公告)日：2006-06-07

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

摘要： A medical device, e.g., an implantable medical device, delivers one or more neurally-excitable stimulation pulses to myocardial tissue during a period when the tissue is refractory. The width of the pulses is less than or equal to approximately one half millisecond. In some embodiments, the current amplitude of the pulses is less than or equal to approximately twenty milliamps. In exemplary embodiments, the medical device delivers a pulse train of six or fewer pulses separated from each other by an interval that is greater than or equal to approximately ten milliseconds. In some embodiments, the medical device delivers pulses according to a schedule stored in a memory, or as a function of a monitored physiological parameter of a patient, such as an intracardiac pressure. In some embodiments, the medical device suspends or withholds delivery of neurally-excitable based on detection of cardiac ischemia.

公开(公告)号：EP2015840A1

公开(公告)日：2009-01-21

申请号：EP07760245.6

申请日：2007-04-06

申请人： MEDTRONIC, INC.

发明人： EULER, David E.

IPC分类号： A61N1/365 ,  A61N1/362

CPC分类号： A61N1/36514 ,  A61N1/3627

摘要： In general, the disclosure describes implantable pulse generators (IPGs) adapted to deliver stimulation to refractory myocardial tissue. An IPG nominally delivers one to six monophasic stimulation pulses. Because monophasic stimulation tends to accumulate polarization, a programmable blanking period of between about 20 milliseconds (ms) and about 300 ms is implemented (subsequent to delivery of the last pulse in a RPS pulse train) to allow recovery from polarization. The stimulation pulse width is about 0.03 ms to about 1.6 ms and voltage amplitude of 0.5 volts to 8 volts at about 50 Hz. The amplitude of electrical current of the stimulation pulses is less than or equal to approximately 50 milliamps. The pulses are delivered to multiple sites within a cardiac chamber and device performance and/or diagnostic information can be stored within a memory structure and reviewed to confirm delivery of a desired therapy regimen.

公开(公告)号：EP1993662A1

公开(公告)日：2008-11-26

申请号：EP07757594.2

申请日：2007-02-28

申请人： MEDTRONIC, INC.

发明人： HETTRICK, Douglas, A. ,  MULLIGAN, Lawrence J. ,  EULER, David E.

IPC分类号： A61N1/362

CPC分类号： A61N1/3627

摘要： Methods and systems for treating patients with diastolic heart failure (DHF) are disclosed which include slowing a patient's heart rate below its intrinsic rate, and controlling the rate using cardiac pacing therapy to improve LV filling and cardiac output. In certain embodiments, a pacing treatment rate may be determined by adjusting an adaptive rate by an amount determined by evaluating one or more patient parameters.