公开(公告)号：US09149638B2

公开(公告)日：2015-10-06

申请号：US11343175

申请日：2006-01-30

申请人： Dwight H. Warkentin ,  David E. Euler

发明人： Dwight H. Warkentin ,  David E. Euler

IPC分类号： A61N1/36 ,  A61N1/362 ,  A61N1/365

CPC分类号： A61N1/3627 ,  A61N1/36564

摘要： A method of controlling pulmonary capillary pressure is disclosed which includes increasing the output of a first ventricle (V1) (e.g., a left ventricle) relative to second ventricle (e.g., right ventricle) by increasing the magnitude of a post extrasystolic potentiation (PESP) therapy effect in the first ventricle relative to the magnitude of a PESP therapy effect produced in the second ventricle. In certain embodiments of the invention, this may be accomplished by adjusting the extra-stimulus interval (ESI) in either or both of the left ventricle and the right ventricle, for example.

摘要翻译： 公开了一种控制肺毛细血管压力的方法，其包括通过增加收缩后增强功能（PESP）的幅度来增加相对于第二脑室（例如，右心室）的第一脑室（V1）（例如，左心室）的输出， 相对于在第二脑室产生的PESP治疗效果的大小，第一脑室的治疗效果。 在本发明的某些实施方案中，例如可以通过调整左心室和右心室中的任一者或两者的额外刺激间隔（ESI）来实现。

公开(公告)号：US20100023079A1

公开(公告)日：2010-01-28

申请号：US12178534

申请日：2008-07-23

申请人： Douglas A. Hettrick ,  Todd Jon Sheldon ,  Paul D. Ziegler ,  David E. Euler

发明人： Douglas A. Hettrick ,  Todd Jon Sheldon ,  Paul D. Ziegler ,  David E. Euler

IPC分类号： A61N1/368

CPC分类号： A61N1/368 ,  A61N1/3682

摘要： A method and apparatus is provided for determining whether a current atrial-ventricular (AV) delay during cardiac pacing is appropriate for proper mechanical coupling of the atrium and ventricle. If proper mechanical coupling is determined to not exist, an additional atrial contraction is induced within the same ventricular cycle to maintain atrial-ventricular mechanical coupling.

摘要翻译： 提供了一种用于确定心脏起搏期间当前心房（AV）延迟是否适合于心房和心室的适当机械耦合的方法和装置。 如果确定不存在适当的机械耦合，则在相同心室周期内诱发另外的心房收缩以维持心房 - 心室机械耦合。

公开(公告)号：US07233822B2

公开(公告)日：2007-06-19

申请号：US10881541

申请日：2004-06-29

申请人： Douglas A. Hettrick ,  David E. Euler ,  Mark L Brown

发明人： Douglas A. Hettrick ,  David E. Euler ,  Mark L Brown

IPC分类号： A61B5/04

CPC分类号： A61B5/6882 ,  A61B5/0031 ,  A61B5/0215 ,  A61B5/0422 ,  A61B5/046 ,  A61B5/0464 ,  A61B5/7257 ,  A61B5/7264 ,  A61N1/3622 ,  A61N1/36564 ,  A61N1/3956

摘要： A system and method for detecting and classifying cardiac arrhythmias based on cardiac pressure signals or the combination of cardiac electrical and cardiac pressure signals. A cardiac electrogram signal is sensed to derive a cardiac rate from which an arrhythmia detection is made when the cardiac rate meets arrhythmia detection criteria. An intracardiac pressure signal is sensed to derive an indicator of tachycardia based on an analysis of the pressure signal in either the time domain or frequency domain. The detected arrhythmia is classified as tachycardia or fibrillation based on the tachycardia indicator wherein the tachycardia indicator is compared to tachycardia detection criteria and the arrhythmia is classified as tachycardia if tachycardia detection criteria are met and the arrhythmia is classified as fibrillation if the tachycardia detection criteria are not met.

摘要翻译： 一种基于心脏压力信号或心脏电压和心脏压力信号的组合来检测和分类心律失常的系统和方法。 感测到心电图信号以导出当心率达到心律失常检测标准时进行心律失常检测的心率。 基于对时域或频域中的压力信号的分析，感测心内压力信号以导出心动过速的指标。 检测到的心律失常根据心动过速指标分类为心动过速指标，其中心动过速指标与心动过速检测标准进行比较，如果心动过速检测标准得到满足，则将心律不齐分类为心动过速，如果心动过速检测标准为 没见过。

公开(公告)号：US09375578B2

公开(公告)日：2016-06-28

申请号：US12178534

申请日：2008-07-23

申请人： Douglas A. Hettrick ,  Todd Jon Sheldon ,  Paul D. Ziegler ,  David E. Euler

发明人： Douglas A. Hettrick ,  Todd Jon Sheldon ,  Paul D. Ziegler ,  David E. Euler

IPC分类号： A61N1/368

CPC分类号： A61N1/368 ,  A61N1/3682

摘要： A method and apparatus is provided for determining whether a current atrial-ventricular (AV) delay during cardiac pacing is appropriate for proper mechanical coupling of the atrium and ventricle. If proper mechanical coupling is determined to not exist, an additional atrial contraction is induced within the same ventricular cycle to maintain atrial-ventricular mechanical coupling.

摘要翻译： 提供了一种用于确定心脏起搏期间当前心房（AV）延迟是否适合于心房和心室的适当机械耦合的方法和装置。 如果确定不存在适当的机械耦合，则在相同心室周期内诱发另外的心房收缩以维持心房 - 心室机械耦合。

公开(公告)号：US09370654B2

公开(公告)日：2016-06-21

申请号：US12360680

申请日：2009-01-27

申请人： Avram Scheiner ,  David E. Euler

发明人： Avram Scheiner ,  David E. Euler

IPC分类号： A61N1/05 ,  A61N1/36 ,  A61B5/00

CPC分类号： A61N1/0556 ,  A61B5/4035 ,  A61B5/4047 ,  A61B5/7217 ,  A61N1/36114

摘要： An implantable medical device and associated method deliver a therapy to an autonomic nerve. The therapy delivery includes delivering therapeutic low frequency (LF) electrical stimulation pulses to the autonomic nerve and delivering a high frequency electrical signal to the autonomic nerve during the LF frequency stimulation pulse delivery. The high frequency stimulation signal blocks activation of autonomic nerve fibers innervating a non-targeted tissue during the therapeutic LF stimulation pulse delivery.

摘要翻译： 可植入医疗装置和相关方法将治疗递送至自主神经。 治疗递送包括在LF频率刺激脉冲传送期间向自主神经递送治疗性低频（LF）电刺激脉冲并将高频电信号传送到自主神经。 高频刺激信号阻止在治疗性LF刺激脉冲输送期间支配非目标组织的自主神经纤维的活化。

公开(公告)号：US07835789B2

公开(公告)日：2010-11-16

申请号：US11379904

申请日：2006-04-24

申请人： David E. Euler

发明人： David E. Euler

IPC分类号： A61N1/362

CPC分类号： A61N1/36514 ,  A61N1/3627

摘要： Implantable pulse generators (IPGs) are 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.

摘要翻译： 植入式脉冲发生器（IPG）适用于将难度增加的心肌组织刺激。 IPG名义上提供一到六个单相刺激脉冲。 因为单相刺激倾向于积聚极化，所以实现约20毫秒（ms）到约300ms之间的可编程消隐周期（在RPS脉冲串中传送最后一个脉冲之后）以允许从极化恢复。 刺激脉冲宽度为约0.03ms至约1.6ms，在约50Hz下的电压振幅为0.5伏至8伏。 刺激脉冲的电流幅度小于或等于约50毫安。 将脉冲输送到心室内的多个部位，并且将装置性能和/或诊断信息存储在存储器结构内并进行审查，以确认所需治疗方案的递送。

公开(公告)号：US08478406B2

公开(公告)日：2013-07-02

申请号：US11379886

申请日：2006-04-24

申请人： John E. Burnes ,  David E. Euler

发明人： John E. Burnes ,  David E. Euler

IPC分类号： 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： 本文公开的难治性周期刺激（RPS）包括通过在不应期期间递送单相刺激脉冲来增强心脏性能的装置和方法。 本公开描述了对RPS的几个系统级改进，其包括以下一个或多个：（i）以自动交替方式在多个位置递送RPS治疗脉冲，以避免在任何一个位置长时间增加需求。 （ii）在多个位点递送RPS治疗脉冲以确定用于慢性RPS治疗递送的一种或多种最佳电极配置。 （iii）使用单独的电极来感测心室活动以适当地时间和调整RPS的应用，从而避免由于在RPS期间递送的能量的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期望的极化影响。

公开(公告)号：US07200438B2

公开(公告)日：2007-04-03

申请号：US10860991

申请日：2004-06-04

申请人： David E. Euler

发明人： David E. Euler

IPC分类号： A61N1/368

CPC分类号： A61N1/3622

摘要： A method and device for delivering cardiac stimulation that includes a first electrode, positioned within a first chamber of a heart, sensing cardiac signals associated with the first chamber and capable of delivering stimulation to the first chamber, and a second electrode, positioned within a second chamber of the heart, sensing cardiac signals associated with the second chamber and capable of delivering stimulation to the second chamber. A processing unit processes the sensed signals and controls the stimulation delivery via the first electrode and the second electrode, determining whether a predetermined rhythm is detected in the first chamber, and delivering high-frequency burst pacing to the first chamber in response to a predetermined rate being sensed in the second chamber during the predetermined rhythm.

摘要翻译： 一种用于递送心脏刺激的方法和装置，其包括位于心脏的第一腔室内的第一电极，感测与第一腔室相关联并能够向第一腔室递送刺激的心脏信号，以及位于第二腔室内的第二电极 心脏的腔室，感测与第二腔室相关联的心脏信号并且能够将刺激传递给第二腔室。 处理单元处理感测到的信号并且控制经由第一电极和第二电极的刺激传递，确定在第一室中是否检测到预定的节律，以及响应于预定的速率将高频脉冲起搏递送到第一腔室 在预定的节奏期间在第二室中被感测。

公开(公告)号：US06532388B1

公开(公告)日：2003-03-11

申请号：US09670369

申请日：2000-09-26

申请人： Michael R. S. Hill ,  Scott E. Jahns ,  James R. Keogh ,  David E. Euler ,  Michael R. Ujhelyi ,  Nancy J. Rakow

发明人： Michael R. S. Hill ,  Scott E. Jahns ,  James R. Keogh ,  David E. Euler ,  Michael R. Ujhelyi ,  Nancy J. Rakow

IPC分类号： A61N118

CPC分类号： A61N1/362 ,  A61M5/14276 ,  A61N1/0517 ,  A61N1/0519 ,  A61N1/0556 ,  A61N1/056 ,  A61N1/36007 ,  A61N1/3601 ,  A61N1/36014 ,  A61N1/36017 ,  A61N1/36114 ,  A61N1/385 ,  A61N1/39

摘要： A method of performing a medical procedure, such as surgery, is provided. A nerve is stimulated to adjust the beating of the heart to a first condition, such as a stopped or slowed condition. The medical procedure is performed on the heart or another organ. The stimulation of the nerve is stopped to adjust the beating of the heart to a second condition, such as a beating condition. The heart itself may also be stimulated to a beating condition, such as by pacing. The stimulation of the nerve may be continued to allow the medical procedure to be continued. Systems and devices for performing the medical procedure are also provided.

摘要翻译： 提供了一种执行诸如手术的医疗程序的方法。 刺激神经以将心脏的跳动调节到第一状态，例如停止或减缓的状况。 医疗程序在心脏或另一个器官上进行。 停止对神经的刺激以将心脏的跳动调节到第二状态，例如打浆状态。 心脏本身也可能被刺激到跳动状态，例如通过起搏。 可以继续刺激神经以允许继续进行医学过程。 还提供用于执行医疗程序的系统和设备。

公开(公告)号：US09101772B2

公开(公告)日：2015-08-11

申请号：US12633893

申请日：2009-12-09

申请人： Karen J. Kleckner ,  Kathleen A. Prieve ,  Jeffrey M. Gillberg ,  Ren Zhou ,  Kenneth M. Anderson ,  D. Curtis Deno ,  Glenn C. Zillmer ,  Ruth N. Klepfer ,  Vincent E. Splett ,  David E. Euler ,  Lawrence J. Mulligan ,  Edwin G. Duffin ,  David A. Igel ,  John E. Burnes

发明人： Karen J. Kleckner ,  Kathleen A. Prieve ,  Jeffrey M. Gillberg ,  Ren Zhou ,  Kenneth M. Anderson ,  D. Curtis Deno ,  Glenn C. Zillmer ,  Ruth N. Klepfer ,  Vincent E. Splett ,  David E. Euler ,  Lawrence J. Mulligan ,  Edwin G. Duffin ,  David A. Igel ,  John E. Burnes

IPC分类号： A61N1/365 ,  A61N1/368 ,  A61N1/362 ,  A61N1/36 ,  A61N1/39

CPC分类号： A61N1/3627 ,  A61N1/36114 ,  A61N1/36521 ,  A61N1/36564 ,  A61N1/36578 ,  A61N1/36585 ,  A61N1/3684 ,  A61N1/3962

摘要： A method of stimulation therapy and an apparatus for providing the therapy which addresses cardiac dysfunction including heart failure. The therapy employs atrial pacing pulses delivered to a heart after the atrial refractory period and timed so that they will not cause a ventricular contraction. These atrial pacing are timed to achieve beneficial effects on myocardial mechanics (efficacy) while maintaining an extremely low level of risk of arrhythmia induction. These methods may be employed individually or in combinations in an external or implantable ESS therapy delivery device.

摘要翻译： 刺激疗法的方法和用于提供包括心力衰竭在内的心脏功能障碍的治疗的装置。 该疗法使用心房起搏脉搏在心房不应期后输送到心脏并且定时，使得它们不会引起心室收缩。 这些心房起搏的时间是为了获得对心肌力学（功效）的有益影响，同时保持心律失常诱导的极低水平的风险。 这些方法可以在外部或可植入的ESS治疗递送装置中单独使用或组合使用。