公开(公告)号：US20100137926A1

公开(公告)日：2010-06-03

申请号：US12697971

申请日：2010-02-01

申请人： Gary W. King ,  Robert Leinders ,  Greg Hrdlicka ,  Michael D. Baudino

发明人： Gary W. King ,  Robert Leinders ,  Greg Hrdlicka ,  Michael D. Baudino

IPC分类号： A61N1/08

CPC分类号： A61N1/36164 ,  A61N1/0531 ,  A61N1/0534 ,  A61N1/0551 ,  A61N1/36017 ,  A61N1/36071 ,  A61N1/36167

摘要： The locus of electrically excitable tissue where action potentials are induced can be controlled using the physiological principle of electrotonus. In one embodiment, first and second pulses are applied to first and second electrodes, respectively, to generate first and second subthreshold potential areas, respectively, within the tissue. The locus within the tissue where action potentials are induced is determined by a superposition of the first and second subthreshold areas according to the physiological principle of electrotonus. In another embodiment, a two-dimensional array of electrodes are formed. The cathode may be positioned near the center of the two-dimensional array or may be left out. The first and second subthreshold areas may thereby be steered. An array of anodal rings may be used to contain the field of excitation.

摘要翻译： 诱导动作电位的电可激发组织的位置可以使用电渗的生理原理进行控制。 在一个实施例中，分别将第一和第二脉冲施加到第一和第二电极，以在组织内分别产生第一和第二亚阈值电位区域。 通过根据电生理原理的第一和第二亚阈值区域的叠加来确定在组织内产生动作电位的位点。 在另一个实施例中，形成二维电极阵列。 阴极可以位于二维阵列的中心附近，或者可以被排除。 从而可以控制第一和第二亚阈值区域。 阳极环阵列可用于包含激发场。

公开(公告)号：US07657318B2

公开(公告)日：2010-02-02

申请号：US11273310

申请日：2005-11-14

申请人： Gary W. King ,  Robert Leinders ,  Greg Hrdlicka ,  Michael D. Baudino

发明人： Gary W. King ,  Robert Leinders ,  Greg Hrdlicka ,  Michael D. Baudino

IPC分类号： A61N1/36

CPC分类号： A61N1/36164 ,  A61N1/0531 ,  A61N1/0534 ,  A61N1/0551 ,  A61N1/36017 ,  A61N1/36071 ,  A61N1/36167

摘要： The locus of electrically excitable tissue where action potentials are induced can be controlled using the physiological principle of electrotonus. In one embodiment, first and second pulses are applied to first and second electrodes, respectively, to generate first and second subthreshold potential areas, respectively, within the tissue. The locus within the tissue where action potentials are induced is determined by a superposition of the first and second subthreshold areas according to the physiological principle of electrotonus. In another embodiment, a two-dimensional array of electrodes are formed. The cathode may be positioned near the center of the two-dimensional array or may be left out. The first and second subthreshold areas may thereby be steered. An array of anodal rings may be used to contain the field of excitation.

摘要翻译： 诱导动作电位的电可激发组织的位置可以使用电渗的生理原理进行控制。 在一个实施例中，分别将第一和第二脉冲施加到第一和第二电极，以在组织内分别产生第一和第二亚阈值电位区域。 通过根据电生理原理的第一和第二亚阈值区域的叠加来确定在组织内产生动作电位的位点。 在另一个实施例中，形成二维电极阵列。 阴极可以位于二维阵列的中心附近，或者可以被排除。 从而可以控制第一和第二亚阈值区域。 阳极环阵列可用于包含激发场。

公开(公告)号：US06505078B1

公开(公告)日：2003-01-07

申请号：US09523072

申请日：2000-03-10

申请人： Gary W. King ,  Robert Leinders ,  Greg Hrdlicka ,  Michael D. Baudino

发明人： Gary W. King ,  Robert Leinders ,  Greg Hrdlicka ,  Michael D. Baudino

IPC分类号： A61N136

CPC分类号： A61N1/36164 ,  A61N1/0531 ,  A61N1/0534 ,  A61N1/0551 ,  A61N1/36017 ,  A61N1/36071 ,  A61N1/36167

摘要： The locus of electrically excitable tissue where action potentials are induced can be controlled using the physiological principle of electrotonus. In one embodiment, first and second pulses are applied to first and second electrodes, respectively, to generate first and second subthreshold potential areas, respectively, within the tissue. The locus within the tissue where action potentials are induced is determined by a superposition of the first and second subthreshold areas according to the physiological principle of electrotonus. In another embodiment, a two-dimensional array of electrodes are formed. The cathode may be positioned near the center of the two-dimensional array or may be left out. The first and second subthreshold areas may thereby be steered. An array of anodal rings may be used to contain the field of excitation.

公开(公告)号：US20060079937A1

公开(公告)日：2006-04-13

申请号：US11273310

申请日：2005-11-14

申请人： Gary King ,  Robert Leinders ,  Greg Hrdlicka ,  Michael Baudino

发明人： Gary King ,  Robert Leinders ,  Greg Hrdlicka ,  Michael Baudino

IPC分类号： A61N1/32 ,  A61N1/00

CPC分类号： A61N1/36164 ,  A61N1/0531 ,  A61N1/0534 ,  A61N1/0551 ,  A61N1/36017 ,  A61N1/36071 ,  A61N1/36167

摘要： The locus of electrically excitable tissue where action potentials are induced can be controlled using the physiological principle of electrotonus. In one embodiment, first and second pulses are applied to first and second electrodes, respectively, to generate first and second subthreshold potential areas, respectively, within the tissue. The locus within the tissue where action potentials are induced is determined by a superposition of the first and second subthreshold areas according to the physiological principle of electrotonus. In another embodiment, a two-dimensional array of electrodes are formed. The cathode may be positioned near the center of the two-dimensional array or may be left out. The first and second subthreshold areas may thereby be steered. An array of anodal rings may be used to contain the field of excitation.

公开(公告)号：US20050240244A1

公开(公告)日：2005-10-27

申请号：US11170497

申请日：2005-06-29

申请人： Robert Leinders ,  Nathan Torgerson ,  Marc Stein ,  Todd Goblish ,  Todd Heathershaw ,  John Rodriguez

发明人： Robert Leinders ,  Nathan Torgerson ,  Marc Stein ,  Todd Goblish ,  Todd Heathershaw ,  John Rodriguez

IPC分类号： A61N1/05 ,  A61N1/34 ,  A61N1/18

CPC分类号： A61N1/36071

摘要： Apparatus and method for independently delivering a plurality of therapy programs in an implantable medical device. A therapy controller configures the device to generate independent pulse trains associated with a plurality of therapy programs and dynamically configures the electrodes to deliver the independent pulse trains to the patient. Once configured, the implantable medical device delivers the plurality of therapy programs to the patient wherein the therapy programs may overlap in time.

摘要翻译： 用于在可植入医疗装置中独立地递送多个治疗程序的装置和方法。 治疗控制器配置该装置以产生与多个治疗程序相关联的独立脉冲序列，并且动态地配置电极以将独立的脉冲序列传递给患者。 一旦配置，可植入医疗装置将多个治疗程序递送到患者，其中治疗程序可能在时间上重叠。

公开(公告)号：US06937891B2

公开(公告)日：2005-08-30

申请号：US10133884

申请日：2002-04-26

申请人： Robert Leinders ,  Nathan A. Torgerson ,  Marc Stein ,  Todd P. Goblish ,  Todd D. Heathershaw ,  John Delfin Rodriguez

发明人： Robert Leinders ,  Nathan A. Torgerson ,  Marc Stein ,  Todd P. Goblish ,  Todd D. Heathershaw ,  John Delfin Rodriguez

IPC分类号： A61N1/05 ,  A61N1/34 ,  A61N1/18

CPC分类号： A61N1/36071

摘要： Apparatus and method for independently delivering a plurality of therapy programs in an implantable medical device. A therapy controller configures the device to generate independent pulse trains associated with a plurality of therapy programs and dynamically configures the electrodes to deliver the independent pulse trains to the patient. Once configured, the implantable medical device delivers the plurality of therapy programs to the patient wherein the therapy programs may overlap in time.

公开(公告)号：US06238420B1

公开(公告)日：2001-05-29

申请号：US09564036

申请日：2000-05-04

申请人： Arnoldus Bakels ,  Robert Leinders ,  Cobus de Roos

发明人： Arnoldus Bakels ,  Robert Leinders ,  Cobus de Roos

IPC分类号： A61N1368

CPC分类号： A61N1/36521 ,  A61N1/3622 ,  A61N1/3627 ,  A61N1/368 ,  A61N1/3682

摘要： A pacing system and method for providing multiple chamber pacing of a patient's heart, and in particular, pacing programmed for treatment of various forms of heart failure. The system utilizes impedance sensing for determining optimum pacing parameters, e.g., for pacing the left ventricle so that left heart output is maximized. The impedance sensing also is used for determination of arrhythmias or progression of heart failure. Impedance sensing is provided for between selected pairs of the four chambers, to enable optimizing of information for control and diagnosis. In a preferred embodiment of the invention, impedance measurements are obtained for determining the timing of right heart valve closure or right ventricular contractions, and the timing of delivery of left ventricular pace pulses is adjusted so as to optimally synchronize left ventricular pacing with the right ventricular contractions. Impedance sensing in the left heart also provides timing of mechanical contraction, and the pacemaker controls pacing to maintain bi-ventricular mechanical synchronization adjusted for maximum cardiac output.

摘要翻译： 用于提供患者心脏的多个室起搏的起搏系统和方法，特别是针对治疗各种形式的心力衰竭的起搏。 系统利用阻抗感测来确定最佳起搏参数，例如用于起搏左心室，使得左心输出最大化。 阻抗检测也用于确定心律失常或心力衰竭进展。 在四个室的选定对之间提供阻抗感测，以实现用于控制和诊断的信息的优化。 在本发明的优选实施例中，获得用于确定右心瓣膜闭合或右心室收缩的时间的阻抗测量值，并且调节左心室起搏脉冲的传递时间，以便最佳地同步左心室起搏与右心室 收缩。 心脏中的阻抗传感还提供机械收缩的时机，并且起搏器控制起搏以维持双心室机械同步，以调节最大心输出量。

公开(公告)号：US06219579B1

公开(公告)日：2001-04-17

申请号：US09493690

申请日：2000-01-28

申请人： Arnoldus Bakels ,  Robert Leinders ,  Cobus de Roos

发明人： Arnoldus Bakels ,  Robert Leinders ,  Cobus de Roos

IPC分类号： A61N1365

CPC分类号： A61N1/36521 ,  A61N1/3622 ,  A61N1/3627 ,  A61N1/368 ,  A61N1/3682

摘要： A pacing system and method for providing multiple chamber pacing of a patient's heart, and in particular, pacing programmed for treatment of various forms of heart failure. The system utilizes impedance sensing for determining optimum pacing parameters, e.g., for pacing the left ventricle so that left heart output is maximized. The impedance sensing also is used for determination of arrhythmias or progression of heart failure. Impedance sensing is provided for between selected pairs of the four chambers, to enable optimizing of information for control and diagnosis. In a preferred embodiment, impedance measurements are obtained for determining the timing of right heart valve closure or right ventricular contractions, and the timing of delivery of left ventricular pace pulses is adjusted so as to optimally synchronize left ventricular pacing with the right ventricular contractions. Impedance sensing in the left heart also provides timing of mechanical contraction, and the pacemaker controls pacing to maintain bi-ventricular mechanical synchronization adjusted for maximum cardiac output.

摘要翻译： 用于提供患者心脏的多个室起搏的起搏系统和方法，特别是针对治疗各种形式的心力衰竭的起搏。 系统利用阻抗感测来确定最佳起搏参数，例如用于起搏左心室，使得左心输出最大化。 阻抗检测也用于确定心律失常或心力衰竭进展。 在四个室的选定对之间提供阻抗感测，以实现用于控制和诊断的信息的优化。 在优选实施例中，获得用于确定右心瓣膜闭合或右心室收缩的时机的阻抗测量值，并且调节左心室起搏脉冲的传送时间，以便使左心室起搏与右心室收缩最佳地同步。 心脏中的阻抗传感还提供机械收缩的时机，并且起搏器控制起搏以维持双心室机械同步，以调节最大心输出量。

公开(公告)号：US20090259278A1

公开(公告)日：2009-10-15

申请号：US12359958

申请日：2009-01-26

申请人： Nathan A. Torgerson ,  Robert Leinders ,  Marc Stein ,  Todd P. Goblish ,  Todd D. Heathershaw ,  John Delfin Rodriguez

发明人： Nathan A. Torgerson ,  Robert Leinders ,  Marc Stein ,  Todd P. Goblish ,  Todd D. Heathershaw ,  John Delfin Rodriguez

IPC分类号： A61N1/36

CPC分类号： A61N1/36125

摘要： Apparatus and method provide flexibility in generating a stimulation waveform to an electrode of an Implantable Neuro Stimulator (INS). The stimulation waveform is synthesized for each rate period interval. Each rate period interval is partitioned into time intervals, during which stimulation pulses, recharging, and time duration delays may be induced. With the embodiment of the invention, a second stimulation pulse, having different electrical characteristics than a first stimulation pulse, may be generated during the rate period interval. An embodiment utilizes apparatus comprising a waveform controller and a waveform generator that are controlled by the waveform controller. The waveform controller uses waveform parameters to instruct the waveform generator to form stimulation pulses. Any of the components may be adjusted or deleted in the generation of the stimulation waveform. The embodiment enables any of the associated waveform parameters to be updated at the waveform controller in order to alter the stimulation waveform.

摘要翻译： 装置和方法提供了向植入式神经刺激器（INS）的电极产生刺激波形的灵活性。 针对每个速率周期间隔合成刺激波形。 每个速率周期间隔被划分成时间间隔，在此时间间隔期间可以诱发刺激脉冲，再充电和持续时间延迟。 利用本发明的实施例，可以在速率周期间隔期间产生具有与第一刺激脉冲不同的电特性的第二刺激脉冲。 实施例利用由波形控制器控制的波形控制器和波形发生器的装置。 波形控制器使用波形参数来指示波形发生器形成刺激脉冲。 可以在产生刺激波形时调整或删除任何组件。 该实施例使得能够在波形控制器处更新相关联的波形参数，以便改变刺激波形。

公开(公告)号：US06754530B2

公开(公告)日：2004-06-22

申请号：US09946495

申请日：2001-09-06

申请人： Arnoldus Bakels ,  Robert Leinders ,  Cobus de Roos

发明人： Arnoldus Bakels ,  Robert Leinders ,  Cobus de Roos

IPC分类号： A61N1365

CPC分类号： A61N1/36521 ,  A61N1/3622 ,  A61N1/3627 ,  A61N1/368 ,  A61N1/3682

摘要： A pacing system and method for providing multiple chamber pacing of a patient's heart, and in particular, pacing programmed for treatment of various forms of heart failure. The system utilizes impedance sensing for determining optimum pacing parameters, e.g., for pacing the left ventricle so that left heart output is maximized. The impedance sensing also is used for determination of arrhythmias or progression of heart failure. Impedance sensing is provided for between selected pairs of the four chambers, to enable optimizing of information for control and diagnosis. In a preferred embodiment of the invention, impedance measurements are obtained for determining the timing of right heart valve closure or right ventricular contractions, and the timing of delivery of left ventricular pace pulses is adjusted so as to optimally synchronize left ventricular pacing with the right ventricular contractions. Impedance sensing in the left heart also provides timing of mechanical contraction, and the pacemaker controls pacing to maintain bi-ventricular mechanical synchronization adjusted for maximum cardiac output.

摘要翻译： 用于提供患者心脏的多个室起搏的起搏系统和方法，特别是针对治疗各种形式的心力衰竭的起搏。 系统利用阻抗感测来确定最佳起搏参数，例如用于起搏左心室，使得左心输出最大化。 阻抗检测也用于确定心律失常或心力衰竭进展。 在四个室的选定对之间提供阻抗感测，以实现用于控制和诊断的信息的优化。 在本发明的优选实施例中，获得用于确定右心瓣膜闭合或右心室收缩的时间的阻抗测量值，并且调节左心室起搏脉冲的传递时间，以便最佳地同步左心室起搏与右心室 收缩。 心脏中的阻抗传感还提供机械收缩的时机，并且起搏器控制起搏以维持双心室机械同步，以调节最大心输出量。