公开(公告)号：US08615296B2

公开(公告)日：2013-12-24

申请号：US11682448

申请日：2007-03-06

申请人： Joseph M. Pastore ,  Tamara Colette Baynham ,  Donald L. Hopper ,  Allan C. Shuros ,  Shantha Arcot-Krishnamurthy

发明人： Joseph M. Pastore ,  Tamara Colette Baynham ,  Donald L. Hopper ,  Allan C. Shuros ,  Shantha Arcot-Krishnamurthy

IPC分类号： A61N1/362

CPC分类号： A61N1/3627 ,  A61N1/36514 ,  A61N1/36521 ,  A61N1/36585

摘要： A cardiac pacing system controls the progression of a cardiac disorder such as heart failure by delivering cardiac pacing to create or augment regional stress in the heart. The cardiac pacing is delivered intermittently, such as on a periodic basis, according to a cardiac stress augmentation pacing sequence that includes alternating pacing and non-pacing periods. One or more physiological signals are monitored for closed-loop control of the cardiac pacing using baseline characteristics of the cardiac disorder, acute cardiac stress created by the cardiac pacing, and/or risk associated with the cardiac pacing.

摘要翻译： 心脏起搏系统通过递送心脏起搏来创建或增加心脏中的区域应力来控制心脏病症如心力衰竭的进展。 根据包括交替起搏和非起搏期的心脏应激增加起搏序列，间歇地递送心脏起搏，例如周期性地起搏。 使用心脏病症的基线特征，由心脏起搏产生的急性心脏应激和/或与心脏起搏相关的风险来监测一个或多个生理信号用于心脏起搏的闭环控制。

公开(公告)号：US20080221636A1

公开(公告)日：2008-09-11

申请号：US11682448

申请日：2007-03-06

申请人： Joseph M. Pastore ,  Tamara Colette Baynham ,  Donald L. Hopper ,  Allan C. Shuros ,  Shantha Arcot-Krishnamurthy

发明人： Joseph M. Pastore ,  Tamara Colette Baynham ,  Donald L. Hopper ,  Allan C. Shuros ,  Shantha Arcot-Krishnamurthy

IPC分类号： A61N1/365

CPC分类号： A61N1/3627 ,  A61N1/36514 ,  A61N1/36521 ,  A61N1/36585

摘要： A cardiac pacing system controls the progression of a cardiac disorder such as heart failure by delivering cardiac pacing to create or augment regional stress in the heart. The cardiac pacing is delivered intermittently, such as on a periodic basis, according to a cardiac stress augmentation pacing sequence that includes alternating pacing and non-pacing periods. One or more physiological signals are monitored for closed-loop control of the cardiac pacing using baseline characteristics of the cardiac disorder, acute cardiac stress created by the cardiac pacing, and/or risk associated with the cardiac pacing.

摘要翻译： 心脏起搏系统通过递送心脏起搏来创建或增加心脏中的区域应力来控制心脏病症如心力衰竭的进展。 根据包括交替起搏和非起搏期的心脏应激增加起搏序列，间歇地递送心脏起搏，例如周期性地起搏。 使用心脏病症的基线特征，由心脏起搏产生的急性心脏应激和/或与心脏起搏相关的风险来监测一个或多个生理信号用于心脏起搏的闭环控制。

公开(公告)号：US20100049270A1

公开(公告)日：2010-02-25

申请号：US12535407

申请日：2009-08-04

申请人： Joseph M. Pastore ,  Shantha Arcot-Krishnamurthy ,  Robert Shipley ,  Allan C. Shuros

发明人： Joseph M. Pastore ,  Shantha Arcot-Krishnamurthy ,  Robert Shipley ,  Allan C. Shuros

IPC分类号： A61N1/365

CPC分类号： A61N1/3627 ,  A61N1/36521 ,  A61N1/36564 ,  A61N1/36578 ,  A61N1/36592 ,  A61N1/3688

摘要： A device and method for delivering electrical stimulation to the heart in order to improve cardiac function in heart failure patients. The stimulation is delivered as high-output pacing in which the stimulation is excitatory and also of sufficient energy to augment myocardial contractility. The device may be configured to deliver high-output pacing upon detection of cardiac decompensation.

摘要翻译： 用于向心脏递送电刺激以改善心力衰竭患者的心脏功能的装置和方法。 刺激作为高产出起搏，其中刺激是兴奋性的，并且具有足够的能量以增加心肌收缩力。 该装置可以被配置为在检测到心脏代偿失调时递送高输出起搏。

公开(公告)号：US08886306B2

公开(公告)日：2014-11-11

申请号：US12535407

申请日：2009-08-04

申请人： Joseph M. Pastore ,  Shantha Arcot-Krishnamurthy ,  Robert Shipley ,  Allan C. Shuros

发明人： Joseph M. Pastore ,  Shantha Arcot-Krishnamurthy ,  Robert Shipley ,  Allan C. Shuros

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

CPC分类号： A61N1/3627 ,  A61N1/36521 ,  A61N1/36564 ,  A61N1/36578 ,  A61N1/36592 ,  A61N1/3688

摘要： A device and method for delivering electrical stimulation to the heart in order to improve cardiac function in heart failure patients. The stimulation is delivered as high-output pacing in which the stimulation is excitatory and also of sufficient energy to augment myocardial contractility. The device may be configured to deliver high-output pacing upon detection of cardiac decompensation.

摘要翻译： 用于向心脏递送电刺激以改善心力衰竭患者的心脏功能的装置和方法。 刺激作为高产出起搏，其中刺激是兴奋性的，并且具有足够的能量以增加心肌收缩力。 该装置可以被配置为在检测到心脏代偿失调时递送高输出起搏。

公开(公告)号：US20100016916A1

公开(公告)日：2010-01-21

申请号：US12504593

申请日：2009-07-16

申请人： Shantha Arcot-Krishnamurthy ,  Joseph M. Pastore ,  Allan C. Shuros ,  Scott A. Meyer ,  Robert Shipley ,  Jason J. Hamann

发明人： Shantha Arcot-Krishnamurthy ,  Joseph M. Pastore ,  Allan C. Shuros ,  Scott A. Meyer ,  Robert Shipley ,  Jason J. Hamann

IPC分类号： A61N1/368

CPC分类号： A61N1/36564 ,  A61N1/36528 ,  A61N1/36571 ,  A61N1/368

摘要： A pacing system delivers cardiac protective pacing therapy (CPPT) to protect the heart from injuries and/or to treat existing injuries. The pacing system receives a set of inputs and delivers optimized cardiac protection pacing tailored for different purposes. The system delivers electrical stimulation to modulate myocardial strain for anti-atherosclerosis therapy and/or to provide therapy for myocardial infarction (MI). In one embodiment, a medical device for treating atherosclerosis is provided. The medical device includes a sensing circuit to receive sensed signals to identify areas of coronary artery disease (CAD) or areas at risk for CAD using the sensed signals. The device also includes a pacemaker circuit adapted to deliver an electrical signal through at least one electrode to a myocardial target adjacent to the identified areas. According to various embodiments, a controller communicates with the sensing circuit and controls the pacemaker circuit to provide intermittent electrical stimulation to the myocardial target to induce periods of stretch on the vessel due to induce myocardial strain changes. The stimulation is targeted to attenuate or prevent atherosclerosis associated with the CAD, according to various embodiments.

摘要翻译： 起搏系统提供心脏保护起搏治疗（CPPT），以保护心脏免受伤害和/或治疗现有的伤害。 起搏系统接收一组输入，并为不同目的提供优化的心脏保护起搏。 该系统提供电刺激以调节用于抗动脉粥样硬化治疗的心肌应变和/或提供心肌梗塞（MI）治疗。 在一个实施方案中，提供了用于治疗动脉粥样硬化的医疗装置。 医疗设备包括感测电路，用于接收感测到的信号，以使用感测到的信号来识别冠状动脉疾病（CAD）或CAD风险区域。 该装置还包括起搏器电路，其适于将电信号通过至少一个电极传递到与所识别的区域相邻的心肌靶。 根据各种实施例，控制器与感测电路通信并控制起搏器电路，以向心肌靶标提供间歇性电刺激，以诱导由于诱发心肌应变变化而在血管上延伸的时间段。 根据各种实施方案，刺激旨在减弱或预防与CAD相关的动脉粥样硬化。

公开(公告)号：US20090192560A1

公开(公告)日：2009-07-30

申请号：US12361353

申请日：2009-01-28

申请人： Shantha Arcot-Krishnamurthy ,  John R. Zielinski ,  Joseph M. Pastore ,  Jeffrey E. Stahmann ,  Allan C. Shuros ,  Robert Shipley

发明人： Shantha Arcot-Krishnamurthy ,  John R. Zielinski ,  Joseph M. Pastore ,  Jeffrey E. Stahmann ,  Allan C. Shuros ,  Robert Shipley

IPC分类号： A61N1/365

CPC分类号： A61N1/3627 ,  A61N1/3688

摘要： This document discusses, among other things, an apparatus comprising at least one implantable cardiac depolarization sensing circuit, an electrical stimulation circuit, and a pacing mode controller. The implantable cardiac depolarization sensing circuit is configured to obtain a sensed depolarization signal from a ventricle and the electrical stimulation circuit is configured to provide pacing electrical stimulation energy to at least one implantable ventricular electrode. The pacing mode controller delivers pacing therapy according to a first pacing mode that is a normal operating mode, and delivers pacing therapy according to second and third pacing modes. The second and third pacing modes increase mechanical stress on at least a particular portion of the ventricle as compared to the pacing therapy delivered during the first pacing mode. The pacing mode controller alternates between the second and third pacing modes when switched from the normal operating mode to a stress augmentation mode.

摘要翻译： 本文件尤其涉及包括至少一个可植入心脏去极化感测电路，电刺激电路和起搏模式控制器的装置。 可植入心脏去极化感测电路被配置为从心室获得感测的去极化信号，并且电刺激电路被配置为向至少一个可植入心室电极提供起搏电刺激能量。 起搏模式控制器按照正常运行模式的第一起搏模式提供起搏治疗，并根据第二和第三起搏模式提供起搏治疗。 与在第一起搏模式期间递送的起搏治疗相比，第二和第三起搏模式增加至少在心室的特定部分上的机械应力。 当从正常操作模式切换到应力增强模式时，起搏模式控制器在第二和第三起搏模式之间交替。

公开(公告)号：US08483826B2

公开(公告)日：2013-07-09

申请号：US12405990

申请日：2009-03-17

申请人： John R. Zielinski ,  Shantha Arcot-Krishnamurthy ,  Joseph M. Pastore ,  Jeffrey E. Stahmann ,  Allan C. Shuros

发明人： John R. Zielinski ,  Shantha Arcot-Krishnamurthy ,  Joseph M. Pastore ,  Jeffrey E. Stahmann ,  Allan C. Shuros

IPC分类号： A61N1/00

CPC分类号： A61N1/3627 ,  A61N1/368 ,  A61N1/3688 ,  A61N1/3962

摘要： This document discusses, among other things, an apparatus comprising an implantable cardiac depolarization sensing circuit, an electrical stimulation circuit, and a pacing mode controller. The pacing mode controller is configured to deliver pacing therapy according to a first pacing mode that is a normal operating mode, and to deliver pacing therapy according to second and third pacing modes. The second and third pacing modes increase mechanical stress on at least a particular portion of the ventricle as compared to the pacing therapy delivered during the first pacing mode. The pacing mode controller alternates between the second and third pacing modes when pacing is changed from the normal operating mode to a stress augmentation mode. The pacing mode controller suspends the change from the normal operating mode to the stress augmentation mode when a condition to prevent the change is detected.

摘要翻译： 本文件尤其涉及包括可植入心脏去极化感测电路，电刺激电路和起搏模式控制器的装置。 起搏模式控制器被配置为根据作为正常操作模式的第一起搏模式提供起搏治疗，并且根据第二和第三起搏模式输送起搏治疗。 与在第一起搏模式期间递送的起搏治疗相比，第二和第三起搏模式增加至少在心室的特定部分上的机械应力。 当起搏从正常操作模式改变为应力增强模式时，起搏模式控制器在第二和第三起搏模式之间交替。 当检测到防止变化的条件时，起搏模式控制器将更改从正常操作模式暂停到应力增强模式。

公开(公告)号：US08140155B2

公开(公告)日：2012-03-20

申请号：US12401194

申请日：2009-03-10

申请人： John R. Zielinski ,  Shantha Arcot-Krishnamurthy ,  Joseph M. Pastore ,  Jeffrey E. Stahmann ,  Allan C. Shuros

发明人： John R. Zielinski ,  Shantha Arcot-Krishnamurthy ,  Joseph M. Pastore ,  Jeffrey E. Stahmann ,  Allan C. Shuros

IPC分类号： A61N1/362

CPC分类号： A61N1/3627 ,  A61N1/3688

摘要： This document discusses, among other things, an apparatus comprising an implantable cardiac depolarization sensing circuit, an electrical stimulation circuit, and a pacing mode controller. The pacing mode controller is configured to deliver pacing therapy according to a first pacing mode that is a normal operating mode, and to deliver pacing therapy according to second and third pacing modes. The second and third pacing modes increase mechanical stress on at least a particular portion of the ventricle as compared to the pacing therapy delivered during the first pacing mode. The pacing mode controller alternates between the second and third pacing modes when switched from the normal operating mode to a stress augmentation mode and stores a statistic related to the stress augmentation mode in a stress augmentation cycle memory area.

摘要翻译： 本文件尤其涉及包括可植入心脏去极化感测电路，电刺激电路和起搏模式控制器的装置。 起搏模式控制器被配置为根据作为正常操作模式的第一起搏模式提供起搏治疗，并且根据第二和第三起搏模式输送起搏治疗。 与在第一起搏模式期间递送的起搏治疗相比，第二和第三起搏模式增加至少在心室的特定部分上的机械应力。 当从正常操作模式切换到应力增强模式时，起搏模式控制器在第二和第三起搏模式之间交替，并将与应力增加模式相关的统计量存储在应力增加周期存储区域中。

公开(公告)号：US20090234416A1

公开(公告)日：2009-09-17

申请号：US12401194

申请日：2009-03-10

申请人： John R. Zielinski ,  Shantha Arcot-Krishnamurthy ,  Joseph M. Pastore ,  Jeffrey E. Stahmann ,  Allan C. Shuros

发明人： John R. Zielinski ,  Shantha Arcot-Krishnamurthy ,  Joseph M. Pastore ,  Jeffrey E. Stahmann ,  Allan C. Shuros

IPC分类号： A61N1/365

CPC分类号： A61N1/3627 ,  A61N1/3688

摘要： This document discusses, among other things, an apparatus comprising an implantable cardiac depolarization sensing circuit, an electrical stimulation circuit, and a pacing mode controller. The pacing mode controller is configured to deliver pacing therapy according to a first pacing mode that is a normal operating mode, and to deliver pacing therapy according to second and third pacing modes. The second and third pacing modes increase mechanical stress on at least a particular portion of the ventricle as compared to the pacing therapy delivered during the first pacing mode. The pacing mode controller alternates between the second and third pacing modes when switched from the normal operating mode to a stress augmentation mode and stores a statistic related to the stress augmentation mode in a stress augmentation cycle memory area.

摘要翻译： 本文件尤其涉及包括可植入心脏去极化感测电路，电刺激电路和起搏模式控制器的装置。 起搏模式控制器被配置为根据作为正常操作模式的第一起搏模式提供起搏治疗，并且根据第二和第三起搏模式输送起搏治疗。 与在第一起搏模式期间递送的起搏治疗相比，第二和第三起搏模式增加至少在心室的特定部分上的机械应力。 当从正常操作模式切换到应力增强模式时，起搏模式控制器在第二和第三起搏模式之间交替，并将与应力增加模式相关的统计量存储在应力增加周期存储区域中。

公开(公告)号：US08548586B2

公开(公告)日：2013-10-01

申请号：US12361353

申请日：2009-01-28

申请人： Shantha Arcot-Krishnamurthy ,  John R. Zielinski ,  Joseph M. Pastore ,  Jeffrey E. Stahmann ,  Allan C. Shuros ,  Robert Shipley

发明人： Shantha Arcot-Krishnamurthy ,  John R. Zielinski ,  Joseph M. Pastore ,  Jeffrey E. Stahmann ,  Allan C. Shuros ,  Robert Shipley

IPC分类号： A61N1/362

CPC分类号： A61N1/3627 ,  A61N1/3688

摘要： This document discusses, among other things, an apparatus comprising at least one implantable cardiac depolarization sensing circuit, an electrical stimulation circuit, and a pacing mode controller. The implantable cardiac depolarization sensing circuit is configured to obtain a sensed depolarization signal from a ventricle and the electrical stimulation circuit is configured to provide pacing electrical stimulation energy to at least one implantable ventricular electrode. The pacing mode controller delivers pacing therapy according to a first pacing mode that is a normal operating mode, and delivers pacing therapy according to second and third pacing modes. The second and third pacing modes increase mechanical stress on at least a particular portion of the ventricle as compared to the pacing therapy delivered during the first pacing mode. The pacing mode controller alternates between the second and third pacing modes when switched from the normal operating mode to a stress augmentation mode.

摘要翻译： 本文件尤其涉及包括至少一个可植入心脏去极化感测电路，电刺激电路和起搏模式控制器的装置。 可植入心脏去极化感测电路被配置为从心室获得感测的去极化信号，并且电刺激电路被配置为向至少一个可植入心室电极提供起搏电刺激能量。 起搏模式控制器按照正常运行模式的第一起搏模式提供起搏治疗，并根据第二和第三起搏模式提供起搏治疗。 与在第一起搏模式期间递送的起搏治疗相比，第二和第三起搏模式增加至少在心室的特定部分上的机械应力。 当从正常操作模式切换到应力增强模式时，起搏模式控制器在第二和第三起搏模式之间交替。