公开(公告)号：US5065759A

公开(公告)日：1991-11-19

申请号：US575289

申请日：1990-08-30

申请人： Malcolm J. S. Begemann ,  Bernhard de Vries ,  Johannes S. van der Veen

发明人： Malcolm J. S. Begemann ,  Bernhard de Vries ,  Johannes S. van der Veen

IPC分类号： A61N1/365

CPC分类号： A61N1/36585

摘要： A pacemaker system is provided for rate responsive pacing, wherein rate is controlled as a function of two or more sensor inputs, each sensor providing a signal representing a respective different control parameter. Preferably a first sensor signal represents a physiologically accurate although slow response signal such as OT interval, and a second sensor represents a relatively fast response such as activity. The two parameter signals are processed so that they are directly comparable and can be compared as indicators of pacing rate throughout the desired pacing range. The algorithm utilizes a parameter control reference curve for each respective parameter, such reference curve representing the desired correlation between pacing rate and the parameter signal. Rate control is accomplished by determining the difference between each processed parameter signal and its corresponding reference point for the current pacing interval, and logically analyzing the two differences to determine which is used to indicate change in pacing rate. Each parameter reference curve is automatically adjustable to correspond to patient conditions. Automatic drift correction of the fast response parameter, such as activity, is used to compensate for conditions where the fast response signal is not likely to be physiologically reflective of the patient condition.

摘要翻译： 提供了一种用于速率响应起搏的起搏器系统，其中速率被控制为两个或更多个传感器输入的函数，每个传感器提供表示相应不同控制参数的信号。 优选地，第一传感器信号表示生理上准确的但是响应速度慢的信号，例如OT间隔，第二传感器表示诸如活动的相对快速的响应。 两个参数信号被处理，使得它们是直接可比较的，并且可以作为整个期望起搏范围的起搏速度的指标进行比较。 该算法对每个相应的参数使用参数控制参考曲线，这种参考曲线表示起搏速率和参数信号之间的期望相关性。 速率控制通过确定每个处理的参数信号与其当前起搏间隔的对应参考点之间的差异来完成，并且逻辑分析两个差异以确定哪个用于指示起搏速率的改变。 每个参数参考曲线可自动调节，以对应于患者状况。 快速响应参数（如活动）的自动漂移校正被用于补偿快速响应信号不太可能在生理上反映患者状况的情况。

公开(公告)号：US07590448B2

公开(公告)日：2009-09-15

申请号：US11380246

申请日：2006-04-26

申请人： Bernhard de Vries

发明人： Bernhard de Vries

IPC分类号： A61N1/362

CPC分类号： A61N1/3622 ,  A61N1/3684

摘要： A multi-site atrial pacemaker capable of delivering pacing pulses to one location synchronized to sensed or paced atrial depolarizations on another location and a method of its use. A defined interval is defined following atrial depolarizations during which such synchronized atrial pacing pulses may not be delivered. The pacemaker automatically adjusts the duration of the defined interval to produce a minimum level of induced tachyarrhythmias. Generally, this desired result is accomplished by measuring coupling intervals of PACs, monitoring occurrences of atrial tachyarrhythmias associated with PACs and adjusting the defined interval accordingly.

摘要翻译： 多站立心房起搏器能够将起搏脉冲发送到与其他位置的感觉或起搏心房去极化同步的一个位置及其使用方法。 定义的间隔在心房去极化之后定义，在此期间可能不能传送这种同步的心房起搏脉冲。 起搏器自动调整定义间隔的持续时间，以产生诱发的快速性心律失常的最低水平。 通常，通过测量PAC的耦合间隔，监测与PAC相关联的心房快速性心律失常的发生并相应地调整所定义的间隔来实现该期望的结果。

公开(公告)号：US5991659A

公开(公告)日：1999-11-23

申请号：US164012

申请日：1998-09-30

申请人： Bernhard de Vries ,  Hendrik Reineman ,  Johannes G. F. Idink ,  Hendrik van Rooijen

发明人： Bernhard de Vries ,  Hendrik Reineman ,  Johannes G. F. Idink ,  Hendrik van Rooijen

IPC分类号： A61N1/368

CPC分类号： A61N1/368

摘要： There is provided a pacemaker system with an SRD detection and intervention feature, which enables a simple way of initiating confirmation of SRD, i.e., looking for an AS/AP transition in a DDD or DDI pacemaker, or a transition from a VS to a VP in a DDI pacemaker. This simple initiation of SRD confirmation is made possible by use of a relatively wide hysteresis band which is normally operative when a spontaneous rate is present, and which tracks physiological changes in the patient's natural rate, across the pacemaker rate range. Transitions which result from a gradual decrease in natural rate and thus represent physiological bradycardia are not interpreted as suggesting SRD. The detection is confirmed only after a predetermined number of pace pulses are delivered at the hysteresis rate, i.e., 1-5 pulses. In a preferred embodiment, after confirmation of SRD, pacing starts at a programmable intervention rate, and rate flywheels downward toward a lower rate limit, with intermittent hysteresis scans at a lower rate to enable recovery of an underlying natural rate. The SRD mode is left whenever recovery of a natural rate is confirmed, as by sensing a predetermined number of consecutive natural atrial beats in DDD mode or atrial and/or ventricular beats in DDI mode.

摘要翻译： 提供了具有SRD检测和干预功能的起搏器系统，其使得能够简单地启动SRD的确认，即寻找DDD或DDI起搏器中的AS / AP转换，或从VS到VP的转换 在DDI起搏器。 SRD确认的这种简单的启动是通过使用相对宽的滞后带来实现的，该磁滞带通常在存在自发速率时起作用，并且跟踪起搏器速率范围内的患者的自然率的生理变化。 由于自然率逐渐降低并因此代表生理性心动过缓而产生的转变不被解释为表明SRD。 只有在以滞后率（即1-5个脉冲）传送预定数量的起搏脉冲之后才能确认检测。 在优选实施例中，在确认SRD之后，起搏以可编程的干预率开始，并且速率向下飞向较低的速率限制，间歇性滞后扫描以较低的速率扫描，以恢复潜在的自然率。 如果通过在DDI模式中感测预定数量的DDD模式中的连续天然心房搏动或心房和/或心室搏动来确认自然率的恢复，则SRD模式是残留的。

公开(公告)号：US20070255325A1

公开(公告)日：2007-11-01

申请号：US11380246

申请日：2006-04-26

申请人： Bernhard de Vries

发明人： Bernhard de Vries

IPC分类号： A61N1/00

CPC分类号： A61N1/3622 ,  A61N1/3684

摘要： A multi-site atrial pacemaker capable of delivering pacing pulses to one location synchronized to sensed or paced atrial depolarizations on another location and a method of its use. A defined interval is defined following atrial depolarizations during which such synchronized atrial pacing pulses may not be delivered. The pacemaker automatically adjusts the duration of the defined interval to produce a minimum level of induced tachyarrhythmias. Generally, this desired result is accomplished by measuring coupling intervals of PACs, monitoring occurrences of atrial tachyarrhythmias associated with PACs and adjusting the defined interval accordingly.

摘要翻译： 多站立心房起搏器能够将起搏脉冲发送到与其他位置的感觉或起搏心房去极化同步的一个位置及其使用方法。 定义的间隔在心房去极化之后定义，在此期间可能不能传送这种同步的心房起搏脉冲。 起搏器自动调整定义间隔的持续时间，以产生诱发的快速性心律失常的最低水平。 通常，通过测量PAC的耦合间隔，监测与PAC相关联的心房快速性心律失常的发生并相应地调整所定义的间隔来实现该期望的结果。

公开(公告)号：US06721599B2

公开(公告)日：2004-04-13

申请号：US09987778

申请日：2001-11-16

申请人： Bernhard de Vries

发明人： Bernhard de Vries

IPC分类号： A61N1365

CPC分类号： A61N1/365

摘要： The invention provides an implantable medical device system and method for determining when a patient is undergoing a sudden rate drop (SRD) that should be treated by intervention therapy. Two SRD detection algorithms are provided. A first algorithm is a rate-based algorithm that looks for rate drops that meet stored SRD criteria, and a second algorithm is a QT-based algorithm that detects when QT variations meet criteria that are associated with rate changes characteristic of onset of NMS. The system provides for a plurality of different intervention pacing therapies that are selected based on which detection algorithm, or both algorithms, indicate SRD. The priority of choice of algorithms is programmable.

摘要翻译： 本发明提供了一种可植入医疗装置系统和方法，用于确定患者何时正在经历应该通过干预治疗治疗的突然的速率下降（SRD）。 提供两种SRD检测算法。 第一种算法是基于速率的算法，其寻找满足存储的SRD标准的速率下降，第二种算法是基于QT的算法，其检测何时QT变化满足与NMS发作特征的速率变化相关的标准。 该系统提供了多种不同的介入起搏疗法，其基于哪种检测算法或两种算法指示SRD来选择。 算法的优先选择是可编程的。