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公开(公告)号：US20100016913A1
公开(公告)日：2010-01-21
申请号：US12504602
申请日：2009-07-16
IPC分类号： A61N1/365
CPC分类号： A61N1/3627 , A61N1/3601 , A61N1/36528 , A61N1/36557 , A61N1/36564 , A61N1/36571 , A61N1/3684
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 each of different purposes. The system delivers electrical stimulation to provide therapy for angina and/or to provide therapy for co-morbidities related to neural imbalance. In one embodiment, a method for treating angina is provided. A signal is sensed indicative of an incidence of angina and an angina region being a myocardial region affected by the angina. The incidence of angina is detected and the angina region is located. A pacing location is selected remote from the angina region, and CPPT is initiated at the pacing location. The CPPT is adapted to create increased stress at the angina region, to promote mass-redistribution and angiogenesis at the angina region to treat the angina.
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，并提供针对不同目的量身定制的优化的心脏保护起搏。 该系统提供电刺激以提供心绞痛治疗和/或为与神经不平衡相关的并发症提供治疗。 在一个实施方案中，提供了治疗心绞痛的方法。 感测到的信号指示心绞痛的发生率，心绞痛区域是受心绞痛影响的心肌区域。 发现心绞痛发生，心绞痛区域位于。 从心绞痛区域选择起搏位置，并在起搏位置启动CPPT。 CPPT适应于在心绞痛区域产生增加的压力，以促进心绞痛区域的质量再分配和血管生成以治疗心绞痛。
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2.发明申请公开(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。
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公开(公告)号：US08401642B2
公开(公告)日：2013-03-19
申请号：US12537165
申请日：2009-08-06
IPC分类号： A61N1/00
CPC分类号： A61N1/36514 , A61N1/3627 , A61N1/36521 , A61N1/36564 , A61N1/36571 , A61N1/3684 , A61N1/3688
摘要： Cardioprotective pre-excitation pacing may be applied to stress or de-stress a particular myocardial region delivering of pacing pulses in a manner that causes a dyssynchronous contraction. Such dyssynchronous contractions are responsible for the desired cardioprotective effects of pre-excitation pacing but may also be hazardous. Described herein is a method and system that uses measures of a patient's physiological response to ventricular dyssynchrony to control the duty cycles of intermittent pre-excitation pacing.
摘要翻译： 心脏保护性预激发起搏可用于以导致同步收缩的方式对起搏脉冲递送的特定心肌区域应力或去应激。 这种异常收缩负责预激励起搏的所需心脏保护作用，但也可能是危险的。 本文描述了一种方法和系统，其使用患者对心室不同步的生理反应的测量来控制间歇性预激励起搏的占空比。
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公开(公告)号：US20100069989A1
公开(公告)日：2010-03-18
申请号：US12537165
申请日：2009-08-06
IPC分类号： A61N1/365
CPC分类号： A61N1/36514 , A61N1/3627 , A61N1/36521 , A61N1/36564 , A61N1/36571 , A61N1/3684 , A61N1/3688
摘要： Cardioprotective pre-excitation pacing may be applied to stress or de-stress a particular myocardial region delivering of pacing pulses in a manner that causes a dyssynchronous contraction. Such dyssynchronous contractions are responsible for the desired cardioprotective effects of pre-excitation pacing but may also be hazardous. Described herein is a method and system that uses measures of a patient's physiological response to ventricular dyssynchrony to control the duty cycles of intermittent pre-excitation pacing.
摘要翻译： 心脏保护性预激发起搏可用于以导致同步收缩的方式对起搏脉冲递送的特定心肌区域应力或去应激。 这种异常收缩负责预激励起搏的所需心脏保护作用，但也可能是危险的。 本文描述了一种方法和系统，其使用患者对心室不同步的生理反应的测量来控制间歇性预激励起搏的占空比。
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公开(公告)号：US20100049270A1
公开(公告)日：2010-02-25
申请号：US12535407
申请日：2009-08-04
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。
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6.发明授权Method and apparatus for safe and efficient delivery of cardiac stress augmentation pacing 有权安全高效地递送心脏应激增加起搏的方法和装置公开(公告)号：US08958873B2
公开(公告)日：2015-02-17
申请号：US12770351
申请日：2010-04-29
CPC分类号： A61N1/3627 , A61N1/37
摘要： A cardiac pacing system controls the progression of a cardiac disorder such as heart failure by delivering cardiac stress augmentation pacing to create or augment regional stress in the heart according to a delivery schedule programmed for a patient. Various events associated with the patient's conditions, activities, and other treatments may render the cardiac stress augmentation pacing risky or ineffective. The system detects such events before and during each cardiac stress augmentation pacing session and modifies the delivery schedule in response to the detection of each event to ensure patient safety and therapy efficiency.
摘要翻译： 心脏起搏系统通过递送心脏应力增加起搏来控制心脏疾病例如心力衰竭的进展，以根据为患者编程的递送计划创建或增加心脏中的区域应力。 与患者病情，活动和其他治疗相关的各种事件可能使心脏应激增加起搏风险或无效。 该系统在每个心脏应激增强起搏会话之前和期间检测这些事件，并根据每个事件的检测来修改递送计划，以确保患者的安全性和治疗效率。
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公开(公告)号：US08886306B2
公开(公告)日：2014-11-11
申请号：US12535407
申请日：2009-08-04
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。
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8.发明申请METHOD AND APPARATUS FOR SAFE AND EFFICIENT DELIVERY OF CARDIAC STRESS AUGMENTATION PACING 有权安全有效地提供CARDIAC应力补充剂的方法和装置公开(公告)号：US20100305648A1
公开(公告)日：2010-12-02
申请号：US12770351
申请日：2010-04-29
CPC分类号： A61N1/3627 , A61N1/37
摘要： A cardiac pacing system controls the progression of a cardiac disorder such as heart failure by delivering cardiac stress augmentation pacing to create or augment regional stress in the heart according to a delivery schedule programmed for a patient. Various events associated with the patient's conditions, activities, and other treatments may render the cardiac stress augmentation pacing risky or ineffective. The system detects such events before and during each cardiac stress augmentation pacing session and modifies the delivery schedule in response to the detection of each event to ensure patient safety and therapy efficiency.
摘要翻译： 心脏起搏系统通过递送心脏应力增加起搏来控制心脏疾病例如心力衰竭的进展，以根据为患者编程的递送计划创建或增加心脏中的区域应力。 与患者病情，活动和其他治疗相关的各种事件可能使心脏应激增加起搏风险或无效。 该系统在每个心脏应激增强起搏会话之前和期间检测这些事件，并根据每个事件的检测来修改递送计划，以确保患者的安全性和治疗效率。
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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。
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公开(公告)号：US20090281591A1
公开(公告)日：2009-11-12
申请号：US12436497
申请日：2009-05-06
IPC分类号： A61N1/365
CPC分类号： A61N1/3627 , A61N1/3682
摘要： A pacing system delivers cardiac protection pacing to protect the heart from injuries. The pacing system receives a set of inputs and calculates parameters for delivering optimized cardiac protection pacing tailored for different stress levels. The system automatically adjusts heart rate to optimize cardiac protection pacing in a closed-loop system. In one embodiment, a method for delivering pacing pulses for cardiac protection is provided. Intrinsic atrioventricular (AV) intervals are sensed. The intrinsic AV interval and a predetermined equation relating the AV interval to an optimal AV delay are used to provide a maximum positive rate of left ventricular pressure change during systole. An AV delay is calculated using a predetermined percentage of the optimal AV delay to deliver ventricular pacing pulses to provide a desired level of stress for cardiac protective pacing therapy (CPPT) to provide a cardiac conditioning therapy to improve autonomic balance.
摘要翻译： 起搏系统提供心脏保护起搏，以保护心脏免受伤害。 起搏系统接收一组输入，并计算用于提供针对不同应力水平定制的优化心脏保护起搏的参数。 系统自动调节心率以优化闭环系统中的心脏保护起搏。 在一个实施例中，提供了一种用于输送用于心脏保护的起搏脉冲的方法。 感测房室内（AV）间隔。 使用本征AV间隔和将AV间隔与最佳AV延迟相关联的预定方程用于在收缩期间提供左心室压力变化的最大正率。 使用预定百分比的最佳AV延迟来计算AV延迟以递送心室起搏脉冲以提供用于心脏保护起搏治疗（CPPT）的期望水平的应力以提供心脏调节疗法以改善自主神经平衡。
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