公开(公告)号：US07260427B2

公开(公告)日：2007-08-21

申请号：US10729301

申请日：2003-12-05

申请人： Yinghong Yu ,  Jiang Ding ,  Jeng Mah ,  Julio Spinelli

发明人： Yinghong Yu ,  Jiang Ding ,  Jeng Mah ,  Julio Spinelli

IPC分类号： A61B5/0452

CPC分类号： A61B5/0452 ,  A61B5/0456 ,  A61B34/20 ,  A61B2034/2072 ,  A61N1/3627 ,  A61N1/3682

摘要： Systems and methods for determining the coronary sinus vein branch location of a left ventricle electrode are disclosed. The systems and methods involve detecting the occurrence of electrical events within the patient's heart including sensing one or more of the electrical events with the electrode and then analyzing the electrical events to determine the electrode's position. The determination of electrode position may be used to automatically adjust operating parameters of a VRT device. Furthermore, the determination of electrode position may be made in real-time during installation of the electrode and a visual indication of the electrode position may be provided on a display screen.

摘要翻译： 公开了用于确定左心室电极的冠状静脉窦静脉分支位置的系统和方法。 系统和方法涉及检测患者心脏内的电事件的发生，包括用电极感测一个或多个电事件，然后分析电气事件以确定电极的位置。 电极位置的确定可用于自动调整VRT器件的工作参数。 此外，可以在电极的安装期间实时地确定电极位置，并且可以在显示屏上提供电极位置的视觉指示。

公开(公告)号：US07158830B2

公开(公告)日：2007-01-02

申请号：US10314899

申请日：2002-12-09

申请人： Yinghong Yu ,  Jiang Ding ,  Julio C. Spinelli ,  Andrew P. Kramer

发明人： Yinghong Yu ,  Jiang Ding ,  Julio C. Spinelli ,  Andrew P. Kramer

IPC分类号： A61N1/365

CPC分类号： A61N1/3627 ,  A61N1/36564 ,  A61N1/3682

摘要： A pacing system for providing optimal hemodynamic cardiac function for parameters such as ventricular synchorny or contractility (peak left ventricle pressure change during systole or LV+dp/dt), or stroke volume (aortic pulse pressure) using system for calculating atrio-ventricular delays for optimal timing of a ventricular pacing pulse. The system providing an option for near optimal pacing of multiple hemodynamic parameters. The system deriving the proper timing using electrical or mechanical events having a predictable relationship with an optimal ventricular pacing timing signal.

摘要翻译： 用于为诸如室性同步或收缩性（心脏收缩期左心室压力变化峰值或LV + dp / dt）之间的参数提供最佳血液动力学心脏功能的起搏系统或用于计算心室延迟的系统的行程体积（主动脉脉压） 心室起搏脉冲的最佳时机。 该系统为多个血液动力学参数的近似最佳起搏提供了选择。 该系统使用与最佳心室起搏定时信号具有可预测关系的电或机械事件导出适当的定时。

公开(公告)号：US20060116727A1

公开(公告)日：2006-06-01

申请号：US11276007

申请日：2006-02-09

申请人： Jiang Ding ,  Julio Spinelli ,  Yinghong Yu ,  Andrew Kramer

发明人： Jiang Ding ,  Julio Spinelli ,  Yinghong Yu ,  Andrew Kramer

IPC分类号： A61N1/36

CPC分类号： A61N1/36592 ,  A61B5/0472 ,  A61N1/3627 ,  A61N1/3684

摘要： A method and apparatus for selection of one or more ventricular chambers to stimulate for ventricular resynchronization therapy. Intrinsic intracardia electrograms that include QRS complexes, are recorded from a left and right ventricle. A timing relationship between the intrinsic intracardia electrograms recorded from the left and right ventricle is then determined. In one embodiment, the timing relationship is determined using a delay between a left ventricular and a right ventricular sensed intrinsic ventricular depolarizations and a duration interval of one or more QRS complexes. In one embodiment, the duration of QRS complexes is determined from either intracardiac electrograms or from surface ECG recordings. One or more ventricular chambers in which to provide pacing pulses are then selected based on the timing relationship between intrinsic intracardia electrograms recorded from the right and left ventricle, and the duration of one or more QRS complexes.

摘要翻译： 用于选择一个或多个心室以刺激心室再同步治疗的方法和装置。 包括QRS复合物在内的心内电图从左心室和右心室记录。 然后确定从左心室和右心室记录的内在心内电描记图之间的时间关系。 在一个实施例中，使用左心室和右心室感测的内心室去极化之间的延迟和一个或多个QRS复合物的持续时间间隔来确定时间关系。 在一个实施方案中，QRS复合物的持续时间由心脏内电刺激图或从表面心电图记录确定。 然后基于从右心室和左心室记录的内在心内电描记图与一个或多个QRS复合物的持续时间之间的时间关系来选择其中提供起搏脉冲的一个或多个心室。

公开(公告)号：US07013176B2

公开(公告)日：2006-03-14

申请号：US10352780

申请日：2003-01-28

申请人： Jiang Ding ,  Yinghong Yu ,  Andrew P. Kramer ,  Lawrence Baumann

发明人： Jiang Ding ,  Yinghong Yu ,  Andrew P. Kramer ,  Lawrence Baumann

IPC分类号： A61N1/365

CPC分类号： A61N1/3627 ,  A61N1/3682 ,  A61N1/3684

摘要： A method and apparatus is disclosed for automatically setting the pacing parameters utilized by an implantable cardiac device in delivering cardiac resynchronization therapy. The selection of the pacing parameters is based at least in part upon measurements of intrinsic cardiac conduction parameters. Among the pacing parameters which may be selected in this way is the atrio-ventricular delay interval used in atrial-tracking and AV sequential pacing modes.

摘要翻译： 公开了一种用于自动设置可植入心脏装置在输送心脏再同步治疗中使用的起搏参数的方法和装置。 起搏参数的选择至少部分地基于固有心脏传导参数的测量。 可以以这种方式选择的起搏参数是在心房跟踪和AV顺序起搏模式中使用的心房延迟间隔。

公开(公告)号：US06999815B2

公开(公告)日：2006-02-14

申请号：US10655569

申请日：2003-09-04

申请人： Jiang Ding ,  Julio C. Spinelli ,  Yinghong Yu ,  Andrew P. Kramer

发明人： Jiang Ding ,  Julio C. Spinelli ,  Yinghong Yu ,  Andrew P. Kramer

IPC分类号： A61N1/362

CPC分类号： A61N1/36592 ,  A61B5/0472 ,  A61N1/3627 ,  A61N1/3684

摘要： A method and apparatus for selection of one or more ventricular chambers to stimulate for ventricular resynchronization therapy. Intrinsic intracardia electrograms that include QRS complexes, are recorded from a left and right ventricle. A timing relationship between the intrinsic intracardia electrograms recorded from the left and right ventricle is then determined. In one embodiment, the timing relationship is determined using a delay between a left ventricular and a right ventricular sensed intrinsic ventricular depolarizations and a duration interval of one or more QRS complexes. In one embodiment, the duration of QRS complexes is determined from either intracardiac electrograms or from surface ECG recordings. One or more ventricular chambers in which to provide pacing pulses are then selected based on the timing relationship between intrinsic intracardia electrograms recorded from the right and left ventricle, and the duration of one or more QRS complexes.

公开(公告)号：US20050131472A1

公开(公告)日：2005-06-16

申请号：US11049181

申请日：2005-02-02

申请人： Jiang Ding ,  Yinghong Yu ,  Andrew Kramer ,  Julio Spinelli

发明人： Jiang Ding ,  Yinghong Yu ,  Andrew Kramer ,  Julio Spinelli

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

CPC分类号： E21B17/01 ,  A61N1/3627 ,  A61N1/3682 ,  E21B43/36

摘要： A pacing system for providing optimal hemodynamic cardiac function for parameters such as contractility (peak left ventricle pressure change during systole or LV+dp/dt), or stroke volume (aortic pulse pressure) using system for calculating atrio-ventricular delays for optimal timing of a ventricular pacing pulse. The system providing an option for near optimal pacing of multiple hemodynamic parameters. The system deriving the proper timing using electrical or mechanical events having a predictable relationship with an optimal ventricular pacing timing signal.

摘要翻译： 一种起搏系统，用于为诸如收缩性（收缩期峰值左心室压力变化或LV + dp / dt）之间的参数或行程体积（主动脉脉压）提供最佳血液动力学心脏功能，使用用于计算心室延迟的系统以获得最佳时机 心室起搏脉搏。 该系统为多个血液动力学参数的近似最佳起搏提供了选择。 该系统使用与最佳心室起搏定时信号具有可预测关系的电或机械事件导出适当的定时。

公开(公告)号：US06768924B2

公开(公告)日：2004-07-27

申请号：US10038225

申请日：2002-01-03

申请人： Jiang Ding ,  Yinghong Yu ,  Julio C. Spinelli ,  Qingsheng Zhu

发明人： Jiang Ding ,  Yinghong Yu ,  Julio C. Spinelli ,  Qingsheng Zhu

IPC分类号： A61N1362

CPC分类号： A61N1/3712 ,  A61N1/3684 ,  A61N1/3714

摘要： An implantable cardiac rhythm/function management device that automatically determines whether or not a pacing stimulus to the ventricles results in capture by detecting propagated depolarizations at stimulating and non-stimulating electrodes. The device of the present invention is suitable for use in either a single or multiple electrode pacing/sensing configuration and may be utilized to verify either atrial or ventricular capture of a heart having either normal or abnormal intrinsic AV conduction.

摘要翻译： 一种植入式心律/功能管理装置，其自动确定对心室的起搏刺激是否通过检测刺激和非刺激电极处的传播去极化而导致捕获。 本发明的装置适用于单电极或多电极起搏/感测配置，并且可用于验证具有正常或异常固有AV传导的心脏的心房或心室捕获。

公开(公告)号：US06684103B2

公开(公告)日：2004-01-27

申请号：US10243811

申请日：2002-09-13

申请人： Jiang Ding ,  Yinghong Yu ,  Andrew P. Kramer ,  Julio Spinelli

发明人： Jiang Ding ,  Yinghong Yu ,  Andrew P. Kramer ,  Julio Spinelli

IPC分类号： A61N1365

CPC分类号： E21B17/01 ,  A61N1/3627 ,  A61N1/3682 ,  E21B43/36

摘要： A pacing system for providing optimal hemodynamic cardiac function for parameters such as contractility (peak left ventricle pressure change during systole or LV+dp/dt), or stroke volume (aortic pulse pressure) using system for calculating atrio-ventricular delays for optimal timing of a ventricular pacing pulse. The system providing an option for near optimal pacing of multiple hemodynamic parameters. The system deriving the proper timing using electrical or mechanical events having a predictable relationship with an optimal ventricular pacing timing signal.

摘要翻译： 一种起搏系统，用于为诸如收缩性（收缩期峰值左心室压力变化或LV + dp / dt）之间的参数或行程体积（主动脉脉压）提供最佳血液动力学心脏功能，使用用于计算心室延迟的系统以获得最佳时机 心室起搏脉搏。 该系统为多个血液动力学参数的近似最佳起搏提供了选择。 该系统使用与最佳心室起搏定时信号具有可预测关系的电或机械事件导出适当的定时。

公开(公告)号：US06453192B1

公开(公告)日：2002-09-17

申请号：US09523616

申请日：2000-03-13

申请人： Jiang Ding ,  Julio C. Spinelli ,  Yinghong Yu

发明人： Jiang Ding ,  Julio C. Spinelli ,  Yinghong Yu

IPC分类号： A61B50452

CPC分类号： A61B5/0468 ,  A61N1/3622

摘要： A method of accurately determining if ectopic beats are occurring in the heart by detecting the time interval, T, between a point Q* defined is the onset of the QRS complex and the peak value of R (T=Q*R) during a heart beat cycle and comparing that time with a running mean value calculated from normal heartbeats. A beat is identified as an ectopic beat if the Q*R time interval for a current beat is at least four standard deviations from the mean Q*R time interval of normal preceding beats. The electrodes for detecting the ectopic beats may be inside the patient's heart or on the patient's skin. If more than one electrode is used for monitoring the depolarization of the heart, then by combining the Q*R intervals (e.g. using a triangulation method) calculated from different electrodes, the location of the ectopic excitation can be determined and identified. The method of determining and localizing ectopic beats may be used in a pacing device to initiate ectopic beat handling procedures and to analyze the nature and possible trend of ectopic activities. This method of using the Q*R interval is independent of the PR or RR intervals normally measured and used to detect early ectopic beats and is therefore a more accurate method, since ectopic beats may occur at any time independent of PR or RR intervals.

摘要翻译： 通过检测定义的点Q *之间的时间间隔T来确定心脏中是否发生异位搏动的方法是QRS复合物的开始和心脏中的R（T = Q * R）的峰值 比较该时间与从正常心跳计算的运行平均值。 如果当前节拍的Q * R时间间隔与正常以前节拍的平均Q * R时间间隔至少有四个标准偏差，则拍子被识别为异位拍子。 用于检测异位搏动的电极可以在患者的心脏内或病人的皮肤上。 如果使用多于一个电极来监测心脏的去极化，则通过组合由不同电极计算的Q * R间隔（例如使用三角测量方法），可以确定和鉴定异位激发的位置。 确定和定位异位搏动的方法可以用于起搏装置中以启动异位搏动处理程序并分析异位活动的性质和可能的趋势。 使用Q * R间隔的这种方法与通常测量的PR或RR间隔无关，用于检测早期异位搏动，因此是更准确的方法，因为异位搏动可以随时独立于PR或RR间期发生。

公开(公告)号：US08538519B2

公开(公告)日：2013-09-17

申请号：US11113827

申请日：2005-04-25

申请人： Jiang Ding ,  Yinghong Yu ,  Milton M. Morris

发明人： Jiang Ding ,  Yinghong Yu ,  Milton M. Morris

IPC分类号： A61N1/365

CPC分类号： A61N1/36528 ,  A61N1/3627 ,  A61N1/3682 ,  A61N1/3684

摘要： A system and method for identifying patients with asynchronous ventricular contractions due to abnormal electro-mechanical coupling and computing optimal pacing parameters for restoring synchronous contractions is disclosed. Such patients may have normal intra-ventricular and inter-ventricular conduction and cannot be identified from intrinsic conduction data alone such as QRS width. Techniques for computing optimal resynchronization pacing in order to compensate for abnormal electro-mechanical coupling are also described.

摘要翻译： 公开了一种用于识别异常心电耦合异常心室收缩患者的系统和方法，并且计算用于恢复同步收缩的最佳起搏参数。 这样的患者可能具有正常的心室内和心室间传导，并且不能从内在传导数据单独识别，如QRS宽度。 还描述了用于计算最佳再同步起搏以补偿异常机电耦合的技术。