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133 条记录 (耗时 0.04 秒)

    Methods and apparatus for reducing the likelihood of atrial fibrillation
    93.
    发明授权
    Methods and apparatus for reducing the likelihood of atrial fibrillation 失效

    公开(公告)号：US06668195B2

    公开(公告)日：2003-12-23

    申请号：US10003936

    申请日：2001-10-30

    申请人： Eduardo N. Warman ,  H. Toby Markowitz

    发明人： Eduardo N. Warman ,  H. Toby Markowitz

    IPC分类号： A61N1362

    CPC分类号： A61N1/3622

    摘要： Methods and apparatus for reducing the incidence of atrial fibrillation includes selecting a desired ventricular rate, pacing the ventricle of the heart at the desired ventricular rate, and pacing the atrium of the heart at twice the desired ventricular rate while the desired ventricular rate is less than a preferred rate. Some methods of the present invention include pacing the atrium of the heart at the desired ventricular rate while the desired ventricular rate is greater than the preferred rate. Other methods of the present invention include pacing the atrium of the heart at a predetermined/preferred atrial rate while the desired ventricular rate is greater than the preferred rate.

    Method and apparatus for detecting cardiac capture
    94.
    发明授权
    Method and apparatus for detecting cardiac capture 失效
    用于检测心脏捕获的方法和装置

    公开(公告)号：US5902325A

    公开(公告)日：1999-05-11

    申请号：US126469

    申请日：1998-07-30

    申请人： Catherine R. Condie ,  Daniel J. Baxter ,  William J. Combs ,  Daniel J. Greeninger ,  Karen J. Kleckner ,  H. Toby Markowitz ,  John C. Stroebel ,  John D. Wahlstrand

    发明人： Catherine R. Condie ,  Daniel J. Baxter ,  William J. Combs ,  Daniel J. Greeninger ,  Karen J. Kleckner ,  H. Toby Markowitz ,  John C. Stroebel ,  John D. Wahlstrand

    IPC分类号： A61N1/365 ,  A61N1/37

    CPC分类号： A61N1/36521 ,  A61N1/3712 ,  A61N1/3714

    摘要： A method and apparatus for automatic determination of a pacemaker patient's pacing stimulation threshold. Circuitry is provided in a pacemaker for obtaining a signal reflecting cardiac impedance, which is known to reliably reflect certain aspects of cardiac function. Circuitry is also provided for monitoring the cardiac impedance waveform during a predetermined capture detect window following delivery of stimulating pulses. One or more values are derived which characterize the morphology of the impedance waveform during the capture detect window associated with each stimulation pulse delivered. These values are compared to predetermined control values in order to assess whether a stimulation pulse has achieved cardiac capture. The assessment of whether cardiac capture has been achieved is also based partly upon the conventional sensing of atrial and/or ventricular cardiac signals occurring during the capture detect window. In one embodiment of the invention, the control values against which impedance waveform characterization values are compared are obtained by delivering a series of stimulation pulses having sufficient energy to ensure that capture is achieved, and by monitoring the impedance waveform during delivery of these pulses.

    摘要翻译： 一种用于自动确定起搏器患者起搏刺激阈值的方法和装置。 在起搏器中提供电路以获得反映心脏阻抗的信号，这已知可靠地反映心脏功能的某些方面。 还提供电路用于在传送刺激脉冲之后的预定捕获检测窗口期间监测心脏阻抗波形。 导出一个或多个值，其表征在与递送的每个刺激脉冲相关联的捕获检测窗口期间阻抗波形的形态。 将这些值与预定的控制值进行比较，以便评估刺激脉冲是否已经实现心脏捕获。 是否已经实现心脏捕获的评估也部分地基于在捕获检测窗口期间发生的心房和/或心室心脏信号的常规感测。 在本发明的一个实施例中，通过递送具有足够能量的一系列刺激脉冲来确定阻抗波形表征值被比较的控制值，以确保实现捕获，并且通过在传送这些脉冲期间监视阻抗波形来获得。

    Dual chamber pacing with atrial and ventricular independence
    95.
    发明授权
    Dual chamber pacing with atrial and ventricular independence 失效
    双室起搏与心房和心室独立

    公开(公告)号：US5643326A

    公开(公告)日：1997-07-01

    申请号：US568440

    申请日：1995-12-07

    申请人： Henry L. Weiner ,  H. Toby Markowitz ,  Michael F. Hess

    发明人： Henry L. Weiner ,  H. Toby Markowitz ,  Michael F. Hess

    IPC分类号： A61N1/368

    CPC分类号： A61N1/368

    摘要： A rate-responsive cardiac pacemaker implements a novel pacing mode, identified as ADIR/VVIR, which is especially effective for patients with Sick Sinus Syndrome and only intermittent atrioventricular block. Within the same pacemaker circuitry, an AAIR pacemaker and a VVI pacemaker (with an escape rate below that of the AAIR pacemaker) are provided with atrial blanking following both atrial and ventricular events. Ventricular blanking after atrial pacing is minimized for better detection of R-waves following an atrial paced event.

    摘要翻译： 速率响应心脏起搏器实现了一种新颖的起搏模式，被认为是ADIR / VVIR，其对于患有窦性窦综合征的患者和仅间歇性房室传导阻滞特别有效。 在相同的起搏器电路中，AAIR起搏器和VVI起搏器（逃逸率低于AAIR起搏器）在心房和心室事件之后都提供心房消隐。 心房起搏后的心室消隐最小化，以便更好地检测心房起搏事件后的R波。

    Fault-tolerant elective replacement indication for implantable medical device
    96.
    发明授权
    Fault-tolerant elective replacement indication for implantable medical device 失效
    用于可植入医疗器械的容错选择性替代指示

    公开(公告)号：US5402070A

    公开(公告)日：1995-03-28

    申请号：US275863

    申请日：1994-07-15

    申请人： Michael B. Shelton ,  Ross O. Starkson ,  Craig L. Schmidt ,  H. Toby Markowitz

    发明人： Michael B. Shelton ,  Ross O. Starkson ,  Craig L. Schmidt ,  H. Toby Markowitz

    IPC分类号： A61N1/37 ,  A61N1/378 ,  G01R31/36

    CPC分类号： G01R31/3662 ,  A61N1/3708 ,  A61N1/378

    摘要： A pacemaker having a fault-tolerant elective replacement indicator (ERI) triggering scheme in which transient excursions of parameters used as criteria for triggering ERI are rejected as triggering events. Periodic assessments of certain indicia of battery depletion are made, and subjected to a long-term low-pass filtering operation in order to reduce the effects of transient excursions of the indicia which result from non-ERI conditions. Over a long period of time (e.g., a day) predetermined threshold values of the indicia of interest must be exceeded a predetermined number of times in order for the device to issue an ERI. In one disclosed embodiment of the invention, the battery's loaded terminal voltage and internal impedance are used as indicators of the battery's depletion level. Periodically, these values are measured and converted to digital values. The digital values are subjected to a low-pass filtering operation to prevent temporary or transient excursions of the impedance and voltage curves from causing ERI to be triggered. In another disclosed embodiment of the invention, a long term fading average of periodically measured values is maintained. When the measured values are found to fulfill the ERI criteria, assessment of the parameters of interest is performed at an increased rate. While assessments are performed at the increased rate, the continuously updated fading average value must fulfill the ERI triggering criteria at least a predetermined number of times before ERI is triggered. If the fading average fails to fulfill the ERI triggering criteria the required number of times, assessments are resumed at the first, slower periodic rate.

    摘要翻译： 具有容错选择性替换指示符（ERI）触发方案的起搏器，其中用作触发ERI的标准的参数的瞬时偏移作为触发事件被拒绝。 进行电池耗尽的某些标记的定期评估，并进行长期低通滤波操作，以减少由非ERI条件引起的标记的瞬时偏移的影响。 在一段长时间（例如，一天）中，为了使设备发布ERI，必须超过预定次数的预定阈值。 在本发明的一个公开的实施例中，电池的负载端子电压和内部阻抗被用作电池耗尽水平的指标。 定期测量这些值并将其转换为数字值。 对数字值进行低通滤波操作，以防止阻抗和电压曲线的暂时或瞬时偏移导致ERI被触发。 在本发明的另一个公开实施例中，维持周期性测量值的长期衰落平均值。 当发现测量值达到ERI标准时，以增加的速率进行感兴趣参数的评估。 虽然以增加的速率进行评估，但连续更新的衰落平均值必须在触发ERI之前至少达到预定次数的ERI触发标准。 如果衰落平均值不符合所需次数的ERI触发标准，则以第一个较慢的周期速率恢复评估。

    Fault-tolerant elective replacement indication for implantable medical device
    97.
    发明授权
    Fault-tolerant elective replacement indication for implantable medical device 失效
    用于可植入医疗器械的容错选择性替代指示

    公开(公告)号：US5370668A

    公开(公告)日：1994-12-06

    申请号：US81746

    申请日：1993-06-22

    申请人： Michael B. Shelton ,  Ross O. Starkson ,  Craig L. Schmidt ,  H. Toby Markowitz

    发明人： Michael B. Shelton ,  Ross O. Starkson ,  Craig L. Schmidt ,  H. Toby Markowitz

    IPC分类号： A61N1/37 ,  A61N1/378 ,  G01R31/36

    CPC分类号： G01R31/3662 ,  A61N1/3708 ,  A61N1/378

    摘要： A pacemaker having a fault-tolerant elective replacement indicator (ERI) triggering scheme in which transient excursions of parameters used as criteria for triggering ERI are rejected as triggering events. Periodic assessments of certain indicia of battery depletion are made, and subjected to a long-term low-pass filtering operation in order to reduce the effects of transient excursions of the indicia which result from non-ERI conditions. Over a long period of time (e.g., a day) predetermined threshold values of the indicia of interest must be exceeded a predetermined number of times in order for the device to issue an ERI. In one disclosed embodiment of the invention, the battery's loaded terminal voltage and internal impedance are used as indicators of the battery's depletion level. Periodically, these values are measured and converted to digital values. The digital values are subjected to a low-pass filtering operation to prevent temporary or transient excursions of the impedance and voltage curves from causing ERI to be triggered. In another disclosed embodiment of the invention, a long term fading average of periodically measured values is maintained. When the measured values are found to fulfill the ERI criteria, assessment of the parameters of interest is performed at an increased rate. While assessments are performed at the increased rate, the continuously updated fading average value must fulfill the ERI triggering criteria at least a predetermined number of times before ERI is triggered. If the fading average fails to fulfill the ERI triggering criteria the required number of times, assessments are resumed at the first, slower periodic rate.

    摘要翻译： 具有容错选择性替换指示符（ERI）触发方案的起搏器，其中用作触发ERI的标准的参数的瞬时偏移作为触发事件被拒绝。 进行电池耗尽的某些标记的定期评估，并进行长期低通滤波操作，以减少由非ERI条件引起的标记的瞬时偏移的影响。 在一段长时间（例如，一天）中，为了使设备发布ERI，必须超过预定次数的预定阈值。 在本发明的一个公开的实施例中，电池的负载端子电压和内部阻抗被用作电池耗尽水平的指标。 定期测量这些值并将其转换为数字值。 对数字值进行低通滤波操作，以防止阻抗和电压曲线的暂时或瞬时偏移导致ERI被触发。 在本发明的另一个公开实施例中，维持周期性测量值的长期衰落平均值。 当发现测量值达到ERI标准时，以增加的速率进行感兴趣参数的评估。 虽然以增加的速率进行评估，但连续更新的衰落平均值必须在触发ERI之前至少达到预定次数的ERI触发标准。 如果衰落平均值不符合所需次数的ERI触发标准，则以第一个较慢的周期速率恢复评估。

    Demand apnea control of central and obstructive sleep apnea
    98.
    发明授权
    Demand apnea control of central and obstructive sleep apnea 失效
    中央和阻碍睡眠APNEA的需求APNEA控制

    公开(公告)号：US5146918A

    公开(公告)日：1992-09-15

    申请号：US671513

    申请日：1991-03-19

    申请人： Michael J. Kallok ,  H. Toby Markowitz

    发明人： Michael J. Kallok ,  H. Toby Markowitz

    IPC分类号： A61N1/08 ,  A61N1/32 ,  A61N1/36

    CPC分类号： A61N1/3601

    摘要： An apparatus and method for the control of both central and obstructive sleep apnea using electrical stimulation on a demand basis. Implantable sensors monitor the respiration cycle and determine the occurrence of apnea events. Central apnea is sensed by the passage of an escape interval of time without the sensing of an inspiratory event and a concurrent decrease in blood oxygen saturation. Obstructive sleep apnea is sensed as an abnormal pressure differential across the airway. The diaphragm is electrically stimulated upon sensing of central apnea. The musculature of the upper airway is electrically stimulated upon sensing of an occurrence of obstructive sleep apnea. Stimulation of the upper airway is provided whenever central apnea is sensed.

    Heart pacemaker with separate A-V intervals for atrial synchronous and atrial-ventricular sequential pacing modes
    100.
    发明授权
    Heart pacemaker with separate A-V intervals for atrial synchronous and atrial-ventricular sequential pacing modes 失效
    心脏起搏器，具有单独的A-V间隔，用于心房同步心房和心房间期起搏模式

    公开(公告)号：US4421116A

    公开(公告)日：1983-12-20

    申请号：US356791

    申请日：1982-03-10

    申请人： H. Toby Markowitz

    发明人： H. Toby Markowitz

    IPC分类号： A61N1/368 ,  A61N1/36

    CPC分类号： A61N1/368 ,  A61N1/3682

    摘要： A dual chamber heart pacemaker has atrial and ventricular pulse generators (21, 22) and sense amplifiers (25, 26) which connect respectively to an atrial terminal (11) and a ventricular terminal (12) for connection to the heart. In an atrial synchronous mode, the pacemaker provides ventricular stimulating pulses in response to detected spontaneous atrial contractions, and spaced from them by an A-V interval determined by a timer (31). In an atrial-ventricular sequential mode, a timer (40) causes the pacemaker to deliver sequential atrial and ventricular stimulation pulses which are separated in time by an A-V interval determined by another timer (30). The atrial-ventricular intervals for atrial synchronous mode and atrial-ventricular sequential mode are independent of each other, permitting selection of different A-V intervals for the two modes of operation.

    摘要翻译： 双室心脏起搏器具有分别连接到心房终端（11）和心室终端（12）的心房和心室脉冲发生器（21,22）和感测放大器（25,26）。 在心房同步模式中，起搏器响应于检测到的自发心房收缩而提供心室刺激脉冲，并且通过由定时器（31）确定的A-V间隔与心室起搏器间隔开。 在心房 - 心室顺序模式中，定时器（40）使得起搏器输送顺序的心房和心室刺激脉冲，其在时间上被由另一定时器（30）确定的A-V间隔分开。 心房同步模式和房室顺序模式的房室间隔彼此独立，允许为两种运作模式选择不同的A-V间隔。