公开(公告)号：US20150045849A1

公开(公告)日：2015-02-12

申请号：US14305832

申请日：2014-06-16

Applicant: Medtronic, Inc.

Inventor： Subham Ghosh ,  Robert W Stadler

IPC: A61N1/368

CPC classification number: A61N1/3686 ,  A61N1/3622 ,  A61N1/3627 ,  A61N1/368 ,  A61N1/3684 ,  A61N1/371

Abstract: Generally, the disclosure is directed one or more methods or systems of cardiac pacing employing a right ventricular electrode and a plurality of left ventricular electrodes. Pacing using the right ventricular electrode and a first one of the left ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes. Pacing using the right ventricular electrode and a second one of the ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes. Employing sums of the measured activation times to select one of the left ventricular electrodes for delivery of subsequent pacing pulses.

Abstract translation: 通常，本公开涉及使用右心室电极和多个左心室电极的一个或多个心脏起搏方法或系统。 使用右心室电极和左心室电极中的第一个进行起搏，并测量其他左心室电极的活化时间。 使用右心室电极和第二个心室电​​极进行起搏，并测量其他左心室电极的活化时间。 使用所测量的激活时间的总和来选择一个左心室电极用于递送随后的起搏脉冲。

公开(公告)号：US20150032174A1

公开(公告)日：2015-01-29

申请号：US13948831

申请日：2013-07-23

Applicant: Medtronic, Inc.

Inventor： Subham Ghosh

IPC: A61N1/365

CPC classification number: A61N1/36585 ,  A61B5/04085 ,  A61N1/36185 ,  A61N1/362 ,  A61N1/372

Abstract: A system and method select a pacing site for a cardiac pacing therapy. A change from a baseline mechanical activity is extracted from a signal of mechanical heart activity during pacing at each one of multiple pacing sites along a heart chamber. A change from a baseline electrical activity is extracted from a signal of electrical heart activity during pacing at each of the of pacing sites. The pacing sites are sorted in a first order based upon the changes in mechanical heart activity and in a second order based upon the changes in electrical heart activity. A pacing site is selected from the multiple pacing sites as a common pacing site between the first order and the second order.

Abstract translation: 系统和方法选择心脏起搏治疗的起搏部位。 在心脏室的多个起搏部位的每一个起搏期间，从机械心脏活动的信号中提取与基线机械活动的变化。 在每个起搏部位的起搏期间，从电气心脏活动的信号中提取基线电活动的变化。 基于机械心脏活动的变化和基于电心脏活动的变化的第二阶段，起搏部位按照第一顺序排序。 从多个起搏站点中选择起始站点作为第一个订单和第二个订单之间的普通起始站点。

公开(公告)号：US20150032171A1

公开(公告)日：2015-01-29

申请号：US13948503

申请日：2013-07-23

Applicant: Medtronic, Inc.

Inventor： Subham Ghosh

IPC: A61N1/368 ,  A61N1/37

CPC classification number: A61N1/3686 ,  A61B5/04012 ,  A61B5/04085 ,  A61B5/0422 ,  A61B2562/046 ,  A61N1/3627 ,  A61N1/3702 ,  A61N1/3704

Abstract: A medical device system performs a method for determining presence of scar tissue through an implanted lead having an electrode for cardiac pacing and sensing. A sensing module senses heart activity with the electrode to produce a unipolar electrogram (EGM) waveform. A processor receives the unipolar EGM waveform and extracts two or more features representative of heart activity at the electrode. Scar tissue is identified at the site of the first electrode based upon at least two of the extracted features indicating scar tissue.

Abstract translation: 医疗装置系统执行用于通过具有用于心脏起搏和感测的电极的植入导线来确定瘢痕组织的存在的方法。 感测模块​​用电极感测心脏活动以产生单极电描记图（EGM）波形。 处理器接收单极EGM波形，并提取代表电极心脏活动的两个或多个特征。 基于指示瘢痕组织的提取特征中的至少两个，在第一电极的位置处鉴定瘢痕组织。

公开(公告)号：US20140323892A1

公开(公告)日：2014-10-30

申请号：US14227955

申请日：2014-03-27

Applicant: Medtronic, Inc.

Inventor： Subham Ghosh ,  Jeffrey Gillberg

IPC: A61B5/044 ,  A61N1/37

CPC classification number: A61B5/044 ,  A61N1/362 ,  A61N1/371 ,  A61N1/37247 ,  A61N2001/083

Abstract: Systems, methods, and interfaces are described herein for identification of effective electrodes to be used in sensing and/or therapy. Two or more portions of a signal monitored using an electrode may be compared to determine whether the electrode is effective. The two or more portions may correspond to the same portion or window of a cardiac cycle. Further, signals from a first electrode and from a second electrode located proximate the first electrode may be compared to determine whether one or both of the electrodes are effective.

Abstract translation: 本文描述了用于识别用于感测和/或治疗的有效电极的系统，方法和界面。 可以比较使用电极监测的信号的两个或多个部分，以确定电极是否有效。 两个或多个部分可以对应于心动周期的相同部分或窗口。 此外，可以比较来自位于第一电极附近的来自第一电极和第二电极的信号，以确定电极中的一个或两个是否有效。

公开(公告)号：US20140323882A1

公开(公告)日：2014-10-30

申请号：US14227919

申请日：2014-03-27

Applicant: Medtronic, Inc.

Inventor： Subham Ghosh ,  Jeffrey Gillberg ,  Manfred Justen ,  Eric Schiling

IPC: A61B5/044 ,  A61B5/0205 ,  A61B5/00 ,  A61N1/365

CPC classification number: A61B5/044 ,  A61B5/0205 ,  A61B5/4029 ,  A61N1/365 ,  A61N1/36585 ,  A61N1/3686 ,  A61N1/371 ,  A61N1/37247

Abstract: Systems, methods, and graphical user interfaces are described herein for identification of optimal electrical vectors for use in assisting a user in implantation of implantable electrodes to be used in cardiac therapy. Cardiac improvement information may be generated for each pacing configuration, and one or more pacing configuration may be selected based on the cardiac improvement information. Optimal electrical vectors using the selected pacing configurations may be identified using longevity information generated for each electrical vector. Electrodes may then be implanted for use in cardiac therapy to form the optimal electrical vector.

Abstract translation: 本文描述了系统，方法和图形用户界面，用于识别用于辅助用户植入用于心脏治疗的可植入电极的最佳电子载体。 可以为每个起搏配置生成心脏改善信息，并且可以基于心脏改善信息来选择一个或多个起搏配置。 可以使用为每个电向量生成的寿命信息来识别使用所选择的起搏配置的最佳电矢量。 然后可以将电极植入用于心脏治疗以形成最佳电子载体。

公开(公告)号：US20140277246A1

公开(公告)日：2014-09-18

申请号：US14212025

申请日：2014-03-14

Applicant: Medtronic, Inc.

Inventor： Richard M.T. Lu ,  Subham Ghosh ,  Robert W. Stadler

IPC: A61N1/37

CPC classification number: A61N1/371 ,  A61B5/046 ,  A61N1/3622 ,  A61N1/3624 ,  A61N1/3684 ,  A61N1/3716

Abstract: The present disclosure pertains to cardiac pacing methods and systems, and, more particularly, to cardiac resynchronization therapy (CRT). In particular, the present disclosure pertains to determining whether a patient is experiencing atrial fibrillation (AF). If the patient is experiencing AF, the efficacy of CRT is determined. A signal is sensed in response to a ventricular pacing stimulus. Through signal processing, a number of features are parsed from the signal and a determination is made as to whether the ventricular pacing stimulus evoked a response from the ventricle.

Abstract translation: 本公开涉及心脏起搏方法和系统，更具体地，涉及心脏再同步治疗（CRT）。 特别地，本公开涉及确定患者是否正在经历心房颤动（AF）。 如果患者正在经历房颤，则CRT的功效是确定的。 响应于心室起搏刺激感测信号。 通过信号处理，从信号中解析出许多特征，并且确定心室起搏刺激是否引起心室的反应。

公开(公告)号：US20140236252A1

公开(公告)日：2014-08-21

申请号：US13772840

申请日：2013-02-21

Applicant: MEDTRONIC, INC.

Inventor： Subham Ghosh ,  Robert W Stadler

IPC: A61N1/37

CPC classification number: A61N1/3686 ,  A61N1/3627 ,  A61N1/3684 ,  A61N1/3712

Abstract: Generally, the disclosure is directed one or more methods or systems of cardiac pacing employing a plurality of left ventricular electrodes. Pacing using a first one of the left ventricular electrodes and measuring activation times at other ones of the left and right ventricular electrodes. Pacing using a second one of the ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes. Employing weighted sums of the measured activation times to measure a fusion index and select one of the left ventricular electrodes for delivery of subsequent pacing pulses based on comparing fusion indices during pacing from different LV electrodes. One or more embodiments use the same fusion index to select an optimal A-V delay by comparing fusion indices during pacing with different A-V delays at resting atrial rates as well as rates above the resting rate.

Abstract translation: 通常，本公开涉及使用多个左心室电极的一个或多个心脏起搏方法或系统。 使用左心室电极中的第一个进行起搏，并测量左心室电极和右心室电极中的其他电极的活化时间。 使用第二个心室电​​极进行起搏，并测量其他左心室电极的活化时间。 使用测量的激活时间的加权和来测量融合指数，并且基于来自不同LV电极的起搏期间的融合指数的比较，选择左心室电极之一用于递送随后的起搏脉冲。 一个或多个实施例使用相同的融合指数来选择最佳A-V延迟，其通过将起搏期间的融合指数与静息心房率下的不同A-V延迟以及高于静息速率的速率进行比较来选择。

公开(公告)号：US20140180355A1

公开(公告)日：2014-06-26

申请号：US14193155

申请日：2014-02-28

Applicant: Medtronic, Inc.

Inventor： Subham Ghosh ,  Robert W. Stadler

IPC: A61N1/37

CPC classification number: A61N1/371 ,  A61N1/3684

Abstract: The present disclosure pertains to cardiac pacing methods and systems, and, more particularly, to cardiac resynchronization therapy (CRT). In particular, the present disclosure pertains to determining the efficacy of CRT through use of an effective capture test (ECT). One or more embodiments comprises sensing a signal in response to a ventricular pacing stimulus. Through signal processing, a number of features are parsed from the signal. Exemplary features parsed from the signal include a maximum amplitude, a maximum time associated with the maximum amplitude, a minimum amplitude, and a minimum time associated with the minimum amplitude. The data is evaluated through use of the ECT. By employing the ECT, efficacy of CRT is easily and automatically evaluated.

Abstract translation: 本公开涉及心脏起搏方法和系统，更具体地，涉及心脏再同步治疗（CRT）。 特别地，本公开涉及通过使用有效捕获测试（ECT）来确定CRT的功效。 一个或多个实施例包括响应于心室起搏刺激来感测信号。 通过信号处理，从信号中解析出许多特征。 从信号解析的示范性特征包括最大幅度，与最大幅度相关联的最大时间，最小幅度以及与最小幅度相关联的最小时间。 通过使用ECT评估数据。 通过使用ECT，CRT的功效易于自动评估。

公开(公告)号：US08750998B1

公开(公告)日：2014-06-10

申请号：US13707366

申请日：2012-12-06

Applicant: Medtronic, Inc.

Inventor： Subham Ghosh ,  Robert W Stadler

IPC: A61N1/08

CPC classification number: A61N1/371

Abstract: The present disclosure pertains to cardiac pacing methods and systems, and, more particularly, to cardiac resynchronization therapy (CRT). In particular, the present disclosure pertains to determining the efficacy of CRT through use of an effective capture test (ECT). One or more embodiments comprises sensing a signal in response to a ventricular pacing stimulus. Through signal processing, a number of features are parsed from the signal. Exemplary features parsed from the signal include a maximum amplitude, a maximum time associated with the maximum amplitude, a minimum amplitude, and a minimum time associated with the minimum amplitude. The data is evaluated through use of the ECT. By employing the ECT, efficacy of CRT is easily and automatically evaluated.

Abstract translation: 本公开涉及心脏起搏方法和系统，更具体地，涉及心脏再同步治疗（CRT）。 特别地，本公开涉及通过使用有效捕获测试（ECT）来确定CRT的功效。 一个或多个实施例包括响应于心室起搏刺激来感测信号。 通过信号处理，从信号中解析出许多特征。 从信号解析的示范性特征包括最大幅度，与最大幅度相关联的最大时间，最小幅度以及与最小幅度相关联的最小时间。 通过使用ECT评估数据。 通过使用ECT，CRT的功效易于自动评估。

公开(公告)号：US08738132B1

公开(公告)日：2014-05-27

申请号：US13707458

申请日：2012-12-06

Applicant: Medtronic, Inc.

Inventor： Subham Ghosh ,  Robert W Stadler

IPC: A61N1/08

CPC classification number: A61N1/3712

Abstract: The present disclosure pertains to cardiac pacing methods and systems, and, more particularly, to cardiac resynchronization therapy (CRT). In particular, the present disclosure pertains to determining the efficacy of CRT through use of an effective capture test (ECT). One or more embodiments comprises sensing a signal in response to a ventricular pacing stimulus. Through signal processing, a number of features are parsed from the signal. Exemplary features parsed from the signal include a maximum amplitude, a maximum time associated with the maximum amplitude, a minimum amplitude, and a minimum time associated with the minimum amplitude. The data is evaluated through use of the ECT. By employing the ECT, efficacy of CRT is easily and automatically evaluated.