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：US20070088401A1

公开(公告)日：2007-04-19

申请号：US11562681

申请日：2006-11-22

申请人： Julio Spinelli ,  Yinghong Yu

发明人： Julio Spinelli ,  Yinghong Yu

IPC分类号： A61N1/362

CPC分类号： A61N1/365 ,  A61N1/3627 ,  A61N1/368 ,  A61N1/3682

摘要： Response to cardiac resynchronization therapy is predicted for a given stimulation site so that an atrioventricular delay of an implantable device administering cardiac resynchronization therapy may be set to a proper amount. The first deflection of ventricular depolarization is measured, such as through a surface electrocardiogram or through an intracardiac electrogram measured by a lead positioned in the heart at the stimulation site. The maximum deflection of the ventricular depolarization is then measured by the lead positioned at the stimulation site. The interval of time between the first deflection and the maximum deflection of the ventricular depolarization is compared to a threshold to determine whether the stimulation site is a responder site. If the interval is larger than the threshold, then the site is a responder and the atrioventricular delay of the implantable device may be set to less than the intrinsic atrioventricular delay of the patient. Otherwise, the atrioventricular may be set to approximately equal the intrinsic atrioventricular delay.

摘要翻译： 对于给定的刺激部位预测对心脏再同步治疗的响应，使得施用心脏再同步治疗的可植入装置的房室延迟可以被设定为适当的量。 测量心室去极化的第一偏转，例如通过表面心电图或通过位于刺激部位心脏中的导线测量的心内电描记图。 然后通过位于刺激部位的引线测量心室去极化的最大偏转。 将心室去极化的第一偏转和最大偏转之间的时间间隔与阈值进行比较以确定刺激位点是否是应答位点。 如果间隔大于阈值，则该位点是响应者，并且可植入装置的房室延迟可被设置为小于患者的内在房室延迟。 否则，房室可以设定为近似等于内在房室延迟。

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：US20060271121A1

公开(公告)日：2006-11-30

申请号：US11136894

申请日：2005-05-25

申请人： Jiang Ding ,  Julio Spinelli ,  Yinghong Yu ,  Jeffrey Stahmann

发明人： Jiang Ding ,  Julio Spinelli ,  Yinghong Yu ,  Jeffrey Stahmann

IPC分类号： A61N1/368

CPC分类号： A61N1/3627 ,  A61B5/053 ,  A61N1/36521 ,  A61N1/3682 ,  A61N1/3684

摘要： This document discusses, among other things, systems, devices, and methods measure an impedance and, in response, adjust an atrioventricular (AV) delay or other cardiac resynchronization therapy (CRT) parameter that synchronizes left and right ventricular contractions. A first example uses parameterizes a first ventricular volume against a second ventricular volume during a cardiac cycle, using a loop area to create a synchronization fraction (SF). The CRT parameter is adjusted in closed-loop fashion to increase the SF. A second example measures a septal-freewall phase difference (PD), and adjusts a CRT parameter to decrease the PD. A third example measures a peak-to-peak volume or maximum rate of change in ventricular volume, and adjusts a CRT parameter to increase the peak-to-peak volume or maximum rate of change in the ventricular volume.

公开(公告)号：US07142922B2

公开(公告)日：2006-11-28

申请号：US10327267

申请日：2002-12-20

申请人： Julio Spinelli ,  Yinghong Yu

发明人： Julio Spinelli ,  Yinghong Yu

IPC分类号： A61B5/04

CPC分类号： A61N1/365 ,  A61N1/3627 ,  A61N1/368 ,  A61N1/3682

摘要： Response to cardiac resynchronization therapy is predicted for a given stimulation site so that an atrioventricular delay of an implantable device administering cardiac resynchronization therapy may be set to a proper amount. The first deflection of ventricular depolarization is measured, such as through a surface electrocardiogram or through an intracardiac electrogram measured by a lead positioned in the heart at the stimulation site. The maximum deflection of the ventricular depolarization is then measured by the lead positioned at the stimulation site. The interval of time between the first deflection and the maximum deflection of the ventricular depolarization is compared to a threshold to determine whether the stimulation site is a responder site. If the interval is larger than the threshold, then the site is a responder and the atrioventricular delay of the implantable device may be set to less than the intrinsic atrioventricular delay of the patient. Otherwise, the atrioventricular may be set to approximately equal the intrinsic atrioventricular delay.

摘要翻译： 对于给定的刺激部位预测对心脏再同步治疗的响应，使得施用心脏再同步治疗的可植入装置的房室延迟可以被设定为适当的量。 测量心室去极化的第一偏转，例如通过表面心电图或通过位于刺激部位心脏中的导线测量的心内电描记图。 然后通过位于刺激部位的引线测量心室去极化的最大偏转。 将心室去极化的第一偏转和最大偏转之间的时间间隔与阈值进行比较以确定刺激位点是否是应答位点。 如果间隔大于阈值，则该位点是响应者，并且可植入装置的房室延迟可被设置为小于患者的内在房室延迟。 否则，房室可以设定为近似等于内在房室延迟。

公开(公告)号：US20060224198A1

公开(公告)日：2006-10-05

申请号：US11097460

申请日：2005-04-01

申请人： Yanting Dong ,  Jiang Ding ,  Douglas Daum ,  Scott Meyer ,  Yinghong Yu

发明人： Yanting Dong ,  Jiang Ding ,  Douglas Daum ,  Scott Meyer ,  Yinghong Yu

IPC分类号： A61N1/362

CPC分类号： A61N1/368 ,  A61N1/3682 ,  A61N1/371

摘要： A method and system are described for determining an optimum atrioventricular delay (AVD) interval and/or ventriculo-ventricular delay (VVD) intervals for delivering ventricular resynchronization pacing in an atrial tracking or atrial sequential pacing mode. Evoked response electrograms recorded at different AVD and VVD intervals are used to determine the extent of paced and intrinsic activation.

摘要翻译： 描述了用于确定用于在心房跟踪或心房顺序起搏模式中递送心室再同步起搏的最佳房室延迟（AVD）间隔和/或心室 - 心室延迟（VVD）间隔的方法和系统。 以不同的AVD和VVD间隔记录的诱发反应电图用于确定起搏和内在激活的程度。

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。