公开(公告)号：US07715917B2

公开(公告)日：2010-05-11

申请号：US11004543

申请日：2004-12-03

申请人： Edward Chinchoy ,  Nirav V. Sheth ,  Kathryn E. Hilpisch ,  Thomas J. Mullen ,  John E. Burnes

发明人： Edward Chinchoy ,  Nirav V. Sheth ,  Kathryn E. Hilpisch ,  Thomas J. Mullen ,  John E. Burnes

IPC分类号： A61N1/00

CPC分类号： A61N1/368 ,  A61N1/3627 ,  A61N1/3682 ,  A61N1/3684

摘要： Determining an optimal atrioventricular interval is of interest for proper delivery of cardiac resynchronization therapy. Although device optimization is gradually and more frequently being performed through a referral process with which the patient undergoes an echocardiographic optimization, the decision of whether to optimize or not is still generally reserved for the implanting physician. Recent abstracts have suggested a formulaic approach for setting A-V interval based on intrinsic electrical sensing, that may possess considerable appeal to clinicians versus a patient average nominal A-V setting of 100 ms. The present invention presents a methods of setting nominal device settings based on entering patient cardiac demographics to determine what A-V setting may be appropriate. The data is based on retrospective analysis of the MIRACLE trial to determine what major factors determined baseline A-V settings.

摘要翻译： 确定最佳房室间隔对于正确递送心脏再同步治疗是有意义的。 尽管通过与患者经历超声心动图优化的转诊过程逐渐且更频繁地进行装置优化，但仍然通常为植入医生保留是否优化的决定。 最近的摘要提出了一种基于固有电学感测设置A-V间隔的公式化方法，这可能对临床医生具有相当大的吸引力，而患者平均标称A-V设置为100 ms。 本发明提供了一种基于输入患者心脏人口统计学来设定标称装置设置以确定什么A-V设置可能适合的方法。 数据基于MIRACLE试验的回顾性分析，以确定确定基线A-V设置的主要因素。

公开(公告)号：US20080269825A1

公开(公告)日：2008-10-30

申请号：US11742210

申请日：2007-04-30

申请人： Edward Chinchoy ,  Michael F. Hess

发明人： Edward Chinchoy ,  Michael F. Hess

IPC分类号： A61N1/37

CPC分类号： A61N1/3627 ,  A61N1/3712

摘要： A system and method for monitoring at least one chamber of a heart (e.g., a left ventricular chamber) during delivery of a refractory period stimulation (RPS) therapy to determine if the desired non-capture (i.e., lack of ventricular mechanical capture due to refractory period stimulation) occurs. The system includes an implantable or external cardiac stimulation device in association with a set of leads such as epicardial, endocardial, and/or coronary sinus leads equipped with motion sensor(s). The device receives and processes acceleration sensor signals to determine a signal characteristic indicative of chamber capture due to pacing stimulus delivery, non-capture due to RPS therapy delivery, and/or contractile status based on the qualities of evoked response to pacing stimulation.

摘要翻译： 一种用于在递送不期期刺激（RPS）治疗期间监测心脏（例如，左心室）的至少一个腔室的系统和方法，以确定是否期望的非捕获（即，由于缺乏心室机械捕获 难治期刺激）发生。 该系统包括与一组引线相关联的可植入或外部心脏刺激装置，例如配备有运动传感器的心外膜，心内膜和/或冠状窦导联。 该装置接收并处理加速度传感器信号以确定指示由于起搏刺激递送，由于RPS治疗递送而导致的非捕获和/或基于对起搏刺激的诱发响应的质量的收缩状态的室捕获的信号特征。

公开(公告)号：US20050165454A1

公开(公告)日：2005-07-28

申请号：US11085844

申请日：2005-03-22

申请人： Edward Chinchoy

发明人： Edward Chinchoy

IPC分类号： A61B5/0215 ,  A61N1/362 ,  A61N1/365 ,  A61N1/368

CPC分类号： A61B5/0215 ,  A61N1/3627 ,  A61N1/36564 ,  A61N1/3682 ,  A61N1/3684

摘要： A method and apparatus for optimizing cardiac resynchronization therapy are provided. An iterative optimization procedure is performed to test the systolic hemodynamic effects of varying A-V-V timing schemes. The hemodynamic effect is assessed based on a surrogate of stroke volume. The stroke volume surrogate is derived from a sensor signal proportional to the blood pressure in the aorta or a major artery. The A-V-V timing scheme corresponding to the highest magnitude stroke volume, as indicated by the stroke volume surrogate, is identified and automatically programmed to maintain optimal A-V-V settings acutely and chronically.

摘要翻译： 提供了一种用于优化心脏再同步治疗的方法和装置。 执行迭代优化程序来测试变化的A-V-V定时方案的收缩期血液动力学效应。 血液动力学效应根据中风量的替代量进行评估。 行程体积替代来自与主动脉或大动脉血压成正比的传感器信号。 识别与行程体积替代指示的对应于最大幅度行程体积的A-V-V定时方案，并自动编程以锐化和长期地维持最佳A-V-V设置。

公开(公告)号：US08150513B2

公开(公告)日：2012-04-03

申请号：US12606983

申请日：2009-10-27

申请人： Edward Chinchoy

发明人： Edward Chinchoy

IPC分类号： A61N1/00

CPC分类号： A61N1/3627 ,  A61N1/36578

摘要： A system and method for monitoring left ventricular (LV) lateral wall motion and for optimizing cardiac pacing intervals based on left ventricular lateral wall motion is provided. The system includes an implantable or external cardiac stimulation device in association with a set of leads including a left ventricular epicardial or coronary sinus lead equipped with a motion sensor electromechanically coupled to the lateral wall of the left ventricle. The device receives and processes wall motion sensor signals to determine a signal characteristic indicative of systolic LV lateral wall motion or acceleration. An automatic pacing interval optimization method evaluates the LV lateral wall motion during varying pacing interval settings, including atrial-ventricular intervals and inter-ventricular intervals and selects the pacing interval setting(s) that correspond to LV lateral wall motion associated with improved cardiac synchrony and hemodynamic performance.

摘要翻译： 提供了一种用于监测左心室（LV）侧壁运动并基于左心室侧壁运动来优化心脏起搏间隔的系统和方法。 该系统包括与一组引线相关联的可植入或外部心脏刺激装置，包括左心室或冠状窦引线，其配备有机电耦合到左心室侧壁的运动传感器。 该装置接收并处理壁运动传感器信号以确定指示收缩期LV侧壁运动或加速度的信号特征。 自动起搏间期优化方法评估在不同的起搏间隔设置期间的LV侧壁运动，包括心室间隔和心室间隔，并且选择对应于与改善的心脏同步相关的LV侧壁运动的起搏间隔设置， 血液动力学性能。

公开(公告)号：US07869876B2

公开(公告)日：2011-01-11

申请号：US11245623

申请日：2005-10-07

申请人： Rajan Prakash ,  Edward Chinchoy ,  Thomas J. Mullen

发明人： Rajan Prakash ,  Edward Chinchoy ,  Thomas J. Mullen

IPC分类号： A61N1/368

CPC分类号： A61N1/368 ,  A61B5/0452 ,  A61B5/1107 ,  A61B2562/0219 ,  A61N1/3627 ,  A61N1/36542 ,  A61N1/3682

摘要： A method for use in an implantable medical device, comprising: sensing a signal corresponding to ventricular wall acceleration; and determining a metric of atrial function using the ventricular wall acceleration signal. The method includes sensing the ventricular wall acceleration signal during at least during a sensing window corresponding to a ventricular filling phase.

摘要翻译： 一种用于可植入医疗装置的方法，包括：感测对应于心室壁加速度的信号; 并使用心室壁加速度信号确定心房功能的度量。 该方法包括在至少在对应于心室填充阶段的感测窗口期间感测心室壁加速度信号。

公开(公告)号：US07787942B2

公开(公告)日：2010-08-31

申请号：US11742210

申请日：2007-04-30

申请人： Edward Chinchoy ,  Michael F. Hess

发明人： Edward Chinchoy ,  Michael F. Hess

IPC分类号： A61B5/04

CPC分类号： A61N1/3627 ,  A61N1/3712

摘要： A system and method for monitoring at least one chamber of a heart (e.g., a left ventricular chamber) during delivery of a refractory period stimulation (RPS) therapy to determine if the desired non-capture (i.e., lack of ventricular mechanical capture due to refractory period stimulation) occurs. The system includes an implantable or external cardiac stimulation device in association with a set of leads such as epicardial, endocardial, and/or coronary sinus leads equipped with motion sensor(s). The device receives and processes acceleration sensor signals to determine a signal characteristic indicative of chamber capture due to pacing stimulus delivery, non-capture due to RPS therapy delivery, and/or contractile status based on the qualities of evoked response to pacing stimulation.

摘要翻译： 一种用于在递送不期期刺激（RPS）治疗期间监测心脏（例如，左心室）的至少一个腔室的系统和方法，以确定是否期望的非捕获（即，由于缺乏心室机械捕获 难治期刺激）发生。 该系统包括与一组引线相关联的可植入或外部心脏刺激装置，例如配备有运动传感器的心外膜，心内膜和/或冠状窦导联。 该装置接收并处理加速度传感器信号以确定指示由于起搏刺激递送，由于RPS治疗递送而导致的非捕获和/或基于对起搏刺激的诱发响应的质量的收缩状态的室捕获的信号特征。

公开(公告)号：US07672715B2

公开(公告)日：2010-03-02

申请号：US11343753

申请日：2006-01-31

申请人： Rajan Prakash ,  Edward Chinchoy ,  Thomas J. Mullen

发明人： Rajan Prakash ,  Edward Chinchoy ,  Thomas J. Mullen

IPC分类号： A61B5/04

CPC分类号： A61N1/368 ,  A61N1/3627 ,  A61N1/36542 ,  A61N1/3682

摘要： An implantable medical device system and associated method are provided for measuring an excitation-physiological response delay. The method includes sensing a first signal responsive to electrical activity in a first cardiac chamber, sensing a second signal responsive to a physiologic response to the electrical activity in the first cardiac chamber; and determining an excitation-physiologic response delay in response to the first signal and the second signal.

摘要翻译： 提供了一种用于测量激发 - 生理反应延迟的可植入医疗装置系统和相关方法。 所述方法包括响应于第一心室中的电活动来感测第一信号，感测响应于对第一心室中的电活动的生理反应的第二信号; 以及响应于所述第一信号和所述第二信号确定激发 - 生理响应延迟。

公开(公告)号：US20100023081A1

公开(公告)日：2010-01-28

申请号：US12181247

申请日：2008-07-28

申请人： Sarah Anne Audet ,  James Kevin Carney ,  William J. Combs ,  Eduardo N. Warman ,  Edward Chinchoy ,  Thomas J. Mullen ,  Brian Bruce Lee ,  Qingshan (Sam) Ye

发明人： Sarah Anne Audet ,  James Kevin Carney ,  William J. Combs ,  Eduardo N. Warman ,  Edward Chinchoy ,  Thomas J. Mullen ,  Brian Bruce Lee ,  Qingshan (Sam) Ye

IPC分类号： A61N1/365

CPC分类号： A61B5/0452 ,  A61B5/0031 ,  A61B5/02028 ,  A61B5/02055 ,  A61B5/02405 ,  A61B5/08 ,  A61B5/11 ,  A61B5/14532 ,  A61B5/14539 ,  A61B5/7275 ,  A61B7/00 ,  A61N1/3627 ,  A61N1/36514

摘要： Heart-monitoring systems, apparatus, and methods adapted to detect CS, CI and/or MI. In one embodiment, a system comprising at least two first-tier sensors capable of measuring and converting into signals at least two aspects related to cardiac function, at least one second-tier sensor that is also a first-tier sensor, at least one signal processor capable of transmitting a first-tier and second-tier trigger signal when coronary syndrome, cardiac ischemia or myocardial infarction has been detected, at least one communication device capable of communicating, at least one control element adapted to produce a first-tier and second-tier trigger signal when at least one first-tier sensor exceeds its threshold signal level, to exclude the signal from the first-tier sensor that exceeded its threshold and lower at least one threshold of the at least one first-tier sensor is provided.

摘要翻译： 适用于检测CS，CI和/或MI的心脏监测系统，装置和方法。 在一个实施例中，一种系统包括至少两个第一层传感器，能够测量和转换成与心脏功能相关的至少两个方面的信号，至少一个第二层传感器，其也是第一层传感器，至少一个信号 处理器能够在冠状动脉综合征，心脏缺血或心肌梗塞已经被检测时发送第一层和第二层触发信号，至少一个能够通信的通信设备，至少一个适于产生第一层和第二层的控制元件 当至少一个第一层传感器超过其阈值信号电平时，将第一层传感器的信号排除超过其阈值并降低至少一个第一层传感器的至少一个阈值。

公开(公告)号：US20070179542A1

公开(公告)日：2007-08-02

申请号：US11344471

申请日：2006-01-31

申请人： Rajan Prakash ,  Edward Chinchoy ,  Thomas Mullen

发明人： Rajan Prakash ,  Edward Chinchoy ,  Thomas Mullen

IPC分类号： A61N1/362

CPC分类号： A61N1/3627 ,  A61N1/36542 ,  A61N1/368 ,  A61N1/3682

摘要： A method for determining an optimal pacing timing control parameter setting is provided for use in an implantable medical device programmed to deliver a pacing pulse in response to the timing control parameter. The method includes storing a user-selected optimization metric, iteratively adjusting the timing control parameter setting, sensing a first signal that varies in response to left ventricular wall acceleration, measuring the user-selected optimization metric in response to the sensed first signal, and determining an optimal timing control parameter value in response to the measured user-selected optimization metric.

摘要翻译： 用于确定最佳起搏定时控制参数设置的方法被提供用于被编程为响应于定时控制参数递送起搏脉冲的可植入医疗设备。 该方法包括存储用户选择的优化度量，迭代地调整定时控制参数设置，感测响应于左心室壁加速度变化的第一信号，响应于感测的第一信号测量用户选择的优化度量，以及确定 响应于所测量的用户选择的优化度量的最佳定时控制参数值。

公开(公告)号：US07192399B2

公开(公告)日：2007-03-20

申请号：US11044645

申请日：2005-01-27

申请人： Barbro M. Kjellstrom ,  Kathryn E. Hilpisch ,  Edward Chinchoy

发明人： Barbro M. Kjellstrom ,  Kathryn E. Hilpisch ,  Edward Chinchoy

IPC分类号： A61B5/02

CPC分类号： A61B5/0205 ,  A61B5/0022 ,  A61B5/0245 ,  A61B5/0402 ,  A61B5/7239 ,  A61N1/3627 ,  A61N1/36564

摘要： A medical device chronically monitors cardiac function in a patient. An input circuit of the medical device receives a pressure signal representative of a pressure sensed within a ventricle of the patient's heart as a function of time. A processor derives from the pressure signal a myocardial performance index based upon pressures in the ventricle. The processor then provides an output based upon the myocardial performance index.

摘要翻译： 医疗器械长期监测患者的心脏功能。 医疗装置的输入电路作为时间的函数接收表示患者心脏的心室内感测到的压力的压力信号。 处理器从压力信号得到基于心室压力的心肌性能指数。 然后处理器基于心肌性能指数提供输出。