公开(公告)号：US07957802B2

公开(公告)日：2011-06-07

申请号：US11894082

申请日：2007-08-20

申请人： Abhilash Patangay ,  Jiang Ding ,  Jonathan T. Kwok ,  Barun Maskara ,  Yinghong Yu

发明人： Abhilash Patangay ,  Jiang Ding ,  Jonathan T. Kwok ,  Barun Maskara ,  Yinghong Yu

IPC分类号： A61N1/362

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

摘要： Optimizing cardiac preload based on measured pulmonary artery pressure involves varying, for each repetition of an acute burst protocol, a parameter of pacing applied to a patient's heart during the acute burst protocol. Pulmonary artery pressure is measured during the repetitions of the acute burst protocol. The length of the repetitions is chosen so that the patient's baroreflex system does not adjust to the varied parameter of pacing during the repetitions of the acute burst protocol. An optimum ventricular preload is determined based on the measured pulmonary artery pressure. Pacing therapy is provided using a value of the parameter that is selected based on the determination of optimum ventricular preload.

摘要翻译： 基于测量的肺动脉压优化心脏预压，对于急性突发协议的每个重复，涉及在急性突发协议期间应用于患者心脏的起搏参数的变化。 在急性突发方案的重复期间测量肺动脉压。 选择重复的长度，使得患者的压力反射系统在急性突发协议的重复期间不适应起搏的不同参数。 基于测量的肺动脉压力确定最佳心室预负荷。 使用基于最佳心室预压的确定选择的参数的值提供起搏治疗。

公开(公告)号：US20090054945A1

公开(公告)日：2009-02-26

申请号：US11894082

申请日：2007-08-20

申请人： Abhilash Patangay ,  Jiang Ding ,  Jonathan T. Kwok ,  Barun Maskara ,  Yinghong Yu

发明人： Abhilash Patangay ,  Jiang Ding ,  Jonathan T. Kwok ,  Barun Maskara ,  Yinghong Yu

IPC分类号： A61N1/05 ,  A61N1/04

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

摘要： Optimizing cardiac preload based on measured pulmonary artery pressure involves varying, for each repetition of an acute burst protocol, a parameter of pacing applied to a patient's heart during the acute burst protocol. Pulmonary artery pressure is measured during the repetitions of the acute burst protocol. An optimum ventricular preload is determined based on the measured pulmonary artery pressure. Pacing therapy is provided using a value of the parameter that is selected based on the determination of optimum ventricular preload.

摘要翻译： 基于测量的肺动脉压优化心脏预压，对于急性突发协议的每个重复，涉及在急性突发协议期间应用于患者心脏的起搏参数的变化。 在急性突发方案的重复期间测量肺动脉压。 基于测量的肺动脉压力确定最佳心室预负荷。 使用基于最佳心室预压的确定选择的参数值来提供起搏治疗。

公开(公告)号：US20080147138A1

公开(公告)日：2008-06-19

申请号：US11610821

申请日：2006-12-14

申请人： Barun Maskara ,  Jiang Ding ,  Imad Libbus

发明人： Barun Maskara ,  Jiang Ding ,  Imad Libbus

IPC分类号： A61N1/05

CPC分类号： A61N1/0587 ,  A61N1/36514 ,  A61N1/3956

摘要： A system comprising an implantable electrical cardiac signal sensing circuit, an implantable sinoatrial cardiac action potential detector circuit, and an implantable electrical stimulation circuit in electrical communication with the electrical cardiac signal sensing circuit and the sinoatrial cardiac action potential detector circuit. The electrical cardiac signal sensing circuit is configured to receive one or more intrinsic heart signals from one or more respective electrodes configured for placement in a vicinity of a sinoatrial node of a subject. The implantable electrical stimulation circuit is configured to initiate delivery of at least one inhibitory electrical stimulation pulse in a vicinity of the sinoatrial node in a timed relationship to a sensed sinoatrial cardiac action potential. Other systems and methods are disclosed.

摘要翻译： 一种包括可植入电气心脏信号感测电路，可植入窦房心脏动作电位检测器电路和与电心脏信号感测电路和窦房心脏动作电位检测器电路电通信的可植入电刺激电路的系统。 电心脏信号感测电路被配置为从被配置为放置在受试者的窦房结附近的一个或多个相应电极接收一个或多个固有心脏信号。 可植入电刺激电路被配置为以与所感测的窦房心脏动作电位的定时关系开始在窦房结附近发送至少一个抑制性电刺激脉冲。 公开了其它系统和方法。

公开(公告)号：US08676314B2

公开(公告)日：2014-03-18

申请号：US12435915

申请日：2009-05-05

申请人： Barun Maskara ,  Jiang Ding ,  M. Jason Brooke

发明人： Barun Maskara ,  Jiang Ding ,  M. Jason Brooke

IPC分类号： A61N1/00

CPC分类号： A61N1/371 ,  A61N1/3627 ,  A61N1/3682 ,  A61N1/3684

摘要： A method of operating a cardiac therapy system to deliver cardiac resynchronization therapy (CRT) pacing that includes pacing both ventricles or pacing only the left ventricle is described. Delivery of the CRT pacing to one or both ventricles is scheduled for a cardiac cycle. If an intrinsic depolarization of a ventricle is detected during a pacing delay of the ventricle, then the scheduled CRT pacing to the ventricle is inhibited for the cycle. The intrinsic interval of the ventricle, such as the intrinsic atrioventricular interval concluded by the intrinsic depolarization, is measured. During a subsequent cardiac cycle, the pacing delay of the ventricle is decreased to be less than or equal to the measured intrinsic interval. Capture of the ventricle is verified after pacing is delivered during the subsequent cardiac cycle.

摘要翻译： 描述了一种操作心脏治疗系统以递送心脏再同步治疗（CRT）起搏的方法，其包括仅对左心室起搏两个心室或起搏。 将CRT起搏送至一个或两个心室，安排进行心动周期。 如果在心室的起搏延迟期间检测到心室的内在去极化，则对该周期抑制预定的对心室的CRT起搏。 测量心室的固有间隔，例如内在去极化结束的内在房室间隔。 在随后的心动周期中，心室的起搏延迟降低到小于或等于测量的固有间期。 在随后的心动周期内进行起搏后验证心室的获取。

公开(公告)号：US20100087889A1

公开(公告)日：2010-04-08

申请号：US12570167

申请日：2009-09-30

申请人： Barun Maskara ,  Jiang Ding

发明人： Barun Maskara ,  Jiang Ding

IPC分类号： A61N1/365

CPC分类号： A61N1/3682 ,  A61N1/3627 ,  A61N1/36507 ,  A61N1/368 ,  A61N1/3684

摘要： Systems and methods for pacing the heart using resynchronization pacing delays that achieve improvement of cardiac function are described. An early activation pacing interval is calculated based on an optimal AV delay and an atrial to early ventricular activation interval between an atrial event and early activation of a ventricular depolarization. The early activation pacing interval for the ventricle is calculated by subtracting the measured AVEA from the calculated optimal AV delay. The early activation pacing interval is initiated responsive to sensing early activation of the ventricle and pacing is delivered relative to expiration of the early activation pacing interval.

摘要翻译： 描述了实现心脏功能改善的再同步起搏延迟来起搏心脏的系统和方法。 基于最佳AV延迟和心房事件与心室去极化的早期激活之间的早期心室激活间隔来计算早期激活起搏间隔。 通过从计算的最佳AV延迟中减去测量的AVEA来计算心室的早期激活起搏间隔。 响应于感测心室的早期激活而启动早期激活起搏间隔，并且相对于早期激活起搏间隔的期满而递送起搏。

公开(公告)号：US08798749B2

公开(公告)日：2014-08-05

申请号：US11610821

申请日：2006-12-14

申请人： Barun Maskara ,  Jiang Ding ,  Imad Libbus

发明人： Barun Maskara ,  Jiang Ding ,  Imad Libbus

IPC分类号： A61N1/365

CPC分类号： A61N1/0587 ,  A61N1/36514 ,  A61N1/3956

摘要： A system comprising an implantable electrical cardiac signal sensing circuit, an implantable sinoatrial cardiac action potential detector circuit, and an implantable electrical stimulation circuit in electrical communication with the electrical cardiac signal sensing circuit and the sinoatrial cardiac action potential detector circuit. The electrical cardiac signal sensing circuit is configured to receive one or more intrinsic heart signals from one or more respective electrodes configured for placement in a vicinity of a sinoatrial node of a subject. The implantable electrical stimulation circuit is configured to initiate delivery of at least one inhibitory electrical stimulation pulse in a vicinity of the sinoatrial node in a timed relationship to a sensed sinoatrial cardiac action potential. Other systems and methods are disclosed.

摘要翻译： 一种包括可植入电气心脏信号感测电路，可植入窦房心脏动作电位检测器电路和与电心脏信号感测电路和窦房心脏动作电位检测器电路电通信的可植入电刺激电路的系统。 电心脏信号感测电路被配置为从被配置为放置在受试者的窦房结附近的一个或多个相应电极接收一个或多个固有心脏信号。 可植入电刺激电路被配置为以与所感测的窦房心脏动作电位的定时关系开始在窦房结附近发送至少一个抑制性电刺激脉冲。 公开了其它系统和方法。

公开(公告)号：US20090281590A1

公开(公告)日：2009-11-12

申请号：US12435915

申请日：2009-05-05

申请人： Barun Maskara ,  Jiang Ding ,  M. Jason Brooke

发明人： Barun Maskara ,  Jiang Ding ,  M. Jason Brooke

IPC分类号： A61N1/365 ,  A61N1/37

CPC分类号： A61N1/371 ,  A61N1/3627 ,  A61N1/3682 ,  A61N1/3684

摘要： A method of operating a cardiac therapy system to deliver cardiac resynchronization therapy (CRT) pacing that includes pacing both ventricles or pacing only the left ventricle is described. Delivery of the CRT pacing to one or both ventricles is scheduled for a cardiac cycle. If an intrinsic depolarization of a ventricle is detected during a pacing delay of the ventricle, then the scheduled CRT pacing to the ventricle is inhibited for the cycle. The intrinsic interval of the ventricle, such as the intrinsic atrioventricular interval concluded by the intrinsic depolarization, is measured. During a subsequent cardiac cycle, the pacing delay of the ventricle is decreased to be less than or equal to the measured intrinsic interval. Capture of the ventricle is verified after pacing is delivered during the subsequent cardiac cycle.

摘要翻译： 描述了一种操作心脏治疗系统以递送心脏再同步治疗（CRT）起搏的方法，其包括仅对左心室起搏两个心室或起搏。 将CRT起搏送至一个或两个心室，安排进行心动周期。 如果在心室的起搏延迟期间检测到心室的内在去极化，则对该周期抑制预定的对心室的CRT起搏。 测量心室的固有间隔，例如内在去极化结束的内在房室间隔。 在随后的心动周期中，心室的起搏延迟降低到小于或等于测量的固有间期。 在随后的心动周期内进行起搏后验证心室的获取。

公开(公告)号：US20090118783A1

公开(公告)日：2009-05-07

申请号：US12235220

申请日：2008-09-22

申请人： Abhilash Patangay ,  Barun Maskara ,  Jonathan Kwok ,  Jiang Ding ,  Yinghong Yu

发明人： Abhilash Patangay ,  Barun Maskara ,  Jonathan Kwok ,  Jiang Ding ,  Yinghong Yu

IPC分类号： A61N1/365

CPC分类号： A61N1/36592 ,  A61N1/3627 ,  A61N1/36564 ,  A61N1/36585 ,  A61N1/3682 ,  A61N1/3684

摘要： Method and systems related to monitoring right ventricular function during pacing by a cardiac rhythm management device are described. One or more pacing parameters are selected to provide cardiac resynchronization therapy. For example, the one or more pacing parameters may be selected to provide an optimal or improved therapy. The heart is paced using the selected pacing parameters. While pacing with the selected parameters, pressure is sensed via a pressure sensor disposed the pulmonary artery. The sensed pressure is analyzed to determine right ventricular function achieved during the pacing using the selected pacing parameters. A signal, such as an alert signal or control signal, is generated based on the right ventricular function achieved during the pacing.

摘要翻译： 描述了通过心律管理装置在起搏期间监测右心室功能相关的方法和系统。 选择一个或多个起搏参数以提供心脏再同步治疗。 例如，可以选择一个或多个起搏参数以提供最佳或改进的治疗。 心脏使用所选择的起搏参数进行起搏。 在使用所选参数进行起搏时，通过设置肺动脉的压力传感器检测压力。 分析检测到的压力以确定使用所选择的起搏参数在起搏期间获得的右心室功能。 基于在起搏期间实现的右心室功能，产生诸如警报信号或控制信号的信号。

公开(公告)号：US08423140B2

公开(公告)日：2013-04-16

申请号：US12787630

申请日：2010-05-26

申请人： Barun Maskara ,  Lili Liu ,  Guy Alvarez ,  Scott A. Meyer

发明人： Barun Maskara ,  Lili Liu ,  Guy Alvarez ,  Scott A. Meyer

IPC分类号： A61N1/08

CPC分类号： A61N1/36564

摘要： A system and method for detecting and treating symptoms of early decompensation utilizing a cardiac rhythm management. The system applies an electrical stimulus to the patient's heart at a first set of pacing parameters including a lower rate limit (LRL) setting, and acquires a coronary venous pressure (CVP) signal from a pressure sensor implanted in a coronary vein of the patient. An average coronary venous end diastolic pressure (CV-EDP) value is calculated from the CVP signal. The system monitors the average CV-EDP value over a predetermined interval, and dynamically adjusts the LRL setting responsive to the detection of a first or a second predetermined event based on the average CV-EDP value.

摘要翻译： 一种利用心律管理检测和治疗早期失代偿症状的系统和方法。 该系统以包括较低速率限制（LRL）设置在内的第一组起搏参数对患者的心脏施加电刺激，并从植入患者冠状静脉的压力传感器获取冠状静脉压（CVP）信号。 根据CVP信号计算平均冠状静脉舒张末期压（CV-EDP）值。 该系统在预定间隔内监视平均CV-EDP值，并且响应于基于平均CV-EDP值的第一或第二预定事件的检测动态地调整LRL设置。

公开(公告)号：US20100305632A1

公开(公告)日：2010-12-02

申请号：US12775215

申请日：2010-05-06

申请人： Barun Maskara ,  Jason J. Hamann ,  Stephen Ruble ,  Craig Stolen

发明人： Barun Maskara ,  Jason J. Hamann ,  Stephen Ruble ,  Craig Stolen

IPC分类号： A61N1/36 ,  A61N1/362

CPC分类号： A61N1/362

摘要： Various embodiments of an implantable system for delivering therapy comprise at least one of a heat sink or source to either reduce or increase temperature of excitable tissue, a pulse generator and at least one stimulation electrode to deliver electrical stimulation to excitable tissue, a memory and a controller. The memory has instructions for performing at least one stimulation routine and at least one thermal routine, and further has integration instructions for integrating the thermal routine(s) with the stimulation routine(s). The controller is configured to operate on the instructions to perform the stimulation routine(s) using the pulse generator and the at least one stimulation electrode, to perform the thermal routine(s) using the heat sink or the heat source, and to operate on the integration instructions to integrate thermal routine(s) with the stimulation routine(s).

摘要翻译： 用于递送治疗的可植入系统的各种实施例包括散热器或源的至少一个，以减少或增加可兴奋组织的温度，脉冲发生器和至少一个刺激电极，以将电刺激递送至可兴奋组织，存储器和 控制器。 存储器具有用于执行至少一个刺激程序和至少一个热程序的指令，并且还具有用于将热程序与刺激程序整合的积分指令。 控制器被配置为根据指令操作以使用脉冲发生器和至少一个刺激电极执行刺激程序，以使用散热器或热源来执行热程序，并且操作在 将热程序与刺激程序集成的集成指令。