公开(公告)号：US20080319494A1

公开(公告)日：2008-12-25

申请号：US12229563

申请日：2008-08-25

申请人： Victor T. Chen ,  Gary T. Seim ,  Milton M. Morris

发明人： Victor T. Chen ,  Gary T. Seim ,  Milton M. Morris

IPC分类号： A61N1/362

CPC分类号： A61N1/3962 ,  A61N1/3622

摘要： A system and method for providing pacing pulses after a cardioversion/defibrillation shock, where the pacing pulses have a pacing rate at an initial value. The pacing rate is decreased from the initial value until at least one intrinsic cardiac contraction is detected. In one embodiment, the pacing rate is decreased by a set amount after pacing a set number of cardiac cycles. Providing the set number of pacing pulses and decreasing the pacing rate by the set amount is then repeated until at least one intrinsic cardiac contraction is detected. An intrinsic cardiac rate is then determined from the at least one intrinsic cardiac contraction. The pacing rate is then increased and maintained to be above (i.e., greater than) the intrinsic cardiac rate.

摘要翻译： 用于在心脏复律/除颤休克之后提供起搏脉冲的系统和方法，其中起搏脉冲具有初始值的起搏速率。 起搏速率从初始值降低到检测到至少一个固有心脏收缩。 在一个实施例中，起搏速率在起搏设定数量的心动周期后降低设定量。 然后重复提供设定数量的起搏脉冲并将起搏速率降低设定量，直到检测到至少一个固有心脏收缩。 然后从至少一个固有心脏收缩确定固有心率。 然后起搏速率增加并保持在高于（即大于）本征心率。

公开(公告)号：US07024240B2

公开(公告)日：2006-04-04

申请号：US10643513

申请日：2003-08-19

申请人： Victor T. Chen ,  Gary T. Seim ,  Carlos Ricci ,  Michael L. Favet ,  Hal Propp

发明人： Victor T. Chen ,  Gary T. Seim ,  Carlos Ricci ,  Michael L. Favet ,  Hal Propp

IPC分类号： A61N1/39

CPC分类号： A61N1/3956

摘要： An implantable cardiac device detects a patient therapy request originating from external to the implantable device. A shock therapy delay period is timed in response to the detection of the patient therapy request. Atrial shock therapy is provided to the patient after expiration of the shock therapy delay period (if the presence of an ongoing atrial arrhythmia is detected). The patient therapy request may be provided by a patient activator including a magnet for operating a reed switch in the implanted device to provide the request. A patient activator including an input and receiver/transmitter circuitry may be employed to request the immediate providing of atrial shock therapy, and/or to set the duration the shock therapy delay period. By allowing specific delays to therapy after a therapy request, a patient can prepare for the requested therapy and thereby mitigate therapy discomfort.

公开(公告)号：US06618617B2

公开(公告)日：2003-09-09

申请号：US09839123

申请日：2001-04-20

申请人： Victor T. Chen ,  Gary T. Seim ,  Carlos Ricci ,  Michael L. Favet ,  Hal Propp

发明人： Victor T. Chen ,  Gary T. Seim ,  Carlos Ricci ,  Michael L. Favet ,  Hal Propp

IPC分类号： A61N139

CPC分类号： A61N1/3956

摘要： An implantable cardiac device detects a patient therapy request originating from external to the implantable device. A shock therapy delay period is timed in response to the detection of the patient therapy request. Atrial shock therapy is provided to the patient after expiration of the shock therapy delay period (if the presence of an ongoing atrial arrhythmia is detected). The patient therapy request may be provided by a patient activator including a magnet for operating a reed switch in the implanted device to provide the request. A patient activator including an input and receiver/transmitter circuitry may be employed to request the immediate providing of atrial shock therapy, and/or to set the duration of the shock therapy delay period. By allowing specific delays to therapy after a therapy request, a patient can prepare for the requested therapy and thereby mitigate therapy discomfort.

公开(公告)号：US06430438B1

公开(公告)日：2002-08-06

申请号：US09316741

申请日：1999-05-21

申请人： Victor T. Chen ,  Jay A. Warren ,  Gary T. Seim ,  David B. Krig ,  Jesse W. Hartley ,  Jeffrey E. Stahmann

发明人： Victor T. Chen ,  Jay A. Warren ,  Gary T. Seim ,  David B. Krig ,  Jesse W. Hartley ,  Jeffrey E. Stahmann

IPC分类号： A61N139

CPC分类号： A61N1/3962 ,  A61N1/3621 ,  A61N1/3627 ,  A61N1/3682 ,  A61N1/395 ,  A61N1/3987

摘要： A cardiac rhythm management system includes atrial shock timing optimization. Because an atrial tachyarrhythmia, such as atrial fibrillation typically causes significant variability in the ventricular heart rate, resulting in potentially proarrhythmic conditions. The system avoids delivering atrial cardioversion/defibrillation therapy during potentially proarrhythmic conditions because doing so could result in dangerous ventricular arrhythmias. Using Ventricular Rate Regularization (“VRR”) techniques, the system actively stabilizes the ventricular heart rate to obtain less potentially proarrhythmic conditions for delivering the atrial tachyarrhythmia therapy. The intrinsic ventricular heart rate is stabilized at a variable VRR-indicated rate, computed using an infinite impulse response (IIR) filter, and based on the underlying intrinsic ventricular heart rate. The system withholds delivery of atrial cardioversion/defibrillation therapy until the intervals between ventricular beats (“V-V intervals”) meet certain criteria that decrease the chance that the atrial cardioversion/defibrillation therapy will induce a ventricular arrhythmia.

摘要翻译： 心律管理系统包括心房休克时序优化。 因为房性心律失常，例如心房颤动，通常会导致心室心率的显着变异，导致潜在的心律失常症状。 该系统避免在潜在的心律失常症状期间进行心房复律/除颤治疗，因为这样做可能导致危险的室性心律失常。 使用心室率正常化（“VRR”）技术，该系统主动地稳定心室心率以获得较少的用于递送心房快速性心律失常治疗的潜在致心律失常状况。 使用无限脉冲响应（IIR）滤波器，并且基于潜在的内部心室心率计算，内在心室心率以可变的VRR指示速率被稳定。 系统禁止心房复律/除颤治疗，直到心室搏动之间的间隔（“V-V间隔”）符合某些标准，可降低心房复律/除颤疗法诱发室性心律失常的机会。

公开(公告)号：US09126051B2

公开(公告)日：2015-09-08

申请号：US13235008

申请日：2011-09-16

申请人： Gary T. Seim

发明人： Gary T. Seim

IPC分类号： A61N1/368

CPC分类号： A61N1/368 ,  A61N1/3682 ,  A61N1/3688

摘要： A device comprises a cardiac contraction sensing circuit, a timer circuit, an electrical stimulation circuit, and a controller. The timer circuit provides a time duration of an atrial-atrial interval between successive atrial contractions, a ventricular-ventricular interval between successive ventricular contractions, and an atrial-ventricular (A-V) interval between an atrial contraction and a same cardiac cycle ventricular contraction. The controller includes an event detection module and a pacing module. The event detection module is configured for determining whether A-V block events are sustained over multiple cardiac cycles. The pacing module is configured for providing pacing therapy according to a primary pacing mode that includes AAI(R) mode with non-tracking VVI backup mode, and for switching the pacing therapy to a secondary tracking pacing mode if A-V block events are sustained over multiple cardiac cycles.

摘要翻译： 一种装置包括心脏收缩感测电路，定时器电路，电刺激电路和控制器。 定时器电路提供连续心房收缩之间的心房间隔的持续时间，连续心室收缩之间的心室 - 心室间隔和心房收缩与相同心动周期心室收缩之间的心房 - 心室（A-V）间隔。 控制器包括事件检测模块和起搏模块。 事件检测模块被配置用于确定A-V块事件是否在多个心动周期上持续。 起搏模块被配置为根据主起搏模式提供起搏治疗，该起搏模式包括具有非跟踪VVI备用模式的AAI（R）模式，以及如果AV阻塞事件持续多次，则将起搏治疗切换到辅助跟踪起搏模式 心脏周期。

公开(公告)号：US08046061B2

公开(公告)日：2011-10-25

申请号：US12229563

申请日：2008-08-25

申请人： Victor T. Chen ,  Gary T. Seim ,  Milton M. Morris

发明人： Victor T. Chen ,  Gary T. Seim ,  Milton M. Morris

IPC分类号： A61N1/39

CPC分类号： A61N1/3962 ,  A61N1/3622

摘要： A system and method for providing pacing pulses after a cardioversion/defibrillation shock, where the pacing pulses have a pacing rate at an initial value. The pacing rate is decreased from the initial value until at least one intrinsic cardiac contraction is detected. In one embodiment, the pacing rate is decreased by a set amount after pacing a set number of cardiac cycles. Providing the set number of pacing pulses and decreasing the pacing rate by the set amount is then repeated until at least one intrinsic cardiac contraction is detected. An intrinsic cardiac rate is then determined from the at least one intrinsic cardiac contraction. The pacing rate is then increased and maintained to be above (i.e., greater than) the intrinsic cardiac rate.

摘要翻译： 用于在心脏复律/除颤休克之后提供起搏脉冲的系统和方法，其中起搏脉冲具有初始值的起搏速率。 起搏速率从初始值降低到检测到至少一个固有心脏收缩。 在一个实施例中，起搏速率在起搏设定数量的心动周期后降低设定量。 然后重复提供设定数量的起搏脉冲并将起搏速率降低设定量，直到检测到至少一个固有心脏收缩。 然后从至少一个固有心脏收缩确定固有心率。 然后起搏速率增加并保持在高于（即大于）本征心率。

公开(公告)号：US20100268293A1

公开(公告)日：2010-10-21

申请号：US12828005

申请日：2010-06-30

申请人： Victor T. Chen ,  Gary T. Seim ,  Carlos Ricci ,  Michael L. Favet ,  Hal Propp

发明人： Victor T. Chen ,  Gary T. Seim ,  Carlos Ricci ,  Michael L. Favet ,  Hal Propp

IPC分类号： A61N1/39

CPC分类号： A61N1/3956

摘要： An implantable cardiac device detects a patient therapy request originating from external to the implantable device. A shock therapy delay period is timed in response to the detection of the patient therapy request. Atrial shock therapy is provided to the patient after expiration of the shock therapy delay period (if the presence of an ongoing atrial arrhythmia is detected). The patient therapy request may be provided by a patient activator including a magnet for operating a reed switch in the implanted device to provide the request. A patient activator including an input and receiver/transmitter circuitry may be employed to request the immediate providing of atrial shock therapy, and/or to set the duration the shock therapy delay period. By allowing specific delays to therapy after a therapy request, a patient can prepare for the requested therapy and thereby mitigate therapy discomfort.

摘要翻译： 可植入心脏装置检测源自可植入装置外部的患者治疗请求。 响应于患者治疗请求的检测，休克治疗延迟期是定时的。 在休克治疗延迟期结束后（如果检测到正在进行的心律失常的存在），向患者提供心房休克疗法。 患者治疗请求可以由患者激活器提供，包括用于在植入装置中操作舌簧开关的磁体以提供请求。 可以使用包括输入和接收器/发射器电路的患者激活器来请求立即提供心房休克疗法和/或设置休克治疗延迟时期的持续时间。 通过在治疗请求后允许特定的延迟治疗，患者可以准备所要求的治疗，从而减轻治疗不适。

公开(公告)号：US20100204742A1

公开(公告)日：2010-08-12

申请号：US12764635

申请日：2010-04-21

申请人： Victor T. Chen ,  Gary T. Seim ,  Hal Propp ,  LeAnne Eberle ,  Lynn TeWinkel

发明人： Victor T. Chen ,  Gary T. Seim ,  Hal Propp ,  LeAnne Eberle ,  Lynn TeWinkel

IPC分类号： A61N1/39

CPC分类号： A61N1/37252 ,  A61N1/3956

摘要： An implanted cardiac device detects an atrial arrhythmia and provides periodically updated atrial arrhythmia status as long as the arrhythmia is ongoing. A patient may request an indication of ongoing atrial arrhythmia status from external to the patient using a patient activator. The patient activator may include a magnet for closing a reed switch in the implanted device to provide the request or may provide the request over a telemetry link to the implanted device. The implanted device may provide the requested atrial arrhythmia status and other information in the form of an audible tone produced by the implanted device or as a message telemetered from the implanted device to the patient activator. The patient activator may include a tone detector and display for providing a visual indication of the atrial arrhythmia status indication. The magnet activator may also be employed to request or withhold atrial shock therapy.

摘要翻译： 植入式心脏装置检测心房心律失常，并且只要心律失常正在进行，就能提供定期更新的心房心律失常状态。 患者可以使用患者激活剂从外部向患者请求持续的心房心律失常状态的指示。 患者激活器可以包括用于关闭植入装置中的舌簧开关以提供请求的磁体，或者可以通过到植入装置的遥测链路提供请求。 植入装置可以以由植入装置产生的听觉音调的形式或作为从植入装置遥测到患者激活器的消息来提供所请求的心房心律失常状态和其他信息。 患者激活器可以包括用于提供心房心律失常状态指示的视觉指示的音调检测器和显示器。 磁铁激活剂也可用于要求或禁止心房休克治疗。

公开(公告)号：US06980857B2

公开(公告)日：2005-12-27

申请号：US09839122

申请日：2001-04-20

申请人： Victor T. Chen ,  Gary T. Seim ,  Hal Propp ,  LeAnne Eberle ,  Lynn TeWinkel

发明人： Victor T. Chen ,  Gary T. Seim ,  Hal Propp ,  LeAnne Eberle ,  Lynn TeWinkel

IPC分类号： A61N1/372 ,  A61N1/39 ,  A61N1/18

CPC分类号： A61N1/37252 ,  A61N1/3956

摘要： An implanted cardiac device detects an atrial arrhythmia and provides periodically updated atrial arrhythmia status as long as the arrhythmia is ongoing. A patient may request an indication of ongoing atrial arrhythmia status from external to the patient using a patient activator. The patient activator may include a magnet for closing a reed switch in the implanted device to provide the request or may provide the request over a telemetry link to the implanted device. The implanted device may provide the requested atrial arrhythmia status and other information in the form of an audible tone produced by the implanted device or as a message telemetered from the implanted device to the patient activator. The patient activator may include a tone detector and display for providing a visual indication of the atrial arrhythmia status indication. The magnet activator may also be employed to request or withhold atrial shock therapy.

摘要翻译： 植入式心脏装置检测心房心律失常，并且只要心律失常正在进行，就能提供定期更新的心房心律失常状态。 患者可以使用患者激活剂从外部向患者请求持续的心房心律失常状态的指示。 患者激活器可以包括用于关闭植入装置中的舌簧开关以提供请求的磁体，或者可以通过到植入装置的遥测链路提供请求。 植入装置可以以由植入装置产生的听觉音调的形式或作为从植入装置遥测到患者激活器的消息来提供所请求的心房心律失常状态和其他信息。 患者激活器可以包括用于提供心房心律失常状态指示的视觉指示的音调检测器和显示器。 磁铁激活剂也可用于要求或禁止心房休克治疗。

公开(公告)号：US06829504B1

公开(公告)日：2004-12-07

申请号：US09662091

申请日：2000-09-14

申请人： Victor T. Chen ,  Gary T. Seim ,  Milton M. Morris

发明人： Victor T. Chen ,  Gary T. Seim ,  Milton M. Morris

IPC分类号： A61N139

CPC分类号： A61N1/3962 ,  A61N1/3622

摘要： A system and method for providing pacing pulses after a cardioversion/defibrillation shock, where the pacing pulses have a pacing rate at an initial value. The pacing rate is decreased from the initial value until at least one intrinsic cardiac contraction is detected. In one embodiment, the pacing rate is decreased by a set amount after pacing a set number of cardiac cycles. Providing the set number of pacing pulses and decreasing the pacing rate by the set amount is then repeated until at least one intrinsic cardiac contraction is detected. An intrinsic cardiac rate is then determined from the at least one intrinsic cardiac contraction. The pacing rate is then increased and maintained to be above (i.e., greater than) the intrinsic cardiac rate.

摘要翻译： 用于在心脏复律/除颤休克之后提供起搏脉冲的系统和方法，其中起搏脉冲具有初始值的起搏速率。 起搏速率从初始值降低到检测到至少一个固有心脏收缩。 在一个实施例中，起搏速率在起搏设定数量的心动周期后降低设定量。 然后重复提供设定数量的起搏脉冲并将起搏速率降低设定量，直到检测到至少一个固有心脏收缩。 然后从至少一个固有心脏收缩确定固有心率。 然后起搏速率增加并保持在高于（即大于）本征心率。