公开(公告)号：US11369798B2

公开(公告)日：2022-06-28

申请号：US16509924

申请日：2019-07-12

Applicant: Medtronic, Inc.

Inventor： Jian Cao ,  Paul J. Degroot ,  Todd J. Sheldon

IPC: A61N1/365 ,  A61N1/37 ,  A61N1/372 ,  A61B5/00 ,  A61N1/375 ,  A61B5/349 ,  A61B5/352

Abstract: An implantable medical device system includes an extracardiac sensing device and an intracardiac pacemaker. The sensing device senses a P-wave attendant to an atrial depolarization of the heart via housing-based electrodes carried by the sensing device when the sensing device is implanted outside the cardiovascular system and sends a trigger signal to the intracardiac pacemaker in response to sensing the P-wave. The intracardiac pacemaker detects the trigger signal and schedules a ventricular pacing pulse in response to the detected trigger signal.

公开(公告)号：US11007369B2

公开(公告)日：2021-05-18

申请号：US16183902

申请日：2018-11-08

Applicant: Medtronic, Inc.

Inventor： Todd J. Sheldon ,  Elizabeth A. Mattson ,  Eric R. Williams

IPC: A61N1/37 ,  A61N1/378 ,  A61N1/39 ,  A61N1/372 ,  A61B5/0472 ,  A61B5/046 ,  A61B5/0464 ,  A61B5/00 ,  A61N1/365 ,  A61N1/375 ,  A61B5/042

Abstract: An implantable medical device system receives a cardiac electrical signal produced by a patient's heart and comprising atrial P-waves and delivers a His bundle pacing pulse to the patient's heart via a His pacing electrode vector. The system determines a timing of a sensed atrial P-wave relative to the His bundle pacing pulse and determines a type of capture of the His bundle pacing pulse in response to the determined timing of the atrial P-wave.

公开(公告)号：USRE48197E1

公开(公告)日：2020-09-08

申请号：US16045277

申请日：2018-07-25

Applicant: Medtronic, Inc.

Inventor： Yong K. Cho ,  Aleksandre T. Sambelashvili ,  Todd J. Sheldon

IPC: A61N1/00 ,  A61N1/365 ,  A61N1/372 ,  A61N1/375 ,  A61N1/06

Abstract: A leadless pacing device (LPD) includes a motion sensor configured to generate a motion signal as a function of heart movement. The LPD is configured to analyze the motion signal within an atrial contraction detection window that begins an atrial contraction detection delay period after activation of the ventricle, and detect a contraction of an atrium of the heart based on the analysis of the motion signal within the atrial contraction detection window. If the LPD does not detect a ventricular depolarization subsequent to the atrial contraction, e.g., with an atrio-ventricular (AV) interval beginning when the atrial contraction was detected, the LPD delivers a ventricular pacing pulse.

公开(公告)号：US10744329B2

公开(公告)日：2020-08-18

申请号：US16027717

申请日：2018-07-05

Applicant: Medtronic, Inc.

Inventor： Todd J. Sheldon ,  Wade M. Demmer ,  Greggory R. Herr

IPC: A61N1/365 ,  A61B5/0456 ,  A61N1/375 ,  A61N1/372 ,  A61N1/368 ,  A61B5/00 ,  A61B5/11 ,  A61N1/05

Abstract: A pacemaker having a motion sensor delivers atrial-synchronized ventricular pacing by detecting events from a signal produced by the motion sensor and delivering ventricular pacing pulses at a rate that tracks the rate of the detected events. The pacemaker is configured to confirm atrial tracking of the ventricular pacing pulses by determining if detected events from the motion sensor signal are atrial events. The pacemaker is configured to adjust a control parameter used for detecting events from the motion sensor signal if atrial tracking is not confirmed.

公开(公告)号：US10286209B2

公开(公告)日：2019-05-14

申请号：US15142814

申请日：2016-04-29

Applicant: MEDTRONIC, INC.

Inventor： Hyun J. Yoon ,  Michael L. Ellingson ,  Wade M. Demmer ,  Jonathan D. Edmonson ,  Matthew J. Hoffman ,  Ben W. Herberg ,  James D. Reinke ,  Todd J. Sheldon ,  Paul R. Solheim ,  Alison M. Seacord

IPC: A61N1/08 ,  A61N1/37 ,  A61N1/39

Abstract: Implantable medical devices automatically switch from a normal mode of operation to an exposure mode of operation and back to the normal mode of operation. The implantable medical devices may utilize hysteresis timers in order to determine if entry and/or exit criteria for the exposure mode are met. The implantable medical devices may utilize additional considerations for entry to the exposure mode such as a confirmation counter or a moving buffer of sensor values. The implantable medical devices may utilize additional considerations for exiting the exposure mode of operation and returning to the normal mode, such as total time in the exposure mode, patient position, and high voltage source charge time in the case of devices with defibrillation capabilities.

公开(公告)号：US20160158557A9

公开(公告)日：2016-06-09

申请号：US14605040

申请日：2015-01-26

Applicant: Medtronic, Inc.

Inventor： Todd J. Sheldon ,  Wade M. Demmer

IPC: A61N1/37

CPC classification number: A61N1/3712 ,  A61N1/3708 ,  A61N1/37205 ,  A61N1/3756

Abstract: According to some methods, for example, preprogrammed in a microprocessor element of an implantable cardiac pacing system, at least one of a number of periodic pacing threshold searches includes steps to reduce an evoked response amplitude threshold for evoked response signal detection. The reduction may be to a minimum value measurable above zero, for example, as determined by establishing a ‘noise floor’. Alternately, amplitudes of test pacing pulses and corresponding post pulse signals are collected and reviewed to search for a break, to determine a lower value to which the evoked response threshold may be adjusted without detecting noise. Subsequent to reducing the threshold, if no evoked response signal is detected for a test pulse applied at or above a predetermined maximum desirable pulse energy, an operational pacing pulse energy is set to greater than or equal to the maximum desirable in conjunction with a reduction in pacing rate.

公开(公告)号：US20160114168A1

公开(公告)日：2016-04-28

申请号：US14821141

申请日：2015-08-07

Applicant: Medtronic, Inc.

Inventor： Wade M Demmer ,  Todd J. Sheldon ,  Margaret G Guo

IPC: A61N1/365 ,  A61B5/04

CPC classification number: A61N1/36592 ,  A61B5/04017 ,  A61N1/3704

Abstract: A pacemaker implantable in a chamber of a patient's heart is configured to produce a filtered cardiac electrical signal by filtering a raw cardiac signal by an adjustable filter of a sensing module of the pacemaker. The sensing module is configured to receive the raw cardiac electrical signal comprising R-waves, T-waves and P-waves via electrodes coupled to the sensing module. The pacemaker is further configured to determine if the T-waves are distinct from the P-waves in the filtered cardiac electrical signal and adjust the filter to increase a difference between a feature of the P-waves and a feature of the T-waves in the filtered cardiac signal when the T-waves are not distinct from the P-waves.

Abstract translation: 可植入患者心脏的室中的起搏器被配置为通过由起搏器的感测模块的可调节过滤器过滤原始心脏信号来产生过滤心电信号。 感测模块​​被配置为通过耦合到感测模块的电极来接收包括R波，T波和P波的原始心电信号。 起搏器进一步被配置为确定T波是否与滤波心电信号中的P波不同，并调整滤波器以增加P波特征与T波特征之间的差异 当T波不与P波不同时，滤波后的心脏信号。

公开(公告)号：US20160015983A1

公开(公告)日：2016-01-21

申请号：US14518128

申请日：2014-10-20

Applicant: Medtronic, Inc.

Inventor： Todd J. Sheldon ,  Matthew D. Bonner ,  Kathryn Hilpisch ,  Noelle C. Neafus ,  Ronan Wood

IPC: A61N1/37

CPC classification number: A61N1/371 ,  A61B17/3468 ,  A61B2017/00358 ,  A61B2017/22035 ,  A61B2018/00642 ,  A61B2090/0811 ,  A61M25/0082 ,  A61N1/056 ,  A61N1/0573 ,  A61N1/372 ,  A61N1/37205 ,  A61N1/3756 ,  A61N2001/058 ,  A61N2001/0585

Abstract: Delivery tools of interventional medical systems facilitate deployment of relatively compact implantable medical devices that include sensing extensions, for example, right ventricular cardiac pacing devices that include a sensing extension for atrial sensing. An entirety of such a device is contained within a delivery tool while a distal-most portion of the tool is navigated to a target implant site; the tool is configured to expose, out from a distal opening thereof, a distal portion of the device for initial deployment, after which sensing, via a sense electrode of the aforementioned sensing extension of the device, can be evaluated without withdrawing the tool from over the remainder of the device that includes the sensing extension.

Abstract translation: 介入医疗系统的传送工具便于部署相对紧凑的植入式医疗设备，其包括感测扩展，例如包括用于心房感测的感测扩展的右心室心脏起搏装置。 整个这样的装置被包含在输送工具内，而工具的最远部分被导航到目标植入部位; 该工具被配置为从其远端开口露出用于初始展开的装置的远端部分，之后可以通过装置的上述感测延伸部分的感测电极感测，而不退出工具 该设备的其余部分包括感测扩展。

公开(公告)号：US20160015968A1

公开(公告)日：2016-01-21

申请号：US14518087

申请日：2014-10-20

Applicant: Medtronic, Inc.

Inventor： Matthew D. Bonner ,  Todd J. Sheldon ,  Kathryn Hilpisch ,  Noelle C. Neafus ,  Ronan Wood

IPC: A61N1/05 ,  A61N1/365 ,  A61N1/362

CPC classification number: A61N1/0592 ,  A61B17/3468 ,  A61B2017/00044 ,  A61B2017/00243 ,  A61B2017/22035 ,  A61B2017/2215 ,  A61M25/0026 ,  A61N1/059 ,  A61N1/3624 ,  A61N1/36507 ,  A61N1/372 ,  A61N1/37205 ,  A61N1/3756

Abstract: Delivery tools of interventional medical systems facilitate deployment of relatively compact implantable medical devices that include extensions, for example, cardiac pacing devices that include an extension for atrial sensing, wherein an entirety of the device is contained within the delivery tool while a distal-most portion of the tool is navigated to a target implant site. Once at the implant site, a device fixation member may be exposed out from a distal opening of the tool, for initial deployment, while the extension remains contained within the delivery tool. The tool includes a grasping mechanism, operable, within and without a lumen of the tool, to alternately grip and release the device extension, for example, to position a distal end of the extension after the tool has been withdrawn from over an entirety of the initially deployed device.

Abstract translation: 介入医疗系统的传送工具便于部署相对紧凑的可植入医疗设备，其包括延伸部，例如包括用于心房感测的延伸部的心脏起搏装置，其中整个装置包含在输送工具内，而最远部分 的工具被导航到目标植入部位。 一旦在植入位置处，装置固定构件可以从工具的远侧开口暴露出来，用于初始部署，同时延伸部分保持在输送工具内。 该工具包括抓握机构，该工具可在该工具的内腔内和不具有内腔的情况下交替地夹持和释放装置延伸部，例如，在该工具已经从整体上撤出之后定位延伸部的远端 初始部署的设备。

公开(公告)号：US20150190644A1

公开(公告)日：2015-07-09

申请号：US14605040

申请日：2015-01-26

Applicant: Medtronic, Inc.

Inventor： Todd J. Sheldon ,  Wade M. Demmer

IPC: A61N1/37

CPC classification number: A61N1/3712 ,  A61N1/3708 ,  A61N1/37205 ,  A61N1/3756

Abstract: According to some methods, for example, preprogrammed in a microprocessor element of an implantable cardiac pacing system, at least one of a number of periodic pacing threshold searches includes steps to reduce an evoked response amplitude threshold for evoked response signal detection. The reduction may be to a minimum value measurable above zero, for example, as determined by establishing a ‘noise floor’. Alternately, amplitudes of test pacing pulses and corresponding post pulse signals are collected and reviewed to search for a break, to determine a lower value to which the evoked response threshold may be adjusted without detecting noise. Subsequent to reducing the threshold, if no evoked response signal is detected for a test pulse applied at or above a predetermined maximum desirable pulse energy, an operational pacing pulse energy is set to greater than or equal to the maximum desirable in conjunction with a reduction in pacing rate.

Abstract translation: 根据一些方法，例如，在可植入心脏起搏系统的微处理器元件中预编程，多个周期性起搏阈值搜索中的至少一个包括减少诱发响应信号检测的诱发响应振幅阈值的步骤。 该减小可以是在零以上可测量的最小值，例如通过建立“本底噪声”确定的最小值。 或者，收集和检查测试起搏脉冲和对应的后脉冲信号的振幅以搜索中断，以确定可以在不检测噪声的情况下调整诱发响应阈值的较低值。 在降低阈值之后，如果对于在预定的最大期望脉冲能量之上或之上施加的测试脉冲没有检测到诱发响应信号，则可以将运行起搏脉冲能量设置为大于或等于期望的最大值， 起搏率