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    Smart delay for intermittent stress therapy
    11.
    发明授权
    Smart delay for intermittent stress therapy 有权
    智能延迟间歇性压力治疗

    公开(公告)号：US08521278B2

    公开(公告)日：2013-08-27

    申请号：US12436497

    申请日：2009-05-06

    申请人： Allan C. Shuros ,  Shantha Arcot-Krishnamurthy ,  Robert Shipley

    发明人： Allan C. Shuros ,  Shantha Arcot-Krishnamurthy ,  Robert Shipley

    IPC分类号： A61N1/00

    CPC分类号： A61N1/3627 ,  A61N1/3682

    摘要： A pacing system delivers cardiac protection pacing to protect the heart from injuries. The pacing system receives a set of inputs and calculates parameters for delivering optimized cardiac protection pacing tailored for different stress levels. The system automatically adjusts heart rate to optimize cardiac protection pacing in a closed-loop system. In one embodiment, a method for delivering pacing pulses for cardiac protection is provided. Intrinsic atrioventricular (AV) intervals are sensed. The intrinsic AV interval and a predetermined equation relating the AV interval to an optimal AV delay are used to provide a maximum positive rate of left ventricular pressure change during systole. An AV delay is calculated using a predetermined percentage of the optimal AV delay to deliver ventricular pacing pulses to provide a desired level of stress for cardiac protective pacing therapy (CPPT) to provide a cardiac conditioning therapy to improve autonomic balance.

    摘要翻译： 起搏系统提供心脏保护起搏，以保护心脏免受伤害。 起搏系统接收一组输入，并计算用于提供针对不同应力水平定制的优化心脏保护起搏的参数。 系统自动调节心率以优化闭环系统中的心脏保护起搏。 在一个实施例中，提供了一种用于输送用于心脏保护的起搏脉冲的方法。 感测房室内（AV）间隔。 使用本征AV间隔和将AV间隔与最佳AV延迟相关联的预定方程用于在收缩期间提供左心室压力变化的最大正率。 使用预定百分比的最佳AV延迟来计算AV延迟以递送心室起搏脉冲以提供用于心脏保护起搏治疗（CPPT）的期望水平的应力以提供心脏调节疗法以改善自主神经平衡。

    Configurable intermittent pacing therapy
    12.
    发明授权
    Configurable intermittent pacing therapy 失效
    可配置的间歇性起搏治疗

    公开(公告)号：US08548586B2

    公开(公告)日：2013-10-01

    申请号：US12361353

    申请日：2009-01-28

    申请人： Shantha Arcot-Krishnamurthy ,  John R. Zielinski ,  Joseph M. Pastore ,  Jeffrey E. Stahmann ,  Allan C. Shuros ,  Robert Shipley

    发明人： Shantha Arcot-Krishnamurthy ,  John R. Zielinski ,  Joseph M. Pastore ,  Jeffrey E. Stahmann ,  Allan C. Shuros ,  Robert Shipley

    IPC分类号： A61N1/362

    CPC分类号： A61N1/3627 ,  A61N1/3688

    摘要： This document discusses, among other things, an apparatus comprising at least one implantable cardiac depolarization sensing circuit, an electrical stimulation circuit, and a pacing mode controller. The implantable cardiac depolarization sensing circuit is configured to obtain a sensed depolarization signal from a ventricle and the electrical stimulation circuit is configured to provide pacing electrical stimulation energy to at least one implantable ventricular electrode. The pacing mode controller delivers pacing therapy according to a first pacing mode that is a normal operating mode, and delivers pacing therapy according to second and third pacing modes. The second and third pacing modes increase mechanical stress on at least a particular portion of the ventricle as compared to the pacing therapy delivered during the first pacing mode. The pacing mode controller alternates between the second and third pacing modes when switched from the normal operating mode to a stress augmentation mode.

    摘要翻译： 本文件尤其涉及包括至少一个可植入心脏去极化感测电路，电刺激电路和起搏模式控制器的装置。 可植入心脏去极化感测电路被配置为从心室获得感测的去极化信号，并且电刺激电路被配置为向至少一个可植入心室电极提供起搏电刺激能量。 起搏模式控制器按照正常运行模式的第一起搏模式提供起搏治疗，并根据第二和第三起搏模式提供起搏治疗。 与在第一起搏模式期间递送的起搏治疗相比，第二和第三起搏模式增加至少在心室的特定部分上的机械应力。 当从正常操作模式切换到应力增强模式时，起搏模式控制器在第二和第三起搏模式之间交替。

    Method and device for cardiac vasoactive therapy
    13.
    发明授权
    Method and device for cardiac vasoactive therapy 失效
    心脏血管活性治疗的方法和装置

    公开(公告)号：US08600499B2

    公开(公告)日：2013-12-03

    申请号：US11566896

    申请日：2006-12-05

    申请人： Allan C. Shuros ,  Shantha Arcot-Krishnamurthy ,  Joseph Walker

    发明人： Allan C. Shuros ,  Shantha Arcot-Krishnamurthy ,  Joseph Walker

    IPC分类号： A61N1/362

    CPC分类号： A61N1/3627 ,  A61F2/82 ,  A61N1/3688

    摘要： A method and device for treating myocardial ischemia in which an implantable pulse generator delivers electrical stimulation to electrodes disposed near a coronary artery. The stimulation parameters may be adjusted to produce vasodilation and/or vasoconstriction of the artery. The device may be configured to operate in a vasodilation and/or vasoconstriction mode in accordance with specified entry and exit conditions.

    摘要翻译： 一种用于治疗心肌缺血的方法和装置，其中植入式脉冲发生器将电刺激递送到设置在冠状动脉附近的电极。 可以调节刺激参数以产生动脉的血管舒张和/或血管收缩。 该装置可以被配置为根据指定的入口和出口条件在血管舒张和/或血管收缩模式中操作。

    Closed-loop control of intermittent excitatory cardiac stimulation for therapeutic effect
    15.
    发明授权
    Closed-loop control of intermittent excitatory cardiac stimulation for therapeutic effect 有权
    间歇兴奋性心脏刺激闭环控制治疗效果

    公开(公告)号：US08131363B2

    公开(公告)日：2012-03-06

    申请号：US11860957

    申请日：2007-09-25

    申请人： Shantha Arcot-Krishnamurthy ,  Allan C. Shuros ,  Christopher Hartemink

    发明人： Shantha Arcot-Krishnamurthy ,  Allan C. Shuros ,  Christopher Hartemink

    IPC分类号： A61N1/365 ,  A61N1/362

    CPC分类号： A61N1/3627

    摘要： A device and method for delivering electrical stimulation to the heart in order to improve cardiac function in heart failure patients. The stimulation is delivered as high-output pacing in which the stimulation is excitatory and also of sufficient energy to augment myocardial contractility. In order to provide a consistent hemodynamic response, the high-output pacing is optimized by delivering it using different parameter sets, evaluating the hemodynamic response thereto as reflected by one or more measured physiological variables, and selecting the parameter set with the best hemodynamic response.

    摘要翻译： 用于向心脏递送电刺激以改善心力衰竭患者的心脏功能的装置和方法。 刺激作为高产出起搏，其中刺激是兴奋性的，并且具有足够的能量以增加心肌收缩力。 为了提供一致的血流动力学响应，通过使用不同的参数组递送高输出起搏，通过一个或多个测量的生理变量反映的血液动力学响应进行评估，并且选择具有最佳血液动力学响应的参数集来优化高输出起搏。

    METHOD AND APPARATUS FOR PACING AND INTERMITTENT ISCHEMIA
    17.
    发明申请
    METHOD AND APPARATUS FOR PACING AND INTERMITTENT ISCHEMIA 审中-公开
    方法和装置用于切割和间歇性间断

    公开(公告)号：US20090318749A1

    公开(公告)日：2009-12-24

    申请号：US12484822

    申请日：2009-06-15

    申请人： Craig Stolen ,  Allan C. Shuros ,  Shantha Arcot-Krishnamurthy ,  Eric A. Mokelke

    发明人： Craig Stolen ,  Allan C. Shuros ,  Shantha Arcot-Krishnamurthy ,  Eric A. Mokelke

    IPC分类号： A61M1/12 ,  A61N1/365

    CPC分类号： A61N1/056 ,  A61B5/02028 ,  A61B5/0215 ,  A61B5/026 ,  A61F2/95 ,  A61N1/3625 ,  A61N1/3627 ,  A61N1/36514 ,  A61N1/36564 ,  A61N1/36571

    摘要： A system delivers multiple enhanced therapies to limit myocardial damage post-revascularization. The system includes a catheter that incorporates features for delivering cardiac protection pacing therapy (CPPT) and intermittent ischemia therapy. In one embodiment, a method for delivering cardiac protection therapies to a heart is provided. One or more catheters are provided having a balloon, at least one pacing electrode and at least one hemodynamic sensor. Cardiac protection pacing therapy (CPPT) and intermittent ischemia therapy are concurrently delivered using the one or more catheters. The pacing and ischemia are adapted to protect the heart from ischemic and reperfusion injuries. The delivery of the CPPT and the intermittent ischemia are controlled using a closed-loop system monitoring a signal sensed by the at least one hemodynamic sensor.

    摘要翻译： 系统提供多种增强疗法以限制血运重建后的心肌损伤。 该系统包括导管，其包括用于递送心脏保护起搏治疗（CPPT）和间歇性缺血治疗的特征。 在一个实施方案中，提供了将心脏保护治疗递送至心脏的方法。 提供一个或多个导管，其具有球囊，至少一个起搏电极和至少一个血流动力学传感器。 使用一个或多个导管同时输送心脏保护起搏治疗（CPPT）和间歇性缺血治疗。 起搏和缺血适应于保护心脏免于缺血和再灌注损伤。 CPPT的传送和间歇性缺血通过监视由至少一个血流动力学传感器感测到的信号的闭环系统来控制。

    Systems, devices and methods for modulating autonomic tone
    19.
    发明授权
    Systems, devices and methods for modulating autonomic tone 有权
    用于调节自主神经色调的系统，装置和方法

    公开(公告)号：US08626288B2

    公开(公告)日：2014-01-07

    申请号：US12397464

    申请日：2009-03-04

    申请人： Allan C. Shuros ,  Shantha Arcot-Krishnamurthy ,  Bruce H. KenKnight ,  Douglas R. Daum

    发明人： Allan C. Shuros ,  Shantha Arcot-Krishnamurthy ,  Bruce H. KenKnight ,  Douglas R. Daum

    IPC分类号： A61N1/368

    CPC分类号： A61N1/362 ,  A61N1/36114 ,  A61N1/3627

    摘要： Various embodiments intermittently deliver a sympathetic stimulus, including deliver a sequence of stress-inducing pacing pulses adapted to increase sympathetic tone during the stress-inducing pacing. The stress-inducing pacing results in a parasympathetic reflex after the sequence of stress-inducing pacing. The embodiment further delivers neural stimulation to elicit a parasympathetic response or a sympathetic response in a coordinated manner with respect to the sequence of stress-inducing pacing pulses. The neural stimulation is timed to elicit the parasympathetic response after the sequence of stress-inducing pacing pulses and concurrent with at least a portion of the parasympathetic reflex to the sequence of stress-inducing pacing to enhance a parasympathetic effect of the parasympathetic reflex, or to elicit the sympathetic response during the sequence of stress-inducing pulses to provide a larger sympathetic stimulus, resulting in an enhanced parasympathetic reflex in response to the large sympathetic stimulus.

    摘要翻译： 各种实施方案间歇地递送交感刺激，包括递送适于在应力诱导起搏期间增加交感神经张力的应力诱发起搏脉冲序列。 应激诱导起搏导致应激诱导起搏顺序后的副交感神经反射。 该实施方案进一步递送神经刺激以相对于应力诱导起搏脉冲的序列以协调的方式引发副交感神经反应或交感神经反应。 神经刺激被定时以在应力诱发起搏脉冲序列之后引起副交感神经反应，并且与应激诱导起搏序列的至少一部分副交感神经反射并发，以增强副交感神经反射的副交感作用，或 在应激诱导脉冲序列期间引起交感神经反应以提供更大的交感神经刺激，导致响应于大的交感神经刺激的增强的副交感神经反射。