公开(公告)号：US20140371808A1

公开(公告)日：2014-12-18

申请号：US14190578

申请日：2014-02-26

Applicant: Medtronic, Inc.

Inventor： Subham Ghosh ,  Jeffrey M. Gillberg

IPC: A61N1/37

CPC classification number: A61B5/04085 ,  A61B5/0452 ,  A61B5/6805 ,  A61B5/7282 ,  A61N1/3627 ,  A61N1/3682 ,  A61N1/3684

Abstract: A method and system of cardiac pacing is disclosed. A baseline rhythm is determined using a plurality of body-surface electrodes. A set of baseline functional electrical metrics is determined in response to determining the baseline rhythm. Resynchronization pacing is delivered using a right ventricular electrode and a pacing left ventricular electrode or only with a left ventricular electrode. A set of functional electrical metrics relating to cardiac depolarization and repolarization is determined in response to resynchronization pacing. A determination is made as to whether relative reduction of at least one functional electrical metric from the set of functional electrical metrics exceeds X % of its corresponding value from the set of baseline functional electrical metrics. A determination is made as to whether an absolute value of at least one electrical metric from the set of the functional electrical metrics is less than Y ms. A determination is made as to whether a site is responsive to cardiac resynchronization therapy (CRT).

公开(公告)号：US08886315B2

公开(公告)日：2014-11-11

申请号：US13706498

申请日：2012-12-06

Applicant: Medtronic, Inc.

Inventor： Subham Ghosh

IPC: A61N1/08 ,  A61B5/0452 ,  A61N1/37 ,  A61B5/042 ,  A61B5/00 ,  A61B5/0464 ,  A61N1/368

CPC classification number: A61N1/3712 ,  A61B5/0006 ,  A61B5/0422 ,  A61B5/04525 ,  A61B5/0464 ,  A61N1/3684

Abstract: A method for monitoring the effectiveness of VSR and for taking action to improve the effectiveness of VSRs, if they are determined to be ineffective, includes comparing the a VSR evoked electrogram to a template electrogram of a pure biventricular paced CRT beat. If the electrograms, or features thereof, are similar, the VSR is determined to be effective. If the VSR is determined to be ineffective, the AV delay of biventricular CRT is shortened in a step-wise fashion in an incremental manner.

Abstract translation: 监测VSR的有效性和采取行动以提高VSR的有效性的方法（如果确定为无效的）包括将VSR诱发的电描记图与纯双心室起搏CRT搏击的模板电描记比较。 如果电描记图或其特征相似，则确定VSR是有效的。 如果VSR被确定为无效，则双向CRT的AV延迟以逐步方式逐渐缩短。

公开(公告)号：US20140323893A1

公开(公告)日：2014-10-30

申请号：US14227962

申请日：2014-03-27

Applicant: Medtronic, Inc.

Inventor： Subham Ghosh ,  Jeffrey Gillberg

IPC: A61B5/044 ,  A61N1/37

CPC classification number: A61B5/044 ,  A61N1/362 ,  A61N1/371 ,  A61N1/37247 ,  A61N2001/083

Abstract: Systems, methods, and interfaces are described herein for identification of effective electrodes to be used in sensing and/or therapy. Two or more portions of a signal monitored using an electrode may be compared to determine whether the electrode is effective. The two or more portions may correspond to the same portion or window of a cardiac cycle. Further, signals from a first electrode and from a second electrode located proximate the first electrode may be compared to determine whether one or both of the electrodes are effective.

公开(公告)号：US20140277233A1

公开(公告)日：2014-09-18

申请号：US13833882

申请日：2013-03-15

Applicant: MEDTRONIC, INC.

Inventor： Subham Ghosh

IPC: A61N1/365

CPC classification number: A61N1/3682 ,  A61N1/3627 ,  A61N1/3684

Abstract: A system and method control a pacing parameter in a closed-loop manner by determining a value of an EGM-based index corresponding an optimal electrical activation condition of a patient's heart and adjusting a pacing therapy to maintain the EGM-based index value. The closed loop control method performed by the system may establish a relationship between an EGM-based index and multiple settings of a pacing control parameter. Values of the EGM-based index are stored with corresponding setting shifts relative to a previously established optimal setting. A processor of an implantable medical device monitors the EGM-based index during cardiac pacing. Responsive to detecting an EGM-based index value corresponding to a non-optimal setting of the control parameter, the processor determines an adjustment of the control parameter from the stored index values and corresponding setting shifts.

Abstract translation: 系统和方法以闭环方式控制起搏参数，通过确定对应于患者心脏的最佳电活化状态的EGM指数的值并调整起搏治疗以维持基于EGM的指数值。 由系统执行的闭环控制方法可以建立基于EGM的索引与起搏控制参数的多个设置之间的关系。 基于EGM的索引的值相对于先前确定的最佳设置存储相应的设置位移。 可植入医疗装置的处理器在心脏起搏期间监测基于EGM的指数。 响应于检测对应于控制参数的非最优设置的基于EGM的索引值，处理器根据存储的索引值和相应的设置偏移来确定控制参数的调整。

公开(公告)号：US20140236253A1

公开(公告)日：2014-08-21

申请号：US13772890

申请日：2013-02-21

Applicant: MEDTRONIC, INC.

Inventor： Subham Ghosh ,  Robert W. Stadler

IPC: A61N1/37

CPC classification number: A61N1/3706 ,  A61N1/3682 ,  A61N1/3684 ,  A61N1/3686

Abstract: Generally, the disclosure is directed one or more methods or systems of cardiac pacing employing a plurality of left ventricular electrodes. Pacing using a first one of the left ventricular electrodes and measuring activation times at other ones of the left and right ventricular electrodes. Pacing using a second one of the ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes. Employing weighted sums of the measured activation times to measure a fusion index and select one of the left ventricular electrodes for delivery of subsequent pacing pulses based on comparing fusion indices during pacing from different LV electrodes. One or more embodiments use the same fusion index to select an optimal A-V delay by comparing fusion indices during pacing with different A-V delays at resting atrial rates as well as rates above the resting rate.

公开(公告)号：US20130190834A1

公开(公告)日：2013-07-25

申请号：US13744038

申请日：2013-01-17

Applicant: MEDTRONIC, INC.

Inventor： Subham Ghosh ,  Robert W. Stadler

IPC: A61N1/365

CPC classification number: A61N1/3682 ,  A61N1/3622 ,  A61N1/3627 ,  A61N1/36514 ,  A61N1/36592 ,  A61N1/3684

Abstract: Methods and/or devices may be configured to monitor ventricular activation times and modify an atrioventricular delay (AV delay) based on the monitored ventricular activation times. Further, the methods and/or devices may determine whether the AV delay should be modified based on the measured activation times before modifying the AV delay.

Abstract translation: 方法和/或设备可以被配置为基于所监测的心室激活时间来监测心室激活时间并修改房室延迟（AV延迟）。 此外，方法和/或设备可以基于在修改AV延迟之前测量的激活时间来确定AV延迟是否应该被修改。