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21.发明授权Method and apparatus for identification of ischemic/infarcted regions and therapy optimization 有权用于鉴别缺血/梗死区域的方法和装置以及治疗优化公开(公告)号：US08219210B2
公开(公告)日：2012-07-10
申请号：US11541837
申请日：2006-10-02
申请人： Shantha Arcot-Krishnamurthy , Allan C. Shuros , Jiang Ding , Yinghong Yu , Michael J. Stucky , Chris Hartemink
发明人： Shantha Arcot-Krishnamurthy , Allan C. Shuros , Jiang Ding , Yinghong Yu , Michael J. Stucky , Chris Hartemink
CPC分类号： A61N1/36585 , A61B5/02028 , A61N1/3627 , A61N1/3682 , A61N1/3684 , A61N1/3702 , G06F19/00
摘要： A method and apparatus is described for detecting and localizing areas of myocardial infarction or ischemia. By pacing sites in proximity to the infarcted or ischemic region with appropriately timed pacing pulses, the region is pre-excited in a manner that lessens the mechanical stress to which it is subjected, thus reducing the metabolic demand of the region and the stimulus for remodeling.
摘要翻译： 描述了用于检测和定位心肌梗死或缺血区域的方法和装置。 通过以适当的定时起搏脉冲对位于梗塞或缺血区域附近的部位进行起搏，该区域以减轻其受到的机械应力的方式预激发，从而降低该区域的代谢需求和重塑的刺激 。
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公开(公告)号：US20120101542A1
公开(公告)日：2012-04-26
申请号：US13277617
申请日：2011-10-20
IPC分类号： A61N1/365
摘要： An A-H delay can be specified, such as by computing the A-H delay using a measured cardiovascular physiologic parameter. The A-H delay can be used for specifying timing between a paced or sensed atrial contraction and a His-bundle pacing time.
摘要翻译： 可以指定A-H延迟，例如通过使用测量的心血管生理参数计算A-H延迟。 A-H延迟可用于指定节奏或感觉到的心房收缩与His束起搏时间之间的时间。
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公开(公告)号：US20100121402A1
公开(公告)日：2010-05-13
申请号：US12615050
申请日：2009-11-09
申请人： Shantha Arcot-Krishnamurthy , Gary T. Seim , Kent Lee , Yanting Dong , Allan C. Shuros , David L. Whitehouse
发明人： Shantha Arcot-Krishnamurthy , Gary T. Seim , Kent Lee , Yanting Dong , Allan C. Shuros , David L. Whitehouse
IPC分类号： A61N1/368
CPC分类号： A61N1/3627 , A61N1/3688
摘要： Cardioprotective pre-excitation pacing may be applied to stress or de-stress a particular myocardial region delivering of pacing pulses in a manner that causes a dyssynchronous contraction. Such dyssynchronous contractions are responsible for the desired cardioprotective effects of pre-excitation pacing. A method and device for applying reverse hysteresis and mode switching to the delivery of such cardioprotective pacing are described.
摘要翻译： 心脏保护性预激发起搏可用于以导致同步收缩的方式对起搏脉冲递送的特定心肌区域应力或去应激。 这种异常收缩负责预激励起搏的所需心脏保护作用。 描述了一种用于将逆向滞后和模式切换应用于这种心脏保护起搏的递送的方法和装置。
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公开(公告)号：US20100087887A1
公开(公告)日：2010-04-08
申请号：US12573533
申请日：2009-10-05
IPC分类号： A61N1/365
CPC分类号： A61N1/3627 , A61N1/3682 , A61N1/3688
摘要： Cardioprotective pre-excitation pacing may be applied to stress or de-stress a particular myocardial region delivering of pacing pulses in a manner that causes a dyssynchronous contraction. Such dyssynchronous contractions are responsible for the desired cardioprotective effects of pre-excitation pacing but may also be hazardous. Described herein is a method and system that uses measures of a patient's heart rate or exertion level to control the duty cycles of intermittent pre-excitation pacing.
摘要翻译： 心脏保护性预激发起搏可用于以导致同步收缩的方式对起搏脉冲递送的特定心肌区域应力或去应激。 这种异常收缩负责预激励起搏的所需心脏保护作用，但也可能是危险的。 这里描述了一种方法和系统，其使用患者心率或运动水平的测量来控制间歇性预激发起搏的占空比。
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25.发明申请公开(公告)号：US20100016916A1
公开(公告)日：2010-01-21
申请号：US12504593
申请日：2009-07-16
申请人： Shantha Arcot-Krishnamurthy , Joseph M. Pastore , Allan C. Shuros , Scott A. Meyer , Robert Shipley , Jason J. Hamann
发明人： Shantha Arcot-Krishnamurthy , Joseph M. Pastore , Allan C. Shuros , Scott A. Meyer , Robert Shipley , Jason J. Hamann
IPC分类号： A61N1/368
CPC分类号： A61N1/36564 , A61N1/36528 , A61N1/36571 , A61N1/368
摘要： A pacing system delivers cardiac protective pacing therapy (CPPT) to protect the heart from injuries and/or to treat existing injuries. The pacing system receives a set of inputs and delivers optimized cardiac protection pacing tailored for different purposes. The system delivers electrical stimulation to modulate myocardial strain for anti-atherosclerosis therapy and/or to provide therapy for myocardial infarction (MI). In one embodiment, a medical device for treating atherosclerosis is provided. The medical device includes a sensing circuit to receive sensed signals to identify areas of coronary artery disease (CAD) or areas at risk for CAD using the sensed signals. The device also includes a pacemaker circuit adapted to deliver an electrical signal through at least one electrode to a myocardial target adjacent to the identified areas. According to various embodiments, a controller communicates with the sensing circuit and controls the pacemaker circuit to provide intermittent electrical stimulation to the myocardial target to induce periods of stretch on the vessel due to induce myocardial strain changes. The stimulation is targeted to attenuate or prevent atherosclerosis associated with the CAD, according to various embodiments.
摘要翻译： 起搏系统提供心脏保护起搏治疗（CPPT），以保护心脏免受伤害和/或治疗现有的伤害。 起搏系统接收一组输入，并为不同目的提供优化的心脏保护起搏。 该系统提供电刺激以调节用于抗动脉粥样硬化治疗的心肌应变和/或提供心肌梗塞（MI）治疗。 在一个实施方案中，提供了用于治疗动脉粥样硬化的医疗装置。 医疗设备包括感测电路，用于接收感测到的信号，以使用感测到的信号来识别冠状动脉疾病（CAD）或CAD风险区域。 该装置还包括起搏器电路，其适于将电信号通过至少一个电极传递到与所识别的区域相邻的心肌靶。 根据各种实施例，控制器与感测电路通信并控制起搏器电路，以向心肌靶标提供间歇性电刺激，以诱导由于诱发心肌应变变化而在血管上延伸的时间段。 根据各种实施方案，刺激旨在减弱或预防与CAD相关的动脉粥样硬化。
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公开(公告)号：US20090234406A1
公开(公告)日：2009-09-17
申请号：US12397464
申请日：2009-03-04
IPC分类号： A61N1/368
CPC分类号： A61N1/362 , A61N1/36114 , A61N1/3627
摘要： Various system embodiments comprise means for intermittently delivering a sympathetic stimulus, including means for delivering 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 includes means for delivering 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： 各种系统实施例包括用于间歇地递送交感刺激的装置，包括用于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的装置。 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。 该实施方案还包括用于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反应或交感反应的装置。 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。
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公开(公告)号：US20090192560A1
公开(公告)日：2009-07-30
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： A61N1/365
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。
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28.发明申请SYSTEMS AND METHODS FOR LOCAL VASOACTIVE RESPONSE USING TEMPERATURE MODULATION 有权使用温度调节的局部血管反应的系统和方法公开(公告)号：US20090024194A1
公开(公告)日：2009-01-22
申请号：US11779162
申请日：2007-07-17
IPC分类号： A61F7/12
CPC分类号： A61F7/12 , A61F7/123 , A61F2007/0056 , A61F2007/0071 , A61F2007/0075 , A61F2007/126
摘要： Disclosed herein, among other things, is a device for providing a localized vasomodulation of a vessel. According to an embodiment, the device includes a thermal element configured to conduct thermal energy between the thermal element and a desired region of the vessel wall to elicit the localized vasomodulation of the vessel at the desired region. The device also includes a controller operationally connected to the thermal element. The controller is adapted to control the conduction of thermal energy between the thermal element and the desired region of the vessel wall to control the localized vasomodulation of the vessel at the desired region. In various embodiments, a sensor connected to the device provides feedback to the controller.
摘要翻译： 这里公开了一种用于提供血管的局部血管调节的装置。 根据实施例，该装置包括热元件，其被配置为在热元件和容器壁的期望区域之间传导热能，以引起容器在期望区域的局部血管调节。 该装置还包括可操作地连接到热元件的控制器。 控制器适于控制热元件与血管壁的所需区域之间的热能传导，以控制血管在所需区域的局部血管调节。 在各种实施例中，连接到设备的传感器向控制器提供反馈。
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公开(公告)号：US09149631B2
公开(公告)日：2015-10-06
申请号：US12236838
申请日：2008-09-24
CPC分类号： A61N1/056 , A61N1/36514
摘要： Systems and methods facilitate placement of a lead in or on a patient's heart. At least one reference sensor is positioned at a right heart location of a patient's heart and a cardiac lead apparatus comprising at least one lead apparatus sensor is advanced to a plurality of left heart locations. Using the reference sensor and the lead apparatus sensor, a distance parameter indicative of a distance between the reference and lead apparatus sensors is measured for each of the plurality of left heart locations. Strain or stress estimates are determined for the plurality of left heart locations derived from the distance parameter measurements. Using the strain or stress estimates, a physician perceivable output is produced indicating suitability of the left heart locations as pacing sites.
摘要翻译： 系统和方法有利于将铅放置在患者心脏中或患者的心脏上。 至少一个参考传感器位于患者心脏的右心脏位置，并且包括至少一个引导装置传感器的心脏引导装置前进到多个左心脏位置。 使用参考传感器和引导装置传感器，针对多个左心脏位置中的每一个测量指示参考和引导装置传感器之间的距离的距离参数。 对于从距离参数测量导出的多个左心脏位置确定应变或应力估计。 使用应变或压力估计，产生医生可感知的输出，指示左心脏位置作为起搏部位的适合性。
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30.发明授权公开(公告)号：US08588907B2
公开(公告)日：2013-11-19
申请号：US13411945
申请日：2012-03-05
IPC分类号： 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。
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