公开(公告)号：US20110071588A1

公开(公告)日：2011-03-24

申请号：US12955218

申请日：2010-11-29

申请人： Jiang Ding ,  Yinghong Yu ,  Andrew P. Kramer ,  Julio Spinelli

发明人： Jiang Ding ,  Yinghong Yu ,  Andrew P. Kramer ,  Julio Spinelli

IPC分类号： A61N1/365

CPC分类号： E21B17/01 ,  A61N1/3627 ,  A61N1/3682 ,  E21B43/36

摘要： A pacing system for providing optimal hemodynamic cardiac function for parameters such as contractility (peak left ventricle pressure change during systole or LV+dp/dt), or stroke volume (aortic pulse pressure) using system for calculating atrio-ventricular delays for optimal timing of a ventricular pacing pulse. The system providing an option for near optimal pacing of multiple hemodynamic parameters. The system deriving the proper timing using electrical or mechanical events having a predictable relationship with an optimal ventricular pacing timing signal.

摘要翻译： 一种起搏系统，用于为诸如收缩性（收缩期峰值左心室压力变化或LV + dp / dt）之间的参数或行程体积（主动脉脉压）提供最佳血液动力学心脏功能，使用用于计算心室延迟的系统以获得最佳时机 心室起搏脉搏。 该系统为多个血液动力学参数的近似最佳起搏提供了选择。 该系统使用与最佳心室起搏定时信号具有可预测关系的电或机械事件导出适当的定时。

公开(公告)号：US20080114410A1

公开(公告)日：2008-05-15

申请号：US12016830

申请日：2008-01-18

申请人： Jiang Ding ,  Julio Spinelli ,  Yinghong Yu ,  Jeffrey Stahmann

发明人： Jiang Ding ,  Julio Spinelli ,  Yinghong Yu ,  Jeffrey Stahmann

IPC分类号： A61N1/365

CPC分类号： A61N1/3627 ,  A61B5/053 ,  A61N1/36521 ,  A61N1/3682 ,  A61N1/3684

摘要： This document discusses, among other things, systems, devices, and methods measure an impedance and, in response, adjust an atrioventricular (AV) delay or other cardiac resynchronization therapy (CRT) parameter that synchronizes left and right ventricular contractions. A first example uses parameterizes a first ventricular volume against a second ventricular volume during a cardiac cycle, using a loop area to create a synchronization fraction (SF). The CRT parameter is adjusted in closed-loop fashion to increase the SF. A second example measures a septal-freewall phase difference (PD), and adjusts a CRT parameter to decrease the PD. A third example measures a peak-to-peak volume or maximum rate of change in ventricular volume, and adjusts a CRT parameter to increase the peak-to-peak volume or maximum rate of change in the ventricular volume.

摘要翻译： 本文件还讨论了系统，设备和方法测量阻抗，并作为响应调整房室（AV）延迟或同步左心室收缩和右心室收缩的其他心脏再同步治疗（CRT）参数。 第一个例子是使用循环区域创建同步分数（SF），在心动周期中使用第一心室容积对第二心室容积进行参数化。 CRT参数以闭环方式调整以增加SF。 第二个例子是测量隔层相位差（PD），并调整CRT参数以减少PD。 第三个例子测量心室容积的峰 - 峰体积或最大变化率，并调整CRT参数以增加心室容积的峰 - 峰体积或最大变化率。

公开(公告)号：US07346393B2

公开(公告)日：2008-03-18

申请号：US10460975

申请日：2003-06-12

申请人： Julio Spinelli ,  Qingsheng Zhu ,  Bruce H. Kenknight ,  Yinghong Yu ,  Jiang Ding

发明人： Julio Spinelli ,  Qingsheng Zhu ,  Bruce H. Kenknight ,  Yinghong Yu ,  Jiang Ding

IPC分类号： A61N1/36

CPC分类号： A61N1/3627

摘要： A cardiac rhythm management system for providing a plurality of therapy modalities. For example, the system may include a cardiac resynchronization therapy module for providing cardiac resynchronization therapy and a pacemaker module for providing bradycardia therapy, as well as a selector module coupled to the cardiac resynchronization therapy module and the bradycardia module. The selector module may select an operating mode from among a plurality of operating modes including the cardiac resynchronization therapy module and the pacemaker module. Various manual and automatic methods may be used to select the operating mode. In addition, a reversion management system may be included to assist the cardiac rhythm management system to recover in case of a disruption to the system.

摘要翻译： 一种用于提供多种治疗方式的心律管理系统。 例如，该系统可以包括用于提供心脏再同步治疗的心脏再同步治疗模块和用于提供心动过缓治疗的起搏器模块，以及耦合到心脏再同步治疗模块和心动过缓模块的选择器模块。 选择器模块可以从包括心脏再同步治疗模块和起搏器模块的多个操作模式中选择操作模式。 可以使用各种手动和自动方法来选择操作模式。 此外，还可以包括回归管理系统以帮助心律管理系统在系统中断的情况下恢复。

公开(公告)号：US20070021789A1

公开(公告)日：2007-01-25

申请号：US11458286

申请日：2006-07-18

申请人： Joseph Pastore ,  Julio Spinelli ,  Frits Prinzen ,  Richard Cornelussen ,  Ward Vanagt

发明人： Joseph Pastore ,  Julio Spinelli ,  Frits Prinzen ,  Richard Cornelussen ,  Ward Vanagt

IPC分类号： A61N1/00

CPC分类号： A61N1/3622

摘要： A device and method for delivering electrical stimulation to the heart in a manner which provides a protective effect is disclosed. The protective effect is produced by configuring a cardiac pacing device to intermittently switch from a normal operating mode to a stress augmentation mode in which the spatial pattern of depolarization is varied to thereby subject a particular region or regions of the ventricular myocardium to increased mechanical stress.

摘要翻译： 公开了以提供保护作用的方式向心脏递送电刺激的装置和方法。 通过将心脏起搏装置配置为间歇地从正常操作模式切换到应力增强模式，其中去极化的空间模式改变从而使心室心肌的特定区域或区域增加机械应力，从而产生保护作用。

公开(公告)号：US20050288720A1

公开(公告)日：2005-12-29

申请号：US10862011

申请日：2004-06-04

申请人： Jeffrey Ross ,  Julio Spinelli ,  Rodney Salo

发明人： Jeffrey Ross ,  Julio Spinelli ,  Rodney Salo

IPC分类号： A61N1/362

CPC分类号： A61N1/3627

摘要： A cardiac rhythm management device is configured to deliver pre-excitation pacing to one or more sites in proximity to an infarcted region of the ventricular myocardium. The pre-excitation pacing in conjunction with counterpulsation therapy serves to either prevent or minimize post-infarct remodeling.

摘要翻译： 心律管理装置被配置为将预激励起搏递送到心室心肌梗塞区域附近的一个或多个部位。 预激励起搏结合反搏疗法可预防或最小化梗死后重塑。

公开(公告)号：US20050283099A1

公开(公告)日：2005-12-22

申请号：US11203756

申请日：2005-08-15

申请人： Qingsheng Zhu ,  Avram Scheiner ,  Julio Spinelli

发明人： Qingsheng Zhu ,  Avram Scheiner ,  Julio Spinelli

IPC分类号： A61N1/05 ,  A61N1/32 ,  A61H1/02

CPC分类号： A61N1/326 ,  A61N1/0587

摘要： A method and device for preventing plaque build-up in a coronary artery includes providing an electrical field generating device, and generating an electrical field in the coronary artery to prevent plaque build-up in the coronary artery. The method further includes sensing the heart rhythm and generating the electrical field after a depolarization wave in the heart. The electrical field is generated by circuitry, in one embodiment implanted circuitry, connected to leads which are epicardially or intracardially positioned on the heart.

摘要翻译： 用于防止冠状动脉斑块积聚的方法和装置包括提供电场产生装置，并且在冠状动脉中产生电场以防止冠状动脉中的斑块积聚。 该方法还包括感测心脏节律并在心脏中去极化波之后产生电场。 电场由电路产生，在一个实施例中，植入电路连接到心外膜或心内置于心脏上的引线。

公开(公告)号：US06280389B1

公开(公告)日：2001-08-28

申请号：US09439228

申请日：1999-11-12

申请人： Jiang Ding ,  Yinghong Yu ,  Julio Spinelli

发明人： Jiang Ding ,  Yinghong Yu ,  Julio Spinelli

IPC分类号： A61B5021

CPC分类号： A61N1/365 ,  A61N1/3622 ,  A61N1/3627 ,  A61N1/37

摘要： A method and apparatus for determining whether a patient with congestive heart failure (CHF) will benefit from pacing therapy through the use of an implantable cardiac rhythm management device. A patient's right ventricular and left ventricular pressures are measured, and the patient's PP_Area is calculated for each normal heartbeat that occurs during the testing period. Depending upon the value of the patient's mean PP_Area, it can be determined whether the patient will or will not respond well acutely to pacing therapy. A mean PP_Area value of greater than or equal to a predetermined threshold, which is about 0.3, indicates that the patient is a responder to pacing therapy, while a value of less than the predetermined threshold of about 0.3 indicates that the patient is a non-responder.

摘要翻译： 一种用于确定患有充血性心力衰竭（CHF）的患者是否将通过使用植入式心律管理装置从起搏治疗中受益的方法和装置。 测量患者的右心室和左心室压力，并计算在测试期间发生的每个正常心跳的患者的PP_Area。 根据患者平均PP_Area的价值，可以确定患者是否会或不会对起搏治疗产生很好的反应。 大于或等于预定阈值（约0.3）的平均PP_Area值表示患者是起搏治疗的应答​​者，而小于约0.3的预定阈值的值表示患者是非 - 响应者。

公开(公告)号：US08639334B2

公开(公告)日：2014-01-28

申请号：US11562681

申请日：2006-11-22

申请人： Julio Spinelli ,  Yinghong Yu

发明人： Julio Spinelli ,  Yinghong Yu

IPC分类号： A61B5/04

CPC分类号： A61N1/365 ,  A61N1/3627 ,  A61N1/368 ,  A61N1/3682

摘要： Response to cardiac resynchronization therapy is predicted for a given stimulation site so that an atrioventricular delay of an implantable device administering cardiac resynchronization therapy may be set to a proper amount. The first deflection of ventricular depolarization is measured, such as through a surface electrocardiogram or through an intracardiac electrogram measured by a lead positioned in the heart at the stimulation site. The maximum deflection of the ventricular depolarization is then measured by the lead positioned at the stimulation site. The interval of time between the first deflection and the maximum deflection of the ventricular depolarization is compared to a threshold to determine whether the stimulation site is a responder site. If the interval is larger than the threshold, then the site is a responder and the atrioventricular delay of the implantable device may be set to less than the intrinsic atrioventricular delay of the patient. Otherwise, the atrioventricular may be set to approximately equal the intrinsic atrioventricular delay.

摘要翻译： 对于给定的刺激部位预测对心脏再同步治疗的响应，使得施用心脏再同步治疗的可植入装置的房室延迟可以被设定为适当的量。 测量心室去极化的第一偏转，例如通过表面心电图或通过位于刺激部位心脏中的导线测量的心内电描记图。 然后通过位于刺激部位的引线测量心室去极化的最大偏转。 将心室去极化的第一偏转和最大偏转之间的时间间隔与阈值进行比较以确定刺激位点是否是应答位点。 如果间隔大于阈值，则该位点是响应者，并且可植入装置的房室延迟可被设置为小于患者的内在房室延迟。 否则，房室可以设定为近似等于内在房室延迟。

公开(公告)号：US20080091138A1

公开(公告)日：2008-04-17

申请号：US11998969

申请日：2007-12-03

申请人： Joseph Pastore ,  Julio Spinelli ,  Helen Reeve ,  Jeffrey Ross ,  Rodney Salo ,  Allan Shuros

发明人： Joseph Pastore ,  Julio Spinelli ,  Helen Reeve ,  Jeffrey Ross ,  Rodney Salo ,  Allan Shuros

IPC分类号： A61M31/00

CPC分类号： A61M5/1723 ,  A61B5/0031 ,  A61B5/1107 ,  A61B5/14532 ,  A61B5/14546 ,  A61B5/4839 ,  A61M5/14244 ,  A61M5/14276 ,  A61M2205/3523 ,  A61N1/3627

摘要： A drug delivery system detects a cardiac condition indicative of a need for increasing a cardiac metabolic level and, in response, releases a drug into tissue or blood to shift a source of metabolically synthesized energy fueling cardiac contraction from fatty acid to glucose. One example of such a system includes an implantable device detecting an ischemia and a transdermal drug delivery device delivering a drug when an ischemic condition is detected. Another example of such a system includes one or more implantable devices detecting a predefined change in cardiac metabolic level and delivering a drug when the change is detected. Such systems are applied to treat, for example, patients suffering ischemia and/or heart failure and patients having suffered myocardial infarction.

摘要翻译： 药物递送系统检测指示需要增加心脏代谢水平的心脏状况，并且作为响应将药物释放到组织或血液中以将促进心脏收缩的代谢合成能量的来源从脂肪酸转移到葡萄糖。 这种系统的一个实例包括检测缺血的可植入装置和当检测到缺血状况时递送药物的透皮药物递送装置。 这种系统的另一个例子包括一个或多个可植入装置，用于检测心脏代谢水平的预定变化并在检测到变化时递送药物。 这种系统被应用于治疗例如患有缺血和/或心力衰竭的患者和患有心肌梗塞的患者。

公开(公告)号：US07313433B2

公开(公告)日：2007-12-25

申请号：US10780794

申请日：2004-02-18

申请人： Yinghong Yu ,  Jiang Ding ,  Julio Spinelli ,  Angelo Aurichio

发明人： Yinghong Yu ,  Jiang Ding ,  Julio Spinelli ,  Angelo Aurichio

IPC分类号： A61B5/04

CPC分类号： A61N1/3627 ,  A61N1/3682

摘要： A method and apparatus for predicting acute response to cardiac resynchronization therapy is disclosed. The method can comprise measuring a first interval during an intrinsic systolic cycle and measuring a second interval during a stimulated systolic cycle. The acute response can be predicted by comparing the percent change in duration between the first interval and the second interval against a pre-determined threshold value. The first and second time intervals can be measured using, for example, a surface ECG or, alternatively, an intracardiac electrogram. In one embodiment, the first interval can be the duration of an intrinsic QRS complex measured during a non-stimulated systolic cycle. Similarly, the second interval can be the duration of a stimulated QRS complex measured during a stimulated systolic cycle.

摘要翻译： 公开了用于预测心脏再同步治疗的急性反应的方法和装置。 该方法可以包括在本征收缩周期期间测量第一间隔并且在刺激的收缩期期间测量第二间隔。 可以通过将第一间隔和第二间隔之间的持续时间的百分比变化与预定阈值进行比较来预测急性反应。 第一和第二时间间隔可以使用例如表面ECG或者心内电描记图来测量。 在一个实施例中，第一间隔可以是在非刺激的收缩期期间测量的固有QRS复合物的持续时间。 类似地，第二间隔可以是在刺激的收缩期期间测量的受激QRS复合物的持续时间。