公开(公告)号：US08055339B2

公开(公告)日：2011-11-08

申请号：US11734120

申请日：2007-04-11

申请人： Gary T. Seim

发明人： Gary T. Seim

IPC分类号： A61N1/368

CPC分类号： A61N1/368 ,  A61N1/3682 ,  A61N1/3688

摘要： A device comprises a cardiac contraction sensing circuit, a timer circuit, an electrical stimulation circuit, and a controller. The timer circuit provides a time duration of an atrial-atrial interval between successive atrial contractions, a ventricular-ventricular interval between successive ventricular contractions, and an atrial-ventricular (A-V) interval between an atrial contraction and a same cardiac cycle ventricular contraction. The controller includes an event detection module and a pacing module. The event detection module is configured for determining whether A-V block events are sustained over multiple cardiac cycles. The pacing module is configured for providing pacing therapy according to a primary pacing mode that includes AAI(R) mode with independent VVI backup mode, and for switching the pacing therapy to a secondary pacing mode if A-V block events are sustained over multiple cardiac cycles. Other devices and methods are described.

摘要翻译： 一种装置包括心脏收缩感测电路，定时器电路，电刺激电路和控制器。 定时器电路提供连续心房收缩之间的心房间隔的持续时间，连续心室收缩之间的心室 - 心室间隔和心房收缩与相同心动周期心室收缩之间的心房 - 心室（A-V）间隔。 控制器包括事件检测模块和起搏模块。 事件检测模块被配置用于确定A-V块事件是否在多个心动周期上持续。 起搏模块被配置为根据主起搏模式提供起搏治疗，该起搏模式包括具有独立VVI备用模式的AAI（R）模式，并且如果A-V阻塞事件在多个心动周期上持续，则用于将起搏治疗切换到辅助起搏模式。 描述其他设备和方法。

公开(公告)号：US07133720B2

公开(公告)日：2006-11-07

申请号：US10896443

申请日：2004-07-22

申请人： Gary T. Seim

发明人： Gary T. Seim

IPC分类号： A61B1/22

CPC分类号： A61N1/395 ,  A61N1/39 ,  A61N1/3956 ,  A61N1/3987

摘要： A cardiac rhythm management system synchronizes the delivery of an atrial defibrillation shock to a ventricular depolarization concluding a present RR interval since the occurrence of the last ventricular depolarization. The present RR interval is deemed “shockable” if, among other things, its ventricular refractory period (VRP), which may be extended by ventricular “noise” occurring during the VRP, is less than a predetermined value, which may be different depending on whether the VRP is initiated by a paced or sensed ventricular depolarization. Alternatively, the present RR interval is deemed shockable if a post-VRP time period before the ventricular depolarization concluding the present RR interval exceeds a predetermined value. In conjunction with one or both of these conditions, other requirements for deeming a present RR interval shockable include comparing the present RR interval duration to a predetermined value, or to a preceding RR or QT interval.

摘要翻译： 心律失常管理系统将心房除颤休克的输送与最后一次心室去极化发生后的心室去极化进行同步。 如果VRP中发生的心室“噪声”可能延长的心室不应期（VRP）除了其他以外，则将RR区间视为“可震荡”，小于预定值，这可能因为 VRP是否由起搏或感觉到的心室去极化引发。 或者，如果结束本RR间期的心室去极化之前的VRP时间段超过预定值，则将本RR间期视为可电击。 结合这些条件中的一个或两个，认为现有RR间隔可电击的其他要求包括将当前RR间隔持续时间与预定值或前一个RR或QT间隔进行比较。

公开(公告)号：US08639324B2

公开(公告)日：2014-01-28

申请号：US13353515

申请日：2012-01-19

申请人： Efdal Elferri ,  Randall L. McPherson ,  Donald L. Hopper ,  Gary T. Seim ,  James O. Gilkerson ,  Dan Li ,  David L. Perschbacher

发明人： Efdal Elferri ,  Randall L. McPherson ,  Donald L. Hopper ,  Gary T. Seim ,  James O. Gilkerson ,  Dan Li ,  David L. Perschbacher

IPC分类号： A61B5/0205 ,  A61N1/365 ,  A61N1/39

CPC分类号： A61N1/36585 ,  A61B5/0464 ,  A61B5/0538 ,  A61B5/0809 ,  A61B5/091 ,  A61B5/686 ,  A61N1/3962

摘要： An implantable or ambulatory medical device can include a cardiac signal sensing circuit configured to provide a sensed cardiac depolarization signal of a heart of a subject, a respiration sensing circuit configured to provide a signal representative of respiration of the subject, and a control circuit communicatively coupled to the cardiac signal sensing circuit and the respiration circuit. The control circuit includes a tachyarrhythmia detection circuit configured to determine heart rate using the depolarization signal, determine a respiration parameter of the subject using the respiration signal, calculate a ratio using the determined heart rate and the determined respiration parameter, generate an indication of tachyarrhythmia when the calculated ratio satisfies a specified detection ratio threshold value, and provide the indication of tachyarrhythmia to a user or process.

摘要翻译： 植入式或动态医疗装置可以包括心脏信号感测电路，该心脏信号感测电路被配置为提供受检者的心脏的感测的心脏去极化信号，被配置为提供代表对象呼吸的信号的呼吸感测电路，以及通信耦合的控制电路 到心脏信号感测电路和呼吸电路。 控制电路包括快速性心律失常检测电路，其被配置为使用去极化信号来确定心率，使用呼吸信号确定受试者的呼吸参数，使用所确定的心率和确定的呼吸参数来计算比率，产生快速性心律失常的指示， 所计算的比率满足规定的检测率阈值，并向用户或过程提供快速性心律失常的指示。

公开(公告)号：US20120150254A1

公开(公告)日：2012-06-14

申请号：US13401965

申请日：2012-02-22

申请人： David L. Perschbacher ,  Richard Milon Dujmovic, JR. ,  Gary T. Seim

发明人： David L. Perschbacher ,  Richard Milon Dujmovic, JR. ,  Gary T. Seim

IPC分类号： A61N1/365

CPC分类号： A61N1/3987 ,  A61N1/3682 ,  A61N1/3937 ,  A61N1/3962

摘要： An atrial event and a ventricular event can be received, and an atrioventricular (AV) delay can be provided using information about the atrial and ventricular events. The AV delay can be increased after a first condition is satisfied to allow a heart to regain intrinsic control of ventricular activation, and changed after a second condition is satisfied to allow the heart to remain in intrinsic control of ventricular activation.

摘要翻译： 可以接收心房事件和心室事件，并且可以使用关于心房和心室事件的信息来提供房室（AV）延迟。 在满足第一条件以允许心脏恢复心室激活的内在控制之后，AV延迟可以增加，并且在第二个条件被满足以允许心脏保持在心室激活的内在控制之后改变。

公开(公告)号：US08135461B2

公开(公告)日：2012-03-13

申请号：US12764635

申请日：2010-04-21

申请人： Victor T. Chen ,  Gary T. Seim ,  Hal M. Propp ,  LeAnne Eberle ,  Lynn TeWinkel

发明人： Victor T. Chen ,  Gary T. Seim ,  Hal M. Propp ,  LeAnne Eberle ,  Lynn TeWinkel

IPC分类号： A61N1/00 ,  A61B5/04

CPC分类号： A61N1/37252 ,  A61N1/3956

摘要： An implanted cardiac device detects an atrial arrhythmia and provides periodically updated atrial arrhythmia status as long as the arrhythmia is ongoing. A patient may request an indication of ongoing atrial arrhythmia status from external to the patient using a patient activator. The patient activator may include a magnet for closing a reed switch in the implanted device to provide the request or may provide the request over a telemetry link to the implanted device. The implanted device may provide the requested atrial arrhythmia status and other information in the form of an audible tone produced by the implanted device or as a message telemetered from the implanted device to the patient activator. The patient activator may include a tone detector and display for providing a visual indication of the atrial arrhythmia status indication. The magnet activator may also be employed to request or withhold atrial shock therapy.

摘要翻译： 植入式心脏装置检测心房心律失常，并且只要心律失常正在进行，就能提供定期更新的心房心律失常状态。 患者可以使用患者激活剂从外部向患者请求持续的心房心律失常状态的指示。 患者激活器可以包括用于关闭植入装置中的舌簧开关以提供请求的磁体，或者可以通过到植入装置的遥测链路提供请求。 植入装置可以以由植入装置产生的听觉音调的形式或作为从植入装置遥测到患者激活器的消息来提供所请求的心房心律失常状态和其他信息。 患者激活器可以包括用于提供心房心律失常状态指示的视觉指示的音调检测器和显示器。 磁铁激活剂也可用于要求或禁止心房休克治疗。

公开(公告)号：US08126551B2

公开(公告)日：2012-02-28

申请号：US12330869

申请日：2008-12-09

申请人： David L. Perschbacher ,  Richard Milon Dujmovic ,  Gary T. Seim

发明人： David L. Perschbacher ,  Richard Milon Dujmovic ,  Gary T. Seim

IPC分类号： A61N1/00

CPC分类号： A61N1/3987 ,  A61N1/3682 ,  A61N1/3937 ,  A61N1/3962

摘要： An atrial event and a ventricular event can be received, and an atrioventricular (AV) delay can be provided using information about the atrial and ventricular events. The AV delay can be increased after a first condition is satisfied to allow a heart to regain intrinsic control of ventricular activation, and changed after a second condition is satisfied to allow the heart to remain in intrinsic control of ventricular activation.

摘要翻译： 可以接收心房事件和心室事件，并且可以使用关于心房和心室事件的信息来提供房室（AV）延迟。 在满足第一条件以允许心脏恢复心室激活的内在控制之后，AV延迟可以增加，并且在第二个条件被满足以允许心脏保持在心室激活的内在控制之后改变。

公开(公告)号：US08050755B2

公开(公告)日：2011-11-01

申请号：US12828005

申请日：2010-06-30

申请人： Victor T. Chen ,  Gary T. Seim ,  Carlos Ricci ,  Michael L. Favet ,  Hal M. Propp

发明人： Victor T. Chen ,  Gary T. Seim ,  Carlos Ricci ,  Michael L. Favet ,  Hal M. Propp

IPC分类号： A61N1/39

CPC分类号： A61N1/3956

摘要： An implantable cardiac device detects a patient therapy request originating from external to the implantable device. A shock therapy delay period is timed in response to the detection of the patient therapy request. Atrial shock therapy is provided to the patient after expiration of the shock therapy delay period (if the presence of an ongoing atrial arrhythmia is detected). The patient therapy request may be provided by a patient activator including a magnet for operating a reed switch in the implanted device to provide the request. A patient activator including an input and receiver/transmitter circuitry may be employed to request the immediate providing of atrial shock therapy, and/or to set the duration the shock therapy delay period. By allowing specific delays to therapy after a therapy request, a patient can prepare for the requested therapy and thereby mitigate therapy discomfort.

摘要翻译： 可植入心脏装置检测源自可植入装置外部的患者治疗请求。 响应于患者治疗请求的检测，休克治疗延迟期是定时的。 在休克治疗延迟期结束后（如果检测到正在进行的心律失常的存在），向患者提供心房休克疗法。 患者治疗请求可以由患者激活器提供，包括用于在植入装置中操作舌簧开关的磁体以提供请求。 可以使用包括输入和接收器/发射器电路的患者激活器来请求立即提供心房休克疗法和/或设置休克治疗延迟时期的持续时间。 通过在治疗请求后允许特定的延迟治疗，患者可以准备所要求的治疗，从而减轻治疗不适。

公开(公告)号：US07120490B2

公开(公告)日：2006-10-10

申请号：US10211414

申请日：2002-08-02

申请人： Victor T. Chen ,  Jay A. Warren ,  Gary T. Seim ,  David B. Krig ,  Jesse W. Hartley ,  Jeffrey E. Stahmann

发明人： Victor T. Chen ,  Jay A. Warren ,  Gary T. Seim ,  David B. Krig ,  Jesse W. Hartley ,  Jeffrey E. Stahmann

IPC分类号： A61N1/39

CPC分类号： A61N1/3962 ,  A61N1/3621 ,  A61N1/3627 ,  A61N1/3682 ,  A61N1/395 ,  A61N1/3987

摘要： A cardiac rhythm management system includes atrial shock timing optimization. Because an atrial tachyarrhythmia, such as atrial fibrillation typically causes significant variability in the ventricular heart rate, resulting in potentially proarrhythmic conditions. The system avoids delivering atrial cardioversion/defibrillation therapy during potentially proarrhythmic conditions because doing so could result in dangerous ventricular arrhythmias. Using Ventricular Rate Regularization (“VRR”) techniques, the system actively stabilizes the ventricular heart rate to obtain less potentially proarrhythmic conditions for delivering the atrial tachyarrhythmia therapy. The intrinsic ventricular heart rate is stabilized at a variable VRR-indicated rate, computed using an infinite impulse response (IIR) filter, and based on the underlying intrinsic ventricular heart rate. The system withholds delivery of atrial cardioversion/defibrillation therapy until the intervals between ventricular beats (“V—V intervals”) meet certain criteria that decrease the chance that the atrial cardioversion/defibrillation therapy will induce a ventricular arrhythmia.

公开(公告)号：US06963776B2

公开(公告)日：2005-11-08

申请号：US09826973

申请日：2001-04-05

申请人： Gary T. Seim

发明人： Gary T. Seim

IPC分类号： A61N1/39 ,  A61N1/362

CPC分类号： A61N1/395 ,  A61N1/39 ,  A61N1/3956 ,  A61N1/3987

摘要： A cardiac rhythm management system synchronizes the delivery of an atrial defibrillation shock to a ventricular depolarization concluding a present RR interval since the occurrence of the last ventricular depolarization. The present RR interval is deemed “shockable” if, among other things, its ventricular refractory period (VRP), which may be extended by ventricular “noise” occurring during the VRP, is less than a predetermined value, which may be different depending on whether the VRP is initiated by a paced or sensed ventricular depolarization. Alternatively, the present RR interval is deemed shockable if a post-VRP time period before the ventricular depolarization concluding the present RR interval exceeds a predetermined value. In conjunction with one or both of these conditions, other requirements for deeming a present RR interval shockable include comparing the present RR interval duration to a predetermined value, or to a preceding RR or QT interval.

摘要翻译： 心律失常管理系统将心房除颤休克的输送与最后一次心室去极化发生后的心室去极化进行同步。 如果VRP中发生的心室“噪声”可能延长的心室不应期（VRP）除了其他以外，则将RR区间视为“可震荡”，小于预定值，这可能因为 VRP是否由起搏或感觉到的心室去极化引发。 或者，如果结束本RR间期的心室去极化之前的VRP时间段超过预定值，则将本RR间期视为可电击。 结合这些条件中的一个或两个，认为现有RR间隔可电击的其他要求包括将当前RR间隔持续时间与预定值或前一个RR或QT间隔进行比较。

公开(公告)号：US06920355B2

公开(公告)日：2005-07-19

申请号：US10150297

申请日：2002-05-17

申请人： Kenneth L. Baker ,  Doug M. Birkholz ,  David L. Perschbacher ,  Andrew P. Kramer ,  Gary T. Seim

发明人： Kenneth L. Baker ,  Doug M. Birkholz ,  David L. Perschbacher ,  Andrew P. Kramer ,  Gary T. Seim

IPC分类号： A61N1/362 ,  A61N1/368

CPC分类号： A61N1/368 ,  A61N1/3622 ,  A61N1/3684

摘要： A hybrid cardiac pacemaker in which the operation of the device is controlled by hardware-based controller as supervised by a microprocessor-based controller. The hardware-based controller comprises a plurality of timers that expire when they reach timer limit values stored in registers updatable by the microprocessor, and a combinational logic array for causing the device to generate pace outputs in accordance with timer expirations and sense signals. The combinational logic array may operate the pacemaker in a number of programmed modes in accordance with a mode value stored in a mode control register by the microprocessor.

摘要翻译： 一种混合心脏起搏器，其中由基于微处理器的控制器监控的由基于硬件的控制器控制该设备的操作。 基于硬件的控制器包括多个定时器，当它们达到存储在可由微处理器更新的寄存器中的定时器限制值时，该定时器到期，以及组合逻辑阵列，用于使该设备根据定时器期满和感测信号产生步进输出。 组合逻辑阵列可以根据由微处理器存储在模式控制寄存器中的模式值，以多种编程模式操作起搏器。