公开(公告)号：US08676310B2

公开(公告)日：2014-03-18

申请号：US12609637

申请日：2009-10-30

申请人： John E. Burnes ,  Paul G. Krause ,  William T. Donofrio

发明人： John E. Burnes ,  Paul G. Krause ,  William T. Donofrio

IPC分类号： A61N1/00 ,  A61B5/04

CPC分类号： A61N1/378 ,  A61N1/36114 ,  A61N1/3962 ,  A61N1/3975

摘要： An implantable medical device (IMD) may include a battery dedicated to providing cardiac stimulation therapy and a separate power source that provides power for electrical stimulation therapy. Such a configuration preserves the battery dedicated for providing cardiac stimulation therapy even if the second power source is depleted. As an example, the IMD may comprise a cardiac stimulation module configured to deliver at least one stimulation therapy selected from a group consisting of pacing, cardioversion and defibrillation. The IMD further comprises a electrical stimulation module configured to deliver electrical stimulation therapy, a first power source including a battery, wherein the first power source is configured to supply power to the cardiac stimulation module and not to the electrical stimulation module, and a second power source. The second power source is configured to supply power to at least the electrical stimulation module.

摘要翻译： 可植入医疗装置（IMD）可以包括专用于提供心脏刺激治疗的电池和为电刺激治疗提供电力的单独电源。 这样的配置即使在第二电源耗尽的情况下也保留专用于提供心脏刺激治疗的电池。 作为示例，IMD可以包括心脏刺激模块，该心脏刺激模块被配置为递送至少一种选自起搏，心脏复律和除颤的刺激疗法。 IMD还包括被配置为递送电刺激治疗的电刺激模块，包括电池的第一电源，其中第一电源被配置为向心脏刺激模块而不是电刺激模块供电，以及第二电源 资源。 第二电源被配置为向至少电刺激模块供电。

公开(公告)号：US08452394B2

公开(公告)日：2013-05-28

申请号：US12362768

申请日：2009-01-30

申请人： John E. Burnes ,  Paul G. Krause ,  William T. Donofrio ,  James D. Reinke ,  Gerald P. Arne ,  David J. Peichel ,  Xiaohong Zhou ,  Timothy Davis

发明人： John E. Burnes ,  Paul G. Krause ,  William T. Donofrio ,  James D. Reinke ,  Gerald P. Arne ,  David J. Peichel ,  Xiaohong Zhou ,  Timothy Davis

IPC分类号： A61N1/00

CPC分类号： A61N1/36114 ,  A61N1/3622 ,  A61N1/37247 ,  A61N1/37258 ,  A61N1/3962 ,  A61N2001/083

摘要： Electrical crosstalk between two implantable medical devices or two different therapy modules of a common implantable medical device may be evaluated, and, in some examples, mitigated. In some examples, one of the implantable medical devices or therapy modules delivers electrical stimulation to a nonmyocardial tissue site or a nonvascular cardiac tissue site, and the other implantable medical device or therapy module delivers cardiac rhythm management therapy to a heart of the patient.

公开(公告)号：US08406893B2

公开(公告)日：2013-03-26

申请号：US12610053

申请日：2009-10-30

申请人： Paul G. Krause ,  William T. Donofrio ,  Gerald P. Arne ,  James D. Reinke ,  David J. Peichel ,  Timothy Davis ,  John E. Burnes

发明人： Paul G. Krause ,  William T. Donofrio ,  Gerald P. Arne ,  James D. Reinke ,  David J. Peichel ,  Timothy Davis ,  John E. Burnes

IPC分类号： A61N1/08

CPC分类号： A61N1/3787 ,  A61N1/3704 ,  A61N1/3718 ,  A61N1/37264 ,  A61N1/37288

摘要： A therapy or monitoring system may implement one or more techniques to mitigate interference between operation of a charging device that charges a first implantable medical device (IMD) implanted in a patient and a second IMD implanted in the patient. In some examples, the techniques may include modifying an operating parameter of the charging device in response to receiving an indication that a second IMD is implanted in the patient. The techniques also may include modifying an operating parameter of the second IMD in response to detecting the presence or operation of the charging device.

摘要翻译： 治疗或监测系统可以实施一种或多种技术，以减轻对植入患者中的第一可植入医疗装置（IMD）充电的充电装置的操作与植入患者体内的第二IMD之间的干扰。 在一些示例中，技术可以包括响应于接收到将第二IMD植入患者中的指示来修改充电装置的操作参数。 这些技术还可以包括响应于检测到充电装置的存在或操作来修改第二IMD的操作参数。

公开(公告)号：US08315713B2

公开(公告)日：2012-11-20

申请号：US12433768

申请日：2009-04-30

申请人： John E. Burnes ,  Mary M. Morris ,  Michael R. S. Hill ,  Avram Scheiner ,  Ruth N. Klepfer ,  Matthew D. Bonner

发明人： John E. Burnes ,  Mary M. Morris ,  Michael R. S. Hill ,  Avram Scheiner ,  Ruth N. Klepfer ,  Matthew D. Bonner

IPC分类号： A61N1/00

CPC分类号： A61N1/36053 ,  A61M25/09 ,  A61N1/05 ,  A61N1/0551 ,  A61N1/0558 ,  A61N1/057 ,  A61N1/36085 ,  A61N1/36114 ,  A61N1/36125 ,  A61N1/36128

摘要： This disclosure is directed to extra, intra, and transvascular medical lead placement techniques for arranging medical leads and electrical stimulation and/or sensing electrodes proximate nerve tissue within a patient.

摘要翻译： 本公开涉及用于在患者体内靠近神经组织布置医疗引线和电刺激和/或感测电极的额外的，内部的和经血管内的医疗引线放置技术。

公开(公告)号：US08301263B2

公开(公告)日：2012-10-30

申请号：US12363180

申请日：2009-01-30

申请人： William T. Donofrio ,  Paul G. Krause ,  Gerald P. Arne ,  John E. Burnes ,  David J. Peichel ,  Xiaohong Zhou

发明人： William T. Donofrio ,  Paul G. Krause ,  Gerald P. Arne ,  John E. Burnes ,  David J. Peichel ,  Xiaohong Zhou

IPC分类号： A61N1/00

CPC分类号： A61N1/37288 ,  A61N1/36114

摘要： A first implantable medical device (IMD) implanted within a patient may communicate with a second IMD implanted within the patient by encoding information in an electrical stimulation signal. The delivery of the electrical stimulation signal may provide therapeutic benefits to the patient. The second IMD may sense the electrical stimulation signal, which may be presented as an artifact in a sensed cardiac signal, and process the sensed signal to retrieve the encoded information. The second IMD may modify its operation based on the received therapy information. Crosstalk between the first and second IMDs may be reduced using various techniques described herein. For example, the first IMD may generate the electrical stimulation signal to include a spread spectrum energy distribution or a predetermined signal signature. The second IMD may effectively remove a least some of the signal artifact in a sensed cardiac signal based on the predetermined signal signature.

摘要翻译： 植入在患者体内的第一可植入医疗装置（IMD）可以通过对电刺激信号中的信息进行编码来与植入患者内的第二IMD进行通信。 电刺激信号的传递可以为患者提供治疗益处。 第二IMD可以感测电刺激信号，其可以被呈现为感测到的心脏信号中的伪像，并且处理感测到的信号以检索经编码的信息。 第二IMD可以基于接收到的治疗信息修改其操作。 可以使用本文所述的各种技术来减少第一和第二IMD之间的串扰。 例如，第一IMD可以产生电刺激信号以包括扩频能量分布或预定信号特征。 基于预定的信号签名，第二IMD可以有效地去除感测到的心脏信号中的至少一些信号伪像。

公开(公告)号：US07715917B2

公开(公告)日：2010-05-11

申请号：US11004543

申请日：2004-12-03

申请人： Edward Chinchoy ,  Nirav V. Sheth ,  Kathryn E. Hilpisch ,  Thomas J. Mullen ,  John E. Burnes

发明人： Edward Chinchoy ,  Nirav V. Sheth ,  Kathryn E. Hilpisch ,  Thomas J. Mullen ,  John E. Burnes

IPC分类号： A61N1/00

CPC分类号： A61N1/368 ,  A61N1/3627 ,  A61N1/3682 ,  A61N1/3684

摘要： Determining an optimal atrioventricular interval is of interest for proper delivery of cardiac resynchronization therapy. Although device optimization is gradually and more frequently being performed through a referral process with which the patient undergoes an echocardiographic optimization, the decision of whether to optimize or not is still generally reserved for the implanting physician. Recent abstracts have suggested a formulaic approach for setting A-V interval based on intrinsic electrical sensing, that may possess considerable appeal to clinicians versus a patient average nominal A-V setting of 100 ms. The present invention presents a methods of setting nominal device settings based on entering patient cardiac demographics to determine what A-V setting may be appropriate. The data is based on retrospective analysis of the MIRACLE trial to determine what major factors determined baseline A-V settings.

摘要翻译： 确定最佳房室间隔对于正确递送心脏再同步治疗是有意义的。 尽管通过与患者经历超声心动图优化的转诊过程逐渐且更频繁地进行装置优化，但仍然通常为植入医生保留是否优化的决定。 最近的摘要提出了一种基于固有电学感测设置A-V间隔的公式化方法，这可能对临床医生具有相当大的吸引力，而患者平均标称A-V设置为100 ms。 本发明提供了一种基于输入患者心脏人口统计学来设定标称装置设置以确定什么A-V设置可能适合的方法。 数据基于MIRACLE试验的回顾性分析，以确定确定基线A-V设置的主要因素。

公开(公告)号：US20100114208A1

公开(公告)日：2010-05-06

申请号：US12362792

申请日：2009-01-30

申请人： William T. Donofrio ,  John E. Burnes ,  Paul G. Krause ,  Gerald P. Arne ,  David J. Peichel ,  Xiaohong Zhou ,  James D. Reinke ,  Timothy Davis

发明人： William T. Donofrio ,  John E. Burnes ,  Paul G. Krause ,  Gerald P. Arne ,  David J. Peichel ,  Xiaohong Zhou ,  James D. Reinke ,  Timothy Davis

IPC分类号： A61N1/08

CPC分类号： A61N1/0551 ,  A61N1/36114 ,  A61N1/3621 ,  A61N1/36521 ,  A61N1/37 ,  A61N1/37247 ,  A61N1/37282 ,  A61N1/3962 ,  A61N2001/083

摘要： Electrical crosstalk between two implantable medical devices or two different therapy modules of a common implantable medical device may be evaluated, and, in some examples, mitigated. In some examples, one of the implantable medical devices or therapy modules delivers electrical stimulation to a nonmyocardial tissue site or a nonvascular cardiac tissue site, and the other implantable medical device or therapy module delivers cardiac rhythm management therapy to a heart of the patient.

公开(公告)号：US20100114202A1

公开(公告)日：2010-05-06

申请号：US12362842

申请日：2009-01-30

申请人： William T. Donofrio ,  John E. Burnes ,  Paul G. Krause ,  Xiaohong Zhou ,  Gerald P. Arne ,  David J. Peichel ,  James D. Reinke

发明人： William T. Donofrio ,  John E. Burnes ,  Paul G. Krause ,  Xiaohong Zhou ,  Gerald P. Arne ,  David J. Peichel ,  James D. Reinke

IPC分类号： A61N1/362 ,  A61B5/00 ,  A61N1/39

CPC分类号： A61N1/3706 ,  A61B5/04288 ,  A61B5/7217 ,  A61N1/025 ,  A61N1/0551 ,  A61N1/36114 ,  A61N1/36185 ,  A61N1/3686 ,  A61N1/3702 ,  A61N1/3718 ,  A61N1/37247 ,  A61N1/37288 ,  A61N1/3962

摘要： Electrical crosstalk between two implantable medical devices or two different therapy modules of a common implantable medical device may be evaluated, and, in some examples, mitigated. In some examples, one of the implantable medical devices or therapy modules delivers electrical stimulation to a nonmyocardial tissue site or a nonvascular cardiac tissue site, and the other implantable medical device or therapy module delivers cardiac rhythm management therapy to a heart of the patient.

公开(公告)号：US20100114189A1

公开(公告)日：2010-05-06

申请号：US12363180

申请日：2009-01-30

申请人： William T. Donofrio ,  Paul G. Krause ,  Gerald P. Arne ,  John E. Burnes ,  David J. Peichel ,  Xiaohong Zhou

发明人： William T. Donofrio ,  Paul G. Krause ,  Gerald P. Arne ,  John E. Burnes ,  David J. Peichel ,  Xiaohong Zhou

IPC分类号： A61N1/36

CPC分类号： A61N1/37288 ,  A61N1/36114

摘要： A first implantable medical device (IMD) implanted within a patient may communicate with a second IMD implanted within the patient by encoding information in an electrical stimulation signal. The delivery of the electrical stimulation signal may provide therapeutic benefits to the patient. The second IMD may sense the electrical stimulation signal, which may be presented as an artifact in a sensed cardiac signal, and process the sensed signal to retrieve the encoded information. The second IMD may modify its operation based on the received therapy information. Crosstalk between the first and second IMDs may be reduced using various techniques described herein. For example, the first IMD may generate the electrical stimulation signal to include a spread spectrum energy distribution or a predetermined signal signature. The second IMD may effectively remove a least some of the signal artifact in a sensed cardiac signal based on the predetermined signal signature.

摘要翻译： 植入在患者体内的第一可植入医疗装置（IMD）可以通过对电刺激信号中的信息进行编码来与植入患者内的第二IMD进行通信。 电刺激信号的传递可以为患者提供治疗益处。 第二IMD可以感测电刺激信号，其可以被呈现为感测到的心脏信号中的伪像，并且处理感测到的信号以检索经编码的信息。 第二IMD可以基于接收到的治疗信息修改其操作。 可以使用本文所述的各种技术来减少第一和第二IMD之间的串扰。 例如，第一IMD可以产生电刺激信号以包括扩频能量分布或预定信号特征。 基于预定的信号签名，第二IMD可以有效地去除感测到的心脏信号中的至少一些信号伪像。

公开(公告)号：US07555336B2

公开(公告)日：2009-06-30

申请号：US11312163

申请日：2005-12-20

申请人： Nirav V. Sheth ,  Karen J. Kleckner ,  John E. Burnes

发明人： Nirav V. Sheth ,  Karen J. Kleckner ,  John E. Burnes

IPC分类号： A61B5/0402

CPC分类号： A61N1/371 ,  A61N1/3712

摘要： The present invention provides a technique for verifying pacing capture of a ventricular chamber, particularly to ensure desired delivery of a ventricular pacing regime (e.g., cardiac resynchronization therapy or “CRT”). The invention also provides for ventricular capture management by delivering a single ventricular pacing stimulus and checking inter-ventricular conduction during a temporal window to determine if the ventricular pacing stimulus captured the chamber. If a loss-of-capture (LOC) signal results from the capture management testing, then the characteristics of the applied pacing pulses are modified and the conduction test repeated. In the event that the LOC signal persists, a pacing mode-switch to an atrial-based pacing therapy and/or non-bi-ventricular pacing regimen can be implemented.

摘要翻译： 本发明提供了一种用于验证心室的起搏捕获的技术，特别是确保心室起搏方案（例如，心脏再同步治疗或“CRT”）的期望递送。 本发明还通过递送单个心室起搏刺激和在时间窗口期间检查心室间传导来确定心室起搏刺激是否捕获腔室来提供心室捕获管理。 如果捕获管理测试产生捕获损失（LOC）信号，则应用起搏脉冲的特性被修改，并重复传导测试。 在LOC信号持续存在的情况下，可以实现起搏模式切换到基于心房的起搏治疗和/或非双心室起搏方案。