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公开(公告)号：US08498704B2
公开(公告)日：2013-07-30
申请号：US13019818
申请日：2011-02-02
IPC分类号： A61N1/00
CPC分类号： A61N1/36564 , A61N1/3621 , A61N1/365
摘要： Described are methods and devices for improving diastolic function with electrostimulation in heart failure patients who exhibit relatively normal systolic function. Such patients are characterized by impaired myocardial relaxation during diastole that prevents adequate filling of the ventricles during diastole to thereby reduce cardiac output. An implantable device is described for effecting strategic and periodic stimulation of the sympathetic nervous system to elicit myocardial adrenergic activation for improved myocardial relaxation.
摘要翻译： 描述了用于在呈现相对正常的收缩功能的心力衰竭患者中用电刺激改善舒张功能的方法和装置。 这些患者的特征在于舒张期期间的心肌松弛受损，其在舒张期期间阻止充足的心室充盈，从而降低心输出量。 描述了可植入装置，用于促进交感神经系统的战略和周期性刺激，以引发心肌肾上腺素能活化以改善心肌松弛。
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公开(公告)号：US08483826B2
公开(公告)日：2013-07-09
申请号：US12405990
申请日：2009-03-17
申请人： John R. Zielinski , Shantha Arcot-Krishnamurthy , Joseph M. Pastore , Jeffrey E. Stahmann , Allan C. Shuros
发明人： John R. Zielinski , Shantha Arcot-Krishnamurthy , Joseph M. Pastore , Jeffrey E. Stahmann , Allan C. Shuros
IPC分类号： A61N1/00
CPC分类号： A61N1/3627 , A61N1/368 , A61N1/3688 , A61N1/3962
摘要： This document discusses, among other things, an apparatus comprising an implantable cardiac depolarization sensing circuit, an electrical stimulation circuit, and a pacing mode controller. The pacing mode controller is configured to deliver pacing therapy according to a first pacing mode that is a normal operating mode, and to deliver 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 pacing is changed from the normal operating mode to a stress augmentation mode. The pacing mode controller suspends the change from the normal operating mode to the stress augmentation mode when a condition to prevent the change is detected.
摘要翻译： 本文件尤其涉及包括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。 起搏模式控制器被配置为根据作为正常操作模式的第一起搏模式提供起搏治疗，并且根据第二和第三起搏模式输送起搏治疗。 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。 当起搏从正常操作模式改变为应力增强模式时，起搏模式控制器在第二和第三起搏模式之间交替。 当检测到防止变化的条件时，起搏模式控制器将更改从正常操作模式暂停到应力增强模式。
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公开(公告)号：US08401642B2
公开(公告)日：2013-03-19
申请号：US12537165
申请日：2009-08-06
IPC分类号： A61N1/00
CPC分类号： A61N1/36514 , A61N1/3627 , A61N1/36521 , A61N1/36564 , A61N1/36571 , A61N1/3684 , 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 physiological response to ventricular dyssynchrony 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。 本文描述了一种方法和系统，其使用患者对心室不同步的生理反应的测量来控制间歇性预激励起搏的占空比。
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34.发明申请公开(公告)号：US20120165891A1
公开(公告)日：2012-06-28
申请号：US13411945
申请日：2012-03-05
IPC分类号： A61N1/365
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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公开(公告)号：US08140155B2
公开(公告)日：2012-03-20
申请号：US12401194
申请日：2009-03-10
申请人： John R. Zielinski , Shantha Arcot-Krishnamurthy , Joseph M. Pastore , Jeffrey E. Stahmann , Allan C. Shuros
发明人： John R. Zielinski , Shantha Arcot-Krishnamurthy , Joseph M. Pastore , Jeffrey E. Stahmann , Allan C. Shuros
IPC分类号： A61N1/362
CPC分类号： A61N1/3627 , A61N1/3688
摘要： This document discusses, among other things, an apparatus comprising an implantable cardiac depolarization sensing circuit, an electrical stimulation circuit, and a pacing mode controller. The pacing mode controller is configured to deliver pacing therapy according to a first pacing mode that is a normal operating mode, and to deliver 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 and stores a statistic related to the stress augmentation mode in a stress augmentation cycle memory area.
摘要翻译： 本文件尤其涉及包括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。 起搏模式控制器被配置为根据作为正常操作模式的第一起搏模式提供起搏治疗，并且根据第二和第三起搏模式输送起搏治疗。 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，并将与应力增加模式相关的统计量存储在应力增加周期存储区域中。
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公开(公告)号：US07778707B2
公开(公告)日：2010-08-17
申请号：US11689032
申请日：2007-03-21
IPC分类号： A61N1/368
CPC分类号： A61N1/3627
摘要： Methods and devices are described for delivering electrical stimulation to the heart in a manner that advantageously redistributes myocardial stress during systole for therapeutic purposes in the treatment of, for example, post-MI and HF patients. Pre-excitation pacing may be applied to deliberately de-stress a particular myocardial region that may be expected to undergo deleterious remodeling, such as the area around a myocardial infarct or a hypertrophying region or to deliberately stress a region remote from the pre-excitation pacing site in order to exert a cardioprotective conditioning effect, similar to the beneficial effects of exercise. Pre-excitation pacing may be advantageously combined with inotropic electrical stimulation applied to the stressed region.
摘要翻译： 描述了将方法和装置以有效地将收缩期内的心肌应力重新分配到治疗目的的治疗目的的心脏和心脏病和心脏病患者的方式，以向心脏递送电刺激。 预激发起搏可以用于故意地减压可能预期会发生有害重建的特定心肌区域，例如心肌梗塞或肥大区域周围的区域，或者故意强迫远离预激励起搏的区域 为了发挥心脏保护性调理作用，类似于运动的有益效果。 预激发起搏可以有利地与施加到应激区域的变力电刺激组合。
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公开(公告)号：US20100069989A1
公开(公告)日：2010-03-18
申请号：US12537165
申请日：2009-08-06
IPC分类号： A61N1/365
CPC分类号： A61N1/36514 , A61N1/3627 , A61N1/36521 , A61N1/36564 , A61N1/36571 , A61N1/3684 , 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 physiological response to ventricular dyssynchrony 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。 本文描述了一种方法和系统，其使用患者对心室不同步的生理反应的测量来控制间歇性预激励起搏的占空比。
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公开(公告)号：US20090281591A1
公开(公告)日：2009-11-12
申请号：US12436497
申请日：2009-05-06
IPC分类号： A61N1/365
CPC分类号： A61N1/3627 , A61N1/3682
摘要： A pacing system delivers cardiac protection pacing to protect the heart from injuries. The pacing system receives a set of inputs and calculates parameters for delivering optimized cardiac protection pacing tailored for different stress levels. The system automatically adjusts heart rate to optimize cardiac protection pacing in a closed-loop system. In one embodiment, a method for delivering pacing pulses for cardiac protection is provided. Intrinsic atrioventricular (AV) intervals are sensed. The intrinsic AV interval and a predetermined equation relating the AV interval to an optimal AV delay are used to provide a maximum positive rate of left ventricular pressure change during systole. An AV delay is calculated using a predetermined percentage of the optimal AV delay to deliver ventricular pacing pulses to provide a desired level of stress for cardiac protective pacing therapy (CPPT) to provide a cardiac conditioning therapy to improve autonomic balance.
摘要翻译： 起搏系统提供心脏保护起搏，以保护心脏免受伤害。 起搏系统接收一组输入，并计算用于提供针对不同应力水平定制的优化心脏保护起搏的参数。 系统自动调节心率以优化闭环系统中的心脏保护起搏。 在一个实施例中，提供了一种用于输送用于心脏保护的起搏脉冲的方法。 感测房室内（AV）间隔。 使用本征AV间隔和将AV间隔与最佳AV延迟相关联的预定方程用于在收缩期间提供左心室压力变化的最大正率。 使用预定百分比的最佳AV延迟来计算AV延迟以递送心室起搏脉冲以提供用于心脏保护起搏治疗（CPPT）的期望水平的应力以提供心脏调节疗法以改善自主神经平衡。
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公开(公告)号：US20090234416A1
公开(公告)日：2009-09-17
申请号：US12401194
申请日：2009-03-10
申请人： John R. Zielinski , Shantha Arcot-Krishnamurthy , Joseph M. Pastore , Jeffrey E. Stahmann , Allan C. Shuros
发明人： John R. Zielinski , Shantha Arcot-Krishnamurthy , Joseph M. Pastore , Jeffrey E. Stahmann , Allan C. Shuros
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 an implantable cardiac depolarization sensing circuit, an electrical stimulation circuit, and a pacing mode controller. The pacing mode controller is configured to deliver pacing therapy according to a first pacing mode that is a normal operating mode, and to deliver 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 and stores a statistic related to the stress augmentation mode in a stress augmentation cycle memory area.
摘要翻译： 本文件尤其涉及包括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。 起搏模式控制器被配置为根据作为正常操作模式的第一起搏模式提供起搏治疗，并且根据第二和第三起搏模式输送起搏治疗。 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，并将与应力增加模式相关的统计量存储在应力增加周期存储区域中。
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公开(公告)号：US20090082823A1
公开(公告)日：2009-03-26
申请号：US11903758
申请日：2007-09-25
IPC分类号： A61N1/365
CPC分类号： A61N1/3682 , A61N1/3627 , A61N1/36514 , A61N1/36535 , A61N1/36585 , A61N1/3688
摘要： An implantable pacing device for delivering ventricular pacing may be configured to intermittently and variably reduce the AV delay interval used in an atrial triggered pacing mode in a manner that simulates exercise. The device may be programmed to intermittently switch to and from a variably shortened AV delay mode according to defined entry and exit conditions.
摘要翻译： 用于递送心室起搏的可植入起搏装置可以被配置为以模拟运动的方式间歇地和可变地减小在心房触发起搏模式中使用的AV延迟间隔。 该设备可以被编程为根据定义的进入和退出条件间歇地切换到可变地缩短的AV延迟模式。
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