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    Method and apparatus for determining optimal pacing therapy timing intervals
    31.
    发明授权
    Method and apparatus for determining optimal pacing therapy timing intervals 有权
    用于确定最佳起搏治疗定时间隔的方法和装置

    公开(公告)号：US07653437B2

    公开(公告)日：2010-01-26

    申请号：US11344471

    申请日：2006-01-31

    申请人： Rajan Prakash ,  Edward Chinchoy ,  Thomas J. Mullen

    发明人： Rajan Prakash ,  Edward Chinchoy ,  Thomas J. Mullen

    IPC分类号： A61N1/368

    CPC分类号： A61N1/3627 ,  A61N1/36542 ,  A61N1/368 ,  A61N1/3682

    摘要： A method for determining an optimal pacing timing control parameter setting is provided for use in an implantable medical device programmed to deliver a pacing pulse in response to the timing control parameter. The method includes storing a user-selected optimization metric, iteratively adjusting the timing control parameter setting, sensing a first signal that varies in response to left ventricular wall acceleration, measuring the user-selected optimization metric in response to the sensed first signal, and determining an optimal timing control parameter value in response to the measured user-selected optimization metric.

    摘要翻译： 用于确定最佳起搏定时控制参数设置的方法被提供用于被编程为响应于定时控制参数递送起搏脉冲的可植入医疗设备。 该方法包括存储用户选择的优化度量，迭代地调整定时控制参数设置，感测响应于左心室壁加速度而变化的第一信号，响应于感测的第一信号测量用户选择的优化度量，以及确定 响应于所测量的用户选择的优化度量的最佳定时控制参数值。

    APPARATUS AND METHODS FOR AUTOMATIC ADJUSTMENT OF AV INTERVAL TO ENSURE DELIVERY OF CARDIAC RESYNCHRONIZATION THERAPY
    32.
    发明申请
    APPARATUS AND METHODS FOR AUTOMATIC ADJUSTMENT OF AV INTERVAL TO ENSURE DELIVERY OF CARDIAC RESYNCHRONIZATION THERAPY 有权
    用于自动调整AV间隔以确保进行心脏再生治疗的装置和方法

    公开(公告)号：US20100016914A1

    公开(公告)日：2010-01-21

    申请号：US12505925

    申请日：2009-07-20

    申请人： Thomas J. Mullen ,  John E. Burnes ,  Aleksandre T. Sambelashvili

    发明人： Thomas J. Mullen ,  John E. Burnes ,  Aleksandre T. Sambelashvili

    IPC分类号： A61N1/365 ,  A61N1/08

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

    摘要： The disclosure provides methods and apparatus of left ventricular pacing including automated adjustment of a atrio-ventricular (AV) pacing delay interval and intrinsic AV nodal conduction testing. It includes—upon expiration or reset of a programmable AV Evaluation Interval (AVEI)—performing the following: temporarily increasing a paced AV interval and a sensed AV interval and testing for adequate AV conduction and measuring an intrinsic atrio-ventricular (PR) interval for a right ventricular (RV) chamber. Thus, in the event that the AV conduction test reveals a physiologically acceptable intrinsic PR interval then storing the physiologically acceptable PR interval in a memory structure (e.g., a median P-R from one or more cardiac cycles). In the event that the AV conduction test reveals an AV conduction block condition or if unacceptably long PR intervals are revealed then a pacing mode-switch to a bi-ventricular (Bi-V) pacing mode occurs and the magnitude of the AVEI is increased.

    摘要翻译： 本公开提供了左心室起搏的方法和装置，包括自动调节心房（AV）起搏延迟间隔和内部AV节点传导测试。 它包括 - 可编程AV评估间隔（AVEI）的到期或复位 - 执行以下操作：临时增加节奏的AV间隔和感测到的AV间隔，并测试足够的AV传导并测量内在的心房（PR）间隔 右心室（RV）室。 因此，在AV传导测试揭示生理上可接受的固有PR间隔的情况下，然后将生理上可接受的PR间期存储在存储器结构中（例如，来自一个或多个心动周期的中值P-R）。 在AV传导测试显示AV传导阻滞状态或者如果不能接受的长PR间隔被揭示的情况下，则起搏模式切换到双心室（Bi-V）起搏模式并且增加AVEI的幅度。

    Adaptive cardiac resynchronization therapy
    34.
    发明授权
    Adaptive cardiac resynchronization therapy 有权
    自适应心脏再同步治疗

    公开(公告)号：US08886307B2

    公开(公告)日：2014-11-11

    申请号：US13361635

    申请日：2012-01-30

    申请人： Aleksandre T. Sambelashvili ,  Thomas J. Mullen ,  Todd J. Sheldon

    发明人： Aleksandre T. Sambelashvili ,  Thomas J. Mullen ,  Todd J. Sheldon

    IPC分类号： A61N1/368

    CPC分类号： A61N1/3714 ,  A61N1/36514 ,  A61N1/36592 ,  A61N1/368 ,  A61N1/3684 ,  A61N1/371

    摘要： Cardiac resynchronization therapy (CRT) delivered to a heart of a patient may be adjusted based on detection of a surrogate indication of the intrinsic atrioventricular conduction of the heart. In some examples, the surrogate indication is determined to be a sense event of the first depolarizing ventricle of the heart within a predetermined period of time following the delivery of a fusion pacing stimulus to the later depolarizing ventricle. In some examples, the CRT is switched from a fusion pacing configuration to a biventricular pacing configuration if the surrogate indication is not detected, and the CRT is maintained in a fusion pacing configuration if the surrogate indication is detected.

    摘要翻译： 可以基于检测心脏的内在房室传导的替代指示来调整输送到患者心脏的心脏再同步治疗（CRT）。 在一些示例中，在将融合起搏刺激递送到后去除极化心室之后的预定时间段内，替代指示被确定为心脏的第一去极化心室的感觉事件。 在一些示例中，如果未检测到替代指示，则CRT从融合起搏配置切换到双心室起搏配置，并且如果检测到替代指示，则CRT保持在融合起搏配置中。

    Pacing therapy adjustment based on ventriculo-atrial delay
    35.
    发明授权
    Pacing therapy adjustment based on ventriculo-atrial delay 有权
    基于心房 - 心房延迟的起搏治疗调整

    公开(公告)号：US08755881B2

    公开(公告)日：2014-06-17

    申请号：US12363439

    申请日：2009-01-30

    申请人： Daniel R. Kaiser ,  Nicholas D. Skadsberg ,  Steven R. Hornberger ,  Thomas J. Mullen

    发明人： Daniel R. Kaiser ,  Nicholas D. Skadsberg ,  Steven R. Hornberger ,  Thomas J. Mullen

    IPC分类号： A61N1/365 ,  A61N1/368

    CPC分类号： A61N1/368 ,  A61N1/3622 ,  A61N1/3682

    摘要： Techniques for adjusting pacing therapy based on ventriculo-atrial delay are described herein. These techniques may be used to control ventricular filling times during the delivery of pacing therapy. In some examples, a device or system delivers pre-excitation fusion pacing therapy to a ventricular chamber, determines a ventriculo-atrial delay interval for the ventricular chamber for at least one cardiac cycle, and adjusts the pacing therapy delivered by the implantable medical device to compensate for decreased ventricular filling time when the ventriculo-atrial delay interval is less than a threshold. In some examples, the device or system may adjust the pacing therapy by decreasing a pacing rate of the implantable medical device, increasing a pre-excitation interval for pacing of the ventricular chamber, and/or switching from a fusion pacing mode to a biventricular pacing mode.

    摘要翻译： 本文描述了基于心房 - 心房延迟来调节起搏治疗的技术。 这些技术可用于控制起搏治疗期间的心室充盈时间。 在一些示例中，装置或系统将预激发融合起搏治疗递送至心室，确定心室至少一个心动周期的心房 - 心房延迟间隔，并调整由可植入医疗装置递送的起搏疗法 补偿当心室 - 心房延迟间隔小于阈值时心室充盈时间减少。 在一些示例中，装置或系统可以通过降低可植入医疗装置的起搏速率，增加心室的起搏间隔和/或从融合起搏模式切换到双心室起搏来调节起搏治疗 模式。

    Apparatus and methods for automatic adjustment of AV interval to ensure delivery of cardiac resynchronization therapy
    37.
    发明授权
    Apparatus and methods for automatic adjustment of AV interval to ensure delivery of cardiac resynchronization therapy 有权
    用于自动调整AV间隔以确保心脏再同步治疗的传递的装置和方法

    公开(公告)号：US08428716B2

    公开(公告)日：2013-04-23

    申请号：US12505925

    申请日：2009-07-20

    申请人： Thomas J. Mullen ,  John E. Burnes ,  Aleksandrew T. Sambelashvili

    发明人： Thomas J. Mullen ,  John E. Burnes ,  Aleksandrew T. Sambelashvili

    IPC分类号： A61N1/365

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

    摘要： A method of left ventricular pacing including automated adjustment of a atrio-ventricular (AV) pacing delay interval and intrinsic AV nodal conduction testing. It includes—upon expiration or reset of a programmable AV Evaluation Interval (AVEI)—performing the following: temporarily increasing a paced AV interval and a sensed AV interval and testing for adequate AV conduction and measuring an intrinsic atrio-ventricular (PR) interval for a right ventricular (RV) chamber. In the event that the AV conduction test reveals an AV conduction block condition then a pacing mode-switch to a bi-ventricular (Bi-V) pacing mode occurs and the magnitude of the AVEI is increased.

    摘要翻译： 一种左心室起搏的方法，包括自动调节心房（AV）起搏延迟间隔和内部AV节点传导测试。 它包括 - 可编程AV评估间隔（AVEI）的到期或复位 - 执行以下操作：临时增加节奏的AV间隔和感测到的AV间隔，并测试足够的AV传导并测量内在的心房（PR）间隔 右心室（RV）室。 在AV导通测试显示AV传导阻滞条件的情况下，起搏模式切换到双心室（Bi-V）起搏模式并且AVEI的幅度增加。

    SYSTEM AND METHOD FOR PACING PARAMETER OPTIMIZATION USING HEART SOUNDS
    38.
    发明申请
    SYSTEM AND METHOD FOR PACING PARAMETER OPTIMIZATION USING HEART SOUNDS 有权
    使用心脏声音进行参数优化的系统和方法

    公开(公告)号：US20130030484A1

    公开(公告)日：2013-01-31

    申请号：US13296605

    申请日：2011-11-15

    申请人： Xusheng Zhang ,  Jeffrey M. Gillberg ,  Thomas J. Mullen

    发明人： Xusheng Zhang ,  Jeffrey M. Gillberg ,  Thomas J. Mullen

    IPC分类号： A61N1/365 ,  A61N1/37

    CPC分类号： A61N1/3627 ,  A61N1/36578 ,  A61N1/3682 ,  A61N1/3684 ,  A61N1/3686 ,  A61N1/3702 ,  A61N1/37247 ,  A61N1/37264

    摘要： A medical device system and associated method predict a patient response to a cardiac therapy. The system includes for delivering cardiac pacing pulses to a patient's heart coupled to a cardiac sensing module and a cardiac pacing module for generating cardiac pacing pulses and controlling delivery of the pacing pulses at multiple pace parameter settings. An acoustical sensor obtains heart sound signals. A processor is enabled to receive the heart sound signals, derive a plurality of heart sound signal parameters from the heart sound signals, and determine a trend of each of the plurality of heart sound signal parameters with respect to the plurality of pace parameter settings. An external display is configured to present the trend of at least one heart sound parameter with respect to the plurality of pace parameter settings.

    摘要翻译： 医疗设备系统和相关方法预测患者对心脏疗法的反应。 该系统包括用于将心脏起搏脉冲传送到与心脏感测模块耦合的患者心脏和心脏起搏模块，用于产生心脏起搏脉冲并且以多个步进参数设置来控制起搏脉冲的递送。 声学传感器获得心音信号。 处理器能够接收心音信号，从心音信号导出多个心音信号参数，并且确定多个心音信号参数中的每一个相对于多个步速参数设置的趋势。 外部显示器被配置为呈现关于多个步速参数设置的至少一个心音参数的趋势。