公开(公告)号：US20170028202A1

公开(公告)日：2017-02-02

申请号：US15222302

申请日：2016-07-28

Applicant: Medtronic, Inc.

Inventor： Subham Ghosh

IPC: A61N1/368 ,  A61N1/372 ,  A61N1/365 ,  A61N1/37 ,  A61B5/042

CPC classification number: A61N1/3684 ,  A61B5/042 ,  A61B5/04525 ,  A61B5/0456 ,  A61B5/0468 ,  A61B5/4836 ,  A61N1/056 ,  A61N1/3627 ,  A61N1/36514 ,  A61N1/3682 ,  A61N1/3688 ,  A61N1/371 ,  A61N1/3712 ,  A61N1/37223 ,  A61N1/3756 ,  A61N1/3956

Abstract: A medical device and medical device system for delivering left ventricular pacing that includes a subcutaneous sensing device having a subcutaneous electrode to sense a subcutaneous cardiac signal and an emitting device to emit a trigger signal in response to the sensed cardiac signal, an intracardiac therapy delivery device to deliver the left ventricular pacing in response to the emitted trigger signal, and a processor configured to determine whether the medical device system is in one of a VVD pacing mode and a VVI pacing mode, determine whether the delivered left ventricular pacing captures the left ventricle, determine whether to adjust a pacing parameter in response to the determination of whether the device system is in one of a VVD pacing mode and a VVI pacing mode and the determination of whether the delivered left ventricular pacing captures the left ventricle, and deliver the left ventricular pacing in response to determining whether to adjust the pacing parameter.

Abstract translation: 一种用于输送左心室起搏的医疗装置和医疗装置系统，其包括皮下感测装置，所述皮下感测装置具有皮下电极以感测皮下心脏信号，并且发射装置响应于感测到的心脏信号而发出触发信号，心内治疗递送装置 以响应于所发射的触发信号递送左心室起搏，以及处理器，其被配置为确定医疗设备系统是否处于VVD起搏模式和VVI起搏模式之一，确定所输送的左心室起搏是否捕获左心室 响应于确定设备系统是否处于VVD起搏模式和VVI起搏模式之一来确定是否调整起搏参数以及确定所输送的左心室起搏是否捕获左心室，并且输出左侧 响应于是否调整起搏参数来确定心室起搏。

公开(公告)号：US09511234B2

公开(公告)日：2016-12-06

申请号：US14305832

申请日：2014-06-16

Applicant: Medtronic, Inc.

Inventor： Subham Ghosh ,  Robert W Stadler

IPC: A61N1/368 ,  A61N1/362 ,  A61N1/37

CPC classification number: A61N1/3686 ,  A61N1/3622 ,  A61N1/3627 ,  A61N1/368 ,  A61N1/3684 ,  A61N1/371

Abstract: Generally, the disclosure is directed one or more methods or systems of cardiac pacing employing a right ventricular electrode and a plurality of left ventricular electrodes. Pacing using the right ventricular electrode and a first one of the left ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes. Pacing using the right ventricular electrode and a second one of the ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes. Employing sums of the measured activation times to select one of the left ventricular electrodes for delivery of subsequent pacing pulses.

公开(公告)号：US20160339248A1

公开(公告)日：2016-11-24

申请号：US15135288

申请日：2016-04-21

Applicant: Medtronic, Inc.

Inventor： Anthony W. Schrock ,  Jean E. Hudson ,  Karen J. Kleckner ,  John D. Wahlstrand ,  Michael W. Heinks ,  Michael L. Hudziak ,  Subham Ghosh ,  Aleksandre T. Sambelashvili

IPC: A61N1/368 ,  A61N1/37 ,  A61N1/362 ,  A61N1/365

CPC classification number: A61N1/3684 ,  A61N1/3627 ,  A61N1/36514 ,  A61N1/36571 ,  A61N1/3686 ,  A61N1/3712

Abstract: An implantable device and associated method for delivering multi-site pacing therapy is disclosed. The device comprises a set of electrodes including a first ventricular electrode and a second ventricular electrode, spatially separated from one another and all coupled to an implantable pulse generator. The device comprises a processor configured for selecting a first cathode and a first anode from the set of electrodes to form a first pacing vector at a first pacing site along a heart chamber and selecting a second cathode and a second anode from the set of electrodes to form a second pacing vector at a second pacing site along the same heart chamber. The pulse generator is configured to deliver first pacing pulses to the first pacing vector and delivering second pacing pulses to the second pacing vector. The pulse generator generates a recharging current for recharging a first coupling capacitor over a first recharge time period in response to the first pacing pulses. The pulse generator for generating a recharging current for recharging a second coupling capacitor over a second recharge time period in response to the second pacing pulses. An order of recharging the first and second coupling capacitors is dependent upon one of ventricular pacing mode, left ventricle to right ventricle delay (V-V) pace delay, multiple point LV delay and latest delivered pacing pulses to one of the first and second pacing vectors.

Abstract translation: 公开了用于输送多部位起搏治疗的可植入装置和相关方法。 该装置包括一组电极，包括第一心室电极和第二心室电极，在空间上彼此分离并且全部耦合到可植入脉冲发生器。 该装置包括处理器，该处理器被配置为从该组电极中选择第一阴极和第一阳极，以沿着心脏室在第一起搏部位处形成第一起搏向量，并从该组电极选择第二阴极和第二阳极， 在同一心室的第二起搏部位形成第二起搏向量。 脉冲发生器被配置为将第一起搏脉冲传送到第一起搏矢量并将第二起搏脉冲传送到第二起搏矢量。 脉冲发生器响应于第一起搏脉冲产生用于在第一再充电时间段内为第一耦合电容器再充电的再充电电流。 所述脉冲发生器用于产生用于响应于所述第二起搏脉冲在第二再充电时间段内为第二耦合电容器再充电的再充电电流。 对第一和​​第二耦合电容器再充电的顺序取决于心室起搏模式，左心室到右心室延迟（V-V）步速延迟，多点LV延迟和最近发出的起搏脉冲之一到第一和第二起搏矢量之一。

公开(公告)号：US20160331258A1

公开(公告)日：2016-11-17

申请号：US14815506

申请日：2015-07-31

Applicant: Medtronic, Inc.

Inventor： Juan Du ,  Subham Ghosh

IPC: A61B5/04 ,  A61B5/00 ,  A61B5/044 ,  A61B5/0408

CPC classification number: A61B5/04012 ,  A61B5/04085 ,  A61B5/044 ,  A61B5/0452 ,  A61B5/7239 ,  A61B5/7282 ,  A61N1/36507

Abstract: A system and associated method is disclosed for determining whether signal is valid. The system comprises an electrode apparatus comprising a plurality of electrodes configured to be located proximate tissue of a patient. A display apparatus comprising a graphical user interface, wherein the graphical user interface is configured to present information to a user. A computing apparatus coupled to the electrode apparatus and display apparatus, wherein the computing apparatus is configured to determine whether a signal acquired from a channel associated with an electrode from the plurality of electrodes is valid and sufficiently strong by i) calculating a first derivative of the signal; ii) determining a minimum and maximum derivative from the first derivative; iii) determining whether signs of the minimum and maximum derivative are different; and in response to determining whether the signs of the minimum and maximum derivative are different, displaying on a display apparatus whether the signal is valid.

Abstract translation: 公开了一种用于确定信号是否有效的系统和相关方法。 该系统包括电极装置，该电极装置包括被配置为位于患者的组织附近的多个电极。 一种显示装置，包括图形用户界面，其中所述图形用户界面被配置为向用户呈现信息。 一种耦合到所述电极装置和显示装置的计算装置，其中所述计算装置被配置为确定从与所述多个电极中的电极相关联的通道获取的信号是否有效并且足够强，i）计算所述电极装置的显示装置的一阶导数 信号; ii）确定一阶导数的最小和最大导数; iii）确定最小和最大导数的符号是​​否不同; 并且响应于确定最小和最大导数的符号是​​否不同，在显示装置上显示信号是否有效。

公开(公告)号：US09272148B2

公开(公告)日：2016-03-01

申请号：US13948831

申请日：2013-07-23

Applicant: Medtronic, Inc.

Inventor： Subham Ghosh

IPC: A61N1/36 ,  A61N1/365 ,  A61N1/362 ,  A61N1/372

CPC classification number: A61N1/36585 ,  A61B5/04085 ,  A61N1/36185 ,  A61N1/362 ,  A61N1/372

Abstract: A system and method select a pacing site for a cardiac pacing therapy. A change from a baseline mechanical activity is extracted from a signal of mechanical heart activity during pacing at each one of multiple pacing sites along a heart chamber. A change from a baseline electrical activity is extracted from a signal of electrical heart activity during pacing at each of the of pacing sites. The pacing sites are sorted in a first order based upon the changes in mechanical heart activity and in a second order based upon the changes in electrical heart activity. A pacing site is selected from the multiple pacing sites as a common pacing site between the first order and the second order.

Abstract translation: 系统和方法选择心脏起搏治疗的起搏部位。 在心脏室的多个起搏部位的每一个起搏期间，从机械心脏活动的信号中提取与基线机械活动的变化。 在每个起搏部位的起搏期间，从电气心脏活动的信号中提取基线电活动的变化。 基于机械心脏活动的变化和基于电心脏活动的变化的第二阶段，起搏部位按照第一顺序排序。 从多个起搏站点中选择起始站点作为第一个订单和第二个订单之间的普通起始站点。

公开(公告)号：US08965489B2

公开(公告)日：2015-02-24

申请号：US13773030

申请日：2013-02-21

Applicant: Medtronic, Inc.

Inventor： Subham Ghosh

IPC: A61B5/04 ,  A61B5/046 ,  A61B5/042 ,  A61B5/0432 ,  A61B5/044 ,  A61B5/00 ,  A61B5/0456

CPC classification number: A61B5/046 ,  A61B5/04012 ,  A61B5/0422 ,  A61B5/0432 ,  A61B5/044 ,  A61B5/0456 ,  A61B5/7239

Abstract: A method and system for determining activation times for electric potentials from complex electrograms to identify the location of arrhythmic sources or drivers. The method includes counting a number deflections in a recorded cardiac electrogram signal from at least one electrode for a predetermined amount of time. A deflection time is identified for each of the counted number of deflections. A most negative slope is identified between each of the identified deflections times. Each of the identified most negative slopes is correlated to a possible activation time. Each possible activation time is associated with a corresponding electrode from the at least one electrode. A spatial voltage gradient at each corresponding electrode is calculated for each possible activation time. The greatest spatial voltage gradient is identified. The greatest spatial voltage gradient is correlated to an activation time.

Abstract translation: 一种用于从复杂电描记图确定电位的激活时间以识别心律失常源或驱动器的位置的方法和系统。 该方法包括在来自至少一个电极的记录的心电图信号中对预定时间量的数量偏转进行计数。 为每个计数的偏转数确定偏转时间。 在确定的每个偏差时间之间确定最负的斜率。 每个确定的最负斜率与可能的激活时间相关。 每个可能的激活时间与来自至少一个电极的相应电极相关联。 对于每个可能的激活时间，计算每个相应电极处的空间电压梯度。 确定最大的空间电压梯度。 最大的空间电压梯度与激活时间相关。

公开(公告)号：US20140163634A1

公开(公告)日：2014-06-12

申请号：US13707440

申请日：2012-12-06

Applicant: MEDTRONIC, INC.

Inventor： Subham Ghosh ,  Robert W. Stadler

IPC: A61N1/37

CPC classification number: A61N1/371 ,  A61B5/0452 ,  A61B5/4836 ,  A61B5/686 ,  A61N1/3627 ,  A61N1/37247

Abstract: The present disclosure pertains to cardiac pacing methods and systems, and, more particularly, to cardiac resynchronization therapy (CRT). In particular, the present disclosure pertains to determining the efficacy of CRT through use of an effective capture test (ECT). One or more embodiments comprises sensing a signal in response to a ventricular pacing stimulus. Through signal processing, a number of features are parsed from the signal. Exemplary features parsed from the signal include a maximum amplitude, a maximum time associated with the maximum amplitude, a minimum amplitude, and a minimum time associated with the minimum amplitude. The data is evaluated through use of the ECT. By employing the ECT, efficacy of CRT is easily and automatically evaluated.

公开(公告)号：US08750999B1

公开(公告)日：2014-06-10

申请号：US13707440

申请日：2012-12-06

Applicant: Medtronic, Inc.

Inventor： Subham Ghosh ,  Robert W Stadler

IPC: A61N1/08

CPC classification number: A61N1/371 ,  A61B5/0452 ,  A61B5/4836 ,  A61B5/686 ,  A61N1/3627 ,  A61N1/37247

Abstract: The present disclosure pertains to cardiac pacing methods and systems, and, more particularly, to cardiac resynchronization therapy (CRT). In particular, the present disclosure pertains to determining the efficacy of CRT through use of an effective capture test (ECT). One or more embodiments comprises sensing a signal in response to a ventricular pacing stimulus. Through signal processing, a number of features are parsed from the signal. Exemplary features parsed from the signal include a maximum amplitude, a maximum time associated with the maximum amplitude, a minimum amplitude, and a minimum time associated with the minimum amplitude. The data is evaluated through use of the ECT. By employing the ECT, efficacy of CRT is easily and automatically evaluated.

公开(公告)号：US20130165983A1

公开(公告)日：2013-06-27

申请号：US13706472

申请日：2012-12-06

Applicant: Medtronic, Inc.

Inventor： Subham Ghosh ,  Robert W. Stadler

IPC: A61N1/37 ,  A61N1/39

CPC classification number: A61N1/3706 ,  A61N1/3622 ,  A61N1/3627 ,  A61N1/3682 ,  A61N1/3937

Abstract: Methods and/or devices may be configured to track effectiveness of pacing therapy by monitoring activation times over time, e.g., between pacing stimulus and electrical activity resulting from the pacing stimulus. Generally, the methods and/or devices may determine whether the delivered pacing therapy was effective based on the measured activation times.

Abstract translation: 方法和/或装置可以被配置为通过监视时间上的激活时间（例如起搏刺激和由起搏刺激产生的电活动之间）来跟踪起搏治疗的有效性。 通常，方法和/或装置可以基于所测量的活化时间确定所输送的起搏治疗是否有效。

公开(公告)号：US12280260B2

公开(公告)日：2025-04-22

申请号：US17521277

申请日：2021-11-08

Applicant: Medtronic, Inc.

Inventor： Subham Ghosh

IPC: A61N1/372 ,  A61N1/37

Abstract: Systems and methods are described herein related to the evaluation and adjustment of left bundle branch (LBB) pacing therapy. Evaluation of the LBB pacing therapy may utilize electrical activity monitored from a plurality of external electrodes. The electrical activity may be used to provided one or more metrics of dispersion of surrogate cardiac electrical activation times, which may then be used to evaluate, and potentially adjust the LBB pacing therapy.